PSYCHOLOGICAL DISORDERSChapter 4 • Psychological Disorders71 The first approach views abnormal behaviour as a deviation from social norms.Many psychologists have stated that ‘abnormal’

Chapter 4 • Psychological Disorders69

PSYPSYPSYPSYPSYCHOLOGICAL DISORDERSCHOLOGICAL DISORDERSCHOLOGICAL DISORDERSCHOLOGICAL DISORDERSCHOLOGICAL DISORDERS

IntroductionConcepts of Abnormality and Psychological DisordersClassification of Psychological DisordersFactors Underlying Abnormal BehaviourMajor Psychological Disorders

Anxiety DisordersSomatoform DisordersDissociative DisordersSalient Features of Somatoform and Dissociative

Disorders (Box 4.1)Mood DisordersSchizophrenic DisordersSub-types of Schizophrenia (Box 4.2)Behavioural and Developmental DisordersSubstance-use DisordersEffects of Alcohol : Some Facts (Box 4.3)Commonly Abused Substances (Box 4.4)

CONTENTS

Key Terms

Summary

Review Questions

Project Ideas

Weblinks

Pedagogical Hints

After reading this chapter, you would be able to:understand the basic issues in abnormal behaviour and the criteria used to identify suchbehaviours,appreciate the factors which cause abnormal behaviour,explain the different models of abnormal behaviour, anddescribe the major psychological disorders.

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CONCEPTS OF ABNORMALITY AND

PSYCHOLOGICAL DISORDERS

Although many definitions of abnormalityhave been used over the years, none haswon universal acceptance. Still, mostdefinitions have certain common features,often called the ‘four Ds’: deviance,distress, dysfunction and danger. That is,psychological disorders are deviant(different, extreme, unusual, even bizarre),distressing (unpleasant and upsetting tothe person and to others), dysfunctional(interfering with the person’s ability tocarry out daily activities in a constructive

You must have come across people who are unhappy, troubled and

dissatisfied. Their minds and hearts are filled with sorrow, unrest and

tension and they feel that they are unable to move ahead in their lives; they

feel life is a painful, uphill struggle, sometimes not worth living. Famous

analytical psychologist Carl Jung has quite remarkably said, “How can I

be substantial without casting a shadow? I must have a dark side, too, if I

am to be whole and by becoming conscious of my shadow, I remember

once more that I am a human being like any other”. At times, some of you

may have felt nervous before an important examination, tense and concerned

about your future career or anxious when someone close to you was unwell.

All of us face major problems at some point of our lives. However, some

people have an extreme reaction to the problems and stresses of life. In this

chapter, we will try to understand what goes wrong when people develop

psychological problems, what are the causes and factors which lead to

abnormal behaviour, and what are the various signs and symptoms

associated with different types of psychological disorders?

The study of psychological disorders has intrigued and mystified all

cultures for more than 2,500 years. Psychological disorders or mental

disorders (as they are commonly referred to), like anything unusual may

make us uncomfortable and even a little frightened. Unhappiness,

discomfort, anxiety, and unrealised potential are seen all over the world.

These failures in living are due mainly to failures in adaptation to life

challenges. As you must have studied in the previous chapters, adaptation

refers to the person’s ability to modify her/his behaviour in response to

changing environmental requirements. When the behaviour cannot be

modified according to the needs of the situation, it is said to be maladaptive.

Abnormal Psychology is the area within psychology that is focused on

maladaptive behaviour – its causes, consequences, and treatment.

Introduction

way), and possibly dangerous (to theperson or to others).

This definition is a useful starting pointfrom which we can explore psychologicalabnormality. Since the word ‘abnormal’literally means “away from the normal”, itimplies deviation from some clearly definednorms or standards. In psychology, wehave no ‘ideal model’ or even ‘normalmodel’ of human behaviour to use as abase for comparison. Various approacheshave been used in distinguishing betweennormal and abnormal behaviours. Fromthese approaches, there emerge two basicand conflicting views :

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The first approach views abnormalbehaviour as a deviation from socialnorms. Many psychologists have statedthat ‘abnormal’ is simply a label that isgiven to a behaviour which is deviant fromsocial expectations. Abnormal behaviour,thoughts and emotions are those that differmarkedly from a society’s ideas of properfunctioning. Each society has norms,which are stated or unstated rules forproper conduct. Behaviours, thoughts andemotions that break societal norms arecalled abnormal. A society’s norms growfrom its particular culture — its history,values, institutions, habits, skills,technology, and arts. Thus, a society whoseculture values competition andassertiveness may accept aggressivebehaviour, whereas one that emphasisescooperation and family values (such as inIndia) may consider aggressive behaviouras unacceptable or even abnormal. Asociety’s values may change over time,causing its views of what is psychologicallyabnormal to change as well. Seriousquestions have been raised about thisdefinition. It is based on the assumptionthat socially accepted behaviour is notabnormal, and that normality is nothingmore than conformity to social norms.

The second approach views abnormalbehaviour as maladaptive. Manypsychologists believe that the best criterionfor determining the normality of behaviouris not whether society accepts it butwhether it fosters the well-being of theindividual and eventually of the group towhich s/he belongs. Well-being is notsimply maintenance and survival but alsoincludes growth and fulfilment, i.e. theactualisation of potential, which you musthave studied in Maslow’s need hierarchytheory. According to this criterion,conforming behaviour can be seen asabnormal if it is maladaptive, i.e. if itinterferes with optimal functioning andgrowth. For example, a student in the class

prefers to remain silent even when s/hehas questions in her/his mind. Describingbehaviour as maladaptive implies that aproblem exists; it also suggests thatvulnerability in the individual, inability tocope, or exceptional stress in theenvironment have led to problems in life.

If you talk to people around, you willsee that they have vague ideas aboutpsychological disorders that arecharacterised by superstition, ignoranceand fear. Again it is commonly believedthat psychological disorder is something tobe ashamed of. The stigma attached tomental illness means that people arehesitant to consult a doctor or psychologistbecause they are ashamed of theirproblems. Actually, psychological disorderwhich indicates a failure in adaptationshould be viewed as any other illness.

Activity4.1

Talk to three people: one of your

friends, a friend of your parents, and

your neighbour.

Ask them if they have seen

someone who is mentally ill or who has

mental problems. Try to understand

why they find this behaviour

abnormal, what are the signs and

symptoms shown by this person, what

caused this behaviour and can this

person be helped.

Share the information you elicited

in class and see if there are some

common features, which make us label

others as ‘abnormal’.

Historical Background

To understand psychological disorders, wewould require a brief historical account ofhow these disorders have been viewed overthe ages. When we study the history ofabnormal psychology, we find that certaintheories have occurred over and over again.

One ancient theory that is stillencountered today holds that abnormalbehaviour can be explained by the

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Psychology72

operation of supernatural and magicalforces such as evil spirits (bhoot-pret), orthe devil (shaitan). Exorcism, i.e. removingthe evil that resides in the individualthrough countermagic and prayer, is stillcommonly used. In many societies, theshaman, or medicine man (ojha) is aperson who is believed to have contact withsupernatural forces and is the mediumthrough which spirits communicate withhuman beings. Through the shaman, anafflicted person can learn which spirits areresponsible for her/his problems and whatneeds to be done to appease them.

A recurring theme in the history ofabnormal psychology is the belief thatindividuals behave strangely because theirbodies and their brains are not workingproperly. This is the biological or organicapproach. In the modern era, there isevidence that body and brain processeshave been linked to many types ofmaladaptive behaviour. For certain types ofdisorders, correcting these defectivebiological processes results in improvedfunctioning.

Another approach is the psychologicalapproach. According to this point of view,psychological problems are caused byinadequacies in the way an individualthinks, feels, or perceives the world.

All three of these perspectives —supernatural, biological or organic, andpsychological — have recurred throughoutthe history of Western civilisation. In theancient Western world, it was philosopher-physicians of ancient Greece such asHippocrates, Socrates, and in particularPlato who developed the organismicapproach and viewed disturbed behaviouras arising out of conflicts between emotionand reason. Galen elaborated on the roleof the four humours in personal characterand temperament. According to him, thematerial world was made up of fourelements, viz. earth, air, fire, and waterwhich combined to form four essential

body fluids, viz. blood, black bile, yellowbile, and phlegm. Each of these fluids wasseen to be responsible for a differenttemperament. Imbalances among thehumours were believed to cause variousdisorders. This is similar to the Indiannotion of the three doshas of vata, pitta

and kapha which were mentioned in theAtharva Veda and Ayurvedic texts. Youhave already read about it in Chapter 2.

In the Middle Ages, demonology andsuperstition gained renewed importance inthe explanation of abnormal behaviour.Demonology related to a belief that peoplewith mental problems were evil and thereare numerous instances of ‘witch-hunts’during this period. During the earlyMiddle Ages, the Christian spirit of charityprevailed and St. Augustine wroteextensively about feelings, mental anguishand conflict. This laid the groundwork formodern psychodynamic theories ofabnormal behaviour.

The Renaissance Period was markedby increased humanism and curiosityabout behaviour. Johann Weyeremphasised psychological conflict anddisturbed interpersonal relationships ascauses of psychological disorders. He alsoinsisted that ‘witches’ were mentallydisturbed and required medical, nottheological, treatment.

The seventeenth and eighteenthcenturies were known as the Age ofReason and Enlightenment, as thescientific method replaced faith and dogmaas ways of understanding abnormalbehaviour. The growth of a scientificattitude towards psychological disorders inthe eighteenth century contributed to theReform Movement and to increasedcompassion for people who suffered fromthese disorders. Reforms of asylums wereinitiated in both Europe and America. Oneaspect of the reform movement was thenew inclination for deinstitutionalisationwhich placed emphasis on providing

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community care for recovered mentally illindividuals.

In recent years, there has been aconvergence of these approaches, whichhas resulted in an interactional, or bio-psycho-social approach. From thisperspective, all three factors, i.e. biological,psychological and social play importantroles in influencing the expression andoutcome of psychological disorders.

CLASSIFICATION OF PSYCHOLOGICAL

DISORDERS

In order to understand psychologicaldisorders, we need to begin by classifyingthem. A classification of such disordersconsists of a list of categories of specificpsychological disorders grouped intovarious classes on the basis of someshared characteristics. Classifications areuseful because they enable users likepsychologists, psychiatrists and socialworkers to communicate with each otherabout the disorder and help inunderstanding the causes of psychologicaldisorders and the processes involved intheir development and maintenance.

The American Psychiatric Association(APA) has published an official manualdescribing and classifying various kinds ofpsychological disorders. The currentversion of it, the Diagnostic andStatistical Manual of Mental Disorders,IV Edition (DSM-IV), evaluates the patienton five axes or dimensions rather than justone broad aspect of ‘mental disorder’.These dimensions relate to biological,psychological, social and other aspects.

The classification scheme officially usedin India and elsewhere is the tenth revisionof the International Classification ofDiseases (ICD-10), which is known as theICD-10 Classification of Behavioural andMental Disorders. It was prepared by theWorld Health Organisation (WHO). For

each disorder, a description of the mainclinical features or symptoms, and of otherassociated features including diagnosticguidelines is provided in this scheme.

Activity4.2

Certain behaviours like eating sand

would be considered abnormal. But not

if it was done after being stranded on

a beach in a plane crash.

Listed below are ‘abnormal’

behaviours followed by situations

where the behaviours might be

considered normal.

(i) talking to yourself - you are

praying.

(ii) standing in the middle of the street

waving your arms wildly - you are

a traffic policeman.

Think about it and list similar

examples.

FACTORS UNDERLYING ABNORMAL

BEHAVIOUR

In order to understand something ascomplex as abnormal behaviour,psychologists use different approaches.Each approach in use today emphasises adifferent aspect of human behaviour, andexplains and treats abnormality in linewith that aspect. These approaches alsoemphasise the role of different factors suchas biological, psychological andinterpersonal, and socio-cultural factors.We will examine some of the approacheswhich are currently being used to explainabnormal behaviour.

Biological factors influence all aspectsof our behaviour. A wide range of biologicalfactors such as faulty genes, endocrineimbalances, malnutrition, injuries andother conditions may interfere with normaldevelopment and functioning of the humanbody. These factors may be potentialcauses of abnormal behaviour. We havealready come across the biological model.According to this model, abnormal

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Psychology74

behaviour has a biochemical orphysiological basis. Biological researchershave found that psychological disordersare often related to problems in thetransmission of messages from one neuronto another. You have studied in Class XI,that a tiny space called synapse separatesone neuron from the next, and the messagemust move across that space. When anelectrical impulse reaches a neuron’sending, the nerve ending is stimulated torelease a chemical, called a neuro-transmitter. Studies indicate thatabnormal activity by certain neuro-transmitters can lead to specificpsychological disorders. Anxiety disordershave been linked to low activity of theneurotransmitter gamma aminobutyric acid

(GABA), schizophrenia to excess activity ofdopamine, and depression to low activityof serotonin.

Genetic factors have been linked tomood disorders, schizophrenia, mentalretardation and other psychologicaldisorders. Researchers have not, however,been able to identify the specific genes thatare the culprits. It appears that in mostcases, no single gene is responsible for aparticular behaviour or a psychologicaldisorder. Infact, many genes combine tohelp bring about our various behavioursand emotional reactions, both functionaland dysfunctional. Although there is soundevidence to believe that genetic/biochemical factors are involved in mentaldisorders as diverse as schizophrenia,depression, anxiety, etc. and biology alonecannot account for most mental disorders.

There are several psychologicalmodels which provide a psychologicalexplanation of mental disorders. Thesemodels maintain that psychological andinterpersonal factors have a significant roleto play in abnormal behaviour. Thesefactors include maternal deprivation(separation from the mother, or lack ofwarmth and stimulation during early

years of life), faulty parent-child relationships(rejection, overprotection, over-permissiveness, faulty discipline, etc.),maladaptive family structures (inadequate ordisturbed family), and severe stress.

The psychological models include thepsychodynamic, behavioural, cognitive,and humanistic-existential models. Thepsychodynamic model is the oldest andmost famous of the modern psychologicalmodels. You have already read about thismodel in Chapter 2 on Self and Personality.Psychodynamic theorists believe thatbehaviour, whether normal or abnormal, isdetermined by psychological forces withinthe person of which s/he is notconsciously aware. These internal forcesare considered dynamic, i.e. they interactwith one another and their interactiongives shape to behaviour, thoughts andemotions. Abnormal symptoms are viewedas the result of conflicts between theseforces. This model was first formulated byFreud who believed that three centralforces shape personality — instinctualneeds, drives and impulses (id), rationalthinking (ego), and moral standards(superego). Freud stated that abnormalbehaviour is a symbolic expression ofunconscious mental conflicts that can begenerally traced to early childhood orinfancy.

Another model that emphasises the roleof psychological factors is the behaviouralmodel. This model states that both normaland abnormal behaviours are learned andpsychological disorders are the result oflearning maladaptive ways of behaving.The model concentrates on behaviours thatare learned through conditioning andproposes that what has been learned canbe unlearned. Learning can take place byclassical conditioning (temporal associationin which two events repeatedly occur closetogether in time), operant conditioning

(behaviour is followed by a reward), andsocial learning (learning by imitating

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others’ behaviour). These three types ofconditioning account for behaviour,whether adaptive or maladaptive.

Psychological factors are alsoemphasised by the cognitive model. Thismodel states that abnormal functioningcan result from cognitive problems. Peoplemay hold assumptions and attitudes aboutthemselves that are irrational andinaccurate. People may also repeatedlythink in illogical ways and makeovergeneralisations, that is, they may drawbroad, negative conclusions on the basisof a single insignificant event.

Another psychological model is thehumanistic-existential model whichfocuses on broader aspects of humanexistence. Humanists believe that humanbeings are born with a natural tendency tobe friendly, cooperative and constructive,and are driven to self-actualise, i.e. to fulfilthis potential for goodness and growth.Existentialists believe that from birth wehave total freedom to give meaning to ourexistence or to avoid that responsibility.Those who shirk from this responsibilitywould live empty, inauthentic, anddysfunctional lives.

In addition to the biological andpsychosocial factors, socio-cultural factorssuch as war and violence, group prejudiceand discrimination, economic andemployment problems, and rapid socialchange, put stress on most of us and canalso lead to psychological problems insome individuals. According to the socio-cultural model, abnormal behaviour isbest understood in light of the social andcultural forces that influence an individual.As behaviour is shaped by societal forces,factors such as family structure andcommunication, social networks, societalconditions, and societal labels and rolesbecome more important. It has been foundthat certain family systems are likely toproduce abnormal functioning in

individual members. Some families have anenmeshed structure in which the members

are overinvolved in each other’s activities,

thoughts, and feelings. Children from thiskind of family may have dif ficulty in

becoming independent in life. The broader

social networks in which people operateinclude their social and professional

relationships. Studies have shown that

people who are isolated and lack socialsupport, i.e. strong and fulfilling

interpersonal relationships in their lives

are likely to become more depressed andremain depressed longer than those who

have good friendships. Socio-cultural

theorists also believe that abnormalfunctioning is influenced by the societal

labels and roles assigned to troubled

people. When people break the norms oftheir society, they are called deviant and

‘mentally ill’. Such labels tend to stick so

that the person may be viewed as ‘crazy’and encouraged to act sick. The person

gradually learns to accept and play the

sick role, and functions in a disturbedmanner.

In addition to these models, one of the

most widely accepted explanations ofabnormal behaviour has been provided by

the diathesis-stress model. This model

states that psychological disorders developwhen a diathesis (biological predisposition

to the disorder) is set off by a stressful

situation. This model has three

components. The first is the diathesis or

the presence of some biological aberration

which may be inherited. The second

component is that the diathesis may carry

a vulnerability to develop a psychological

disorder. This means that the person is ‘at

risk’ or ‘predisposed’ to develop the

disorder. The third component is the

presence of pathogenic stressors, i.e.

factors/stressors that may lead to

psychopathology. If such “at risk” persons

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are exposed to these stressors, theirpredisposition may actually evolve into adisorder. This model has been applied toseveral disorders including anxiety,depression, and schizophrenia.

MAJOR PSYCHOLOGICAL DISORDERS

Anxiety Disorders

One day while driving home, Deb felt his

heart beating rapidly, he started sweating

profusely, and even felt short of breath. He

was so scared that he stopped the car and

stepped out. In the next few months, these

attacks increased and now he was hesitant

to drive for fear of being caught in traffic

during an attack. Deb started feeling that

he had gone crazy and would die. Soon he

remained indoors and refused to move out

of the house.

We experience anxiety when we are

waiting to take an examination, or to visita dentist, or even to give a solo

performance. This is normal and expected

and even motivates us to do our task well.On the other hand, high levels of anxiety

that are distressing and interfere with

effective functioning indicate the presenceof an anxiety disorder — the most common

category of psychological disorders.

Everyone has worries and fears. Theterm anxiety is usually defined as a

diffuse, vague, very unpleasant feeling of

fear and apprehension. The anxiousindividual also shows combinations of the

following symptoms: rapid heart rate,

shortness of breath, diarrhoea, loss ofappetite, fainting, dizziness, sweating,

sleeplessness, frequent urination and

tremors. There are many types of anxietydisorders (see Table 4.2). They include

generalised anxiety disorder, which

consists of prolonged, vague, unexplainedand intense fears that are not attached to

any particular object. The symptoms

include worry and apprehensive feelingsabout the future; hypervigilance, whichinvolves constantly scanning theenvironment for dangers. It is marked bymotor tension, as a result of which theperson is unable to relax, is restless, andvisibly shaky and tense.

Another type of anxiety disorder ispanic disorder, which consists ofrecurrent anxiety attacks in which theperson experiences intense terror. A panicattack denotes an abrupt surge of intenseanxiety rising to a peak when thoughts ofa particular stimuli are present. Suchthoughts occur in an unpredictablemanner. The clinical features includeshortness of breath, dizziness, trembling,palpitations, choking, nausea, chest painor discomfort, fear of going crazy, losing

control or dying.You might have met or heard of

someone who was afraid to travel in a liftor climb to the tenth floor of a building, or

refused to enter a room if s/he saw alizard. You may have also felt it yourself orseen a friend unable to speak a word of awell-memorised and rehearsed speech

before an audience. These kinds of fearsare termed as phobias. People who havephobias have irrational fears related tospecific objects, people, or situations.

Phobias often develop gradually or beginwith a generalised anxiety disorder.Phobias can be grouped into three maintypes, i.e. specific phobias, social phobias,

and agoraphobia.

Specific phobias are the mostcommonly occurring type of phobia. Thisgroup includes irrational fears such as

intense fear of a certain type of animal, orof being in an enclosed space. Intense andincapacitating fear and embarrassmentwhen dealing with others characterises

social phobias. Agoraphobia is the termused when people develop a fear ofentering unfamiliar situations. Many

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agoraphobics are afraid of leaving theirhome. So their ability to carry out normallife activities is severely limited.

Have you ever noticed someonewashing their hands everytime they touchsomething, or washing even things likecoins, or stepping only within the patternson the floor or road while walking? Peopleaffected by obsessive-compulsivedisorder are unable to control theirpreoccupation with specific ideas or areunable to prevent themselves from

repeatedly carrying out a particular act orseries of acts that affect their ability tocarry out normal activities. Obsessivebehaviour is the inability to stop thinkingabout a particular idea or topic. The personinvolved, often finds these thoughts to beunpleasant and shameful. Compulsivebehaviour is the need to perform certainbehaviours over and over again. Manycompulsions deal with counting, ordering,checking, touching and washing.

Very often people who have been caughtin a natural disaster (such as tsunami) orhave been victims of bomb blasts byterrorists, or been in a serious accident orin a war-related situation, experience post-traumatic stress disorder (PTSD). PTSDsymptoms vary widely but may includerecurrent dreams, flashbacks, impairedconcentration, and emotional numbing.

Somatoform Disorders

These are conditions in which there arephysical symptoms in the absence of aphysical disease. In somatoform disorders,the individual has psychological difficultiesand complains of physical symptoms, forwhich there is no biological cause.Somatoform disorders include pain

disorders, somatisation disorders,

conversion disorders, and hypochondriasis.

Recall how you felt before your

Class X Board examination. How did

you feel when the examinations were

drawing near (one month before the

examinations; one week before the

examinations; on the day of the

examination, and when you were

entering the examination hall)? Also try

to recollect what you felt when you

were awaiting your results. Write down

your experiences in terms of bodily

symptoms (e.g. ‘butterflies in the

stomach’, clammy hands, excessive

perspiration, etc.) as well as mental

experiences (e.g. tension, worry,

pressure, etc.). Compare your

symptoms with those of your

classmates and classify them as Mild,

Moderate, or Severe.

Activity4.3

1. Generalised Anxiety Disorder : prolonged, vague, unexplained and intense fears that have noobject, accompanied by hypervigilance and motor tension.

2. Panic Disorder : frequent anxiety attacks characterised by feelings of intense terror and dread;unpredictable ‘panic attacks’ along with physiological symptoms like breathlessness,palpitations, trembling, dizziness, and a sense of loosing control or even dying.

3. Phobias : irrational fears related to specific objects, interactions with others, and unfamiliarsituations.

4. Obsessive-compulsive Disorder : being preoccupied with certain thoughts that are viewed bythe person to be embarrassing or shameful, and being unable to check the impulse to repeatedlycarry out certain acts like checking, washing, counting, etc.

5. Post-traumatic Stress Disorder (PTSD) : recurrent dreams, flashbacks, impaired concentration,and emotional numbing followed by a traumatic or stressful event like a natural disaster,serious accident, etc.

Table 4.1 : Major Anxiety Disorders and their Symptoms© NCERT

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Pain disorders involve reports ofextreme and incapacitating pain, eitherwithout any identifiable biologicalsymptoms or greatly in excess of whatmight be expected to accompany biologicalsymptoms. How people interpret paininfluences their overall adjustment. Somepain sufferers can learn to use activecoping, i.e. remaining active and ignoringthe pain. Others engage in passive coping,which leads to reduced activity and socialwithdrawal.

Patients with somatisation disordershave multiple and recurrent or chronicbodily complaints. These complaints arelikely to be presented in a dramatic andexaggerated way. Common complaints areheadaches, fatigue, heart palpitations,fainting spells, vomiting, and allergies.Patients with this disorder believe that theyare sick, provide long and detailed historiesof their illness, and take large quantitiesof medicine.

The symptoms of conversion disordersare the reported loss of part or all of somebasic body functions. Paralysis, blindness,deafness and difficulty in walking aregenerally among the symptoms reported.

These symptoms often occur after astressful experience and may be quitesudden.

Hypochondriasis is diagnosed if aperson has a persistent belief that s/hehas a serious illness, despite medicalreassurance, lack of physical findings,and failure to develop the disease.Hypochondriacs have an obsessivepreoccupation and concern with thecondition of their bodily organs, and theycontinually worry about their health.

Dissociative Disorders

Dissociation can be viewed as severance ofthe connections between ideas andemotions. Dissociation involves feelings ofunreality, estrangement, depersonalisation,and sometimes a loss or shift of identity.Sudden temporary alterations ofconsciousness that blot out painfulexperiences are a defining characteristic ofdissociative disorders. Four conditionsare included in this group: dissociativeamnesia, dissociative fugue, dissociative

identity disorder, and depersonalisation.Salient features of somatoform anddissociative disorders are given in Box 4.1.

Box4.1

Salient Features of Somatoform and Dissociative Disorders

Dissociative Disorders

Dissociative amnesia : The person is unableto recall important, personal informationoften related to a stressful and traumaticreport. The extent of forgetting is beyondnormal.

Dissociative fugue : The person suffers froma rare disorder that combines amnesia withtravelling away from a stressfulenvironment.

Dissociative identity (multiple personality) :The person exhibits two or more separateand contrasting personalities associatedwith a history of physical abuse.

Somatoform Disorders

Hypochondriasis : A person interpretsinsignificant symptoms as signs of a seriousillness despite repeated medical evaluationthat point to no pathology/disease.

Somatisation : A person exhibits vague andrecurring physical/bodily symptoms such aspain, acidity, etc., without any organic cause.

Conversion : The person suffers from a lossor impairment of motor or sensory function(e.g., paralysis, blindness, etc.) that has nophysical cause but may be a response tostress and psychological problems.

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Dissociative amnesia is characterisedby extensive but selective memory loss thathas no known organic cause (e.g., headinjury). Some people cannot rememberanything about their past. Others can nolonger recall specific events, people, places,or objects, while their memory for otherevents remains intact. This disorder isoften associated with an overwhelmingstress.

Dissociative fugue has, as its essentialfeature, an unexpected travel away fromhome and workplace, the assumption of anew identity, and the inability to recall theprevious identity. The fugue usually endswhen the person suddenly ‘wakes up’ withno memory of the events that occurredduring the fugue.

Dissociative identity disorder, oftenreferred to as multiple personality, is themost dramatic of the dissociative disorders.It is often associated with traumaticexperiences in childhood. In this disorder,the person assumes alternate personalitiesthat may or may not be aware of eachother.

Depersonalisation involves adreamlike state in which the person has asense of being separated both from self andfrom reality. In depersonalisation, there isa change of self-perception, and theperson’s sense of reality is temporarily lostor changed.

Mood Disorders

Mood disorders are characterised bydisturbances in mood or prolongedemotional state. The most common mooddisorder is depression, which covers avariety of negative moods and behaviouralchanges. Depression can refer to asymptom or a disorder. In day-to-day life,we often use the term depression to referto normal feelings after a significant loss,such as the break-up of a relationship, orthe failure to attain a significant goal. The

main types of mood disorders includedepressive, manic and bipolar disorders.

Major depressive disorder is defined as aperiod of depressed mood and/or loss of

interest or pleasure in most activities,together with other symptoms which mayinclude change in body weight, constantsleep problems, tiredness, inability to think

clearly, agitation, greatly slowed behaviour,and thoughts of death and suicide. Othersymptoms include excessive guilt orfeelings of worthlessness.

Factors Predisposing towards

Depression : Genetic make-up, or heredityis an important risk factor for majordepression and bipolar disorders. Age is

also a risk factor. For instance, women areparticularly at risk during youngadulthood, while for men the risk ishighest in early middle age. Similarly

gender also plays a great role in thisdifferential risk addition. For example,women in comparison to men are morelikely to report a depressive disorder. Otherrisk factors are experiencing negative life

events and lack of social support.Another less common mood disorder is

mania . People suffering from maniabecome euphoric (‘high’), extremely active,

excessively talkative, and easilydistractible. Manic episodes rarely appearby themselves; they usually alternate withdepression. Such a mood disorder, in

which both mania and depression arealternately present, is sometimesinterrupted by periods of normal mood.This is known as bipolar mood disorder.Bipolar mood disorders were earlierreferred to as manic-depressive disorders.

Among the mood disorders, the lifetimerisk of a suicide attempt is highest in caseof bipolar mood disorders. Several riskfactors in addition to mental health statusof a person predict the likelihood ofsuicide. These include age, gender,ethnicity, or race and recent occurrence of

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serious life events. Teenagers and youngadults are as much at high risk for suicide,as those who are over 70 years. Gender isalso an influencing factor, i.e. men have ahigher rate of contemplated suicide thanwomen. Other factors that affect suiciderates are cultural attitudes toward suicide.In Japan, for instance, suicide is theculturally appropriate way to deal withfeeling of shame and disgrace. Negativeexpectations, hopelessness, settingunrealistically high standards, and beingover -critical in self-evaluation areimportant themes for those who havesuicidal preoccupations.

Suicide can be prevented by beingalert to some of the symptoms whichinclude :• changes in eating and sleeping habits• withdrawal from friends, family and

regular activities• violent actions, rebellious behaviour,

running away• drug and alcohol abuse• marked personality change• persistent boredom• difficulty in concentration• complaints about physical symptoms,

and• loss of interest in pleasurable activities.

However, seeking timely help from aprofessional counsellor/psychologistcan help to prevent the likelihood ofsuicide.

Schizophrenic Disorders

Schizophrenia is the descriptive term fora group of psychotic disorders in whichpersonal, social and occupational

functioning deteriorate as a result ofdisturbed thought processes, strangeperceptions, unusual emotional states, andmotor abnormalities. It is a debilitating

disorder. The social and psychologicalcosts of schizophrenia are tremendous,both to patients as well as to their familiesand society.

Symptoms of Schizophrenia

The symptoms of schizophrenia can begrouped into three categories, viz. positivesymptoms (i.e. excesses of thought,

emotion, and behaviour), negativesymptoms (i.e. deficits of thought,emotion, and behaviour), andpsychomotor symptoms.

Positive symptoms are ‘pathologicalexcesses’ or ‘bizarre additions’ to a person’sbehaviour. Delusions, disorganisedthinking and speech, heightenedperception and hallucinations, and

inappropriate affect are the ones mostoften found in schizophrenia.

Many people with schizophreniadevelop delusions. A delusion is a false

belief that is firmly held on inadequategrounds. It is not affected by rationalargument, and has no basis in reality.Delusions of persecution are the most

common in schizophrenia. People with thisdelusion believe that they are being plottedagainst, spied on, slandered, threatened,attacked or deliberately victimised. People

with schizophrenia may also experiencedelusions of reference in which theyattach special and personal meaning to theactions of others or to objects and events.

In delusions of grandeur, people believethemselves to be specially empoweredpersons and in delusions of control, they

You may have got some bad news in

the family (for example, death of a

close relative) or watched your

favourite character dying in a film or

got less marks than you hoped for or

lost your pet. This may have made you

sad and depressed and hopeless

about the future. Try and recall such

incidents in your life. List the

situations that led to this reaction.

Compare your list and reactions with

those of others in class.

Activity4.4

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believe that their feelings, thoughts andactions are controlled by others.

People with schizophrenia may not beable to think logically and may speak in

peculiar ways. These formal thoughtdisorders can make communicationextremely difficult. These include rapidlyshifting from one topic to another so that

the normal structure of thinking ismuddled and becomes illogical (loosening

of associations, derailment), inventing newwords or phrases (neologisms), and

persistent and inappropriate repetition ofthe same thoughts (perseveration).

Schizophrenics may have hallucina-tions, i.e. perceptions that occur in the

absence of external stimuli. Auditoryhallucinations are most common inschizophrenia. Patients hear sounds orvoices that speak words, phrases and

sentences directly to the patient (second-

person hallucination) or talk to one anotherreferring to the patient as s/he (third-

person hallucination). Hallucinations canalso involve the other senses. These

include tactile hallucinations (i.e. formsof tingling, burning), somatic hallucina-tions (i.e. something happening inside thebody such as a snake crawling inside one’s

stomach), visual hallucinations (i.e. vagueperceptions of colour or distinct visions ofpeople or objects), gustatory hallucina-tions (i.e. food or drink taste strange), and

olfactory hallucinations (i.e. smell ofpoison or smoke).

People with schizophrenia also showinappropriate affect, i.e. emotions that

are unsuited to the situation.Negative symptoms are ‘pathological

deficits’ and include poverty of speech,blunted and flat affect, loss of volition,

and social withdrawal. People withschizophrenia show alogia or poverty ofspeech, i.e. a reduction in speech andspeech content. Many people with

schizophrenia show less anger, sadness,

joy, and other feelings than most peopledo. Thus they have blunted affect. Some

show no emotions at all, a condition

known as flat affect. Also patients withschizophrenia experience avolition, or

apathy and an inability to start or complete

a course of action. People with thisdisorder may withdraw socially and

become totally focused on their own ideas

and fantasies.People with schizophrenia also show

psychomotor symptoms. They move less

spontaneously or make odd grimaces andgestures. These symptoms may take

extreme forms known as catatonia. People

in a catatonic stupor remain motionlessand silent for long stretches of time. Some

show catatonic rigidity, i.e. maintaining

a rigid, upright posture for hours. Othersexhibit catatonic posturing, i.e. assuming

awkward, bizarre positions for long periods

Activity4.5

Can you list some characters in films

you have seen or books you have read

who suffered from any of the disorders

we have studied here like depression

or schizophrenia showing some of

these delusions?

Can you identify which kind of

delusion each of these is?

1. A person who believes that s/he

is going to be the next President of

India.

2. One who believes that the

intelligence agencies/police are

conspiring to trap her/him in a spy

scandal.

3. One who believes that s/he is the

incarnation of God and can make

things happen.

4. One who believes that the tsunami

occurred to prevent her/him from

enjoying her/his holidays.

5. One who believes that her/his

actions are controlled by the

satellite through a chip implanted

in her/his brain by some

extraterrestrial beings.

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Psychology82

of time. Sub-types of schizophrenia andtheir characteristics are described briefly inBox 4.2.

Behavioural and DevelopmentalDisorders

Apart from those mentioned above, thereare certain disorders that are specific tochildren and if neglected can lead toserious consequences later in life. Childrenhave less self-understanding and they havenot yet developed a stable sense of identitynor do they have an adequate frame ofreference regarding reality, possibility, andvalue. As a result, they are unable to copewith stressful events which might bereflected in behavioural and emotionalproblems. On the other hand, althoughtheir inexperience and lack of self-sufficiency make them easily upset byproblems that seem minor to an adult,children typically bounce back morequickly.

We will now discuss several disordersof childhood like Attention-deficitHyperactivity Disorder (ADHD), ConductDisorder, and Separation AnxietyDisorder. These disorders, if not attended,can lead to more serious and chronicdisorders as the child moves intoadulthood.

Classification of children’s disordershas followed a different path than that of

adult disorders. Achenbach has identifiedtwo factors, i.e. externalisation andinternalisation, which include the majorityof childhood behaviour problems. Theexternalising disorders, or undercontrolledproblems, include behaviours that aredisruptive and often aggressive and aversiveto others in the child’s environment. Theinternalising disorders, or overcontrolledproblems, are those conditions where thechild experiences depression, anxiety, anddiscomfort that may not be evident toothers.

There are several disorders in whichchildren display disruptive or externalisingbehaviours. We will now focus on threeprominent disorders, viz. Attention-deficit

Hyperactivity Disorder (ADHD),Oppositional Defiant Disorder (ODD), andConduct Disorder.

The two main features of ADHD areinattention and hyperactivity-impulsivity. Children who are inattentivefind it difficult to sustain mental effortduring work or play. They have a hard timekeeping their minds on any one thing orin following instructions. Commoncomplaints are that the child does notlisten, cannot concentrate, does not followinstructions, is disorganised, easilydistracted, forgetful, does not finishassignments, and is quick to lose interestin boring activities. Children who areimpulsive seem unable to control their

Box4.2

Sub-types of Schizophrenia

According to DSM-IV-TR, the sub-types of schizophrenia and their characteristics are :

• Paranoid type : Preoccupation with delusions or auditory hallucinations; nodisorganised speech or behaviour or inappropriate affect.

• Disorganised type : Disorganised speech and behaviour; inappropriate or flat affect;no catatonic symptoms.

• Catatonic type : Extreme motor immobility; excessive motor inactivity; extremenegativism (i.e. resistance to instructions) or mutism (i.e. refusing to speak).

• Undifferentiated type : Does not fit any of the sub-types but meets symptom criteria.

• Residual type : Has experienced at least one episode of schizophrenia; no positivesymptoms but shows negative symptoms.

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immediate reactions or to think before theyact. They find it difficult to wait or taketurns, have difficulty resisting immediatetemptations or delaying gratification. Minormishaps such as knocking things over arecommon whereas more serious accidentsand injuries can also occur. Hyperactivityalso takes many forms. Children withADHD are in constant motion. Sitting stillthrough a lesson is impossible for them.The child may fidget, squirm, climb andrun around the room aimlessly. Parentsand teachers describe them as ‘driven bya motor’, always on the go, and talkincessantly. Boys are four times morelikely to be given this diagnosis thangirls.

Children with Oppositional DefiantDisorder (ODD) display age-inappropriateamounts of stubbornness, are irritable,defiant, disobedient, and behave in ahostile manner. Unlike ADHD, the rates ofODD in boys and girls are not verydifferent. The terms Conduct Disorder andAntisocial Behaviour refer to age-inappropriate actions and attitudes thatviolate family expectations, societal norms,and the personal or property rights ofothers. The behaviours typical of conductdisorder include aggressive actions thatcause or threaten harm to people oranimals, non-aggressive conduct thatcauses property damage, majordeceitfulness or theft, and serious ruleviolations. Children show many differenttypes of aggressive behaviour, such asverbal aggression (i.e. name-calling,swearing), physical aggression (i.e. hitting,fighting), hostile aggression (i.e. directedat inflicting injury to others), andproactive aggression (i.e. dominating andbullying others without provocation).

Internalising disorders includeSeparation Anxiety Disorder (SAD) andDepression. Separation anxiety disorder isan internalising disorder unique tochildren. Its most prominent symptom is

excessive anxiety or even panicexperienced by children at being separatedfrom their parents. Children with SADmay have difficulty being in a room bythemselves, going to school alone, arefearful of entering new situations, and clingto and shadow their parents’ every move.To avoid separation, children with SADmay fuss, scream, throw severe tantrums,or make suicidal gestures.

The ways in which children expressand experience depression are related totheir level of physical, emotional, andcognitive development. An infant may showsadness by being passive andunresponsive; a pre-schooler may appearwithdrawn and inhibited; a school-agechild may be argumentative andcombative; and a teenager may expressfeelings of guilt and hopelessness.

Children may also have more seriousdisorders called Pervasive DevelopmentalDisorders . These disorders arecharacterised by severe and widespreadimpairments in social interaction andcommunication skills, and stereotypedpatterns of behaviours, interests andactivities. Autistic disorder or autism isone of the most common of these disorders.Children with autistic disorder have markeddif ficulties in social interaction andcommunication, a restricted range ofinterests, and strong desire for routine.About 70 per cent of children with autismare also mentally retarded.

Children with autism experienceprofound difficulties in relating to otherpeople. They are unable to initiate socialbehaviour and seem unresponsive to otherpeople’s feelings. They are unable to shareexperiences or emotions with others. Theyalso show serious abnormalities incommunication and language that persistover time. Many autistic children neverdevelop speech and those who do, haverepetitive and deviant speech patterns.Children with autism often show narrow

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Psychology84

patterns of interests and repetitivebehaviours such as lining up objects orstereotyped body movements such asrocking. These motor movements may beself-stimulatory such as hand flapping orself-injurious such as banging their headagainst the wall.

Another group of disorders which areof special interest to young people areeating disorders. These include anorexia

nervosa, bulimia nervosa, and binge eating.In anorexia nervosa, the individual has adistorted body image that leads her/him tosee herself/himself as overweight. Oftenrefusing to eat, exercising compulsivelyand developing unusual habits such asrefusing to eat in front of others, theanorexic may lose large amounts of weightand even starve herself/himself to death.In bulimia nervosa, the individual may eatexcessive amounts of food, then purge her/his body of food by using medicines suchas laxatives or diuretics or by vomiting.The person often feels disgusted andashamed when s/he binges and is relievedof tension and negative emotions afterpurging. In binge eating, there arefrequent episodes of out-of-control eating.

Intellectual Disability

You have already read about variationsin intelligence in Chapter 1. Intellectualdisability refers to below averageintellectual functioning (with an IQ ofapproximately 70 or below), and deficits orimpairments in adaptive behaviour (i.e. inthe areas of communication, self-care,home living, social/interpersonal skills,functional academic skills, work, etc.)which are manifested before the age of 18years. Table 4.2 describes characteristicsof the intellectually disabled persons.

Substance-use Disorders

Addictive behaviour, whether it involvesexcessive intake of high calorie food

resulting in extreme obesity or involvingthe abuse of substances such as alcoholor cocaine, is one of the most severeproblems being faced by society today.

Disorders relating to maladaptivebehaviours resulting from regular andconsistent use of the substance involvedare called substance abuse disorders.These disorders include problemsassociated with using and abusing suchdrugs as alcohol, cocaine and heroin,which alter the way people think, feel andbehave. There are two sub-groups ofsubstance-use disorders, i.e. those relatedto substance dependence and those relatedto substance abuse.

In substance dependence, there isintense craving for the substance to whichthe person is addicted, and the personshows tolerance, withdrawal symptomsand compulsive drug-taking. Tolerancemeans that the person has to use moreand more of a substance to get the sameeffect. Withdrawal refers to physicalsymptoms that occur when a person stopsor cuts down on the use of a psychoactivesubstance, i.e. a substance that has theability to change an individual’sconsciousness, mood and thinkingprocesses.

In substance abuse, there arerecurrent and significant adverseconsequences related to the use ofsubstances. People who regularly ingestdrugs damage their family and socialrelationships, perform poorly at work, andcreate physical hazards.

We will now focus on the three mostcommon forms of substance abuse, viz.alcohol abuse and dependence, heroinabuse and dependence, and cocaineabuse and dependence.

Alcohol Abuse and Dependence

People who abuse alcohol drink largeamounts regularly and rely on it to help

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Box4.3

Effects of Alcohol : Some Facts

• All alcohol beverages contain ethyl alcohol.• This chemical is absorbed into the blood and carried into the central nervous system

(brain and spinal cord) where it depresses or slows down functioning.• Ethyl alcohol depresses those areas in the brain that control judgment and inhibition;

people become more talkative and friendly, and they feel more confident and happy.• As alcohol is absorbed, it affects other areas of the brain. For example, drinkers are

unable to make sound judgments, speech becomes less careful and less clear, andmemory falters; many people become emotional, loud and aggressive.

• Motor difficulties increase. For example, people become unsteady when they walk andclumsy in performing simple activities; vision becomes blurred and they have troublein hearing; they have difficulty in driving or in solving simple problems.

them face difficult situations. Eventuallythe drinking interferes with their socialbehaviour and ability to think and work.

For many people the pattern of alcoholabuse extends to dependence. That is,their bodies build up a tolerance for

Table 4.2 : Characteristics of Individuals with Different Levels of Intellectual Disability

Area of Mild Moderate Severe

Functioning (IQ range = 55 to (IQ range = 35–40 (IQ range = 20–25 to

approximately 70) to approximately approximately 35–40)

50–55) and Profound

(IQ = below 20–25)

Self-help Skills Feeds and dresses Has difficulties and No skills to partial

self and cares for requires training but skills, but some can

own toilet needs can learn adequate care for personal needs

self-help skills on limited basis

Speech and Receptive and Receptive and Receptive language

Communication expressive language expressive language is limited;

is adequate; is adequate; expressive language

understands has speech problems is poor

communication

Academics Optimal learning Very few academic No academic skills

environment; third skills; first or second

to sixth grade grade is maximal

Social Skills Has friends; can Capable of making Not capable of having

learn to adjust friends but has real friends; no social

quickly difficulty in many interactions

social situations

Vocational Can hold a job; Sheltered work Generally no

Adjustment competitive to semi- environment; usually employment; usually

competitive; primarily needs consistent needs constant care

unskilled work supervision

Adult Living Usually marries, Usually does not No marriage or

has children; needs marry or have children; always

help during stress children; dependent dependent on others

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Psychology86

Box4.4

Commonly Abused Substances (Following the DSM-IV-TR Classification)

• Alcohol• Amphetamines: dextroamphetamines, metaamphetamines, diet pills• Caffeine: coffee, tea, caffeinated soda, analgesics, chocolate, cocoa

• Cannabis: marijuana or ‘bhang’, hashish, sensimilla

• Cocaine• Hallucinogens: LSD, mescaline• Inhalants: gasoline, glue, paint thinners, spray paints, typewriter correction fluid,

sprays

• Nicotine: cigarettes, tobacco

• Opioid: morphine, heroin, cough syrup, painkillers (analgesics, anaesthetics)• Phencyclidine• Sedatives

Key Terms

Abnormal psychology, Antisocial behaviour, Anxiety, Autism, Deinstitutionalisation, Delusions,Diathesis-stress model, Eating disorders, Genetics, Hallucinations, Hyperactivity, Hypochondriasis,Intellectual disability, Mood disorders, Neurotransmitters, Norms, Obsessive-compulsive disorders,Phobias, Schizophrenia, Somatoform disorders, Substance abuses.

alcohol and they need to drink evengreater amounts to feel its effects. Theyalso experience withdrawal responseswhen they stop drinking. Alcoholismdestroys millions of families, socialrelationships and careers. Intoxicateddrivers are responsible for many roadaccidents. It also has serious effects onthe children of persons with this disorder.These children have higher rates ofpsychological problems, particularlyanxiety, depression, phobias andsubstance-related disorders. Excessivedrinking can seriously damage physicalhealth. Some of the ill-effects of alcohol onhealth and psychological functioning arepresented in Box 4.3.

danger of heroin abuse is an overdose,

which slows down the respiratory centres

in the brain, almost paralysing breathing,

and in many cases causing death.

Cocaine Abuse and Dependence

Regular use of cocaine may lead to a

pattern of abuse in which the person may

be intoxicated throughout the day and

function poorly in social relationships and

at work. It may also cause problems in

short-term memory and attention.

Dependence may develop, so that cocaine

dominates the person’s life, more of the

drug is needed to get the desired effects,

Heroin Abuse and Dependence

Heroin intake significantly interferes withsocial and occupational functioning. Mostabusers further develop a dependence onheroin, revolving their lives around thesubstance, building up a tolerance for it,and experiencing a withdrawal reactionwhen they stop taking it. The most direct

and stopping it results in feelings of

depression, fatigue, sleep problems,irritability and anxiety. Cocaine poses

serious dangers. It has dangerous effects

on psychological functioning and physicalwell-being.

Some of the commonly abused

substances are given in Box 4.4.

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Review Questions

1. Identify the symptoms associated with depression and mania.2. Describe the characteristics of hyperactive children.3. What do you understand by substance abuse and dependence?4. Can a distorted body image lead to eating disorders? Classify the various forms of it.5. “Physicians make diagnosis looking at a person’s physical symptoms”. How are

psychological disorders diagnosed?6. Distinguish between obsessions and compulsions.7. Can a long-standing pattern of deviant behaviour be considered abnormal? Elaborate.8. While speaking in public the patient changes topics frequently, is this a positive or

a negative symptom of schizophrenia? Describe the other symptoms and sub-typesof schizophrenia.

9. What do you understand by the term ‘dissociation’? Discuss its various forms.10. What are phobias? If someone had an intense fear of snakes, could this simple phobia

be a result of faulty learning? Analyse how this phobia could have developed.11. Anxiety has been called the “butterflies in the stomach feeling”. At what stage does

anxiety become a disorder? Discuss its types.

• Abnormal behaviour is behaviour that is deviant, distressing, dysfunctional, and

dangerous. Those behaviours are seen as abnormal which represent a deviation

from social norms and which interfere with optimal functioning and growth.

• In the history of abnormal behaviour, the three perspectives are, i.e. the supernatural,

the biological or organic, and the psychological. In interactional or bio-psycho-social

approach, all three factors, viz. biological, psychological and social play important

roles in psychological disorders.

• Classification of psychological disorders has been done by the WHO (ICD-10) and

the American Psychiatric Association (DSM-IV-TR).

• A variety of models have been used to explain abnormal behaviour. These are the

biological, psychodynamic, behavioural, cognitive, humanistic-existential, diathesis-

stress systems, and socio-cultural approaches.

• The major psychological disorders include anxiety, somatoform, dissociative, mood,

schizophrenic, developmental and behavioural, and substance-use disorders.

ProjectIdeas

1. All of us have changes in mood or mood swings all day. Keep a small diary or notebook withyou and jot down your emotional experiences over 3–4 days. As you go through the day (forinstance, when you wake up, go to school/college, meet your friends, return home), youwill observe that there are many highs and lows, ups and downs in your moods. Note downwhen you felt happy or unhappy, felt joy or sadness, felt anger, irritation and other commonlyexperienced emotions. Also note down the situations which elicited these various emotions.After collecting this information, you will have a better understanding of your own moodsand how they fluctuate through the day.

2. Studies have shown that current standards of physical attractiveness have contributed toeating disorders. Thinness is valued in fashion models, actors, and dancers. To study this,observe the people around you. Select at least 10 people (they may include your family,friends and other acquaintances), and rate them in terms of Large, Average and Thin. Thenpick up any fashion or film magazine. Look at the pictures of models, winners of beautycompetitions, and film stars. Write a paragraph or two describing the magazine’s messageto its readers about the normal or acceptable male or female body. Does this view matchwhat you see as normal body types in the general population?

3. Make a list of movies, TV shows, or plays you have seen where a particular psychologicaldisorder has been highlighted. Match the symptoms shown to the ones you have read.Prepare a report.

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Psychology88

Pedagogical Hints

1. The contents on psychologicaldisorders have to be handledsensitively. After becoming familiarwith various kinds of disorders andtheir symptoms, students maybegin to feel and may express thatthey are suffering from one or moreof the given disorders. It isimportant to explain to thestudents, not to draw any definiteconclusions on the basis of somesigns/symptoms experienced.

2. Students need to be made awarethat mere knowledge andinformation about psychologicaldisorders do not provide thenecessary skills for eitherdiagnosing or treating psychologicaldisorders.

3. Students should be discouragedfrom attempting to treat each other,as they are not qualified to do so.Specialised training in clinicalpsychology/counselling is requiredto undertake psycho-diagnostictesting.

Weblinks

http://www.mental-health-matters.com/disordershttp://allpsych.comhttp://mentalhealth.com

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PSYCHOLOGICAL DISORDERSChapter 4 • Psychological Disorders71 The first approach views abnormal behaviour as a deviation from social norms.Many psychologists have stated that ‘abnormal’

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