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gical problems that typically
are painful or impair an area of functioning.
Included are disorders that emerge in infancy,
childhood, or adolescence
b) Axis II. Personality Disorders & Mental Retardation
(ii) Details mental retardation and personality
disorders, i.e., dysfunctional patterns of perceiving
and responding to the world
c) Axis III. General Medical Conditions
(iii) Codes physical problems that are relevant to
understanding or treating an individual’s
psychological disorders, as detailed on Axes I and II
d) Axis IV. Psychosocial and Environmental Problems
(iv) Codes psychosocial and environmental stressors
that may impact diagnosis and treatment of an
individual’s disorder and his or her likelihood of
recovery
e) Axis V: Global Assessment of Functioning
(v) Codes the individual’s overall level of current
functioning in the psychological, social, and
occupational domains
5. Full diagnosis, in accordance with the DSM system, involves
consideration of each axis
6. Methods used to organize and present categories have shifted with
each revision of the DSM. DSM-III-R felt neurotic disorders and
psychotic disorders had become too generalized in meaning to
remain useful as diagnostic categories.
7. In addition to the diagnoses on the five traditional axes, DSM-IV-TR
provides an appendix that describes about 25 culture-bound
syndromes–recurrent, locality-specific patterns of aberrant behavior
and troubling experience that may or may not be likened to a
particular DSM-IV-TR diagnostic category. Such syndromes include:
a) Boufée delirante: A sudden outburst of agitated and
aggressive behavior, marked confusion, and psychomotor
excitement (West Africa and Haiti)
b) Koro: An episode of sudden and intense anxiety that the
penis will recede into the body and possibly cause death
(South and East Asia)
c) Taijin kyofusho: An individual’s intense fear that his or her
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body, its parts or its functions, displease, embarrass, or are
offensive to other people (Japan)
III. Major Types of Psychological Disorders
A. Important Disorders not Covered in Psychology and Life.
1. Substance-use disorders include both dependence on and abuse of
alcohol and drugs
2. Somatoform disorders involve physical symptoms that arise without a
physical cause
3. Sexual disorders involve problems with sexual inhibition or
dysfunction, and deviant sexual practices
4. Disorders usually first diagnosed in infancy, childhood, or adolescence
include mental retardation, communication disorders (such as
stuttering), and autism
5. Eating disorders, such as anorexia and bulimia.
6. Some individuals experience more than one disorder at some point
in their life span; this is known as comorbidity, the co-occurrence of
diseases
B. Anxiety Disorders: Types
1. Involve the experiencing of fear or anxiety in certain life situations
when that anxiety is problematic enough to interfere with the ability
to function or to enjoy life
2. Generalized Anxiety Disorder: manifests itself as feeling anxious or
worried most of the time, when not faced with any specific danger.
Presenting symptoms must include at least three of the following:
a) Muscle tension
b) Fatigue
c) Restlessness
d) Poor concentration
e) Irritability
f) Sleep difficulties
3. Panic Disorder manifests in unexpected, severe panic attacks that
begin with a feeling of intense apprehension, fear, or terror. Attacks
are unexpected, in the sense that they are not evoked by something
concrete in the situation. One manifestation of panic disorder is
agoraphobia, an extreme fear of being in public places or open spaces
from which escape may be difficult or embarrassing.
4. Phobias are diagnosed when the individual suffers from a persistent
and irrational fear of a specific object, activity, or situation, when
that fear is excessive and unreasonable, given the reality of the
threat. Phobias interfere with adjustment, cause significant distress,
and inhibit necessary action toward goals. DSM-IV-TR defines two
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categories of phobias.
a) Social phobia is a persistent, irrational fear, arising in
anticipation of a public situation in which an individual can
be observed by others
b) Specific phobias occur in response to several different types of
objects or situations
5. Obsessive-Compulsive Disorder is an anxiety disorder in which the
individual becomes locked into specific patterns of thought and
behavior. It may best be defined in terms of its component parts
a) Obsessions are thoughts, images, or impulses that recur or
persist despite the individual’s efforts to suppress them.
They are experienced as an unwanted invasion of
consciousness, seem to be senseless or repugnant, and are
unacceptable to the individual experiencing them.
b) Compulsions are repetitive, purposeful acts performed
according to certain rules, in a ritualized manner, and in
response to an obsession. The behavior is performed to
reduce or prevent the discomfort associated with some
dreaded situation, but it is either unreasonable or clearly
excessive.
6. Posttraumatic stress disorder (PTSD), an anxiety disorder, is
characterized by the persistent reexperiencing of traumatic events
through distressing recollections, dreams, hallucinations, or
flashbacks
C. Anxiety Disorders: Causes
1. Biological: This view posits a predisposition to fear whatever is
related to sources of serious danger in the evolutionary past, thus the
preparedness hypothesis suggests that we carry an evolutionary
tendency to respond quickly and “thoughtlessly” to once-feared
stimuli. Some evidence is available linking this disorder to
abnormalities in the basal ganglia and frontal lobe of the brain.
2. Psychodynamic: This model begins with the assumption that
symptoms of anxiety disorders derive from underlying psychic
conflicts or fears, with the symptoms being attempts to protect the
individual from psychological pain
3. Behavioral explanations of anxiety focus on the way symptoms of
anxiety disorders are reinforced or conditioned
4. Cognitive perspectives concentrate on the perceptual processes or
attitudes that may distort a person’s estimate of the danger he or she
is facing. Individuals suffering from anxiety disorders may interpret
their own distress as a sign of imminent danger
D. Mood Disorders: Types
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1. A mood disorder is an emotional disturbance, such as a severe
depression or depression alternating with manic states
2. Major Depressive Disorder occurs so frequently that it has been called
the “common cold” of psychopathology; virtually everyone has
experienced elements of this disorder at some time during their
lives.
3. Bipolar depression is characterized by periods of severe depression,
alternating with manic episodes
E. Mood Disorders: Causes
1. Biological: Growing evidence suggests that the incidence of mood
disorder is influenced by genetic factors
2. Psychodynamic: This approach purports the causal mechanism(s) to
be unconscious conflicts and hostile feelings originating in
childhood. Freud believed the source of depression to be displaced
anger, originally directed at someone else, and now turned inward
against the self
3. Behavioral: This approach focuses on the impact and effects of the
amount of positive reinforcement and punishments the individual
receives. Lacking a sufficient level of reinforcement, the individual
feels sad and withdraws from others.
4. Two Cognitive Theories:
a) Beck argued that depressed people have negative cognitive
sets, which promote a pattern of negative thought that
clouds all experiences and produces the other characteristic
signs of depression. Negative thought patterns include
negative views of (1) themselves; (2) ongoing experiences;
and (3) the future.
b) Seligman’s learned helplessness paradigm, the “explanatory
style view of depression, in which individuals believe
(correctly or not) that they have no control of future
outcomes of importance to them. Learned helplessness is
marked by deficits in three areas: (1) motivational; (2)
emotional; and (3) cognitive.
F. Gender Differences in Depression
1. Women suffer from depression twice as often as men
2. Research suggests differences in response style may originate in
childhood
a) When women experience sadness, they tend to think about
causes and implications of their feelings, a ruminative
response style with an obsessive focus on problems, thus
increasing depression.
b) Men attempt actively to distract themselves from negative
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feelings through physical exercis
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