Abnormal Psychology Chief Guide 2022 2023

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Good Shepherd Professional Training Services (GSPTS) – National Review Center for Psychology and Counseling,
Psychologists and Psychometricians National Review Program 2022-2023
August 2022-February 2023, Manila, Philippines
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INTRODUCTION TO ABNORMAL  AIDS: divine punishment for
PSYCHOLOGY homosexuality
 Exorcism
REFERENCES:  Reliable
 Nolen-Hoeksema  If not, other methods are used such
 Barlow and Durand as beating and confinement
 Halgin and Whitbourne  Hanging people over a pit full of
 Oltmanns and Emery poisonous snakes
 Kring and Johnson  Dipping on icy water
 DSM IV-TR and DSM 5
 Sadock, B.J., & Sadock, V.A. (2007). Mass Hysteria
Kaplan & Sadock’s Synopsis of  Large-scale outbreak of bizarre
Psychiatry (10th ed.) Philadelphia, behavior
USA: Lippincott Williams & Wilkins  Middle ages
 they lent support to the notion of
HISTORICAL PERSPECTIVES possession
 Running in the streets, dancing,
shout, rave, jump
A. Supernatural tradition  Saint Vitus’ Dance and Tarantism
 Demons and Witches  Reaction to insect bites
 Supernatural causes of psychological
 disorders Moon and Stars
 Work of the devil  Paracelsus
 Witchcraft  Rejected possession
 Suggested that the movement of the
Treatment moon and the stars had an effect on
 Exorcism human behavior
 Shaving a cross pattern in the hair  Lunatic
 securing sufferers to a wall near the
front of a church Biological tradition
 Hippocrates-Father of modern
Supernatural tradition In the medicine
modern times of the Philippines:  He and his associates:
What can this be equated to? Hippocratic Corpus (450 and
350BC)
 Gayuma, Barang at Kulam  Suggested that psychological
 Engkanto at Diwata disorders can be treated like
 Pinaglaruan ng Duwende, Nuno sa other diseases.
punso  caused by brain trauma or
 Undin, Siokoy genetics
 GREEK TRADITION IN
Treatment for Possession MEDICINE
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 Abnormal behavior had Treatment
natural causes, not because  Bloodletting
of demonological accounts  Medical Treatment: bed rest,
 Galen’s 4 Humors healthy diet, exercise and etc.
 Disease as a unitary concept:  Acupuncture (China)
no distinction between
mental and physical The 19th Century
 All problems are caused by  Syphilis
imbalance in the body  STD caused by a bacterial
 Hippocratic-Galenic microorganism entering the
Approach: brain
 Behavioral and Cognitive
Symptoms include believing
that everyone is plotting
HUMORAL THEORY against you or that you are
God, as well as other bizarre
Four Humors behaviors
 Blood (heart)  Cure for syphilis: penicillin
 Black Bile (spleen)  John P. Grey
 Yellow Bile (liver)  Champion of the BT in the US
 Phlegm (brain)  His position is that the cause
of insanity is always physical
Four conditions in which  Mentally ill patients are to be
biles respond treated as though they are
 Heat, dryness, moisture and physically ill
cold
4 types of Personality based  DEVELOPMENT OF

on humoral theory TREATMENTS
 Sanguine  1927: Insulin Shock Therapy
 Melancholic  1930s: Electric Shock and
 Phlegmatic Brain Surgery
 Choleric  Effects of such and of drugs
are discovered by accident
Biological tradition  1950s, the first effective
 Hysteria drugs for severe psychotic
 Akin to Somatoform Disorders disorders were developed in
 China a systematic way
 Yin and Yang
 Cold and dark wind Consequences of the Biological Tradition
 Warm, life-sustaining wind
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 Grey and colleagues reducing “animal magnetism,” which
interest in treating mental patients could become blocked
(brain pathology)  Jean Charcot: Started the
 Hospitalization of patients practice of hypnosis as
 Places of treatment Focus was on treatment modality
 Diagnosis  Freud and Breuer
 Responsibility of patients  Hypnosis 🡪
 Study of brain pathology Unconscious
 Emil Kraepelin (1913)- One of the  Catharsis
founding fathers of psychiatry  Anna O. -
Psychological tradition Psychoanalytic Theory

 Plato  Freud
 causes of maladaptive  Structure of the mind
behavior  Defense Mechanisms
 Social and cultural  Psychosexual Development
influences Stages
 Learning that took place in  Conscious versus
that environment unconscious:
 Precursor to modern  Id : Pleasure principle, Illogical,
psychosocial approaches emotional, irrational
 Moral Therapy  Ego - Reality principle, Logical and
 19th century psychosocial rational
approach to mental  Superego- Moral principles,
disorders Balances Id and Ego
 Moral = emotional or mental
 Treating patients as normally  Defense Mechanisms
as possible  Unconscious protective
 th
16 century Asylums turned processes that keep primitive
habitable and therapeutic emotions associated with
 Decline of Moral therapy conflicts in check so that the
(mid 19th century ego can continue its
 Dorothea Dix and mental coordinating function.
hygiene movement
 Psychosexual stages
Psychoanalytic Theory  Freud’s developmental
 Patients were hypnotized perspective on the study of
 Anton Mesmer: suggested to abnormal behavior stemming
his patients that their from infancy and early
problem was caused by an childhood
undetectable fluid found in  Oral
all living organisms called  Anal
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 Phallic  Contributions
 Latency  Unconscious processes
 Genital  Emotions triggered by cues
 “Therapeutic alliance”
 Modern Ego Psychology (Anna  Defense mechanisms
Freud, 1895-1982)
 Self-Psychology (Kohut, Freud’s students de-emphasize sexuality
1977)
 Object Relations Theory Carl Jung
 Melanie Klein and Otto  Collective Unconscious
Kernberg  Spiritual and Religious Drives
 Children  Enduring Personality Traits:
incorporation of Introversion and Extroversion
“objects”
 Images Alred Adler 1870-1937)
 Memories  Birth Order
 Values of significant  Inferiority Complex and Striving for
others Superiority
 Psychoanalytic Psychotherapy  Human nature is positive
 Unearth intrapsychic  Self-actualization
conflicts
 Long-term treatment model Erik Erikson (1902-1994)
 Techniques  Theory of Psychosocial stages of
 Free Association Dev’t
 Dream Analysis
 Transference/Counter- Carl Rogers (1902–1987)
Transference  Humanistic Theory
 Efficacy Data are Limited  Theoretical constructs
 Emphasizes conflicts and  Intrinsic goodness
unconscious  Striving for self-actualization
 Trauma and active defense  “Blocked” growth
mechanisms  Person-centered therapy
 Focus on: Affect, Avoidance,  Unconditional Positive
Patterns Regard
 Past experience, Interpersonal  Empathy
experience, Therapeutic  -giving a person the chance to
relationship, develop or grow unfettered by
Wishes, dreams, fantasies threats to self
 Criticisms
 Pejorative terms (e.g., neurosis) Abraham Maslow (1908–1970)
 Unscientific  Hierarchy of Needs
 Untested  Humanistic Theory
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The Present: The Scientific Method
Behavioral Model and an Integrative Approach
 Classical Conditioning  Defining and studying
 Ivan Pavlov (1849–1936) psychopathology Requires a broad
 Ubiquitous form of learning approach Multiple, interactive
 Unconditioned stimulus influences:
(UCS)  Biological, psychological,
 Unconditioned response social factors
(UCR)  Scientific emphasis
 Conditioned stimulus (CS)  Neuroscience
 Conditioned response (CR)  Cognitive, behavioral
 Stimulus generalization sciences
 Extinction
 Introspection PSYCHOPATHOLOGY IN THE
HISTORICAL CONTEXT
Behaviorism  Creation of the asylum
 John B. Watson (1878–1958)  Europe in the Middle Ages:
 Scientific emphasis “lunatics”, “idiots”
 Objective  Family, not community
 “Little Albert” experiment responsibility
 1600s to 1700s = insane asylums
Behavior Therapy  Change is societal perspective
 Mary Cover Jones  Early asylums: human warehouses
 Preexisting phobia
extinguished by exposure
and modeling  19th Century: Moral treatment
 Joseph Wolpe (1915–1997) movement
 Systematic desensitization  Large institutions led to the
 Relaxation development of new
 The Behavioral Model - Operant professions such as
Conditioning psychiatry
 E.L. Thorndike (1874–1949)  Worcester Lunatic Hospital:
 Law of effect: consequences A Model Institution
shape behavior  Woodward’s ideas about the
 B.F. Skinner (1904–1990) causes of disorders
 Behavior “operates” represented a combination
on environment of physical and moral
 Reinforcements, considerations.
Punishments, Lessons from history
Behavior “shaping”  Invention of public mental
hospitals: systematic
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observation and scientific DETERMINANTS OF
inquiry PSYCHOPATHOLOGICAL BEHAVIOR
 Psychiatry as a professional  BIOLOGICAL DETERMINANTS OF
group BEHAVIOR
 Expanded public concern on  Can be predisposing or
solving problems of mental precipitating factor
disorders  PSYCHOLOGICAL DETERMINANTS OF
 Some misguided and naïve BEHAVIOR
aspects of 19th century  Can be predisposing or
psychiatry precipitating factor
 Masturbation leads to  SOCIO-CULTURAL DETERMINANTS
mental disorders OF BEHAVIOR
 precipitating factor
PRESENT PERSPECTIVES
CLINICAL ASSESSMENT AND DIAGNOSIS
Modern perspectives
 Pharmacotherapy  ASSESSMENT
 Use of drugs in therapy  Gathering information
 Psychotherapy regarding people’s
 Problems: Deinstitutionalization symptoms and the possible
 Deinstitutionalization causes of these symptoms.
 Move to integrate patients with  DIAGNOSIS
their communities: community-  A label for a set of symptoms
based treatment facilities that often occur together
 process of determining
DETERMINANTS OF whether the particular
PSYCHOPATHOLOGY problem afflicting the
individual meets all criteria
 BEHAVIOR IS DETERMINED for a psychological disorder
 DETERMINANTS OF BEHAVIOR
 Pre-Genital Stages in the  CLINICAL ASSESSMENT
Psychosexual Stages of  the systematic evaluation
Development (Freud) and measurement of
 Fixation psychological, biological, and
 Caused by over-gratification social factors in an individual
 Makes the individual not presenting with a possible
want to leave the stage psychological disorder
 Frustration
 Cause of fixation
 Opposite of over-  Assessment Tools
gratification
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 Tools have been developed  Consistency of a test in
by clinicians to gather measuring what it is
information supposed to measure
 Assessment tools need to be
Valid, Reliable and
Standardized  TEST-RETEST RELIABILITY
 Consistency of the test
results over time
 Validity  ALTERNATE FORM RELIABILITY
 Accuracy of a test to  Results on a similar version
measure what it is supposed of the test are similar
to measure  INTERNAL RELIABILITY
 Similarity in people’s
answers among different
parts of the same test
 FACE VALIDITY  INTERRATER RELIABILITY
 Based from face value, it can  Interjudge Reliability
measure what it purports to
measure
 CONTENT VALIDITY  Standardization
 Extent to which a test  A way to improve validity
assesses all the important and reliability
aspects of a phenomenon
that it purports to measure DIFFERENT KINDS OF ASSESSMENT TOOLS
 CONCURRENT VALIDITY  CLINICAL INTERVIEW
 extent to which a test yields  SYMPTOM QUESTIONNAIRES
the same results as other,  BEHAVIORAL OBSERVATIONS AND
established measures of the SELF-MONITORING
same behavior, thoughts, or  PERSONALITY INVENTORIES
feelings  INTELLIGENCE TESTS
 PREDICTIVE VALIDITY  NEUROPSYCHOLOGICAL TESTS
 good at predicting how a  BRAIN IMAGING TECHNIQUES
person will think, act, or feel  PSYCHOPHYSIOLOGICAL TESTS &
in the future PHYSICAL EXAMINATION
 CONSTRUCT VALIDITY  PROJECTIVE TESTS
 extent to which a test  CLINICAL INTERVIEW
measures what it is supposed  Much of the information is
to measure and not gather through an initial
something else altogether interview
 May include a Mental Status
ASSESSMENT RELIABILITY Exam
 Reliability  Person’s general functioning
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 Mental Status Exam Beck Depression Inventory
 Appearance and (BDI), Trauma Symptom
Behavior Inventory (TSI), Harvard T
 Thought Processes Scale
 Speech  BEHAVIORAL OBSERVATIONS AND
 Mood and Affect SELF-MONITORING
 Intellectual  Behavioral Observation
Functioning  to assess deficits in skills or
 Memory and ways of handling situations
Attention  looking for specific behaviors
 Orientation/Sensoriu and what precedes and
m follows these behaviors
 Time, place, person,  Advantage: not relying on
object self-reports
 Disadvantage: changing of
 Structured Interviews behavior when observed;
 Series of questions different
asked about a conclusions/observer
particular symptom  ABCs of Observation
that is currently  Antecedents
experienced or  Behavior
experienced in the  Consequences
past  Self-Monitoring
 format of the  Keeping track of
questions and the behaviors
entire interview is  Disadvantage: bias of
standardized, and the the individual to
clinician uses report behaviors
concrete criteria to  Advantage: discovery
score the person’s of triggers of certain
answers behaviors
 SYMPTOM QUESTIONNAIRES  PERSONALITY INVENTORIES

 Quick way to identify  Questionnaires meant to
symptoms assess people’s typical ways
 Questionnaires can cover a of thinking, feeling, and
wide variety of symptoms behaving
representing several  Part of an assessment
different disorders procedure to obtain
 Focus on the symptoms of information on people’s well-
specific disorders being, self-concept, attitudes
and beliefs, ways of coping,
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perceptions of their  COMPUTERIZED
environment and social TOMOGRAPHY (CT)
resources, and vulnerabilities  Enhanced x-ray
 MMPI – Minnesota procedure
Multiphasic Personality  Brain structure
Inventory  POSITRON-EMISSION
 MMPI-2: 567 items TOMOGRAPHY
 Brain activity
 INTELLIGENCE TESTS  Requires injecting the
 In clinical practice, patient with a
intelligence tests are used to harmless radioactive
get a sense of an individual’s isotope, such as
intellectual strengths and fluorodeoxyglucose
weaknesses, particularly
when mental retardation or  SINGLE PHOTON EMISSION
brain damage is suspected COMPUTED TOMOGRAPHY
 Wechsler Adult Intelligence (SPECT)
Scale, the Stanford-Binet  Similar to PET but
Intelligence Test , and the different tracer
Wechsler Intelligence Scale substance, lesser
for Children accuracy, cheaper
 MAGNETIC RESONANCE
 NEUROPSYCHOLOGICAL TESTS IMAGING
 Useful in detecting specific  Detailed structure of brain
cognitive deficits such as a anatomy
memory problem  fMRI - functions
 Used when impairment in 
neurological functioning is  PSYCHOPHYSIOLOGICAL TESTS &
suspected PHYSICAL EXAMINATION
 Paper-and-pencil  alternative methods to CT,
 Bender-Gestalt Test (Bender PET, SPECT, and MRI used to
Visual Motor Gestalt Test, detect changes in the brain
BVMGT), Strength of Grip and nervous system that
Test reflect emotional and
 psychological changes
 BRAIN IMAGING TECHNIQUES  Electroencephalogram (EEG)
 To identify specific deficits – electrical activity along the
and possible brain scalp produced by the firing
abnormalities of specific neurons in the
 To determine if there is brain brain
injury, tumors, or damage  By Physician
 Brain Activity and Structure
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 Can show the medical
condition DIAGNOSIS
 Rule out medical conditions
 Conditions associated with  Syndrome: Label that is attached to
medical conditions a set of symptoms that occur
together.
 PROJECTIVE TESTS  Observe humans and identify
syndromes based on frequently co-
 PROJECTIVE HYPOTHESIS occurring symptoms
 When people attempt to  Several symptoms make up a
understand an ambiguous or syndrome, but people differ in
vague stimulus, their which of these symptoms they
interpretation of the experience most strongly
stimulus reflects their needs,  List of symptoms that co-occur
feelings, experiences, prior within the individual
conditioning, thought DIAGNOSIS
processes and so forth (L. K.
Frank, 1939)  Symptomatic Diagnosis:
 People are thought to Aimed to remove the
project these issues onto symptoms
their description of the  Characterological Diagnosis:
“content” of the stimulus Aimed at identifying the
 Useful in uncovering the personality dynamics –
unconscious issues or character
motives of a person or in
cases when the person is  Look into the typical signs
resistant or heavily biasing and symptoms manifested by
the information he or she the individual
presents to the assessor  With the symptoms, one can
 Rorschach Inkblot Test, identify the disorder
Thematic Apperception Test,
Sentence Completion Tests,
HTP, DAPT  Look into the personality
dynamics, personality,
CHALLENGES IN ASSESSMENT psychodynamics, or behavior
 Resistance dynamics
 Does not want to provide  Needs, motives – satisfied or
information unsatisfied
 Inability to Provide Information  Conflicts
 Assessing Children  Unresolved conflicts
 Assessing Individuals Across Cultures  Fixations
 Avoiding Barnum Effect  Coping mechanisms
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 Defense mechanisms  Interpretative Phase
 Makinginferences
 PSYCHODIAGNOSIS  Making interpretations
 Full evaluation of the  Formulating theories
patient’s personality
structure and functioning
 Give emphasis on the specific  Classification
behavior patterns of the  referring simply to any effort
patient to construct groups or
categories and to assign
 PSYCHODIAGNOSIS objects or people to these
 Classify the disorder of the categories on the basis of
patient their shared attributes or
 Do differential diagnosis relations—a nomothetic
 Psychodiagnostic impression strategy.
can change  Taxonomy
 Consider other factors such  which is the classification of
as duration entities for scientific
purposes
APPROACH IN DIAGNOSIS  Nosology
 applying a taxonomic system
to psychological or medical
 Idiographic Approach phenomena or other clinical
 Specific to the patient areas
 Nomothetic Approach  Nomenclature
 Universal or global  describes the names or
labels of the disorders that
GOALS OF DIAGNOSIS make up the nosology
 Aimed at treatment rather than
classification CLASSIFICATION ISSUES
 Prognosis
 Development of Insight  CATEGORICAL vs. DIMENSIONAL
APPROACHES
PHASES OF DIAGNOSIS  Categories: all or nothing;
clearly differentiate
 Dimensions: quantifying
 DESCRIPTIVE PHASE attributes and coming up
 Give a battery of with a composite score
psychological tests
 Interview
 Organogenic vs. Psychogenic  Classical Categorical Approach
 2. INFERENTIAL PHASE  Categories
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 Criteria  Clinical Disorders & Other
Conditions That May Be a
 Dimensional Approach Focus of Clinical Attention
 note the variety of  Axis II
cognitions, moods, and  Personality Disorders &
behaviors with which the Mental Retardation
patient presents and  Axis III
quantify them on a scale  General Medical Conditions
 Personality Disorders (Axis II)  Axis IV
 Psychosocial and
 Prototypical Approach Environmental Problems
 identifi es certain essential  Axis V
 characteristics of an entity so  Global Assessment of
that it can be classified, but it Functioning
also allows certain
nonessential variations that ONE NEEDS TO REVIEW DSM IV-TR IN
do not necessarily change ORDER TO SEE THE CHANGES MADE IN THE
the classification DSM V. THE AXIS IS NO LONGER USED IN
THE DSM V.
Diagnostic and Statistical Manual of
Mental Disorders Axis I
 Official Manual for Diagnosing Clinical Disorders and Other Conditions
Psychological Disorders That May Be a focus of Clinical Attention
 American Psychiatric Association  When an individual has more than
 DSM : 1952 one Axis I disorder, all of these
 DSM-II: 1968 should be reported. If more than
 DSM-III: 1980 one Axis I disorder is present, the
 DSM-IIIR: 1987 principal diagnosis or the reason for
 DSM-IV: 1994 visit should be indicated by listing it
 DSM-IV-TR: 2000 first
 DSM-V: 2013
Principal Diagnosis – condition established
 Uses a Multi-axial System after study to be chiefly responsible for
 5 axes or dimensions used to occasioning the admission of the individual
evaluate an individual *Reason for visit – when more than one
 First two are actual diagnosis diagnosis is given for an individual in an
of disorders; the 3 are outpatient setting, this is the condition that
criteria required for such is chiefly responsible for the ambulatory
diagnosis care medical services received during the
visit
 Axis I  When the individual has both Axis I
and Axis II disorder, the principal
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diagnosis or the reason for visit will
be assumed to be in Axis I unless the  If there are no General Medical
Axis II diagnosis is followed by the Conditions to report, code “none”
qualifying phrase “Principal for Axis 3
Diagnosis” or “Reason for visit”  If the diagnosis for a General
 If no Axis I disorder is present, this Medical Condition is deferred,
should be coded as V71.09 pending due to gathering
 If an Axis I diagnosis is deferred, information , code “deferred” on
pending the gathering of additional Axis 3
information, this should be coded as
799.9 Axis IV
Psychosocial and Environmental Problems
Axis II
Personality Disorders & Mental  May be a negative life event, an
Retardation environmental deficiency or
 Also used for noting prominent difficulty, a familial or other
maladaptive personality features interpersonal stress, an inadequacy
and defense mechanisms of a social support or personal
 All should be reported when the resources or other problem relating
individual has more than one Axis II to the context in which a person’s
disorder difficulties have developed
 So called positive stressors should
be listed only if they constitute or
 If an Axis II diagnosis is deferred, lead to a problem
pending the gathering of additional  Should only include those that have
information, this should be coded as been present in the year preceding
799.9 the current evaluation. However,
 If no Axis II disorder is present, this the clinician may choose to note the
should be coded as V71.09 problems occurring prior to the
previous year if these clearly
Axis III contribute to the mental disorder or
General Medical Conditions have become a focus of treatment
 Current general medical condition
that are potentially relevant to the Categories:
understanding or management of 1. Problems with primary support
the mental disorder group
 Can be related to mental disorders 2. Problems related to the social
 May be directly etiological to the environment
development or worsening of 3. Educational problems
mental symptoms and that the 4. Occupational problems
mechanism for this effect is 5. Housing problems
physiological 6. Economic problems
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7. Problems with access to health care wide range of activities, socially
services effective, generally satisfied with
8. Problems related to interaction with life, no more than everyday
the legal systems/crime problems or concerns
9. Other psychological and  80 -71 If symptoms are present, they
environmental problems are transient and expectable
reactions to psychological stressors,
no more than slight impairment in
 If there are no Social or social, occupational, or social
Environmental problems with the functioning
patient code “none” on Axis 4  70- 61 Some mild symptoms or
some difficulty in social, occupation,
Axis V or school functioning but generally
Global Assessment of Functioning functioning well, has some
(GAF) meaningful interpersonal
relationships
 60 – 51 Moderate symptoms or
 Clinician’s judgment of the moderate difficulty in social,
individual’s overall level of occupational, school functioning
functioning  50 – 41 Serious symptoms or any
 This information is useful in planning serious impairment in social,
treatment and measuring its impact occupational, school functioning
and in predicting outcome  40 – 31Some impairment in reality
 Tracks clinical progress in global testing or communication or major
terms using a single measure impairment in social, occupational,
 Has 10 ranges of functioning and has school functioning
2 components – symptom severity  30 -21 Behavior is influenced by
and functioning delusions or hallucination or serious
 When the 2 components are impairment in communication or
discordant, the final GAF rating judgment or inability to function in
always reflects the worse of the two almost all areas
 20 – 11 Some danger of hurting self
or others or occasionally fails to
 100-91 = Superior functioning in a maintain minimal personal hygiene
wide range of activities, life’s or gross impairment in
problems never seem to get out of communication
hand, is sought out by others  10 – 1 Persistent danger of severely
because of his/her many positive hurting self or others, or persistent
qualities. No symptoms inability to maintain minimal
 90 – 81 Absent or minimal personal hygiene or serious suicidal
symptoms, good functioning in all act with clear expectation of death
areas, interested and involved in a  0 inadequate information
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found out by a doctor that he had chronic
angle-closure glaucoma
Axis I: 309.81 Post Traumatic Stress
Disorder, Chronic, With Delayed Onset
296.34 Major Depressive Case 4:
Disorder, Recurrent, Severe without A man never had a long term relationship
Psychotic Features with any person of the opposite sex. Some
300.02 Generalized Anxiety of his former partners told the psychologist
Disorder (provisional) that they left this man due to his inability to
Axis II: V71.09 No Diagnosis hold a job.
Axis III: None
Axis IV: Occupational Problems: Inability to
establish ties with co-workers Dangers of Diagnosis
Axis V: GAF=65 (Intake) 1. The person labeled as abnormal is
GAF=75 (Current) treated differently by society and
this treatment can continue long
SAMPLE CASE after the person stops exhibiting the
behaviors labeled normal.
Case 1: 2. Another danger in labeling people is
A person is reported to have a major the idea of stigmatization.
depressive disorder, single episode, severe
without psychotic features, coupled with Avoiding Dangers of Diagnosis
alcohol abuse. This person also suffers from  DIAGNOSIS is important, however,
having a dependent personality disorder, clinicians and researchers need to
and the use of denial a defense mechanism. communicate regarding definitions
This was manifested after being given a of disorders.
memo from work stating that he could lose  When a system of definitions of
hi job. disorder is agreed on, then can
communication about disorders be
Case 2 improved.
A woman has been observed to have a
dysthymic disorder. When she was younger I. DETERMINANTS OF PSYCHOPATHOLOGY
she was diagnosed to have a reading
disorder. A medical doctor also diagnosed
her with recurrent otitis media, while a  BIOLOGICAL DETERMINANTS
social worker found out that she was a  PSYCHOLOGICAL DETERMINANTS
victim of child neglect  SOCIO-CULTURAL DETERMINANTS
Case 3 CONSIDER THE FOLLOWING:

A man was diagnosed to have a mood
disorder due to his hyperthyroidism,
resulting to a severe depression. It was also  PREDISPOSING FACTORS
P a g e 17 | 41
 A factor that makes someone Ex. The german sleep experiments
prone or susceptible to
a certain pathology 3. Obnoxious Agents
 Remote Effect -toxichemicals (toxic chemicals) like lead
does not come out at an early poisoning or carbon monoxide poisoning
stage -psychoactive drugs like alcohol or
only when triggered methametamine
4. Accidents
 PRECIPITATING FACTORS -those that damage the brain
 Factors that trigger the onset -brain injury leading to abnormal behavior
of a certain disorder
 Immediate Effect 5. Body Constitutions
-biological make-up of the person
BIOLOGICAL DETERMINANTS OF BEHAVIOR -ex. Condition of the receptors (any organ
Can be predisposing or precipitating factor that responds to any stimulus)
Ex. Conversion Disorders – a somatoform
disorder, eyes: conversion blindness, when
 A. GENETIC FACTOR eyes are weak and the person is subjected
 B. BIOLOGICAL DEPRIVATION to a traumatic event
 C. OBNOXIOUS AGENTS Ears: conversion deafness: one experiences
 D. ACCIDENTS deafness w/o any biological
 E. BODY CONSTITUTIONS source/condition
 F. BIOCHEMICAL FACTORS Defense to anxiety/avoid anxiety provoking
stimuli related to the trauma
1. Genetic Factors – hereditary
Ex. Huntington’s disease – transmitted 6. Biochemical factors
through a dominant gene; directly -in some cases of neurotransmitters
transferred from a parent to a child; Ex. Dopamine hypothesis: lower dopamine
progressive disease level in the brain is associated with
Symptoms: chorea – abnormal contractions parkinson’s disease
of large groups of muscles which appear High levels = schizophrenia
like dancing Norepinephrine: depression
Dementia – intellectual deterioration PSYCHOLOGICAL DETERMINANTS OF

BEHAVIOR
2. Biological Deprivation Can be predisposing or precipitating factor
-such as nutrition, minerals, vitamins
Ex. In ortomolecular medicine: a
schizophrenic patient is given a massive  A. STRESS
dose of vitamins  B. FRUSTRATION
-lack of sleep
P a g e 18 | 41
 C. OVER-USE OF DEFENSE Sour graping, sweet lemoning, rat. By
MECHANISMS comparison, by procrastination, by
 D. PSYCHOLOGICAL DEPRIVATION predestination (using destiny), by
exception (first time, only time),
sympathism (seeking sympathy for the
A. Stress – precipitating factor ego, putting one’s self in a low
 A person who is more stressed is position/underdog)
more prone to disorders
 Psychoneuroimmunology; diathesis- D. Psychological Deprivation - lack of
stress model attention, affection
-parental rejection
B. Frustration – precipitating factors -abandonment
-can be personal (personal -need for achievement, prestige and
inadequacies) or environmental recognition can lead to narcissistic
behavior
C. Over-use of defense mechanisms Cause is disordered motivation which
Defense mechanisms- protect the ego refers to:
(why do we need to protect the ego? 1. Excessive negative motivation – guilt
Executive of the personality) that leads to depression then to
-there should only be moderate use suicide
-over-use can lead to defense Guilt which leads to OCD =
mechanisms being symptoms of ablutomania compulsive washing of hands
psychopathology
2. Excessively weak or strong
Ex. Denial – can lead to conversion motivation
symptoms (tunnel vision: eccentric, Persons with weak need for
narrowing field of vision bec of the independence will develop
denial of a large part of reality) a. Dependent
Regression – disorganized schizophrenic personality disorder
Reaction Formation – a mother who b. Anorexia nervosa – weak or loss of
experienced rejection during childhood apettite
may become overcaring and c. Phobic reaction zoophobia vs.
overprotective “the lady doth protest zoophilia
too much, methinks” d. OCD
OCD
Isolation – isolating and idea from SOCIO-CULTURAL DETERMINANTS OF
affect, so as not to feel guilty. BEHAVIOR -precipitating factor
pathological gambling
Rationalization – giving justification for
one’s unacceptable reality to make it  A. POVERTY/UNEMPLOYMENT
acceptable  B. WAR
 C. RACIAL DISCRIMINATION
P a g e 19 | 41
 D. RURAL-URBAN SETTING Role of Neurotransmitter
 RESIDENTIAL MOBILITY Systems
 Malfunctioning of
Neurotransmitter systems
II. PERSPECTIVES IN EXPLAINING THE
CAUSE OF ABNORMAL BEHAVIOR Psychological symptoms may
Note: Review the different theories. be the consequence of
malfunctioning in
neurotransmitter systems;
 BIOLOGICAL PERSPECTIVES psychological experiences
 PSYCHOLOGICAL PERSPECTIVES also may cause changes in
 SOCIOCULTURAL PERSPECTIVES neurotransmitter system
functioning
A. BIOLOGICAL PERSPECTIVE
NEUROBIOLOGICAL PERSPECTIVES
 Nervous system controls our  Role of Receptors on the Dendrites
behavior  Few Receptors or not
 Ex.: Generalized Anxiety sensitive enough
Disorder (GAD)GABA System is  the neuron will not
less functioning be able to make
adequate use of the
 BRAIN DYSFUNCTION neurotransmitter
 BIOCHEMICAL IMBALANCE available in the
 GENETIC ABNORMALITIES synapse
 Too Many Receptors
BRAIN DYSFUNCTION or oversensitive
 Biochemical imbalance  the neuron may be
 Genetic Abnormalities overexposed to the
neurotransmitter that
Note: Review the parts and is in the synapse.
functions of the brain.
Review the different
neurotransmitters.  The amount of a
neurotransmitter available in the
synapse can be affected by two
 Result of Injury processes.
 From diseases that cause  The process of reuptake
deterioration occurs when the initial
 Ex. Schizophrenia – cerebral neuron releasing the
cortex does not function neurotransmitter into the
effectively or normally. synapse reabsorbs the
neurotransmitter,
P a g e 20 | 41
decreasing the amount left Other biochemical theories of
in the synapse. psychopathology focus on the
 Another process, called body’s endocrine system. This
degradation, occurs when system of glands produces
the receiving neuron chemicals called hormones,
releases an enzyme into which are released directly into
the synapse that breaks the blood. A hormone carries
down the neurotransmitter messages throughout the body,
into other biochemicals. potentially affecting a person’s
The reuptake and moods, levels of energy, and
degradation of reactions to stress.
neurotransmitters happen Pituitary Gland – master gland
naturally. PG and Hypothalamus illustrates
 When one or both of these the relationship of the Nervous
processes malfunction, System to the Endocrine System
abnormally high or low CRF is carried from the
levels of neurotransmitter hypothalamus to the pituitary
in the synapse result. through a channel-like structure.
The CRF stimulates the pituitary
to release the body’s major
 Arithmomania – uncontrollable urge stress hormone,
to count, involves the frontal lobe adrenocorticotrophic hormone
(prefrontal cortex) (ACTH). ACTH, in turn, is carried
 Feedback Loop – controls our by the bloodstream to the
behavior,diminished serotonin adrenal glands and to various
sensitivity, over-arousal happens, other organs of the body,
causes dysfunction n the feedback causing the release of about 30
loop and there is lack of control in hormones, each of which plays a
behavior role in the body’s adjustment to
emergency situations
anxiety and depression suggest
 The Role of the Endocrine System that these disorders result from
 Hormones dysregulation, or malfunctioning,
 Pituitary Gland and of a system called the
Hypothalamus hypothalamicpituitary- adrenal
 Stress Response axis
 corticotropin
release factor BEHAVIORAL GENETICS
(CRF)
 HPA Axis – anxiety
and depression  Study of the genetics of
Example: personality and abnormality
P a g e 21 | 41
 Alteration in the gene  Influences of punishments
structure can cause and reinforcements in
abnormalities producing behavior
 Genes and the Environment  Classical Conditioning
 Operant Conditioning
 Modeling
B. PSYCHOLOGICAL PERSPECTIVE  Observational
Learning
 Cognitive Perspective
 BEHAVIORAL PERSPECTIVE  Thoughts or beliefs shape
 COGNITIVE PERSPECTIVE our behaviors and the
 PSYCHODYNAMIC PERSPECTIVE emotions we experience
 HUMANISTIC PERSPECTIVE  causal attribution
 Specific answers to
“why” questions
 Psychodynamic Perspective  global assumptions
 all behavior, thoughts, and  Broad beliefs
emotions, whether normal or
abnormal, are influenced to Dysfunctional beliefs
a large extent by
unconscious processes
 Need and Motives,  1. I should be loved by everyone for
conscious or everything I do.
unconscious  2. It is better to avoid problems than
 Conflicts to face them.
 Defense mechanisms  3. I should be completely
 Kleptomania: unconscious need for competent, intelligent, and
affection and attention achieving in all I do.
 Ablutomania: guilt for wrong doing  4. I must have perfect self-control.
 Thanatomania-urge to go to funerals
 Ego-dystonic - unacceptable to the
ego  Humanistic Perspective
 Ego syntonic- acceptable  Assumption that humans
 Depression: have an innate capacity for
 Psychodynamic: lost of self-esteem goodness and for living a full
 Anger turned inward life.
 Feeling of helplessness  humanistic theorists
 Conversion blindness – denial recognized that we often are
not aware of the forces
shaping our behavior and
 Behavioral Perspective that the environment can
P a g e 22 | 41
play a strong role in our I. UNDERSTANDING ABNORMALITY
happiness or unhappiness Normal and Abnormal
 Self-actualization
 People often experience conflict Criteria for Normality
because of differences between Normality is average. This means
their true self—the ideal self they that what is accepted by the majority is
wish to be—and the self they feel considered normal. The problem here is
they ought to be to please others. that majority behavior is not always
This conflict can lead to emotional acceptable.
distress, unhealthy behaviors, and Normality is Social Conformity.
even loss of touch with reality. Anyone who conforms to social norms is
normal.
SOCIO-CULTURAL PERSPECTIVES Normality is Social Comfort. If a
 suggest that we need to person feels comfort or pleasure, then
look beyond the individual it is normal
or even the family to the Normality is Ideal. What is good,
larger society to understand what is socially acceptable and
people’s problems something that causes personal
comfort.
(1) socio-economic Normality is a Process. No one is
disadvantage is a risk factor instantly normal, we undergo certain
for a wide range of mental processes and undergo adjustment.
health problems Example, coping
(2) the upheaval and
disintegration of societies due Cultural Relativism
to war, famine, and natural -the view that there are no universal
disaster are potent risk standards or rules for labeling a
factors for mental health behavior as abnormal
problems -behaviors can only be abnormal
(3) Social norms and policies relative to cultural norms
that stigmatize and
marginalize groups
(4) societies may influence 1. Culture and gender can affect
the types of ways how people express their
psychopathology their symptoms.
members show by having 2. Culture and gender can influence
implicit or explicit rules about people’s willingness to admit
what types of abnormal certain types of behavior.
behavior are acceptable 3. Culture and gender can influence
the types of treatments deemed
acceptable or helpful for
maladaptive behaviors
P a g e 23 | 41
Sensorium- sometimes used as another
Unusualness- Behaviors that are term for consciousness; refers to the
deviant, or unusual, are considered state of functioning of the special senses
abnormal
Distress-behaviors should be considered Disorientation
abnormal only if the individual suffers disturbed orientation regarding
distress and wishes to be rid of the time, place, or person.
behaviors Delirium
Mental Illness -Behaviors are not patient exhibits confusion,
abnormal unless a part of a mental restlessness, bewilderment, and
illness. a disoriented reaction that is
usually associated with
The Four D’s of Abnormality hallucinations and fear.
Dysfunction Clouding of consciousness
Distress a state of perceptual and
Deviance cognitive confusion.
Dangerousness
Stupor
a general condition wherein the
II. Recognizing Psychopathology patient exhibits extreme
 Typical Signs and Symptoms of unresponsiveness and loss of
Psychopathology orientation to the environment.
Twilight state
Sadock, B.J., & Sadock, V.A. (2007). a disturbance in consciousness,
Kaplan & Sadock’s Synopsis of with hallucinations.
Psychiatry (10th ed.) Philadelphia, Dreamlike state
USA: Lippincott Williams & Wilkins another term for psychomotor
epilepsy or complex partial
seizure.
Sign- Objective; Based from a clinician’s Distractibility
observation the inability to concentrate or
Symptom- Subjective; Experiences of the focus attention because patient
patient is easily drawn to irrelevant
SYNDROME- constellation of signs and external stimuli.
symptoms that make up a recognizable Selective attention
condition, is often used to show the blocking out of anxiety-causing
overlap of the two stimuli.
Hyper vigilance
DISTURBANCES OF CONSCIOUSNESS excessive focus and attention is
given to all internal and external
Consciousness- state of awareness stimuli due to paranoia.
Apperception -perception modified by
one’s own thoughts and emotions
P a g e 24 | 41
DISTURBANCES OF SUGGESTIBILITY characterized by a severe reduction in
the intensity of the externalized feeling
Suggestibility - uncritical and compliant tone.
response to influence or an idea.
Restricted or constricted affect
Folie a deux (or folie a trois) reduction in the intensity of
emotional/mental illness shared feeling tone
between two (or three) persons It is less severe than blunted
also called shared psychosis affect.
between two (or three) persons. Flat affect
the absence or near absence of
Hypnosis any signs of affective expression.
artificially induced consciousness It can be characterized by an
characterized by heightened immobile face and a monotonous
suggestibility voice.
Labile affect
DISTURBANCES IN EMOTION rapid and abrupt changes in the
emotional feeling tone which is
Emotion unrelated to an external stimuli
a complex feeling or state related to Euphoria
mood and affect with psychic, intense elation with feelings of
somatic, and behavioral components. grandeur.
Ecstasy
Affect feeling of intense rapture or
the expression or outward delight.
manifestation of emotion Depression
the psychopathological feeling of
Appropriate affect sadness.
a normal condition wherein emotional
tone is in harmony or is consistent with Anhedonia
the accompanying thought, idea, or loss of interest and withdrawal
speech. It is also described as broad or from all regular and pleasurable
full affect wherein a full range of activities. Often associated with
emotions is appropriately expressed. depression.
Grief or Mourning
Inappropriate affect sadness that is appropriate to a
inconsistency between the emotional real loss.
tone and the idea, thought, or speech Alexithymia
accompanying it. the inability or difficulty in
describing one’s moods or
Blunted affect emotions.
P a g e 25 | 41
Anhedonia which are most often associated with
loss of interest and withdrawal depression; also known as vegetative
from all regular and pleasurable signs.
activities. Often associated with
depression. Anorexia
Grief or Mourning loss of or decrease in appetite.
sadness that is appropriate to a Hyperphagia
real loss. increase in appetite and food
Alexithymia intake.
the inability or difficulty in Hypersomnia
describing one’s moods or excessive sleeping.
emotions.
Insomnia
Agitation difficulty or lack the lack of ability
motor restlessness associated to fall asleep.
with severe anxiety. Initial
Tension difficulty in falling asleep. (early
unpleasant increased motor and onset)
psychological activity. Middle
Panic difficulty in sleeping through the
acute, episodic, intense anxiety night without waking up;
attack associated with difficulty in going back to sleep if
overwhelming feelings of dread. awaken in the middle of the
Apathy night. (middle onset)
dulled emotional tone associated Terminal
with indifference or detachment early morning awakening. (late
Ambivalence onset)
presence of two opposing
impulses toward the same thing, Diurnal variation
in the same person, at the same mood is regularly worst in
time. morning, immediately after
awakening, and improves as the
day progresses.
PHYSIOLOGICAL DISTRUBANCES Diminished libido

ASSOCIATED WITH MOOD decreased sexual interest, drive,
and performance.
Physiological disturbances associated Increased libido is usually
with mood associated with manic states.
Signs that refer to the somatic (usually Constipation

autonomic) dysfunction of a person, inability or difficulty in defecating
P a g e 26 | 41
voluntary assumption of an
inappropriate or bizarre posture
which is generally maintained for
long periods of time.
Cerea Flexibilitas (Waxy Flexibility)
DISTURBANCES IN MOTOR a condition wherein the person
FUNCTIONING can be molded into a position
that is then maintained. When
Echopraxia the examiner moves the person’s
the person’s pathological limb, the limb feels as if it were
imitation of movements of made of wax.
another person.
Catatonia Cataplexy
motor anomalies in non-organic temporary muscle weakness and
disorders (as opposed to loss of muscle tone precipitated
disturbances of consciousness by a variety of emotional states.
and motor activity secondary to Stereotypy
organic pathology) repetitive fixed pattern of
Negativism physical action or speech.
motiveless resistance to all
instructions or to all attempts to
be moved. Mannerism
deep-seated/ingrained and
Catalepsy habitual involuntary movement.
general term used to describe an
immobile position that is Automatism
constantly maintained. automatic performance of an act
Catatonic Excitement or acts generally representative
agitated, purposeless motor of unconscious symbolic activity.
activity that is uninfluenced by Command Automatism
external stimuli. automatic following of
Catatonic Stupor suggestions. (automatic
noticeable slowed motor activity, obedience)
often to a point of immobility and Mutism
seeming unawareness of voicelessness that is not caused
surroundings. by structural abnormalities or
Catatonic Rigidity physical conditions.
voluntary assumption of a rigid
posture, held against all efforts to Overactivity
be moved. abnormality in motor behavior that can
Catatonic Posturing manifest itself as psychomotor agitation,
hyperactivity, tic, sleepwalking, or
compulsions
P a g e 27 | 41
Psychomotor Agitation simple, imitative motor activity of
excessive motor and cognitive overactivity, childhood.
usually nonproductive and in response to Aggression
inner tension. forceful goal-directed action that may
Hyperactivity (Hyperkinesis) be verbal or physical; the motor
restless, aggressive, and destructive activity, counterpart of the affect of rage,
often associated with some underlying anger, or hostility.
organic pathology. Acting out
Tic direct expression of an unconscious
involuntary, spasmodic motor movement. wish or impulse in action;
Sleepwalking (Somnambulism) unconscious fantasy is lived out
motor activity during sleep. impulsively in behavior.
Akathisia DISTURBANCES IN THINKING

subjective feeling of muscular tension
secondary to antipsychotic or other Thinking
medication, which can cause restlessness, the goal-directed flow of ideas.
pacing, repeated sitting and standing; can be Symbols and associations initiated by
mistaken for psychotic agitation. problem or task and leading toward a
reality-oriented conclusion.
Compulsion
uncontrollable impulse to perform an act GENERAL DISTURBANCES IN THE FORM
repetitively OF THINKING
Dipsomania – compulsion to drink alcohol. Mental disorder

clinically significant behavioral or
Kleptomania – compulsion to steal. psychological syndrome that is
associated with distress or disability,
Nymphomania – excessive and compulsive and not just an expected response to
need for coitus in a woman. a particular event.
Psychosis
Satyriasis – excessive and compulsive need inability to distinguish reality from
for coitus in a man. fantasy. Impairment in reality testing,
Trichotillomania – compulsion to pull out with creation of a new reality.
one’s hair. Reality testing
the objective evaluation and
Ritual – automatic activity compulsive in judgment of the world outside the self.
nature, anxiety-reducing in origin.
Formal though disorder
Hypoactivity (Hypokinesis)
decreased motor and cognitive disturbance in the form of thought
activity, as in psychomotor instead of the content of thought.
retardation; visible slowing of Thinking is characterized by loosened
thought, speech and movements. associations, neologisms, and
Mimicry illogical constructs.
P a g e 28 | 41
Thought process is disordered and  new word or phrase whose
the person defined psychotic. derivation cannot be understood
 often seen in schizophrenia
Illogical thinking  it has also been used to mean a
thinking containing erroneous word that has been incorrectly
conclusions or internal constructed but whose origins
contradictions. It is considered are nonetheless understandable
psychopathological only when it is (e.g., headshoe to mean hat), but
marked and when not caused by such constructions are more
cultural values or intellectual deficit. properly referred to as word
approximations.
Dereism Word Salad
mental activity not concordant with incoherent, essentially
logic experience. incomprehensible, mixture of words
and phrases commonly seen in far-
advanced cases of
SPECIFIC DISTURBANCES IN THE FORM OF schizophrenia (See also
THOUGHT incoherence.).
Circumstantiality
Autistic Thinking disturbance in the associative thought
thinking that gratifies unfulfilled and speech processes in which a
desires but has no regard for reality patient digresses into unnecessary
a preoccupation phase in children in details and inappropriate thoughts
which thoughts, words, or actions before communicating the central
assume power. idea
Magical thinking observed in schizophrenia,
a form of dereistic thought; thinking obsessional disturbances, and
similar to that of the preoperational certain cases of dementia.
phase in children (Jean Piaget), in Tangentiality
which thoughts, words, or actions oblique, digressive, or even
assume power (e.g., to cause or to irrelevant manner of speech in which
prevent events). the central idea is not
Primary process thinking communicated.
general term for thinking that is Incoherence
dereistic thought that, generally is not
illogical and magical understandable
normally found in dreams, abnormally patient never gets from desired point
in psychotics. to desired goal.
Perseveration
GENERAL DISTURBANCES IN THE FORM pathological repetition of the same
OR PROCESS OF THINKING response to different stimuli, as in a
repetition of the same verbal
response to different questions
 Neologism
P a g e 29 | 41
persistent repetition of specific words
or concepts in the process of Clang association
speaking. association or speech directed by the
Seen in cognitive disorders, sound of a word rather than by its
schizophrenia, and other mental meaning
illness. words have no logical connection
Verbigeration punning and rhyming may dominate
meaningless and stereotyped the verbal behavior.
repetition of words or phrases, as Seen most frequently in
seen in schizophrenia schizophrenia or mania.
also called cataphasia. Blocking
Echolalia abrupt interaction in train of thinking
a person’s psychopathological before a thought or idea is finished
repeating of words or phrases of by after brief pause, person indicates no
another recall of what was being said or was
tends to be repetitive and persistent going to be said.
Seen in certain kinds of Glossolalia
schizophrenia, particularly the unintelligible jargon that has meaning
catatonic types. to the speaker but not to the listener
Condensation occurs in schizophrenia.
mental process in which one symbol  Poverty of content
stands for a number of components.  thought that gives little
Irrelevant answer information because of
answer that is not in harmony with vagueness, empty repetitions, or
question asked. obscure phrases.
 Overvalued idea
Loosening of associations  false or unreasonable belief or
characteristic schizophrenic thinking idea that is sustained beyond the
or speech disturbance involving a bounds of reason; it is held with
disorder in the logical progression of less intensity or duration than a
thoughts delusion, but is usually
manifested as a failure to associated with mental illness.
communicate verbally adequately  Delusion
unrelated and unconnected ideas  false belief, based on incorrect
shift from one subject to another. inference about external reality,
Derailment not consistent with patient’s
gradual or sudden deviation in train of intelligence and cultural
thought without blocking background that cannot be
sometimes used synonymously with corrected by reasoning
loosening of association.
Flight of ideas SPECIFIC DISTURBANCES IN THE
rapid succession of fragmentary CONTENT OF THOUGHT
thoughts or speech in which content
changes abruptly and speech may be Bizarre delusion
incoherent.
P a g e 30 | 41
false belief that is patently absurd or false belief that a person's will,
fantastic (e.g., invaders from space thoughts, or feelings are being
have implanted electrodes in a controlled by external forces.
person's brain), common in Thought withdrawal
schizophrenia. Thought insertion
Systematized delusion Thought broadcasting
group of elaborate delusions related
to a single event or theme. Delusion of infidelity
Mood-congruent delusion false belief that one's lover is
delusion with content that is mood unfaithful. Sometimes called
appropriate (e.g., depressed patients pathological jealousy.
who believe that they are responsible Erotomania
for the destruction of the world). delusional belief, more common in
Mood-incongruent delusion women than in men, that someone is
delusion with content that has no deeply in love with them (also known
association to mood or is mood- as de Clérembault syndrome).
neutral. Pseudologia fantastica
Nihilistic delusion a type of lying, in which the person
depressive delusion that the world appears to believe in the reality of his
and everything related to it have or her fantasies and acts on them.
ceased to exist. Preoccupation of thought
Delusion of poverty centering of thought content on a
false belief that one is bereft or will particular idea, associated with a
be deprived of all material strong affective tone, such as a
possessions paranoid trend or a suicidal or
Somatic Delusion homicidal preoccupation.
delusion pertaining to the functioning Egomania
of one's body. morbid self-preoccupation or self-
centeredness.
Paranoid delusions Monomania
includes persecutory delusions and mental state characterized by
delusions of reference, control, and preoccupation with one subject.
grandeur Hypochondria
 Delusion of persecution exaggerated concern about health
 Delusion of grandeur that is based not on real medical
Delusion of reference pathology, but on unrealistic
interpretations of physical signs or
Delusion of self-accusation sensations as abnormal.
false feeling of remorse and guilt. Obsession
Seen in depression with psychotic persistent and recurrent idea,
features. thought, or impulse that cannot be
eliminated from consciousness by
Delusion of control logic or reasoning
obsessions are involuntary and ego-
dystonic.
P a g e 31 | 41
 ideas, thoughts, feelings as
expressed through language;
Compulsion communication through the use of
pathological need to act on an words and language.
impulse that, if resisted, produces
anxiety Pressure of Speech
repetitive behavior in response to an rapid speech that is increased in
obsession or performed according to amount difficult to interpret.
certain rules, with no true end in itself Volubility (logorrhea)
other than to prevent something from copious, coherent, logical speech
occurring in the future. excessive talking observed in manic
episodes of bipolar disorder.
Coprolalia (also known as tachylogia,
involuntary use of vulgar or obscene verbomania)
language. Observed in some cases of
schizophrenia and in Tourette's Poverty of Speech
syndrome. restriction in the amount of speech
Phobia used; replies may be mono-syllabic.
persistent, pathological, unrealistic,
intense fear of an object or situation Dysarthria
the phobic person may realize that difficulty in articulation, not in word
the fear is irrational but, nonetheless, finding or in grammar.
cannot dispel it. Excessively loud or soft speech
loss of modulation of normal speech
volume
 Simple phobia may reflect a variety of pathological
 Social phobia conditions ranging from psychosis to
 Acrophobia depression to deafness.
 Algophobia Stuttering
 Claustrophobia frequent repetition or prolongation of
 Xenophobia a sound or syllable, leading to
 Zoophobia markedly impaired speech fluency.
Cluttering
Noesis erratic and dysrhythmic speech,
a revelation in which immense consisting of rapid and jerky spurts.
illumination occurs in association with
a sense that one has been chosen to APHASIC DISTURBANCES
lead and command.
Unio mystica Dysarthria
feeling of mystic unity with an infinite difficulty in articulation, not in word
power. finding or in grammar.
Excessively loud or soft speech
DISTURBANCE IN SPEECH loss of modulation of normal speech
volume
Speech
P a g e 32 | 41
may reflect a variety of pathological hallucinations indicate a psychotic
conditions ranging from psychosis to disturbance only when associated
depression to deafness. with impairment in reality testing
Stuttering Hypnagogic Hallucination
frequent repetition or prolongation of false sensory perception occurring
a sound or syllable, leading to while falling asleep; generally
markedly impaired speech fluency. considered a non-pathological
Cluttering phenomenon.
erratic and dysrhythmic speech, Hypnopompic Hallucination
consisting of rapid and jerky spurts. false perception occurring while
awakening from sleep
generally considered non-
 Syntactical Aphasia pathological.
 inability to arrange words in
proper sequence. Auditory Hallucination
 Jargon Aphasia false perception of sound, usually
 words produced are totally voices but also other noises such as
neologistic music; most common hallucination in
 nonsense words repeated with psychiatric disorders.
various intonations and
inflections. Visual Hallucination
 Global Aphasia false perception involving sight
 combination of a grossly non- consisting of both formed images(e.g.
fluent aphasia and a severe people) and unformed images (e.g.
fluent aphasia. flashes of light)
most common in organically
DISTURBANCES OF PERCEPTION determined disorders.
Olfactory Hallucination
Perception false perception in smell
process of transferring physical most common in organic disorders.
stimulation into psychological Gustatory Hallucination
information; the mental process by which false perception of taste, such as
sensory stimuli are brought into unpleasant taste caused by an
awareness. uncinate seizure
most common in organic disorders.
Illusion Tactile (Haptic) Hallucination
misperception or misinterpretation of false perception of touch or surface
real external sensory stimuli. sensation, as from an amputated limb
(phantom limb), crawling sensation
Hallucination on or under the skin (formication).
false sensory perception not
associated with real external stimuli Somatic Hallucination
there may or may not be a delusional false sensation of things occurring in
interpretation of the hallucinatory or to the body, most often visceral in
experience
P a g e 33 | 41
origin (also known as cenesthetsic inability to recognize illness as
hallucination). occurring to oneself.
Autotopagnosia
Lilliputian Hallucination inability to recognize a body part as
false perception in which objects are one’s own.
seen as reduced in size (also termed Visual Agnosia
micropsia). inability to recognize objects or
persons.
Mood-congruent Hallucination Astereognosia
a kind of hallucination wherein the inability to recognize objects by touch.
content of which is consistent with
either a depressed or manic mood Prosopagnosia
(e.g. a depressed patient hears inability to recognize faces.
voices saying that the patient is a bad
person Apraxia
a manic patient hears voices saying inability to carry out specific tasks.
that the patient is inflated of worth,
power, knowledge, etc.) DISTURBANCES ASSOCIATED WITH
CONVERSION AND ASSOCIATIVE
Mood-incongruent Hallucination DISSOCIATION
Hallucination whose content is not
consistent with either depressed or Astereognosia
manic mood (e.g. in depression, -inability to recognize objects by touch.
hallucinations not involving such
themes as guilt, deserved Prosopagnosia- inability to recognize faces.
punishment, or inadequacy
in mania, hallucinations not involving Apraxia- inability to carry out specific tasks.
such themes as inflated worth or
power) Somatization of repressed material or the
development of physical symptoms and
Hallucinosis distortions involving the voluntary muscle
Hallucinations, most often auditory, or special sense organs
that are associated with chronic not under voluntary control and not
alcohol abuse and that occur within a explained by any physical disorder
clear sensorium.
Trailing Phenomenon
perceptual abnormality associated DISTURBANCES ASSOCIATED WITH
with hallucinogenic drugs in which CONVERSION AND DISSOCIATIVE
moving object are seen as a series of PHENOMENA
discrete and discontinuous stages.
Hysterical Anesthesia
DISTURBANCES ASSOCIATED WITH loss of sensory modalities resulting
ORGANIC MENTAL DISORDER from emotional conflicts.
Macropsia
Anosognosia
P a g e 34 | 41
state in which objects seem larger Retrospective falsification
than they are. memory becomes unintentionally
Micropsia (unconsciously) distorted by being
state in which objects seem smaller filtered through patient’s present
than they are (both macropsia and emotional, cognitive, and experiential
micropsia can also be associated with state.
clear organic conditions such as
complex partial seizures). Confabulation
unconscious filling of gaps in memory
Depersonalization by imagined or untrue experiences
a subjective sense of being unreal, that patient believes but that have no
strange, or unfamiliar to oneself. basis in fact; most often associated
Derealization with organic pathology.
a subjective sense that the
environment is strange or unreal Déjà vu
a feeling of changed reality. illusion of visual recognition in which
Fugue a new situation is correctly regarded
taking on a new identity with amnesia as a repetition of a previous memory.
for the old identity
often involves travel or wandering to Déjà entendu
new environments. illusion of auditory recognition.
Multiple personality
one person who appears at different Déjà pense
times to be in possession of an illusion that a new thought is
entirely different personality and recognized as a thought previously
character. felt or expressed.
Jamias vu
DISTURBANCES OF MEMORY false feeling of unfamiliarity with a
real situation one has experienced.
Memory
function by which information stored in the False memory
brain is later recalled to consciousness a person’s recollection and belief by
the patient of an event that did not
Amnesia actually occur.
partial or total inability to recall past
experiences; may be organic or emotional Hypermnesia
in origin. exaggerated degree of retention and
Paramnesia recall.
falsification of memory by distortion of
recall. Eidetic image
visual memory of almost hallucinatory
Fausse reconnaissance vividness.
false recognition.
Screen memory
P a g e 35 | 41
a consciously tolerable memory Lack of intelligence to a degree in
covering for a painful memory. which there is interference with social
and vocational performance
Repression
a defense mechanism characterized Mild
by unconscious forgetting of I.Q. of 50 or 55 to approximately 70
unacceptable ideas or impulses. Moderate
I.Q. of 35 or 40 to 50 or 55
Lethologica Severe
temporary inability to remember a I.Q. of 20 or 25 to 35 or 40
name or a proper noun. Profound
Blackout I.Q. below 20 or 25
amnesia experienced by alcoholics
about behavior during drinking bouts Dementia
usually indicates that reversible brain organic and global deterioration of
damage has occurred. intellectual functioning without
clouding of consciousness
LEVELS OF MEMORY Pseudodementia
clinical features resembling a
Immediate dementia not caused by an organic
reproduction or recall of perceived mental dysfunction
material within seconds to minutes. most often caused by depression.
Concrete thinking
Recent literal thinking
recall of events over past few days. limited use of metaphor without
understanding of nuances of meaning
Recent past one dimensional thought.
recall of events over past few months. Abstract thinking
ability to appreciate nuances of
Remote meaning
recall of events in distant past. multidimensional thinking with ability
to use metaphors and hypotheses
DISTURBANCES OF INTELLIGENCE appropriately.
Intelligence Research Methods
the ability to understand, recall, Examining Abnormal Behavior

mobilized, and constructively
integrates previous learning in  Important Questions
meeting new situations.  What problems cause
distress or impair function?
Mental Retardation  Why do people behave in
unusual ways?
P a g e 36 | 41
 How can we help them  Statistical Methods
develop more adaptive  Branch of mathematics
behaviors?  Reduces biases
 Statistical vs. Clinical Significance
Basic Components of a Research Study  Chance?
 Hypothesis  Meaningful?
 “Educated Guess”  Does one mean the other?
 Scientific hypotheses must  Effect size and social validity
be testable
 Not all hypotheses The “Average” Client
are
 Research Design  Patient Uniformity Myth
 A method to test hypotheses  Averages
 Independent variable  Variability within groups
 Dependent variable
Studying Individual Cases
 Striking a balance in the relationship
between:  Case Studies
 Internal validity  Extensive observation
 External validity  Detailed description
 Hypothesis Testing  Foundation for early
 Minimizing Confounds developments
 Control groups  Freud
 Randomization  Unique problems
 Analog models  Contributions/Challenges to
 Generalizability theories
 Limitations—Reactivity
Research by Correlation
 The Nature of Correlation

 Statistical relationship
 No manipulated independent
variable
 Correlation and Causation

are different
 Causation has
Directionality
 Correlation
 Nature and
Statistical versus Clinical Significance
Strength of
Association
P a g e 37 | 41
 –1.0 to 0 to
+1.0  Nature of Single Subject Design
Epidemiological Research  Rigorous study of single
cases
Population based  Variance in conditions and
 Incidence = number of new cases in time
a given time period  Repeated measurement
 Prevalence = total number of cases  Evaluation of:
in a given time period  Variability
 Level
Research by Experiment  Trend
 Nature of Experimental Research
 Manipulate independent
variable
 Observe effects on
dependent variable
 Attempt to determine
causality
 Premium on internal validity
Research by Experiment
 Group Experimental Designs
 Clinical trials
 Control Groups
 Matched control groups
 Age, gender,
socioeconomics, etc.
 Placebo
 Single-blind
 Double-blind
 Minimizes allegiance
effects
 Comparative Treatment Designs

 Compares different forms of Withdrawal designs
treatment in similar persons  Baseline
 Process research—  Ethical concerns
“Why does it work?”
 Outcomes—“What Multiple baseline
does it change?” Independent variable and multiple
Independent variables
Single-Case Experimental Designs
P a g e 38 | 41
Improved internal validity experienced by people with
psychological disorders
Single-Case Experimental Designs

 Strategies Used in Genetic Research
 Basic genetic epidemiology—Is
there a genetic component?
 Advanced genetic
epidemiology—How do genes
exert effects?
 Gene finding—Which genes are
responsible?
 Molecular genetics—What do
genes do and how do they
interact?
Genetics and Research Across Time and

Cultures
 Family Studies
 Proband
 First- or second-degree
relatives
 Familial aggregation
 Issue of shared environment
Genetics and Research Across Time and  Adoption Studies

Cultures  Sibling pairs separated after
birth
 Parcels out effects of
 Behavioral Genetics environment
 Interactions of genes,  Observed frequency versus
experience, and behavior chance
 Phenotype—observable
characteristics or behavior  Twin Studies
 Genotype—genetic makeup  Identical or monozygotic
of individuals  Fraternal or dizygotic
 Endophenotype—genetic  Confounds: Family
mechanisms that ultimately environment effects
contribute to the underlying  Parents and others
problems causing the  Twins themselves
symptoms and difficulties
 Genetic Linkage Studies
 Localization of genes
P a g e 39 | 41
 Genetic markers Studying Behavior Across Cultures
 Confluence of disorders and
markers  Value of Cross-Cultural Research
 Overcoming ethnocentric
 Association Studies views
 Markers in people with and  Increases understanding of
without the disorder  Etiologies
 Identifies polygenetic  Symptom
influences presentations
 Treatments
 Prevention Research
 Universal prevention  Difficulties in cross-cultural research
 Selective prevention  Definitions
 Indicated prevention  Variance in presentation
 Cross-Sectional designs  Thresholds
 Cohorts  Equivalence in outcomes
 Retrospective
information The Power of a Program of Research
 Longitudinal designs  Components of a Research Program
 Cross-generational  Conducted in stages
effect  Multiple perspectives
 Sequential design  Replication
Studying Behavior Over Time Research Ethics

 When does science trump one’s
 Time-Based Research Strategies right to treatment?
 Cross-sectional designs  Institutional Review Boards
 Cohort effect—  Informed consent
confounding of age  Competence—Ability
and experience to provide consent
 Cross-generational  Voluntarism—Lack of
effect—trying to coercion
generalize findings to  Full information—
groups whose Necessary to make an
experiences are very informed decision
different from those  Comprehension—
of the study Understand benefits /
participants risks
 Longitudinal designs  APA ethics
 Cross-generational
effect Prevention Research and Strategies
 Sequential designs  Targets: Entire Populations
P a g e 40 | 41
 Health promotion/positive
development
 Skill building to avoid
problems
 Universal prevention
 Target specific risk
factors
 Targets: select populations

 Selective prevention
 Targets groups at risk
 Indicated prevention
 Individuals in early
stages of problems
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P a g e 1 | 41

4 types of Personality based  DEVELOPMENT OF

Psychological tradition Psychoanalytic Theory

 SYMPTOM QUESTIONNAIRES  PERSONALITY INVENTORIES

Case 3 CONSIDER THE FOLLOWING:

Dementia – intellectual deterioration PSYCHOLOGICAL DETERMINANTS OF

PHYSIOLOGICAL DISTRUBANCES Diminished libido

Signs that refer to the somatic (usually Constipation

Akathisia DISTURBANCES IN THINKING

Dipsomania – compulsion to drink alcohol. Mental disorder

Intelligence Research Methods

the ability to understand, recall, Examining Abnormal Behavior

 The Nature of Correlation

 Correlation and Causation

 Comparative Treatment Designs

Single-Case Experimental Designs

Genetics and Research Across Time and

Genetics and Research Across Time and  Adoption Studies

Studying Behavior Over Time Research Ethics

 Targets: select populations

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