Clinical Psychology Chapter 5 Quiz

Course Information

• Course title: Clinical Psychology and Psychotherapy Approaches
• Course code: PSYF231
• Instructor: Assoc. Prof. Siyabend KAYA
• Instructor's credentials: PhD, GMBPsS
• Institution: Abdullah Gul University

Chapter 5: Nature of Psychopathology

• This chapter focuses on overarching issues in clinical psychology regarding psychological problems, not specific types of abnormal behavior
• The learning objectives focus on the processes by which behaviors are considered maladaptive or abnormal
• Key aspect for consideration of normal or abnormal behavior is the processes used to determine abnormality/maladaptivity
• Two broad approaches in determining abnormality are
  • process of defining abnormality as normal or maladaptive behavior
  • Processes used by clinicians to determine whether a behavior is abnormal or maladaptive

Vignette 5.1

• Clinical psychology graduate student (Vincent) discusses different models of understanding psychological problems and how these affect appropriate treatment.
• One model focuses on treatment targeting underlying causes of symptoms.
• The other model focuses on symptom reduction
• Specific example provided of a depression treatment model focusing on either symptom reduction vs. addressing the reported cause of the symptoms.

Vignette 5.2

• Psychologist (Dr. A) assessing a father of a child with cancer
• Aiming to determine if the responses & behaviors exhibited by the father (e.g., anxiety, depression) are normal reactions to the stress of a serious event, or indicative of a diagnosable disorder.
• This analysis will inform recommendations regarding an appropriate course of treatment(supportive or in-depth)
• This determination is crucial in tailoring a suitable treatment plan

Vignette 5.4

• Psychologist (Dr. C) attempting to understand the underlying causes of psychological difficulties, especially the relationship between depression and chronic pain.
• Research will determine whether depression is a cause of pain, influences experience of pain, or a consequence of pain.
• Variables considered are attitudes, thoughts, interpersonal styles, and experiences of loss in childhood.

Psychological Problems Clinical Psychologists Focus On

• Determining if behavior is normal or abnormal in individuals, couples, or families
• Questioning whether a behavior is abnormal or maladaptive is complex, approached in two ways
  • processes for defining a behavior as abnormal or maladaptive
  • Processes clinicians use for determining abnormality/maladaptivity

Indicators of Abnormality (Defining Psychological Problems)

• No single behavior defines abnormality
• Indicators used for determining abnormality frequently involve multiple factors concerning an individual or couple/family.
• Several areas of difficulty increase the probability of a mental disorder
  • Subjective distress
  • Maladaptiveness
  • Statistical deviancy
  • Violation of societal standards
  • Social discomfort
  • Irrationality and unpredictability
  • Dangerousness

1. Subjective Distress

• Presence of psychological pain or anguish
• Not always present (e.g., mania)
• Not the only or sufficient criteria for abnormality
• Usually coupled with other issues

2. Maladaptiveness

• Behaviors interfering with well-being or social functioning
• Examples: extreme food restriction (anorexia), social isolation

2. Maladaptiveness (continued)

• Not all maladaptive behaviors are abnormal
• Examples: criminal behavior serving individual goals

3. Statistical Deviancy

• Behavior that is rare
• Doesn't equal abnormality
• Examples: Genius, perfect pitch; common cold
• Doesn't imply abnormality

4. Violation of Societal Standards

• Behavior deviating from social norms
• Norms can be formal (laws), informal (social rules)
• Examples: driving or TV viewing habits, considered abnormal in specific cultures

5. Social Discomfort

• Behavior provoking or eliciting discomfort or unease
• Often not legally or formally defined but still recognized as abnormal, as it affects social interactions
• Example: someone sitting next to an empty seat in a bus

6. Irrationality and Unpredictability

• Behavior deviating from expectations/predictability, considered abnormal when out of context.
• Example: someone screaming and yelling obscenities without apparent reason
• Context plays a critical role in determining abnormality
• Uncharacteristic behaviour of someone, if no apparent reason, may be considered abnormal

7. Dangerousness

• The risk a person may pose to self or others; cannot be the sole determinant
• Not all people posing danger are psychologically abnormal; examples: soldiers (combat) or poor drivers

7. Dangerousness (continued)

• Engaging in risky behaviors not always indicative of a mental illness
• Dangerousness is more of an exception than the rule for people with a mental illness
• Dangerousness is not, by itself, sufficient in defining abnormality
• Is one of multiple factors that may be seen in abnormality

Indicators of Abnormality (Summary)

• Each indicator has strengths and weaknesses
• Clinicians may simultaneously use multiple indicators

Issues in Defining Psychological Problems

• Defining abnormal behavior is complex
• Symptoms or issues that aren't formal mental disorders can still create problems in living
• Common problems in individuals that suffer from psychological disorders may be the focus of treatment

What Problems do people face

• Relationship problems
• Personal issues (self-esteem, identity-related problems)
• Achievement problems (feelings of stagnation, work issues)
• Physical concerns
• Problems related to loss (death, divorce)

7. Emotional Regulation

• Emotions can be a major indicator of psychopathology,
• Anxiety, depression, and anger are typical of many psychological disorders
• Difficulty controlling or regulating emotions and expressing them can also be a crucial characteristic of psychopathology.

8. Thoughts/Cognitions, Intellectual Functioning, Information Processing

• Thoughts, thought processes (cognitions) are examined in psychopathology
• Unusual beliefs (delusions) are seen in various mental disorders (e.g., schizophrenia)
• Cognitive processes (e.g., rumination) are potentially problematic
• Problems with thinking are a cause and a symptom of many psychological disorders

9. Perceptions

• Perceptual processes and experiences are examined in psychopathology
• Example difficulties: hallucinations (hearing voices, seeing images/images)
• Difficulty perceiving the world as dangerous or hostile can be a form of psychopathology

10. Interpersonal Processes

• Relationships (intimate, friendships, support groups, work, family are of interest to clinical psychologists
• Relationship schemas (representations)
• Unrealistically low, high, reactive self-views are common psychological issues

11. Regulatory or Coping Behavior

• How people handle anxiety, and stressors is a focus of clinical psychologists
• Coping strategies that are ineffective can negatively impact mental health.
• Maturity and effectiveness of strategies are important
• Problems can arise from dealing with internal and external challenges
• Can be a factor in psychopathology

12. Development

• Crucial for clinical psychologists for understanding abnormality, especially for children and adolescents
• Assessment of developmental milestones and expectations
• Previous and current experiences, relationships, challenges, etc are examined as indicators of psychological well-being or disorder.

13. Environment

• Clinicians consider environmental influences in diagnosing psychological problems.
• Environment can cause and perpetuate difficulties
• Modifying environment can be a therapy focus.

14. Important Concepts (Signs and Symptoms)

• 'Sign' observable by a clinician, potentially unseen to patient (e.g., schizophrenia)
• 'Symptom' reported by a patient (e.g., emotional pain).
• 'Syndrome' A set of signs or symptoms indicative of an underlying issue or disorder.
• 'Disorder' A clinically recognizable set of signs, symptoms, and/or behaviors causing distress.

15. DSM and ICD

• Diagnostic and statistical manual of mental disorders (DSM) and the International Classification of Diseases (ICD) are formal systems for diagnosing psychological disorders (DSM is more popularly used).