There is a very broad range of psychological disorders. The DSM-IV-TR lists more than two hundred psychological disorders that differ in symptoms and the degree to which they affect a person's ability to function.
It is normal for someone to feel anxious on occasion. Generalized anxiety disorder is diagnosed when a person engages in excessive worry about all sorts of things and feels anxious and tense much of the time. Most people who have this disorder function quite well. They can do well at work, have good relationships, and be good parents. It is the fact that they suffer so much from their anxiety that leads to a diagnosis. In contrast, schizophrenia can be completely debilitating. Many people with schizophrenia cannot hold a job, are hospitalized frequently, have difficulty in relationships, and are incapable of good parenting. Common symptoms of schizophrenia include delusions (a system of false beliefs, such as believing there is a vast conspiracy among extraterrestrrial beings to control the government); hallucinations (seeing things that are not there or hearing voices that other people cannot hear); incoherence (talking in a way that no one can understand); or emotions that are expressed out of context (laughing when telling a sad story). The symptoms of schizophrenia make it difficult or impossible for the person to function normally.
Many disorders are marked by both subjective distress and impaired functioning. One such disorder is obsessive-compulsive disorder (OCD). An obsession is a recurrent, usually unpleasant thought, image, or impulse that intrudes into a person's awareness. Some examples are believing that one is contaminated by germs, picturing oneself stabbing one's children, or thinking that every bump hit in the road while driving could have been a person struck by the car. Obsessions cause a great deal of distress. Obsessions typically lead to the development of compulsions. A compulsion is a repetitive act that is used by the person to stop the obsession and decrease the anxiety caused by the obsession. People who believe they have been contaminated may wash themselves for hours on end; those who believe that they have hit another person while driving may not be able to resist the urge to stop and look for someone injured. Behavioral compulsions can sometimes occupy so much time that the person cannot meet the demands of everyday life.
The most important goal of researchers in the field of psychopathology is to discover the causes (etiology) of each disorder. If the causes for disorders were known, then psychologists could design effective treatments and, it would be hoped, be able to prevent the development of many disorders. Unfortunately, theories of psychological disorders are in their infancy, and there are many more questions than there are answers. There is no general agreement among psychologists as to where to look for answers to the question of etiology. Consequently, some researchers stress the importance of biological causes, other researchers focus on psychological processes in the development of disorders, while still others emphasize the crucial role of learning experiences in the development of behavior disorders. All these approaches are important, and each supplies a piece of the puzzle of psy-chopathology, but all approaches have their limitations.
the learning approach. Psychologists who work within this model of psychopathology believe that abnormal behavior is learned through past experiences. The same principles that are used to explain the development of normal behavior are used to explain the development of abnormal behavior. For example, a child can learn to be a conscientious student by observing role models who are conscientious in their work. Another child may learn to break the rules of society by watching a parent break the same rules. In each case, observational learning is at work, but the outcome is very different. In another example of a learning principle, a person who is hungry and hears someone preparing food in the kitchen may begin to salivate because the sounds of food preparation have, in the past, preceded eating food and food makes the person salivate. Those sounds from the kitchen are stimuli that have become conditioned so that the person learns to have the same reaction to the sounds as to food (salivation). This learning process is called classical conditioning. In a different example, experiencing pain and having one's life threatened causes fear. A person who is attacked and bitten by a dog might well develop a fear response to all dogs that is severe enough to lead to a diagnosis of a phobia. Just as the sounds in the kitchen elicit salivation, the sight of a dog elicits an emotional response. The same underlying principle of classical conditioning can account for the development of normal behavior as well as a disorder. There are many other principles of learning besides observational learning and classical conditioning. Together, psychologists use them to account for forms of psychopathology more complex than are exemplified here. Nonetheless, there are many disorders in which a learning approach to etiology seems farfetched. For exam ple, no one believes that mental retardation, childhood autism, or schizophrenia can be explained by learning principles alone.
the psychological approach. This model, sometimes called the cognitive approach, holds that many forms of psychopathology are best understood by studying the mind. Some psychologists within this tradition believe that the most important aspect of the mind is the unconscious. The Austrian psychoanalyst Sigmund Freud (1856-1939) believed that many forms of psychopathology are due to intense conflicts of which the person is unaware but which, nevertheless, produce symptoms of disorders.
Many psychological disorders are associated with obvious problems in thinking. Schizophrenics, people with attention-deficit hyperactivity disorder (ADHD), and those who suffer from depression all show difficulties in concentration. Memory problems are central in people who develop amnesia in response to psychological trauma. People who are paranoid show abnormalities in the way they interpret the behavior of others. Indeed, it is difficult to find examples of psychopathology in which thinking is not disordered in some way, be it mild or severe. Within the cognitive approach, depression is one of the disorders that receives the most attention. People who are depressed often show problems in emotion (feeling sad), behavior (withdrawing from people), and thinking. The cognitive formulation assumes that thinking is central, specifically the way depressed people think about the world, themselves, and the future. Dysfunctional thinking is believed to give rise to the other aspects of depression. Most of the research in the field of psychopathology derives from the cognitive perspective. One of the major challenges to this approach is determining whether thinking patterns cause disorders or whether they are aspects of disorders that, themselves, are caused by nonpsychological factors. For example, depressed people have a pessimistic view of their futures. Does pessimism figure into the cause of the depression, or might depression be caused by biological factors and pessimism is just one of the symptoms of depression?
the biological approach. The biological (biogenic) approach assumes that many forms of psychopathology are caused by abnormalities of the body, usually the brain. These abnormalities can be inherited or can occur for other reasons. What these "other reasons" are is unclear, but they may include birth complications, environmental toxins, or illness of the mother during pregnancy.
Schizophrenia is one disorder that receives much attention among those researchers who follow the biogenic approach. A great deal of research has been conducted on the importance of neurotransmitters. Nerve cells in the brain are not connected; there is a small space between them. A nerve impulse travels this space by the release of chemicals in one nerve cell, called neurotransmitters, which carry the impulse to the receptors of the next cell. There are a large number of neurotransmitters, and new ones are discovered periodically. Early research on the relationship between neurotrans-mitters and psychopathology tended to view the problem as "too much" or
"too little" of the amount of neurotransmitters. It is now known that the situation is much more complicated. In schizophrenia, the neurotransmitter dopamine has received most of the attention, with many studies suggesting that excessive amounts of dopamine cause some of the symptoms of schizophrenia. In fact, drugs that reduce the availability of dopamine to the cells are successful in alleviating some symptoms of the disorder. However, not all people with schizophrenia are helped by these drugs, and some people are helped by drugs that one would not prescribe if the sole cause of schizophrenia is too much dopamine. Researchers are finding that the way in which do-pamine and another neurotransmitter, serotonin, work together may lead to a better biological theory of schizophrenia than the excessive dopamine hypothesis.
The biological approach is a highly technical field, and it relies heavily on advances in technologies for studying the brain. Powerful new tools for studying the brain are invented at a rapid pace. For example, researchers are now able to use neuroimaging techniques to watch how the brain responds and changes from second to second.
Heredity appears to be important in understanding who develops what kind of psychological disorder, but it is often unknown exactly what is inherited that causes the disorder. The fact that schizophrenia runs in families does not reveal what is being passed on from generation to generation. The fact that inheritance works at the level of gene transmission places hereditary research squarely within the biological approach.
One method for addressing the question of whether a disorder can be inherited is by studying twins. Some twins are identical; each twin has the same genes as the other. Other twins share only half of their genes; these are fraternal twins. If one identical twin has schizophrenia and the disorder is entirely inherited, the other twin should also develop schizophrenia. Among identical twins, if one twin is schizophrenic, the other twin has a 48 percent chance of having the same disorder, not a 100 percent chance. For fraternal twins, if one is schizophrenic, there is a 17 percent chance that the other twin will have the disorder. If neither twin has schizophrenia, and no one else in the immediate family has the disorder, there is only a 1 percent chance of developing this form of psychopathology.
Two important points can be made. First, genes matter in the transmission of schizophrenia. Second, the disorder is not entirely due to heredity. Researchers who focus on heredity have found that some other disorders seem to have a genetic component, but no mental illness has been found to be entirely due to heredity. Clearly, there are other factors operating, and the biological approach must be integrated with other approaches to gain a full picture of the etiology of psychopathology.
the biopsychosocial approach. As its name suggests, the biopsycho-social approach seeks to understand psychopathology by examining the interactive influences of biology, cognitive processes, and learning. This is the most popular model of psychopathology and, in its most basic form, is also referred to as the diathesis-stress model. A diathesis is a predisposing factor, and the diathesis may be biological or psychological. When discussing biological diatheses, most theories assume that the diathesis is present at birth. A problem with the regulation of neurotransmitters, which may lead to schizophrenia or depression, is one example. An example of a psychological diathesis is when a person's style of thinking predisposes him or her to a disorder. For instance, pessimism—minimizing good things that happen, maximizing negative events, and attributing failures to personal defects—may predispose a person to depression. The stress aspect of the diathesis-stress model refers to the negative life experiences of the person. An early, chaotic family environment, child abuse, and being raised or living in a high-crime neighborhood are examples of stressful environments. From this perspective, a person will develop a disorder who has a predisposition for the disorder, in combination with certain life experiences that trigger the disorder.
Because the biological, learning, and psychological approaches have all contributed to the understanding of psychopathology, it is no surprise that most psychologists want to combine the best of each approach—hence, the biopsychosocial model. Given the present state of knowledge, each model represents more of an assumption about how psychopathology develops rather than a single theory with widespread scientific support. For virtually every psychological disorder, psychologists debate the causes of the disorder.
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It seems like you hear it all the time from nearly every one you know I'm SO stressed out!? Pressures abound in this world today. Those pressures cause stress and anxiety, and often we are ill-equipped to deal with those stressors that trigger anxiety and other feelings that can make us sick. Literally, sick.