PSYCH257 Chapter Notes - Chapter 1: Psychopathology, Dsm-5, Dorothea Dix
22 May 2018
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CHAPTER 1: Abnormal Behaviour in Historical Context
Defining a Psychological Disorder
PSYCHOLOGICAL DISORDER: a psychological dysfunction within an individual that is associated with distress or
impairment in functioning and a response that is not typical or culturally expected
● Most psychological disorders are simply extreme expressions of otherwise normal emotions, behaviours, and
cognitive processes
●PHOBIA: a psychological disorder characterized by marked and persistent fear of an object or a situation
The Three D’s
There are three main elements that make up a psychological disorder:
1. Dysfunction → refers to a breakdown in cognitive, emotional, or behavioural functioning
○ Knowing where to draw the line between normal and abnormal dysfunction is often difficult
○ Problems are often considered to exist on a continuum or as a dimension rather than categories
2. Distress or Impairment → feeling extremely upset about a problem
○ Impairment: some type of interference with functioning
○ AT LEAST one of the two MUST apply
3. Deviance → atypical or not culturally expected; deviates from the normal
○ The greater the deviation, the more abnormal it is
○ Different from socio-cultural norms (e.g. losing weight or fasting for a month is religious for Muslims;
Ramadan); what is considered harmful in one culture may not be so in another
Furthering the Definition of a Psychological Disorder
● Another concept that is useful when considering the definition of a psychological disorder is to determine whether
the behaviour is beyond the individual’s control
● Difficult to define normal and abnormal
● Most widely accepted definition used in the DSM-5, “behavioural, psychological, or biological dysfunctions that are
unexpected in their cultural context and associated with present distress and impairment in functioning or
increased risk of suffering, death, pain, or impairment
● Consider how apparent the disease or disorder matches a “typical” profile of a disorder
The Science of Psychopathology
PSYCHOPATHOLOGY: is the scientific study of psychological disorders
Field of Psychology Professions: Clinical and counselling psychologists, psychiatrists, psychiatric social workers,
psychiatric nurses, marriage and family therapists, and mental health counsellors
Profession (Psychology)
Details
Clinical Psychologist
● Clinical psychologists typically receive a Ph.D (Doctor of Philosophy)
follow a course of graduate-level study that lasts six to seven years
● Clinical psychologists usually concentrate on more severe
psychological disorders
Counselling Psychologist
● Counselling psychologists study and treat adjustment and vocational
issues encountered by relatively healthy individuals
Psychiatrist
● Psychiatrists first earn an M.D. in medical school and then specialize
in psychiatry during a four-year residence
● Investigate at a bio point of view, make diagnoses, offer treatment
(bio, drug, psychosocial)
Psychiatric Social Workers
● Psychiatric social workers earn a MA degree in social work as they
develop expertise in collecting info relevant to social and family
situations of those w/ a psychological disorder
Psychiatric Nurses
● Have advanced degrees (MA or Ph.D)
● Specialize in the care and treatment of patients with psychological
disorders usually in hospitals as part of a treatment team
Marriage and Family Therapists and
Mental Health Counsellors
● Spend one or two years earning a MA degree and provide clinical
services in hospitals or clinic
● Under the supervision of a doctoral-level clinician
Other information on psych professions:
● Label of ‘psychologist’ conveys info about the training and qualifications of the professional, whereas the label of
‘psychotherapist’ does not always
● The terms ‘therapist’ and ‘psychotherapist’ are not specific to a particular profession (e.g. social workers,
psychologists, and psychiatrists can identify as psychotherapists)
The Scientist-Practitioner
The most important recent development in the history of psychopathology is the adoption of scientific methods to learn
more about the nature of psychological disorders, their causes, and their treatment
●SCIENTIST-PRACTITIONER: mental health professionals that take a scientific approach to their clinical work
Three Proponents of a Scientist-Practitioner
1. Consumer of Science → enhancing the practice (keeping up with the latest scientific developments, etc.)
2. Evaluator of Practice → determining the effectiveness of the practice
3. Creator of Science → conducting research that leads to new procedures useful in practice
Clinical Description
Clinical terms in the field of psychology:
●PRESENTS: is a traditional shorthand way of indicating why the person came to the clinic
●PRESENTING PROBLEM: a patient ‘presents’ a specific problem or set of problems
●CLINICAL DESCRIPTION: represents a unique combination of behaviours, thoughts, and feelings that make up a
specific disorder
●CLINICAL: refers both to the types of problems or disorders you would find in a clinic or hospital and to the
activities connected with assessment and treatment
One important function of the clinical description is → to specify what makes the disorder different from normal behaviour
or from other disorders; statistical data may also be relevant
●PREVALENCE: how many people in a specific population have the disorder
●INCIDENCE: how many new cases occur during a given period (such as a year)
●SEX RATIO: what proportion of male and females have the disorder
●AGE OF ONSET: typical age of when the disorder develops
●COURSE: most disorder follow a somewhat individual pattern
○Chronic course: the disorder tends to last a long time, sometimes a whole lifetime (e.g. schizophrenia)
○Episodic course: individual is likely to recover within a few months, only to have a recurrence of the
disorder later in life (e.g. mood disorders)
○Time-limited course: the disorder will improve without treatment in a relatively short period of time with
little or no risk of recurrence (e.g. certain sleep disorders)
●ETIOLOGY: also known as the study of origins, has to do with why a disorder beings (what causes it) and
includes biological, psychological, and social dimensions
Closely related differences in the course of disorders are differences in onset
●Acute onset: disorders begin suddenly
●Insidious onset: disorders develop gradually over an extended time
● Important to know the typical course of disorder to know how best to deal with the problem
Document Summary
Psychological disorder : a psychological dysfunction within an individual that is associated with distress or impairment in functioning and a response that is not typical or culturally expected. Most psychological disorders are simply extreme expressions of otherwise normal emotions, behaviours, and cognitive processes. Phobia : a psychological disorder characterized by marked and persistent fear of an object or a situation. There are three main elements that make up a psychological disorder: dysfunction refers to a breakdown in cognitive, emotional, or behavioural functioning. Knowing where to draw the line between normal and abnormal dysfunction is often difficult. Problems are often considered to exist on a continuum or as a dimension rather than categories: distress or impairment feeling extremely upset about a problem. Impairment: some type of interference with functioning. At least one of the two must apply: deviance atypical or not culturally expected; deviates from the normal. The greater the deviation, the more abnormal it is.
