5.4 Selection of Categories of Psychological Disorders

Neurodevelopmental disorders impact behavior, cognition, and social skills during development. ADHD and autism spectrum disorder are key examples. These disorders can stem from environmental factors, physiological issues, or genetic influences.

Neurodevelopmental Disorders

Neurodevelopmental disorders appear early in childhood and affect a person's ability to function in daily life. These disorders impact behavior, learning, communication, and social interactions. Diagnosing them involves looking at whether a child’s development aligns with typical expectations for their age and maturity level.

Characteristics of neurodevelopmental disorders

Neurodevelopmental disorders typically emerge during childhood and can significantly impact daily functioning. These conditions affect how the brain develops and processes information, leading to challenges in various areas of life.

Key characteristics include:

• Delays in reaching developmental milestones
• Difficulties with social interaction and communication
• Problems with attention, memory, or learning
• Challenges with motor skills or coordination

The most common disorders include:

• ADHD (Attention-Deficit/Hyperactivity Disorder)
  • Difficulty maintaining attention
  • Hyperactive behavior
  • Impulsive actions
• Autism Spectrum Disorder (ASD)
  • Social communication challenges
  • Restricted interests
  • Repetitive behaviors

Causes of neurodevelopmental disorders

Multiple factors can contribute to the development of these disorders. Understanding these causes helps inform treatment approaches and early intervention strategies.

Environmental factors include:

• Exposure to toxins during pregnancy, such as lead or alcohol
• Premature birth or low birth weight
• Complications during birth affecting brain development
• Maternal stress or illness
• Early childhood trauma or neglect

Biological influences:

• Differences in brain structure and function, especially in areas related to attention and social behavior
• Imbalances in neurotransmitters that affect mood and impulse control
• Hormonal irregularities

Genetic factors play a significant role through:

• Family history of neurodevelopmental disorders increasing the likelihood of diagnosis
• Specific genetic mutations or variations linked to conditions like ADHD and ASD

Schizophrenic Spectrum Disorders

Schizophrenic spectrum disorders involve disruptions in thinking, perception, emotion, and behavior. These disorders can be acute (short-term and severe) or chronic (long-lasting and persistent). Symptoms vary but generally affect one or more of five key areas: delusions, hallucinations, disorganized thinking or speech, disorganized motor behavior, and negative symptoms.

Symptoms of Schizophrenic Spectrum Disorders

Symptoms are typically classified as positive symptoms, which involve the presence of unusual behaviors or experiences, and negative symptoms, which involve the absence of typical behaviors or emotions.

Delusions (false beliefs)

• Believing something untrue despite evidence to the contrary
• Common types include delusions of persecution (believing others are out to harm them) and delusions of grandeur (believing they have special powers or importance)

Hallucinations (false perceptions)

• Experiencing sensations that are not real, such as hearing voices or seeing things that are not there
• Can involve any of the senses, though auditory hallucinations are the most common

Disorganized thinking or speech

• Difficulty organizing thoughts, leading to fragmented or confused speech
• May result in word salad, where words are strung together without logical meaning

Disorganized motor behavior

• Unpredictable or unusual movements, ranging from agitation to a complete lack of movement
• May include catatonia, which can manifest as excessive movement or remaining motionless for long periods

Negative symptoms (lack of typical behaviors)

• Flat affect, or showing little to no emotional expression
• Catatonic stupor, where a person is unresponsive and lacks movement or speech

Causes of schizophrenia

The exact cause of schizophrenia is not fully understood, but research suggests a combination of genetic and biological factors.

Genetic factors:

• A family history of schizophrenia increases the likelihood of developing the disorder
• Specific gene variations may contribute to susceptibility
• Interactions between genes and environment

Biological factors:

• Imbalances in dopamine, a neurotransmitter involved in thinking and perception (known as the dopamine hypothesis)
• Differences in brain structure and function, such as enlarged ventricles and reduced activity in certain brain areas
• Neurotransmitter irregulaties

Prenatal and environmental factors:

• Exposure to viruses or malnutrition during pregnancy
• Stressful life events or drug use may trigger symptoms in genetically vulnerable individuals

Obsessive-compulsive disorders

Symptoms of obsessive-compulsive disorders

Obsessive-compulsive disorders are characterized by the presence of obsessions (intrusive, unwanted thoughts) and/or compulsions (repetitive behaviors or mental acts aimed at reducing anxiety) 🔁

• Obsessive-compulsive disorder (OCD) involves both obsessions and compulsions that are time-consuming and cause significant distress or impairment
• Hoarding disorder is persistent difficulty discarding possessions, leading to clutter that impairs living spaces and causes distress
• Obsessions and compulsions can center around various themes like contamination, symmetry, or harm
• Individuals with OCD often recognize their thoughts and behaviors as irrational but feel unable to control them
• Learned associations (classical conditioning), maladaptive thinking patterns (cognitive distortions), emotional dysregulation, and biological or genetic factors can all contribute to the development of obsessive-compulsive disorders

Causes of obsessive-compulsive disorders

Obsessive-compulsive disorders (OCD) develop from a mix of learned behaviors, cognitive patterns, emotional responses, and biological factors. These influences interact, shaping how obsessions and compulsions emerge and persist.

Learned associations

• Classical conditioning, where neutral stimuli become associated with anxiety or distress through repeated pairings with aversive experiences
• Negative reinforcement, where compulsive behaviors are strengthened by their ability to temporarily reduce anxiety
• Observational learning, where individuals develop obsessions or compulsions by witnessing others' behaviors

Maladaptive thinking patterns

• Cognitive distortions like overestimating the likelihood or severity of negative outcomes (thought-action fusion)
• Inflated sense of responsibility for preventing harm or making mistakes
• Difficulty tolerating uncertainty or ambiguity, leading to excessive checking or reassurance-seeking

Emotional dysregulation

• Inability to effectively manage or cope with intrusive thoughts or urges
• Heightened sensitivity to feelings of disgust or contamination
• Avoidance behaviors that prevent learning to tolerate or overcome obsessions

Biological and genetic factors

• Imbalances in neurotransmitters like serotonin and dopamine
• Abnormalities in brain structure or function, particularly in regions involved in habit formation (basal ganglia) and emotional regulation (prefrontal cortex)
• Family history of OCD or related disorders, suggesting a genetic component
• Interaction between genetic predisposition and environmental triggers (stressful life events, trauma)

Dissociative Disorders

Dissociative disorders involve disruptions in awareness, memory, identity, and perception. These disruptions can be temporary or long-lasting and often occur in response to trauma or extreme stress.

Symptoms of dissociative disorders

People with dissociative disorders may experience a disconnect between their thoughts, emotions, identity, or surroundings. Symptoms vary depending on the type of disorder.

• Dissociative amnesia is inability to recall important personal information, often related to a stressful or traumatic event
• Dissociative fugue involves amnesia accompanied by unexpected travel or wandering and confusion about one's identity
• Dissociative identity disorder (formerly multiple personality disorder) is characterized by the presence of two or more distinct personality states or identities
  • Dissociative symptoms can be sudden and transient or more persistent and chronic
  • Individuals with dissociative disorders may feel detached from their thoughts, feelings, or body (depersonalization) or from their surroundings (derealization)
• Traumatic experiences, chronic stress, and a history of childhood abuse or neglect are the primary causes of dissociative disorders

Causes of dissociative disorders

Dissociative disorders are primarily linked to trauma and chronic stress, particularly during childhood.

Traumatic experiences

• Exposure to severe, repeated, or prolonged trauma, particularly during childhood (physical, sexual, or emotional abuse)
• Witnessing or experiencing life-threatening events (natural disasters, combat, violent assaults)
• Dissociation as a coping mechanism to detach from overwhelming emotions or memories

Chronic stress

• Persistent exposure to high levels of stress, leading to emotional exhaustion and detachment
• Lack of healthy coping strategies or support systems to manage ongoing stressors
• Dissociation as a means of escaping from feelings of helplessness or hopelessness

Childhood abuse or neglect

• Early experiences of abuse or neglect can disrupt normal identity development and emotional regulation
• Dissociation as a way to compartmentalize or "split off" painful memories or aspects of the self
• Lack of secure attachment relationships or consistent caregiving can contribute to dissociative tendencies

Genetic and biological factors

• Some evidence suggests a genetic component to dissociation, with higher rates among first-degree relatives
• Abnormalities in brain structure or function, particularly in regions involved in memory and emotion processing
• Interaction between genetic predisposition and environmental stressors

Trauma Disorders

Trauma disorders develop after exposure to a highly stressful or life-threatening event. These disorders involve intense psychological distress and can significantly impact daily functioning.

Symptoms of trauma disorders

Trauma disorders involve psychological distress following exposure to a traumatic or stressful event. Posttraumatic stress disorder (PTSD) is the primary trauma disorder in scope for the AP Psych exam

Symptoms of PTSD may include:

• intrusive memories – flashbacks and nightmares that bring back the traumatic experience
• avoidance behaviors – where individuals stay away from trauma-related places, people, or conversations
• negative changes in mood and thinking – persistent fear, guilt, or detachment from others
• hyperarousal – heightened alertness, irritability, difficulty sleeping, or being easily startled

Duration and impact:

• PTSD can be acute (lasting less than 3 months) or chronic (lasting 3 months or more)
• Trauma disorders can significantly impair social, occupational, and academic functioning

Causes of trauma disorders

The development of trauma disorders is influenced by exposure to traumatic events, individual coping mechanisms, and biological factors.

• Exposure to traumatic events
  • Direct experience of actual or threatened death, serious injury, or sexual violence
  • Witnessing traumatic events happening to others, particularly loved ones
  • Learning about traumatic events happening to close family members or friends
  • Repeated or extreme exposure to aversive details of traumatic events (first responders, journalists)
• Individual differences in coping and resilience
  • Pre-existing mental health conditions (depression, anxiety) can increase vulnerability to PTSD
  • Lack of healthy coping strategies or social support systems to process traumatic experiences
  • Tendency to blame oneself or feel guilt or shame related to the traumatic event
• Biological and genetic factors
  • Imbalances in stress-related hormones (cortisol) and neurotransmitters (norepinephrine)
  • Abnormalities in brain structure or function, particularly in regions involved in fear processing (amygdala) and memory consolidation (hippocampus)
  • Family history of PTSD or other mental health conditions, suggesting a genetic component
  • Interaction between genetic predisposition and environmental stressors

Eating Disorders

Feeding and eating disorders involve disturbances in food intake that affect both physical health and mental well-being. These disorders often lead to serious medical complications and emotional distress.

Symptoms of eating disorders

Eating disorders impact a person’s relationship with food, body image, and self-control. Two key disorders in this category are anorexia nervosa and bulimia nervosa. Both disorders can have serious health consequences, including heart problems, digestive issues, and hormonal imbalances. Psychological effects include anxiety, depression, and social withdrawal.

Anorexia nervosa

• Extreme restriction of food intake, leading to significant weight loss and nutritional deficiencies
• Intense fear of gaining weight, even when underweight
• Distorted body image, where individuals see themselves as overweight despite being dangerously thin
• Excessive exercise, fasting, or use of weight-control measures to maintain low body weight

Bulimia nervosa

• Cycles of binge eating, where large amounts of food are consumed in a short period
• Compensatory behaviors to prevent weight gain, such as vomiting, excessive exercise, or laxative use
• Feelings of loss of control during binge episodes, followed by guilt or shame
• Maintaining a weight that is often within a normal range, making it less visibly obvious than anorexia

Causes of Eating Disorders

The development of eating disorders is influenced by biological, psychological, and social factors. Since multiple factors contribute to these disorders, treatment often involves medical care, therapy, and nutritional counseling. Early intervention can improve recovery outcomes and help individuals develop a healthier relationship with food and their bodies.

Biological and genetic factors

• Imbalances in neurotransmitters like serotonin and dopamine, which regulate appetite and mood
• Genetic predisposition, with a higher risk if a family member has an eating disorder
• Hormonal differences that may affect hunger and satiety cues

Psychological factors

• Perfectionism and high self-criticism, leading to strict control over food and body image
• Low self-esteem and anxiety, which contribute to unhealthy eating behaviors
• Distorted body image and fear of gaining weight, often reinforced by social pressures

Social and cultural influences

• Societal emphasis on thinness and beauty standards, especially in media and fashion
• Peer pressure and dieting culture, which can normalize extreme weight-control behaviors
• Stressful life events, trauma, or family dynamics that contribute to disordered eating patterns

Personality Disorders

Personality disorders involve long-term patterns of thinking, feeling, and behaving that deviate from cultural expectations and cause significant distress or difficulty in daily life. These patterns typically emerge in adolescence or early adulthood and remain stable over time.

Personality disorders are grouped into three clusters based on shared characteristics: Cluster A (odd or eccentric), Cluster B (dramatic or emotional), and Cluster C (anxious or fearful). Each cluster has distinct symptoms and possible causes.

Cluster A: Odd or Eccentric Personality Disorders

People with these disorders may appear socially detached, suspicious, or unusual in their thoughts and behaviors.

Paranoid Personality Disorder

• Extreme distrust and suspicion of others
• Belief that others have harmful intentions, even without evidence
• Difficulty trusting close friends, family, or coworkers

Schizoid Personality Disorder

• Strong preference for being alone and avoiding social relationships
• Limited emotional expression and indifference to praise or criticism
• Lack of interest in forming close connections

Schizotypal Personality Disorder

• Unusual thinking patterns, beliefs, or behaviors
• Social anxiety and discomfort in close relationships
• Odd speech, appearance, or belief in supernatural influences (such as telepathy)

Cluster B: Dramatic, Emotional, or Erratic Personality Disorders

This cluster includes disorders where individuals experience intense emotions, unstable relationships, impulsivity, and difficulty regulating behavior.

Antisocial Personality Disorder

• Disregard for rules, laws, and the rights of others
• Manipulative or deceitful behavior, lack of empathy
• Impulsivity and frequent aggression

Borderline Personality Disorder

• Intense fear of abandonment and unstable relationships
• Rapid mood swings and impulsive behaviors
• Self-harming tendencies and chronic feelings of emptiness

Histrionic Personality Disorder

• Excessive attention-seeking and emotional overreaction
• Strong emotions that shift quickly
• Constant need for approval and dramatic behavior

Narcissistic Personality Disorder

• Inflated sense of self-importance and entitlement
• Lack of empathy for others, need for excessive admiration
• Sensitivity to criticism despite appearing confident

Cluster C: Anxious or Fearful Personality Disorders

This cluster includes disorders where individuals struggle with excessive anxiety, fear of social rejection, and need for control or reassurance.

Avoidant Personality Disorder

• Fear of rejection and strong feelings of inadequacy
• Avoidance of social situations despite wanting relationships
• Extreme sensitivity to criticism

Dependent Personality Disorder

• Strong need for reassurance and support from others
• Difficulty making decisions without guidance
• Fear of being alone and submissive behavior in relationships

Obsessive-Compulsive Personality Disorder (OCPD)

• Preoccupation with order, perfection, and rigid control
• Difficulty delegating tasks and extreme focus on work over relationships
• Strong need for structure and resistance to change

Causes of Personality Disorders

Personality disorders develop from a mix of biological, psychological, and environmental factors. While the exact causes vary, research suggests that genetics, brain function, early life experiences, and social influences all play a role in shaping personality and behavior.

Genetic and Biological Factors

• Family studies suggest a genetic link, as personality disorders are more common in individuals with relatives who have similar conditions.
• Differences in brain structure and function may affect emotional regulation, impulse control, and social behavior.
• Imbalances in neurotransmitters like serotonin and dopamine may contribute to mood instability, impulsivity, and aggression.

Early Life Experiences

• Childhood trauma and neglect – Abuse, emotional neglect, or chaotic family environments can shape personality and coping mechanisms.
• Inconsistent or extreme parenting styles – Overly strict, neglectful, or unpredictable parenting may contribute to insecure attachment and emotional dysregulation.
• Unresolved childhood conflicts – Experiences of abandonment, rejection, or instability may lead to difficulties in relationships and self-identity.

Social and Environmental Influences

• Cultural and societal expectations – Pressure to conform to specific social roles or ideals may contribute to perfectionism, dependency, or avoidance behaviors.
• Peer relationships and social rejection – Bullying, isolation, or difficulty forming connections can reinforce maladaptive personality traits.
• Stressful life events – Significant losses, instability, or prolonged stress may trigger or worsen symptoms of personality disorders.