Psychopathology
Book: Scientific study of mental illness Lecture: the suffering of the soul
Etiology
What causes mental illness?
Diagnosis
How do we classify mental disorders?
Treatment
How do we help someone with mental illness?
Mental Disorder/Illness
variety of health concerns related to mood, cognition, and behavior- there is no one definition of mental illness- In medicine a disorder is a functional abnormality or disturbance
The 3 D's
Deviance: Deviation from what is acceptable or common in society.
Distress: Suffering, anguish, or pain.
Dysfunction: Impairment in functioning- DANGER is not required
The Psychoanalytic Perspective
SIGMUND FREUD
General Beliefs:
Drives and desires (ID) are in conflict with values and beliefs(SUPEREGO)
major drives: eros and thanatos
people develop defense mechanisms
Repression: would be associated with related stress and trauma
Pathology:
Repressed
The Biological Perspective
focus of the brain and nervous system- How would a physician handle the situation?
pathology:
Brain chemistry!!!!
biological abnormalities, brain regions and chemistry
therapeutic process/treatment
medication, electroconvulsive therapy, surgery
Sympatheti
Sociocultural Perspective
General Beliefs:
social relations and cultre shape our experience
we exist within systems of privilege and oppression, and social labels and roles
-maladaptive social labels/roles
pathology:
oppressive social system
maladaptive labels/roles
unhealthy fami
Humanistic Perspective
Carl Rogers- as children we look to our parents and others for love and self-worth
Beliefs: from childhood we look up to self-worth and expectations of others
pathology: conditional parenting
incongruence between the real self and ideal self
therapeutic p
cognitive perspective
Aaron Beck- psychology suffering it due to our thoughts
beliefs: organizing data in different cognitive schemas-ways of viewing the world by seeking confirmation bias
pathology:
1. distorted thinking
2. automatic thoughts
3. assumptions
4. core beliefs
th
Behavioral Persepctive
Joseph Wolpe
Beliefs: classical and operant conditioning.
Pathology: learned anxiety response to a stimulus- classical
behavior that is rewarded- operant
Therapeutic Process:
Systematic desensitization- relaxation- exposure over time, slowly step by step,
David Rosenhan
sane vs insane experiment, there is no difference
Social Labeling
labels society puts on people that puts them in a box
Systematic Desensitization
Pairing relaxation with the stimuli that arouse anxiety.
Become relaxed during time of anxiety
Exposure Treatment
Repeatedly introducing people to the things they fear and avoid.
Face anxiety over and over again until they stop
Issues with diagnosing Mental Illness
Limitations:
1. Diagnostic criteria is often vague and subjective
2. Susceptible to bias
3. Different definitions- DSM-5 and ICD
Critiques
1. Diagnosis ENHANCES the possibility of stigma and discrimination.
2. Because of bias as we put people in boxes
3.
Acute vs Post Traumatic Stress Disorder
Common symptoms:
1. Intrusion- nightmares- FLASHBACK- re-experiencing the trauma
2. Avoidance-refusing to do something you would originally do
3. Negative Mood- irritability
4. Arousal -hypervigilance- being jumpy
Distress
These symptoms can be present in
Diathesis- Stress Model
Diathesis - DISPOSITION or vulnerability what we are born with
Stress - adverse EXPERIENCES leading to mental strain.
Stress Response: response or INTERPRETATION of adverse experience-stress is interpreted as challenging or overwhelming
Psychological diso
psychosis
complete lost of reality
Dissociation
detachment from reality
Disconnection between thoughts, emotions, identity, consciousness, and memory.
Intact reality testing
Dissociative Amnesia
inability to recall autobiographical information that is inconsistent with normal forgetting
no physical cause
usually unaware- people can recover without treatment!!
Dissociative Identity Disorder
1. Presence of two or more distinct personality states
2. Recurrent episodes of dissociative amnesia.
loss of control
treatment: Integrate fragmented spects of identity
more education
treatment: EMDR, DBT, Medication
Depersonalization/Derealization Disorder
Depersonalization: extreme detachment from self.
Derealization: extreme detachment from world.
Ongoing experiences
Causes: Defense Mechanism (Repression), Reinforcement (Operant Conditioning), Social Enactment
treatment: EMDR, DBT, Medication
EMDR
Treating the trauma
Dialectical Behavior Therapy (DBT)
Treating the symptoms
Cognitive Processing Therapy
helpful ways to think about trauma, and deal with it
Prolonged Exposure
re-experiencing the traumatic event through remembering it and engaging with, rather than avoiding, reminders of the trauma (triggers).
Somatization
the presentation or experience of mental phenomena as physical (somatic) symptoms.
Illness Anxiety Disorder
1. Chronic preoccupation with having or acquiring a serious illness.
-At least 6 months of preoccupation.
-Specific illness that is feared may change.
2. Excessive health-related behaviors (you are scared what they are going to tell you) or maladaptive av
Somatic Symptom Disorder
1. Presence of chronic somatic symptoms that are highly distressing or significantly disrupting daily life.
-Symptoms are persistent
2. Presence of excessive thoughts, feelings, or behaviors related to the somatic symptoms
Conversion Disorder
1. Somatic symptoms manifest themselves in an apparent neurological-like condition.
Examples may include seizures, paralysis, anesthesia, or blindness, deafness- must ensure the doctors clear them first
2. Incompatibility between the symptom and recognize
Fictitious Disorder
INTENTIONALLY FAKING
1. Falsification of physical or psychological signs or symptoms, or induction of injury or disease, associated with identified deception.
2. The individual presents as ill, impaired, or injured.
3. The deceptive behavior is evident ev
Malingering
Patient is intentionally producing symptoms motivated by external incentives.
External incentives would include avoiding military duty, obtain financial compensation, obtain drugs, or avoid a jail sentence.
external incentive
Cluster A
ODD"- schizophrenia
1. Paranoid Personality Disorder
2. Schizoid Personality Disorder
3. Schizotypal Personality Disorder
Cluster B
DRAMATIC"- genetic predisposition in combination with dysfunctional early environments.
1. Antisocial Personality Disorder
2. Borderline Personality Disorder
3.Histrionic Personality Disorder
4. Narcissistic Personality Disorder
Cluster C
ANXIOUS"
1. Avoidant Personality Disorder
2. Dependent Personality Disorder
3. Obsessive-Compulsive Personality Disorder
Personality Disorders
Enduring, persistent, inflexible, rigid, wide ranging maladaptive patterns of thinking, feeling, and acting that are outside of one's culture.
Benefit of Mental Illness
benefits:
1. Research: Allows for comprehensive research on prognosis and etiology. Brain scans, begin to understand what is going on with that person
2. Treatment: Allows for tailored treatment approaches and improved patient care.
3. Support: Provides o
What personality disorders treatment with psychodynamic/psychodynamic
Histrionic Personality Disorder
Dependent Personality Disorder
Obsessive-Compulsive Personality Disorder
biological perspective career
physician, nurse, neurologist
brain area smaller with individuals with PTSD
hippocampus
2 major influences on people from sociocultural society?
culture and social relations
how would someone from sociocultural treat with somatic symptoms disorder?
there is a difference in language for different symptoms
Rogers proposed: common factors across helping professions that are associated with positive treatment
1. genuineness
2. empathy
3. unconditional positive regard
what personality disorders are often treated through a cognitive or CBT approach
dependent
OCPD
avoidant
behavior therapy that has been shown in the research to be effective treatment for PTSD trauma
prolonged exposure treatment
behavior therapy that has been shown to help with borderline personality disorder
DBT
what disorders have a strong genetic component?
Cluster A disorder
Borderline persoanlity
OCPD
anti-social disorder
PTSD
Acute SD
Factors increase developing PTSD and ASD
how serve the trauma is
limited social support
pre-existing anxiety
previous history of trauma
somatic symptoms
headache, nausea, fatigue, muscle soreness
Paranoid Personality Disorder "Acusatory
Extreme mistrust and suspicious of others.
dx: A pervasive distrust and suspiciousness of others such that their motivates are interpreted as malevolent, beginning by early adulthood and present in a variety of contexts
avoidant vs schizoid
avoidant: desire for relationship
schizoid: no desire for relationship- limited emotional expression
Schizoid Personality Disorder "Aloof
Extreme avoidance of social relationships because of lack of interest in social connection.
Tend to have limited emotional expression.
NO emotional expression at all, with NO interest in social relationship
Schizotypal Personality Disorder "Awkward
Difficulty maintaining relationship due to eccentricities in behavior and thinking.
Tends to engage in magical thinking where they think that two random events are causally linked.-I saw a butterfly on my way to class today therefore I will get an A on my
Antisocial Personality Disorder
Pervasive pattern of disregard for moral values and societal norms.
charming
Tend to have less empathy and diminished impulse control.
Generally have little (if any) remorse or guilt about harming others
They can fake it and cry, to make others feel bad
l
Histrionic Personality Disorder
1. attention seeking and excessive emotionality.
ANY attention
psychodynamic therapy
Narcissistic Personality Disorder
1. grandiose self-image
2. lack empathy
3. desire for admiration
POSITIVE attention
Borderline Personality Disorder
1. extreme emotional instability
2. unstable interpersonal relationships
3. terrified of abandonment
either "all good" or "all bad".
Difficulty regulating emotions=difficulty with personal relationships
DBT
ODC vs OCPD
ODC: they know they have irrational thoughts-ego-dystonic,
OCPD:they don't know they have irrational thoughts- ego-sintonic
avoidant vs dependent
both fear abandonment and seek closeness
a: great emotional instability- can love and hate
d: emotional stability- never hate
Avoidant Personality Disorder
1. social inhibition and feelings of inadequacy.
2.. hypersensitive to criticism
3. desire close relationships
4. Avoid almost all social situations
harsh criticism and rejection in early childhood
Dependent Personality Disorder
1. need to be taken care of by others.
2. Often submissive and "clingy".
3. intense fear of separation
move from one romantic relationship to another
overprotective parenting style
Obsessive-Compulsive Personality Disorder
1. preoccupation with orderliness, perfectionism, and complete control.
2. inefficient and inflexible
EGO-SYNTONIC
overly harsh parenting
Psychopathology
Book: Scientific study of mental illness Lecture: the suffering of the soul
Etiology
What causes mental illness?
Diagnosis
How do we classify mental disorders?
Treatment
How do we help someone with mental illness?
Mental Disorder/Illness
variety of health concerns related to mood, cognition, and behavior- there is no one definition of mental illness- In medicine a disorder is a functional abnormality or disturbance
The 3 D's
Deviance: Deviation from what is acceptable or common in society.
Distress: Suffering, anguish, or pain.
Dysfunction: Impairment in functioning- DANGER is not required
The Psychoanalytic Perspective
SIGMUND FREUD
General Beliefs:
Drives and desires (ID) are in conflict with values and beliefs(SUPEREGO)
major drives: eros and thanatos
people develop defense mechanisms
Repression: would be associated with related stress and trauma
Pathology:
Repressed
The Biological Perspective
focus of the brain and nervous system- How would a physician handle the situation?
pathology:
Brain chemistry!!!!
biological abnormalities, brain regions and chemistry
therapeutic process/treatment
medication, electroconvulsive therapy, surgery
Sympatheti
Sociocultural Perspective
General Beliefs:
social relations and cultre shape our experience
we exist within systems of privilege and oppression, and social labels and roles
-maladaptive social labels/roles
pathology:
oppressive social system
maladaptive labels/roles
unhealthy fami
Humanistic Perspective
Carl Rogers- as children we look to our parents and others for love and self-worth
Beliefs: from childhood we look up to self-worth and expectations of others
pathology: conditional parenting
incongruence between the real self and ideal self
therapeutic p
cognitive perspective
Aaron Beck- psychology suffering it due to our thoughts
beliefs: organizing data in different cognitive schemas-ways of viewing the world by seeking confirmation bias
pathology:
1. distorted thinking
2. automatic thoughts
3. assumptions
4. core beliefs
th
Behavioral Persepctive
Joseph Wolpe
Beliefs: classical and operant conditioning.
Pathology: learned anxiety response to a stimulus- classical
behavior that is rewarded- operant
Therapeutic Process:
Systematic desensitization- relaxation- exposure over time, slowly step by step,
David Rosenhan
sane vs insane experiment, there is no difference
Social Labeling
labels society puts on people that puts them in a box
Systematic Desensitization
Pairing relaxation with the stimuli that arouse anxiety.
Become relaxed during time of anxiety
Exposure Treatment
Repeatedly introducing people to the things they fear and avoid.
Face anxiety over and over again until they stop
Issues with diagnosing Mental Illness
Limitations:
1. Diagnostic criteria is often vague and subjective
2. Susceptible to bias
3. Different definitions- DSM-5 and ICD
Critiques
1. Diagnosis ENHANCES the possibility of stigma and discrimination.
2. Because of bias as we put people in boxes
3.
Acute vs Post Traumatic Stress Disorder
Common symptoms:
1. Intrusion- nightmares- FLASHBACK- re-experiencing the trauma
2. Avoidance-refusing to do something you would originally do
3. Negative Mood- irritability
4. Arousal -hypervigilance- being jumpy
Distress
These symptoms can be present in
Diathesis- Stress Model
Diathesis - DISPOSITION or vulnerability what we are born with
Stress - adverse EXPERIENCES leading to mental strain.
Stress Response: response or INTERPRETATION of adverse experience-stress is interpreted as challenging or overwhelming
Psychological diso
psychosis
complete lost of reality
Dissociation
detachment from reality
Disconnection between thoughts, emotions, identity, consciousness, and memory.
Intact reality testing
Dissociative Amnesia
inability to recall autobiographical information that is inconsistent with normal forgetting
no physical cause
usually unaware- people can recover without treatment!!
Dissociative Identity Disorder
1. Presence of two or more distinct personality states
2. Recurrent episodes of dissociative amnesia.
loss of control
treatment: Integrate fragmented spects of identity
more education
treatment: EMDR, DBT, Medication
Depersonalization/Derealization Disorder
Depersonalization: extreme detachment from self.
Derealization: extreme detachment from world.
Ongoing experiences
Causes: Defense Mechanism (Repression), Reinforcement (Operant Conditioning), Social Enactment
treatment: EMDR, DBT, Medication
EMDR
Treating the trauma
Dialectical Behavior Therapy (DBT)
Treating the symptoms
Cognitive Processing Therapy
helpful ways to think about trauma, and deal with it
Prolonged Exposure
re-experiencing the traumatic event through remembering it and engaging with, rather than avoiding, reminders of the trauma (triggers).
Somatization
the presentation or experience of mental phenomena as physical (somatic) symptoms.
Illness Anxiety Disorder
1. Chronic preoccupation with having or acquiring a serious illness.
-At least 6 months of preoccupation.
-Specific illness that is feared may change.
2. Excessive health-related behaviors (you are scared what they are going to tell you) or maladaptive av
Somatic Symptom Disorder
1. Presence of chronic somatic symptoms that are highly distressing or significantly disrupting daily life.
-Symptoms are persistent
2. Presence of excessive thoughts, feelings, or behaviors related to the somatic symptoms
Conversion Disorder
1. Somatic symptoms manifest themselves in an apparent neurological-like condition.
Examples may include seizures, paralysis, anesthesia, or blindness, deafness- must ensure the doctors clear them first
2. Incompatibility between the symptom and recognize
Fictitious Disorder
INTENTIONALLY FAKING
1. Falsification of physical or psychological signs or symptoms, or induction of injury or disease, associated with identified deception.
2. The individual presents as ill, impaired, or injured.
3. The deceptive behavior is evident ev
Malingering
Patient is intentionally producing symptoms motivated by external incentives.
External incentives would include avoiding military duty, obtain financial compensation, obtain drugs, or avoid a jail sentence.
external incentive
Cluster A
ODD"- schizophrenia
1. Paranoid Personality Disorder
2. Schizoid Personality Disorder
3. Schizotypal Personality Disorder
Cluster B
DRAMATIC"- genetic predisposition in combination with dysfunctional early environments.
1. Antisocial Personality Disorder
2. Borderline Personality Disorder
3.Histrionic Personality Disorder
4. Narcissistic Personality Disorder
Cluster C
ANXIOUS"
1. Avoidant Personality Disorder
2. Dependent Personality Disorder
3. Obsessive-Compulsive Personality Disorder
Personality Disorders
Enduring, persistent, inflexible, rigid, wide ranging maladaptive patterns of thinking, feeling, and acting that are outside of one's culture.
Benefit of Mental Illness
benefits:
1. Research: Allows for comprehensive research on prognosis and etiology. Brain scans, begin to understand what is going on with that person
2. Treatment: Allows for tailored treatment approaches and improved patient care.
3. Support: Provides o
What personality disorders treatment with psychodynamic/psychodynamic
Histrionic Personality Disorder
Dependent Personality Disorder
Obsessive-Compulsive Personality Disorder
biological perspective career
physician, nurse, neurologist
brain area smaller with individuals with PTSD
hippocampus
2 major influences on people from sociocultural society?
culture and social relations
how would someone from sociocultural treat with somatic symptoms disorder?
there is a difference in language for different symptoms
Rogers proposed: common factors across helping professions that are associated with positive treatment
1. genuineness
2. empathy
3. unconditional positive regard
what personality disorders are often treated through a cognitive or CBT approach
dependent
OCPD
avoidant
behavior therapy that has been shown in the research to be effective treatment for PTSD trauma
prolonged exposure treatment
behavior therapy that has been shown to help with borderline personality disorder
DBT
what disorders have a strong genetic component?
Cluster A disorder
Borderline persoanlity
OCPD
anti-social disorder
PTSD
Acute SD
Factors increase developing PTSD and ASD
how serve the trauma is
limited social support
pre-existing anxiety
previous history of trauma
somatic symptoms
headache, nausea, fatigue, muscle soreness
Paranoid Personality Disorder "Acusatory
Extreme mistrust and suspicious of others.
dx: A pervasive distrust and suspiciousness of others such that their motivates are interpreted as malevolent, beginning by early adulthood and present in a variety of contexts
avoidant vs schizoid
avoidant: desire for relationship
schizoid: no desire for relationship- limited emotional expression
Schizoid Personality Disorder "Aloof
Extreme avoidance of social relationships because of lack of interest in social connection.
Tend to have limited emotional expression.
NO emotional expression at all, with NO interest in social relationship
Schizotypal Personality Disorder "Awkward
Difficulty maintaining relationship due to eccentricities in behavior and thinking.
Tends to engage in magical thinking where they think that two random events are causally linked.-I saw a butterfly on my way to class today therefore I will get an A on my
Antisocial Personality Disorder
Pervasive pattern of disregard for moral values and societal norms.
charming
Tend to have less empathy and diminished impulse control.
Generally have little (if any) remorse or guilt about harming others
They can fake it and cry, to make others feel bad
l
Histrionic Personality Disorder
1. attention seeking and excessive emotionality.
ANY attention
psychodynamic therapy
Narcissistic Personality Disorder
1. grandiose self-image
2. lack empathy
3. desire for admiration
POSITIVE attention
Borderline Personality Disorder
1. extreme emotional instability
2. unstable interpersonal relationships
3. terrified of abandonment
either "all good" or "all bad".
Difficulty regulating emotions=difficulty with personal relationships
DBT
ODC vs OCPD
ODC: they know they have irrational thoughts-ego-dystonic,
OCPD:they don't know they have irrational thoughts- ego-sintonic
avoidant vs dependent
both fear abandonment and seek closeness
a: great emotional instability- can love and hate
d: emotional stability- never hate
Avoidant Personality Disorder
1. social inhibition and feelings of inadequacy.
2.. hypersensitive to criticism
3. desire close relationships
4. Avoid almost all social situations
harsh criticism and rejection in early childhood
Dependent Personality Disorder
1. need to be taken care of by others.
2. Often submissive and "clingy".
3. intense fear of separation
move from one romantic relationship to another
overprotective parenting style
Obsessive-Compulsive Personality Disorder
1. preoccupation with orderliness, perfectionism, and complete control.
2. inefficient and inflexible
EGO-SYNTONIC
overly harsh parenting