Lecture 12: Psychopathology and Unipolar Depression
Intro to Psychopathology
Models of abnormality
Major classifications of mental disorders (DSM)
Diagnosis and symptomology
The Medical Model
Four possible causes
The Psychodynamic Model
Causes and treatment
The Cognitive-Behavioural Model
Cognitive mechanisms of depression
The Humanistic Model
Client-centred and existential therapies
The Socio-Cultural Model
Group and family therapies
Clinical depression has been called the common cold of psychopathology. It affects at
least 10% of the population at some point in their lives. Schizophrenia however is far
less common, affecting 1.7%.
Models of Abnormality
1. Medical: behaviour is symptomatic of physiological abnormality
2. Psychodynamic: behaviour is symptomatic of unresolved intrapsychic
3. Behavioural: behaviour is maladaptive responding due to faulty
learning; not symptomatic of underlying pathology; treat the behaviour
4. Cognitive: behaviour is symptomatic of faulty thinking or beliefs
about self and the world
5. Humanistic: behaviour is symptomatic of inability to fulfill human
needs and capabilities
6. Socio-Cultural: behaviour is symptomatic of dysfunctional
environments; such as family, society, or culture
• The perspectives do not necessarily contradict each other; rather they seem to
borrow ideas from one another.
• The DSM (the diagnostic statistical manual):
o Now in its 4 edition, called DSM-IV
o Sought to bring the abnormality models together to agree on
symptomology, and in turn helps to diagnose
o Disorder classifications include:
Disorders first diagnosed in infancy, childhood, and adolescence Delirium, dementia, and other cognitive
Schizophrenia and other psychotics
Sexual and gender identity
• Depressive episodes are common people have bad days, it is inevitable. We
need to ensure that when depression is diagnosed, that it is actually abnormal and
not a random occurrence.
o Diagnostic criteria for major depressive episodes:
At least 5 symptoms must be present within a two week period in
order to deem a person “clinically depressed”. This personality
must be opposite from who you normally are.
• Depressed most of the day
• Diminished interest or pleasure in activities
• Significant weight loss/gain when not dieting/decrease or
increase in appetite
• Psychomotor agitation/retardation
• Feelings of worthlessness/excessive guilt
• Difficulty concentrating
• Recurrent thoughts of death and suicide, without a specific
plan/attempts at suicide
Most of these symptoms, such as suicidal tendencies and lack of
motivation, tend to contradict each other. In this example, lack of
motivation stops the patient from committing suicide while
• The Medical Model
o Four possible causes:
Germ: you can “catch” depression as though it were a virus
Genetics: You inherit a predisposition to the disorder.
• i.e.: the 5HTT gene Neuro-anatomical: a structural problem with your nervous system
causes you to get the disorder.
Neuro-chemical: neuro-transmitters effected and in turn triggers
o The Catecholamine Hypothesis:
Includes norepinephrine, epinephrine, and dopamine.
A study was conducted initially to find a cure for the common
cold, where instead they stumbled upon this theory.
• This drug increases levels of norepinephrine, and in turn
alleviates the symptoms of depression.
• “Tricyclical Antidepressants” treatment of choice
o Elevated levels of norepinephrine and serotonin
o Serotonin was believed to be responsible for
suicidal thoughts and norepinephrine for depression
o These antidepressants, while they alleviated the
symptoms while on the pills, did not cure
o T.A’s were found to have a correlation with
dependence and addiction.
• SSRI’s (Selective Serotonin Re-uptake Inhibitors):
o Scientists found most of the correlation between
amines and depression resided in simply serotonin.
o Now this is usually the first choice of treatment
o Inhibits re-uptake of serotonin, thereby increasing
levels without adding
o Has fewer side effects and is less addictive than the
o Tends to diminish reoccurrence of the disorder
• The last resort MAO Inhibitors
o Mono-amine oxidate inhibitors
o Not selective, very risky
o Side effects include:
Taken with alcohol, cheese, fish, etc.
often results in death
• Psychodynamic Model
o Believe that it is the result of an unresolved conflict that results in anger
being turned inwards, and thereby leading to depression.
i.e.: Debbie’s Electra Issues patient has to overcome her hatred
towards her mother that she had been internalizing and directing at
o Treatment lasts 1-2 years (being that of therapy).
o If left untreated, 50% of clinical episodes heal themselves. • Cognitive-Behavioural Model
o The emphasis is placed on the pessimistic interpretation that the patients
seem to engage in.
o Cognitive Mechanisms
The Cognitive Triad:
• Negative thoughts about:
o Ongoing experience (misinterpretations)
o The future (hopelessness)
Treated with a combination of drugs and motivational techniques
(self efficacy) to regain confidence in themselves and their
• i.e.: Frankie and the showers the patient had to do
everything by himself in order to gain confidence that he