Understanding Psychopathology  Creator of Science – conducting research or synthesizes both

 Clinical Description. Causes (Etiology). Treatment and outcome.

 Psychological Disorders –
 Clinical Description
 Psychological dysfunction - breakdown in Cognitive, Behavioral and
 Presents – the presenting problem of the patients; first step in
Emotional
determining clinical descriptions
 Personal distress or impairment – extremely upset
 Clinical - both type of problems disorders that you would find in the
 Individual vs. Others
clinic and activities connected with assessment and treatment
 Appropriateness to situations
 Prevalence – how many people in the population as a whole have
 Degree of impairment
disorder
 Response is a typical and not culturally expected
 Incidence – how many new cases occur during a given period
 Deviations from “average”
 Sex-ratio – percentage of males and females have the disorder
 Violations of social norms
 Typical age of onset – which often differs from one disorder to another
 Harmful dysfunctions – Jerome Wakefield – out of control
 Course – individual patterns
behaviors of individual
 Chronic – last a long time, sometimes a lifetime
 DSM 5: Behavioral, psychological, or biological dysfunctions that are unexpected  Episodic - recurrent
in their cultural context associated with present distress or impairment in  Time-Limited – improve without treatment in a short period
functioning or increased risk of suffering, death, pain, or impairment
 Onset
 Prototype – typical profiles  Acute – begin suddenly
 Dimensional estimates of the severity of the specific disorders  Insidious – develop gradually over an extended period
 Psychopathology – scientific study of psychological disorder  Prognosis – anticipated course of disorder
 Clinical and Counseling Psychologist ( PhD, PsyD)  Good – will probably recover
 Psychiatrist (MD)  Guarded – outcome doesn’t look good
 Psychiatric Social Workers (MSW)  Age of onset may shape presentation
 Psychiatric Nurses (MN, MSN, PhD)  Developmental Psychology – study of changes in behavior
 Marriage and Family Therapist (MA, MS, MFT)  Developmental Psychopathology – study of changes in
 Mental Health Counselors (MA, MS) abnormal behavior
 The scientist-practitioners – interaction of clinical work and science  Life-span Developmental Psychopathology - study of abnormal
 Consumer of Science – Enhancing the practice or informs practice behavior across the entire age span
 Evaluator of Science – Determining the effectiveness of the practice or  Causation, treatment and etiology outcomes
utilize science  Etiology – causes or development of psychopathology
  Treatment – drugs and/or psychosocial  Treatment – rest, sleep, healthy and happy
 Historical Conceptions of Abnormal Behavior environment. Bath, ointments and various potions.
 Supernatural Model – divinities, demons, spirits and other  Nicholas Oresme – disease of melancholy (depression)
phenomena such as magnetic field or the moons or the was the source of some bizarre behavior rather than
stars demons
 Soul/psyche – the mind  Treatment for Possession
 Separate from the body  Mass hysteria
 Biological Model  St. Vitus Dance
 Psychological Model  Tarantism
o The Supernatural Tradition  Modern mass hysteria
 Deviance – Battle of “Good” vs. “Evil”  Emotion contagion
 Etiology – devil, witchcrafts and sorcery  “mob psychology”
 Great Persian Empire (900-600 BC) – all physical and  The Moon and the stars
mental disorders were considered the work of the devil  Moon and the stars
 14th to 15th century Europe  Paracelsus
 Barbara Tuchman – ably captures the conflicting  Lunancy
tides of opinion on the origins and treatment of  Modern Example – Astrology
insanity during the bleak and tumultuous period o The Biological Tradition
 Demons and Witches  Hippocrates
 Treatment:  Father of modern Western medicine
 Exorcism – religious rituals were performed in  Hippocratic Corpus
an effort to rid the victim of evil spirits  Etiology – physical disease and genetics
 Shaving the pattern of the cross in the hair of  Precursor to somatoform disorders
the victim’s head and securing sufferers to a  Hysteria
wall near the front of the church so that they  Galen
might benefit from hearing Mass  Hippocratic foundation
 Stress and Melancholy  Galenic-Hippocratic Tradition
 Etiology – natural, curable phenomenon  Humoral Theory of mental illness
 Illness model  Blood, black bile, yellow bile and phlegm
 Still connected with sin  Blood – came from the heart
  Black bile – from spleen  Etiology – physical ill
 Phlegm – from the brain  Treatment – rest, diet, and room temperature
 Yellow bile/choler – from liver  Improved hospital conditions
 Believed that disease results from too much or too little
of one of the humor  The Development of Biological Treatment
Examples:  The Consequences of the Biological Traditions
 Melancholia (depression) – too much black bile 
 Melancholer – means “black bile”
 Etiology – brain chemical imbalances AN INTEGRATIVE APPROACH TO PSYCHOPATHOLOGY
 4 basic qualities – heat, dryness, moisture, cold
 Sometimes applied to personality traits
Examples:
 Sanguine (red, like blood) – ruddy in
complexion, cheerful and optimistic
 Phlegmatic – apathy or sluggishness or
calm under stress
 Choleric – hot tempered
 Treatment: environmental regulation
 Heat, dryness, moisture and cold
 Bloodletting, induced vomiting
 19 Century
th

 Syphilis and general paresis

 STD with psychosis like symptoms
 Delusions
 Hallucinations
 Etiology – bacterial microorganism
 Louis Pasteur germs Theory
 Biological basis for madness
 John Grey
 American proponent of biological tradition
  Inter-rater reliability – two or more raters will get the same
answer
 Test-retest reliability – same result from same test different
period
 Validity – measures what is designed to measure
 Concurrent - comparing the results of assessment
 Predictive – tells what will happen in the future
 Standardization – standards to ensure consistency across different
measurements
 Procedures of testing
 Scoring
CLINICAL ASESSMENT AND DIAGNOSIS  Evaluating data
 Clinical Assessment
Assessing Psychological Disorders
 Clinical Interview
 Clinical Assessment – systematic evaluation and measurement of  Mental status exam
psychological, biological and social factors  Physical examinations
 Diagnosis - process of determining whether the particular problems meets  Behavioral observations and assessment
the all criteria for psychological disorders  Psychological tests
 Purpose:  CLINICAL INTERVIEWS – clinical core, structured and assesses multiple domains
 Understanding individuals such as CURRENT AND PAST BEHAVIORS, ATTITIDES, EMOTIONS, DETTAILED
 Predicting behaviors HISTORY AND PRESENTING PROBLEMS
 Treatment planning  Mental Status Exam – systematic observations of individual’s behaviors;
 Evaluating outcomes pseudo-mental status exam; structured and detailed
 Appearance and Behaviors
 Funnel Analogy:
 Thoughts processes
 Broad, multidimensional start
 Mood and affect
 Narrow to specific problems
 Intellectual functioning
 KEY CONCEPTS IN ASSESSMENTS
 Sensorium
 Reliability - measurement of consistency; “agreement”
 Semi- Structured Interview
 Assess most critical items
  Departures from format
 Unstructured – no systematic format
 PHYSICAL EXAMINATION – diagnose or rule out physical etiologies
 Toxicities
 Medication side effects
 Allergic reactions
 Metabolic Conditions
 BEHAVIORAL ASSESSMENT –
 PSYCHOLOGICAL TEST -