Abnormal Psychology
#BLEPP
Source: Barlow, Durand & Hofmann (2018), Comer & Comer (2017), Hooley, Butcher, Nock & Mineka (2017), DSM-V,
DSM-V-TR, Psych Pearls
o Normal Behavior – one behavior that is like other
people in the society
Hellow, future RPm!
▪ Normality is social conformity – some
behaviors are non-conforming but normal
Doubt is definitely going to eat you this review season. I
▪ Normality is personal comfort
just want you to know that it is very VALID to feel that
▪ Normality is a process
way. But always remember to go back to the reason why
o Criteria for determining Abnormal Behavior
you are doing this.
✓ Norm-violation
✓ Statistical rarity
May this reviewer help you pass the boards like it did to
✓ Personal Discomfort
me and to many people that I know <3
✓ Deviation
✓ Maladaptiveness
We will be remembered
o Clinical Assessment – the systematic evaluation and
measurement of psychological, biological, and social
Normalcy and Abnormalcy (5)
factors in an individual presenting with a possible
Recognizing Normal and Abnormal manifestations of
psychological disorder
behavior
o Diagnosis – process of determining whether the
o Psychological
Disorder
–
psychological
particular problem afflicting the individual meets all
dysfunction within an individual associated with
criteria for a psychological disorder
distress or impairment in functioning and a response
o Epidemiology – study of the distribution of diseases,
that is not typical or culturally expected
disorders, or health-related behaviors in a given
o 4 D’s of Psychological Disorder
population
a. Psychological Dysfunction – refers to a breakdown
o
Prevalence – number of active cases in a population
in cognitive, emotional, or behavioral functioning
during a given period of time
▪ Interferes daily functioning
o Point Prevalence – proportion of actual, active cases
b. Distress or Impairment – individual is extremely
upset and cannot function properly
of a disorder in a given population at a given point in
▪ Either to self or to others
time
c. Atypical or Not Culturally Expected (Deviance) –
o 1 Year Prevalence – everyone who experienced
deviates from the average or the norm of the culture
depression at any point in time throughout the entire
▪ Not just to the society but deviation from the
year
person’s usual behavior
o Lifetime Prevalence – estimate number of people
d. Dangerousness – creates potential harm to self
who have had a particular disorder at any time in
(suicidal gestures) and others (excessive aggression)
their lives
e. Duration – how long the mental state has been
o Incidence – number of new cases occur over a given
persisting
period of time
▪ Constant fluctuation of mood, thoughts, and
o Sign – manifestation of disease that the physicians
behaviors is normal, but if changes is sustained,
receive
persistent and pervasive, it can be concerning
o
Symptom – subjective representation of the
o Psychopathology – scientific study of mental
complaints of the patient
disorders
o Syndrome – group of symptoms that occur together
o Clinical Psychology – applied branch of psychology
more often by chance
that seeks to understand, assess, and treat
psychological conditions in a clinical setting
DSM-IV Axis
Axis I: Clinical Disorder
o Abnormal Psychology – branch of psychology that
Axis II: Personality Disorders & Mental Retardation
studies unusual patterns of behavior, emotions, and
Axis III: General Mental Conditions
thought which may or may not indicate an underlying
Axis IV: Psychosocial & Environmental Problems
condition
The reviewers I made are FREE :D instead of selling it, you can share the drive link to others :D Let’s help each other <3
See u soon, future RPms! - Aly
Abnormal Psychology
#BLEPP
Source: Barlow, Durand & Hofmann (2018), Comer & Comer (2017), Hooley, Butcher, Nock & Mineka (2017), DSM-V,
DSM-V-TR, Psych Pearls
o Twin Studies – usually conducted to identical twins
Axis V: Global Assessment of Functioning
Theoretical Approaches in Explaining the Etiology of
because they share genetic makeup’
Psychological Disorders (20)
o Those people who reported more severe stressful life
o One-Dimensional – looking for a single cause
events and had at least one short allele of the 5-HTT
o Multidimensional – looking for a systemic cause
gene were at greater risk of developing depression
Genetic contributions
(Caspi et al., 2003) (serotonin-transporter gene)
o Genes – long molecules of DNA at various locations
o Epigenetics – factors other than inherited DNA
on chromosomes, within cell nucleus
sequence, such as new learning or stress, that alter
▪ Chromosomes: the chain-like structures within a
the phenotypic expression of genes
cell nucleus that contain the genes
Biological and Neurological Bases
▪ Genes: carries of the information we inherit from
o Neuroscience – study of the nervous system,
our parents
especially the brain to understand behavior,
o 46 Chromosomes, 23 Pairs, 22 Pairs of Autosomes,
emotions, and cognitive processes
1 pair Sex Chromosomes
High
Low
o XX – female, XY – male
Dopamine
Schizophrenia
Parkinson’s
o Dominant and Recessive
Acetylcholine
Alzheimer’s
o Phenotypes – observable characteristics
(Dementia)
o Genotypes – unique genetic makeup
Norepinephrine Mania
Depression
o Polymorphisms – naturally occurring variations of
GABA
Relaxation
Anxiety/OCD
genes
Serotonin
Mania
Depression
o Polygenic – influenced by multiple genes or by
Anxiety
multiple polymorphisms of genes with any one gene
Eating
having only very small effects
Disorders
o Endophenotypes – genetic mechanisms that
Epinephrine
Stress
Fatigue
ultimately contribute to the underlying problems
Sleep Disorders
causing the symptoms and difficulties experienced
Glutamate
Psychosis
Huntington’s
Neuron Death
Disease
by people with psychological disorders
Endorphin
Eating
o Basic Genetic Epidemiology – statistical analysis of
Disorders
family, twin, and adoption studies; if the disorder can
o
Synapse
–
a
tiny
fluid-filled
space
between
the axon
be inherited and how much is attributable to genetics
endings of one neuron and the dendrites or cell body
o Advanced Genetic Epidemiology – studies the
of another neuron
factors that influence the disorder
o
Agonist – effectively increase the activity of the
o Gene Finding – what gene influences the behavior
neurotransmitters (Excitatory)
o Molecular Genetics – biological analysis of
o Antagonist – decrease or block neurotransmitter
individual DNA samples; biological processes genes
(Inhibitory)
affect to produce symptoms of the disorder
o Inverse Agonists – produces effects opposite to
o Family Studies – examine behavioral pattern or
those produced by the neurotransmitters
emotional trait in the context of the family
o Reuptake – neurotransmitter is released, quickly
o Proband – family member with the trait singled out
broken down and brought back to the synaptic cleft
for study
o Hormones – chemical messengers secreted by the
endocrine glands in the body
▪ The first person in the family to be identified as
o
Neurotransmitter – chemical messengers of the
possibly having genetic disorder and who may
body
receive genetic counseling or testing
a)
Glutamate (E) [ memory ]– most abundant in
o Adoption Studies – identify adoptees who have a
the brain and plays a key role in thinking,
particular behavioral pattern or psychological
learning, and memory
disorder and attempt to locate first-degree relatives
who were raised in different family settings
The reviewers I made are FREE :D instead of selling it, you can share the drive link to others :D Let’s help each other <3
See u soon, future RPms! - Aly
Abnormal Psychology
#BLEPP
Source: Barlow, Durand & Hofmann (2018), Comer & Comer (2017), Hooley, Butcher, Nock & Mineka (2017), DSM-V,
DSM-V-TR, Psych Pearls
b) GABA (I) [ calming ]– most common inhibitory
▪ Left Hemisphere – responsible for verbal and
neurotransmitter in the brain and regulates mood,
other cognitive processes
irritability, sleep, seizures
▪ Right Hemisphere – perceiving the world
c) Serotonin (I) [ mood ]– regulates mood, sleep
around us and creating images
patterns, sexuality, appetite, and pain
▪ Lobes: Frontal, Parietal, Occipital, Temporal
d) Dopamine [ pleasure ]– body reward system,
▪ Prefrontal Cortex – area responsible for higher
pleasures, achieving heightened arousal and
cognitive functions
learning
▪ HPA Axis – Hypothalamus, Pituitary Gland,
e) Epinephrine [ fight-or-flight ] – responsible for
Adrenal Cortex
fight-or-flight response
o Somatic Nervous System – controls the muscles
f) Norepinephrine [ concentration ] – alertness,
o Autonomic Nervous System – regulate
arousal, decision-making, attention, and focus
cardiovascular system and endocrine system
g) Endorphins [ euphoria ]– natural pain reliever,
▪ Sympathetic – fight or flight responses
reduces pain
▪ Parasympathetic – calms the sympathetic
h) Acetylcholine (E) [ learning ] – regulates heart
nervous system; rest and digest functions
rate, blood pressure and gut motility, role in
o Endocrine System – glands produce hormones that
muscle contraction, memory, motivation, sexual
is released to the blood streams
desire, sleep, and learning
▪ Pituitary – master gland
o Brain Stem – lower and more ancient part of the
▪ Thyroid – controls metabolism and growth
brain; essential for autonomic functioning such as
(thyroxine)
breathing, heartbeat, etc.
▪ Parathyroid – controls the levels of calcium
▪ Hindbrain – contains the medulla, pons, and
▪ Adrenal – controls metabolism, blood pressure,
cerebellum; regulates many autonomic activities
sex development, stress (epinephrine)
such as breathing, heartbeat, and digestion
▪ Pineal – releases melatonin
▪ Cerebellum – controls motor coordination
▪ Pancreas – creates insulin
abnormalities associated with autism
▪ Testes – makes sperm and release testosterone
▪ Midbrain – coordinates movements with sensory
▪ Ovaries – releases estrogen, progesterone, and
input and contains parts of reticular activating
testosterone
system (contributes to sleep, arousal and tension)
Hypothalamic-Pituitary-Adrenal Axis
▪ Thalamus and Hypothalamus – involves in
1. Messages in the form of corticotropin-releasing
regulating behavior, emotions, and hormones
hormone (CRH) travel from the hypothalamus to
o Limbic System – located around the edge of the
pituitary gland
center of the brain
2. Pituitary Gland releases adrenocorticotropic
▪ Hippocampus, Cingulate Gyrus, Septum, and
hormone (ACTH), which stimulates the cortical part of
Amygdala
the adrenal gland (located at the top of the kidney) to
▪ Amygdala – emotions
produce epinephrine (adrenaline) and cortisol (stress
▪ Hippocampus – shrinks when a person have
hormone), which is released into the general circulation
depression
3. Cortisol gives negative feedback to the
▪ Regulate emotional experiences and expressions
hypothalamus and pituitary to decrease their release of
and, to some extent, our ability to learn and to
CRH and ACTH, which in turn reduces the release of
control impulses
adrenaline and cortisol
o Basal Ganglia – base of the forebrain, includes
o Temperament – refers to a child’s reactivity and
caudate nucleus
characteristic ways of self-regulation
▪ Damage involved changing our posture or
▪ As early as 2-3 months of age, approx. five
twitching or shaking
dimensions of temperaments can be identified:
▪ Related to Parkinson’s Disease
fearfulness, irritability/frustration, positive affect,
o Cerebral Cortex – provides us with our distinctly
activity level, and attentional persistence/effortful
human qualities, allowing us to look to the future and
control
plan, to reason, and to create
o Permissive Hypothesis – when serotonin
(norepinephrine)
levels
are
low,
other
The reviewers I made are FREE :D instead of selling it, you can share the drive link to others :D Let’s help each other <3
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Abnormal Psychology
#BLEPP
Source: Barlow, Durand & Hofmann (2018), Comer & Comer (2017), Hooley, Butcher, Nock & Mineka (2017), DSM-V,
DSM-V-TR, Psych Pearls
neurotransmitters are permitted to range more
▪ E.g., You are afraid of fury dogs because they
widely, become dysregulated, and contribute to
once attacked you. Now, whenever you see
mood irregularities
something fury, your body trembles, you cannot
breathe properly and wanted to go away.
Structure
Associated Behaviors
o Introspection – Edward Titchener; subjects report
Corpus Callosum
Communication between right
their inner thoughts and feelings after experiencing
and left hemisphere
certain stimuli
Limbic System
Attention, Emotion, “fight or
o
John B. Watson – founder of behaviorism
flight”
▪
Little Albert
Frontal Lobe
Learning,
abstracting,
o Systematic Desensitization – patients were
reasoning, inhibiting
gradually introduced to the objects or situations they
Hypothalamus
Regulation of metabolism,
feared so that their fear could extinguish
temperature, and emotions
o
Operant Conditioning – behavior changes as a
Temporal Lobe
Discrimination
of
sounds,
function of what follows the behavior (rewards or
verbal, and speech behavior
punishment)
Reticular
Arousal Reactions, Information
▪ B.F. Skinner
Formation
Screening
▪ Edward Thorndike – Law of effect (behavior can
Medulla
Breathing, Blood Pressure, other
be strengthened or weakened)
vital functions
▪
Reinforcement – reward
Cerebellum
Fine
motor
coordination,
▪
Shaping – process of reinforcing successive
posture, and balance
approximations to a final behavior or set of
Occipital Lobe
Visual Discrimination and some
behaviors
aspects of visual memory
o Social Learning – Albert Bandura
Thalamus
Major relay station for messages
▪ Modeling/observational learning: process of
from parts of the body,
learning in which an individual acquires
important sensations of pain
responses by observing and imitating others
Parietal Lobe
Somesthetic
and
motor
▪ Observational learning
discriminations and functions
▪ Social Cognitive Theory: people observe
Sensory Strip
Integration
of
sensory
models, learns chunks of behavior, and mentally
information from various parts
put chunks together into complex new behavior
of the body
patterns
Motor Strip
Regulation
of
voluntary
▪ Albert Bandura
movement
▪ Hitting Doll experiment
Learning
▪ Self-Efficacy – person’s confidence in their own
o Classical Conditioning – type of learning in which
abilities to accomplish their goals
neutral stimulus is paired with response until it elicits
o Learned Helplessness – when rats or other animals
that response
encounter conditions over which they have no
▪ Unconditioned Stimulus – natural stimulus
control, they give up attempting to cope and seem to
▪ Unconditioned Response – natural or unlearned
develop the animal equivalent of depression
response
▪ Martin Seligman and colleagues
▪ Conditioned Stimulus – newly conditioned
▪ People make an attribution that they have no
event introduced
control, and become depressed
▪ Conditioned Response – response from the
▪ Causes: coercive, ineffective, inconsistent
conditioned stimulus
parents, media violence, peer rejection
▪ Extinction – without CS showed long enough,
▪ Internal: negative effects due to internal failings
the behavior could be eliminated
▪ Stable: even after a particular negative events
o Stimulus Generalization – strength of the response
pass, additional bad things will “always be my
to similar objects or people is usually a function of
fault” remains
how similar these objects or people are
▪ Global: attributions extend across a variety of
issues
The reviewers I made are FREE :D instead of selling it, you can share the drive link to others :D Let’s help each other <3
See u soon, future RPms! - Aly
Abnormal Psychology
#BLEPP
Source: Barlow, Durand & Hofmann (2018), Comer & Comer (2017), Hooley, Butcher, Nock & Mineka (2017), DSM-V,
DSM-V-TR, Psych Pearls
▪ Learned Optimism – if people faced with
▪ Tends to Overgeneralize (draw broad negative
considerable stress and difficulty in their lives,
conclusions on the basis of single insignificant
nevertheless, display optimistic, upbeat attitude,
event) [ Cognitive Bias ]
they are likely to function better psychologically
▪ Depressive Cognitive Triad: depressed people
and physically
make cognitive errors in thinking negatively
▪ Positive Psychology
about themselves, immediate world, and their
o Prepared Learning – we have become highly
future
prepared for learning about certain types of objects
▪ Beck Hopelessness Scale
or situations over the course of evolution because this
▪ Negative Schema: an enduring negative
knowledge contributes to the survival of the species
cognitive system about some aspects of life
▪ Learning from ancestors
▪ Self-Blame Schema: people feel personally
o Hopelessness Theory – desirable outcomes will not
responsible for every bad happenings
occur, and that the person has no responses available
▪ Negative Self-Evaluation Schema: “can never
to change this situation
do anything correctly”
Cognitive theories with Psychoanalytic
▪ False Consensus Effect/False Consensus Bias:
o Fear – fight or flight response
people tend to overestimate the extent to which
▪ Evolutionary adaptation
their opinions, beliefs, preferences, values, and
▪ White with fear, trembling, faster breathing,
habits are normal and typical of the others
increase in glucose, pupil dilate, hearing become
(“Everyone shares the same opinion as me,”)
more acute, digestive system stops, pressure to
Negative Cognitive Styles:
urinate, defecate, vomit to reduce waste materials
Dichotomous Thinking/Absolutist/Black and White
o Introjection – direct all their feelings for the loved
Thinking
one, including sadness and anger, toward themselves
- seeing only of the extremes of things, never the
o Symbolic or Imagined Loss – person equates other
middle
kinds of events with the loss of a loved one
- “either I ace this test or fail,”
▪ Does not necessarily involve death of a person
Overgeneralization
▪ E.g., an athlete got injured and can no longer do
- making generalizations about a negative aspect
the sport they have been doing for a long time
- “bagsak ako sa physics, hindi na ko makaka-graduate
▪ Introjected Loss: actual death of a person
ng college,”
o Attributional Style – ways in which people explain
Personalization
the cause of events within their lives
- tendency for individuals to relate external events to
Internal-External – who or what is responsible for the
themselves, even when there is no basis for making this
event
connection
- whether something unique about the person (internal)
- egocentric thinking, everything is about him
or something about the situation caused the event
- “kasalanan ko kung bakit umiyak yung bata”
(external)
Selective Abstraction
Stable-Unstable – perceived permanence of the cause
- focuses on the negative
- an event can be viewed as constant and likely to
- detail is taken out of context and believed whilst
happen again (stable) or it only happens once (unstable)
everything else in the context is ignored
Global-Specific – universal throughout your like
- /almost good feedback except for one /focused on that
(global) or specific to a part of your life (specific)
single feedback
o Cognitive Theory of Depression - persons
Arbitrary Inference
susceptible
to
depression
develop
- evident when depressed individuals emphasize the
inaccurate/unhelpful core beliefs about themselves,
negative rather than the positive aspects of a situation
others, and the world as a result of their learning
- only accepts negative thoughts
histories
- no logical reasoning
▪ Depressed people consistently think in illogical
- interpreting a situation when there is no factual
ways and keep arriving at self-defeating
evidence
conclusions
- /passed, “chamba”, /negative “kasalanan ko kasi”
The reviewers I made are FREE :D instead of selling it, you can share the drive link to others :D Let’s help each other <3
See u soon, future RPms! - Aly
Abnormal Psychology
#BLEPP
Source: Barlow, Durand & Hofmann (2018), Comer & Comer (2017), Hooley, Butcher, Nock & Mineka (2017), DSM-V,
DSM-V-TR, Psych Pearls
o Types of Amnesia:
Labeling and Mislabeling
1. Biogenic – caused by brain damage or disease
- portraying one’s identity on the basis of imperfections
▪ Retrograde – inability to retrieve information
and mistakes made in the past and allowing them to
that was acquired before (remote memory loss)
define one’s true identity
▪ Anterograde – inability to transfer new
- /bullied for being dark-skinned, “I am ugly.”
information from the short-term store to longMinimization
term store (recent memory loss)
- downplaying the significance of an event or emotion
2.
Psychogenic
or Dissociative or Functional –
- common strategy in dealing with feelings of guilt
caused
by
psychological
trauma, repressed memories
- “Parang nakakarami ka na ah,”
▪ Generalized – origin is rare psychological
“Luh parang tanga, sampung bote pa lang”
disorder and spontaneous recovery from amnesia
Magnification
in a comparatively short period of time
- effects of one’s behaviors are magnified
▪ Localized – no memory of specific events
- /may konting mantsa sa damit, “Iniisip siguro nila
▪ Selective – can only recall only small parts of the
hindi ako naglalaba,”
events
o General Adaption to Stress Theory –
▪ Situation-Specific – result of severely stressful
understanding the relationship between stressful
event, as part of PTSD
events and the body’s response to stress
▪ Global – cannot recall both past and present; total
▪ Alarm: fight-or-flight response
memory loss
▪ Resistance: coping mechanisms
o
Memory
– the process by which we encode, store,
▪ Exhaustion: body defenses resources are
and
retrieve
information
depleted
▪ Declarative: factual information
▪ Hans Selye
▪ Procedural: skills and habits
o Stress-Appraisal/Cognitive Appraisal Theory –
▪ Semantic: general knowledge and facts, logic
stress is a two-way process, it involves a production
▪ Episodic: events that occur in a particular time,
of stressors and the response of an individual
place, or context
subjected to these stressors
o
Three-System
Approach to Memory – information
o Primary Appraisal: an individual tends to ask
must travel if it is to be remembered
questions like, “What does this stressor and/or
▪ Sensory: initial storage of information, perceived
situation mean?”, and “How can it influence me?”
by the senses
▪ Understanding the stressor
▪
Short-Term Memory: holds info for 15 to 20
o Secondary Appraisal: involves those feelings
seconds
related to dealing with the stressor or the stress it
▪
Long-Term Memory – stores on a relatively
produces
permanent basis, although, at times, it can be
▪ Deals with the stressor
difficult to retrieve
▪ Starts to assess internal and external resources
o Chunks – meaningful grouping of stimuli that can
available to solve the problem
be stored as a unit in STM
▪ Positive: “I can do it if I do my best,”
o
Rehearsal – repetition of information that has
▪ Negative: “I cannot do it.”
entered the STM
Memory Disorders
▪
Repetitive: as long as it is repeated, it states in
Anosognosia: no memories of his own illness
the STM
Confabulation: filling in memory gaps with imaginary
▪
Elaborative: transfers info to LTM
experiences
o
Tip-Of-The-Tongue
Phenomenon – inability to
Disorientation: cannot identify or recognize time,
recall
information
that
one realizes one knows
places, and persons
o
Retrieval
Cue
–
allow
us to recall more easily
De Javu: unfamiliar perceived as familiar
▪
Recall:
memory
task in which specific
Jamais Vu: familiar perceived as unfamiliar
information is retrieved
Hypermnesia: increased memory
▪ Recognition: individual is presented with a
Paramnesia: false or perverted memory
stimulus and asked whether they have been
Amnesia: loss of memory
The reviewers I made are FREE :D instead of selling it, you can share the drive link to others :D Let’s help each other <3
See u soon, future RPms! - Aly
Abnormal Psychology
#BLEPP
Source: Barlow, Durand & Hofmann (2018), Comer & Comer (2017), Hooley, Butcher, Nock & Mineka (2017), DSM-V,
DSM-V-TR, Psych Pearls
exposed to it in the past or to identify it from the
o Lewinsohn’s Behavioral Theory - depression is
list of alternatives
caused by a combination of stressors in a person's
o Levels-Of-Processing Theory – degree to which
environment and a lack of personal skills
new materials is mentally analyzed
diathesis-stress model
▪ Implicit Memory: can be recalled automatically
o Diathesis-Stress Model – individuals inherit
without thinking
tendencies to express certain traits or behaviors,
▪ Explicit Memory: requires conscious retrieval of
which may then be activated under conditions of
information
stress (Eric Kandel)
o Constructive Processes – memories are influenced
▪ Diathesis – a condition that makes someone
by the meaning we give to them
susceptible to developing disorder (vulnerability)
▪ Autobiographical: episodes from our own lives
▪ Stress – the response or experience of an
▪ Flashbulb Memories: specific or surprising
individual to demands that he or she perceives as
events that are so vivid in memory it as if they
taxing or exceeding his or her personal resources
represented a snapshot of the event
▪ The higher vulnerability, the lesser life stress
o Forgetting – permits us to form general impressions
needed to trigger traits
and recollections
▪ Disturbances stem from a genetic predisposition
▪ Helps us avoid being burdened and distracted by
triggered by stress
trivial stores of meaningless data
Predisposing Factor – cause of a disorder (i.e.,
▪ Failure of Encoding: failure to pay attention
situations that trigger the development of the disorder)
and place information in memory
Precipitating Factor – factors that allow the disorders
▪ Decay: loss of information due to non-use
to develop (i.e., factors that could contribute to the
▪ Cue-Dependent
Forgetting:
insufficient
development of a disorder)
retrieval cues
Protective Factor – reduces the severity of the
▪ Proactive Interference: learned earlier disrupts
problems
the recall of newer material; you forget the new
Perpetuating Factor – factors that maintain the
info
problem once established
▪ Retroactive Interference: difficulty in recalling
Gene-Environment Interaction
info learned earlier because of later exposure to
o Gene-Environment Correlation Model – people
different material; you forget the old info
might have genetically determined tendency to
o Learned Helplessness (Martin Seligman) – if they
create the environment risk factors that trigger a
learn that nothing they do helps them avoid the
genetic vulnerability
shocks, they eventually become helpless, give up,
o In most cases, genetic factors are not necessary and
and manifest an animal equivalent of depression
sufficient to cause mental disorders but instead can
▪ Anxiety is the first response to a stressful
contribute to a vulnerability or diathesis to develop
situation
psychopathology that only happens if there is a
▪ The depressive attributional style is (1) internal,
significant stressor in the person’s life
(2) stable, (3) global
o Epigenetics – study how your behavior and
o Aaron T. Beck suggested that depression may result
environment can cause changes that affect your
from a tendency to interpret everyday events in a
genes work
negative way
o Reciprocal Gene-Environment Model – claims
▪ Depressive Cognitive Triad – they make
that people with a genetic predisposition to a disorder
cognitive errors in thinking negatively about
may also have a genetic tendency to create
themselves, their immediate world, and their
environmental factors that promote the disorder
future
3 kinds of Gene-Environment Correlations
▪ Series of negative events in childhood,
Passive Gene-Environment – parent provide for their
individuals may develop deep-seated negative
children is influenced partly by the parents’ genotypes
schema, an enduring negative cognitive belief
Evocative Gene-Environment – child’s genotype
system about some aspect of life
evokes certain kind of reactions from other people
The reviewers I made are FREE :D instead of selling it, you can share the drive link to others :D Let’s help each other <3
See u soon, future RPms! - Aly
Abnormal Psychology
#BLEPP
Source: Barlow, Durand & Hofmann (2018), Comer & Comer (2017), Hooley, Butcher, Nock & Mineka (2017), DSM-V,
DSM-V-TR, Psych Pearls
▪ Their risk-taking behavior does not guarantee
- Genetic makeup may affect the reactions of other
death
people to a child and, hence, the kind of social
o
Subintentional
Death – a death in which the victim
environment that the child will experience
plays an indirect, hidden, partial, or unconscious role
Active Gene-Environment – children’s genotype
o Suicide is officially the 11th cause of death in US
influence the kinds of environment they seek
o Suicidal Ideation – thinking seriously about suicide
Role of culture, social interactions, and interpersonal
o Suicidal Plans – formulation of a specific method
factors in the development
for killing oneself
o Sociogenic Factors:
o
Suicidal Attempts – the person survives from
a. Unemployment
attempts
b. Poverty
o Emile Durkheim’s Suicide Types:
c. Crime
a. Altruistic – formalized suicides; dishonor to self,
d. Poor Educational Level
family, or society
o People who are isolated and lack social support or
b.
Egoistic – loss of social supports as an important
intimacy in their lives are more likely to become
provocation for suicide
depressed when under stress and to remain depressed
c. Anomic – result of marked disruptions, such as
longer than people with supportive spouses or warm
sudden loss of job
friendships
d. Fatalistic – loss of control over one’s own destiny
o People’s online relationships tend to parallel their
o Freud believed that suicide indicated unconscious
offline relationships
hostility directed inward to the self rather than
o Family Systems Theory – family is a system of
outward to the person or situation causing the anger
interacting parts who interact with one another in
o If a family member committed a suicide, there is an
consistent ways and follow rules unique to each
increased risk that someone else will also
family
o Low levels of serotonin is associated with suicide
▪ Structure and communication patterns of some
and with violent suicide attempts (low levels of
families actually force individual members to
serotonin is linked with impulsivity, instability, and
behave in a way that otherwise seems abnormal
the tendency to overreact to situation)
o An individual’s behavior, whether normal or
o The stress of a friend’s suicide or some other major
abnormal, is best understood in the light of the
stress may affect several individuals who are
individual’s unique cultural context
vulnerable because of existing psychological
o Multicultural Perspective – each culture within
disorders
large society has a particular set of values and beliefs,
o
Hopelessness – pessimistic belief that one’s present
as well as special external pressures, that help
circumstances, problems, or mood will not change
account for the behavior and functioning of its
o
Dichotomous Thinking – viewing problems and
members (Culturally Diverse Perspective)
solutions in rigid either/or terms
Suicide
o Common triggering factors:
o Suicide – self-inflicted death in which the person
✓ Stressful events
acts intentionally, directly, and consciously
✓ Mood and thought changes
o Death Seekers – clearly intend to end their lives at
✓ Alcohol and other drug use
the time they attempt suicide
✓ Mental disorders
▪ May last only a short time
✓ Modeling
o Death Initiators – clearly intent to end their lives,
o One of the signs of suicides is when the client are
but they act out of a belief that the process is already
giving away their prized possessions
under the way and that they are simply hastening the
Psychological
Disorders and Specific Symptoms based
process
on
DSM-5
(50)
o Death Ignorers – do not believe that their selfo Ego-Syntonic – actions that align with the client’s
inflicted death will mean the end of their existence
personal goals, values, and beliefs
o Death Darers – experience mixed feelings, or
o Ego-Dystonic – actions that are inconsistent with the
ambivalence, about their intent to die, even at the
client’s ego
moment of their attempt, and they show this
ambivalence in the act itself
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Source: Barlow, Durand & Hofmann (2018), Comer & Comer (2017), Hooley, Butcher, Nock & Mineka (2017), DSM-V,
DSM-V-TR, Psych Pearls
o Primary Gain – psychological disorder manifesting
Specific Phobia (≥ 6 months)
physically
- irrational fear of a specific object or situation that
o Secondary Gain – they act sick because they want
markedly interferes with an individual’s ability to
external reinforcement (malingering)
function
Differentiating Anxiety disorders
- acquired through direct experience, experiencing in
Separation Anxiety Disorder (≥ 4 wks, C; ≥ 6 mos,
false alarm, and observation
A)
- it only fears one setting, unlike Agoraphobia (which
- concerns with real or imagined separating from
requires 3 settings), then Specific Phobia-Situational
attachment figures
can be diagnosed
- separation may lead to extreme anxiety and panic
- usually develops during childhood
attacks
- there may be genetic susceptibility to certain
- not entirely responsible for school absences or
category of specific phobia
school avoidance
- Animal, Natural Envi, and Situational-Specific
- do not attend school so they won’t be separated with
Phobias ~ Women > Men
their attachment figure
- Blood-Injection-Injury Phobia ~ Women = Men
- fear of possible separation is the central thought
- increased risk for the development of other disorder
- concerned about the proximity and safety of key
such as other anxiety disorders, depressive and bipolar
attachment figures
disorders, substance related disorders, somatic
- develops after life stress, bullying and a history of
disorders, and PD
parental overprotection and intrusiveness
- 6 months or more
- heritable
Social Anxiety Disorder (≥ 6 months)
- highly co-morbid with GAD and Specific Phobia in
- fear or anxiety about possible embarrassment or
children
scrutiny
- for Adults, common comorbidities inc. phobia,
- can have panic attacks but it is cued by social
PTSD, Panic Disorder, GAD, SAD, Agora, OCD,
situations
Prolonged Grief Disorder, PD (Dependent, Avoidant,
- typically have adequate age-appropriate social
and OCPD), MDE and Bipolar Disorders
relationships and social communication capacity
- at least 4 weeks (children) or 6 months or more
- Self-medication with substances is common
(adults)
- Blushing: hallmark physical response of Social
Selective Mutism (≥ 1 month)
Anxiety Disorder
- rare childhood disorder
- heritable
- characterized by a lack of speech in one or more
- Paruresis: difficulty peeing in public restrooms or
setting in which speaking is socially expected
with people nearby
- restricted to a specific social situation
- Chronic Isolation in the course of Social Anxiety
- a child could speak in one setting but cannot/do not
Disorder may result to MDD
in another setting
- frequently co-morbid with BDD and Avoidant PD
- not better explained by communication disorder
- In children, comorbidities with high-functioning
- only diagnosed when a child has established a
ASD and Selective Mutism are common
capacity to speak in some social situations
- 6 months or more
- learn to perform avoidance and safety behaviors to
Panic Disorder (≥ 1 month)
avoid disasters
- cannot be diagnosed unless full symptom panic
- children with selective mutism are almost always
attacks were experienced
given an addtl. Diagnosis of another anxiety disorder
- norepinephrine activities are irregular
(usually, Social Anxiety)
- abrupt surge of intense fear or discomfort out of
- increased abnormalities in the auditory efferent
nowhere, with no triggers
neural activity during vocalization
- followed by persistent concerns about more attacks
- parents are described to be overprotective or more
or the consequences of it or maladaptive change in
controlling
behavior related to the attacks
- at least 1 month
- women > men
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Source: Barlow, Durand & Hofmann (2018), Comer & Comer (2017), Hooley, Butcher, Nock & Mineka (2017), DSM-V,
DSM-V-TR, Psych Pearls
Agoraphobia (≥ 6 months)
Posttraumatic Stress Disorder (≥ 1 month)
- developed after a person has unexpected panic
- exposure to actual death, injury or sexual violence
attacks
(direct experience, witness, learning that the event
- fear in two or more situations (public transpo, open
happened to a close family, repeated exposure)
spaces, enclosed spaces, standing in line, being
- more than 1 month
outside of the home alone) due to thoughts that escape
- heightened activity in the HPA axis
might be difficult or no one will help them in case
- requires trauma exposure precede the onset of the
panic-like symptoms would manifest
symptoms
- has the strongest and most specific association with
- With Delayed Expression: if full criteria are not met
the genetic factor that represent proneness to phobia
until at least 6 months after the event
- 90% of individuals with agoraphobia also have other
- too much use of dissociation
mental disorders
Acute Stress Disorder (3 days ≤ ∞ ≤ 1 month)
- 6 months or more
- exposure to trauma (direct experience, witness,
Generalized Anxiety Disorder (≥ 6 months)
learning that event occurred to close fam, repeated
- difficulty to control worry
exposure)
- excessive anxiety and worry occurring more days
- 3 days to 1 month after trauma exposure
than not for at least 6 months, about a number of
- if the symptoms persists for more than 1 month and
events or activities
meet the criteria for PTSD, then PTSD will be
- “the world is a dangerous place”
diagnosed
- intense cognitive processing in the frontal lobes,
Adjustment Disorder (within 3 months)
particularly in the left hemisphere
- development of emotional or behavior symptoms in
- intense worrying may act as avoidance
response to identifiable stressors occurring within 3
- worry whether or not they are judged/evaluated
months of the onset of the stressors
- fear circuit is excessively active
- If symptoms persist beyond 6 months after the
- decreased GABA activity
stressor or its consequences have ceased, the diagnosis
Differentiating
Trauma-and-Stressor
Related
will no longer apply (Other specified Trauma- and
Disorders
Stressor-Related Disorder)
Reactive Attachment Disorder
- May sometimes be diagnosed instead of
bereavement if bereavement is judged to be out of
- withdrawn toward adult caregivers
proportion to what would be expected or significantly
- evident before age 5 years
impairs self-care and interpersonal relations
- history of severe social neglect
- persons from disadvantaged life circumstances
- Persistent: more than 12 months
experience a high rate of stressors and may be at risk
- Severe: when a child exhibits all symptoms of the
for adjustment disorders
disorder, with each symptom manifesting at relatively
high levels
Prolonged Grief Disorder (nearly everyday)
- significantly impairs young children’s abilities to
- death, at least 12 months, of a person close to the
relate interpersonally to adults or peers
bereaved individual (6 months for children)
- co-morbid with cognitive delays, language delays
- focused on loss and separation from a loved one
and stereotypies
rather than reflecting generalized low mood
- internalizing symptoms may also co-occur
- distress from a deceased person
Disinhibited Social Engagement Disorder
- heightened by increased dependency on the deceased
prior to death
- actively approaches and interacts with unfamiliar
- women >>>
adults
- increased tobacco and alcohol use and other medical
- can be distinguished from ADHD by not showing
conditions
difficulties in attention or hyperactivity
- co-morbid with MDD, PTSD and substance-use
- Persistent: more than 12 months
disorders (also, Separation Anxiety Disorder)
- Severe: when a child exhibits all symptoms of the
disorder, with each symptom manifesting at relatively
high levels
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Source: Barlow, Durand & Hofmann (2018), Comer & Comer (2017), Hooley, Butcher, Nock & Mineka (2017), DSM-V,
DSM-V-TR, Psych Pearls
Differentiating OCD-Related Disorders
excessive eating and gradual development of morbid
Obsessive-Compulsive Disorder
obesity
- With Excessive Acquisition: if difficulty discarding
- Obsessions: intrusive and mostly nonsensical
possessions is accompanied by excessive acquisitions
thoughts, images, or urges that the individual tries to
of items that are not needed or for which there is not
resist or eliminate
available space
- Compulsions: thoughts or actions used to suppress
- other common features: indecisiveness,
the obsessions and provide relief
perfectionism, avoidance, procrastination, difficulty
- Sensory Phenomena: physical experiences that
planning, and organizing tasks
precede compulsions
- Animal Hoarding
- common to avoid people, places, and things that
- not direct consequence of neurodevelopmental
trigger OC
disorder, nor delusion, nor psychomotor retardation,
- Accommodation: involvement of family and friends
fatigue, or loss of energy
in compulsive rituals
- risks: perinatal events, premature birth, tobacco use
Trichotillomania
during pregnancy, sexual and physical abuse or other
- should not be diagnosed when hair removal is
environmental factors like infectious agents
performed solely for cosmetic reasons
- Tic Disorders is common to co-occur in patients
- may be triggered by feelings of anxiety of boredom,
with OCD
may be preceded by an increasing sense of tension or
- obsessions usually do not involve real life concerns
may lead to gratification, pleasure, or sense of relief
and can include one, irrational, or magical content
when the hair is pulled out
- In BDD and Tricho, the compulsive behavior is
- hair pulling does not usually occur in the presence of
limited to hair pulling or distortions in absence of
other individuals, except immediate family members
obsessions
- disorder is more common in individual with OCD
- obsessions and compulsions are not limited to
and their first-degree relatives
concerns about weight and food
- diagnosis will be OCD, if there is obsession of
- Compulsions are usually preceded by obsessions,
symmetry
tics are often preceded by premonitory sensory urges
- someone with ASD could have hair-pulling
Body Dysmorphic Disorder
behaviors when frustrated or angry, so if it’s
impairing then it can be diagnosed as stereotypic
- preoccupation with some imagined defect
movement disorder
- imagined ugliness
- note the delusion or hallucination, if then, psychotic
- with muscle dysmorphia: preoccupied with the idea
disorder
that his or her body build is too small
- accompanied by MDD and Excoriation disorder
- have ideas or delusions of reference
- associated with high levels of anxiety, social
Excoriation
avoidance, depressed mood, negative affectivity,
- skin-picking
rejection sensitivity, and perfectionism
- note delusion or tactile hallucination
- as well as low extroversion and low self-esteem
- In absence of deception, excoriation disorder can be
- associated with abnormalities in emotion regulation,
diagnosed if there are repeated attempts to decrease or
attention, and executive function
stop skin picking
- excessive appearance-related preoccupations and
Explaining Somatic Symptom Disorders
repetitive behaviors that are time-consuming
Somatic Symptom Disorder
- can be co-morbid with eating disorders, MDD,
- one or more symptoms cause distress and disruption
Social Anxiety, and substance-related disorders
of daily life
Hoarding
- chronic, influenced by the number of symptoms,
- difficulty discarding or parting with possessions
age, level of impairment, and any comorbidity
- Prader-Willi Syndrome: characterized by severe
- cognitive features include attention focused on
hypotonia, poor appetite, and feeding difficulties in
somatic symptoms, attribution of normal bodily
early infancy, followed in early childhood by
sensations to physical illness, worry about illness, a
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Source: Barlow, Durand & Hofmann (2018), Comer & Comer (2017), Hooley, Butcher, Nock & Mineka (2017), DSM-V,
DSM-V-TR, Psych Pearls
self-concept of bodily weakness, and intolerance of
conditions is diagnosed when the psychological traits
bodily complaints
or behaviors do not meet criteria for a mental
- typically present to general health services rather
diagnosis
than mental health services
Factitious Disorder
- more frequent in individuals with few years of
- Imposed on Self: individual present himself or
education and low socioeconomic status
herself as ill
- ineffectiveness of analgesics, history of mental
- Imposed on Another: presents another individual as
disorders, unclear palliative factors, persistence
ill
without cessation, and stress
- absence of obvious rewards
- must be accompanied by excessive or
- Malingering: false medical symptoms or
disproportionate thoughts, feelings, or behavior
exaggerating existing symptoms in hopes of being
- focus is on the distress that particular symptoms
rewarded
cause
Evaluating DID from other Disorders
- individual’s belief that somatic symptoms might
Depersonalization-Derealization Disorder
reflect serious underlying physical illness are not held
- Depersonalization: your perception alters so that
with delusional intensity
you temporarily lose the sense of your own reality, as
- with enhanced perceptual sensitivity to illness cues
if you are in a dream watching yourself
Illness Anxiety Disorder (≥ 6 months)
- Derealization: your sense of external world is lost;
- preoccupation with having or acquiring serious
thing may seem to change shape or size, people may
illness
seem dead or mechanical
- usually minimal to no symptoms, mild intensity
- characterized by the presence of constellation of
- interpret ambiguous stimuli as threatening
typical depersonalization/derealization symptoms and
- develop in the context of a stressful life
the absence of manifestations of illness anxiety
- People who develop these disorders tend to have a
disorder
disproportionate incidence of disease in their family
- must precede the onset of major depressive epi or
when they were children
clearly continues even after its resolution
- co-occurs with anxiety disorders, OCD, and
- when symptoms occur ONLY during panic attacks,
depressive disorders
it must not be diagnosed with D/DD
- history of child abuse and neglect
Dissociative Amnesia
- 2-3x more common in women
- inability to recall important autobiographical
- Panic Disorder and depressive disorders commonly
information, usually of traumatic or stressful nature,
co-occur with Conversion Disorder
that is inconsistent with ordinary forgetting
- also, Somatic Symptom Disorder
- usually localized or selective amnesia for specific
Conversion Disorder (Functional Neurological
events, then generalized, if entire life history
Symptom Disorder)
- Dissociative Fugue: memory loss revolves around
- altered voluntary motor or sensory function
specific incident, an unexpected trip; individuals just
- incompatibility between the symptom and
take off and later find themselves in a new place,
recognized neurological or medical conditions
unable to remember why or how you got there
- unexpected neurological disease cause for the
- If a person experiencing PTSD cannot recall part or
symptoms is rarely found at follow-up
all of specific trauma event and that extends to beyond
- too much use of denial
the immediate time of the trauma, comorbid diagnosis
Psychological Factors affecting other Medical
of DA may be warranted
Conditions
- there must be no true neurocognitive deficits
- medical symptom is present
- too much use of repression
- psychological or behavioral factors affect medical
Dissociative Identity Disorder
condition
- disruption of identity characterized by two or more
- psychological or behavioral factors are judged to
distinct personality states
affect the course of medical condition
- host personality: the person who becomes the patient
- Psychological factors affecting other medical
and asks for treatment; developed later
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Source: Barlow, Durand & Hofmann (2018), Comer & Comer (2017), Hooley, Butcher, Nock & Mineka (2017), DSM-V,
DSM-V-TR, Psych Pearls
- switch: transition from one personality to another
- children with DMDD should not have symptoms that
- extreme subtype of PTSD
meet criteria for BD, as in that context, only the
- Hypnotic Trance: tend to be focused on one aspect
bipolar disorder diagnosis should be made
of their world and they become vulnerable to
- if children have symptoms that meet criteria for
suggestions by the hypnotist
ODD or IED and DMDD, then only DMDD is the
- present with comorbid depression, anxiety,
diagnosis
substance abuse, self-injury, or another common
Major Depressive Disorder (≥ 2 weeks)
symptom
- at least 2 weeks of either anhedonia or depressed
- early life trauma represent as risk factor
mood
- several brain regions have been implicated in the
- associated with high mortality
pathophysiology of DID, including the orbitofrontal
- hyperactivity in HPA axis and it appears to be
cortex, hippocampus, parahippocampal gyrus, and
associated with melancholia, psychotic features, and
amygdala
risks for eventual suicide
- does not have a classic bipolar sleep disturbance
- “other specified depressive disorder” can be made in
- Individuals with schizophrenia have low hypnotic
addition to the diagnosis of psychotic disorder, if the
capacity, whilst, individuals with DID have highest
depressive symptoms meet full criteria for MDE
hypnotic capacity among all clinical groups
- in schizoaffective, delusions or hallucinations occur
- appear to encapsulate a variety of severe personality
exclusively for 2 weeks without MDE
disorder features
- Seasonal, Catatonic, Melancholic
- too much use of dissociation
- other disorders with which MDD co-occurs are
- comorbid with PTSD, depressive disorders,
substance-related disorders, panic disorder, GAD,
substance-related disorders, feeding and eating
PTSD, OCD, AN, BN, and Borderline PD
disorders, etc.
Persistent Depressive Disorder (Dysthymia) (≥ 2
- most common forms of functional neurological
yrs)
symptom disorder include nonepileptic seizures, gait
- depressed mood for at least 2 years
disturbances, and paralyses
- if full criteria for a MDE has been met at some point
Illustrating Depressive Disorders
during the period of illness, a diagnosis of MDD
Unipolar Disorders
would apply. Otherwise, a diagnosis of “other
Disruptive Mood Dysregulation Disorder (3x or
specified depressive disorder” or “unspecified
more/week, ≥ 12 months)
depressive disorder” should be given
- recurrent temper outburst (verbally or behaviorally)
- a separate diagnosis of PDD is not made if the
that are grossly out of proportion
symptom occur only during the course of the
- 3 or more times/week
psychotic disorder
- irritable or angry most of the day
- Double Depression: suffer from both MDE and PDD
- 12 or more months, at least 2 settings
with fewer symptoms
- onset should be after 6 yrs-18yrs
Premenstrual Dysphoric Disorder
- factors associated with disrupted family life
- majority of menstrual cycles, at least 5 symptoms
- family history of depression may be a risk factor
must be present
- do not occur exclusively during MDE
- delusions and hallucinations have been described in
- bipolar = episodic, DMDD = persistent
the late luteal phase of the menstrual cycle but are rare
- diagnosis cannot be assigned to a child who has ever
o Seasonal Affective Disorder – episodes must have
experienced full-duration hypomanic or manic episode
occurred for at least 2 yrs with no evidence of
(irritable or euphoric) or who has ever had a manic or
nonseasonal MDE during that period of time
hypomanic episode lasting more than 1 day
▪ Cabin fever
- presence of severe and frequently recurrent outburst
o Integrated Grief – acute grief, the finality of death
and persistent disruption in mood between outburst
and its consequences are acknowledged and the
- severe in at least one setting and mild to moderate to
individual adjusts to the loss
second setting
o Complicated Grief – this reaction can develop
without preexisting depressed state
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DSM-V-TR, Psych Pearls
o Bipolar disorder may simply be a more severe variant
- When any child is being assessed for Mania, it is
of mood disorders
essential that the symptoms represent clear change
o Depression and mania appear to be the world’s first
from the child’s typical behavior
documented mental illnesses
- Symptoms of mood lability and impulsivity must
o Aretaeus of Cappadocia – combined these two
represent a distinct episode of illness, or there must be
groups of symptoms into bipolar disorder by stating
a noticeable increase in these symptoms over the
that mania was a worsened state of melancholia
individual’s baseline in order to justify an additional
o Theophile Bonet – began using the term
diagnosis of BP1
melancholicus mania in 1679
- Young people who meet DSM-5 diagnostic criteria
o Willis – described Melancholia and Mania as
for BP display significant impairment in functioning,
distempers of raving in his writing
including previous hospitalization, MDD, treatment
o Emil Kraeplin – employed a unifying approach to
with medications, and co-occurring disruptive
the classification of mood disorders, resulting in
behavior and anxiety disorder
bipolar disorder being subsumed within the category
- Youths may show irritability and rage or silly, giddy,
of manic-depressive insanity (MDI)
overexcited, overly talkative behavior
▪ Individuals with this diagnosis experienced mild
- generally shorter than MDE, lasting from 4-6
residual states after recovery from individual
months if left untreated
episodes and mild fluctuations between episodes
- most frequently comorbid disorders are anxiety
▪ Adolf Meyer, Karl Abraham, and Melanie Klein,
disorders, alcohol use disorder, other substance
were some of the first to make references to
disorders, and ADHD
manic-depressive symptoms in children
- high rates of serious co-occurring and often
o Things to consider in the Dx of Depressive Disorder
untreated medical conditions
DUE to another med condition:
Bipolar II (Hypomanic, ≥ 4 days)
✓ No depressive prior to the onset of medical
- MDE + Hypomanic episodes
condition (e.g., before Manny was diagnosed
- often begins with depressive episodes
with cancer, he never experienced depressive
- highly recurrent
episodes)
- once hypomanic episode has occurred, it never
✓ the probability that a medical condition has a
reverts back to MDD
potential to cause a depressive disorder
- BP2 is distinguished from cyclothymic disorder by
Bipolar Disorders
the presence of one or more hypomanic episodes and
Bipolar I (Manic, ≥ 1 week)
one or more MDE
- at least 1 manic episode (elation and euphoria)
- common feature is impulsivity
- children should be judged according to his or her
- heightened levels of creativity during hypomanic
own baseline in determining whether a particular
episodes
behavior is normal or evidence of manic episode
- perform more poorly than healthy individuals on
- first ep usually MDE
cognitive tests, may contribute to vocational
- factors that should be considered: family history,
difficulties
onset, medical history, presence of psychotic
- more often than not associated with one or more cosymptoms, history of lack of response to
occurring mental disorders, with anxiety disorders
antidepressant treatment or the emergence of manic
being the most common
episode during antidepressant treatment
- risk tends to be highest among relatives of
- The diagnosis is “Bipolar I disorder, with psychotic
individuals with BPII, as opposed to individuals with
features” if the psychotic symptoms have occurred
BP1 or MDD
EXCLUSIVELY during manic and major depressive
Cyclothymic Disorder (≥ 2 years, ≥ 1 year for
episodes
Children and Adolescents)
- Symptoms of mania in BP1 occur in distinct
- milder but more chronic version of bipolar disorder
episodes and typically begin in late adolescence or
- do not meet the complete criteria for depressive
early adulthood
symptoms and hypomanic symptoms
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Source: Barlow, Durand & Hofmann (2018), Comer & Comer (2017), Hooley, Butcher, Nock & Mineka (2017), DSM-V,
DSM-V-TR, Psych Pearls
- MDD, BP1, and BP2 are more common among first
- repeated regurgitation of food for at least 1 month
degree biological relatives of indivs with cyclothymic
- infants with rumination disorder display
disorder
characteristic position of straining and arching the
- substance-related disorders and sleep disorders may
back with head held back, making sucking movements
be present in individuals with cyclothymic disorder
with their tongue (give an impression of pleasure or
satisfaction)
o Adolescents with Mania often have complex
- irritable and hungry between episodes
presentations that include psychotic symptoms
- features: weight loss and failure to make expected
o Adolescents may have prolonged early course and a
weight gains
poorer response to treatment
- re-chewed, re-swallowed, or spit-out
o Children often seem to exhibit a very rapid
- not attributable to gastrointestinal or other medical
fluctuation in mood symptoms, especially when such
condition
symptoms are co-morbid with other disorders
- self-soothing or self-stimulating
o Irritability in children with BD is very severe,
- can occur in the context of a concurrent medical
persistent, highly disabling, and often associated
condition or another mental disorder
with violence
o Clients experience difficulties in emotion regulation
Avoidant/Restrictive Food Intake Disorder
o Emotional Overregulation also is related to
- eating or feeding disturbance
behavioral inhibition and may lead to internalizing
- lack of interest in eating food
problems in children
- dependence on enteral feeding or nutritional
o Emotion Reactivity – refers to individual
supplements
differences in the threshold and intensity of
- risks: familial anxiety
emotional experience, which provide clues to an
- A/RFID co-morbid with ASD has male
individual’s level of distress and sensitivity to the
predominance
environment
- requires that the disturbance of intake is beyond that
▪ Increased in children with bipolar disorder
directly accounted for by physical symptoms
o Emotion Regulation – involves enhancing,
consistent with medical condition; the eating
maintaining, or inhibiting emotional arousal, which
disturbance may also persist after being triggered by
is usually done for a specific purpose or goal
medical condition and following resolution of the
o Dysregulation – means that existing control
medical condition
structures operate maladaptively
- if eating problems is the focus, then A/RFID, if
o Emotions help young children learn more about
weight, then Anorexia Nervosa
themselves and their surroundings, as part of
- might precede the onset of Anorexia Nervosa
learning to identify and monitor their feelings and
- Food Avoidance Emotional Disorder
behavior
- co-morbid with Anxiety disorders, ADHD, ID
Explaining Eating and Sleeping Disorders
Anorexia Nervosa
Eating Disorders
- fear of gaining weight
Pica (≥ 1 month)
- subtypes: binge-eating/purging type and restricting
- eating of non-nutritive, nonfood substances for at
type
least 1 month
- associated with stressful life event
- no biological abnormalities found
- additional diagnosis of BDD may be considered if
- neglect, lack of supervision, and developmental
the distortion is unrelated to body shape and size
delay can increase the risk for this condition
(there is a separation distortion in mind happening)
- inappropriate to the developmental age
- amenorrhea and cardiovascular problems
- co-morbid with ASD, ID, and to some degree, schizo
- very underweight
and OCD
- Bipolar, Depressive, and anxiety disorders
- can be associated with trichotillomania and
commonly co-occur with Anorexia Nervosa
excoriation, which the skin or hair is typically
- Alcohol use Disorder and other substance disorder
ingested
may also be co-morbid with Anorexia, especially
Rumination Disorder (≥ 1 month)
those with binge eating/purging type
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DSM-V-TR, Psych Pearls
Bulimia Nervosa (once a week, for 3 months)
Without constipation and overflow incontinence
- recurrent episodes of binge-eating then purging to
Sleeping Disorders
prevent weight gain
o Dyssomnias – difficulties in getting enough sleep,
- binge-eating for at least once a week for 3 months
problems with sleeping when you want to and
- normal weight
complaints about the quality of sleep
- chronic purging can result to enlargement of salivary
o Parasomnias – characterized by abnormal behavior
gland caused by repeated vomiting, causing chubby
or physiological events that occur during sleep
face
o REM Sleep – during which the majority of typical
- electrolyte imbalance that may lead to arrythmia,
story-like dreams occur (20%-25% of total sleep)
seizures, and renal failure
NREM Sleep Stage 1 (N1) – transition from
Binge-Eating Disorder (once a week, for 3 months)
wakefulness to sleep and occupies about 5% of time
spent asleep in healthy adults
- recurrent episodes of just binge eating
- do not show marked or sustained dietary restriction
NREM Sleep Stage 2 (N2) – characterized by specific
designed to influence body weight and shape between
electroencephalographic waveforms (sleep spindles
binge-eating episodes
and K complexes), occupies about 50% of time spent
- consume more calories in laboratory studies of
sleep
eating behavior and have greater functional
NREM Sleep Stage 3 (N3) – slow wave sleep; deepest
impairment, lower quality life, more subjective
level of sleep
distress, and greater psychiatric comorbidity
o Sleep Continuity – overall balance of sleep and
- usually overweight
wakefulness during night of sleep
- most common comorbid disorders – MDD and
Sleep Latency – amount of time required to fall asleep
alcohol use disorder
Wake after Asleep onset – the amount of awake time
Elimination Disorders
between initial sleep onset and final awakening
Enuresis
Number of awakenings
- repeated voiding of urine in bed, voluntary or
Sleep Efficiency – ratio of actual time spent asleep to
intentional
time spent in bed
- on nocturnal, voiding usually happens during REM
o Sleep Architecture – amount and distribution of
Sleep
specific sleep stages
- enuretic events most commonly occur in the early
▪ Measures the amount of REM sleep and each
afternoon on school days or after returning to school
NREM sleep stage, relative amount of REM sleep
- developmental delays, including speech, language,
and NREM sleep stages, and latency between
learning, and motor skills delay are present in a portion
sleep onset and the first REM period
of children with enuresis
Insomnia (3 nights/week, ≥ 3 months)
- difficulty initiating and maintaining sleep
Subtypes:
- early-morning awakening with inability to return to
Nocturnal (monosymptomatic enuresis)
sleep
Diurnal (Urinary Incontinence)
- at least 3 nights/week, for at least 3 months
Nocturnal and Diurnal (nonmonosymptomatic
- Rebound Insomnia: sleep problems re-appearing, but
enuresis)
sometimes worst
Encopresis (one event each month for ≥ 3 months)
- situational, persistent, or recurrent, episodic
- repeated passage of feces into inappropriate places
Hypersomnolence Disorder (3x/week, ≥ 3 months)
- feels ashamed and may wish to avoid situations that
- excessive sleepiness despite having at least 7 hours
might lead to embarrassment
of main sleep
- Enuresis is often present in children with encopresis,
- recurrent periods of sleep or lapses into sleep within
particularly in children with encopresis, without
the same day
constipation and overflow incontinence
- take longer naps, have trouble waking from naps,
and do not feel alert afterward
Subtypes:
- at least 3x/week, for at least 3 months
With constipation and overflow incontinence
Narcolepsy (3x/week, ≥ 3 months)
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DSM-V-TR, Psych Pearls
- recurrent episodes of irrepressible need to sleep,
- during REM sleep
lapsing into sleep, or napping with cataplexy,
- upon awakening, the individual is completely awake,
hypocretin deficiency, and evidence from
alert, and not confused
polysomnography showing REM sleep latency less
Restless Legs Disorder (3x/week, ≥ 3 months)
than or equal to 15 mins
- urge to move the legs, usually accompanied or in
- 3x/week, for at least 3 months
response to uncomfortable and unpleasant sensations
Obstructive Sleep Apnea Hypopnea
of the legs
- at least 4 obstructive apneas or hypopneas per hour
- during rests
of sleep or evidence from polysomnography of 15 or
- sense of relief during the movement
more obstructive apneas and/or hypopneas per hour of
- worse in evening
sleep
- 3x/week, for at least 3 months
- Apnea: absence of airflow
Evaluating Sexual dysfunctions, Paraphilic disorders,
- Hypopnea: reduction in airflow
and Gender Dysphoria
Central Sleep Apnea
Sexual Dysfunctions
- evidence by polysomnography of 5 or more central
Delayed Ejaculation (≥ 6 months)
apneas per hour of sleep
- delay or absence of ejaculation
- Cheyne-Stokes Breathing: an abnormal pattern of
- associated with highly frequent masturbation, use of
breathing characterized by progressively deeper, and
masturbation techniques not easily duplicated by a
sometimes faster, breathing followed by a gradual
partner, and marked disparities between sexual
decrease that results in a temporary stop in breathing
fantasies during masturbation and the reality of sex
called an apnea
with a partner
Sleep-Related Hypoventilation
- less coital activity, higher levels of relationship
distress, sexual dissatisfaction, lower subjective
- Polysomnography demonstrates episodes of
arousal, anxiety about their sexual performance, and
decreased respiration associated with elevated CO2
general health issues than sexually functional men
levels
- at least 6 months
Circadian Rhythm Sleep-Wake Disorders
- either lifelong or acquired, generalized or situational
- persistent or recurrent pattern of sleep disruption due
- common in severe forms of MDD
to alteration of the circadian system or misalignment
Erectile Disorder (≥ 6 months)
between the endogenous circadian rhythm
- difficulty having, maintaining erection and decrease
- leads to excessive sleepiness or insomnia, or both
in erectile rigidity
Non-REM Sleep Arousal Disorders
- low self-esteem, low self-confidence, and a
- incomplete awakening from sleep: sleepwalking or
decreased sense of masculinity, and may experience
sleep terrors
depressed mood
- cannot remember anything when they woke up
- strongly associated with feelings of guilt, self-blame,
- occur mostly in childhood and non-rem sleeps
sense of failure, anger, and concern about
- produce rapid and complete awakening without
disappointing one’s partner
confusion, amnesia, or motor activity
- decreased sexual satisfaction and reduced sexual
Nightmare Disorder
desire
- repeated occurrences of extended, extremely
- co-morbid with other sexual disorders, anxiety and
dysphoric, and well-remembered dreams that usually
depressive disorders
involve efforts to avoid threats to survival, security, or
- at least 6 months
physical integrity
Female Orgasmic Disorder
- upon awakening, they become oriented and alert
- delay or absence of orgasm and reduced intensity of
- appear in children exposed to acute or chronic
orgasmic sensations
psychosocial stressors
- greater difficulty communicating about sexual issues
- occur during REM Sleep
- high levels of sexual satisfaction despite rarely or
REM Sleep Behavior Disorder
never experiencing orgasm
- repeated episodes of arousal during sleep associated
with vocalization and/or complex motor behaviors
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DSM-V-TR, Psych Pearls
Paraphilic Disorders
- may have co-occurring sexual interest/arousal
difficulties
Voyeuristic Disorder (≥ 6 months)
- at least 6 months
- intense arousal from observing an unsuspecting
- either lifelong or acquired, generalized or situational
naked person for at least 6 months
Female Sexual Interest/Arousal Disorder (≥ 6
- nonconsensual
months)
- childhood sexual abuses, substance misuse, and
sexual preoccupation/hypersexuality
- absent/reduced interest in sexual activity
- at least 18 yrs old
- associated with problems in experiencing orgasm,
pain experienced during sexual activity, infrequent
Exhibitionistic Disorder (≥ 6 months)
sexual activity, and couple-level discrepancies in
- intense arousal from exposing genitals to an
desire
unsuspecting person for at least 6 months
- no sexual thoughts or fantasies, no initiation, no
- nonconsensual
sexual excitement or pleasure during sex
Frotteuristic Disorder (≥ 6 months)
- distressing low desire is associated with depression,
- intense arousal from touching or rubbing genitals
thyroid problems, anxiety, urinary incontinence, and
against nonconsenting person for at least 6 months
other medical factors
- nonconsensual
- at least 6 months
Sexual Masochism (≥ 6 months)
Genito-Pelvic Pain/Penetration Disorder (≥ 6
- intense sexual arousal from the act of being
months)
humiliated, beaten, bound, or otherwise made to suffer
- difficulties in vaginal penetration during intercourse
for at least 6 months
- vaginal pain during intercourse or penetration
Sexual Sadism (≥ 6 months)
attempts
- intense sexual arousal from the physical suffering of
- anxiety about anticipating vulvovaginal or pelvic
another person for at least 6 months
pain
Pedophilic Disorder (≥ 6 months)
- frequently associated with other sexual dysfunctions,
- intense sexually arousing fantasies, urges, or
particularly reduced sexual desire and interest
behaviors involving prepubescent child or children for
- pattern of avoidance is similar to that seen in phobic
at least 6 months
disorders
- has ACTED on these urges
- at least 6 months
- at least 16 yrs old and at least 5 yrs older than the
Male Hypoactive Sexual Disorder (≥ 6 months)
child or children
- persistently deficient or absent sexual/erotic thoughts
Fetishistic Disorder (≥ 6 months)
or fantasies and desire for sexual activity
- intense sexual arousal from either the use of
- sometimes associated with erectile and/or
nonliving objects or highly specific focus on
ejaculatory concerns
nongenital body parts for at least 6 months
- rarely the sole sexual diagnosis in men
- not limited to cross-dressing or sex toys
- at least 6 months
Transvestic Disorder (≥ 6 months)
Premature (Early) Ejaculation (≥ 6 months)
- intense arousal from cross-dressing for at least 6
- ejaculation approx. 1 min following vaginal
months
penetration or even before the individual wishes it
Gender Dysphoria
- complain a sense of lack of control over ejaculation
Gender Dysphoria (≥ 6 months)
and report apprehension about their anticipated
- marked incongruence between one’s
inability to delay ejaculation on future sexual
experienced/expressed gender and assigned gender,
encounters
for at least 6 months
- associated with erectile problems
- intersexuality or hermaphroditism
- at least 6 months and must be experienced on almost
- slightly higher levels of testosterone or estrogen at
all or all occasions
certain critical periods of development
- show elevated levels of anxiety, disruptive, impulsecontrol, and depressive disorders
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DSM-V-TR, Psych Pearls
Explaining Substance-Related and Addictive Disorder
2. Prodromal Stage – drinking heavily but with few
o Substance – chemical compounds that are ingested
outward signs of a problem
to alter mood or behavior
3. Crucial Stage – loss of control, with occasional
o Psychoactive substances – alter mood, behavior, or
binges
both
4. Chronic Stage – primary daily activities involve
o Substance Use – ingestion of psychoactive
getting and drinking alcohol
substances in moderate amounts that does not
Caffeine – most common psychoactive substance
significantly interfere with social, educational, or
- “gentle stimulant”
occupational functioning
- found in tea, coffee, soda, and cocoa products
o Substance Intoxication – physiological reaction to
Cannabis (Marijuana) – reactions include mood
ingested substances
swings or even dream-like experiences
o Substance Use Disorders – how much of a
- chronic and heavy users report tolerance, especially
substance is ingested is problematic
to euphoric high: they are unable to reach the levels of
o Physiological Dependence – meaning the use of
pleasure they experienced earlier
increasingly greater amounts of the drug to
Hallucinogens – most common, “LSD” produced
experience the same effect (tolerance) and a negative
synthetically in the laboratory
physical response when the substance is no longer
- others: psilocybin (mushroom), lysergic acid amide
ingested (withdrawal)
(seeds of morning glory plant), dimethyltryptamine
Alcohol – produced when certain yeast react with
(DMT), and mescaline
sugar and water, then fermentation takes place
- Phencyclidine (PCP) is snorted, smoked, or injected
- depressant
intravenously, and it causes impulsivity and
- inhibitions are reduced and we become more
aggressiveness
outgoing
Inhalant – solvents, aerosol sprays, gases, nitrites,
- with more drinking, alcohol depresses the brain
usually found at home or workplace
which impedes the functioning
Opioid – natural chemicals in the opium poppy that
- Withdrawal Delirium (Delirium Tremens): condition
have narcotic effect (relieves pain and induce sleep)
that can produce frightening hallucinations and body
- includes natural opiates, synthetic variation, and the
tremors
comparable substances that occur naturally in the
- Breathalyzer: measures levels of intoxication
brain
- GABA seems to be particularly sensitive to alcohol
- also includes Heroin
- The Glutamate system is involve why alcohol affects
Sedative-, Hypnotic-, or Anxiolytic- - calming,
our cognitive abilities
sleep-inducing, and anxiety-reducing
- Two types of organic brain syndromes may result
- includes barbiturates and benzodiazepines
from long-term alcohol use: Dementia and
- barbiturates and benzodiazepines relax the muscles
Wernicke-Korsakoff Syndrome (Confusion, loss of
and can produce mild feeling of well being
muscle coordination, and unintelligible speech,
- combining alcohol with these substances can be fatal
believed to be cause by a deficiency of thiamine)
(Manilyn Monroe case)
- Fetal Alcohol Syndrome
Stimulant – most commonly consumed psychoactive
- Alcohol Dehydrogenase: metabolize alcohol
drugs in US
- Korsakoff syndrome: is a chronic memory disorder
- includes caffeine, nicotine, amphetamines, and
caused by severe deficiency of thiamine (vitamin Bcocaine
1).
- Amphetamine: can induce feelings of elation and
- Korsakoff syndrome is most caused by alcohol
vigor and can reduce fatigue; prescribed to people
misuse, but certain other conditions also can cause the
with narcolepsy and ADHD
syndrome
- another variants of Amphetamine are Methylenedioxymethamphetamine or ecstasy club drug (makes
Four-Stage Model for the progression of
you feel euphoric) and methamphetamine (crystal
Alcoholism:
meth)
1. Pre-Alcoholic Stage – drinking occasionally with
few serious consequences
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DSM-V-TR, Psych Pearls
- Cocaine: increases alertness, produces euphoria,
- An additional diagnosis of gambling disorder should
increases blood pressure and pulse, and causes
be given only if the gambling behavior is not better
insomnia and loss of appetite
explained by manic episodes
- Intranasal use and oral use of substances result in
- associated with poor general health
more gradual progression occurring over months to
Explaining Disruptive, Impulse-Control disorders,
years
and Conduct Disorder
Tobacco – contains nicotine
Oppositional Defiant Disorder (≥ 6 months
- linked with signs of negative affect such as
- angry irritable mood, argumentative/defiant behavior
depression, anxiety, and anger
against authority figure for at least 6 months
- being depressed increases your risk of becoming
- annoys others
dependent on nicotine and, at the same time, being
- blames others for his/her mistakes
dependent will increase your risk of becoming
- two of the most co-occurring conditions w ODD are
depressed
ADHD and CD
o Acute alcohol withdrawal occurs as an episode
- precedes the development of conduct disorder,
usually lasting 4-5 days and only after extended
common in children with the childhood-onset subtype
periods of heavy drinking
- conveys risk for the development of anxiety
o Withdrawal is rare for individuals younger than 30
disorders and MDD
years
- increased risk for a number of problems in
o The symptoms of an alcohol-induced mental
adjustment as adults
disorder are likely to remain clinically relevant as
- less severe than CD and do not include aggression
long as the individual continues to experience severe
towards people, property (IED)
intoxication or withdrawal
- co-morbid with ADHD
o Genetic factors may affect how people experience
- diagnosis should not be made if the symptoms occur
and metabolize certain drugs
exclusively during the course of a mood disorder
o Positive and Negative Reinforcement
- if criteria for DMDD are met, then DMDD is given
o Opponent-Process Theory – an increase in positive
even if all criteria for ODD are met
feelings will be followed shortly by an increase in
Intermittent Explosive Disorder (2x/week, for 3
negative feelings and vice versa
months)
o Expectancy Effect – expectancies develop before
- behavioral outburst, failure to control aggressive
people actually use drugs, perhaps as a result of loved
impulses
one’s use, advertising, etc.
- verbal aggression, physical aggression twice weekly
o Treatment:
Nicotine
replacement
therapy,
for a period of 3 months
Bupropion, Naltrexone, Acamprosate, Disulfiram,
- at least 6 yrs of age
Methadone, Buprenorphine, Aversion Therapy, In- quite common regardless of the presence of ADHD
patient treatments, Aversion Therapy, etc.
or other disruptive, impulse-control, and conduct
o Cross-Tolerance – tolerance for a substance has not
disorders
taken before as a result of using another substance
- depressive disorders, anxiety disorders, and
similar to it
substance use disorders are associated
o Synergistic Effect – an increase of effects that
- presence of serotogenic abnormalities, globally and
occurs when more than one substance is acting on the
in the brain, specifically in areas of limbic system and
body at the same time
orbitofrontal cortex
Gambling Disorder (within 12 months)
- amygdala responses to anger stimuli are greater
- persistent and recurring gambling behavior
- volume of gray matter in several frontolimbic
- at least 4-symptoms within 12 months
regions is reduced
- Onset can occur during adolescence or young
- Also, should not be made in children and adolescents
adulthood but in other individuals it manifests during
ages 6-18 years, when the impulsive aggressive
middle or even older adulthood
outbursts occur in the context of an adjustment
- Progression appears to be more rapid in women than
disorder
in men
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DSM-V-TR, Psych Pearls
- A diagnosis of DMDD can only be given when the
- arousal before the act
onset of recurrent, problematic, impulsive aggressive
- fascination to fire and its situational context
outburst is before age of 10 years
- not done for monetary gain or etc.
- A diagnosis of DMDD should be made for the first
- separate diagnosis is not given when fire setting
time after 18 years
occurs as part of CD, manic episode, or antisocial
- Aggression in ODD is typically characterized by
personality disorder
temper tantrums and verbal arguments with authority
- high co-occurrence of substance-use disorders,
figures, whereas IED are in response to a broader
gambling, depressive and bipolar disorders, and other
array of provocation and include physical assault
disruptive impulse-control, and conduct disorders
- co-morbid with depressive disorders, anxiety
Kleptomania
disorders, PTSD, Bulimia, Binge-eating, and
- failure to resist impulses to steal objects that are not
substance use disorder
need for personal use
Conduct Disorder
- there is an attempt to resist the impulse to steal, and
- repetitive and persistent pattern of behavior in which
they are aware that the act is wrong and senseless
the basic rights of others or major age-appropriate
- increase tension before committing the theft
societal norms or rules are violated
- pleasure after committing the theft
- often bullies, initiates fights, physically cruel,
- often feels depressed or guilty about the thefts
destroying properties, theft, serious violation of rules
- associated with compulsive buying and depressive,
- Onset may occur as early as the preschool years, but
bipolar, anxiety, eating, personality, substance-use
the first significant symptoms usually emerge during
and other disorders
the period from middle childhood through middle
Illustrating the different Personality Disorders
adolescence
Cluster A
- ODD is the most common precursor to the
Paranoid
childhood-onset type
- excessively mistrustful and suspicious of others,
- Physically aggressive symptoms = childhood
without justification
- Nonaggressive symptoms = adolescence
- problems with close relationships
- May be diagnosed in adults, though onset is rare
- overt argumentativeness, in recurrent complaining,
after age 16 years
or by hostile aloofness
- Childhood-onset type predicts a worse prognosis and
- need to have a high degree of control over those
an increased risk of criminal behavior in adulthood
around them
- When criteria for both ODD and CD are met, both
- rigid, critical of others, and unable to collaborate,
diagnoses can be given
although they have great difficulty accepting criticism
- When criteria for both ADHD and CD are met, both
themselves
diagnoses can be given
- more common among relatives who have
- Individuals with conduct disorder will display
schizophrenia
substantial levels of aggressive or nonaggressive
- maybe due to early mistreatment or traumatic
conduct problems during periods in which there is no
childhood experiences
mood disturbance, either historically or concurrently
- associated with prior history of childhood
- If criteria for both IED and CD has been met, the
mistreatment, externalizing symptoms, bullying, and
diagnosis of IED should be given only when the
adult appearance of interpersonal aggression
recurrent impulsive aggressive outbursts warrant
- “I cannot trust people”
independent clinical attention
- too much use of projection
- CD is diagnosed only when the conduct problems
- Males = Females
represent a repetitive and persistent pattern that is
- may experience brief psychotic episodes
associated with impairment in social, academic, or
- may develop MDD, Agoraphobia, and OCD
occupational functioning
- most common co-occurring PD appear to be
Pyromania
schizotypal, schizoid, narcissistic, avoidant, and
- purposeful fire setting on more than one occasion
borderline
- make considerable advance prep for starting a fire
Schizoid
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DSM-V-TR, Psych Pearls
- detachment from social relationships and limited
- often intense, going from anger to deep depression in
range of emotions
a short time
- difficulty expressing anger, even in response to
- prevalent in families with history of mood disorders
direct provocation, which contributes to the
- if co-occurs with mood disorders, both are diagnosed
impression that they lack emotion
- recovery is more difficult and less stable
- tendency to turn inward and away from the outside
- “sad gorl iz me”
world
- Females = Males
- childhood shyness is reported as a precursor to later
- common co-occurring disorders incl. depressive and
personality disorder
bipolar disorders, substance use disorders, anxiety
- “Relationships are messy and undesirable”
disorders, eating disorders, PTSD, and ADHD
- Males > Females
Narcissistic
- sometimes, experience brief psychotic episodes
- they consider themselves different from others and
Schizotypal
deserve special treatment
- typically socially isolated and behave in ways that
- unreasonable sense of self-importance and are so
would seem unusual to many of us, and they tend to
preoccupied with themselves that they lack sensitivity
be suspicious and to have odd beliefs
and compassion
- ideas of reference: false beliefs that random or
- grandiosity
irrelevant occurrences in the world directly relate to
- very sensitive to criticism
oneself
- interpersonal relations are typically impaired
- have odd beliefs or engage in magical thinking
because of problems related to self-preoccupation,
- associated with childhood mistreatment and could be
entitlement, need for admiration, and relative
resulted from PTSD symptoms
disregard for sensitivities of others
- “It is better to be isolated from others”
- “I am the greatest in the world”
- Males > Females
- Males > Females
- often seek treatment for the associated symptoms of
Antisocial
anxiety or depression rather than PD
- characterized as having history of failing to comply
Cluster B
with social norms
Histrionic
- at least 18 years of age
- evidence of CD before 15 years old
- tend to be overly dramatic and almost to be acting
- irresponsible, impulsive, and deceitful
- express emotions in an exaggerated manner
- lacking in conscience and empathy, selfishly take
- characterized by social dominance
what they want and do as they please, violating social
- more likely to get divorced or never get married
norms and expectations
- have tendency to get bored with their usual routine
- CD will be given if the criteria for Antisocial PD is
- histrionic and antisocial co-occur more often
not met
- “ako ang bida”
- Underarousal Hypothesis: psychopaths have
- Females > Males
abnormally low levels of cortical arousal
Borderline
- Fearlessness Hypothesis: psychopaths possess a
- moods and relationships are unstable, and usually
higher threshold for experiencing fear than most other
they have poor self-image
individuals
- have pattern of undermining themselves at the
- “I am entitled to break rules”
moment the goal is about to be realized
- Males > Females
- may feel more secure with transitional object than
- may experience dysphoria, incl. complaints of
interpersonal relationships
tension, inability to tolerate boredom, and depressed
- often feel empty and are great risk of dying by their
mood
own hands
- often engage to suicidal behaviors
- tend to have turbulent relationships, fearing
abandonment but lacking control over their emotions
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DSM-V-TR, Psych Pearls
Cluster C
o Philippe Pinel – French physician who described
cases of schizophrenia
Avoidant
o
Benedict Morel – used the term demence precoce
- extremely sensitive of the opinion of others and
meaning early or premature loss of mind to describe
although they desire social relationship, their anxiety
schizophrenia
leads them to avoid
o Emil Kraepelin – unified the distinct categories of
- they are likely to misinterpret social responses as
schizophrenia under the name Dementia Praecox
critical, which in turn confirms their self-doubts
▪
Combined several symptoms of insanity that had
- low self-esteem and hypersensitivity to rejection
usually been viewed as reflecting separate and
- have insecure attachment style characterized by
distinct disorders:
desire for emotional attachment
a. Catatonia – alternating immobility and excited
- extremely low self-esteem cause them to be limited
agitation
with friendships and dependent to those they feel
b. Hebephrenia – silly and immature emotionality
comfy with
c. Paranoia – delusions of grandeur or persecution
- feel chronically rejected by others and pessimistic
▪ Distinguished dementia praecox
about their future
▪ Also noted the numerous symptoms in people
- negative self-concept
with dementia praecox, including hallucinations,
- Social Anxiety Disorder – negative evaluations
delusions, negativism, and stereotyped behavior
- “If they knew the real me, they would reject me”
o Eugen Bleuler – introduced the term schizophrenia
- Females > Males
(“splitting of mind”)
Dependent
▪
Associative Splitting
- rely on others to make ordinary decisions and even
o Positive Symptoms:
important ones which results in an unreasonable fear
1. Delusions – misrepresentation of reality (disorder
of abandonment
of thought content)
- characterized by pessimism and self-doubt and tend
Persecutory
– belief that one is going to be harmed,
to belittle their abilities and assets
harassed
and
so forth
- take criticism and disapproval as proof of their
Referential – certain gestures, comments,
worthlessness and lose faith in themselves
environmental cues, and so forth are directed at one- agree with other people’s opinion just to be not
self
rejected
Grandiose – when an individual believes that he or
- feel uncomfortable or helpless when alone
she has exceptional abilities, wealth, or fame
- “I need people to survive and be happy”
- Females > Males
Erotomanic – when an individual believes falsely
that another person is in love with him or her
Obsessive-Compulsive
Nihilistic – conviction that a major catastrophe will
- perfectionist
occur
- fixation on things being done “the right way”
- this preoccupation with details prevents them from
Somatic – focus on preoccupations regarding health
completing much of anything
and organ function
- need to control
Thought Withdrawal – thoughts have been
- when criteria for both OCD and OCPD are met, both
“removed” by outside force
can be given
Thought Insertion – thoughts have been put into
- “I am perfectionist, everything should be done under
one’s mind
my control and liking”
Delusions of Control – one’s body or actions are
- Males > Females
being acted on or manipulated by some outside force
Illustrating Schizophrenia
Capgras Syndrome – person believes someone he or
o John Haslam – superintendent of a British Hospital
she knows has been replaced by a double
who outlined a description of the symptoms of
Cotard’s Syndrome – the person believes he or she is
Schizophrenia in his book Observations on Madness
dead
and Melancholy
Clerambault Syndrome - characterized by the
delusional idea, usually in a young woman, that a man
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DSM-V-TR, Psych Pearls
whom she considers to be of higher social and/or
- Clang Associations: are groups of words chosen
professional standing is in love with her
because of the catchy way they sound, not because of
what they mean
Fregoli Syndrome – a person holds a delusional
"Gusto ko ng arrozcaldo, na apurado pero
belief that different people are in fact a single person
bugbog sarado na may champorado at biglang
who changes his or her appearance or is in disguise
dehado,"
▪ Motivational View of Delusions – look at these
- Loose Association: a loose connection between
beliefs as attempts to deal with and relieve
thoughts that are often unrelated
anxiety and stress
"Umuwi ako ng probinsya. Favorite ko ang
▪ Deficit View of Delusions – sees these beliefs as
Speak Now TV. Ay! Malamig pala sa North Pole.
a resulting from brain dysfunction that creates
Eto nga pala anak ko. Ang sakit mo naman sa
these disordered cognitions or perceptions
puso,"
2. Hallucinations – experience of sensory events
- Neologism: creating a new word meaning only to that
without any input from the surrounding
person
environment
Lathyzoid. Oh, hindi mo alam meaning diba?
Auditory Hallucination – most common form
that's the point.
experienced by people with schizophrenia
- Word Salad: combination of words that have no
Autoscopic Hallucination - individual experiences,
meaning
all or part of the person's own body appeared within
"Mine enchanted why sparks fly grow
the external space, viewed from his/her physical body
superman,"
Hypnagogic Hallucination – happens during sleep
Inappropriate Affect – laughing or crying at improper
Ictal Hallucination – associated with temporal lobe
times
foci
Grossly Disorganized or abnormal motor behavior
Hypnopompic Hallucinations – happens when
– childlike silliness to unpredictable agitation
waking up
o Neologisms – construction of new words in order to
▪ Most active part during Hallucination is Broca’s
communicate with schizophrenics thoughts
Area (speech production)
o More severe symptoms of schizophrenia first occur
o Negative Symptoms – usually indicate absence or
in late adolescence or early adulthood
insufficiency of normal behavior
o
Prodromal Stage – 1-2 year period before the
Avolition – inability to initiate and persist activities
serious symptoms occur but when less severe yet
Anhedonia – lack of pleasure
unusual behaviors start to show themselves
Asociality – lack of interest in social interactions
o
Schizophrenia is partially the result of excessive
Flat Affect/Affective Flattening – do not show
stimulation of striatal dopamine d2 receptors
emotions when you would normally expect them to
o
It appears that several brain sites are implicated in the
o Disorganized Symptoms
cognitive dysfunction observed among people with
Disorganized Speech – individual may switch from
schizophrenia, especially prefrontal cortex, various
one topic to another (derailment or loose associations)
related cortical regions and subcortical circuits,
or answers to questions may be related or completely
including thalamus and the striatum
unrelated (tangentiality)
o
Schizophrenogenic Mother – used for a time to
- Circumstantiality: excessive and irrelevant detail in
describe a mother whose cold, dominant, and
descriptions with the person eventually making his/her
rejecting nature was thought to cause schizophrenia
point
in her children
"Kumuha ako ng Koko Crunch sa sm, katabi ng
o
Double bind communication – used to portray
honey gold flakes, nasa taas niya yung kellogs, color
communication style that produced conflicting
green yung milo.. masarap yung Koko Crunch,"
messages, which caused schizophrenia to develop
- Concrete Thinking: unable to abstract and speaks in
o
Families with high expressed emotion view the
concrete, literal terms
symptoms of schizophrenia as controllable and that
Kapag sinabihan mo siya ng "Break a leg", iisipin
the hostility arises when family members think that
niya na babaliin niya dapat ang legs niya
patients just do not want help themselves
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DSM-V-TR, Psych Pearls
Delusional Disorder (≥ 1 month)
- major mood ep + delusions or hallucinations for 2 or
more weeks
- one or more delusions for at least 1 month
- some individuals tend to change diagnosis into mood
- persistent belief that is contrary to the reality in the
disorder or to schizophrenia over time
absence of other characteristics of schizophrenia
- Anosognosia (poor insight) common in
- tend not to have flat affect, anhedonia, or other
schizoaffective but less severe than in schizophrenia
negative symptoms
- socially isolated due to being suspicious
Neurodevelopmental Disorders
- Shared Psychotic Disorder (Folie a Deux):
Intellectual Developmental Disorder
condition in which an individual develops delusions
- includes both intellectual and adaptive functioning
simply as a result of a close relationship with a
deficits in conceptual, social, and practical domains
delusional individual
- difficulties with day-to-day activities to an extent
- Erotomanic, Grandiose, Jealous, Persecutory,
that reflects both severity of their cognitive deficits
Somatic, Mixed, Unspecified
and the type and amount of assistance their receive
- functioning is better than what is observed in
- difficulties in conceptual, social, and judgement
Schizophrenia
- causes: deprivation, abuse, neglect, exposure to
- eventually develop schizophrenia
disease or drugs during pre-natal, difficulties during
- absence of active phase of schizophrenia (Attenuated
labor and delivery, infections, and head injury
Psychosis Syndrome)
- Phenylketonuria, Lesch-Nyhan Syndrome, Down
Brief Psychotic Disorder (1 day ≤ ∞ ≤ 1 month)
Syndrome, Fragile X Syndrome
- presence of one of the ff: delusions, hallucinations,
- generally nonprogressive, there are period of
disorganized speech, catatonic behavior for at least 1
worsening, then stabilization, and in others
day but less than 1 month, with eventual full return to
progressive of intellectual function in varying degrees
premorbid level of functioning
- 2 SD below the mean
- typically experience emotional turmoil or
- lifelong
overwhelming confusion
- most common co-occurring neurodevelopmental and
- can experience relapse
other mental disorders are ADHD, Depressive and
- if psychotic symptoms persist for at least 1 day in
Bipolar disorder, anxiety disorders, ASD, stereotypic
PD, an additional diagnosis of Brief Psychotic
movement disorder, impulse-control disorders, and
Disorder may be appropriate
major neurocog. disorders
Schizophreniform Disorder (1 month ≤ ∞ ≤ 6
Components of Intellectual Functioning
months)
1. Verbal Comprehension
- two or more of the following, present during a 12. Working Memory
month period: delusions, hallucinations, disorganized
3. Perceptual Reasoning
speech, catatonic behavior, negative symptoms
4. Quantitative Reasoning
- at least 1 month BUT less than 6 months
5. Abstract Thought
- development similar to schizophrenia
6. Cognitive Efficacy
Schizophrenia (≥ 6 months)
- two or more of the following, present during 1DSM-IV Criteria Intellectual Disability Severity
month period: delusions, hallucinations, disorganized
1. IQ 50-69 Mild – can live independently;
speech, catatonic behavior, negative symptoms
intermittent support needed
- disturbance in one or more major areas
2. IQ 36-64 Moderate – moderate levels of support;
- at least 6 months
limited support needed in daily situations
- abrupt or insidious
IQ 20-35 Severe – requires daily assistance; extensive
- prognosis is influenced both by duration and by
support needed
severity of illness and gender
IQ <20 Profound – requires 24-hour care; pervasive
- possible reduced psychotic experience during late
support needed for every aspect
life
- often have congenital syndrome
- too much use of regression
Global Developmental Delay
Schizoaffective Disorder (≥ 2 weeks)
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- for children under 5 years old when they fail to meet
- deficient Communication, Restrictive/Repetitive
expected developmental milestone in several areas of
Actions/Behaviors, Impaired Social Interaction
functioning
- evident in early childhood
- failure to develop age-appropriate social
Language Disorder
relationships, social reciprocity, nonverbal comms,
- difficulties in acquisition and use of language
and initiating and maintaining social relationships
modalities due to DEFICITS in comprehension and
- inability to engage in joint attention
production
- maintenance of sameness
- reduced vocab, limited sentence structure,
- The developmental course and absence of restrictive,
impairments in discourse
repetitive behaviors and unusual interests in ADHD
- can be adept at accommodating to their limited
help in differentiating ASD and ADHD
language
- A concurrent diagnosis of ADHD should be
- shy or reticent to talk
considered when attentional difficulties or
- regional, social, or cultural/ethnic variations must be
hyperactivity exceeds that typically seen in
considered when an individual is being assessed
individuals of comparable mental age
- declines in critical social communication behavior
- ADHD is one of the most common comorbidities in
during the first two years of life are evident in most
ASD
children with ASD, thus, it must be not confused with
- A diagnosis of ASD in individual with IDD is
LD
appropriate when social communication and
- associated with SLD, IDD, ADHD, ASD, and DCD
interaction are significantly impaired relative to the
Speech Sound Disorder
developmental level of the individual’s nonverbal
- difficulty in speech sound production
skills
- children’s progression in mastering speech sound
- IDD is appropriate diagnosis when there is no
production should result in most intelligible speech by
apparent discrepancy between the level of social
3 years old
communicative skills and other intellectual skills
- continuous use of immature phonological
- The diagnosis of ASD supersedes that of social
simplification processes when the child has already
communication disorder whenever the criteria for
passed the age wherein most of them can now produce
ASD are met, and care should be taken to enquire
words clearly
carefully regarding past or current restricted/repetitive
- when LD is present, Speech Sound Disorder has
behavior
poorer prognosis
- Rett Disorder – genetic condition that affects
- selective mutism may develop
mostly females and is characterized by hand wringing
- co-occur with language disorder
and poor coordination
Childhood-Onset Fluency Disorder (stuttering)
- Clear genetic component
- disturbances in normal fluency and time patterning
- Evidence of brain damage combined with
of speech that are inappropriate for the individual’s
psychosocial influences
age and language skills
Attention-Deficit/Hyperactivity Disorder (≥ 6
- can be insidious or more sudden
months)
Social (Pragmatic) Communication Disorder
- pattern of inattention and/or hyperactivity- difficulties in the social use of verbal and nonverbal
impulsivity that interferes functioning for at least 6
communication
months
- deficits in using communication for social purposes
- dislikes organization, focused work
in a manner that is appropriate for the social context
- often losses things, forgets daily activities, and easily
- difficulties in following the rules of conversating and
distracted
do not understand metaphors, etc.
- fidgets a lot, stands up when seating is expected,
- current symptoms or developmental history fails to
always “on the go”
reveal evidence that could meet the
- present in two or more settings
restrictive/repetitive patterns of behavior, interests, or
- difficulty sustaining their attention on task or activity
activities of ASD
- in pre-school, main manifestation is hyperactivity
Autism Spectrum Disorder
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DSM-V-TR, Psych Pearls
- Fidgetiness and restlessness in ADHD are typically
- reversible
generalized and not characterized by repetitive
- occurs during the course of dementia
stereotypic movements
- full recovery with or without treatment
- A diagnosis of ADHD in IDD requires that
Major Neurocognitive Disorder
inattention or hyperactivity be excessive for mental
- gradual deterioration of brain functioning that affects
age
memory, judgement, language, and other advanced
Specific Learning Disorder (≥ 6 months)
cognitive process
- difficulties learning and using academic skills for at
Mild Neurocognitive Disorder
least 6 months, despite interventions
- early stages of cognitive declines
- academic skills are substantially and quantifiably
- most impairments in cognitive abilities but can, with
below those expected for the individual’s
some accommodations
chronological age, IQ, and education
o Dementia – describe a group of symptoms affecting
Developmental Coordination Disorder
memory, thinking, and social abilities severely
- acquisition and execution of coordinated motor skills
enough to interfere daily life
are below expected given the chronological age
Alzheimer’s
- clumsiness, slowness, and inaccuracy of
– most common type of neurocognitive disorder,
performance of motor skills
usually occurring after the age 65, marked most
Stereotypic Movement Disorder
prominently by memory impairment
- repetitive, seemingly driven, and apparently
- Usually begins with mild memory problems, lapses
purposeless motor behavior
of attention, and difficulties in language and
- may result in self-injury
communication
Tic Disorders
- Excessive senile plaques (sphere-shaped deposits of
beta-amyloid protein that form in the spaces between
- Tourette’s: both motor and one or more vocal tics
certain neurons and in certain blood vessels of the
for more than 1 year
brain as people age) and neurofibrillary tangles
- Persistent: single or multiple motor or vocal tics, but
(twisted protein fibers that form within certain
NOT BOTH for more than 1 year
neurons)
- Provisional: single or multiple more and/or vocal
- includes multiple cognitive deficits that develop
tics for less than 1 year since the first onset
gradually and steadily
- Motor Stereotypies are defined as involuntary
- inability to integrate new information results to
rhythmic, repetitive, predictable movements that
failure to learn new association
appear purposeful but serve no obvious adaptive
- Anomia, Apraxia, Agnosia, Amnesia, Aphasia
function; often self-soothing or pleasurable and stop
- cognitive deterioration is slow during the early and
with distraction
later stages but more rapid during middle stages
Neurocognitive Disorders
Vascular Injury
o Diffuse – widespread damage
o Focal – involve circumscribed areas of abnormal
- when the blood vessels in the brain are blocked or
change in brain structure
damaged and no longer carry oxygen and other
nutrients to certain areas of brain tissues, damage
Delirium
results
- characterized by impaired consciousness and
- declines in speed of information processing and
cognition during the course of several hours or days
executive functioning
- appear confused, disoriented, and out of touch with
Frontotemporal Degeneration
their surroundings
- often associated with disturbance in sleep-wake
- categorize a variety of brain disorders that damage
cycle (daytime sleepiness, nighttime agitation,
the frontal or temporal regions of the brain – areas that
difficulty falling asleep, excessive sleepiness, or
affect personality, language, and behavior
wakefulness at night)
- declines in appropriate behavior or language
- effects may more lasting
- Pick’s Disease: rare neurological condition that
- can be experienced by children who have high fevers
produces symptoms similar to Alzheimer’s, usually
or taking certain medication
occurring in relatively early in life (40s or 50s)
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DSM-V-TR, Psych Pearls
Traumatic Brain Injury
- caused by single dominant gene (Huntingtin Gene)
on Chromosome 4
- symptoms must persist for at least a week following
- loss of cells in the basal ganglia and cortex
the trauma, including executive dysfunction and
problems with learning and memory
Prion Disease
Lewy Body Disease
- caused by prions (proteins that can reproduce and
cause damage to brain cells leading to neurocognitive
- involves the buildup of clumps of protein deposits
decline
called Lewy Bodies, within many neurons
- no treatment but not contagious
- Features significant movement difficulties, visual
- Creutzfeldt-Jakob Disease: symptoms include
hallucinations, and sleep disturbances
spasms of the body caused by slow acting virus that
- Second most common neurocognitive disorder
may live in the body for years before the disease
- gradual and include impairment in alertness and
develops
attention, vivid visual hallucinations, and motor
impairment
Therapeutic Interventions of Psychological Disorders
Parkinson’s Disease
(10)
- slowly progressive neurological disorder marked by
Different Psychological Interventions
tremors, rigidity, and unsteadiness
Treatment: Definition of Terms
- motor problems, tend to have stooped posture, slow
o Idiographic Data – specific details and background
body movements (bradykinesia), tremors, and
information
jerkiness
▪ Specific or unique information
- can also involve depression, anxiety, apathy,
o Nomothetic – broad information, nature, and
cognitive problems, and even positive symptoms
treatment
- damage in dopamine pathways, loss of dopamine
▪
Generalization or commonalities with other
neurons in substantia nigra
context
- second most common neurodegenerative disorder
o
Treatment
– also known as therapy, procedure
HIV Infection
designed to change abnormal behavior to a more
- HIV infection seems to be responsible for the
normal behavior
neurological impairment
▪
Consists of client, therapies, and series of contact
- early symptoms: cognitive slowness, impaired
attention, and forgetfulness
between them
- clumsy, repetitive movements, and become apathetic
Psychological Interventions
and socially withdrawn
Psychodynamic
- sometimes referred as Subcortical Dementia
1. Free Association – therapist tells the patient to
- more likely to experience depression and anxiety
describe any thought, feeling, or image that comes to
- involves various changes in the brain such as
mind even if it seems unimportant
generalized atrophy, edema, inflammation, and
2. Transference – they act and feel toward the
patches of demyelination
therapist as they did toward important person in their
Substance-Use
lives
- use of different psychoactive substances + poor diet
3. Resistance – unconscious refusal to participate
- include memory impairment, aphasia, apraxia,
fully in the therapy
agnosia, or disturbance in executive functioning
4. Dreams interpretation – can reveal unconscious
Huntington’s
instincts, needs, and wishes
- inherited progressive disease in which memory
- Manifest: consciously remembered dream
problems, along with personality changes and mood
- Latent: meaning
difficulties, worsen over time
5. Catharsis – reliving past repressed feelings
- characterized by chronic, progressive chorea with
- powerful emotional release that, when successful, is
subtle cognitive problems
accompanied by cognitive insight and positive change
- Have movement problems too, such as severe
6. Working Through – patient and therapist must
twitching and spasms
examine the same issues over and over in the course
- rare degenerative disorder of CNS
of many sessions
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DSM-V-TR, Psych Pearls
7. Short-Term Psychodynamic Therapies – patient
respect, individual responsible behavior, and
choose a single problem, a dynamic focus to work on
meaningful activity
and work only on the psychodynamic issues that relate
11. Parent Management Training – combine family
to it
and cognitive-behavioral interventions to improve
8. Relational Psychoanalytic Therapy – therapist
family functioning and help parents deal with their
disclosing things about themselves, particularly their
children more effectively
own reactions to patients, and try to establish more
12. Gestalt Therapy – clinicians actively move
equal relationships with patients
clients toward self-recognition and self-acceptance by
8. Hypnotherapy – patient undergoes hypnosis and is
using techniques such as role playing and selfthen guided to recall forgotten events or perform other
discovery exercises
therapeutic activities
13. Interpersonal Social Rhythm Therapy – derived
9. Play Therapy – an approach to treating childhood
from interpersonal psychotherapy for depression and
disorders that helps children express their conflicts
behavioral intervention for social rhythm and sleepand feelings indirectly by drawing, playing, and
wake regulation
making stories
- focus on the difficulties that children and adolescents
with BD have with the rhythmicity of their behaviors
Humanistic
Cognitive
1. Client-Centered Therapy – clinicians try to help
clients by accepting, empathizing accurately, and
1. Cognitive-Behavioral Therapy – seek to help
conveying genuineness (Carl Rogers)
clients change both counterproductive behaviors and
dysfunctional ways of thinking
2. Support Group
- Rational-Emotive Behavioral Therapy: change and
3. Home-Based Self-Help Programs
identify irrational assumptions
4. Social Skills Training
- Mindfulness-Based CBT (Acceptance and
5. Family Therapy – therapist meets with the all the
Commitment Therapy): “thoughts are mere events of
members of a family and helps them to change in
mind”
therapeutic ways
- Behavioral Activation: therapy for depression in
- Maudsley Model: blames neither the parents nor the
which the client is guided systematically increase the
child for the disease
number of constructive and pleasurable activities and
6. Group Therapy – group of people with similar
events in his or her life
problems meet together with a therapist to work on
- Cognitive Remediation: focuses on the cognitive
those problems
impairments that often characterize people with
7. Psychological Debriefing – form of crisis
schizophrenia, particularly their difficulties in
intervention in which victims are helped to talk their
attention, planning, and memory
feelings and reactions to traumatic experiences
- Panic Control Treatment: clients are educated about
- critical incident stress debriefing
the nature of anxiety and panic and involves teaching
8. Interpersonal Psychotherapy (IPT) – treatment
people with panic disorder to control their breathing,
for depression that based on belief that clarifying and
then people are taught about the logical errors that
changing one’s interpersonal problems will help lead
people who have panic disorders are prone to making
to recovery
and learn to subject their own automatic thoughts to
- improving interpersonal functioning, addresses
logical re-analysis
current problems and relationships rather than
- Enhanced CBT (CBT-E): focuses on addressing,
childhood or developmental issues
disrupting, and modifying the factors that maintain the
9. Motivational Interviewing – use mixture of
eating disorders
empathy and inquiring review to motivate clients to
- Hallucination Reinterpretation and Acceptance:
recognize they have serious psychological problem
designed to help how people view and react to their
and to commit to making constructive choices and
hallucinations, so they will not suffer the fear and
behavior changes
confusion produced by their delusional
10. Milieu Therapy – institutions can help patients
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DSM-V-TR, Psych Pearls
- Dialectical Behavior Therapy: can help people who
- increase the activity of serotonin and norepinephrine
have difficulty with emotional regulation or are
3. Antipsychotic – correct grossly confused or
exhibiting self-destructive behaviors; accept the
distorted thinking
reality of their lives and their behaviors
- relieve anxiety by altering the activity of dopamine
2. Neutralizing – attempting to eliminate thoughts
4. Vagus Nerve Stimulation – treatment for
that one finds unacceptable by thinking or behaving in
depression in which implanted pulse generator sends
ways that make up for those thoughts and so put right
regular electrical signals to a person’s vagus nerve,
internally
then stimulates the brain
3. Exposure and Response (Ritual) Prevention –
5. Electroconvulsive Therapy – electrodes attached
treatment of OCD that exposes client to anxietyto patient’s head and send an electrical current
arousing thoughts or situations and then prevents the
through the brain, causing seizure
client from performing his or her compulsive acts
6. Transcranial Magnetic Stimulation –
4. Beck’s Cognitive Therapy – people identify and
electromagnetic coil, which placed on or above a
change the maladaptive assumptions and ways of
person’s head sends a current into the person’s brain
thinking that help cause their psychological disorders
7. Mood Stabilizers – stabilize the moods of people
5. Aversion Therapy – client is repeatedly presented
suffering from bipolar disorder
with unpleasant stimuli while performing undesirable
- also known as antibipolar drugs
behavior such as taking drug
- Lithium: metallic element that occurs in nature as
6. Relapse-Prevention Training – treatment for
mineral salt and is an effective treatment for bipolar
alcohol use disorder in which clients are taught to
disorders
keep track of their drinking behavior, apply coping
8. Detoxification – systematic and medically
strategies in situation that typically trigger excessive
supervised withdrawal from a drug
drinking, and plan for risky situations and reactions
- Disulfiram: causes violent vomiting when followed
7. Cognitive Processing Therapy – intervention for
by ingestion of alcohol
people with PTSD in which therapist guide
9. Antagonist Drug – block or change the effects of
individuals to examine and change the dysfunctional
an addictive drug
attitudes and styles of interpretation they have
10. Antianxiety – also called as minor tranquilizers,
developed as a result of their traumatic experiences,
help in reducing tension and anxiety
thus, enabling them to deal with difficult memories
11. SSRIs – treat depression by increasing the levels
and feelings
of serotonin in the brain
8. Mentalization – uses therapeutic relationship to
- block reabsorption of serotonin into neurons
help patients develop the skills they need to accurately
Behavioral
understand their own feelings and emotions, as well as
1. Exposure Treatment – behavior-focused
the feelings and emotions of others
intervention in which fearful people are repeatedly
9. Affectual Awareness – help identify and counter
exposed to the objects they dread
negative attitudes that one holds toward sex
- Virtual Therapy/Virtual Reality Treatment:
10. Positive Family Interaction Therapy – involves
cognitive-behavioral intervention that uses VR as an
both individual CBT with the client as well as
exposure tool
additional family sessions
- Prolonged Exposure: clients confront not only
Biological
trauma-related objects and situations, but also their
1. Sedative-Hypnotic Drugs – also called as
painful memories of traumatic experiences
anxiolytic, produce feelings of relaxation and
- Eye Movement Desensitization and Reprocessing
drowsiness
(EMDR): clients move their eyes in a rhythmic
- Benzodiazepines: sedative that slow down body and
manner from side to side while flooding their minds
brain’s function (depressant)
with images of objects and situations they ordinarily
- Barbiturates: medication that causes relaxation and
avoid
drowsiness (depressant)
- Participant Modeling: therapist calmly models ways
of interacting with the phobic stimulus or situation
2. Antidepressant – improve the mood of people with
depression
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- Interoceptive Exposure: deliberate exposure to
- Exposure Therapy
feared internal sensations
- Social Skills Training
- D-Cycloserine
2. Systematic Desensitization – exposure therapy
that uses relaxation training and a fear hierarchy to
Panic Attacks
- Antidepressant
help clients with phobias react calmly to the objects or
- CBT (Panic Control
situations they dread
Treatments)
- Anxiolytics
3. Flooding (Implosive Therapy) – exposure therapy
in which clients are exposed repeatedly and
Obsessive-Compulsive
- Free Association
intensively to a feared object and made to see that it is
Disorder
- Short-Term
actually harmless
Psychodynamic Therapy
- Neutralizing
4. Token Economy Programs – behavior-focused
- Exposure and Response
program in which a person’s desirable behaviors are
Prevention
reinforced systematically throughout the day by the
- Antidepressant
awarding of tokens that can be exchanged for goods
- Positive Family
or privileges
Interaction Therapy
5. Contingency Management – an operant
Body
Dysmorphic - Antidepressants
conditioning training program wherein clients are
Disorder
- Exposure and Response
offered incentives that are contingent on the
Prevention
submission of drug-free urine specimens
PTSD and Acute Stress - Antidepressant
Illustrate the Application of Psychological
Disorder
- CBT (MindfulnessInterventions for treatment
Based)
Disorder
Treatment
- Exposure Therapy
Generalized
Anxiety - Free Association
(Virtual Reality Therapy,
Disorder
- Dream Interpretation
Prolonged Exposure)
- Transference
- Group and Family
- Resistance
Therapy
- Client-Centered
- Psychological
Therapy
Debriefing
- CBT (Rational-Emotive
Dissociative Amnesia
- Psychodynamic
Therapy, MindfulnessTherapy
Based CBT)
- Hypnotic Therapy
- Benzodiazepines
- Drug Therapy (Amytal,
- Antidepressant
Pentothal)
- Antipsychotic
Dissociative
Identity - Psychodynamic
- Play Therapy
Disorder
- Supportive
Specific Phobia
- Exposure Treatments
- Cognitive
- Participant Modeling
- Drug Therapy
- Systematic
Depression
- Free Association
Desensitization
- CBT (Behavioral
- Flooding
Activation, Acceptance
Agoraphobia,
- Exposure Therapy
and Commitment
Separation
Anxiety (Prolonged Exposure)
Therapy)
Disorder
- Support Group
- Beck’s Cognitive
- Home-Based Self-Help
Therapy
– Programs
- Antidepressant
- Benzodiazepines, SSRIs
- Vagus Nerve
Social Anxiety
- Benzodiazepines
Stimulation
- Antidepressants
- CBT
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DSM-V-TR, Psych Pearls
- Electroconvulsive
Binge-Eating
- CBT
Therapy
- Antidepressant
- Transcranial Magnetic
Substance-Use
- Aversion Therapy
Stimulation
Disorders
- Contingency
- Interpersonal
Management
Psychotherapy
- Relapse Prevention
- Couple Therapy
Training
Bipolar Disorder
- Psychotropic Drugs
- CBT (Acceptance and
- Mood Stabilizers
Commitment Therapy)
- Antipsychotics
- Detoxification
- Antidepressant
- Antagonist Drugs
- Lithium
- Drug Maintenance
- Interpersonal Social
Therapy
Rhythm Therapy
- Self-Help Programs
- Family Intervention
- Community-Based
Prevention Programs
Suicide Attempts
- CBT (Mindfulness- Disulfiram
Based)
- Dialectal Behavior
Sexual Dysfunctions
- Affectual Awareness
Therapy (DBT)
- Self-Instruction
Training
Conversion and Somatic - Education
- Hormone Treatments
Symptom Disorders
- Reinforcement
- Cognitive Restructuring
Gender Dysphoria
- hormone administration
- CBT
- gender-confirmation
surgery/genderPhysical Disorders
- Relaxation Training
reassignment surgery
- Biofeedback
- Meditation
Schizophrenia
- Milieu Therapy
- Hypnosis
- Token Economy
- Self-Instruction
program
Training
- Antipsychotic Drugs
- Support Groups
- CBT (Cognitive
Remediation,
Anorexia
- Nutritional
Hallucination
Rehabilitation (tube and
Reinterpretation and
intravenous feedings)
Acceptance)
- Motivational
- Family Therapy
Interviewing
- Social Therapy
- CBT
- Family Therapy
Paranoid PD
- CBT
- Antidepressants
- Anxiety-Reduction
- Antipsychotic
Techniques
- Antipsychotic drugs
Bulimia
- Nutritional
Rehabilitation
Schizoid PD
- Social Skills Program
- Antidepressant
- Group Therapy
- CBT (Exposure and
- CBT
Response Prevention,
Schizotypal PD
- CBT
CBT-E)
- Speech Lessons
- Interpersonal
- Social Skills training
Psychotherapy
- Antipsychotic Drugs
- Psychodynamic
(low doses)
Therapy
Antisocial PD
- Antipsychotic Drugs
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especially when they are combined with
- CBT
Borderline PD
- Relational
psychotropic medications
Psychoanalytic Therapy
o Most patients have fewer new episodes of manic
- DBT
episodes by taking lithium and other mood stabilizers
- Mentalization
o Antipsychotic drugs reduced positive symptoms in
- antidepressant
around 70% of patients diagnosed with
- antibipolar
schizophrenia
- antianxiety
o Exposure therapies are effective with phobias
- antipsychotic
o Benzodiazepines can be effective in many cases of
Histrionic PD
- CBT
panic disorder, although they are used less often than
- Psychodynamic
depressants
Therapy
o CBT are equally effective as antidepressant drugs in
- Group Therapy
the treatment of panic disorders
Avoidant
PD
and - CBT
o Antidepressant drugs bring improvement to between
Dependent PD
- Psychodynamic
50 and 60 percent of those with obsessiveTherapy
- Exposure treatments
compulsive disorder
- Antianxiety
o Structures in the circuit do indeed seem to
- Antidepressant
interconnect more appropriately after individuals
- Short-term
with OCD respond successfully to antidepressant
psychotherapy
treatment
Obsessive-Compulsive
- SSRIs
o Long-term psychodynamic therapy is only
PD
occasionally helpful in cases of unipolar depression
Conduct Disorder
- Parent Management
(short-term >>>>)
Training
o Culture-Sensitive approaches increasingly are being
Encopresis, Enuresis
- dry-bed training
combined with traditional forms of psychotherapy to
(reinforcement)
help minority clients overcome their disorders
- biofeedback training
o
ECT has apparent effectiveness with severe
- family therapy
depression, especially when patients follow up the
ADHD
- Methylphenidate
initial cluster of sessions with continuation or
(Stimulant)
maintenance therapy, either ongoing antidepressant
- CBT
- Parent Management
medications or periodic ECT sessions
Training
o CBT, Interpersonal, and Biological Therapies are all
Autism
Spectrum - CBT
effective treatment for unipolar depression
Disorder
- Communication
o However, drug therapy reduced depressive
Training
symptoms more quickly than CB and Interpersonal
- Parent training
therapies, but these psychotherapies had matched the
- Community Integration
drugs in effectiveness by the final 4 weeks of
- Psychotropic Drugs
treatment
Intellectual Disability
- special education
o CBT and Interpersonal Therapies lower the
Evaluate the Efficacy of Psychological Interventions
likelihood of relapse
o Psychodynamic therapy seems to help most in cases
o Token Economies help reduce psychotic and related
of depression that are modest or moderate in severity
behaviors, however, its uncontrolled
and that involve clear history of childhood loss or
o Drugs appear more effective treatment for
trauma
schizophrenia than any other approaches used alone,
o Short-term
psychodynamic
therapies
have
such as psychotherapy, milieu therapy, or
performed better than long-term approaches,
electroconvulsive therapy
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anger, or grief; screaming; attacks of crying;
o Psychotherapy is successful in many more cases of
trembling; heat in the chest rising into the head; and
schizophrenia these days (CBT, Family Therapy,
becoming verbally and physically aggressive
Social Therapy)
o Dhat Syndrome – coined in South Asia (India)
o For people with schizophrenia, cognitive
characterized by young male patients who attributed
remediation brings about moderate improvements in
their symptoms to semen loss
attention, planning, memory, and problem-solving
o Koro - acute anxiety and a deep-seated fear of
o CBTs often help people with schizophrenia feel more
shrinkage of the penis and its ultimate retraction into
control over their hallucinations and reduce their
the abdomen, which will cause death
delusional ideas
o Khyal Cap – syndrome found among Cambodians
o For certain phobia, such as small-animal phobia,
characterized by panic attacks
flying phobia, claustrophobia, BI phobia, exposure
o Kufungisisa – overthinking; idiom of distress and
therapy is often highly effective when administered
cultural explanation among the Shona of Zimbabwe
in a single long session
o Maladi Moun – Haiti; sent sickness; interpersonal
envy and malice cause people to harm their enemies
o Medication treatments are ineffective by themselves,
by “sending illness”
and there is even some evidence that anti-anxiety
o Nervios – among Latinos; general state of
medications may interfere with beneficial effects of
vulnerability to stressful life experiences and to
exposure therapy
difficult life circumstances
o D-Cycloserine can enhance the effectiveness of
o
Shenjing Shuairuo – syndrome composed of
exposure therapy for fear of heights in a virtual
weakness, emotions, excitement, nervous pain, and
reality environment
sleep
o In the long-term, after medication for panic disorder
o Susto – distress and misfortune prevalent among
has been tapered, clients who have been on
some Latinos in US, attributed to a frightening event
medication with or without cognitive or behavioral
that causes the soul to leave the body and results to
treatment seem to show a greater likelihood of
unhappiness and sickness, as well as functioning in
relapse
key social roles
o CBT has been found to be useful in helping people
▪ Cause: induvial believes that he or she has
become the subject of black magic
who have used benzodiazepines for over a year to
▪ Similar to Maladi Moun
successfully taper their medications
o Taijin Kyufusho - an intense fear that one's body
o A major disadvantage of medication treatment for
parts or functions displease, embarrass or are
OCD is that when the medication is discontinued
offensive to others
relapse rates are generally very high
o Amok - syndrome or pattern of behavior
o Family therapy is more helpful for some patients
acknowledged in Southeast Asia (Malaysia,
with Anorexia Nervosa then for others
Philippines, Indonesia) characterized by sudden
o DBT, the most effective treatment for Borderline
outbursts and frenzied violent behaviors after a
Personality Disorder
period of brooding and quiet
o Positive Family Interaction Therapy demonstrated
o The likelihood of having a particular phobia is
70% response rate compared to more traditional
powerfully influenced by gender
model of individual CBT with psychoeducation
o Males are more likely than females to self-medicate
their fear and panic with alcohol and in so doing start
Socio-Cultural Factors and Ethics (5)
down the slippery slope to addiction
Identifying Socio-Cultural factors
o
BN, AN, and BDD is common to females
o Stigma – a strong lack of respect for a person or a
o
Well-established ability of women to recall
group or a bad opinion of them because they have
emotional memories somewhat better than men may
doen something society does not approve off
facilitate emotional processing and long-term
o Ataque de Nervous – syndrome among individuals
treatment gains
of Latino Descent, characterized by symptoms of
o
Dissociative Trance – counterpart of DID in eastern
intense emotional upset, including acute anxiety,
countries; sapi
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DSM-V-TR, Psych Pearls
o Experiences during different periods of development
o Only discuss confidential information with persons
may influence our vulnerability to other types of
clearly concerned/involved with the matters
stress or to differing psychological disorders
o Disclosure is allowed with appropriate consent
▪ No consent is not allowed UNLESS mandated by
Ethics
the law
o If mistakes was made, they should do something to
o No disclosure of confidential information that could
correct or minimize the mistakes
lead to the identification of a client unless they have
o If an ethical violation made by another psychologist
obtained prior consent or the disclosure cannot be
was witnessed, they should resolve the issue with
avoided
informal resolution, as long as it does not violate any
▪ Only disclose necessary information
confidentiality rights that may be involved
o Exemptions to disclosure:
o When they are tasked to provide services to clients
✓ If the client is disguised/identity is protected
who are deprived with mental health services (e.g.,
✓ Has consent
communities far from the urban cities), however,
✓ Legally mandated
they were still not able to obtain the needed
o
Opinions written on recommendations, reports, and
competence for the job, they could still provide
diagnostic or evaluative statements must be based
services AS LONG AS they make reasonable effort
and sufficient to their findings
to obtain the competence required, just to ensure that
o Only provide statements after conducting
the services were not denied to those communities
examinations to support their statements
o During emergencies, psychologists provide services
o Informed Consent, except:
to individuals, even though they are yet to complete
✓ Mandated by law
the competency/training needed just to ensure that
✓ Routine
services were not denied. However, the services are
✓ Evaluating decisional capacity
discontinued once the appropriate services are
▪ If the person has a questionable capacity to
available
consent, it must be obtained using the language
o Informed Consent:
that is reasonably understandable to the person
✓ When
conducting
research,
providing
being assessed
assessment, therapy, counseling, or consultation
o In the absence of client/patient release, psychologists
✓ For legally INCAPABLE, they must provide
must provide test data only as required by law
appropriate explanation, assent, consider the
o Psychological assessment techniques done by
client’s preferences and best interests, and obtain
unqualified persons, except during training purposes,
permission from a legally authorized person
given it is supervised
✓ If COURT ORDERED, they must inform the
o
When conducting or providing services to several
nature of the services, whether it is court order or
persons who have a relationship, they should clarify
mandated, as well as, its limits of confidentiality
which of them is the clients and the relationship
before proceeding
he/she will have with each person
✓ Must document written or oral consent,
▪ If conflicting roles would arise, he/she must
permission, and assent
clarify, modify, or withdraw from roles
o In case of interruption of services (such as death,
appropriately
relocation, illness, retirement), psychologists must
o
Psychologists
do not engage in sexual intimacies
make reasonable efforts to plan for continuing
with former clients/patients for AT LEAST TWO
services
YEARS after termination of therapy
▪ Unless stated in the contract
o Terminate therapy when the client no longer needs
o Psychologists should discuss the limits of
the service, is not likely to benefit, or is being harmed
confidentiality, uses of the information that would be
by continued service
generated from the services to the persons and
▪
Also, when threatened or endangered by the
organizations with whom they establish a scientific
client
or professional relationships
▪ Must provide pretermination counseling and
o Before recording voices or images, they must obtain
suggest alternative service providers as
permission first from all persons involved or their
appropriate
legal rep
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DSM-V-TR, Psych Pearls
o Telepsychology – provision of psychological
Global Health Crisis and Mental Health Law (10)
services using telecommunication technologies
Different Issues and Concerns on the Impact of
▪ Must ensure competence with both the
COVID-19 on the Mental Health of people
technologies used and the potential impact of
o After acquiring COVID-19 (or even prior), a person
technologies on clients/patients, supervisees or
may experience cognitive and attention deficits
other professionals
(brain fog), anxiety and depression, psychosis,
▪ Ensure ethical and professional standards of care
seizures, and even suicidal behavior
and practice
o Data suggests that people are more likely to develop
▪ Informed consent must still be obtained, which
mental illness or disorders in the months following
specifically addresses the unique concerns related
infection, including symptoms of PTSD
to the telepsychology services they provide
o
People who are more likely to experience the
▪ Should
include
the
manner
of
symptoms of mental illnesses or disorders during the
telecommunication, the boundaries they will
pandemic:
establish, and the procedures for responding to
electronic communications
a) People from racial and ethnic minority
▪ When necessary, psychologists obtain the
b) Mothers and pregnant people
appropriate consultation with technology experts
c) People experiencing poverty
to
augment
their
knowledge
of
d) Children
telecommunication technologies in order to apply
e) PWDs
security measures in their practices that will
f) People with pre-existing mental illnesses
protect and maintain the confidentiality of data
g) Health Care Workers
and information related to their clients/patients.
Online
Classes
▪ Some of the potential risks to confidentiality
o Online learning in nursing education is not
include considerations related to uses of search
significantly different from blended or face-to-face
engines and participation in social networking
learning in terms of its impact on knowledge
sites.
acquisition and attitudes toward learning (Kim &
▪ Psychologists are encouraged to weigh the risks
Kim, 2022)
and benefits of dual relationships that may
develop with their clients/patients, due to the use
o Online Learning caused by the COVID-19 Pandemic
of telecommunication technologies, before
brought negative learning attitudes and poorer
engaging in such relationships
learning performance compared to classroom
▪ Psychologists who use social networking sites for
learning, especially during the early days of the
both professional and personal purposes are
pandemic (Chen et.al., 2022)
encouraged to review and educate themselves
o Learning in the new normal has been a challenge to
about the potential risks to privacy and
institutions, more particularly to students and
confidentiality and consider utilizing all available
educators (Ignacio, 2021)
privacy settings to reduce these risks
▪
Not all institutions have the capability to deliver
▪ Psychologists are encouraged to create policies
online classes due lack of equipment, technical
and procedures for the secure destruction of data
know-how
and information and the technologies used to
o
In
the Philippines, children in vulnerable groups
create, store and transmit the data and
information.
have no access to quality education. They also
▪ Psychologists are thus encouraged to be
struggle to find distance learning opportunities.
knowledgeable about, and account for, the unique
According to UNESCO, about 28 million learners
impacts, suitability for diverse populations, and
are affected by school closures. Unfortunately, the
limitations on test administration and on test and
COVID-19 pandemic will severely affect their
other data interpretations when these
learning quality without the help of government and
psychological tests and other assessment
nongovernment organizations.
procedures are considered for and conducted via
telepsychology
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DSM-V-TR, Psych Pearls
o The findings revealed that the online learning
have children in their household (Agrawal et.al.,
challenges of college students varied in terms of type
2021)
and extent. Their greatest challenge was linked to
o The results of the present study showed that the
their learning environment at home, while their least
mental health of young people did not significantly
challenge was technological literacy and
improve in the time period after vaccinations became
competency. The findings further revealed that the
widely available and promoted in Austria and Turkey
COVID-19 pandemic had the greatest impact on the
(Chen et. Al., 2023)
quality of the learning experience and students’
▪ The impact of age may be related to more
mental health (Barrot, Llenares, & del Rosario,
pronounced uncertainty and anxiety among
2021)
younger groups, as unpredictable pandemic
Frontliners
circumstances make it even more difficult for
o Insomnia was found to be the most common mental
them to plan their future, as they cross the
health problem, followed by anxiety, PTSD,
threshold to adulthood and independence.
depression and stress in healthcare workers in the
▪ a number of recent studies have confirmed that
face of the COVID-19 pandemic (Hayati et.al., 2023)
younger adults and females in particular suffered
o Post-traumatic stress disorder was the most common
from the adverse outcomes associated with the
mental health disorder reported by healthcare
COVID-19 pandemic
workers during the COVID-19 pandemic, followed
o An overwhelming majority of Filipinos surveyed
by anxiety, depression, and distress (Advani et.al.,
(over 15,600 participants) currently distrust available
2021)
vaccines, their efficacy against the original and
o Besides the lack of personal protective equipment,
emerging strains, the cost of being vaccinated, and
our frontliners are underpaid and do not get the
the authenticity of vaccine samples available in the
respect they deserve. They answer “to the call of duty
country (CNN Philippines, 2021; Sabillo 2021).
while battling fear and anxiety”.7 Aside from this,
Lockdown
they also experience pressure, stress, insomnia,
o Anxiety,
depression,
irritability,
boredom,
denial, anger, and fear (Biana & Joaquin, 2020)
inattention and fear of COVID-19 are predominant
o According to WHO, Exposure to excessive stress,
new-onset psychological problems in children during
for prolonged periods can have many harmful
the COVID-19 pandemic. Children with pre-existing
consequences on the emotional and mental wellbehavioral problems like autism and attention deficit
being of frontline workers. It can:
hyperactivity disorder have a high probability of
✓ lead to burnout.
worsening of their behavioral symptoms (Gupta et.
✓ trigger the onset of common mental disorders
Al., 2020)
such as depression and anxiety or post-traumatic
o The review highlights the need for mental health
stress disorder (PTSD).
services to address the increased mental health
✓ result in unhealthy behaviours like using tobacco,
symptoms in people with pre-existing mental
alcohol or other substances, which may lead to
illnesses during a pandemic (Duddu et. Al., 2020)
substance use disorders.
o Students and unemployed respondents are highly
✓ result in frequent absence from work or reduced
vulnerable to COVID stress and its mental health
productivity while at work.
implications. Men and women did not significantly
✓ increase the risk of suicide among frontline
differ in distress (Acebes & Montano, 2020)
workers, particularly health care workers
o Cluster analysis revealed two age clusters—those
Vaccination
between 16 and 35 years and those 36 years and
o COVID-19 vaccination is associated with larger
above. The younger group reported greater
reductions in anxiety or depression symptoms among
depression, anxiety, and stress symptoms and poorer
individuals with lower education levels, who rent
psychological well-being compared to the older
their housing, who are not able to telework, and who
group. The younger group also reported less
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DSM-V-TR, Psych Pearls
resilience, nonreactivity, and use of spiritual coping
"unpaid wages due to poor or no Internet
compared to the older group. The results suggest that
connection," "unjust sanctions due to technical
the young are most vulnerable during the pandemic,
problems," and "shouldering of Internet and utility
and findings suggest what might be done to provide
expenses by employees." Up to 77% of respondents
them mental health psychosocial support. (Alampay,
say that they've been shouldering their own Internet
Hechanova & Valentin, 2022)
costs while 54% did not receive Internet allowance
Teleconsultation
and 20% did not receive work laptops.
o Telephone-delivered psychotherapy has increased
o Dr. Agnes Casiño of the National Center for Mental
utility as a method of service delivery in the current
Health (NCMH) said maintaining work-life balance
world, where several barriers, including economic
in a work from home setup is hard especially when
hardships and limited access to care, may prevent
one has to take on different roles at different times in
people from receiving the treatment they need
the same place.
(Arafat, Hawlader & Zaman, 2021)
o Employees pointed out that with the new work
▪ telemedicine is perfectly suitable to treat the
arrangement, they still find satisfaction, enjoyment,
mental health problems of the people in this
and fulfilment given the necessary condition at
pandemic situation without increasing the risk of
home. However, detrimental factors like balancing
infection, promoting health and prolonging life as
work and family, difficulty focusing on work tasks
well.
and collaborating with colleagues, poor working
Work From Home
environment, and slow internet connectivity lead to
o The top factors that contribute to people’s stress,
isolation, stress, and anxiety.
anxiety, and depression are financial considerations,
▪ women experienced higher stress and exhaustion
health concerns, and inconsistencies in the
with working from home compared to men due to
workplace setup (Del Mundo, 2022)
familial and domestic responsibilities.
▪ When experienced with frequency, these result in
Children
burnout, loss of drive and focus, and struggles
o Learning deficits are particularly large among
with work-life balance
children from low socio-economic backgrounds
o The switch to a work from home status has
(Betthäuser, Bach-Mortensen & Engzell, 2022)
contributed to the higher critical levels in our
o “In 2020, schools globally were fully closed for an
workforce’s mental health. Those who are working
average of 79 teaching days, while the Philippines
from home are 3.7 times more likely to have critical
has been closed for more than a year, forcing students
anxiety levels and 6 times more likely to have critical
to enroll in distance learning modalities. The
depression levels.
associated consequences of school closures –
o Another survey by Lenovo Philippines as early as
learning loss, mental distress, missed vaccinations,
April reported that up to 87% employees were ready
and heightened risk of drop out, child labour, and
to shift to WFH when required. "Our survey suggests
child marriage – will be felt by many children,
that the employee experience was already changing
especially the youngest learners in critical
before the pandemic hit," said Michael Ngan,
development
stages,”
UNICEF
Philippines
president and general manager of Lenovo
Representative Oyunsaikhan Dendevnorov says.
Philippines, reported Business Mirror.
o While children are more vulnerable to these
o On top of the mental health issues that WFH
detriments, there remains the absence of unified and
employees are now facing are logistical concerns
comprehensive strategies in mitigating the
surrounding the adjustment to the telecommuting
deterioration of the mental health of Filipino children
scheme. A BPO Industry Employees Network survey
(Biag, 2021)
revealed common issues faced by WFH employees,
including: "lack of logistical assistance (such as
delivery of equipment)," "longer working hours,"
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DSM-V-TR, Psych Pearls
Evaluating the Impact of Global Health Crisis and
Authority (PSA) data that showed suicide incidents
other mental health conditions on the implementation
increasing by 57 percent for 2020, compared to 2019.
of RA 11036
o She said she is seeking a policy measure dedicated to
o Dr. Razel Nikka Hao, DOH Disease Prevention and
“enhancing the delivery of mental health services to
Control Bureau director, reported to the committee
the people,” especially since recent studies showed
that since RA 11036 was passed, 62 of their
that only around five percent of the whole health
personnel were trained on Basic Institutional Review
budget was allocated to mental health concerns.
Board (IRB); 51 as future trainers for IRB; 1,556
o The DOH has launched a multi-sectoral approach for
completed the World Health Organization Quality
mental health with programs and interventions
Rights e-training; 28 with Lived Experiences
across a variety of settings (e.g. workplaces, schools,
completed the course on mental health advocacy and
communities) aimed at high-risk groups. The
leadership (pilot implementation); and over about 40
commemoration of World Suicide Prevention Day
media practitioners were trained on responsible and
also calls attention to the plight of those who are
ethical reporting and portrayal of suicide (pilot
undergoing severe forms of depression.
implementation).
o Another project is the development of a multio DepEd officials noted that after the pandemic
sectoral National Suicide Prevention Strategy, which
lockdowns, the transition from blended learning to
includes psychosocial services such as the NCMH’s
in-person classes also created new pressures on
Crisis Hotline “Kamusta Ka? Tara Usap Tayo,”
students. But there are no programs specifically
launched on 2 May 2019. The hotline is available
designed to promote mental health for any age group.
24/7 for prompt psychological first aid. The UP
Bullying has been a serious problem in schools even
Diliman Psychosocial Services (UPD PsychServ)
before the pandemic, with social media facilitating
has also provided free counseling via telephone for
the abuse, and DepEd officials believe bullying cases
front liners. RA 11036 or the (“Mental Health Act”)
are also underreported.
mandates the provision of comprehensive suicide
o Despite passing the Philippine Mental Health Act
prevention
services
encompassing
crisis
(RA 11036), access to mental health care remains
intervention, and a response strategy on a nationwide
limited. Most pediatricians, adolescent medicine
scale.
specialists, and psychiatrists practice in urban areas
Additional Notes
in the country. Moreover, payment for mental health
o Leta Hollingworth – believed that many mentally
consultation remains an out-of-pocket expense for
defective children were actually suffering from
Filipinos (Malaluan et. Al., 2022)
emotional and behavioral problems primarily due to
o Rep. Florida Robes said that aside from minimum
inept treatment by adults and a lack of appropriate
health standards and protocols aimed at halting the
intellectual challenge
spread of COVID-19 in communities, local
o Monomania – partial delusion
government units (LGUs) should also establish
o Neurasthenia – characterized by persistent and
mental help desks in every barangay to address those
distressing complaint of increased fatigue after
suffering from anxiety or depression as a result of the
mental effort or persistent and distressing complaints
pandemic (Quismorio, 2020)
of bodily weakness and exhaustion after minimal
o In a statement on Monday, Deputy Speaker Loren
effect
Legarda said that the government must work to
o Psychasthenia – anxiety, excessive worrying and
address the mental health issues of Filipinos, who
doubting
have struggled to cope with the demands and the
o Phonasthenia – weakness or hoarseness of voice
problems brought by the COVID-19 pandemic.
o Jean Esquirol – first to describe a medical disorder
o Legarda, who was co-author of Republic Act No.
quite similar to contemporary OCD and classified it
11036, was referring to a Philippine Statistics
as monomania
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Abnormal Psychology
#BLEPP
Source: Barlow, Durand & Hofmann (2018), Comer & Comer (2017), Hooley, Butcher, Nock & Mineka (2017), DSM-V,
DSM-V-TR, Psych Pearls
o Freud and Pierre Janet isolated OCD from
neurasthenia
o Pierre Janet – proposed that obsessional patients
possessed an abnormal personality (psychasthenia)
with features such as anxiety, excessive worrying and
doubting, and described the successful treatment of
compulsions and rituals with techniques that are
similar to the ones used currently in behavioral
therapy
end
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