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Understand mental disorders, their classification, etiology, and clinical presentations.
A flowchart showing how predisposition and environment interact to produce a disorder.
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Psychopathology is the scientific study of mental disorders, including their classification, causes, symptoms, and treatment. Understanding psychopathology requires knowledge of normal psychological functioning, the criteria for defining abnormality, and the biological, psychological, and social factors contributing to mental illness.
Criteria for Abnormality:
Statistical Infrequency: Behaviors that are rare in the population. Limitation: Some rare behaviors are desirable (genius).
Violation of Norms: Behavior that deviates from social or cultural expectations. Limitation: Norms vary across cultures and time.
Personal Distress: Subjective suffering or unhappiness. Limitation: Some disorders involve lack of insight; some distress is adaptive.
Maladaptiveness: Behavior interferes with functioning. Most useful criterion but still requires judgment.
The Four Ds: - Deviance: Different from cultural norms - Distress: Causes suffering - Dysfunction: Impairs daily functioning - Danger: Risk of harm to self or others
Dimensional vs. Categorical Approaches: Mental disorders may exist on continua with normal functioning rather than as discrete categories.
DSM-5-TR (Diagnostic and Statistical Manual of Mental Disorders): - Published by American Psychiatric Association - Standard classification in North America - Categorical system with diagnostic criteria - Includes specifiers for severity and course - Organized by disorder categories
ICD-11 (International Classification of Diseases): - Published by World Health Organization - Global standard for health statistics - Chapter 06 covers mental disorders - Greater cross-cultural applicability
Key Changes in DSM-5: - Eliminated multiaxial system - Reorganized disorder categories - Added dimensional assessments - New disorders added (e.g., Disruptive Mood Dysregulation) - Bereavement exclusion removed from depression
Major Depressive Disorder: - Five or more symptoms for 2+ weeks - Depressed mood or loss of interest/pleasure required - Other symptoms: weight changes, sleep disturbance, fatigue, worthlessness, concentration problems, suicidal ideation - Significant distress or impairment
Persistent Depressive Disorder (Dysthymia): - Depressed mood most days for 2+ years - Less severe but chronic
Bipolar I Disorder: - At least one manic episode (elevated mood, decreased sleep, grandiosity, racing thoughts, impulsivity) - Depressive episodes common but not required
Bipolar II Disorder: - Hypomanic episodes (less severe than mania) - Major depressive episodes
Cyclothymic Disorder: - Chronic mood fluctuations - Hypomanic and depressive symptoms (2+ years)
Etiology: Genetic factors, neurotransmitter dysregulation (serotonin, norepinephrine, dopamine), HPA axis dysfunction, cognitive factors (negative schemas, rumination), life stress.
Generalized Anxiety Disorder (GAD): - Excessive worry about multiple domains - Difficulty controlling worry - Physical symptoms (restlessness, fatigue, concentration problems, irritability, muscle tension, sleep disturbance)
Panic Disorder: - Recurrent unexpected panic attacks - Worry about future attacks or maladaptive behavior changes - Panic attacks: Intense fear with physical symptoms (palpitations, sweating, trembling, shortness of breath)
Specific Phobia: - Marked fear of specific objects or situations - Avoidance or intense distress - Types: Animal, natural environment, blood-injection-injury, situational, other
Social Anxiety Disorder: - Fear of social situations where scrutiny is possible - Fear of acting in embarrassing ways - Avoidance or intense anxiety
Agoraphobia: - Fear of situations where escape might be difficult - Two or more: public transportation, open spaces, enclosed spaces, crowds, being outside alone
Schizophrenia: - Two or more of the following for 1+ month (at least one from 1-3): 1. Delusions (fixed false beliefs) 2. Hallucinations (perceptions without external stimuli) 3. Disorganized speech 4. Grossly disorganized or catatonic behavior 5. Negative symptoms (diminished expression, avolition) - Continuous signs for 6+ months - Significant impairment
Positive Symptoms: Excesses (delusions, hallucinations) Negative Symptoms: Deficits (flat affect, alogia, anhedonia, avolition) Cognitive Symptoms: Attention, memory, executive function deficits
Related Disorders: - Schizoaffective Disorder: Mood episode concurrent with schizophrenia symptoms - Brief Psychotic Disorder: Duration 1 day to 1 month - Schizophreniform Disorder: Duration 1-6 months
Etiology: Genetic vulnerability, dopamine hypothesis, neurodevelopmental factors, environmental factors (urban birth, migration, cannabis use)
Definition: Enduring patterns of inner experience and behavior that deviate markedly from cultural expectations, are pervasive and inflexible, begin in adolescence or early adulthood, and cause distress or impairment.
Cluster A (Odd/Eccentric): - Paranoid: Distrust and suspiciousness - Schizoid: Detachment from social relationships - Schizotypal: Discomfort with close relationships, cognitive distortions
Cluster B (Dramatic/Emotional): - Antisocial: Disregard for rights of others - Borderline: Instability in relationships, self-image, emotions; impulsivity - Histrionic: Excessive emotionality and attention-seeking - Narcissistic: Grandiosity, need for admiration, lack of empathy
Cluster C (Anxious/Fearful): - Avoidant: Social inhibition, feelings of inadequacy, hypersensitivity - Dependent: Excessive need to be taken care of - Obsessive-Compulsive PD: Preoccupation with orderliness, perfectionism, control
Alternative Model (DSM-5 Section III): Dimensional approach assessing personality functioning and pathological traits.
Apply your knowledge of psychological assessment by practicing with these educational simulations. These tools are designed for psychology students to learn about test structure, scoring, and interpretation.
Comparison of the two major classification systems for mental disorders.
| DSM-5-TR | ICD-11 | |
|---|---|---|
| Publisher | American Psychiatric Association (APA) | World Health Organization (WHO) |
| Primary Use | Clinical diagnosis in North America | Global health statistics and clinical use |
| Scope | Mental disorders only | All medical and mental disorders |
4 questions to test your understanding of this topic
American Psychiatric Association (2022). Diagnostic and Statistical Manual of Mental Disorders (5th ed., text rev.). American Psychiatric Publishing.
Barlow, D. H., & Durand, V. M. (2021). Abnormal Psychology: An Integrative Approach. Cengage Learning (9th ed.).
Kring, A. M., & Johnson, S. L. (2021). Abnormal Psychology: The Science and Treatment of Psychological Disorders. Wiley (14th ed.).
Nolen-Hoeksema, S. (2020). Abnormal Psychology. McGraw-Hill (8th ed.).
Comer, R. J., & Comer, J. S. (2021). Fundamentals of Abnormal Psychology. Worth Publishers (10th ed.).
Insel, T. R., et al. (2010). Research Domain Criteria (RDoC): Toward a New Classification Framework for Research on Mental Disorders. American Journal of Psychiatry, 167(7), 748-751.
Beck, A. T., & Bredemeier, K. (2016). A Unified Model of Depression: Integrating Clinical, Cognitive, Biological, and Evolutionary Perspectives. Clinical Psychological Science, 4(4), 596-619.
Craske, M. G., et al. (2017). Anxiety Disorders. Nature Reviews Disease Primers, 3, 17024.
Howes, O. D., & Murray, R. M. (2014). Schizophrenia: An Integrated Sociodevelopmental-Cognitive Model. The Lancet, 383(9929), 1677-1687.
Skodol, A. E., et al. (2011). Personality Disorder Types Proposed for DSM-5. Journal of Personality Disorders, 25(2), 136-169.
