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PSYCH 2AP3 Study Guide - Midterm Guide: Extraversion And Introversion, Dsm-5, Psychopathology

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Richard B Day
Study Guide

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Criteria of Abnormality
Impairment Criterion
oBehaviour/thinking/emotions impair social, occupational, personal relationships, education, danger to
others/yourself (i.e. terrorists may be well-educated, does this make them mentally ill? A mother who dies to save
her child?)
Personal Distress Criterion
oSymptoms cause significant concern for the individual; disturbed by thoughts or feelings (intense fear, shame, guilt,
etc.) (i.e. schizophrenia are not bothered by their thoughts – blame it on the world around them)
Abnormality is a matter of agreement among professionals
Models of Psychopathology
Biomedical Model : a mental disorder is a physical disorder, physical problem with the brain/nervous system that leads to the
psychological symptoms
oArose from the observation of syphilitic infection and mercury poisoning causing mental disturbances
oChemical imbalance
oTerminology of “sick”, “mental illness” or “nervous breakdown”
oTreatment : physical/pharmacological methods
oProblem :
No biological cause has been found for any disorder in the DSM
No biological tests to diagnose mental disorder
Despite the psychotic drugs, prevalence has not decreased but increased
Psychodynamic Model : symptoms do not result from any physical/physiological problem but have purely psychological
causes; result of maladaptive psychological responses to internal, unconscious conflict – tension between the conscious and
unconscious mind
oProcesses that lead to disorder are the same that produce/maintain normalcy and order
oTreatment : bringing buried conflict into consciousness
oE.g. anxiety, somatic symptom, dissociative disorders
Behavioural Model : disorder IS the behaviour that has been learned through processes of reward, punishment and
generalization and that become inappropriate, maladaptive, dangerous or self-destructive; no internal/physical problem; no
precursor – development based
oSame processes that maintain normality and abnormality
oTreatment : changing the conditions of learning and schedules of reward to modify behaviour
oE.g. phobias, OCD
Sociocultural Model : abnormal behaviour result from stresses from the environment; caused by the society or culture
oObservation that there is more psychopathology in lower socioeconomic strata; maladaptive and criminal behaviour
increase in difficult economic times and under the pressures of environmental stress (i.e. temperature)
oRelationship between early social environment and brain functioning/mental illness
oProblem : Lack of explanatory mechanisms; no obvious treatment; more conservative social climate
oNew epigenetic research
Epigenetic markers are placed on genes and shut them off – changes how they work; personal experiences
(including parents, grandparents etc.) changes our epigenome
oMiller & Chen (2007) : high SES at 2-3 years old had better regulation of inflammatory responses – not due to
current SES and not changed by later changes in SES; low SES predicts proinflammatory phenotype
oSchreier & Chen (2010) : parents childhood SES predicted BP in 11-15 year olds; high SES – high BP; effect not due
to current situation
oMurphy et al (2013) : targeted social rejection in adolescent females showed an increase of proinflammatory genes;
effect more pronounced in females of high self-reported social status
Cognitive Model : abnormality results from maladaptive/incorrect ways of selecting information or interpreting events;
learned maladaptive behaviour – the thoughts and interpretation (consistent with behavioural model); its not the actual events
its how we interpret the events
oTreatment : training to think differently about themselves and their situation through practice and reward
oPopular and successful
oE.g. anxiety, depression, personality disorders

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History of Diagnostic and Statistical Manual of Mental Disorders (DSM)
DSM-I (1952) : 106 categories; bias toward psychodynamic interpretation; no drugs so based on psychological; emphasize
clinical utility
DSM-II : reduced psychodynamic bias – more objective; neuroses (w/o loss of reality) vs. psychoses (loss of reality w/
DSM-III : atheoretical – based on symptoms rather than assumption of causes; abandoned psychodynamic view; more toward
biomedical model and ICD
DSM-III-R : revision of DSM-III
DSM-IV : fewer differences with ICD-10
DSM-IV-TR : no change in categories/diagnostic criteria; descriptive text updated/modified
DSM-5 (2013) : ~300 categories
oCategories reorganized
“Disorders first Diagnosed in infancy, Childhood and Adolescence” removed
OCD moved to its own category
Organized in lifespan order; earliest disorders to late-life disorders
Subcategories of schizophrenia gone
Several Pervasive Developmental Disorders into ASD
Added Hoarding and Excoriation Disorders
Defining Mental Disorder: syndrome characterized by clinically significant disturbance in cognition, emotion, regulation or
behaviour that reflects dysfunction in psychological, biological or developmental processes underlying mental functioning; associated
with distress and impaired functions; culture/subjective exceptions
Defining Normal: cannot separate normal and pathological symptom expressions; a generic diagnostic criterion requiring distress or
disability has been used to establish disorder thresholds (clinically significant)
A list of labels for symptoms that identifies dysfunction
Identifies based on distress, impaired functioning or increased risk of impairment
Helps clinicians decide on appropriate treatment that may be effective
Facilitates and regulates communication; common language between clinicians and researchers
Criticisms of DSM
Assumption that similar symptoms have similar causes and therefore can be labeled the same
Treats disorders a discrete entities – but really exist on a continuum (i.e. severity)
“Fads” in diagnosis; labeled based on popularity, new discoveries or based on interest
Labeling biases on subsequent diagnosis and treatment (focus on aspects of pervious diagnosis)
No known relation between categories and causes (i.e. genetic causes span across many disorders)
Comorbidity Problem : meeting criteria for several disorders at the same time; 70% of all patients who meet criteria for one
disorder also meet for at least one other disorder  categorization may be wrong
‘Not Otherwise Specified’ Problem : a subcategory of major categories that contain symptoms that look like they belong in
the category but don’t meet the criteria for any other subcategory
Straddles Category Problem : disorders present with symptoms from two different categories (disorder present with a mixture
of symptoms) (i.e. schizophrenia affective disorder)
Inclusion of symptoms that don’t seem like mental disorders (extreme ends of normal) – if problem is listed in DSM then
treatment payment options are available
oChildhood learning disorders (not good at math … math disorder??)
oSleep disorders
oSubstance-related disorders (abuse/overdose- behaviour disorders – habits)
oIntellectual development disorders (genetic basis, is it considered mental?)
oFactitious disorder (symptoms include pretending to have a mental disorder)

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Broadened criteria allow normality to be given a diagnostic label
oRemoval of bereavement exclusion (grieving from a loved one – now you may be considered to have depression and
receive antidepressants)
oAddition of ‘Disruptive Mood Dysregulation Disorder’ for tantrums – growing concern that too many children were
being diagnosed with bipolar disorder
oAddition of ‘Mild Neurocognitive Disorder’ for ‘senior moments” – making an ordinary thing that occurs naturally a
psychiatric condition
oAddition of ‘Binge Eating Disorder’ – very broad, loosely defined (pig out once – could be considered)
Continues weaknesses of earlier editions – not working toward scientific classification but continuing on the flawed set of
Psychiatric knowledge had not advanced enough for revision to DSM-5 – may have just done it for income
Categorizes what are dimensional conditions into categories and “boxes” – they vary quantitatively (in severity, etc. – this
distinction is not made)
Creates new mental disorders to benefit pharmaceutical industries
Threshold for several diagnoses has been broadened – many more people qualify for certain disorders and therefore treatment
and drugs – medicalizing normal reactions
Interpreting DSM Categories
Does not mean symptoms are purely ‘mental, may have physical aspects – mind and body are not separate entities
Does not identify categories as diseases (no accepted medical definition)
oSame symptoms may have different causes
oSame causes may have different symptoms
oSame category for people with different symptoms
Not a cookbook – requires clinical judgment; attaching a label even without meeting criteria
No clear boundaries between disorders or between disorder and no disorder
Must be used with cultural sensitivity; awareness of social norms
Common in clinical settings (i.e. anxiety, mood disorders)
Debilitating; focus of much research (i.e. schizophrenia, mood disorders)
Illuminate psychological functions/issues – powers of the mind (i.e. dissociative, somatoform disorders)
Recent focus of public interest/research (i.e. ADHD, ASD)
Area of controversy (i.e. DID)
Sufficient vs. Necessary
Sufficient : A is sufficient cause of effect B (A is only needed)
Necessary and Sufficient : if you don't have A, can never get B
Ex. Fire: need fuel (necessary but not sufficient); oxygen (necessary but not sufficient); heat (necessary but not sufficient)
Diathesis-Stress Model
Stress and diathesis are both necessary for a disorder – neither one is sufficient
Diathesis : predisposition or tendency to get a disorder based on genes, neurochemistry or brain structure and function
Stress : an external stress (i.e. personal relationship, employment, education, poverty, etc.)
Once level of stress rises above normal, level of functioning decreases to low (problems, distress) and further declines to very
low (psychopathology, mental disorder)
Environmental Sensitivity
Low Susceptibility to Environmental Variation : maintain a steady normal level of functioning regardless of negative or
positive environment
High susceptibility to Environmental Variation : with negative environmental variables, level of functioning plummets to
psychopathology; positive environmental variables, level of function exceeds normal to improved and optimal
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