5.4 - Selection of Categories of Psychological Disorders - notes

Overview of psychological disorders

Psychological disorders are conditions that affect a person's thoughts, emotions, or behaviors in ways that cause distress or impair daily functioning. These range from neurodevelopmental issues that emerge early in life to personality disorders that manifest in enduring patterns of behavior.

Each disorder has distinct symptoms and potential causes, often involving a mix of biological, environmental, and social factors. Understanding these disorders helps in recognizing how mental health impacts individuals and society, as well as informing approaches to treatment and support.

Symptoms and causes of neurodevelopmental disorders

Neurodevelopmental disorders are conditions that begin during the developmental period, often in childhood, and impact behaviors relative to a person's age or maturity level. These disorders can affect learning, social interaction, and daily functioning.

Selected disorders and their symptoms

• Attention-Deficit/Hyperactivity Disorder (ADHD) - Characterized by inattention, hyperactivity, and impulsivity that are inconsistent with developmental level. Symptoms may include difficulty sustaining attention, excessive fidgeting, or interrupting others.
• Autism Spectrum Disorder (ASD) - Involves challenges with social communication and interaction, alongside restricted or repetitive behaviors. Symptoms can range from difficulty with eye contact to intense focus on specific interests or routines.

Possible causes

• Environmental factors - Exposure to toxins or stressors during pregnancy, such as maternal smoking or infections, may increase risk.
• Physiological factors - Brain structure or function abnormalities can contribute to symptom development.
• Genetic factors - Many neurodevelopmental disorders have a hereditary component, with specific genes linked to increased likelihood of ADHD or ASD.

Symptoms and causes of schizophrenic spectrum disorders

Schizophrenic spectrum disorders involve severe disturbances in thought, perception, and behavior, often disrupting a person's connection with reality. These disorders can be acute (short-term) or chronic (long-term).

Symptoms of schizophrenia

Schizophrenia is characterized by issues in five key areas, split into positive and negative symptoms:

Positive symptoms:

• Delusions - False beliefs, such as delusions of persecution (believing others are plotting against them) or grandeur (believing they have exceptional powers or status).
• Hallucinations - False perceptions involving any of the senses, most commonly auditory hallucinations like hearing voices.
• Disorganized thinking or speech - Manifests as incoherent or illogical speech, such as tangentiality (straying off-topic) or word salad (nonsensical stringing of words).
• Disorganized motor behavior - Includes erratic movements or catatonic excitement (excessive, purposeless activity).

Negative symptoms:

• Flat affect - Lack of emotional expression.
• Avolition - Decreased motivation to initiate and sustain goal-directed behavior.

Possible causes

• Genetic factors - A family history of schizophrenia increases risk, suggesting a hereditary link.
• Biological factors - Prenatal exposure to viruses or imbalances in neurotransmitters like dopamine (known as the dopamine hypothesis) may contribute to the disorder.

Symptoms and causes of depressive disorders

Depressive disorders are marked by persistent feelings of sadness, emptiness, or irritability, accompanied by physical and cognitive changes that hinder daily functioning.

Selected disorders and their symptoms

• Major Depressive Disorder (MDD) - Involves intense, persistent sadness or loss of interest in activities for at least two weeks, often with symptoms like fatigue, changes in appetite, or feelings of worthlessness.
• Persistent Depressive Disorder (PDD) - A chronic form of depression with less severe but longer-lasting symptoms (at least two years), including low energy, poor concentration, or hopelessness.

Possible causes

• Biological factors - Imbalances in brain chemicals like serotonin or structural changes in the brain may play a role.
• Genetic factors - A family history of depression increases the likelihood of developing these disorders.
• Social and cultural factors - Stressful life events, societal pressures, or cultural stigma around mental health can contribute.
• Behavioral and cognitive factors - Negative thinking patterns or learned helplessness (believing one cannot control outcomes) may exacerbate depressive symptoms.

Symptoms and causes of bipolar disorders

Bipolar disorders feature alternating periods of mania (elevated mood or energy) and depression, with cycles varying in duration and intensity.

Selected disorders and their symptoms

• Bipolar I Disorder - Characterized by at least one manic episode, which may include excessive energy, racing thoughts, or risky behavior, often followed by depressive episodes.
• Bipolar II Disorder - Involves at least one hypomanic episode (a less severe form of mania) and one major depressive episode, with less extreme highs compared to Bipolar I.

Possible causes

• Biological factors - Brain chemistry imbalances or abnormalities in brain structure may contribute.
• Genetic factors - Strong hereditary links exist, with higher risk if close relatives have bipolar disorder.
• Social, cultural, behavioral, and cognitive factors - Stressful environments, cultural attitudes toward mental health, maladaptive behaviors, or distorted thinking can influence the onset or severity of episodes.

Symptoms and causes of anxiety disorders

Anxiety disorders are defined by excessive fear or anxiety that disrupts normal behavior, often triggered by specific stimuli or situations.

Selected disorders and their symptoms

• Specific Phobia - Intense fear of a particular object or situation, such as acrophobia (fear of heights) or arachnophobia (fear of spiders).
• Agoraphobia - Fear of situations where escape might be difficult, including public transportation, open or enclosed spaces, crowds, or being alone outside the home.
• Panic Disorder - Recurrent, unexpected panic attacks with intense terror and physical symptoms like heart palpitations. It can be culture-bound, such as ataque de nervios (common among Caribbean or Iberian descent individuals, involving uncontrollable shouting or trembling).
• Social Anxiety Disorder (Social Phobia) - Fear of being judged or scrutinized by others. A culture-bound form is taijin kyofusho (common in Japanese populations, involving fear that one's body is offensive to others).
• Generalized Anxiety Disorder (GAD) - Persistent, excessive worry about various aspects of life without a specific trigger, often accompanied by restlessness or difficulty concentrating.

Possible causes

• Learned associations - Anxiety can develop from associating certain stimuli with fear through past experiences.
• Maladaptive thinking or emotional responses - Distorted thought patterns, like catastrophizing, can fuel anxiety.
• Biological and genetic factors - Brain chemistry imbalances or a family history of anxiety disorders may increase risk.

Symptoms and causes of obsessive-compulsive and related disorders

Obsessive-compulsive and related disorders involve intrusive thoughts or repetitive behaviors that significantly interfere with daily life.

Selected disorders and their symptoms

• Obsessive-Compulsive Disorder (OCD) - Characterized by obsessions (persistent, unwanted thoughts) and compulsions (repetitive behaviors or mental acts aimed at reducing anxiety from obsessions), such as excessive hand-washing or checking.
• Hoarding Disorder - Persistent difficulty discarding possessions, leading to cluttered living spaces and distress or functional impairment.

Possible causes

• Learned associations - Behaviors may develop from past experiences linking certain actions with relief from anxiety.
• Maladaptive thinking or emotional responses - Irrational beliefs about danger or responsibility can drive obsessive thoughts.
• Biological and genetic factors - Brain abnormalities, such as in the frontal cortex, or genetic predisposition may contribute.

Symptoms and causes of dissociative disorders

Dissociative disorders involve disruptions in consciousness, memory, identity, or perception, often as a response to overwhelming stress.

Selected disorders and their symptoms

• Dissociative Amnesia - Inability to recall important personal information, often related to trauma, with or without fugue (sudden, unexpected travel or wandering with identity confusion).
• Dissociative Identity Disorder (DID) - Presence of two or more distinct identities or personality states that control behavior at different times, often with memory gaps between identities.

Possible causes

These disorders are frequently linked to severe trauma, such as abuse or life-threatening events, as a coping mechanism to detach from reality.

Symptoms and causes of trauma and stressor-related disorders

Trauma and stressor-related disorders arise after exposure to traumatic or stressful events, leading to significant psychological distress.

Selected disorder and its symptoms

Posttraumatic Stress Disorder (PTSD) involves symptoms like hypervigilance (constant alertness), severe anxiety, flashbacks (reliving the traumatic event), insomnia (difficulty sleeping), emotional detachment, and hostility following a traumatic experience.

Possible causes

Direct exposure to or witnessing traumatic events, such as combat, natural disasters, or personal assault, often triggers these disorders.

Symptoms and causes of feeding and eating disorders

Feeding and eating disorders involve abnormal eating behaviors that negatively affect physical or psychological health.

Selected disorders and their symptoms

• Anorexia Nervosa - Characterized by restricted food intake, intense fear of gaining weight, and distorted body image, often leading to severe weight loss.
• Bulimia Nervosa - Involves cycles of binge eating followed by purging (vomiting or using laxatives) to prevent weight gain, often with feelings of loss of control during binges.

Possible causes

• Biological and genetic factors - Imbalances in brain chemicals or a family history of eating disorders may increase risk.
• Social and cultural factors - Societal emphasis on thinness or cultural ideals of beauty can contribute significantly.
• Behavioral and cognitive factors - Perfectionism, low self-esteem, or maladaptive coping mechanisms often play a role.

Symptoms and causes of personality disorders

Personality disorders are enduring patterns of behavior and inner experience that deviate from cultural norms, causing distress or impairment. They are grouped into three clusters based on shared characteristics.

Clusters and selected disorders

Cluster A (odd or eccentric):

• Paranoid Personality Disorder - Distrust and suspicion of others' motives.
• Schizoid Personality Disorder - Detachment from social relationships and limited emotional expression.
• Schizotypal Personality Disorder - Eccentric behavior, odd beliefs, and discomfort in close relationships.

Cluster B (dramatic, emotional, or erratic):

• Antisocial Personality Disorder - Disregard for others' rights, often involving deceit or aggression.
• Histrionic Personality Disorder - Excessive attention-seeking and emotional overreaction.
• Narcissistic Personality Disorder - Grandiosity, need for admiration, and lack of empathy.
• Borderline Personality Disorder - Instability in relationships, self-image, and emotions, often with impulsivity.

Cluster C (anxious or fearful):

• Avoidant Personality Disorder - Social inhibition, feelings of inadequacy, and hypersensitivity to criticism.
• Dependent Personality Disorder - Excessive need to be taken care of, leading to submissive behavior.
• Obsessive-Compulsive Personality Disorder - Preoccupation with orderliness, perfectionism, and control (distinct from OCD).

Possible causes

• Biological and genetic factors - Brain structure differences or hereditary traits may contribute.
• Social and cultural factors - Early environment, parenting styles, or cultural expectations can shape personality traits.
• Behavioral and cognitive factors - Learned patterns of behavior or distorted thinking can reinforce maladaptive traits over time.