INSTRUCTOR’S RESOURCE MANUAL
PSYCHOPATHOLOGY: A CLINICAL SCIENCE APPROACH
19TH EDITION
CHAPTER 1: PSYCHOPATHOLOGY: OVERVIEW AND RESEARCH
APPROACHES
Detailed Chapter Outline
INTRODUCTION
1. Psychopathology is concerned with understanding the nature, causes, and
treatment of mental disorders.
2. Family aggregation is whether a disorder runs in families.
I. HOW ARE MENTAL DISORDERS DEFINED?
Learning Objective 1.1: Explain how we define and classify mental disorders.
A. Indicators of Abnormality
1. No one behavior or single indicator is enough to define abnormality. However,
the more that someone has difficulties in the following areas, the more likely it is
that they have some form of mental disorder:
a. Subjective distress: If people suffer or experience psychological pain, we are
inclined to consider this indicative of a psychological problem; however,
although subjective distress is an element of a mental disorder in many cases,
it is neither a sufficient condition nor even a necessary condition for us to
consider that something is psychopathological.
b. Maladaptiveness: Any behavior that is maladaptive for the individual or
toward society (e.g., anorexia) is maladaptive.
c. Statistical deviancy: The outdated term abnormal literally means “away from
the normal.” Just because something is statistically common or uncommon,
though, does not reflect abnormality (e.g., having an intellectual disability,
which is statistically rare, represents a deviation from the normal).
d. Violation of the standards of society: All cultures have rules. Some of these
are formalized as laws; others form the norms and moral standards that we are
, taught to follow. When people fail to follow the conventional social and moral
rules of their cultural group, we may consider their behavior to be abnormal
(e.g., the Amish of Pennsylvania not driving cars or watching television).
e. Social discomfort: Not all rules are explicit, and it doesn’t bother us when
some rules are violated. However, when someone breaks a social rule and
those around this individual experience a sense of discomfort or unease (e.g.,
if you are sitting on an almost empty bus and someone gets on and sits
directly next to you), it may be considered an abnormal behavior.
f. Irrationality and unpredictability: People are expected to behave in socially
acceptable ways and abide by social rules. For example, if someone next to
you started screaming and yelling obscenities at nothing, this behavior would
be viewed as unpredictable, disorganized, and irrational.
g. Dangerousness: This describes someone who is clearly a danger to himself or
another person. Therapists are required to hospitalize suicidal clients, and if
they have a client who makes an explicit threat to harm another person, they
are required to contact both the police and the person who is the target of the
threat. But if we rely only on dangerousness as our sole feature of
abnormality, we will run into problems. For example, someone who engages
in high-risk sports such as free diving or base jumping is not immediately
considered mentally ill.
2. Decisions about psychopathology involve social judgments. Therefore, culture
plays a role in determining what is deviant.
B. The DSM-5-TR and the Definition of Mental Disorder
1. In the United States, the accepted standard for defining various types of mental
disorders is the American Psychological Association’s Diagnostic and Statistical
Manual of Mental Disorders.
2. Commonly referred to as DSM, it is revised and updated from time to time. The
current version, DSM-5, was published in 2013, with a revision (DSM-5-TR)
published in 2022.
3. Within DSM-5-TR, a mental disorder is defined as a syndrome that is present in
an individual and involves clinically significant disturbance in behavior, emotion
regulation, or cognitive functioning. These disturbances are thought to reflect a
dysfunction in biological, psychological, or developmental processes that are
necessary for mental functioning.
, 4. DSM-5 also recognizes that mental disorders are usually associated with
significant distress or disability in key areas of functioning, such as social,
occupational, and other activities.
a. Predictable or culturally approved responses to common stressors or losses
(such as the death of a loved one) are excluded.
b. It is also important that this dysfunctional pattern of behavior not stem from
social deviance or conflicts that the person has with society as a whole.
c. This new DSM-5-TR definition of mental illness was based on input from
various DSM-5 work groups as well as other sources.
d. Keep in mind that any definition of psychopathology or mental disorder must
be somewhat arbitrary.
e. The World Health Organization publishes the International Classification of
Diseases for use in countries outside the United States. The 11th edition is the
most recent.
II. CLASSIFICATION AND DIAGNOSIS
Learning Objective 1.2: Describe the advantages and disadvantages of classification.
1. At the most fundamental level, classification systems provide us with a
nomenclature (a naming system). This gives clinicians and researchers both a
common language and shorthand terms for complex clinical conditions.
2. Classification systems enable us to structure information in a more helpful
manner. They facilitate research, which gives us more information and facilitates
greater understanding about what causes various disorders and how they might
best be treated.
3. Classification facilitates research, which gives us more information and facilitates
greater understanding, not only about what causes various disorders, but also how
they might best be treated.
4. Defining the domain of what is considered pathological establishes the range of
problems that the mental health professional can address, and thus delineates
which types of psychological difficulties warrant insurance reimbursement and
the extent of such reimbursement.
A. What Are the Disadvantages of Classification?
1. Using any form of shorthand inevitably leads to a loss of information.
, 2. As we simplify through classification, we lose personal details about the actual
individual with the disorder.
3. Stigma, or disgrace, is still associated with having a psychiatric diagnosis.
4. Stereotyping, or forming automatic beliefs about other people, may lead to
incorrect inferences about those who have been diagnosed.
a. We unavoidably learn stereotypes as a result of growing up in a particular
culture (e.g., people who wear glasses are more intelligent; New Yorkers are
rude).
5. A stigma could be perpetuated by the problem of labeling.
a. It is important to keep in mind that classification systems don’t classify
people; they classify the disorders that people have.
6. When someone has an illness, we should take care not to define them by that
illness. Respectful and appropriate language should be used instead. For example,
it was once quite common for mental health professionals to describe a patient as
“a schizophrenic” or “a manic-depressive.” Now it is more widely acknowledged
that it is more accurate and considerate to use “person-first language”—“a person
with schizophrenia” or “a person with bipolar disorder.”
B. How Can We Reduce Prejudicial Attitudes Toward People Who Are Mentally Ill?
1. Prejudicial attitudes are common.
2. The results of a study by Arthur and colleagues (2010) suggest that stereotyping,
labeling, and stigma toward people with mental illness are not restricted to
industrialized countries.
3. For a long time, it was thought that educating people that mental disorders were
“real” brain disorders might be a solution, but sadly this does not seem to be the
case. Increases in the proportion of people who understand that mental disorders
have neurological causes have not resulted in decreases in stigma.
4. Stigma can be reduced by interventions that explain that there isn’t a sharp line
between mental health and mental illness.
5. Stigma does seem to be reduced by having more contact with people in the
stigmatized group. However, studies suggest that people may tend to avoid those
with mental illness because of the psychophysiological arousal and distress they
may experience.
PSYCHOPATHOLOGY: A CLINICAL SCIENCE APPROACH
19TH EDITION
CHAPTER 1: PSYCHOPATHOLOGY: OVERVIEW AND RESEARCH
APPROACHES
Detailed Chapter Outline
INTRODUCTION
1. Psychopathology is concerned with understanding the nature, causes, and
treatment of mental disorders.
2. Family aggregation is whether a disorder runs in families.
I. HOW ARE MENTAL DISORDERS DEFINED?
Learning Objective 1.1: Explain how we define and classify mental disorders.
A. Indicators of Abnormality
1. No one behavior or single indicator is enough to define abnormality. However,
the more that someone has difficulties in the following areas, the more likely it is
that they have some form of mental disorder:
a. Subjective distress: If people suffer or experience psychological pain, we are
inclined to consider this indicative of a psychological problem; however,
although subjective distress is an element of a mental disorder in many cases,
it is neither a sufficient condition nor even a necessary condition for us to
consider that something is psychopathological.
b. Maladaptiveness: Any behavior that is maladaptive for the individual or
toward society (e.g., anorexia) is maladaptive.
c. Statistical deviancy: The outdated term abnormal literally means “away from
the normal.” Just because something is statistically common or uncommon,
though, does not reflect abnormality (e.g., having an intellectual disability,
which is statistically rare, represents a deviation from the normal).
d. Violation of the standards of society: All cultures have rules. Some of these
are formalized as laws; others form the norms and moral standards that we are
, taught to follow. When people fail to follow the conventional social and moral
rules of their cultural group, we may consider their behavior to be abnormal
(e.g., the Amish of Pennsylvania not driving cars or watching television).
e. Social discomfort: Not all rules are explicit, and it doesn’t bother us when
some rules are violated. However, when someone breaks a social rule and
those around this individual experience a sense of discomfort or unease (e.g.,
if you are sitting on an almost empty bus and someone gets on and sits
directly next to you), it may be considered an abnormal behavior.
f. Irrationality and unpredictability: People are expected to behave in socially
acceptable ways and abide by social rules. For example, if someone next to
you started screaming and yelling obscenities at nothing, this behavior would
be viewed as unpredictable, disorganized, and irrational.
g. Dangerousness: This describes someone who is clearly a danger to himself or
another person. Therapists are required to hospitalize suicidal clients, and if
they have a client who makes an explicit threat to harm another person, they
are required to contact both the police and the person who is the target of the
threat. But if we rely only on dangerousness as our sole feature of
abnormality, we will run into problems. For example, someone who engages
in high-risk sports such as free diving or base jumping is not immediately
considered mentally ill.
2. Decisions about psychopathology involve social judgments. Therefore, culture
plays a role in determining what is deviant.
B. The DSM-5-TR and the Definition of Mental Disorder
1. In the United States, the accepted standard for defining various types of mental
disorders is the American Psychological Association’s Diagnostic and Statistical
Manual of Mental Disorders.
2. Commonly referred to as DSM, it is revised and updated from time to time. The
current version, DSM-5, was published in 2013, with a revision (DSM-5-TR)
published in 2022.
3. Within DSM-5-TR, a mental disorder is defined as a syndrome that is present in
an individual and involves clinically significant disturbance in behavior, emotion
regulation, or cognitive functioning. These disturbances are thought to reflect a
dysfunction in biological, psychological, or developmental processes that are
necessary for mental functioning.
, 4. DSM-5 also recognizes that mental disorders are usually associated with
significant distress or disability in key areas of functioning, such as social,
occupational, and other activities.
a. Predictable or culturally approved responses to common stressors or losses
(such as the death of a loved one) are excluded.
b. It is also important that this dysfunctional pattern of behavior not stem from
social deviance or conflicts that the person has with society as a whole.
c. This new DSM-5-TR definition of mental illness was based on input from
various DSM-5 work groups as well as other sources.
d. Keep in mind that any definition of psychopathology or mental disorder must
be somewhat arbitrary.
e. The World Health Organization publishes the International Classification of
Diseases for use in countries outside the United States. The 11th edition is the
most recent.
II. CLASSIFICATION AND DIAGNOSIS
Learning Objective 1.2: Describe the advantages and disadvantages of classification.
1. At the most fundamental level, classification systems provide us with a
nomenclature (a naming system). This gives clinicians and researchers both a
common language and shorthand terms for complex clinical conditions.
2. Classification systems enable us to structure information in a more helpful
manner. They facilitate research, which gives us more information and facilitates
greater understanding about what causes various disorders and how they might
best be treated.
3. Classification facilitates research, which gives us more information and facilitates
greater understanding, not only about what causes various disorders, but also how
they might best be treated.
4. Defining the domain of what is considered pathological establishes the range of
problems that the mental health professional can address, and thus delineates
which types of psychological difficulties warrant insurance reimbursement and
the extent of such reimbursement.
A. What Are the Disadvantages of Classification?
1. Using any form of shorthand inevitably leads to a loss of information.
, 2. As we simplify through classification, we lose personal details about the actual
individual with the disorder.
3. Stigma, or disgrace, is still associated with having a psychiatric diagnosis.
4. Stereotyping, or forming automatic beliefs about other people, may lead to
incorrect inferences about those who have been diagnosed.
a. We unavoidably learn stereotypes as a result of growing up in a particular
culture (e.g., people who wear glasses are more intelligent; New Yorkers are
rude).
5. A stigma could be perpetuated by the problem of labeling.
a. It is important to keep in mind that classification systems don’t classify
people; they classify the disorders that people have.
6. When someone has an illness, we should take care not to define them by that
illness. Respectful and appropriate language should be used instead. For example,
it was once quite common for mental health professionals to describe a patient as
“a schizophrenic” or “a manic-depressive.” Now it is more widely acknowledged
that it is more accurate and considerate to use “person-first language”—“a person
with schizophrenia” or “a person with bipolar disorder.”
B. How Can We Reduce Prejudicial Attitudes Toward People Who Are Mentally Ill?
1. Prejudicial attitudes are common.
2. The results of a study by Arthur and colleagues (2010) suggest that stereotyping,
labeling, and stigma toward people with mental illness are not restricted to
industrialized countries.
3. For a long time, it was thought that educating people that mental disorders were
“real” brain disorders might be a solution, but sadly this does not seem to be the
case. Increases in the proportion of people who understand that mental disorders
have neurological causes have not resulted in decreases in stigma.
4. Stigma can be reduced by interventions that explain that there isn’t a sharp line
between mental health and mental illness.
5. Stigma does seem to be reduced by having more contact with people in the
stigmatized group. However, studies suggest that people may tend to avoid those
with mental illness because of the psychophysiological arousal and distress they
may experience.
