UNIT 5.4 · MENTAL AND PHYSICAL HEALTH
Categories of Psychological Disorders — AP Psychology Notes
Compare key disorder categories, symptoms and possible causes, including OCD, PTSD, mood and neurodevelopmental disorders.

Overview of Disorder Categories
Possible influences: Selected disorders can involve biological or genetic vulnerabilities, learned associations, thinking patterns and social or developmental context. Avoid one-cause claims: an association with adversity, a brain finding or a behavior does not prove why a particular person developed a disorder.
Distinguish patterns before choosing an exam answer
- Persistent worry
GAD: broad, hard-to-control worry over time - Unexpected attacks
Panic disorder: attacks plus persistent concern or behavior change - Intrusions and rituals
OCD: unwanted obsessions or compulsions - After trauma
PTSD: intrusion, avoidance, mood/cognition and arousal changes
The DSM-5 organizes psychological disorders into major categories based on shared characteristics. This unit covers the most important categories and specific disorders you need to know for the AP Psychology exam.
For each disorder, focus on understanding the key symptoms, not just memorizing names. Be able to recognize disorders from symptom descriptions and distinguish between similar disorders.
Remember that having some symptoms doesn't mean someone has a disorder — symptoms must be severe enough to cause significant distress or impairment and meet specific diagnostic criteria.
Anxiety Disorders
Overview
Anxiety disorders involve excessive fear or anxiety that is disproportionate to the situation and interferes with daily functioning. Prevalence comparisons depend on the population and measurement period.
Generalized Anxiety Disorder (GAD)
Persistent, excessive worry about everyday concerns for at least 6 months. The person finds it difficult to control the worry.
Key Symptoms:
- Chronic, excessive worry about multiple areas (work, health, family, finances)
- Difficulty controlling worry
- Restlessness, feeling on edge
- Easily fatigued
- Difficulty concentrating, mind going blank
- Irritability
- Muscle tension
- Sleep disturbances
Example: Person constantly worries about everything — will I be late? Did I lock the door? Will my family be safe? — even when there's no real reason for concern. Worry interferes with concentration and causes physical tension.
Panic Disorder
Panic disorder involves recurrent unexpected panic attacks plus at least one month of persistent concern about further attacks or their consequences, or maladaptive behavioral change. A panic attack can occur in other disorders and is not by itself panic disorder.
Panic Attack Symptoms:
Sudden surge of intense fear or discomfort that peaks within minutes:
- Pounding heart, rapid heart rate
- Sweating, trembling, shaking
- Shortness of breath, feeling of choking
- Chest pain or discomfort
- Nausea, dizziness, lightheadedness
- Chills or heat sensations
- Numbness or tingling
- Feeling of unreality (derealization) or detachment from self (depersonalization)
- Fear of losing control or "going crazy"
- Fear of dying
Key feature: Attacks are unexpected — no obvious trigger. Person develops anticipatory anxiety about having another attack and may avoid situations where attacks occurred.
Phobias (Phobic Disorders)
Persistent, irrational fear of and avoidance of a specific object, activity, or situation. Fear is excessive and unreasonable.
Specific Phobia
Intense fear of specific object or situation
- Animal type: Spiders, snakes, dogs
- Natural environment: Heights, storms, water
- Blood-injection-injury: Seeing blood, getting injections
- Situational: Flying, elevators, enclosed spaces (claustrophobia)
Social Anxiety Disorder (Social Phobia)
Intense fear of social situations where person might be scrutinized or judged
- Fear of public speaking, performing, eating in public
- Fear of embarrassment or humiliation
- Avoids social situations
- Physical symptoms: blushing, sweating, trembling
Agoraphobia
Fear of situations where escape might be difficult or help unavailable if panic symptoms occur
- Fear of open spaces, crowds, public transportation
- Fear of leaving home
- Often accompanies panic disorder
- Person requires companion to go out or stays home
Obsessive-Compulsive and Related Disorders
Hoarding disorder
Persistent difficulty discarding possessions, because of a perceived need to save them and distress about parting with them, can lead to clutter that substantially compromises living spaces and functioning. This differs from an organized collection. It is in the obsessive-compulsive and related family, but is not simply another name for OCD.
Obsessive-Compulsive Disorder (OCD)
OCD involves obsessions, compulsions or both that are time-consuming (often over one hour a day) or cause clinically significant distress or impairment. Insight varies; unwanted intrusive thoughts do not mean a person intends to act on them.
Obsessions
Recurrent, intrusive thoughts, urges, or images that cause anxiety or distress. Person tries to ignore or suppress them.
- Contamination concerns (germs, dirt, illness)
- Need for symmetry or exactness
- Aggressive or horrific thoughts (harming loved ones)
- Sexual or religious obsessions
- Fear of losing things or forgetting
Compulsions
Repetitive behaviors or mental acts performed in response to obsessions to reduce anxiety or prevent dreaded event. Excessive and not realistically connected to outcome.
- Excessive hand washing, cleaning, showering
- Checking (locks, appliances, switches)
- Counting, repeating actions
- Ordering, arranging in precise way
- Mental rituals (praying, counting, repeating words)
Example: Person obsessed with contamination washes hands 50+ times daily until skin bleeds. Knows it's excessive but can't stop. Or checks door lock 20 times before leaving, driven by intrusive thought "house will be robbed if not locked perfectly."
Mood Disorders (Depressive and Bipolar Disorders)
Persistent depressive disorder (PDD)
PDD involves a chronic depressive pattern, typically depressed mood for much of the day on more days than not over at least two years in adults (one year in children and adolescents), with associated symptoms and impairment. Chronicity is a key distinction; it does not imply every case is mild.
Major Depressive Disorder (MDD)
Presence of depressed mood or loss of interest/pleasure for at least 2 weeks, plus additional symptoms. Significantly impairs functioning.
Core Symptoms (Need 5+, including at least one core):
- Depressed mood: Sad, empty, hopeless most of the day, nearly every day
- Anhedonia: Loss of interest or pleasure in activities once enjoyed
- Weight/appetite changes: Significant weight loss/gain or change in appetite
- Sleep disturbances: Insomnia or hypersomnia (sleeping too much)
- Psychomotor changes: Agitation or retardation (slowed movements/speech)
- Fatigue: Loss of energy nearly every day
- Worthlessness/guilt: Feelings of worthlessness or excessive guilt
- Concentration problems: Difficulty thinking, concentrating, making decisions
- Suicidal ideation: Recurrent thoughts of death or suicide
Important Notes:
- NOT just sadness — clinical depression is more severe and persistent
- Grief and depression can overlap; bereavement does not automatically exclude major depression, and sadness after loss is not by itself a disorder.
- Can include severe cases with psychotic features (hallucinations, delusions)
- More common in women than men
Bipolar Disorder
Bipolar disorders involve manic or hypomanic episodes, with depressive episodes in many cases. Episodes are sustained changes in mood and energy, not simply everyday mood swings or a required alternating sequence.
Manic Episode
A manic episode involves elevated, expansive or irritable mood and increased energy/activity, typically at least one week, or any duration if hospitalization is necessary. Severity, associated symptoms and exclusions also matter.
- Inflated self-esteem or grandiosity: Unrealistic belief in one's abilities
- Decreased need for sleep: Feel rested after 3 hours
- More talkative: Pressured speech, hard to interrupt
- Flight of ideas: Racing thoughts
- Distractibility: Attention easily drawn to irrelevant stimuli
- Increased goal-directed activity: Excessive involvement in activities
- Excessive risky behaviors: Spending sprees, sexual indiscretions, reckless driving
Hypomanic Episode
Similar to manic but less severe. Lasts at least 4 days. Noticeable change in functioning but not severe impairment. No psychotic features. Person may feel productive and good.
Types of Bipolar Disorder:
- Bipolar I: At least one manic episode (may or may not have depressive episodes)
- Bipolar II: At least one hypomanic episode AND one major depressive episode (no full manic episodes)
Illustration: A manic episode may involve markedly reduced need for sleep, grandiosity, increased activity and risky spending. A depressive episode may occur at another time, but a compulsory “crash” or regular alternation is not part of the definition.
Schizophrenia Spectrum Disorders
Schizophrenia
Schizophrenia is a severe disorder characterized by disturbances in thought, perception, emotion, and behavior. Lasts at least 6 months with active symptoms for at least 1 month.
Positive vs. Negative Symptoms
Know the difference between positive symptoms (excess/distortion of normal functions) and negative symptoms (absence/reduction of normal functions). Frequently tested!
Positive Symptoms (Presence of Abnormal Behaviors)
"Adding" something that shouldn't be there — excesses or distortions
Hallucinations
False sensory experiences — seeing, hearing, feeling, smelling, or tasting things that aren't there. Auditory hallucinations (hearing voices) most common.
Delusions
False beliefs maintained despite contradictory evidence. Types:
- Persecutory: Belief others are plotting against you
- Grandiose: Inflated belief in one's power, importance, identity
- Reference: Believing TV, radio, internet are sending you special messages
- Control: Belief that thoughts/actions are controlled by external forces
Disorganized Speech
Incoherent, illogical speech patterns. Word salad (jumbled words), loose associations (jumping between unrelated topics), clang associations (rhyming without meaning).
Disorganized or Catatonic Behavior
Unpredictable agitation, inappropriate behaviors, catatonia (reduced reactivity, rigid posture, lack of response).
Negative Symptoms (Absence of Normal Behaviors)
"Subtracting" something that should be there — reduction or absence of normal functions
- Flat affect: Reduced emotional expression, monotone voice, expressionless face
- Avolition: Lack of motivation to initiate or sustain purposeful activities
- Alogia: Poverty of speech — brief, empty replies
- Anhedonia: Inability to experience pleasure
- Social withdrawal: Lack of interest in social interactions
Important Facts:
- Onset typically late adolescence/early adulthood
- Prevalence estimates vary with the definition, population and observation period; a single approximate number is not a diagnostic criterion.
- Strong genetic component
- Biological research implicates interacting genetic and brain processes, including dopamine signaling; no single scan or chemical imbalance explains all cases.
- Antipsychotics often reduce positive symptoms; effects on negative symptoms and functioning vary
Dissociative Disorders
Overview
Dissociative disorders involve disruptions in consciousness, memory, identity, or perception. Often linked to trauma as a psychological defense mechanism.
Dissociative Identity Disorder (DID)
Dissociative identity disorder involves identity disruption with distinct identity states and recurrent memory gaps beyond ordinary forgetting. “Multiple personality disorder” is an older name; DID is different from schizophrenia.
Key Features:
- Two or more distinct identities or personality states (alters)
- Each identity has own pattern of perceiving, relating, thinking
- Gaps in memory for everyday events, personal information, traumatic events
- Identities may have different names, ages, genders, behaviors
- Switching between identities
- Often associated with severe childhood trauma/abuse
DID is recognized in diagnostic systems. Its assessment and explanatory models require care: consider memory gaps, impairment, cultural context and alternative explanations. A diagnosis or an isolated symptom does not independently verify a specific traumatic memory.
Dissociative Amnesia
Inability to recall important personal information, usually traumatic or stressful. Too extensive to be ordinary forgetfulness.
Types:
- Localized: Can't remember specific event or period (e.g., car accident)
- With dissociative fugue: Sudden travel away from home, confusion about identity, may assume new identity
Trauma- and Stressor-Related Disorders
Posttraumatic stress disorder (PTSD)
After exposure to a qualifying traumatic event, PTSD can include intrusive memories or nightmares, avoidance, negative changes in thoughts and mood, and altered arousal such as hypervigilance. Symptoms persist for more than one month and cause distress or impairment. Most people exposed to trauma do not develop PTSD; risk and resilience reflect multiple influences.
Compare intrusion and avoidance after trauma with unexpected panic attacks or repetitive OCD rituals. These categories can co-occur, but they are not interchangeable.
Personality Disorders
Personality disorder clusters
- Cluster A: Paranoid (pervasive distrust), schizoid (detachment and restricted expression) and schizotypal (social difficulties with eccentric behavior and unusual beliefs or perceptions).
- Cluster B: Antisocial and borderline, detailed below, plus histrionic (pervasive excessive emotionality and attention-seeking) and narcissistic (grandiosity, need for admiration and difficulties with empathy).
- Cluster C: Avoidant (social inhibition and rejection sensitivity), dependent (excessive need for care and difficulty acting independently) and obsessive-compulsive personality disorder (perfectionism, order and control at the expense of flexibility).
These are abbreviated study distinctions, not personality insults or diagnoses. OCPD is different from OCD; a preference for neatness or an isolated behavior does not meet the criteria.
Overview
Personality disorders are enduring patterns of inner experience and behavior that deviate from cultural expectations, are inflexible, begin in adolescence/early adulthood, are stable over time, and lead to distress or impairment.
Antisocial Personality Disorder (ASPD)
Antisocial personality disorder involves a pervasive pattern of disregard for others’ rights since age 15. Diagnosis requires age 18 or older and evidence of conduct disorder before 15; one inconsiderate or unlawful act is insufficient.
Key Features:
- Failure to conform to social norms, repeated lawbreaking
- Deceitfulness, lying, conning others
- Impulsivity, failure to plan ahead
- Irritability and aggressiveness, repeated fights/assaults
- Reckless disregard for safety of self or others
- Consistent irresponsibility (work, financial obligations)
- Lack of remorse — indifferent to or rationalizes hurting others
- Often charming and manipulative
- Evidence of conduct disorder before age 15
Borderline Personality Disorder (BPD)
Pattern of instability in relationships, self-image, emotions, and marked impulsivity.
Key Features:
- Frantic efforts to avoid real or imagined abandonment
- Unstable, intense relationships (alternating idealization and devaluation)
- Identity disturbance — unstable self-image
- Impulsivity in potentially damaging areas (spending, sex, substance use, reckless driving, binge eating)
- Recurrent suicidal behavior, gestures, threats, or self-harm
- Emotional instability — intense episodes of sadness, anxiety, irritability
- Chronic feelings of emptiness
- Inappropriate intense anger or difficulty controlling anger
- Stress-related paranoid thoughts or dissociation
Eating Disorders
Anorexia Nervosa
Restriction of food intake leading to significantly low body weight, intense fear of gaining weight, and distorted body image.
Key Features:
- Restriction of energy intake leading to significantly low body weight
- Intense fear of gaining weight or becoming fat, even though underweight
- Disturbance in body image — sees self as fat despite being thin
- Denial of seriousness of low body weight
- Types: Restricting (diet/exercise) or Binge-Eating/Purging
- More common in females
- Anorexia nervosa can carry serious medical risks and elevated mortality; avoid ranking all mental disorders without a defined population, period and measure.
Bulimia Nervosa
Recurrent episodes of binge eating followed by compensatory behaviors to prevent weight gain.
Key Features:
- Binge eating: Eating large amount in discrete period, sense of lack of control
- Compensatory behaviors: Self-induced vomiting, laxatives, fasting, excessive exercise
- Occurs at least once per week for 3 months
- Self-evaluation unduly influenced by body shape and weight
- Bulimia can occur at different body sizes. Weight or appearance alone cannot establish or rule out an eating disorder.
- Feelings of shame, guilt, disgust after binging
Binge Eating Disorder
Recurrent binge eating WITHOUT compensatory behaviors (no purging).
Key Features:
- Recurrent binge eating episodes (at least once/week for 3 months)
- Eating much more rapidly than normal
- Eating until uncomfortably full
- Eating large amounts when not physically hungry
- Eating alone due to embarrassment
- Feeling disgusted, depressed, or guilty after
- NO regular compensatory behaviors (no purging)
- Binge eating disorder can occur across body sizes; body size alone does not identify a person’s eating behavior or diagnosis.
Neurodevelopmental Disorders
Development and context: ADHD assessment considers symptoms lasting at least six months, several symptoms before age 12, impairment and symptoms in more than one setting. Autism involves social-communication differences and restricted/repetitive patterns with varied support needs. Neither diagnosis follows from one behavior, and autism does not imply an absence of empathy or ability.
Attention-Deficit/Hyperactivity Disorder (ADHD)
Persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development. Begins in childhood.
Inattention Symptoms:
- Fails to give close attention to details, makes careless mistakes
- Difficulty sustaining attention in tasks
- Doesn't seem to listen when spoken to directly
- Doesn't follow through on instructions, fails to finish tasks
- Difficulty organizing tasks and activities
- Avoids tasks requiring sustained mental effort
- Loses things necessary for tasks
- Easily distracted by extraneous stimuli
- Forgetful in daily activities
Hyperactivity-Impulsivity Symptoms:
- Fidgets, taps hands/feet, squirms
- Leaves seat when expected to remain seated
- Runs/climbs inappropriately (or restlessness in adults)
- Unable to engage quietly in leisure activities
- Always "on the go," acts as if "driven by a motor"
- Talks excessively
- Blurts out answers before questions completed
- Difficulty waiting turn
- Interrupts or intrudes on others
Three Presentations:
- Predominantly inattentive
- Predominantly hyperactive-impulsive
- Combined presentation (both)
Autism Spectrum Disorder (ASD)
Persistent deficits in social communication and interaction, plus restricted, repetitive patterns of behavior. Present from early childhood.
Social Communication Deficits:
- Deficits in social-emotional reciprocity (back-and-forth conversation, sharing emotions)
- Deficits in nonverbal communication (eye contact, body language, facial expressions)
- Deficits in developing and maintaining relationships
- Difficulty understanding social cues
Restricted, Repetitive Patterns:
- Stereotyped or repetitive motor movements, speech (echolalia — repeating words)
- Insistence on sameness, inflexible adherence to routines
- Highly restricted, fixated interests
- Hyper- or hypo-reactivity to sensory input (bothered by textures, sounds)
- Wide range of severity (spectrum)
AP Exam Strategy
Multiple Choice Tips
- Know KEY symptoms, not just names: Recognize disorders from symptom descriptions
- Distinguish similar disorders: GAD vs. panic disorder, major depression vs. bipolar, anorexia vs. bulimia
- Master positive vs. negative symptoms: Schizophrenia — positive (hallucinations, delusions) vs. negative (flat affect, avolition)
- Know duration criteria: Major depression (2+ weeks), GAD (6+ months), schizophrenia (6+ months)
- Understand OCD structure: Obsessions (intrusive thoughts) + compulsions (repetitive behaviors)
- Recognize bipolar distinctions: bipolar I requires mania; bipolar II requires hypomania and major depression with no manic episode. Alternation is not mandatory.
- Know eating-disorder distinctions: restriction with significantly low weight in anorexia; binge eating with recurrent compensation in bulimia; binge eating without regular compensation in binge eating disorder. Appearance alone is insufficient.
Free Response Question (FRQ) Tips
- Apply concepts to exam scenarios: identify the best-supported category from the provided evidence and distinguish it from alternatives; brief classroom cases cannot establish a real clinical diagnosis.
- List specific symptoms: Don't just say "depression" — name symptoms (anhedonia, fatigue, worthlessness)
- Explain positive vs. negative: For schizophrenia, categorize symptoms correctly and explain difference
- Compare disorders: Show understanding of similarities and key differences
- Use proper terminology: "Obsessions" not "worries," "delusions" not "false ideas"
- Connect symptoms to impairment: Explain how symptoms interfere with functioning
- Know comorbidity: Disorders often co-occur (panic disorder with agoraphobia)
Quick Review Summary
The Big Picture
Anxiety disorders include GAD, panic disorder and phobias. OCD and hoarding belong to a separate related-disorders family; PTSD is trauma-related. Depression and bipolar disorders differ in episode patterns, especially mania or hypomania. Schizophrenia involves psychotic and other symptoms; “positive” means added experiences and “negative” means reduced functions, not good versus bad. Dissociative disorders concern disruptions in memory or identity. Personality, eating and neurodevelopmental disorders have distinct patterns and assessment requirements. Use symptom, duration and impairment evidence; appearance or a short checklist cannot establish a diagnosis.
Essential Disorders to Know
- Generalized Anxiety Disorder
- Panic Disorder
- Phobias (Specific, Social, Agoraphobia)
- Obsessive-Compulsive Disorder
- Major Depressive Disorder
- Bipolar Disorder
- Schizophrenia
- Positive symptoms
- Negative symptoms
- Dissociative Identity Disorder
- Dissociative Amnesia
- Antisocial Personality Disorder
- Borderline Personality Disorder
- Anorexia Nervosa
- Bulimia Nervosa
- Binge Eating Disorder
- ADHD
- Autism Spectrum Disorder
Quick FAQs
Is OCD an anxiety disorder in DSM-5-TR?
OCD is in the obsessive-compulsive and related disorders family. Anxiety may be prominent, but the diagnostic family is distinct.
Does bipolar I require a major depressive episode?
No. A manic episode is required; depressive episodes may occur but are not necessary for bipolar I. Bipolar II requires hypomania and major depression without a manic episode.