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Introduction to psychopathology
Psychopathology is the study of the symptoms, causes, and treatments of mental disorders.
DSM-5 describes a Mental Disorder as a syndrome characterized by clinically significant
disturbance in an individual’s cognition, emotion regulation, or behavior that is deviant,
distressful and dysfunctional.
•Dysfunction (Impairment of Functioning)
The individual's behaviour must significantly interfere with daily activities (social and
occupational) that were otherwise normal & functional
• Deviance
Different, extreme, unusual
Deviation from majority (Statistical Definition)- atypical or unexpected in the cultural
context. Rare behavior (behaviors, thoughts, and/or emotions) that deviates from the
average. More deviation, more abnormal.
From social norms: Stated and unstated rules for proper conduct in a given society or
culture. Judgments of deviance depend on specific social context.
•Distress
Behaviour must be distressing for the individual. Personal suffering defines abnormality.

Mental health The World Health Organization (WHO) defines: “...Mental health is a state of
well-being in which an individual realizes his or her own abilities, can cope with the normal
stresses of life, can work productively and is able to make a contribution to his or her
community” (WHO, (2018). [Strengthening mental health promotion. Geneva, WHO].
Maladaptive behaviour/Adaptive failures
Most psychological disorders are simply extreme expressions of otherwise normal emotions,
behaviours, and cognitive processes.
Ultimately, a society selects the general criteria for defining abnormality and then uses those
criteria to judge particular cases.
CLINICAL ASSESSMENT
Clinical assessment is the systematic evaluation and measurement of psychological, biological,
and social factors in an individual presenting with a possible psychological disorder.
DIAGNOSIS
Diagnosis is the process of determining whether the particular problem afflicting the individual
meets all criteria for a psychological disorder, as set forth in the Diagnostic and Statistical
Manual of Mental Disorders (DSM 5).
 Diagnostic and Statistical Manual of Mental Disorders--American Psychiatric Association
(2013).
 [Attempts to classify -- traced back to Ayurveda and Plato]
 ICD-10 (1992)--WHO's classification -International Classification of Diseases: Chapter 5.
CAUSES (Etiology) of mental disorders
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Predisposing Factors
(to dispose beforehand; to give an inclination or tendency to beforehand; make susceptible). It determines an
individual's susceptibility to Mental Illness. It will interact with precipitating factors to result in Mental Illness. These
factors determine person's vulnerability to causes acting close to the time of the illness.
Precipitating Factors
These are events that occur shortly before the onset of a disorder and appear to have induced it. The type of
disorder depends partly on the constitutional factors of the patient.
Perpetuating Factors
These factors prolong the course of a disorder after it has been provoked, e.g. Marital disharmony for alcoholism.
Multiple causes
Explanations of abnormal behavior must consider biological, psychological, social, and sociocultural elements.
Biological factors involve genetics, brain anatomy and physiology, central nervous system functioning, autonomic
nervous system reactivity etc. Psychological factors involve personality, cognition, emotions, learning, coping skills,
self-efficacy, values, and the like. Social factors indicate family and other interpersonal relationships, social support,
belonging, love, marital status, community connections, and so forth. Sociocultural factors mainly refer to race,
gender, sexual orientation, spirituality or religion, socioeconomic status, ethnicity, and culture.
Biological Factors
It can refer either to the causes of disease or to the mechanisms by which disease and its effects are produced. e.g.
endocrinal abnormalities like Thyroid defects can lead to diminished mental activities or over excitability.
 Interference with Brain Tissue by changes in Blood Chemistry
Disturbance in blood sugar level, (hypoglycemia) results in mental illness symptoms, e.g. irritability, outbursts of
temperament, hallucinations.
Disturbance in acid-alkali levels produce confusion, fading of memory or total dementia
Insufficiency of oxygen in cardiovascular diseases damage brain tissues resulting in irritability, bad temper, and
temporary loss of normal mental capacities.
 Physical Illness
Organic Causes-Neuro Biological Causes
Alzheimer's disease, CNS infections, maternal exposure to viral infections.
Loss of brain tissue---injuries, infections like syphilis, encephalitis. The after effects of brain injury are frequently
serious because of a progressive intellectual and emotional degeneration that may cause convulsive seizures, de-
mentia, and personality disorders.
Head injuries--Cerebral oedema, haemorrhage etc. can cause psychosis, anxiety disorders
 Physical Defects
Deafness, cleft lip, blindness, etc. create a sense of inability to meet the social situation that leads to feelings of
insecurity and inferiority.
 Natural Disasters
Physical stress like war, famine, earthquake, floods, cyclone, house collapse, etc. causes separation which leads to
depression.
 Drug Intoxications
Steroids, LSD, morphine, cocaine, lead, etc. consuming for longtime leads to brain dysfunction, dementia.
Alcoholism causes dementia, delirium tremens and personality deterioration.
• Prolonged Mental Work under Anxiety
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Constant intellectual work does not cause Mental Illness, but the fatigue which is produced by persistent anxiety or
by boredom causes exhaustion, sleeplessness, behaviour deterioration particularly in Transition periods in the life.
For example, in adolescents-puberty--Perceiving stressful situations, Educational achievements.
Young adults: Vocational, pregnancy, child birth, marriage, family settlement.
Involution period or Climacteric period, e.g. Female-after menopause; Male-after 55 years.
Decline in the functioning levels of endocrine and reproductive systems leads to frustration.
Feelings of Dependency, insecurity.
Senility or Old age: Degenerative changes in the old age produces senile dementia, insecurity, loss of mental
capacities.
• Malnutrition
B-complex deficiency produces nerve cells or brain tissue damage results in symptoms of Mental Illness.
•Psychological Factors
 Strained interpersonal relationship in home, school, working place
 Marital disharmony (bias associated with marital relationship/strained interpersonal relationship among
couple)
 Family disharmony
 Sexual maladjustment
 Death of a loved one
 Bad temperamental effects
 Abnormal parent-child relationship
 Tender mindedness
 Traumatic experiences during childhood, adolescence
 Loss of job, prestige-grief reactions.
Childhood Insecurities
 Maternal deprivation-lack of warmth, care, security
 Defective personality of parents
 Over protection, under protection
 Favouritism
 Unhealthy comparison of children
 Over strict or discipline
 Leniency
 Guilt feeling about masturbation
 Worry about sex
 Persons with high or low intellectual ability
 Traumatic experiences
Socio-cultural factors
 Poverty, financial difficulties, too much income
 Bad habits-alcoholism, gambling, prostitution
 Political upheavals
 Social crisis
 Lack of resources
 Violence
 Homelessness
 Discrimination
 Unwarranted negative view of the world
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 Migration from village to urban life; unable to adjust

 Generation gap
 Occupational difficulties ( Unhappy working conditions, Strained relationship between boss, other colleagues
or with superiors, Shift system, Lack of job satisfaction, Intermittent employment or unemployment
 Educational and Scholastic Problems
Unhealthy comparison, teachers' attitude, favouritism by teachers, discriminations, inadequate
recreational and library facilities, lack of proper seating arrangement, rapid change in
curriculum.
 Marital Problems
Strained relationship, marital disharmony childlessness, too many issues, divorce, separation.
 Family
Broken family, strained interpersonal relationship or too big or small family.
 Adverse Physical Environment
Influence of neighbours, friends, over crowding, housing, polluted environment, slums, lack of civic facilities.
 Religious and spiritual Factors
Beliefs and practices of the sect to which one belongs and individual beliefs. Uncertainty, disharmony and lack
meaning in one's own life.
Spiritual Views and Interventions
For most of the twentieth century, clinical scientists viewed religion as a negative factor in mental health.This
alienation now seems to be ending: Numerous books have been published. Researchers have begun to
systematically study the influence of religion and spirituality on mental health. Many therapists now address
spiritual issues when treating religious clients.
Multidimensional Models ( Integrative Models)
Unlike One-Dimensional Models (biological model), Multidimensional Models are Interdisciplinary, interactive , and
integrative. Many theorists, clinicians, and practitioners adhere to a Biopsychosocial Model. Abnormality results
from the interaction of genetic, biological, developmental, emotional, behavioral, cognitive, spiritual, social, and
societal influences. Diathesis-stress approach is also popular: [Diathesis = predisposition (bio, psycho, or social)]
No one theoretical perspective is adequate to explain the complexity of the human condition and the development
of mental disorders. Multiple factors influence the development of any single disorder.
Not all dimensions contribute equally to a disorder. The multidimensional biopsychosociocultural model
acknowledges that factors may combine in complex and reciprocal ways so that people exposed to the same
influences may not develop the same disorder and that different individuals exposed to different factors may
develop similar mental disorders.
The biological and psychological strengths and assets of a person and positive aspects of the person’s social and
sociocultural environment can help protect against psychopathology, minimize symptoms, or facilitate recovery
from mental illness. (Sue, D., Sue, D. W. Sue, D, Sue, S. (2016). Understanding abnormal behavior. USA: Cengage
Learning.)
SYMPTOMS & SIGNS IN MENTAL ILLNESS
A subjective complaint by an individual to a doctor or psychotherapist. It is a departure from normal condition or
functioning which may be a sign of an underlying disorder. The clinical manifestations are the end-products of
various forces of adaptation to cope with stress situation. The intensity and persistence of symptoms will indicate
manifestation of the disease. A single sign or symptom does not necessarily indicate illness. Most disorders are
syndromes.—a group of signs and symptoms that occur together and constitute a recognizable disorder.