Involves disruptions in emotional, behavioural, or thought processes that lead to personal distress or that block one’s ability to achieve important goals

Abnormal/Clinical psychology

Area of psychological investigation most directly concerned with understanding the nature of individual pathologies of mind, mood, and behaviour

Etiology of disorders

- Vulnerability Stress/Diathesis Stress Model

o Diathesis (vulnerability) + STRESS = disorder

o Stress (environmental stimulus) triggers psychopathology

o Stressors: loss of job, divorce, death in family, being stuck in traffic

o Neither a diathesis or a stress alone is sufficient to cause disorder

Historical Views

- Psychological theories

o psychological factors like stress caused problems

o Freud revived the theory; able to compete with supernatural and biological approaches

§ Model of unconscious conflicts – id, ego, superego

- Supernatural theories

- Early views linked psychological disorders with evil (demonological view

Resulted in more harmful treatments like exorcism, drinking foul concoctions, witches put to death (mostly women), trephining

- Biological theories

o Ancient Greece: four humors of body – excess black bile leads to depression, excess yellow bile leads to irratibility (blood letting)

Historical Classifications

- View that disorders reflected disease or sickness

o Philippe Pinel & classification of disorders by patterns of symptoms – thought, behaviour, mood

- Classification systems given medical basis

§ Emil Kraepelin

o Made effective drug therapies possible

o Paresis, melancholia, dementia, epilepsy (1880)

Etiology of Disorders

- Etiology

o The factors that cause or contribute to the development of psychological and medical problems

- Biological approaches assume structural abnormalities, biochemical processes, and genetic influences

- Psychological approaches focus on personal experiences, traumas, conflicts, and environmental factors as roots of disorders

o Psychodynamic, behavioural, cognitive, & sociocultural perspectives

Classifying Disorders

- Psychological diagnosis

o A label given to an abnormality by classifying and categorizing the observed behaviour pattern into an approved diagnostic system

- Diagnostic systems should involve …

a) Common shorthand language

b) Understanding of causality

c) Treatment plan

- DSM-IV-TR (2000)

o Diagnostic and Statistical Manual of Mental Disorders

o Classifies, defines, describes over 200 disorders

o First DSM was published in 1952, DSM-V published in 2013

o Divided into axes

o Comorbidity = the co-occurrence of diseases, most common with anxiety, mood disorders, alcohol/drug abuse/dependence

§ Prevalence rates listed in Report on Mental Illness in Canada

§ International Classification of Diseases (ICD-10)

DSM 5 (May, 2013)
Add dimensional assessments – not just presence of symptom, but also severity rating
Removal of multi-axial system
Chapters organized based on similarities in disorders underlying vulnerabilities (but not a one size fits all – ex. pg. 634)
Chapters reorganized and new diagnoses (Hoarding D/O, Skin Picking D/O

Anxiety Disorders

- Anxiety disorders

o Class of disorders that involves anxiety that interferes with ability to function effectively

o Disorders differ in extent that anxiety is experienced, severity of anxiety, and situations that trigger disorders

o 5 major categories of anxiety disorders

o Share emotional (fear - apprehension), physiological (heart racing), cognitive (I to afraid to come to class), and behavioural symptoms (avoidance)

Types of Anxiety Disorders

Generalized Anxiety Disorder

Feelings of anxiety and worry most of the time without specific threats or danger

Must also display physical and cognitive symptoms of impairment

Restless, muscle tension, easily fatigue, concentration issues

Majority of the day for 6 months

Panic Disorder

Experience of unexpected and severe panic attacks that are brief in duration

Include intense psychological and physical symptoms

Palpitations, trembling, sweating, chest pain, choking

1. Phobias

- Suffering from a persistent and irrational fear of a specific object, activity, or situation that is excessive and unreasonable given the reality of the threat

- Social phobias = public situations involving being observed by others

- Specific phobias = related to types of objects or situations

o animal, natural environment, blood-injection-injury, situational , not otherwise specified

- Obsessive-Compulsive Disorder (OCD)

- Obsessions = thoughts, images, impulses that recur despite efforts to suppress them and cause distress

- Compulsions = repetitive and purposeful acts performed according to certain rules or in a ritualized manner in response to an obsession (used to reduce discomfort)

Post-Traumatic Stress Disorder (PTSD)

Disorder characterized by persistent re-experience of traumatic events through distressing recollections, dreams, hallucinations, or flashbacks

Often comorbid with other disorders (e.g., depression, substance abuse)

Causes of Anxiety Disorders

- Biological - evolutionary preparedness, neurotransmitter GABA, neuroimagining

- Psychodynamic - anxiety stems from underlying psychic conflicts or are substitutions for forbidden impulses

- Behavioural - anxiety linked to reinforcement or conditioning, disorder may be maintained by reinforcement contingencies

- Cognitive - focus on perceptual processes, attitudes, interpretations that distort estimates of danger or fear

Mood Disorders - KNOW

- Major Depressive Disorder

o Severity of symptoms differ

o Share emotional, motivational, cognitive, and somatic symptoms

- Bipolar Disorder

- Characterized by periods of severe depression alternating with manic episodes

- Manic episode – involve feelings and actions that are unusually elated, expansive, and often excessive (e.g., decreased need for sleep)

o Also associated with unwarranted optimism and risk-taking

o Goals are blocked or thwarted

o Depression sets in when dealing with damage of frenzy

o Duration vary from person to person – some people experience short manic and depressive episodes

o Some individuals cycle back and forth (some rapidly)

Causes of Mood Disorders

Biological – neurotransmitters of serotonin and norepinephrine linked to depression (reduced levels) and mania (increased levels)

Twin studies on mood d/o – 67% identical, 20% fraternal

Psychodynamic – unconscious conflicts and hostile feelings originating in early childhood are transferred to adult symptoms – turned inward

Behavioural – focuses on positive reinforcements (lacking) and punishments (in excess)

Cognitive – cognitive triad (Beck) – negative view of self, negative view of ongoing experiences - the world, and negative view of future and learned helplessness - people believe bad things are going to happen and can’t do anything about it

Seligman's Attribution theory = internal-stable-global vs. external, unstable, specific)

Mood Disorders and Gender

- Depression rate for women is 2x more than men

o Greater likelihood of negative experiences – sexual abuse, poverty, single parent, taking care of parents

o Internal-global-explanatory style

o Rumination on causes & implications – learned helplessness (people believe bad things are going to happen and can’t do anything about it).

- Depression linked to suicide attempts

o Women make 3x more attempts than men

o Men are more likely to commit suicide

o Suicide most common in Canadian youth aged 15-24, especially in northern provinces and territories (Dr. David Danto's Research)

o Final stage of inner turmoil

Somatoform Disorders

Somatic Disorders

Physical illnesses or complaints that cannot be fully explained by actual medical conditions

Anxiety Illness Disorder/Hypochondriasis – preoccupation & belief they are physically ill or will get physically ill despite medical reassurances – often go from doctor to doctor

Somatic Symptom Disorder/Somatization disorder/Pain Disorder – long history of physical complaints that are not medically explained They cross many medical categories – must have 4 pain symptoms (eg. headaches/stomach aches), 2 gastrointestinal (eg. Nausea), 1 sexual symptom, and 1 neurological (eg. Double vision)

Conversion disorder/functional neurological symptom disorder – loss of motor or sensory functioning not explained by nervous system or physical

Dissociative Disorders

- Dissociative disorders

o Disturbance in the integration of identity, memory, or consciousness – often a survival mechanism from traumatic past

§ Dissociative amnesia – forgetting of important personal experiences caused by psychological experiences in the absence of any organic dysfunction

§ Dissociative Fuge - period of “wandering” that involves a loss of memory and a change of identity

§ Dissociative identity disorder (DID) – disorder in which two or more distinct personalities exist within the same individual (unique behavioural patterns)

· Formerly called multiple personality disorder or split personality

· Three Faces of Eve, Sybil

Schizophrenia

- Schizophrenic disorder

o Severe form of psychopathology in which personality seems to disintegrate, thought and perception are distorted, and emotions are blunted

o Symptoms can involve illogical thinking, hallucinations, delusions, language problems, flat emotions, psychomotor disturbances

o Existence of both positive (hallucinations, delusions, disorganization – type 1) and negative symptoms (flat affect – type 2)

o Relatively rare – 1% of the population

o Some experience a few episodes, while others it is life long

- Uncommon disorder affecting more men than women

o Can appear gradually or with sudden break – men experience the break on average younger than women

o Characterized by 3 types of serious problems

§ Delusions and hallucinations

§ Disorganized thinking, emotions, behavior

§ Reduced enjoyment and interests

Delusions: False beliefs that distort reality

Hallucinations: False perceptual experiences that distort reality

Causes of Schizoprenia

Biological factors

⇧ genetic relatedness = ⇧ risk – both parents (46%) or identical twins (48%)

Biological markers – brain abnormalities in ventricles, (flow of cerebrospinal fluid) which impacts support/stability, chemical balances, loss of cortical tissue and activity in frontal & temporal lobe

Environmental conditions

Diathesis-stress hypothesis – genetic factors place individuals at risk but environmental factors trigger the manifestation of the disorder – lack of support (empathy), housing/safety

Deviations in parental interactions may play a role (expressed emotion) – emotionally overinvested, critical, hostile

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