These notes cover the entire module and include all the DSM-5 criteria for various disorders. A table of contents and table of figures is also included. It covers Chapters 1-3, 5-8, and 10-13 of the prescribed textbook.
Contents
Chapter 1: Abnormal Behaviour in Historical Context .......................................................................................................................................................... 3
Chapter 2: An Integrative Approach to Psychopathology ................................................................................................................................................. 15
Chapter 3: Clinical Assessment and Diagnosis ....................................................................................................................................................................... 30
Chapter 5: Anxiety, Trauma- and Stressor-Related, and Obsessive-Compulsive and Related Disorders .................................................. 42
Chapter 6: Somatic Symptom and Related Disorders and Dissociative Disorders ............................................................................................... 59
Chapter 7: Mood Disorders and Suicide .................................................................................................................................................................................... 69
Chapter 8: Disorders of Neurovegetative Function ............................................................................................................................................................. 84
Chapter 10: Sexual Dysfunctions, Paraphilic Disorders, and Gender Dysphoria ................................................................................................... 91
Chapter 11: Substance-Related, Addictive, and Impulse-Control Disorders .........................................................................................................105
Chapter 12: Personality Disorders .............................................................................................................................................................................................122
Chapter 13: Schizophrenia Spectrum and Other Psychotic Disorders .....................................................................................................................135
List of figures
Table 1: Diagnostic Criteria for Panic Attack ................................................................................................................................................................................................... 42
Table 2: Diagnostic Criteria for Generalised Anxiety Disorder ............................................................................................................................................................... 45
Table 3: Diagnostic Criteria for Panic Disorder ............................................................................................................................................................................................. 46
Table 4: Diagnostic Criteria for Agoraphobia .................................................................................................................................................................................................. 47
Table 5: Diagnostic Criteria for Specific Phobia ............................................................................................................................................................................................ 49
Table 6: Diagnostic Criteria for Social Anxiety Disorder (Social Phobia) ............................................................................................................................................ 51
Table 7: Diagnostic Criteria for Post-Traumatic Stress Disorder ........................................................................................................................................................... 52
Table 8: Diagnostic Criteria for Obsessive-Compulsive Disorder .......................................................................................................................................................... 55
Table 9: Types of Obsession and Compulsions ............................................................................................................................................................................................... 55
Table 10: Diagnostic Criteria for Body Dysmorphic Disorder ................................................................................................................................................................. 57
Table 11: Diagnostic Criteria for Somatic Symptom Disorder................................................................................................................................................................. 59
Table 12: Diagnostic Criteria for Illness Anxiety Disorder ....................................................................................................................................................................... 60
Table 13: Diagnostic Criteria for Conversion Disorder (Functional Neurological Symptom Disorder) ................................................................................. 62
Table 14: Differentiating Between Conversion Disorder and Malingering ......................................................................................................................................... 63
Table 15: Diagnostic Criteria for Factitious Disorder ................................................................................................................................................................................. 63
Table 16: Functional Somatic Syndromes......................................................................................................................................................................................................... 64
Table 17: Diagnostic Criteria for Depersonalisation-Derealisation Disorder ................................................................................................................................... 65
Table 18: Diagnostic Criteria for Dissociative Amnesia ............................................................................................................................................................................. 65
Table 19: Diagnostic Criteria for Dissociative Identity Disorder ............................................................................................................................................................ 66
Table 20: Criteria for Major Depressive Episode ........................................................................................................................................................................................... 69
Table 21: Criteria for Manic Episode ................................................................................................................................................................................................................. 70
Table 22: Diagnostic Criteria for Major Depressive Disorder .................................................................................................................................................................. 71
Table 23: Diagnostic Criteria for Persistent Depressive Disorder (Dysthymia)............................................................................................................................... 71
Table 24: Diagnostic Criteria for Premenstrual Dysphoric Disorder .................................................................................................................................................... 73
Table 25: Diagnostic Criteria for Disruptive Mood Dysregulation Disorder ...................................................................................................................................... 73
Table 26: Diagnostic Criteria for Bipolar I Disorder .................................................................................................................................................................................... 74
Table 27: Diagnostic Criteria for Bipolar II Disorder .................................................................................................................................................................................. 74
Table 28: Diagnostic Criteria for Cyclothymic Disorder ............................................................................................................................................................................ 75
Table 29: Diagnostic Criteria for Anorexia Nervosa .................................................................................................................................................................................... 85
Table 30: Diagnostic Criteria for Bulimia Nervosa ....................................................................................................................................................................................... 86
Table 31: Diagnostic Criteria for Binge-Eating Disorder ........................................................................................................................................................................... 87
Table 32: Categories of Sexual Dysfunction ..................................................................................................................................................................................................... 93
Table 33: Diagnostic Criteria for Male Hypoactive Sexual Desire Disorder ....................................................................................................................................... 94
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,Psychology 324
Table 34: Diagnostic Criteria for Female Sexual Interest/Arousal Desire Disorder ....................................................................................................................... 94
Table 35: Criteria for Female Orgasmic Disorder .......................................................................................................................................................................................... 95
Table 36: Criteria for Premature Ejaculation .................................................................................................................................................................................................. 95
Table 37: Criteria for Genito-Pelvic Pain/Penetration Disorder ............................................................................................................................................................ 95
Table 38: Criteria for Frotteuristic Disorder ................................................................................................................................................................................................... 99
Table 39: Criteria for Fetishistic Disorder ........................................................................................................................................................................................................ 99
Table 40: Criteria for Voyeuristic and Exhibitionistic Disorders ............................................................................................................................................................ 99
Table 41: Criteria for Transvestic Disorder ...................................................................................................................................................................................................100
Table 42: Criteria for Sexual Sadism Disorder and Sexual Masochism Disorder ............................................................................................................................100
Table 43: Criteria for Paedophilic Disorder ...................................................................................................................................................................................................101
Table 44: Criteria for Other Specified Paraphilic Disorder ......................................................................................................................................................................101
Table 45: Criteria for Gender Dysphoria .........................................................................................................................................................................................................102
Table 46: Diagnostic Criteria for Alcohol Use Disorder.............................................................................................................................................................................107
Table 47: Diagnostic Criteria for Sedative-, Hypnotic-, or Anxiolytic-Related Disorders ............................................................................................................109
Table 48: Diagnostic Criteria for Stimulant Use Disorder ........................................................................................................................................................................110
Table 49: Diagnostic Criteria for Tobacco Use Disorder ...........................................................................................................................................................................111
Table 50: Diagnostic Criteria for Caffeine Intoxication .............................................................................................................................................................................112
Table 51: Diagnostic Criteria for Opioid Use Disorder ..............................................................................................................................................................................112
Table 52: Diagnostic Criteria for Cannabis Use Disorder .........................................................................................................................................................................113
Table 53: Diagnostic Criteria for Hallucinogen Use Disorder .................................................................................................................................................................114
Table 54: Diagnostic Criteria for Inhalant Use Disorder ...........................................................................................................................................................................115
Table 55: Principles of Effective Treatment for Illicit Substance Use ..................................................................................................................................................117
Table 56: Diagnostic Criteria for Gambling Disorder .................................................................................................................................................................................120
Table 57: Personality Disorders .........................................................................................................................................................................................................................122
Table 58: Diagnostic Criteria for Paranoid Personality Disorder ..........................................................................................................................................................124
Table 59: Diagnostic Criteria for Schizoid Personality Disorder ...........................................................................................................................................................125
Table 60: Diagnostic Criteria for Schizotypal Personality Disorder .....................................................................................................................................................126
Table 61: Diagnostic Criteria for Antisocial Personality Disorder ........................................................................................................................................................127
Table 62: Diagnostic Criteria for Conduct Disorder....................................................................................................................................................................................128
Table 63: Diagnostic Criteria for Borderline Personality Disorder ......................................................................................................................................................129
Table 64: Diagnostic Criteria for Histrionic Personality Disorder ........................................................................................................................................................131
Table 65: Diagnostic Criteria for Narcissistic Personality Disorder .....................................................................................................................................................131
Table 66: Diagnostic Criteria for Avoidant Personality Disorder ..........................................................................................................................................................132
Table 67: Diagnostic Criteria for Dependent Personality Disorder ......................................................................................................................................................133
Table 68: Diagnostic Criteria for Obsessive-Compulsive Personality Disorder...............................................................................................................................134
Table 69: Diagnostic Criteria for Schizophrenia ..........................................................................................................................................................................................136
Table 70: Diagnostic Criteria for Catatonia Associated with Another Mental Disorder (Catatonia Specifier) ....................................................................138
Table 71: Diagnostic Criteria for Schizophreniform Disorder ................................................................................................................................................................140
Table 72: Diagnostic Criteria for Schizoaffective Disorder ......................................................................................................................................................................140
Table 73: Diagnostic Criteria for Delusional Disorder ...............................................................................................................................................................................141
Table 74: Diagnostic Criteria for Substance/Medication-Induced Psychotic Disorder ................................................................................................................141
Table 75: Diagnostic Criteria for Psychotic Disorder Associated with Another Medical Condition ........................................................................................141
Table 76: Diagnostic Criteria for Brief Psychotic Disorder ......................................................................................................................................................................142
Table 77: An Integrative Treatment Approach to Schizophrenia ..........................................................................................................................................................146
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,Psychology 324
Chapter 1: Abnormal Behaviour in Historical
Context
Understanding psychopathology
What is a psychological disorder?
• Psychological disorder – psychological dysfunction associated with distress or impairment in
functioning that is not a typical or culturally expected response → abnormal behaviour
• No one criterion defines abnormality
• Cultural lenses require attention
o Disorders are defined in relation to cultural, social, and familial norms and values
o Shape the experience and expression of symptoms, signs, and behaviours
o South African practitioners → require knowledge of indigenous cultural knowledge systems
o The level at which an experience becomes problematic/pathological will differ
▪ Abnormality depends on individually internalised cultural norms, as well as those applied
by others around them
• South Africa → traditional medicine is an important source of psychiatric support
o Complementary/parallel to conventional medicine
Psychological dysfunction
• Characterised by a breakdown in cognitive, emotional or behavioural functioning
• Normal functioning and abnormal dysfunction → on a continuum/dimension rather than categories
that are either present or absent
• Having a dysfunction → does not meet criteria for a psychological disorder by itself
Culture-bound personal distress or impairment
• Behaviour must be associated with culture-bound distress to be classified as abnormal
o This alone does still not define abnormal behaviour
• Cannot define psychological behaviour by distress alone → often it is normal to be distressed
• Impairment in function → a useful concept but it can be subjective
o Most psychological disorders → extreme expressions of otherwise normal emotions, behaviours,
and cognitive processes
▪ Guided by worldviews
Atypical or not culturally expected
• A response must be atypical or not culturally expected
o Only one criterion → also not sufficient by itself
• Something can be considered abnormal because it occurs infrequently → not necessarily a disorder
• Cultural differences in psychological disorders
o Behaviour is abnormal if it violates social norms
▪ The social standard of ‘normal’ is misused → harmful dysfunction
• Determine whether the behaviour is outside the person’s control
An accepted definition
• Difficult to define ‘normal’ and ‘abnormal
• DSM-5 → behavioural, psychological, or biological dysfunctions that are unexpected in their cultural
context and associated with present distress and impairment in functioning, or increased risk of
suffering, death, pain, or impairment
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, Psychology 324
• Consider how an apparent disease/disorder matches a ‘typical’ profile wen most or all symptoms that
experts agree are part of the disorder are present
o Typical profile → prototype
A brief overview of psychological disorders in South Africa
• High prevalence of substance use disorders
• About 30% of people will suffer from a mental disorder during their lifetime
• Reasons for relatively high prevalence of mental disorder:
o The past continues to have an effect
▪ Racial discrimination
▪ Political violence
o The present has its own effects
▪ Gender inequality
▪ Criminal violence
o Poverty contributes to vulnerability
• Socioeconomic privilege may protect against stressors and reduce prevalence of psychiatric
disorders
The science of psychopathology
• Psychopathology – the scientific study of psychological disorders
• Field of medical health practitioners
• Clinical and counselling psychologists → Master’s degree
o Clinical → concentrate on severe psychological disorders
o Counselling → study and treat adjustment and vocational issues encountered by relatively
healthy individuals
• Psychiatrists → doctorate and medical degree
o Investigate the nature and causes of disorders
o Tend to have a biological point of view
o Make diagnoses and offer treatment
▪ Emphasise medication or other biological treatments as well as psychosocial treatments
• Psychiatric social worker → degree in social work
o Collect information relevant to the social and family situation of the individual
o Home visits and community-based work
• Psychiatric nurse → diploma in psychiatric nursing
o Specialise in the care and treatment of patients with disorders
The scientist-practitioner
• Scientist-practitioners – mental health professionals who apply scientific methods to their work
o Keep current in latest research on diagnosis and treatment
o Evaluate their own methods for effectiveness
o Generate their own research to discover new knowledge
o Consumer of science, evaluator of science, and creator of science
• Three major categories in the study of psychological disorders
o 1. Clinical description
o 2. Causation/aetiology
o 3. Treatment and outcome
Clinical description
• Presenting problem – original complaint reported by the client to the therapist
o Actual treated problem may be a modification derived from the presenting problem
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