Abnormal Psychology
Understanding mental disorders: what they are, how they develop, and how they're treated.
Defining Abnormality
The Four Ds
| Criterion | Description | Example |
|---|---|---|
| Deviance | Statistically unusual or socially unacceptable | Hearing voices |
| Distress | Causes suffering | Intense anxiety |
| Dysfunction | Impairs functioning | Can't work or maintain relationships |
| Danger | Risk to self or others | Suicidal ideation |
No single criterion is sufficient. Clinical judgment considers context.
Major Categories of Disorders
Anxiety Disorders
Characterized by: Excessive fear, anxiety, and related behavioral disturbances.
| Disorder | Core Feature |
|---|---|
| Generalized Anxiety Disorder (GAD) | Chronic, excessive worry about many things |
| Panic Disorder | Recurrent unexpected panic attacks |
| Social Anxiety Disorder | Intense fear of social situations |
| Specific Phobias | Intense fear of specific objects/situations |
| Agoraphobia | Fear of places where escape might be difficult |
Key symptoms of panic attack:
- Racing heart
- Sweating
- Trembling
- Shortness of breath
- Chest pain
- Nausea
- Dizziness
- Fear of dying or losing control
Mood Disorders
Major Depressive Disorder:
| Symptom Category | Examples |
|---|---|
| Emotional | Sadness, emptiness, hopelessness |
| Cognitive | Difficulty concentrating, negative thoughts, guilt |
| Physical | Changes in sleep, appetite, energy, psychomotor changes |
| Behavioral | Withdrawal, reduced activity, suicidal behavior |
Diagnosis requires: 5+ symptoms for 2+ weeks, including depressed mood or loss of interest.
Bipolar Disorder:
| Type | Pattern |
|---|---|
| Bipolar I | Manic episodes (may have depression) |
| Bipolar II | Hypomanic episodes + major depression |
| Cyclothymia | Chronic fluctuating mood (less severe) |
Manic episode features:
- Decreased need for sleep
- Grandiosity
- Racing thoughts
- Increased activity
- Risky behavior
- Pressured speech
Trauma and Stress-Related Disorders
PTSD (Post-Traumatic Stress Disorder):
| Symptom Cluster | Examples |
|---|---|
| Intrusion | Flashbacks, nightmares, intrusive memories |
| Avoidance | Avoiding reminders, emotional numbing |
| Negative cognitions/mood | Guilt, shame, detachment, negative beliefs |
| Arousal | Hypervigilance, startle response, sleep problems |
Not everyone exposed to trauma develops PTSD. Risk factors include trauma severity, prior trauma, lack of support.
Obsessive-Compulsive and Related Disorders
OCD components:
- Obsessions: Intrusive, unwanted thoughts causing anxiety
- Compulsions: Repetitive behaviors to reduce anxiety
Common themes:
| Obsession | Compulsion |
|---|---|
| Contamination | Washing, cleaning |
| Doubt | Checking |
| Symmetry/order | Ordering, arranging |
| Forbidden thoughts | Mental rituals |
| Harm | Checking, avoidance |
Personality Disorders
Enduring patterns of inner experience and behavior that deviate from cultural expectations.
| Cluster | Disorders | Common Features |
|---|---|---|
| A (Odd/Eccentric) | Paranoid, Schizoid, Schizotypal | Distrust, detachment, oddness |
| B (Dramatic/Erratic) | Antisocial, Borderline, Histrionic, Narcissistic | Emotional instability, impulsivity |
| C (Anxious/Fearful) | Avoidant, Dependent, Obsessive-Compulsive | Fear, anxiety, inhibition |
Borderline Personality Disorder (common, treatable):
- Unstable relationships
- Identity disturbance
- Impulsivity
- Emotional instability
- Fear of abandonment
- Self-harm
- Emptiness
Schizophrenia Spectrum
Positive symptoms (additions to normal experience):
- Hallucinations (usually auditory)
- Delusions
- Disorganized speech
- Disorganized behavior
Negative symptoms (subtractions from normal experience):
- Flat affect
- Avolition (lack of motivation)
- Alogia (poverty of speech)
- Anhedonia (inability to feel pleasure)
- Social withdrawal
Substance Use Disorders
Defined by: Problematic pattern of use leading to significant impairment.
Key features:
- Tolerance (need more for same effect)
- Withdrawal (symptoms when stopping)
- Loss of control
- Continued use despite problems
- Craving
- Neglecting responsibilities
Eating Disorders
| Disorder | Core Feature |
|---|---|
| Anorexia Nervosa | Restriction, fear of weight gain, body image disturbance |
| Bulimia Nervosa | Binge eating + compensatory behaviors |
| Binge Eating Disorder | Binge eating without compensation |
Neurodevelopmental Disorders
| Disorder | Core Features |
|---|---|
| ADHD | Inattention, hyperactivity, impulsivity |
| Autism Spectrum | Social communication deficits, restricted/repetitive behaviors |
| Specific Learning Disorders | Difficulties in reading, writing, or math |
Causes of Mental Disorders
Biopsychosocial Model
| Factor | Examples |
|---|---|
| Biological | Genetics, brain chemistry, brain structure, hormones |
| Psychological | Thinking patterns, coping styles, trauma, attachment |
| Social | Family, culture, socioeconomic status, life events |
All disorders involve interaction of multiple factors.
Diathesis-Stress Model
Vulnerability (Diathesis) + Stress → Disorder
- Genetic predisposition + life stressor → depression
- Biological vulnerability + trauma → PTSD
- Temperament + environment → anxiety
Protective factors can buffer against risk.
Treatment Approaches
Psychotherapy
| Type | Focus | Best For |
|---|---|---|
| CBT (Cognitive-Behavioral) | Thoughts and behaviors | Depression, anxiety, OCD, PTSD |
| DBT (Dialectical Behavior) | Emotion regulation, mindfulness | Borderline, self-harm |
| Psychodynamic | Unconscious patterns, relationships | Personality issues, insight-oriented |
| Exposure therapy | Facing feared stimuli | Phobias, OCD, PTSD |
| ACT (Acceptance and Commitment) | Values-based action, acceptance | Anxiety, depression, chronic pain |
Medication
| Class | Use | Examples |
|---|---|---|
| Antidepressants (SSRIs) | Depression, anxiety | Prozac, Zoloft, Lexapro |
| Antipsychotics | Schizophrenia, bipolar | Risperdal, Abilify, Seroquel |
| Mood stabilizers | Bipolar | Lithium, Depakote |
| Anxiolytics | Anxiety (short-term) | Xanax, Ativan, Klonopin |
| Stimulants | ADHD | Adderall, Ritalin |
Other Treatments
- ECT (Electroconvulsive Therapy): Severe depression, rapid response needed
- TMS (Transcranial Magnetic Stimulation): Depression
- Hospitalization: Acute crisis, safety concerns
- Support groups: Community, shared experience
- Lifestyle interventions: Exercise, sleep, nutrition
Recognizing Warning Signs
In Yourself
Seek help if:
- Symptoms persist for weeks
- Functioning is impaired (work, relationships)
- You're using substances to cope
- Thoughts of self-harm or suicide
- Others express concern
- Quality of life is significantly reduced
In Others
Signs someone may need help:
- Significant behavior change
- Withdrawal from relationships
- Declining performance
- Substance use increase
- Talking about hopelessness
- Giving away possessions
- Expressing suicidal thoughts
Suicide Warning Signs
Take seriously:
- Talking about wanting to die
- Looking for means (weapons, pills)
- Talking about being a burden
- Increased substance use
- Hopelessness
- Withdrawal
- Giving away possessions
- Saying goodbye
What to do:
- Ask directly about suicidal thoughts
- Listen without judgment
- Stay with them
- Remove means if possible
- Get professional help
Crisis resources:
- National Suicide Prevention Lifeline: 988
- Crisis Text Line: Text HOME to 741741
Reducing Stigma
Facts vs. Myths
| Myth | Fact |
|---|---|
| Mental illness is rare | 1 in 5 adults experience mental illness |
| It's a personal weakness | It's a medical condition |
| People can just "snap out of it" | Treatment is often needed |
| People with mental illness are dangerous | Vast majority are not |
| Treatment doesn't work | Most conditions are highly treatable |
Fighting Stigma
- Use person-first language ("person with schizophrenia")
- Educate yourself and others
- Share stories (when appropriate)
- Challenge stereotypes
- Treat mental health like physical health
Practical Applications
Maintaining Mental Health
- Regular sleep, exercise, nutrition
- Social connection
- Stress management
- Purpose and meaning
- Professional help when needed
- Limit substance use
Supporting Others
- Listen without judgment
- Express concern gently
- Offer practical help
- Don't try to fix
- Encourage professional help
- Stay connected
- Educate yourself about their condition
Seeking Help
Types of professionals:
| Professional | Training | What They Do |
|---|---|---|
| Psychiatrist | MD + psychiatric training | Medication, diagnosis |
| Psychologist | PhD/PsyD | Assessment, therapy |
| Therapist/Counselor | Master's degree | Therapy |
| Social Worker | MSW | Therapy, case management |
| Primary Care Doctor | MD | Initial assessment, medication, referral |
Finding help:
- Ask primary care doctor
- Check insurance network
- Psychology Today therapist finder
- Employee Assistance Program (EAP)
- Community mental health centers