Introduction to Psychopathology; Theories and Etiology

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Abnormal behaviour is characterized by the 4 D’s which is what, and the 2 other characteristics.

deviance, distress, dysfunction, and danger, statistical infrequency and diagnosis by an expert

Deviance

behaviours that violate the social norms however, it by itself doesn’t mean you have a mental disorder. (ex. lack of empathy, sexual perihelia)

Distress

Psychological suffering or discomfort that causes significant emotional pain or impairment in daily functioning. However, it by itself does not mean you have a mental disorder or not everyone who has a mental disorder is distressed.

Dysfunction

impairment in daily functioning that affects one's ability to perform normal activities or meet everyday demands. Alone, it does not indicate a mental disorder but is the better criteria for mental disorders.

Danger

the risk of harm to oneself or others, which may be associated with certain mental disorders. However, not all individuals with mental disorders are dangerous. Additionally, doing dangerous (adventurous) stuff doesn’t mean you have a disorder.

Statistical infrequency

A criterion for identifying abnormal behavior based on how rare or uncommon a behavior is within a population. Behaviors that are statistically infrequent may not necessarily indicate a mental disorder.

Diagnosis by an expert

the process of identifying a mental disorder based on clinical evaluation, patient history, and standardized criteria, typically conducted by a trained mental health professional.

DSM-5 Definition of Mental Disorders

A mental disorder is a syndrome characterized by clinically significant disturbance in an individual’s cognition, emotion regulation, or behaviour that reflects a dysfunction in the psychological, biological, or developmental process underlying mental functioning.

Exclusion criteria for definition of mental disorders

1. Expectable and culturally appropriate response to a particular event (such as the death of a loved one)

2. Deviant behaviour (such as political disagreement, religious or sexual minorities)

3. Conflict between the individual and society (Such as voluntary effort to express individuality)

What is psychopathology?

The study of abnormal behaviour or psychological processes that underscore mental disabilities & abnormal behaviourand their impact on individuals and society.

_ in _ Canadians experiences a mental disorder or addiction

1 in 5

By the time Canadians reach 40 years old, _____% have or have had a mental disorder

50%

70% of mental health problems have their onset during

childhood or adolescence

What age range is more likely to experience mental and/or substance use disorders than any other age group?

Young people aged 15 to 24

56% of highschool students report mild or serious mental disorders because of?

puberty/hormones and other social aspects

Men have higher rates of _______ than women while women have higher rates of __________ disorders

addiction; mood & anxiety

T or F: Canadians in the lowest income group are 3 to 4 times more likely than those in the highest income group to report poor to fair mental health

True. Low socioeconomic status as well as lower education is strongly tied to poor mental health

How much do mental disorders cut from a person’s life expactancy

10 to 20 years

Suicide affects people of all ages and backgrounds. Over how many Canadians per year die by suicide?

4500 — that’s about 12 suicides per day

Leading cause of disability in Canada

Mental disorders

At least _______ employed Canadians are unable to work due to mental health problems

500,000

The presence of more than one condition during the same period of time

Comorbidity in mental health

What are epidemiologists now looking at with mental disorders?

Looking at the functional impairment associated with mental disorders rather than at the absolute number of people who have these problems.

The extent of functional impairment and loss associated with a health problem

Disease burden

Disability-Adjusted Life Years (DALYs)

A measure of disease burden by combining mortality (premature death) and disability (lost years of healthy life/living with disability)

One DALY equals what

One lost year of healthy life

T or F: The economic cost of mental disorders is comparable to physical diseases.

True, with significant impacts on healthcare systems and economies.

Mental disorders account for _____ % of disabilities in developed countries.

47% even if they only account for 1% of all deaths

The total cost of mental illness in Canada and why is the bulk of cost this much?

Estimated at $51 billion; The bulk of costs are related to production losses — reducing the # of workers available (More Canadians could’ve worked had it not been of mental disorders)

Effect of the first year of the Covid-19 pandemic on mental health

Canadians experiencing high to extremely high depression doubled and anxiety quadrupled. Rates of substance abuse and abuse went up significantly.

T or F: Access to mental health care in Canada isn’t difficult and costly

False; Access to mental health care remains difficult, somewhat disorganized and sometimes costly

Understanding the causes of mental disorders require what

A theoretical perspective

5 different theories for explaining the causes of mental disorders

1. Classical and current psychodynamic paradigm

2. Cognitive behavioural paradigm

3. Humanistic paradigm

4. Systems theory / biopsychosocial theory

5. Biological paradigm (Biological factors)

Freud’s model of the mind is divided in what 3 personality structures

Id, Ego, and Superego

Personality structure governed by the pleasure principle

Id - impulses and desires

Personality structure governed by the reality principle

Ego - reality and logic

Personality structure governed by the moral principle

Superego - morality and guilt

The theoretical model in explaining mental disorders believed that human behaviour and personality are driven by unconscious forces, childhood experiences, and biological urges (libido).

Psychodynamic theory

The theoretical model in explaining mental disorders focused on conditioning/learned behaviours and thought patterns

Cognitive-behavioral theory

Based on the psychodynamic paradigm, mental disorders are caused by

Fixation at a stage (due to trauma) or inability to use defense mechanisms properly leading to mental illness.

Defense mechanisms

Unconscious processes that serve to protect the ego but overuse can lead to problems

The full development of personality structures (id, ego, superego) happens how

Resolution of the Oedipus complex with children identifying with the same-sex parent and taking on their behaviours and values.

What is libido according to Freud

Libido, according to Freud, is the psychic energy associated with the sexual drive, which plays a crucial role in human motivation and personality development.

What does not constitute a mental disorder?

1. Normal responses to life events (ex. grieving after a death)

2. Deviant behaviour (ex. being LGBTQ+, political activism)

3. Personal conflicts with society (ex. challenging cultural norms)
   
   A mental disorder must cause significant suffering or dysfunction

Where does “normal” end and “abnormal” begin

The distinction between normal and abnormal behavior is often determined by the context, cultural norms, time period, and the degree of dysfunction or distress it causes to the individual.

What happens when a child gets stuck on one Psychosexual Stage of Development?

May develop personality problems later in life (ex., Fixation in the oral stage (not weaned properly) →, may lead to smoking, nail-biting, or overeating as an adult.)

When does the Oedipus Complex occur?

During the Phallic Stage where the child’s libido is focused on their genitals

Unconscious psychological strategies we use to protect ourselves from anxiety.

Defense mechanisms. Freud believed that when people face anxiety from conflicts (like the Oedipus Complex), they use defense mechanisms to cope.

Freud believed mental disorders happen when?

Fixation at a psychosexual stage caused by trauma / parental neglect and if someone experiences too much emotional pain, their defense mechanisms break down.

the least sophisticated/adaptive and most unconscious defense mechanism. They often distort reality in extreme ways and are commonly seen in children or adults with personality disorders.

Primitive (immature) defenses

Types of primitive defenses

Denial, regression and projection

A smoker who insists, “I don’t have a health problem,” despite being diagnosed with lung disease. — What kind of defense mechanism is this?

Denial - Primitive defense: The person completely rejects the truth rather than dealing with it.

An adult throws a tantrum when they don’t get their way, or a child starts wetting the bed again after a new sibling is born. — What kind of defense mechanism is this?

Regression - primitive defense: The individual reverts to earlier behaviors typical of a younger age in response to stress or anxiety.

A cheating spouse accuses their partner of being unfaithful. — What kind of defense mechanism is this?

Projection - primitive defense: The person avoids guilt by shifting their emotions onto others.

defenses that are more sophisticated but still distort reality. They are commonly seen in adults under stress or people with anxiety disorders.

Higher-level (neurotic) defense

A person who was abused as a child has no memory of it but struggles with anxiety in adulthood. — What kind of defense mechanism is this?

Repression - Neurotic defense: Unconsciously pushing distressing memories or thoughts into the unconscious.

After being diagnosed with cancer, someone focuses only on treatment options and statistics rather than their feelings. — What kind of defense mechanism is this?

Intellectualization - Neurotic defense: Using logic and facts to avoid and disconnect from emotions emotions instead of processing them.

Someone who is secretly angry at their boss acts overly kind and respectful. — What kind of defense mechanism is this?

Reaction formation - Neurotic defense: Acting in the opposite way of one’s true feelings to reduce anxiety.

A man who is frustrated with his boss yells at his wife instead. — What kind of defense mechanism is this?

Displacement - Neurotic defense: Redirecting emotions from the original source of frustration to a safer target.

the healthiest defense mechanisms because they help people manage emotions effectively without major distortions.

Mature defenses

Types of neurotic defenses

Repression, intellectualization, reaction formation and displacement

Types of mature defenses

Humor, suppression and sublimation

A person who loses their job jokes, “Guess I finally have time for my dream career—professional napper!” — What kind of defense mechanism is this?

Humour - Mature defense: Finding something funny in difficult situations, helps reduce stress without avoiding reality.

A student who is stressed about an upcoming exam decides to focus on relaxing for a short break before studying again. — What kind of defense mechanism is this?

Suppression - mature defense: Consciously choosing to delay thinking about distressing thoughts, acknowledges stress but controls their response.

Someone with aggressive tendencies becomes a boxer or a firefighter instead of acting violently.

Sublimation - mature defense: Channeling negative emotions or impulses into socially acceptable activities, helping to maintain emotional balance.

A modern version of psychodynamic theory built on Freud’s ideas but focuses more on relationships and early experiences with caregivers rather than just unconscious drives like sex and aggression.

Object Relations Theory (Current psychodynamic paradigm)

What is objects relations theory?

The way we relate to other people is shaped by our early childhood relationships, especially with parents. These relationships create mental representations ("objects") that we carry into adulthood.

What is an "object" in Object Relations Theory and how are they created?

An "object" is a mental image or representation of a person (usually a caregiver). These mental images are stored in the unconscious and influence how we interact with others. They are created during childhood with every interaction we have with caregivers internalized as a mental "template" for future relationships. These early experiences shape how we view Ourselves (self-esteem, self-worth), Others (trust, expectations in relationships) and The world (safe vs. dangerous).

two levels of personality organization from a psychodynamic perspective

Neurotic level and Borderline level

Individuals function well in everyday life but have internal conflicts that cause distress. They may struggle with self-criticism, anxiety, or guilt, but they maintain stable relationships, jobs, and reality testing.

Neurotic level personality organization

Individuals have difficulty maintaining a stable identity, relationships, and emotional regulation. Their emotions are intense and unpredictable, and they often see people as either "all good" or "all bad" (splitting).

Borderline level personality organization

believes that all behaviours (even disordered ones) are learned, reinforced, and can be changed.

The cognitive behavioural paradigm

How do we learn behaviours?

Reinforcement and punishment, either direct or vicarious

A type of learning where an involuntary response (emotion, reflex) is linked to a new stimulus and involves the autonomic nervous system (controls emotions, heart rate, fear responses, etc.).

Classical conditioning (Pavlov)

A type of learning where voluntary behaviours are shaped by rewards or punishments and involve the somatic nervous system (voluntary movements & actions).

Operant conditioning (Skinner)

People can learn behaviors simply by watching others, without direct reinforcement or punishment. This is why children imitate parents, teachers, celebrities, and peers.

Social learning theory (Bandura)

All cognitive-behavioral approaches share three core principles which is?

1. Thinking affects emotions and bvehaviours

2. Thoughts can be monitored and changes

   1. By altering one’s thoughts, a person will experience desired behavioural and emotional change

How does the Cognitive-Behavioral Paradigm believe that mental disorders develop

due to distorted thinking patterns and learned behaviors—which can be monitored and changed.

Model that Albert Ellis developed with Rational Emotive Therapy (RET), which states that our beliefs shape our emotional responses, not just life events themselves.

The ABC Model: Activating event, Beliefs in relation to event, Consequences of life events

Theory that states that mental health problems stem from negative thinking patterns (emotions and behaviours are heavily influenced by beliefs and interpretation of events) with 3 main levels of cognition

Cognitive Behavioral Theory (CBT)

Deeply ingrained core beliefs about oneself, others, and the world and are often developed early in life and can be positive or negative.

Schemas (1st level of cognition)

How people interpret and filter information based on their schemas.

Information processing and intermediate beliefs (2nd level of cognition)

Instant, involuntary thoughts that pop into our minds in response to situations.

Automatic thoughts (3rd level of cognition)

Consists in bringing a person’s attention to their automatic thoughts, their information processing errors, and eventually their deeper set schemas and helping them modify those

Cognitive Behavior Therapy (CBT)

Newer approaches to CBT incorporate what to help people

mindfulness and acceptance strategies

This perspective focuses on personal growth, free will, and the search for meaning in life.

Humanistic-existensial paradigm

Humanistic-existential psychology states that humans are naturally driven towards?

self-actualization and personal growth.

According to the Humanistic-Existential approach, mental disorders arise from?

when a person’s ability to grow is blocked—often by external pressures, self-doubt, or trauma.

How is self-fulfilment achieved according to Carl Rogers?

By accepting oneself and trusting one’s experiences so that one can also accept others in genuine relationships

What does Rogers say about how psychological distress happens?

when a person cannot trust their own experiences.

How does mental disorder arise according to Maslow?

Abraham Maslow believed humans have a hierarchy of needs, and mental health improves when these needs are met. If basic needs are unmet, people struggle to reach higher levels of personal growth. Mental disorders may arise from deficiencies in lower needs (e.g., someone without safety may develop chronic anxiety).

Existential theorists believe mental disorders stem from?

Mental disorders (especially anxiety and depression) arise from not confronting inevitable human realities / existential challenges. People who avoid facing these realities may develop symptoms like apathy, avoidance, addiction, or existential dread

A modern extension of humanistic psychology, focused on well-being, strengths, and happiness. Rather than just treating mental illness, it encourages personal fulfillment and flourishing.

Positive psychology

explains mental disorders as the result of interactions between biological, psychological, and social factors. Instead of blaming one single cause, this approach looks at how multiple influences interact over time to shape mental health.

Biopsychosocial model also known as Systems Theory

Looking at mental health as a complex system with multiple causes

Holism

Looking at only one cause (ex., saying depression is caused by only genetics)

Reductionism

A person’s genetic or biological vulnerabilty to mental illness

Diathesis

According to the diathesis-stress model, how does mental illness arise

Mental illness occurs when vulnerability and stress (environmental triggers) combine

“PTSD can be caused by war, abuse or a car accident” is an example of?

Equifinality — Different causes can lead to the same disorder

“Two people who experience childhood neglect, 1 develops depression while the other develops antisocial behaviour” is an example of?

Multifinality — The same cause can lead to different disorders