UNIT IB – MENTAL ILLNESS

In the United States, the accepted standard for defining various types of mental
disorders is the American Psychiatric Association’s Diagnostic and Statistical
Manual of Mental Disorders. Within DSM-5, a mental disorder is defined as a
syndrome that is present in an individual and that involves clinically significant
disturbance in behaviour, emotion regulation, or cognitive functioning. DSM-5
also recognises that mental disorders are usually associated with significant
distress or disability in key areas of functioning such as social, occupational or
other activities.
THE PSYCHOANALYTICAL PERSPECTIVE
Sigmund Freud founded the psychoanalytic school. He emphasized the role of
unconscious motives and thoughts and their dynamic interrelationships in the
determination of both normal and abnormal behavior. According to Freud, the
conscious part of the mind represents a relatively small area, whereas the
unconscious part, like the submerged part of an iceberg, is the much larger portion.
In the depths of the unconscious are the hurtful memories, forbidden desires, and
other experiences that have been repressed—that is, pushed out of consciousness.
However, Freud believed that unconscious material continues to seek
expression and emerges in fantasies, dreams, slips of the tongue, and so forth.
Until such unconscious material is brought to awareness and integrated into the
conscious part of the mind it may lead to irrational and maladaptive behavior.
Freud theorized that a person’s behavior results from the interaction of three
key components of the personality or psyche: the id, ego, and superego. The id is
the instinctual and unorganized part of personality. From the time of birth, the id
attempts to reduce tension created by primitive drives related to hunger, sex,
aggression, and irrational impulses. The id operates according to the pleasure
principle in which the goal is the immediate reduction of tension and the
maximization of satisfaction. However, in most cases, reality prevents the
fulfillment of the demands of the pleasure principle: We cannot always eat when
we are hungry, and we can discharge our sexual drives only when the time and
place are appropriate. To account for this fact of life, Freud suggested a second
component of personality, which he called the ego.
The ego is the rational and logical part of personality that attempts to balance
the desires of the id and the realities of the objective, outside world. It starts to
develop soon after birth. In contrast to the pleasure-seeking id, the ego operates
according to the reality principle. In a sense, then, the ego is the “executive” of
personality: It makes decisions, controls actions, and allows thinking and problem
solving of a higher order than the id’s capabilities permit.
The superego is the final personality structure to develop in childhood.
According to Freud, the superego is the part of personality that harshly judges the
morality of our behavior. It represents the rights and wrong of society as taught
and modeled by a person’s parents, teachers, and other significant individuals. The
superego includes the conscience, which prevents us from behaving in a morally
improper way by making us feel guilty if we do wrong. The superego helps us
control impulses coming from the id, making our behavior less selfish and more
virtuous.
Neither the id nor superego parts of personality are realistic, practical, or
logical in that they do not consider the realities society imposes. For example, the
superego, if left to operate by itself and without restraint, would create
perfectionists unable to make the moral compromises that life sometimes requires.
On the other hand, an unrestrained id would produce a primitive, pleasure-seeking,
thoughtless individual on a mission to fulfill every desire without delay.
Consequently, the ego must constrain and negotiate between the conflicting
demands of the superego and id.
PSYCHOLOGICAL CAUSAL FACTORS
This refers to the types of psychological factors that make people vulnerable to
disorder or that may precipitate disorder. Psychological factors are those
developmental influences—often unpredictable and uncontrollable negative events
—that may handicap a person psychologically, making him or her less resourceful
in coping with events. Four possible categories of psychological causal factors
that can each have important detrimental effects on a child’s socioemotional
development are: (1) early deprivation or trauma, (2) inadequate parenting styles,
(3) marital discord and divorce, and (4) maladaptive peer relationships.
Such factors typically do not operate alone. Rather, they interact with each
other and with other psychological factors, as well as with particular genetic and
temperamental factors and with particular sociocultural settings or environments.
EARLY DEPRIVATION OR TRAUMA:
Children who do not have the resources that are typically supplied by parents
or parental surrogates may be left with deep and sometimes irreversible
psychological scars. The needed resources range from food and shelter to love and
attention. Deprivation of such resources can occur in several forms. The most
severe manifestations of deprivation are usually seen among abandoned or
orphaned children, who may be either institutionalized or placed in a succession of
unwholesome and inadequate foster homes. However, it can also occur in intact
families where, for one reason or another, parents are unable (for instance, because
of mental disorder) or unwilling to provide close and frequent human attention and
nurturing.

INSTITUTIONALIZATION:
In some cases children are raised in an institution where, compared with an
ordinary home, there is likely to be less warmth and physical contact, less
intellectual, emotional, and social stimulation and a lack of encouragement and
help in positive learning. Current estimates are that worldwide up to 8 million
children live in orphanages (Bos et al., 2011).
Research done when institutionalization was more common in the United
States and the United Kingdom makes it clear that the long-range prognosis for
most children who suffer early and prolonged environmental and social
deprivation through institutionalization is unfavorable, especially if the
institutionalization lasts longer than 6 months. Many children institutionalized in
infancy and early childhood show severe emotional, behavioral, and learning
problems and are at risk for disturbed attachment relationships and
psychopathology. Institutionalization later in childhood of a child who has already
had good attachment experiences was not found to be so damaging (Rutter, 1987).
However, even some of the children institutionalized at an early age show
resilience and do well in adolescence and adulthood. In some cases this is because
of influential protective factors, which include having some positive experiences at
school, whether in the form of social relationships or athletic or academic success,
and having a supportive marital partner in adulthood; these successes probably
contribute to a better sense of self-esteem or self-efficacy.
NEGLECT AND ABUSE IN THE HOME:
Most infants subjected to parental deprivation are not separated from their
parents but, rather, suffer from maltreatment at home. Parents can neglect a child
in various ways — by physical neglect, denial of love and affection, lack of
interest in the child’s activities and achievements, or failure to spend time with the
child or to supervise his or her activities. Cases of parental abuse (which are less
common than neglect) involve cruel treatment in the form of emotional, physical,
or sexual abuse.
Outright parental abuse (physical or sexual or both) of children has been
associated with many negative effects on their emotional, intellectual, and physical
development, although some studies have suggested that, at least among infants,
gross neglect may be worse than having an abusive relationship. Abused children
often have a tendency to be overly aggressive (both verbally and physically), even
to the extent of bullying. Some even respond with anger and aggression to friendly
overtures from peers. Researchers have also found that maltreated children often
have difficulties in linguistic development significant problems in behavioral,
emotional, and social functioning, including conduct disorder, depression and
anxiety, and impaired relationships with peers, who tend to avoid or reject them.
Abused and maltreated infants and toddlers are also quite likely to develop
atypical patterns of attachment characterized by insecure, disorganized, and
inconsistent behavior with the primary caregiver. For example, such a child might
at one point act dazed and show frozen behavior when reunited with his or her
caregiver. However, at another point he or she might actually approach the
caregiver but then immediately reject and avoid her.
A significant portion of these children continue to show these confused patterns
of relating to caregivers up to at least age 13. Moreover, they are likely to expect
others to treat them in a similar negative manner and to not expect that they will
fare well in such relationships. Consequently, they may selectively avoid new
experiences that could correct their expectations.
These effects of early abuse may endure into adolescence and adulthood. For
example, previously abused or neglected children have, on average, lower levels of
education, employment, and earnings. Childhood physical abuse predicts both
familial and nonfamilial violence in adolescence and adulthood, especially in
abused men. Thus, a significant proportion of parents who reject or abuse their
children have themselves been the victims of parental rejection.
It is important to remember that maltreated children—whether the
maltreatment comes from abuse or from deprivation—can improve to at least some
extent when the caregiving environment improves. Moreover, there are always a
range of effects, and those children who are least likely to show these negative
outcomes tend to have one or more protective factors such as a good relationship
with some adult during childhood, a higher IQ, positive school experiences, or
physical attractiveness.
SEPARATION:
Bowlby summarized the traumatic effects, for children from 2 to 5 years old, of
being separated from their parents during prolonged periods of hospitalization. The
short-term effects of the separation can include significant despair during the
separation as well as detachment from the parents upon reunion.
The longer-term effects of early separation from one or both parents can cause
increased vulnerability to stressors later in adulthood, such as making it more
likely that the person will become depressed or show other psychiatric symptoms.
The long-term effects of separation depend heavily on whether support and
reassurance are given a child by parents or other significant people, which is most
likely if the child has a secure relationship with at least one parent.
 PARENTING STYLES:

Even in the absence of severe deprivation, neglect, or trauma, many kinds of

deviations in parenting can have profound effects on a child’s subsequent ability to
cope with life’s challenges and thus can create a child’s vulnerability to various
forms of psychopathology. Therefore, the psychological viewpoints on causes of
psychopathology all focus on the behavioral tendencies a child acquires in the
course of early social interaction with others—chiefly parents or parental
surrogates.
A parent–child relationship is always bidirectional - the behavior of each
person affects the behavior of the other. Some children are easier to love than
others; some parents are more sensitive than others to an infant’s needs.
In general, it has been found that parents who have various forms of
psychopathology (including schizophrenia, depression, antisocial personality
disorder, and alcohol abuse or dependence) tend to have one or more children who
are at heightened risk for a wide range of developmental difficulties (unless
protective factors are also present).
 The focus of most research in this area has been on mothers, but there is good
evidence that fathers with mental disorders or others who are minimally involved
in caretaking in infancy can also make significant contributions to child and
adolescent psychopathology, especially to problems such as depression, conduct
disorder, delinquency, and attention-deficit disorder.
MARITAL DISCORD: when it is long-standing it is likely to be frustrating, hurtful,
and generally damaging in its effects on both adults and their children.
One study showed that children of parents with high levels of overt conflict
showed a greater disposition to behave aggressively toward both their peers and their
parents than children from less conflictual marriages (Cummings et al., 2004; Du
Rocher et al., 2004; see also Amato, 2006).
Another study found that college students who reported high levels of marital
conflict in their parents also showed elevated conflict in their own romantic
relationships, which in turn was linked to poorer quality of their own romantic
relationships.
Interestingly, one study found that children could be buffered against many of
the damaging effects of marital conflict if one or both parents had the following
characteristics: warmth, proneness to giving praise and approval, and ability to inhibit
rejecting behavior toward their children (Katz & Gottman, 1997)
Recent longitudinal studies have clearly documented that the damaging effects
of serious marital discord on children continue into adulthood: The offspring’s own
marriages are more likely to be marked by discord (whether or not the parents
divorced).
Some of this intergenerational transmission of marital discord may be the result
of the offspring having learned negative interaction styles by observing their own
parents’ marital interactions (Amato, 2006; Amato & Booth, 2001)
DIVORCED FAMILIES:
Estimates are that about 20 percent of children under the age of 18 are living in
a single-parent household—some with unwed parents and some with divorced parents.
Nearly half of all marriages end in divorce.
Divorce rates in north-east states are relatively higher than elsewhere in India:
Mizoram has the highest divorce rate (4.08%), more than four times that of Nagaland,
the state with the second highest rate (0.88%).
Effects of Divorce on Parents: Unhappy marriages are difficult, but ending a
marital relationship can also be enormously stressful for the adults, both mentally and
physically. The negative effects are often temporary, with most people being able to
adapt constructively within 2 to 3 years, but some adults never fully recover (Amato,
2000; Hetherington, 2003a).
In their reviews of the effects of divorce on adults, Amato and Keith (1991a)
concluded that it is a major source of psychopathology as well as of physical illness,
death, suicide, and homicide.
It should also be recognized, however, that divorce actually benefits some
individuals (Amato, 2000, 2010)—with some evidence that women are more likely to
benefit than men (Hetherington, 2003a).
There is also some evidence that individuals who were in high-distress
marriages before divorce are more likely to show an increase in happiness than are
individuals who were in low-distress marriages before divorce (Amato & Hohmann-
Marriott, 2007).
In addition, favorable adjustment after divorce is positively associated with
higher income, dating someone steadily, remarriage, having had relatively favorable
attitudes toward divorce before it happened, and being the partner who initiated the
divorce (Amato, 2000).
Effects of Divorce on Children: Divorce can have traumatic effects on children, too.
Feelings of insecurity and rejection may be aggravated by conflicting loyalties
and, sometimes, by the spoiling the children may receive while staying with one of the
parents. Not surprisingly, some children do develop serious maladaptive responses.
Temperamentally difficult children are likely to have a more difficult time
adjusting than are temperamentally easy children (Hetherington et al., 1989).
Somewhat ironically, difficult children may be the ones whose parents are more
likely to divorce, perhaps because having difficult children is likely to exacerbate
marital problems (Block et al., 1986; Hetherington, 1999).
Delinquency and a wide range of other psychological problems such as anxiety
and depression are much more frequent among children and adolescents from
divorced families than among those from intact families, although it is likely that a
contributing factor here is prior or continuing parental strife (Chase-Lansdale et al.,
1995; Strohschein, 2005).
On average, compared to young adults from families without divorce, young
adults from divorced families have somewhat lower educational attainment, lower
incomes, lower life satisfaction, and an increased probability of being on welfare and
having children out of wedlock (Chase Lansdale et al., 1995; Hetherington et al.,
1998).
Children from divorced families are also more likely to have their own
marriages end in divorce (Amato & DeBoer, 2001; Hetherington, 2003b).
 Delinquency and a wide range of other psychological problems such as anxiety
and depression are much more frequent among children and adolescents from
divorced families than among those from intact families, although it is likely that a
contributing factor here is prior or continuing parental strife (Chase-Lansdale et al.,
1995; Strohschein, 2005).
On average, compared to young adults from families without divorce, young
adults from divorced families have somewhat lower educational attainment, lower
incomes, lower life satisfaction, and an increased probability of being on welfare and
having children out of wedlock (ChaseLansdale et al., 1995; Hetherington et al.,
1998).
Children from divorced families are also more likely to have their own
marriages end in divorce (Amato & DeBoer, 2001; Hetherington, 2003b).
• Nevertheless, many children adjust quite well to the divorce of their parents.
• Amato and Keith (1991a, 1991b) also found that the negative effects of divorce
seemed to decrease from the 1950s through the 1980s (particularly since 1970),
perhaps because the stigma of divorce was decreasing.
The effects of divorce on children are often more favorable than the effects of
remaining in a home torn by marital conflict and dissension.

REFERENCE:
Butcher, J.N., Hooley, J.M., Mineka, S. & Kapur, P. (2019). Abnormal
Psychology.17th Edition. Pearson India Education Services Pvt. Ltd.