ABNORMAL PSYCHOLOGY
5.2 PSYCHOLOGICAL DISORDERS
DP2
Ms Lindström
LEARNING OUTCOMES
Evaluate psychological research (through theories and
studies) relevant to the study of abnormal behaviour
 Discuss the interaction of biological, cognitive, and
sociocultural factors in abnormal behaviour
 Discuss symptoms and prevalence of one disorder from
two of the following groups: Anxiety disorders (PTSD)
and affective disorders (major depression), eating
disorders (bulimia)
 Analyze the etiologies ( the cause in terms of
biological, cognitive, and sociocultural factors) of one
disorder from two of the following groups: anxiety
disorders, affective disorders, eating disorders (for
example: PTSD and unipolar depression)
 Discuss cultural and gender variations in prevalence of
disorders
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PSYCHOLOGICAL TESTS
On paper: Test by human relations department
 Yale- BOCS
Many psychological online tests:
 http://www.bbc.co.uk/science/humanbody/mind/in
dex_surveys.shtml
 http://www.psychologytoday.com/tests
 http://www.healthyplace.com/psychological-tests/
 http://testyourself.psychtests.com/
PTSD TEST online:
 http://www.healthyplace.com/psychologicaltests/ptsd-test/
INTRODUCTION TO PSYCHOLOGICAL
DISORDERS
Symptomology:
Refers to the
identification of the
symptoms.
For example by using a
diagnostic manual
(DSM-IV)
Finding out WHAT the
person suffers from
Etiology:
More difficult to do
IB course focuses on: the
biological, cognitive and
sociocultural factors
WHY people suffers
from a disorder
DATA WHICH ASSIST IN THE DIAGNOSIS
Prevalence rate:
Is the measure of the
total number of cases of
the disorder in a given
population
Lifetime prevalence:
Is the percentage of the
population that will
experience the disorder
at some time in their
life
Onset age:
Is the average age at
which the disorder is
likely to appear
WE ARE GOING TO STUDY TWO DISORDERS FROM
TWO DIFFERENT CLASSIFICATIONS OF ABNORMAL
EHAVIOUR
Two from:
 Anxiety disorders (for example PTSD)
 Affective disorder (major depression)
 Eating disorder (bulimia)

We will study:
Major depression
PTSD
MAJOR DEPRESSION
Part of 5.2
MAJOR DEPRESSION
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Belong to Affective disorders: dysfunctional
moods
Do be a thinker on p. 149
DEPRESSION – WHAT TYPE?
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Major depressive disorder (also known as
recurrent depressive disorder, clinical depression,
major depression, unipolar depression, or
unipolar disorder
The term unipolar refers to the presence of one
pole, or one extreme of mood- depressed mood.
This may be compared with bipolar depression
which has the two poles of depressed mood and
mania
IS IT NOT…
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A depressed mood caused by substances (such as
drugs, alcohol, medications)
Major depressive disorder cannot be diagnosed if
a person has a history of manic or mixed episodes
(e.g., a bipolar disorder)
Further, the symptoms are not better accounted
for by bereavement (i.e., after the loss of a loved
one)
ABCS SYMPTOMS
OF MAJOR DEPRESSION (P. 149)
 Affective:
feelings of guilt and sadness, lack of
enjoyment or pleasure in familiar activities or
company
 Behavioural:
passivity, lack of initiative
 Cognitive:
frequent negative thoughts, faulty
attribution of blame, low self-esteem, suicidal
thoughts, irrational hopelessness, may also experience
difficulties in concentration and anability to make
decisions
 Somatic:
loss of energy, insomnia or hypersomnia,
weight loss/gain, diminished libido
CRITERIA FOR MAJOR DEPRESSION IN
DSM-IV

See handout
YOU SHOULD…
Understand
that mood
disorders are diagnosed
based on the extent,
severity, and duration of
the symptoms.
VIDEO
Depression

http://www.youtube.com/watch?v=IeZCmqePLzM
&feature=fvwrel
DEPRESSION
The problems that depressed people suffer from
can become long-lasting or recurrent and lead to
substantial impairments in an individual’s ability
to take care of his or her everyday
responsibilities.
 At its worst, depression can lead to suicide.
Almost 1 million lives are lost yearly due to
suicide, which translates to 3000 suicide deaths
every day.
 For every person who completes a suicide, 20 or
more may attempt to end his or her life (WHO,
2012).

DEPRESSION
Tends to be a recurrent disorder, with 80%
experiencing a subsequent episode
 An episode usually last three to four months
 The average number of episodes is four
 In app. 12 % of cases depression becomes a
chronic disorder (lasting about two years)
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HOW COMMON IS DEPRESSION?
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According to the World Health Organization, unipolar
depressive disorders were ranked as the third leading
cause of the global burden of disease in 2004 and will
move into the first place by 2030.
Depression is a significant contributor to the global burden
of disease and affects people in all communities across the
world.
Today, depression is estimated to affect 350 million
people.
HOW COMMON IS DEPRESSION?
The World Mental Health Survey conducted in
17 countries found that on average about 1 in 20 people
reported having an episode of depression in the
previous year.
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Kessler et al. 1993 found a lifetime prevalence for major
depression of 21,3 % in women compared to 12,7 % in men.
HOW COMMON IS DEPRESSION IN SWEDEN?
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”Ungefär 5 % av Sveriges befolkning lider av
depression. Undersökningar har visat att minst 25 %
av alla kvinnor och 15 % av alla män någon gång
under livet kommer att drabbas av en depression som
kräver behandling.
Det finns studier som talar för att depressioner har
blivit vanligare under de senaste 50 åren, och att
människor insjuknar i lägre åldrar än tidigare.
Depression är en av Sveriges stora folksjukdomar.”
(Läkemedelsverket)
HOW COMMON IS DEPRESSION IN
SWEDEN?
Depression är mycket vanlig. I Sverige drabbas
35% av befolkningen av depression någon
gång i livet. Enligt hittills allmänt spridd
uppfattning är kvinnor dubbelt så ofta
deprimerade som män, 50% av kvinnorna och 25%
av männen får diagnosendepression någon gång i
sitt liv. Ny forskning tyder på att depression
förekommer lika ofta hos män som hos kvinnor om
man inräknar männens annorlundasymtombild och
därmed odiagnostiserad depression.

Akademiska sjukhuset, Landstinget i Uppsala län
ETIOLOGY OF MAJOR DEPRESSION:
Task:6
of you per factor
(that is: biological, cognitive,
sociocultural) be ready to present
to the rest on Friday with a quiz
afterwards to test the others
Use the book, and the p. 172-173
in Oxford revision guides
SOCIOCULTURAL FACTORS

Which factors do you think play a role here?
SOCIOCULTURAL FACTORS
Poverty or living in a violent
relationship have been linked to
depression. Stress and lack of social
support could also be reasons.
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Could the sociocultural factors play a part in why
the rates of depression is higher in women?
See Brown and Harris 1978 study about social
factors in depression. Read it (p.156) and write a
summary stating the aim, procedure and
findings.
SOCIOCULTURAL FACTORS
Prince 1968. Earlier reports claimed that
there was no depression in Africa and
various regions of Asia, but this study found that
rates of reported depression rise with
Westernisation in the former colonial countries.
The negative symptoms of depression (loss of
appetite, insomnia, inability to experience sexual
pleasure, fatigue) are present but in most nonWestern cultures the experience of guilt is mostly
absent
 ¬ Kleinman (1982) showed that in China
somatization served as a typical channel of
expression and as a basic component of
depressive experience.
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COGNITIVE FACTORS
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Deals with the role of thinking and negative cognitive
schemas
Seligman (1975) ‘Learned helplessness theory’
Seligman (1975) was studying escape learning and
found that dogs, forced to stay in a box where they were
repeatedly shocked, soon gave up and stopped trying to
escape.
Moreover, 65% of the dogs didn't try to escape the next
day when the box was modified so they could easily
escape. They just laid down and whined. They had
learned helplessness. Seligman said human depression
with its passivity and withdrawal might be due to
"learned helplessness."
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COGNITIVE FACTORS
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Albert Ellis: irrational and illogical cognitions will lead to
disturbances of mood (depression)
For example: “I didn’t get the highest score on the test – I
must be stupid”
• Aaron Beck: Faulty thinking
Cognitive theory of depression (A cognitive triad ,
see next slide), a thinking style that gives the person a
negative self-schema (a very pessimistic view on oneself
and life in general) which makes it very difficult to see
anything positive in life.
CBT: cognitive behavioural therapy
BECK'S SIX TYPES OF FAULTY THINKING
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ARBITRARY INFERENCE - Drawing conclusions about oneself or the world without
sufficient and relevant information. Example: A man not hired by a potential employer
perceives himself as "totally worthless" and believes he probably will never find
employment of any sort.
SELECTIVE ABSTRACTION - Drawing conclusion from very isolated details and events
without considering the larger context or picture. Example: A student who receives a C on
an exam becomes depressed and stops attending classes even though he has A's and B's in
his other courses. The student measures his worth by failures, errors, and weaknesses
rathter than by successes or strengths.
OVERGENERALIZATION - Holding extreme beliefs on the basis of a single incident and
applying it to a different or dissimilar and inappropriate situation. Example: A depressed
woman who has relationship problems with her boss may believe she is a failure in all
other types of relationships.
MAGNIFICATION AND EXAGGERATION - The process of overestimating the
significance of negative events. Example: A runner experiences shortness of breath and
interprets it as a major health problem, possibly even an indication of imminent death.
PERSONALIZATION - Relating external events to one another when no objective basis
for such a connection is apparent. Example: A student who raises his hand in class and is
not called on by the professor believes that the instructor dislikes or is biased against him.
POLARIZED THINKING - An "all-or-nothing," "good or bad," and "either-or" approach to
viewing the world. Example: At one extreme, a woman who perceives herself as "perfect"
and immune from making mistakes; at the other extreme, a woman who believes she is
totally incompetent.
HOMEWORK FOR MONDAY
Beck's Six Types of Faulty Thinking
Know them so well you could perform them…
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EVALUATION
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Unclear whether this cognition is the cause of
depression or if they are symptoms (or consequence)
of depression.
CBT – if it works…
One researcher who claims that it is a link between
negative cognitions and depression is Alloy et al.
1999, who conducted a longitudinal prospective study
using young Americans for six years.
Chosen based on their thinking style ( positive or
negative)
After the six years only 1 % of those in the positive
thinking group had developed depression compared to
17% in the negative thinking group.
BIOLOGICAL FACTORS
A large Swedish twin study (Kendler et al. 2006)
used 42000 participants (!)
 Telephone interviews to diagnose depression on the
basis of a) the presence of most of the DSM-IV
symptoms or b) having had a prescription for
antidepressants.
 Results: they found the following concordance rates:
0,44% for MZ females and 0,31% for MZ males
Compared to 0,16% for DZ females and 0,11% DZ males
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Genetics: Nurnberger and Gershon (1982):
Studied results from 7 studies and found:
MZ 65%; DZ 14% Concordance is not 100%
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BIOLOGICAL FACTORS
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•Rampello et al (2000): imbalance of several
neurotransmitters (dopamine, serotonin,
noradrenaline and acetylcholine)
Serotonin hypothesis (low levels of serotonin)
All SSRI (selective serotonin reuptake inhibitor)
drugs such as prozac, zoloft and paxil are
common sold anti-depressants which should be in
favour of those hypotheses, right?
Critisims: Kirsch et al. 2002: effectiveness?
Placebo?
INTERACTIONIST APPROACH
The
diathesis-stress model: a
model that claims that
depression may be the result of a
hereditary predisposition, but in
interaction with events in the
environment.
GENDER CONSIDERATIONS IN
MAJOR DEPRESSIVE DISORDER
GENDER CONSIDERATIONS
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Statistically women are two to three times more likely
to become clinically depressed (Williams and
Hargreaves 1995)
While depression is the leading cause of disability for both
males and females, the burden of depression is 50%
higher for females than males (WHO, 2008). In fact,
depression is the leading cause of disease burden for women in
both high-income and low- and middle-income countries
(WHO, 2008).
Research in developing countries suggests that
maternal depression may be a risk factor for poor
growth in young children (Rahman et al, 2008). This risk
factor could mean that maternal mental health in low-income
countries may have a substantial influence on growth during
childhood, with the effects of depression affecting not only this
generation but also the next.
“Why are so many women depressed?” Read the article
(on the course website)
GENDER STUDIES
Williams and Hargreaves (1995) argue that
hormonal changes of the menstrual cycle
may have an effect in change of mood even though it
cannot be said to directly cause depression.
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Cochrane (1995) identifies a number of nonbiological explanations of women’s greater
susceptibility to depression:
¬ Girls have a greater risk to experience sexual abuse
¬ Learned helplessness as a result of general female
gender role
¬ Female-male difference in rate of depression highest
between ages of 20-50. These are the years where
females have a hard life being mothers, working etc.
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GENDER STUDIES
Harris and Brown (1978): The theory of
social factors in depression
- It was more common among those women who
had experienced at least one severe life event or
major difficulty
- - social class factor: more common among
working class than middle class
- . The more children…
- Women who were widowed, divorced or separated
had higher rates of depression
Social stress plays a role!
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CULTURAL CONSIDERATIONS IN
MAJOR DEPRESSION
WHY ARE THERE CULTURAL DIFFERENCES
IN PREVALENCE OF DISORDERS?
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Different cultures have different concepts of what
is abnormal behavior
Social problems/pressures and cultural
differences may lead to a higher prevalence of
disorders in some cultures
CULTURAL DIFFERENCES IN
PREVALENCE OF DEPRESSION

Weisman et al. 1996
Lifetime prevalence
 19 % Libanon
 1,5 % Taiwan
 3 % Korea
 16,4 % France
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DIFFERENT CULTURES HAVE DIFFERENT
CONCEPTS OF WHAT IS ABNORMAL
BEHAVIOR
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Okello and Ekblad (2006): In Uganda depression is seen as
“illness of thoughts” and not a biological illness. Therefore, it is
believed that depressed do not need medicine, unless the disorder
is chronic or recurring.
Cooper et al (1972): New York psychiatrists are twice as likely
to diagnose patients with schizophrenia than London
psychiatrists, who in turn are twice as likely to diagnose mania or
depression when shown the same videotaped clinical interviews.
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Different countries use different diagnostic tools: E.g. ICD10, CCMD, DSM-IV-TR
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Homosexuality was considered to be abnormal until DSM-III
(1980). It is still considered abnormal in many countries.
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Unmarried mothers in Britain and political dissidents in the
Soviet unions were once confined to institutions for abnormality.
The tendency for American black slaves in the 1800s to try flee
captivity was considered to be a mental illness.
SOCIAL PROBLEMS/PRESSURES AND CULTURAL
DIFFERENCES MAY LEAD TO HIGHER A PREVALENCE
OF DISORDERS IN SOME CULTURES
Chiao & Blinsky (2010): Depression is associated
with individualism.
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In cultures with high levels of community,
religiosity, and traditional family roles,
depression is less prevalent (e.g. Wu and
Anthony 2000)
(Becker (1995): After the introduction of
television in Fiji, eating disorders in women
increased)
POSSIBLE ESSAY QUESTION P. 155
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Discuss the interaction of biological,
cognitive and sociocultural factors in
abnormal behaviour.
See assessment advice
Use 30 minutes to write and answer with
the book as help,
 Then use 10-15 min. to read and give
feedback to someone else’s answer. Hand in.
