Ab Psych Bleep Rev

Abnormal Psychology
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Source: Barlow, Durand & Hofmann (2018), Comer & Comer (2017), DSM-V, DSM-V-TR, Psych Pearls
Normalcy and Abnormalcy (5) Theoretical Approaches in Explaining the Etiology of
Recognizing Normal and Abnormal manifestations of Psychological Disorders (20)
behavior o One-Dimensional – looking for a single cause
o Psychological Disorder – psychological o Multidimensional – looking for a systemic cause
dysfunction within an individual associated with Genetic contributions
distress or impairment in functioning and a response o Genes – long molecules of DNA at various locations
that is not typical or culturally expected on chromosomes, within cell nucleus
o 4 D’s of Psychological Disorder o 46 Chromosomes, 23 Pairs, 22 Pairs of Autosomes,
a. Psychological Dysfunction – refers to a breakdown 1 pair Sex Chromosomes
in cognitive, emotional, or behavioral functioning o XX – female, XY – male
▪ Interferes daily functioning o Dominant and Recessive
b. Distress or Impairment – individual is extremely o Phenotypes – observable characteristics
upset and cannot function properly o Genotypes – unique genetic makeup
▪ Either to self or to others o Endophenotypes – genetic mechanisms that
c. Atypical or Not Culturally Expected (Deviance) –
ultimately contribute to the underlying problems
deviates from the average or the norm of the culture
▪ Not just to the society but deviation from the causing the symptoms and difficulties experienced
person’s usual behavior by people with psychological disorders
d. Dangerousness – creates potential harm to self o Basic Genetic Epidemiology – statistical analysis of
(suicidal gestures) and others (excessive aggression) family, twin, and adoption studies; if the disorder can
o Psychopathology – scientific study of mental be inherited and how much is attributable to genetics
disorders o Advanced Genetic Epidemiology – studies the
o Clinical Psychology – applied branch of psychology factors that influence the disorder
that seeks to understand, assess, and treat o Gene Finding – what gene influences the behavior
psychological conditions in a clinical setting o Molecular Genetics – biological analysis of
o Abnormal Psychology – branch of psychology that individual DNA samples; biological processes genes
studies unusual patterns of behavior, emotions, and affect to produce symptoms of the disorder
thought which may or may not indicate an underlying o Family Studies – examine behavioral pattern or
condition emotional trait in the context of the family
o Normal Behavior – one behavior that is like other o Proband – family member with the trait singled out
people in the society for study
▪ Normality is social conformity – some ▪ The first person in the family to be identified as
behaviors are non-conforming but normal possibly having genetic disorder and who may
▪ Normality is personal comfort receive genetic counseling or testing
▪ Normality is a process o Adoption Studies – identify adoptees who have a
o Criteria for determining Abnormal Behavior particular behavioral pattern or psychological
✓ Norm-violation disorder and attempt to locate first-degree relatives
✓ Statistical rarity who were raised in different family settings
✓ Personal Discomfort o Twin Studies – usually conducted to identical twins
✓ Deviation because they share genetic makeup’
✓ Maladaptiveness o Those people who reported more severe stressful life
o Clinical Assessment – the systematic evaluation and events and had at least one short allele of the 5-HTT
measurement of psychological, biological, and social gene were at greater risk of developing depression
factors in an individual presenting with a possible (Caspi et al., 2003) (serotonin-transporter gene)
psychological disorder o Epigenetics – factors other than inherited DNA
o Diagnosis – process of determining whether the sequence, such as new learning or stress, that alter
particular problem afflicting the individual meets all the phenotypic expression of genes
criteria for a psychological disorder
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Abnormal Psychology
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Biological and Neurological Bases o Brain Stem – lower and more ancient part of the
o Neuroscience – study of the nervous system, brain; essential for autonomic functioning such as
especially the brain to understand behavior, breathing, heartbeat, etc.
emotions, and cognitive processes ▪ Hindbrain – contains the medulla, pons, and
High Low cerebellum; regulates many autonomic activities
Dopamine Schizophrenia Parkinson’s such as breathing, heartbeat, and digestion
▪ Cerebellum – controls motor coordination
Acetylcholine Alzheimer’s
abnormalities associated with autism
(Dementia)
▪ Midbrain – coordinates movements with sensory
Norepinephrine Mania Depression
input and contains parts of reticular activating
GABA Relaxation Anxiety/OCD
system (contributes to sleep, arousal and tension)
Serotonin Mania Depression
▪ Thalamus and Hypothalamus – involves in
Anxiety
regulating behavior, emotions, and hormones
Eating
o Limbic System – located around the edge of the
Disorders
center of the brain
Epinephrine Stress Fatigue ▪ Hippocampus, Cingulate Gyrus, Septum, and
Sleep Disorders Amygdala
Glutamate Psychosis Huntington’s ▪ Amygdala – emotions
Neuron Death Disease ▪ Hippocampus – shrinks when a person have
Endorphin Eating depression
Disorders ▪ Regulate emotional experiences and expressions
o Agonist – effectively increase the activity of the and, to some extent, our ability to learn and to
neurotransmitters (Excitatory) control impulses
o Antagonist – decrease or block neurotransmitter o Basal Ganglia – base of the forebrain, includes
(Inhibitory) caudate nucleus
o Inverse Agonists – produces effects opposite to ▪ Damage involved changing our posture or
those produced by the neurotransmitters twitching or shaking
o Reuptake – neurotransmitter is released, quickly ▪ Related to Parkinson’s Disease
broken down and brought back to the synaptic cleft o Cerebral Cortex – provides us with our distinctly
o Neurotransmitter – chemical messengers of the human qualities, allowing us to look to the future and
body plan, to reason, and to create
a) Glutamate (E) [ memory ]– most abundant in ▪ Left Hemisphere – responsible for verbal and
the brain and plays a key role in thinking, other cognitive processes
learning, and memory ▪ Right Hemisphere – perceiving the world
b) GABA (I) [ calming ]– most common inhibitory around us and creating images
neurotransmitter in the brain and regulates mood, ▪ Lobes: Frontal, Parietal, Occipital, Temporal
irritability, sleep, seizures ▪ Prefrontal Cortex – area responsible for higher
c) Serotonin (I) [ mood ]– regulates mood, sleep cognitive functions
patterns, sexuality, appetite, and pain ▪ HPA Axis – Hypothalamus, Pituitary Gland,
d) Dopamine [ pleasure ]– body reward system, Adrenal Cortex
pleasures, achieving heightened arousal and o Somatic Nervous System – controls the muscles
learning o Autonomic Nervous System – regulate
e) Epinephrine [ fight-or-flight ] – responsible for cardiovascular system and endocrine system
fight-or-flight response ▪ Sympathetic – fight or flight responses
f) Norepinephrine [ concentration ] – alertness, ▪ Parasympathetic – calms the sympathetic
arousal, decision-making, attention, and focus nervous system; rest and digest functions
g) Endorphins [ euphoria ]– natural pain reliever, o Endocrine System – glands produce hormones that
reduces pain is released to the blood streams
h) Acetylcholine (E) [ learning ] – regulates heart ▪ Pituitary – master gland
rate, blood pressure and gut motility, role in ▪ Thyroid – controls metabolism and growth
muscle contraction, memory, motivation, sexual (thyroxine)
desire, sleep, and learning ▪ Parathyroid – controls the levels of calcium
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▪ Adrenal – controls metabolism, blood pressure, ▪ Modeling/observational learning: process of
sex development, stress (epinephrine) learning in which an individual acquires
▪ Pineal – releases melatonin responses by observing and imitating others
▪ Pancreas – creates insulin ▪ Observational learning
▪ Testes – makes sperm and release testosterone ▪ Social Cognitive Theory: people observe
▪ Ovaries – releases estrogen, progesterone, and models, learns chunks of behavior, and mentally
testosterone put chunks together into complex new behavior
o Permissive Hypothesis – when serotonin patterns
(norepinephrine) levels are low, other ▪ Albert Bandura
neurotransmitters are permitted to range more ▪ Hitting Doll experiment
widely, become dysregulated, and contribute to ▪ Self-Efficacy – person’s confidence in their own
mood irregularities abilities to accomplish their goals
Learning o Learned Helplessness – when rats or other animals
o Classical Conditioning – type of learning in which encounter conditions over which they have no
neutral stimulus is paired with response until it elicits control, they give up attempting to cope and seem to
that response develop the animal equivalent of depression
▪ Unconditioned Stimulus – natural stimulus ▪ Martin Seligman and colleagues
▪ Unconditioned Response – natural or unlearned ▪ People make an attribution that they have no
response control, and become depressed
▪ Conditioned Stimulus – newly conditioned ▪ Causes: coercive, ineffective, inconsistent
event introduced parents, media violence, peer rejection
▪ Conditioned Response – response from the ▪ Internal: negative effects due to internal failings
conditioned stimulus ▪ Stable: even after a particular negative events
▪ Extinction – without CS showed long enough, pass, additional bad things will “always be my
the behavior could be eliminated fault” remains
o Stimulus Generalization – strength of the response ▪ Global: attributions extend across a variety of
to similar objects or people is usually a function of issues
how similar these objects or people are ▪ Learned Optimism – if people faced with
▪ E.g., You are afraid of fury dogs because they considerable stress and difficulty in their lives,
once attacked you. Now, whenever you see nevertheless, display optimistic, upbeat attitude,
something fury, your body trembles, you cannot they are likely to function better psychologically
breathe properly and wanted to go away. and physically
o Introspection – Edward Titchener; subjects report ▪ Positive Psychology
their inner thoughts and feelings after experiencing o Prepared Learning – we have become highly
certain stimuli prepared for learning about certain types of objects
o John B. Watson – founder of behaviorism or situations over the course of evolution because this
▪ Little Albert knowledge contributes to the survival of the species
o Systematic Desensitization – patients were ▪ Learning from ancestors
gradually introduced to the objects or situations they o Hopelessness Theory – desirable outcomes will not
feared so that their fear could extinguish occur, and that the person has no responses available
o Operant Conditioning – behavior changes as a to change this situation
function of what follows the behavior (rewards or Cognitive theories with Psychoanalytic
punishment) o Fear – fight or flight response
▪ B.F. Skinner ▪ Evolutionary adaptation
▪ Edward Thorndike – Law of effect (behavior can ▪ White with fear, trembling, faster breathing,
be strengthened or weakened) increase in glucose, pupil dilate, hearing become
▪ Reinforcement – reward more acute, digestive system stops, pressure to
▪ Shaping – process of reinforcing successive urinate, defecate, vomit to reduce waste materials
approximations to a final behavior or set of o Introjection – direct all their feelings for the loved
behaviors one, including sadness and anger, toward themselves
o Social Learning – Albert Bandura o Symbolic or Imagined Loss – person equates other
kinds of events with the loss of a loved one
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o Attributional Style – ways in which people explain - tendency for individuals to relate external events to
the cause of events within their lives themselves, even when there is no basis for making this
Internal-External – who or what is responsible for the connection
event - egocentric thinking, everything is about him
- whether something unique about the person (internal) - “kasalanan ko kung bakit umiyak yung bata”
or something about the situation caused the event Selective Abstraction
(external) - focuses on the negative
Stable-Unstable – perceived permanence of the cause - detail is taken out of context and believed whilst
- an event can be viewed as constant and likely to everything else in the context is ignored
happen again (stable) or it only happens once (unstable) - /almost good feedback except for one /focused on that
Global-Specific – universal throughout your like single feedback
(global) or specific to a part of your life (specific) Arbitrary Inference
o Cognitive Theory of Depression - persons - evident when depressed individuals emphasize the
susceptible to depression develop negative rather than the positive aspects of a situation
inaccurate/unhelpful core beliefs about themselves, - only accepts negative thoughts
others, and the world as a result of their learning - no logical reasoning
histories - interpreting a situation when there is no factual
▪ Depressed people consistently think in illogical evidence
ways and keep arriving at self-defeating - /passed, “chamba”, /negative “kasalanan ko kasi”
conclusions Labeling and Mislabeling
▪ Tends to Overgeneralize (draw broad negative - portraying one’s identity on the basis of imperfections
conclusions on the basis of single insignificant and mistakes made in the past and allowing them to
event) [ Cognitive Bias ] define one’s true identity
▪ Depressive Cognitive Triad: depressed people - /bullied for being dark-skinned, “I am ugly.”
make cognitive errors in thinking negatively Minimization
about themselves, immediate world, and their - downplaying the significance of an event or emotion
future - common strategy in dealing with feelings of guilt
▪ Beck Hopelessness Scale - “Parang nakakarami ka na ah,”
▪ Negative Schema: an enduring negative “Luh parang tanga, sampung bote pa lang”
cognitive system about some aspects of life Magnification
▪ Self-Blame Schema: people feel personally - effects of one’s behaviors are magnified
responsible for every bad happenings - /may konting mantsa sa damit, “Iniisip siguro nila
▪ Negative Self-Evaluation Schema: “can never hindi ako naglalaba,”
do anything correctly” o General Adaption to Stress Theory –
▪ False Consensus Effect/False Consensus Bias: understanding the relationship between stressful
people tend to overestimate the extent to which events and the body’s response to stress
their opinions, beliefs, preferences, values, and ▪ Alarm: fight-or-flight response
habits are normal and typical of the others ▪ Resistance: coping mechanisms
(“Everyone shares the same opinion as me,”) ▪ Exhaustion: body defenses resources are
Negative Cognitive Styles: depleted
Dichotomous Thinking/Absolutist/Black and White ▪ Hans Selye
Thinking o Stress-Appraisal/Cognitive Appraisal Theory –
- seeing only of the extremes of things, never the stress is a two-way process, it involves a production
middle of stressors and the response of an individual
- “either I ace this test or fail,” subjected to these stressors
Overgeneralization o Primary Appraisal: an individual tends to ask
- making generalizations about a negative aspect questions like, “What does this stressor and/or
- “bagsak ako sa physics, hindi na ko makaka-graduate situation mean?”, and “How can it influence me?”
ng college,” ▪ Understanding the stressor
Personalization
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o Secondary Appraisal: involves those feelings ▪ Long-Term Memory – stores on a relatively
related to dealing with the stressor or the stress it permanent basis, although, at times, it can be
produces difficult to retrieve
▪ Deals with the stressor o Chunks – meaningful grouping of stimuli that can
▪ Starts to assess internal and external resources be stored as a unit in STM
available to solve the problem o Rehearsal – repetition of information that has
▪ Positive: “I can do it if I do my best,” entered the STM
▪ Negative: “I cannot do it.” ▪ Repetitive: as long as it is repeated, it states in
Memory Disorders the STM
Anosognosia: no memories of his own illness ▪ Elaborative: transfers info to LTM
Confabulation: filling in memory gaps with imaginary o Tip-Of-The-Tongue Phenomenon – inability to
experiences recall information that one realizes one knows
Disorientation: cannot identify or recognize time, o Retrieval Cue – allow us to recall more easily
places, and persons ▪ Recall: memory task in which specific
De Javu: unfamiliar perceived as familiar information is retrieved
Jamais Vu: familiar perceived as unfamiliar ▪ Recognition: individual is presented with a
Hypermnesia: increased memory stimulus and asked whether they have been
Paramnesia: false or perverted memory exposed to it in the past or to identify it from the
Amnesia: loss of memory list of alternatives
o Types of Amnesia: o Levels-Of-Processing Theory – degree to which
1. Biogenic – caused by brain damage or disease new materials is mentally analyzed
▪ Retrograde – inability to retrieve information ▪ Implicit Memory: can be recalled automatically
that was acquired before (remote memory loss) without thinking
▪ Anterograde – inability to transfer new ▪ Explicit Memory: requires conscious retrieval of
information from the short-term store to long- information
term store (recent memory loss) o Constructive Processes – memories are influenced
2. Psychogenic or Dissociative or Functional – by the meaning we give to them
caused by psychological trauma, repressed memories ▪ Autobiographical: episodes from our own lives
▪ Generalized – origin is rare psychological ▪ Flashbulb Memories: specific or surprising
disorder and spontaneous recovery from amnesia events that are so vivid in memory it as if they
in a comparatively short period of time represented a snapshot of the event
▪ Localized – no memory of specific events o Forgetting – permits us to form general impressions
▪ Selective – can only recall only small parts of the and recollections
events ▪ Helps us avoid being burdened and distracted by
▪ Situation-Specific – result of severely stressful trivial stores of meaningless data
event, as part of PTSD ▪ Failure of Encoding: failure to pay attention
▪ Global – cannot recall both past and present; total and place information in memory
memory loss ▪ Decay: loss of information due to non-use
o Memory – the process by which we encode, store, ▪ Cue-Dependent Forgetting: insufficient
and retrieve information retrieval cues
▪ Declarative: factual information ▪ Proactive Interference: learned earlier disrupts
▪ Procedural: skills and habits the recall of newer material; you forget the new
▪ Semantic: general knowledge and facts, logic info
▪ Episodic: events that occur in a particular time, ▪ Retroactive Interference: difficulty in recalling
place, or context info learned earlier because of later exposure to
o Three-System Approach to Memory – information different material; you forget the old info
must travel if it is to be remembered o Learned Helplessness (Martin Seligman) – if they
▪ Sensory: initial storage of information, perceived learn that nothing they do helps them avoid the
by the senses shocks, they eventually become helpless, give up,
▪ Short-Term Memory: holds info for 15 to 20 and manifest an animal equivalent of depression
seconds ▪ Anxiety is the first response to a stressful
situation
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▪ The depressive attributional style is (1) internal, Role of culture, social interactions, and interpersonal
(2) stable, (3) global factors in the development
o Aaron T. Beck suggested that depression may result o Sociogenic Factors:
from a tendency to interpret everyday events in a a. Unemployment
negative way b. Poverty
▪ Depressive Cognitive Triad – they make c. Crime
cognitive errors in thinking negatively about d. Poor Educational Level
themselves, their immediate world, and their o People who are isolated and lack social support or
future intimacy in their lives are more likely to become
▪ Series of negative events in childhood, depressed when under stress and to remain depressed
individuals may develop deep-seated negative longer than people with supportive spouses or warm
schema, an enduring negative cognitive belief friendships
system about some aspect of life o People’s online relationships tend to parallel their
o Lewinsohn’s Behavioral Theory - depression is offline relationships
caused by a combination of stressors in a person's o Family Systems Theory – family is a system of
environment and a lack of personal skills interacting parts who interact with one another in
diathesis-stress model consistent ways and follow rules unique to each
o Diathesis-Stress Model – individuals inherit family
tendencies to express certain traits or behaviors, ▪ Structure and communication patterns of some
which may then be activated under conditions of families actually force individual members to
stress (Eric Kandel) behave in a way that otherwise seems abnormal
▪ Diathesis – a condition that makes someone o An individual’s behavior, whether normal or
susceptible to developing disorder (vulnerability) abnormal, is best understood in the light of the
▪ The higher vulnerability, the lesser life stress individual’s unique cultural context
needed to trigger traits o Multicultural Perspective – each culture within
▪ Disturbances stem from a genetic predisposition large society has a particular set of values and beliefs,
triggered by stress as well as special external pressures, that help
▪ Predisposing Factor: cause of a disorder (i.e., account for the behavior and functioning of its
situations that trigger the development of the members (Culturally Diverse Perspective)
disorder) Suicide
▪ Precipitating Factor: factors that allow the o Suicide – self-inflicted death in which the person
disorders to develop (i.e., factors that could acts intentionally, directly, and consciously
contribute to the development of a disorder) o Death Seekers – clearly intend to end their lives at
▪ Protective Factor: reduces the severity of the the time they attempt suicide
problems ▪ May last only a short time
▪ Perpetuating Factor: factors that maintain the o Death Initiators – clearly intent to end their lives,
problem once established but they act out of a belief that the process is already
Gene-Environment Interaction under the way and that they are simply hastening the
o Gene-Environment Correlation Model – people process
might have genetically determined tendency to o Death Ignorers – do not believe that their self-
create the environment risk factors that trigger a inflicted death will mean the end of their existence
genetic vulnerability o Death Darers – experience mixed feelings, or
o Epigenetics – study how your behavior and ambivalence, about their intent to die, even at the
environment can cause changes that affect your moment of their attempt, and they show this
genes work ambivalence in the act itself
o Reciprocal Gene-Environment Model – claims ▪ Their risk-taking behavior does not guarantee
that people with a genetic predisposition to a disorder death
may also have a genetic tendency to create o Subintentional Death – a death in which the victim
environmental factors that promote the disorder plays an indirect, hidden, partial, or unconscious role
o Suicide is officially the 11th cause of death in US
o Suicidal Ideation – thinking seriously about suicide
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o Suicidal Plans – formulation of a specific method Selective Mutism
for killing oneself - rare childhood disorder
o Suicidal Attempts – the person survives from - characterized by a lack of speech in one or more
attempts setting in which speaking is socially expected
o Emile Durkheim’s Suicide Types: - restricted to a specific social situation
a. Altruistic – formalized suicides; dishonor to self, - a child could speak in one setting but cannot/do not in
family, or society another setting
b. Egoistic – loss of social supports as an important - not better explained by communication disorder
provocation for suicide - only diagnosed when a child has established a
c. Anomic – result of marked disruptions, such as capacity to speak in some social situations
sudden loss of job - learn to perform avoidance and safety behaviors to
d. Fatalistic – loss of control over one’s own destiny avoid disasters
o Freud believed that suicide indicated unconscious - at least 1 month
hostility directed inward to the self rather than Specific Phobia
outward to the person or situation causing the anger - irrational fear of a specific object or situation that
o If a family member committed a suicide, there is an markedly interferes with an individual’s ability to
increased risk that someone else will also function
o Low levels of serotonin is associated with suicide - acquired through direct experience, experiencing in
and with violent suicide attempts (low levels of false alarm, and observation
serotonin is linked with impulsivity, instability, and - it only fears one setting, unlike Agoraphobia (which
the tendency to overreact to situation) requires 3 settings), then Specific Phobia-Situational
o The stress of a friend’s suicide or some other major can be diagnosed
stress may affect several individuals who are - 6 months or more
vulnerable because of existing psychological Social Anxiety Disorder
disorders - fear or anxiety about possible embarrassment or
o Hopelessness – pessimistic belief that one’s present scrutiny
circumstances, problems, or mood will not change - can have panic attacks but it is cued by social
o Dichotomous Thinking – viewing problems and situations
solutions in rigid either/or terms - typically have adequate age-appropriate social
o Common triggering factors: relationships and social communication capacity
✓ Stressful events - 6 months or more
✓ Mood and thought changes Panic Disorder
✓ Alcohol and other drug use - cannot be diagnosed unless full symptom panic
✓ Mental disorders attacks were experienced
✓ Modeling - norepinephrine activities are irregular
Psychological Disorders and Specific Symptoms based - abrupt surge of intense fear or discomfort out of
on DSM-5 (50) nowhere, with no triggers
Differentiating Anxiety disorders - followed by persistent concerns about more attacks or
Separation Anxiety Disorder the consequences of it or maladaptive change in
- concerns with real or imagined separating from behavior related to the attacks
attachment figures Agoraphobia
- separation may lead to extreme anxiety and panic - developed after a person has unexpected panic attacks
attacks - fear in two or more situations (public transpo, open
- not entirely responsible for school absences or school spaces, enclosed spaces, standing in line, being outside
avoidance of the home alone) due to thoughts that escape might
- do not attend school so they won’t be separated with be difficult or no one will help them in case panic-like
their attachment figure symptoms would manifest
- fear of possible separation is the central thought - 6 months or more
- concerned about the proximity and safety of key Generalized Anxiety Disorder
attachment figures - difficulty to control worry
- at least 4 weeks (children) or 6 months or more - excessive anxiety and worry occurring more days than
(adults)
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not for at least 6 months, about a number of events or than reflecting generalized low mood
activities - distress from a deceased person
- “the world is a dangerous place” Differentiating OCD-Related Disorders
- intense cognitive processing in the frontal lobes, Obsessive-Compulsive Disorder
particularly in the left hemisphere - Obsessions: intrusive and mostly nonsensical
- intense worrying may act as avoidance thoughts, images, or urges that the individual tries to
- worry whether or not they are judged/evaluated resist or eliminate
- fear circuit is excessively active - Compulsions: thoughts or actions used to suppress the
Differentiating Trauma-and-Stressor Related obsessions and provide relief
Disorders - Tic Disorders is common to co-occur in patients with
Reactive Attachment Disorder OCD
- withdrawn toward adult caregivers - obsessions usually do not involve real life concerns
- evident before age 5 years and can include one, irrational, or magical content
- history of severe social neglect - In BDD and Tricho, the compulsive behavior is
Disinhibited Social Engagement Disorder limited to hair pulling or distortions in absence of
- actively approaches and interacts with unfamiliar obsessions
adults - obsessions and compulsions are not limited to
- can be distinguished from ADHD by not showing concerns about weight and food
difficulties in attention or hyperactivity - Compulsions are usually preceded by obsessions, tics
Posttraumatic Stress Disorder are often preceded by premonitory sensory urges
- exposure to actual death, injury or sexual violence Body Dysmorphic Disorder
(direct experience, witness, learning that the event - preoccupation with some imagined defect
happened to a close family, repeated exposure) - imagined ugliness
- more than 1 month - excessive appearance-related preoccupations and
- heightened activity in the HPA axis repetitive behaviors that are time-consuming
- requires trauma exposure precede the onset of the - can be co-morbid with eating disorders
symptoms Hoarding
- too much use of dissociation - difficulty discarding or parting with possessions
Acute Stress Disorder - Prader-Willi Syndrome: characterized by severe
- exposure to trauma (direct experience, witness, hypotonia, poor appetite, and feeding difficulties in
learning that event occurred to close fam, repeated early infancy, followed in early childhood by excessive
exposure) eating and gradual development of morbid obesity
- 3 days to 1 month after trauma exposure - not direct consequence of neurodevelopmental
- if the symptoms persists for more than 1 month and disorder, nor delusion, nor psychomotor retardation,
meet the criteria for PTSD, then PTSD will be fatigue, or loss of energy
diagnosed Trichotillomania
Adjustment Disorder - should not be diagnosed when hair removal is
- development of emotional or behavior symptoms in performed solely for cosmetic reasons
response to identifiable stressors occurring within 3 - diagnosis will be OCD, if there is obsession of
months of the onset of the stressors symmetry
- If symptoms persist beyond 6 months after the stressor - someone with ASD could have hair-pulling behaviors
or its consequences have ceased, the diagnosis will no when frustrated or angry, so if it’s impairing then it can
longer apply be diagnosed as stereotypic movement disorder
- May sometimes be diagnosed instead of bereavement - note the delusion or hallucination, if then, psychotic
if bereavement is judged to be out of proportion to what disorder
would be expected or significantly impairs self-care Excoriation
and interpersonal relations - note delusion or tactile hallucination
Prolonged Grief Disorder - In absence of deception, excoriation disorder can be
- death, at least 12 months, of a person close to the diagnosed if there are repeated attempts to decrease or
bereaved individual (6 months for children) stop skin picking
- focused on loss and separation from a loved one rather
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Explaining Somatic Symptom Disorders Evaluating DID from other Disorders
Somatic Symptom Disorder Depersonalization-Derealization Disorder
- one or more symptoms cause distress and disruption - Depersonalization: your perception alters so that you
of daily life temporarily lose the sense of your own reality, as if you
- chronic, influenced by the number of symptoms, age, are in a dream watching yourself
level of impairment, and any comorbidity - Derealization: your sense of external world is lost;
- ineffectiveness of analgesics, history of mental thing may seem to change shape or size, people may
disorders, unclear palliative factors, persistence seem dead or mechanical
without cessation, and stress - characterized by the presence of constellation of
- must be accompanied by excessive or typical depersonalization/derealization symptoms and
disproportionate thoughts, feelings, or behavior the absence of manifestations of illness anxiety
- focus is on the distress that particular symptoms cause disorder
- individual’s belief that somatic symptoms might - must precede the onset of major depressive epi or
reflect serious underlying physical illness are not held clearly continues even after its resolution
with delusional intensity - when symptoms occur ONLY during panic attacks, it
- with enhanced perceptual sensitivity to illness cues must not be diagnosed with D/DD
Illness Anxiety Disorder Dissociative Amnesia
- preoccupation with having or acquiring serious illness - inability to recall important autobiographical
- usually minimal to no symptoms, mild intensity information, usually of traumatic or stressful nature,
- interpret ambiguous stimuli as threatening that is inconsistent with ordinary forgetting
- develop in the context of a stressful life - usually localized or selective amnesia for specific
- People who develop these disorders tend to have a events, then generalized, if entire life history
disproportionate incidence of disease in their family - Dissociative Fugue: memory loss revolves around
when they were children specific incident, an unexpected trip; individuals just
Conversion Disorder (Functional Neurological take off and later find themselves in a new place, unable
Symptom Disorder) to remember why or how you got there
- altered voluntary motor or sensory function - If a person experiencing PTSD cannot recall part or
- incompatibility between the symptom and recognized all of specific trauma event and that extends to beyond
neurological or medical conditions the immediate time of the trauma, comorbid diagnosis
- unexpected neurological disease cause for the of DA may be warranted
symptoms is rarely found at follow-up - there must be no true neurocognitive deficits
- too much use of denial - too much use of repression
Psychological Factors affecting other Medical Dissociative Identity Disorder
Conditions - disruption of identity characterized by two or more
- medical symptom is present distinct personality states
- psychological or behavioral factors affect medical - host personality: the person who becomes the patient
condition and asks for treatment; developed later
- psychological or behavioral factors are judged to - switch: transition from one personality to another
affect the course of medical condition - extreme subtype of PTSD
- Psychological factors affecting other medical - Hypnotic Trance: tend to be focused on one aspect of
conditions is diagnosed when the psychological traits their world and they become vulnerable to suggestions
or behaviors do not meet criteria for a mental diagnosis by the hypnotist
Factitious Disorder - does not have a classic bipolar sleep disturbance
- Imposed on Self: individual present himself or herself - Individuals with schizophrenia have low hypnotic
as ill capacity, whilst, individuals with DID have highest
- Imposed on Another: presents another individual as ill hypnotic capacity among all clinical groups
- absence of obvious rewards - appear to encapsulate a variety of severe personality
- Malingering: false medical symptoms or exaggerating disorder features
existing symptoms in hopes of being rewarded - too much use of dissociation
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Illustrating Depressive Disorders o Bipolar disorder may simply be a more severe variant
Unipolar Disorders of mood disorders
Disruptive Mood Dysregulation Disorder Bipolar Disorders
- recurrent temper outburst (verbally or behaviorally) Bipolar I
that are grossly out of proportion - at least 1 manic episode
- 3 or more times/week - children should be judged according to his or her
- irritable or angry most of the day own baseline in determining whether a particular
- 12 or more months, at least 2 settings behavior is normal or evidence of manic episode
- onset should be after 6 yrs-18yrs - first ep usually MDE
- do not occur exclusively during MDE - factors that should be considered: family history,
- bipolar = episodic, DMD = persistent onset, medical history, presence of psychotic
- diagnosis cannot be assigned to a child who has ever symptoms, history of lack of response to
experienced full-duration hypomanic or manic episode antidepressant treatment or the emergence of manic
(irritable or euphoric) or who has ever had a manic or episode during antidepressant treatment
hypomanic episode lasting more than 1 day - The diagnosis is “Bipolar I disorder, with psychotic
- presence of severe and frequently recurrent outburst features” if the psychotic symptoms have occurred
and persistent disruption in mood between outburst EXCLUSIVELY during manic and major depressive
- severe in at least one setting and mild to moderate to episodes
second setting - Symptoms of mania in BP1 occur in distinct
Major Depressive Disorder episodes and typically begin in late adolescence or
- at least 2 weeks of either anhedonia or depressed early adulthood
mood - When any child is being assessed for Mania, it is
- “other specified depressive disorder” can be made in essential that the symptoms represent clear change
addition to the diagnosis of psychotic disorder from the child’s typical behavior
- in schizoaffective, delusions or hallucinations occur - Symptoms of mood lability and impulsivity must
exclusively for 2 weeks without MDE represent a distinct episode of illness, or there must be
- Seasonal, Catatonic, Melancholic a noticeable increase in these symptoms over the
Persistent Depressive Disorder (Dysthymia) individual’s baseline in order to justify an additional
- depressed mood for at least 2 years diagnosis of BP1
- if full criteria for a MDE has been met at some point Bipolar II
during the period of illness, a diagnosis of MDD - MDE + Hypomanic episodes
would apply. Otherwise, a diagnosis of “other - often begins with depressive episodes
specified depressive disorder” or “unspecified - highly recurrent
depressive disorder” should be given - once hypomanic episode has occurred, it never
- a separate diagnosis of PDD is not made if the reverts back to MDD
symptom occur only during the course of the - BP2 is distinguished from cyclEothymic disorder by
psychotic disorder the presence of one or more hypomanic episodes and
- Double Depression: suffer from both MDE and PDD one or more MDE
with fewer symptoms Cyclothymic Disorder
Premenstrual Dysphoric Disorder - milder but more chronic version of bipolar disorder
- majority of menstrual cycles, at least 5 symptoms - do not meet the complete criteria for depressive
must be present symptoms and hypomanic symptoms
o Seasonal Affective Disorder – episodes must have Explaining Eating and Sleeping Disorders
occurred for at least 2 yrs with no evidence of Eating Disorders
nonseasonal MDE during that period of time Pica
▪ Cabin fever - eating of non-nutritive, nonfood substances for at
o Integrated Grief – acute grief, the finality of death least 1 month
and its consequences are acknowledged and the - inappropriate to the developmental age
individual adjusts to the loss Rumination Disorder
o Complicated Grief – this reaction can develop - repeated regurgitation of food for at least 1 month
without preexisting depressed state - re-chewed, re-swallowed, or spit-out
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- not attributable to gastrointestinal or other medical - difficulty initiating and maintaining sleep
condition - early-morning awakening with inability to return to
- self-soothing or self-stimulating sleep
Avoidant/Restrictive Food Intake Disorder - at least 3 nights/week, for at least 3 months
- eating or feeding disturbance - Rebound Insomnia: sleep problems re-appearing, but
- lack of interest in eating food sometimes worst
- dependence on enteral feeding or nutritional - situational, persistent, or recurrent, episodic
supplements Hypersomnolence Disorder
- requires that the disturbance of intake is beyond that - excessive sleepiness despite having at least 7 hours
directly accounted for by physical symptoms of main sleep
consistent with medical condition; the eating - recurrent periods of sleep or lapses into sleep within
disturbance may also persist after being triggered by the same day
medical condition and following resolution of the - take longer naps, have trouble waking from naps,
medical condition and do not feel alert afterward
- if eating problems is the focus, then A/RFID, if - at least 3x/week, for at least 3 months
weight, then Anorexia Nervosa Narcolepsy
- might precede the onset of Anorexia Nervosa - recurrent episodes of irrepressible need to sleep,
Anorexia Nervosa lapsing into sleep, or napping with cataplexy,
- fear of gaining weight hypocretin deficiency, and evidence from
- subtypes: binge-eating/purging type and restricting polysomnography showing REM sleep latency less
type than or equal to 15 mins
- associated with stressful life event - 3x/week, for at least 3 months
- BDD may be considered if the distortion is unrelated Obstructive Sleep Apnea Hypopnea
to body shape and size - at least 4 obstructive apneas or hypopneas per hour
- amenorrhea and cardiovascular problems of sleep or evidence from polysomnography of 15 or
- very underweight more obstructive apneas and/or hypopneas per hour of
Bulimia Nervosa sleep
- recurrent episodes of binge-eating then purging to - Apnea: absence of airflow
prevent weight gain - Hypopnea: reduction in airflow
- binge-eating for at least once a week for 3 months Central Sleep Apnea
- normal weight - evidence by polysomnography of 5 or more central
- chronic purging can result to enlargement of salivary apneas per hour of sleep
gland caused by repeated vomiting, causing chubby - Cheyne-Stokes Breathing: an abnormal pattern of
face breathing characterized by progressively deeper, and
- electrolyte imbalance that may lead to arrythmia, sometimes faster, breathing followed by a gradual
seizures, and renal failure decrease that results in a temporary stop in breathing
Binge-Eating Disorder called an apnea
- recurrent episodes of just binge eating Sleep-Related Hypoventilation
- do not show marked or sustained dietary restriction - Polysomnography demonstrates episodes of
designed to influence body weight and shape between decreased respiration associated with elevated CO2
binge-eating episodes levels
- usually overweight Circadian Rhythm Sleep-Wake Disorders
Elimination Disorders - persistent or recurrent pattern of sleep disruption due
Enuresis to alteration of the circadian system or misalignment
- repeated voiding of urine in bed, voluntary or between the endogenous circadian rhythm
intentional - leads to excessive sleepiness or insomnia, or both
Encopresis Non-REM Sleep Arousal Disorders
- repeated passage of feces into inappropriate places - incomplete awakening from sleep: sleepwalking or
Sleeping Disorders sleep terrors
Insomnia - cannot remember anything when they woke up
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- occur mostly in childhood and non-rem sleeps - anxiety about anticipating vulvovaginal or pelvic
- produce rapid and complete awakening without pain
confusion, amnesia, or motor activity - at least 6 months
Nightmare Disorder Male Hypoactive Sexual Disorder
- repeated occurrences of extended, extremely - persistently deficient or absent sexual/erotic thoughts
dysphoric, and well-remembered dreams that usually or fantasies and desire for sexual activity
involve efforts to avoid threats to survival, security, or - at least 6 months
physical integrity Premature (Early) Ejaculation
- upon awakening, they become oriented and alert - ejaculation approx. 1 min following vaginal
- appear in children exposed to acute or chronic penetration or even before the individual wishes it
psychosocial stressors - at least 6 months and must be experienced on almost
- occur during REM Sleep all or all occasions
REM Sleep Behavior Disorder Paraphilic disorders
- repeated episodes of arousal during sleep associated Voyeuristic Disorder
with vocalization and/or complex motor behaviors - intense arousal from observing an unsuspecting
- during REM sleep naked person for at least 6 months
- upon awakening, the individual is completely awake, - nonconsensual
alert, and not confused - at least 18 yrs old
Restless Legs Disorder Exhibitionistic Disorder
- urge to move the legs, usually accompanied or in - intense arousal from exposing genitals to an
response to uncomfortable and unpleasant sensations unsuspecting person for at least 6 months
of the legs - nonconsensual
- during rests Frotteuristic Disorder
- sense of relief during the movement - intense arousal from touching or rubbing genitals
- worse in evening against nonconsenting person for at least 6 months
- 3x/week, for at least 3 months - nonconsensual
Evaluating Sexual dysfunctions, Paraphilic disorders, Sexual Masochism
and Gender Dysphoria - intense sexual arousal from the act of being
Sexual Dysfunctions humiliated, beaten, bound, or otherwise made to suffer
Delayed Ejaculation for at least 6 months
- delay or absence of ejaculation Sexual Sadism
- at least 6 months - intense sexual arousal from the physical suffering of
- either lifelong or acquired, generalized or situational another person for at least 6 months
Erectile Disorder Pedophilic Disorder
- difficulty having, maintaining erection and decrease - intense sexually arousing fantasies, urges, or
in erectile rigidity behaviors involving prepubescent child or children for
- at least 6 months at least 6 months
Female Orgasmic Disorder - has ACTED on these urges
- delay or absence of orgasm and reduced intensity of - at least 16 yrs old and at least 5 yrs older than the
orgasmic sensations child or children
- at least 6 months Fetishistic Disorder
- either lifelong or acquired, generalized or situational - intense sexual arousal from either the use of
Female Sexual Interest/Arousal Disorder nonliving objects or highly specific focus on
- absent/reduced interest in sexual activity nongenital body parts for at least 6 months
- no sexual thoughts or fantasies, no initiation, no - not limited to cross-dressing or sex toys
sexual excitement or pleasure during sex Transvestic Disorder
- at least 6 months - intense arousal from cross-dressing for at least 6
Genito-Pelvic Pain/Penetration Disorder months
- difficulties in vaginal penetration during intercourse
- vaginal pain during intercourse or penetration
attempts
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Gender Dysphoria Caffeine – most common psychoactive substance
Gender Dysphoria - “gentle stimulant”
- marked incongruence between one’s - found in tea, coffee, soda, and cocoa products
experienced/expressed gender and assigned gender, for Cannabis (Marijuana) – reactions include mood
at least 6 months swings or even dream-like experiences
- intersexuality or hermaphroditism - chronic and heavy users report tolerance, especially
- slightly higher levels of testosterone or estrogen at to euphoric high: they are unable to reach the levels of
certain critical periods of development pleasure they experienced earlier
Explaining Substance-Related and Addictive Disorder Hallucinogens – most common, “LSD” produced
o Substance – chemical compounds that are ingested synthetically in the laboratory
to alter mood or behavior - others: psilocybin (mushroom), lysergic acid amide
o Psychoactive substances – alter mood, behavior, or (seeds of morning glory plant), dimethyltryptamine
both (DMT), and mescaline
o Substance Use – ingestion of psychoactive - Phencyclidine (PCP) is snorted, smoked, or injected
substances in moderate amounts that does not intravenously, and it causes impulsivity and
significantly interfere with social, educational, or aggressiveness
occupational functioning Inhalant – solvents, aerosol sprays, gases, nitrites,
o Substance Intoxication – physiological reaction to usually found at home or workplace
ingested substances Opioid – natural chemicals in the opium poppy that
o Substance Use Disorders – how much of a have narcotic effect (relieves pain and induce sleep)
substance is ingested is problematic - includes natural opiates, synthetic variation, and the
o Physiological Dependence – meaning the use of comparable substances that occur naturally in the brain
increasingly greater amounts of the drug to - also includes Heroin
experience the same effect (tolerance) and a negative Sedative-, Hypnotic-, or Anxiolytic- - calming, sleep-
physical response when the substance is no longer inducing, and anxiety-reducing
ingested (withdrawal) - includes barbiturates and benzodiazepines
Alcohol – produced when certain yeast react with sugar - barbiturates and benzodiazepines relax the muscles
and water, then fermentation takes place and can produce mild feeling of well being
- depressant - combining alcohol with these substances can be fatal
- inhibitions are reduced and we become more outgoing (Manilyn Monroe case)
- with more drinking, alcohol depresses the brain which Stimulant – most commonly consumed psychoactive
impedes the functioning drugs in US
- Withdrawal Delirium (Delirium Tremens): condition - includes caffeine, nicotine, amphetamines, and
that can produce frightening hallucinations and body cocaine
tremors - Amphetamine: can induce feelings of elation and
- Breathalyzer: measures levels of intoxication vigor and can reduce fatigue; prescribed to people with
- GABA seems to be particularly sensitive to alcohol narcolepsy and ADHD
- The Glutamate system is involve why alcohol affects - another variants of Amphetamine are Methylene-
our cognitive abilities dioxymethamphetamine or ecstasy club drug (makes
- Two types of organic brain syndromes may result you feel euphoric) and methamphetamine (crystal
from long-term alcohol use: Dementia and Wernicke- meth)
Korsakoff Syndrome (Confusion, loss of muscle - Cocaine: increases alertness, produces euphoria,
coordination, and unintelligible speech, believed to be increases blood pressure and pulse, and causes
cause by a deficiency of thiamine) insomnia and loss of appetite
- Fetal Alcohol Syndrome - Intranasal use and oral use of substances result in
- Alcohol Dehydrogenase: metabolize alcohol more gradual progression occurring over months to
- Korsakoff syndrome: is a chronic memory disorder years
caused by severe deficiency of thiamine (vitamin B-1). Tobacco – contains nicotine
- Korsakoff syndrome is most caused by alcohol - linked with signs of negative affect such as
misuse, but certain other conditions also can cause the depression, anxiety, and anger
syndrome
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- being depressed increases your risk of becoming - conveys risk for the development of anxiety disorders
dependent on nicotine and, at the same time, being and MDD
dependent will increase your risk of becoming - increased risk for a number of problems in adjustment
depressed as adults
o Acute alcohol withdrawal occurs as an episode - less severe than CD and do not include aggression
usually lasting 4-5 days and only after extended towards people, property (IED)
periods of heavy drinking - co-morbid with ADHD
o Withdrawal is rare for individuals younger than 30 - diagnosis should not be made if the symptoms occur
years exclusively during the course of a mood disorder
o The symptoms of an alcohol-induced mental - if criteria for DMDD are met, then DMM is given
disorder are likely to remain clinically relevant as even if all criteria for ODD are met
long as the individual continues to experience severe Intermittent Explosive Disorder
intoxication or withdrawal - behavioral outburst, failure to control aggressive
o Genetic factors may affect how people experience impulses
and metabolize certain drugs - verbal aggression, physical aggression twice weekly
o Positive and Negative Reinforcement for a period of 3 months
o Opponent-Process Theory – an increase in positive - at least 6 yrs of age
feelings will be followed shortly by an increase in - quite common regardless of the presence of ADHD or
negative feelings and vice versa other disruptive, impulse-control, and conduct
o Expectancy Effect – expectancies develop before disorders
people actually use drugs, perhaps as a result of loved - Also should not be made in children and adolescents
one’s use, advertising, etc. ages 6-18 years, when the impulsive aggressive
o Treatment: Nicotine replacement therapy, outbursts occur in the context of an adjustment disorder
Bupropion, Naltrexone, Acamprosate, Disulfiram, - A diagnosis of DMDD can only be given when the
Methadone, Buprenorphine, Aversion Therapy, In- onset of recurrent, problematic, impulsive aggressive
patient treatments, Aversion Therapy, etc. outburst is before age of 10 years
o Cross-Tolerance – tolerance for a substance has not - A diagnosis of DMDD should be made for the first
taken before as a result of using another substance time after 18 years
similar to it - Aggression in ODD is typically characterized by
o Synergistic Effect – an increase of effects that temper tantrums and verbal arguments with authority
occurs when more than one substance is acting on the figures, whereas IED are in response to a broader array
body at the same time of provocation and include physical assault
Gambling Disorder Conduct Disorder
- persistent and recurring gambling behavior - repetitive and persistent pattern of behavior in which
- at least 4-symptoms within 12 months the basic rights of others or major age-appropriate
- Onset can occur during adolescence or young societal norms or rules are violated
adulthood but in other individuals it manifests during - often bullies, initiates fights, physically cruel,
middle or even older adulthood destroying properties, theft, serious violation of rules
- Progression appears to be more rapid in women than - Onset may occur as early as the preschool years, but
in men the first significant symptoms usually emerge during
- An additional diagnosis of gambling disorder should the period from middle childhood through middle
be given only if the gambling behavior is not better adolescence
explained by manic episodes - ODD is the most common precursor to the childhood-
Explaining Disruptive, Impulse-Control disorders, onset type
and Conduct Disorder - Physically aggressive symptoms = childhood
Oppositional Defiant Disorder - Nonaggressive symptoms = adolescence
- angry irritable mood, argumentative/defiant behavior - May be diagnosed in adults, though onset is rare after
against authority figure for at least 6 months age 16 years
- annoys others - Childhood-onset type predicts a worse prognosis and
- blames others for his/her mistakes an increased risk of criminal behavior in adulthood
- precedes the development of conduct disorder
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- When criteria for both ODD and CD are met, both Schizotypal
diagnoses can be given - typically socially isolated and behave in ways that
- When criteria for both ADHD and CD are met, both would seem unusual to many of us, and they tend to be
diagnoses can be given suspicious and to have odd beliefs
- Individuals with conduct disorder will display - “ideas of reference” – false beliefs that random or
substantial levels of aggressive or nonaggressive irrelevant occurrences in the world directly relate to
conduct problems during periods in which there is no oneself
mood disturbance, either historically or concurrently - have odd beliefs or engage in magical thinking
- If criteria for both IED and CD has been met, the - associated with childhood mistreatment and could be
diagnosis of IED should be given only when the resulted from PTSD symptoms
recurrent impulsive aggressive outbursts warrant - “It is better to be isolated from others”
independent clinical attention Cluster B
- CD is diagnosed only when the conduct problems Histrionic
represent a repetitive and persistent pattern that is - tend to be overly dramatic and almost to be acting
associated with impairment in social, academic, or - express emotions in an exaggerated manner
occupational functioning - histrionic and antisocial co-occur more often
Pyromania - “ako ang bida”
- purposeful fire setting on more than one occasion Borderline
- arousal before the act - moods and relationships are unstable, and usually
- fascination to fire and its situational context they have poor self-image
- not done for monetary gain or etc. - often feel empty and are great risk of dying by their
- separate diagnosis is not given when fire setting own hands
occurs as part of CD, manic episode, or antisocial - often engage to suicidal behaviors
personality disorder - tend to have turbulent relationships, fearing
Kleptomania abandonment but lacking control over their emotions
- failure to resist impulses to steal objects that are not - often intense, going from anger to deep depression in
need for personal use a short time
- increase tension before committing the theft - prevalent in families with history of mood disorders
- pleasure after committing the theft - if co-occurs with mood disorders, both are diagnosed
Illustrating the different Personality Disorders - recovery is more difficult and less stable
Cluster A - “sad gorl iz me”
Paranoid Narcissistic
- excessively mistrustful and suspicious of others, - they consider themselves different from others and
without justification deserve special treatment
- more common among relatives who have - unreasonable sense of self-importance and are so
schizophrenia preoccupied with themselves that they lack sensitivity
- maybe due to early mistreatment or traumatic and compassion
childhood experiences - grandiosity
- associated with prior history of childhood - “I am the greatest in the world”
mistreatment, externalizing symptoms, bullying, and Antisocial
adult appearance of interpersonal aggression - characterized as having history of failing to comply
- “I cannot trust people” with social norms
- too much use of projection - at least 18 years of age
Schizoid - evidence of CD before 15 years old
- detachment from social relationships and limited - irresponsible, impulsive, and deceitful
range of emotions - lacking in conscience and empathy, selfishly take
- tendency to turn inward and away from the outside what they want and do as they please, violating social
world norms and expectations
- childhood shyness is reported as a precursor to later - CD will be given if the criteria for Antisocial PD is
personality disorder not met
- “Relationships are messy and undesirable”
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- Underarousal Hypothesis: psychopaths have ▪ Combined several symptoms of insanity that had
abnormally low levels of cortical arousal usually been viewed as reflecting separate and
- Fearlessness Hypothesis: psychopaths possess a distinct disorders:
higher threshold for experiencing fear than most other a. Catatonia – alternating immobility and excited
individuals agitation
- “I am entitled to break rules” b. Hebephrenia – silly and immature emotionality
Cluster C c. Paranoia – delusions of grandeur or persecution
Avoidant ▪ Distinguished dementia praecox
- extremely sensitive of the opinion of others and ▪ Also noted the numerous symptoms in people
although they desire social relationship, their anxiety with dementia praecox, including hallucinations,
leads them to avoid delusions, negativism, and stereotyped behavior
- extremely low self-esteem cause them to be limited o Eugen Bleuler – introduced the term schizophrenia
with friendships and dependent to those they feel (“splitting of mind”)
comfy with ▪ Associative Splitting
- feel chronically rejected by others and pessimistic o Positive Symptoms:
about their future 1. Delusions – misrepresentation of reality (disorder
- negative self-concept of thought content)
- Social Anxiety Disorder – negative evaluations ▪ Persecutory – belief that one is going to be
- “If they knew the real me, they would reject me” harmed, harassed and so forth
Dependent ▪ Referential – certain gestures, comments,
- rely on others to make ordinary decisions and even environmental cues, and so forth are directed at
important ones which results in an unreasonable fear of one-self)
abandonment ▪ Grandiose – when an individual believes that he
- agree with other people’s opinion just to be not or she has exceptional abilities, wealth, or fame
rejected ▪ Erotomanic – when an individual believes
- feel uncomfortable or helpless when alone falsely that another person is in love with him or
- “I need people to survive and be happy” her
Obsessive-Compulsive ▪ Nihilistic – conviction that a major catastrophe
- perfectionist will occur
- fixation on things being done “the right way” ▪ Somatic – focus on preoccupations regarding
- this preoccupation with details prevents them from health and organ function
completing much of anything ▪ Thought Withdrawal – thoughts have been
- need to control “removed” by outside force
- when criteria for both OCD and OCPD are met, both ▪ Thought Insertion – thoughts have been put into
can be given one’s mind
- “I am perfectionist, everything should be done under ▪ Delusions of Control – one’s body or actions are
my control and liking” being acted on or manipulated by some outside
Illustrating Schizophrenia force
o John Haslam – superintendent of a British Hospital ▪ Capgras Syndrome – person believes someone
who outlined a description of the symptoms of he or she knows has been replaced by a double
Schizophrenia in his book Observations on Madness ▪ Cotard’s Syndrome – the person believes he or
and Melancholy she is dead
o Philippe Pinel – French physician who described ▪ Clerambault Syndrome - characterized by the
cases of schizophrenia delusional idea, usually in a young woman, that a
o Benedict Morel – used the term demence precoce man whom she considers to be of higher social
meaning early or premature loss of mind to describe and/or professional standing is in love with her
schizophrenia ▪ Fregoli Syndrome – a person holds a delusional
o Emil Kraepelin – unified the distinct categories of belief that different people are in fact a single
schizophrenia under the name Dementia Praecox person who changes his or her appearance or is in
disguise
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▪ Motivational View of Delusions – look at these o Prodromal Stage – 1-2 year period before the
beliefs as attempts to deal with and relieve serious symptoms occur but when less severe yet
anxiety and stress unusual behaviors start to show themselves
▪ Deficit View of Delusions – sees these beliefs as o Schizophrenia is partially the result of excessive
a resulting from brain dysfunction that creates stimulation of striatal dopamine d2 receptors
these disordered cognitions or perceptions o It appears that several brain sites are implicated in the
2. Hallucinations – experience of sensory events cognitive dysfunction observed among people with
without any input from the surrounding schizophrenia, especially prefrontal cortex, various
environment related cortical regions and subcortical circuits,
▪ Auditory Hallucination – most common form including thalamus and the striatum
experienced by people with schizophrenia o Schizophrenogenic Mother – used for a time to
▪ Most active part during Hallucination is Broca’s describe a mother whose cold, dominant, and
Area (speech production) rejecting nature was thought to cause schizophrenia
▪ Autoscopic Hallucination - individual in her children
experiences, all or part of the person's own body o Double bind communication – used to portray
appeared within the external space, viewed from communication style that produced conflicting
his/her physical body messages, which cased schizophrenia to develop
▪ Hypnagogic Hallucination – happens during o Families with high expressed emotion view the
sleep symptoms of schizophrenia as controllable and that
▪ Ictal Hallucination – associated with temporal the hostility arises when family members think that
lobe foci patients just do not want help themselves
▪ Hypnopompic Hallucinations – happens when Delusional Disorder
waking up - one or more delusions for at least 1 month
o Negative Symptoms – usually indicate absence or - persistent belief that is contrary to the reality in the
insufficiency of normal behavior absence of other characteristics of schizophrenia
a. Avolition – inability to initiate and persist - tend not to have flat affect, anhedonia, or other
activities negative symptoms
b. Anhedonia – lack of pleasure - socially isolated due to being suspicious
c. Asociality – lack of interest in social interactions - Shared Psychotic Disorder (Folie a Deux): condition
d. Flat Affect/Affective Flattening – do not show in which an individual develops delusions simply as a
emotions when you would normally expect them result of a close relationship with a delusional
to individual
o Disorganized Symptoms - Erotomanic, Grandiose, Jealous, Persecutory,
1. Disorganized Speech – individual may switch Somatic, Mixed, Unspecified
from one topic to another (derailment or loose - functioning is better than what is observed in
associations) or answers to questions may be Schizophrenia
related or completely unrelated (tangentiality) - eventually develop schizophrenia
▪ Word Salad - absence of active phase of schizophrenia
▪ Clang associations – are groups of words chosen Brief Psychotic Disorder
because of the catchy way they sound, not - presence of one of the ff: delusions, hallucinations,
because of what they mean disorganized speech, catatonic behavior for at least 1
2. Inappropriate Affect – laughing or crying at day but less than 1 month, with eventual full return to
improper times premorbid level of functioning
3. Grossly Disorganized or abnormal motor - can experience relapse
behavior – childlike silliness to unpredictable - if psychotic symptoms persist for at least 1 day in PD,
agitation an additional diagnosis of Brief Psychotic Disorder
o Neologisms – construction of new words in order to may be appropriate
communicate with schizophrenics thoughts Schizophreniform Disorder
o More severe symptoms of schizophrenia first occur - two or more of the following, present during a 1-
in late adolescence or early adulthood month period: delusions, hallucinations, disorganized
speech, catatonic behavior, negative symptoms
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- at least 1 month BUT less than 6 months Speech Sound Disorder
- development similar to schizophrenia - difficulty in speech sound production
Schizophrenia - children’s progression in mastering speech sound
- two or more of the following, present during 1-month production should result in most intelligible speech by
period: delusions, hallucinations, disorganized speech, 3 years old
catatonic behavior, negative symptoms - continuous use of immature phonological
- disturbance in one or more major areas simplification processes when the child has already
- at least 6 months passed the age wherein most of them can now produce
- abrupt or insidious words clearly
- prognosis is influenced both by duration and by - when LD is present, Speech Sound Disorder has
severity of illness and gender poorer prognosis
- possible reduced psychotic experience during late life - selective mutism may develop
- too much use of regression Childhood-Onset Fluency Disorder (stuttering)
Schizoaffective Disorder - disturbances in normal fluency and time patterning of
- major mood ep + delusions or hallucinations for 2 or speech that are inappropriate for the individual’s age
more weeks and language skills
- some individuals tend to change diagnosis into mood - can be insidious or more sudden
disorder or to schizophrenia over time Social (Pragmatic) Communication Disorder
Neurodevelopmental Disorders - difficulties in the social use of verbal and nonverbal
Intellectual Developmental Disorder communication
- includes both intellectual and adaptive functioning - deficits in using communication for social purposes in
deficits in conceptual, social, and practical domains a manner that is appropriate for the social context
- difficulties with day-to-day activities to an extent that - difficulties in following the rules of conversating and
reflects both severity of their cognitive deficits and the do not understand metaphors, etc.
type and amount of assistance their receive - current symptoms or developmental history fails to
- difficulties in conceptual, social, and judgement reveal evidence that could meet the
- causes: deprivation, abuse, neglect, exposure to restrictive/repetitive patterns of behavior, interests, or
disease or drugs during pre-natal, difficulties during activities of ASD
labor and delivery, infections, and head injury Autism Spectrum Disorder
- Phenylketonuria, Lesch-Nyhan Syndrome, Down - deficient Communication, Restrictive/Repetitive
Syndrome, Fragile X Syndrome Actions/Behaviors, Impaired Social Interaction
- generally nonprogressive, there are period of - evident in early childhood
worsening, then stabilization, and in others progressive - failure to develop age-appropriate social
of intellectual function in varying degrees relationships, social reciprocity, nonverbal comms, and
- lifelong initiating and maintaining social relationships
Global Developmental Delay - inability to engage in joint attention
- for children under 5 years old when they fail to meet - maintenance of sameness
expected developmental milestone in several areas of - The developmental course and absence of restrictive,
functioning repetitive behaviors and unusual interests in ADHD
Language Disorder help in differentiating ASD and ADHD
- difficulties in acquisition and use of language - A concurrent diagnosis of ADHD should be
modalities due to DEFICITS in comprehension and considered when attentional difficulties or
production hyperactivity exceeds that typically seen in individuals
- reduced vocab, limited sentence structure, of comparable mental age
impairments in discourse - ADHD is one of the most common comorbidities in
- regional, social, or cultural/ethnic variations must be ASD
considered when an individual is being assessed - A diagnosis of ASD in individual with IDD is
- declines in critical social communication behavior appropriate when social communication and
during the first two years of life are evident in most interaction are significantly impaired relative to the
children with ASD, thus, it must be not confused with developmental level of the individual’s nonverbal skills
LD
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- IDD is appropriate diagnosis when there is no - Motor Stereotypies are defined as involuntary
apparent discrepancy between the level of social rhythmic, repetitive, predictable movements that
communicative skills and other intellectual skills appear purposeful but serve no obvious adaptive
- The diagnosis of ASD supersedes that of social function; often self-soothing or pleasurable and stop
communication disorder whenever the criteria for ASD with distraction
are met, and care should be taken to enquire carefully Neurocognitive Disorders
regarding past or current restricted/repetitive behavior Delirium
- Rett Disorder – genetic condition that affects mostly - characterized by impaired consciousness and
females and is characterized by hand wringing and poor cognition during the course of several hours or days
coordination - appear confused, disoriented, and out of touch with
- Clear genetic component their surroundings
- Evidence of brain damage combined with - effects may more lasting
psychosocial influences - can be experienced by children who have high fevers
Attention-Deficit/Hyperactivity Disorder or taking certain medication
- pattern of inattention and/or hyperactivity-impulsivity - reversible
that interferes functioning for at least 6 months - occurs during the course of dementia
- dislikes organization, focused work - full recovery with or without treatment
- often losses things, forgets daily activities, and easily Major Neurocognitive Disorder
distracted - gradual deterioration of brain functioning that affects
- fidgets a lot, stands up when seating is expected, memory, judgement, language, and other advanced
always “on the go” cognitive process
- present in two or more settings Mild Neurocognitive Disorder
- difficulty sustaining their attention on task or activity - early stages of cognitive declines
- in pre-school, main manifestation is hyperactivity - most impairments in cognitive abilities but can, with
- Fidgetiness and restlessness in ADHD are typically some accomodations
generalized and not characterized by repetitive o Dementia – describe a group of symptoms affecting
stereotypic movements memory, thinking, and social abilities severely
- A diagnosis of ADHD in IDD requires that inattention enough to interfere daily life
or hyperactivity be excessive for mental age Alzheimer’s
Specific Learning Disorder – most common type of neurocognitive disorder,
- difficulties learning and using academic skills for at usually occurring after the age 65, marked most
least 6 months, despite interventions prominently by memory impairment
- academic skills are substantially and quantifiably - Usually begins with mild memory problems, lapses of
below those expected for the individual’s chronological attention, and difficulties in language and
age, IQ, and education communication
Developmental Coordination Disorder - Excessive senile plaques (sphere-shaped deposits of
- acquisition and execution of coordinated motor skills beta-amyloid protein that form in the spaces between
are below expected given the chronological age certain neurons and in certain blood vessels of the brain
- clumsiness, slowness, and inaccuracy of performance as people age) and neurofibrillary tangles (twisted
of motor skills protein fibers that form within certain neurons)
Stereotypic Movement Disorder - includes multiple cognitive deficits that develop
- repetitive, seemingly driven, and apparently gradually and steadily
purposeless motor behavior - inability to integrate new information results to failure
- may result in self-injury to learn new association
Tic Disorders - Anomia, Apraxia, Agnosia, Amnesia, Aphasia
- Tourette’s: both motor and one or more vocal tics for - cognitive deterioration is slow during the early and
more than 1 year later stages but more rapid during middle stages
- Persistent: single or multiple motor or vocal tics, but Vascular Injury
NOT BOTH for more than 1 year - when the blood vessels in the brain are blocked or
- Provisional: single or multiple more and/or vocal tics damaged and no longer carry oxygen and other
for less than 1 year since the first onset
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nutrients to certain areas of brain tissues, damage - caused by prions (proteins that can reproduce and
results cause damage to brain cells leading to neurocognitive
- declines in speed of information processing and decline
executive functioning - no treatment but not contagious
Frontotemporal Degeneration - Creutzfeldt-Jakob Disease: symptoms include spasms
- categorize a variety of brain disorders that damage the of the body caused by slow acting virus that may live
frontal or temporal regions of the brain – areas that in the body for years before the disease develops
affect personality, language, and behavior Therapeutic Interventions of Psychological Disorders
- declines in appropriate behavior or language (10)
- Pick’s Disease: rare neurological condition that Different Psychological Interventions
produces symptoms similar to Alzheimer’s, usually Treatment: Definition of Terms
occurring in relatively early in life (40s or 50s) o Idiographic Data – specific details and background
Traumatic Brain Injury information
- symptoms must persist for at least a week following ▪ Specific or unique information
the trauma, including executive dysfunction and
o Nomothetic – broad information, nature, and
problems with learning and memory
treatment
Lewy Body Disease
▪ Generalization or commonalities with other
- involves the buildup of clumps of protein deposits
called Lewy Bodies, within many neurons context
- Features significant movement difficulties, visual o Treatment – also known as therapy, procedure
hallucinations, and sleep disturbances designed to change abnormal behavior to a more
- Second most common neurocognitive disorder normal behavior
- gradual and include impairment in alertness and ▪ Consists of client, therapies, and series of contact
attention, vivid visual hallucinations, and motor between them
impairment Psychological Interventions
Parkinson’s Disease Psychodynamic
- slowly progressive neurological disorder marked by 1. Free Association – therapist tells the patient to
tremors, rigidity, and unsteadiness describe any thought, feeling, or image that comes to
- motor problems, tend to have stooped posture, slow mind even if it seems unimportant
body movements (bradykinesia), tremors, and jerkiness 2. Transference – they act and feel toward the therapist
- damage in dopamine pathways as they did toward important person in their lives
HIV Infection 3. Resistance – unconscious refusal to participate fully
- HIV infection seems to be responsible for the in the therapy
neurological impairment 4. Dreams interpretation – can reveal unconscious
- early symptoms: cognitive slowness, impaired instincts, needs, and wishes
attention, and forgetfulness - Manifest: consciously remembered dream
- clumsy, repetitive movements, and become apathetic - Latent: meaning
and socially withdrawn 5. Catharsis – reliving past repressed feelings
- sometimes referred as Subcortical Dementia 6. Working Through – patient and therapist must
- more likely to experience depression and anxiety examine the same issues over and over in the course of
Substance-Use many sessions
- use of different psychoactive substances + poor diet 7. Short-Term Psychodynamic Therapies – patient
- include memory impairment, aphasia, apraxia, choose a single problem, a dynamic focus to work on
agnosia, or disturbance in executive functioning and work only on the psychodynamic issues that relate
Huntington’s to it
- inherited progressive disease in which memory 8. Relational Psychoanalytic Therapy – therapist
problems, along with personality changes and mood disclosing things about themselves, particularly their
difficulties, worsen over time own reactions to patients, and try to establish more
- Have movement problems too, such as severe equal relationships with patients
twitching and spasms
Prion Disease
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8. Hypnotherapy – patient undergoes hypnosis and is - Mindfulness-Based CBT (Acceptance and
then guided to recall forgotten events or perform other Commitment Therapy)
therapeutic activities - Behavioral Activation: therapy for depression in
9. Play Therapy – an approach to treating childhood which the client is guided systematically increase the
disorders that helps children express their conflicts and number of constructive and pleasurable activities and
feelings indirectly by drawing, playing, and making events in his or her life
stories - Cognitive Remediation: focuses on the cognitive
Humanistic impairments that often characterize people with
1. Client-Centered Therapy – clinicians try to help schizophrenia, particularly their difficulties in
clients by accepting, empathizing accurately, and attention, planning, and memory
conveying genuineness (Carl Rogers) - Hallucination Reinterpretation and Acceptance
2. Support Group 2. Neutralizing – attempting to eliminate thoughts that
3. Home-Based Self-Help Programs one finds unacceptable by thinking or behaving in ways
4. Social Skills Training that make up for those thoughts and so put right
5. Family Therapy – therapist meets with the all the internally
members of a family and helps them to change in 3. Exposure and Response (Ritual) Prevention –
therapeutic ways treatment of OCD that exposes client to anxiety-
6. Group Therapy – group of people with similar arousing thoughts or situations and then prevents the
problems meet together with a therapist to work on client from performing his or her compulsive acts
those problems 4. Beck’s Cognitive Therapy – people identify and
7. Psychological Debriefing – form of crisis change the maladaptive assumptions and ways of
intervention in which victims are helped to talk their thinking that help cause their psychological disorders
feelings and reactions to traumatic experiences 5. Aversion Therapy – client are repeatedly presented
- critical incident stress debriefing with unpleasant stimuli while performing undesirable
8. Interpersonal Psychotherapy (IPT) – treatment for behavior such as taking drug
depression that based on belief that clarifying and 6. Relapse-Prevention Training – treatment for
changing one’s interpersonal problems will help lead to alcohol use disorder in which clients are taught to keep
recovery track of their drinking behavior, apply coping strategies
9. Motivational Interviewing – use mixture of in situation that typically trigger excessive drinking,
empathy and inquiring review to motivate clients to and plan ahead for risky situations and reactions
recognize they have serious psychological problem and 7. Cognitive Processing Therapy – intervention for
to commit to making constructive choices and behavior people with PTSD in which therapist guide individuals
changes to examine and change the dysfunctional attitudes and
10. Milieu Therapy – institutions can help patients styles of interpretation they have developed as a result
recover by creating a climate that promotes self- of their traumatic experiences, thus, enabling them to
respect, individual responsible behavior, and deal with difficult memories and feelings
meaningful activity Biological
11. Parent Management Training – combine family 1. Sedative-Hypnotic Drugs – also called as
and cognitive-behavioral interventions to improve anxiolytic, produce feelings of relaxation and
family functioning and help parents deal with their drowsiness
children more effectively - Benzodiazepines: sedative that slow down body and
12. Gestalt Therapy – clinicians actively move clients brain’s function (depressant)
toward self-recognition and self-acceptance by using - Barbiturates: medication that causes relaxation and
techniques such as role playing and self-discovery drowsiness (depressant)
exercises 2. Antidepressant – improve the mood of people with
Cognitive depression
1. Cognitive-Behavioral Therapy – seek to help - increase the activity of serotonin and norepinephrine
clients change both counterproductive behaviors and 3. Antipsychotic – correct grossly confused or
dysfunctional ways of thinking distorted thinking
- Rational-Emotive Behavioral Therapy - relieve anxiety by altering the activity of dopamine
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4. Vagus Nerve Stimulation – treatment for 5. Contingency Management – an operant
depression in which implanted pulse generator sends conditioning training program wherein clients are
regular electrical signals to a person’s vagus nerve, then offered incentives that are contingent on the
stimulates the brain submission of drug-free urine specimens
5. Electroconvulsive Therapy – electrodes attached to Illustrate the Application of Psychological
patient’s head and send an electrical current through the Interventions for treatment
brain, causing seizure Disorder Treatment
6. Transcranial Magnetic Stimulation – Generalized Anxiety - Free Association
electromagnetic coil, which placed on or above a Disorder - Dreams
person’s head sends a current into the person’s brain - Transference
7. Mood Stabilizers – stabilize the moods of people - Resistance
suffering from bipolar disorder - Client-Centered
- also known as antibipolar drugs Therapy
- Lithium: metallic element that occurs in nature as - CBT (Rational-Emotive
mineral salt and is an effective treatment for bipolar Therapy, Mindfulness-
disorders Based CBT)
8. Detoxification – systematic and medically - Benzodiazepines
supervised withdrawal from a drug - Antidepressant
9. Antagonist Drug – block or change the effects of an - Antipsychotic
addictive drug - Play Therapy
10. Antianxiety – also called as minor tranquilizers, Specific Phobia - Exposure Treatments
help in reducing tension and anxiety - Systematic
11. SSRIs – treat depression by increasing the levels of - Desensitization
serotonin in the brain - Flooding
- block reabsorption of serotonin into neurons Agoraphobia, - Exposure Therapy
Behavioral Separation Anxiety - Support Group
1. Exposure Treatment – behavior-focused Disorder - Home-Based Self-Help
intervention in which fearful people are repeatedly – Programs
exposed to the objects they dread - Benzodiazepines, SSRIs
- Virtual Therapy/Virtual Reality Treatment: cognitive- Social Anxiety - Benzodiazepines
behavioral intervention that uses VR as an exposure - Antidepressant
tool - CBT
- Prolonged Exposure: clients confront now only - Exposure Therapy
trauma-related objects and situations, but also their - Social Skills Training
painful memories of traumatic experiences - D-Cycloserine
- Eye Movement Desensitization and Reprocessing Panic Attacks - Antidepressant
(EMDR): clients move their eyes in a rhythmic nabber - CBT
from side to side while flooding their minds with Obsessive-Compulsive - Free Association
images of objects and situations they ordinarily avoid Disorder - Short-Term
2. Systematic Desensitization – exposure therapy that - Psychodynamic
uses relaxation training and a fear hierarchy to help Therapy
clients with phobias react calmly to the objects or - Neutralizing
situations they dread - Exposure and Response
3. Flooding – exposure therapy in which clients are Prevention
exposed repeatedly and intensively to a feared object - Antidepressant
and made to see that it is actually harmless PTSD and Acute Stress - Antidepressant
4. Token Economy Programs – behavior-focused Disorder - CBT (Mindfulness-
program in which a person’s desirable behaviors are Based)
reinforced systematically throughout the day by the - Exposure Therapy
awarding of tokens that can be exchanged for goods or (Virtual Reality Therapy,
privileges Prolonged Exposure)
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- Group and Family Anorexia - Nutritional
Therapy Rehabilitation (tube and
- Psychological intravenous feedings)
Debriefing - Motivational
Dissociative Amnesia - Psychodynamic Interviewing
Therapy - CBT
- Hypnotic Therapy - Family Therapy
- Drug Therapy (Amytal, Bulimia - Nutritional
Pentothal) Rehabilitation
Dissociative Identity - Psychodynamic - Antidepressant
Disorder - Supportive - CBT (Exposure and
- Cognitive Response Prevention)
- Drug Therapy - Interpersonal
Depression - Free Association Psychotherapy
- CBT (Behavioral - Psychodynamic
Activation, Acceptance Therapy
and Commitment Binge-Eating - CBT
Therapy) - Antidepressant
- Beck’s Cognitive Substance-Use - Aversion Therapy
Therapy Disorders - Contingency
- Antidepressant Management
- Vagus Nerve - Relapse Prevention
Stimulation Training
- Electroconvulsive - CBT (Acceptance and
Therapy Commitment Therapy)
- Transcranial Magnetic - Detoxification
Stimulation - Antagonist Drugs
- Interpersonal - Drug Maintenance
Psychotherapy Therapy
- Couple Therapy - Self-Help Programs
Bipolar Disorder - Psychotropic Drugs - Community-Based
- Mood Stabilizers Prevention Programs
- Antipsychotics Sexual Dysfunctions - Affectual Awareness
- Antidepressant - Self-Instruction
- Lithium Training
Suicide Attempts - CBT (Mindfulness- - Hormone Treatments
Based) Gender Dysphoria - hormone administration
- Dialectal Behavior - gender-confirmation
Therapy (DBT) surgery/gender-
Conversion and Somatic - Education reassignment surgery
Symptom Disorders - Reinforcement Schizophrenia - Milieu Therapy
- Cognitive Restructuring - Token Economy
- CBT program
Physical Disorders - Relaxation Training - Antipsychotic Drugs
- Biofeedback - CBT (Cognitive
- Meditation Remediation,
- Hypnosis Hallucination
- Self-Instruction Reinterpretation and
Training Acceptance)
- Support Groups - Family Therapy
- Social Therapy
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Paranoid PD - CBT Evaluate the Efficacy of Psychological Interventions
- Anxiety-Reduction o Psychodynamic therapy seems to help most in cases
Techniques of depression that are modest or moderate in severity
- Antipsychotic drugs and that involve clear history of childhood loss or
Schizoid PD - Social Skills Program trauma
- Group Therapy o Short-term psychodynamic therapies have
- CBT performed better than long-term approaches,
Schizotypal PD - CBT
especially when they are combined with
- Speech Lessons
psychotropic medications
- Social Skills training
- Antipsychotic Drugs o Most patients have fewer new episodes of manic
Antisocial PD - Antipsychotic Drugs episodes by taking lithium and other mood stabilizers
- CBT o Antipsychotic drugs reduced positive symptoms in
Borderline PD - Relational around 70% of patients diagnosed with
Psychoanalytic Therapy schizophrenia
- DBT o Exposure therapies are effective with phobias
- antidepressant o Benzodiazepines can be effective in many cases of
- antibipolar panic disorder, although they are used less often than
- antianxiety depressants
- antipsychotic o CBT are equally effective as antidepressant drugs in
Histrionic PD - CBT the treatment of panic disorders
- Psychodynamic o Antidepressant drugs bring improvement to between
Therapy 50 and 60 percent of those with obsessive-
- Group Therapy
compulsive disorder
Avoidant PD - CBT
o Structures in the circuit do indeed seem to
- Psychodynamic
Therapy interconnect more appropriately after individuals
- Exposure treatments with OCD respond successfully to antidepressant
- Antianxiety treatment
- Antidepressant o Long-term psychodynamic therapy is only
Obsessive-Compulsive - SSRIs occasionally helpful in cases of unipolar depression
PD (short-term >>>>)
Conduct Disorder - Parent Management o Culture-Sensitive approaches increasingly are being
Training combined with traditional forms of psychotherapy to
Encopresis, Enuresis - dry-bed training help minority clients overcome their disorders
(reinforcement) o ECT has apparent effectiveness with severe
- biofeedback training depression, especially when patients follow up the
- family therapy initial cluster of sessions with continuation or
ADHD - Methylphenidate maintenance therapy, either ongoing antidepressant
(Stimulant)
medications or periodic ECT sessions
- CBT
- Parent Management o CBT, Interpersonal, and Biological Therapies are all
Training effective treatment for unipolar depression
Autism Spectrum - CBT o However, drug therapy reduced depressive
Disorder - Communication symptoms more quickly that CB and Interpersonal
Training therapies, but these psychotherapies had matched the
- Parent training drugs in effectiveness by the final 4 weeks of
- Community Integration treatment
- Psychotropic Drugs o CBT and Interpersonal Therapies lower the
Intellectual Disability - special education likelihood of relapse
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o Token Economies help reduce psychotic and related ▪ Cause: induvial believes that he or she has
behaviors, however, its uncontrolled become the subject of black magic
o Drugs appear more effective treatment for ▪ Similar to Maladi Moun
schizophrenia than any other approaches used alone, o Taijin Kyufusho - an intense fear that one's body
such as psychotherapy, milieu therapy, or parts or functions displease, embarrass or are
electroconvulsive therapy offensive to others
o Amok - syndrome or pattern of behavior
o Psychotherapy is successful in many more cases of
acknowledged in Southeast Asia (Malaysia,
schizophrenia these days (CBT, Family Therapy,
Philippines, Indonesia) characterized by sudden
Social Therapy) outbursts and frenzied violent behaviors after a
o For people with schizophrenia, cognitive period of brooding and quiet
remediation brings about moderate improvements in o The likelihood of having a particular phobia is
attention, planning, memory, and problem-solving powerfully influenced by gender
o CBTs often help people with schizophrenia feel more o Males are more likely than females to self-medicate
control over their hallucinations and reduce their their fear and panic with alcohol and in so doing start
delusional ideas down the slippery slope to addiction
Socio-Cultural Factors and Ethics (5) o BN, AN, and BDD is common to females
Identifying Socio-Cultural factors o Well-established ability of women to recall
o Stigma – a strong lack of respect for a person or a emotional memories somewhat better than men may
facilitate emotional processing and long-term
group or a bad opinion of them because they have
treatment gains
doen something society does not approve off
o Dissociative Trance – counterpart of DID in eastern
o Ataque de Nervous – syndrome among individuals countries; sapi
of Latino Descent, characterized by symptoms of o Experiences during different periods of development
intense emotional upset, including acute anxiety, may influence our vulnerability to other types of
anger, or grief; screaming; attacks of crying; stress or to differing psychological disorders
trembling; heat in the chest rising into the head; and Ethics
becoming verbally and physically aggressive
o If mistakes was made, they should do something to
o Dhat Syndrome – coined in South Asia (India)
correct or minimize the mistakes
characterized by young male patients who attributed
o If an ethical violation made by another psychologist
their symptoms to semen loss
was witnessed, they should resolve the issue with
o Koro - acute anxiety and a deep-seated fear of
informal resolution, as long as it does not violate any
shrinkage of the penis and its ultimate retraction into
confidentiality rights that may be involved
the abdomen, which will cause death
o When they are tasked to provide services to clients
o Khyal Cap – syndrome found among Cambodians
who are deprived with mental health services (e.g.,
characterized by panic attacks
communities far from the urban cities), however,
o Kufungisisa – overthinking; idiom of distress and
they were still not able to obtain the needed
cultural explanation among the Shona of Zimbabwe
competence for the job, they could still provide
o Maladi Moun – Haiti; sent sickness; interpersonal
services AS LONG AS they make reasonable effort
envy and malice cause people to harm their enemies
to obtain the competence required, just to ensure that
by “sending illness”
the services were not denied to those communities
o Nervios – among Latinos; general state of
o During emergencies, psychologists provide services
vulnerability to stressful life experiences and to
to individuals, even though they are yet to complete
difficult life circumstances
the competency/training needed just to ensure that
o Shenjing Shuairuo – syndrome composed of
services were not denied. However, the services are
weakness, emotions, excitement, nervous pain, and
discontinued once the appropriate services are
sleep
available
o Susto – distress and misfortune prevalent among
o Informed Consent:
some Latinos in US, attributed to a frightening event
✓ When conducting research, providing
that causes the soul to leave the body and results to
assessment, therapy, counseling, or consultation
unhappiness and sickness, as well as functioning in
✓ For legally INCAPABLE, they must provide
key social roles
appropriate explanation, assent, consider the
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client’s preferences and best interests, and obtain o Psychological assessment techniques done by
permission from a legally authorized person unqualified persons, except during training purposes,
✓ If COURT ORDERED, they must inform the given it is supervised
nature of the services, whether it is court order or o When conducting or providing services to several
mandated, as well as, its limits of confidentiality persons who have a relationship, they should clarify
before proceeding which of them is the clients and the relationship
✓ Must document written or oral consent, he/she will have with each person
permission, and assent ▪ If conflicting roles would arise, he/she must
o In case of interruption of services (such as death, clarify, modify, or withdraw from roles
relocation, illness, retirement), psychologists must appropriately
make reasonable efforts to plan for continuing o Psychologists do not engage in sexual intimacies
services with former clients/patients for AT LEAST TWO
▪ Unless stated in the contract YEARS after termination of therapy
o Psychologists should discuss the limits of o Terminate therapy when the client no longer needs
confidentiality, uses of the information that would be the service, is not likely to benefit, or is being harmed
generated from the services to the persons and by continued service
organizations with whom they establish a scientific ▪ Also, when threatened or endangered by the
or professional relationships client
o Before recording voices or images, they must obtain ▪ Must provide pretermination counseling and
permission first from all persons involved or their suggest alternative service providers as
legal rep appropriate
o Only discuss confidential information with persons o Telepsychology – provision of psychological
clearly concerned/involved with the matters services using telecommunication technologies
o Disclosure is allowed with appropriate consent ▪ Must ensure competence with both the
▪ No consent is not allowed UNLESS mandated by technologies used and the potential impact of
the law technologies on clients/patients, supervisees or
o No disclosure of confidential information that could other professionals
lead to the identification of a client unless they have ▪ Ensure ethical and professional standards of care
obtained prior consent or the disclosure cannot be and practice
avoided ▪ Informed consent must still be obtained, which
▪ Only disclose necessary information specifically addresses the unique concerns related
o Exemptions to disclosure: to the telepsychology services they provide
✓ If the client is disguised/identity is protected ▪ Should include the manner of
✓ Has consent telecommunication, the boundaries they will
✓ Legally mandated establish, and the procedures for responding to
o Opinions written on recommendations, reports, and electronic communications
diagnostic or evaluative statements must be based ▪ When necessary, psychologists obtain the
and sufficient to their findings appropriate consultation with technology experts
o Only provide statements after conducting to augment their knowledge of
examinations to support their statements telecommunication technologies in order to apply
o Informed Consent, except: security measures in their practices that will
✓ Mandated by law protect and maintain the confidentiality of data
✓ Routine and information related to their clients/patients.
✓ Evaluating decisional capacity ▪ Some of the potential risks to confidentiality
▪ If the person has a questionable capacity to include considerations related to uses of search
consent, it must be obtained using the language engines and participation in social networking
that is reasonably understandable to the person sites.
being assessed ▪ Psychologists are encouraged to weigh the risks
o In the absence of client/patient release, psychologists and benefits of dual relationships that may
must provide test data only as required by law develop with their clients/patients, due to the use
of telecommunication technologies, before
engaging in such relationships
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▪ Psychologists who use social networking sites for learning, especially during the early days of the
both professional and personal purposes are pandemic (Chen et.al., 2022)
encouraged to review and educate themselves o Learning in the new normal has been a challenge to
about the potential risks to privacy and institutions, more particularly to students and
confidentiality and consider utilizing all available educators (Ignacio, 2021)
privacy settings to reduce these risks ▪ Not all institutions have the capability to deliver
▪ Psychologists are encouraged to create policies
online classes due lack of equipment, technical
and procedures for the secure destruction of data
know-how
and information and the technologies used to
create, store and transmit the data and o In the Philippines, children in vulnerable groups
information. have no access to quality education. They also
▪ Psychologists are thus encouraged to be struggle to find distance learning opportunities.
knowledgeable about, and account for, the unique According to UNESCO, about 28 million learners
impacts, suitability for diverse populations, and are affected by school closures. Unfortunately, the
limitations on test administration and on test and COVID-19 pandemic will severely affect their
other data interpretations when these learning quality without the help of government and
psychological tests and other assessment nongovernment organizations.
procedures are considered for and conducted via o The findings revealed that the online learning
telepsychology challenges of college students varied in terms of type
Global Health Crisis and Mental Health Law (10) and extent. Their greatest challenge was linked to
Different Issues and Concerns on the Impact of their learning environment at home, while their least
COVID-19 on the Mental Health of people challenge was technological literacy and
o After acquiring COVID-19 (or even prior), a person competency. The findings further revealed that the
may experience cognitive and attention deficits COVID-19 pandemic had the greatest impact on the
(brain fog), anxiety and depression, psychosis, quality of the learning experience and students’
seizures, and even suicidal behavior mental health (Barrot, Llenares, & del Rosario,
o Data suggests that people are more likely to develop 2021)
mental illness or disorders in the months following Frontliners
infection, including symptoms of PTSD o Insomnia was found to be the most common mental
o People who are more likely to experience the health problem, followed by anxiety, PTSD,
symptoms of mental illnesses or disorders during the depression and stress in healthcare workers in the
pandemic: face of the COVID-19 pandemic (Hayati et.al., 2023)
a) People from racial and ethnic minority o Post-traumatic stress disorder was the most common
b) Mothers and pregnant people mental health disorder reported by healthcare
c) People experiencing poverty workers during the COVID-19 pandemic, followed
d) Children by anxiety, depression, and distress (Advani et.al.,
e) PWDs 2021)
f) People with pre-existing mental illnesses o Besides the lack of personal protective equipment,
g) Health Care Workers our frontliners are underpaid and do not get the
Online Classes respect they deserve. They answer “to the call of duty
o Online learning in nursing education is not while battling fear and anxiety”.7 Aside from this,
significantly different from blended or face-to-face they also experience pressure, stress, insomnia,
learning in terms of its impact on knowledge denial, anger, and fear (Biana & Joaquin, 2020)
acquisition and attitudes toward learning (Kim & o According to WHO, Exposure to excessive stress,
Kim, 2022) for prolonged periods can have many harmful
o Online Learning caused by the COVID-19 Pandemic consequences on the emotional and mental well-
brought negative learning attitudes and poorer being of frontline workers. It can:
learning performance compared to classroom ✓ lead to burnout.
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✓ trigger the onset of common mental disorders worsening of their behavioral symptoms (Gupta et.
such as depression and anxiety or post-traumatic Al., 2020)
stress disorder (PTSD). o The review highlights the need for mental health
✓ result in unhealthy behaviours like using tobacco, services to address the increased mental health
alcohol or other substances, which may lead to symptoms in people with pre-existing mental
substance use disorders. illnesses during a pandemic (Duddu et. Al., 2020)
✓ result in frequent absence from work or reduced o Students and unemployed respondents are highly
productivity while at work. vulnerable to COVID stress and its mental health
✓ increase the risk of suicide among frontline implications. Men and women did not significantly
workers, particularly health care workers differ in distress (Acebes & Montano, 2020)
o Cluster analysis revealed two age clusters—those
between 16 and 35 years and those 36 years and
Vaccination above. The younger group reported greater
o COVID-19 vaccination is associated with larger depression, anxiety, and stress symptoms and poorer
reductions in anxiety or depression symptoms among psychological well-being compared to the older
individuals with lower education levels, who rent group. The younger group also reported less
their housing, who are not able to telework, and who resilience, nonreactivity, and use of spiritual coping
have children in their household (Agrawal et.al., compared to the older group. The results suggest that
2021) the young are most vulnerable during the pandemic,
o The results of the present study showed that the and findings suggest what might be done to provide
mental health of young people did not significantly them mental health psychosocial support. (Alampay,
improve in the time period after vaccinations became Hechanova & Valentin, 2022)
widely available and promoted in Austria and Turkey Teleconsultation
(Chen et. Al., 2023) o Telephone-delivered psychotherapy has increased
▪ The impact of age may be related to more utility as a method of service delivery in the current
pronounced uncertainty and anxiety among world, where several barriers, including economic
younger groups, as unpredictable pandemic hardships and limited access to care, may prevent
circumstances make it even more difficult for people from receiving the treatment they need
them to plan their future, as they cross the (Arafat, Hawlader & Zaman, 2021)
threshold to adulthood and independence. ▪ telemedicine is perfectly suitable to treat the
▪ a number of recent studies have confirmed that mental health problems of the people in this
younger adults and females in particular suffered pandemic situation without increasing the risk of
from the adverse outcomes associated with the infection, promoting health and prolonging life as
COVID-19 pandemic well.
o An overwhelming majority of Filipinos surveyed Work From Home
(over 15,600 participants) currently distrust available o The top factors that contribute to people’s stress,
vaccines, their efficacy against the original and anxiety, and depression are financial considerations,
emerging strains, the cost of being vaccinated, and health concerns, and inconsistencies in the
the authenticity of vaccine samples available in the workplace setup (Del Mundo, 2022)
country (CNN Philippines, 2021; Sabillo 2021). ▪ When experienced with frequency, these result in
Lockdown burnout, loss of drive and focus, and struggles
o Anxiety, depression, irritability, boredom, with work-life balance
inattention and fear of COVID-19 are predominant o The switch to a work from home status has
new-onset psychological problems in children during contributed to the higher critical levels in our
the COVID-19 pandemic. Children with pre-existing workforce’s mental health. Those who are working
behavioral problems like autism and attention deficit from home are 3.7 times more likely to have critical
hyperactivity disorder have a high probability of anxiety levels and 6 times more likely to have critical
depression levels.
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#BLEPP2023
o Another survey by Lenovo Philippines as early as child marriage – will be felt by many children,
April reported that up to 87% employees were ready especially the youngest learners in critical
to shift to WFH when required. "Our survey suggests development stages,” UNICEF Philippines
that the employee experience was already changing Representative Oyunsaikhan Dendevnorov says.
before the pandemic hit," said Michael Ngan, o While children are more vulnerable to these
president and general manager of Lenovo detriments, there remains the absence of unified and
Philippines, reported Business Mirror. comprehensive strategies in mitigating the
o On top of the mental health issues that WFH deterioration of the mental health of Filipino children
employees are now facing are logistical concerns (Biag, 2021)
surrounding the adjustment to the telecommuting Evaluating the Impact of Global Health Crisis and
scheme. A BPO Industry Employees Network survey other mental health conditions on the implementation
revealed common issues faced by WFH employees, of RA 11036
including: "lack of logistical assistance (such as o Dr. Razel Nikka Hao, DOH Disease Prevention and
delivery of equipment)," "longer working hours," Control Bureau director, reported to the committee
"unpaid wages due to poor or no Internet that since RA 11036 was passed, 62 of their
connection," "unjust sanctions due to technical personnel were trained on Basic Institutional Review
problems," and "shouldering of Internet and utility Board (IRB); 51 as future trainers for IRB; 1,556
expenses by employees." Up to 77% of respondents completed the World Health Organization Quality
say that they've been shouldering their own Internet Rights e-training; 28 with Lived Experiences
costs while 54% did not receive Internet allowance completed the course on mental health advocacy and
and 20% did not receive work laptops. leadership (pilot implementation); and over about 40
o Dr. Agnes Casiño of the National Center for Mental media practitioners were trained on responsible and
Health (NCMH) said maintaining work-life balance ethical reporting and portrayal of suicide (pilot
in a work from home setup is hard especially when implementation).
one has to take on different roles at different times in o DepEd officials noted that after the pandemic
the same place. lockdowns, the transition from blended learning to
o Employees pointed out that with the new work in-person classes also created new pressures on
arrangement, they still find satisfaction, enjoyment, students. But there are no programs specifically
and fulfilment given the necessary condition at designed to promote mental health for any age group.
home. However, detrimental factors like balancing Bullying has been a serious problem in schools even
work and family, difficulty focusing on work tasks before the pandemic, with social media facilitating
and collaborating with colleagues, poor working the abuse, and DepEd officials believe bullying cases
environment, and slow internet connectivity lead to are also underreported.
isolation, stress, and anxiety. o Despite passing the Philippine Mental Health Act
▪ women experienced higher stress and exhaustion (RA 11036), access to mental health care remains
with working from home compared to men due to limited. Most pediatricians, adolescent medicine
familial and domestic responsibilities. specialists, and psychiatrists practice in urban areas
Children in the country. Moreover, payment for mental health
o Learning deficits are particularly large among consultation remains an out-of-pocket expense for
children from low socio-economic backgrounds Filipinos (Malaluan et. Al., 2022)
(Betthäuser, Bach-Mortensen & Engzell, 2022) o Rep. Florida Robes said that aside from minimum
o “In 2020, schools globally were fully closed for an health standards and protocols aimed at halting the
average of 79 teaching days, while the Philippines spread of COVID-19 in communities, local
has been closed for more than a year, forcing students government units (LGUs) should also establish
to enroll in distance learning modalities. The mental help desks in every barangay to address those
associated consequences of school closures – suffering from anxiety or depression as a result of the
learning loss, mental distress, missed vaccinations, pandemic (Quismorio, 2020)
and heightened risk of drop out, child labour, and
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#BLEPP2023
o In a statement on Monday, Deputy Speaker Loren
Legarda said that the government must work to
address the mental health issues of Filipinos, who
have struggled to cope with the demands and the
problems brought by the COVID-19 pandemic.
o Legarda, who was co-author of Republic Act No.
11036, was referring to a Philippine Statistics
Authority (PSA) data that showed suicide incidents
increasing by 57 percent for 2020, compared to 2019.
o She said she is seeking a policy measure dedicated to
“enhancing the delivery of mental health services to
the people,” especially since recent studies showed
that only around five percent of the whole health
budget was allocated to mental health concerns.
o The DOH has launched a multi-sectoral approach for
mental health with programs and interventions
across a variety of settings (e.g. workplaces, schools,
communities) aimed at high-risk groups. The
commemoration of World Suicide Prevention Day
also calls attention to the plight of those who are
undergoing severe forms of depression.
o Another project is the development of a multi-
sectoral National Suicide Prevention Strategy, which
includes psychosocial services such as the NCMH’s
Crisis Hotline “Kamusta Ka? Tara Usap Tayo,”
launched on 2 May 2019. The hotline is available
24/7 for prompt psychological first aid. The UP
Diliman Psychosocial Services (UPD PsychServ)
has also provided free counseling via telephone for
front liners. RA 11036 or the (“Mental Health Act”)
mandates the provision of comprehensive suicide
prevention services encompassing crisis
intervention, and a response strategy on a nationwide
scale.
end
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congratulations on reaching the end of this reviewer!! i

one day, we will be remembered.

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