(Part - 1) - Psychological Disorders Class 12 Psychology

Various definitions of abnormality have been proposed, but none has gained universal acceptance. Most definitions share common features known as the four Ds: deviance, distress, dysfunction, and danger.

Psychological disorders are typically considered deviant, distressing, dysfunctional, and potentially dangerous.

• Deviation from Norms:
  • The term 'abnormal' suggests a departure from established norms or standards.
  • Psychology lacks an 'ideal' or 'normal' model of human behavior for comparison.
  • Abnormal behavior is often seen as a deviation from social norms and societal expectations.
• Views on Abnormal Behavior:
  • There are two primary views on abnormal behavior: deviation from social norms and maladaptive behavior.
  • Deviation from social norms refers to behaviors that significantly differ from societal expectations.
  • Maladaptive behavior is defined by its hindrance to the individual's well-being and growth.
• Stigma Surrounding Psychological Disorders:
  • There is a common stigma attached to mental illness, leading individuals to feel ashamed of seeking help.
  • Psychological disorders should be viewed as any other illness, indicating a failure in adaptation.

Historical Background

(a) The organismic approach was introduced by Ancient Greek philosophers such as Hippocrates, Socrates, and Plato, who believed that disturbed behavior was a result of conflicts between emotions and reasoning. Galen also had a similar perspective, where he theorized that temperament was influenced by an imbalance in four humours, much like the concept of tridoshas.
(b) During the Middle Ages, people with mental health issues were commonly associated with demons and superstition. St. Augustine discussed the topics of emotions, mental distress, and inner conflict, which established the foundation for contemporary psychodynamic theories.
(c) During the Renaissance period, there was an increased focus on humanism and curiosity about behavior. Johann Weyer suggested that psychic disorders were caused by troubled interpersonal relationships and that mentally disturbed individuals required medical treatment instead of theological treatment.
(d) The Age of Reason and Enlightenment in the 17th and 18th centuries led to the growth of the scientific method, which replaced faith and dogma. This movement contributed to reforms in society, including increased compassion for those who were suffering from mental health issues. Asylums were reformed, deinstitutionalization occurred, and community care was emphasized.
(e) In recent years, there has been a convergence of approaches resulting in an interactional biopsychosocial approach.
There are various factors underlying abnormal behavior, including biological, psychological, and interpersonal factors:

• Biological factors, such as faulty genes, endocrine imbalances, and malnutrition, can affect normal development and functioning, resulting in behavior with a biochemical or physiological basis. For instance, abnormal activity of neurotransmitters, which are responsible for transmitting messages between neurons, can lead to specific psychological disorders, such as low activity of gamma amino butyric acid (GABA) in anxiety disorders, low activity of serotonin in depression, and excess activity of dopamine in schizophrenia. While scientific evidence links genetic factors to depression, anxiety, mood disorders, schizophrenia, and mental retardation, it is unable to identify specific genes and there is no single gene responsible for a particular behavior. Therefore, biological factors alone cannot account for a mental disorder.
• Psychological and interpersonal factors can also affect abnormal behavior. Maternal deprivation, faulty parent-child relationships (such as rejection, overprotection, over-permissiveness, or faulty discipline), maladaptive family structures, and severe stress are examples of such factors.

Classification Of Psychological Disorders

• Psychological disorders are categorized based on a list of specific disorders that share similar characteristics and grouped into various classes. 
• These classifications are beneficial to psychologists, psychiatrists, social workers, and other professionals in the field as they allow them to:
  (i) Facilitate communication between professionals regarding the disorder
  (ii) Assist in comprehending the origins and mechanisms involved in the development and persistence of psychological disorders.
• Official manuals that provide descriptions and classifications for different types of psychological disorders include:
  (i) The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), which is currently published by the American Psychiatric Association (APA). This manual presents specific clinical criteria that indicate whether a disorder is present or not.
  (iii) The International Classification of Diseases (ICD-10), which is a classification of behavioral and mental disorders published by the World Health Organization (WHO). For each disorder, the manual provides a description of the primary clinical features or symptoms, as well as any associated features and diagnostic guidelines.

Factors Underlying Abnormal Behavior

• Biological factors can have a significant impact on behavior, including the development and functioning of the human body. These factors can include genetic abnormalities, endocrine imbalances, malnutrition, injuries, and other conditions.
  (i) Psychological disorders can often be linked to issues with the transmission of messages between neurons. When an electrical impulse reaches the end of a neuron, it triggers the release of a chemical known as a neurotransmitter.
  (ii) Disorders can arise when there is abnormal activity in the release of neurotransmitters. For example, low levels of the neurotransmitter gamma-aminobutyric acid (GABA) can lead to anxiety disorders, while excess levels of dopamine can cause schizophrenia. Low levels of serotonin can result in depression.
• Mood disorders, schizophrenia, depression, anxiety, mental retardation and other disorders have been found to be associated with genetic factors, but there is no conclusive evidence to suggest that a specific gene is solely responsible for causing these disorders. Rather, it is believed that a combination of genes contributes to the development of these disorders. While there is strong evidence linking genes to psychological disorders, it is important to note that genetic factors are not the only contributors to these disorders.
•  Genetic factors have been associated with bipolar and related disorders, schizophrenia, intellectual disability, and other psychological conditions. However, researchers have not pinpointed the specific genes responsible for these disorders. It seems that most behaviors and psychological disorders are not caused by a single gene. Instead, a combination of many genes contributes to both functional and dysfunctional behaviors and emotional reactions. While there is solid evidence supporting the role of genetic and biochemical factors in conditions like schizophrenia, depression, and anxiety, biological factors alone cannot explain most mental disorders.
• Psychological Model: Psychological Disorders various psychological factors that may contribute to the development of psychological disorders, including maladaptive family structures, faulty parent-child relationships, severe stress, and maternal deprivation.
  Other models that offer explanations of psychological disorders include:
  (i) The Psychodynamic Model emphasizes that both normal and abnormal human behavior is a result of psychological forces, such as the Id, Ego, and Superego, in the unconscious mind. The relative strength of these forces determines a person's personality.
  (ii) The Behavioral Model posits that human behavior can be learned and unlearned. Abnormal behavior results from maladaptive ways of behaving that are learned. The most prominent theories of the behavioral model are classical conditioning, operant conditioning, and social learning.
  The Cognitive Model asserts that faulty thinking, negative and irrational beliefs about oneself and others, and drawing broad negative conclusions based on insignificant events can lead to abnormal behavior.
  (iii) The Humanistic-Existential Model views human beings positively and believes that they are inherently cooperative, positive, and capable of self-actualization. Those who lack meaning in their lives tend to feel empty, depressed, and dysfunctional.
  (iv) The Sociocultural Model explains human behavior, whether normal or abnormal, through various sociocultural factors such as employment conditions, war, prejudice, discrimination, and culture (collectivistic or individualistic).
  (v) The Diathesis Stress Model proposes that psychological disorders develop when a diathesis (biological predisposition to the disorder) is triggered by a stressful situation.

Major Psychological Disorders

As per the information provided in the class on Psychological Disorders, the DSM-5 covers several major psychological disorders:

Anxiety Disorders

Anxiety disorders are characterized by an overall feeling of fear and apprehension, accompanied by symptoms such as rapid heart rate, sweating, dizziness, and fainting.
The major types of anxiety disorders are as follows:

• Generalised Anxiety Disorders: Generalized Anxiety Disorder is characterized by a persistent, excessive, and unrealistic worry and fear about everyday life events and activities, without any apparent cause or specific trigger. Its symptoms include restlessness, feeling on edge, difficulty concentrating, irritability, muscle tension, and sleep disturbances. People with this disorder find it challenging to control their worrying and have difficulty relaxing.
• Panic Disorder: This category of anxiety disorder is characterized by frequent episodes of sudden and overwhelming terror or fear, known as panic attacks, that are often triggered by specific situations or stimuli. Symptoms can include shortness of breath, chest pain, choking sensation, nausea, fear of dying or going crazy, and other physical and emotional symptoms.
• Phobias: Phobias as irrational fears related to a specific object, person, or situation. There are three types of phobias:
  (i) Specific phobias: These are highly irrational fears, such as the fear of a specific type of animal or being enclosed in a small space.
  (ii) Social phobias: This is an intense fear of embarrassment when dealing with others in public.
  (iii) Agoraphobia: This is the fear of entering unfamiliar situations, and people with agoraphobia may have difficulty leaving their homes, which prevents them from carrying out their normal activities.
• Separation Anxiety Disorder: Separation Anxiety Disorder is characterized by an extreme fear of being separated from individuals with whom an emotional attachment has been formed, to the extent that it impairs normal development. Children with this disorder exhibit symptoms such as a reluctance to go to school alone, constantly following their parents, and throwing fits when they are away from their parents for even a short period of time.

Obsessive-Compulsive and Related Disorders

• Individuals with OCD are excessively focused on a specific idea or thought and are unable to stop themselves from performing a certain behavior that disrupts their regular daily activities.
• Obsessive behavior refers to the inability to cease thinking about a specific behavior or thought.
• Compulsive behavior refers to the urge to repeatedly engage in certain behaviors.

Trauma and Stress- Related Disorder

• Individuals who have been exposed to bomb blasts or terrorist attacks often suffer from Post Traumatic Stress Disorder (PTSD). 
• This disorder is characterized by recurrent nightmares, frequent flashbacks, and emotional distress.