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ABNORMAL PSYCHOLOGY

I. Understanding Abnormality
Normal and Abnormal

Criteria for Normality

Normality is average. This means that what is accepted by the majority is considered normal. The
problem here is that majority behavior is not always acceptable.
Normality is Social Conformity. Anyone who conforms to social norms is normal.
Normality is Social Comfort. If a person feels comfort or pleasure, then it is normal
Normality is Ideal. What is good, what is socially acceptable and something that causes personal
comfort.
Normality is a Process. No one is instantly normal, we undergo certain processes and undergo
adjustment. Example, coping

Cultural Relativism
-the view that there are no universal standards or rules for labeling a behavior as abnormal
-behaviors can only be abnormal relative to cultural norms

1. Culture and gender can affect ways how people express their symptoms.
2. Culture and gender can influence peoples willingness to admit certain types of behavior.
3. Culture and gender can influence the types of treatments deemed acceptable or helpful for
maladaptive behaviors

Unusualness- Behaviors that are deviant, or unusual, are considered abnormal

Distress-behaviors should be considered abnormal only if the individual suffers distress and wishes
to be rid of the behaviors
Mental Illness -Behaviors are not abnormal unless a part of a mental illness.

The Four Ds of Abnormality

Dysfunction
Distress
Deviance
Dangerousness

II. Recognizing Psychopathology

Typical Signs and Symptoms of Psychopathology

Sadock, B.J., & Sadock, V.A. (2007). Kaplan & Sadocks Synopsis of Psychiatry (10th ed.) Philadelphia,
USA: Lippincott Williams & Wilkins

Sign- Objective; Based from a clinicians observation

Symptom- Subjective; Experiences of the patient
SYNDROME- constellation of signs and symptoms that make up a recognizable condition, is often
used to show the overlap of the two

DISTURBANCES OF CONSCIOUSNESS

Consciousness- state of awareness

Apperception -perception modified by ones own thoughts and emotions
Sensorium- sometimes used as another term for consciousness; refers to the state of functioning
of the special senses

Disorientation
disturbed orientation regarding time, place, or person.
Delirium
patient exhibits confusion, restlessness, bewilderment, and a disoriented reaction
that is usually associated with hallucinations and fear.
Clouding of consciousness
a state of perceptual and cognitive confusion.
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Stupor
a general condition wherein the patient exhibits extreme unresponsiveness and loss
of orientation to the environment.
Twilight state
a disturbance in consciousness, with hallucinations.
Dreamlike state
another term for psychomotor epilepsy or complex partial seizure.
Distractibility
the inability to concentrate or focus attention because patient is easily drawn to
irrelevant external stimuli.
Selective attention
blocking out of anxiety-causing stimuli.
Hyper vigilance
excessive focus and attention is given to all internal and external stimuli due to
paranoia.

DISTURBANCES OF SUGGESTIBILITY

Suggestibility - uncritical and compliant response to influence or an idea.

Folie a deux (or folie a trois)

emotional/mental illness shared between two (or three) persons
also called shared psychosis between two (or three) persons.

Hypnosis
artificially induced consciousness characterized by heightened suggestibility

DISTURBANCES IN EMOTION

Emotion
a complex feeling or state related to mood and affect with psychic, somatic, and
behavioral components.

Affect
the expression or outward manifestation of emotion

Appropriate affect
a normal condition wherein emotional tone is in harmony or is consistent with the
accompanying thought, idea, or speech. It is also described as broad or full affect wherein
a full range of emotions is appropriately expressed.

Inappropriate affect
inconsistency between the emotional tone and the idea, thought, or speech accompanying
it.

Blunted affect
characterized by a severe reduction in the intensity of the externalized feeling tone.

Restricted or constricted affect

reduction in the intensity of feeling tone
It is less severe than blunted affect.
Flat affect
the absence or near absence of any signs of affective expression.
It can be characterized by an immobile face and a monotonous voice.
Labile affect
rapid and abrupt changes in the emotional feeling tone which is unrelated to an
external stimuli
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Euphoria
intense elation with feelings of grandeur.
Ecstasy
feeling of intense rapture or delight.
Depression
the psychopathological feeling of sadness.

Anhedonia
loss of interest and withdrawal from all regular and pleasurable activities. Often
associated with depression.
Grief or Mourning
sadness that is appropriate to a real loss.
Alexithymia
the inability or difficulty in describing ones moods or emotions.

Anhedonia
loss of interest and withdrawal from all regular and pleasurable activities. Often
associated with depression.
Grief or Mourning
sadness that is appropriate to a real loss.
Alexithymia
the inability or difficulty in describing ones moods or emotions.

Agitation
motor restlessness associated with severe anxiety.
Tension
unpleasant increased motor and psychological activity.
Panic
acute, episodic, intense anxiety attack associated with overwhelming feelings of
dread.
Apathy
dulled emotional tone associated with indifference or detachment
Ambivalence
presence of two opposing impulses toward the same thing, in the same person, at
the same time.

PHYSIOLOGICAL DISTRUBANCES ASSOCIATED WITH MOOD

Physiological disturbances associated with mood

Signs that refer to the somatic (usually autonomic) dysfunction of a person, which are
most often associated with depression; also known as vegetative signs.

Anorexia
loss of or decrease in appetite.
Hyperphagia
increase in appetite and food intake.
Hypersomnia
excessive sleeping.

Insomnia
difficulty or lack the lack of ability to fall asleep.
Initial
difficulty in falling asleep. (early onset)
Middle
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difficulty in sleeping through the night without waking up; difficulty in going back to
sleep if awaken in the middle of the night. (middle onset)
Terminal
early morning awakening. (late onset)

Diurnal variation
mood is regularly worst in morning, immediately after awakening, and improves as
the day progresses.

Diminished libido
decreased sexual interest, drive, and performance.
Increased libido is usually associated with manic states.

Constipation
inability or difficulty in defecating

DISTURBANCES IN MOTOR FUNCTIONING

Echopraxia
the persons pathological imitation of movements of another person.
Catatonia
motor anomalies in non-organic disorders (as opposed to disturbances of
consciousness and motor activity secondary to organic pathology)
Negativism
motiveless resistance to all instructions or to all attempts to be moved.

Catalepsy
general term used to describe an immobile position that is constantly maintained.
Catatonic Excitement
agitated, purposeless motor activity that is uninfluenced by external stimuli.
Catatonic Stupor
noticeable slowed motor activity, often to a point of immobility and seeming
unawareness of surroundings.
Catatonic Rigidity
voluntary assumption of a rigid posture, held against all efforts to be moved.
Catatonic Posturing
voluntary assumption of an inappropriate or bizarre posture which is generally
maintained for long periods of time.
Cerea Flexibilitas (Waxy Flexibility)
a condition wherein the person can be molded into a position that is then
maintained. When the examiner moves the persons limb, the limb feels as if it were
made of wax.

Cataplexy
temporary muscle weakness and loss of muscle tone precipitated by a variety of
emotional states.
Stereotypy
repetitive fixed pattern of physical action or speech.

Mannerism
deep-seated/ingrained and habitual involuntary movement.
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Automatism
automatic performance of an act or acts generally representative of unconscious
symbolic activity.
Command Automatism
automatic following of suggestions. (automatic obedience)
Mutism
voicelessness that is not caused by structural abnormalities or physical conditions.

Overactivity
abnormality in motor behavior that can manifest itself as psychomotor agitation,
hyperactivity, tic, sleepwalking, or compulsions
Psychomotor Agitation
excessive motor and cognitive overactivity, usually nonproductive and in response to inner
tension.
Hyperactivity (Hyperkinesis)
restless, aggressive, and destructive activity, often associated with some underlying organic
pathology.
Tic
involuntary, spasmodic motor movement.
Sleepwalking (Somnambulism)
motor activity during sleep.

Akathisia
subjective feeling of muscular tension secondary to antipsychotic or other medication,
which can cause restlessness, pacing, repeated sitting and standing; can be mistaken for
psychotic agitation.

Compulsion
uncontrollable impulse to perform an act repetitively

Dipsomania compulsion to drink alcohol.

Kleptomania compulsion to steal.

Nymphomania excessive and compulsive need for coitus in a woman.

Satyriasis excessive and compulsive need for coitus in a man.

Trichotillomania compulsion to pull out ones hair.

Ritual automatic activity compulsive in nature, anxiety-reducing in origin.

Hypoactivity (Hypokinesis)
decreased motor and cognitive activity, as in psychomotor retardation; visible
slowing of thought, speech and movements.
Mimicry
simple, imitative motor activity of childhood.
Aggression
forceful goal-directed action that may be verbal or physical; the motor counterpart
of the affect of rage, anger, or hostility.
Acting out
direct expression of an unconscious wish or impulse in action; unconscious fantasy is
lived out impulsively in behavior.

DISTURBANCES IN THINKING

Thinking
the goal-directed flow of ideas.
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Symbols and associations initiated by problem or task and leading toward a reality-
oriented conclusion.

GENERAL DISTURBANCES IN THE FORM OF THINKING

Mental disorder
clinically significant behavioral or psychological syndrome that is associated with
distress or disability, and not just an expected response to a particular event.
Psychosis
inability to distinguish reality from fantasy. Impairment in reality testing, with
creation of a new reality.
Reality testing
the objective evaluation and judgment of the world outside the self.

Formal though disorder

disturbance in the form of thought instead of the content of thought.

Thinking is characterized by loosened associations, neologisms, and illogical
constructs.
Thought process is disordered and the person defined psychotic.

Illogical thinking
thinking containing erroneous conclusions or internal contradictions. It is considered
psychopathological only when it is marked and when not caused by cultural values or
intellectual deficit.

Dereism
mental activity not concordant with logic experience.

SPECIFIC DISTURBANCES IN THE FORM OF THOUGHT

Autistic Thinking
thinking that gratifies unfulfilled desires but has no regard for reality
a preoccupation phase in children in which thoughts, words, or actions assume
power.
Magical thinking
a form of dereistic thought; thinking similar to that of the preoperational phase in
children (Jean Piaget), in which thoughts, words, or actions assume power (e.g., to
cause or to prevent events).
Primary process thinking
general term for thinking that is dereistic
illogical and magical
normally found in dreams, abnormally in psychotics.

GENERAL DISTURBANCES IN THE FORM OR PROCESS OF THINKING

Neologism
new word or phrase whose derivation cannot be understood
often seen in schizophrenia
it has also been used to mean a word that has been incorrectly constructed but
whose origins are nonetheless understandable (e.g., headshoe to mean hat), but
such constructions are more properly referred to as word approximations.
Word Salad
incoherent, essentially incomprehensible, mixture of words and phrases commonly
seen in far-advanced cases of schizophrenia (See also incoherence.).
Circumstantiality
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disturbance in the associative thought and speech processes in which a patient

digresses into unnecessary details and inappropriate thoughts before communicating
the central idea
observed in schizophrenia, obsessional disturbances, and certain cases of dementia.
Tangentiality
oblique, digressive, or even irrelevant manner of speech in which the central idea is
not communicated.
Incoherence
thought that, generally is not understandable
patient never gets from desired point to desired goal.
Perseveration
pathological repetition of the same response to different stimuli, as in a repetition of
the same verbal response to different questions
persistent repetition of specific words or concepts in the process of speaking.
Seen in cognitive disorders, schizophrenia, and other mental illness.
Verbigeration
meaningless and stereotyped repetition of words or phrases, as seen in
schizophrenia
also called cataphasia.
Echolalia
a persons psychopathological repeating of words or phrases of by another
tends to be repetitive and persistent
Seen in certain kinds of schizophrenia, particularly the catatonic types.
Condensation
mental process in which one symbol stands for a number of components.
Irrelevant answer
answer that is not in harmony with question asked.

Loosening of associations
characteristic schizophrenic thinking or speech disturbance involving a disorder in
the logical progression of thoughts
manifested as a failure to communicate verbally adequately
unrelated and unconnected ideas shift from one subject to another.
Derailment
gradual or sudden deviation in train of thought without blocking
sometimes used synonymously with loosening of association.
Flight of ideas
rapid succession of fragmentary thoughts or speech in which content changes
abruptly and speech may be incoherent.

Clang association
association or speech directed by the sound of a word rather than by its meaning
words have no logical connection
punning and rhyming may dominate the verbal behavior.
Seen most frequently in schizophrenia or mania.
Blocking
abrupt interaction in train of thinking before a thought or idea is finished after brief
pause, person indicates no recall of what was being said or was going to be said.
Glossolalia
unintelligible jargon that has meaning to the speaker but not to the listener
occurs in schizophrenia.
Poverty of content
thought that gives little information because of vagueness, empty repetitions, or
obscure phrases.
Overvalued idea
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false or unreasonable belief or idea that is sustained beyond the bounds of

reason; it is held with less intensity or duration than a delusion, but is usually
associated with mental illness.
Delusion
false belief, based on incorrect inference about external reality, not consistent
with patients intelligence and cultural background that cannot be corrected by
reasoning

SPECIFIC DISTURBANCES IN THE CONTENT OF THOUGHT

Bizarre delusion
false belief that is patently absurd or fantastic (e.g., invaders from space have
implanted electrodes in a person's brain), common in schizophrenia.
Systematized delusion
group of elaborate delusions related to a single event or theme.
Mood-congruent delusion
delusion with content that is mood appropriate (e.g., depressed patients who believe
that they are responsible for the destruction of the world).
Mood-incongruent delusion
delusion with content that has no association to mood or is mood-neutral.
Nihilistic delusion
depressive delusion that the world and everything related to it have ceased to exist.
Delusion of poverty
false belief that one is bereft or will be deprived of all material possessions
Somatic Delusion
delusion pertaining to the functioning of one's body.

Paranoid delusions
includes persecutory delusions and delusions of reference, control, and grandeur
Delusion of persecution
Delusion of grandeur
Delusion of reference

Delusion of self-accusation
false feeling of remorse and guilt. Seen in depression with psychotic features.

Delusion of control
false belief that a person's will, thoughts, or feelings are being controlled by external
forces.
Thought withdrawal
Thought insertion
Thought broadcasting

Delusion of infidelity
false belief that one's lover is unfaithful. Sometimes called pathological jealousy.
Erotomania
delusional belief, more common in women than in men, that someone is deeply in
love with them (also known as de Clrembault syndrome).
Pseudologia fantastica
a type of lying, in which the person appears to believe in the reality of his or her
fantasies and acts on them.
Preoccupation of thought
centering of thought content on a particular idea, associated with a strong affective
tone, such as a paranoid trend or a suicidal or homicidal preoccupation.
Egomania
morbid self-preoccupation or self-centeredness.
Monomania
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mental state characterized by preoccupation with one subject.

Hypochondria
exaggerated concern about health that is based not on real medical pathology, but
on unrealistic interpretations of physical signs or sensations as abnormal.
Obsession
persistent and recurrent idea, thought, or impulse that cannot be eliminated from
consciousness by logic or reasoning
obsessions are involuntary and ego-dystonic.

Compulsion
pathological need to act on an impulse that, if resisted, produces anxiety
repetitive behavior in response to an obsession or performed according to certain
rules, with no true end in itself other than to prevent something from occurring in
the future.

Coprolalia
involuntary use of vulgar or obscene language. Observed in some cases of
schizophrenia and in Tourette's syndrome.
Phobia
persistent, pathological, unrealistic, intense fear of an object or situation
the phobic person may realize that the fear is irrational but, nonetheless, cannot
dispel it.

Simple phobia
Social phobia
Acrophobia
Algophobia
Claustrophobia
Xenophobia
Zoophobia

Noesis
a revelation in which immense illumination occurs in association with a sense that
one has been chosen to lead and command.
Unio mystica
feeling of mystic unity with an infinite power.

DISTURBANCE IN SPEECH

Speech
ideas, thoughts, feelings as expressed through language; communication through the
use of words and language.

Pressure of Speech
rapid speech that is increased in amount difficult to interpret.
Volubility (logorrhea)
copious, coherent, logical speech
excessive talking observed in manic episodes of bipolar disorder.
(also known as tachylogia, verbomania)

Poverty of Speech
restriction in the amount of speech used; replies may be mono-syllabic.

Dysarthria
difficulty in articulation, not in word finding or in grammar.
Excessively loud or soft speech
loss of modulation of normal speech volume
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may reflect a variety of pathological conditions ranging from psychosis to depression

to deafness.
Stuttering
frequent repetition or prolongation of a sound or syllable, leading to markedly
impaired speech fluency.
Cluttering
erratic and dysrhythmic speech, consisting of rapid and jerky spurts.

APHASIC DISTURBANCES

Dysarthria
difficulty in articulation, not in word finding or in grammar.
Excessively loud or soft speech
loss of modulation of normal speech volume
may reflect a variety of pathological conditions ranging from psychosis to depression
to deafness.
Stuttering
frequent repetition or prolongation of a sound or syllable, leading to markedly
impaired speech fluency.
Cluttering
erratic and dysrhythmic speech, consisting of rapid and jerky spurts.

Syntactical Aphasia
inability to arrange words in proper sequence.
Jargon Aphasia
words produced are totally neologistic
nonsense words repeated with various intonations and inflections.
Global Aphasia
combination of a grossly non-fluent aphasia and a severe fluent aphasia.

DISTURBANCES OF PERCEPTION

Perception
process of transferring physical stimulation into psychological information; the mental
process by which sensory stimuli are brought into awareness.

Illusion
misperception or misinterpretation of real external sensory stimuli.

Hallucination
false sensory perception not associated with real external stimuli
there may or may not be a delusional interpretation of the hallucinatory experience
hallucinations indicate a psychotic disturbance only when associated with impairment
in reality testing
Hypnagogic Hallucination
false sensory perception occurring while falling asleep; generally considered a non-
pathological phenomenon.
Hypnopompic Hallucination
false perception occurring while awakening from sleep
generally considered non-pathological.

Auditory Hallucination
false perception of sound, usually voices but also other noises such as music; most
common hallucination in psychiatric disorders.

Visual Hallucination
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false perception involving sight consisting of both formed images(e.g. people) and
unformed images (e.g. flashes of light)
most common in organically determined disorders.
Olfactory Hallucination
false perception in smell
most common in organic disorders.
Gustatory Hallucination
false perception of taste, such as unpleasant taste caused by an uncinate seizure
most common in organic disorders.
Tactile (Haptic) Hallucination
false perception of touch or surface sensation, as from an amputated limb (phantom
limb), crawling sensation on or under the skin (formication).

Somatic Hallucination
false sensation of things occurring in or to the body, most often visceral in origin
(also known as cenesthetsic hallucination).

Lilliputian Hallucination
false perception in which objects are seen as reduced in size (also termed
micropsia).

Mood-congruent Hallucination
a kind of hallucination wherein the content of which is consistent with either a
depressed or manic mood (e.g. a depressed patient hears voices saying that the
patient is a bad person
a manic patient hears voices saying that the patient is inflated of worth, power,
knowledge, etc.)

Mood-incongruent Hallucination
Hallucination whose content is not consistent with either depressed or manic mood
(e.g. in depression, hallucinations not involving such themes as guilt, deserved
punishment, or inadequacy
in mania, hallucinations not involving such themes as inflated worth or power)

Hallucinosis
Hallucinations, most often auditory, that are associated with chronic alcohol abuse
and that occur within a clear sensorium.
Trailing Phenomenon
perceptual abnormality associated with hallucinogenic drugs in which moving object
are seen as a series of discrete and discontinuous stages.

DISTURBANCES ASSOCIATED WITH ORGANIC MENTAL DISORDER

Anosognosia
inability to recognize illness as occurring to oneself.
Autotopagnosia
inability to recognize a body part as ones own.
Visual Agnosia
inability to recognize objects or persons.
Astereognosia
inability to recognize objects by touch.

Prosopagnosia
inability to recognize faces.
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Apraxia
inability to carry out specific tasks.

DISTURBANCES ASSOCIATED WITH CONVERSION AND ASSOCIATIVE

DISSOCIATION

Astereognosia
-inability to recognize objects by touch.

Prosopagnosia- inability to recognize faces.

Apraxia- inability to carry out specific tasks.

Somatization of repressed material or the development of physical symptoms and

distortions involving the voluntary muscle or special sense organs
not under voluntary control and not explained by any physical disorder

DISTURBANCES ASSOCIATED WITH CONVERSION AND DISSOCIATIVE PHENOMENA

Hysterical Anesthesia
loss of sensory modalities resulting from emotional conflicts.
Macropsia
state in which objects seem larger than they are.
Micropsia
state in which objects seem smaller than they are (both macropsia and micropsia can
also be associated with clear organic conditions such as complex partial seizures).

Depersonalization
a subjective sense of being unreal, strange, or unfamiliar to oneself.
Derealization
a subjective sense that the environment is strange or unreal
a feeling of changed reality.
Fugue
taking on a new identity with amnesia for the old identity
often involves travel or wandering to new environments.
Multiple personality
one person who appears at different times to be in possession of an entirely
different personality and character.

DISTURBANCES OF MEMORY

Memory
function by which information stored in the brain is later recalled to consciousness

Amnesia
partial or total inability to recall past experiences; may be organic or emotional in origin.
Paramnesia
falsification of memory by distortion of recall.

Fausse reconnaissance
false recognition.

Retrospective falsification
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memory becomes unintentionally (unconsciously) distorted by being filtered through

patients present emotional, cognitive, and experiential state.

Confabulation
unconscious filling of gaps in memory by imagined or untrue experiences that patient
believes but that have no basis in fact; most often associated with organic pathology.

Dj vu
illusion of visual recognition in which a new situation is correctly regarded as a
repetition of a previous memory.

Dj entendu
illusion of auditory recognition.

Dj pense
illusion that a new thought is recognized as a thought previously felt or expressed.

Jamias vu
false feeling of unfamiliarity with a real situation one has experienced.

False memory
a persons recollection and belief by the patient of an event that did not actually
occur.

Hypermnesia
exaggerated degree of retention and recall.

Eidetic image
visual memory of almost hallucinatory vividness.

Screen memory
a consciously tolerable memory covering for a painful memory.

Repression
a defense mechanism characterized by unconscious forgetting of unacceptable ideas
or impulses.

Lethologica
temporary inability to remember a name or a proper noun.
Blackout
amnesia experienced by alcoholics about behavior during drinking bouts
usually indicates that reversible brain damage has occurred.

LEVELS OF MEMORY

Immediate
reproduction or recall of perceived material within seconds to minutes.

Recent
recall of events over past few days.

Recent past
recall of events over past few months.

Remote
recall of events in distant past.
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DISTURBANCES OF INTELLIGENCE

Intelligence

the ability to understand, recall, mobilized, and constructively integrates previous

learning in meeting new situations.

Mental Retardation

Lack of intelligence to a degree in which there is interference with social and

vocational performance

Mild
I.Q. of 50 or 55 to approximately 70
Moderate
I.Q. of 35 or 40 to 50 or 55
Severe
I.Q. of 20 or 25 to 35 or 40
Profound
I.Q. below 20 or 25

Dementia
organic and global deterioration of intellectual functioning without clouding of
consciousness
Pseudodementia
clinical features resembling a dementia not caused by an organic mental dysfunction
most often caused by depression.
Concrete thinking
literal thinking
limited use of metaphor without understanding of nuances of meaning
one dimensional thought.
Abstract thinking
ability to appreciate nuances of meaning
multidimensional thinking with ability to use metaphors and hypotheses
appropriately.