6.

psychological disorder

6.1 definition and nature of psychological disorder

A psychological disorder is an ongoing dysfunctional pattern of thought, emotion,

and behavior that causes significant distress, and that is considered deviant in
that person’s culture or society (Butcher, Mineka, & Hooley, 2007). Psychological
disorders have much in common with other medical disorders. They are out of
the patient’s control, they may in some cases be treated by drugs, and their
treatment is often covered by medical insurance. Like medical problems,
psychological disorders have both biological (nature) as well as environmental
(nurture) influences. These causal influences are reflected in the bio-psycho-social
model of illness (Engel, 1977).

The bio-psycho-social model of illness is a way of understanding disorder that

assumes that disorder is caused by biological, psychological, and social
factors (Figure 8.1 “The Bio-Psycho-Social Model”). The biological component of
the bio-psycho-social model refers to the influences on disorder that come from
the functioning of the individual’s body. Particularly important are genetic
characteristics that make some people more vulnerable to a disorder than others
and the influence of neurotransmitters. The psychological component of the bio-
psycho-social model refers to the influences that come from the individual, such
as patterns of negative thinking and stress responses. The social component of the
bio-psycho-social model refers to the influences on disorder due to social and
cultural factors such as socioeconomic status, homelessness, abuse, and
discrimination.
Figure 8.1 The Bio-Psycho-Social Model
 Psychological disorder can be defined as a pattern of behavioral or psychological
symptoms that causes significant distress, impairs the ability to function in one or
more areas of life or both.
To determine any behavior as away from normal, seven considerations are used
as the distinguishing criteria. They are:
 Suffering – experiencing distress and discomfort in one՚s own life.
 Maladaptiveness – engaging in behavior or thought pattern which makes it
more difficult to lead one’s life.
 Irrationality – unable to communicate in a reasonable manner with others.
 Unpredictability – acting in ways which are entirely unexpected.
 Vividness and intensity – experience sensations which are far more vivid and
intense than those of other people.
 Observer discomfort – acting in ways which others find embarrassing.
 Violation of moral and ideal standards – habitual breaking of norms.

6.2 Cause of psychological disorder

There is no single cause for mental illness. A number of factors can contribute to
risk for mental illness, such as

 Your genes and family history

 Your life experiences, such as stress or a history of abuse, especially if they
happen in childhood
 Biological factors such as chemical imbalances in the brain
 A traumatic brain injury
 A mother's exposure to viruses or toxic chemicals while pregnant
 Use of alcohol or recreational drugs
 Having a serious medical condition like cancer
  Having few friends, and feeling lonely or isolated
Psychological disorders are not caused by character flaws. They have nothing to
do with being lazy or weak.

6.3 Types of psychological disorder

Common types of psychological disorder:

1. Anxiety Disorder
Anxiety disorders are a cluster of mental disorders characterized by significant and
uncontrollable feelings of anxiety and fear such that a person's social, occupational, and
personal function are significantly impaired. Anxiety is a worry about future events, while
fear is a reaction to current events. Anxiety may cause physical and cognitive symptoms
such as restlessness, irritability, easy fatigability, difficulty concentrating, increased heart
rate, chest pain, abdominal pain, and many others. In casual discourse the words anxiety
and fear are often used interchangeably; in clinical usage, they have distinct meanings:
anxiety is defined as an unpleasant emotional state for which the cause is either not readily
identified or perceived to be uncontrollable or unavoidable, whereas fear is an emotional
and physiological response to a recognized external threat. The umbrella term anxiety
disorder refers to a number of specific disorders that include fears (phobias) or anxiety
symptoms.
2. Psychosis
Psychosis is an abnormal condition of the mind that results in difficulties determining what is
real and what is not real. Symptoms may include delusions and hallucinations. Other
symptoms may include incoherent speech and behavior that is inappropriate for the
situation. There may also be sleep problems, social withdrawal, lack of motivation, and
difficulties carrying out daily activities. Psychosis can have serious adverse outcomes.
3. Autism spectrum
Autism spectrum, also known as autism spectrum disorder (ASD), is a range of mental
disorders of the neurodevelopmental type. It includes autism and Asperger syndrome.
Individuals on the autistic spectrum often experience difficulties with social communication
and interaction and restricted, repetitive patterns of behavior, interests, or activities.
Symptoms are typically recognized between one and two years of age. Long-term problems
may include difficulties in performing daily tasks, creating and keeping relationships, and
maintaining a job.
4. Schizophrenia
Schizophrenia is a mental disorder characterized by continuous or relapsing episodes of
psychosis. Major symptoms include hallucinations (typically hearing voices), delusions, and
disorganized thinking. Other symptoms include social withdrawal, decreased emotional
expression, and apathy. Symptoms typically come on gradually, begin in young adulthood,
and in many cases never resolve. There is no objective diagnostic test; the diagnosis is used
to describe observed behavior that may stem from numerous different causes. Besides
observed behavior, doctors will also take a history that includes the person's reported
experiences, and reports of others familiar with the person, when making a diagnosis. To
diagnose someone with schizophrenia, doctors are supposed to confirm that symptoms and
functional impairment are present for six months (DSM-5) or one month (ICD-11). Many
people with schizophrenia have other mental disorders, especially substance use disorders,
depressive disorders, anxiety disorders, and obsessive–compulsive disorder.
5. Bipolar Disorder
Bipolar disorder, previously known as manic depression, is a mood disorder characterized by
periods of depression and periods of abnormally elevated mood that last from days to
weeks each. If the elevated mood is severe or associated with psychosis, it is called mania; if
it is less severe, it is called hypomania. During mania, an individual behaves or feels
abnormally energetic, happy, or irritable, and they often make impulsive decisions with little
regard for the consequences. There is usually also a reduced need for sleep during manic
phases. During periods of depression, the individual may experience crying and have a
negative outlook on life and poor eye contact with others. The risk of suicide is high; over a
period of 20 years, 6% of those with bipolar disorder died by suicide, while 30–40% engaged
in self-harm. Other mental health issues, such as anxiety disorders and substance use
disorders, are commonly associated with bipolar disorder.
6. Asperger syndrome
Asperger syndrome (AS), also known as Asperger's, is a neurodevelopmental disorder
characterized by significant difficulties in social interaction and nonverbal communication,
along with restricted and repetitive patterns of behavior and interests. It is an autism
spectrum disorder (ASD), but differs from other ASDs by relatively unimpaired language and
intelligence. Although not required for diagnosis, physical clumsiness and unusual use of
language are common. Signs usually begin before two years of age and in many cases never
resolve.
7. Conduct Disorder
Conduct disorder (CD) is a mental disorder diagnosed in childhood or adolescence that
presents itself through a repetitive and persistent pattern of behavior that includes theft,
lies, physical violence that may lead to destruction and wanton breaking of rules, in which
the basic rights of others or major age-appropriate norms are violated. These behaviors are
often referred to as "antisocial behaviors." It is often seen as the precursor to antisocial
personality disorder, which is per definition not diagnosed until the individual is 18 years
old. Conduct disorder may result from parental rejection and neglect and can be treated
with family therapy, as well as behavioral modifications and pharmacotherapy. Conduct
disorder is estimated to affect 51.1 million people globally as of 2013.
8. Panic attack
Panic attacks are sudden periods of intense fear and discomfort that may include
palpitations, sweating, chest pain, shaking, shortness of breath, numbness, or a feeling of
impending doom or of losing control. Typically, symptoms reach a peak within ten minutes
of onset, and last for roughly 30 minutes, but the duration can vary from seconds to hours.
Panic attacks themselves are not physically dangerous.
9. Factitious Disorder
A factitious disorder is a condition that englobes several symptoms of ADHD, depression and
anxiety. People with a factitious disorder may present a similar behaviour to those other
mental illnesses making it harder to identify and diagnose.
10. Schizoaffective Disorder
Schizoaffective disorder (SZA, SZD or SAD) is a mental disorder characterized by abnormal
thought processes and an unstable mood. The diagnosis is made when the person has
symptoms of both schizophrenia (usually psychosis) and a mood disorder—either bipolar
disorder or depression. The main criterion for the schizoaffective disorder diagnosis is the
presence of psychotic symptoms for at least two weeks without any mood symptoms
present. Schizoaffective disorder can often be misdiagnosed when the correct diagnosis may
be psychotic depression, psychotic bipolar disorder, schizophreniform disorder, or
schizophrenia. It is imperative for providers to accurately diagnose patients, as treatment
and prognosis differs greatly for each of these diagnoses.

6.4 The possible treatment techniques of psychological disorder

Step in the treatment of psychological disorders is recognizing that a problem

exists. Often, people who have psychological disorders deny their problem and do
not seek medical care for their symptoms. Regular medical care can be helpful
because it allows a health care professional to provide early screening tests.
Regular medical care also provides an opportunity for your health care
professional to promptly evaluate symptoms and your risks for developing
psychological disorders.

Treatment frequently involves psychotherapy to work on behaviors, skill

development, and thought process. Initial hospitalization may be necessary for
coexisting medical problems, serious complications, severe disorders, or
substance abuse. Medications can be quite helpful for some personality disorders.
Significant improvement can occur with proper treatment.

Common treatments of psychological disorders include:

 Ant anxiety medications

 Antidepressant medications to improve moods
 Antipsychotic medications to treat disordered thought patterns and
altered perceptions
 Cognitive behavioral therapy to work on thought patterns and behavior
 Family therapy to help develop support and understanding
 Group therapy
 Hospitalization for coexisting medical problems, serious complications,
severe disorders, or substance abuse
 Identification and treatment of coexisting conditions
 Individual therapy
 Mood-stabilizing medications
 Psychodynamic therapy to work on discovering and understanding past
issues and their relationship to current thoughts and behaviors
 Support groups
 Talk therapy