PSYC 1020 Psychological Disorders (Chapter 14)

A Brief History of Psychological Disorders

Psychopathology
- Psychopathology: sickness or disorder of the mind; psychological disorder
- Earliest views:
• “Madness,” demonic possession, or evil spirits
Treating Psychological Disorders in an Ancient World
- Trephination: the process of creating a hole in the skull for a variety of purposes
• Mental illness or epilepsy -> spiritual/demonic possession
• Headaches
• Dates back 7,000 - 10,000 years ago
• The oldest surgical procedure
- Humorism (the four humours): a system of medicine detailing a persons temperament
(personality) and the makeup and workings of the human body
• Have origins in Ancient Egyptian medicine or Mesopotamia
• Ancient Greek thinkers (particularly, Hippocrates) systemized the four
humours, which were further developed by Galen
- For the body to be healthy, all four humors needed to be balanced in
amount and strength
• The humors:
- Black bile (melancholy -> depression, cancer)
- Yellow bile (choleric -> aggression, ambition, decisive)
- Phlegm (reserved behaviour -> apathy)
- Blood (sanguine -> enthusiastic, social, active)
• Treatment -> purging, staving, vomiting, or bloodletting
- Bloodletting: the practice of withdrawing blood from a persons veins for
therapeutic reasons
• 17th century France -> Jacques Ferrand believed bloodletting would cure heartbreak
• 18th century London -> bleeding patients at the infamous St. Mary of Bethlehem
(“Bedlam”) institution

Asylums
- Mental asylums: institutions created for the speci c purpose of housing people with
psychological disorders
• Focus -> removing mentally ill people from society (not treatment)
- “Treatments” included:
• Being kept in windowless dungeons, being beaten, staying chained to bed, little to no
contact with caregivers

Treating Patients with Kindness and Based on Evidence

- Philippe Pinel (1793):
• Head physician at Bicetre Hospital in Paris
• Believed that medical treatments should be based on empirical observations and asylum
patients should be treated humanely
- Jean-Baptiste Pussin
• Former patient at this hospital
• Treated patients with kindness
• Inspired Pinel to remove patients from chains
- Moral treatment: a therapy that involves close contact with and careful observation of
patients

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Dorothea Dix
- 19th century -> led e orts for mental health care in the US
- Led an investigation into the treatment of psychological patients in asylums, jails, hospitals
-> discovered the systems were underfunded and unregulated, resulting in major abuse of
patients
- Her ndings resulted in reform e orts for the treatment of patients in the US
- Reform e orts resulted in mental asylums in the US, with the sole purpose of caring for
psychological patients

More “Morden” Asylums

- Still lthy, still o ered little treatment, often kept people for decades
- Thankfully, things have changed
How Do We Identify Psychological Disorders?
- The four D’s
• Deviance: departure of what is normal/usual
- Refers to behaviours, thoughts, and feelings that are not in line with generally accepted
standards
- Culturally based
• Distress
- Behaviours, thoughts, and feelings, that are upsetting and cause pain, su ering, or
sorrow
• Dysfunctional
- Behaviours, thoughts, and feelings are disruptive to ones regular routine or interfere
with day-to-day functioning
• Dangerous
- Behaviours, thoughts, and feelings may lead to harm or injury to self or others
- The Fifth D
• Duration: the interval between the onset of a psychiatric disorder and the administration of
the rst pharmacological treatment
- To get a diagnosis, the abnormal behaviours need to persist for speci c amount of time
Psychological Disorders
- Patterns of deviant and dysfunctional behaviours, thoughts, and/or feelings that cause
signi cant distress, and may even be dangerous, and last for a speci c amount of time

How Does A Society Decide if Someone Has A Psychological Disorder?

- Almost any behaviour is appropriate in the right context
- Certain criteria for identifying if a behaviour represents psychopathology:
1. Does the person act in a way that deviates from cultural norms for acceptable
behaviour? (Deviance)
2. Is the behaviour maladaptive? (Dangerous)
3. Is the behaviour self-destructive, does it cause the individual personal distress, or does
it threaten people in the community (Distress)
4. Does the behaviour cause discomfort and concern to others, thus impairing a person’s
social relationships? (Dysfunctional)

Does the Person Act in a Way that Deviates from Cultural Norms for Acceptable Behaviour
- Psychological disorders are common in all countries and all societies
- There are some disorders that are more culturally-based, and some that are more
biologically-based

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Is Behaviour Maladaptive?
- Does the behaviour interfere with the persons ability to respond appropriately in some
situations?
• ex. impulsivity and ADHD -> feeling the need to interrupt others during a work meeting
without considering whether its the right time to speak
- Impulsivity interferes with their ability to respond in a socially appropriate way
- This can a ect their relationships and work performance
Is the Behaviour Self-destructive, Does it Cause the IndividualPersonal Distress, or Does it
Threaten People in the Community
- ex. substance abuse disorder
• Self-destructive: a persons drinking excessively despite knowing it harms their health (ie.
liver damage, worsening a chronic condition)
• Distressful: feelings of deep shame, guilt, or depression about their inability to stop
drinking
• Threatening: driving under the in uence, which puts others at risk of harm
- ex. social anxiety disorder
• Discomfort/concern to others: a person with SAD may avoid social gatherings, causing
concern among friends/family who might worry about their well-being
• Impairing social relationships: avoidance of social situations can lead to lack of meaningful
social connections
- Harder to make/maintain friendships -> exacerbates feelings of isolation and distress

PSYC 1020 Psychological Disorders (Chapter 14)

History of Classifying Psychological Disorders: The DSM and RDoC

Approaches to Classifying Psychopathology

- Categorical approach: implies that a person either has a psychological disorder or does not
have a psychological disorder
• ex. the DSM
- Dimensional approach: considers psychological disorders along with a continuum on which
people can vary in degree rather than in kind
• ex. the RDoC
Classifying Disorders: A (Western) History
- 1840 -> First attempt in the US to gather information about mental health
• “Idiocy, Insanity”
- 1883 -> Emil Kraplin
• Published a system of psychological disorders centred around a pattern of symptoms
• 7 categories
The Beginning of Diagnostic Manuals
- 1918: American Medico-Psychological Association changed its name to the American
Psychological Association (APA)
• Issues the Statistical Manual for Use of Institutions for the Insane
The First Diagnostic Manual
- 1921: American Medical Association’s standard Classi ed Nomenclature of Disease
• APA collaborated with the New York Academy of Medicine to develop psychiatric
classi cations
- 22 di erent categories, 21 were psychotic conditions
• Meant for diagnosing inpatients with severe psychiatric/neurological disorders

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Diagnostic Manuals
- 1946: US army psychiatrists following WW2
• High proportion of soldiers in combat su ered psychiatric breakdowns
• Kinds of breakdowns thy had (clearly response to stressful situations) weren’t
encompassed by existing manual (in-patients)
• Model for rst DSM
Diagnostic and Statistical Manual for Mental Disorders (DSM-I) 1952
- Published by the APA
- Combined 2 major in uences
• Adolf Meyer -> emphasized how most mental disorders represented personality reactions
to psychological, social, and biological factors
• Sigmund Freud -> general underlying processes rather than outward symptoms
- Unreliable diagnostic tool, but rst tool to focus on clinical use
- 10 categories for psychoses and psychoneuroses
- 7 categories for disorders of character, behaviour, and intelligence
Diagnostic and Statistical Manual for Mental Disorders (DSM-2) 1968
- 193 personality disturbances
- Based in psychoanalytic theory
- Unreliable diagnostic tool:
• Didn’t pay a lot of attention to symptoms of some conditions, much more general in their
outlook
- Eliminated the term reaction, but kept the term neurosis
- Increased attention to children and adolescents not seen in pervious version
- Diagnosis of homosexuality renamed “sexual orientation disturbance”
Diagnostic and Statistical Manual for Mental Disorders (DSM-3) 1980
- 228 mental disorders
- Becoming more symptom-based (multiaxial)
- Why?
• Research psychiatrists
- Consistent diagnostic criteria across di erent clinicians
• Pharmaceutical industry
- Products originally marketed for general conditions, nit particular diagnoses
- This changed in the 1970s with the FDA (US regulation board) could no longer
advertise their products for the “stress free life” (common marketing technique)
• Needed to prove e ectiveness with particular conditions (concrete, measurable)
• Third-party healthy insurance
- In the 50’s, most patients paid out of pocket for
therapists
- Included explicit diagnostic criteria
• Goal: standardized diagnostic reliability (better
treatment, randomized clinical trials became easier)
- Becoming multiaxial
• Multiaxial: a system/method of evaluation, grounded
in the biopsychosoical model of assessment that
considers multiple factors in mental health diagnoses
- Responsible for the shift to biological psychiatry
Medical Model
- Research psychiatry + pharmaceuticals + insurance
• Needed measurable kinds of conditions (not found in the DSM 1 and 2)

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- Some disorders may not be a disease
• ex. managing alcoholism involves controlling your own behaviour. Can you do that with
cancer?

Diagnostic and Statistical Manual for Mental Disorders (DSM-3-R) 1987

- 253 diagnoses
• The inclusion of social anxiety disorder
• Addition of sleep disorders
- Categories renamed, reorganized, and signi cant changes in criteria were made
- DSM-3 revised due to inconsistencies in the system, diagnostic criteria in DMS-3 unclear
DMS-3 to DMS-3-TR
DSM-3 DMS-3-TR

Attention De cit Disorder with Hyperactivity Attention-De cit-Hyperactivity Disorder

Paranoid Disorders Delusional Disorders

Compulsive Personality Disorder Obsessive Compulsive Personality Disorder

Ego-Dystonic Sexuality Sexual Disorder not Other Speci ed

Diagnostic and Statistical Manual for Mental Disorders (DSM-IV) 1994

- 383 diagnoses
- Clinical signi cance criterion
• Categorizes disorders into “classes” (group similar disorders)
• “Aspergers Syndrome” eliminated and merged with “Autism Spectrum Disorder)
- Still multiaxial
Diagnostic and Statistical Manual for Mental Disorders (DSM-IV-TR) 2000
- 383 diagnoses
- Improvement in diagnostic descriptions
- Heavily research based
Diagnostic and Statistical Manual for Mental Disorders (DSM-V) 2013
- 541 diagnoses
- Advances in biology and neuroscience, reclassi cation of disorders
- No longer multiaxial, no more GAF (general, assessment of function, or axis V)
DSM-IV-TR to DSM-V
DSM-IV-TR DMS-V

Substance-Related Disorders Substance-Related and Addictive Disorders*

Mood Disorders Bipolar and Related Disorders

Depressive Disorders

Sexual and Gender Identity Disorders Sexual Dysfunctions

Gender Dysphoria*
Paraphillic Disorders

Sleep Disorders Sleep-Wake Disorders

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Interrater Reliability for the DSM-V
- Criteria covers a wide range of illness severity
Diagnostic and Statistical Manual for Mental Disorders (DSM-V-TR) 2022
- Identi ed out-of-date information in the DSM-V
- Clari ed certain diagnostic criteria
- Ensured appropriate attention to risk factors
• Racism, discrimination
History of the DSM - Brief Recap

Problems with the DSM

- Takes a categorical approach (very black/white)
• Doesn’t capture severity of the disorder
• Misleading in that there is a distinct “cut-o ” between absence and presence of a disorder
• Refers on social consensus of what constitutes a disorder
- We know comorobidities exist -> people seldom t precisely into particular categories
Other Diagnostic Manuals
- International Statistical Classi cation of Diseases and Related Health Problems (ICD)
- Psychodynamic Diagnostic Manual (PDM)
- Research Domain Criteria (RDoC)
• 2010-> US National Institute of Mental Health (NIMH) proposed a new way of classifying/
understanding psychological disorders based on a dimensional approach
• A method that de nes basic aspects of functioning and considers them across multiple
levels of analysis, from genes to brain systems to behaviour
- Internal/external models of disorders
- Hierarchical Taxonomy of Psychopathology (HiTOP)
Classifying Disorders
- Internal vs external disorders
• Internalizing disorders: characterized by negative emotions; can be divided into broad
categories that re ect the emotions of distress and fear
- ex. major depressive disorder, generalized anxiety disorder, panic disorder
- Tend to be more prevalent in individuals identifying as women
• Externalizing disorders: characterized by impulsive or out-of-control behaviour
- ex. alcoholism, conduct disorders, antisocial personality disorder
- Tend to be more prevalent in individuals identifying as men
- Gender di erences likely due to di erences in cultural norms/expectations
- But some psychological disorders not based on cultural norms

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PSYC 1020 Psychological Disorders (Chapter 14)
Psychological Disorders Can Di er Based on Culture and Genetics

What is the Role of Culture in Psychological Disorders?

- Cultural concepts of distress: a pattern of mental illness, distress, and/or symptoms that is
unique to a speci c ethnic or cultural population and does not conform to standard
classi cations of psychiatric disorders
- Some “abnormal” behaviours are not culturally speci c*
• eg. Schizophrenia, bipolar disorder, panic disorder -> stronger biological bases \
- These disorders may have di erent names in di erent cultures
Examples of Culturally Bound Disorders
- Koro: an episode of sudden and intense anxiety that the genitals will recede into the body
and possibly cause death
• Chinese, Malaysian, and Indonesian cultures
- Amok Syndrome: a period of brooding followed by a sudden outburst of indiscriminate
murderous frenzy, sometimes provoked by an insult, jealously, or sense of desperation
• Brunei, Singapore, Malaysia, Indonesia, Phillippines, Timor-Leste cultures
- Ghost sickness: begins following the passing of loved one and includes symptoms of
lethargy, nightmares, and feelings of dread and impending doom
• Navajo, Muscogee/Creek cultures
Are All Psychological Disorders Culturally Bound?
NO!

The Diathesis-stress Model

- Diathesis-stress model: a diagnostic model proposing that a
disorder may develop when an underlying vulnerability is coupled
with a precipitating event

Biological Factors
- Genetics -> identi ed via twin and adoption studies
• ex. depression (inherited gene associated with depression +
traumatic/adverse life event)
• Reminds us of the role of nature and nurture
- Reminds us that single explanations of behaviour (nature or nurture, environment or genetics)
is rarely enough for understanding psychological disorders

Situational Factors
- Thoughts/emotions shaped by environments can in uence behaviour
- Family systems model: a diagnostic model that considers problems within an individual as
indicating problems within the family
• Problems that arise within an individual are manifestations of problems within the family
• Developing a pro le of an individual’s family interactions:
- Can help identify factors that may be contributing to the disorder
- Can help determine the course of treatment
- Can determine whether the family would be supportive or not of the treatment
- Sociocultural model: a diagnostic model that views psychopathology as the result of the
interaction between individuals and their cultures
• ex. rates of schizophrenia seem to be higher in individuals with lower SES
• May result due to di erences in expectations, norms, and opportunities among classes
- Health disparities?
- Eccentric behaviour among the elite = amusing and more tolerated

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Cognitive-behavioural Factors
- Cognitive-behavioural approach: a diagnostic model that views psychopathology as the
result of learned, maladaptive thoughts and beliefs
• Thoughts can become disordered and produce maladaptive thoughts and beliefs
• Because they are learned, they can be unlearned through treatment
- Individuals can be made aware of thought processes that can lead to maladaptive
emotions/behaviours, and can learn to condition new responses to the problematic
thoughts/stimuli

Cultural Syndromes
- Most psychological disorders = universal + culture-speci c symptoms
• Depression -> major mental health problem around the world, but the way it manifests can
vary by culture
- There is a need for clinicians to understand the cultural context, so they can include
culturally appropriate treatments in the patients treatment plan

Universal vs Culture-speci c
- Some disorders are more in uenced by culture
- And other disorders are more in uenced by genetics (and not gender-based)
• eg. Schizophrenia, bipolar disorder

PSYC 1020 Psychological Disorders (Chapter 14)

Psychological Disorders

Recall..
- Psychopathology: sickness or disorder of the mind; psychological disorder
• Patterns of deviant and dysfunctional behaviours, thoughts, and/or feelings that cause
signi cant distress, and may even be dangerous, and last for a speci c amount of time

Patterns Underlying Psychopathology

- Onset: the chronological age or situational period when the symptoms of a disorder rst
appear in an individual
• eg. when does it actually start?
- Prognosis: the likely course of (trajectory, development) of a disorder
• eg. what will happen next? When will the disorder go into remission?
- Risk factors: a set of biological, psychological, and social characteristics that increase the
likelihood of having the disorder
- Etiology: the biological, psychological, and/or social causes of a disorder
• eg. what causes the disorder? What makes one individual more likely to have the disorder
than another individual?
- Comorbidities: other psychological or physical disorders that frequency co-occur with the
disorder in question
• eg. what other disorders often appear with this one?
Anxiety Disorders
- Fear and anxiety are adaptive reactions to threats
- It is typical to be fearful of a hungry lion, or anxious about an upcoming exam
- Normal reactions to environmental stressor
- However, anxiety that interferes with normal functioning is maladaptive
- Anxiety Disorders: psychological disorders characterized by excessive fear and anxiety in
the absence of true danger

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- Very common -> about 30% of people in Canada will experience one, although only about
5% of people are ever diagnosed

Types of Anxiety Disorders

- Speci c phobia
• Phobia: fear of a speci c object or situation
• Phobic disorder: disorder characterized by marked, persistent, excessive fear of speci c
objects, activities or situations
- Diagnosed with a speci c phobia disorder based on the object of fear
- Speci c phobia (12% prevalence)
• Animals (eg. dogs, cats, spiders)
• Natural environments (eg. earthquakes, darkness)
• Situations (eg. elevators, enclosed spaces)
• Medical events (eg. blood, injections)
• Other (eg. loud noises, costumed characters)
- Social phobia: maladaptive fear of being publicly humiliated or embarrassed (13%
prevalence)
• Usually, the person recognizes the irrationality of their fear, but cannot control it
• eg. Agoraphobia: an anxiety disorder marked by fear of being in situations in which
escape may be di cult or impossible
- The fear of situations where escape might be di cult or help unavailable in case of a
panic attack or other embarrassing or incapacitating symptoms
- Social anxiety disorder
• Social anxiety disorder/social phobia: a fear of being negatively evaluated by others
• About 8%-13% of the population experience social anxiety disorder at some point in their
life
• Typically develops during puberty
• The more social fears a person has, the more likely they are to develop other disorders (ie.
depression, substance abuse problems)
- Generalized anxiety disorder
• Generalized anxiety disorder: a di use state of constant anxiety not associated with any
speci c object or event
- Worries are not focused on any speci c threat
• Onset rarely occurs prior to adolescence
- Median age for diagnosis (DSM) is 30 years old
- Many patients report having symptoms for a long time before reporting them
• In the population, the level of anxiety is constant throughout the lifespan
- Content of worries and changes
• For individuals, severity of symptoms waxes and wanes across the lifespan
• Full remission is rare
- Panic Disorder
• Panic Disorder: sudden occurrence of multiple psychological and physical symptoms
typically associated with terror
- Shortness of breath
- Heart palpitations
- Sweating
- Dizziness
- Derealization (feeling that the world is unreal)
- Fear of death/“losing one’s mind”
• Panic disorders are relatively common
- About ⅓ of Canadians experience a panic attack once or more per year
• Typically, during extreme stress
• These occasional panic episodes are not su cient for a diagnosis

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- To be diagnoses, an individual must experience
• Recurrent, unexpected attacks
• Signi cant fear of another attack
Why are Phobic Disorders so Common?
- Biological preparedness -> we may be evolutionarily adapted to fear certain types of stimuli
• Evidence for this hypothesis comes from conditioning
- Monkeys can be easily conditioned to fear snakes, but not owers
• These fears may be overdeveloped in some individuals

Mood Disorders
- Mood: longer-lasting (than emotions), less intense (than emotions) states that are not
a ected by a speci c object or event
- Mood disorders are some of the most well-known psychological disorders
• Mental disorders that have mood disturbance as their prominent feature
- Manic episode: a distinct period of high energy and increased activity
- Depressive episode: a distinct period of sad mood and loss of intrest or pleasure
Types of Mood Disorders
- Present in 22% of the female Canadian population and 14% of the male Canadian
population
• Hormonal di erences
• Di erent coping strategies
- About 1 in 12 Canadians will experience major depression in their lives
Major Depressive Disorder
- Major depressive disorder: a disorder characterized by severe negative moods or lack of
intrest in normally pleasurable activities
• The most well-known depressive disorder
• Onset -> may appear at any age, but is most likely to appear in the mid-20s
• Prognosis:
- ⅖ of individuals recover within 3 months
- ⅘ of individuals recover within 1 year
- ⅕ of individuals do not experience remission
• Risk factors
- Temperamental (particularly neuroticism, or negative a ect)
- Environmental (childhood experiences, stressful life events)
- Biological (neurotransmitter imbalance)
- Genetic (family members with MDD are 2-4 times more likely to be diagnosed with MDD
[40% heritability])
• Comorbidity
- Substance-related disorders, panic disorders, obsessive-compulsive disorder, anorexia
nervosa, bulimia nervosa
• Its not the content of things we think about that causes depression, but the way we think
about things
• Do SSRI’s help depression?
- Evidence is unclear
• Learned helplessness: a cognitive model of depression
in which people feel unable to control events int tier
lives
- Attribute failures to internal characteristics
- Believe failures are permanent (stable)
- Believe failures are global (apply too many areas of

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life)
• Sometimes depression lasts for a long time
• Moderate depressive symptoms that last for more than 2 years are referred to as
dysthymia or dysthymic disorder
- When dysthymia is punctuated by episodes of major depression, it is called double
depression

Bipolar Disorder
- Mood disorders are not always unipolar
- Bipolar disorders: characterized by cycles of abnormal, persistent high mood (mania) and
low mood (depression)
- Bipolar I Disorder: a disorder characterized by extremely elevated moods during manic
episodes and, frequently, depressive episodes as well
• Prevalence
- 1 in 40 individuals
- No di erent between men and women (1:1)
• Onset
- Mean age of rst episode = 18 years
• Onset can also occur for the rst time in the 60s and 70s
• Prognosis
- 90% of individuals who experience a manic episode will experience more of them
throughout life
- Full remission is very rare
• Risk factors
- Genetic (among the most heritable disorders; coincidence among identical twins =
40-70%
- Environmental (high stress, highly emotionally expressive family members, separation/
divorce)
- Psychological (high neuroticism, high conscientiousness)
• Comorbidity
- Anxiety disorders
- Substance use disorders
- Attention de cit hyperactivity disorder (ADHD)
- Behavioural disorders
- Bipolar II Disorder: a disorder characterized by alternating periods of extremely depressed
and mildly elevated moods

Obsessive-Compulsive and Related Disorders

- Obsessions: recurrent, unwanted, and intrusive thoughts, fears, urges, or images
• eg. fear of germs
- Compositions: behaviours in response to obsession
• eg. repetitive hand washing
- Obsessive-Compulsive Disorder (OCD): a disorder characterized by frequent intrusive
thoughts and compulsive actions
• Not all people with OCD engage in compulsions
• Pure obsession: obsessive thoughts that are not accompanied by an associated behaviour
• Prevalence
- 1 in 100 individuals
• Onset
- Mean age of onset = 15 years
- Slightly more common in women than in men
• Prognosis
- Generally treatable with the right treatment

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• Risk factors
- Learned behaviours (classical and operant conditioning)
- Partly genetic
- Infections (autoimmune response)
• Comorbidities
- Mood disorders
- Bipolar disorders
- Anxiety disorders
- Alcohol dependence
Hoarding Disorder
- Type of Obsessive-Compulsive Disorder
- Di culty in getting rid of useless possessions
- Results in excessive accumulation of items
- Areas in living space become unusable and hazardous
Trauma and Stress Related Disorders
- Trauma: a prolonged psychological and physiological response to a distressing event, often
one that profoundly violates the person’s beliefs about the world
• Not every encounter with a distressing event is traumatic
• Trauma is de ned by the subjective response, not the even itself
- Stress: a type of response that typically involves an unpleasant state, such as anxiety or
tension
- Trauma di ers from stress in the way the events are remembered and relived
Post-Traumatic Stress Disorder (PTSD)
- PTSD: A disorder that involves frequent nightmares, intrusive thoughts, and ashbacks
related to an earlier trauma
- Prevalence
• Around 7% of the population, and are common in women
- Prognosis
• Lasts about 6 years without treatment
• With treatment, about 30% of people recover completely
- Risk factors
• Poor social support
• Negative outlook (in general) before the trauma
• Experiencing other psychiatric disorders or substance abuse
- Comorbidities
• Mood disorders
• Substance Use disorders
• Anxiety disorders
Dissociative Disorders
- Dissociative Disorders: disorders that involve disruption of identity, of memory, or of
conscious awareness
- Thought to be functional response to an extremely distressing or traumatic event
- Serve a self-protective purpose by splitting the event o from the rest of the persons life/
identity
- Most people who experience these disorders report being severely abused as children
- Types
• Dissociative Amnesia: A person forgets that an event happened or loses awareness of a
substantial block of time
• Dissociative fugue: rare and extreme; a complete loss of identity

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Borderline Personality Disorder
- Borderline Personality Disorder: a personality disorder characterized by disturbances in
identity, in a ect, and in impulse control
- Associated with interpersonal trauma in childhood
- Could be considered a form on complex PTSD
- Prevalence:
• 1-2% of adults
• Twice as common in women than in men
- Characterized by:
• Relational instability: trouble having relationships
• Emotional instability
• Impulsivity
- Intense emotions that change quickly
- Thinking in absolutes of all good or bad
Antisocial Personality Disorder
- Antisocial Personality Disorder: a personality disorder in which people engage in socially
undesirable behaviour, are hedonistic and impulsive, and lack of empathy
• Also, distinctly low arousal (trilling-seeking behaviour becomes common)
- Occurs on the same continuum as psychopathy
- Prevalence:
• 1-4% of the population
• Much more common in men than in women
Schizophrenia
- Schizophrenia: A psychological disorder characterized by alterations in thoughts, in
perceptions, or in consciousness, resulting in psychosis
• Characterized by combination of motor, cognitive, behavioural, and perceptual
abnormalities
- Symptoms can be classi ed into positive or negative symptoms
• Positive symptoms: features that are present in schizophrenia but not in normal
behaviour
- Delusion: false beliefs based on incorrect inferences about reality
- Hallucinations: false sensory perceptions that are experienced without an external
source
• Auditory, visual, olfactory, somatosensory
- Disorganized speech: incorrect speech patterns that involve frequently changing topics
and saying strange or inappropriate things
- Disorganized/catatonic behaviour: acting in strange or unusual ways, including strange
movement of limbs, bizarre speech, and inappropriate self-care (ex. failing to dress
appropriately or bathe)
• Negative symptoms: symptoms of schizophrenia that are marked by de cits in
functioning, such as apathy, lack of emotion, slowed speech/movement
- Prevalence
• 1 in 200 people
• Similar rates for men and women
- Onset
• 18 - 20 years of age
• Early adulthood
- Risk factors
• Mostly genetics
• Reduction in brain tissue and enlarged ventricles

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• Some environmental in uence (cannabis in adolescence, dysfunctional families, urban
living)
- Prognosis
• Full remission is rare (about 15% of individuals fully recover)
Substance - Related Disorders
- Substance related disorders: lead to physiological dependence (withdrawal) and tolerance
• Withdrawal: a physiological and psychological state characterized by feelings of anxiety,
tension, and cravings for the addictive substances
• Tolerance: a person needs to consume more of a particular substance to achieve the
same subjective e ects
- Addiction: a behavioural disorder (to be speci ed substance) where use of substance
continues despite negative consequences and a desire to quit
• Alcohol use disorder, cannabis use disorder, opioid use disorder
- Prevalence
• 8-10% of people aged 12 or older are addicted to alcohol/other drugs
- Onset
• Typically seen from age 12 into adulthood
- Risk factors
• Genetic component (lots of people dabble in illicit substances and dont become addicted)
• Environment components (ex. Vietnam veterans)
- Prognosis
• Lifelong disease, but recovery is possible
- Gambling Disorder: repeatedly placing bets to risk some money and gain even more
• Chasing a feeling of euphoria
• Considered a behavioural addiction
Eating Disorders
- A ect all types of people
• More frequently diagnosed in women (cultural norms?)
- Three most common eating disorders
• Anorexia nervosa: excessive fear of becoming fat and severely restricting how much they
eat
- Most often begins in early adolescence
• Boys and girls are equally likely to develop anorexia
- Self-imposed starvation
- Treatment almost always requires medial intervention
• Bulimia nervosa: a disorder characterized by the alternation of dieting, binge eating, and
purging or other harmful compensatory behaviours
- Abusing laxatives, exercising compulsively
- Often develops during late adolescence
• Ouch more frequency diagnosed in women than in men
- Often associated with dental and cardiac disorders
• Binge-eating disorder: an eating disorder characterized by binge eating, causing
signi cant distress
- At least once a week, and no purging follows the binge
- Distinct from anorexia nervosa and bulimia nervosa
Bases of Eating Disorders
- Genetic component + environmental factors
• When people have genetic predispositions for eating disorders, they tend to develop the
disorders if they live in societies with an abundance of food
- Cultural variations

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• Particularly in the incidence of bulimia
PSYC 1020 Psychological Disorders (Chapter 14)
Childhood Psychological Disorders

Autism Spectrum Disorders

- Autism Disorder: characterized by impaired communication, restricted interests, and
de cits in social interaction
- varies considerably in severity
- ~1-2% of children have a disorder along the autism spectrum
• Usually diagnosed during childhood, but the disorder is lifelong
- Boys are 5 times more likely to be diagnosed than girls
- Two essential features
• Impaires in social interactions
- Verbal and/or non verbal communication
• Restrictive or receptive behaviours, interests, or activities
Bases of Autism Spectrum Disorder
- ASD is the result of biological factors
• Evidence of a strong genetic component
- In identical twins -> if one is diagnosed with ASD, the other twin has a 70-90% chance
of being diagnosed
• Gene mutations
- Cause cells to have an abnormal copy of DNA segments which can a ect the way
neural networks are formed during childhood development
- Exposure to teratogens or pathogens that a ect brain development
- Presence of infections and certain immune cells in the womb can increase likelihood of
development of ASD
- Prenatal and/or early childhood events that may disrupt brain function
- Brains of children with autism grow unusually large in rst few months of life, than growth
slows until age 5
- Brains do not develop normally during adolescence
• Atypical connections in regions underlying environmental exibility
Could ASD Be Related to Other Biological Disorders?
- It is likely that autism and schizophrenia share several genetic mutations
- Similar symptoms:
• Social impairment, avoidance of eye contact
What we Do Know For Sure…
- Vaccines do not cause autism
- We know that babies receive vaccinations around the same time that behaviours with ASD
begin to emerge
- But.. We also know that correlation does not equal causation
- Where did this idea come from?
• A very fraudulent study, including falsifying medical records and nancial con icts of
interest

Attention-De cit/Hyperactivity Disorder

- Attention-De cit/Hyperactivity Disorder: a disorder characterized by restlessness,
inattentiveness, and impulsivity
- In order to receive a diagnosis of ADHD (according to the DSM5):
• Need 6 or more symptoms of inattention

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• Need 6 or more symptoms of hyperactivity or impulsiveness
• These symptoms need to last of at least 6 months
• These symptoms need to interfere with functioning or development
• These symptoms must be present before the age of 12 years
• These symptoms must occur in multiple settings

Why are ADHD Diagnoses Most Common Among White Boys?

- Stereotyped behaviour
• What are the role of cultural norms?
- WEIRD stereotypes
Bases of ADHD
- Behavioural pro les of children with ADHD vary, so the causes of the disorder likely vary as
well
- Some factors that could play a role
• Environmental
- Disorganized/inconsistent parenting
- Social disadvantage
• Genetic
• Developmental
- Reduced metabolism in brain regions involved in self-regulation of motor functions and
of attentional systems
- Reduced volume in brain regions involving attention, cognitive and motor control,
emotional regulation, and motivation
- Potential delay in the maturation of basal ganglia

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