5 Mental and Physical Health

Syllabus
2025
Section
5
Level
—

5.1 Introduction to Health Psychology

Syllabus
2025
Topic
5.1
Level
—

What Health Psychology Connects

Health psychology addresses physical health and wellness as they relate to behavior and mental processes. It asks how what people do, think, and feel is associated with health—and how health experiences are associated with behavior and mental life.

Domain Health-psychology focus
Physical health Bodily health conditions and functioning
Wellness Overall state of functioning and well-being
Behavior Actions relevant to health and responses to health conditions
Mental processes Thoughts, emotions, perceptions, and other internal processes related to health

A health psychologist might examine a relationship among a health-related action, a person's thoughts or emotions, and a physical or wellness outcome. The psychological task is to identify the measured relationship and evidence, not to assume that any association proves one-way causation.

Health psychology is not limited to diagnosing physical disease, and it does not treat health as purely mental. Its scope is the connection among physical health, wellness, behavior, and mental processes.

Stressors Differ in Meaning, Duration, and Health Impact

Stress can heighten susceptibility to disorders and disease. It is linked with physiological issues including hypertension, headaches, and immune suppression. A link means stress contributes to risk; it does not mean every stressed person develops the same condition or that stress is the only cause.

Stressor category Distinguishing feature
Eustress Experienced as motivating
Distress Experienced as debilitating
Trauma An intensely stressful experience
Daily hassle A smaller recurring stressor whose effects can accumulate
Adverse childhood experience (ACE) Childhood source of stress that can affect a person across the lifespan

The same demand may be interpreted as motivating by one person and debilitating by another. Duration also matters: a single daily hassle may be limited, but repeated hassles can build up over time and contribute to sustained stress.

Eustress is still stress; the term identifies a motivating appraisal rather than the absence of physiological activation. An ACE is a source of later risk, not a guarantee of a particular lifelong outcome.

How the Stress Response Changes Over Time

GAS phase What happens
Alarm reaction The stressor is encountered and a fight-flight-freeze response begins
Resistance The person confronts or adapts to the continuing stress while resources remain engaged
Exhaustion The stress subsides or resources are spent; susceptibility to illness is greatest

General adaptation syndrome describes a process, so phase order matters. Alarm is the initial response, resistance is sustained confrontation, and exhaustion reflects the endpoint of prolonged resource use or the period after the stress subsides.

Tend-and-befriend theory proposes another stress reaction: tending to one's own needs or the needs of others and seeking connection. The CED reports that this pattern seems to occur mostly in women; this is a research tendency, not a rule that excludes men or requires every woman to respond this way.

Fight-flight-freeze and tend-and-befriend describe reaction patterns; problem-focused and emotion-focused coping describe strategies for managing stress. Do not treat reaction and coping as the same stage.

Change the Problem or Manage the Emotion

Coping form Primary target CED-supported example
Problem-focused The stress-producing problem Work through possible solutions until one is found
Emotion-focused The emotional reaction to stress Deep breathing, meditation, or medication aimed at reducing the stressful emotional response

To classify a coping response, ask what the person is trying to change. Creating and carrying out a solution targets the problem. Regulating distress targets the emotional response even if the stressor itself remains.

The two forms are not mutually exclusive. A person can use deep breathing to manage emotion and then work through a practical solution. Each action is classified by its immediate target.

Emotion-focused coping is not automatically avoidance, and problem-focused coping is not simply thinking about a problem. The defining difference is regulation of emotion versus action toward solving the stressor.

5.2 Positive Psychology

Syllabus
2025
Topic
5.2
Level
—

Positive Psychology Studies What Supports Flourishing

Positive psychology seeks to identify factors associated with healthy and constructive functioning. Its targets include well-being, resilience, positive emotions, and psychological health.

Target Research focus
Well-being How positively a person experiences and evaluates life
Resilience Positive adaptation or recovery when facing difficulty
Positive emotions Pleasant emotional experiences and their relationships with behavior and thought
Psychological health Healthy mental functioning, not only the absence of symptoms

A study that asks which experiences or practices relate to resilience or subjective well-being uses a positive-psychology approach. The approach still requires systematic evidence; calling an experience 'positive' does not establish that it causes the same benefit for everyone.

Positive psychology does not deny stress, trauma, or psychological disorders. It changes the research question toward factors that may support positive functioning.

Positive Experiences Can Support Well-Being and Growth

Positive-psychology idea CED relationship
Expressing gratitude Increases subjective well-being
Exercising signature strengths or virtues People report greater happiness and subjective well-being
Posttraumatic growth Positive growth may occur after trauma or stress

A classification of character strengths groups virtues into six categories: wisdom, courage, humanity, justice, temperance, and transcendence. A signature strength is a strength especially characteristic of the individual; applying it is the experience linked with the reported outcome, not merely knowing the category name.

Posttraumatic growth means a positive change may emerge after trauma or stress. The word 'may' is essential: growth is a possible outcome, can coexist with distress, and should not be assumed from the fact that trauma occurred.

Subjective well-being is the person's experienced or reported well-being; it is not identical to an externally measured life condition. Positive experiences are associated with beneficial outcomes but do not make negative emotion or difficulty disappear.

5.3 Explaining and Classifying Psychological Disorders

Syllabus
2025
Topic
5.3
Level
—

Identification Requires Impairment, Context, and Evidence

Identification factor Question it raises
Dysfunction Does the pattern interfere with important areas of functioning?
Perceived distress Does the person experience significant suffering or difficulty?
Deviation from social norms Is the pattern outside expectations in the relevant social and cultural context?

These factors are considered together and in context. Deviation alone is not enough: cultural and societal norms influence judgment, and racism, sexism, ageism, stigma, or other discrimination can distort who is labeled and how a diagnosis is received.

Classification system Developer Role
DSM American Psychiatric Association Classifies mental disorders
ICD World Health Organization Classifies mental disorders

Classification can support communication, evidence-based decisions, and access to appropriate help, but it can also contribute to stigma or biased treatment. Diagnosis therefore requires specialized training and evidence-based tools. DSM and ICD are updated as research and practice advance.

Unusual behavior is not automatically disordered, and a checklist used without specialized training is not a valid diagnosis. Classification describes a clinically evaluated pattern, not the whole person.

Perspectives Locate Causes in Different Processes

Perspective Primary causal focus
Behavioral Maladaptive learned associations among stimuli and responses
Psychodynamic Unconscious thoughts and experiences, often developing in childhood
Humanistic Limited social support and inability to fulfill one's potential
Cognitive Maladaptive thoughts, beliefs, attitudes, or emotions
Evolutionary Behaviors or mental processes that reduce likelihood of survival
Sociocultural Maladaptive social and cultural relationships or dynamics
Biological Physiological or genetic issues

To identify a perspective, locate the proposed cause—not the symptom being described. A learned association indicates a behavioral explanation; maladaptive belief patterns indicate a cognitive explanation; a physiological or genetic mechanism indicates a biological explanation.

An eclectic approach deliberately uses more than one psychological perspective when diagnosing or treating a client. It can combine complementary explanations rather than assuming that one perspective accounts for every contributing factor.

A perspective is a framework for explaining possible causes; it is not itself a disorder or a diagnostic test. Multiple perspectives can propose different mechanisms for the same observed pattern.

Interaction Models Combine Risk Factors

Model Factors combined Core claim
Biopsychosocial Biological, psychological, and sociocultural Any psychological problem may involve a combination across these domains
Diathesis-stress Genetic vulnerability (diathesis) and stressful life experience Disorder develops through the combination of vulnerability and stress

A biopsychosocial explanation might examine a physiological predisposition, maladaptive beliefs, and a stressful social environment together. The model organizes kinds of contributors; it does not require that all three contribute equally in every case.

In a diathesis-stress explanation, a genetic vulnerability may not produce a disorder on its own, and a stressful experience may not affect every person in the same way. Risk changes through their combination.

The models are not interchangeable. Biopsychosocial is a broad multi-domain framework; diathesis-stress is a specific vulnerability-by-stress mechanism. Neither model says that one factor alone guarantees a disorder.

5.4 Selection of Categories of Psychological Disorders

Syllabus
2025
Topic
5.4
Level
—

Neurodevelopmental Disorders Begin During Development

Neurodevelopmental disorders begin during the developmental period. Their symptoms are evaluated in relation to behavior expected for the person's age or maturity range, so the same behavior cannot be interpreted without developmental context.

AP scope element CED boundary
Selected disorders Attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD)
Symptom frame Whether behavior is appropriate for age or maturity range
Possible causes Environmental, physiological, or genetic

A valid description connects the observed pattern to developmental timing and functioning rather than treating one isolated behavior as sufficient. Possible causes identify domains to investigate; they do not prove that one factor produced a disorder.

The CED names ADHD and ASD here but does not supply full diagnostic criteria. Age-inappropriate behavior may be relevant evidence, but diagnosis requires a broader trained assessment.

Schizophrenia Symptoms Add, Disorganize, or Remove Function

Area CED description Symptom type
Delusion False belief, such as persecution or grandeur Positive
Hallucination False perception involving one or more senses Positive
Disorganized thinking or speech May include word salad, a nonsensical string of words Positive
Disorganized motor behavior May include catatonic excitement or stupor Positive or negative manifestation
Negative symptom Lack of a typical behavior, such as flat affect or movement Negative

Schizophrenia can be acute or chronic. Positive symptoms add or markedly distort experience or behavior; negative symptoms involve a reduction or absence of typical functioning. Catatonia can appear as excitement or as stupor, so its manifestation determines the classification.

Possible causes suggest genetic or biological links, including prenatal virus exposure and neurotransmitter imbalance described by the dopamine hypothesis. These are risk explanations, not single-case proof.

Hallucinations are perceptions; delusions are beliefs. Schizophrenia is not the same as dissociative identity disorder, and the presence of one unusual experience alone does not establish a diagnosis.

Depressive Disorders Combine Mood Change and Impaired Function

Depressive disorders involve a sad, empty, or irritable mood together with physical and cognitive changes that affect the person's ability to function. The functional effect separates a clinically relevant pattern from an ordinary temporary mood alone.

AP scope Included content
Selected disorders Major depressive disorder and persistent depressive disorder
Possible-cause domains Biological, genetic, social, cultural, behavioral, or cognitive

Relevant evidence can include mood plus changes in areas such as thought, sleep, appetite, pleasure, or other functioning when supported by the scenario. A causal explanation must name the supported domain rather than assume every depressive pattern has the same origin.

Sadness by itself is not equivalent to a depressive disorder. The CED names the two selected disorders but does not provide subtype duration thresholds here, so those thresholds should not be invented.

Bipolar Disorders Alternate Mania and Depression

Bipolar disorders are characterized by periods of mania and periods of depression. Bipolar cycling means these mood periods alternate, and each period can last a different amount of time.

AP scope element Included content
Selected disorders Bipolar I disorder and Bipolar II disorder
Defining pattern Alternating periods of mania and depression
Possible-cause domains Biological, genetic, social, cultural, behavioral, or cognitive

The key evidence is a pattern across time, not simply intense emotion at one moment. Possible causes may come from several domains, so a biological risk finding and a social stressor can both be relevant without either being a universal cause.

Bipolar cycling is not ordinary rapid mood change in everyday situations. The CED names Bipolar I and II but does not specify their distinguishing episode thresholds here, so the card does not add them.

Anxiety Disorders Differ by the Focus of Fear

Disorder Distinguishing focus
Specific phobia A particular object or situation, such as heights or spiders
Agoraphobia Situations such as transport, open or enclosed spaces, crowds or lines, or being outside home alone
Panic disorder Unanticipated, overwhelming panic attacks involving biological, cognitive, and emotional fear
Social anxiety disorder Intense fear of being judged or watched by others
Generalized anxiety disorder Prolonged nonspecific anxiety or fear

The CED includes culture-bound manifestations. Ataque de nervios is associated mainly with people of Caribbean or Iberian descent. Taijin kyofusho, associated mainly with Japanese people, involves fear that others judge one's body as undesirable, offensive, or unpleasing.

Possible causes include learned associations, maladaptive thinking or emotional responses, and biological or genetic sources. The supported cause must be inferred from evidence in the scenario, not from the disorder label alone.

Agoraphobia is not simply fear of open spaces, and social anxiety is not merely shyness. Social anxiety is distinct from, though it may include, agoraphobia.

Obsessions and Compulsions Form a Thought–Action Cycle

Construct CED meaning Role in the cycle
Obsession Intrusive thought Produces a concern or distress that the person experiences
Compulsion Intrusive, often repetitive behavior intended to address an obsession Acts as the attempted response to the obsession

The selected disorders in AP scope are obsessive-compulsive disorder and hoarding disorder. Possible causes may involve learned associations, maladaptive thinking or emotional responses, and biological or genetic sources.

A repetitive action counts as a compulsion in this framework when it is intended to address an obsession, such as reducing anxiety linked to the intrusive thought. Repetition alone does not reveal the function of the behavior.

An obsession is not ordinary enthusiasm, and a compulsion is not merely a preferred routine. The CED names hoarding disorder but does not provide separate criteria here, so none are inferred.

Dissociation Disrupts Integration of Experience

Dissociative disorders involve disruptions or separations in normally integrated experience. The CED domains include consciousness, memory, identity, emotion, perception, body representation, motor control, and behavior.

AP scope element Included content
Selected disorders Dissociative amnesia, with or without fugue, and dissociative identity disorder
Possible causes Experience of trauma or stress

To recognize this category, identify which aspect of experience is disconnected—for example memory or identity—rather than looking for a hallucination or delusion. Trauma or stress is a possible causal context, not proof from symptoms alone.

Dissociation is not the same as schizophrenia. The CED names amnesia with and without fugue but does not give a separate fugue criterion here, so the card does not invent one.

PTSD Links Trauma Exposure to Continuing Distress

Trauma and stressor-related disorders begin with exposure to a traumatic or stressful event followed by psychological distress. The selected disorder in AP scope is posttraumatic stress disorder (PTSD).

CED-listed possible symptoms are hypervigilance, severe anxiety, flashbacks to traumatic or stressful experiences, insomnia, emotional detachment, and hostility. A scenario may show more than one because the category includes cognitive, emotional, behavioral, and arousal-related effects.

The diagnostic learning link is temporal and contextual: a trauma or stressor is experienced, and continuing psychological distress follows. Possible causes therefore involve the experience of trauma or stress.

Experiencing stress or one short-lived reaction does not by itself establish PTSD. The CED supplies a category pattern, while diagnosis requires trained assessment of the complete presentation.

Feeding and Eating Disorders Impair Health or Function

Feeding and eating disorders involve altered consumption or absorption of food that impairs physical health or psychological functioning. The impairment is part of the category definition; a food preference alone is not enough.

AP scope element Included content
Selected disorders Anorexia nervosa and bulimia nervosa
Possible-cause domains Biological, genetic, social, cultural, behavioral, or cognitive

A description should identify the altered food-related pattern and its effect on health or psychological functioning. A cause explanation should name the supported domain and avoid assuming that culture, biology, or cognition acts alone in every case.

The CED names anorexia nervosa and bulimia nervosa but does not give their differential diagnostic criteria in this Objective. Do not infer a diagnosis from body size, one meal, or appearance.

Personality Disorders Are Enduring, Pervasive Patterns

Personality disorders involve an enduring pattern of internal experience and behavior that deviates from the person's culture, is pervasive and inflexible, begins in adolescence or early adulthood, remains stable over time, and causes personal distress or impairment.

Cluster CED description Selected disorders
A Odd or eccentric Paranoid, schizoid, schizotypal
B Dramatic, emotional, or erratic Antisocial, histrionic, narcissistic, borderline
C Anxious or fearful Avoidant, dependent, obsessive-compulsive personality

Possible causes may involve biological, genetic, social, cultural, behavioral, or cognitive sources. The classification focuses on a stable pattern across contexts and time, not on one isolated trait or reaction.

A personality trait is not automatically a personality disorder; the pattern must be enduring, pervasive, inflexible, culturally deviant, and linked with distress or impairment. Obsessive-compulsive personality disorder is listed in Cluster C and is not the same label as obsessive-compulsive disorder.

5.5 Treatment of Psychological Disorders

Syllabus
2025
Topic
5.5
Level
—

Effective Therapy Combines Evidence and Relationship

Meta-analytic studies combine findings across many psychotherapy studies. Many researchers using this approach conclude that psychotherapies are generally effective. This supports a broad trend, not a claim that every therapy works equally well for every client or disorder.

Treatment element Role
Meta-analytic evidence Estimates overall patterns across studies
Evidence-based intervention Uses research evidence to help build a treatment plan
Cultural humility Keeps the therapist attentive to the client's cultural context and limits of the therapist's assumptions
Therapeutic alliance Establishes a collaborative working relationship needed to deliver therapy successfully

A sound treatment plan therefore needs more than a technique name: it connects an evidence-supported intervention with the client's needs and context, while the therapeutic alliance supports successful delivery.

General effectiveness does not prove that one approach is best in every case. An evidence-based technique and a strong alliance serve complementary rather than interchangeable functions.

Treatment Shifted from Institutions to Decentralized Care

As psychotropic medication therapy became more widely used and effective, hospitals and asylums deinstitutionalized large numbers of people in the late twentieth century. Treatment increasingly moved away from long-term centralized institutions toward decentralized settings.

Trend Meaning
Deinstitutionalization Large-scale movement of people out of hospitals and asylums
Decentralized treatment Care delivered outside one large long-term institution
Combined treatment Medication used together with psychological therapy

The modern preference described by the CED is often a combination of medication and psychological therapies. Each component targets different aspects of a disorder, so combination does not mean they are the same intervention.

The historical trend does not show that medication alone addresses every psychological or social need. It explains a change in treatment setting and practice, not a universal outcome for every person.

Four Ethical Duties Guide Psychological Treatment

APA principle Treatment duty
Nonmaleficence Avoid causing harm
Fidelity Maintain trust and professional responsibility
Integrity Act honestly and accurately
Respect for people's rights and dignity Protect autonomy, privacy, and human worth

The principles work together. A therapist considering an intervention must weigh possible harm, preserve a trustworthy professional relationship, describe the treatment honestly, and respect the client's rights and dignity.

A helpful intention does not remove ethical duties. Clinical and therapeutic situations require psychologists to follow the principles throughout assessment, planning, delivery, and communication.

Therapy Techniques Follow Different Change Mechanisms

Approach CED techniques Intended change
Psychodynamic Free association, dream interpretation Uncover unconscious material
Cognitive Cognitive restructuring, fear hierarchies; examine the cognitive triad of negative thoughts about self, world, and future Change maladaptive thinking
Applied behavior analysis Exposure or systematic desensitization, aversion therapy, token economies Apply conditioning principles to behavior
Biofeedback Condition regulation of body systems such as sympathetic and parasympathetic activity Improve control of bodily responses linked with anxiety or depression
Cognitive-behavioral Dialectical behavior therapy, rational-emotive behavior therapy Combine cognitive and behavioral techniques
Humanistic/person-centered Active listening, unconditional positive regard Provide a client-centered relationship

Identify a technique by its mechanism. Changing a maladaptive interpretation is cognitive; changing learned behavior through conditioning is behavioral; using both is cognitive-behavioral. Active listening and unconditional positive regard indicate a person-centered approach.

A fear hierarchy is listed with cognitive therapies in this CED, while systematic desensitization is an exposure method using behavioral principles. Similar topics do not make their mechanisms identical.

Group and Individual Therapy Differ in Who Participates

Format Participants in the therapeutic session Distinct interaction source
Individual therapy One client works with a therapist Therapist–client interaction
Group therapy Multiple clients participate with a therapist or therapists Therapist interaction plus interaction among group members

The difference is the treatment format, not necessarily the theoretical perspective. A cognitive, behavioral, or other technique can be delivered in a format whose participants and interactions differ.

The CED Objective asks for the distinction but supplies no claim that one format is always more effective. Do not infer superiority, confidentiality practices, or outcomes not provided by evidence.

Hypnosis Has Supported Uses—and Clear Limits

Claim about hypnosis Research status in the CED
Treating pain Has shown effectiveness
Treating anxiety Has shown effectiveness
Retrieving accurate memories Not supported
Regressing a person in age Not supported

An evidence-based use must match the supported outcome. Data showing reduced chronic pain after hypnosis can support a treatment claim about pain; it cannot be repurposed as evidence that hypnosis recovers accurate memories.

A vivid or confident recollection produced under hypnosis is not evidence of accuracy. Effectiveness for pain or anxiety does not validate unrelated claims about memory or age regression.

Biological Interventions Target Brain and Body Processes

Medication class or example Biological principle
Antidepressants Interact with specific central nervous system neurotransmitters
Antianxiety drugs Interact with specific central nervous system neurotransmitters
Lithium Addresses a possible biochemical cause through biological action
Antipsychotic medication Interacts with neurotransmitter systems to treat psychotic symptoms

Psychoactive medications can cause side effects. Tardive dyskinesia is a movement disorder related to dopamine regulation in the nervous system and is an important risk associated with some medication use.

Surgical or invasive intervention CED scope
Psychosurgery May involve lesioning
TMS Transcranial magnetic stimulation
Electroconvulsive therapy Listed biological intervention
Lobotomy Historical psychosurgery, popular in the mid-twentieth century and rarely, if ever, performed today

Biological interventions are not interchangeable: medications act through biochemical systems, while procedures intervene differently. The CED describes categories and risks, not instructions for choosing or administering treatment.