Abnormal Psychology

Terminology

Term Definition

Aetiology The study of the causation of mental disorders

Clinical picture The constellation of visible signs or symptoms associated with a

particular mental disorder, the interpretation of which leads to a specific
diagnosis

Comorbity A mental disorder existing simultaneously but independently with

another mental disorder in the same individual

Dangerousness The extent to which an individual with a mental disorder is likely to

cause harm to themselves or others

Delusions False belief that is held strongly by an individual, even though they are
presented with evidence to the contrary

Deviance The extent to which an individual’s behavior and attitudes differ from
norms or accepted social standards

Diagnoses The determination of the nature of a case of a mental disorder or the

distinguishing of one mental disorders from another, based on
identifying signs and symptoms of a mental disorder

Differential The determination of which disorder may be producing the symptoms of

diagnoses a mental disorder

Distress The level of anxiety, sorrow, or pain an individual subjectively

experiences to a mental disorder

Disorder Refers to conditions in which there is disturbances of the usual orderly

processes on an individual’s development

Epidemiology The study of patterns, causes and effects of diseases or disorders in

specific populations

Hallucination A false perception in the absence of external stimuli that appears to the
individual to be real and to be in the outside world. A hallucination can
occur in any sensory modality (visual, auditory, tactile, etc.)

Malingering Pretending to suffer from a psychosocial or physical illness or

exaggerating symptoms to avoid unwelcome duties such as work,

1
 military, etc. or to gain benefits such as financial compensations

Prognoses The prediction of the probable course and outcome of a disorder for an
individual

Prevalence Prevalence is the percentage of a population that exhibits a disorder

during a specified time period

Symptoms Subjective complaints of the individual

Signs Physical changes observed in the individual presenting for treatment

Syndrome Common patterns of symptoms over time

Abnormality:
- characterized by an individual displaying behavior that is rare or unusual.
- It is behavior that is regarded as unhelpful or maladaptive to situations or the context in
which individuals live is seen as constituting abnormal behavior.
- In the context of mental health, abnormality often suggests that it is impairments in an
individual’s daily functioning.
- The Medical Model of Mental Disorders proposes that it is useful to think of mental
illness as a disease and to identify and classify symptoms in a similar way as the
symptoms and signs of physical diseases are diagnosed.

Mental Disorder Books

The International Classification of Diseases The Diagnostic and Statistical Manual of

(ICD-10) Mental Disorders (DSM-5)

Associated with WHO Associated with American Psychiatric

Association

Note: there is an eleventh edition of the ICD however it is only in use from January 2022

DSM-5 Categories
1. Anxiety disorder, OCD and Trauma Disorders
- The categories of ‘anxiety disorders, obsessive compulsive disorder and related
disorders and trauma-related disorders’ have a significant overlap of symptoms but are
separately accounted for in the DSM-5.
- Anxiety disorders are a class of disorders marked by feelings of excessive fear and
anxiety and related disturbances in their behavior.
- Individuals fear real or perceived threats and anxiously anticipate future threats.
- There are three main types of anxiety disorders:

a. Generalized anxiety disorder

2
 b. Specific phobic disorder
c. Panic disorder

Generalized Anxiety Disorders:

- marked by chronic, high levels of anxiety that is not tied to any specific threat.
- People with this disorder are often accompanied with physical symptoms such as
trembling, muscle tension diarrhea, dizziness, sweating, etc.
- Their degree of worry is out of proportion to the actual likelihood or impact of the
anticipated event.
- They report experiencing distress in relation to how much they worry and their worrying
impairs their daily functioning significantly.

Specific phobic disorder:

- an irrational fear of a specific object or situation that may interfere with an individual’s
ability to function.
- Mild phobias are extremely common.
- Phobic reactions tend to be accompanied by physical symptoms such as trembling and
palpitations.

Panic disorder:
- characterized by recurrent attacks or surges of overwhelming anxiety that usually occur
suddenly and unexpectedly.
- These paralyzing feelings are accompanied by physical symptoms of anxiety which are
sometimes misinterpreted as heart attacks.
- After a number of panic attack, victims often become apprehensive, wondering when
their next panic attack will occur.
- The onset of a panic disorder typically occurs during late adolescence or early adulthood
and about 2 out of 3 people who are diagnosed with panic disorders are female.

Agoraphobia:
- the fear of going out into public out of the fear of a panic attack occurring in public.
- The individual’s fear is triggered by real or anticipated exposure to situations involving
the use of public transport, being in open spaces, being in enclosed spaces, standing in
lines or being in crowd, etc.

Aetiology of Anxiety Disorders (developed out of complicated interactions between biological

and psychological factors)

1. Biological factors (genetic vulnerability and neurochemical factors)

2. Conditioning and learning (acquired through classical and operant conditioning)
3. Cognitive factors (maintain that some people are more prone to anxiety by the way they
think)
4. Stress (link between stress and phobic/panic disorders)

3
Obsessive Compulsive and Related Disorders:
- characterized by obsessions and/or compulsions.
- Obsessions are the thoughts that repeatedly intrude in one’s consciousness in a
distressing way.
- Compulsions are actions that one feels forced to carry out. OCD is marked by persistent,
uncontrollable instructions of unwanted thoughts (obsessions) and urges to engage in
senseless rituals.
- Obsessions often center on inflicting harm on others, personal failures, sexual acts etc.
o People troubled by obsessions may feel that they have lost their minds.

Trauma and Stressor Related Disorders:

- post-traumatic stress disorder (PTSD) involves enduring psychological disturbances
attributed to the experience of major traumatic event.
- Common symptoms pf PTSD include re-experiencing the traumatic event in the form of
nightmares and flashbacks, emotional numbing, alienation, problems in social relations,
anxiety, anger guilt, etc.
- It also leads to increased vulnerability associated with greater personal injuries and
losses, greater intensity of exposure to the traumatic event and more exposure to
aftermath of event.
- Individuals who have especially intense emotional reactions during or immediately after
the traumatic event go onto show elevated vulnerability to PTSD.

Dissociative Amnesia:
- a sudden loss of memory for important personal information that is too extensive to be
due to normal forgetting.
- Cases of amnesia have been observed after people have experienced disasters,
accidents, combat stress, physical abuse, and rape or after they have witnessed the
violent death of a parent.

Dissociative Identity Disorder:

- involves a disruption of identity marked by the experience of two or more largely
complete and usually very different personalities.
- This disorder was formally known as multiple personality disorder.
- In dissociative identity disorder, the divergences in behavior go far beyond those people
normally display in adapting to different roles in life.
- People with DID feel like they have more than one identity.
- Each personality will have their own name, memories, traits, physical mannerisms, and
autonomy.
- In DID, various personalities generally report that they are unaware of each other.
- The alternative personalities commonly display traits that are quite foreign to the original
personality.

4
 - The disparities between identities can be bizarre. Most individuals with DID also have a
history of anxiety, mood, or personality disorders. DID is seen in more women than in
men.

Depressive and Bipolar-related Disorders:

- mood disturbances can be terribly debilitating but individuals with a depressive or bipolar
disorder may still lead to very productive lives because such disorders tend to be
episodic.
- Mood disturbances often come and go.
- Depressive disorders and bipolar are marked by emotional disturbances of varied kinds
that may spill over to disrupt physical, perceptual, social and thought processes.

a. Unipolar disorder: people experience emotional extremes at just one end of the mood
continuum. Such people are troubled only with depression.
b. Bipolar disorder: people are vulnerable to emotional extremes at both ends of the mood
continuum, People with bipolar disorder go through periods of both depression and
mania.

Major Depressive Disorder:

- people show feelings of sadness despair, loss of interest in previous sources of
pleasure.
- Negative emotions from the core of the depressive syndrome.
- A central feature of depression is anhedonia which is a diminished ability to experience
pleasure.
- Depressed people lack energy or motivation.
- There are alterations in appetite and sleep patterns.
- Anxiety, irritability, and brooding are also commonly observed.
- Depression plunges people into feelings of hopelessness, dejection, and boundless guilt.
The onset of depression can occur at any point in the lifespan.
- Evidence suggests that an early age of onset is associated with more episodes of
depression and greater impairment in social and occupational functioning, although
depression tends to be episodic, some people suffer from chronic major depression that
may persist for years.
- Chronic major depression is associated with severe impairment of functioning. People
with chronic depression tend to have a relatively early onset and high rates of additional
disorders.
- Depression is seen twice as high in women than in men.

Bipolar Disorder:
- characterized by the experience of one or more hypomaniac or manic episodes as well
as periods of depression.
- One manic episode is sufficient to qualify for this diagnosis.
- The symptoms seen in manic periods are generally the opposite of those seen in
depression.

5
 o In a manic episode, a person’s mood becomes elevated to the point of euphoria.
o Self-esteem is boosted as the person bubbles over with energy and optimism.
o Because of the increased energy, many individuals with bipolar disorder report
temporary surges or productivity and creativity.
- Bipolar disorders are much less common than unipolar disorder. The onset of bipolar
disorder is age related and the typical age is the late teens or early twenties.

Aetiology of Depressive and Bipolar Disorders (the causal routes of depressive and bipolar
disorders indicate intricate interactions among psychological and biological factors)

1. Genetic vulnerability - concordance rates and twin studies suggest that genetic factors
are involved in mood disorders and hereditary acts as a predisposition to such disorders.

2. Neuroanatomical and neurochemical factors - the association between depression and

reduced hippocampal volume.

3. Hormonal factors - hypothalamic-pituitary-adrenocortical axis and the release of

chemicals which influence one’s emotions.

4. Cognitive factors - maintain that some people are more prone to disorder by the way
they think and through learned helplessness.

5. Interpersonal roots - behavioral approaches, social skills, a lack of reinforces and low
social support.

6. Precipitating stress - stress is influential in triggering depression as recurrent episodes of

depression increase.

Somatic symptom disorder:

- characterized by somatic (bodily) symptoms that are either very distressing or result in a
significant disruption of functioning, as well as excessive and disproportionate thoughts,
feelings and behaviors regarding those symptoms.
- To be diagnosed with SSD, an individual must be persistently symptomatic for at least
six months.
- The somatic symptoms must be significantly distressing or disruptive to daily life and
must be accompanied by excessive thoughts, feelings and behaviors.

Illness anxiety disorder:

- within illness anxiety disorder, illness and somatic concerns become central features of
the individual’s identity and self-image.
- Individuals repeatedly examine themselves, do excessive information gathering on
suspected illnesses and continually seek reassurance and soothing from others.
- Some individuals avoid situations that they feel may compromise their health status.

6
 - Individuals may consult multiple physicians for the same problem and not be satisfied
with the results despite extensive medical visits.

Conversion disorder:
- the essential feature is neurological symptoms that are incompatible with neurological
disorders.
- It is 2-3 times more common in female as women rely on emotional expression.
- If these outlets for expression are restricted, some may develop conversion disorder
caused by the body converting psychological issues into physical symptoms.
- Conversion disorder in females is often characterized by pain, paralysis and other
neurological symptoms.

Factitious disorder:
- the essential feature is the intentional falsification of medicine or psychological signs and
symptoms in oneself or others.
- It embodies persistent problems related to the perception and identity of an individual.
- When an individual falsifies illness in another vulnerable other, the diagnosis is made in
relation to the perpetrator, not the victim.
- The victim may be given a diagnosis which is popularized as Munchausen syndrome.

Schizophrenia:
- a class of disorders marked by delusions, hallucinations, disorganized speech and the
deterioration of adaptive behavior.
- People with schizophrenia disorders often display some of the same symptoms seen in
people with severe mood disorders.
- Several symptoms are commonly seen:

a. Delusions and irrational thought - false beliefs that are maintained even though they are
clearly out of the obvious. Delusion Grandeur is when people maintain that they are
famous or important. A person’s train of thought deteriorates.

b. Hallucinations - sensory perceptions that occur in the absence of a real, external

stimulus or gross distortions of perceptual input. People with schizophrenia frequently
report that they hear voices of non-existent or absent people talking to them.

c. Disturbed emotion - normal emotional tone can be disrupted in schizophrenia in various

ways. Some victims show little emotional response (blunted or flat affect) whilst others
show inappropriate emotional responses that do not match with the situation. People
may also become emotionally volatile.

d. Positive and negative symptoms - negative symptoms involve behavioral deficits such as
flattened affect, asociaity, anhedonia (lack of pleasure), apathy (lack of emotion),
impaired attention and alogia (reduced amount of speech). Positive symptoms involve
behavioral excesses or peculiarities such as hallucinations delusions, wild flights of

7
 deas. A prominence of positive symptoms is associated with better adjustment prior to
the onset of schizophrenia and greater responsiveness to treatment.

Aetiology of Schizophrenia

1. Genetic vulnerability - child born with parents who both have schizophrenia has a 40%
chance of developing the disorder themselves. Schizophrenia is associated with
chromosomal abnormalities not evident in bipolar disorder.

2. Neurochemical factors - psychotic disorders are accompanied by changes in the activity

of one or more neurotransmitters in the brain. Dopamine hypothesis asserts that excess
dopamine activity acts as the neurochemical basis for schizophrenia.

3. Structural abnormalities in the brain - cognitive deficits. Enlarged ventricles are assumed
to reflect the degeneration of nearby brain tissue which could contribute to
schizophrenia.

4. Neurodevelopmental hypothesis - theory asserts that schizophrenia is caused in part by

various disruptions in the normal maturational process of the brain before or at birth.
Insults to brain during sensitive phrases of prenatal development or birth could cause
subtle neurological damage that elevates an individual’s vulnerability to schizophrenia in
later years.

5. Expressed emotion - expressed emotion is the degree to which a relative or a patient

displays highly critical or emotionally over-involved attitudes towards the patient.

6. Precipitating stress - various biological and psychological factors influence individual’s

vulnerability to schizophrenia.

Personality Disorders:
- individuals with personality disorders have prominent interpersonal difficulties.
- Personality disorders are associated with ways of thinking and feeling about oneself and
others that significantly affect how an individual functions in many aspects of life.
- Personality disorders are marked by extreme personality traits that cause subjective
distress or impaired social and occupational functioning.
- Personality disorders are diagnosed in early adulthood although the traits stem from
childhood. There are three clusters that make up personality disorder:

Cluster A - odd or eccentric

Paranoid personality disorder Guarded, defensive, distrustful

8
 Schizotypal personality disorder Eccentric, self-estranged, bizarre, absent

Schizoid personality disorder Apathetic, indifferent remote, solitary

Cluster B - dramatic, emotional, or erratic

Antisocial personality disorder Impulsive, irresponsible, deviant, unruly

Borderline personality disorder Unpredictable, manipulative, unstable

Histrionic personality disorder Dramatic, seductive, shallow, vain

Narcissistic personality disorder Egotistical, arrogant, important

Cluster C - anxious or fearful

Avoidant personality disorder Hesitant, self-conscious, anxious, lonely

Dependent personality disorder Helpless, incompetent, immature

Obsessive-compulsive personality disorder Restrained, rigid rule-bound, conscious

Aetiology of Personality Disorders

➔ Involves interactions between genetic predispositions and environmental factors such as

cognitive styles, coping patterns and exposure to stress.
➔ Influenced by hereditary and data from families and twins.
➔ Environmental factors
➔ Different constellations of environmental factors have been implicated.

Eating Disorders:
- severe disturbances in eating behavior that is characterized by the preoccupation with
weight and unhealthy efforts to control weight.
- There is no psychological disorder associated with greater fatality rates.

Anorexia nervosa
- involves intense fear of gaining weight, disturbed body image, refusal to maintain normal
weight and use of dangerous measures to lose weight.
- People drastically reduce their intake of food and sometimes literally starve themselves.
- It can eventually lead to a cascade of medical problems such as amenorrhea (the loss of
menstrual cycles in women), gastrointestinal problems, low blood pressure,
osteoporosis, and metabolic disturbances.

9
 - Anorexic people generally do not recognize the maladaptive over-controlling quality of
their behavior.

Bing-eating type
- individuals attempt to lose weight by forcing themselves to vomit after food, by misusing
laxatives or by excessive exercise.

Bulimia nervosa
- involves habitually engaging in out-of-control overeating followed by unhealthy
compensatory efforts such as self-induced vomiting, fasting, abuse of laxatives and
diuretics and excessive exercise.
- People with bulimia nervosa typically maintain a reasonably normal weight.
- Medical problems include cardiac arrythmias, dental problems, metabolic deficiencies,
and gastrointestinal problems.
- Psychological disturbances include depression, anxiety disorders and substance related
disorders.
- Bulimia is a less-life threatening condition. People with bulimia are more likely to
recognize that their eating behavior is pathological as they recognize being unable to
control their eating patterns.

The similarities between anorexia and bulimia:

- Morbid fear of becoming fat,
- Preoccupation with food and Rigid,
- maladaptive approaches to controlling weight.

Binge-eating disorder:
- an eating disorder that masks itself as basic overeating.
- It can easily go undetected, and it effects more man and women than anorexia.
- It involves eating binges that cause distress to the individual concerned but unlike
bulimia, it does not involve purging fasting or vomiting.
- Individuals with this disorder are often overweight and may find their bodies and their
habit or overeating as disgusting. It can be caused by stressed.

Etiology of Eating Disorders

- Genetic vulnerability
o There is convincing evidence for a hereditary component in both anorexia nervosa and
bulimia nervosa, with genetics probably playing a stronger role in anorexia.
o A genetic predisposition also appears to contribute to binge-eating disorder, but there are
fewer studies of this newer diagnosis.
- Personality factors
o Certain personality traits may increase vulnerability to eating disorders.

10
 o There are innumerable exceptions, but victims of anorexia nervosa tend to be obsessive,
rigid, and emotionally restrained, whereas victims of bulimia nervosa tend to be
impulsive, overly sensitive, and low in self-esteem
- Cultural values
o In Western society, young women are socialized to believe they must be attractive.
o To be attractive, they think they must be as thin as the actresses and fashion models who
dominate the media.
o Thanks to this cultural milieu, many young women are dissatisfied with their weight
because the societal ideals promoted by the media are unattainable for most of them
o Unfortunately, in a small portion of these women, the pressure to be thin, in combination
with genetic vulnerability, family pathology, and other factors, leads to unhealthy efforts to
control weight.
- Role of the family
o The principal issue appears to be that some mothers contribute to eating disorders simply
by endorsing society’s message that “you can never be too thin” and by modelling un-
healthy dieting behaviours of their own
o In conjunction with media pressures, this role modelling leads many daughters to
internalize the idea that the thinner you are, the more attractive you are.
o Of course, peers can also endorse beliefs and model behaviours that promote eating
disorders
- Cognitive factors
o Many theorists emphasize the role of disturbed thinking in the etiology of eating disorders
o For example, anorexic patients’ typical belief that they are fat when they are really
wasting away is a dramatic illustration of how thinking goes awry.
o Patients with eating disorders display rigid, all-or-none thinking and many maladaptive
beliefs
o Such thoughts may include “I must be thin to be accepted”; “If I am not in complete
control, I will lose all control”; “If I gain one pound, I’ll go on to gain enormous weight.”
o Additional research is needed to determine whether distorted thinking is a cause or
merely a symptom of eating disorders

11