PYC 4802 SUMMARY NOTES
PSYCHOPATHOLOGY
1. THEME 2: Trauma and stressor related disorders
• ACUTE STRESS DISORDER
2. THEME 3: Substance-related and Addictive disorders
• ALCOHOL-RELATED & ADDICTIVE DISORDER
3. THEME 4: Depressive disorders (Adult depression)
• MAJOR DEPRESSIVE DISORDER
4. THEME 5: Child abuse
• PEDOPHILIC DISORDER
,1. THEME 2: Trauma and stressor related disorders
When is a trauma- or stressor-related response abnormal?
- The definition of a trauma is in many ways defined by the
individual's sociocultural background, both directly, and indirectly
through the beliefs and attitudes he/she has acquired and
internalized.
- If it leads to negative consequences (e.g. poor job-
performance, social withdrawal, anhedonia – loss of
experiencing pleasure.
- In trauma- and stressor-related disorders exposure to a traumatic
or stressful event is listed as the major diagnostic criterion.
- Anxiety, dissociation, or obsessive-compulsive responses may also
be part of the psychological distress response to experiencing a
traumatic event.
- Acute stress disorder (ASD) and PTSD are the 2 disorders that
have special relevance to South Africa with its high rates of
violence and crime.
- These disorders are extreme psychological reactions to an intensely
traumatic or violent event such as assault, sexual assault, natural
disasters, and wartime trauma.
- The risk of developing either ASD or PTSD depends on a number of
variable, including the type of trauma and degree of perceived
threat, the magnitude of the event, the extent of exposure to the
stressor, and risk and protective factors specific to the individual.
- The trauma may be so overwhelming that the person finds it
difficult to process or make sense of the event.
- Indirect exposure could also lead to ASD and PTSD.
- A diagnosis of ASD and PTSD requires direct or indirect exposure
to the traumatic event, as well as symptoms from these major
symptom clusters:
o Intrusion symptoms
o Avoidance
o Negative alterations in mood or cognition
o Arousal and changes in reactivity
o Recurrent symptoms of depersonalisation – feeling
detached from one’s own body or thoughts
o Or derealisation – a persistent sense of unreality
- ASD – present of at least 9 symptoms from any of these clusters.
- PTSD – present at least 1 or 2 symptoms from each individual cluster.
- If someone with ASD experiences distressing symptoms for
more than 30 days, diagnosis may be changed to PTSD.
- Person has to be exposed to either – death, threatened death,
actual or threatened serious injury, or actual or threatened
sexual violence to be diagnosed with either ASD or PTSD.
,Causative factors (Aetiology/Etiology)
- Fear and anxiety involve behavioural, autonomic, and endocrine
changes aimed at increasing an organism’s chance of survival.
Our senses take information from our environment, which
guides our behaviour.
- Severe physical injuries or more personalised trauma are more
likely to result in PTSD.
- Factors such as a person’s cognitive style, childhood history,
genetic vulnerability, and availability pf social support also
moderate the impact of a traumatic event.
Neurochemistry
- Multiple neurotransmitters have been found to play a role in fear
and anxiety behaviour. Neurotransmitters implicated in anxiety
disorders include serotonin, glutamate, GABA (gamma-amino
butyric acid), and norepinephrine (noradrenaline).
- Serotonin – enhances fear and anxiety, and its anxiety-enhancing
(anxiogenic) effects respond to selective serotonin reuptake
inhibitors (SSRI), selective serotonin-norepinephrine reuptake
inhibitors (SNRI), and other classes of pharmacological drugs.
- Norepinephrine neurons are projected to different areas of the
brain by a structure called the locus coeruleus – these neurons
regulate mood, cognition, and sleep.
Brain structure and functioning
- The amygdala and insula have been identified as 2 structures that
seem to be overtly responsive in the brains of people with high
levels of anxiety.
- Amygdala – Associated with the storage of emotional memories,
processing fear and other aspects of emotional and social
behaviour. It is central in investigating anxiety responses. This
structure plays a critical role in mediating emotions, such as
anxiety.
- Limbic system – A critical function of it is mediating autonomic,
emotional, and behavioural responses to threat, and it also plays a
significant function in the storage of emotional memories. Some of
these limbic structures are suggested to be hyperresponsive in
anxiety-prone individuals.
Genetics
- Genetics play a role in anxiety disorders – however, the
specificity of the genetic predisposition is unclear.
- The heritability estimates of anxiety disorders suggest a moderate
level of clustering of certain traits within a family, which may result
in a temperament that later increases one’s risk of developing an
anxiety disorder – heritability estimates suggest that anxious traits
and anxiety disorders share a moderate heritability.
, Psychodynamic models
- Psychopathology stems from an impoverished relationship
with parental figures.
- Children experience a void-like state in the absence of emotional
proximity, mirroring, and containment by key relational figures –
this triggers a state of anxiety followed by the activation of a
defence.
- These defences attempt to prevent a dangerous intrapsychic
situation from becoming traumatic.
- The primary anxieties or psychological threats faced by children
are usually related to abandonment or the loss of an object, loss of
the object’s affection, castration anxiety, and superego anxiety
(guilt).
Behavioural models
- These models describe how pathological anxiety and phobias are
acquired through traumatic exposure and aversive classical
conditioning.
- Through the process of Pavlovian fear conditioning, a non-
threatening object or environmental stimulus (conditional
stimulus) is paired with a fear- producing (dangerous and
threatening) stimulus, resulting in a phobic reaction.
- Through a process of operant conditioning, pathological fears are
maintained
– Involves a process of reinforcement, in which the phobic person
actively undertakes to avoid the feared object – The avoidance
results in a reduction in anxiety (negative reinforcement), which
serves to maintain the fear.
Cognitive models
- Prominent frame for effective disorders such as anxiety and
depression.
- These models propose that cognitive processes determine the way
we select, interpret, and process information from the environment,
and that cognitive processes mediate all emotional and behavioural
responses.
- Aaron Beck developed a cognitive theory of anxiety – while
cognitive appraisal of environmental threat is necessary for
survival, anxious individuals incorrectly overestimate the degree of
this threat and they underestimate their ability to cope.
- Cognitive approaches propose an interactional model that
examines how relevant life stressors interact with cognitive
vulnerability.
- Beck also proposed that emotions are triggered by dysfunctional
thoughts, beliefs, and attitudes, and that these beliefs lead to
avoidant behaviour.
Humanistic and existential models
PSYCHOPATHOLOGY
1. THEME 2: Trauma and stressor related disorders
• ACUTE STRESS DISORDER
2. THEME 3: Substance-related and Addictive disorders
• ALCOHOL-RELATED & ADDICTIVE DISORDER
3. THEME 4: Depressive disorders (Adult depression)
• MAJOR DEPRESSIVE DISORDER
4. THEME 5: Child abuse
• PEDOPHILIC DISORDER
,1. THEME 2: Trauma and stressor related disorders
When is a trauma- or stressor-related response abnormal?
- The definition of a trauma is in many ways defined by the
individual's sociocultural background, both directly, and indirectly
through the beliefs and attitudes he/she has acquired and
internalized.
- If it leads to negative consequences (e.g. poor job-
performance, social withdrawal, anhedonia – loss of
experiencing pleasure.
- In trauma- and stressor-related disorders exposure to a traumatic
or stressful event is listed as the major diagnostic criterion.
- Anxiety, dissociation, or obsessive-compulsive responses may also
be part of the psychological distress response to experiencing a
traumatic event.
- Acute stress disorder (ASD) and PTSD are the 2 disorders that
have special relevance to South Africa with its high rates of
violence and crime.
- These disorders are extreme psychological reactions to an intensely
traumatic or violent event such as assault, sexual assault, natural
disasters, and wartime trauma.
- The risk of developing either ASD or PTSD depends on a number of
variable, including the type of trauma and degree of perceived
threat, the magnitude of the event, the extent of exposure to the
stressor, and risk and protective factors specific to the individual.
- The trauma may be so overwhelming that the person finds it
difficult to process or make sense of the event.
- Indirect exposure could also lead to ASD and PTSD.
- A diagnosis of ASD and PTSD requires direct or indirect exposure
to the traumatic event, as well as symptoms from these major
symptom clusters:
o Intrusion symptoms
o Avoidance
o Negative alterations in mood or cognition
o Arousal and changes in reactivity
o Recurrent symptoms of depersonalisation – feeling
detached from one’s own body or thoughts
o Or derealisation – a persistent sense of unreality
- ASD – present of at least 9 symptoms from any of these clusters.
- PTSD – present at least 1 or 2 symptoms from each individual cluster.
- If someone with ASD experiences distressing symptoms for
more than 30 days, diagnosis may be changed to PTSD.
- Person has to be exposed to either – death, threatened death,
actual or threatened serious injury, or actual or threatened
sexual violence to be diagnosed with either ASD or PTSD.
,Causative factors (Aetiology/Etiology)
- Fear and anxiety involve behavioural, autonomic, and endocrine
changes aimed at increasing an organism’s chance of survival.
Our senses take information from our environment, which
guides our behaviour.
- Severe physical injuries or more personalised trauma are more
likely to result in PTSD.
- Factors such as a person’s cognitive style, childhood history,
genetic vulnerability, and availability pf social support also
moderate the impact of a traumatic event.
Neurochemistry
- Multiple neurotransmitters have been found to play a role in fear
and anxiety behaviour. Neurotransmitters implicated in anxiety
disorders include serotonin, glutamate, GABA (gamma-amino
butyric acid), and norepinephrine (noradrenaline).
- Serotonin – enhances fear and anxiety, and its anxiety-enhancing
(anxiogenic) effects respond to selective serotonin reuptake
inhibitors (SSRI), selective serotonin-norepinephrine reuptake
inhibitors (SNRI), and other classes of pharmacological drugs.
- Norepinephrine neurons are projected to different areas of the
brain by a structure called the locus coeruleus – these neurons
regulate mood, cognition, and sleep.
Brain structure and functioning
- The amygdala and insula have been identified as 2 structures that
seem to be overtly responsive in the brains of people with high
levels of anxiety.
- Amygdala – Associated with the storage of emotional memories,
processing fear and other aspects of emotional and social
behaviour. It is central in investigating anxiety responses. This
structure plays a critical role in mediating emotions, such as
anxiety.
- Limbic system – A critical function of it is mediating autonomic,
emotional, and behavioural responses to threat, and it also plays a
significant function in the storage of emotional memories. Some of
these limbic structures are suggested to be hyperresponsive in
anxiety-prone individuals.
Genetics
- Genetics play a role in anxiety disorders – however, the
specificity of the genetic predisposition is unclear.
- The heritability estimates of anxiety disorders suggest a moderate
level of clustering of certain traits within a family, which may result
in a temperament that later increases one’s risk of developing an
anxiety disorder – heritability estimates suggest that anxious traits
and anxiety disorders share a moderate heritability.
, Psychodynamic models
- Psychopathology stems from an impoverished relationship
with parental figures.
- Children experience a void-like state in the absence of emotional
proximity, mirroring, and containment by key relational figures –
this triggers a state of anxiety followed by the activation of a
defence.
- These defences attempt to prevent a dangerous intrapsychic
situation from becoming traumatic.
- The primary anxieties or psychological threats faced by children
are usually related to abandonment or the loss of an object, loss of
the object’s affection, castration anxiety, and superego anxiety
(guilt).
Behavioural models
- These models describe how pathological anxiety and phobias are
acquired through traumatic exposure and aversive classical
conditioning.
- Through the process of Pavlovian fear conditioning, a non-
threatening object or environmental stimulus (conditional
stimulus) is paired with a fear- producing (dangerous and
threatening) stimulus, resulting in a phobic reaction.
- Through a process of operant conditioning, pathological fears are
maintained
– Involves a process of reinforcement, in which the phobic person
actively undertakes to avoid the feared object – The avoidance
results in a reduction in anxiety (negative reinforcement), which
serves to maintain the fear.
Cognitive models
- Prominent frame for effective disorders such as anxiety and
depression.
- These models propose that cognitive processes determine the way
we select, interpret, and process information from the environment,
and that cognitive processes mediate all emotional and behavioural
responses.
- Aaron Beck developed a cognitive theory of anxiety – while
cognitive appraisal of environmental threat is necessary for
survival, anxious individuals incorrectly overestimate the degree of
this threat and they underestimate their ability to cope.
- Cognitive approaches propose an interactional model that
examines how relevant life stressors interact with cognitive
vulnerability.
- Beck also proposed that emotions are triggered by dysfunctional
thoughts, beliefs, and attitudes, and that these beliefs lead to
avoidant behaviour.
Humanistic and existential models
