Understanding Psychopathology cognition, emotion regulation, or behavior that
Part 1 reflects a dysfunction in the psychological,
Definitions of Abnormality
There are many ways in which behavior may be
considered as abnormal, whether it is by
psychologists or people in general.
Statistical Deviation
The core illustration here is that behavior becomes
considered as abnormal when it significantly
deviates from the average or the majority.
Social Norm Violation
In the layman’s perspective, behaviors or actions
that break social “rules” are considered to be
abnormal.
Maladaptive Behavior
There are two aspects to maladaptive behavior –
maladaptive to oneself and maladaptive to society.
Personal Distress
The presence of distress in the way a person
conducts their day-to-day life may warrant
consideration into abnormality.
Deviation from an Ideal
This would indicate that inability to reach or
conform to that ideal would already be thought of
as abnormal or a sign of a mental disorder.
Medical Disorder
Abnormal behavior is a symptom of a physical
ailment. Take for example, Alzheimer’s disease is
primarily caused by atrophy of certain regions of
the brain.
Key Characteristics in the DSM Definition of
Mental Disorder
 DISTRESS
 DEVIANCE
 DYSFUNCTION
DSM 5 - Diagnostic and Statistical Manual of
Mental Disorders
The DSM requires the following in its
consideration of what constitutes as a mental
disorder:
“A mental disorder is a syndrome (pattern that
occurs in an individual) characterized by clinically
significant disturbance in an individual’s
biological, or developmental processes underlying
mental functioning. Mental disorders are usually
associated with significant distress or disability in
social, occupational, or other important activities.”
And specified some disqualifiers:
“An expectable or culturally approved response to
a common stressor or loss, such as the death of a
loved one, is not a mental disorder. Socially
deviant behavior (e.g., political, religious, or
sexual) and conflicts that are primarily between
the individual and society are not mental disorders
unless the deviance or conflict results from a
dysfunction in the individual, as described above.”
Some Ds to Digest:
Dysfunction, Distress, Disability, and Deviance
o Psychological Dysfunction refers to a
breakdown in cognitive, emotional, or
behavioral functioning and causes interference
to one’s daily life.
(e.g., Cognitive functions such as reasoning and
decision-making are not being performed properly
contrary to that person’s typical capabilities)
o Distress. The disorder being experienced is
unpleasant or unsettling for the person.
o Disability or Impairment in some important
areas of life, having great difficulty
performing certain actions due to their existing
condition.
o Deviance. Atypical, or unusual behavior
whether regarding society at large or to the
person’s usual disposition
o Danger. When the behavior being exhibited
poses risk of harm to the person themself
and/or to others, in certain disorders, this is
also one of the symptoms to watch out for.
NOTE:
Distress or deviance by themselves cannot
constitute a mental disorder. Context and severity
of these behaviors must always be noted, along
with the extent of how these experiences have
affected one’s typical life.
 Understanding Psychopathology
Part 2
Historical Conceptions of Abnormal Behavior
o Supernatural
o Biological
o Psychological
SUPERNATURAL
o Demons and Witches
• 14th century: insanity = the devil
• Usually treated with exorcisms: rituals to
rid someone of negative spirits.
• Sometimes treated by shaving a cross into
their head or
• chaining them close to a church so they
could hear Mass.
• Salem Witch trials
• Other treatments for possession included
ice baths, confinement, beatings, and
swims in ice water.
o Stress and Melancholy
Insanity = Stress
• Depression and Anxiety were caused by
being too stressed out.
• Main factor of treatment was rest, though
baths and ointments were also used.
• Often, these people were moved to villages
where neighbors took turns caring for them.
• We now know this is beneficial.
o Hysteria
Mass Hysteria: sudden bizarre behavior by
many people
• People would spontaneously dance and
scream their way into the streets.
• People can literally make themselves ill
from nothing more than an idea.
• It’s a collective stress reaction and found
in normal people.
o Moon and Stars
• Insanity = positioning of moon and stars
• This perspective still exists today.
• "Lunatic"
BIOLOGICAL
Hippocrates assumed that normal brain
functioning was related to four bodily fluids or
humors: blood, black bile, yellow bile, and
phlegm.
o Blood came from the heart, Blood: related to
air, with moist and warm qualities.
o Black bile from the spleen, Black bile:
related to earth, with cold and dry properties.
o Phlegm from the brain, Phlegm: related to
water, with moist and cold qualities.
o Choler or Yellow Bile from the liver. Yellow
bile: related to fire, with dry and warm
properties.
Too much black bile was thought to cause
melancholia (depression). In fact, the term
melancholier, which means “black bile,” is still
used today in its derivative form melancholy to
Refer to aspects of depression.
Sanguine (literal meaning “red, like blood”)
Melancholic means depressive (depression was
thought to be caused by black bile flooding the
brain)
Phlegmatic personality (from the humor phlegm)
indicates apathy and sluggishness but can also
mean being calm under stress.
Choleric person (from yellow bile or choler) is
hot tempered.
Treatment in relation to Humors
Bloodletting: removal of blood with the use of
leeches
Purging: cabbage + tobacco to induce vomit
In China, the ideas were similar, except for instead
of humors, they believed in "wind" moving
through the body, wherein:
Insanity = improper wind flow
Yin and Yang:
Yin is cold, dark wind.
Yang is warm, life-sustaining wind.
o Female Hysteria
The term "hysteria" was coined by Hippocrates,
though it stems from the Greek word for "uterus."
Occurred primarily in women, so it was thought to
be by the "wandering womb" or the uterus moving
around the body Treatment applied was marriage
or enticement / scaring of the uterus
Later identified as somatic symptom disorder,
where physical symptoms are the result of the
mind rather than a physical ailment.
o Syphilis
• Advanced syphilis causes bacteria to enter
the brain, resulting in delusions of
persecution and delusions of grandeur.
Consistent with general paresis* which
resulted in death.
Cure: malaria
• General paresis: general paralysis of the
insane or paralytic dementia, is a severe
neuropsychiatric disorder, classified as an
organic mental disorder and caused by the
chronic meningoencephalitis that leads to
cerebral atrophy in late-stage syphilis.
Physicians found that injecting malaria to
patients who were determined to have general
paresis was curative.
The high fever from malaria killed off the
bacteria from syphilis.
First time "madness" had been cured by
treating an infection and ultimately led to the
discovery of penicillin.
John Grey
o Believed the mental was ALWAYS related to
the physical, therefore it should be treated as
such with rest, diet, and comfortable settings.
Biological Treatments
o Insulin shock therapy or insulin coma
therapy was a form of psychiatric treatment in
which patients were repeatedly injected with
large doses of insulin to produce daily comas
over several weeks. used extensively in the
1940s and 1950s, mainly for schizophrenia.
o Electric shock therapy or electroconvulsive
therapy is a procedure, done under general
anesthesia, in which small electric currents are
passed through the brain, intentionally
triggering a brief seizure. ECT seems to cause
changes in brain chemistry that can quickly
reverse symptoms of certain mental health
conditions.
ECT often works when other treatments
are unsuccessful and when the full course
of treatment is completed, but it may not
work for everyone.
Lobotomy or leucotomy was a form of
psychosurgery, a neurosurgical treatment of a
mental disorder that involves severing connections
in the brain's prefrontal cortex. Most of the
connections to and from the prefrontal cortex, the
anterior part of the frontal lobes of the brain, are
severed.
Medication
The 1950's arrived with neuroleptics (hardcore
tranquilizers) which somehow worked.
• Benzodiazepines (valium) were the most
widely prescribed drugs in the 70's
Benzodiazepines, as depressants—drugs which
lower brain activity—they are prescribed to treat
conditions such as anxiety, insomnia, seizures.
• Bromides were an exciting new drug
creation, however they quickly left the scene
and took their serious side effects with them
• Antipsychotics, also known as neuroleptics,
are a class of psychotropic medication
primarily used to manage psychosis,
principally in schizophrenia.
PSYCHOLOGICAL
Emil Kraepelin: first to distinguish between
disorders; different treatments for different
disorders and all of their treatments were humane.
Plato: believed that maladaptive behavior was
caused by social and cultural surroundings which
was a precursor to psychosocial treatment.
Aristotle: also believed in social environment and
early learning as having a role in the development
of behavior.
Moral Therapy
An approach to insanity based on treating
inpatients as normal and in a setting that
mimicked real life. Involved relationships with
workers and individual attention.
o Philippe Pinel's national movement in
France: their goal was to unchain the patients
and treat them far better than they had been in
asylums (like prisons)
Pinel's efforts waned and so did quality of care.
The Civil War caused hospitals to be too
overloaded to provide the personal attention that Current model: integrative and
patients needed, much less the immigrants. multidimensional

Dorothea Dix & Mental Hygiene Movement:

reformed asylums similar to Pinel, however, the
idea that mental illnesses were caused by brain
pathology, which was "unmeasurable," led to the
decline of moral therapy and increasing attention
was then put toward behaviorism, since behavior
can be studied and measured.

Psychoanalytic Therapy
Based on Freud's theory of the makeup of the
mind.

Mesmer's hypnotism
Used hypnosis to ask patients about their thoughts
and feelings, which came out more clearly than
when they were not hypnotized, they thought they
"discovered" the unconscious mind.

Speaking about traumatic or emotional events

was therapeutic, called "catharsis."

Structure of the Mind

Consists of three parts:
o Id
o Ego
o Superego

Humanistic Approach
o Unconditional positive regard; acceptance no
matter what; no judgment, no condemnation
requires empathy based on understanding that
people are more different than alike

Behaviorism & Classical Conditioning

o Pavlov’s classical conditioning
o Skinner's operant conditioning

INTEGRATIVE APPROACH
o Of the three traditions, no one theory can stand
alone. We need all of the theories - biological,
behavioral, cognitive, emotional, and social
- to come together to create a complete
picture.

o Behavior, normal and abnormal, is the result

of an interaction between the psychological,
biological, and social influences.
 ABNORMAL PSYCHOLOGY
Lecture 3
Clinical Description
Presenting problem
 determining the presenting problem is the
first step in determining one's clinical
description.
Prevalence
 Number of people displaying a disorder in a
total population at any given time
Incidence
 Number of new cases of a disorder
appearing during a specific period.
Course -pattern of development and change of a
disorder over time.
o Chronic course - lasts for a long time.
o Episodic course - recovery within a few
months is likely but recurrence may happen
later.
o Time-limited course - the disorder will
improve without treatment in a relatively
short period.
Onset - first appearance of the signs or symptoms
of a disorder.
o Acute onset - sudden beginning of a
disorder
o Insidious onset - development of a
disorder that occurs gradually over an
extended period.
Prognosis - predicted future development of a
disorder over time.
o Good - the individual will probably
recover.
o Guarded - the probable outcome does not
look good.
Comorbidity - presence of two or more disorders
in an individual at the same time
o The presence of one or more disorders in
addition to a primary disease or disorder.
o The interactive effect of such additional
disorders or diseases.
Etiology
o cause or source of a disorder
o what contributes to the development of
psychopathology?
ASSESSING PSYCHOLOGICAL
DISORDERS
1. Clinical Interview
2. Behavioral Assessment
3. Psychological Testing
4. Physical Examination
5. Neuropsychological Testing
6. Psychophysiological Assessment
7. Neuroimaging
CLINICAL ASSESSMENT is the systematic
evaluation and measurement of psychological,
biological, and social factors in an individual
presenting with a possible psychological disorder.
DIAGNOSIS is the process of determining
whether the problem afflicting the individual
meets all criteria for a psychological disorder, as
set forth in the DSM-5-TR (American Psychiatric
Association, 2022).
Value of Assessment depends on:
o Reliability - The degree to which a
measurement is consistent.
interrater reliability
test–retest reliability
o Validity - The degree to which a technique
measures what it is designed to measure.
concurrent or descriptive validity
Predictive validity
o Standardization - Application of certain
standards to ensure consistency across
different measurements.
The Clinical Interview - gathers information on
current and past behavior, attitudes.
The Mental Status Exam - To organize
information obtained.
The exam covers five categories:
• Appearance and behavior
• Thought processes.
• Mood and affect.
• Intellectual functioning
• Sensorium
Semi structured interviews are made up of
questions that have been carefully phrased and
tested to elicit useful information in a consistent
manner so that clinicians can be sure they have
inquired about the most important aspects of
particular. Disorders
Behavioral assessment takes this process one
step further by using direct observation to
formally assess an individual’s thoughts, feelings,
and behavior in specific situations or contexts.
Behavioral assessment may be more appropriate
than an interview in terms of assessing individuals
who are not old enough or skilled enough to report
their problems and experiences.
The ABCs of Observation
A - (antecedent)
B - (behavior)
C - (consequence)
informal observation. A problem with this type
of observation is that it relies on the observer’s
recollection, as well as interpretation, of the
events.
Formal observation involves identifying specific
behaviors that are observable and measurable
(called an operational definition).
Self-Monitoring
People can also observe their own behavior to find
patterns, a technique known as self-monitoring
or self-observation.
• A phenomenon known as reactivity can
distort any observational data.
• dimensional, and prototypical approaches. Our
Assessing Psychological Disorders
• Clinical assessment is the systematic
evaluation and measurement of psychological,
biological, and social factors in an individual
with a possible psychological disorder;
diagnosis is the process of determining that
those factors meet all criteria for a specific
psychological disorder.
• Reliability, validity, and standardization are
important components in determining the
value of a psychological assessment.
• To assess various aspects of psychological
disorders, clinicians may first interview and
take an informal mental status exam of the
patient. More systematic observations of
behavior are called behavioral assessment.
• A variety of psychological tests can be used
during assessment, including projective tests,
in which the patient responds to ambiguous
stimuli by projecting unconscious thoughts;
personality inventories, in which the patient
takes a self-report questionnaire designed to
assess personal traits; and intelligence testing,
which provides a score known as an
intelligence quotient (IQ).
• Biological aspects of psychological disorders
may be assessed through neuropsychological
testing designed to identify possible areas of
brain dysfunction. Neuroimaging can be used
more directly to identify brain structure and
function. Finally, psychophysiological
assessment refers to measurable changes in the
nervous system, reflecting emotional or
psychological events that might be relevant to
a psychological disorder.
Diagnosing Psychological Disorders
The term classification refers to any effort to
construct groups or categories and to assign
objects or people to the categories based on their
shared attributes or relations. Methods of
classification include classical categorical,
current system of classification, the Diagnostic
and Statistical Manual, fifth edition (DSM-5), is
based on a prototypical approach in which certain
essential characteristics are identified but certain
“nonessential” variations do not necessarily
change the classification. The DSM-5 categories
are based on empirical findings to identify the
criteria for each diagnosis. Although this system is
the best to date in terms of scientific
underpinnings, it is far from perfect, and research
continues the most useful way to classify
psychological disorders.
 strategies, and indicated prevention
strategies.
LECTURE 5
Research Methods
• The clinical picture, causal factors, and
Examining Abnormal Behavior treatment process and outcome can all be
• Research involves establishing a hypothesis influenced by cultural factors.
that is then tested. In abnormal psychology, • The more the findings of a research program
research focuses on hypotheses meant to are replicated, the more they gain in
explain the nature, the causes, or the credibility.
treatment of a disorder. • Ethics are important to the research process,
Types of Research Methods and ethical guidelines are spelled out by
• The individual case study is used to study one many professional organizations to ensure the
or more individuals in depth. Although case well-being of research participants.
studies have an important role in the • Ethical concerns are being addressed through
theoretical development of psychology, they informed consent and through the inclusion
are not subject to experimental control and of consumers in research design,
must necessarily be suspect in terms of both implementation, and interpretation.
internal and external validity.
• Research by correlation can tell us whether a
relationship exists between two variables, but
it does not tell us if that relationship is a
causal one. Epidemiological research is a
type of correlational research that reveals the
incidence, distribution, and consequences of a
particular problem in one or more
populations.
• Research by experiment can follow one of
two designs: group or single case. In both
designs, a variable (or variables) is
manipulated, and the effects are observed to
determine the nature of a causal relationship.
Genetics and Behavior across Time and
Cultures
• Genetic research focuses on the role of
genetics in behavior. These research
strategies include family studies, adoption
studies, twin studies, genetic linkage
analyses, and association studies.
• Research strategies that examine
psychopathology across time include cross-
sectional and longitudinal designs. Both
focus on differences in behavior or attitudes
at different ages, but the former does so by
looking at different individuals at different
ages and the latter looks at the same
individuals at different ages.
• Prevention research can be viewed in four
broad categories: health promotion or
positive development strategies, universal
prevention strategies, selective prevention
 LECTURE 2
An Integrative Approach to Psychopathology
One-Dimensional versus Multidimensional
Models
• The causes of abnormal behavior are complex
and fascinating. Psychological disorders are
caused by a complex interplay of nature
(biology) and nurture (psychosocial factors).
• To identify the causes of a psychological
disorder in a given person we must consider
the interaction of all relevant dimensions:
genetic contributions, the role of the nervous
system, behavioral and cognitive processes,
emotional influences, social and interpersonal
influences, and developmental factors. Thus,
we have arrived at a multidimensional
integrative approach to the cause of
psychological disorders.
Genetic Contributions to Psychopathology
• The genetic influence on much of our
development and most of our behavior,
personality, and even IQ score is polygenic—
that is, influenced by many genes. This is
assumed to be the case in abnormal behavior
as well, although research is beginning to
identify specific small groups of genes that
relate to some major psychological disorders.
• In studying causal relationships in
psychopathology, researchers look at the
interactions of genetic and environmental
effects. In the diathesis–stress model,
individuals are assumed to inherit certain
vulnerabilities that make them susceptible to
a disorder when the right kind of stressor
comes along. In the gene–environment
correlation or reciprocal gene–environment
model, the individual’s genetic vulnerability
toward a certain disorder may make it more
likely that the person will experience the
stressor that, in turn, triggers the genetic
vulnerability and thus the disorder. In
epigenetics, the immediate effects of the
environment (such as early stressful
experiences) influence cells that turn certain
genes on or off. This effect may be passed
down through several generations.
Neuroscience and Its Contributions to
Psychopathology
• Brain science and the field of neuroscience
promise much as we try to unravel the
mysteries of psychopathology. Within the
nervous system, levels of neurotransmitter
and neuroendocrine activity interact in
complex ways to modulate and regulate
emotions and behavior and contribute to
psychological disorders.
• Critical to our understanding of
psychopathology are the neurotransmitter
currents called brain circuits. Of the
neurotransmitters that may play a key role,
we investigated five: serotonin, gamma-
aminobutyric acid (GABA), glutamate,
norepinephrine, and dopamine.
Behavioral and Cognitive Science
• The relatively new field of cognitive science
provides a valuable perspective on how
behavioral and cognitive influences affect the
learning and adaptation each of us experience
throughout life. Clearly, such influences not
only contribute to psychological disorders but
also may directly modify brain functioning,
brain structure, and even genetic expression.
We examined some research in this field by
looking at learned helplessness, modeling,
prepared learning, and implicit memory
Emotions
• Emotions have a direct and dramatic impact
on our functioning and play a central role in
many mental disorders. Mood, a persistent
period of emotionality, is often evident in
psychological disorders.
Cultural, Social, and Interpersonal Factors
• Social and interpersonal influences profoundly
affect both psychological disorders and
biology.
Life-Span Development
• In considering a multidimensional integrative
approach to psychopathology, it is important
to remember the principle of equifinality,
which reminds us that we must consider the
various paths to a particular outcome, not just
the result.
 LECTURE 4
Clinical Assessment and Diagnosis
Understanding and Defining Mood Disorders
• Mood disorders are among the most common
psychological disorders, and the risk of
developing them is increasing worldwide,
particularly in younger people.
• Two fundamental experiences can contribute
either singly or in combination to all specific
mood disorders: a major depressive episode
and mania. A less severe episode of mania that
does not cause impairment in social or
occupational functioning is known as a
hypomanic episode. An episode of mania
coupled with anxiety or depression is known
as a mixed episode or mixed state.
• An individual who suffers from episodes of
depression only is said to have a unipolar
disorder. An individual who alternates
between depression and mania has a bipolar
disorder.
• Major depressive disorder may be a single
episode or recurrent, but it is always time-
limited; in another form of depression,
persistent depressive disorder (dysthymia), the
symptoms are often somewhat milder but
remain relatively unchanged over long
periods. In some cases, fewer symptoms are
observed than in a major depressive episode,
but they persist for at least two years
(persistent depressive disorder) (dysthymia);
in other cases, a major depressive episode will
last at least two years (chronic major
depressive episode). In cases of double
depression, a form of persistent depressive
disorder, an individual experiences both major
depressive episodes and persistent depressive
disorder (dysthymia).
• Approximately 20% of bereaved individuals
may experience a complicated grief reaction in
which the normal grief response develops into
a full-blown mood disorder.
• The key identifying feature of bipolar
disorders is an alternation of manic episodes
and major depressive episodes. Cyclothymic
disorder is a milder but more chronic version
of bipolar disorder.
• Patterns of additional features that sometimes
accompany mood disorders, called specifiers,
may predict the course or patient response to
treatment, as does the temporal patterning or
course of mood disorders. One pattern,
seasonal affective disorder, most often occurs
in winter.
Prevalence of Mood Disorders
• Mood disorders in children are fundamentally
similar to mood disorders in adults.
Symptoms of depression are increasing
dramatically in our elderly population.
• The experience of anxiety across cultures
varies, and it can be difficult to make
comparisons—especially, for example, when
we attempt to compare subjective feelings of
depression.
Causes of Mood Disorders
• The causes of mood disorders lie in a
complex interaction of biological,
psychological, and social factors. From a
biological perspective, researchers are
particularly interested in the stress hypothesis
and the role of neurohormones. Psychological
theories of depression focus on learned
helplessness and the depressive cognitive
schemas, as well as interpersonal disruptions.
Treatment of Mood Disorders
• A variety of treatments, both biological and
psychological, have proved effective for the
mood disorders, at least in the short term. For
those individuals who do not respond to
antidepressant drugs or psychosocial
treatments, a more dramatic physical
treatment, electroconvulsive therapy, is
sometimes used. Two psychological
treatments—cognitive therapy and
interpersonal psychotherapy— seem effective
in treating depressive disorders.
• Relapse and recurrence of mood disorders are
common in the long term, and treatment
efforts must focus on maintenance treatment,
that is, on preventing relapse or recurrence.
Suicide
• Suicide is often associated with mood
disorders but can occur in their absence or in
the presence of other disorders. It is the 10th
leading cause of death among all people in the
United States, but among adolescents, it is the
3rd leading cause of death.
• In understanding suicidal behavior, three
indices are important: suicidal ideation
(serious thoughts about committing suicide),
suicidal plans (a detailed method for killing
oneself), and suicidal attempts (that are not
successful). Important, too, in learning about
risk factors for suicides is the psychological
autopsy, in which the psychological profile of
an individual who has committed suicide is
reconstructed and examined for clues.