Mental Disorders

• What are mental disorders? 
• Perspectives on mental disorders 
• Phobia!

Mental disorder = maladaptive psychological process

Maladaptive psychological process must:

• Involve clinically significant distress and/or impaired functioning
• Have an internal source
• Be manifested involuntarily

Perspectives on Cause

Psychodynamic Perspective

• Conflicts among id, ego, superego

• Genetic disorder, neurochemical dysfunction, disease

• Interaction with the environment

• Interaction with the larger environment ­ culture

• The fine line between "normal" and "abnormal"

Phobia!

"The only thing we have to fear is fear itself - nameless, unreasoning, unjustified terror which paralyzes needed efforts to convert retreat into advance." -- FDR, 1933. 

"My heart starts beating so fast that it feels like it’s going to explode. My throat closes and I can’t breathe so I start to choke. My hands start sweating and I get so dizzy I have to hold onto the furniture or the wall to keep from falling or fainting. I know I’m going to die. I want to run but I don’t know where." --Phobia sufferer.
 
 

Types of phobias

Agoraphobia (with or without panic attacks)

• Irrational anxiety about being in places from which escape might be difficult or embarrassing

• Irrational anxiety elicited by exposure to certain types of social or performance situations, also leading to avoidance behavior.

• Persistent and irrational fear in the presence of some specific stimulus which commonly elicits avoidance.
• Animal, natural environment, blood-injection-injury, situational, or other types

Symptoms

Persistent and irrational panic, dread, horror, terror in a harmless situation.

Person realizes that the fear goes beyond normal boundaries.

Reaction is automatic, uncontrollable, persuasive, and practically takes over thought.

Person suffers from all the physical reactions associated with extreme fear, i.e.., rapid heart rate, shortness of breath, trembling, overwhelming desire to flee.

Avoidance or flight interferes with every-day activities. 
 
 

Meeting the criteria for a mental disorder

Clinically significant distress and/or impaired functioning

• Agoraphobics don’t leave home. 
• Acrophobics will not live in high-rises.

• Auroraphobics may have never seen the Northern lights.

• Arachnophobics cannot pick up a plastic spider. 
• All phobics recognize their irrational fear but can do nothing about it.

Phobia Scale

Rate pictures 

• How fearful does this make you feel?

3=somewhat fearful

5=very fearful

• To what extent would you try to avoid encountering this situation?

3=might avoid

5=avoid at all costs
 

Picture	Description	Fear Rating	Avoidance Rating
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Perspectives on Phobia...

Psychodynamic Perspective

• Fear of abandonment by a cold or nonnurturing mother.
• Generalized to phobic or other anxiety disorder.

• Greater blood flow and metabolism in right hemisphere than in left.
• Humans have a predisposition to develop certain phobias and not others.
• Identical twins reared apart have developed identical phobias.

Cognitive/Behavioral Perspective

• Previous experience or model.
• Adaptive advantage to learn very quickly.
• Social phobics tend to have been shy, timid children

• Cultural predisposition, e.g., taijin kyofusho.
• Evolutionary basis in patterns of dominance and submission.