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DSM-V reviewer (Part 1)
BS Psychology (Cavite State University)
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Understanding Psychopathology
I. Psychological Disorder
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or a problematic abnormal behavior
A psychological dysfunction within an
individual that is associated with
distress or impairment in functioning
and a response that is not typical or
culturally expected.
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Breakdown in cognitive, emotional,
or behavioral functioning
Knowing the borderline between
normal and abnormal dysfunction is
often difficult
Continuum or dimension is
considered rather what categories are
present or absent
Just having dysfunction is not
enough to meet the criteria for a
psychological disorder
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Behavior must be associated with
distress to be classified as a disorder
This criterion does not define
problematic abnormal behavior; it is
often quite normal to be distressed.
Distress and suffering are a natural
part of life and do not in themselves
constitute a psychological disorder.
There are also psychological
disorders, by definition, suffering
and distress are absent.
Defining psychological disorder by
distress alone doesn’t work, although
the concept of distress contributes to
a good definition.
Useful but not entirely satisfactory
Being shy or lazy is different from
impaired social functioning.
Most psychological disorders are
simple extreme expressions of
otherwise normal emotions,
behaviors, and cognitive processes.
Atypical
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Distress
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Psychological Dysfunction
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Important but also insufficient by
itself
Sometimes, one considered abnormal
because it occurs infrequently that
deviates from the average.
The greater the deviation; the more
abnormal it is.
Many are far from the average in
their behavior but few would be
considered disordered.
Some of them are talented or
eccentric, such as artists, movie stars
and athletes.
We accept extreme behaviors by
entertainers, such as Lady Gaga,
that would not be tolerated in other
members of our society
Not culturally expected
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Violating social norms, even if a
number of people are sympathetic to
your point of view
Useful in considering important
cultural difference in psychological
disorders.
Some religious behaviors may seem
unusual to us but are culturally or
individually appropriate.
A social standard of normal has been
misused.
Impairment
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Harmful dysfunction; useful to
determine whether the behavior is
out of individual’s control or
something the person doesn’t want to
do.
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(2) associated with distress or impairment in
functioning and
(3) a response that is not typical or culturally
expected.
Accepted Definition
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(1) a psychological dysfunction within an
individual that is
Psychological disorder describes
behavioral, 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,
pair, or impairment.
This definition can be useful across
cultures and subcultures if we pay
careful attention to what is functional
or dysfunctional (or out of control) in
a given society.
Never easy to decide what represents
dysfunction.
Consider how the apparent disease or
disorder matches a “typical” profile
of a disorder.
Typical profile is called prototype.
Prototypes are used for the diagnosis
in DSM-5. All diagnostic criteria in
DSM-5 are all prototypes.
Patient may have only some features
or symptoms of the disorder
(minimum number) and still meet the
criteria for the disorder because the
set of symptoms are close to the
prototype.
DSM-5, compare to DSM-IV, has the
additional dimensional estimation of
the severity of specific disorders.
Summary: A psychological disorder is
All three basic criteria must be met; no one
criterion alone has yet been identified that
defines the essence of abnormality.
II. The Science of Psychopathology
Psychopathology
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Scientific study of psychological
disorders
In this field are specially trained
professionals, including clinical and
counseling psychologists,
psychiatrists, psychiatric social
workers, and psychiatric nurses, as
well as marriage and family
therapists and mental health
counselors.
Clinical psychologists and
counseling psychologists receive the
Ph.D, doctor of philosophy, degree
Psychiatrists first earn an M.D.
degree in medical school and then
specialize in psychiatry during
residency training that lasts 3 to 4
years.
Psychiatrists investigate the nature
and causes of psychological
disorders, from biological point of
view, and make diagnoses and offer
treatments.
Psychiatrists emphasizes drugs or
other biological treatments.
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Psychiatric social workers typically
earn a master’s degree in social work
as they develop expertise in
collecting information relevant to the
social and family situation of the
individual with a psychological
disorder.
Social workers also treat disorders,
often concentrating on family
problems associated with them.
Psychiatric nurses have advanced
degrees, such as a master’s or even a
Ph.D., and specialize in the care of
the treatment of patients with
psychological disorders, usually in
hospitals as a part of a treatment
team.
Marriage and family therapist and
mental health counselors typically
spend 1 to 2 years earning a master’s
degree and are employed to provide
clinical services by hospitals or
clinics, usually under the supervision
of doctoral-level clinician.
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Summary:
The field of psychopathology is concerned with
the scientific study of psychological disorders.
Trained mental health professionals range from
clinical and counseling psychologists to
psychiatrists and psychiatric social workers and
nurses. Each profession requires a specific type
of training.
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The Scientist-practitioner
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Many mental health professionals
take a scientific approach to their
clinical work and therefore are called
scientist-practitioners
Mental health practitioners may
function as scientist-practitioner in
one or more of three ways:
1. Consumer of science – They
kept up with the latest scientific
developments in their field and
use the most current diagnostic
and treatment procedures. They
are the consumers of science of
psychopathology to the
advantage of their patients.
2. Evaluator of science – Evaluate
their own assessments or
treatment procedures to see
whether they work. They are
accountable not only to their
patients but also to the
government agencies and
insurance companies that pay for
the treatment so they must
demonstrate clearly whether their
treatments are effective or not.
3. Creator of Science – They might
conduct research, often in clinics
or hospitals that produces new
information about disorders or
their treatment, thus becoming
immune to the fads that plague
our field. Without scientific data,
practitioner would not use the
procedure.
Such data flow from research that
attempts three basic things: to
describe psychological disorders, to
determine their causes, and to treat
them
Summary:
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Using scientific methods, mental health
professionals can function as scientist
practitioners. They not only keep up with the
latest findings but also use scientific data to
evaluate their own work, and they often conduct
research within their clinics or hospitals.
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Clinical Description
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In hospitals and clinics, we often say
that a patient “presents” with a
specific problem or set of problems
or we discuss the presenting
problem.
Presents is a traditional shorthand
way of indicating why the person
came to the clinic.
Presenting problem is the first step
in determining clinical description.
Clinical description represents the
unique combination of behaviors,
thoughts, and feelings that make up a
specific disorder.
Clinical refers both to the types of
problems or disorders that you would
find in a clinic or hospital and to the
activities connected with assessment
and treatment.
One important function of clinical
description is to specify what makes
the disorder different from normal
behavior or from other disorders.
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Statistical data may also be relevant
Prevalence – how many of the
people in the population as a whole
have the disorder?
Prevalence represents the incidence
of the disorders.
Incidence – The number of new
occurrences of a particular disease in
the population over a period of time
Also includes sex ratio - percentage
between male and female-, and
typical age of onset, which often
differs from one disorder to another.
Course - Most disorders follow a
somewhat individual pattern, such
from having different symptoms, age
of onset, and possibly a different sex
ratio and prevalence.
Example:
o Schizophrenia follows a
chronic course meaning
they tend to last a long
time or even lifetime.
o Other disorders like mood
disorders follow an
episodic course that is
likely to recover within a
few months only to suffer
a recurrence of the
disorder at a later time.
This pattern may repeat
throughout a person’s life.
o Other disorders may have
a time-limited course that
the disorder will improve
without treatment in a
relatively short period
with little or no risk or
recurrence.
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Differences in course of
disorders are closely related to
differences in onset.
Acute onset – begin suddenly;
Time-limited
Insidious onset - develop
gradually over an extended
period
Important to know the typical
course of disorder so that we can
know what to expect in the future
and how best to deal with the
problem.
Knowing the typical course of
the disorder is important part of
clinical description.
Prognosis – anticipated course of
a disorder. Much like an
assumption made from limited
information, without any formal
testing.
Patient’s age may also be an
important part of the clinical
description. Some psychological
disorders occur in childhood that
may present differently in
adulthood or old age.
Developmental psychology study of changes in behavior over
time
Developmental
psychopathology- study of
changes in abnormal behavior.
Life-span developmental
psychopathology - Study of
abnormal behavior across the
entire age span. The field is
relatively new but expanding
rapidly.
Causation, Treatment, and Etiology
Outcomes
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Etiology
o Study of origins.
o Why the disorder begins (what
causes it).
o Includes biological, psychological,
and social dimensions
Treatment
o Successful treatment (new drugs and
psychosocial treatment) for a
disorder may give us some hints
about the nature of the disorder and
its causes.
Psychopathology is rarely is simple.
Effect does not necessarily imply the
cause.
Example: To use a common example,
you might take an aspirin to relieve a
tension headache you developed during
a grueling day of taking exams. If you
then feel better, that does not mean that
the headache was caused by a lack of
aspirin. Nevertheless, many people seek
treatment for psychological disorders,
and treatment can provide interesting
hints about the nature of the disorder
II. Historical Conceptions of Abnormal
Behavior
Supernatural model – divinities, demons,
spirits, or other phenomena such as magnetic
fields or the moon or the stars.
Soul or the psyche – considered separate
from the body. Mind influence the body, and
body influence the mind.
Three models:
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1. Supernatural (exorcism to rid the
body of the supernatural spirits)
2. Biological (emphasize physical care
and the search for medical cures,
especially drugs.)
3. Psychological model (use
psychosocial treatments, beginning
with moral therapy and including
modern psychotherapy)
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Old but continue to be used today.
The Supernatural Tradition
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For much of our recorded history,
deviant behavior has been considered a
reflection of the battle between good and
evil.
When confronted with unexplainable,
irrational behavior and by suffering and
upheaval, people have perceived evil.
In the Great Persian Empire from 900 to
600 B.C., all physical and mental
disorders were considered the work of
the devil
I. Demons and Witches
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Last quarter of 14th century, religious and
lay authorities supported these popular
superstitions, and society as a whole
began to believe more strongly in the
existence and power of demons and
witches
Catholic Church had split, and a second
center, complete with a pope, emerged in
the south of France to compete with
Rome.
Roman Church fought back against the
evil in the world that it believed must
have been behind this heresy.
People increasingly turned to magic and
sorcery to solve their problems.
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Bizarre behavior of the people afflicted
with psychological disorders was seen as
the work of the devil and witches.
Individuals possessed by the evil spirits
were probably responsible for any
misfortune experienced by people in the
local community, which inspired drastic
action against the possessed.
Exorcism- A treatment by which various
religious rituals were performed in an
effort to rid the victim of evil spirits.
Shaving the pattern of a cross in the hair
of the victim’s head
Securing sufferers to a wall near the
front of a church so that they might
benefit from hearing Mass.
Sorcery and witches cause madness and
other evils that continued into the 15th
century
Evil continued to be blamed for
unexplainable behavior, even after the
founding of US.
Witch trials in the late 17th century,
which resulted in the hanging deaths of
20 women.
During the Middle Ages, individuals with
psychological disorders were sometimes thought
to be possessed by evil spirits and exorcisms
were attempted through rituals.
II. Stress and Melancholy
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An equally strong opinion, even
during this period, reflected the
enlightened view that insanity was a
natural phenomenon, caused by
mental or emotional stress, and that it
was curable.
Mental depression and anxiety were
recognized as illnesses, although
symptoms such as despair and
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lethargy were often identified by the
church with the sin of acedia, or
sloth.
Common treatments: Rest, sleep,
and a healthy and happy
environment.
Other treatments: Baths, ointments,
and various potions.
During 14th and 15th centuries, people
with insanity and others with
physical deformities or disabilities
were often moved form house to
house in medieval villages as
neighbors took turns caring for them.
Medieval practice of keeping people
with psychological disturbances in
their own community is beneficial.
In 14th century, Nicholas Oresme,
suggested that the disease of
melancholy (depression) was the
source of some bizarre behavior,
rather than demons.
He pointed out that much of the
evidence for the existence of sorcery
and witchcraft, particularly among
those considered insane, was
obtained from people who were
tortured and who, understandably,
confessed to anything.
Some assumed that demonic
influences were predominant
explanations of abnormal behavior
during the Middle Ages.
Some believed that the supernatural
had little or no influence.
As we see in the handling of the
severe psychological disorder
experienced by late-14th-century
King Charles VI of France, both
influences were strong, sometimes
alternating in the treatment of the
same case.
III. Treatments for possession
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Possession, is not always connected with
sin but may be seen as involuntary and
the possessed individual as blameless.
Exorcisms at least have the virtue of
being relatively painless.
They sometimes work, as do other forms
of faith healing
In Middle Ages, if exorcism failed, some
authorities thought that steps were
necessary to make the body
uninhabitable by evil spirits, and many
people were subjected to confinement,
beatings, and other forms of torture.
A creative “therapist” decided that
hanging people over a pit full of
poisonous snakes might scare the evil
spirits right out of their bodies.
Strangely, this approach sometimes
worked; most of the individuals would
suddenly come to their senses and
experience the relief form their
symptoms.
Many other treatments based on the
hypothesized therapeutic element of
shock were developed, including
dunkings in ice-cold water.
Trepanning- drilling hole on skull
IV. Mass Hysteria
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Large-scale outbreaks of bizarre
behavior
In Europe, whole groups of people were
simultaneously compelled to run out in
the streets, dance, shout, rave, and jump
around in patterns as if they were at a
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particular wild party late at night (still
called a rave today, but with music).
Saint Vitus’s Dance and tarantism
In attempt to explain the inexplicable,
several reasons were offered in addition
to possession; insect bites, and mass
hysteria.
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V. Modern Mass Hysteria
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Mass hysteria may simply demonstrate
the phenomenon of emotion contagion,
in which the experience of an emotion
seems to spread to those around us.
If someone nearby becomes frightened
or sad, chances are that, for the moment,
you also will feel fear or sadness.
People are also suggestible when they
are in states of high emotion.
Mob Psychology – If one person
identifies a “cause: of the problem,
others will probably assume that their
own reactions have the same course.
It was assumed that victims had to be in
contact with each other for the contagion
to occur.
Case of emotion contagion occurring
across social networks, raising the
possibility that episodes of mass hysteria
may increase.
The Biological Tradition
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Paracelsus, a Swiss physician rejected
notions of possession by the devil,
suggesting instead that the movements of
the moon and stars had profound effects
on people’s psychological functioning.
Important to the biological tradition are a
man, Hippocrates; a disease, syphilis;
and the early consequences of believing
that psychological disorders are
biologically caused
I. Hippocrates & Galen
Hippocrates
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VI. The Moon and the Stars
Paracelsus speculated that the
gravitational effects of the moon on
bodily fluids might be possible cause of
mental disorders.
 The influential theory inspired the
word lunatic, which is derived from
the Latin word luna, meaning moon.
 Millions of people around the world
are convinced in this.
 This belied is most noticeable today
in the followers of astrology, who
hold that their behavior and the
major events in their lives can be
predicted by their day-to-day
relationship to the position of the
planets. Although no serious
evidence has ever confirmed such a
connection.
Greek Physician
Considered the father of modern
Western medicine
Hippocratic Corpus
o Suggested that psychological
disorders could be treated like
any other disease.
o Also believed that psychological
disorders might also be caused by
brain pathology or brain trauma
and could be influenced by
heredity (genetics)
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Considered the brain to be the seat of
wisdom, consciousness, intelligence, and
emotion
Concluded that disorders involving these
functions would logically be located in
the brain.
Recognized the importance of
psychological and interpersonal
contributions to psychopathology, such
as the sometimes-negative effects of
family stress.
Galen
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Roman Physician
Later adopted the ideas of Hippocrates
Hippocratic-Galenic Approach
Humoral Theory of Disorders –
o Normal brain functioning was
related to four body fluids or the
humor:
 Blood (Heart)
 Black bile (Spleen)
 Yellow bile (Liver)
 Phlegm (Brain)
o Diseases resulted from too much
or too little of one of the humors.
o Biochemical Imbalances
o Too much black bile –
Melancholia (depression).
Melencholer means black bile.
o Humoral theory was, perhaps, the
first example of associating
psychological disorders with a
“chemical imbalance”, an
approach that is widespread
today.
Four basic qualities of Greeks:
o Heat, dryness, moisture, and cold
o Conception of Greeks
o Related to four humors
1. Sanguine (red like blood) –
ruddy complexion,
presumably from copious
blood flowing through the
body, and cheerful and
optimistic, although insomnia
and delirium were thought to
be caused by excessive blood
in the brain
2. Melancholic (depressive) –
depression was thought to be
caused by black bile flooding
the brain.
3. Phlegmatic (humor phlegm)
- indicates apathy and
sluggishness but can also
mean being clam under
stress.
4. Choleric (yellow bile or
choler) – hot tempered.
o Excesses of one or more humors
were treated by regulating the
environment to increase or
decrease heat, dryness, moisture,
or cold, depending on which
humor was out of balance.
o Bleeding or bloodletting Carefully measured amount of
blood was removed from the
body, often with leeches.
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Bloodletting, the
extraction of blood from
patients, was intended to
restore the balance of
humors in the body
o Induce vomiting
o Anatomy of Melancholy by
Robert Burton
 Eating tabacco and a halfboiled cabbage to induce
vomiting
Ancient China
o Also existed throughout Asia
o Chinese focused on the
movement of air or wind
throughout the body.
o Yin (cold, dark wind)
o Yang (warm, life-sustaining
wind)
o Unexplained mental disorders
were caused by blockages of
wind or presence of Yin which
opposed to Yang.
o Treatment involved restoring
proper flow of wind through
various methods, including
acupuncture.
Hysteria
o Coined by Hippocrates
o To describe a concept, he learned
from the Egyptians, who had
identified what we now call the
somatic symptom disorders.
o Physical symptoms appear to be
the result of a medical problem
for which no physical cause can
be found, such as paralysis and
some kinds of blindness
o Mistakenly assumed that only
restricted to women, since it
mostly occurs in women.
o Presumed cause; The empty
uterus wandered to various parts
of the body in search of
conception.
o Greek word for “uterus” is
hysteron
o Marriage as prescribed cure,
occasionally, fumigation
(pinapausukan ang vagina) of
the vagina to lure the uterus back
to its natural location.
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II. The 19th Century
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The biological tradition waxed and
waned during the centuries after
Hippocrates and Galen but was
reinvigorated in the 19th century because
of two factors:
1. Discovery of the nature and
cause of syphilis
2. Strong support from the wellrespected American
psychiatrist John P. Grey.
Syphilis
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Behavioral and cognitive symptoms of
what now known as advanced syphilis.
Advanced Syphilis – a sexually
transmitted disease caused by a
bacterial microorganism entering the
brain, include believing that everyone is
plotting against you (delusion of
persecution) or that you are a GOD
(delusion of grandeur), as well as other
bizarre behaviors.
Although similar to psychosis,
researchers recognized that a subgroup
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of apparently psychotic patients
deteriorated steadily, becoming
paralyzed and dying within 5 years of
onset.
Psychosis – psychological disorders
characterized in part by beliefs that are
not based in reality (delusions),
perceptions that are not based in reality
(hallucinations), or both.
General paresis - designed disease in
1825, that has consistent symptoms
(presentation) and a consistent course
that resulted in death.
Louis Pasteur’s germ theory of disease
facilitated the identification of specific
bacterial microorganism that caused
syphilis.
Discovery of a cure for general paresis
Recovery of patients with general paresis
contacted malaria.
Injection of other patient’s blood with
malaria to patient with general paresis.
High fever “burned out” the syphilis
bacteria.
Clinical investigators discovered that
penicillin cures syphilis, but with
malaria cure, “madness” and associated
behavioral and cognitive symptoms for
the first time were traced directly to a
curable infection.
Mental health professionals then
assumed that comparable causes and
cures might be discovered for all
psychological disorders.
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Most influential American psychiatrist
Editor of American Journal of Insanity
Precursor of the current American
Journal of Psychiatry
Flagship publication of the American
Psychiatric Association (APA)
His position was that insanity were
always caused by physical.
Believed that mentally ill patient should
be treated as physically ill.
Rest, diet, and proper room temperature
and ventilation.
Invention of the rotary fan to ventilate
his large hospital.
Great improvement of hospital condition
and became more humane, livable
institution.
Become so large and impersonal that
individual attention was not possible.
Almost took 100 years before
community mental health movement was
successful in reducing the population of
mental hospitals with controversial
policy of deinstitutionalization.
Deinstitutionalization – Patients were
discharge of the facilities into a less/non
isolated community.
Negative consequence; Large number of
chronically disabled patients homeless
on the streets of cities.
III. The Development of Biological
Treatments
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John P. Grey
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Accidental discovery of drug effects on
psyche of people.
Insulin- boost appetite (patients not
eating) but found could be used for
calming effect.
Insulin shock therapy- Daily dose of
insulin or increasing dosage of insulin to
cause repeated or temporary comatose.
Benjamin Franklin – Accidentally
found that mild and modest electric
shock to head produced brief
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convulsion/seizures and amnesia, but
otherwise did little harm.
Wondered if head electric shocking
could be used as treatment for
depression as it made the patient
strangely elated.
Joseph von Meduna – Hungarian
Psychiatrist observed that schizophrenia
was rarely found with patients with
epilepsy but never proved to be true.
Induced brain seizures might cure
schizophrenia.
Ugo Cerletti & Lucio Bini – Italian
physician use six small head electric
shock to depressed patient, convulsion,
and then recovered.
Electroconvulsive therapy – Greatly
modified and still used up to modern day
controversially.
1950s - First effective drugs for severe
psychotic.
Opium used as sedatives, along with
countless herbs and folk remedies.
Rauwolfia serpentine (reserpine) &
Neuroleptics (major tranquilizers) –
diminished hallucinatory and delusional
thoughts.
Control
agitation
and
aggressiveness.
Benzodiazepines (Valium & Librium)
- minor tranquilizers that reduces
anxiety.
Alexander and Selesnick - point out
that “The general pattern of drug
therapy for mental illness has been one
of initial enthusiasm followed by
disappointment”
Bromides – A sedating drugs, used to
treat anxiety, found effective for many
psychological and emotional symptoms,
then found out it causes undesirable

physical symptoms, and the drug
disappears from the field.
Neuroleptics – Chronic tremors and
shaking side effects, positive effects on
psychotic symptoms or hallucinations,
delusions and agitation.
III. Consequences of the Biological Tradition
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Focused on diagnosis, legal questions
about responsibilities of patients for their
actions during periods of insanity, and
study of brain pathology, instead of the
treatment.
Emil Kraepelin – One of the founding
fathers of modern psychology. One of
the first to distinguish various
psychological disorders, different age of
onset and time course, and different
causes.
Useful
description
of
schizophrenic disorders sill used today.
Scientific approach to psychological
disorders and their classification.
Humane based treatments
The Psychological Tradition
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Plato – maladaptive behavior was
caused by social and cultural influence,
and learning in the environment.
Treatment should be related to
reeducation through rational discussion.
Modern Psychosocial treatment –
Causation of psychopathology, focuses
on psychological, social and cultural
factors.
Aristotle – Influence of social
environment and early learning on later
psychopathology.
Importance of fantasies, dreams, and
cognitions.
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Developments in psychoanalytic thought
and cognitive science.
Advocate humane and responsible care
for individuals with psychological
disturbances.
I. Moral Therapy
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19th century, influential psychosocial
approach
Moral – emotional or psychological
factors rather than to a code of conduct.
Treating institutionalized patients in
setting with normal social interactions.
Relationship careful nurturing
Individual attention = positive
consequences
Elimination of restraint and seclusion
method
Patients cared with massaged and
soothing music.
Jean-Baptiste Pussin - Removal of all
chains used to restrain patients and
instituting humane and positive
psychological interventions.
Asylums appeared in 16th century, more
like prison than hospital.
The rise of Moral therapy in Europe and
the United States that made asylums
habitable and even therapeutic.
II. Asylum Reform and the Decline of Moral
Therapy

Factors to the Decline of humane
treatment:
1. Moral therapy is the best when
patients in institution is 200 or
fewer. After Civil War,
immigrants of US, mentally ill
patients population increased up
to 1000 to 2000 and more.
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Immigrants were not granted the
same attention as locals,
therefore not given moral
treatments even with sufficient
personnel.
2. Great crusader Dorothea Dix
campaigned endlessly for reform
in the treatment of insanity.
Revolt against the abuse in
insanity treatment, mental
hygiene movement.
 Dorothea Dix (1802–
1887) began the mental
hygiene movement and
spent much of her life
campaigning for reform
in the treatment of the
mentally ill.
 Through her effort,
availability of humane
treatment spread through
U.S Institutions.
 The hero of 19th century
 Unforeseen consequence
of heroism, substantial
increase of mental
patients.
 Transition from moral
therapy to custodial care
due to insufficient
hospital staffs.
 Mental illness was caused
by brain pathology and,
therefore, was incurable.
Psychological Tradition lay dormant for
a time
Reemerge in several different schools of
thoughts in the 20th century.
The two major approach:
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o Psychoanalysis based on
Sigmund Freud’s theory of the
structure of the mind and role of
unconscious processes in
determining behavior.
o Behaviorism associated with
John B. Watson, Ivan Pavlov, and
B.F. Skinner which focuses on
learning and adaptation effect on
the development of
psychopathology.
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III. Psychoanalytic Theory
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Franz Anton Mesmer (1734-1815) –
Suggested that his patients’ problem was
caused by undetectable fluid in their
body called “Animal magnetism” that
could become blocked.
Franz Anton Mesmer and other early
therapists often used hypnosis and/or
strong suggestions to cure their patients.
Animal magnetism (Mesmerism) –
Claimed to be an invisible natural force
possessed by all living things.
Benjamin Franklin concluded that
anime magnetism or mesmerism is
nothing more than a strong suggestion.
Franz Anton Mesmer widely regarded
as the father of hypnosis.
Hypnosis – a state in which extremely
suggestible subjects appear to be in a
trance or in half-conscious state.
Jean-Martin Charcot (1825-1893) –
Demonstrated some mesmerism
techniques that were effective with some
psychological disorders, contribute to the
legitimize the practice of hypnosis.
Sigmund Freud & Josef Breuer,
experimented with different hypnotic
procedure.
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They discovered the unconscious mind
and influence on the production of
psychological disorders.
Catharsis - Second discovery of Freud
and Breuer, therapeutic recall and relive
emotional trauma that has been made
unconscious and release the tension.
Also referred to as the Release of
emotional material.
Insight – relationship between current
emotions and earlier events
Breuer’s classic description of
hysterical symptoms of Anna O’s case.
The case of Anna O. – Hysterical case.
Vision blurred, paralyzed right arm and
both legs, and soon began speaking
difficulty and unpredictable behavior.
o Breuer dealt with one symptom
at a time through hypnosis and
subsequent “talking through”.
o Hysterical ailments disappeared
but only after treatment was
administered for each respective
behavior.
Freud took this basic conversation and
expanded them into the psychoanalytic
model.
Psychoanalytic Theory – the most
comprehensive theory yet constructed on
the development and structure of our
personality.
Speculated where this development
could go wrong and produce
psychological disorders.
Three major facets of psychoanalytic
theory:
1. The structure of the mind and
distinct functions of personality
that sometimes clash with one
other.
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2. The defense mechanism with
which the mind defense itself
from these clashes, or conflicts.
3. The stages of early
psychosexual development that
provide grist for the mill of our
inner conflicts.
The Structure of the Mind
o The mind has three major parts or
functions:
a. Id
 The source of our strong sexual
and aggressive feelings or
energies. The animal within us.
 Libido - The energy and drive
force within it.
 Thanatos - Less important
source of energy, the death
instinct. Not well conceptualized
by Freud.
 Operates according to pleasure
principle.
 Primary process – way of
processing information which
thinking is emotional, irrational,
illogical, filled with fantasies,
and preoccupied with sex,
aggression, selfishness, and
envy.
b. Ego
 Ensures that we act realistically
Operates according to the reality
principle
 Characterized by logic and
reason which are referred to as
the secondary process opposing
the primary process.
 Executive or manager of the
mind
c. Superego
 The conscience
 Represents the moral principles
 Purpose is to counteract the
potentially dangerous aggressive
and sexual drives of id
o Intrapsychic conflicts – unsuccessful
mediation of ego, and the id or superego
becomes dominated, it creates conflict
that would overtake us and
psychological disorders will develop.
o Freud believed that the id and the
superego are almost entirely
unconscious, that we are only fully
aware of the secondary processes of the
ego, which is a relatively small part of
the mind.

Defense Mechanism
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The unconscious protective processes
that keep primitive emotions associated
with conflicts in check so that the ego
can continue its coordinating function.
Conceptualized ng Sigmund Freud but
developed by Anna Freud.
Denial (refuse to accept) – Refuses to
acknowledge some aspect of objective
reality or subjective experience that is
apparent to others
Displacement (transfer target of release
to someone) - Transfers a feeling about,
or a response to, an object that causes
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discomfort onto another, usually lessthreatening, object or person.
Projection (blaming/see your faults in
others) – Falsely attributes own
unacceptable feelings, impulses, or
thoughts to another individual or object.
Rationalization (excuses and
justification) – Conceal the true
motivation for actions, thoughts, or
feelings through elaborate reassuring or
self-serving but incorrect explanations.
Reaction formation (opposite
response/pretend you’re different)–
Substitutes behavior, thoughts, or
feelings that are the direct opposite of
unacceptable ones.
Repression (unconscious forgetting)–
Blocks disturbing wishes, thoughts, or
experiences from conscious awareness.
Freudian Slips & Dreams.
Sublimation (revert to socially
acceptable action of response)- Directs
potentially maladaptive feelings or
impulses into socially acceptable
behavior.
The Psychosexual Stages of Development
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During infancy and early childhood,
everyone passes through a number of
psychosexual stages of development
Five stages:
1. Oral
 2 years from birth
 Central focus on the need
for food.
 The act of sucking
 The lips, tongue, and
mouth become the focus
of libidinal drives.
Principal course of
pleasure is focused on the
libidinal drives
 Conflict: Weaning away
from mother’s breast
 Erogenous zone: mouth
 Fixation – if did not
receive appropriate
gratification during
specific stage, it will
leave a particularly strong
impression. (e.g., fixation
at the oral stage,
excessive thumb sucking,
and oral simulation
through eating, chewing
pencils, or biting
fingernails.)
 Adult personality
characteristic with oral
fixation: dependency
and passivity, or
rebelliousness and
cynicism.
2. Anal
 2-3 years old
 Erogenous zone:
anus. Bowel and
bladder control.
 Defecating or
retaining feces
 Conflict: toilet
training
3. Phallic
 3-6 years old
 Erogenous zone:
Genitals
 Early genital selfsimulation
 Oedipus Rex – Fated
to kills his father and,
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unknowingly, to
marry his mother.
 Castration anxiety –
fear of son to have his
genitals removed by
his father.
 Oedipus complex –
Sexual desire of male
child towards his
mother, and eliminate
the father.
 Electra complex –
Oedipus complex
female counterpart.
Wanting to replace the
mother and possess
her father. They feel
Penis envy from his
father and brothers.
4. Latency
 6 years old to puberty
 Libido inactive
 Social
interactions
mostly with same sex
peers.
5. Genital
 Beyond puberty
 Maturation of sexual
interest
 Attracted to opposite
sex peers.
Neuroses or Neurotic disorders –
disorders of the nervous system. All
nonpsychotic psychological disorders
resulted from underlying unconscious
conflicts, the anxiety that resulted from
those conflicts, and implementation of
ego defense mechanism.
Later Developments in Psychoanalytic
Thought
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Anna Freud (1895-1982) – Focuses on
how the defense mechanism of the ego
determine our behavior.
Ego Psychology – Individual slowly
accumulates adaptational capacities,
skills in reality testing, and defenses.
o Abnormal behavior develops
when the ego is deficient in
regulating such functions as
delaying and controlling
impulses or in marshaling
appropriate normal defenses to
strong internal conflicts.
Heinz Kohut (1913-1981) – Focused on
a theory of the formation of self-concept
and the crucial attributes of the self the
allow individual to progress toward
health, or conversely, to develop
neurosis. Become known as Selfpsychology.
Object relations - Study of how
children incorporate the images, the
memories, and sometimes the values of a
person who was important to them and
to whom they were emotionally
attached.
o Object – important people
o Introjection – the process of
incorporation
o You tend to see the world
through the eyes of the person
incorporated into yourself.
o Focuses on how these disparate
images come together to make up
a person’s identity and on the
conflicts that may emerge.
Carl Jung (1875-1961) & Alfred Adler
(1970-1937) – Freud’s students and
rejects Freud’s ideas and form their own
school.
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o Believe that the basic quality of
human nature is positive
o Strong drive toward selfactualization or realizing one’s
full potential.
o Believed that by removing
barriers to both internal and
external growth, the individual
would improve and flourish.
Collective unconscious – Concept
introduced by Carl Jung, which is a
wisdom accumulated by society and
culture that is stored deep in individual
memories and passed down from
generation to generation.
o Spiritual and religious drives are
as much a part of human nature
as are sexual drives.
o Importance of enduring
personality traits such as
introversion and Extroversion.
o Introversion – Tendency to be
shy and withdrawn
o Extroversion – Tendency to be
friendly and outgoing
Inferiority Complex - Term created by
Alfred Adler, which focuses on the
feelings of inferiority and striving for
superiority.
Karen Horney & Erich Fromm –
Emphasized on development over the
life span and influence of culture and
society on personality.
Erik Erikson – Best-known theorist,
theory of development across the life
span, described in some detail the crises
and conflicts that accompany the eight
specific stages; Stages of Psychosocial
Development:
o Infant : Infant to 18 months
(hope) – Trust vs. Mistrust
o Toddler : 18 months to 3 years
(will) – Autonomy vs. Shame and
Doubt
o Pre-schooler : 3 to 5 years
(purpose) – Initiative vs. Guilt
o Grade-schooler : 5 to 13 years
(competency) – Industry vs.
inferiority
o Teenager : 13 to 21 years
(fidelity) – Identity vs. Role
Confusion
o Young adult : 21 to 39 years
(love) - Intimacy vs. Isolation
o Middle-age adult : 40 to 65
years (care) - Generativity vs.
Stagnation
o Older adult : 65 and older
(wisdom) – Ego integrity vs.
Despair
Psychoanalytic Psychotherapy
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Free association – Developed by Freud,
which patients are instructed to say
whatever comes to mind without the
usual socially required censoring.
o The goal is reveal emotionally
charged material that may be
repressed because it is too painful
or threatening to bring into
consciousness.
Dream Analysis – Therapist interprets
the content of dreams, supposedly
reflecting the primary-process thinking
of the id, and systematically related the
dreams to symbolic because the patient
may resist the efforts of the therapist to
uncover repressed and sensitive conflicts
and may deny the interpretations.
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o The goal is to help the patient
gain insight into the nature of the
conflicts.
Psychoanalyst – The therapist.
Two phenomenon involves
psychoanalyst-patient relationship:
o Transference – Patient come to
relate to the therapist much as
they did to important figures in
their childhood, particularly their
parents.
 The patient will fall
deeply in love with the
therapist, which reflects
strong positive feelings
that existed earlier for a
parent.
o Countertransference –
Therapists project some of their
own personal issues and feelings,
usually positive, onto the patient.
 Against the ethics for the
therapist to project their
feelings. They should be
trained well to deal with
their own feelings as well
as their patient’s.
Classical psychoanalysis - Requires
therapy four to five times a week for 2 to
5 years to analyze unconscious conflicts,
resolve them, and restructure the
personality to put the ego back in charge.
Psychodynamic psychotherapy – Uses
eclectic mixture of tactics with a social
and interpersonal focus.
The seven tactics of psychodynamic
psychotherapy:
1. a focus on affect and the
expression of patients’ emotions

2. an exploration of patients’
attempts to avoid topics or
engage in activities that hinder
the progress of therapy
3. the identification of patterns in
patients’ actions, thoughts,
feelings, experiences, and
relationships
4. an emphasis on past experiences
5. a focus on patients’ interpersonal
experiences
6. an emphasis on the therapeutic
relationship
7. an exploration of patients’
wishes, dreams, or fantasies
Two additional features characterize
psychodynamic psychotherapy:
1. Significantly briefer than
classical psychoanalysis
2. Psychodynamic therapists
deemphasize the goal of
personality reconstruction,
focusing instead on relieving the
suffering associated with
psychological disorders.
The Major Criticism of Psychoanalysis
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Basically unscientific, relies on the
reports by patient of the events happened
years ago.
No careful measurement of any of these
psychological phenomena and no
obvious way to prove or disapprove the
basic hypotheses of psychoanalysis
Measurement and the ability to prove or
disapprove a theory as the foundations of
scientific approach.
Therapeutic alliance
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An important area of study across most
therapeutic strategies.
Relationship between the therapist and
patient.
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III. Humanistic Theory
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Carl Jung & Alfred Adler emphasizes the
positive, optimistic side of human nature
Jung talked about setting goals, looking
toward the future, and realizing one’s
fullest potential.
Adler believed that human nature
reaches its fullest potential when we
contribute to the welfare of other
individuals and to society as a whole.
o Believed that everyone strives to
reach superior levels of
intellectual and moral
development.
Self-actualization – Everyone could
reach their highest potential, in all areas
of functioning, if only we had the
freedom to grow.
Hierarchy of needs – Most systematic
description of the structure of personality
by Abraham Maslow.
o Physiological needs: Food,
water, warmth, rest
o Safety needs: Security and
safety
o Belongingness and love need:
intimate relationship, and friends
o Esteem needs: prestige and
feeling of accomplishment
o Self-actualization: achieving
one’s full potential, including
creative activities.
o Maslow hypothesized that we
cannot progress up the hierarchy
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until we have satisfied the needs
at lower levels.
Person-centered therapy – Originated
by the most influential humanist, Carl
Rogers, which the therapist takes a
passive role, making as few
interpretations as possible.
o The point is to give the
individual a chance to develop
during the course of therapy,
unfettered by the threats to the
self.
Unconditional positive regard – the
complete and almost unqualified
acceptance of most of the client’s
feelings and actions, is critical to the
humanistic approach.
o Full/positive acceptance of the
therapist towards the client’s
feelings and thoughts.
Empathy – Sympathetic understanding
of the individual’s particular view of the
world.
The hoped-for result of person-centered
therapy is that clients will be more
straightforward and honest with
themselves and will access their innate
tendencies toward growth.
IV. The Behavioral Model

Also known as the Cognitivebehavioral model or social learning
model
Classical Conditioning
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Study examining why dogs salivate
before the presentation of food
Initiated by Ivan Petrovich Pavlov
Classical Conditioning – A type of
learning in which a neutral stimulus is
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paired with a response until it elicits that
response.
Conditioning – or Conditioned
response, resulted from an accident in
translation from the original Russian.
o One way in which we acquire
new information, particularly
information that is somewhat
emotional in nature.
Stimulus generalization – Response
generalizes to similar stimuli.
o The strength of the response to
similar objects or people is
usually a function of how
similar these objects or people
are.
Unconditioned stimulus (UCS) – no
conditions must be present for the
response to occur.
Unconditioned response (UCR) –
natural or unlearned response
Conditioned stimulus (CS) – a
condition that makes a response that is
associated with something else.
Conditioned response (CR) – learned
response through repetition.
Extinction - Fading and disappearance
of behavior that was previously learned
by association with another event.
Introspection – a study emphasized by
Edward Titchener.
o Armchair psychology;
inconsistent & discouraging to
many psychologist
o Subjects simply reported on their
inner thoughts and feelings after
experiencing certain stimuli.
Watson & the Rise of Behaviorism

John B. Watson (1878-1958) – Founder
of behaviorism
Mary Cover Jones (1896–1987) was
one of the first psychologists to use
behavioral techniques to free a patient
from phobia.
The Beginnings of Behavior Therapy
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Systematic desensitization – bestknown technique of Joseph Wolpe
(1915-1997), Individuals were gradually
introduced to the objects or situations
they feared so that their fear could
extinguish; that is, they could test reality
and see that nothing bad happened in the
presence of phobic object or scene.
o Patients carefully and
systematically imagine the
phobic scene, and induce
relaxation.
o One of the first wide-scale
applications of new science of
behaviorism to psychopathology.
Systematic desensitization become
called behavior therapy by Hans
Eysenck and Stanley Rachman from
London.
B. F. Skinner & Operant Conditioning
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
B. F. Skinner (1904–1990) studied
operant conditioning, a form of
learning that is central to
psychopathology.
Operant Conditioning – A type of
learning in which behavior changes as a
function of what follows the behavior.
o The term Operant Conditioning
coined because behavior operates
on the environment and changes
in some way.
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o For example, the boy’s behavior
affects his parents’ behavior and
probably the behavior of other
customers. Therefore, he changes
his environment.
o Schedules of reinforcement –
All behavior are arranged in an
endless variety way.
o Believed that punishment as a
consequence is relatively
ineffective in the long run.
Reinforcement - the reward, it
connotes the effect of the behavior.
Shaping – A process of reinforcing
successive approximations to a final
behavior or set of behavior.
Law of effect - Work of Edward L.
Thorndike (1874-1949), behavior is
either strengthen (likely to be repeated
more frequently) or weakened (likely to
occur less frequent) depending on the
consequences of that behavior.
The Present: The Scientific Method and an
Integrative Approach

With the increasing sophistication of our
scientific tools, and new knowledge
from cognitive science, behavioral
science, and neuroscience, we now
realize that no contribution to
psychological disorders ever occurs in
isolation. Our behavior, both normal and
abnormal, is a product of a continual
interaction of psychological,
biological, and social influences.
Timeline of Significant Events
An Integrative Approach to Psychopathology
One-Dimensional Model
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Also called Unidimensional model
Attempts to trace the origins of behavior
to a single cause
Two main views of the past:
o Mental disorders are cause
primarily by biological problems
o Abnormal behavior is essentially
psychosocial
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Two overly simplistic views:
o Set up a fake “either/or”
dichotomy between nature and
nurture
o Fail to recognize the reciprocal
influences of on one other
o Mask the importance of
acknowledging the biological,
psychological, social, and sociocultural dimensions in the origin
of mental disorders
vulnerabilities, chemical imbalances,
brain dysfunctions, and temperament
(body fluid) interact with the other
influence (ex. Behavioral) to cause
psychopathology.
Emotional Influence

Multidimensional Model
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
Implies that any particular influence
contributing to psychopathology cannot
be considered out of context
Complex causes of abnormal behavior
Psychological disorders are caused by
nature (biology) and by nurture
(psychosocial factors), and you would be
right on both counts-but also wrong on
both counts.
Psychopathology can be caused by
multiple influences of multi factors.
Such influences are biological,
behavioral, social, emotional, and
cognitive
Emotions could actually trigger
biological dysfunctions and influence the
way individuals perceive an event. A
particular emotion can cause physical
and psychological changes which
manifest in thought and behavior.
Social Influence

The way people react or support an
individual during a particular situation
may also contribute with/to the other
influences which strengthen the
psychopathological vulnerabilities of the
individual.
Developmental Influence

The fact that an individual is evolving
and is always subjected to changes
throughout his/her developmental stages,
his/her way of reacting to a certain event
or situation may vary as he/she ages or
mature
Behavioral Influence

This explains that a certain abnormality
can be developed because of a learned
response that is being elicited by a
certain stimulus which is also a
contributing factor with/to other
influences.
Biological Influence

In this viewpoint, factors such as
biological dysfunctions, genetic
● A dominant gene is one of a pair of genes
that strongly influences a particular
trait
●
Recessive genes, by contrast, must
be paired with another (recessive) gene to
determine a trait. Otherwise, it won’t have
any effect.
●
Polygenic- influenced by many genes,
each contributing tiny effect. This
means they are influenced by multiple genes
or by multiple polymorphisms of
genes, with anyone gene having only very
small effects.
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●
Genotype- total genetic endowment,
meaning what you inherit
● Phenotype- Observed structural and
functional characteristics. What is
expressed (interaction between genes and
environment.
D. Diathesis-Stress Model
● Individuals inherit tendencies to express
certain traits or behaviors, which may
then be activated under conditions of stress
● the theory that mental and physical
disorders develop from a genetic or biological
predisposition for that illness (diathesis)
combined with stressful conditions that
play a precipitating or facilitating role.
Serotonin transporter genes
a. 2 long = less possibility to develop
depression
b. 1 long and 1 short = moderate
c. 2 short = predisposition
E. Gene-Environment Correlation Model
● A genetic endowment may increase the
probability that an individual will
experience stressful life events
● Biological and environmental factors are
being considered in presenting
problems.
F. Epigenetics vs Nongenomic
● Epigenetics
- These are changes that do not occur on the
gene itself but can change
the expression of genes brought by the
environment. So environmental
factors such as stress, nutrition, and others
affect the genetic expression
e, which is then immediately passed down to
the next generation.
●
Nongenomic
- Meaning that a certain psychopathological or
disorder can not only be
accounted to genetics and that strong
environmental influences
sufficiently override genetic factors as causal
factor of psychopathology
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