Psychopathology and Abnormal Behavior

Psychopathology Definition

The scientific study of psychological disorders
Studies mental disorders and unusual or maladaptive behaviors
Includes symptoms, causes, course, development, treatments, strategies, and more
Includes the lived experience of mental illness

Definitions of Abnormality

Cultural Factors: what is abnormal in one society may be a strength in another
Temporal Factors: what is abnormal at one time may not be so at another
Situational Factors: the cultural norm may adjust to a particular circumstance.

What is Abnormal Behavior: Key Definitions

DSM V: “behavioural, emotional or cognitive dysfunctions that are unexpected in their cultural context and associated with personal distress or substantial impairment in functioning”
Sue, Sue & Sue (2003): “behaviour that departs from the norm and that harms the affected individual or others.”

Features of Abnormal Behavior

Psychological Dysfunction: impairment in cognitive, emotional, or behavioral functioning
Personal Distress: an individual's feelings of discomfort and/or upset
Atypical or Unexpected Cultural Response: deviant behavior for the specific group or society
Dangerousness: harmful or potentially harmful behavior towards oneself or others

Mythic Perceptions of Mental Illness

People with mental illness are weak
People with mental illness could just snap out of it if they wanted to
Creative people are a little “crazy”
People with mental disorders are dangerous
Most older people are senile
Asthma is caused by emotional problems
Suicidal individuals rarely talk about suicide
Criminals are born “bad”

Psychopathology Assessment

How do we measure severity, symptoms, and features?
Example Assessment Tools:
- Mini Mental State exam
- Beck Depression Inventory

### Psychopathology Treatment

Psychological Treatments:
- Cognitive behavior therapy
- Systemic family therapy
- Dialectic behavior therapy
- Interpersonal psychotherapy
Pharmacological Treatments: the use of medications to treat symptoms

Terminology

Psychological disorder or psychological abnormality considered preferred terms
Mental illness is a less preferred term

Trauma

Trauma occurs when a stressor exceeds a person's coping abilities.
Trauma symptoms include intense fear, helplessness, or horror.
Trauma can result in lasting mental and physical effects.
Trauma can be a single incident, such as witnessing a car accident, or complex and recurring, such as abuse or neglect.

Childhood Trauma

Childhood trauma refers to an experience that is emotionally painful for a child and overwhelms their coping abilities.
Types of childhood trauma include single incident trauma and complex trauma.
Complex trauma often involves a repeated threat from an attachment figure.

Complex Trauma & Developmental Trauma

Complex trauma often involves repeated threat from an attachment figure, such as abuse or neglect, and can have profound effects on a child's life.
Developmental trauma is linked to early unmet needs and can damage developing brain architecture.
Developmental trauma often occurs when a child's attachment needs aren't met, impacting their ability to regulate stress.

Symptoms of Traumatic Stress

Dissociation is a protective reaction to overwhelming stress, where sensory awareness is lost.
Dissociation can involve avoidance, compliance, fainting, and a feeling of detachment from reality.
Hyperarousal is characterized by constant vigilance or resistance to situations.
Children are more likely to experience dissociation than hyperarousal in response to trauma.
Attachment challenges present as a "push-pull" dynamic, where the child seeks closeness but then pushes away.
Parents personalizing a child's negative behavior can worsen attachment challenges.

Symptoms of Traumatic Stress cont'd

Behavioral control difficulties include poor impulse control, self-destructive behavior, sleep disturbances, eating disorders, and fear-driven responses.
Children who experience trauma can engage in risky behaviors.
Trauma can manifest biologically as problems with movement and sensation, hypersensitivity to physical contact, or insensitivity to pain.
Traumatized children may experience physical symptoms, such as difficulty sleeping, eating, headaches, stomach aches, a weakened immune system, and disrupted toilet training.
Hypervigilance (chronic physical arousal) is a common symptom of traumatic stress.
Mood regulation can be challenging for children exposed to trauma.

Trauma

Trauma occurs when a stressor overwhelms someone's coping resources.
This is often due to the threat of death or serious injury to oneself or someone else.
A threat to one's physical, sexual, and psychological integrity or someone else's can also trigger trauma.
The individual's response is characterized by intense fear, helplessness, or horror.

Childhood Trauma

Childhood trauma is defined as a child’s experience of an emotionally painful or distressful event that overwhelms their ability to cope.
It involves repeated threats (uncontrollable danger) or neglect/deprivation (lack of care).
It exceeds the child’s coping resources leading to prolonged stress.
There are long-lasting mental and physical effects.

Childhood Trauma: Types

Single incident Trauma:
- A one-off event such as witnessing a car accident or being mugged at gunpoint.
Complex trauma:
- Threat happens repeatedly and often involves an attachment figure as the perpetrator.
- Includes abuse and neglect, domestic violence, and living in a violent community.

DSM-V Criteria for PTSD

Exposure to actual or threatened death, serious injury, or sexual violence (direct experience, witnessing, or hearing about in close friend or family member; repeated or extreme exposure to traumatic details)
Intrusive symptoms (intrusive memories, dreams, dissociation, flashbacks, distress, and/or physiological reactions)
Persistent avoidance
Altered cognitions or mood (inability to remember aspects of trauma, persistent negative self-beliefs or beliefs about the cause/consequences of the event, detachment, mood, loss of pleasure)
Arousal & reactivity (sleep, hypervigilance, irritability, and anger)
Symptoms last more than one month
Clinically significant distress or impairment
Not due to effects of substance

Complex Trauma and Developmental Trauma

Complex trauma is associated with the failure of protectors and caregivers to provide nurturing to the child.
It has profound and far-reaching effects on nearly every aspect of the child’s life.
The injuries acquired through stress dysregulation due to unmet infant attachment needs are described as developmental trauma.
Unregulated stress in early years can damage developing brain architecture.
Children with unmet attachment needs often cannot regulate stress.

Complex Trauma: Characteristics

Multiple, chronic, and prolonged
Often of an interpersonal nature - early life onset
Negative changes in a child’s neurological, biological, and emotional development
Effects are cumulative
- Social, emotional, and cognitive impairment
- Higher risks for medical conditions (heart disease, severe obesity)
- Higher risk for substance abuse, depression.
- Inability to form healthy attachments

Symptoms of Traumatic Stress: Dissociation

Sensory awareness is lost as a protective reaction to the pain of overwhelming stress.
This is often expressed through avoidance, compliance (appeasement), dissociation, or fainting.
Traumatized children experience a feeling of detachment or depersonalization, as if they are “observing” something happening to them that is unreal.
They may feel like they can make themselves ‘disappear’ when under stress.

Symptoms of Traumatic Stress: Hyperarousal

Stress remains in awareness, leading to the “fight or flight” response, characterized by vigilance, resistance (freezing), defiance, and aggression.
The younger the individual is, the more likely they are to use dissociative adaptations rather than hyper-arousal responses.

Symptoms of Traumatic Stress: Attachment Challenges

This is marked by the “pull/push” dynamic, where the child desires closeness but then pushes away.
Parents may personalize the child’s negative behavior, leading to further attachment challenges.

Symptoms of Traumatic Stress: Behavioral Control

Includes poor impulse control, self-destructive behavior/aggression, sleep disturbances/eating disorders, and fear-driven responses.
High-risk behaviors are often a result of control issues - children feeling out of control try to control everything in whatever way they can.

Symptoms of Traumatic Stress: Biology

Physical problems with movement and sensation, including hypersensitivity to physical contact and insensitivity to pain.
Unexplained physical symptoms and increased medical problems (difficulty sleeping, eating, headaches, stomach aches; lowered immune system; disrupted toilet training/wetting).
Hypervigilance (chronic physical arousal)