INTRODUCTION
RELEVANT TERMINOLOGY:
Prevalence: how many people in the population have the disorder.
Incidence: how many new people get the disorder within a time frame,
Onset: at what age do most people get the disorder.
Aetiology: what causes/contributes to the development of a disorder.
Prognosis: The predicted course of a condition after diagnosis.
Differential diagnosis: The process of distinguishing between two or more disorders
with similar or overlapping signs and symptoms.
THEORIES AND MODELS IN PSYCHOPATHOLGY
BIOMEDICAL APPROACHES:
Psychological symptoms caused by biological factors: infections, genetic
vulnerability, physical abuse/deprivation, brain injury, chemical/hormonal imbalance
and substance use.
Aim: identify the agent or mechanism causing the condition.
Evaluation: clear pathway, sometimes leading to focused interventions. Treatments
usually deliver fast results and no moral judgement or guilt.
BEHAVIOURAL APPROACHES:
Focuses on observable behaviour. Focuses on learning and the environmental factors
that maintain behaviours.
Methods: classical conditioning, operant conditioning, observational learning.
Aim: study how behaviour was acquired and how to shape/eliminate behaviours.
Evaluation: extremely effective in a short time for some problems (phobias, sexual
dysfunctions), but hardly for others (schiz). Some techniques can be
insensitive/unethical.
COGNITIVE APPROACHES:
Based on the idea of processing- how incoming info from the environment interacts
w/ internal processes to produce an emotional and cognitive experience.
Processes: perception, attention, recognition, reasoning and judgement.
Evaluation: robust evidence for cognitive biases in ppl w/ psychological problems.
CA are strongest when combined w/ behavioural approaches. CBT is most prevailing
intervention.
PSYCHODYNAMIC APPROACHES:
Emphasises the role of internal mental processes and early childhood experiences.
Psychopathology results from unconscious conflicts in the individual. Processing
happens at an unconscious level that we develop defence mechanisms to avoid the
conflict.
Evaluation: good evidence for the role of early childhood experiences in many
mental disorders. Evidence from trials is weaker, difficult to standardise interventions.
, EATING DISORDERS
DSM-5: Eating disorders are characterized by a persistent disturbance of eating or eating-
related behaviour that results in the altered consumption or absorption of food and that
significantly impairs physical health or psychosocial functioning.
DEFINITIONS:
Feeding disorders: involve behavioural disturbances that are not related to body
weight and shape concerns, such as eating of non-edible substances.
Eating disorders: involve abnormal eating behaviour and preoccupation with food as
well as prominent body weight and shape concerns.
Types of eating disorders: anorexia nervosa, bulimia nervosa, binge eating disorder,
pica, rumination disorder, etc.
Incidence of ED: A representative study (Micali et al., 2013) identified incidence of
37.2 diagnosis per 100 000 (2009). The incidence of the diagnosed ED was highest
for girls aged 15– 19 and for boys aged 10–14.
Prevalence of ED:
Lifetime prevalence for women (DSM-5) anorexia nervosa 1.7%, bulimia
nervosa 0.8%, binge eating disorder 2.3% (Smink et al., 2014).
In males: AN: 0.3% (USA), 0.24 % (Finland), BN: 0.5% (USA), BED: 2%
(USA), 0.3% (Europe). (Smink et al., 2012).
ANOREXIA NERVOSA DIAGNOSIS: (DSM-5)
Persistent restriction of energy intake leading to significantly low body weight.
Disturbance in one of the following: the way one's body weight or shape is
experienced, undue influence of body shape and weight on self-evaluation &
persistent lack of recognition of the seriousness of the current low body weight.
Either an intense fear of gaining weight or persistent behaviour that interferes with
weight gain, despite significantly low weight.
Associated factors:
Physical: Amenorhea, Lanugo hair,
thinning hair & hormonal alterations.
Psychological: obsessive
preoccupation w/ food, depression,
irritability, excessive energy &
inflexible thinking.
BULIMIA NERVOSA DIAGNOSIS: (DSM-5)
Recurrent episodes of binge eating, characterised by both eating, in a discrete period
of time (2hrs), a large amount of food, and a sense of lack of control over eating
during the episode.
Recurrent inappropriate compensatory behaviour in order to prevent weight gain eg
fasting, self-induced vomiting, misuse of laxatives and excessive exercise.
, The binge eating and inappropriate compensatory behaviours both occur, on average,
at least once a week for three months.
Self-evaluation is unduly influenced by body shape and weight.
Associated factors
BINGE EATING DISORDER DIAGNOSIS: (DSM-5)
Recurrent episodes of binge eating episodes that are associated w/ eating faster than
normal, eating until feeling uncomfortably full, eating large amounts of food when
not feeling hungry, eating alone due to embarrassment & feeling disgusted with
oneself and depressed afterwards.
Marked distress regarding binge eating (BE) is present. BE occurs, on average, at
least once a week for three months
Associated factors
AETIOLOGY OF ED:
Biological factors: low factors in frontal lobes (behavioural regulation) and
alterations with the amygdala (linked with fear), AN is associated w/ loss of grey and
white matter which can be associated with loss of communication between parts of
the brain.
Individual factors: Think often about food and eating, obsessive thinking, dieting is
a strong risk factor to developing ED. Very centred thinking towards their body and
is parallel to their sense of self-worth.
Family & peer influences: strange family dynamics such as dysfunctional
communication, and also a modelling effect (parents concerned with their own
weight) with a preoccupation with physical appearance, weight and food intake. Also
peer criticism over appearance and food intake.
Objectification theory: Posits that women (particularly) learn to view their bodies as
commodities, subject to the male gaze.
DEPRESSIVE DISORDERS
Diagnostic criteria of depressive disorders
RELEVANT TERMINOLOGY:
Prevalence: how many people in the population have the disorder.
Incidence: how many new people get the disorder within a time frame,
Onset: at what age do most people get the disorder.
Aetiology: what causes/contributes to the development of a disorder.
Prognosis: The predicted course of a condition after diagnosis.
Differential diagnosis: The process of distinguishing between two or more disorders
with similar or overlapping signs and symptoms.
THEORIES AND MODELS IN PSYCHOPATHOLGY
BIOMEDICAL APPROACHES:
Psychological symptoms caused by biological factors: infections, genetic
vulnerability, physical abuse/deprivation, brain injury, chemical/hormonal imbalance
and substance use.
Aim: identify the agent or mechanism causing the condition.
Evaluation: clear pathway, sometimes leading to focused interventions. Treatments
usually deliver fast results and no moral judgement or guilt.
BEHAVIOURAL APPROACHES:
Focuses on observable behaviour. Focuses on learning and the environmental factors
that maintain behaviours.
Methods: classical conditioning, operant conditioning, observational learning.
Aim: study how behaviour was acquired and how to shape/eliminate behaviours.
Evaluation: extremely effective in a short time for some problems (phobias, sexual
dysfunctions), but hardly for others (schiz). Some techniques can be
insensitive/unethical.
COGNITIVE APPROACHES:
Based on the idea of processing- how incoming info from the environment interacts
w/ internal processes to produce an emotional and cognitive experience.
Processes: perception, attention, recognition, reasoning and judgement.
Evaluation: robust evidence for cognitive biases in ppl w/ psychological problems.
CA are strongest when combined w/ behavioural approaches. CBT is most prevailing
intervention.
PSYCHODYNAMIC APPROACHES:
Emphasises the role of internal mental processes and early childhood experiences.
Psychopathology results from unconscious conflicts in the individual. Processing
happens at an unconscious level that we develop defence mechanisms to avoid the
conflict.
Evaluation: good evidence for the role of early childhood experiences in many
mental disorders. Evidence from trials is weaker, difficult to standardise interventions.
, EATING DISORDERS
DSM-5: Eating disorders are characterized by a persistent disturbance of eating or eating-
related behaviour that results in the altered consumption or absorption of food and that
significantly impairs physical health or psychosocial functioning.
DEFINITIONS:
Feeding disorders: involve behavioural disturbances that are not related to body
weight and shape concerns, such as eating of non-edible substances.
Eating disorders: involve abnormal eating behaviour and preoccupation with food as
well as prominent body weight and shape concerns.
Types of eating disorders: anorexia nervosa, bulimia nervosa, binge eating disorder,
pica, rumination disorder, etc.
Incidence of ED: A representative study (Micali et al., 2013) identified incidence of
37.2 diagnosis per 100 000 (2009). The incidence of the diagnosed ED was highest
for girls aged 15– 19 and for boys aged 10–14.
Prevalence of ED:
Lifetime prevalence for women (DSM-5) anorexia nervosa 1.7%, bulimia
nervosa 0.8%, binge eating disorder 2.3% (Smink et al., 2014).
In males: AN: 0.3% (USA), 0.24 % (Finland), BN: 0.5% (USA), BED: 2%
(USA), 0.3% (Europe). (Smink et al., 2012).
ANOREXIA NERVOSA DIAGNOSIS: (DSM-5)
Persistent restriction of energy intake leading to significantly low body weight.
Disturbance in one of the following: the way one's body weight or shape is
experienced, undue influence of body shape and weight on self-evaluation &
persistent lack of recognition of the seriousness of the current low body weight.
Either an intense fear of gaining weight or persistent behaviour that interferes with
weight gain, despite significantly low weight.
Associated factors:
Physical: Amenorhea, Lanugo hair,
thinning hair & hormonal alterations.
Psychological: obsessive
preoccupation w/ food, depression,
irritability, excessive energy &
inflexible thinking.
BULIMIA NERVOSA DIAGNOSIS: (DSM-5)
Recurrent episodes of binge eating, characterised by both eating, in a discrete period
of time (2hrs), a large amount of food, and a sense of lack of control over eating
during the episode.
Recurrent inappropriate compensatory behaviour in order to prevent weight gain eg
fasting, self-induced vomiting, misuse of laxatives and excessive exercise.
, The binge eating and inappropriate compensatory behaviours both occur, on average,
at least once a week for three months.
Self-evaluation is unduly influenced by body shape and weight.
Associated factors
BINGE EATING DISORDER DIAGNOSIS: (DSM-5)
Recurrent episodes of binge eating episodes that are associated w/ eating faster than
normal, eating until feeling uncomfortably full, eating large amounts of food when
not feeling hungry, eating alone due to embarrassment & feeling disgusted with
oneself and depressed afterwards.
Marked distress regarding binge eating (BE) is present. BE occurs, on average, at
least once a week for three months
Associated factors
AETIOLOGY OF ED:
Biological factors: low factors in frontal lobes (behavioural regulation) and
alterations with the amygdala (linked with fear), AN is associated w/ loss of grey and
white matter which can be associated with loss of communication between parts of
the brain.
Individual factors: Think often about food and eating, obsessive thinking, dieting is
a strong risk factor to developing ED. Very centred thinking towards their body and
is parallel to their sense of self-worth.
Family & peer influences: strange family dynamics such as dysfunctional
communication, and also a modelling effect (parents concerned with their own
weight) with a preoccupation with physical appearance, weight and food intake. Also
peer criticism over appearance and food intake.
Objectification theory: Posits that women (particularly) learn to view their bodies as
commodities, subject to the male gaze.
DEPRESSIVE DISORDERS
Diagnostic criteria of depressive disorders
