psychopathology

I. History of Psychopathology

Distinguishing Normality from Abnormality

• Criteria: Deviance, distress, dysfunction, danger.

• Cultural and situational influences impact definitions.

Three Etiological Theories of Mental Illness

1. Supernatural: Possession, divine punishment; treated with exorcisms, trepanation.

2. Biological: Physical causes (e.g., Hippocrates’ humors); treated with bloodletting, diet changes.

3. Psychological: Mental/emotional stress; treated with therapy, moral treatment.

Historical Beliefs and Treatments

• Ancient Greeks: Imbalances in bodily fluids (humors).

• Middle Ages: Witchcraft, demonic possession.

• Renaissance: More humane treatments emerge (Weyer).

• 18th-19th Century: Moral treatment (Pinel, Tuke, Rush, Dix).

Moral Treatment

• Intent: Humane, compassionate care.

• Outcome: Temporary improvement, but overcrowding and lack of funding led to decline.

Key Figures in Psychopathology

• Hippocrates: First biological approach (humors theory).

• Plato: Psychological origins of distress.

• Johann Weyer: Early advocate against witch hunts, mental illness as a medical condition.

• Philippe Pinel & William Tuke: Advocated for moral treatment.

• Dorothea Dix: Pushed for asylum reform in the U.S.

• Benjamin Rush: Father of American psychiatry.

Insurance and Mental Health Care

• Managed Care: Cost containment, provider restrictions.

• Parity Law: Requires equal coverage for mental and physical health.

• Affordable Care Act (ACA): Expanded mental health coverage.

II. Diagnostic Process and Therapeutic Orientations

Assessment Methods

• Interviews: Structured vs. unstructured.

  • Pros: Rich detail, rapport-building.

  • Cons: Subjective, interviewer bias.

• Self-Report Inventories: Standardized tests (e.g., Beck Depression Inventory).

  • Pros: Quick, cost-effective.

  • Cons: Self-report bias.

• Neurological Tests: EEG (brain waves), PET (metabolism), MRI (structure).

  • Used to: Identify brain abnormalities.

Major Psychological Perspectives

1. Biological: Neurotransmitters, genetics; treated with medication, ECT.

2. Behavioral: Conditioning and reinforcement; treated with exposure therapy.

3. Cognitive: Thought patterns; treated with CBT.

4. Humanistic: Self-actualization, client-centered therapy.

History of Diagnostic Process

• Kraepelin: Early classification of disorders.

• DSM vs. ICD: DSM (U.S., detailed criteria); ICD (global, broad categories).

• History of DSM: DSM-I (1952) to DSM-5 (2013), increasing specificity.

• Pros/Cons of Diagnostic Labels:

  • Pros: Facilitates treatment, research.

  • Cons: Stigmatization, potential misdiagnosis.

III. Psychological Disorders

Anxiety and Stress-Related Disorders

• Generalized Anxiety Disorder: Persistent worry, muscle tension.

• Social Anxiety Disorder: Fear of social judgment.

• Panic Disorder: Sudden panic attacks.

• Phobias: Irrational fears of objects/situations.

• Obsessive-Compulsive Disorder (OCD): Obsessions (intrusive thoughts) + compulsions (rituals).

• Trichotillomania/Excoriation Disorder: Hair-pulling, skin-picking.

• PTSD vs. Acute Stress Disorder: PTSD lasts >1 month, ASD resolves within a month.

Neurotransmitters & Brain Structures

• Serotonin: Mood regulation (low in depression, anxiety).

• Dopamine: Reward/motivation (high in schizophrenia, low in Parkinson’s).

• GABA: Inhibitory, calming (low in anxiety disorders).

• Glutamate: Excitatory, learning/memory.

IV. Treatment Approaches

Effectiveness of Therapy

• 75% benefit from psychotherapy; 5% worsen.

Medications & Neurotransmitter Effects

• SSRIs (increase serotonin, used for depression/anxiety).

• Benzodiazepines (increase GABA, treat anxiety but addictive).

• Antipsychotics (reduce dopamine, treat schizophrenia).

Trauma-Focused vs. Non-Trauma-Focused Therapies for PTSD

• Trauma-Focused: Exposure therapy, cognitive processing therapy.

• Non-Trauma-Focused: Stress management, relaxation techniques.

Exposure Therapies

• Systematic desensitization, flooding, ERP (exposure & response prevention).

Cognitive-Behavioral Therapies

• REBT (Rational Emotive Behavior Therapy): Challenges irrational thoughts.

• CBT (Cognitive Behavioral Therapy): Identifies and modifies negative thinking patterns.

• ERP (Exposure & Response Prevention): Exposes patients to feared stimuli while preventing compulsive responses (OCD treatment).

Study Tip: Focus on key definitions, historical trends, and differences between disorders/treatments. Use flashcards, practice questions, and summaries to reinforce learning!