What is a mental disorder?

Mental disorders refer to a wide range of mental health conditions — disorders that affect your mood, thinking and eY haviour. Examples of mental illness include depression, anxiety disorders, schizophrenia, eating disorders and addictive behaviors. Many people have mental health concerns from time to time.

Kurt Schneider: It’s also about how these persons are socially interacting.

Abnormal psychology = Field of research that focuses on every psychological thing that deviates from the norm.

What is abnormal?

  • Statistical perspective
    • How prevalent is this behavior in the surrounding?
  • Social perspective
    • What does society think is appropriate/normal?
  • Psychological perspective

DSM 5 = A way to examine if a person is at risk for a certain disorder.

Key criterion: A consistent pattern of inner experiences and behaviors that clearly deviate from what is expected within the culture of the person involved.

Pattern must be expressed in 2 or more of these areas:

  • Cognitions
  • Affect
  • Interpersonal functioning
  • Impulse control

It is important to be aware of context when evaluating psychological disorders.

  • Culture
    • Abnormalities for a certain culture could be normal for others.
  • Age
    • Abnormalities for adults could be normal for young people
    • Be careful with diagnosing a person who is younger than 18.
  • Gender
    • Men are more likely to exhibit externalizing behavior.
    • Women are more likely to exhibit internalizing behavior.

In DSM-5 there are 10 personality disorders divided in three clusters.

The dramatic (emotional) cluster (Cluster t)

Antisocidl persondlity disorder

  • Does not care about others’ boundaries, feelings, well-being.
    • (Fits image of a psychopath) – Begins in childhood.
  • Behavior gets worse as they grow older.
  • No symptoms before age 16 means that it is unlikely that the disorder will emerge but antisocial behavior at age 16 is usually not indicative of APD.
  • Core symptoms
    • Doesn’t conform to social norms.
    • Lack of guilt.
  • Closely linked to psychopathy.
    • Seemingly friendly and smart, but several ASD symptoms.

Borderline persondlity disorder –    Keywords: instability & extreme.

  • Relationships
  • Self
  • Emotions
  • Able to find stability.
    • Need for structure and support.
    • Considerate, diplomatic partner.

Histrionic persondlity disorder

  • Core symptoms
    • Extreme attention seeking
    • Very emotional
  • Key features
    • Flirty and provocative
    • Voices opinions in a dramatic manner
    • Displays emotions in public
    • Extreme need for attention
  • Cultural differences in behavior
  • Gender differences in manifestation
    • Men: hypermasculine behavior
    • Women: hyperfeminine

Ndrcissistic persondlity disorder

  • Core symptoms
    • Strong need to be admired
    • Thinks of self as very important
    • Lack of insight into others’ feelings and emotions
  • Expect admiration from others
    • Reason = Narcissistic paradox

 Narcissistic person has fragile self-esteem.

  • Inability to recognize others’ needs.
  • Becomes envious easily.
  • Individuals with NPD sometimes successful  High self-esteem and ambition.
    • Often difficult to get along with.

The eccentric cluster (Cluster A)

Shizoid dnd Schizotypdl persondlity disorder

  • Schizoid
    • Social apathy
      • Appears to have no need for social relations.
      • Clumsy in social situations.
      • Passive whenever something unpleasant happens.
    • Schizotypal
      • Anxiety/discomfort in social situations
        • Often ‘weird’ or eccentric – Consider culture!

Pdrdnoid persondlity disorder

  • Core symptom = Perceiving others as threatening.
  • Other symptoms
    • Incorrect interpretations of others’ behavior.
    • Pathologically jealous.
    • Communicating distrust in a hostile manner.

The anxious cluster (Cluster C)

Associated with an intention to avoid anxiety. But ineffective due to neurotic paradox.

Avoiddnt persondlity disorder

  • Core symptom
    • Feeling inferior and very sensitive to (negative) feedback.
  • Other important symptoms  Neurotic paradox:
    • Do not engage in activities to avoid rejection, disappointment.
    • Have low levels of self-esteem

Dependent persondlity disorder

  • Core symptom
    • Excessive need to be taken care of.
  • Important features
    • Submissive behavior (to get others to take care of you)
    • Difficulty making decisions
    • Avoids disagreement
    • Difficulty working independently
    • Accept extreme behavior of others to gain/keep support and confirmation.

Obsessive-compulsive persondlity disorder

  • Core symptom
    • Being preoccupied with order and highly perfectionistic.
  • Important features
    • Workaholic
    • Moral inflexibility
    • Greedy
    • Rigid and stubborn
  • OCPD is NOT obsessive-compulsive disorder (SEE BOOK)  It is however a risk factor for OCD.

Prevalence = The proportion of a population who have (or had) a specific characteristic in a given time period.

Total prevalence of personality disorders is +/- 13%.

  • See book for difference between disorders.

There is a lot of overlap in symptoms of different personality disorders.

Categories or dimensions?

Cdtegoricdl dpprodch:

  • Someone either has a personality disorder or doesn’t.

Dimensiondl dpprodch

  • Example: gradations in psychopathy.
  • Especially: Personality pathology as an extreme score on big five traits.
    • Theoretical evidence (Widiger, Miller):

 Example: Schizoid personality disorder.  Partly used in DSM-5.

DSM-5  PID-5

Looks at personality traits that could have psychopathological factors.

  • Negative affectivity
  • Detachment
  • Disinhibition
  • Psychoticism
  • Antagonism

(illustration: Watson et al., 2013)