These notes are summarized but comprehensive notes on the sections:
1. Theories of Psychopathology
2. Schizophrenia
3. Anxiety Disorders
4. Mood Disorders
5. Childhood Disorders
6. Intellectual Disability
From the UCT PSY2014S Module in 2023
Psych Test Notes
Theories of Psychopathology
Psychopathology - the study of psychological disorders. Multidimensional approach to understanding
psychopathology - spiritual is often excluded.
Defining Abnormality
Used by psychologists to determine whether psychological functioning/behaviour is abnormal.
For something to be considered a psychological disorder, at least t wo of the criteria below must be met:
1. Unusualness (for that specific person, the symptoms are outside of their usual behaviour).
2. Deviance from the social norm. (Varies across people, cultures and time).
3. Significant distress (Symptoms bother and worry them).
4. Maladaptive (Effects functioning - impairs ability to adapt to daily life).
5. Danger to self or others.
- Symptoms of distress are ‘normal’ under certain circumstances, however in certain situations it can be cause for
concern if you do not feel distressed. It is important to consider sociocultural factors.
DSM-5’s Definition of a Mental Disorder
A mental disorder is: A clinically significant disturbance in cognition, emotion regulation or behaviour. It reflects a
dysfunction in the psychological, biological or developmental processes underlying mental functioning. It is unusually
assosciated with significant distress or disability.
A mental disorder is not: An expectable or culturally approved response to a common stressor or loss. It is not
socially deviant behaviour bet ween an individual and society.
History of psychopathology
Three main historical approaches (in use outside of psychology):
1. Demonic Possessions (People’s behaviour is believed to change due to demonic possession. An exorcism or trephination
is performed to release the demons)
2. Witchcraft (Women were persectued for being witches historically. It was a form of social control to prevent
women from deviating from the socail norm)
3. The moon and stars affect mental state - think of astrology
The 19th century saw a moveent towards more humane treatments
- Moral therapy originated as a sytem with Phillipe Pinel and Jean-Baptiste Pussin. They saw the conditions as
inhumane and non-effective. They believed in treating institutionalised patients as normally as possible and
creating a setting that encouraged social interaction. They publicaly unchained inmates and eliminated restraint
and seclusion. They intriduced positive consequences for appropriate interactions and behaviour. This led to patients
being cured and returning home.
- In 1905 it was discovered that general paresis (psychological symptoms including personality and mood changes
and dementia) had a physical cause - untreated syphillis. This lent support to the Somatogenic Hypothesis which is
that biological impairments explain psychological problems. The biological model and research emerged as an
explanation.
Psychiatry emerged to find biological causes for psychological disorder. Anti-psychotic medication for schizophrenia
was developed, allowing people to function as normal. The term mental illness arose. The medical model and
psychiatry arose with there being categorical classification of mental disorders in the DSM. Introduced scientific
thinking and focus was on identifying biological causes and treatments.
The DSM-5
- Disorders are classified according to symptom presentation and shared risk factors.
- 20 chapters
- For each disorder:
Symptoms
Diagnostic criteria
Assosciated features
Prevalence.
,Benefits to Classifying mental disorders:
- Creates a common language for research and data sharing
- Understanding the causes of psychopathology
- Developing effective treatment and prevention strategies
- Assessing the effectiveness of treatments
- Organising ser vices and support
- Forensics, compensation and medical aid
Criticisims to classifying mental disorders:
- Based upon the medical model
- Largely ignores contextual factors (like recent bereavement)
- Locates pathology within the individual
- Assumes universality of symptom presentation
- Labelling peopleee can be stigmatising and harmful
- Defines disorders as discrete entities
- High rates of comorbidity (79% meet the criteria for more than 1 disorder)
Biological factors
Genetic Contributions to psychopathology:
Genome: All the heredity information of an organismthat is encoded in DNA (20 000 genes). No single gene causes a
psychological disorder. Genetic factors make some contrubution to all disorders but account for less than half of
the explanation. Nature vs Nurture debate is too simplistic. Environmental factors in the form of social and
cultural influences can determine whether genes are ‘turned on’ (i.e., a genetic vulnerability is triggered).
Epigenetics and psychology:
Epigenetics = The study of factors other than inherited DNA sequence, such as new learning or stress, that alter
the phenotypic expression of genes
Examples
Study of children with a predisposition toward antisocial personality disorder who were adopted into adverse
home environments were more likely to be aggressive as adults
Extremely chaotic early environments can override genetic factors and alter neuroendocrine function to
increase the likelihood of later behavioural and emotional disorders
The Diathesis-Stress Model
Individuals inherit tendencies to express certain traits or behaviors, which may then be activated under
conditions of stress
The smaller the genetic vulnerability, the greater the life stress required to produce a disorder (vice versa)
Only 2 will develop for e.g., Depression because glass is full. 1 will need a lot ore life stressors to activate the gene
or predisposition.
Some diseases have much higher genetic predispositions than others.
Popular model but it may be overly simplistic
The gene-environment correlation model
A genetic endowment may increase the likelihood that a person may experience stressful life events that lead to
the development of a psychological disorder
There are other genetic traits that increase the likelihood! Genes do not act on their own.
Psychoanalytic Theory – Sigmund Freud and Joseph Bruer
Unconscious conflicts, urges and desires cause disorders.
Disorders are rooted in unconscious conflicts that originate in early childhood (under hypnosis they discovered
this) It is therapeutic (cathartic) to recall and relive unconscious emotional trauma and to release the
accompanying tension (through hypnosis – cannot remember what they talked about – because it was the
unconscious mind and defenses are no longer there)
These are battles bet ween the id, the ego and the superego, usually to do with sexual and aggressive impulses
Defense mechanisms assist us to avoid confronting these conflicts, which remain hidden in the unconscious.
,The structure of personality
The Id, Ego & Superego shape personality and may lead to symptoms of psychopathology
Defense mechanisms protect us from anxiety associated with inner conflict
Conscious: Contact with the outside world – 1. Ego = psychological component. 2. Reality principle
Preconscious: material just beneath the surface of awareness. 2. Secondary process thinking (reality testing). 3.
Superego = social component and moral imperative.
Unconscious: difficult to retrieve material (well below the surface of awareness). 4. ID = biological drives, pleasure
principle and wish fulfilment.
Born as ID. As we grow, we self-develop the superego – moral compass. Strong ID – impulse control disorders.
Superego disorders – suppress needs and desires – too rule abiding and perfectionists.
Defence Mechanisms
Anxiety is experienced when the ego cannot deal with the demands of the ID, superego and the constraints of
reality. Anxiety is an unpleasant state that we seek to avoid. The ego develops defence mechanisms to deal with
this anxiety. Defence mechanisms usually work unconsciously to distort reality, but we could be aware of them at
times. Can be unhealthy or adaptive (help functioning).
Repression - Motivated forgetting of emotionally threatening memories or impulses
Reaction formation - Forming an emotional reacyion or attitude that is the opposite of one’s threatening or
unacceptable actual thoughts
Displacement - Directingan impulse from a socially unacceptable target to a more acceptable one
Rationalisation - Making up acceptable excuses for unacceptable behaviour
Sublimation - Transforming a socially unacceptable impulse into an admired and socially valued goal
Psychoanalytic theories
Psychoanalysis (Freud)
He proposed that there is an unconscious mind into which we repress all of our threatening urges and desires. He
believed these repressed urges, in trying to surface, created his patients’ nervous disorders. Early childhood
experiences are NB – root of issues. Today instead of psychotherapy it is psychodynamic therapy.
Insight therapy that is long-term
The purpose of therapy is to recover and resolve unconscious conflicts, motives and defences
Therapist adopts a blank slate approach (cannot see facial expressions – no influence)
Modern psychodynamic therapy has more genuine connection
Therapeutic Techniques
Probing the unconscious:
Free association – say whatever comes into your mind. When your mind is wandering, there is space for
unconscious material to come out freely. Talk freely until you reach your unconscious mind.
Dream analysis – symbolic for you (subjective to each person)
Transference – client transfers anxieties onto the therapist. Internal assumptions come out. Therapist looks for
patterns in assumptions/things people say. I notice when I or you do this or this you seem to assume this.
Resistance – client resists dealing with a specific thing. Once this is picked up, you know it is something serious
that the client needs to deal with, given enough time.
Offering interpretations to the patient (tell client what you’ve noticed)
Bowlby’s Evolutionary Theory of Attachment
John Bowlby is the founder of attachment theory
The drive to maintain proximity to one’s caregiver influences an infant/child’s behaviour
The attachment relationship to the caregiver(s) is critical to the infant’s physical and emotional survival and
development
The infant must adapt to the caregiver, defensively excluding behaviours that threaten the emotional bond.
Babies must fit in and do what pleases the caregiver so they can continue receiving their love and affection.
(Detrimental with abusive parents)
Goes both ways. Parents must be responsive as inconsistency is confusing for babies!
, Bowlby: Infant-Caregiver Relationship
“the infant and young child should experience a warm, intimate, and continuous relationship with his mother (or
permanent mother substitute) in which both find satisfaction and enjoyment”
The infant develops a sense of whether they are worthy of love and support and whether the caregiver can be
trusted to provide care and support
During infancy and childhood, these views of the self and other develop into sophisticated internal working models
of what to expect from close others
Early experiences influence attachment style e.g. secure, avoidant, ambivalent, disorganized
Causes of psychopathology – psychological factors
Behavioural Processes –
Human behaviour, including psychopathology is based on principles of learning and adaptation to one’s environment
Whilst Freud believed all phobia stems from repressed conflict and cannot be cured without psychoanalysis to
uncover repressed material, Watson believed phobias are learnt through a process of conditioning. All behaviour is
a result of a stimulus-response relationship.
Social learning theory – behaviours are learned through obser vation and imitation; cognitions also play a role in
terms of judgements about what may happen to you if you behave in a certain way
Prepared learning – learning to fear some objects more easily than others is adaptive; linked to genetics
(sur vival)
Classical conditioning (Pavlov) – can be a cause of some psychological disorders. Anxiety and trauma related
disorders for example. Learned behavior through association. This example shows panic disorder. Panic attack
happens while driving. Fear of panic gets paired with driving. Fear of driving is thus conditioned. Avoidant
behavior then acts as negative reinforcement of that fear response to driving. Cannot fully explain certain
behaviours.
Unconditioned stimulus – a stimulus that reliably produces a naturally occurring response. Unconditioned response
– unlearned, naturally occurring/involuntary reflex elicited by US. Neutral stimulus – any stimulus not usually
triggering a UR. Conditioned stimulus – through pairing the NS and US, the CS produces a learned response.
Conditioned response – learned response to the CS. [E.g., fear of lift…US = trapped. UR = panic. NS = lift. US =
trapped. UR = panic. CS = lift. CR = panic]
Stimulus Generalization: After conditioning, other stimuli similar to the conditioned stimulus may trigger the
same response
Operant conditioning (Skinner)
Skinner continued after Watson, researching classical conditioning and developed his own theory of how
voluntary behaviour is learned called operant conditioning. In this theory, behavioural responses that are
followed by pleasurable consequences are strengthened/reinforced and actions followed by punishment are not
repeated.
Positive reinforcement – adding something pleasant (a reward) after a response increases the likelihood that the
response will be repeated
Negative reinforcement – a response is followed by an unpleasant stimulus being taken away or removed,
increasing the likelihood the response will be repeated.
Punishment – positive (adding an unpleasant stimulus to decrease behaviour)/negative(taking away a pleasant
stimulus to decrease behaviour)
Behaviours that are positively reinforced (maintains the disorder or decreases the symptoms of the disorder)
Behaviours that are negatively reinforced (maintain the disorder)
Punishment (not very effective in changing behaviours)
Emotional Influences
Most theorists agree that emotion is an action tendency accompanied by a feeling state that motivates us to act
Short-lived, temporary state (different to a mood which is persistent). Three related components i.e. behaviour (an
action causes an emotion), physiology (genetics) and cognition (influenced by your thoughts). Emotions influence our
thoughts, behaviour and biology and contribute to psychopathology. In therapy you can intervene at different
levels – help change thoughts, or alter abnormal behaviour. Intervening at the biological level, will affect
thoughts and feelings. Cant control feelings but you can change your emotional states. Too simplistic to only work
on this.
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