Psychological Disorders

• almost half of Australians aged 16 to 85 years (45 per cent or 7.3 million) experienced an anxiety, affective or substance use disorder at some point in their lifetime
• The number of new cases that occur during a given period is often referred to as the incidence of a disorder.
• Prevalence refers to the number of people who have a disorder during a specified period of time (i.e. both new and previously existing cases).
• However, personal distress is neither necessary nor sufficient to define abnormality
• Behaviours that interfere with a person’s ability to work or to experience satisfying relationships with other people are likely to be seen as maladaptive and self-defeating, especially if the person seems unable to control such behaviours
• we are likely to label behaviours as abnormal if they are intensely distressing to the individual
• The third criterion for abnormality is society’s judgements concerning the deviance of a given behaviour.
• define abnormal behaviour as behaviour that is personally distressing, personally dysfunctional and/or so culturally deviant that other people judge it to be inappropriate or maladaptive.
• more than 300 disorders are included in the diagnostic manual of the American Psychiatric Association—the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition)
• The biological emphasis was given impetus by the discovery that general paresis, a disorder characterised in its advanced stages by mental deterioration and bizarre behaviour, resulted from severe brain deterioration caused by the sexually transmitted disease syphilis. This was a breakthrough—the first demonstration that a psychological disorder was caused by an underlying physical malady.
• Sigmund Freud’s theory of psychoanalysis ushered in new, psychological interpretations of disordered behaviour. As we shall see, psychodynamic theories of abnormal behaviour were soon joined by other models based on behavioural, cognitive and humanistic concepts.
• According to the vulnerability-stress model (sometimes called the diathesis-stress model), each of us has some degree of vulnerability (ranging from very low to very high) for developing a psychological disorder, given sufficient stress. The vulnerability, or predisposition, can have a biological basis, such as our genotype, over- or underactivity of a neurotransmitter system in the brain, a highly sensitive autonomic nervous system or a hormonal factor.
• a predisposition creates a disorder only when a stressor—some recent or current event that requires a person to cope—combines with the vulnerability to trigger the disorder
• anxiety, a natural response to perceived threat.
• Anxiety responses have four components: (1) a subjective-emotional component, including feelings of fear and apprehension; (2) a cognitive component, including worrisome thoughts and a sense of inability to cope; (3) physiological responses, including increased heart rate and blood pressure, muscle tension, rapid breathing, nausea or dry mouth; and (4) behavioural responses, such as avoidance of certain situations and impaired performance on other tasks
• the frequency and intensity of anxiety responses are out of proportion to the situations that trigger them.
• Large-scale epidemiological studies indicate that anxiety disorders are the most prevalent psychological disorders in Australia, affecting 14.4 per cent of Australians aged 16 to 85 in a given year
• Phobias are strong and irrational fears of certain objects or situations
• Agoraphobia involves an excessive fear of

  situations such as using public transport, being in a crowd or being outside the

  home. The individual fears these situations because they believe that escape would be difficult, or help unavailable if panic- like symptoms or other distressing, embarrassing or incapacitating events were to occur
• social phobia fear social situations in which they may be negatively evaluated by others
• Specific phobias are characterised by an intense fear of a specific object or situation
• panic disorder occur suddenly and unpredictably, and they are much more intense
• A formal diagnosis of a panic disorder requires recurrent panic attacks that do not seem tied to environmental stimuli. In addition, such unexpected panic attacks are then followed by psychological or behavioural problems, such as persistent, intense worry and fear about experiencing further panic attacks, and/or behavioural changes aimed at reducing the likelihood of their occurrence.
• Many people who experience recurrent panic attacks develop agoraphobia.
• generalised anxiety disorder is a chronic (ongoing) state of diffuse, or free- floating, anxiety and worry that is not attached to specific situations or objects.
• Obsessions are repetitive and unwelcome thoughts, images or impulses that invade consciousness, are often abhorrent to the person and are very difficult to dismiss or control.
• Compulsions are repetitive behavioural responses—like the woman’s cleaning rituals—that can be resisted only with great difficulty.
• Compulsions may be overt (observable by others) or covert.
• PTSD is a severe disorder that can occur in people who have been exposed to traumatic life events
• Intrusion symptoms in PTSD include intrusive images, memories, and dreams that cause the person to re-experience the traumatic event as if it were recurring again and again.
• Persistent avoidance of any reminders of the traumatic event is a common symptom of PTSD.
• Negative changes in cognition and mood, which can involve fear, helplessness, self-blame, anger or hopelessness, are often seen in individuals with PTSD.
• Changes in arousal and reactivity, which can manifest in sleep disturbance, poor concentration, hypervigilance, exaggerated startle responses, and reckless or impulsive behaviours, are common in PTSD.
• the risk of PTSD increased with combat exposure. Civilian war victims may be even more vulnerable than soldiers
• Traumas caused by human actions, such as war, rape and torture, are 5 to 10 times more likely to precipitate PTSD than are natural disasters, such as hurricanes and earthquakes
• Compared with men, women exhibit twice the rate of PTSD following exposure to traumatic events
• Genetic factors may create a vulnerability to anxiety disorders (Jang, 2005). Where clinical levels of anxiety are concerned, identical twins have a concordance rate (i.e. if one twin has it, so does the other)
• suggests that the genetically caused vulnerability may take the form of an autonomic nervous system that overreacts to perceived threat, creating high levels of physiological arousal.
• According to Freud, neurotic anxiety occurs when unacceptable impulses threaten to overwhelm the ego’s defences and explode into consciousness or action.
• How the ego’s defence mechanisms deal with neurotic anxiety determines the form of the anxiety disorder