Chapter 18. Psychological Disorders

Chapter Resources

Leanne Stevens; Jennifer Stamp; Kevin LeBlanc (editors - original chapter); and Jessica Motherwell McFarlane (editor - adapted chapter)

Summary

What Are Psychological Disorders?

Psychological disorders are conditions characterised by abnormal thoughts, feelings, and behaviours. Although challenging, it is essential for psychologists and mental health professionals to agree on what kinds of inner experiences and behaviours constitute the presence of a psychological disorder. Inner experiences and behaviours that are atypical or violate social norms could signify the presence of a disorder; however, each of these criteria alone is inadequate. Harmful dysfunction describes the view that psychological disorders result from the inability of an internal mechanism to perform its natural function. Many of the features of harmful dysfunction conceptualisation have been incorporated in the APA’s formal definition of psychological disorders. According to this definition, the presence of a psychological disorder is signalled by significant disturbances in thoughts, feelings, and behaviours; these disturbances must reflect some kind of dysfunction (biological, psychological, or developmental), must cause significant impairment in one’s life, and must not reflect culturally expected reactions to certain life events.

Diagnosing and Classifying Psychological Disorders

The diagnosis and classification of psychological disorders is essential in studying and treating psychopathology. The classification system used by most US professionals is the DSM-5. The first edition of the DSM was published in 1952 and has undergone numerous revisions. The 5th and most recent edition, the DSM-5, was published in 2013. The diagnostic manual includes a total of 237 specific diagnosable disorders, each described in detail, including its symptoms, prevalence, risk factors, and comorbidity. Over time, the number of diagnosable conditions listed in the DSM has grown steadily, prompting criticism from some. Nevertheless, the diagnostic criteria in the DSM are more explicit than that of any other system, which makes the DSM system highly desirable for both clinical diagnosis and research.

Perspectives on Psychological Disorders

Psychopathology is very complex, involving a plethora of etiological theories and perspectives. For centuries, psychological disorders were viewed primarily from a supernatural perspective and thought to arise from divine forces or possession by spirits. Some cultures continue to hold this supernatural belief. Today, many who study psychopathology view mental illness from a biological perspective, whereby psychological disorders are thought to result largely from faulty biological processes. Indeed, scientific advances over the last several decades have provided a better understanding of the genetic, neurological, hormonal, and biochemical bases of psychopathology. The psychological perspective, in contrast, emphasises the importance of psychological factors (e.g., stress and thoughts) and environmental factors in the development of psychological disorders. A contemporary, promising approach is to view disorders as originating from an integration of biological and psychosocial factors. The diathesis-stress model suggests that people with an underlying diathesis, or vulnerability, for a psychological disorder are more likely than those without the diathesis to develop the disorder when faced with stressful events.

Neurodevelopmental Disorders

Neurodevelopmental disorders are a group of disorders that are typically diagnosed during childhood and characterised by developmental deficits in personal, social, academic, and intellectual realms. These disorders include attention deficit/hyperactivity disorder (ADHD) and autism spectrum disorder. ADHD is characterised by a pervasive pattern of inattention and/or hyperactive and impulsive behaviour that interferes with normal functioning. Genetic and neurobiological factors contribute to the development of ADHD, which can persist well into adulthood and is often associated with poor long-term outcomes. The major features of autism spectrum disorder include deficits in social interaction and communication and repetitive movements or interests. As with ADHD, genetic factors appear to play a prominent role in the development of autism spectrum disorder; exposure to environmental pollutants such as mercury have also been linked to the development of this disorder. Although it is believed by some that autism is triggered by the MMR vaccination, evidence does not support this claim.

Schizophrenia

Schizophrenia is a severe disorder characterised by a complete breakdown in one’s ability to function in life; it often requires hospitalisation. People with schizophrenia experience hallucinations and delusions and have extreme difficulty regulating their emotions and behaviour. Thinking is incoherent and disorganised, behaviour is extremely bizarre, emotions are flat, and motivation to engage in most basic life activities is lacking. Considerable evidence shows that genetic factors play a central role in schizophrenia; however, adoption studies have highlighted the additional importance of environmental factors. Neurotransmitter and brain abnormalities, which may be linked to environmental factors such as obstetric complications or exposure to influenza during the gestational period, have also been implicated. A promising new area of schizophrenia research involves identifying individuals who show prodromal symptoms and following them over time to determine which factors best predict the development of schizophrenia. Future research may enable us to pinpoint those especially at risk for developing schizophrenia and who may benefit from early intervention.

Mood Disorders

Mood disorders are those in which the person experiences severe disturbances in mood and emotion. They include depressive disorders and bipolar and related disorders. Depressive disorders include major depressive disorder, which is characterised by episodes of profound sadness and loss of interest or pleasure in usual activities and other associated features, and persistent depressive disorder, which is marked by a chronic state of sadness. Bipolar disorder is characterised by mood states that vacillate between sadness and euphoria; a diagnosis of bipolar disorder requires experiencing at least one manic episode, which is defined as a period of extreme euphoria, irritability, and increased activity. Mood disorders appear to have a genetic component, with genetic factors playing a more prominent role in bipolar disorder than in depression. Both biological and psychological factors are important in the development of depression.

Anxiety Disorders

Anxiety disorders are a group of disorders in which a person experiences excessive, persistent, and distressing fear and anxiety that interferes with normal functioning. Anxiety disorders include: a specific phobia (unrealistic fear); social anxiety disorder (extreme fear and avoidance of social situations); panic disorder (being suddenly overwhelmed by panic even though there is no apparent reason to be frightened); agoraphobia (an intense fear and avoidance of situations in which it might be difficult to escape); and generalised anxiety disorder (a relatively continuous state of tension, apprehension, and dread).

Obsessive-Compulsive and Related Disorders

Obsessive-compulsive and related disorders are a group of DSM-5 disorders that overlap somewhat in that they each involve intrusive thoughts and/or repetitive behaviours. Perhaps the most recognised of these disorders is obsessive-compulsive disorder, in which a person is obsessed with unwanted, unpleasant thoughts and/or compulsively engages in repetitive behaviours or mental acts, perhaps as a way of coping with the obsessions. Body dysmorphic disorder is characterised by the individual becoming excessively preoccupied with one or more perceived flaws in his physical appearance that are either nonexistent or unnoticeable to others. Preoccupation with the perceived physical defects causes the person to experience significant anxiety regarding how he appears to others. Hoarding disorder is characterised by persistent difficulty in discarding or parting with objects, regardless of their actual value, often resulting in the accumulation of items that clutter and congest the person’s living area.

Posttraumatic Stress Disorder

Posttraumatic stress disorder (PTSD) was described through much of the 20th century and was referred to as shell shock and combat neurosis in the belief that its symptoms were thought to emerge from the stress of active combat. Today, PTSD is defined as a disorder in which the experience of a traumatic or profoundly stressful event, such as combat, sexual assault, or natural disaster, produces a constellation of symptoms that must last for one month or more. These symptoms include intrusive and distressing memories of the event, flashbacks, avoidance of stimuli or situations that are connected to the event, persistently negative emotional states, feeling detached from others, irritability, proneness toward outbursts, and a tendency to be easily startled. Not everyone who experiences a traumatic event will develop PTSD; a variety of risk factors associated with its development have been identified.

Dissociative Disorders

The main characteristic of dissociative disorders is that people become dissociated from their sense of self, resulting in memory and identity disturbances. Dissociative disorders listed in the DSM-5 include dissociative amnesia, depersonalisation/derealisation disorder, and dissociative identity disorder. A person with dissociative amnesia is unable to recall important personal information, often after a stressful or traumatic experience.

Depersonalisation/derealisation disorder is characterised by recurring episodes of depersonalisation (i.e., detachment from or unfamiliarity with the self) and/or derealisation (i.e., detachment from or unfamiliarity with the world). A person with dissociative identity disorder exhibits two or more well-defined and distinct personalities or identities, as well as memory gaps for the time during which another identity was present.

Dissociative identity disorder has generated controversy, mainly because some believe its symptoms can be faked by patients if presenting its symptoms somehow benefits the patient in avoiding negative consequences or taking responsibility for one’s actions. The diagnostic rates of this disorder have increased dramatically following its portrayal in popular culture. However, many people legitimately suffer over the course of a lifetime with this disorder.

Personality Disorders

Individuals with personality disorders exhibit a personality style that is inflexible, causes distress and impairment, and creates problems for themselves and others. The DSM-5 recognises 10 personality disorders, organised into three clusters. The disorders in Cluster A include those characterised by a personality style that is odd and eccentric. Cluster B includes personality disorders characterised chiefly by a personality style that is impulsive, dramatic, highly emotional, and erratic, and those in Cluster C are characterised by a nervous and fearful personality style. Two Cluster B personality disorders, borderline personality disorder and antisocial personality disorder, are especially problematic. People with borderline personality disorder show marked instability in mood, behaviour, and self-image, as well as impulsivity. They cannot stand to be alone, are unpredictable, have a history of stormy relationships, and frequently display intense and inappropriate anger. Genetic factors and adverse childhood experiences (e.g., sexual abuse) appear to be important in its development. People with antisocial personality display a lack of regard for the rights of others; they are impulsive, deceitful, irresponsible, and unburdened by any sense of guilt. Genetic factors and socialisation both appear to be important in the origin of antisocial personality disorder. Research has also shown that those with this disorder do not experience emotions the way most other people do.

Review Questions

Multiple Choice Questions

  1. In the harmful dysfunction definition of psychological disorders, dysfunction involves ________.
    1. the inability of an psychological mechanism to perform its function
    2. the breakdown of social order in one’s community
    3. communication problems in one’s immediate family
    4. all the above
  2. Patterns of inner experience and behaviour are thought to reflect the presence of a psychological disorder if they ________.
    1. are highly atypical
    2. lead to significant distress and impairment in one’s life
    3. embarrass one’s friends and/or family
    4. violate the norms of one’s culture
  3. The letters in the abbreviation DSM-5 stand for ________.
    1. Diseases and Statistics Manual of Medicine
    2. Diagnosable Standards Manual of Mental Disorders
    3. Diseases and Symptoms Manual of Mental Disorders
    4. Diagnostic and Statistical Manual of Mental Disorders.
  4. A study based on over 9,000 US residents found that the most prevalent disorder was ________.
    1. major depressive disorder
    2. social anxiety disorder
    3. obsessive-compulsive disorder
    4. specific phobia
  5. The diathesis-stress model presumes that psychopathology results from ________.
    1. vulnerability and adverse experiences
    2. biochemical factors
    3. chemical imbalances and structural abnormalities in the brain
    4. adverse childhood experiences
  6. Dr. Anastasia believes that major depressive disorder is caused by an over-secretion of cortisol. Dr. Anastasia’s view on the cause of major depressive disorder reflects a ________ perspective.
    1. psychological
    2. supernatural
    3. biological
    4. diathesis-stress
  7. In which of the following anxiety disorders is the person in a continuous state of excessive, pointless worry and apprehension?
    1. panic disorder
    2. generalised anxiety disorder
    3. agoraphobia
    4. social anxiety disorder
  8. Which of the following would constitute a safety behaviour?
    1. encountering a phobic stimulus in the company of other people
    2. avoiding a field where snakes are likely to be present
    3. avoiding eye contact
    4. worrying as a distraction from painful memories
  9. Which of the following best illustrates a compulsion?
    1. mentally counting backward from 1,000
    2. persistent fear of germs
    3. thoughts of harming a neighbour
    4. falsely believing that a spouse has been cheating
  10. Research indicates that the symptoms of OCD ________.
    1. are similar to the symptoms of panic disorder
    2. are triggered by low levels of stress hormones
    3. are related to hyperactivity in the orbitofrontal cortex
    4. are reduced if people are asked to view photos of stimuli that trigger the symptoms
  11. Symptoms of PTSD include all of the following except ________.
    1. intrusive thoughts or memories of a traumatic event
    2. avoidance of things that remind one of a traumatic event
    3. jumpiness
    4. physical complaints that cannot be explained medically
  12. Which of the following elevates the risk for developing PTSD?
    1. severity of the trauma
    2. frequency of the trauma
    3. high levels of intelligence
    4. social support
  13. Common symptoms of major depressive disorder include all of the following except ________.
    1. periods of extreme elation and euphoria
    2. difficulty concentrating and making decisions
    3. loss of interest or pleasure in usual activities
    4. psychomotor agitation and retardation
  14. Clifford falsely believes that the police have planted secret cameras in his home to monitor their every movement. Clifford’s belief is an example of ________.
    1. a delusion
    2. a hallucination
    3. tangentiality
    4. a negative symptom
  15. A study of adoptees whose biological mothers had schizophrenia found that the adoptees were most likely to develop schizophrenia ________.
    1. if their childhood friends later developed schizophrenia
    2. if they abused drugs during adolescence
    3. if they were raised in a disturbed adoptive home environment
    4. regardless of whether they were raised in a healthy or disturbed home environment
  16. Dissociative amnesia involves ________.
    1. memory loss following head trauma
    2. memory loss following stress
    3. feeling detached from the self
    4. feeling detached from the world
  17. Dissociative identity disorder mainly involves ________.
    1. depersonalisation
    2. derealisation
    3. schizophrenia
    4. different personalities
  18. Which of the following is not a primary characteristic of ADHD?
    1. short attention span
    2. difficulty concentrating and distractibility
    3. restricted and fixated interest
    4. excessive fidgeting and squirming
  19. One of the primary characteristics of autism spectrum disorder is ________.
    1. bed-wetting
    2. difficulty relating to others
    3. short attention span
    4. intense and inappropriate interest in others
  20. People with borderline personality disorder often ________.
    1. try to be the centre of attention
    2. are shy and withdrawn
    3. are impulsive and unpredictable
    4. tend to accomplish goals through cruelty
  21. Antisocial personality disorder is associated with ________.
    1. emotional deficits
    2. memory deficits
    3. parental overprotection
    4. increased empathy

Critical Thinking Questions

  1. Discuss why thoughts, feelings, or behaviours that are merely atypical or unusual would not necessarily signify the presence of a psychological disorder. Provide an example.
  2. Describe the DSM-5. What is it, what kind of information does it contain, and why is it important to the study and treatment of psychological disorders?
  3. The International Classification of Diseases (ICD) and the DSM differ in various ways. What are some of the differences in these two classification systems?
  4. Why is the perspective one uses in explaining a psychological disorder important?
  5. Describe how cognitive theories of the etiology of anxiety disorders differ from learning theories.
  6. Discuss the common elements of each of the three disorders covered in this section: obsessive-compulsive disorder, body dysmorphic disorder, and hoarding disorder.
  7. List some of the risk factors associated with the development of PTSD following a traumatic event.
  8. Why is research following individuals who show prodromal symptoms of schizophrenia so important?
  9. The prevalence of most psychological disorders has increased since the 1980s. However, as discussed in this section, scientific publications regarding dissociative amnesia peaked in the mid-1990s but then declined steeply through 2003. In addition, no fictional or nonfictional description of individuals showing dissociative amnesia following a trauma exists prior to 1800. How would you explain this phenomenon?
  10. Compare the factors that are important in the development of ADHD with those that are important in the development of autism spectrum disorder.
  11. Imagine that a child has a genetic vulnerability to antisocial personality disorder. How might this child’s environment shape the likelihood of developing this personality disorder?

Personal Application Questions

  1. Identify a behaviour that is considered unusual or abnormal in your own culture; however, it would be considered normal and expected in another culture.
  2. Even today, some believe that certain occurrences have supernatural causes. Think of an event, recent or historical, for which others have provided a supernatural explanation.
  3. Think of someone you know who seems to have a tendency to make negative, self-defeating explanations for negative life events. How might this tendency lead to future problems? What steps do you think could be taken to change this thinking style?
  4. Try to find an example (via a search engine) of a past instance in which a person committed a horrible crime, was apprehended, and later claimed to have dissociative identity disorder during the trial. What was the outcome? Was the person revealed to be faking? If so, how was this determined?
  5. Discuss the characteristics of autism spectrum disorder with a few of your friends or members of your family (choose friends or family members who know little about the disorder) and ask them if they think the cause is due to bad parenting or vaccinations. If they indicate that they believe either one to be true, why do you think this might be the case? What would be your response?

Review Questions Answers

Multiple Choice Question Answers

  1. A
  2. B
  3. D
  4. A
  5. A
  6. C
  7. B
  8. C
  9. A
  10. C
  11. D
  12. A
  13. A
  14. A
  15. C
  16. B
  17. D
  18. C
  19. B
  20. C
  21. A

Critical Thinking Question Answers

  1. Just because something is atypical or unusual does not mean it is disordered. A person may experience atypical inner experiences or exhibit unusual behaviours, but she would not be considered disordered if they are not distressing, disturbing, or reflecting a dysfunction. For example, a classmate might stay up all night studying before exams; although atypical, this behaviour is unlikely to possess any of the other criteria for psychological disorder mentioned previously.
  2. The DSM-5 is the classification system of psychological disorders preferred by most US mental health professionals, and it is published by the American Psychiatric Association (APA). It consists of broad categories of disorders and specific disorders that fall within each category. Each disorder has an explicit description of its symptoms, as well as information concerning prevalence, risk factors, and comorbidity. The DSM-5 provides a common language that enables mental health professionals to communicate effectively about sets of symptoms.
  3. The ICD is used primarily for making clinical diagnoses and more broadly for examining the general health of populations and monitoring the international prevalence of diseases and other health problems. While the DSM is also used for diagnostic purposes, it is also highly valued as a research tool. For example, much of the data regarding the etiology and treatment of psychological disorders are based on diagnostic criteria set forth in the DSM.
  4. The perspective one uses in explaining a psychological disorder consists of assumptions that will guide how to best study and understand the nature of a disorder, including its causes, and how to most effectively treat the disorder.
  5. Learning theories suggest that some anxiety disorders, especially specific phobia, can develop through a number of learning mechanisms. These mechanisms can include classical and operant conditioning, modelling, or vicarious learning. Cognitive theories, in contrast, assume that some anxiety disorders, especially panic disorder, develop through cognitive misinterpretations of anxiety and other symptoms.
  6. Each of the three disorders is characterised by repetitive thoughts and urges, as well as an uncontrollable need to engage in repetitive behaviour and mental acts. For example, repetitive thoughts include concerns about contamination (OCD), imagined physical defects (body dysmorphic disorder), and discarding one’s possessions (hoarding disorder). Uncontrollable needs to engage in repetitive behaviours and mental acts include persistent handwashing (OCD), constantly looking in the mirror (body dysmorphic disorder) and engaging in efforts to acquire new possessions (hoarding disorder).
  7. Risk factors associated with PTSD include gender (female), low socioeconomic status, low intelligence, personal and family history of mental illness, and childhood abuse or trauma. Personality factors, including neuroticism and somatisation, may also serve as risk factors. Also, certain versions of a gene that regulates serotonin may constitute a diathesis.
  8. This kind of research is important because it enables investigators to identify potential warning signs that predict the onset of schizophrenia. Once such factors are identified, interventions may be developed.
  9. Several explanations are possible. One explanation is that perhaps there is little scientific interest in this phenomenon, maybe because it has yet to gain consistent scientific acceptance. Another possible explanation is that perhaps dissociative amnesia was fashionable at the time publications dealing with this topic peaked (1990s) and since that time it has become less fashionable.
  10. Genetic factors appear to play a major role in the development of both ADHD and autism spectrum disorder; studies show higher rates of concordance among identical twins than among fraternal twins for both disorders. In ADHD, genes that regulate dopamine have been implicated; in autism spectrum disorder, de novo genetic mutations appear to be important. Imaging studies suggest that abnormalities in the frontal lobes may be important in the development of ADHD. Parenting practices are not connected to the development of either disorder. Although environmental toxins are generally unimportant in the development of ADHD, exposure to cigarette smoke during the prenatal period has been linked to the development of the disorder. A number of environmental factors are thought to be associated with an increased risk for autism spectrum disorder: exposure to pollutants, an urban versus rural residence, and vitamin D deficiency. Although some people continue to believe that MMR vaccinations can cause autism spectrum disorder (due to an influential paper that was later retracted), there is no scientific evidence that supports this assertion.
  11. The environment is likely to be very instrumental in determining the likelihood of developing antisocial personality disorder. Research has shown that adverse family environments (e.g., divorce or marital problems, legal problems, and drug use) are connected to antisocial personality disorder, particularly if one is genetically vulnerable. Beyond one’s family environment, peer group delinquency and community variables (e.g., economic deprivation, community disorganisation, drug use, and the presence of adult antisocial models) heighten the risk of violent behaviour.

Key Terms

Key Terms

  • Adaptive information processing model of PTSD: suggests that past trauma can continue to cause emotional distress if the memory of that trauma is not fully processed.
  • ADHD-C: attention deficit/hyperactivity disorder with a mix of symptoms in both inattentive and hyperactive/impulsive categories.
  • ADHD-HI: attention deficit/hyperactivity disorder with symptoms that primarily fall into the hyperactivity and impulsivity category. People with ADHD-HI have trouble with impulse control, may display a high level of activity and energy in inappropriate situations, and have relatively fewer symptoms in the inattentive category.
  • ADHD-PI: attention deficit/hyperactivity disorder with symptoms that primarily fall into the inattentive category. People with ADHD-PI have trouble maintaining attention and have relatively fewer symptoms in the hyperactivity and impulsivity category.
  • Agoraphobia: anxiety disorder characterised by intense fear, anxiety, and avoidance of situations in which it might be difficult to escape if one experiences symptoms of a panic attack.
  • Alexithymia: a condition that involves a reduced ability to identify and sense one’s own emotions and the emotions of others.
  • Alterations in arousal and reactivity: one of the four categories of PTSD symptoms; includes irritability or aggression, increased risk-taking, hyper-vigilance, jumpiness, and difficulty with concentration or sleep.
  • Amyloid-beta plaque: an extracellular accumulation of amyloid; thought to be the potential cause or by-product of Alzheimer’s disease.
  • Antisocial personality disorder: characterised by a lack of regard for others’ rights, impulsivity, deceitfulness, irresponsibility, and lack of remorse over misdeeds
  • Anxiety disorder: characterised by excessive and persistent fear and anxiety, and by related disturbances in behaviour.
  • Applied behavioural analysis: a behavioural modification strategy that involves punishing autistic traits and behaviours that are deemed maladaptive, while rewarding behaviours that are deemed appropriate; this therapy is not accepted by the broader autistic community.
  • Attention deficit/hyperactivity disorder (ADHD): a neurotype characterised by differences and difficulties in attention and emotional and behavioural regulation. This neurotype is often also associated with differences in sensory processing and executive function.
  • Atypical: describes behaviours or feelings that deviate from the norm.
  • Augmentative and alternative communication (AAC): techniques and technologies meant to supplement or allow for communication when expressive speech or language is difficult or impossible. AAC includes but isn’t limited to sign languages, text-to-speech devices, and image-based systems like picture cards and communication boards.
  • Autistic burnout: a state resulting from prolonged stress and a mismatch of expectations and abilities without enough accommodation or support. This state is associated with long term fatigue, reduced function, loss of previously acquired skills, and an increase in sensory issues.
  • Autistic meltdown: a response similar to fight or flight that autistic people experience when they are experiencing a level of stress and overstimulation that they aren’t able to manage. Meltdowns involve bursts of uncontrolled behaviour that may serve to externalise stress and reduce the level of internal tension the autistic person is experiencing.
  • Autistic shutdown: a response to overwhelming stress and overstimulation in which an autistic person experiences dissociation or withdrawal from the current sensory environment. Shutdowns involve reduced responsiveness, loss of function, and fatigue, and may serve to reduce tension by decreasing the amount of stimulation the individual experiences.
  • Autism spectrum disorder: a neurotype characterised by difficulty in neurotypical social interaction and communication, and by restricted or repetitive patterns of thought and behaviour. This neurotype is also generally associated with differences in sensory processing.
  • Avoidance symptoms: one of the four categories of PTSD; occurs when the individual avoids stimuli or thoughts and feelings associated with the trauma.
  • Behavioural parent training: a kind of therapy designed to teach parents of people with ADHD how to manage emotions and communicate effectively so that they can support their children in forming habits and learning skills that suit their needs and neurotype.
  • Biomarker: unique molecules produced during pathological processes that can be used to detect the presence of a disease.
  • Bipolar and related disorders: group of mood disorders in which mania is the defining feature.
  • Bipolar disorder: mood disorder characterised by mood states that vacillate between depression and mania.
  • Body dysmorphic disorder: involves excessive preoccupation with an imagined defect in physical appearance.
  • Borderline personality disorder: instability in interpersonal relationships, self-image, and mood, as well as impulsivity; key features include intolerance of being alone and fear of abandonment, unstable relationships, unpredictable behaviour and moods, and intense and inappropriate anger.
  • Catatonic behaviour: decreased reactivity to the environment; includes posturing and catatonic stupor.
  • Cognitive behavioural therapy (CBT): a kind of therapy that aims to systematically identify maladaptive patterns of thought and behaviour so that they can be addressed and replaced with more effective strategies.
  • Comorbidity: co-occurrence of two disorders in the same individual.
  • Complex PTSD (C-PTSD): a variant of PTSD included in the 11th revision of the International Classification of Diseases (ICD-11) but as yet to be included in the DSM.
  • Delusion: belief that is contrary to reality and is firmly held despite contradictory evidence.
  • Depersonalisation/derealisation disorder: dissociative disorder in which people feel detached from the self (depersonalisation), and the world feels artificial and unreal (derealisation).
  • Depressive disorder: one of a group of mood disorders in which depression is the defining feature.
  • Diagnosis: determination of which disorder a set of symptoms represents.
  • Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5): authoritative index of mental disorders and the criteria for their diagnosis; published by the American Psychiatric Association (APA).
  • Diathesis-stress model: suggests that people with a predisposition for a disorder (a diathesis) are more likely to develop the disorder when faced with stress; model of psychopathology.
  • Disorganised thinking: disjointed and incoherent thought processes, usually detected by what a person says.
  • Disorganised/abnormal motor behaviour: highly unusual behaviours and movements (such as child-like behaviours), repeated and purposeless movements, and displaying odd facial expressions and gestures.
  • Dissociative amnesia: dissociative disorder characterised by an inability to recall important personal information, usually following an extremely stressful or traumatic experience.
  • Dissociative disorders: group of DSM-5 disorders in which the primary feature is that a person becomes dissociated, or split off, from his or her core sense of self, resulting in disturbances in identity and memory.
  • Dissociative fugue: symptom of dissociative amnesia in which a person suddenly wanders away from their home and experiences confusion about their identity.
  • Dissociative identity disorder: dissociative disorder (formerly known as multiple personality disorder) in which a person exhibits two or more distinct, well-defined personalities or identities and experiences memory gaps for the time during which another identity emerged.
  • Dopamine hypothesis: theory of schizophrenia that proposes that an overabundance of dopamine or dopamine receptors is responsible for the onset and maintenance of schizophrenia.
  • Etiology: cause or causes of a psychological disorder.
  • Executive functions: a set of cognitive skills that involve self-control, self-monitoring, planning and organisation, and working memory.
  • Flashback: psychological state lasting from a few seconds to several days, during which one relives a traumatic event and behaves as though the event were occurring at that moment.
  • Flight of ideas: symptom of mania that involves an abrupt switch in conversation from one topic to another.
  • Generalised anxiety disorder: characterised by a continuous state of excessive, uncontrollable, and pointless worry and apprehension.
  • Global processing: processing the sum of parts, or the end product of a number of local details as they are combined; for example, processing the way a song sounds as a whole, rather than focusing on individual notes or instruments.
  • Grandiose delusion: characterised by beliefs that one holds special power, unique knowledge, or is extremely important.
  • Habituation: a reduction in the response of the nervous system to stimuli that are unchanging or consistently present.
  • Hallucination: perceptual experience that occurs in the absence of external stimulation, such as the auditory hallucinations (hearing voices) common to schizophrenia.
  • Harmful dysfunction: model of psychological disorders resulting from the inability of an internal mechanism to perform its natural function.
  • Hoarding disorder: characterised by persistent difficulty in parting with possessions, regardless of their actual value or usefulness.
  • Hopelessness theory: cognitive theory of depression proposing that a style of thinking that perceives negative life events as having stable and global causes leads to a sense of hopelessness and then to depression.
  • Hyperfocus: an intense state of attention towards a particular subject, during which the individual may seem to ignore all other stimuli and may lose their sense of time; generally this occurs during tasks that are enjoyable.
  • Hyperlexia: the ability to read significantly above the expected level for one’s age.
  • Hyperreactivity: a larger than average reaction to certain sensory stimuli.
  • Hyporeactivity: a smaller than average reaction to certain sensory stimuli or a lack of reaction to certain sensory stimuli.
  • Identity first language: a way to refer to people that uses their condition or neurotype as a noun. This is meant to acknowledge that the neurotype or condition is actually a part of the person’s identity which cannot be separated from them. For example, referring to someone as an autistic person is a use of identity first language.
  • Interoception: one’s perception of sensations that come from inside the body, including heartbeat, respiration, pain, sensations involved in digestion, and nervous system activity related to emotions.
  • Intrusion symptoms: one of the four categories of PTSD symptoms; occurs when the traumatic event is re-experienced through memories, nightmares, flashbacks, and emotional or physical reactivity after exposure to stimuli associated with the trauma.
  • International Classification of Diseases (ICD): authoritative index of mental and physical diseases, including infectious diseases, and the criteria for their diagnosis; published by the World Health Organization (WHO).
  • Learning and Cognitive Processing Model of PTSD: suggests that some symptoms are developed and maintained through classical conditioning.
  • Local processing: processing local details, the individual details that make up a bigger picture; for example, processing the colours that are used in a painting rather than processing the painting as a whole.
  • Locus coeruleus: area of the brainstem that contains norepinephrine, a neurotransmitter that triggers the body’s fight-or-flight response; has been implicated in panic disorder.
  • Major depressive disorder: commonly referred to as “depression” or “major depression”’ characterised by sadness or loss of pleasure in usual activities, as well other symptoms.
  • Mania: state of extreme elation and agitation.
  • Manic episode: period in which an individual experiences mania, characterised by extremely cheerful and euphoric mood, excessive talkativeness, irritability, increased activity levels, and other symptoms.
  • Masking: a strategy that involves learning and performing neurotypical behaviours, while suppressing and resisting autistic behaviours with the intent to blend in for safety, to avoid stigma, and to succeed in a neurotypical social context.
  • Medical model of disability: a model that identifies disability as a defect rather than a difference of needs. This model positions the disabled person as a victim of their disability and places responsibility on the individual. This model aims to prevent and eliminate disability.
  • Mindfulness techniques and training: a kind of attention training therapy or technique that aims to teach participants to remain cognitively present and avoid internal distractions, like stressful thoughts or worries about the future, as well as external distractions, like ambient noise.
  • Mood disorder: one of a group of disorders characterised by severe disturbances in mood and emotions; the categories of mood disorders listed in the DSM-5 are bipolar and related disorders and depressive disorders.
  • Negative alterations in cognitions and mood: one of the four categories of PTSD symptoms; involves pervasive negative mood, feelings of isolation, extreme negative beliefs about the self or the world, and problems with memory, often specific to trauma-related memories.
  • Negative symptom: characterised by decreases and absences in certain normal behaviours, emotions, or drives, such as an expressionless face, lack of motivation to engage in activities, reduced speech, lack of social engagement, and inability to experience pleasure.
  • Neurodegenerative disease: a brain disorder characterised by the dysfunction and subsequent death of neurons.
  • Neurodevelopmental disorder: one of the disorders that are first diagnosed in childhood and involve developmental problems in academic, intellectual and social functioning.
  • Neurodiversity: the spectrum of brain organisation and function that can occur in a population of healthy humans.
  • Neurotype: the kind of brain organisation and function a person has, influencing the way they perceive, interpret, and respond to the world.
  • Neurotypical: a person who has a neurotype that functions similarly to the majority of people of the same age in their culture.
  • Neurodivergent: a person who has a neurotype that functions differently from the majority of people of the same age in their culture.
  • Obsessive-compulsive and related disorders: group of overlapping disorders listed in the DSM-5 that involves intrusive, unpleasant thoughts and/or repetitive behaviours.
  • Obsessive-compulsive disorder: characterised by the tendency to experience intrusive and unwanted thoughts and urges (obsession) and/or the need to engage in repetitive behaviours or mental acts (compulsions) in response to the unwanted thoughts and urges.
  • Occupational therapy: a form of therapy that aims to help individuals improve function in daily life, often by identifying barriers, developing strategies to address those barriers, and identifying relevant supports. For example, someone who has lost function in their hands may need an occupational therapist to identify exercises that will help them regain function, and to help them find accommodations so that they can condition themselves to engage in daily activities while they are recovering.
  • Orbitofrontal cortex: area of the frontal lobe involved in learning and decision-making.
  • Panic attack: period of extreme fear or discomfort that develops abruptly; symptoms of panic attacks are both physiological and psychological.
  • Panic disorder: anxiety disorder characterised by unexpected panic attacks, along with at least one month of worry about panic attacks or self-defeating behaviour related to the attacks.
  • Paranoid delusion: characterised by one’s beliefs that others are out to harm them.
  • Peripartum onset: subtype of depression that applies to those who experience an episode of major depression either during pregnancy or in the four weeks following childbirth.
  • Persistent depressive disorder: depressive disorder characterised by a chronically sad and melancholy mood.
  • Person-first language: a way to refer to people that uses their condition or neurotype as an adjective, with the intent to separate the person from the condition. This kind of language is meant to present the condition or neurotype as separable from the person. For example, referring to someone as a person with ADHD is a use of person first language.
  • Personality disorder: group of DSM-5 disorders characterised by an inflexible and pervasive personality style that differs markedly from the expectations of one’s culture and causes distress and impairment; people with these disorders have a personality style that frequently brings them into conflict with others and disrupts their ability to develop and maintain social relationships.
  • Posttraumatic stress disorder (PTSD): experiencing a profoundly traumatic event leads to a constellation of symptoms that includes intrusive and distressing memories of the event, avoidance of stimuli connected to the event, negative emotional states, feelings of detachment from others, irritability, proneness toward outbursts, hypervigilance, and a tendency to startle easily; these symptoms must occur for at least one month.
  • Prodromal symptom: in schizophrenia, one of the early minor symptoms of psychosis.
  • Psychological disorder: condition characterised by abnormal thoughts, feelings, and behaviours.
  • Psychopathology: study of psychological disorders, including their symptoms, causes, and treatment; manifestation of a psychological disorder.
  • Rumination: in depression, tendency to repetitively and passively dwell on one’s depressed symptoms, their meanings, and their consequences.
  • Safety behaviour: mental and behavioural acts designed to reduce anxiety in social situations by reducing the chance of negative social outcomes; common in social anxiety disorder.
  • Schizophrenia: severe disorder characterised by major disturbances in thought, perception, emotion, and behaviour with symptoms that include hallucinations, delusions, disorganised thinking and behaviour, and negative symptoms.
  • Seasonal pattern: subtype of depression in which a person experiences the symptoms of major depressive disorder only during a particular time of year.
  • Social anxiety disorder: characterised by extreme and persistent fear or anxiety and avoidance of social situations in which one could potentially be evaluated negatively by others.
  • Social model of disability: a model that positions disability as a problem that results from barriers in society that disadvantage people who have different needs. This model aims to improve rights and accessibility for disabled people.
  • Social skills training: a therapy designed to teach autistic people to communicate and interact in more neurotypical ways; this therapy is controversial in the autistic community, as it is argued that it devalues autistic social skills.
  • Somatic delusion: belief that something highly unusual is happening to one’s body or internal organs.
  • Specific phobia: anxiety disorder characterised by excessive, distressing, and persistent fear or anxiety about a specific object or situation.
  • Stimulant medication: drugs that increase the activity of certain parts of the nervous system. Certain stimulants are regularly prescribed for people with ADHD, as they can help promote activity in parts of the brain that are found to be underactive, particularly the frontal lobe.
  • Stims/stimming: repetitive body movements/behaviours or noises, which can help to regulate one’s level of stimulation. During overstimulation, stimming can help to block out undesirable environmental stimuli. During under-stimulation, stimming can help to generate increased internal stimulation.
  • Suicidal ideation: thoughts of death by suicide, thinking about or planning suicide, or making a suicide attempt.
  • Suicide: death caused by intentional, self-directed injurious behaviour.
  • Supernatural: describes a force beyond scientific understanding.
  • Tau fibrillary tangles: intracellular, string-like proteins thought to be the cause or by-product of Alzheimer’s disease.
  • Ventricle: one of the fluid-filled cavities within the brain.
  • Working memory: a component of short-term memory responsible for holding and processing units of information that are in immediate use.

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This chapter is largely based on the “Psychopathology” chapter in Introduction to Psychology & Neuroscience (2nd Edition) edited by Leanne Stevens, Jennifer Stamp, & Kevin LeBlanc, which is licensed under a CC BY 4.0 licence. It was adapted by Jessica Motherwell McFarlane to add some new resources and sections.

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