Mental Disorders: Types and Causes

• What is “abnormal”?
• Mental disorders are characterized by abnormal behaviour, thoughts and feelings
• “abnormal” – any departure from the norm (different)
• Examples??
• Pejorative connotation – characteristics we dislike or fear
• Behaviour is maladaptive
• Causes distress or discomfort, often interfere with people’s ability to lead useful, productive lives, make it impossible for people to hold jobs, raise families, or relate to others socially
• How about a person who holds a belief that violates a social norm?

Causes

• Interaction among hereditary, cognitive, and environmental factors
• Cognitive factors include distorted perceptions and maladaptive thought patterns
• Environmental factors encompass a person’s family history, present social interactions, effects of prenatal health and nutrition, childhood diseases, exposure to drugs and environmental toxins
• Perspectives on the Causes of Mental Disorders
• The Psychodynamic Perspective
• The Medical Perspective
• The Cognitive-Behavioral Perspective
• The Humanistic Perspective
• The Sociocultural Perspective
• The Psychodynamic Perspective
• Intrapsychic conflict between id, ego, superego
• Defense mechanisms are ineffective, resulting in mental disorders that may involve anxiety, obsessive thoughts and compulsive behaviour, depressions, distorted perceptions and patterns of thinking

The Medical Perspective

• Greek physician Hippocrates – excesses in the four humors (black bile, yellow bile, blood, phlegm) led to emotional problems
• Greek and Roman physicians developed the concept of mental illness
• Confinement in specialized institutions or asylums
• 18^th and 19^th centuries – reforms in institutional care of people with mental disorders took place
• Present day: treated on an out-patient basis with drugs
• Specific brain and nervous system abnormalities

The Cognitive-Behavioral Perspective

• Learned maladaptive behaviour patterns that can best be understood by focusing on environmental factors and a person’s perception of those factors
• Mental disorder is caused by the person’s interaction with his/her environment
• Therapists encourage their clients to replace or substitute maladaptive thoughts and behaviors with more adaptive ones

The Humanistic Perspective

• Mental disorders arise when people perceive that they must earn the positive regard of others
• They become overly sensitive to the demands and criticisms of others, they lack confidence in their abilities and are unhappy with the kind of people they are
• They may feel that they have no control over the outcomes of the events in their lives
• The Sociocultural Perspective
• The role of culture in which people live as a contributing factor to the development of a mental disorder
• Normal and abnormal behaviours defined by culture

Culture-bound syndromes

• How cultures label and interpret mental disorders and how people with mental disorders react to their culture’s treatment of them
• Culture-bound syndromes
• Only found within a few cultures
• Polynesia: cafard – a sudden display of homicidal behaviour followed by exhaustion
• Southeast Asia: koro – an intense fear that the p*nis will retract into the body, resulting in death
• Japan: Taijin – an intense fear that their appearance, body odors, or behaviours are offensive to others
• Nigerian students studying in the U.S.: brain fag – difficulty studying, remembering, and concentrating

The Diathesis-Stress Model

• Combinations of a person’s genetics and early learning experiences yields a predisposition (diathesis) for a particular mental disorder
• A mental disorder will only develop if that person is confronted with stressors that exceed his/her coping abilities
• Example: schizophrenia

Prevalence of Mental Disorders

• Kessler et al. (1994) interviewed nearly 8100 people (ages 18 to 54) in the U.S.
• Most common types: Substance use disorders, anxiety disorders, mood disorders followed by antisocial personality disorder and schizophrenia and other psychotic disorders
• Fairly high frequency in our culture
• Men are about twice as likely as women to suffer from substance use disorders and about four times as likely to suffer from antisocial personality disorder
• Common among women: mood and anxiety disorder

1) Anxiety Disorders

• Panic Disorder
• Phobic Disorders
• Obsessive-Compulsive Disorder
• Panic Disorder
• Panic – feeling of fear mixed with hopelessness or helplessness (car accident, trapped in an elevator)
• Panic disorder – episodic attacks of acute anxiety (few seconds-few hours)
• Women are approximately twice as likely as men to suffer from panic disorder
• Onset in young adulthood
• Symptoms: shortness of breath, clammy sweat, irregularities in heartbeat, dizziness, faintness, feelings of unreality, feelings of death
• Anticipatory anxiety: a fear of having a panic attack
• Causes: Heredity, sensitivity to risk/danger in the environment
• Phobic Disorders
• Phobias: irrational fears of specific objects/situations which interfere with their lifestyle
• 3 types: agoraphobia (fear of being in public places, most severe), social phobia (fear of being exposed to possible scrutiny by others and fears that he/she may do something embarrasing), specific phobia (includes all other phobias, caused by a traumatic experience)
• Males and females are equally likely to exhibit social phobia
• Females are more likely to develop agoraphobia
• Social phobia tends to begin during teenage years
• Learned via classical conditioning (direct / vicarious)
• Obsessive-Compulsive Disorder
• Obsessions: re-occurring thoughts
• Compulsions: behaviours that are constantly performed
• Interferes with daily life
• People with this disorder recognize that their thoughts and behaviours are senseless and wish that they would go away
• Females are more likely than males to have this diagnosis
• Begins in young adulthood
• Four categories of compulsions: counting, checking, cleaning, avoidance
• Causes: defense mechanisms (obsessions occupy the mind and displace painful thoughts), persisting thoughts (competent at all times, avoid criticism, worry about punishment)

2) Somatoform Disorders

• Somatization Disorder (occurs mostly among women, complaints of wide-ranging physical ailments for which there is no apparent biological basis, nonexistent in men)
• Resembles hypochondriasis (persistent and excessive worry about developing a serious illness, spend a lot of time in doctors’ offices and in hospitals)
• Causes: runs in families, most common in poorly educated women of low socioeconomic status

3) Dissociative Disorders

• Anxiety is reduced by a sudden disruption in consciousness, which in turn, produces changes in one’s sense of identity
• Psychogenic amnesia
• Psychogenic fugue
• Multiple personality disorder
• Dissociative Disorders cont’d
• Psychogenic amnesia: A person “forgets” all his or her past life, along with the conflicts that were present, and begins a new one
• Psychogenic fugue (flight): special form of amnesia in which a person deliberately leaves home and starts a new life elsewhere
• Multiple personality disorder (now known as dissociative identity disorder): presence of two or more separate personalities within the individual
• Least understood because they are rare

4) Antisocial Personality Disorder

• Failure to conform to standards of decency, repeated lying and stealing, a failure to sustain long-lasting and loving relationships, complete lack of guilt
• At least 3 types of antisocial behaviour before age 15 and at least 4 after age 18 in order to be diagnosed
• In adulthood: inability to sustain consistent work behaviour, lack of ability to function as a responsible parent, repeated criminal activity, aggressiveness, failure to plan ahead, habitual lying, reckless or drunken driving, promiscuity
• Causes: upbringing (families that contain alcoholics and psychopaths), parenting (parents who ignore children, unsupervised for prolonged periods, harsh punishment, verbal abuse), perception of the world (world is hostile, interpret others’ actions as threatening)

5) Schizophrenic Disorders

• Schizophrenia – group of psychological disorders involving distortions of thought, perception, and emotion; bizarre behaviour; and social withdrawal
• Delusions: beliefs that are contrary to fact
• Hallucinations: perceptions of stimuli that are not actually present (usually auditory)

Catatonic schizophrenia

• Motor disturbances, including catatonic postures (bizarre, stationary poses maintained for hours) and waxy flexibility (person’s limbs can be molded into new positions, which are then maintained)
• Paranoid schizophrenia
• Delusions of persecution, grandeur, or control
• Persecution: false beliefs that others are plotting and conspiring against oneself
• Grandeur: false beliefs in one’s power and importance (godlike powers)
• Control: related to delusions of persecution (person believes that he or she is being controlled by others through such means as radar)
• Disorganized schizophrenia
• Characterized primarily by disturbances of thought
• Often display signs of emotion (silly laughter) that are inappropriate to the circumstances, speech tends to be a jumble of words
• Causes: heredity (predisposition), schizophrenic symptoms continue to exhibit in family environments with expressed emotion (expressions of criticism, hostility, and emotional overinvolvement by family members)

6) Mood Disorders

• Bipolar disorder: alternating periods of mania (wild excitement) and depression
• Major depression: persistent and severe feelings of sadness and worthlessness accompanied by changes in appetite, sleeping and behaviour, more common in females
• Seasonal affective disorder: a mood disorder characterized by depression, lethargy, sleep disturbances, craving for carbohydrates, occurs generally during the winter (treated with exposure to bright lights)

Causes of Mood Disorders

• Heredity
• Biochemical abnormalities (underactivity of neurons that secrete norepinephrine or serotonin)
• Environmental factors (events that disrupt a person’s daily routine and social contacts)