KEY: notes, definitions, examples, theories

Chapter 14: Psychological Disorders

14.1: What Does it Mean to Have a Psychological Disorder?

-​ Psychological Disorder: syndrome characterized as clinically significant disturbance in an
individual's cognition, emotion regulation or behaviour that reflects a dysfunction in the
psychological, biological or development process underlying mental functioning.
-​ Abnormal Psychology: study of PD
↳​ Behaviours that most people do are normal, behaviours done by the minority is abnormal
↳​ Abnormal behaviour deviates from some ideal manner of behaving
○​ This approach works when observing or experiencing abnormal behaviour, but is
very subjective because different cultures define different ideals
●​ Eg. Hearing voices is abnormal in western culture but not in other
cultures.
↳​ Behaviours that cause harm to others are viewed as less than ideal, in all cultures
-​ Comorbid Disorders: 2+ disorders in the same individual
-​ Abnormal Behaviour: behaviour that is distressing and harmful to the self or to others.

14.2: Can We Predict Who Will Develop a Psychological Disorder?

-​ Diathesis-stress model: model that suggests that the experience of stress interacts with a person’s
pre-existing vulnerability to make a psychological disorder
↳​ Proposed for many disorders like schizophrenia and depression.
↳​ This model can be used to predict who had a better chance of developing a PD, using the
persons/peoples life circumstances

14.3: How Are Psychological Disorders Diagnosed?

-​ Diagnosed purely on the basis of observable behaviours
-​ Professionals refer to the “Diagnostic and Statistical Manual of Mental Disorders (DSM)” by
APA.
↳​ Another widely used is the “International Statistical Classification of Diseases and
Related Health Problems” by WHO.
○​ Contains a record of all diseases and injuries that people might have throughout
their lifespan.
↳​ DSM remains the most used tool in NA for psychological disorder diagnosis.

14.4: What Do Psychological Perspectives Tell Us about Disorders?

-​ Study of PD provides an example of how integration of multiple perspectives is useful.
↳​ Biological, clinical, developmental, cognitive, social/personality all have their own takes
on disorders.
↳​ Considering all perspectives allows us to have a greater appreciation of the complex
interactions that occur among individuals
 ↳​ Help us understand the reciprocal relationships among factors leading to PD
↳​ Single-perspective thinking= single-perspective treatment
○​ Understanding all perspectives allows for the best treatments.

14.5: Which Disorders Emerge in Childhood?

-​ Disorders developed in childhood are called “neurodevelopmental disorders”
1.​ ASD/Autism Spectrum Disorder: combination of autism and Asperger’s syndrome
○​ Deficits in social relatedness, and communication skills, often accompanied by
repetitive, ritualistic behaviour
○​ 1/66 children 5-17 are diagnosed with ASD
○​ The Concordance rate for ASD in MZ twins is 76-88%. (if one twin has
ASD, the other twin is likely to as well)
○​ In typical brains, 174 genes are expressed differently in frontal lobes than
temporal lobes, ASD brains, no gene showed evidence of being expressed
differently between the frontal and temporal lobes
○​ ASD people have narrower minicolumns which contain normal number of
cells but they are spaced apart more, which can connect with ASD people
having detailed focus and having unusual interests and hobbies over
understanding and social environment processing
-​ Minicolumns are in the cerebral cortex responsible for information
response.
-​ Smaller mc= favour detail, larger mc= favour generalization
-​ Language, face recognition and following peoples gaze
requires generalization.
○​ Older parents are more likely to give birth to child with ASD
○​ Prenatal exposure to infection and nutritional factors increases ASD
chances and use of SSRIs during pregnancy is associated with higher risk
of child having ASD.
2.​ ADHD/Attention Deficit Hyperactivity Disorder: difficult with attention, hyperactivity or
both.
○​ Criteria is difficult to distinguish in children
○​ Often treated with medication
○​ Inability to maintain sustained attention or on-task behaviour for a length of time
appropriate for his/her age
○​ Problems following instructions, organizing, completing work, high level of
motor activity and can’t sit or be still, noisy, active and take action without
thinking.
○​ Occurs in 5% of children worldwide, most common childhood PD
○​ Causes are unknown, but twin studies show genetic roles, heritability= 70%+
○​ Environmental factors: lead contamination, low birth weight, prenatal exposure
to tobacco, alcohol and other drugs.
 ○​ Frontal lobes may be underactive in ADHD, leading to not inhibiting unwanted
behaviour, and hyperactivity and impulsivity.
○​ Smaller volume of amygdala, basal ganglia, hippocampus, and disruption in
corpus callosum (connects two cerebral hemispheres) are all correlated with
ADHD symptoms.
○​ Frontal lobes and prefrontal areas mature slower in ADHD kids.
○​ Meds for ADHD boost dopamine activity in prefrontal and basal ganglia,
meaning that ADHD brains have lower than normal amounts of dopamine.
3.​ Conduct disorder: repetitive and persistent pattern of behaviour where basic rights of
others or age appropriate norms/rules are violated.
○​ Have a tendency to be aggressive or have antisocial behaviour, disregard social
norms and rules, may steal or other behaviours that violate rights.
○​ Viewed as a precursor to antisocial PD
○​ Frequent and persistent disobeyment of parents and physical aggression, interfere
with child’s ability to attend school or develop relationships with others
○​ Diagnosis: antisocial behaviour + lack of remorse, empathy or concern + absence
of any sincere emotion = diagnosed with conduct disorder
○​ Prevalence is 4.2%
○​ Resulting from many factors like disadvantaged backgrounds (physically abused,
harsh and inconsistent parenting practices and lack of adult support), low
neighborhood quality, prenatal alcohol abuse and maternal smoking during
pregnancy leads to being more likely to have conduct disorder.
○​ Can be treated via prevention programs to reduce rates of conduct disorder

14.6: What is Schizophrenia?

-​ Schizophrenia: disorder of hallucinations, delusions, disorganized thought and speech, disorders
of movement, restricted affect and avolition
↳​ Avolition: symptom of mental health conditions that involves lack of motivation and
inability to start or continue activities
-​ Not the most common disorder, 1% of the population have it.
↳​ Most dramatic PD
↳​ Distorts perception, cognition, movement and emotion
-​ Associated within a group of disorders called “Schizophrenia Spectrum and other Psychotic
Disorders”
-​ Affect women and men the same, symptoms appear earlier in men than women
-​ First signs occur in 18-25 for men, 25-35 for women
-​ Symptoms: delusions, hallucinations, disorganized speech, disordered movement, indicating a
state of psychosis, do not show outward signs of emotion and do not have goal-oriented
behaviour (avolition), disorganized patterns of speech, have difficulty isolating secondary
meanings for some words
↳​ Eg of not isolating secondary meaning. The word jam can refer to either a fruit spread for
toast or an impromptu musical session. Most people would use context (a conversation
about food or music) to decide which meaning was appropriate. Patients with
 schizophrenia might not experience this filtering, leading their thoughts to jump from
food to jazz and then on to other atypical connections.
-​ Delusions: unrealistic beliefs
↳​ Many forms like paranoia (delusions of persecutions), grandiosity (feelings of unrealistic
power or importance) and control
-​ Hallucinations: false perceptions
↳​ In schizophrenia, it is mostly auditory, often hearing voices which are real sensations
correlated with increased activity in primary auditory cortex of temporal lobe
-​ Have trains of thoughts because they don’t inhibit making connections among ideas
-​ Some patients may be unusually active, others may barely move throughout the day
-​ Have unusual behaviour slike grimaces and gestures, may experience catatonia
↳​ Catatonia: maintenance of awkward or unusual body positions for hours at a time, but do
not seem to respond to other people and their environment
-​ Genetics: close family with schizophrenia will likely be passed down
-​ Have absence of enlarged ventricles (fluid filled spaces in brain not responsible for any specific
behaviour)
-​ Lower level of frontal lobe activity at rest and during cognitive tasks related to emotional
disturbances and social withdrawal in schizophrenia
↳​ Since frontal lobe activity is less and olfaction management travels through FL, some
patients have difficulty with sense of smell.
-​ Distorted in brain’s default network
-​ Involves abnormal brain development, have big loss of grey matter in teen years
-​ Abnormalities in dopamine, so drug used to increase it produce hallucinations and paranoid
delusions (often dopamine blocking meds are used)
-​ Disturbances in the balance between brain excitation and inhibition, not related to any one
neurochemical system, might also contribute to symptoms of schizophrenia
-​ Environmental: extreme stress from many things, mothers exposure to viral illness during
pregnancy, marijuana use bc it reduces white matter volume

-​ Bipolar Disorder: mood disorder characterized by alternating periods of mania and depression.
↳​ Bridge between psychotic disorders and depressive disorders.
-​ Manic phase: “a distinct period of abnormally and persistently elevated, expansive, or irritable
mood, abnormally and persistently increased goal-directed activity or energy”
↳​ Feel unrealistically special, little speech, speech and have difficulty concentrating, shift
ideas often, run on high speed, BUT increase productive goal-oriented behaviour
-​ Hospitalization if often needed for patient protection
-​ Prevalence is 2.2-2.6%
-​ Under 18 with these symptoms = disruptive mood dysregulation disorder
-​ Occurs in men and women equally, symptoms differ though
-​ Concordance rate: 70%
-​ Diet helps to prevent bipolar disorder like Omega-3 fatty acids, generally found in fish
↳​ The impact of omega-3 fatty acids on a person’s vulnerability for bipolar disorder might
be more important during prenatal development than later in life.
14.7: What is Major Depressive Disorder (MDD)?
-​ Major Depressive Disorder: disorder characterized by periods of depressed mood, loss of pleasure
in normal activities, disturbance in sleep and appetite, difficulty concentrating, feelings of
hopelessness and possible ideas of suicide.
↳​ Also experience Anhedonia: person’s disinterest in activities that used to provide pleasure
(sex, eating, social activities)
↳​ Must show at least 5 symptoms one of which is depressed mood or anhedonia
↳​ Remaining symptoms are physical or cognitive
○​ Physial: disturbances in autonomic function found in presence of high level stress​
●​ Eg. sleep and eating disturbance
○​ Cognitive: disturbances in thinking, behaviour and functions
●​ Difficulty concentrating, hopelessness, worthlessness, thoughts of suicide
-​ One of most frequently diagnosed PD, 7% of adult pop/year
-​ 11% of Canadian men and 16% of Canadian women will have MDD in their lives.
↳​ Female hormones might participate in moods like hormonal changes, postpartum and
menopause.
↳​ May also be more likely to admit having MDD and seek help, whereas men might cover
it up and engage in coping like drinking.
-​ Younger people are more likely to get MDD than older bc MDD decreases with age.
-​ Occurs when a person experiences a reduction in positive reinforcement or increases of negative
outcomes.
↳​ Results from learned helplessness: state where experiencing random or uncontrolled
consequences leads to feeling helplessness and possibly depression. (just constant
low-self esteem)
-​ Cognitive theories say depression is because of a combination of negative thoughts about the self,
world and future.
↳​ Rumination: repetitively focuses on the fact that one is depressed, arising from attempts
to gain insight into the problem but too much of that interferes with problem solving.
↳​ Women are more likely to ruminate, men are more likely to find distractions.
-​ MDD might be influenced by the types of attributions a person makes
↳​ People who make internal, stable and global attributions are prone to depression.
-​ Social theories say MDD can occur from loneliness
↳​ Older adults have increased depressive symptoms from being lonely.
↳​ Symptoms of MDD may protect people from additional negative interactions by reducing
their social activities.
-​ Heritability is 40%
↳​ Many genes are associated like genes affecting serotonin function.
↳​ Serotonin: regulation of mood, appetite, sleep
↳​ Most MDD meds boost serotonin activity at the synapse
-​ Anterior cingulate cortex plays a role in regulating emotion through connection with amygdala
↳​ In MDD, cingulate cortex is overactive, when it should normally be lower to improve
mood
-​ MDD people spend too much time in REM and meds help to reduce this.
-​ People with MDD especially those who are young are more prone to suicide
 ↳​ 75% of people who attempt suicide show prior evidence of their intent.
↳​ Hopelessness, rage or increased drug and alcohol use are common responses to suicide
thoughts.
-​ Experience of immense stress frequently occurs before the onset of a depressive episode

14.8: What is an Anxiety Disorder?

-​ Anxiety disorders: disorder featuring anxiety that is not proportional to a person’s circumstances
-​ Have two components: strong negative emotions, and physical tension because of anticipation of
danger.
-​ Most common psychological disorder among Canadian adults
-​ Genetic vulnerabilities occur in people for anxiety, but not specific types of anxiety
-​ Women are more likely to be diagnosed with anxiety disorders than men
-​ Do not impair a person’s ability to think realistically.
1.​ Specific Phobias: fear of objects or situations
↳​ Eg. animals, natural phenomena, blood and injury or situations.
↳​ Might be exaggerations of sense of caution
↳​ Cognitions influence specific phobias
2.​ Social Anxiety Disorder: fear of being criticised by others
↳​ Feel immense anxiety while doing things that most people take lightly light introducing
yourself to others
↳​ Usually begins in adolescence
↳​ Spotlight effect is very exaggerated with people who have SAD
↳​ More prevalent in collectivistic cultures
3.​ Panic Disorder: repeated panic attacks and fear of future attacks
↳​ Affect 2.7% of population, with women more likely to experience panic attacks and
disorder
↳​ Begin to occur in adolescence and young adulthood
↳​ People with panic disorder have more orexin (important in wakefulness, vigilance and
appetite) so this may lead to panic attacks
↳​ Interpretation of the body like increased heart rate could lead to panic.
↳​ Many people worry about appearing weird or crazy to other people, which can lead to
increased anxiety and more panic attacks
↳​ A panic attack could occur as a result of a chain of events:A person with a biological
predisposition to panic, possibly involving the orexin systems of the brain,is exposed to
social stressors in the form of parental loss or separation or significant life stressors,
interprets physical symptoms of arousal as threatening or embarrassing, and finally has
cognitions leading to panic that are modulated by that individual’s cultural expectations.
4.​ Agoraphobia: fear of open spaces, common outcome of panic disorder
↳​ Prevents working or engaging in normal social activities
↳​ Fear being in crowds
5.​ Generalized Anxiety Disorder: excessive anxiety and worry that is not correlated with a specific
object or situation
↳​ Experiences lots of worry about life in general, not something specific
 ↳​ Associated with physical complaints like headache, stomachache, muscle tension, and
often coexisting with other anxiety disorders or substance use or depression.
↳​ Amygdala connection with frontal lobes not responding properly could lead to GAD
-​ Have higher levels of activity in cortex, thalamus, amygdala and hypothalamus
↳​ Many situations are able to trigger coping responses but just leads to constant worry.
↳​ Lower socioeconomic classes are likely to get GAD, and disruptions in social
connectivity can lead to GAD
↳​ GAD is most likely to occur in individuals with a high-reactive temperament, possibly
because of their genetic background, who subsequently develop schemas and other
cognitive patterns that maintain high levels of worry.

14.9: OCD and Related Disorders

-​ Obsessive Compulsive Disorder: intrusive obsessions and compulsions
↳​ Engage in repetitive, ritualistic behaviours, haunted by distressing and intrusive thoughts
↳​ Occurs in late adolescence or early adulthood
↳​ Common obsessions: concerns for contamination, repeated doubts, ordering,
inappropriate impulses
↳​ Common compulsions: frequent hand washing, checking, counting, ordering objects and
needing reassurance
-​ Efforts to ward off anxiety from obsessions
↳​ Concordance rate: 63-87%
↳​ May arise from head trauma, brain inflammation from encephalitis, and seizures/
↳​ People with OCD have high activity in the orbitofrontal cortex, prefrontal cortex, anterior
cingulate gyrus and caudate nucleus of basal ganglia.
↳​ Have lower amounts of serotonin activity
-​ The lower the serotonin=higher OCD experience
↳​ Engaging in compulsive behaviour for more than one hour a day is considered abnormal
↳​ Culture plays a role in how often OCD occurs and what obsessions and compulsions are
more likely
-​ Body Dysmorphic Disorder: unrealistic perception of physical flaws
↳​ Often undergo many cosmetic surgeries and perfect their bodies through bodybuilding or
other strategies
↳​ Significant influence of heredity
↳​ Visual perception of subtle facial distortions appear better than normal, so they notice
flaws that normal people can’t see

14.10: What is Post-Traumatic Stress Disorder?

-​ Post-Traumatic Stress Disorder: disorder caused by traumatic experiences, leading to flashbacks,
dreams, hypervigilance and avoidance of stimuli associated with the traumatic event.
↳​ Unique disorder because it only occurs with one specific cause: you must have
experienced trauma
↳​ Combat is the most likely experience that leads to PTSD
↳​ Eg. PTSD can also occur from car accidents, assaults, abuse and natural disasters
 ↳​ Symptoms: hypervigilance, avoidance of stimuli, emotional numbing and re-experiencing
the trauma in repetitive intrusive thought, flashbacks or dreams
↳​ Children with PTSD re-enact their trauma in play
↳​ 8% of people will have PTSD
↳​ Emergency workers, female refugees and Indigenous people are at higher risk of getting
PTSD
↳​ PTSD is correlated with a smaller hippocampal volume
↳​ PTSD related damage also occurs in anterior cingulate cortex
↳​ Correlated with lower levels of benzodiazepine activity in frontal cortex
↳​ Show conditioned responses to stimuli associated with the trauma faced
↳​ Show increased generalization to conditioned fear stimuli meaning that overtime they
will be responsive to more stimuli, not less
↳​ People will low social support are more likely to get PTSD
↳​ PTSD is also more common in certain ethnicities than others

14.11: What are Dissociative Disorders?

-​ Dissociative Disorder: disruptions in a person's identity, memory or consciousness.
1.​ Amnesia: person forgets important info about specific event that fellows a traumatic
event
2.​ Dissociative Fugue: people become confused with their identity and combine this loss
with sudden travel and assumption of a new identity, last short-time
3.​ Depersonalization/Derealization Disorder: person experiences strong feelings of unreality
about the self or surrounding environment
-​ Feel like they are watching their behaviour from outside their bodies
-​ Retain ability to understand that their feelings are not realistic
-​ They feel outside their bodies but don’t believe it is really happening
4.​ Dissociative Identity Disorder: experience of two distinct personality states
-​ Susceptible to hypnosis, likely to fantasize, can’t differentiate reality and fantasy

14.12: What are Somatic Symptom Disorder and Related Disorders?

-​ Somatic Symptom Disorder: physical symptoms that don’t have an underlying medical cause.
↳​ Spend lots of time thinking about the seriousness of their symptoms, leading to high
anxiety.
↳​ Vague pain complaints, gastrointestinal upset, sexual issues, amnesia, breathing problems
or unexplained sensory/motor problems
↳​ Report high numbers of physical complaints, risk of being dependant on pain meds and
can insist on unnecessary medical tests and procedures

14.13: What are Personality Disorders?

-​ Personality Disorder: impairments in identity, personality traits, and in establishing empathy or
intimacy.
↳​ Cannot be diagnosed under age 18
1.​ Antisocial Personality Disorder: unusual lack of remorse, empathy, or regard for normal
social rules and conventions.
○​ Risk and irresponsible behaviour, forming shallow relationships with others.
○​ Prevalence in males in Canada is 74.9%
○​ 0.2-3.3% of population experience ASPD in a given year
○​ No not engage in criminal behaviour
○​ Having antisocial parents suggests a genetic contribution.
○​ Child maltreatment, lack of response to emotions can lead to antisocial behavior
○​ ASPD is associated with abnormalities of orbitofrontal cortex, leading to poor
judgement and impulsivity
2.​ Borderline Personality Disorder: instability in interpersonal relationships, self-image and
emotion
○​ Idea that this disorder fell on the “border” between anxiety and psychosis
○​ Engage in frantic efforts to avoid abandonment, behave impulsive and
self-destructing, suicide behaviours are common, love can turn into anger fast
○​ Affects 2% of population, with more women to men
○​ Vulnerable to other disorders like bipolar, substance abuse, eating disorders, etc
○​ 5x more common among close relatives with the disorder than general
population, suggesting a biological reason
○​ Traumatic experiences interact with a genetic reason to produce this disorder
3.​ Narcissistic Personality Disorder: grandiosity, need for admiration and low empathy
○​ Intersection of narcissism and social media use (younger people show more
narcissistic than older adults)
○​ Grandiose Narcissist: shows inflated views of self-worth, aggressiveness and
dominance
○​ Vulnerable Narcissist: combines inflated views of self-worth with insecurity,
defensiveness and negative emotions
○​ Roots of narcissism might be found in development of self-esteem in childhood
○​ Narcissistic traits can be somewhat heritable
○​ Parenting styles also largely affect how narcissism occurs in a person
Lecture Notes:
-​ Mental disorder: persistent disturbance or dysfunction in behavior, thoughts or emotions that
causes significant distress or impairment
-​ Medical model: atypical, distressing psychological experience are classified as illnesses that have
biological causes.
-​ Biopsychosocial model: used in modern psychology, it is a atypical, distressing psychological
experience classified as illnesses that have biological, psychological and social causes.
-​ Psychopathology: scientific study of mental disorders
-​ Psychopathy: specific term used in describing aspects of antisocial personality disorder (where
the term “psychopath” comes from)
-​ Overpathologizing: attributing diverse or atypical behaviours or thoughts to psychological illness,
particularly when diagnostic criteria are not met.
↳​ Eg. she's so OCD, he's so bipolar today, they don’t actually have the diagnostic criteria to
have the illness because we seek labels and categories as humans
-​ Diagnostic Criteria: set of symptoms, behaviours and characteristics that must be present in order
to diagnose an individual with a disorder, “What are the features of the disorder?”
↳​ Criteria of physiological disorders are simple, for psychological disorders it is more
complex
↳​ Eg. you must test positive for COVID-19 to have it (physiological), but there's no nasal
swab test for depression
↳​ Psychological disorder measurements: questionnaires, interviews, behavioural
observation, neuroimaging
-​ Mental Health manuals: DSM (used in canada, only mental illness), APA (used in North
America), ICD-11 (International Classification of Diseases, covers mental and physical illness,
used elsewhere)
↳​ DSM uses a biopsychosocial models
○​ Divides mental disorders in 22 categories; anxiety, depressive, bipolar,
personality, obsessive-compulsive, and many more
○​ Has diagnostic criteria, onset, prognosis, risk factors, etiology and comorbidities
1.​ Diagnostic criteria: causes major distress and affects functioning, can’t
be caused by substance use or other medical conditions, cannot be better
described by another DSM diagnosis
2.​ Onset: chronological age or situation period when the symptoms of a
disorder first appear in an individual, “When does it usually start?”
3.​ Prognosis: likely course of a disorder, “What will happen next? When
will the disorder go into remission?”
4.​ Risk factors: set of biological, psychological and social
CHARACTERISTICS that increase the likelihood of having the disorder
5.​ Etiology: biological, psychological and social CAUSES of a disorder.
“What causes the disorder, what makes one individual more likely to
have the disorder than another individual?”
-​ Diathesis- stress model: risk for a disorder combines with life
factors to lead to the disorder
 6.​ Comorbidities: other psychological or physical disorders that frequently
co-occur with the disorder in question, “What other disorders appear with
this one?”
-​ Eg. people who have general anxiety disorder, you are more at
risk for depression.
-​ Eg. substance use disorders are highly comorbid with anxiety
and mood disorders
○​ DSM can lead to overpathologizing and is a black and white system
Mental Illnesses
-​ Anxiety Disorders: mental health conditions that cause more than normal feelings of fear
↳​ Fear and anxiety are adaptive reactions to threats
↳​ Are pathological: meaning they prevent us from performing day to day activities because
of the anxiety (not adaptive/normal)
↳​ Anxiety that interferes with our normal functioning is maladaptive (too much of anxiety
reduces functioning)
○​ Decreases fitness for survival/succeed
↳​ Very common disorder in Canada (30% of people will have it, 5% are ever diagnosed)
↳​ DSM recognizes 12 disorders of anxiety
1.​ Generalized Anxiety Disorder: worries are not focused on any specific threat but
rather focuses on many things, varies from individual to individual
●​ Criteria: 50% of days in 6 months must include excessive anxiety and
worry, hard to control the worry, experience 3+ symptoms like
restlessness, concentration difficulty, fatigue, irritability, muscle tension,
sleep disturbance
●​ Entirely based on self report
●​ Onset: usually diagnosed earliest at puberty, medium age of diagnosis is
30
●​ Population wise: level of anxiety is constant throughout lifespan (no
specific age which anxiety will be higher)
●​ Indivival wise: severity of symptoms will vary across the lifespan (there
are points in life when the anxiety was high and points when it was low)
●​ Full remission from anxiety is rare
2.​ Phobic Disorder: marked, persistent, excessive fear of specific objects, activities
or situations
●​ The person knows the irrationality of the fear, but cannot control it
●​ Specific Phobia: fear of animals, natural environments, situations,
medical events and other
●​ Social Anxiety Disorder: fear of being publicly humiliated or
embarrassed
-​ Performance only specifier: not afraid of one-on-one, but afraid
of standing up in front of many people
●​ How do phobias develop: preparedness theory: we are evolutionary
adopted to fear certain stimulus
 -​ It is easy to eradicate fears through conditioning, but hard to
condition the starting of a new fear
●​ 12-13% of population have phobic disorders
3.​ Panic Disorder:
-​ Mood: emotional states that are long lasting and nonspecific
-​ Mood Disorders: depressive and bipolar related disorders
↳​ Depressive disorders: affect lots of people, more women are diagnosed with depression
than men for many reasons (hormonal/biological, different coping strategies, differences
in childhood adversity
○​ 7% of canadians are diagnosed with depression
1.​ Major Depressive Disorder: most well known, consists of 1+ episodes lasting 2+
weeks
●​ 5+ of the symptoms must be present daily for most of the day for 2-week
period (symptoms: *depressed mood, *loss of interest or
pleasure/anhedonia, big weight loss/gain, insomnia/hypersomnia,
psychomotor agitation/excessive fidgeting or retardation/slowing down
motor functions, fatigue or loss of energy, feelings of worthlessness or
guilt, diminished concentration, recurring thoughts of suicide)
-​ *= one of the two must be present in the 5+ symptoms
●​ Symptoms must cause clinically significant distress, cannot be because
of another medical condition/substance use, not better explained by
schizophrenic disorder no evidence of mania.
●​ Onset: any age but more likely in 18-29 year old group
●​ Prognosis: rarely experience remission without treatment, some may
experience remission between episodes, approx 80% of depressive
people experience recovery within 1 year,
●​ Chronicity: associated with underlying personality dimensions and
presence of other disorders
●​ Risk factors: temperamental (personality specifically high in
neuroticism) environmental (adverse childhood and stressful life events),
genetics (family with MDD are 2-4x more likely to be diagnosed with
MDD, 40% heritability), comorbidity (substance-related disorders, panic,
OCD, anorexia, bulimia, etc)
●​ Psychological factors can also cause risk factors for depression
-​ Attribution theory: the way a person thinks about failure makes
them more or less likely to be depressed (believe failures are
permanent, and internal)
2.​
↳​ Bipolar Disorders:
↳​ Serious Mental Illnesses: significant disturbances in thinking, emotion and behaviour
leading to severe distress and impairment
○​ Psychosis: experience where a person's perceptions, thoughts and mood and
behaviour are altered (have loss of contact with reality)
 ○​ SSD, Bipolar disorders, MDD, Dementia and many other disorders have
psychotic symptoms
○​ Everyone who has psychosis does not experience schizophrenia, but everyone
who experiences schizophrenia experiences
↳​ Schizophrenia Spectrum Disorders:
○​ Schizophrenia: at least two symptoms required (positive symptoms/ increase
problems: delusions, hallucinations, disorganized speech, disorganized, negative
symptoms/ decrease function: loss of pleasure, social/occupational impairment)
●​ If person had autism or communication disorders they must have
hallucination or delusions to be schizophrenic
●​ Signs of disturbance for at least 6 months, rule out substance use or other
medical conditions
●​ Delusions include paranoia, grandiose, referential, thought control
●​ Hallucinations include auditory, vidual, olfactory, tactile and gustatory.
●​ Women often get diagnosed later than men
●​ Comorbid experiences: depression, social anxiety disorder, PTSD, ASD,
medical comorbidity
○​ Schizoaffective disorder
○​ Delusional disorder
○​ Schizophreniform disorder
○​ Brief psychotic disorder
○​ Substance/medication induced psychotic disorder