PSYCHOPATHOLOGY

OF EVERYDAY LIFE

PALS SEMINAR 1
 MIND MAPS
Each group will start a mind map for the anxiety disorder
written on their paper.
Work together to fill in anything you can recall ie.
treatments, diagnostic criteria, examples and case studies
etc
Work on that paper for 5 min then we will swap them
around.
ANXIETY DISORDERS
 Specific phobia
Marked fear or anxiety about a specific object or situation.
Note: in children, the fear or anxiety may be expressed by crying, tantrums, freezing or clinging.
The phobic object or situation almost always provokes immediate fear or anxiety.
The phobic object or situation is actively avoided or endured with intense fear or anxiety.
The fear or anxiety is out of proportion to the actual danger posed by the specific object or situation
and to the sociocultural context.
The fear, anxiety or avoidance is persistent, typically lasting for 6 months or more.
Diagnostic
The fear, anxiety or avoidance causes clinically significant distress or impairment in social,
criteria
occupational, or other areas of functioning.
The disturbance is not better explained by the sympotoms of another mental disorder, including fear,
anxiety, and avoidance of situations associated with panic-like symptoms or other incapacitating
symptoms (as in agoraphobia); objects or situations related to obsessions (as in obsessive-
compulsive disorder); reminders of traumatic events (as in posttraumatic stress disorder); separation
from home or attachment figures (as in separation anxiety disorder); or social situations (as in social
anxiety disorder)
Exposure therapy: In vivo, Imaginary, Virtual reality; Gradual (step by step) vs flooding (deep end)
Treatment 70-85% of people show significant clinical improvement (Roth & Fonagy, 2009) BUT Premature
termination of therapy is not uncommon
Aetiology and epidemiology
Lifetime prevalence 3-15% - 8.1% in high income
Epidemiology countries
Eaton et al. (2017). The Lancet Psychiatry, 5, 678-676

Aetiology
Classical conditioning eg little Albert
Some people overrepresent memories of
certain events (eg flashbulb memories)
Can be learned indirectly/socially
 Panic Disorder
Panic Disorder: Reccurrent unexpected panic attacks and for a one-month period or more of:
Persistent worry about having additional attacks
Worry about the implications of the attacks
Significant change in behaviour because of the attacks

Diagnostic
Panic attack: a discrete period of intense fear in which 4 of the following symptoms abruptly
criteria
develop and peak within 10 minutes:
Palpitations or rapid heart rate, sweating, trembling or shaking, shortness of breath,
feeling of choking, chest pain or discomfort, chills or hot flushes, nausea, feeling dizzy or
faint, derealisation or depersonalisation, fear of loss of control or going crazy, fear of
dying, paresthesias.

No difference in psychotherapy vs pharmacotherapy (Cuijpers et al. 2013)

Treatment
CBT, antidepressants (SSRIs, SNRIs), benzodiazepines
 Epidemiology
Lifetime prevalence of panic attacks: 13.2%
Among those with panic attacks, 66.5% report recurrent attacks and 12.8% meet criteria for panic
disorder
Panic attack in past year: 4.9%
1.7% population prevalence lifetime panic disorder
34.5% of lifetime panic disorder patients have experienced panic attack(s) in the past year
1% past year panic disorder
Most develop panic disorder between 18-29
Women 1.8x more likely to meet diagnosis criteria than men
Low household income increases odds ratio to 1.5

30-50% people affected will have agoraphobia

Avoidance of situations where escape would be difficult
50-60% have lifetime major depression
1/3 with current depression
20-15% have history of substance dependence
 Social Anxiety Disorder
Marked fear, anxiety or avoidance of social interactions and situations in which one is
scrutinised, or situations in which one is the focus of attention (such as being observed
while speaking, eating or performing)
Fear of negative judgement from others, in particular, fear of being embarrassed,
humiliated, rejected or of offending others
Diagnostic
Fear is out of proportion to the actual threat posed
criteria
The individual recognises that the symptoms are excessive or unreasonable
Physical symptoms and symptoms of blushing, fear of vomiting, or urgency or fear of
micturition or defaecation
Typically persists for at least 6 months
Social anxiety can be limited to performance situations only

Exposure therapy, applied relaxation, social skills training, cognitive restructuring

Treatment
Rodebaugh et al. (2004). Clinical Psychology Review, 24, 883-908.
 Aetiology and epidemiology
Epidemiology
4.0% lifetime prevalence, 2.4%
Aetiology
past-year prevalence, 1.3% past-
month prevalence
75% have developed before age
Note:
20 Biological and
47.0% lifetime comorbidity with environmental
factors = distal
mood disorder, 59.8% lifetime factors
comorbidity with another anxiety
disorder, 26.7% lifetime
comorbidity with substance use
disorder
38% receiving some treatment
Stein et al. (2017). BMC Medicine, 15: 143.
 Generalized anxiety disorder
Excessive anxiety and worry about various events have occurred more days than not for at
least 6 months
The person finds it difficult to control the worry
The anxiety and worried are associated with at least three of the following six symptoms
(only one symptom is required in children): restlessness or a feeling of being keyed up or "on
Diagnostic
edge", being easily fatigued, having difficulty concentrating, irritability, muscle tension, and
criteria
sleep disturbance
The anxiety, worry, or associated physical symptoms cause clinically significant distress or
impairment in important areas of functioning
The disturbance is not due to the physiological effects of a substance or medical condition
The disturbance is not better accounted for by another mental disorder
Only about 50% of patients respond to medications and/or psychotherapy (cognitive
behavioural therapy)
Treatment Insufficient evidence for medication vs CBT - combined therapy recommended in complex
cases
Treat comorbidities - eg substance use (35%), sleep problems, physical illness
 Aetiology and epidemiology
4-7% of general population
Epidemiology Typical onset in childhood or adolescence
Females more at risk than makes - 2:1
90% have at least one other lifetime disorder, such as panic disorder or
depression (not typically neurodevelopmental or personality disorders,
although this is possible)
66% have another current such disorder
Worse prognosis over 5 years than panic disorder

Aetiology Avoidance model of worry (Borkovex), Intolerance of uncertainty model (Dugas and
Ladouceur), meta-cognitive model (Wells), Contrast-avoidance model
10 minute break
Content recap
Weeks 1,2,5,6
 What is Mental Health? DSM-5 Mental Disorder

Week 1 “Mental health is a state of

well-being in which the
“A clinically significant
disturbance in an individual’s
Introduction, History, & Diagnosis individual realises their own cognition, emotion regulation
abilities, can cope with the or behaviour…usually
Learning Criteria: normal stresses of life, and is associated with significant
able to make a contribution to distress or disability in social,
1) What is Mental (Ill) Health?
their community.” (World occupational or other
Health Organisation, 2007) important activities”
2) What is a Psychological Disorder

and what is not? Different Approaches Paradigms cont.

Categorical vs Dimensional Cognitive Paradigm:
3) Different approaches to E.g: DSM-5 is categorical, Thoughts, emotions, and
RDoC is dimensional behaviours are intertwined
classifying mental-ill health
Paradigms (CBT)
4) Behavioural, Cognitive, and Behavioural Paradigm: to Biopsychosocial Paradigm:
interrupt and/or change Integrates biological, social,
Biopsychosocial Paradigms stimulus response and psychological factors
associations and how they intertwine
 Categorical Models of Psychopathology

Week 2 Dominant Categorical Models

DSM (Diagnostic and Statistical Manual of Mental
Models of Psychopathology Disorders)
ICD (International Classification of Diseases)
Models:
Hybrid Models of Psychopathology
1) Categorical and Hybrid Models
Dominant Hybrid Model
2) Vulnerability Models/Progression MMPI-2 (Minnesota Multi-phasic Personality Inventory-
2)
Models The model is a true/false self report questionnaire which
measures a person's "psychological state". It is typically
3) Transdiagnostic Models used to assess faking, lying, and exaggeration.

4) Data focused models

5) Psychological, Biological, and
Social/Environmental Models
 Vulnerability Models of Psychopathology

Week 2 Diathesis-stress Model

Diathesis: Few or no copies of a protective genetic
Models of Psychopathology variation
Stress: Commonly life events, and not just negative ones
Models:
1) Categorical and Hybrid Models

2) Vulnerability Models/Progression

Models
Progression Models of Psychopatholgy

3) Transdiagnostic Models Clinical Staging Model (McGorry et al., 2018)

Treatment according to stage of disorder
4) Data focused models
5) Psychological, Biological, and
Social/Environmental Models
 Transdiagnostic Models of Psychopathology

Week 2 Hierarchical Taxonomy of Psychopathology (Hi-TOP)

Organises into subsections and hierarchy
Models of Psychopathology

Models:
1) Categorical and Hybrid Models

2) Vulnerability Models/Progression

Models

3) Transdiagnostic Models

4) Data focused models

5) Psychological, Biological, and
Currently we are most interested in the sub-factors of
Social/Environmental Models
fear, as it is most relevant to the assignment
 Data Focused Models of Psychopathology

Week 2 Normative Statistical Modelling

Focuses on data informed developmental trajectories
Models of Psychopathology
Research Domain Criteria (RDoC, Insel et al., 2010)
Models:
1) Categorical and Hybrid Models

2) Vulnerability Models/Progression

Models

3) Transdiagnostic Models

4) Data focused models

5) Psychological, Biological, and Uses data to analyse factors that contribute to
Social/Environmental Models neurodevelopment
It is used to identify common genetic markers which
indicate specific disorder
 Psychological, Biological, and Social/Environmental

Week 2 Biological Paradigm

Genetics
Models of Psychopathology Structural brain damage
Neurochemistry
Models: Functional connectivity
Psychological Paradigm
1) Categorical and Hybrid Models
The interactions of thoughts, behaviour, emotion
Social/Environmental Paradigm
2) Vulnerability Models/Progression

Models

3) Transdiagnostic Models

4) Data focused models

5) Psychological, Biological, and
Social/Environmental Models
 Culture and Psychoppathology

Week 5 Psychiatric assessment needs to consider sociocultural

factors. Cultural considerations include:
Cultural Considerations Cultural explanations of disorder
Psychosocial factors relating to levels of functioning

Cultural Syndrome
A cluster or group of co-occurring relatively invariant
symptoms found in a specific cultural group, community or
context. It may or may not be recognised as an illness in the
community. E.g Longing for Country

Cultural Idiom for Distress

A way of talking about a shared suffering and distress
among individuals of a cultural group. E.g “Kufungisisa”

Cultural Explanation
A label or feature of an explanatory model that provides a
culturally conceived aetiology for symptoms, illness, or
distress. E.g “Maladi moun”
 Stigma

Week 5
Stigma
Public stigma manifests in:
Stereotypes
Prejudice
Discrimination

Reducing Stigma
Social Contact:
Being in contact with someone with
lived experiences. This is beneficial Perspective of the stigmatised:
for both parties Perceived stigma: Individuals awareness of public stigma
Psychoeducation Anticipated stigma: Expectation to experience stigma
Correct, in-depth explanation of Experienced stigma: Lived experience of stigma
mental ill-health.
Helps dispel myths and wrong Corrigan's Model of Self Stigma:
perceptions. Awareness, agreement, application to the self, damage to
the self
 Lifestyle Factors and Behaviour Change

Week 6
Lifestyle Factors

Outline of Behaviour Change Model

If-then planning:
If I find myself in X situation, then I
will perform goal directed response Motivation is critical to behaviour change, it is the first step
Y Self efficacy: ones belief in the ability to execute a
behaviour
Breaking and Making a Habit Vicarious experiences: other people can do something
Habits are automatic behaviours Mastery experiences: I did something
that are often enacted outside of Verbal Persuasion: someone said I can do something
our awareness. They are created Emotional regulation: my feelings dictate if I can
through cues and behaviours. SMART GOALS: Specific, measurable, achievable, relevant,
timed.
Action: Assessing skills and teaching the skills.
Discuss the previous Shifting
statement. Examine a concepts of
mental health Cross-cultural
minimum of two of the and Illness variations in
Effects of concepts of
following issues: destigmatising states
mental health
initiatives and illness
The prevalence,
The intersection reliability, and
between culture and validity of an an
mental illness anxiety disorder
diagnosis
Contemporary
models of
psychopathology
“DSM anxiety
eg clinical
staging, HiTOP, disorders are not
Overlap of
RDoC etc
genuine states of anxiety with
Biomarkers
mental ill-health”. trait
and/or
characteristics
behavioural
like neuroticism
Discuss your approach with your indicators of
table groups then we will come anxiety
back together to unpack the Treatment outcomes
question and efficacy for anxiety
disorders
 STUDY TIPS
Put all diagnostic criteria into a 'mini DSM'
Focus on what distinguishes disorders under the same
umbrella from one another
Peerwise
Use recent and relevant references in study - aim for
within 5 years ideally
Don't do a wishy-washy argument - can be complex
without being vague/broad/on the fence
Use wording of question in argument
Cite as you write
APA 7 in page formatting too - goes beyond referencing
Grammarly
If stuggling with essay writing - Academic Skills Hub
KAHOOT TIME !!
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