Abnormal Psychology Chapter

Abnormal Behavior in Historical Context

• Abnormal behavior is a psychological dysfunction associated with distress or impairment in functioning and a response that is not typical or culturally expected.
• The concept of impairment is useful, although not entirely satisfactory, and the behavior must be associated with distress to be classified as abnormal.

Definition of Psychological Disorder

• The most widely accepted definition used in DSM-5 describes behavioral, psychological, or biological dysfunctions that are unexpected in their cultural context and associated with present distress and impairment in functioning, or increased risk of suffering, death, pain, or impairment.

Psychopathology

• Psychopathology is the scientific study of psychological disorders.
• Counseling psychologists tend to study and treat adjustment and vocational issues encountered by relatively healthy individuals.
• Clinical psychologists concentrate on more severe psychological disorders.

Professionals in the Field

• Psychiatrists earn an M.D. degree in medical school and then specialize in psychiatry during residency training, investigating the nature and causes of psychological disorders, making diagnoses, and offering treatments.
• Psychiatric social workers earn a master's degree in social work, collecting information relevant to the social and family situation of the individual with a psychological disorder, and treating disorders.
• Psychiatric nurses have advanced degrees, such as a master's or Ph.D., and specialize in the care and treatment of patients with psychological disorders.
• Marriage and family therapists and mental health counselors typically spend 1-2 years earning a master's degree and provide clinical services.

Epidemiology

• Prevalence refers to the number of people in the population as a whole who have a disorder.
• Incidence refers to the number of new cases that occur during a given period.

Course of a Disorder

• The course of a disorder refers to its pattern over time, including chronic, episodic, or time-limited courses.
• Prognosis refers to the anticipated course of a disorder, including the likelihood of recovery.

Historical Conceptions of Abnormal Behavior

• The supernatural tradition attributes abnormal behavior to agents outside the body and environment, such as demons, spirits, or the moon.
• In the Middle Ages, treatments for abnormal behavior included exorcism, confinement, beatings, and other forms of torture.

The Biological Tradition

• The Greek physician Hippocrates is considered the father of modern Western medicine, suggesting that psychological disorders could be treated like any other disease.
• Hippocrates believed that the brain was the seat of wisdom, consciousness, intelligence, and emotion, and that disorders involving these functions would logically be located in the brain.
• The humoral theory of disorders attributed disease to an imbalance of four bodily fluids or humors: blood, black bile, yellow bile, and phlegm.

The Psychological Tradition

• The psychological tradition emphasizes the role of emotional and psychological factors in abnormal behavior.
• Moral therapy, developed in the 19th century, emphasized treating institutionalized patients as normally as possible in a setting that encouraged and reinforced normal social interaction.
• Philippe Pinel and Jean-Baptiste Pussin introduced humane and positive psychological interventions, including removing chains used to restrain patients.

An Integrative Approach to Psychopathology

• No influence operates in isolation, and biological and psychological factors interact and influence each other to create a psychological disorder.
• Huntington's disease and phenylketonuria (PKU) are examples of disorders caused by genetic defects, but with little contribution from other genes or environmental background.
• Linkage studies attempt to identify the location of genes contributing to a disorder by studying individuals who share the same disorder and other features, such as eye color.
• The environment may occasionally turn on certain genes, leading to changes in the number of receptors at the end of a neuron, which affects biochemical functioning in the brain.### Interaction between Genetic Vulnerability and Environmental Stress
• Genetic vulnerability can increase the likelihood of experiencing stressful life events
• People with a genetic vulnerability to a certain disorder may have a personality trait that makes them more prone to accidents, for example, impulsiveness
• The interaction between genetic and environmental factors influences the development of behavior and personality

The Central Nervous System (CNS)

• The CNS consists of the brain and spinal cord
• There are two main parts of the CNS: the central nervous system and the peripheral nervous system

Neurons

• Dendrites receive messages from other neurons, which are converted into electrical impulses
• Axons transmit impulses to other neurons
• Neurons are not directly connected; there is a small space (synaptic cleft) between them
• Neurotransmitters are biochemicals that transmit impulses across the synaptic cleft

Brain Structure

• The brain stem is the lower, more ancient part of the brain, handling essential automatic functions
• The forebrain is more advanced and evolved more recently
• The hindbrain regulates automatic activities, such as breathing, heartbeat, and digestion
• The cerebellum controls motor coordination and may be associated with autism
• The midbrain coordinates movement with sensory input and contains parts of the reticular activating system
• The thalamus and hypothalamus regulate behavior and emotion, and function as a relay between the forebrain and brain stem
• The limbic system, located at the base of the forebrain, regulates emotional experiences and expressions, and is involved in basic drives such as sex, aggression, hunger, and thirst
• The basal ganglia, also at the base of the forebrain, control motor activity
• The cerebral cortex, the largest part of the forebrain, provides distinctly human qualities such as planning, reasoning, and creating

Brain Regions

• The temporal lobe is associated with recognizing sights and sounds, and long-term memory storage
• The parietal lobe is associated with recognizing sensations of touch and monitoring body positioning
• The occipital lobe is associated with integrating and making sense of visual inputs
• The frontal lobe is associated with higher cognitive functions, such as thinking, reasoning, and planning, and is involved in psychopathology

The Peripheral Nervous System (PNS)

• The PNS coordinates with the brain stem to ensure the body is functioning properly
• The PNS has two main components: the somatic nervous system and the autonomic nervous system
• The somatic nervous system controls muscles, while the autonomic nervous system regulates the cardiovascular and endocrine systems
• The autonomic nervous system has two divisions: the sympathetic nervous system and the parasympathetic nervous system
• The sympathetic nervous system mobilizes the body during times of stress or danger, while the parasympathetic nervous system balances the sympathetic system and facilitates the storage of energy

Endocrine System

• The endocrine system produces hormones that are released directly into the bloodstream
• The hypothalamus connects to the pituitary gland, which regulates the endocrine system
• The pituitary gland stimulates the adrenal glands, which produce epinephrine and cortisol
• The hypothalamic-pituitary-adrenocortical (HPA) axis is a system that regulates stress response

Neurotransmitters

• Research on neurotransmitter function focuses on changes in activity levels
• Agonists, antagonists, and inverse agonists are used to study neurotransmitter function
• Neurotransmitters can be classified into two categories: amino acid and monoamine neurotransmitters
• Glutamate is an excitatory neurotransmitter that "turns on" neurons
• GABA (gamma-aminobutyric acid) is an inhibitory neurotransmitter that regulates the transmission of information
• The GABA system is involved in reducing anxiety, anger, and aggression
• Serotonin, norepinephrine, and dopamine are monoamine neurotransmitters that influence behavior, mood, and thought processes
• SSRIs (selective-serotonin reuptake inhibitors) are used to treat anxiety, mood, and eating disorders
• Norepinephrine is involved in regulating behavioral tendencies, such as alarm responses and panic
• Dopamine is involved in the pathophysiology of schizophrenia, addiction, depression, and attention deficit hyperactivity disorder

Cognitive Science

• Cognitive science is concerned with how we acquire and process information, and how we store and retrieve it
• Learned helplessness is a phenomenon in which organisms learn to feel helpless in the face of uncontrollable events
• Modeling or observational learning occurs when we learn by observing others
• Prepared learning refers to the idea that we have evolved to learn about certain types of objects or situations that contribute to the survival of the species

Clinical Assessment and Diagnosis

• Clinical assessment is the systematic evaluation of psychological, biological, and social factors in an individual
• Diagnosis is the process of determining whether a particular problem meets the criteria for a psychological disorder
• Affect refers to the feeling state that accompanies verbal expressions
• Neuroimaging techniques, such as CT, MRI, PET, and SPECT scans, are used to visualize the brain structure and function### EEG and ERP
• EEG (Electroencephalogram) records low-voltage currents from different places on the scalp
• ERP (Event-Related Potential) records EEG patterns in response to specific events or stimuli

Research Strategies

• Idiographic strategy: focuses on individual differences and unique characteristics
• Nomothetic strategy: focuses on general laws and principles that apply to a group or population
• Classification: categorizes objects or people based on shared attributes or relations
• Taxonomy: classification system used in science to categorize entities (e.g., insects, rocks, behaviors)
• Nosology: classification system used in medicine to categorize diseases or disorders
• Nomenclature: system of names or labels used to describe diseases or disorders

History of DSM

• DSM-I (1952): first Diagnostic and Statistical Manual of Mental Disorders
• DSM-II (1968): second edition, updated criteria and categories
• DSM-III (1980): radical changes, introduced multiaxial system and precise diagnostic criteria
• DSM-IV (1994): updated criteria, eliminated distinction between organic and non-organic disorders
• DSM-IV-TR (2000): text revision, clarified criteria and improved consistency
• DSM-5 (2013): major changes, removed multiaxial system, introduced dimensional assessment

Multiaxial System

• Axis I: clinical disorders (e.g., schizophrenia, mood disorder)
• Axis II: personality disorders and intellectual disability
• Axis III: physical disorders and conditions
• Axis IV: psychosocial and environmental problems
• Axis V: global assessment of functioning

Research Methods

• Correlational research: studies relationships between variables
• Epidemiology: studies incidence, distribution, and consequences of a problem in a population
• Placebo effect: phenomenon where expectation of change leads to actual change
• Comparative treatment research: compares different treatments for a disorder
• Single-case experimental design: studies individual cases with repeated measurements
• Endophenotypes: genetic mechanisms underlying psychological disorders

Prevention and Intervention Strategies

• Health promotion/positive development: focuses on skill-building and protective behaviors
• Universal prevention: targets entire populations to prevent problems
• Selective prevention: targets specific groups at risk
• Indicated prevention: targets individuals showing early signs of problems

Anxiety and Panic Disorders

• Anxiety: negative mood state with bodily symptoms and apprehension
• Fear: immediate emotional response to current danger
• Panic attack: sudden experience of intense fear or discomfort, accompanied by physical symptoms
• Panic disorder: recurrent unexpected panic attacks
• Generalized anxiety disorder (GAD): excessive anxiety and worry for at least 6 months