Psychology 318
Table of Contents
Psychology 318 .......................................................................................................................................1
Chapter 1: Abnormal Behaviour in Historical Context ........................................................................................ 3
What is psychopathology? .......................................................................................................................................................... 3
What is a psychological disorder? .............................................................................................................................................. 3
Distress, impairment, and cultural context ................................................................................................................................ 3
Psychological disorder ................................................................................................................................................................ 3
Studying psychological disorders: Clinical Description ............................................................................................................... 3
Causation, treatment, and outcome .......................................................................................................................................... 4
Historical conceptions of abnormal behaviour........................................................................................................................... 4
Psychological tradition ................................................................................................................................................................ 4
Psychoanalytic theory ................................................................................................................................................................. 4
Psychoanalytic psychotherapy: the ‘Talking’ Cure ..................................................................................................................... 5
Psychodynamic psychotherapy................................................................................................................................................... 6
Humanistic theory ....................................................................................................................................................................... 6
Behavioural Model ...................................................................................................................................................................... 6
Present: Scientific Method and an Integrative Approach .......................................................................................................... 7
Chapter 2: Integrative Approach to Psychopathology ........................................................................................ 8
One-Dimensional Versus Multidimensional Models .................................................................................................................. 8
Genetic contributions to Psychopathology ................................................................................................................................ 8
Neuroscience and its Contributions to Psychopathology ........................................................................................................... 9
Behavioural and Cognitive Science ........................................................................................................................................... 10
Emotions ................................................................................................................................................................................... 11
Culture, Gender, Social and Interpersonal Factors ................................................................................................................... 11
Life-Span Development and developmental influences over psychopathology ...................................................................... 12
Chapter 3: Clinical Assessment and Diagnosis ................................................................................................. 13
Assessing Psychological Disorders ............................................................................................................................................ 13
Key Concepts ............................................................................................................................................................................. 13
Assessment Techniques ............................................................................................................................................................ 14
Diagnosing Psychological Disorders.......................................................................................................................................... 16
Classification Issues ................................................................................................................................................................... 17
History of Diagnostic Assessment through DSM-5 ................................................................................................................... 17
Readings .................................................................................................................................................................................... 18
Chapter 5: Anxiety Disorders .......................................................................................................................... 21
Complexity of Anxiety Disorders............................................................................................................................................... 21
Specific Anxiety Disorders ......................................................................................................................................................... 23
Chapter 5: Trauma and Stressor Related Disorders.......................................................................................... 32
PTSD (Post Traumatic Stress Disorder) ..................................................................................................................................... 32
Adjustment Disorders ............................................................................................................................................................... 34
Attachment Disorders ............................................................................................................................................................... 34
Readings .................................................................................................................................................................................... 34
Chapter 5: Obsessive-Compulsive and Related Disorders ................................................................................ 36
Obsessive-Compulsive Disorder (OCD) ..................................................................................................................................... 36
Tic disorder................................................................................................................................................................................ 37
Body Dysmorphic Disorder (BDD) ............................................................................................................................................. 38
Hoarding Disorder ..................................................................................................................................................................... 38
Trichotillomania (Hair Pulling Disorder) ................................................................................................................................... 38
Excoriation (Skin Picking Disorder) ........................................................................................................................................... 39
Readings .................................................................................................................................................................................... 39
Chapter 7: Mood Disorders ............................................................................................................................ 40
Mariska Bester 2021 © 1
, Major depressive episode ......................................................................................................................................................... 40
Manic episode ........................................................................................................................................................................... 41
Mood Episodes.......................................................................................................................................................................... 41
Depressive disorders ................................................................................................................................................................. 43
Bipolar disorders ....................................................................................................................................................................... 45
Mood disorders ......................................................................................................................................................................... 46
Suicide ....................................................................................................................................................................................... 53
Readings .................................................................................................................................................................................... 54
Mariska Bester 2021 © 2
,Chapter 1: Abnormal Behaviour in Historical Context
What is psychopathology?
- Psychopathology: scientific study of psychology dysfunction, mental
o Looks at theoretical underpinnings
o Ideology – how the disorder was developed, factors that contributed to development of this
disorder
o At progression – how it started, improvement, regression
o At symptomatology – all the symptoms of person with mental disorder
o Diagnosis – formal diagnosis from clinical psychologist, psychiatrist, as well as treatment for
diagnosis
- Draws on research from many different areas, bio-chemistry, pharmacology, psychology, psychiatry,
neurology
- Refers to behavioural / cognitive manifestations of these disorders
What is a psychological disorder?
- Psychological dysfunction associated with distress and / or impairment in functioning
o Behaving or thinking differently than they usually do, stresses the person out – why am I stressing,
why am I not wanting to be around people?
o Interrupts your usual day, such as not spending time with people if you usually do, sleeping more
or less, not doing hobbies you usually do, not able to complete tasks
- Involves a response that is not typical of the person / culturally expected
- May include cognitive, behavioural and or emotional elements – could be 1, 2 or all 3
Distress, impairment, and cultural context
- Distress is normal in some situations
- Dysfunctional distress occurs when person is much more distressed than others would be – such as
being in a space with a lot of fear and stress that it is impairing their functioning (eg: being stressed
when going out with friends significantly more than your friends are)
- Noticeable and pervasive (all the time) – (eg: each time I am socialising, I am experiencing this distress)
- Impairment: must be pervasive and/or significant
o Mental disorders are often exaggerations of normal processes (extreme shyness / sadness)
o Culture: consider ‘normalcy’ relative to behaviour of others in same cultural context; some
behaviour is expected in some cultures, some not
- Rule of thumb: mental disorder = harmful dysfunction
Psychological disorder
- Definition (D): behavioural, psychological, or biological dysfunctions that are unexpected in their
cultural context and associated with present distress and/or impairment in functioning or increased
risk of suffering, death, pain, or impairment
- Psychological dysfunction; distress / impairment; atypical response
Studying psychological disorders: Clinical Description
- Begins with the presenting problem
o Original complaint reported – recorded verbatim from client, and more things may be added later
on but this is where you start
o Symptoms (eg: chronic worry, panic attacks); this is what I am feeling, thinking, different to how I
normally act symptoms are picked out from what they tell us
- Description aims to:
o Distinguish clinically significant (completely changes the way the person behaves, responds to
things and manages themselves) dysfunction from common human experience
- Describe prevalence (how many people in population have the disorder) + incidence (number of new
cases over period of time) of disorders
Mariska Bester 2021 © 3
, - Focus
o Clinical description – includes symptoms etc
o Causation – aetiology, how did the disorder come about, what factors are present, biological,
genetics, psychosocial factors etc
o Treatment and outcome – using both above to see what the outcome of treatment would be
- Describe onset of disorders
o Acute (suddenly) vs insidious (gradually) onset
- Describe course of disorders
o Episodic (short period of time, eg major depression), time-limited (remains for limited time) or
chronic (long time, eg schizophrenia) course
- Prognosis – predict outcome of treatment
o Good (good support structure, taking medication etc = good chance of recovery) vs guarded (not
following treatment properly, not going to therapy, no support structure etc)
- Consider age of onset, which may shape presentation; some only in children, some can only be
diagnosed later on in life (such as schizophrenia)
Causation, treatment, and outcome
- Aetiology
o What contributes to the development of psychopathology? What caused it?
o Biological + psychological + social aspects
- Treatment development
o How can we help alleviate psychological suffering? Or alleviate the symptoms the person has?
o Includes pharmacological, psychosocial interventions and/or combined treatments
Historical conceptions of abnormal behaviour
- Major psychological disorders have existed across time and cultures
- Perceived causes and treatment of abnormal behaviour varied widely, depending on context
- 3 dominant traditions have existed in the past to explain abnormal behaviour
o Supernatural (good vs evil; demons and witches; exorcism to treat)
o Biological (Hippocrates – Western medicine – mental illness as having physical / biological roots;
brain trauma / head injury)
o Psychological (Freud, psychoanalysis, moral theory)
Psychological tradition
- Rise of moral therapy
o Became popular in first half of 19th century
o ‘moral’ = referring to psychological / emotional factors
o Social and psychological factors would impact the environment and how they would respond;
treatment was to re-educate person through rational discussion
o Main idea: treat patients as normally as possible in normal environment
o More humane treatment of institutionalized patients
o Encouraged and reinforced social interaction
- Proponents of moral therapy
o Philippe Pinel and Jean-Baptiste Pussin – patients should not be restrained
o Benjamin Rush – led reforms in USA
o Dorothea Dix – mental hygiene movement; model therapy could be done very well in small groups
or one on one. Too many people eventually though, and those asylums were formed after civil
war.
- Asylum reform – more patients getting care
o Moral therapy declined because more difficult with large groups of patients
- Soon followed by emergence of competing alternative psychological models; Freud or behaviourism
Psychoanalytic theory
- Freudian theory of the structure and function of the mind
Mariska Bester 2021 © 4
Table of Contents
Psychology 318 .......................................................................................................................................1
Chapter 1: Abnormal Behaviour in Historical Context ........................................................................................ 3
What is psychopathology? .......................................................................................................................................................... 3
What is a psychological disorder? .............................................................................................................................................. 3
Distress, impairment, and cultural context ................................................................................................................................ 3
Psychological disorder ................................................................................................................................................................ 3
Studying psychological disorders: Clinical Description ............................................................................................................... 3
Causation, treatment, and outcome .......................................................................................................................................... 4
Historical conceptions of abnormal behaviour........................................................................................................................... 4
Psychological tradition ................................................................................................................................................................ 4
Psychoanalytic theory ................................................................................................................................................................. 4
Psychoanalytic psychotherapy: the ‘Talking’ Cure ..................................................................................................................... 5
Psychodynamic psychotherapy................................................................................................................................................... 6
Humanistic theory ....................................................................................................................................................................... 6
Behavioural Model ...................................................................................................................................................................... 6
Present: Scientific Method and an Integrative Approach .......................................................................................................... 7
Chapter 2: Integrative Approach to Psychopathology ........................................................................................ 8
One-Dimensional Versus Multidimensional Models .................................................................................................................. 8
Genetic contributions to Psychopathology ................................................................................................................................ 8
Neuroscience and its Contributions to Psychopathology ........................................................................................................... 9
Behavioural and Cognitive Science ........................................................................................................................................... 10
Emotions ................................................................................................................................................................................... 11
Culture, Gender, Social and Interpersonal Factors ................................................................................................................... 11
Life-Span Development and developmental influences over psychopathology ...................................................................... 12
Chapter 3: Clinical Assessment and Diagnosis ................................................................................................. 13
Assessing Psychological Disorders ............................................................................................................................................ 13
Key Concepts ............................................................................................................................................................................. 13
Assessment Techniques ............................................................................................................................................................ 14
Diagnosing Psychological Disorders.......................................................................................................................................... 16
Classification Issues ................................................................................................................................................................... 17
History of Diagnostic Assessment through DSM-5 ................................................................................................................... 17
Readings .................................................................................................................................................................................... 18
Chapter 5: Anxiety Disorders .......................................................................................................................... 21
Complexity of Anxiety Disorders............................................................................................................................................... 21
Specific Anxiety Disorders ......................................................................................................................................................... 23
Chapter 5: Trauma and Stressor Related Disorders.......................................................................................... 32
PTSD (Post Traumatic Stress Disorder) ..................................................................................................................................... 32
Adjustment Disorders ............................................................................................................................................................... 34
Attachment Disorders ............................................................................................................................................................... 34
Readings .................................................................................................................................................................................... 34
Chapter 5: Obsessive-Compulsive and Related Disorders ................................................................................ 36
Obsessive-Compulsive Disorder (OCD) ..................................................................................................................................... 36
Tic disorder................................................................................................................................................................................ 37
Body Dysmorphic Disorder (BDD) ............................................................................................................................................. 38
Hoarding Disorder ..................................................................................................................................................................... 38
Trichotillomania (Hair Pulling Disorder) ................................................................................................................................... 38
Excoriation (Skin Picking Disorder) ........................................................................................................................................... 39
Readings .................................................................................................................................................................................... 39
Chapter 7: Mood Disorders ............................................................................................................................ 40
Mariska Bester 2021 © 1
, Major depressive episode ......................................................................................................................................................... 40
Manic episode ........................................................................................................................................................................... 41
Mood Episodes.......................................................................................................................................................................... 41
Depressive disorders ................................................................................................................................................................. 43
Bipolar disorders ....................................................................................................................................................................... 45
Mood disorders ......................................................................................................................................................................... 46
Suicide ....................................................................................................................................................................................... 53
Readings .................................................................................................................................................................................... 54
Mariska Bester 2021 © 2
,Chapter 1: Abnormal Behaviour in Historical Context
What is psychopathology?
- Psychopathology: scientific study of psychology dysfunction, mental
o Looks at theoretical underpinnings
o Ideology – how the disorder was developed, factors that contributed to development of this
disorder
o At progression – how it started, improvement, regression
o At symptomatology – all the symptoms of person with mental disorder
o Diagnosis – formal diagnosis from clinical psychologist, psychiatrist, as well as treatment for
diagnosis
- Draws on research from many different areas, bio-chemistry, pharmacology, psychology, psychiatry,
neurology
- Refers to behavioural / cognitive manifestations of these disorders
What is a psychological disorder?
- Psychological dysfunction associated with distress and / or impairment in functioning
o Behaving or thinking differently than they usually do, stresses the person out – why am I stressing,
why am I not wanting to be around people?
o Interrupts your usual day, such as not spending time with people if you usually do, sleeping more
or less, not doing hobbies you usually do, not able to complete tasks
- Involves a response that is not typical of the person / culturally expected
- May include cognitive, behavioural and or emotional elements – could be 1, 2 or all 3
Distress, impairment, and cultural context
- Distress is normal in some situations
- Dysfunctional distress occurs when person is much more distressed than others would be – such as
being in a space with a lot of fear and stress that it is impairing their functioning (eg: being stressed
when going out with friends significantly more than your friends are)
- Noticeable and pervasive (all the time) – (eg: each time I am socialising, I am experiencing this distress)
- Impairment: must be pervasive and/or significant
o Mental disorders are often exaggerations of normal processes (extreme shyness / sadness)
o Culture: consider ‘normalcy’ relative to behaviour of others in same cultural context; some
behaviour is expected in some cultures, some not
- Rule of thumb: mental disorder = harmful dysfunction
Psychological disorder
- Definition (D): behavioural, psychological, or biological dysfunctions that are unexpected in their
cultural context and associated with present distress and/or impairment in functioning or increased
risk of suffering, death, pain, or impairment
- Psychological dysfunction; distress / impairment; atypical response
Studying psychological disorders: Clinical Description
- Begins with the presenting problem
o Original complaint reported – recorded verbatim from client, and more things may be added later
on but this is where you start
o Symptoms (eg: chronic worry, panic attacks); this is what I am feeling, thinking, different to how I
normally act symptoms are picked out from what they tell us
- Description aims to:
o Distinguish clinically significant (completely changes the way the person behaves, responds to
things and manages themselves) dysfunction from common human experience
- Describe prevalence (how many people in population have the disorder) + incidence (number of new
cases over period of time) of disorders
Mariska Bester 2021 © 3
, - Focus
o Clinical description – includes symptoms etc
o Causation – aetiology, how did the disorder come about, what factors are present, biological,
genetics, psychosocial factors etc
o Treatment and outcome – using both above to see what the outcome of treatment would be
- Describe onset of disorders
o Acute (suddenly) vs insidious (gradually) onset
- Describe course of disorders
o Episodic (short period of time, eg major depression), time-limited (remains for limited time) or
chronic (long time, eg schizophrenia) course
- Prognosis – predict outcome of treatment
o Good (good support structure, taking medication etc = good chance of recovery) vs guarded (not
following treatment properly, not going to therapy, no support structure etc)
- Consider age of onset, which may shape presentation; some only in children, some can only be
diagnosed later on in life (such as schizophrenia)
Causation, treatment, and outcome
- Aetiology
o What contributes to the development of psychopathology? What caused it?
o Biological + psychological + social aspects
- Treatment development
o How can we help alleviate psychological suffering? Or alleviate the symptoms the person has?
o Includes pharmacological, psychosocial interventions and/or combined treatments
Historical conceptions of abnormal behaviour
- Major psychological disorders have existed across time and cultures
- Perceived causes and treatment of abnormal behaviour varied widely, depending on context
- 3 dominant traditions have existed in the past to explain abnormal behaviour
o Supernatural (good vs evil; demons and witches; exorcism to treat)
o Biological (Hippocrates – Western medicine – mental illness as having physical / biological roots;
brain trauma / head injury)
o Psychological (Freud, psychoanalysis, moral theory)
Psychological tradition
- Rise of moral therapy
o Became popular in first half of 19th century
o ‘moral’ = referring to psychological / emotional factors
o Social and psychological factors would impact the environment and how they would respond;
treatment was to re-educate person through rational discussion
o Main idea: treat patients as normally as possible in normal environment
o More humane treatment of institutionalized patients
o Encouraged and reinforced social interaction
- Proponents of moral therapy
o Philippe Pinel and Jean-Baptiste Pussin – patients should not be restrained
o Benjamin Rush – led reforms in USA
o Dorothea Dix – mental hygiene movement; model therapy could be done very well in small groups
or one on one. Too many people eventually though, and those asylums were formed after civil
war.
- Asylum reform – more patients getting care
o Moral therapy declined because more difficult with large groups of patients
- Soon followed by emergence of competing alternative psychological models; Freud or behaviourism
Psychoanalytic theory
- Freudian theory of the structure and function of the mind
Mariska Bester 2021 © 4
