INTRODUCTION TO

PSYCHOLOGY II
Chapter 14 – Part 1
Psychological Disorders I
Bahçeşehir University

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Are you normal?

• What is a normal behavior?

• How do you know that a mental process is maladaptive or
abnormal?
• Are you normal?

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Changing Concept of Abnormality

• In ancient time, holes were cut in an ill person’s head to let

evil spirits out.
• A process called trephining.

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Changing Concept of Abnormality

• Hippocrates believed that mental illness came from an

imbalance in the body’s four humors:

• Phlegm (mucus), black bile, blood, and yellow bile.

(calm temperament, melancholy temperament, active and
social temperament, anger)

• First recorded attempt to link abnormal behavior to biological

processes.

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Changing Concept of Abnormality

• In the Middle Ages, the mentally ill were called witches.

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Changing Concept of Abnormality

• Today, psychological disorders are viewed from a medical

model:
• They can be diagnosed by looking at various symptoms.

• They have an etiology (origin or causes), course, and prognosis

(predicted future course).

• They are treatable:

• Some can be cured for good
• Others need lifelong attention…

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Changing Concept of Abnormality

• Psychopathology: the study of abnormal behavior.

• Psychological disorders: any pattern of behavior that 
• Causes people significant distress
• Causes people to harm others and/or themselves
• Harms people’s ability to function in daily life

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Changing Concept of Abnormality

• Defining normality/normal behavior is not as easy as it may

seem.
• Here are some helping criteria to identify abnormality:
• Statistical or Social Norm Deviance
• Subjective Discomfort
• Inability to Function Normally

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Changing Concept of Abnormality

• Statistical or Social Norm Deviance:

• Frequently occurring behavior is normal.
• Rarely occurring behavior is abnormal.
• E.g., refusing to wear clothes in a society that does not
permit nudity.

• But NOT all deviant behavior is abnormal (e.g., being a monk in

the U.S.).

• Watch out for the situational context!

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Changing Concept of Abnormality

• Subjective Discomfort:
• The experience of a great deal of personal discomfort or
emotional distress can be a sign of abnormality.

• This distress probably emerges when the individual engages in

certain activities or thoughts.
• E.g., fear of leaving home will give a person a huge anxiety and inability to
leave home.

• Watch out: NOT all abnormal behavior will come with

subjective discomfort.
• E.g., a serial killer would probably not feel any kind of discomfort.

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Changing Concept of Abnormality
• Inability to Function Normally
• Thinking or behavior that does not allow the person to fit into society
or function normally can also be labeled as abnormal.

• These types of behavior are called maladaptive

• Finding it hard to adapt to the demands of daily life

• Key element in the definition of abnormality

• Maladaptive thinking and behavior may initially seem to help the

individual cope with distress, but will eventually become harmful or
damaging
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Models of Abnormality:
Biological Model
• Biological Model
• Claim: Psychological disorders have biological or medical
causes.
• Faulty neurotransmitter systems
• Genetic problems
• Brian damage and dysfunction
• Some combination of those

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Models of Abnormality:
Psychological Models
• Psychological Models
• Psychodynamic view
• Behaviorism
• Cognitive perspective
• Sociocultural perspective
• Biopsychosocial view

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Models of Abnormality:
Psychological Models
• Psychodynamic View
• Claim: Abnormal behavior is caused by repressed conflicts
and urges that are fighting to become conscious.
• E.g., A woman who slept with her brother-in-law feels “dirty” all the
time, washing her hands constantly to keep those thoughts and
memories away, as if ridding herself of the symbolically “dirty”
thoughts.

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Models of Abnormality:
Psychological Models
• Behaviorism
• Claim: Abnormal behavior is learned, just like normal
behavior.
• E.g., Fear of spiders is explained as a conditioned response, with the
“screaming” reaction positively reinforced by the attention of others. 

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Models of Abnormality:
Psychological Models
• Cognitive Perspective
• Claim: Abnormal behavior comes from irrational beliefs and
illogical patterns of thought.
• E.g., Fear of spiders is explained as distorted thinking: “All spiders are
trying to bite me, and I will die”. 
• Such distorted thinking puts an individual at greater risk for
depression and anxiety compared to other individuals.

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Models of Abnormality:
Psychological Models
• Sociocultural Perspective
• Claim: Abnormal behavior is the product of family, social,
and cultural influences.

• Cultural relativity refers to the need to consider unique

characteristics of a culture in which behavior takes place to be
able to correctly diagnose and treat the disorder.

• Culture-bound syndromes refers to the disorders found only in

particular cultures.
• E.g., Anorexia nervosa is mostly found in Western societies.

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Models of Abnormality:
Psychological Models
• Biopsychosocial View
• Claim: Biological, psychological, and social (or cultural)
influences interact with one another in causing psychological
disorders.
• A genetically inherited tendency for anxiety may not develop into a
full-blown disorder unless the family and social environments
produce the right stressors at the right time during development.

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Diagnosing and Classifying Disorders

• Need for
• A common set of terms
• A systematic way of description

• These also facilitate communication among psychological

professionals and other healthcare providers.

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Diagnosing and Classifying Disorders

• The Diagnostic and Statistical Manual of Mental Disorders, Fifth

Edition, Global Edition (DSM-5)
• Manual of psychological disorders and their symptoms

• International Classification of Diseases (ICD)

• An international resource published by the World Health Organization (WHO)

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 An overview of the psychological disorders
that will be discussed
• Disorders of Anxiety, Trauma, and Stress
• Phobia, panic disorders, generalized anxiety disorder, OCD, acute stress disorder and PTSD.

• Disorders of Mood (Affective Disorders)

• Major depression, bipolar disorder.

• Eating Disorders
• Anorexia nervosa, bulimia nervosa, binge eating.

• Dissociative Disorders (altered identities)

• Schizophrenia (altered reality)

• Personality Disorders
• Anti-social personality disorder, borderline disorder.
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Disorders of Anxiety, Trauma, and Stress

• The main symptom: Excessive or unrealistic worry and

fearfulness

• Free-floating anxiety: Anxiety unrelated to any realistic,

known source
• Often a symptom of an anxiety disorder
(Freud, 1977)

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Disorders of Anxiety, Trauma, and Stress

• PHOBIC DISORDERS
• An irrational, persistent fear of an object, situation, or
social activity
• Avoiding a snake vs. avoiding pictures of a snake?

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Disorders of Anxiety, Trauma, and Stress

• PHOBIC DISORDERS
• Social Phobia (Social Anxiety Disorder):
• Fear of interacting with others or being in social
situations.
• People with social anxiety disorder is afraid of being
negatively evaluated by others.
• Being in social situations might lead to embarrassment or
humiliation for those people.
• They often have a history of being shy as children.

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Disorders of Anxiety, Trauma, and Stress

• PHOBIC DISORDERS
• Specific Phobia:
• Fear of objects, specific situations, or events.
• Fear of a specific animal
• Fear of being in small, enclosed spaces (claustrophobia)
• Fear of injections (trypanophobia)
• Fear of dental work (odontophobia)
• Fear of blood (hematophobia)
• Fear of heights (acrophobia)

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Disorders of Anxiety, Trauma, and Stress

• PHOBIC DISORDERS
• Agoraphobia:
• Fear of being in a place or situation from which escape is
difficult or impossible if something should go wrong.
• Greek word that literally means “fear of the marketplace”.

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Disorders of Anxiety, Trauma, and Stress

• PHOBIC DISORDERS
• Agoraphobia:
• The anxiety should be present two situations below:
1. Public transportation,
2. Out in an open place (parking lot or bridge),
3. An enclosed place (grocery store, movie theater)
4. In crowd (concert),
5. Being out of the home alone

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Disorders of Anxiety, Trauma, and Stress

• PANIC DISORDER
• Characterized by panic attacks that occur frequently
enough, so that the person have difficulty in adjusting to
daily life.
• Panic attack: A sudden onset of intense panic, in which
multiple physical symptoms of stress occur.
• People having a panic attack usually think that they are
having a heart attack and/or that they will die.

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Disorders of Anxiety, Trauma, and Stress

• GENERALIZED ANXIETY DISORDER

• Characterized by excessive anxieties and worries:
• Must occur in most days
• For at least 6 months.
• Feelings of anxiety have no particular source that can be
pinpointed (free-floating anxiety).
• Nevertheless, the person cannot control those feelings
despite effort.

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Disorders of Anxiety, Trauma, and Stress

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Disorders of Anxiety, Trauma, and Stress

• OBSESSIVE-COMPULSIVE DISORDER (OCD)

OCD falls under the category “Obsessive-Compulsive and Related
Disorders” in DSM-5.
• Characterized by intruding, recurring thoughts or obsessions
that create anxiety, which are relieved by performing a
repetitive, ritualistic behavior or mental acts (compulsion).
• Example for Obsession: fear that germs are on one’s hands.
• Example for Compulsion: repeated hand washing.
• Not because the person likes washing hands, but because the person
feels compelled to do so!
• Inability to wash hands will create great distress for this person.

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Disorders of Anxiety, Trauma, and Stress

• ACUTE STRESS DISORDER (ASD)

ASD falls under the category “Trauma- and Stressor-Related
Disorders” in DSM-5.
• A disorder that results from exposure to a major, traumatic
stressor.
• Symptoms include:
• Anxiety, depression, recurring nightmares, sleep disturbances, problems
in concentration, flashbacks
• Symptoms appear right after the traumatic event, and last for
as long as one month after the event.

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Disorders of Anxiety, Trauma, and Stress

• POSTTRAUMATIC STRESS DISORDER (PTSD)

PTSD is falls under the category “Trauma- and Stressor-Related
Disorders” in DSM-5.
• A disorder where the symptoms of acute stress disorder last for
more than one month.
• Symptoms of PTSD may not develop until more than 6 months
after a traumatic event.
• Women are at higher risk for PTSD (almost twice).

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Disorders of Anxiety, Trauma, and Stress

• POSTTRAUMATIC STRESS DISORDER (PTSD)

• Severe PTSD has been linked to a decrease in the size of
hippocampus in children.
• May have effects on children’s learning because
hippocampus plays a role in forming new declarative
memories.
• A 7-year study with old veterans found that those with PTSD
were more likely to develop dementia than those without
PTSD.

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Causes of Anxiety, Trauma, and Stress
Disorders
• Different perspectives offer different explanations for
psychological disorders.
• Those explanations are very similar for all psychological disorders.
• E.g., psychodynamic explanations always focus on repressed
urges, thoughts, or desires when explaining different
psychological disorders.

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Causes of Anxiety, Trauma, and Stress
Disorders
• PSYCHODYNAMIC EXPLANATIONS:
• Point to repressed urges and desires that are trying to surface.
• The anxiety created by those urges and desires is controlled by
the abnormal behavior.
• A phobia is an example of displacement (remember the
psychological defense mechanisms)
• The phobic object is just a symbol for the real thing buried in the
unconscious.
• Fear of heights  a hidden suicidal desire

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Causes of Anxiety, Trauma, and Stress
Disorders
• BEHAVIORIST APPROACH:
• The disordered behavior is learned through reinforcement.
• A phobia is nothing more than a classically conditioned fear
response.
• Remember “Little Albert”, who was conditioned to fear furry objects.

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Causes of Anxiety, Trauma, and Stress
Disorders
• COGNITIVE PSYCHOLOGY EXPLANATIONS:
• Excessive anxiety comes from illogical, irrational thought
processes:
• Magnification: the tendency to interpret situations as far more
dangerous, harmful, or important than they actually are.
• All-or-nothing thinking: the belief that one’s performance must be
perfect, or else the result is a failure.
• Overgeneralization: the interpretation of a single negative event as a
never-ending pattern of failure and defeat.
• Minimization: the tendency to give little or no importance to one’s
successes or positive events and traits.

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Causes of Anxiety, Trauma, and Stress
Disorders
• BIOLOGICAL EXPLANATIONS:
• Genetics
• Several anxiety disorders run in families.

• Brain studies
• There is more brain activity in amygdala and limbic system for people
with phobia, PTSD, and social anxiety disorder
• compared to people without these disorders.

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Disorders of Mood

• Mood (affective) disorders are disturbances in emotion.

• Emotions have a broad range.
• People usually have emotions in the middle of this range.
• But when stress or some other factors may push an individual
to one extreme or the other, mood disorders can result.
• Mood disorders can be relatively mild, moderate, or extreme
(existing at either end of the range of emotions).

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Disorders of Mood

• DSM-5 reclassified the disorders that were previously and

collectively classified as “mood disorders”:
• The new classification involves mood disorders under two
headings:
1. “Depressive Disorders”
2. “Bipolar and Related Disorders”

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Disorders of Mood

• MAJOR DEPRESSIVE DISORDER

• Characterized by severely depressed mood that comes on
suddenly.
• It may have no external cause.
• Or it may seem to be too severe for the cause(s).

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Disorders of Mood

• MAJOR DEPRESSIVE DISORDER

• People with major depressive disorder fall at the far extreme of
sadness.
• Some symptoms (on a daily basis and for most of the day):
• Feeling depressed for most of the day, everyday
• Taking little or no pleasure in any activities
• Sleep problems: trouble sleeping or sleeping too much
• Changes in appetite and weight
• Feelings of excessive guilt or worthlessness
• Trouble concentrating
• Delusional thinking and hallucinations
• Thoughts of death and attempts of suicide

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Disorders of Mood

• MAJOR DEPRESSIVE DISORDER

• SEASONAL AFFECTIVE DISORDER (SAD):
• A mood disorder caused by the body’s reaction to low levels of
sunlight in the winter months.
• Goes away with the coming of spring and summer.

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Disorders of Mood

• BIPOLAR DISORDER
• Characterized by periods of mood that may range from normal
to manic, with or without episodes of severe depression.
• Manic episode: a period of excessive excitement, energy, and
elation or irritability.
• Bipolar I: without episodes of depression
• Bipolar II: interspersed with episodes of major depression and
hypomania (a level that is less severe than full mania).

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Disorders of Mood

• BIPOLAR DISORDER
• Manic episodes are characterized by feelings of extreme
happiness (euphoric feeling) without a real cause.
• Restlessness, irritability, inability to sit still or remain inactive,
rapid speech (jumping from one topic to another), and
seemingly unlimited energy are also common.
• The person may become aggressive when not allowed to carry
out delusional plans.
• People in the manic stage can be very creative unless they
become disorganized due to mania.

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Causes of Disordered Mood

• PSYCHODYNAMIC VIEW
• Links depression to repressed anger which was originally aimed
at parents or other authority figures.

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Causes of Disordered Mood

• BEHAVIORAL THEORIES
• Link depression to learned helplessness.
• Learned helplessness has been associated with an increase in
self-defeating thoughts in people who experienced
uncontrollable, painful events.

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Causes of Disordered Mood

• (SOCIAL) COGNITIVE THEORIES

• Link depression to distorted, illogical thinking:
• Exaggerating negative events and minimizing positive ones.
• In the social cognitive view, depressed people continually have
negative, self-defeating thoughts about themselves.
• Support for the social cognitive view:
• Therapies for depression that focus on changing the way of thinking
appear to be more effective compared to the therapies that focus on
changing behavior (Strunk et al., 2010)

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Causes of Disordered Mood

• BIOLOGICAL EXPLANATIONS
• Focus on the effects of specific neurotransmitters:
• Serotonin
• Norepinephrine
• Dopamine

• Genetic origins
• Twin studies show that if one identical twin has either major depression
or bipolar disorder, the chance that the other twin will also develop a
mood disorder are about 40-70%.

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