PYC4802/101/0/2015

Tutorial letter 101/0/2015

Psychopathology

PYC4802
Year module
Department of Psychology
IMPORTANT INFORMATION:
This tutorial letter contains important information about your module.

CONTENTS
Page
1.

INTRODUCTION ..................................................................................................... 3

1.1

Turorial material ....................................................................................................... 4

2.

PURPOSE OF AND OUTCOMES FOR THE MODULE ......................................... 4

2.1

Purpose ................................................................................................................... 4

2.2

Outcomes ................................................................................................................ 4

3.

LECTURER(S) AND CONTACT DETAILS ............................................................ 6

3.1

Lecturer(s) ............................................................................................................... 6

3.2

Department .............................................................................................................. 7

3.3

University ................................................................................................................. 7

4.

MODULE-RELATED RESOURCES ....................................................................... 7

4.1

Prescribed book....................................................................................................... 7

4.2

Recommended books (subject to availability) ......................................................... 8

4.3

Electronic Reserves (e-Reserves) ......................................................................... 10

5.

STUDENT SUPPORT SERVICES FOR THE MODULE ....................................... 14

6.

MODULE-SPECIFIC STUDY PLAN ..................................................................... 17

7.

MODULE PRACTICAL WORK AND WORK-INTEGRATED LEARNING ........... 18

8.

ASSESSMENT ...................................................................................................... 18

8.1

Assessment plan ................................................................................................... 19

8.2

General assignment numbers ............................................................................... 21

8.2.1

Unique assignment numbers ................................................................................. 21

8.2.2

Due dates for assignments .................................................................................... 21

9.

OTHER ASSESSMENT METHODS ..................................................................... 47

10.

EXAMINATION ..................................................................................................... 47

11.

FREQUENTLY ASKED QUESTIONS .................................................................. 70

12.

CONCLUSION ...................................................................................................... 70

Please note / important notes:

Formal tuition in this course will be conducted in English only. Where capability exists, and upon request, individual consultations will be conducted in any preferred South African language.

2

PYC4802/101

1.

INTRODUCTION

Dear Student
Welcome to our postgraduate module in Psychopathology! We trust that you will find the experience of studying abnormal behaviour at honours level rich and rewarding.
We also hope that the module proves to be interesting, informative, and useful for deepening and developing your expertise in researching, identifying, and classifying abnormal behaviour.
This Tutorial Letter PYC4802/101/0/2015 is vitally important for your studies in psychopathology. It is your only guide that contains the information you need concerning this module.
All study material indicated in this tutorial letter (including this tutorial letter) can be downloaded from myUnisa, and study related queries can be found in my Studies @
Unisa.
Please read this tutorial letter carefully and completely. Since tutorial material is the major means of distance teaching, it is essential to make regular use of the internet and myUnisa. Should you encounter academic problems, do not hesitate to contact us by writing a letter, e-mailing, phoning, sending a fax, or making an appointment to come and see us. Wherever we can we will strive to assist you with regard to academic and personal problems.
Prior learning we assume to be in place:
We assume that you have previously acquired the following levels of learning and competencies in order to gain from this course:
You have successfully completed a BA, BA (BSW), or a BSc degree on NQF level 7.
You have successfully completed Psychology 3, with an average of at least 60%.
You are able to take responsibility for your own learning in a structured learning environment. You are able to identify, analyse and reflect upon complex texts with regard to real life problems.
You are able to communicate your views coherently and reliably by using basic conventions of academic discourse.
You are committed to strive for life-long learning within the context of ethical behaviour. 3

1.1

Turorial material

Your tutorial material consists of the following:
1.

Tutorial Letter PSYHONM/301 (which contains the rules and regulations for all honours courses).

2.

This tutorial letter PYC4802/101 (which serves as your study guide and examination guide).

3.

The booklet entitled my Studies @ Unisa (which provides you with assistance for the following:
▪ Contact addresses for the various departments
▪ How to submit assignments via myUnisa
▪ Other questions you may have.

Some of this tutorial material may not have been available when you registered.
Tutorial material that was not available when you registered will be posted to you as soon as possible, but is also available on myUnisa, and can be obtained by downloading, saving, and/or printing the documents.

2.
2.1

PURPOSE OF AND OUTCOMES FOR THE MODULE
Purpose

The purpose of this module is to deepen your understanding of the complexity of
Psychopathology within different contexts.
Range statements for the whole module: The scope of this module ranges from an in-depth study of selected themes with regard to psychological disorders/ phenomena in the world with the aim of researching, analysing, discussing, and synthesising these disorders/phenomena in the context of the physical, psychological and social environment of individuals.
2.2

Outcomes

A range of tasks in tutorial letters, assignments, and an examination will show that you can do the following:
Outcome 1: Use general and qualitative research skills.
Assessment criteria:
We will know that you are competent in using general and qualitative research skills when you can do the following:
Analyse, explain, describe and discuss new information from many recommended books, journal articles and additional sources within the framework of, and relevant to the selected themes, by critically synthesising the new information with the DSM criteria. 4

PYC4802/101

Select, order, and relate the new information according to the focus of each theme into a coherent discussion with specific emphasis on relevance to the problem statement or question.
Outcome 2: Use relevant theories, models, and the latest DSM classification system for describing, explaining, assessing, and classifying abnormal behaviour.
Assessment criteria:
We will know that you are competent in using relevant theories, models, and the latest DSM classification system for describing, explaining, assessing, and classifying abnormal behaviour, when you can do the following:
Analyse questions and select relevant data and underlying knowledge (also from other modules) in order to describe, explain, assess, and classify abnormal behaviour, identify connections, and infer hidden meanings from a theme and across themes, by means of discussing the process and choice of arguments.
Outcome 3: Use academic discourse and referencing techniques.
Assessment criteria:
We will know that you are competent in using academic discourse and referencing techniques, when you can do the following:
Analyse questions and select relevant data in order to evaluate psychological disorders, abnormal behaviour, and dysfunctional interactional patterns, identify connections, and infer hidden meanings within and across themes, by justifying and referencing the process and choice of arguments.
Apply the APA style of referencing and acknowledge all literary sources appropriately in the text and in the reference section (refer to Tutorial Letter PSYHONM/301).
Cross-field outcomes and embedded knowledge
The following competencies and cross-field outcomes with regard to the honours course in psychopathology are assessed indirectly. The three formative assessment tasks that will assist you in acquiring the skills that should enable you to demonstrate your competence during the one cumulative assessment task should have developed your proficiency, mind and character in the following ways:
•

The ability to conduct literature studies in preparation for further studies.

•

An increase in awareness of your responsibility for primary and tertiary prevention and for the promotion of mental health within your family, community, and other contexts.

•

An increase in sensitivity and compassion towards all individuals who suffer from mental disorders.

•

The ability to promote the eradication of a judgmental attitude within contexts of minimal information, strangeness, difference, and otherness.
5

•

3.

The ability to actively participate in eradicating bad behaviour, violence, child abuse, substance related problems, depression, and environmental destruction. LECTURER(S) AND CONTACT DETAILS

You can communicate in the following ways: by telephone, fax, e-mail, prearranged personal visit, and by letter (surface- and airmail). The following telephone numbers and e-mail addresses are provided for your convenience.
(Always provide your student number and a contact number where you can be reached when e-mailing your lecturers.) Although lecturers are always willing to help you with your academic problems, they may not always be sitting next to their telephone. They are required to give and attend courses, go to meetings, attend conferences, provide masters and doctoral supervision, do research, read, write, conduct discussion classes, and do community work. They may also be on study leave, sick leave or on vacation. It is therefore important to adhere to the following principles when you want to contact a lecturer.
Please phone lecturers for academic queries and direct all other queries and requests to Ms Phuthi. When you cannot reach the person you have phoned, phone
Ms Phuthi or the departmental secretary, who will connect you to an available lecturer. You can also send an e-mail to Ms Phuthi, who will forward your e-mail to the relevant lecturer.
If you wish to contact a lecturer by sending a letter to the fax number of the
Department of Psychology please indicate the paper code (PYC4802) and the lecturer’s name.
Note: No study material may be sent to students by fax, since you can download all study materials from myUnisa.
3.1

Lecturer(s)
Your Psychopathology team consists of the following lecturers:
Mr B Palakatsela

palakbr@unisa.ac.za

Ms C Laidlaw

+27 12 4298294

laidlc@unisa.ac.za

Mrs PB Mokgatlhe

+27 12 429 8238

mokgapb@unisa.ac.za

Mr FP Visser

+27 12 429 8894

vissefp@unisa.ac.za

Mrs JK Moodley

+27 12 429 8069

moodljk@unisa.ac.za

Dr BC von Krosigk
(Module Leader)

6

+27 12 429 3778

+27 12 429 8224

vkrosbc@unisa.ac.za

PYC4802/101

3.2

Department
Ms MG Phuthi
(Honours Secretary)
Departmental Secretary

+27 12 429 8223

Departmental Fax

3.3

+27 12 429 8309

+27 12 429 3414

University
Postal Address:

32695

Website

www.unisa.ac.za

E-mail

Study-info@unisa.ac.za

Fax

4.1

PO Box 392
UNISA
0003

SMS

4.

phuthmg@unisa.ac.za

(012) 429-4150

MODULE-RELATED RESOURCES
Prescribed book

Burke, A. (Ed.). (2012). Abnormal Psychology: A South African Perspective (2nd ed.).
Cape Town, South Africa: Oxford University Press Southern Africa.
ISBN: 13: 978 0 19 5998375
The prescribed book needs to be purchased as soon as possible from any official bookseller, by consulting the list of official booksellers and their addresses in the brochure my Studies @ Unisa. Should you encounter any difficulties with obtaining books from these bookshops, please contact the Prescribed Book section at e-mail vospresc@unisa.ac.za or telephone +27 12 429 4152.

7

4.2

Recommended books (subject to availability)

The preferred way of requesting recommended or additional books is online via the library’s catalogue.
Go to http://oasis.unisa.ac.za, or via myUnisa, go to http://my.unisa.ac.za > Login > Library > Library catalogue, or for mobile access (AirPAC), go to http://oasis.unisa.ac.za/airpac
Recommended books may also be requested telephonically from the Main Library in
Pretoria. Please refer to section 5 Student support services for this module
List of recommended books for PYC4802 for 2015
TITLE
SHELF NUMBER

AUTHOR

Abnormal child psychology
618.9289 MASH

Mash, Eric J

Abnormal psychology
616.89 ABNO

Kring, Ann M.

Abnormal psychology
616.89 DAVI

Davison, Gerald C

Abnormal psychology
616.89 NOLE

Nolen-Hoeksema, Susan

Abnormal psychology: an integ
616.89 BARL

Barlow, David H.

Abnormal psychology: media & research update
616.89 NOLE

Nolen-Hoeksema, Susan

Adolescence and youth: psychological development in a changing world
305.235 CONG

Conger, John Janeway

Child abuse: implications for child development
362.76 WOLF

Wolfe, David A.

Child abuse and culture: working with diverse families
362.7653 FONT
Child abuse and neglect: facing the challenge 362.76 CHIL
8

Fontes, Lisa Aronson

Stainton Rogers, Wendy.

PYC4802/101

Child clinician's handbook
618.9289 KRON

Kronenberger, Willia

Development through the lifespan
155 BERK

Berk, Laura E.

Effective interventions for child abuse and neglect
362.768 MACD

Macdonald, Geraldine

Family therapy: a systemic integration
616.89156 BECV

Becvar, Dorothy Ströh

Family therapy techniques
616.89156 MINU

Minuchin, Salvador.

Living in the labyrinth:
616.831 FRIE

Friel McGowin, Diana

Mental health: the nutrition
616.891 HOLF

Holford, Patrick.

Patrick Holford's new optimum nutrition of the mind
613.2 HOLF

Holford, Patrick.

Psychopathology and social prejudice
362.20968 PSYC

Hook, Derek

The new optimum nutrition bible
613.2 HOLF

Holford, Patrick.

To be old and sad: understanding
Depression in the elderly
618.9768527 BILL

Billig, Nathan

Understanding abnormal behavior
616.89 SUED

Sue, David.

Understanding child abuse and neglect
362.760973 TOWE

Crosson-Tower, Cynth

Understanding child maltreatment
362.76 SCAN

Scannapieco, Maria.

9

4.3

Electronic Reserves (e-Reserves)

Recommended material can be downloaded from the library’s catalogue at http://oasis.unisa.ac.za. Under search options, click on Course code search and type in your course code, for example, PYC4802. Click on the Electronic reserves for the current year. The recommended articles are available in PDF (portable document format).
Requests for photocopies of journal articles (or extracts from books) must be made on the standardised PERIODICAL REQUEST CARDS. Fully completed request cards should be posted or faxed to the Main Library (fax no. (012) 4298128). Requests in faxed or mailed letters or lists will be referred back to you.
Periodical request cards are available from the Library (tel. +27 12 429 3134).
Photocopies will be sent by air-mail only if request cards are accompanied by the appropriate air-mail postage. See my Studies @ Unisa for tariffs.
Requests for photocopies to be air-mailed may, therefore, not be faxed.

ELECTRONIC RESERVES ARTICLE LIST
PYC4802 2015

First Author

Year

Title

Journal/Publication

Volume

Pages

Sheridan,
Michael J.

(1995)

A proposed intergenerational model of substance abuse, family functioning, and abuse/neglect / Michael J.
Sheridan.

Child Abuse & Neglect

Vol. 19, no. 5

p. 519530.

Alexander,
Pamela C.

1985

A systems theory conceptualization of incest /
Pamela C. Alexander.

Family Process.

Vol. 24, no. 1

p. 79-88.

Makovec, M.R.

2010

Adolescent substance dependency in relation to parental substance (ab)use

Zdrav Var

49

1-10

Flemons,
Douglas G.

1989

An ecosystemic view of family Family therapy. violence / Douglas G.
Flemons

Vol. 16, no. 1

p. 1-10.

Bala, N.

(2007)

An historical perspective on family violence and child abuse: comment on Moloney et al N. Bala

Vol. 14

p. 271278

10

Journal of Family Studies

PYC4802/101

Emery, Robert
E.

1998

An overview of the nature, causes, and consequences of abusive family relationships /
Robert E. Emery and Lisa
Laumann-Billings

American psychologist.

Vol. 53, no. 2

p. 121135.

Phend, C.

(2009)

APA: borderline Personality
Disorder Often Missed First
Time Around / C. Phend

MedPage Today

Vol. 22

p. 1-3

Oldham, J. M.

(2009)

Borderline Personality
Disorder Comes of Age. John
M Oldham

American Journal of
Psychiatry.

Vol. 166, no. 5

p. 509511

Kernberg, O.F.

(2009)

Borderline Personality
Disorder. O.F. Kernberg

American Journal of
Psychiatry.

Vol. 166, no. 5

p. 505508

Hoffman, P.D.

(2007)

Borderline Personality
Disorder: a Most
Misunderstood Illness / P.D.
Hoffman

National Education Alliance for Borderline Personality
Disorder

Winter

p. 1-2

Gunderson,
J.G.

(2009)

Borderline Personality
Disorder: Ontogeny of a
Diagnosis John G
Gunderson.

American Journal of
Psychiatry

Vol. 166, no. 5

p. 530539.

Richter, L.M.

(2008)

Child abuse in South Africa:
Rights and Wrongs. L.M.
Richter

Child Abuse Review .

Vol. 17

p. 79-93

Suprina, J.S.

(2005)

Child abuse, society, and individual psychology: whats power got to do with it? J.S.
Suprina

Journal of Individual
Psychology .-

Vol. 61, no 3

p. 14-23

Krestan, JoAnn.

1990

Codependency : the social reconstruction of female experience / Jo-Ann Krestan and Claudia Bepko.

Smith College Studies in
Social Work

Vol. 60, no. 3

p. 216232.

Knudsen, T.M.

2012

Codependency, perceived interparental conflict, and substance abuse in the family of origin

The American Journal of
Family Therapy

40

245-257

Gregory, V. L.

2010

Cognitive-Behavioural
Therapy for Schizophrenia:
Applications to Social Work
Practice

Social Work in Mental Health

8

140-159.

McQueen, D.

2009

Depression in adults: Some basic facts

Psychoanalytic
Psychotherapy

23(3)

225-235

Maj, M.

2012

Development and validation of the current concept of
Major Depression

Psychopathology

45

135-146

Hill, J.

2009

Developmental perspectives on adult depression

Psychoanalytic
Psychotherapy

23(3)

200-212

11

Keane,
Terence Martin

(1997)

Differentiating post-traumatic stress disorder (PTSD) from major depression (MDD) and generalized anxiety disorder
(GAD) / Terence M. Keane,
Kathryn L. Taylor and Walter
E. Penk.

Journal of anxiety disorders.

Vol. 11, no. 3

p. 317328.

Menard, C.

(2004)

Epidemiology of multiple childhood traumatic events: child abuse, parental psychopathology and other family-level stressors / C.
Menard

Social Psychiatry and
Psychiatric Epidemiology

Vol. 39

p. 857865

Frederick, J.

(2007)

Exploring the relationship between poverty, childhood adversity and child abuse from the perspective of adulthood J. Frederick

Child Abuse Review .

Vol. 16

p. 323341

Sheridan,
Michael J.

1993

Family dynamics and individual characteristics of adult children of alcoholics : an empirical analysis /
Michael J. Sheridan, Robert
G. Green.

Journal of Social Service
Research

Vol. 17, no. 1/2

p. 73-97.

Ponder, F.T.

2009

Family of origin addiction patterns amongst counselling and psychology students

The Forum on Public Policy

Browne,
Dorothy
Howze.

1988

High risk infants and child maltreatment : conceptual and research model for determining factors predictive of child maltreatment /
Dorothy Howze Browne.

Early Child Development and
Care

Vol. 31

p. 43-53.

Milevsy, A.

2007

Maternal and
Paternalparenting styles in adolescents: associations with self-esteem, depression and life-satisfaction A.
Milevsky

Journal of Child and Family
Studies.

Vol. 16
(1)

p. 39 - 47

(1994)

Physical symptoms in posttraumatic stress disorder /
A.C. Mcfarlane ... [et al.]

Journal of psychosomatic research. Vol. 38, no. 7

p. 715726.

Meyer, P. S.

2012

Positive Living: A Pilot Study of Group Positive
Psychotherapy for people with Schizophrenia.

The Journal of Positive
Psychology

7(3)

239-248

De Silva,
Padmal

1993

Post-traumatic stress disorder International Review of
: cross-cultural aspects /
Psychiatry
Padmal de Silva.

Vol. 5

p. 217229.

Nutt, D. (Ed.)

2000.

Post-traumatic Stress
Disorder: Diagnosis,
Management and Treatment /
D. Nutt

12

Post-traumatic Stress
Disorder: Diagnosis,
Management and Treatment
/D. Nutt. Blackwell Science
Inc.USA ,

1-11

p. 147161

PYC4802/101

Averill, Patricia
M.

(2000)

Posttraumatic stress disorder in older adults : a conceptual review / Patricia M. Averill and J. Gayle Beck.

Journal of anxiety disorder.

Rosen, G.M.

2004.

Posttraumatic Stress
Disorder: Issues and controversies / G. M. Rosen

Post-traumatic Stress
Disorder: Issues and controversies /G.M. Rosen
Blackwell Science Inc.USA ,

Christoffersen,
M.N.

(2009)

Prevention of child abuse and neglect and improvements in child development M.N.
Christoffersen

Child Abuse Review .

Vol. 18

p. 24-40

Giel, R.

1990

Psychosocial processes in disasters / R. Giel.

International Journal of
Mental Health

Vol. 19, no. 1

p. 7-20.

Fontao, M. I.

2011

Psychosocial treatment in group format with people diagnosed with schizophrenia: Results and limitations of empirical research. Psychosis: Psychological,
Social and Integrative
Approaches

3(3)

226-234.

Goodman, M.

(2009)

Quieting the Affective Storm of Borderline Personality
Disorder. M. Goodman.

American Journal of
Psychiatry.

Vol. 166, no. 5

p. 522528

Teychenne, M.

2010

Sedentary behavior and depression among adults: A review International Journal of
Behavioral Medicine

17

246-254

Mork, E.

2012

Self-Harm in Patients with
Schizophrenia Spectrum
Disorders

Archives of Suicide Research

16

111-123

Brown, Pamela
J.

(1994)

Substance abuse and posttraumatic stress disorder comorbidity / Pamela J.
Brown and Jessica Wolfe.

Drug and alcohol dependence. Vol. 35

p. 51-59.

Kagee, A.

2010

Symptoms of depression and anxiety among a sample of
South African patients living with HIV

AIDS Care: Psychological and Socio-medical Aspects of
AIDS/HIV

22(2)

159-165

Schumn, J.A.

(2005)

The double-barreled burden of child abuse and current stressful circumstances on adult women: the kindling effect of early traumatic experience / J.A. Schumn

Journal of Traumatic Stress

Vol. 18

p. 467476

The effect of interpersonal touch during childhood on adult attachment and depression: A neglected area of family and developmental psychology? Journal of Child and Family
Studies

19

109-117

Takeuchi, M. S. 2012

Vol. 14, no. 2

p. 133156.

p. 147161

13

Carroll, Joseph
C.

(1977)

Aggressive Behavior
The intergenerational transmission of family violence : the long-term effects of aggressive behavior
/ Joseph C. Carroll.

Vol. 3

p. 289299.

Williams, L.M.

2002

The Seven Ps for fighting depression Journal of Clinical Activities,
Assignments & Handouts in
Psychotherapy Practice

2(1)

51-57

Velleman, R

2007

Understanding and modifying the impact of parents substance misuse on children
/ R. Velleman

Advances in Psychiatric
Treatment

Vol. 13

p. 79-89

Joseph, S.

1997

Understanding PostTraumatic Stress: psychosocial perspective on
PTSD and treatment / S.
Joseph

Understanding PostTraumatic Stress: psychosocial perspective on
PTSD and treatment /S.
Joseph. John Wiley and Sons
Inc.

p. 51-67

Morgan, J.P.

1995

What is Co-dependency / J.
P. Morgan

Journal of Clinical Psychology Vol. 47
(5)

p. 720729

Brookfield, S.

2011

When the Black Dog Barks:
An Autoethnography of Adult
Learning in and on Clinical
Depression

New Directions for Adult and
Continuing Education

132

35-42

Cox, R.B. Jr

2013

Working with couples and substance abuse:
Recommendations for clinical practice The American Journal of
Family Therapy

41

160-172

5.

STUDENT SUPPORT SERVICES FOR THE MODULE

Important information appears in your my Studies @ Unisa brochure. myUnisa What is myUnisa? myUnisa is an Internet facility offered free of charge to all registered Unisa students.
With the aid of this, you will ultimately be able to perform all study-related functions on the Internet. The following functions have been implemented on myUnisa:
•
•
•
•

you can submit written assignments via myUnisa

•
14

you can contact your lecturers via e-mail you can download study material placed on myUnisa you can check whether your assignments have been received and marked

you can look up your assignment or exam marks as soon as they are released PYC4802/101
•

you can join a discussion forum (e.g. to discuss your course with other students doing the same module)

•

you can order books from the library, and search for books on the library database To make use of myUnisa, you will need a computer and an Internet connection, as well as a browser such as Mozilla Firefox, Google Chrome or Internet Explorer.
See my Studies @ Unisa for further information.
UNISA LIBRARY
Unisa Library services information and login
In order to access the library’s online resources and services you will be required to provide your login details, that is, your student number and your myUnisa password.
This will enable you to do the following:
• View or print your electronic course material
• Request library material
• View and renew your library material
• Download, print and study the library’s e-resources
Requesting books from the library
Electronic book requests
The preferred way of requesting recommended or additional books is online via the library’s catalogue.
Go to http://oasis.unisa.ac.za, or via myUnisa, go to http://my.unisa.ac.za > Login > Library > Library catalogue, or for mobile access (AirPAC), go to http://oasis.unisa.ac.za/airpac
Telephonic book requests
This can be done on +27 12 429 3133. Please supply the reservation order number
(RON).
Postal requests
Books may also be requested by completing one library book request card for each book. Request cards are included in your study package. These should be faxed to
+27 12 429 8128, or mailed to:
The Head: Request Services
Department of Library Services
PO Box 392
UNISA 0003

15

Enquiries about requested books should be addressed to bib-circ@unisa.ac.za
Please note: Book requests should not be sent to this email address.
Telephonic enquiries can be made at +27 12 429 3133/3134, and an after-hour voicemail service is also available at these numbers.
Requesting journal articles from the library
Electronic course material / e-Reserves
Recommended material can be downloaded from the library’s catalogue at http://oasis.unisa.ac.za. Under search options, click on Course code search and type in your course code, for example, PYC4802. Click on the Electronic reserves for the current year. The recommended articles are available in PDF (portable document format). The Adobe Reader should be loaded on your computer so that you can view or print scanned PDF documents. This can be done free of charge at http://www.adobe.com.
Additional journal articles
The preferred way of requesting journal articles is online via the library’s catalogue.
Go to http://oasis.unisa.ac.za or via myUnisa, go to http://my.unisa.ac.za > Login > Library > Library catalogue, or for mobile access (AirPAC), go to http://oasis.unisa.ac.za/airpac
Telephonic requests
Telephonic requests can be done at +27 12 429 3133/3134. Please supply the reservation order number (RON) if available.
Postal requests
Journal articles may also be requested by completing an article request card for each item.
These should be mailed to the same address as postal requests above or faxed to
+27 12 429 8128.
Enquiries about requested articles should be addressed to bib-circ@unisa.ac.za, and telephonic enquiries can be made at +27 12 429 3432.
Requesting literature searches from the library
You may request a list of references on your topic from the library’s Information
Search Librarians if you are enrolled for an undergraduate course which has a research essay. To request a literature search, go to the catalogue’s homepage, and click on Request a Literature Search, fill in the form and return it to the address provided. Services offered by the Unisa Library
The my Studies @ Unisa booklet, which is part of your registration package, lists all the services offered by the Unisa Library at http://www.unisa.ac.za/contents/myStudies/docs/myStudies_unisa2012.pdf 16

PYC4802/101

Group discussions
There are no group discussions for this module.

6.

MODULE-SPECIFIC STUDY PLAN

General time management and planning
Use the brochure my Studies @ Unisa for general time management and planning skills. General outline for this module
The honours module in Psychopathology differs from your previous experience of undergraduate studies. It consists of an introduction to a research method approach to studying a small selection of disorders more in-depth than you have done before.
The aim is to do the following:
Explore the five (5) themes by reading and studying all the prescribed and preferably all the recommended literature sources mentioned in this tutorial letter. View the selected disorders in a way that allows you to understand and apply different theoretical perspectives from which the selected disorders can be explained. (These perspectives formed part of your undergraduate studies as part of the abnormal behaviour and mental health and personality theory modules.) Integrate the knowledge from your undergraduate modules with the more in-depth knowledge of your honours modules, and apply your newly synthesised knowledge to the disorders in each theme. (Boundaries between subjects are artificial, and everything you have learnt from the first year modules until now forms part of your repertoire of knowledge that is in the process of becoming wider and deeper with every further application of your intellect in the field of psychology.)
Write about what you have read and studied by applying scholarly methods of presenting your thoughts in the form of a scholarly essay (in Assignment 03) by solving the problems posed in the assignment question.
Should you have forgotten or missed aspects of your psychological foundational training on one or more undergraduate levels, you need to fill the gaps on your own by engaging in extra reading. The short summaries of the different psychological approaches to understanding abnormal behaviour and mental health on pages 22 to
27 in this tutorial letter are an indication of which theories/ modules/ approaches/ perspectives amongst others are used to explain abnormal and normal behaviour.
However, for the purpose of this module, you are required to explain the disorders covered in the five (5) themes from the perspective of the following models:
•
•
•
•

The psychoanalytic and psychodynamic models/approaches/perspectives
The cognitive and behavioural models/approaches/perspectives
The family systems model/approach/perspective
The medical model in the context of the DSM 5 classification system.

17

The five (5) themes we focus on this year form some of the core problem areas in our
African and South African society. Most of these disorders can be prevented, but before we can do so, we need to study diligently what is already known about these disorders, how we can identify them, how we explain them, and how we classify them according to the DSM 5, (which is the short form for The American Psychiatric
Association’s (2013). Diagnostic and Statistical Manual of Mental Disorders (5th
Edition). Washington, DC: American Psychiatric Association.) Ideally we would like you to engage in your own learning by finding recent publications on this year’s themes in order to deepen your understanding even further. That is however not always possible, but certainly something to aspire towards. Reading extensively is however within every individual’s reach; so, let that be your goal – it is the secret habit of every true academic.

7.

MODULE PRACTICAL WORK AND WORK-INTEGRATED
LEARNING

No practical work is required for this module.

8.

ASSESSMENT

Assessment strategy and plan
Three formative assessment tasks (assignments) and one cumulative assessment task (examination) are set for this module spaced over a period of 10 months. Three compulsory assignments need to be submitted for gaining admission to the examination. Assessing assignments
Assignments 1 and 2 consist of multiple choice questions which will be marked by computer. In the case of wrong answers, students are required to re-work the prescribed and recommended literature with the aim of understanding the material better. Assignment 3 consists of an essay that will be marked. Feedback will be provided.
The purpose of the first three formative tasks (assignments) involves the acquisition of new knowledge and the demonstration of your capability to systematically order the new information by making distinctions between the content and process literature, between the general and specific information, and the implicit and explicit outcomes of your literature study by applying your critical thinking skills to the selected literature sources.
The tasks will be structured in such a way that you are required to complete a number of steps that will enable you to acquire new knowledge by studying the literature for every theme, analyse a particular question on a particular theme, compile a profile for a scholarly discussion (table of contents), and comprehensively reply to the question, or solve the problem statement (by writing an essay) within certain limits by relating the new information to the DSM-5 diagnostic criteria for each disorder. 18

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Throughout the essay task, frequent in-text referencing in the latest APA (American
Psychological Association, 6th edition) style of referencing with regard to the literary material, indicates that you are familiar with the literature. A complete reference list of the sources you have consulted, referred to and cited in your essay, needs to be included at the end of the essay, according to the latest APA style of referencing.
Assessing the examination
The cumulative assessment task (examination) consists of a three hour examination at the end of the academic year around October. You are expected to demonstrate your acquired skills with regard to solving problems in the context of critically engaging in psychological discourse, without having to reference your reading list.
The primary lecturers/assessors will know that you are competent when you provide well thought through responses to a number of new, unseen problems/questions during a limited time span of three hours. Four short essays with reference to the year’s selection of themes will be the compulsory requirement for demonstrating your academic competence in psychopathology, based on the selection of prescribed and recommended books, journal articles, and additional material you studied throughout the year. Use the focus points to direct your learning, since the examination questions are often directly or indirectly related to all or some focus points of each theme. A second examiner/assessor reviews your answers to the set questions by checking for consistency in the assessment process. An external examiner/assessor reviews a representative sample of all student answers in conjunction with the marks allocated by the primary lecturers/assessors and the course content.
All assessors are registered with the relevant ETQA.
Supplementary examinations
Students who fail to obtain the required 50% (with a sub-minimum of 40%) for the year are provided with the opportunity to write a supplementary examination in the following year.
8.1

Assessment plan

Admission to the examination
You are required to submit Assignments 01, 02, and 03 in order to obtain admission to the examination.
Mark distribution: Year mark 20% + Examination mark 80% = Final mark 100%
Active student
Assignment 1 counts 100 marks. It records you as an active student.

19

Year mark
Assignment 2 counts 100 marks. 10% of your mark out of 100 contributes to your final mark for the course.
Assignment 3 counts 100 marks. 10% of your mark out of 100 contributes to your final mark for the course.
Examination mark
The examination counts 100 marks. 80% of your examination mark out of 100 contributes to your final mark for the course.
Your final mark consists of your year mark (20% of your results for assignments 2 and 3) plus your examination mark (80% of your results for the examination).
Examination
The format of the examination paper is the same as last year’s examination paper, which can be viewed on myUnisa. Please note that the content has changed. You are required to answer 4 essay questions that can range between 20 and 30 marks each, with a total of 100 marks.
Examination guidelines
You will receive four (4) questions from Themes 2 to 5 (Theme 1: Schizophrenia will not be examined, since you have already received marks in the form of the year mark for the content of that theme in Assignment 03.) Your examination answers should be in essay style, and you do not need to add references.
Your examination answers are assessed by evaluating the following:
•
•
•
•
•

•

20

Did you answer the question comprehensively?
Did you use the recommended literature, and your additional reading to answer the question?
Have you presented the full DSM 5 criteria and integrated them with the recommended journal articles and books?
Have you thought about the information by integrating it meaningfully in your answer? Have you introduced your answer to each question adequately by a brief introduction, which includes necessary definitions of the terms you are using, important diagnostic criteria, and other important details for creating the relevant context for your discussion with regard to answering the question?
Is your conclusion of each essay relevant to and essential for bringing your discussion to a close, by rounding it off with an appropriately placed final conclusive comment?

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Assignment 3 Guidelines
Assignment 03 is assessed according to the same criteria as the examination.
However, you are required to provide a list of references in APA style and cite extensively within your text as you use the thoughts, ideas and conclusions of the people whose articles and books you have consulted. You will receive personalised feedback for Assignment 03. We urge you to engage with this feedback as a part of your examination preparation. The questions in the examination will be similar in kind to the assignment question, and if you are able to construct one answer by following the process for your assignment, you should be able to respond adequately in the examination, provided you have studied the literature, engaged in critical thinking and thoughtfully incorporated the full DSM 5 criteria.
8.2

General assignment numbers

Assignments are numbered consecutively per module from 01 to 03. Each assignment for each module has a unique assignment number listed under 8.2.1.
For this module you are required to submit Assignments 01, 02, and 03 on the dates listed in 8.2.2, together with each assignment’s unique assignment number listed under 8.2.1 for your module code.
8.2.1

Unique assignment numbers

Attach the relevant unique assignment number for your course to each assignment before submitting it.
Unique assignment number for Assignment 01:
PYC4802: 667931
Unique assignment number for Assignment 02:
PYC4802: 668036
Unique Assignment number for Assignment 03:
PYC4802: 668049
8.2.2

Due dates for assignments

Assignment 01:

Closing date 14 April 2015

Assignment 01 consists of 10 multiple-choice questions which count 100 marks.
Examination admission can be earned by handing in Assignment 01, 02, and 03 irrespective of the marks you receive. Unfortunately, no extension can be granted for Assignment 01, since this Assignment serves to record you as an active student.
Assignment 02:

Closing date 12 May 2015

Assignment 02 consists of 10 multiple-choice questions which count 100 marks.
Examination admission can be earned by handing in Assignment 01, 02, and 03
21

irrespective of the marks you receive. Unfortunately, no extension can be granted for Assignment 02.
10% of your marks for Assignment 02 will contribute towards your year mark.
Assignment 03:

Closing date: 17 June 2015

Assignment 03 consists of a comprehensive answer to the question on
Schizophrenia (Length: Twelve pages in Arial, Font size 12, Line spacing 1.5, without counting the cover page, the page of contents, and the reference page, submitted in
PDF format). 10% of your marks for Assignment 03 will contribute towards your year mark. When you receive your marks by SMS, please wait until you have received your assignment with the feedback before you phone or e-mail the lecturer who marked your assignment. (Contact Ms Phuthi for the telephone numbers of the lecturers/markers not listed in this Tutorial Letter.)
NB: Always save and keep a copy of your assignment before making your final submission as this protects your work in the case of loss. Please note that it is your responsibility to keep records of your assignments.
8.3

Submission of assignments

For detailed information and requirements as far as the submission of assignments is concerned, see my Studies @ Unisa, which you received with your tutorial material.

This is the short version for submitting an assignment via myUnisa:
•
Go to myUnisa
•
Log in with your student number and password.
•
Select the module from the orange bar.
•
Click on assignments in the menu on the left-hand side of the screen.
•
Click on the assignment number you want to submit.
•
Follow the instructions
•
If the system is down, do not panic. Stay calm and re-submit your assignment until the system has recovered, even if that means the assignment will be three days late. You will not be penalised for system failures. 22

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8.4

Assignments

ASSIGNMENT 01
Closing date 14 April 2015
Unique Assignment number for PYC4802:

667931

No extension can be granted for this assignment.
Assignment 01 is based on the revision of a small portion of some of your undergraduate modules, in particular Personality Theories, and Abnormal Behaviour and Mental Health. At the end of this section, you will find a list of recommended reading sources you can consult to refresh your memory.
Introduction and orientation
Reflect for a moment on what you consider to be the purpose of studying psychopathology. Very often we are perplexed about people's behaviour. For instance, why does a father kill his whole family and then himself? Some people appear to behave in self-defeating ways by slowly destroying themselves through the abuse of drugs, alcohol or food. What is the basis of such destructive life-styles? Of course there are no hard and fast rules for finding conclusive answers to these questions, but there are many stimulating and thought-provoking theories and views on the nature, origin, and maintenance of abnormal behaviour, and in our study of psychopathology we use them to understand more about the complex nature of problematic human behaviour, including our own.
What follows is a brief outline of the different models of mental illness, each presenting possibilities as well as limitations. Each of the perspectives presents its own unique explanation and identification of abnormal behaviour. In some respects these viewpoints may seem incompatible and in others they overlap. Some are broad enough to encompass most kinds of mental disturbance, while others are more limited in scope. A thorough knowledge of each of these perspectives is, however, essential to understanding abnormal behaviour.
The medical model
Probably the single most influential theoretical perspective on Abnormal Behaviour is the medical model, the influence of which can be seen in the common acceptance of the term “mental illness”. As the name of this model indicates, it approaches mental illness as medical science would approach any other illness. When studying
Abnormal Behaviour, this model typically focuses on underlying physiological defects within the individual. The traditional model of psychopathology emphasises disease and symptomatology in abnormal mental and interpersonal functioning. Other names used for this model include “biochemical”, “psycho-medical” or “psychiatric” model.
The DSM diagnostic system is based on this model.
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The psychodynamic model
The psychodynamic perspective is a collection of theories and therapies united by a common concern with the dynamics (that is, the motivating or driving forces of the mind) and the critical influential role the first years of life play in human development.
This model encompasses Freud's original psychoanalytical views and takes his ideas much further. When studying abnormal behaviour this model typically focuses on the underlying intra-psychic conflicts and maintains, furthermore, that psychological problems in later life can always be traced back to unresolved childhood conflicts.
The cognitive-behavioural models
Historically, the learning-theory approach has confined itself to identifying abnormal behaviour and the mechanisms that underlie them. A recent trend includes a focus on certain patterns of thought, or cognitions that seem to contribute to maladaptive behaviour. This model, also called “learning theory”, emphasises the role of learning, whether it be the simple conditioning of a response to a stimulus (the central theme of behaviourism), or the processing of information in learning (the central theme of the cognitive approach). The cognitive approach emphasises that the way in which people interpret events may be almost as important as the events themselves.
Another trend in this approach is termed social learning theory.
The humanistic-existential models
These perspectives regard human beings as decision-making, reality-creating agents at the centre of their experiential world. The humanistic approach emphasises human positive potential and abilities within their contexts of living, and abnormal behaviour is seen as the result of the fact that these potentials were blocked. The existential approach emphasises the individual's ability or inability to take responsibility or not for their decisions or indecisions, as well as being responsible for their resultant existential anxiety, fear of death and satisfaction or dissatisfaction. The humanisticexistential perspective, however, is optimistic by placing great faith in people's ability to learn to make new choices that will liberate their unique human qualities.
The family systems model
A shift away from the narrow focus of linear thinking has gradually occurred by placing symptomatology in the context of the family. This shift, known as “family systems theory”, gives new meanings to symptoms and so-called abnormal (or deviant) behaviour by recognising the communicative function of symptoms. This model is based on cybernetics (circular thinking). Note that this approach focuses on interaction and the interrelatedness of the parts of a family system.
The family-systems approach sees mental disorders as necessarily involving the network of relationships binding the individual. The abnormality of the individual, in this view, can only be understood in the context of the family system in which it arises. 24

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The ecosystemic model
Ecosystemic thinking embodies a further shift, from so-called “first-order cybernetics" to “second-order cybernetics”, where the focus is no longer on interaction, but on meanings and the co-creation and attribution of meaning within systems.
Ecosystemic thinking acknowledges that philosophical and scientific theories and findings about the nature of humanity are not objective, but are situated within our culture and influence our conceptions of what constitutes adaptive and maladaptive behaviour, or, in other words, what it is to be a person. The ecosystemic approach, like the family systems approach, looks not only at the individual for the meaning of abnormal behaviour but also beyond the individual, to his/her context. The ecosystemic perspective is important in calling attention to the meanings attributed to psychological problems by everyone involved in the particular situation, including the therapist. By working through each of the perspectives pertaining to psychopathology concentrate on the basic tenets (principles/ideas) of each approach.
For example:
The classical medical model emphasises the similarities between psychological disorders and medical diseases and is based on three main assumptions:
• the patient suffers from a disease
• a specific symptom reflects this disease
• each disease has a specific cause.
Diagnosis and classification of symptoms are of prime importance. If a specific syndrome (set of symptoms) can be determined, then there should be a corresponding treatment of a somatic type. The correct treatment is assumed to relieve the symptoms and to restore the patient back to health. Modern thinking of the medical model focuses on biochemistry of brain functioning and indicates that there is interaction of mind and body which produces the maladaptive behaviour.
Another example:
A viewpoint respecting cybernetic epistemology includes the following essential characteristics: •
•
•
•
•
•

an observing system (i.e. the inclusion of the therapist's own context) a collaborative rather than a hierarchical structure goals that emphasise setting a context for change, not specifying a change ways to guard against too much instrumentality a circular assessment of the problem a nonperjorative, nonjudgmental view
(Becvar & Becvar, 2009)

25

Each of the perspectives mentioned above presents with its own unique explanation and identification of abnormal behaviour. Here you need to consider the following:
•

How is abnormality viewed in each model?

For example: The medical model
In the medical model the abnormality is viewed as an organic dysfunction which results in maladaptive behaviour. This view of psychopathology is thus linear, deterministic and reductionistic because human behaviour is considered to be caused by physiological processes existing prior to the behaviour in question, and the influence and effect of interactional processes is, by and large, ignored (except the interview between patient and doctor). In fact, in its extreme form, the medical model considers social and psychological influences as insignificant. Thus, from this theoretical standpoint, for the human being to function normally a biochemical balance must be maintained in the body and brain in conjunction with a particular brain structure. The one who determines this normality is the expert - the objective, neutral and value-free specialist in his/her field. The subjective views of the personin-the-street have no significance and s/he is thus not directly involved in the diagnostic process.
For example: The family-systems approach
The family-systems approach sees mental disorders as necessarily involving the network of relationships around the individual. The abnormality of the individual, in this view, can only be understood in the context of the family system in which it arises. In order to understand the way in which the family-systems approach differs from and/or resembles other theoretical orientations, you need to consider that this process does not refer to a group of similar theories but to the epistemological base they share. Here, for instance, you may want to consider issues such as:
•
•
•
•
•
•
•
•
•

biological versus psychological processes intrapsychic versus interpsychic processes innate versus learned causes holism versus reductionism [atomism] empirical reality versus subjective reality context versus individual linear versus circular causality seat of responsibility the role of the diagnostician/therapist.

Linear versus circular causality, for example, has to do with the direction of cause,
NOT with the number of causes as some literature sources indicate. Linear causality means that a particular cause (or more than one cause in combination) leads to a specific effect (e.g. a virus causes an illness). Circular causality means that two (or more) elements reciprocally cause each other (e.g. a virus in the body creates
26

PYC4802/101 extreme pain and discomfort which can be interpreted as laziness by ignorant others, or diagnosed as an infection by those who have insight. Such an interpretation or diagnosis can affect the patient’s life in terms of demonstrating depressive symptoms and feelings of being misunderstood/misdiagnosed or taking charge of their health for assisting in the healing process. These feelings or positive actions are then fed back into the system by reciprocally changing the patient by either confirming unfounded judgements by others through continuing depression or by recuperating and rejecting those who made unfounded judgements due to a lack of knowledge or insight.)
For example: The humanistic-existential perspective
The humanistic-existential perspective does not see abnormal behaviour as the result of organic dysfunction, childhood trauma or inappropriate learning, but as a linear consequence of conditional regard from others, especially during the developmental years. The humanistic-existential model differs from the others in the importance it assigns to individual responsibility. Human beings are seen as born with an innate tendency to actualise themselves and often problems can be linearly traced to poor choices. The humanistic-existential perspective is optimistic by placing great faith in people's ability to learn to make new choices that will liberate their unique human qualities.
With its emphasis on the importance of each individual's experience of the world, this perspective necessarily lacks a precise, universal theory and rejects the idea that a single set of psychological formulas can be applied to all people. It emphasises the positive rather than the negative (such as people's capacity to change and to make new choices) rather than only focusing on the immediate problems they are experiencing. The limitations and specific contributions of each model to the understanding of what it means to be human.
For example: The medial model
The medical model has done much to elevate the position of the mentally disturbed in our society. The contention that mentally disturbed people are ill, rather than possessed by demons or punished by gods, serves to focus attention on the fact that these people need help, humane care and treatment.
Like the psychodynamic, cognitive-behavioural and humanistic-existential approaches, the medical model places the origin of psychological abnormality primarily within the individual’s body and brain. Unlike the psychodynamic and humanistic-existential approaches, the medical model regards the individual's subjective experience (e.g. hallucinations, feelings of despondency) only as symptoms with regard to diagnosis. The general focus on observable behavioural symptoms of abnormality is shared by the medical and cognitive-behavioural approaches. The medical model has been criticised for reducing a person to the status of an object, not capable of intentional thought and action, resulting in the dehumanisation of people. By understanding the aetiology of abnormality as within the individual, this model contrasts with the family systems and ecosystemic

27

approaches as it only considers the impact of social or cultural contexts on individual pathology in a linear way, as for example in the diathesis-stress view.
Psychopathology cannot be divorced from mental health, which explains why strong emphasis is currently being placed on attempts to prevent psychopathology and abnormal behaviour. From the basic assumptions you have gleaned from the study of each model, formulate how each perspective views mental health. It is also important to examine current generally-accepted notions of mental health.
For example: The humanistic-existential paradigm
Within the humanist-existential paradigm individual psychological health is understood to include the fostering of satisfying relationships and a socially constructive way of life. Thus, through the concept of self-actualisation, the humanistic-existential perspective displays an understanding of the individual as functioning within a broader context. This displays a similarity with the family-systems approach in understanding people.
Another example
Davison and Neale (1990) discuss several popularly used general definitions of abnormal behaviour such as the following:
•
•
•
•

it is behaviour which is statistically infrequent it is a state which involves personal suffering it is behaviour which creates disability it is behaviour which violates social norms and causes observer discomfort.

And another example
Rosenhan and Seligman (1995), also from a general perspective, suggest that mental health is a transient, relative state of optimal living which normal people experience at different levels at different times. Any relevant understanding of mental health must take into account the fact that the specific meaning of mental health is borne of a particular context and is thus related to prevailing ideologies. A definition which perhaps partially fulfils this requirement is one which states that:
Mental health refers to those conditions in a society leading to a situation where people in their individual capacities and in interaction with one another as members of groups and communities, are able to live lives of quality in all contexts of their existence, and where the option for actualising their potential are present (Report by the Council Committee: Mental Health, 1989).
For example
Considering Jahoda's six criteria for mental health add depth to the Council
Committee's definition and also provides a context for developing a definition of abnormal behaviour:
•
28

the attitude of the individual toward him-/herself

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•
•
•
•
•

the nature of an individual's personal growth and self-actualisation the degree to which an individual exhibits integration of personality the degree of autonomy or self-determination an individual exhibits the degree to which, what the individual sees corresponds to what is actually there the degree to which an individual exhibits environmental mastery.

These criteria explain mental health in terms of degree and dimensions. Thus an individual may exhibit little mental illness along one dimension, much disturbance along another dimension and may function normally along yet another.
Additional reading
Books
Barlow, D.H., & Durand, V.M. (2009). Abnormal psychology: An integrative approach. (5th ed.). Belmont: Wadsworth/Cengage Learning. (Chapters 1 to 3)
Becvar, D.S., & Becvar, R.J. (2006 or 2009). Family therapy: A systemic integration
(6th ed. or 7th ed.). Boston: Allyn & Bacon.
Davison, G.C. (2004, 2007, or 2011). Abnormal psychology (9th ed., 10th ed., or 11th ed.) Hoboken NJ: Wiley.
Hook, D., & Eagle, G. (2002). Psychopathology and social prejudice. Cape Town:
University of Cape Town Press.
Nolen-Hoeksema, S. (2008). Abnormal Psychology (4th ed.). New York: McGraw-Hill.
Any child and adult developmental psychology book.
Any personality theory book.
Journal articles
Bateson, G. (1971). A systems approach. International Journal of Psychiatry, 9, 242244.
Cottone, R.R. (1989). Defining the psychomedical and systemic paradigms in marital and family therapy. Journal of Marital and Family Therapy, 15(3), 225-235.
Aim of Assignment 01
Awakening your awareness to important aspects of your undergraduate studies that have a bearing on the honours module in Psychopathology.
Recall the information from your undergraduate studies, or study the books and articles mentioned above and do the following:

29

Answer the following 10 questions by using the mark-reading sheet you should have received with your study material. Attach the unique assignment numbers for PYC4802 and submit your answers as Assignment 01.
1.

Circular causality means
(1)
(2)
(3)
(4)

2.

A psychologist who believes that people’s behaviour is pre-determined and views human beings as having no freedom of choice might be using the … model of psychopathology
(1)
(2)
(3)
(4)

3.

biological psychodynamic humanistic
1 and 2

A psychologist who believes that abnormal behaviour can be eliminated by making the client aware of the underlying intrapsychic processes is using the … model
(1)
(2)
(3)
(4)

4.

A causes B and B causes C
A causes B and C causes B
A and B together cause C
A causes B and B causes A

biochemical behaviourist psychoanalytic humanistic The medical model focuses on …
(1)
(2)
(3)
(4)

intrapsychic conflicts underlying physiological defects the driving forces of the mind the communicative function of symptoms

5.

Identify the statement which is NOT true with regard to the integrative approach. (1)

The integration of psychological theories leads to a better understanding of psychopathology. Both abnormal and normal behaviour are the product of a continual interaction of psychological, biological and social influences.
Our thoughts, feelings and actions can influence the structure and function of our brain.
Explanations of psychopathology need to include multidimensional, integrative and reciprocal influences.

(2)
(3)
(4)

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6.

The structure of the mind is the locus for explaining abnormal behaviour by the....
(1)
(2)
(3)
(4)

7.

From a cognitive perspective abnormal behaviour can be explained as...
(1)
(2)
(3)
(4)

8.

the subjective experiences of conditioning. a need for restructuring social relations. a neglect of the inner determinants of behaviour. the result of maladaptive thinking.

Which one of the following statements is an aspect of labelling people’s impairment in cognitive or behavioural functioning?
(1)
(2)
(3)
(4)

9.

Freudians
Humanistic-existentialists
Neuroscientists
Family systems therapists

A deviation from normal behaviour is evidence of a psychological disorder. The spastic is booked for a brain scan and mental status exam tomorrow.
Abnormal behaviour is the result of poor ego defence mechanisms.
Personal discomfort signals the presence of a psychological disorder.

The diagnostic report states: “The patient was oriented to time and place, showed appropriate affect, and could do simple calculations. Short and long-term memory were intact.” The health professional has conducted . .
..
(1)
(2)
(3)
(4)

A mental status exam.
Psycho-physiological testing.
Projective testing.
A reliability evaluation.

10. Which research study/studies focuses/focus on the interaction between the environment and genetics in the development of psychological disorders? (1)
(2)
(3)
(4)

Adoption studies.
Family studies.
Genetic linkage analysis.
All of the above.
End of Assignment 01

Submit your answers to assignment 01 not later than the 14th April 2015, since no extension can be granted for this assignment.

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ASSIGNMENT 02:
Closing date 12 May 2015
Unique Assignment number for PYC4802:

668036

10% of your mark contributes towards the year mark.

Assignment 02 is based on your prescribed book, chapter 3:
Burke, A. (Ed.). (2012). Abnormal Psychology: A South African Perspective (2nd ed.).
Cape Town, South Africa: Oxford University Press Southern Africa.
In order to do this assignment you are required to familiarise yourself with a different view on mental health, mental wellness and abnormal psychology. Study the entire
Chapter 3: Abnormal Psychology from a Mental Wellness Perspective and answer the following 10 questions.
1.

Which of the following statement(s) are true when approaching abnormal psychology from a psychological well-being perspective?
(a)

It utilises a strength-based approach to pathology and dysfunction at the individual and community level.

(b)

It utilises a problem orientated approach to pathology and dysfunction at the individual and community level.

(c)

Adaptive and maladaptive psychological functioning are acquired and maintained through the same process, but differ in degree rather than in quality. (d)

Adaptive and maladaptive psychological functioning progress along two distinct process continuums, the intersection of which, determines the severity of pathology experienced and exhibited.

Choose the correct alternative:
(1) a and c
(2)
(3)

b and c

(4)

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a and d

b and d

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2.

Ryff (Ryff and Keyes, 1995) lists the six basic elements to positive functioning as:
(1)
(2)

Self- acceptance, purpose in life, autonomy, positive relations with others, environmental mastery, personal growth

(3)

Self-acceptance, personal growth, maturity, balance, self- transcendence, self- actualisation

(4)
3.

Maturity, balance, productivity, purpose in life, self- acceptance, autonomy

Creativity, citizenship, self- regulation, kindness, maturity, purpose in life.

Hedonic well-being . . .
(a)
(b)

is characterised by meaning, purpose, and the realisation of one’s potential. relates to subjective experiences of pleasure and life satisfaction.

(c)

focuses mainly on optimal functioning in terms of individual fulfilment.

(d)

is focused on the concept of happiness.

Choose the correct alternative:
(1) a and b
(2) b and c
(3) b and d
(4) All of the above
4.

Keyes (1998) . . .
(a)
(b)

argues for the study of optimal social functioning of individuals in terms of their social engagement and societal embededness. provides a conceptual analysis of social well-being that consists of five dimensions i.e. social coherence, social awareness, social conceptualisation, social actualisation and social integration.

(c)

proposes that well-being may be defined along the continuums of eudaimonic and social well-being.

(d)

identified a psychological well-being factor consisting of satisfaction with life, positive affect balance and a sense of coherence.
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Choose the correct alternative:
(1)

a, b and c

(2) a only
(3)
(4)
5.

d only
All of the above

According to Westerhof and Keyes’s (2010) . . .
(a)

mental health is viewed along a mental health continuum as a complete state consisting of the presence and/or absence of mental illness and mental health symptoms.

(b)

mental Health is described along a two-continuum model where one continuum indicates the presence or absence of mental health, and the other shows the presence or absence of mental illness.

(c)

the four levels of well-being identified along the mental health continuum are flourishing, anguishing, lamenting and floundering.

(d)

the four levels of well-being identified along the mental health continuum are flourishing, languishing, struggling and floundering.

Choose the correct alternative:
(1)
(2)

a and d

(3)

b and c

(4)
6.

a and c

b and d

According to Keyes and Lopez (2005), an individual who exhibits low levels of mental health and high levels of mental illness is categorised as .
(1) floundering
(2) anguishing
(3) struggling
(4) languishing

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7.

The Values in Action classification system . . .
(a) identifies ways of doing well.
(b) identifies ways of doing poorly.
(c) categorises and describes 24 characteristic strengths with reference to six broad virtue classes i.e. wisdom, courage, humanity, justice, temperance, transcendence. (d) categorises chauvinism as an exaggeration on the virtue justice.
Choose the correct alternative:
(1)
(2)

b only

(3)

None of the above

(4)
8.

a and c

All of the above

Mindfulness . . .
(a)

is a cognitive strength protecting against mental illness.

(b)

allows openness and flexibility in interpreting the world around us.

(c)

includes qualities like non-judging, non-striving and patience.

(d)

helps deal with uncertainty as it helps the individual to accept that things change and that change need not be feared.

Choose the correct alternative:
(1)
(2)

b only

(3)

c only

(4)
9.

a only

All of the above

According to Maes and Karoly (2005), self-regulation . . .
(1) involves the ability to monitor one’s own other’s feelings and emotions, to discriminate among them and to use the information to guides one’s thinking and actions.
35

(2) is a systematic process of human behaviour that involves setting personal goals and steering behaviour toward the achievement of established goals.
(3) is directed towards regulating emotional responses to problems.
(4) involves the use of realistic strategies that could make a tangible difference in the situation that causes stress.
10. Well-being therapy . . .
(a) is a well-established long-term psychotherapeutic strategy based on Ryff’s model of psychological well-being.
(b) is based on the premise that an increase in psychological well-being may have a protective effect in terms of vulnerability to chronic and acute life stresses. (c) may involve a structured, directive psychotherapeutic strategy aimed at directing a client towards self-direction as guided by one’s own socially accepted internal standards.
(d) promotes emotion-focused, problem-focused and avoidance strategies to self-autonomy. Choose the correct alternative:
(1)

a and b

(2)

b and c

(3)

c and d

(4)

All of the above
End of Assignment 02

Submit your Assignment 02 answers not later than the 12th May 2015, since no extension can be granted for this assignment.

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PYC4802/101

ASSIGNMENT 03:
Closing date 17 June 2015
Unique Assignment number for PYC4802:

668049

10% of your mark contributes towards the year mark

THEME 01
Schizophrenia Spectrum and Other Psychotic Disorders
Schizophrenia
Introduction
Schizophrenia is one of the most prevalent psychiatric and psychological disorders amongst those suffering from mental illness both nationally and internationally. In addition Schizophrenia poses many challenges that range from treatment issues, cost of long-term care and medication to the individual afflicted by the disorder suffering severe psychological difficulties and challenges. Family guidance and psycho-education pertaining to this disorder is also a very important aspect to consider when dealing with the disorder. With this in mind the inclusion of this disorder for this module is highly appropriate. This theme’s structure and contents will guide you towards a better understanding of the disorder in addition to equipping you with the necessary knowledge on aspects of the disorder such as the diagnostic criteria, hallmark features and different types of Schizophrenia. You are expected to familiarise yourself fully with the content of this theme in addition to adding to your knowledge and understanding of the disorder by doing further reading that will further your knowledge on Schizophrenia, as this will put you in a position to not only complete the various learning activities and answer the assignment question, but also to be more fully knowledgeable and versant on the disorder as a whole.
Description
The aim of this learning opportunity is to guide you through the main / important aspects of Schizophrenia. The sub-themes mentioned above will form the basic structure and/or path that you will follow in order to reach an understanding of the complex disorder Schizophrenia in our society today. Schizophrenia is a difficult and challenging disorder for those who suffer from it and the family members living with the individual who suffers from Schizophrenia. In addition Schizophrenia can present

37

with unique difficulties for professional individuals, such as psychiatrists and psychologists who attempt to treat this psychotic disorder.
In working through the course material, you will gain specific knowledge in addition to a better understanding of Schizophrenia as part of the psychotic spectrum disorders.
Assessment Criteria
You will have sufficient knowledge of Schizophrenia if you display adequate knowledge of the following:
01

A Definition of Schizophrenia

02

The complete DSM 5 Diagnostic Criteria of Schizophrenia

03

The Clinical Picture of Schizophrenia

Method
In this theme we will consider the complex psychotic spectrum disorder of
Schizophrenia. You will be guided through the information systematically. Activities
01 to 04 build upon one another and it is important that you complete every activity and master the information contained in each Activity before proceeding to the next one. However, you may also need to revise completed activities and elaborate on the content of previously completed activities, thereby ensuring a dynamic, consistent and continuous engagement with the learning material.
1)

Introduction to Activity 01:

Schizophrenia is defined as a severe psychotic illness characterised by an array of diverse symptoms including extreme oddities in perception, thinking, action, sense of self and the manner in which the self relates to others. The hallmark characteristic of
Schizophrenia is a significant loss of contact with reality, referred to as psychosis. In addition the disorder is characterised by hallucinations most often auditory and/or visual hallucinations (seeing or hearing things that others cannot see or hear, in essence a sensory experience very real for the sufferer in the absence of any real external perceptual stimuli), delusions (a fixed, false belief held by the sufferer despite clear evidence to the contrary), apathy and indifference, withdrawal behaviour in addition to an incapacity to work and attend to tasks of daily living, disorganised speech, disorganised or catatonic behaviour and positive and negative symptomatology. These will be discussed further in Activity 03 below.
The section above was adapted from:
Butcher, J. N., Mineka, S. & Hooley, J. M. (2010). Abnormal Psychology. (14th ed.).
Boston: Allyn & Bacon

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Activity 01: A Definition of Schizophrenia
Compile an adequate and comprehensive definition of Schizophrenia
Use your prescribed book Chapter 6 as a resource:
Burke, A. (Ed.). (2012). Abnormal Psychology: A South African Perspective (2nd ed.).
Cape Town, South Africa: Oxford University Press Southern Africa. (Chapter 6)
2)

Introduction to Activity 02:

The DSM 5 (APA,2013) identifies the following diagnostic criteria for Schizophrenia:
Diagnostic diagnostic criteria for Schizophrenia
DSM 5 criteria for Major Depressive Disorder

(APA, 2013, pp.160-162)
(APA, 2013, p.99)

Two (or more) of the following, each present for a significant portion of time during a 1-month period (or less if successfully treated). At least one of these must be (1), (2), or (3):
1.

Delusions

2.

Hallucinations

3.

Disorganized speech (e.g., frequent derailment or incoherence)

4.

Grossly disorganized or catatonic behavior

5.

Negative symptoms ( i.e., diminished emotional expression or avolition

For a significant portion of the time since the onset of the disturbance, level of functioning in one or more major areas, such as work, interpersonal relations, or self-care, is markedly below the level achieved prior to the onset (or when the onset is in childhood or adolescence, there is failure to achieve the expected level of interpersonal, academic, or occupational functioning).
Continuous signs of the disturbance persist for at least 6 months. This 6-month period must include at least 1 month of symptoms (or less if successfully treated) that meet Criterion A (i.e., active-phase symptoms) and may include periods of prodromal or residual symptoms. During these prodromal or residual periods, the signs of the disturbance may be manifested by only negative symptoms or by two or more symptoms listed in Criterion A present in an attenuated form (e.g., odd beliefs, unusual perceptual experiences).

39

Schizoaffective disorder and depressive or bipolar disorder with psychotic features have been ruled out because either 1) no major depressive or manic episodes have occurred concurrently with the active-phase symptoms, or 2) if mood episodes have occurred during active-phase symptoms, they have been present for a minority of the total duration of the active and residual periods of the illness.
The disturbance is not attributable to the physiological effects of a substance
(e.g., a drug of abuse, a medication) or another medical condition.
F. If there is a history of autistic spectrum disorder or a communication disorder

of childhood onset, the additional diagnosis of schizophrenia is made only if prominent delusions or hallucinations, in addition to the other required symptoms of schizophrenia, are also present for at least 1 month (or less if successfully treated). (APA, 2013, p.99)
Activity 02: The Diagnostic Criteria of Schizophrenia
Provide the full diagnostic criteria for Schizophrenia (learn them well)
3)

Introduction to Activity 03:

The clinical picture of Schizophrenia follows roughly the same description as the diagnostic criteria as per the DSM 5 as noted in Activity 02. In addition it is important to note the main or hallmark features of the disorder, namely:
Hallucinations: a sensory experience that seems real to the person having it but that occurs in the absence of any real external stimuli. Hallucinations can occur in any sensory modality – auditory (pertaining to hearing), visual (pertaining to sight / seeing), olfactory (pertaining to the sense of smell or the act of smelling), tactile
(pertaining or relating to touch), or gustatory (pertaining to the sense of taste). Of these auditory hallucinations is by far the most common occurrence in individuals with Schizophrenia who suffers from hallucinations. Hallucinations often have relevance to the individual sufferer at some affective, conceptual or behavioural level and those individuals can become emotionally involved in their hallucinations, often incorporating them into their delusions. In some cases individual sufferers can act on their hallucinations and do what the voices tell them to do.
Delusions: a fixed false belief erroneously held by the individual who suffers from
Schizophrenia despite clear contradictory evidence. Individuals who suffer from delusions believe things that other individuals who share their social, religious and cultural backgrounds do not believe. Delusions involve a disturbance in the content of thought. Although delusions are common in Schizophrenia it is important to
40

PYC4802/101 remember that not all individuals who have delusions necessarily suffer from
Schizophrenia. Certain types of delusions or false beliefs are quite characteristic in
Schizophrenia, and these include the beliefs that one’s thoughts, feelings or actions are being controlled by external agents, that one’s private thoughts are being broadcast indiscriminately to others, that thoughts are being inserted into one’s mind by some external agent, or that some external agent has robbed one of one’s thoughts. Delusions of reference, where some neutral environmental event such as a television programme or a radio broadcast is believed to have special and personal meaning intended only for the individual sufferer, is also a common occurrence.
Individuals with delusions can also believe that they have odd or strange bodily changes or that their organs are removed when it is not so.
Disorganised Speech: Disorganised speech is the external manifestation of a disorder in the form of thought. Sufferers often fail to make sense despite seemingly conforming to the semantic and syntactic rules that governs verbal communication.
This failure is not due to low intellectual functioning, poor education or cultural deprivation. The words used or word combinations sound communicative, but the listener is left with little or no understanding of what the sufferer said. Sufferers can make up words (neologisms), they can derail (losing their train of thought), associations made can be loose (loosening of associations) and in the extreme form disorganised speech can lead to total incoherence.
Disorganised or Catatonic Behaviour: Goal directed behaviour is almost universally disrupted or lost in Schizophrenia. The impairment occurs in areas of daily living / functioning, such as work, social relations and self-care to the extent that others note that the sufferer is not him- / herself anymore. Personal hygiene might not be maintained and a profound disregard for personal safety and health might be evident. Grossly disorganised behaviour can also manifest in silliness or unusual dress sense. Catatonia is an even more striking behavioural disturbance where the sufferer may show virtual absence of all movement or speech in what is referred to as a catatonic stupor. At other times the sufferer might hold an unusual posture for an extended period of time without noticeable discomfort.
Positive and Negative Symptoms: Positive symptoms are those symptoms in which an excess or distortion of normal behavioural and experiential repertoire is evident, such as hallucinations and delusions. Negative Symptoms reflect an absence or deficit in behaviours that are normally present, including flat or blunted emotional expressiveness, alogia (very little speech) and avolition (no ability to engage and maintain goal-directed activities). Although many sufferers display both positive and negative symptoms during the course of the disorder, a preponderance of negative symptoms in the clinical picture of the individual with Schizophrenia is not a good sign of the sufferer’s prognosis (future outcome). The section above was adapted from:
Butcher, J. N., Mineka, S. & Hooley, J. M. (2010). Abnormal Psychology. (14th ed.). Boston: Allyn & Bacon
41

Activity 03: The Clinical Picture of Schizophrenia
Provide the Clinical Picture of Schizophrenia
Use chapter 6 of your prescribed book as a resource:
Burke, A. (Ed.). (2012). Abnormal Psychology: A South African Perspective (2nd ed.). Cape Town, South Africa: Oxford University Press Southern Africa.
Study
You are now ready to study the articles below in order to gather enough relevant information that assists you in critically thinking about your selection of information in order to compile an answer to the question for assignment 03. Use the chapter on
Schizophrenia as well as the wellness chapter in your prescribed book as an essential point of departure for preparing and structuring your essay.
Prescribed Reading
Book
Burke, A. (Ed.). (2012). Abnormal Psychology: A South African Perspective (2nd ed.).
Cape Town, South Africa: Oxford University Press Southern Africa.
Articles (download and study these from the list of e-Reserves)
Fontao, M. & Hoffmann, K. (2011). Psychosocial Treatment in Group Format with
People Diagnosed with Schizophrenia: Results and limitations of empirical research. Psychosis: Psychological, Social and Integrative Approaches, 3(3), 226234.
Gregory, V. L. (2010). Cognitive-Behavioural Therapy for Schizophrenia: Applications to Social Work Practice. Social Work in Mental Health, 8, 140-159.
Meyer, P. S., Johnson, D. P., Parks, A., Iwanki, C. & Penn, D. L. (2012). Positive
Living: A Pilot Study of Group Positive Psychotherapy for people with
Schizophrenia. The Journal of Positive Psychology, 7(3), 239-248.
Mork, E., Mehlum, L., Barrett, E., Agartz, I., Harkavy-Friedman, J. M., Lorentz, S.,
Melle, I., Andreassen, O. A. & Walby, F. A. (2012). Self-Harm in Patients with
Schizophrenia Spectrum Disorders. Archives of Suicide Research, 16, 111-123.
Additional Reading
Books
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of
Mental Disorders: Fifth Edition (DSM-5). Arlington VA: American Psychiatric
Association

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Butcher, J. N., Mineka, S. & Hooley, J. M. (2010). Abnormal Psychology. (14th ed.).
Boston: Allyn & Bacon.
Sadock, B. J. & Sadock, V. A. (2004). Kaplan & Sadock’s Synopsis of Psychiatry. (9th ed.). Philadelphia: Lippincott Williams & Wilkins.
Question for Assignment 03: Schizophrenia
Critically discuss how people who have been diagnosed with Schizophrenia are able to live positively with their disorder.
(12-15 pages content in addition to a Title page, Table of Contents and
Reference list.)
HOT TIP:
Analyse the question before you begin to structure your discussion by making use of relevant headings according to your analysis of the question.
The focus throughout your final writing process should be the question you are required to answer by thinking about whether what you have learnt/read is or could be feasible under which conditions and why, and which is not feasible under which conditions and why.
A comprehensive presentation of the literature you have consulted is not considered to be a critical discussion - it is only the preliminary conscious making of the information you will need in order to think critically about the literature you have consulted in relation to your analysis of the question.
[Total: 100 Marks]

Please submit your Assignment 03 in PDF format with the Plagiarism
Declaration on the next page. Take your time and take care in submitting your assignment with all the correct codes and numbers in the prescribed spaces.

43

Plagiarism is the act of taking words, ideas and thoughts of others and passing them off as your own. It is a form of theft which involves a number of dishonest academic activities.
The Disciplinary Code for Students is given to all students at registration.
You are advised to study the Code, especially Sections 2.1.13 and
2.1.14 (pp. 3-4). Kindly read the University’s Policy on Copyright
Infringement and Plagiarism as well.
Please cut out and include the declaration below on the cover page of your Assignment 3

44

PY
YC4802/10
01

PLAGIARISM DEC
CLARATION
N

1.

I know that pla agiarism is wrong. Pl s lagiarism is using another’s work s and pretending that it is on g ne’s own w work. 2.

I hav used the American Psycholog ve e n gical Assoc ciation (APA as the
A)
conv vention fo citation and re or n eferencing. Each significant cont tribution to, and quota ation in, this assignment from the work, or s work of other people has been attri ks s ibuted and has been c cited and referenced. 3.

This assignmen is my ow work. s nt wn 4.

I have not allo owed, and w not allo anyone to copy m work wit will ow, e my th the i intention of passing it off as his or her own w f o work. 5.

I ac cknowledge that copy e ying someo one else's assignmen or part of nt, it, is wrong, and declare th this ass d hat signment is my own wo ork URE: _____
__________
_________
_____
SIGNATU

__________
_______
DATE: __

End of Assignment 03

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9.

OTHER ASSESSMENT METHODS

There are no other assessment methods for this module.

10.

EXAMINATION

Use the my Studies @ Unisa brochure for general examination guidelines and examination preparation guidelines.
Examination admission
To qualify for examination admission, you are required to submit Assignments 01,
02, and 03 irrespective of the marks you obtain. Assignments must be submitted on their particular closing dates. However, we urge you to try and submit your assignments before the due date in order to avoid possible system problems that may result in student-panic-attacks and stress-related-confusion.
Study
Themes 02 to 05 consist of your examination curriculum that you are required to study on your own. Apply the same process you have learnt for preparing assignments 03, or use your own process.

THEME 02
Trauma and Stressor Related Disorders
Acute and Posttraumatic Stress Disorders
Introduction to the theme
The relationship between illness and stress is embedded in complex mutual interactions between biological, psychological, social, and socio-cultural factors, and although stressor-related effects have always been present, there was no stressorrelated category name in the DSM until now. In the past, Acute and Posttraumatic
Stress Disorders were categorized as Anxiety Disorders in the DSM-IV-TR until the end of 2012. However, since the inception of the DSM-5 in May 2013, a new DSM-5 category, Trauma- and Stressor-Related Disorders, has become the officially recognized diagnostic category for the following two childhood disorders - Reactive
Attachment Disorder and Disinhibited Social Engagement Disorder - and three childhood/adulthood disorders - Acute Stress Disorder, Posttraumatic Stress
Disorder and Adjustment Disorders.

47

Focus
This module will specifically focus on the following:
1.
2.
3.
4.

DSM-5 Diagnostic Criteria of Acute Stress Disorder
DSM-5 Diagnostic Criteria of Posttraumatic Stress Disorder
Causative Factors (Aetiology)
Impact of these disorders on human functioning.

The presence of psychological distress which usually follows the exposure to such a traumatic or stressful event typically manifests as symptoms of anhedonia (loss of experiencing pleasure), dysphoria (a state of feeling sad, unwell or unhappy), externalising angry and aggressive symptoms, or dissociative symptoms, in addition to the typical presence of anxiety- and fear-based symptoms. This combination of anxiety, dissociative, depressive, aggressive, angry, and fear based symptoms has therefore baffled clinicians for many years, and stress and trauma related disorders were thus relegated to a wide spectrum of different DSM categories. This heterogeneous group of symptoms has also been recognised in the Adjustment
Disorders, Reactive Attachment Disorder and Disinhibited Social Engagement
Disorder. In the case of Reactive Attachment Disorder and Disinhibited Social
Engagement Disorder, social neglect was found to be the common etiological foundation for traumatic experiences in children below the age of 5. Social neglect of children can lead to either internalising, depressive, withdrawn behaviour, as depicted in Reactive Attachment Disorder, or Disinhibiting and Externalising behaviour, as depicted in Disinhibited Social Engagement Disorder.
Outcomes
When you have studied the DSM-5 diagnostic criteria for Acute Stress Disorder and for Posttraumatic Stress Disorder below you should be able to do the following: •
•
•
•
•

48

define Acute Stress Disorder define Posttraumatic Stress Disorder identify individuals who are suffering from Acute Stress Disorder identify individuals who are suffering from Posttraumatic Stress Disorder know the DSM 5 diagnostic criteria for Acute and Posttraumatic Stress
Disorder

PYC4802/101

DSM-5 diagnostic criteria for Acute Stress Disorder
(APA, 2013, pp. 280-281)

A.

Exposure to actual or threatened death, serious injury, or sexual violation in one
(or more) of the following ways:
1. Directly experiencing the traumatic event(s).
2. Witnessing in person the event(s) as it occurred to others.
3. Learning that the traumatic event(s) occurred to a close family member or close friend. In cases of actual or threatened death of a family member or friend, the event(s) must have been violent or accidental.
4. Experiencing repeated or extreme exposure to aversive details of the traumatic event(s) (e.g., first responders collecting human remains; police officers repeatedly exposed to details of child abuse).

Note: Criterion A4 does not apply to exposure through electronic media, television, movies, or pictures, unless this exposure is work related.
B.

Presence of nine (or more) of the following symptoms from any of the five categories of intrusion, negative mood, dissociation, avoidance, and arousal, beginning or worsening after the traumatic event(s) occurred:
Intrusion Symptoms
1. Recurrent, involuntary, and intrusive distressing memories of the traumatic events.
Note: In children repetitive play may occur in which themes or aspects of the traumatic event(s) are expressed.
2. Recurrent distressing dreams in which the content and/or affect of the dream are related to the traumatic event(s).
Note: In children, there may be frightening dreams without recognizable content. 3. Dissociative reactions (e.g., flashbacks) in which the individual feels or acts as if the traumatic event(s) were recurring. (Such reactions may occur on a continuum, with the most extreme expression being a complete loss of awareness of present surroundings.)
Note: In children, trauma-specific reenactment may occur in play.
4. Intense or prolonged psychological distress or marked physiological reactions in response to internal or external cues that symbolize or esemble an aspect of the traumatic event(s).
Negative Mood
5. Persistent inability to experience positive emotions (e.g., inability to experience happiness, satisfaction, or loving feelings).
Dissociative Symptoms
6. An altered sense of reality of one’s surroundings or oneself (e.g., seeing oneself from another’s perspective, being in a daze, time slowing).
7. Inability to remember an important aspect of the traumatic event(s) typically due to dissociative amnesia and not to other factors such as head injury, alcohol, or drugs).
Avoidance Symptoms
8. Efforts to avoid distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s).
49

9.

Efforts to avoid external reminders (people, places, conversations, activities, objects, situations) that arouse distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s). Arousal Symptoms
10. Sleep disturbance (e.g., difficulty falling or staying asleep, or restless sleep. 11. Irritable behavior and angry outbursts (with little or no provocation) typically expressed as verbal or physical aggression toward people or objects. 12. Hypervigilance.
13. Problems with concentration.
14. Exaggerated startle response.

C.

Duration of the disturbance (symptoms in Criterion B) is 3 days to 1 month after trauma exposure.
Note: Symptoms typically begin immediately after the trauma, but persistence for at least three days and up to a month is needed to meet disorder criteria.

D.

The disturbance causes clinically significant distress or impairment in social occupational, or other important areas of functioning.

E.

The disturbance is not attributable to the physiological effects of a substance
(e.g., medication, alcohol) or another medical condition (e.g., mild traumatic brain injury) and is not better explained by brief psychotic disorder.

(APA, 2013, pp. 280-281)

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DSM-5 diagnostic criteria for Posttraumatic Stress Disorder
(APA, 2013, pp. 271-272)

Note: The following criteria apply to adults, adolescents, and children older than 6 years. A.

Exposure to actual or threatened death, serious injury, or sexual violence in one (or more) of the following ways:
1. Directly experiencing the traumatic event(s).
2. Witnessing in person the event(s) as it occurred to others.
3. Learning that the traumatic event(s) occurred to a close family member or close friend. In cases of actual or threatened death of a family member or friend, the event(s) must have been violent or accidental.
4. Experiencing repeated or extreme exposure to aversive details of the traumatic event(s) (e.g., first responders collecting human remains; police officers repeatedly exposed to details of child abuse).
Note: Criterion A4 does not apply to exposure through electronic media, television, movies, or pictures, unless this exposure is work related.

B.

Presence of one (or more) of the following intrusion symptoms associated with the traumatic event(s), beginning after the traumatic event(s) occurred:
1. Recurrent, involuntary, and intrusive distressing memories of the traumatic events.
Note: In children older than 6 years repetitive play may occur in which themes or aspects of the traumatic event(s) are expressed.
2. Recurrent distressing dreams in which the content and/or affect of the dream are related to the traumatic event(s).
Note: In children, there may be frightening dreams without recognizable content. 3. Dissociative reactions (e.g., flashbacks) in which the individual feels or acts as if the traumatic event(s) were recurring. (Such reactions may occur on a continuum, with the most extreme expression being a complete loss of awareness of present surroundings.)
Note: In children, trauma-specific reenactment may occur in play.
4. Intense or prolonged psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event(s). 5. Marked physiological reactions to internal or external cues that symbolize or resemble an aspect of the traumatic event(s).

C.

Persistent avoidance of stimuli associated with the traumatic event(s), beginning after the traumatic event(s) occurred, as evidenced by one or both of the following:
1. Avoidance of or efforts to avoid distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s).
2. Avoidance of or efforts to avoid external reminders (people, places, conversations, activities, objects, situations) that arouse distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s).

51

D.

Negative alterations in cognitions and mood associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following:
1. Inability to remember an important aspect of the traumatic event(s)
(typically due to dissociative amnesia and not to other factors such as head injury, alcohol or drugs).
2. Persistent and exaggerated negative beliefs or expectations about oneself, others, or the world (e.g., “I am bad,” “No one can be trusted”,
“The world is completely dangerous”, “My whole nervous system is permanently ruined”).
3. Persistent, distorted cognitions about the cause or consequences of the traumatic event(s) that lead the individual to blame himself/herself or others. 4. Persistent negative emotional state (e.g., fear, horror, anger, guilt or shame). 5. Markedly diminished interest or participation in significant activities.
6. Feelings of detachment or estrangement from others.
7. Persistent inability to experience positive emotions (e.g., inability to experience happiness, satisfaction, or loving feelings).

E.

Marked alterations in arousal and reactivity associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following:
1. Irritable behavior and angry outbursts (with little or no provocation) typically expressed as verbal or physical aggression toward people or objects.
2. Reckless or self-destructive behavior.
3. Hypervigilance.
4. Exaggerated startle response.
5. Problems with concentration.
6. Sleep disturbance (e.g., difficulty falling or staying asleep, or restless sleep.

F.

Duration of the disturbance (Criteria B, C, D, and E) is more than 1 month.

G.

The disturbance causes clinically significant distress or impairment in social occupational, or other important areas of functioning.

H.

The disturbance is not attributable to the physiological effects of a substance
(e.g., medication, alcohol) or another medical condition.

Specify whether:
With dissociative symptoms: The individual’s symptoms meet the criteria for posttraumatic stress disorder, and in addition, in response to the stressor, the individual experiences persistent or recurrent symptoms of either of the following: 1. Depersonalization: Persistent or recurrent experiences of feeling detached from, as if one were an outside observer of, one’s mental processes or body (e.g., feeling as though one were in a dream; feeling a sense of unreality of self or body or of time moving slowly.)

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2. Derealization: Persistent or recurrent experiences of unreality of surroundings (e.g., the world around the individual is experienced as unreal, dreamlike, distant, or distorted.)
Note: To use this subtype, the dissociative symptoms must not be attributable to the physiological effects of a substance (e.g., blackouts, behavior during alcohol intoxication) or another medical condition (e.g., complex partial seizures).

Specify if:
With delayed expression: If the full diagnostic criteria are not met until at least 6 months after the event (although the onset and expression of some symptoms may be immediate).”
(APA, 2013, pp. 271-272)

Anxiety is part of human existence and it is often a normal adaptive and positive response. Anxiety can also serve as a drive that leads to functional behaviour, for example, preparing the body for the fight-or-flight response. Most people feel anxiety sometimes, while others feel anxiety most of the time.
Making a psychological diagnosis when anxiety is evident is not always as clear-cut as theory would have us believe. Anxiety features not only in the anxiety disorders, but in many other psychological disorders as well. Consider for example a mood disorder involving a major depressive episode where, according to the DSM-5 classification system (APA, 2013), frequently presented symptoms involve anxiety, phobias and even panic attacks (which might even occur in a pattern that meets the criteria for a full blown panic disorder). In children the presence of separation anxiety is often a feature of a major depressive episode. Other pathological behaviours that have a high correlation with the experience of anxiety are substance-related disorders, especially Alcohol Use Disorder. (You might find it useful to refer to the theme on substance-related disorders.) It is, however, not always clear which one of these abnormal behaviours was the cause and which the result.
Another difficulty with identifying a disorder is that the symptoms of various disorders overlap. For instance many individuals who have experienced a panic attack may subsequently develop phobic avoidance behaviour or individuals with obsessive thoughts might also be considered chronic worriers.
The question that needs to be asked is: “When is a trauma- or stressor-related response abnormal?”
A trauma- or stressor-related response is considered to be abnormal if it leads to negative consequences (e.g. poor job-performance, social withdrawal, anhedonia).
Include the following points in your exploration of this theme
In trauma- and stressor-related disorders exposure to a traumatic or stressful event is listed as the major diagnostic criterion. Anxiety, dissociation, or obsessive53

compulsive responses may also be part of the psychological distress response to experiencing a traumatic event.
Familiarise yourself with the following:
•

The impact of these disorders on human functioning.

•

You may want to study this theme in relation to the other themes in this module e.g. mood disorders, substance related disorders and Borderline
Personality Disorder.

Acute Stress Disorder (ASD) and Post-traumatic Stress Disorder (PTSD) are the two disorders that have special relevance to our country with its high rates of violence and crime. These disorders are extreme psychological reactions to an intensely traumatic or violent event such as assault, sexual assault, natural disasters, accidents and wartime trauma.
In working through this theme you need to pay attention to the following issues:
•

theories as to why some people who experience a traumatic event develop
ASD or PTSD, whereas others who experience the same event do not

•

factors that seem to predispose individuals towards developing ASD/PTSD, factors operating simultaneously with the traumatic event, and factors operating after the trauma that might have an influence on prognosis

•

the occurrence of vicariously acquired PTSD, especially by children observing domestic violence

• the influence that the specific life-stage of the individual suffering from
PTSD has on the manner in which this disorder will manifest
• the difficulty in differentiating between ASD/PTSD and other pre-morbid and co-morbid psychological disorders.
Another issue worth addressing is the role of anxiety disorders, obsessivecompulsive and related disorders, and dissociative disorders as possible aetiological factors in the development of ASD/PTSD. The aetiology and manifestation of these disorders are closely related to the presence and role of anxiety, which can play a part in the development of ASD/PTSD.
Here you need to concentrate on the following:
•
•

54

the clinical manifestation and aetiology of anxiety disorders, obsessivecompulsive and related disorders, and dissociative disorders the relationship between the anxiety disorders and other disorders in which anxiety features strongly and the resultant difficulty in making a clear-cut diagnosis of ASD/PTSD based on the manifestation of symptoms

PYC4802/101
•

the role of anxiety in the individual anxiety disorders as well as in the relevant dissociative, mood and substance-related disorders

•

the relationship between anxiety disorders as well as dissociative, mood and substance-related disorders and the possible underlying presence of
PTSD.

Study the chapter on trauma- and stress-related disorders in your prescribed book by keeping in mind that ASD/PTSD are no longer a part of the Anxiety Disorders. They are now officially classified as Trauma- and Stress-Related Disorders.
Prescribed Reading
Book
Burke, A. (Ed.). (2012). Abnormal Psychology: A South African Perspective (2nd ed.).
Cape Town, South Africa: Oxford University Press Southern Africa.
Recommended Reading
Journal articles (Refer to the list of e-Reserves)
Averill, P.M. (2000). Posttraumatic stress disorder in older adults: A Conceptual
Review. Journal of Anxiety Disorders, 14(2), 133-156.
Brown, P.J., & Wolfe, J. (1994). Substance abuse and post-traumatic stress disorder comorbidity. Drug and Alcohol Dependence, 35, 51-59.
De Silva, P. (1993). Post-traumatic stress disorder: Cross-cultural aspects.
International Review of Psychiatry, 5, 217-229.
Giel, R. (1990). Psychosocial processes in disasters. International Journal of Mental
Health, 19(1), 7-20.
Joseph, S. (1997). Understanding post-traumatic stress (pp. 51-67). West Sussex:
Wiley & Sons.
Keane, M.T., Taylor, K.L., & Penk, W.E. (1997). Differentiating post-traumatic stress disorder (PTSD) from major depression (MDD) and generalized anxiety disorder
(GAD). Journal of Anxiety Disorders, 11(3), 317-328.
McFarlane, A.C., Atchison, M., Rafalowicz, E., & Papay, P. (1994). Physical symptoms in post-traumatic stress disorder. Journal of Psychosomatic Research,
38(7), 715-726.
Nutt, D., Davidson, J.R.T., & Zohar, J., (Eds.) (2000). Post-traumatic stress disorder diagnosis, management and treatment (pp. 147-161). Malden, MA: Blackwell
Science.
Rosen, G.M., (Ed.) (2004). Posttraumatic Stress Disorder: Issues and controversies
(pp.147-161). West Sussex, England: John Wiley & Sons.
55

Additional Reading
Journal Articles
Burger, L., Van Staden, F., & Nieuwoudt, J. (1989). The Free State floods: A case study. South African Journal of Psychology, 19(4), 205-209.
Dobson, K.S. (1985). The relationship between anxiety and depression. Clinical
Psychology Review, 5, 307-324.
Connors, M.E. (1994). Symptom formation: An integrative self psychological perspective. Psychoanalytic Psychology, 11(4), 509-523.
Dohrenwend, B.P. (2000). The role of adversity and stress in psychopathology:
Some evidence and its implications for theory and research. The Journal of Health and Social Behavior, 41,1-19.
Green, B.L., & Lindy, J.D. (1994). Post-traumatic stress disorder in victims of disasters. Psychiatric Clinics of North America, 17(2), 301-309.
Kume, G.D. (2006). Posttraumatic stress: New research (pp. 23-80). New York: Nova
Science.
Meichenbaum, D. (1994). Treating post-traumatic stress disorder: A handbook and
Practice Manual for Therapy (pp. 14-257). New York: Wiley & Sons.
Miller, T.W. (1995). Stress adaption in children: Theoretical models. Journal of
Contemporary Psychotherapy, 25(1), 5-14.
Perrin, S., Smith, P., & Yule, W. (2000). Practitioner Review: The assessment and treatment of post-traumatic stress disorder in children and adolescents. Journal of
Child Psychology and Psychiatry, 41(3), 277-289.
Stevens, J.L., & Goosen, J. (1995). The nature of post-traumatic stress disorder
(PTSD) in the gold mine industry: A pilot study. Paper presented at the first Annual
Congress of the Psychological Society of South Africa. University of NatalPietermaritzburg.
Turnbull, J.M. (1989). Anxiety and physical illness in the elderly. Journal of Clinical
Psychiatry, 50(11), 40-45.

End of Theme 2

56

PYC4802/101

THEME 03
Substance-Related and Addictive Disorders
Introduction to the theme
The aim of this theme is to present an overarching context (epistemological, neurological, social, interpersonal, and personal) within which Substance-Related and Addictive Disorders occur. This theme therefore identifies and defines the addiction syndrome, and examines the physiological, psychological and social variables considered in making a diagnosis.
Objectives
•

To assess accurately those individuals regarded as having a SubstanceRelated or Addictive Disorder.

•

To understand the use of the DSM in the process of diagnosis.

•

To understand the role of an individual's support system in his/her treatment.

Focus points
•

Define Substance Use Disorder and describe the social, physical and psychological signs and symptoms associated with Substance-Related and
Addictive Disorders. The notions of causality are fundamental in assessment.
The drinking patterns that lead to Alcohol-Related and Addictive Disorders, for instance, are diverse but all can be considered from four interconnecting aspects: sociocultural, behavioural/psychological, physical, and spiritual.

•

Define Substance Dependence and describe its social, physical and psychological signs and symptoms. Physiological, psychological and sociocultural variants are all important effects of chemical dependency on the life of the individual.

•

Consider the concept of Substance Use Disorder as a disease, and define Alcohol Use Disorder (alcoholism). It is important to distinguish between a problem drinker and an alcoholic.

•

Define co-morbidity.

•

Theories offer behavioural scientists a general conceptual framework for understanding individuals in a wide range of situations. Assess the literature concerning the origins of Alcohol Use Disorder.

•

Study the concept of co-dependency in couples who are diagnosed with an
Alcohol-Related and Addictive Disorder.

57

There are two types of bias common among practitioners in their approach to social problems, namely the bias toward intrapersonal qualities and a bias toward extraneous or situational factors. The former or psychodynamic orientation to
Alcohol-Related and Addictive Disorder is considered risky in so far as the client's relapse is concerned and not very conducive to recovery. At the other extreme, the situational bias may furnish the client with just the rationale needed to drink some more. The ecological-interactionist perspective offers a framework that focuses directly and continuously upon the specific aspects of the unique social setting and the individual's dynamic role within it. The development of the ecological therapies, for example, has given to alcohol-related therapy tools to launch a multi-effort attack on both the intrapsychic and interpersonal components of the alcohol-related and addictive syndrome.
The multidimensional nature of Alcohol-Related and other Addictive Disorders dictates that the biological dynamics, the individual's peculiar style of cognitive functioning and the sociocultural aspects of the individual should be considered.
Explore, therefore, the biological realm, the psychological dimension and the social dynamics pertaining to Substance-Related Disorders, when you focus on the effects of any Addictive Disorder on family dynamics, and the major characteristics of codependency.
Study
Study the chapter of substance related and addictive disorders in your prescribed book, the prescribed and recommended journal articles, and the DSM-5 diagnostic criteria for Alcohol Use Disorder presented below.

DSM-5 diagnostic criteria for Alcohol Use Disorder
(APA, 2013, pp.490-491)

A

A problematic pattern of alcohol use leading to clinically significant impairment or distress, as manifested by 2 (or more) of the following, occurring within a 12month period:
1. Alcohol is often taken in larger amounts or over a longer period than was intended. 2. There is a persistent desire or unsuccessful efforts to cut down or control alcohol use.
3. A great deal of time is spent in activities necessary to obtain alcohol,use alcohol, o recover from the effects.
4. Craving,or a strong desire or urge to use alcohol.
5. Recurrent alcohol use resulting in a failure to fulfil major role obligations at work, school, or home.

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PYC4802/101
6. Continued alcohol use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of alcohol.
7. Important Social, occupational,or recreational activities are given up or reduced because of alcohol use.
8. Recurrent alcohol use in situations in which it is physically hazardous.
9. Alcohol use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by alcohol.
10. Tolerance, as defined by either of the following:
a. A need for markedly increased amounts of alcohol to achieve intoxication or desired effect.
b. A markedly diminished effect with continued use of the same amount of alcohol (Note: Tolerance is not counted for those taking medications under medical supervision such as analgesics, antidepressants, antanxiety medications or beta-blockers.)
11. Withdrawal, as manifested by either of the following:
a. The characteristic withdrawal syndrome for alcohol (refer to Criteria
A and B of the criteria set for alcohol withdrawal, pp. 499-500).
b. Alcohol (or a closely related substance such as a benzodiazepine) is taken to relieve or avoid withdrawal symptoms.
(Note: Withdrawal is not counted for those taking medications under medical supervision such as analgesics, antidepressants, anti-anxiety medications or beta-blockers.) Specify current severity:
Mild: Presence of 2-3 symptoms.
Moderate: Presence of 4 to 5 symptoms
Severe: Presence of 6 or more symptoms
(APA, 2013, pp.490-491)

Prescribed Reading
Book
Burke, A. (Ed.) (2012). Abnormal Psychology: A South African Perspective (2nd ed.).
Cape Town, South Africa: Oxford University Press, Southern Africa.

59

Journal Articles (Refer to the list of e-Reserves)
Cox, R. B., Ketner, J. S., & Blow, A. J. (2013). Working with couples and substance abuse: recommendations for clinical practice. American Journal of Family
Therapy, 41(2), 160-172.
Knudson, T. M. & Terrell, H.K. (2012). Codependency, perceived interparental conflict, and substance abuse in the family of origin. The American Journal of
Family Therapy, 40 245–257. DOI: 10.1080/01926187.2011.610725
Makovec, M. R., Sernec, K., Rus, V. S., Čebašek-Travnik, Z., Tomori, M. & Ziherl, S.
(2010). Adolescent substance dependency in relation to parental substance
(ab)use. Zdrav Var, 49, 1-10. DOI 10.2478/v10152-010-0001-1
Ponder, F. T. & Slate, J. R. (2009). Family of origin addiction patterns amongst counseling and psychology students. Published by the Forum on Public Policy
Copyright © The Forum on Public Policy 2009, 1-11. All Rights Reserved.
Recommended Reading
Journal Articles (Refer to the list of e-Reserves)
Krestan, J. & Bepko, C. (1990). Codependency: The social reconstruction of female experience. Smith College Studies in Social Work, 60(3), 216-232.
Morgan, J.P. (1991). What is co-dependency? Journal of Clinical Psychology, 5,
720-729.
Sheridan, M. J. (1995). A proposed intergenerational model of substance abuse, family functioning, and abuse/neglect. Child Abuse and Neglect, 19(5), 519-530.
Sheridan, M. J. & Green, R. G. (1993). Family dynamics and individual characteristics of adult children of alcoholics: An empirical study. Journal of Social
Service Research, 17(1/2), 73-97.
Books
Barlow, D.H., & Durand, V.M. (2009). Abnormal psychology: An integrative approach
(5th ed.). Belmont: Wadsworth/Cengage Learning. (Or 4th ed.)
Davison, G.C. (2004). Abnormal psychology (9th ed.). New York: Wiley.
Davison, G.C. (2007). Abnormal psychology (10th ed.). New York: Wiley.
Nolen-Hoeksema, S. (2008). Abnormal psychology (4th ed.). New York: McGraw-Hill.
Sue, D., Sue, D., & Sue, S. (2010). Understanding abnormal behaviour (9th ed.).
Boston: Houghton Mifflin. (Or any other edition.)

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Additional Reading
Books
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of
Mental Disorders: Fifth Edition (DSM-5). Arlington VA: American Psychiatric
Association
Brown, S. (1985). Treating the alcoholic. New York: Wiley.
McNee, C. A. & Di Nitto, D. M. (2012). Chemical Dependency: a systems approach
(4thed). Boston: Pearson publications.
Metzgar, L. (1988). From denial to recovery. Washington, D.C.: Josey-Bass.
Journal Articles
Gleeson, A. (1991). Family therapy and substance abuse.
Zealand Journal of Family Therapy, 12(2), 91-98.

Australian and New

Sandoz, C.J. (1991). Locus of control, emotional maturity and family dynamics as components of recovery in recovering alcoholics. Alcoholism Treatment Quarterly,
8(4), 17-31.
Sayre, L., Cornille, T.A., Rohrer, G., & Hicks, M.W. (1992). Family outreach residential addiction treatment: Changes in addicts’ beliefs about social support.
Alcoholism Treatment Quarterly, 9(1), 51-66.
Swaim, R.C., Oetting, E.R., Thurman, P.J., Beauvais, F., & Edwards, R.W. (1993).
American Indian adolescent drug use and socialization characteristics: A crosscultural comparison. Journal of Cross-cultural Psychology, 24(1), 53-70.
Velleman, R. & Templeton, L. (2007). Understanding and modifying the impact of parents’ substance misuse on children. Advances in Psychiatric Treatment, 13,
79-89.
End of Theme 03

61

Theme 04
Depressive Disorders
Adult Depression
Introduction to the theme
A mood can be defined as a sustained emotional state that lasts over a period of time, unlike emotions which are more spontaneous and reactive to a particular stimulus or event. According to the DSM-5 classification system (APA, 2013) a
Depressive Disorder is a mental disorder where an individual feels depressed and outwardly displays signs/symptoms of depression for a significant duration of time.
Importantly, the individual’s mood impairs social, occupational, or other important areas of functioning. The disorder also occurs in the absence of a clearly identifiable stressor or trigger. According to the DSM-5 classification system (APA, 2013, p. 155),
“depressive disorders are identified by the presence of sad, empty, or irritable mood, accompanied by somatic and cognitive changes that significantly affect the individual’s capacity to function”. All depressive disorders by definition will include a depressive episode, while their differences lie in their duration, timing or aetiology.
Major Depressive Disorder symptoms must occur for at least two weeks.
Objectives
You are required to obtain the prescribed and recommended literature listed below by downloading the articles from the e-Reserves list on myUnisa. Study the chapter on the depressive disorders in your prescribed book as well as the journal articles by focusing on the following:
•
•
•

Identifying Major Depressive Disorder according to the DSM-5 classification system
Identifying the causes (aetiology) of a Major Depressive Disorder
Identifying, explaining and describing the interactions among the various factors that play a role in the causation (aetiology) of a Major Depressive
Disorder

Note: Since the DSM-5 was only published in June 2013, the available prescribed books and articles are based on the DSM-IV-TR. We have thus provided you with the
DSM-5 diagnostic criteria for Major Depressive Disorder below.

Diagnostic criteria for Major Depressive Disorder
(APA, 2013, pp.160-162)

A.

62

Five (or more) of the following symptoms have been present during the same
2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure. PYC4802/101
Note: Do not include symptoms that are clearly due to another medical condition. 1.

2.

Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation made by others).

3.

Significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day. (Note: In children, consider failure to make expected weight gain.)

4.

Insomnia or hypersomnia nearly every day.

5.

Psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down).

6.

Fatigue or loss of energy nearly every day.

7.

Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick).

8.

Diminished ability to think or concentrate, or indecisiveness, nearly every day
(either by subjective account or as observed by others).

9.

B.

Depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad or empty) or observation made by others
(e.g., appears tearful). Note: In children and adolescents, can be irritable mood.

Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

C.

The episode is not attributable to the physiological effects of a substance or to another medical condition.
Note: Criteria A-C represent a major depressive episode.
D.

The occurrence of the major depressive episode is not better explained by schizoaffective disorder, schizophrenia, schizophreniform disorder, delusional disorder, or other specified and unspecified schizophrenia spectrum and other psychotic disorders.

E.

There has never been a manic episode or a hypomanic episode.
Note: This exclusion does not apply if all of the manic-like or hypomanic-like episodes are substance-induced or are attributable to the physiological effects of another medical condition.

(APA, 2013, pp.160-162)

63

Specify the following:
•
•

Whether it is a single episode or a recurrent episode.
The current severity (e.g., mild, moderate, severe, with psychotic features, in partial remission, in full remission, unspecified).
• Whether it is with anxious distress, with mixed features, with melancholic features, with atypical features, with mood-congruent psychotic features, with mood incongruent psychotic features, with catatonia, with post-partum onset, with seasonal pattern.

(Adapted from: APA, 2013, pp.160-162)

Prescribed Reading
Book
Burke, A. (Ed.) (2012). Abnormal Psychology: A South African Perspective (2nd ed.).
Cape Town, South Africa: Oxford University Press, Southern Africa. (Chapter 5)
Journal Articles (Refer to the list of e-Reserves)
Hill, J. (2009). Developmental perspectives on adult depression. Psychoanalytic
Psychotherapy, 23(3), 200-212. DOI: 10.1080/02668730903227263
Kagee, A., & Martin, L. (2010). Symptoms of depression and anxiety among a sample of South African patients living with HIV. AIDS Care: Psychological and
Socio-medical
Aspects of AIDS/HIV,
22(2),
159-165.
DOI:
10.1080/09540120903111445
McQueen, D. (2009). Depression in adults: Some basic facts. Psychoanalytic
Psychotherapy, 23(3), 225-235. DOI: 10.1080/02668730903226463
Maj, M. (2012). Development and validation of the current concept of Major
Depression. Psychopathology, 45,135–146. DOI: 10.1159/000329100
Recommended Reading
Books (Refer to the recommended book list)
Barlow, D.H., & Durand, V.M. (2009). Abnormal psychology: An integrative approach
(5th ed.). Belmont, CA: Wadsworth/Cengage Learning. (Or 4thedition.)
Davison, G.C. (2004). Abnormal psychology (9th ed.). New York: Wiley.
Davison, G.C. (2007). Abnormal psychology (10th ed.). New York: Wiley.
Kronenberger, W.G., & Meyer, R.G. (2001). The child clinician's handbook (2nd ed.).
Boston, MA: Allyn & Bacon.
Nolen-Hoeksema, S. (2008). Abnormal Psychology (4th ed.). New York: McGraw-Hill.
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Journal Articles (Refer to the list of e-Reserves)
Brookfield, S. (2011). When the black dog barks: An autoethnography of adult learning in and on clinical depression. New Directions for Adult and Continuing
Education (132), 35-42. DOI: 10.1002/ace.
Takeuchi, M. S., Miyaoka, H., Tomoda A., Suzuki, M., Liu, Q., & Kitamura, T. (2012).
The effect of interpersonal touch during childhood on adult attachment and depression: A neglected area of family and developmental psychology? Journal of
Child and Family Studies, 19, 109–117. DOI 10.1007/s10826-009-9290-x
Williams, L.M. (2002). The Seven Ps for fighting depression. Journal of Clinical
Activities, Assignments & Handouts in Psychotherapy Practice, 2(1), 51-57. DOI:
10.1300/J182v02n01_06
Additional Reading
Book
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of
Mental Disorders: Fifth Edition (DSM-5). Arlington VA: American Psychiatric
Association

End of Theme 04

65

THEME 05
Personality Disorders
Borderline Personality Disorder
Focus
• In this theme the focus falls on Personality Disorders in general as well as the
Borderline Personality Disorder in particular.
• Your aim should be to grasp the difficulty in identifying Borderline Personality
Disorder.
Study
In order to achieve the above aim, you need to study the following:
The Personality Disorder chapter in the prescribed book
The prescribed journal articles (e-Reserves)
The DSM-5 diagnostic criteria for Borderline Personality Disorder below
The DSM-5 General diagnostic criteria for a Personality Disorder below
Introduction
According to the DSM-5 classification system (APA, 2013) a Personality Disorder is an enduring pattern of inner experience and behaviour that deviates markedly from the expectations of the individual’s culture, is pervasive and inflexible, has an onset in adolescence or early adulthood, is stable over time, and leads to distress or impairment. The aetiology of Personality Disorders is mainly attributed to the development of immature and distorted patterns of personality functioning which lead to persistent maladaptive ways of perceiving, thinking, relating to others, and interacting with the world.
The DSM-5 lists 10 Personality Disorders in three clusters. The clusters and
Personality Disorders are:
•

Cluster A: Odd or eccentric behaviour - (Paranoid, Schizoid and Schizotypal
Personality Disorders)
• Paranoid Personality Disorder is characterised by a pattern of distrust and suspiciousness such that others’ motives are interpreted as malevolent.
• Schizoid Personality Disorder is characterised by a pattern of detachment from social relationships and a restricted range of emotional expression.
• Schizotypal Personality Disorder is characterised by a pattern of acute discomfort in close relationships, cognitive or perceptual distortions, and eccentricities of behaviour.

•

Cluster B: Dramatic, emotional or erratic behaviour - (Histrionic, Narcissistic,
Antisocial and Borderline Personality Disorders)
• Histrionic Personality Disorder is characterised by a pattern of excessive emotionality and attention seeking.

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PYC4802/101
•
•
•
•

Narcissistic Personality Disorder is characterised by a pattern of grandiosity, need for admiration, and lack of empathy.
Antisocial Personality Disorder is characterised by a pattern of disregard for, and violation of, the rights of others.
Borderline Personality Disorder is characterised by a pattern of instability in interpersonal relationships, self-image, affect, and marked impulsivity.

Cluster C: Anxious and fearful behaviour - (Avoidant, Dependent and
Obsessive-Compulsive Personality Disorders)
• Avoidant Personality Disorder is characterised by a pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation.
• Dependent Personality Disorder is characterised by a pattern of submissive and clinging behaviour related to an excessive need to be taken care of.
• Obsessive-Compulsive Personality Disorder is characterised by a pattern of preoccupation with orderliness, perfectionism, and control. Personality
Disorder Not Otherwise Specified is an additional category provided for two situations: Below you will find the general diagnostic criteria for a Personality Disorder according to the DSM-5 classification system.
DSM-5 General diagnostic criteria for a Personality Disorder
(APA, 2013, pp. 646-647)

A

An enduring pattern of inner experience and behaviour that deviates markedly from the expectations of the individual’s culture. This pattern is manifested in two (or more) of the following areas:

B
1.

C
D
E
F
G

Cognition (i.e. ways of perceiving and interpreting self, other people, and events).
2.
Affectivity (i.e. the range, intensity, lability, and appropriateness of emotional response).
3.
Interpersonal functioning.
4.
Impulse control.
The enduring pattern is inflexible and pervasive across a broad range of personal and social situations.
The enduring pattern leads to clinically significant distress or impairment in social, occupational, or other important areas of functioning. The pattern is stable and of long duration, and its onset can be traced back at least to adolescence or early adulthood.
The enduring pattern is not better explained as a manifestation or consequence of another mental disorder.
The enduring pattern is not attributable to the physiological effects of a substance (e.g. a drug of abuse, a medication) or another medical condition (e.g. head trauma).

(APA, 2013, p. 646-647)
67

Personality disorders in general severely limit an individual’s approach to living.
Working and interacting in stress-producing situations allows these individuals to only respond with their limited, rigid, and narrow range of thinking and behaviour, which tends to create a tremendous amount of personal distress, disability and health expense. The DSM-5 classification system applies the following diagnostic criteria for identifying Borderline Personality Disorder.
DSM-5 Diagnostic criteria for Borderline Personality Disorder
(APA, 2013, p. 663)

A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)

Frantic efforts to avoid real or imagined abandonment. (Note: Do not include suicidal or self-mutilating behaviour covered in Criterion 5
A pattern of unstable and intense interpersonal relationships characterised by alternating between extremes of idealisation and devaluation Identity disturbance: markedly and persistently unstable self-image or sense of self
Impulsivity in at least two areas that are potentially self-damaging (e.g. spending, sex, substance abuse, reckless driving, binge eating). (Note:
Do not include suicidal or self-mutilating behaviour covered in Criterion 5)
Recurrent suicidal behaviour, gestures, or threats, or self-mutilating behaviour Affective instability due to a marked reactivity of mood (e.g. intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days)
Chronic feelings of emptiness
Inappropriate, intense anger or difficulty controlling anger (e.g. frequent displays of temper, constant anger, recurrent physical fights)
Transient, stress-related paranoid ideation or severe dissociative symptoms. (APA, 2013, p. 663)
In order to diagnose Personality Disorders, individuals need to be assessed with regard to their long-term patterns of functioning over time and across different situations. Personality traits of individuals need to be separated from other symptoms that may have appeared after certain stressors, traumatic experiences, and/or transient mental states, which are usually diagnosed on axis 1, (e.g. Mood and
Anxiety Disorders, Substance Intoxication). Complications may arise when clinicians limit assessment to only one interview, since stability over time and across situations is a critical feature for making a diagnosis of a Personality Disorder. More than one
68

PYC4802/101 interview and supplementing that information by other informants is thus essential.
Both sets of criteria (i.e. General diagnostic criteria for a Personality Disorder together with at least 5 specific Diagnostic criteria, for example, for Borderline
Personality Disorder) need to be taken into consideration for fulfilling the conditions for making a diagnosis of Borderline Personality Disorder.
The possibility of identifying a Personality Disorder requires that these relatively stable traits across time and situations are present since at least adolescence and become manifest as complying with most criteria by early adulthood, since diagnosing Personality Disorders is only possible after the age of 18.
Although Personality Disorders have always been considered difficult to treat, recent evidence based therapies proved to be highly successful in treating individuals diagnosed with Borderline Personality Disorder. Interestingly these therapies were successful if they had a reasonable intellectual foundation and were carried out by reasonable people in a reasonably consistent manner.
Prescribed Book
Burke, A. (Ed.). (2012). Abnormal Psychology: A South African Perspective (2nd ed.).
Cape Town, South Africa: Oxford University Press Southern Africa. (Chapter 12)
Prescribed Journal Articles (Refer to the list of e-Reserves)
Goodman, M., Hazlett, E.A., New, A.S., Koenigsberg, H.W., & Siever, L. (2009).
Quieting the affective storm of Borderline Personality Disorder. American Journal of Psychiatry, 166, 522-528.
Gunderson, J.G. (2009). Borderline Personality Disorder: Ontogeny of a diagnosis.
American Journal of Psychiatry, 166, 530-539.
Hoffman, P.D. (2007). Borderline Personality Disorder: A most misunderstood illness.
National Education Alliance for Borderline Personality Disorder, NAMI Advocate,
Winter 2007.
Kernberg, O.F., & Michels, R. (2009). Borderline Personality Disorder. American
Journal of Psychiatry, 166, 505-508.
Meyerson D. (2009). Is Borderline Personality Disorder under diagnosed? APA 2009, in C. Phend. (2009). APA: Borderline Personality Disorder often missed first time around. Medpage Today.
Oldham, J.M. (2009). Borderline Personality Disorder comes of age. American
Journal of Psychiatry, 166, 509-511.
End of Theme 05
End of Examination Preparation

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11.

FREQUENTLY ASKED QUESTIONS

Q:
A:

How long should Assignment 03 be?
12-15 pages without the cover page, table of contents, and the list references

Q:
A:

What must we study for the examination?
Themes 2, 3, 4, and 5.

Q:

Are we going to receive guidelines for the examinations in another tutorial letter? No. The guidelines are in this tutorial letter.

A:
Q:
A:

Do you have any special advice for us for the examination?
Yes. Study the themes well.
Take note of the focus points, outcomes and aims.
Study the diagnostic criteria.
In the examiniation:
Analyse the examination question before you attempt to answer it.
Think and answer the examination question comprehensively.

Q:
A:

How many questions are we going to get in the exam?
4 compulsory questions.

Q:
A:

Where can I get help with regard to study methods?
The my Studies @ Unisa brochure contains an A-Z guide of the most relevant study information.

Q:

I do not want to waste my time by studying irrelevant information. Could you please clarify for me exactly what I need to study for the examination?
The course content for the examination is contained and limited to 4 themes.
The prescribed literature (book and journal articles) needs to be studied, understood, thought about and integrated. A synthesised relevant answer to the question needs to be presented.

A:

12.

CONCLUSION

May you find the information you need, the understanding you require, and the insight you have been waiting for with regard to acquiring an appreciation of the complexity of conceptualising mental health and abnormal behaviour in our society!
Good luck with your studies and SUCCESS in the examination!

Your PYC4802 Team

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