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PSY100H1 Lecture Notes - Bipolar Disorder, Psychopathology, Panic Disorder

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Chapter 13 - Disorders of mind and body
Psychopathology -- sickness or disorder of the mind.
Prevailing view in 20th century is that the origins of psychopathology are in psychological turmoil and
biological dysfunction. Freud was the first to develop a theory of psychopathology and to propose specific
treatment techniques based on his theory.
Diagnostic and Statistical Manual of Metal Disorders (DSM): a handbook of clinical disorders used for
diagnosing psychopathology
Multiaxial system: based on the growing realization that mental health is affected by a variety of factors
Assessment: examination of a person’s mental state in order to diagnose possible mental illness
Cognitive-behavioural approach: a diagnostic model that views psychopathology as the result of learned,
maladaptive cognitions
Diathesis-stress model: a diagnostic model that proposes that a disorder may develop when an underlying
vulnerability is coupled with a precipitating event
Anxiety disorders: characterized by the experience of excessive anxiety in the absence of true danger
Phobia: an irrational fear of a specific object or situation
Generalized anxiety disorder: a diffuse state of constant anxiety not associated with any specific object
or event
Panic disorder: an anxiety disorder characterized by sudden, overwhelming attacks of terror
Agoraphobia: an anxiety disorder marked by fear of being in situations in which escape may be difficult or
Obsessive-compulsive disorder (OCD): an anxiety disorder characterized by frequent intrusive thoughts
and compulsive actions, basal ganglia is smaller and has structural abnormalities (impulse control)
Major depression: characterized by severe negative moods and lack of interest in normally pleasurable
Dysthymia: a form of depression that is not severe enough to be diagnosed as major depression
Bipolar disorder: a mood disorder characterized by alternating periods of depression and mania
Cyclothymia: a less extreme form of bipolar disorder
Seasonal affective disorder (SAD): a disorder in which periods of depression occur during the times of
year with less sun
Learned helplessness model: a cognitive model of depression in which people feel unable to control
events around them
Schizophrenia: a mental disorder characterized by alterations in perceptions, emotions, thoughts or
Positive symptoms: symptoms of schizophrenia, such as delusions and hallucinations, that are excesses in
Negative symptoms: symptoms of schizophrenia marked by deficits in functioning such as apathy, lack of
emotion, and slowed speech and movement
Delusions: false personal beliefs based on incorrect inferences about reality
Hallucinations: false sensory perceptions that are experienced without an external source
Loosening of associations: a speech pattern among schizophrenic patients in which their thoughts are
disorganized or meaningless
Personality disorder: a class of mental disorders marked by inflexible and maladaptive ways of interacting
with the world
Borderline personality disorder: a personality disorder characterized by identify, affective, and impulse
Antisocial personality disorder: marked by a lack of empathy and remorse
Autism: a developmental disorder involving deficits in social interactions, impaired communication and
restricted interests
-Asperger’s syndrome: high-functioning autism, in which children of normal intelligence have
specific deficits in social interactions
Attention-deficit/hyperactivity disorder (ADHD): characterized by restless, inattentive and impulsive
Classification and Conceptualization
-Must be maladaptive rather than deviant
-The diagnostic criteria for all major disorders include the stipulation that the symptoms of the
disorder must interfere with the least one aspect of the person’s life.
-Kraepelin: first to propose classification system for mental disorders and disorders were grouped
based on the groups of symptoms that occurred together
-Diagnostic and Statistical Manual of Mental Disorders was published in 1952 which has a multi-axial
system (mental health is affected by variety of factors, not given a single label) table 13.1 pg 525
Mental disorders must be assessed before diagnosis

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-Assessment: examining a person’s mental functions and psychological health
-Goal of assessment is to make a diagnosis
-Course and probable outcome (prognosis) of different mental disorders vary
Mental Status Exams: are used to provide a snapshot of a person’s psychological functioning. Used when
person comes into emergency room
Clinical interview: is the most common method of psychological assessment. Ask about current symptoms
and recent experiences
-Most interviews in past have been unstructured, highly idiosyncratic (subjective)
-Too dependent on quality of interviewer
Structured interviews: standardized questions asked in same order every time, diagnoses based on
specific patterns of responding. Facilitate assessment as well as research and treatment.
-Most commonly used: Structured Clinical Interview for DSM (SCID)makes diagnoses according to DSM
Behavioral assessments: observe behavior, especially useful for children
-Subsequent assessment with MRI or PET might be used to examine whether there is specific brain
damage, as might be caused by a tumour or an injury
Neuropsychological testing: given tasks used to assess the person’s ability to plan, coordinate and their
memory. Showing weakness in any of these areas might indicate a problem in a certain brain region. E.g. if
person has difficulty following a different rule for categorizing objects likely to have impairments in frontal
Psychological testing: is also widely used, different kinds
-Assessment of personality
-Beck Depression Inventory scale
-Most commonly used is the Minnesota Multiphasic Personality Inventory, has ten clinical scales,
oIt has criticisms: might not be good for some groups like poor, elderly, or racial minorities. The
scores that are considered normal are based on studies in which such people are inadequately
Mental disorders have many causes
Psychological factors
-Early DSM influenced heavily by Freud - focus on unconscious conflicts, sexual in nature, dated back
to childhood. Symptoms discussed more in terms of inner causes than external behaviors
-Thoughts and emotions are shaped by environment and can profoundly influence behavior
-Family system model: idea that the behavior of an individual must be considered within a social
context, in particular, the family
-Sociocultural model: psychopathology as a result of interaction between individual and culture.
e.g., schizophrenia more common in lower socio-economic classes. Due to differences in lifestyle,
expectations, and opportunities among classes of society
Cognitive-behavioral approach: abnormal behavior is learned
-Whereas psychoanalytic approach based on unconscious internal factors, behavioral approach based
on OBSERVABLE variables
-E.g., Little Albert and white rat many fears are learned rather than innate.
-Strict behaviorists believe that mental disorders are results of classical and operant conditioning,
including the thoughts and beliefs. However these are on conscious level. People can be made aware
of the thought processes that give rise to maladaptive behaviour
Biological: how physiological factors, such as genetics, cause mental illness
-Evidence is emerging that neurological dysfunction contributes to the manifestation of many mental
-Structural imaging has shown neuroanatomical differences, perhaps due to genetics, between those
with mental disorders in those without
-Another source of insight is the role of neurotransmitters in mental disorders
Integrating the factors involved:
-Most useful way to think about causes
-Diathesis-stress model: that a disorder may develop when the underlying vulnerability (diathesis)
is coupled with a precipitating event. (nurture causes nature to act)
Legal System has a different approach to psychopathology
The notion of insanity is actually legal and not psychological
-According to legal system, person is not responsible if at the time of the crime a mental disorder led
to an inability to appreciate the criminality of the act
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