PSYC1002B-Psychological Disorders

Q: What did early societies believe caused mental illness?

• Unusual behaviour was believed to come from spirit possession or demonic influence.

• Disorders like psychosis, delirium, convulsions, epilepsy, dementia, Tourette’s syndrome, paranoia, trance, and fugue states were seen as evidence of spiritual disturbance.

• Treatments were religious or ritualistic, not medical — people underwent exorcisms or trephining to “release” spirits.

Q: What is Trephining (or Trepanation)?

• An ancient practice of drilling a hole into the skull to let out “evil spirits.”

• Thought to cure seizures, headaches, or mental illness by giving demons a way to escape.

• Archaeological evidence shows this was practiced for thousands of years.

• “Trephination kits” were actual surgical tools used in these procedures.

Q: What are the Four Humours and what did they represent?

• Theory proposed by Hippocrates and Galen.

• Claimed the body contained four fluids whose balance determined health, emotion, and personality:

  1. Blood (Sanguine)

  2. Phlegm (Phlegmatic)

  3. Yellow Bile (Choleric)

  4. Black Bile (Melancholic)

• An imbalance in any fluid caused both disease and mental disorder.

Q: What happens when someone has too much Blood (sanguine temperament)?

• Personality: arrogant, indulgent, narcissistic, outgoing.

• Element & Season: Air / Spring.

• Colour & Symbol: Red – Aang.

• Associated with excessive optimism or pleasure-seeking

Q: What happens when someone has too much Phlegm (phlegmatic temperament)?

• Personality: calm, unemotional, peaceful, slow to anger.

• Element & Season: Water / Winter.

• Colour & Symbol: White – Katara.

• Thought to make people lazy or apathetic if extreme.

Q: What happens when someone has too much Yellow Bile (choleric temperament)?

• Personality: ambitious, fiery, energetic, hot-tempered.

• Element & Season: Fire / Summer.

• Colour & Symbol: Gold – Zuko.

• Often linked to leadership and anger issues.

Q: What happens when someone has too much Black Bile (melancholic temperament)?

• Personality: thoughtful, reflective, creative, but prone to sadness or depression.

• Element & Season: Earth / Autumn.

• Colour & Symbol: Brown – Toph.

• Seen as the root of melancholy and dysthymia.

Q: How did prehistoric people interpret mental illness?

• Attributed abnormal behaviour to spirit possession.

• Used shamanic rituals or trephining to drive spirits out.

Q: What was Demonic Possession and how was it treated?

• The belief that demons caused mental illness.

• Treatments included prayer, exorcisms, and torture.

Q: What was the Inquisition’s role in mental health history?

• The Holy Inquisition (13th century onward) targeted those accused of heresy or witchcraft.

• Many individuals showing symptoms of mental illness were executed or tortured.

• Malleus Maleficarum (“The Witch’s Hammer”) served as a manual for identifying witches.

Q: What were the Salem Witch Trials and what caused them?

• 1692 event in Massachusetts where young women accused others of witchcraft.

• Historians now suggest ergot poisoning (a fungus causing hallucinations) and mass hysteria played a role.

Q: What is Religious Glossolalia (“speaking in tongues”)?

• The act of speaking in unintelligible languages believed to be inspired by God.

• Often interpreted as divine communication but can also be understood as a form of altered consciousness.

Q: What is Phrenology and who developed it?

• Created by Franz Joseph Gall (18th century).

• Claimed that bumps and shapes of the skull revealed personality traits and mental abilities.

• Example of early pseudoscience linking physical form to behaviour.

• Influenced the idea of brain localization but eventually discredited.

Q: What were early Insane Asylums like?

• Built to isolate those considered “mad.”

• Example: St Mary of Bethlehem Hospital (“Bedlam”).

• Conditions were inhumane — patients were chained, neglected, and viewed by the public for entertainment.

Q: Who was Franz Anton Mesmer and what did he propose?

• An Austrian physician who believed in a universal “magnetic fluid.”

• Developed Mesmerism — using magnets and gestures to “rebalance” energy fields.

• Patients often felt better due to psychological suggestion, not magnetism.

• Gave us the term “mesmerized.”

Q: Who coined the term Hypnosis and what does it mean?

• James Braid (1843) coined “hypnosis.”

• Described it as a “nervous sleep,” an altered yet focused state of consciousness.

• Differs from sleep — the person is still responsive and can access unconscious material.

Q: How did Freud use and interpret hypnosis?

• Freud called it the “royal road to the unconscious.”

• Used it to reveal hidden conflicts and repressed memories.

• Later replaced hypnosis with free association and dream analysis.

• Represented by the iceberg model — only a small part of the mind (conscious) is visible.

Q: What criteria define abnormal behaviour?

1. Deviant: Breaks societal norms.

2. Maladaptive: Interferes with daily functioning (e.g., addiction, obsession).

3. Dangerous: Poses risk to self or others.

• Any combination can signal psychological disorder.

Q: What is the Medical (Biological) Model?

• Views mental disorders as illnesses of the body or brain.

• Caused by neurotransmitter imbalances, hormonal changes, genetic factors, or brain damage.

• Supports biological treatments like medication or surgery

Q: What is the Psychological Model?

• Focuses on internal conflicts and learned behaviours.

• Includes:

  • Psychoanalytic (Freud): unconscious conflicts.

  • Cognitive/Behavioural: distorted thinking and maladaptive learning (e.g., seeing harmless situations as threatening).

Q: What is the Humanistic Model?

• Emphasizes personal growth, free will, and self-actualization.

• Disorders arise when there is a gap between real self and ideal self.

Q: What is the Socio-Cultural Model?

• Explains disorders through social and cultural context.

• Notes that some disorders are culture-bound (e.g., eating disorders in Western cultures).

• Highlights the impact of poverty, discrimination, and cultural norms.

Q: What is the Interactionist Perspective?

• Integrates biological, psychological, and sociocultural factors.

• Recognizes that mental health results from their combined influence rather than a single cause.

Q: What is the DSM and who publishes it?

• Manual published by the American Psychiatric Association (APA).

• Provides official diagnostic criteria for mental disorders.

• Used by clinicians to diagnose and treat patients consistently

Q: What are Axis I disorders?

• Disorders first diagnosed in infancy, childhood, or adolescence, or those that are clinical in nature.

• Includes:

  • Substance-related disorders

  • Schizophrenia & other psychotic disorders

  • Mood disorders (e.g., major depression, SAD)

  • Anxiety disorders

  • Somatoform & Dissociative disorders

  • Sexual & Eating disorders

  • Sleep and Impulse-control disorders

Q: What is Major Depressive Disorder?

• Persistent sadness, loss of interest, fatigue, feelings of worthlessness.

• Biological and environmental roots.

• Seasonal Affective Disorder (SAD): follows a seasonal pattern, often winter, due to reduced sunlight.

• Postpartum Depression: appears after childbirth; more common among immigrant women because of relocation stress and low social support.

Q: What are Anxiety Disorders?

• Disorders marked by excessive fear, worry, or tension.

• Linked with early-life stress, genetics, and learned responses.

• Examples: GAD, Panic Disorder, Phobias, PTSD, OCD.

Q: What is Schizophrenia?

• A major psychotic disorder characterized by a split from reality.

• Core features:

  • Hallucinations: sensory experiences without external stimulus.

  • Delusions: fixed false beliefs, e.g., persecution or grandeur.

  • Thought disorder: disorganized or incoherent speech.

  • Persecutory ideation: intense paranoia.

  • Perseveration: repetition of words or ideas.

  • Withdrawal and loss of contact with reality.

Q: What are the subtypes of Schizophrenia?

• Paranoid: dominated by delusions of persecution and grandeur.

• Catatonic: marked by motor disturbances (e.g., immobility, rigid posture).

• Undifferentiated: mixture of various symptoms not fitting one category.

Q: What is Dissociative Identity Disorder (DID)?

• Formerly “Multiple Personality Disorder.”

• Presence of two or more distinct identities, each with unique traits and memories.

• Includes amnesia for everyday events or trauma.

• Causes distress or impaired functioning.

• Not part of cultural or religious practice and not caused by substances or medical conditions.

• Often mistaken for Schizophrenia but involves identity splitting, not hallucination.

Q: What ae Personality Disorders?

• Enduring patterns of thinking and behaving that deviate from cultural expectations.

• Cause distress or impair relationships and work.

• Grouped into Clusters A, B, and C.

Q: What is Paranoid Personality Disorder?

• Chronic distrust and suspicion of others.

• Similar to the paranoid subtype of schizophrenia but without psychosis.

Q: What is Schizoid Personality Disorder?

• Extreme detachment and lack of interest in social relationships.

• Emotionally cold and isolated.

Q: What is Schizotypal Personality Disorder?

• Odd behaviours and beliefs (e.g., magical thinking, telepathy).

• Discomfort in close relationships; precursor traits to schizophrenia.

Q: What is Antisocial Personality Disorder (ASPD)?

• Pervasive pattern of disregard for others’ rights, often beginning in childhood.

• Traits: impulsive, callous, manipulative, aggressive, irresponsible.

• Lack of remorse; may be charming but deceptive.

• More common in men.

• Must be 18 + and have a history of conduct disorder before age 15.

Q: What are the DSM criteria for Antisocial Personality Disorder?

Pattern of disregard for others since age 15 (as shown by 3 + traits):
 • Repeated illegal acts
 • Deceitfulness or use of aliases
 • Impulsivity / poor planning
 • Irritability and aggression
 • Reckless disregard for safety
 • Irresponsibility at work / finances
 • Lack of remorse for harm done
B) Individual ≥ 18 years.
C) Evidence of Conduct Disorder before 15.
D) Not exclusively during Schizophrenia or Mania.

Q: What is Borderline Personality Disorder?

• Instability in self-image, emotions, and relationships.

• Intense fear of abandonment.

• Rapid switching between idealizing and devaluing others.

• Impulsive behaviour and self-harm risk common.

Q: What is Histrionic Personality Disorder?

• Excessive emotionality and attention-seeking.

• May use drama or appearance to gain approval.

Q: What is Narcissistic Personality Disorder?

• Grandiose self-importance and need for admiration.

• Feels entitled to special treatment.

• Lacks empathy and often exploits others.

• Manifests in arrogant expectations of privilege.

What is Avoidant Personality Disorder?

• Social inhibition and feelings of inadequacy.

• Avoids interaction for fear of criticism.

Q: What is Dependent Personality Disorder?

• Excessive need to be cared for.

• Submissive, clingy, and fearful of separation.

Q: What is Obsessive-Compulsive Personality Disorder (OCPD)?

• Preoccupation with orderliness, perfectionism, and control.

• Different from OCD because it lacks true obsessions or compulsions.

Q: What is Magical Thinking?

• Belief that unrelated events are causally connected without real basis.

• Examples:
   • “Clapping makes the traffic light change.”
   • “Stepping on a crack brings bad luck.”
   • “Killing a spider will make it rain.”

• Appears in OCD and Schizotypal Personality Disorder.

Q: What is Obsessive-Compulsive Disorder (OCD)?

• Obsessions: unwanted, intrusive thoughts.

• Compulsions: repetitive rituals to reduce anxiety.

• Themes: contamination, harm, failure, or sin.

• Example: Howie Mandel’s germ phobia and cleaning rituals.

Q: What is Hoarding Disorder?

• Persistent difficulty discarding items regardless of value.

• Leads to clutter and safety hazards.

• Severity tends to increase with age.

Q: What is Tardive Dyskinesia?

• Neurological damage from long-term antipsychotic use.

• Symptoms: repetitive involuntary movements (e.g., tongue, limbs, face).

• Can be permanent.

• Treated with Cogentin (benztropine), an anti-Parkinson drug.

Q: What is Von Münchhausen Syndrome?

• A factitious disorder where a person fakes or induces illness for attention or sympathy.

• No external reward other than emotional gratification.

Q: What is Malingering?

• Faking illness or symptoms for personal gain, such as money or avoiding work / punishment.

• Different from factitious disorders because motivation is external (secondary gain).

Q: What is Suicidal Ideation?

• Thinking about, planning, or imagining suicide.

• May or may not include intent to act.

Q: How can clinicians distinguish genuine vs. malingered suicidal intent?

• Genuine intent: consistent planning, expressed hopelessness, withdrawal.

• Malingered intent: attention-seeking or for gain (e.g., avoiding responsibility).

Q: What is Self-Mutilation?

• Intentional self-injury not meant to cause death.

• Functions as emotional release or control mechanism.

Q: Who was Sybil and why is her case important?

• Sybil was a woman diagnosed with 16 personalities in the 1970s.

• Made DID famous through the book and film.

• Hypnosis was used to reveal alters — later criticized for possible suggestion effects.

Q: What is The Three Faces of Eve about?

• 1957 case of a woman with three distinct personalities.

• Used as an early clinical example of DID in psychology education.

Q: Who was Ken Bianchi and why is his case controversial?

• One of the “Hillside Stranglers” (1970s Los Angeles serial killers).

• Claimed to have multiple personalities to avoid conviction.

• Psychologists debated whether his DID was faked for legal gain.

Q: Who was Billy Milligan and what happened to him?

• Subject of The Minds of Billy Milligan (Daniel Keyes).

• Diagnosed with 24 personalities after being charged with rape and robbery at Ohio State University.

• Found Not Guilty by Reason of Insanity (NGRI) and hospitalized at Athens Mental Health Center in Ohio.

• Case sparked debate about the validity of DID in court.