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PSY2014S Abnormal Psychology and Cognitive Neuroscience Lecture Notes
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All lecture notes from the 2021 UCT PSY2014S course
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PSY2014S Abnormal Psychology and Cognitive NeuroscienceLecture 1: Introduction to Theories of Psychopathology
According to the DSM-5, a mental disorder is a clinically significant disturbance in cognition,
emotion regulation or behaviour. It reflects a dysfunction in the psychological, biological or
developmental process underlying mental functioning and is usually associated with significant
distress or disability.
It is NOT an expectable or culturally approved response to a common stressor or loss, nr is it
socially deviant behaviour between an individual and society.
The working definition of abnormality is used by psychologists to determine whether psychological
functioning or behaviour is abnormal. Psychological disorders need to meet at least two of the
following criteria in order to be diagnosed:
1. Unusualness
2. Deviance from the social norm
3. Significant distress experienced by the patient
4. Maladaptive behaviour
5. Danger to self or others
Symptoms of distress or ‘normal’ under certain environmental or social circumstances, so it is
important to consider sociocultural factors when evaluating whether an individual qualifies to be
diagnosed with a psychological disorder.
1. Social Anxiety Disorder (Social Phobia)
Marked fear or anxiety about one or more social situations in which the individual is exposed to
possible scrutiny by others.
The individual fears negative evaluation and social situations almost always provoke fear or anxiety.
The social situations are usually avoided, or endured with intense fear or anxiety (maladaptive
behaviour).
The fear or anxiety needs to be persistent for over 6 months in order to qualify as a symptom.
Social anxiety disorder causes clinically significant distress or impairs daily functioning.
Today, psychologists take a biopsychosocial approach when analyzing the causes of psychological
disorders. Historically, psychological disorders were believed to have been the results of demonic
possession, witchcraft or the moon and stars interfering with one’s mind. In the seventeenth
century, people with psychological disorders were deemed unfit to function in normal society and
were sent to insane asylums (which were no better than zoos).
In the 19th century there was a movement towards more humane treatments of mental disorders.
Moral therapy originated as a system with Philipe Pinel and Jean-Baptise Pussin and encompassed
treating institutionalized patients as normally as possible, eliminating restraint and seclusion tactics
and instead placing those suffering in settings that encouraged social interaction. There were
positive consequences for appropriate actions and behaviour, and this of course eventually led to
many patients being cured and returning home.
Up until the early 1900’s there were no theories providing a link between biological factors and
psychological symptoms. In 1905 it was discovered that general paresis was caused by untreated
syphilis. Once patients were treated for syphilis they no longer experienced personality changes
and dementia, this discovery lending support to the somatogenic hypothesis – biological
impairments cause/ explain psychological problems. This gave rise to the medical model and
psychiatry – psychoanalysis and behaviorist and humanistic models emerging in the early 20th
century.
Psychoanalytic theory was pioneered by Freud and Breuer. It states that disorders are rooted in
unconscious conflicts from early childhood – these battles occurring between the id, ego and
superego. Defense mechanisms assist us in avoiding confronting mental conflict, which as a result
, remain hidden in the unconscious. Freud also theorized that early psychosexual development
results in inner conflict. He had his patients talk to him about their problems and voice what they
were feeling, and he would in turn analyze these thoughts – Freudian psychoanalysis.
According to Freud, the id, ego and superego shape personality and may lead to psychopathology.
The id is amoral and ‘child-like,’ failing to consider consequences for actions.
The ego operates at a mostly conscious level of awareness, and is more rational and logical than
the id – the role of the ego is to satisfy the needs of the id without negative consequences.
The superego is the moral center of the personality, and it develops as a preschooler begins to
learn societal rules and expectations.
Conflict between the id, ego and superego leads to anxiety that can lead to defense mechanisms
arising as a method of dealing with the anxiety.
Freud believed that the early years of one’s life are crucial to development:
, Developmental problems with any of these early stages reflect negatively in one’s adult life, for
example someone who supposedly did not find balance between their id, ego and superego during
the anal stage is likely to be messy and selfish and careless, whilst someone who did is likely to be
perfectionistic, considerate and neat.
Freuds therapeutic process focusses on probing the unconscious mind. To do this, free association
(saying anything that comes to mind) was encouraged, or a probing word was used to try to reveal
unconscious thoughts and feelings. Dream analysis was also employed, as well as transference
(the feelings the therapist evokes in the patient such as fear that the therapist will abandon them
because someone abandoned the patient in early childhood). Psychoanalysts also examine
resistance in therapy and try to explain why a patient may be hesitant to come back to therapy after
potentially having spoken about something difficult.
There is little evidence that psychoanalysis works, but Freud’s work contributed to talk-therapy and
modern psychodynamic treatments.
Lecture 2: Understanding Psychopathology
1. The Humanistic Theory
Humanists were critical of behavioral and psychoanalytic models, and stated that they were too
focused on psychological and behavioral mechanisms to the point where psychologists lost sight on
the individual themselves. They reminded us that it is important to consider the ‘whole’ person and
not only their symptoms.
Humanists believe that people are essentially good, and can solve their own problems and make
positive life choices. Through self-actualization, all people can reach their full potential provided they
are given the freedom to grow. Certain factors can prevent self-actualization, and the main aim of
humanistic therapy is help the patient recognize their obstacles and help them to overcome them
and become fully self-actualized.
Roger’s theory of personality development proposes that we each have a self-concept. When asked
to describe ourselves, the words we use reflect our self-concept. Unconditional positive regard
results in self-image being similar to the ideal self. There is more of an overlap and the individual is
able to self-actualize. By contrast, conditional positive regard makes it difficult for self-image to be
similar to the ideal self. In this instance, self-actualization is more difficult. Anxiety occurs when
experiences threaten a person’s view of themselves.
Roger’s person-centered therapy is non-directive, client-centered and relationship-based. It
assumes that all people are intrinsically motivated toward optimal, positive psychological
functioning. The quality of the therapeutic relationship is the primary determinant of the outcome of
the therapeutic process, and the client is the primary agent for constructive self-change. Person-
centered psychology offers a distinctive understanding of people from the stance of thwarted
potential rather than from an illness ideology.
, The goal of Roger’s person-centered therapy is to develop the client to a point where they are
successful in experiencing and accepting themselves and are able to resolve their own conflicts and
difficulties. The therapist provides a supportive emotional climate for their clients and expresses
empathy and unconditional positive regard. In this form of therapy, insight is an essential tool.
Unconditional positive regard is essentially valuing the humanity of your client unconditionally. It is
manifested in the therapist’s consistent acceptance and enduring warmth towards the client, and
sabotages conditions of worth a client may have developed. Unconditional positive regard is not
‘liking’ a client, and it can be hard to maintain their attitude toward clients who are particularly
challenging.
Empathy is the process of being with a client whereby the therapist lays aside their own way of
experiencing and perceiving reality and sensing and responding to the perceptions and experiences
of their client. Communicating empathy makes the client feel understood, decreases feelings of
alienation, facilitates deeper exploration of thoughts and feelings and increases the client’s self-
awareness/ insight.
2. The Behavioural Model
This model explains human behaviour, including psychopathology, based on the principles of
learning and adaptation to one’s environment. The main components of the behavioural model are
classical and operant conditioning.
Classical conditioning (Pavlov) involves a neutral stimulus, unconditioned stimulus, unconditioned
response, conditioned stimulus and conditioned response. It may explain the avoidant tactics of
those diagnosed with panic disorder, e.g.
Experiencing repeated panic attacks while driving elicits a fear response that the person will have
another panic attack while driving.
Fears can be overcome through a process known as systematic desensitization (Wolpe) whereby
gradual systematic exposure to the feared stimulus renders a more and more calm response. The
feared stimulus is paired with relaxation.
Operant conditioning (Skinner) involves positive or negative reinforcement of certain behaviours.
Reinforcement refers to the consequences of a behaviour that strengthens the frequency of a
behaviour occurring. Positive reinforcement increases the frequency of the behaviour through a
reward system, negative reinforcement involves removing a stimulus in order to elicit a positive
outcome, e.g. avoiding anxiety-provoking situations in order to avoid having panic attacks.
Punishment is not very effective in changing behaviour.
If a child is rewarded for behaving in a vindictive way, they will be more likely to continue behaving
this way. In contrast, if a child receives a reward for following the rules, they will be more likely to
follow the rules in the future.
Lecture 3: Aetiology/ Causes of Psychopathology
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