Clinical Psychology Lecture 4 Psychopathology Psychopathology generally defined as problematic patterns of thought feeling or behavior that disrupt an individual s sense of well being or social or occupational functioning Basic tasks o Define abnormality concepts o Identify specific instances classification o Explain abnormality theory o Treat or intervene to address the problem psychotherapy Defining abnormality What makes something abnormal o Deviance being different from what is normal in social environment Statistical deviance for example mental retardation is a statistical deviation from the average IQ o Personal distress pain some suffering and pain is normal so it s not o Danger to self or others except most conditions do not satisfy this always a disease criteria o Dysfunction interference with adaptive functioning Determining if the condition interferes with everyday life is subjective It is an act of social and cultural judgment Mental illness as a social construct o Szasz Myth of Mental Illness conformity function The labels of mental illness force people to conform to social norms o Labeling theory stigmatization and self fulfilling prophecy are related to poverty and social class Often times poor people are classified as psychopathological o Defining and identifying abnormal behavior is an act of social judgment It doesn t make it wrong and all cultures do it What is psychopathology Workability remedy to the problem Goodness of fit model psychopathology and abnormality are reflections of a poor person environment fit the way people interact handle things etc Identifying Psychopathology o Psychiatric classification organizational system from which diagnoses can be made Classification systems are necessary because it is a way to simplify and group things o Bases for classifying symptoms and syndromes are descriptive Causes etiology are theoretical Responses to treatment Classification DSM IV TR Diagnostic and Statistical Manual of Mental Disorders 4th edition text revision Published by American Psychiatric Association It has a descriptive approach that is symptom and syndrome based and atheoretical The categorical system rules in or out of discrete categories Major Categories of Disorders o Axis I not necessarily permanent Anxiety disorders OCD panic PSTD Mood disorders depression bipolar Schizophrenia psychotic disorders delusions thought disturbance Somatoform disorders disorder where the complaint is a physical symptom with a psychological cause category that Freud worked with Dissociative disorders disturbances in memory identity or consciousness category Freud worked with Multiple personality disorder Very rare disorder Impulse control disorders loss of impulse control Characterized by compulsive gambling etc Sexual disorders sexual dysfunction disorders like erectile dysfunction etc that are more psychological cause Sexual deviation disorders like paraphilia fetishes pedophilia etc More common in men often secretive Substance related disorders problematic because they are secretive or hidden Addictive behaviors Eating disorders impulse control disorders Anorexia bulimia binging Sleep disorders problems with sleeping failure to sleep night terror disorder etc Childhood adolescence category of things that normally arise in childhood and adolescence Examples conduct disorder autism ADD ADHD etc o Axis II life long pervasive disorders highly resistant to change and treatment In DSM 5 this isn t present anymore Personality disorders borderline personality disorder anti social personality disorder OCD etc Mental retardation educational purposes Anxiety stress fear used interchangeably though they have slightly different uses and implications State of unrest or alarm brought on by a situation that is perceived as a threat to our sense of safety and well being Ways of experiencing stress and anxiety o Frustrated goal directed behavior is blocked o Pressured meeting expectations raised stakes o Conflicted incompatible goals or choices difficulty with decision making and approach and avoidance conflicts o Endangered life threatening resource insufficiency Sources of stress daily hassles life changes major life events traumatic events and chronic negative conditions poverty job stress psychosocial stress chronic health problems etc Major features intense frequent often overwhelming feelings of anxiety out of proportion to the situation results in impairment like physiological autonomic arousal and cognitive worry apprehensive expectation Strong desire to escape or avoid behavioral is most important Anxiety disorders highly co morbid with each other o Specific phobias are an excessive unrealistic fear of a specific situation or object People who suffer from this avoid it or have intense distress when doing it o Social phobia or social anxiety disorder fear of negative evaluation by others o Generalized anxiety disorder persistent excessive worry over uncontrollable negative events They have apprehensive expectation People with this feel the need to control everything o Panic disorder recurrent unexpected uncued panic attacks Fear of fear and agoraphobia which is fear of an open space that you cant get out of Treatment for this is to induce the feelings of panic and then learn to tolerate it o Obsessive compulsive disorder unwanted intrusive anxiety producing thoughts Ritualistic behaviors designed to reduce or control anxiety o Post traumatic stress disorder extreme response to severe stressor Predisposing factors are autonomic arousability cognitive and stress resistant personality Autonomic arousability is when the sympathetic nervous system is hyperaroused which means there is high reactivity and slow recovery Cognitive means that control orientation and explanatory style and expectancy Behavioral and Cognitive Behavioral Treatments symptoms are learned response maladaptive response is replaced with more adaptive response and learned through new conditioning experiences escape and avoidance behaviors must be stopped Exposure and response prevention is systematic desensitization or flood ERP for OCD and panic control therapy The goal is to expose to the situation and prevent avoidance by allowing new experience with the feared situation Coping with stress problem solving and emotion focused Emotion an intrapersonal state that occurs in response to either an external or internal event and typically involves a physiological component a cognitive component and a behavioral