Understanding Psychological Disorders: The Neuropsychosocial Approach 55
Mental health professionals need to keep in mind, however, cultural factors
that may contribute to what appear to be maladaptive cognitive distortions, but
in fact refl ect appropriate social behavior in a patient’s culture. For instance,
some cultures, such as that of Japan, have a social norm of responding to a
compliment with a self-deprecating statement. It is only through careful evalua-
tion that a clinician can discern whether such self-deprecating behavior refl ects
a patient’s attempt to show good manners or his or her core maladaptive
dysfunctional beliefs about self.
Biases in mental processes and distortions in mental contents affect each
other (see Figure 2.8), and their interactions can make people more vulnerable
to psychopathology. Unfortunately, once someone has a psychological disorder,
these biases and distortions can become self-perpetuating: People see what they
believe they will see. Someone who feels unlovable, for instance, becomes alert
for—and will remember—any hint of rejection, which then confi rms the belief of
being unlovable.
Emotion
Part of being human is to know the ups and downs of emotions—such as joy, ela-
tion, happiness, love, pride, sadness, fear, anger, guilt, relief. When our emotions
are negative—that is, when they make us feel uncomfortable—we often try to make
ourselves feel better. When we are afraid, we try to avoid what’s making us afraid
or calm ourselves down; when we feel guilty, we seek to relieve the guilt. Yet not ev-
eryone experiences the normal range of emotions or is equally effective in regulating
emotions. Many psychological disorders include problems that involve emotions:
not feeling or expressing enough emotions (such as showing no response to a situa-
tion where others would be joyous or sad), having emotions that are inappropriate
or inappropriately excessive for the situation (such as feeling sad to the point of cry-
ing for no apparent reason), or having emotions that are diffi cult to regulate (such
as not being able to overcome a fear of fl ying, even though you know that such fear
is irrational) (American Psychiatric Association, 2000).
But what, specifi cally, are emotions? To psychologists, an emotion is a short-
lived experience evoked by a stimulus that produces a mental response, a typical
behavior, and a positive or negative subjective feeling. The stimulus that initiates
an emotion could be physical: It can be a kiss, the letter F on an essay you get back
from a professor, or the sounds of a tune you listen to on your computer. Alterna-
tively, the stimulus can occur only in the mind, such as remembering a sad occasion
or tune or imagining your perfect mate.
Mental health clinicians and researchers sometimes use the word affect to
refer to an emotion that is associated with a particular idea or behavior, simi-
lar to an attitude.Affect is also used to describe how emotion is expressed, as
when noting that a patient has inappropriate affect—the patient’s expression of
emotion is not appropriate to what he or she is saying or not appropriate to the
situation. An example is a person laughing at a funeral or talking about some-
thing very sad or traumatic while smiling, or, conversely, talking about a happy
event while looking sad or angry. Flat affect is a lack of, or considerably dimin-
ished, emotional expression, such as occurs when someone speaks robotically and
shows little facial expression. People with some psychological disorders, such as
schizophrenia, frequently display inappropriate or fl at affect. Affect that changes
very rapidly—too rapidly—is said to be labile, and it may indicate a psychological
disorder; for instance, some people with depression may quickly shift emotions
from sad to angry or irritable.
In the fi lm Grey Gardens, Little Edie and her mother often displayed inappropri-
ate affect, and Little Edie’s emotions were sometimes labile, rapidly changing from
anger to happy excitement to relative calm. For instance, at one point, Big Edie re-
counts that when Little Edie had moved to New York City, Big Edie wanted Mr. Beale
to return to Grey Gardens. Little Edie immediately started yelling, “You’re making
Emotion
A short-lived experience evoked by a
stimulus that produces a mental response, a
typical behavior, and a positive or negative
subjective feeling.
Affect
An emotion that is associated with a particular
idea or behavior, similar to an attitude.
Inappropriate affect
An expression of emotion that is not
appropriate to what a person is saying
or not appropriate to the situation.
Flat affect
A lack of, or considerably diminished,
emotional expression, such as occurs when
someone speaks robotically and shows little
facial expression.
Some disorders are characterized by inappro-
priate affect—expressions of emotion that are
inappropriate to the situation. This young man
appears to have inappropriate affect.
Girl Ray/Getty Images
2.8 • Biased Mental Processes and
Distorted Mental Contents Biases in
mental processes can infl uence the contents
of people’s thoughts by making certain stimuli
more prominent and easier to call to mind,
which can lead to cognitive distortions. The
reverse is also true: Cognitive distortions can
create a bias in what people pay attention to,
perceive, and remember.
Figure 2.8
28 Bi d M t l P d
g
Biased
Mental Processes
Attention
Perception
Memory
Distorted
Mental Contents
Cognitive
distortions