# 15.E: Psychological Disorders (Exercises)

## 15.1: What Are Psychological Disorders?

A psychological disorder is a condition characterized by abnormal thoughts, feelings, and behaviors. Psychopathology is the study of psychological disorders, including their symptoms, etiology (i.e., their causes), and treatment. The term psychopathology can also refer to the manifestation of a psychological disorder. Although consensus can be difficult, it is extremely important for mental health professionals to agree on what kinds of thoughts, feelings, and behaviors are truly abnormal.

### Review Questions

#### Q1

In the harmful dysfunction definition of psychological disorders, dysfunction involves ________.

1. the inability of an psychological mechanism to perform its function
2. the breakdown of social order in one’s community
3. communication problems in one’s immediate family
4. all the above

#### Q2

Patterns of inner experience and behavior are thought to reflect the presence of a psychological disorder if they ________.

1. are highly atypical
2. lead to significant distress and impairment in one’s life
3. embarrass one’s friends and/or family
4. violate the norms of one’s culture

### Critical Thinking Question

#### Q3

Discuss why thoughts, feelings, or behaviors that are merely atypical or unusual would not necessarily signify the presence of a psychological disorder. Provide an example.

### Personal Application Question

#### Q4

Identify a behavior that is considered unusual or abnormal in your own culture; however, it would be considered normal and expected in another culture.

### Solution

A

B

#### S3

Just because something is atypical or unusual does not mean it is disordered. A person may experience atypical inner experiences or exhibit unusual behaviors, but she would not be considered disordered if they are not distressing, disturbing, or reflecting a dysfunction. For example, a classmate might stay up all night studying before exams; although atypical, this behavior is unlikely to possess any of the other criteria for psychological disorder mentioned previously.

## 15.2: Diagnosing and Classifying Psychological Disorders

A first step in the study of psychological disorders is carefully and systematically discerning significant signs and symptoms. How do mental health professionals ascertain whether or not a person’s inner states and behaviors truly represent a psychological disorder? Arriving at a proper diagnosis—that is, appropriately identifying and labeling a set of defined symptoms—is absolutely crucial.

### Review Questions

#### Q1

The letters in the abbreviation DSM-5 stand for ________.

1. Diseases and Statistics Manual of Medicine
2. Diagnosable Standards Manual of Mental Disorders
3. Diseases and Symptoms Manual of Mental Disorders
4. Diagnostic and Statistical Manual of Mental Disorders

#### Q2

A study based on over $$9,000$$ U. S. residents found that the most prevalent disorder was ________.

1. major depressive disorder
2. social anxiety disorder
3. obsessive-compulsive disorder
4. specific phobia

### Critical Thinking Questions

#### Q3

Describe the DSM-5. What is it, what kind of information does it contain, and why is it important to the study and treatment of psychological disorders?

#### Q4

The International Classification of Diseases (ICD) and the DSM differ in various ways. What are some of the differences in these two classification systems?

### Solution

D

A

#### S3

The DSM-5 is the classification system of psychological disorders preferred by most U.S. mental health professionals, and it is published by the American Psychiatric Association (APA). It consists of broad categories of disorders and specific disorders that fall within each category. Each disorder has an explicit description of its symptoms, as well as information concerning prevalence, risk factors, and comorbidity. The DSM-5 provides a common language that enables mental health professionals to communicate effectively about sets of symptoms.

#### S4

The ICD is used primarily for making clinical diagnoses and more broadly for examining the general health of populations and monitoring the international prevalence of diseases and other health problems. While the DSM is also used for diagnostic purposes, it is also highly valued as a research tool. For example, much of the data regarding the etiology and treatment of psychological disorders are based on diagnostic criteria set forth in the DSM.

## 15.3: Perspectives on Psychological Disorders

Scientists and mental health professionals may adopt different perspectives in attempting to understand or explain the underlying mechanisms that contribute to the development of a psychological disorder. The perspective used in explaining a psychological disorder is extremely important, in that it will consist of explicit assumptions regarding how best to study the disorder, its etiology, and what kinds of therapies or treatments are most beneficial.

### Review Questions

#### Q1

The diathesis-stress model presumes that psychopathology results from ________.

2. biochemical factors
3. chemical imbalances and structural abnormalities in the brain

#### Q2

Dr. Anastasia believes that major depressive disorder is caused by an over-secretion of cortisol. His view on the cause of major depressive disorder reflects a ________ perspective.

1. psychological
2. supernatural
3. biological
4. diathesis-stress

### Critical Thinking Question

#### Q3

Why is the perspective one uses in explaining a psychological disorder important?

### Personal Application Question

#### Q4

Even today, some believe that certain occurrences have supernatural causes. Think of an event, recent or historical, for which others have provided supernatural explanation.

### Solution

A

C

#### S3

The perspective one uses in explaining a psychological disorder consists of assumptions that will guide how to best study and understand the nature of a disorder, including its causes, and how to most effectively treat the disorder.

## 15.4: Anxiety Disorders

Anxiety disorders are characterized by excessive and persistent fear and anxiety, and by related disturbances in behavior (APA, 2013). Although anxiety is universally experienced, anxiety disorders cause considerable distress. As a group, anxiety disorders are common: approximately $$25\%-30\%$$ of the U.S. population meets the criteria for at least one anxiety disorder during their lifetime. Also, these disorders appear to be much more common in women than they are in men.

### Review Questions

#### Q1

In which of the following anxiety disorders is the person in a continuous state of excessive, pointless worry and apprehension?

1. panic disorder
2. generalized anxiety disorder
3. agoraphobia
4. social anxiety disorder

#### Q2

Which of the following would constitute a safety behavior?

1. encountering a phobic stimulus in the company of other people
2. avoiding a field where snakes are likely to be present
3. avoiding eye contact
4. worrying as a distraction from painful memories

### Critical Thinking Question

#### Q3

Describe how cognitive theories of the etiology of anxiety disorders differ from learning theories.

### Solution

B

C

#### S3

Learning theories suggest that some anxiety disorders, especially specific phobia, can develop through a number of learning mechanisms. These mechanisms can include classical and operant conditioning, modeling, or vicarious learning. Cognitive theories, in contrast, assume that some anxiety disorder, especially panic disorder, develop through cognitive misinterpretations of anxiety and other symptoms.

## 15.5: Obsessive-Compulsive and Related Disorders

Obsessive-compulsive and related disorders are a group of overlapping disorders that generally involve intrusive, unpleasant thoughts and repetitive behaviors. Many of us experience unwanted thoughts from time to time and many of us engage in repetitive behaviors on occasion. However, obsessive-compulsive and related disorders elevate the unwanted thoughts and repetitive behaviors to a status so intense that these cognitions and activities disrupt daily life.

### Review Questions

#### Q1

Which of the following best illustrates a compulsion?

1. mentally counting backward from $$1,000$$
2. persistent fear of germs
3. thoughts of harming a neighbor
4. falsely believing that a spouse has been cheating

#### Q2

Research indicates that the symptoms of OCD ________.

1. are similar to the symptoms of panic disorder
2. are triggered by low levels of stress hormones
3. are related to hyperactivity in the orbitofrontal cortex
4. are reduced if people are asked to view photos of stimuli that trigger the symptoms

### Critical Thinking Questions

#### Q3

Discuss the common elements of each of the three disorders covered in this section: obsessive-compulsive disorder, body dysmorphic disorder, and hoarding disorder.

### Solution

A

C

#### S3

Each of the three disorders is characterized by repetitive thoughts and urges, as well as an uncontrollable need to engage in repetitive behavior and mental acts. For example, repetitive thoughts include concerns over contamination (OCD), imaged physical defects (body dysmorphic disorder), and over discarding one’s possessions (hoarding disorder). An uncontrollable need to engage in repetitive behaviors and mental acts include persistent hand-washing (OCD), constantly looking in the mirror (body dysmorphic disorder), and engaging in efforts to acquire new possessions (hoarding disorder).

## 15.6: Posttraumatic Stress Disorder

Extremely stressful or traumatic events, such as combat, natural disasters, and terrorist attacks, place the people who experience them at an increased risk for developing psychological disorders such as posttraumatic stress disorder (PTSD). Throughout much of the $$20^{th}$$ century, this disorder was called shell shock and combat neurosis because its symptoms were observed in soldiers who had engaged in wartime combat.

### Review Questions

#### Q1

Symptoms of PTSD include all of the following except ________.

1. intrusive thoughts or memories of a traumatic event
2. avoidance of things that remind one of a traumatic event
3. jumpiness
4. physical complaints that cannot be explained medically

#### Q2

Which of the following elevates the risk for developing PTSD?

1. severity of the trauma
2. frequency of the trauma
3. high levels of intelligence
4. social support

### Critical Thinking Question

#### Q3

List some of the risk factors associated with the development of PTSD following a traumatic event.

### Solution

D

A

#### S3

Risk factors associated with PTSD include gender (female), low socioeconomic status, low intelligence, personal and family history of mental illness, and childhood abuse or trauma. Personality factors, including neuroticism and somatization, may also serve as risk factors. Also, certain versions of a gene that regulates serotonin may constitute a diathesis.

## 15.7: Mood Disorders

All of us experience fluctuations in our moods and emotional states, and often these fluctuations are caused by events in our lives. We become elated if our favorite team wins the World Series and dejected if a romantic relationship ends or if we lose our job. At times, we feel fantastic or miserable for no clear reason. People with mood disorders also experience mood fluctuations, but their fluctuations are extreme, distort their outlook on life, and impair their ability to function.

### Review Questions

#### Q1

Common symptoms of major depressive disorder include all of the following except ________.

1. periods of extreme elation and euphoria
2. difficulty concentrating and making decisions
3. loss of interest or pleasure in usual activities
4. psychomotor agitation and retardation

#### Q2

Suicide rates are ________ among men than among women, and they are ________ during the winter holiday season than during the spring months.

1. higher; higher
2. lower; lower
3. higher; lower
4. lower; higher

### Critical Thinking Question

#### Q3

Describe several of the factors associated with suicide.

### Personal Application Question

#### Q4

Think of someone you know who seems to have a tendency to make negative, self-defeating explanations for negative life events. How might this tendency lead to future problems? What steps do you think could be taken to change this thinking style?

### Solution

A

C

#### S3

The risk of suicide is high among people with mental health problems, including mood disorders and substance abuse problems. The risk is also high among those who have made a prior suicide attempt and who have lethal means to commit suicide. Rates of suicide are higher among men and during the springtime, and they are higher in the mountain states of the west than in other regions of the United States. Research has also shown that suicides can have a “contagious” effect on people, and that it is associated with serotonin dysfunction.

## 15.8: Schizophrenia

Schizophrenia is a devastating psychological disorder that is characterized by major disturbances in thought, perception, emotion, and behavior. About $$1\%$$ of the population experiences schizophrenia in their lifetime, and usually the disorder is first diagnosed during early adulthood (early to mid-$$20s$$). Most people with schizophrenia experience significant difficulties in many day-to-day activities, such as holding a job, paying bills, caring for oneself and maintaining relationships with others.

### Review Questions

#### Q1

Clifford falsely believes that the police have planted secret cameras in his home to monitor his every movement. Clifford’s belief is an example of ________.

1. a delusion
2. a hallucination
3. tangentiality
4. a negative symptom

#### Q2

A study of adoptees whose biological mothers had schizophrenia found that the adoptees were most likely to develop schizophrenia ________.

1. if their childhood friends later developed schizophrenia
2. if they abused drugs during adolescence
3. if they were raised in a disturbed adoptive home environment
4. regardless of whether they were raised in a healthy or disturbed home environment

### Critical Thinking Question

#### Q3

Why is research following individuals who show prodromal symptoms of schizophrenia so important?

### Solution

A

C

#### S3

This kind of research is important because it enables investigators to identify potential warning signs that predict the onset of schizophrenia. Once such factors are identified, interventions may be developed.

## 15.9: Dissociative Disorders

Dissociative disorders are characterized by an individual becoming split off, or dissociated, from her core sense of self. Memory and identity become disturbed; these disturbances have a psychological rather than physical cause. Dissociative disorders listed in the DSM-5 include dissociative amnesia, depersonalization/derealization disorder, and dissociative identity disorder.

### Review Questions

#### Q1

Dissociative amnesia involves ________.

1. memory loss following head trauma
2. memory loss following stress
3. feeling detached from the self
4. feeling detached from the world

#### Q2

Dissociative identity disorder mainly involves ________.

1. depersonalization
2. derealization
3. schizophrenia
4. different personalities

### Critical Thinking Question

#### Q3

The prevalence of most psychological disorders has increased since the 1980s. However, as discussed in this section, scientific publications regarding dissociative amnesia peaked in the mid-1990s but then declined steeply through 2003. In addition, no fictional or nonfictional description of individuals showing dissociative amnesia following a trauma exists prior to 1800. How would you explain this phenomenon?

### Personal Application Question

#### Q4

Try to find an example (via a search engine) of a past instance in which a person committed a horrible crime, was apprehended, and later claimed to have dissociative identity disorder during the trial. What was the outcome? Was the person revealed to be faking? If so, how was this determined?

### Solution

B

D

#### S3

Several explanations are possible. One explanation is that perhaps there is little scientific interest in this phenomenon, maybe because it has yet to gain consistent scientific acceptance. Another possible explanation is that perhaps the dissociative amnesia was fashionable at the time publications dealing with this topic peaked (1990s); perhaps since that time it has become less fashionable.

## 15.10: Personality Disorders

The term personality refers loosely to one’s stable, consistent, and distinctive way of thinking about, feeling, acting, and relating to the world. People with personality disorders exhibit a personality style that differs markedly from the expectations of their culture, is pervasive and inflexible, begins in adolescence or early adulthood, and causes distress or impairment (APA, 2013).

### Review Questions

#### Q1

People with borderline personality disorder often ________.

1. try to be the center of attention
2. are shy and withdrawn
3. are impulsive and unpredictable
4. tend to accomplish goals through cruelty

#### Q2

Antisocial personality disorder is associated with ________.

1. emotional deficits
2. memory deficits
3. parental overprotection
4. increased empathy

### Critical Thinking Question

#### Q3

Imagine that a child has a genetic vulnerability to antisocial personality disorder. How might this child’s environment shape the likelihood of developing this personality disorder?

### Solution

C

A

#### S3

The environment is likely to be very instrumental in determining the likelihood of developing antisocial personality disorder. Research has shown that adverse family environments (e.g., divorce or marital problems, legal problems, and drug use) are connected to antisocial personality disorder, particularly if one is genetically vulnerable. Beyond one’s family environment, peer group delinquency and community variables (e.g., economic deprivation, community disorganization, drug use, and the presence of adult antisocial models) heighten the risk of violent behavior.

## 15.11: Disorders in Childhood

Most of the disorders we have discussed so far are typically diagnosed in adulthood, although they can and sometimes do occur during childhood. However, there are a group of conditions that, when present, are diagnosed early in childhood, often before the time a child enters school. These conditions are listed in the DSM-5 as neurodevelopmental disorders, and they involve developmental problems in personal, social, academic, and intellectual functioning (APA, 2013).

### Review Questions

#### Q1

Which of the following is not a primary characteristic of ADHD?

1. short attention span
2. difficulty concentrating and distractibility
3. restricted and fixated interest
4. excessive fidgeting and squirming

#### Q2

One of the primary characteristics of autism spectrum disorder is ________.

1. bed-wetting
2. difficulty relating to others
3. short attention span
4. intense and inappropriate interest in others

### Critical Thinking Questions

#### Q3

Compare the factors that are important in the development of ADHD with those that are important in the development of autism spectrum disorder.

### Personal Application Question

#### Q4

Discuss the characteristics of autism spectrum disorder with a few of your friends or members of your family (choose friends or family members who know little about the disorder) and ask them if they think the cause is due to bad parenting or vaccinations. If they indicate that they believe either to be true, why do you think this might be the case? What would be your response?

### Solution

C

B

#### S3

Genetic factors appear to play a major role in the development of both ADHD and autism spectrum disorder: studies show higher rates of concordance among identical twins than among fraternal twins for both disorders. In ADHD, genes that regulate dopamine have been implicated; in autism spectrum disorder, de novo genetic mutations appear to be important. Imaging studies suggest that abnormalities in the frontal lobes may be important in the development of ADHD. Parenting practices are not connected to the development of either disorder. Although environmental toxins are generally unimportant in the development of ADHD, exposure to cigarette smoke during the prenatal period has been linked to the development of the disorder; a number of environmental factors are thought to be associated with an increased risk for autism spectrum disorder: exposure to pollutants, an urban versus rural residence, and vitamin D deficiency. Although some people continue to believe that MMR vaccinations can cause autism spectrum disorder (due to an influential paper that was later retracted), there is no scientific evidence that supports this assertion.