Psychological Disorders

Question 1

Psychopathology literally translates to ‘sickness of the mind’ but more formally refers to patterns of thought, feeling or behaviour that significantly disrupt personal, social (family and friends) and occupational functioning and cause significant distress to the person and significant others

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Question 2

According to Thomas Szasz (1974), psychopathology is a myth; instead ‘mental illness’ is a socially constructed and stigmatic label to punish people when they do not conform to social or cultural norms; thus, it is on cultural norms that we distinguish ‘normal’ from ‘abnormal’ behaviour. There is validity is Szasz’s assertion because the line between normal and abnormal behaviour changes with culture (e.g. homosexuality) and because negative labels can enter a self-fulfilling prophecy where people ‘act into’ the expectations placed on them

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Question 3

Two limitations of the assertion that ‘mental illness is not real’ is that:

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(i) the symptoms of many mental disorders are recognised cross-culturally (i.e. they are not just socially constructed because they are independent of cultural factors), and
(ii) the disruption to a person’s well being is significant enough to warrant differentiating normal from abnormal behaviour and for creating ‘categories’ or types of mental illnesses.

Question 4

The term psychopathology is most synonymous (i.e. similar to/interchangeable with) with mental disorder/mental illness because they both refer to significant disruption to people’s lives; however ‘mental disorder’ more specifically refers to a clinically recognisable set of symptoms and behaviors that usually need treatments to be alleviated; also, mental disorders are simply ‘mental health problems’ at more intense levels

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Question 5

Mental health problems refer to the normal and wide range of emotional and behavioral abnormalities that affect almost all people at some point throughout their lives, and can include cognitive impairment and disability, phobias, panic attacks, drug-related harm, anxiety, personality disorders, depressive disorders and symptoms of psychoses

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Question 6

Mental health refers to a state of emotional and social wellbeing where the individual realises their own abilities, can cope with the normal stresses of life, can work productively and contribute to the community

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Question 7

There are five main theoretical approaches to psychopathology: (i) psychodynamic, (ii) cognitive-behavioural, (iii) biological, (iv) systems and (v) evolutionary; each of these are best used in complement as they are not mutually exclusive and competing theories

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Question 8

The psychodynamic perspective argues that there are three broad types of psychopathology along a continuum of functioning from least to most disturbed:

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(i) neuroses refer to normal and everyday problems in living; they occur in almost all people at some point in their life but do not stop people from functioning reasonably well;
(ii) personality disorders where a person exhibits more enduring maladaptive patterns of thought, feeling and behaviour that are leading to chronic disturbances in interpersonal relationships and occupational functioning; that is, they have difficulty maintaining meaningful relationships and employment, they interpret interpersonal events in highly distorted ways and are chronically vulnerable to depression and anxiety, and
(iii) psychoses refer to gross disturbances in mental functioning to the point where there is a loss of touch with reality (e.g. hallucinations and delusions)

Question 9

The three types of psychopathology differ in etiology (the cause or origin of the disorder): neuroses and personality disorders stem mostly from environmental experiences (esp. traumas experienced in childhood) and psychoses stem mostly from biological factors with some stressors from environment

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Question 10

The cognitive-behavioural perspective integrates classical and operant conditioning (behaviorism) with theories of social cognition; from the behaviourist point of view, mental disorders develop because of associations with a previously neutral stimulus that has become paired with an emotionally arousing one; from the point of view of cognitive psychology, there is an emphasis on dysfunctional attitudes, beliefs and cognitive processes (e.g. irrational beliefs and maladaptive cognitive processes)

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Question 11

In the biological approach, mental disorders result from brain dysfunction in specific parts of the brain or in the functioning of neurotransmitters

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Question 12

In the systems approach, mental disorders and abnormal behaviour are explained in terms of the social context or social system that that individual belongs to; since each person is a member of a system or social group (e.g. couple, family etc.) and thus the parts are interdependent, dysfunction in part results from dysfunction in another

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Question 13

According to the evolutionary perspective, symptoms of mental illness have evolved because they are useful to ensuring the species survives and reproduces, but individuals with extreme levels of these symptoms require therapy

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Question 14

Both nature and nurture contribute to the occurrence of mental illness; according to the ‘diathesis-stress model’, a mental illness occurs under an episode of stress because of an underlying vulnerability that is either biological (e.g. genetic predisposition) or environmental (e.g. childhood trauma

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Question 15

The Diagnostic and Statistical Manual of Mental Disorders (5th Ed.) [DSM-V] is a descriptive diagnostic handbook used by clinical psychologists; that is, it is atheoretical and it assumes that mental illness can be differentiated from mental health and that different categories of mental illness can be described

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Question 16

One common type of ‘disruptive, impulse-control and conduct disorders’ is conduct disorder. Conduct disorder is characterised by the persistent violation of societal norms and the rights of others; symptoms include physical aggression toward people and animals, chronic fighting, persistent lying, vandalism, stealing, resent taking direction, lack of empathy and compassion; prevalence is greater in boys (4.5%) than girls (1.6%); nature and nurture both contribute (e.g. low reactivity in the ANS and ineffectively lax or excessively punitive parenting)

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Question 17

One common type of ‘neurodevelopmental disorder’ is attention deficit hyperactivity disorder (ADHD). ADHD is characterised by inattention, impulsiveness and hyperactivity that is inappropriate for the child’s age; prevalence is approximately 5% of school-aged children; twice as many boys than girls are diagnosed with ADHD; inattention is more common than hyperactivity; nature and nurture both contribute (e.g. genetic CNS dysfunction and environmental risk factors such as maternal psychopathology and paternal criminality)

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Question 18

Substance abuse refers to the continued use of a substance that negatively affects psychological and social functioning, that can be any substance, e.g. Alcohol, marijuana, cocaine, heroin etc.

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Question 19

The most common ‘substance related disorder’ is alcoholism (the abuse of alcohol); 1 in 20 adults in Australia are alcoholic; alcoholism is second only to tobacco as a preventable cause of drug related harm in Australia; both nature and nurture contribute (e.g. children of alcoholics are four times more likely to develop alcoholism than children of non-alcoholics because of a physiological and social predisposition to find alcohol rewarding)

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Question 20

Schizophrenia is a broad umbrella term for psychotic disorders in which there are disturbances in thought, perception, behavior, language, communication and/or emotion

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Question 21

Schizophrenia begin the late teens/early twenties; about 0.2% (or 40 000) people in Australia have been diagnosed with schizophrenia; both nature and nurture contribute (e.g. an underlying biological vulnerability predisposes people to develop the disorder under an episode of stress; the diathesis-stress model)

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Question 22

People with schizophrenia often experience (i) delusions which refer to false beliefs that firmly held despite evidence to the contrary e.g. delusions of persecution, grandeur, identity and being controlled, (ii) loosening of associations so conscious thought travels along uncontrolled and associative lines rather than controlled and purposeful and logical lines, (iii) hallucinations which refer to perceptual experiences that distort, or occur without, external stimulation, e.g. hearing voices and (iv) flat or inappropriate affect

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Question 23

Symptoms of schizophrenia can be grouped into (i) positive or (ii) negative; positive symptoms signal the presence of something not usually there (e.g. delusions, hallucinations) and negative symptoms signal the absence of a function that is usually there (e.g. appropriate affect, complex thought)

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Question 24

Mood disorders are characterised by significant disruption to emotion or mood. They include depressive and bipolar disorders

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Question 25

Depressive disorders are characterised by low mood and somatic and cognitive difficulties

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Question 26

There are two main types of ‘depressive disorders’: (i) major depressive disorder is the most severe type of depressive disorder in which there is a significant depressed mood and loss of interest in activities that were once pleasurable (anhedonia); it is also characterised by disturbances in sleep, appetite, energy and concentration, feelings of worthlessness and thoughts of suicide; it typically lasts about five months; the prevalence rate is about twice as high for females with 3.4% of men and 6.8% of women in Australia suffering from major depression; (ii) persistent depressive disorder (aka dysthymic disorder) is a less severe type of depressive disorder; it is characterised by chronic low-level depression that lasts for more than two years, with some intervals of normal moods, but those intervals don’t last for more than a few weeks or months

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Question 27

The most common type of ‘bipolar related disorders’ is bipolar disorder, characterised by significant disruption in emotion (e.g. severe sadness) and mood (e.g. dangerously positive mania)

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Question 28

Individuals with bipolar disorder swing between manic episodes and intense depression; during the manic phases, there is an excessive degree of happiness; abnormally high elevated or expansive moods; a belief the person can do anything; the risk of developing bipolar is low – the prevalence rate in Australia is only 1.5% but it can be one of the most debilitating and lethal psychiatric disorders with an associated suicide rate between 10-20%

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Question 29

Both nature and nurture contribute to mood disorders (e.g. genes, neurotransmitters, negative life events, cognitive errors) but unlike schizophrenia, depressive disorders do not require a biological vulnerability (i.e. the heritability for major depression is less that the heritability of schizophrenia at about 30–40%); according to Beck, dysfunctional thoughts occur about (i) the world, (ii) the self and (iii) the future

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Question 30

Although anxiety is a normal and useful emotion because it signals potential danger, in anxiety disorders, the anxiety is intense, frequent and/or continuous; these ‘false alarms’ lead to dysfunctional avoidance behaviour

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Question 31

Anxiety disorders are one of the most frequently occurring categories of mental disorders (prevalence is about 10%); women are nearly twice as likely to be afflicted than men; anxiety disorders are most commonly associated with depression; both nature and nurture contribute to anxiety disorders (e.g. generalised anxiety disorder and negative life events) and like depression, genetic vulnerability is not essential; people diagnosed with one type of anxiety disorder tend to have others

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Question 32

Some of the most common types of ‘anxiety disorders’ are: (i) phobias -irrational fears, e.g. fear of flying etc.), (ii) social anxiety disorder (aka social phobia - a specific and common type of phobia in which there is an irrational fear when the person is in a specific social or performance situation, such as public speaking anxiety, intense anxiety when socially interacting with others, (iii) panic disorder - attacks of intense fear and feelings of doom or terror that are not justified by the situation; symptoms include shortness of breath, palpitations, fear of dying, fear of going crazy etc.), and(iv) agoraphobia - a fear of being in places or situations from which escape might be difficult e.g. crowded shop

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Question 33

One common type of ‘obsessive compulsive and related disorders’ is obsessive compulsive disorder (OCD) - marked by recurrent obsessions and compulsions; obsessions refer to persistent irrational thoughts or ideas and compulsions refer to highly stereotyped behaviours or mental acts that are performed in response to an obsession to ward off those obsessive thoughts; people with OCD often recognise that their compulsions are as irrational but if you prevent them from carrying them out, this then causes them anxiety or panic)

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Question 34

One common type of ‘trauma related disorders’ is post-traumatic stress disorder (PTSD) - marked by flashbacks and recurrent thoughts of a psychologically distressing event that is typically outside the range of usual human experience e.g. witnessing a murder; PTSD Develops in about 10% of people who experience a traumatic event and symptoms include things like nightmares, flashbacks, constant scanning of the environment, emotional avoidance, and an exaggerated startle response, etc

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Question 35

The two most common types of ‘eating disorders’ are: (i) anorexia nervosa when an individual starves themselves, exercises excessively or eliminates food in other ways (e.g. vomiting) until they are at least 15% below what should be their ideal body weight; it is a life-threatening illness and patients have distorted body image; about 1-2% female population in Australia are diagnosed with anorexia and about 10 x more females than males are diagnosed with it; it typically begins in adolescence or the early adult years and (ii) bulimia nervosa is marked by a ‘binge and purge syndrome’; during the purging phase they resort to vomiting or using laxatives, etc.; the purging is associated with feelings of relief, depression and feeling out of control; unlike anorexia, bulimia is almost exclusive to females and affects about 3-5% of the female population

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Question 36

Both nature and nurture contribute to eating disorders (e.g. problems with serotonin regulation, societal messages that equate beauty = thinness, and personality – the desire for perfection and control)

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Question 37

In ‘dissociative disorders’, individuals experience disruption in consciousness, memory, sense of identity or perception and it usually occurs in response to an overwhelming psychological pain, e.g. physical abuse or rape; patients may have significant periods of amnesia as if the mind were separate (dissociated) from the body; the most severe type of dissociative disorder is called Dissociative identity disorder (also known as ‘multiple personality disorder’) and it is marked by the existence of at least two distinct personalities within the same person

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Question 38

Personality disorders refer to chronic and severe disturbances that substantially inhibit an individual’s capacity to love and work; the prevalence is quite high with estimates of about 10% in the general population

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Question 39

There are several different types of ‘personality disorders’: [Cluster A] (i) paranoid personalities are high on distrust and suspiciousness, (ii) schizoid personalities are detached from social relationships and have a restricted range of emotional expression, (iii) schizotypal personalities display acute discomfort in close relationships, cognitive or perceptual distortions and eccentricity, [Cluster B] (iv) antisocial personalities disregard and violate the rights of others, (v) borderline personalities are high on impulsivity and instability in their interpersonal relationships, self concept and emotion, (vi) histrionic personalities have excessive emotionality and attention seeking, (vii) narcissistic personalities are high on grandiosity, need for admiration and lack empathy, Cluster C avoidant personalities exhibit social inhibition and avoidance, feelings of inadequacy and hypersensitivity to negative evaluation, (ix) dependent personalities are submissive, display clinging behaviour and excessive need to be taken care of and (x) obsessive-compulsive personalities have a preoccupation with orderliness, perfectionism and control

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Question 40

Two common personality disorders are: (i) borderline personality disorder - marked by unstable interpersonal relationships, dramatic mood swings, unstable sense of identity, intense fears of separation and abandonment, manipulativeness and impulsive behaviour; also marked by self mutilating behaviour (e.g. wrist slashing); women are three times more likely to be diagnosed with borderline PD than men; about 10% of patients with this disorder commit suicide and (ii) antisocial personality disorder - marked by irresponsible and socially disruptive behaviour; it is similar to conduct disorder in childhood; it is characterised by stealing, destroying property, lack of remorse or empathy; often these people appear charming and are described as ‘con artists’; this disorder is more prevalent in men than women, and is more common in poor urban areas

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Question 41

Both nature and nurture contribute to personality disorders (e.g. troubled attachments with mothers during early childhood can render people vulnerable in adult intimate relationships, and genetic factors become more important because the heritability of personality increase with age

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