Psychopathology & Stress – Quick Review

Background and DSM-V

  • Psychopathology = study of mental disorders (symptoms, causes, treatment)

  • Psychological disorder = abnormal thoughts, feelings, behaviours, physiology causing impairment

  • DSM-V (APA) = classification guide; key criterion → functional impairment across settings

Affective (Mood) Disorders

  • Depression core: sadness, anhedonia, hopelessness, worthlessness

    • Major depressive disorder = persistent symptoms at least two weeks

    • Seasonal pattern, postpartum, persistent (dysthymia > one to two years)

    • Biology → low serotonin, altered prefrontal cortex & amygdala activity

    • Cognitive views: Beck’s negative triad, hopelessness theory, rumination

    • Diathesis-stress model: genetic vulnerability + environment ➔ disorder

  • Bipolar disorder = cycles of mania and depression

    • Manic episode ≈ three to seven days; ↑ energy, flight of ideas, risk-taking

    • High comorbidity (anxiety, substance use), more common in men, elevated suicide risk

Anxiety & Related Disorders

  • Generalized anxiety = excessive, uncontrollable worry without clear source

  • Panic disorder = recurrent panic attacks (racing heart, breathlessness)

  • Obsessive-compulsive disorder = intrusive thoughts ➔ compulsions; orbitofrontal cortex involved

  • Phobias = irrational fear of specific object or event

  • Social anxiety = fear of scrutiny in social situations

Somatoform Disorders

  • Physical symptoms with no medical basis

    • Hypochondriasis = fear of illness

    • Conversion disorder = neurological-type symptoms without cause

Dissociative Disorders

  • Fragmented memory/identity

    • Dissociative amnesia, fugue, identity disorder (multiple identities; childhood trauma common)

    • Depersonalization (self detachment) / derealization (world detachment)

  • Post-traumatic stress disorder = severe stress response after trauma

Psychotic Disorders

  • Schizophrenia

    • Positive: hallucinations, delusions

    • Negative: flat affect, avolition, alogia, anhedonia, asociality

    • Motor: catatonia

    • Cognitive/disorganized symptoms

Personality Disorders

  • Enduring maladaptive personality styles

    • Cluster A (odd-eccentric): paranoid, schizoid, schizotypal

    • Cluster B (dramatic-impulsive): borderline, antisocial

    • Cluster C (anxious-fearful): avoidant, dependent, obsessive-compulsive (perfectionistic)

Theories of Psychopathology

  • Supernatural: spirits, possession

  • Biological: genes, neurochemistry, brain structure

  • Diathesis-stress: predisposition activated by stressors

Stress: Definitions & Appraisal

  • Stress = process of perceiving/responding to threats or challenges

    • Primary appraisal = judge event’s significance/threat

    • Secondary appraisal = assess resources & trigger physiological response

  • Eustress = beneficial, optimal stress; Distress = excessive, harmful

Stimulus- vs Response-Based Views

  • Stimulus: focus on external stressors (e.g., workload, disaster)

  • Response: focus on internal reactions (e.g., heart rate, cortisol)

  • Combined view gives full picture

General Adaptation Syndrome (Selye)

  • Alarm → sympathetic activation (fight-or-flight)

  • Resistance → continued arousal, adaptation attempts

  • Exhaustion → resource depletion, illness vulnerability

Physiological Mechanisms

  • Sympathetic nervous system → adrenaline, norepinephrine (fast)

  • HPA axis → CRF → ACTH → cortisol (slower, sustains energy; chronic elevation harms immunity, heart)

Types of Stressors

  • Chronic (ongoing), Acute (short-term), Traumatic events, Major life changes, Daily hassles

  • Work stress: job strain (high demand/low control), burnout (exhaustion, cynicism)

Social Readjustment Rating Scale (SRRS)

  • Assigns life-change units to events; high cumulative score predicts illness risk

Stress & Health

  • Chronic stress ➔ psychophysiological disorders (hypertension, heart disease, immune suppression)