Chapter 10: Psychological Disorders
Diagnosing Psychological Disorders: Boundary between normal and ● Two main functions:
abnormal = fuzzy, clinicians rely on many factors + a set of criteria ○ Reducing ambiguity and subjectivity by providing
known as the 4 Ds: a common set of criteria to categorize and
● Deviance: Abnormal thoughts, emotions and behaviours that describe mental disorders
deviate from those deemed acceptable by society (both way ○ Allowing researchers and psychologists to use a
above and way below standards) common language when discussing their cases and
○ Abnormality is defined by whether the research findings
individual's behaviour is accepted by the culture to ● DSM-III used multiaxial system of classifications (required
which that individual belongs (otherwise minority assessment of individuals to be placed on five separate axes
group practices would be labelled deviant) describing mental health factors)
● Distress: The intense, negative feelings felt by individuals ○ Many felt the boundaries were too rigid (most
with psychological disorders (anxiety, sadness, despair, etc) disorders don’t have well defined borders and
○ However not all disorders are accompanied by instead lie on a spectrum, new division recognizes
feelings of distress (ie sociopathy) fluid boundaries between mental disorders)
● Dysfunction: An impaired ability to perform everyday ● Three sections of DSM-5
functions, maladaptive ○ DSM-5 Basics: Includes brief intro to manual,
○ May lead to job loss + failed relationships history of its development and guidelines on how
○ Some behaviour = intentionally maladaptive but to use it effectively
not indicative of mental illness (ie hunger strikes ○ Diagnostic Criteria and Codes: Contains
as protest) diagnostic criteria and codes for all discussed
● Danger: Dangerous/violent behaviour directed at oneself or mental disorders, DSM-5 = first DSM harmonized
at others with the WHO’s international classification of
○ Criterion alone does not qualify for the diagnosis disease (ICD) codes, disorders are organized on an
of a psychological disorder (ie skydiving, refusing age timeline (younger age-of-onset = first)
proper medication, eating unhealthy) ○ Emerging Measures and Models: Describes
Labelling Theory of Mental Illness: Being labelled deviant can result conditions + info/research in need of further
in changes of self-perception and perception by others, decreasing study/evidence to be considered for widespread
social opportunities clinical use
● Ex: Study demonstrating the effects of labelling/stereotypes ● DSM-5 also provides info on:
on health professionals, 8 fake patients (all confirmed to be ○ Epidemiology: The study of the distribution of
sane) committed to different psychiatric hospitals + faking mental or physical disorders in a population
symptoms of schizophrenia (ie hearing voices), 7/8 were ○ Prevalence: The percentage of a population that
admitted + diagnosed with schizophrenia, admitted patients exhibits a disorder during a specified time period
reported being dehumanized + ignored by staff despite (most interesting to note 12-month or lifetime
returning to their normal behaviour (claimed they no longer prevalence rates)
heard voices), Psychiatric staff continued to interpret their ■ Point Prevalence: Measured at a specific
behaviour as abnormal/evidence of mental illness, after instance in time (can miss episodic
about 19 days all pseudo patients were discharged and given disorders)
the label of schizophrenia in remission (no longer appearing ■ Annual Prevalence: Includes anyone
to have the symptoms of the disorder) who has the disorder or has had the
● To minimize consequences associated with labelling, the disorder, within the past year
APA recommends clinicians to apply diagnostic labels to ■ Lifetime Prevalence: Includes anyone
people’s disorders and not to people themselves (correct = a who has the disorder or has had the
person with schizophrenia, incorrect = a schizophrenic) disorder, within their lifetime
Medical Students’ Disease: A condition reported in medical students ○ Comorbidity: The coexistence of two or more
when they perceive that either themselves or others around them have disorders at the same time
the symptoms of the diseases they are studying ○ Prognosis: The forecast about the probable course
● However it's perfectly normal to relate to symptoms of of an illness
mental illness as these are normal traits/behaviours simply ■ Acute Prognosis: Short-lasting with
displayed to an excessive degree sudden onset (ie sudden heart attack)
Symptom: Any action, thought or feeling that could be a potential ■ Chronic Disorders: Long-lasting and
indicator of mental illness develop over time
Syndrome: A collection of interrelated symptoms ■ Episodic Prognosis: Have recurrent
Diagnostic and Statistical Manual of Mental Disorders (DSM): First phases, separated by periods of normal
diagnostic classification system of psychological disorders published functioning
by the APA ● Gender + culture info = provided when relevant (ie
● Does not offer an explanation for the disorder or suggest individuals from Japan/Korea with social anxiety may fear
treatment methods offending others in social situations rather than
● Has undergone many revisions/improvements (current self-embarrassment like North Americans with social
version = DSM-5/fifth version) anxiety)
● Criticism: Despite its shift away from rigid boundaries, it
still employs system where individuals either do or don’t
meet diagnostic criteria for mental disorders (categorical
, Chapter 10: Psychological Disorders
classification model with discrete categories) so subclinical
Symptomology Epidemiology
cases of disorders causing severe impairment but not
qualifying for a full-blown diagnosis may go untreated
Major - Decreased mood; Lifetime Prevalence Rate:
○ Dimensional Classification Model: Classifies how
Depressive loss of motivation; - 16% [N. America]
psychological disorders differ from normal
Disorder significant - 10% [Canada]
functioning in degree rather than kind, better
(MDD) fluctuations in
suited than categorical classification
weight; lack of 12 Month Prevalence Rate: 7%
● Criticism: High degree of comorbidity among many of its
aka energy; thoughts of
diagnoses (diagnostic criteria overlaps too much so a
Unipolar suicide; feelings of Gender Differences:
broader label encompassing redundant disorders may allow
Depression emptiness, - Twice as common in females
for more effective diagnosis/treatment)
worthlessness and - females = likely to engage in
Category Diagnosis 12-Month guilt ruminative coping (focus on
Prevalence - Neurocognitive depressive symptoms, think
(%) Deficits: negatively) + adopt relational
difficulties with self-regulatory style (sensitive to
Depressive Major depressive disorder 7 memory, attention, discrepancies between beliefs
Disorder Dysthymia 0.5 decision-making they hold about themselves and
and cognitive ideals they perceive others hold
Bipolar and Bipolar I 0.6 speed for them) + subject to higher
Related Disorders Bipolar II 0.3-0.8 - Symptoms must likelihoods of sexual abuse,
be continually poverty and gender role
Anxiety Panic disorder 2-3 experienced for at constraints
Disorders Social anxiety disorder 7 least 2 weeks - Males = likely to distract
Specific phobia 7-9 - One or more themselves from depressive
Generalized anxiety disorder 2.9 depressive feelings
episodes warrants a - Female age-of-onset = 17.9 yrs
Schizophrenia Schizophrenia 0.3-0.7 diagnosis - Male age-of-onset = 18.4 yrs
(lifetime)
Dysthymia - Similar but less 12 Month Prevalence Rate: 7%
Depressive Disorders: Class of disorders marked by intense and
severe symptoms
prolonged emotional disturbances that may disrupt physical,
aka of MDD
perceptual, social and thought processes, even lead to death
Persistent - Consistent, not
● Depressive disorders are heterogeneous (two people
Depressive episodic,
diagnosed with same disorder may experience different
Disorder symptoms
symptoms + their courses of illness may vary greatly)
(PDD) - Symptoms must
● DSM includes specifiers within depressive disorders to
be present for at
assist with diagnosis and treatment
least 2 years, with
○ Postpartum: Postpartum depression occurs within
periods of
four weeks of childbirth, severe cases = psychotic
normalcy lasting
features = death of newborn
no longer than 2
○ Seasonal Pattern: Seasonal Affective Disorder
months
(SAD) = depression that follows a specific season,
some patients’ syndromes are tied to fluctuations Bipolar/Manic-Depressive Disorder (BD): Involves cycles between
in latitude and climate, winter = most common episodes of depression and mania (excessively elated mood)
season, more common in low winter sunlight ● Bipolar I: Characterized by at least one manic episode and
countries (ie Canada, U.S.), one treatment = usually one depressive episode, typical conception of BD
phototherapy (patients exposed to therapeutic (incorporates two most extreme mood states)
light) ● Bipolar II: Requires one hypomanic episode and usually one
● Frequently comorbid with anxiety disorders, personality depressive episode
disorders and substance abuse ○ Hypomanic Episodes: Not full-blown manic
● However, many individuals live average lives and even episodes, mood disturbances are not severe
achieve great accomplishments (likely due to episodic enough to cause marked impairment or
nature of these disorders (come and go, scattered among hospitalization, no psychotic features (delusions or
periods of normal functioning) + successful treatment hallucinations), may even result in a dramatic
increase in efficiency, accomplishments, creativity
● Rapid-cycling: May be applied to either BD I or BD II,
requires occurrence of four or more distinct mood episodes
within 12 months
● Cyclothymic Disorder/Cyclothymia: Characterized by
chronic but relatively mild symptoms of bipolar disturbance,
patients have periods of hypomania + mild depressive
symptoms for at least 2 years, periods of normalcy last no
longer than 2 months
Diagnosing Psychological Disorders: Boundary between normal and ● Two main functions:
abnormal = fuzzy, clinicians rely on many factors + a set of criteria ○ Reducing ambiguity and subjectivity by providing
known as the 4 Ds: a common set of criteria to categorize and
● Deviance: Abnormal thoughts, emotions and behaviours that describe mental disorders
deviate from those deemed acceptable by society (both way ○ Allowing researchers and psychologists to use a
above and way below standards) common language when discussing their cases and
○ Abnormality is defined by whether the research findings
individual's behaviour is accepted by the culture to ● DSM-III used multiaxial system of classifications (required
which that individual belongs (otherwise minority assessment of individuals to be placed on five separate axes
group practices would be labelled deviant) describing mental health factors)
● Distress: The intense, negative feelings felt by individuals ○ Many felt the boundaries were too rigid (most
with psychological disorders (anxiety, sadness, despair, etc) disorders don’t have well defined borders and
○ However not all disorders are accompanied by instead lie on a spectrum, new division recognizes
feelings of distress (ie sociopathy) fluid boundaries between mental disorders)
● Dysfunction: An impaired ability to perform everyday ● Three sections of DSM-5
functions, maladaptive ○ DSM-5 Basics: Includes brief intro to manual,
○ May lead to job loss + failed relationships history of its development and guidelines on how
○ Some behaviour = intentionally maladaptive but to use it effectively
not indicative of mental illness (ie hunger strikes ○ Diagnostic Criteria and Codes: Contains
as protest) diagnostic criteria and codes for all discussed
● Danger: Dangerous/violent behaviour directed at oneself or mental disorders, DSM-5 = first DSM harmonized
at others with the WHO’s international classification of
○ Criterion alone does not qualify for the diagnosis disease (ICD) codes, disorders are organized on an
of a psychological disorder (ie skydiving, refusing age timeline (younger age-of-onset = first)
proper medication, eating unhealthy) ○ Emerging Measures and Models: Describes
Labelling Theory of Mental Illness: Being labelled deviant can result conditions + info/research in need of further
in changes of self-perception and perception by others, decreasing study/evidence to be considered for widespread
social opportunities clinical use
● Ex: Study demonstrating the effects of labelling/stereotypes ● DSM-5 also provides info on:
on health professionals, 8 fake patients (all confirmed to be ○ Epidemiology: The study of the distribution of
sane) committed to different psychiatric hospitals + faking mental or physical disorders in a population
symptoms of schizophrenia (ie hearing voices), 7/8 were ○ Prevalence: The percentage of a population that
admitted + diagnosed with schizophrenia, admitted patients exhibits a disorder during a specified time period
reported being dehumanized + ignored by staff despite (most interesting to note 12-month or lifetime
returning to their normal behaviour (claimed they no longer prevalence rates)
heard voices), Psychiatric staff continued to interpret their ■ Point Prevalence: Measured at a specific
behaviour as abnormal/evidence of mental illness, after instance in time (can miss episodic
about 19 days all pseudo patients were discharged and given disorders)
the label of schizophrenia in remission (no longer appearing ■ Annual Prevalence: Includes anyone
to have the symptoms of the disorder) who has the disorder or has had the
● To minimize consequences associated with labelling, the disorder, within the past year
APA recommends clinicians to apply diagnostic labels to ■ Lifetime Prevalence: Includes anyone
people’s disorders and not to people themselves (correct = a who has the disorder or has had the
person with schizophrenia, incorrect = a schizophrenic) disorder, within their lifetime
Medical Students’ Disease: A condition reported in medical students ○ Comorbidity: The coexistence of two or more
when they perceive that either themselves or others around them have disorders at the same time
the symptoms of the diseases they are studying ○ Prognosis: The forecast about the probable course
● However it's perfectly normal to relate to symptoms of of an illness
mental illness as these are normal traits/behaviours simply ■ Acute Prognosis: Short-lasting with
displayed to an excessive degree sudden onset (ie sudden heart attack)
Symptom: Any action, thought or feeling that could be a potential ■ Chronic Disorders: Long-lasting and
indicator of mental illness develop over time
Syndrome: A collection of interrelated symptoms ■ Episodic Prognosis: Have recurrent
Diagnostic and Statistical Manual of Mental Disorders (DSM): First phases, separated by periods of normal
diagnostic classification system of psychological disorders published functioning
by the APA ● Gender + culture info = provided when relevant (ie
● Does not offer an explanation for the disorder or suggest individuals from Japan/Korea with social anxiety may fear
treatment methods offending others in social situations rather than
● Has undergone many revisions/improvements (current self-embarrassment like North Americans with social
version = DSM-5/fifth version) anxiety)
● Criticism: Despite its shift away from rigid boundaries, it
still employs system where individuals either do or don’t
meet diagnostic criteria for mental disorders (categorical
, Chapter 10: Psychological Disorders
classification model with discrete categories) so subclinical
Symptomology Epidemiology
cases of disorders causing severe impairment but not
qualifying for a full-blown diagnosis may go untreated
Major - Decreased mood; Lifetime Prevalence Rate:
○ Dimensional Classification Model: Classifies how
Depressive loss of motivation; - 16% [N. America]
psychological disorders differ from normal
Disorder significant - 10% [Canada]
functioning in degree rather than kind, better
(MDD) fluctuations in
suited than categorical classification
weight; lack of 12 Month Prevalence Rate: 7%
● Criticism: High degree of comorbidity among many of its
aka energy; thoughts of
diagnoses (diagnostic criteria overlaps too much so a
Unipolar suicide; feelings of Gender Differences:
broader label encompassing redundant disorders may allow
Depression emptiness, - Twice as common in females
for more effective diagnosis/treatment)
worthlessness and - females = likely to engage in
Category Diagnosis 12-Month guilt ruminative coping (focus on
Prevalence - Neurocognitive depressive symptoms, think
(%) Deficits: negatively) + adopt relational
difficulties with self-regulatory style (sensitive to
Depressive Major depressive disorder 7 memory, attention, discrepancies between beliefs
Disorder Dysthymia 0.5 decision-making they hold about themselves and
and cognitive ideals they perceive others hold
Bipolar and Bipolar I 0.6 speed for them) + subject to higher
Related Disorders Bipolar II 0.3-0.8 - Symptoms must likelihoods of sexual abuse,
be continually poverty and gender role
Anxiety Panic disorder 2-3 experienced for at constraints
Disorders Social anxiety disorder 7 least 2 weeks - Males = likely to distract
Specific phobia 7-9 - One or more themselves from depressive
Generalized anxiety disorder 2.9 depressive feelings
episodes warrants a - Female age-of-onset = 17.9 yrs
Schizophrenia Schizophrenia 0.3-0.7 diagnosis - Male age-of-onset = 18.4 yrs
(lifetime)
Dysthymia - Similar but less 12 Month Prevalence Rate: 7%
Depressive Disorders: Class of disorders marked by intense and
severe symptoms
prolonged emotional disturbances that may disrupt physical,
aka of MDD
perceptual, social and thought processes, even lead to death
Persistent - Consistent, not
● Depressive disorders are heterogeneous (two people
Depressive episodic,
diagnosed with same disorder may experience different
Disorder symptoms
symptoms + their courses of illness may vary greatly)
(PDD) - Symptoms must
● DSM includes specifiers within depressive disorders to
be present for at
assist with diagnosis and treatment
least 2 years, with
○ Postpartum: Postpartum depression occurs within
periods of
four weeks of childbirth, severe cases = psychotic
normalcy lasting
features = death of newborn
no longer than 2
○ Seasonal Pattern: Seasonal Affective Disorder
months
(SAD) = depression that follows a specific season,
some patients’ syndromes are tied to fluctuations Bipolar/Manic-Depressive Disorder (BD): Involves cycles between
in latitude and climate, winter = most common episodes of depression and mania (excessively elated mood)
season, more common in low winter sunlight ● Bipolar I: Characterized by at least one manic episode and
countries (ie Canada, U.S.), one treatment = usually one depressive episode, typical conception of BD
phototherapy (patients exposed to therapeutic (incorporates two most extreme mood states)
light) ● Bipolar II: Requires one hypomanic episode and usually one
● Frequently comorbid with anxiety disorders, personality depressive episode
disorders and substance abuse ○ Hypomanic Episodes: Not full-blown manic
● However, many individuals live average lives and even episodes, mood disturbances are not severe
achieve great accomplishments (likely due to episodic enough to cause marked impairment or
nature of these disorders (come and go, scattered among hospitalization, no psychotic features (delusions or
periods of normal functioning) + successful treatment hallucinations), may even result in a dramatic
increase in efficiency, accomplishments, creativity
● Rapid-cycling: May be applied to either BD I or BD II,
requires occurrence of four or more distinct mood episodes
within 12 months
● Cyclothymic Disorder/Cyclothymia: Characterized by
chronic but relatively mild symptoms of bipolar disturbance,
patients have periods of hypomania + mild depressive
symptoms for at least 2 years, periods of normalcy last no
longer than 2 months
