Notes on “Psychopathology”
 Satya Piccioni
 Mood disorders can also be called affective disorders
   They involve a prolonged and fundamental disturbance of mood
    and emotions
 Phobic disorders:
   A phobia is an extreme irrational fear of some specific object or
    situation.
 DSM-IV-TR identifies three categories of phobia
   Agoraphobia (without history of panic disorder)
     Most common (60% of all phobias)
     Occurs predominantly in women
     Commonly defined as fear of open spaces
     Mitchel (1982) – agoraphobia is a form of separation anxiety
 Social phobia
   Intense and excessive fear of being observed by other people
   E.g eating or drinking in public or talking to the other member of sex
 Specific phobia
   Most phobias fall in this category
   Are very specific
   Generally less disruptive than agoraphobia
   Can develop at any point in life
Case study 1:

 3-year-old girl suddenly developed recurrent bronchitis
 Got worse when she attended nursery
 Trouble was traced to slippers of a boy in the same class
   Every time the girl saw them she began to retch and cough –
    became upset
   Even mention of “Popeye” induced coughing
 Following behavior therapy, the girl recovered
Case study 2:

 Obsession without the compulsion
 Sutherland, 1976
 Example of obsession occurring without compulsive behavior is sexual
  jealousy – extreme case described by Stuart Sutherland (1976):
    Sutherland was happily married for several years when his wife suddenly
       revealed she’d been having an affair (but had no wish to end their marriage)
      At first was able to accept situation
      Then found that the increased honest actually improved their marriage
      After asking his wife for further details, he became obsessed – vivid images
       of his wife in moments of sexual passion with her lover…etc.
      He had to leave his teaching and research duties
      After several months of therapy he managed to reduce his obsession
       sufficiently enough to return to work
Case study 3:
 Rauch et al. (1994)
 Simulated OCD symptoms by presenting patients with
  stimuli especially selected for them
   E.g. glove contaminated with household rubbish
 This produced increased blood flow in the PFC and certain
  regions of the basal ganglia
 OCD patients have a smaller putamen than controls
  (Rosenberg et al. 1997)
Major characteristics of PTSD:
 Increased arousal
 Persistent defenses of avoidance and repression
 Intrusions
   Based on Gelder et al., 1999
Claridge & Davis (2003) suggest mood
            disorders and anxiety have much in
                        common:
 Occur more frequently than other types of disorders
 Symptoms are more continuous than normal personality
 Considerably symptom overlap between them (e.g. focus on
  negative and threatening events and stimuli)
 It has been proposed that there should be a new DSM
  category – mixed anxiety disorder (MAD)
Claridge & Davis claim there are at
least two distinct forms of depression:
 Melancholic type
   Characterized by profound anhedonia
   Associated with apathy, inactivity, excessive sleeping and
    severely depressed mood
 Agitated type
   Characterized by difficulty in recovering from emotionally
    stressful events and obvious signs of anxiety and restlessness
What are body rhythms?
 Body rhythms are biological processes that show cyclical
  variation over time…ranging from hours to years and
  reflect the influence of the earths rotation upon us… it's
  living inhabitants, along with plants and animals.

 There are three rhythms that we will focus our attention
  upon throughout this module.
 Circadian Infradian, and ultradian biological rhythms.
Body rhythms cont…
 Circadian rhythms:
 (circa = approx & diem = day) go over 24hrs. Humans
  demonstrate a series of changes including temperature heart
  respiration and metabolism over this period. We
  (psychologists) are most interested in the sleep-wake cycle.

 Ultradian rhythms:
 (Meaning less than one day) Sleep is a good example of an
  ultradian rhythm, as you sleep you pass through differing
  stages of sleep (e.g. light and deep sleep lasting about 90
  minutes.)
Body rhythms cont…
 Infradian rhythm: (meaning more than 1 day). An
  example of a infradian rhythm would be a woman's
  menstrual cycle which lasts for 28 days.
 A circannial cycle occurs yearly/annually. An example
  of this would be non human animals hibernation and
  waking patterns.
Research studies into Circadian rhythms.
 Siffre (1975) Spent 6 months inside a cave and found
  that his natural Circadian rhythm was just over 24hrs,
  but would sometimes change to 48hrs.
 There were no zeitgebers such as natural light or
  sounds. He had no idea what time it was, although he
  did have contact with outside world via telephone. He
  had food and drink and so on. His behaviour such as
  when he slept/woke and when he ate his meals was
  monitored. From this study it was concluded our internal
  clock must have a 25 hr cycle and that our zeitgebers
  must reset the clock to our usual 24-hr day.
Research studies into infradian rhythms.
 Monthly cycles...the function of this cycle is to regulate
  ovulation.
Research studies into infradian rhythms.
 Seasonal Affective Disorder (SAD). Research has shown that the
  hormone melatonin is secreted when it is dark...the more
  darkness...the more melatonin. This leads to severe disruption in
  mood.
Evaluation of studies into infradian
rhythms.
 Menstrual cycles can also be disrupted by other factors
  as well as hormones...research has shown that when a
  several women live in a house together and they are not
  taking oral contraceptives they tend to fall in line with
  each other and menstruate at the same time this be
  possibly due to pheromones being released chemically
  and giving a scent.

 SAD a greater understanding of this condition has lead
  to successful therapies such as phototherapy- very strong
  lights to increase the level of melatonin.
The role of Endogenous pacemakers &
Exogenous Zeitgebers.
 The main pacemaker for endogenous (internal) rhythms is the
  suprachiasmatic nucleus (SCN). This is a small group of
  cells located in the area of the brain called the
  hypothalamus. Its called the SCN because it lies just above
  the optic chiasm, therefore it can receive information
  directly from the eye and the rhythm can be rest by the
  amount of light entering the eye.
The consequences of disrupting
Biological rhythms.
 When external cues change we have to re-adjust our
  internal clock…….

 JET LAG                SHIFT WORK.

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Psychopathology

  • 2.  Mood disorders can also be called affective disorders  They involve a prolonged and fundamental disturbance of mood and emotions  Phobic disorders:  A phobia is an extreme irrational fear of some specific object or situation.
  • 3.  DSM-IV-TR identifies three categories of phobia  Agoraphobia (without history of panic disorder)  Most common (60% of all phobias)  Occurs predominantly in women  Commonly defined as fear of open spaces  Mitchel (1982) – agoraphobia is a form of separation anxiety
  • 4.  Social phobia  Intense and excessive fear of being observed by other people  E.g eating or drinking in public or talking to the other member of sex  Specific phobia  Most phobias fall in this category  Are very specific  Generally less disruptive than agoraphobia  Can develop at any point in life
  • 5. Case study 1:  3-year-old girl suddenly developed recurrent bronchitis  Got worse when she attended nursery  Trouble was traced to slippers of a boy in the same class  Every time the girl saw them she began to retch and cough – became upset  Even mention of “Popeye” induced coughing  Following behavior therapy, the girl recovered
  • 6. Case study 2:  Obsession without the compulsion  Sutherland, 1976  Example of obsession occurring without compulsive behavior is sexual jealousy – extreme case described by Stuart Sutherland (1976):  Sutherland was happily married for several years when his wife suddenly revealed she’d been having an affair (but had no wish to end their marriage)  At first was able to accept situation  Then found that the increased honest actually improved their marriage  After asking his wife for further details, he became obsessed – vivid images of his wife in moments of sexual passion with her lover…etc.  He had to leave his teaching and research duties  After several months of therapy he managed to reduce his obsession sufficiently enough to return to work
  • 7. Case study 3:  Rauch et al. (1994)  Simulated OCD symptoms by presenting patients with stimuli especially selected for them  E.g. glove contaminated with household rubbish  This produced increased blood flow in the PFC and certain regions of the basal ganglia  OCD patients have a smaller putamen than controls (Rosenberg et al. 1997)
  • 8. Major characteristics of PTSD:  Increased arousal  Persistent defenses of avoidance and repression  Intrusions  Based on Gelder et al., 1999
  • 9. Claridge & Davis (2003) suggest mood disorders and anxiety have much in common:  Occur more frequently than other types of disorders  Symptoms are more continuous than normal personality  Considerably symptom overlap between them (e.g. focus on negative and threatening events and stimuli)  It has been proposed that there should be a new DSM category – mixed anxiety disorder (MAD)
  • 10. Claridge & Davis claim there are at least two distinct forms of depression:  Melancholic type  Characterized by profound anhedonia  Associated with apathy, inactivity, excessive sleeping and severely depressed mood  Agitated type  Characterized by difficulty in recovering from emotionally stressful events and obvious signs of anxiety and restlessness
  • 11. What are body rhythms?  Body rhythms are biological processes that show cyclical variation over time…ranging from hours to years and reflect the influence of the earths rotation upon us… it's living inhabitants, along with plants and animals.  There are three rhythms that we will focus our attention upon throughout this module.  Circadian Infradian, and ultradian biological rhythms.
  • 12. Body rhythms cont…  Circadian rhythms:  (circa = approx & diem = day) go over 24hrs. Humans demonstrate a series of changes including temperature heart respiration and metabolism over this period. We (psychologists) are most interested in the sleep-wake cycle.  Ultradian rhythms:  (Meaning less than one day) Sleep is a good example of an ultradian rhythm, as you sleep you pass through differing stages of sleep (e.g. light and deep sleep lasting about 90 minutes.)
  • 13. Body rhythms cont…  Infradian rhythm: (meaning more than 1 day). An example of a infradian rhythm would be a woman's menstrual cycle which lasts for 28 days.  A circannial cycle occurs yearly/annually. An example of this would be non human animals hibernation and waking patterns.
  • 14. Research studies into Circadian rhythms.  Siffre (1975) Spent 6 months inside a cave and found that his natural Circadian rhythm was just over 24hrs, but would sometimes change to 48hrs.  There were no zeitgebers such as natural light or sounds. He had no idea what time it was, although he did have contact with outside world via telephone. He had food and drink and so on. His behaviour such as when he slept/woke and when he ate his meals was monitored. From this study it was concluded our internal clock must have a 25 hr cycle and that our zeitgebers must reset the clock to our usual 24-hr day.
  • 15. Research studies into infradian rhythms.  Monthly cycles...the function of this cycle is to regulate ovulation.
  • 16. Research studies into infradian rhythms.  Seasonal Affective Disorder (SAD). Research has shown that the hormone melatonin is secreted when it is dark...the more darkness...the more melatonin. This leads to severe disruption in mood.
  • 17. Evaluation of studies into infradian rhythms.  Menstrual cycles can also be disrupted by other factors as well as hormones...research has shown that when a several women live in a house together and they are not taking oral contraceptives they tend to fall in line with each other and menstruate at the same time this be possibly due to pheromones being released chemically and giving a scent.  SAD a greater understanding of this condition has lead to successful therapies such as phototherapy- very strong lights to increase the level of melatonin.
  • 18. The role of Endogenous pacemakers & Exogenous Zeitgebers.  The main pacemaker for endogenous (internal) rhythms is the suprachiasmatic nucleus (SCN). This is a small group of cells located in the area of the brain called the hypothalamus. Its called the SCN because it lies just above the optic chiasm, therefore it can receive information directly from the eye and the rhythm can be rest by the amount of light entering the eye.
  • 19. The consequences of disrupting Biological rhythms.  When external cues change we have to re-adjust our internal clock…….  JET LAG SHIFT WORK.