Many mental health professionals view psychological disorders as harmful dysfunctions that cause atypical, disturbing, maladaptive, and unjustifiable behavior. 

The medical model proposes that it is useful to think of abnormal behavior as a disease, so that people recognize that it can be treated. 

Criteria for Abnormal Behavior:

• Deviance – behavior that is not considered acceptable by societal norms and expectations

• Dysfunctional/Maladaptive – behavior that inhibits daily life and the ability to function normally

• Personal Distress – behavior that is hurtful to the individual emotionally, physically, and/or socially

In the 1800’s, disturbed people were no longer thought of as mad men, but as mentally ill. They were put in hospitals, but the treatment did not improve.

• Hospitals were nothing more than barbaric prisons.

• The patients were chained and locked away.

• Some hospitals like Bedlam in England- charged admission for the public to see the patients.

The medical model seeks to see and treat mental illness like any other illness. Psychological disorders can be seen as psychopathology,  an illness of the mind. Disorders can be diagnosed, labeled as a collection of symptoms that tend to go together. People with disorders can be treated, attended to, given therapy, all with a goal of restoring mental health. Clinical psychologists work with physicians to understand the mind and body link. 

Psychologist David Rosenhan grew suspicious of the effectiveness of mental hospitals and their nurses' ability to diagnose and treat patients. He conducted an experiment where he sent in healthy individuals who faked having hallucinations, then acted normal. Their stays in the hospital averaged 19 days and all but one were diagnosed as having "schizophrenia in remission" prior to their release. He released his findings and told the hospitals to expect more psuedopatients. The hospitals were more skeptical of those coming to them for help, rejecting a variety of patients. Unbeknownst to them, Rosenhan never sent anyone, so the hospitals failed twice. His research increased care and diagnostic procedures, as well as, limited the use of applying labels on patients.

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is the formal classification system used in the diagnosis of psychological disorders. Known as the “psychologist’s bible”, it contains the symptoms and signs for every known disorder. It has a multiaxial system, dividing information into five categories (or axes): clinical syndromes, personality disorders or mental retardation, general medical conditions, psychosocial and environmental problems, and global assessment of functioning scale. 

• Comorbidity – the coexistence of two or more disorders

Insanity is not a psychological term, but a legal one. Insanity is a legal status indicating that a person cannot be held responsible for his or her actions because of mental illness. 

The insanity defense is used when a mental disorder makes a person unable to distinguish right from wrong. This is only applicable in criminal proceedings, not civil proceedings.

Civil proceedings often lead to involuntary commitment (people are hospitalized in a psychiatric facility against their will). This is the case when legal/medical professionals believe the person is either a threat to themselves, a threat to society, and/or unable to provide for their basic care. 

Anxiety disorders are a class of disorders marked by feelings of excessive apprehension and anxiety.Many patient fears something awful will happen to them. They are in a state of intense apprehension, uneasiness, uncertainty, or fear.  

• Five Types:

  • Generalized anxiety disorder

  • Phobic disorder

  • Panic disorder

  • OCD

  • PTSD

Mood disorders are a class of disorders marked by emotional disturbances of varied kinds that may spill over to disrupt physical, perceptual, social, and thought processes. 

Two basic types:

• • Unipolar: emotional extremes at just one end of the spectrum, as seen in depression

  • Bipolar: emotional extremes at both ends of the mood continuum

Bipolar disorder (a.k.a. manic-depressive disorder) is characterized by the experience of one or more manic episodes as well as periods of depression. In a manic episode, a person’s mood is the complete opposite of depression, with high self-esteem, optimism, energy, and extravagant plans. The person might not sleep for days, talk quickly, and experience poor judgment.

Bipolar I

• More Severe

• Marked with swings of Mania and Low Depression

• Treated with Mood Stabilizers – Lithium and Anti-Depressants (SSRI’s) Zoloft, Paxil, etc. 

Bipolar II

• Less Severe – many aren’t diagnosed until years after episodes.

• Swings of hypomania and a depression.

• Same treatments as Bipolar I

Cyclothymia

• A relatively mild mood disorder. 

• Moods swing between short periods of mild depression and hypomania(an elevated mood)

• People with cyclothymic disorder have milder symptoms than occur in full-blown bipolar disorder.

Disruptive Mood Dysregulation

• Cases where bipolar symptoms are present in adolescents and children. Many young people have cycles from depression to extended rage rather than mania.

Genetics

• Depressive disorders and bipolar disorders appear to run in families.

• Twin Study: if one identical twin has a disorder there is a 1 in 2 chance that the other twin will have it. 

The Brain

• Brain activity is diminished in depression and increased in mania.

• Brain structure: smaller frontal lobes in depression and fewer axons in bipolar disorder

• Brain cell communication (neurotransmitters): 

  • more norepinephrine (arousing) in mania, less in depression 

  • reduced serotonin in depression

Schizophrenic disorders are a class of disorders marked by delusions, hallucinations, disorganized speech, and deterioration of adaptive behavior. 

Symptoms:

• Delusions: false beliefs that are maintained even though they are clearly out of touch with reality

  • Ex. Believing you are royalty

• Hallucinations: sensory perceptions that occur in the absence of a real, external stimulus or are gross distortions of perceptual input

  • Ex. Hearing voices

• Noticeable deterioration of a person’s routine functioning

  • Ex. Neglecting personal hygiene

• Chaotic thought patterns

• Disturbed emotions

Due to criticism over the four types of schizophrenia, some suggest dividing those afflicted into two categories:

• • Negative symptoms involves behavioral deficits, such as flattened emotions, social withdrawal, apathy, impaired attention, and poverty of speech.

  • Positive symptoms involve behavioral excesses or peculiarities, such as hallucinations, delusions, bizarre behavior, and wild flights of ideas. 

• Emerges in adolescence or early adulthood

• Treatment options vary depending on the type and severity of the disorder (roughly 20% of those suffering from schizophrenia enjoy a full recovery)

• A child born to schizophrenic parents has about a 46% probability of developing a schizophrenic disorder, where as one who has no family history of schizophrenia has a 1% probability. 

• Has been linked to excess dopamine activity and disruptions in brain activity

Dissociative disorders are a class of disorders in which people lose contact with portions of their consciousness or memory, resulting in disruptions in their sense of identity. 

Personality disorders are a class of disorders marked by extreme, inflexible personality traits that cause subjective distress or impaired social and occupational functioning. Criticism on the diagnosis of personality disorders emerges because of their cross-over with other types of disorders.

• Lacks empathy, overly self involved

• Preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love

• Can only associate with equally “special” individuals

• Sense of entitlement

• Thinking that they are the  center of the universe.

• Inappropriate sexual seductive or provocative behavior

• Displays rapidly shifting and shallow emotions

• Show self dramatization, theatricality, exaggerated expression of emotion

• Considers relationships to be more intimate than reality 

• very impulsive, often demonstrating self-injurious behaviors (risky sexual behaviors, cutting, suicide attempts, reckless driving, binge eating)

• frantic efforts to avoid real or imagined abandonment 

• abandonment fears are related to an intolerance of being alone, need to have other people with them at all times

• inappropriate anger, chronic feelings of emptiness

A somatoform disorder exists when a person manifests a psychological problem through a physical symptom or illness. 

Illness anxiety disorder or hypochondriasis is worrying excessively that you are or may become seriously ill. You may have no physical symptoms. 

Psychotherapy is an emotionally charged, confiding interaction between a trained therapist and someone who suffers from psychological difficulties.

In their efforts to help people, mental health professionals use many treatment methods.

• • Insight therapy

  • Behavior therapy

  • Biomedical therapy

Clinical psychologists and counseling psychologists specialize in the diagnosis and treatment of psychological disorders and everyday behavioral problems. Psychiatrists are physicians who specialize in the diagnosis and treatment of psychological disorders. While psychiatrists depend on medication and psychoanalysis for treatment, psychologists depend on behavioral methods. Some psychologists and psychiatrists can specialize in a certain disorder or group of patients. 

Biomedical therapies are psychological interactions intended to reduce symptoms associated with psychological disorders (ex. Medication, electro-convulsion, brain stimulation, etc.).

Psychopharmacology is the treatment of mental disorders with medication.  

• • Anti-anxiety drugs

  • Antipsychotics

  • Antidepressants

  • Mood-stabilizers

Deinstitutionalization refers to transferring the treatment of mental illness from inpatient institutions to community-based facilities that emphasize out-patient care. 

• • Growing trend as more drug therapies are developed and fewer professionals are available for care

  • Lead to an increase in the homeless population

Spontaneous remission is a recovery from a disorder that occurs without formal treatment. Some disorders can be cured through treatments, others will require treatment for the rest of the patients’ lives. It depends on the type and severity of the disorder.