Today I finished my last exam (Psychopathology) for the semester. Before I pack my notes away till forever (since it’s a stand-alone subject basically), here are a few facts that might be of interest. I picked one or two for all the disorders we’ve covered. We didn’t learn anything about treatment, only of the prognosis and possible causes.

DISCLAIMER: While I try to avoid any diagnostic information, nonetheless do NOT use any of this information out of context in any sort of diagnostic way for yourself or anyone else. For a full criteria of what is considered necessary for a certain disorder consult the DSM-IV.

Definition of Abnormality
The underlying problem with the whole idea of mental illness is how to define “abnormal”. There are four ways, and different disorders focus on one or a mix of ways to address “abnormality. However, each one has their own problems. The ways are:

  1. Statistical model – Abnormality defined as infrequent occurence; the rule of thumb being the top and bottom 5% of the population. While it’s the most “objective” way to categorise people, some disorders (e.g. depression, some sexual dysfunctions like premature ejaculation) is quite common in the population and so it doesn’t really fit with the statistical model
  2. Cultural model – Abnormality defined as breaking implicit rules of society. While this allows for cultural variation, it can be very pejorative and difficult to measure. For example, homosexuality and nymphomania was considered a disorder before but is no longer.
  3. Danger model – Abnormality defined if posed as a risk to danger to self or others. However this only works for certain disorders (e.g. anorexia and bulimia), and is difficult to define, and may be abused
  4. Distress model – Abnormality defined if behaviours cause personal suffering or distress. While many disorders do cause suffering (e.g. depression, phobias), others like mania, where the person subjectively feel very high and good about themselves, isn’t actually under any distress.

Historical Context
In the middle ages, many mental illnesses were thought to be the person being possessed by the devil or demons. If exorcism didn’t work, the person would be confined, beaten and tortured to make the body uninhabitable by evil spirits.

In the 19th century, John P. Grey, the most influential American psychiatrist, deemed that if mental illness the brain patholody was unknown, therefore mental illness is uncurable. This thought became widespread so mental illness patients were just institutionalised and cared for and there psychiatrist focused on diagnosis rather than treatment.

Mood Disorders
Suicide rates are higher in the elderly than in any other group. However, there’s been relatively little media attention and psychological research on that, perhaps because suicide rates in the young are seen as more tragic than the old.

One theory put forth about depression is called Learned Helplessness (proposed by Seligman). Baiscally is that those who are depress develop the idea that they have no control over their lives. Problems they confront are intpreted to be internal, stable and global. For example, if someone with learned helplessess fails a maths test, they would think that it’s all their fault (internal, as opposed to e.g. it was a hard test), that they will always fail (stable, as opposed to thinking that it was just a one-off bad test) and that they are a failure at everything (global, as opposed to thinking that one is just bad at maths). However, this theory is not perfect as it doesn’t explain why depression goes away (major depression occur in episodes, and even if left untreated, the person would eventually stop getting depressed though it may take years with much suffering and another cycle may begin again).

Anxiety Disorders
EEG beta activity in people with Generalised Anxiety Disorder show intense left hemisphere of the brain. This suggest that these people engage in frantic, intense thought process/worry without images; they are so preoccupied with thinking about upcoming problems, they don’t go through the process of creating images of potential threat in their head. While they may avoid unpleasant imagery, they are never able to work through their problems to arrive at a solution.

A phobia to blood, injections and/or injuries is shown to run in families more strongly than any other phobic disorder.

Schizophrenia
Using brain-imaging technique (SPECT) on those who experience hallucinations, it was found that it is the Broca’s area (involved in speech production) rather than the Wernicke’s rea (involved in language comprehension) that lit up. This supports the theory htat people who are hallucinating are not hearing the voices of others but are listening to their own voices and thoughts but cannot recognise the difference.

A study by Brown showed that former patients who had limited contact with their relatives did better. Schizophrenics living with a family with high expression emotion (too much involvement in their lives, “overprotection”, intrusiveness) are 3.7x more likely to relapse than living with a low expressed emotions family.

Development Disorders
The type of medication given to children with Attention Deficit Disorder is usually some kind of stimulant (like Ritalin). It’s counter-intuitive to give overly implusive, restless, hyperactive children a stimulant drug, but the theory is that ADD children have understimulated brains that cause them to be overly active to try to compensate and find a balance. Hence, a stimulant that perks up the brain actually does reduce the hyperactive behaviours.

Substance-Related Disorders
While some people feel perked up and less inhibited after consuming alcohol, it is nonetheless a depressant. But what happens is, it first depresses the inhibitory centres of the brain, which gives the relaxed but “I can say whatever, whee!!” feeling. But the more drunk, the more other parts of the brain would get depressed, and one wouldl soon feel woozy and eventually pass out as more parts of the brain are depressed.

Opiates like methadone and heroine induces a state of euphoria, drowsiness and slows your breathing. However, at too high a dosage, it can completely depress the respiratory system and death from suffocation can result.

Sexual Disorders
In one interview with 100 random married couples, 40% of men reported occasional erectile or ejaculatory diffficulties and 64% of women reported occasional dysfunctions of arousal/orgasm. However, these dysfunctions didn’t detract from the respondents’ overall sexual satisfaction. The best predictor of sexual distress among women were deficits in general emotional well-being or relationship with the partner during sexual relations. Sex definitely isn’t everything!

Interviews with exhibitionists (in terms of those who flash at people) is that their mentality isn’t to scare or shock people. Apparently, the aim of their behaviour is hopefully to arouse the person whom they flash at. Unfortunately, a study found that 28% of “targets” of flashers are 5-13 year olds. =/

Dissociative and Somatoform Disorders
While most people know what Deja vu is, there is also a collorary called “Jamais vu” which is where everything around you seems unfamiliar but you know you’ve seen/been there before.

Aaaaand now I’m sick of typing. :P We’ve learnt MUCH more than that, that’s just a very small slice of the miscellaneous data we’ve come across. For ethical reasons I don’t want to post an incomplete picture of diagnosis of any disorder but it is interesting. I thoroughly enjoyed this course, there are many more applicable theories to everyday life than one would think. For example, stay away from drugs, people! :P