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• 18% of people are currently diagnosed with a mental disorder, which is known as point prevalence.
• 50% of people can be diagnosed with a mental disorder at some time in their life, which is known as the lifetime prevalence.

Psychological Disorder

• It involves psychological dysfunction within an individual.
• It’s associated with significant distress or impairment.
• The response isn't typical or culturally expected.
• Psychological function involves sensation and perception systems.
• Hallucinations can occur when psychological functions go awry.
• Auditory hallucinations are the most common, particularly in schizophrenia
• Visual hallucinations can be caused by drug overdose or brain issues.
• Fear can be a dysfunction within an emotion system.
• Examples of emotional dysfunctions are anxiety and depression.
• Sleep dysfunctions can also occur.
• Typical sadness and distress can manifest.
• This includes grief responses to accidents, traumatic events, or loss.
• PTSD can arise when past trauma continues to affect daily life.
• DSM stands for Diagnostic and Statistical Manual of Mental Disorders.
• The American Psychiatric Association publishes the DSM.

Tourette's Disorder

• It involves involuntary, sudden bodily movements, unlike tremors.
• Multiple motor tics must be present.
• Neurologists, not psychiatrists, typically observe motor tics alone.
• Vocal and motor tics together fit DSM criteria and are seen by psychiatrists.
• Involuntary vocal movements not representing thoughts can be a symptom.
• Tics must persist for more than one year.
• Tics cause significant impairment.
• Onset occurs before age 18.
• After age 18, it's not diagnosed as Tourette's; it's considered another neurological condition that hinders thinking.

Associated Features of Tourette's

• They may be present within some individuals that have a diagnosis that one wants to be aware of for a client.
• They are not required nor do they affect everyone with the disorder.
• Obsessions and compulsions are more often seen in those with Tourette's but not required.
• Only 10% of people with Tourette's have coprolalia.
• Coprolalia includes uncontrollable swearing or vocalizing obscenities.
• Copropraxia includes uncontrollable obscene gestures and is a motor tic.
• Echolalia includes an uncontrollable repetition of another person's spoken words.

Diagnostic Criteria

• The criteria are required for diagnosis and without them, there will not have the disorder.

Course for Tourette's

• Typical onset is between ages 4-6.
• Peak severity occurs around ages 10-12.
• Prevalence is rare, affecting 3-8 per 1,000 children (0.3 - 0.8%).
• Males are three times more affected than females.
• Differences in sex presentations for disorders are descriptive.
• Most adults have less severe symptoms than when they were children.
• People that have diagnostic criteria for the disorder barely meet the case and have it mild, as a clinician is more frequent to see mild cases than severe cases.

Risks for Tourette's disorder

• There is some genetic influence on risk.
• Genetic risk usually interacts with environmental factors.
• Environmental factors to be uncovered include low birth weight, maternal smoking during pregnancy, and increased paternal age.
• Increased risk is increased likelihood, but is not destined.
• A risk factor does not mean having the disorder.
• Environmental factors are usually broad and relate to the disorder.
• Treatment for Tourette's helps 60-80% of people who improve with specific drugs like haloperidol, pimozide, and clonidine.
• Antipsychotic medications can be beneficial and show clinical benefit, but it is not a cure.
• Medication helps to manage the symptoms but is not a cure.
• Behavioral techniques are not effective.
• When under stress, their ticking behavior is increased.
• Stress exacerbates symptoms generally.
• Psychotherapy helps with life management.
• Stress management results with less stress and fewer symptoms.
• Stigma and impacts on self-esteem are also factors.
• Trying to suppress tics adds more stress; increases frequency of symptoms
• Singing and athletic movements do not intrude.

Physical vs Mental Illness

• Should Tourette's be considered a physical illness or a mental disorder?
• It displays physical signs like tics, shows genetic links, and responds to medication.
• No clear dividing line exists between physical and mental illnesses.
• As a clinical psychologist you want to ask when their last physical was.
• Depression could be linked got hypothyroidism and psychotherapy won't help.

Models of Psychopathology

• They focus on certain individuals or specific situations.
• The process is as follows:
• Clinical Description and Assessment is performed.
• Explanation and Understanding (etiology) is performed.
• Treatment is administered.
• Changes can be made to make the person suffer less.

Traditional Models

• Psychodynamic Model comes from Sigmund Freud.
• People’s behavior comes from unconscious desires.
• Unmet desires can conflict and lead to suffering and impaired behavior.
• Phenomenological Model comes out of philosophy.
• It focuses on how people understand broader meaning of life, which relates to how others are influenced.
• The model provides limited insight on what causes psychopathology.

Behavioral Model

• Focuses on the environmental learning model.
• Abnormal behavior is just a different learning history than normal behavior
• Help them relearn reactions to environmental stimuli
• Cognitive Model
• Looks at theoretical causes.
• These causes are unconscious conflicts.
• Lack of meaning or distortion of life experiences.
• Maladaptive learning
• Faulty thinking.
• Theoretical cures include insight into unconscious conflicts.
• This is hard to achieve because there is resistance at the unconscious level.
• Develop life meaning, mature relationships, unlearn the maladaptive, or relearn.
• Learn new ways of interpreting life experiences.

Classical Conditioning

• Ivan Pavlov was not a psychologist.
• Unconditioned means unlearned.
• The stimulus = meat (US).
• This means anything an animal can detect in its environment.
• The response is salvation (UR).
• Conditioned stimulus is neutral = tone (CS).
• The conditioned response is salvation (CR).
• Extinction happens with repeated presentation of the CS alone.
• This results in the elimination of the CR.
• Classical conditioning plays a role in anxiety and fear disorders.

Operant Conditioning

• B.F. Skinner researched operant conditioning.
• Skinner Boxes are where birds are trained.
• At eye level there is a key, a translucent disk, to indicate different conditions for that bird.
• The bird can detect how much the bird pecks on the key for food delivery.
• Consequences that follow the behavior will determine how often the bird will peck.
• An antecedent is the (A) stimulus.
• For example, Green light and Red light.
• Behavior is the (B) response.
• For behavior, Peck is the example.
• The consequent it the C stimulus.
• Consequence examples are grain, shock, ending shocks, and end access to grain.
• The effect can be increase pecking or decrease pecking behavior.
• Positive reinforcement encourages behavior by giving a stimulus or by removing a stimulus; for example, Praise.
• Positive punishment decreases behavior by spanking.
• Negative reinforcement removes a response.
• Buckling seatbelts and taking medicine for headaches are examples.
• The removal of the headache is a negative reinforcer that encourages you to take medicine.
• Negative punishment removes a stimulus like timeout.

Token Economies

• Tokens given following desirable behavior.
• Tokens taken away following undesirable behavior.
• Tokens used to "purchase" items like cigarettes and passes.
• It can modify how people interact with better social skills.
• The cognitive model follows pattern.
• Antecedent is the specific life event.
• Belief is triggered by event.
• Consequent (emotion & behavior) results.
• For example, failed exam -> I'm a failure at life -> depressed and low self-esteem
• You dispute the belief in Cognitive Behavioral Therapy (CBT).

Cognitive Contributions to Depression

• Automatic negative thoughts that are not conscious until activated by a stressor, according to Aaron T. Beck.
• Dysfunctional Core Beliefs occur.
• The Depressive Cognitive Triad consists of:
• "I am no good."
• "My world is bleak."
• "My future is hopeless."
• Two types depression; helpless type (“I am inadequate”) [introjective] and unlovable type (“I am unattractive/unworthy”) [anaclitic].

Classification and Diagnosis- CBT

• This is displayed in the cognitive behavioral triangle of thoughts, behavior, and emotion.
• CBT says thoughts and behaviors impact emotions.
• Intervention will manipulate thoughts and behaviors to effect emotions.
• Detection: What is happening in their life. Record what they are doing, what they are thinking, and what they are feeling. Always involved in CBT because memories get distorted easily.
• Record thoughts and feelings (Column Thought Record).
• Discover along with the client what is going on in their life, known as analysis.
• How are the cognitions emotions and behaviors connected. Look for ongoing patterns of influence.
• Change: Challenge beliefs and change behaviors to accomplish goals of therapy.

Features of CBT

• It is very collaborative and transparent.
• Work with client to identify relationships between components of the thoughts. Get them to identify the patterns of thought and to build thoughts for themselves.
• CBT is effective intervention compared to others. Patients often improve in terms of emotions and patterns of behaviors, known as empirical analysis.
• Come up with patterns to see how thoughts, behaviors, and emotions are related.
• Test out whether the pattern is correct or not, by having the client think about themselves differently and see react/feel.
• Time limited, 12-24 sessions to get the job done.
• Psychodynamic therapy is unlimited.
• The aim is is to build a set of complete and effective skills with complete focus.
• It is Skill focused , Making suggestions to change and build set of skills on their own.
• Symptoms are the main focus.
• Focuses on the how to change symptoms to feel better.

Present Focused

• Present Focused: What are they doing, thinking, feeling on a day-to-day basis.
• The CBT triangle, then looks at personality, then relationship dynamics
• It is not focused on parents, or how they grow up.
• The therapeutic relationship is the Best predictor of how therapy is going.

Biomedical Model

• Deviant behaviors, thoughts, and feelings are symptoms of an underlying disease.
• Disease: a condition of an organ system in the body in which its functions are disturbed.
• Symptom complex (syndrome) includes Patterns of signs and symptoms that show they have a particular disease/disorder.
• Sign: Objective.
• Symptom: Subjective.
• Natural course of each disorder or disease looks at the natural course of each disorder or disease.
• Onset can be acute (fast) versus gradual.
• Schizophrenia is an active phase (hearing voices that others don’t) vs brief psychotic disorder (sudden onset and offset of delusions)
• Other conditions are related to the age of the patient/individual.
• An example would be Tourette's tics vs. neurological disorders
• The Outcome (prognosis) of a disease if it goes untreated vs. is treated.
• Specific pathophysiology includes a physiological mechanism.
• Having specific pathophysiology means that the disorder is actually a disease.
• Indicating that you know more.
• Differential diagnosis allows for Accurate prediction and Effective treatment selection.
• Biological Contributions to understanding abnormal behavior include pscyhopharmacology, Cognitive neuroscience, and Behavior genetics.
• Advantages of Classifying Abnormal behavior: Facilitates communication and record keeping, Advances clinical prediction, and Advances the discovery of causes.

Construction of Classifications

• The use of a Hierarchical taxonomy of psychopathology (HiTOP) is more utilized in research settings.
• Categories within a taxonomy that are Clinically derived often Appeal to consensus among authorities.
• Statistically derived categories makes use of Use of statistical procedures.
• This can be done through Factor and Cluster analysis.
• With the validated abstract concepts, theories in mature sciences can result.
• Cognitive behavioral neuroscience can understand normal and abnormal behavior, Using CBN to understand how the brain works, and Research Domain Criteria (RDoC).
• Main principle it circuits.
• Not ready for clinical use.

Clinically Derived System

• Diagnostic and Statistical Manual of Mental Disorders (DSM) 5th Edition: More descriptive and has cause no theoretical causes (by the American Psychiatric Association).
• International Classification of Disease is for both medicine an psychiatry.
• The PDM is the only Manual. This will probably replace the DSM.
• DSM Revisions for psychiatrists of US that make use of this classification system: All based consensus of authority figures.
• DSM-5 (2013) edition included revisions, updates and the incorporation of previous editions.

Using DSM

• Must have Inclusion and exclusion criteria as well as diagnostic rules. You have to follow the rules.

Added to DSM

• Why do we add disorders? To Identify new problems that did not exist before.
• The "New" Disorders include Phencyclidine Use Disorder , Internet Gaming Disorder recognizing old problems that were officially acknowledged before, Post-Traumatic Stress Disorder ,Caffeine Withdraw.
• Splitting broader categories into narrower more homogeneous groups makes it easier for doctors to create a treatment plan that caters more to the need of the clients.
• High co-morbidity between specific diagnostic categories includes (simultaneous and longitudinal).
• Symptoms form a continuous dimension of frequency or severity.

Certainty of the Bad things happening

• Anxiety is Apprehensive anticipation of a future uncertain danger.
• Fear is Emergency or alarm reaction to an immediate or imminent danger
• Real versus stress, it is future versus present.

Components of Anxiety

• Certainty: Certain Shock → Low Anxiety ; Uncertain Shock → High Anxiety
• Severity: Certain Severity of Shock → Low Anxiety; Uncertain Severity of Shock → High Anxiety
• Timing: Predictable Shock → Low Anxiety; Unpredictable Shock → High Anxiety
• Uncertainty causes increased level of distress
• Perceived Control - Reduces Anxiety: Building a skill set so people can have control over the world around them
• Anxiety disorders, obsessive-compulsive and related disorders and trauma and stressor disorders stem from anxiety disorders, according to to DSM-IV vs DSM-5

DSM 5 Anxiety Disorder are...

• Separation Anxiety Disorder: Most are children, inappropriate fear or anxiety concerning separation from those whom the individual is attached.
• The fear, anxiety or avoidance of separation is persistent for more than: 4 weeks in children or adolescence; 6 months in adults.
• They have the following prevalence; Children: 4%, Adolescence: 2%, Adults: 1-2%
• General Anxiety Disorder: Excessive, uncontrollable anxiety and worry about a number of events or activities more days than not for at least 6 months and 3 or more of these symptoms:

The symptom may include: restlessness, easily fatigued, difficulty concentrating, irritability, muscle tension, and sleep disturbance. The prevalence 5.7% and Sex female.

• Onset 50% before adolescence and chronic course are also relevant
• Family and genetic factors of anxiety

This will make you prone to having major issues in your life!

Other ways to deal with stress include treatment options as follows:

• Benzodiazepines can only be short-term.
• Selective Serotonin Reuptake Inhibitors (SSRIs) has potential.
• Cognitive Therapy correct threat magnifying thoughts.
• Potential is endless with having medication and cognitive awareness!
• Panic Disorder- Recurrent, unexpected panic attacks; 1 month and persistent concern or worry about additional attacks or their consequences

66% of people with it is female with early onset

• Panic Alarm Reaction patterns are cued, uncued, and situations. It has a great impact to the client and what they may feel. Agoraphobia- Anxiety is about being in places or situations where escape would be difficult if panic attack.

Other common things found are specific phobias or social anxiety.

• Symptoms: Marked fear or anxiety about a specific object or situation.

The DSM says that 20% of the population can be diagnosed with an anxiety disorder.

• 2/10 or 20% of population can be diagnosed with an anxiety disorder.
• Stress exacerbates the symptoms. You need good coping mechanism.
• Most common Phobias are about Animal Phobia and about the Natural World.
• The Specific Treatment has High success rate and is Easy to treat.

Prepared Learning

• We are genetically equipped through evolution to easily learn to fear certain objects Exposures:
• Real to avoid something bad in the future
• Exposure can be Imaginary or virtual
• If they handle a snake, they copy
• Change your expectations and modify what you think
• If you are having Social anxieties it is mainly about the scrutiny. It is not all of the time. You worry if will evaluate.

Many people feel the below; however, if are feeling any of these symptoms for more than 6 months, you need to speak to a psychologist for guidance.

• Trauma or the stress
• The reactive Attachment disorder is related to neglect from very young and small age

PTSD Disorder

• The Exposure to actual or threatened death can lead Trauma.
• The persistent negative beliefs about one' self is a great indicator of PTSD.
• The hypervigilance causes startle issues.
• PTSD must meet certain criteria in each point

The symptoms must come one month

• Complex PTSD is where the Person has trauma over period of months or years.
• You show more symptoms if have PTSD. These are harder to assess without some guidance.
• With cognitive you can have Prozac and Paxil and those can come and help with the anxiety disorders

OCD

• Have reoccurring thought or action
• Have a compulsion to do it.
• If you have the thought for more than 1 hours (daily) and you can't stop it, you need to get some help and guidance.
• OCD can have a big impact to the way a person will feel.

Hoarding

• If you feel and if you have any feeling related to having and not getting rid of stuff then you for sure have a potential to get the bad stuff; however, if you are not going to have some feelings associated with getting rid of something then good and you should be fine.

There are OCD disorders that may or may trigger the other factors.