Introduction to Abnormal Psychology

• The text is about an introduction to abnormal psychology
• It defines its key terms and concepts, diagnostic criteria, and the biopsychosocial model

Abnormal Psychology

• It is a psychology branch focused on psychopathology and abnormal behavior
• It studies unusual patterns of emotion, behavior, and thought
• These patterns may or may not precipitate a mental disorder
• It is the study of people who are "abnormal" or "atypical" compared to a given society

Defining Abnormality

• Abnormality can be defined statistically
  • Trait, thinking, or behavior is abnormal if it is rare or statistically unusual
  • Fails to distinguish between desirable and undesirable behavior
  • Many rare behaviors have no bearing on normality or abnormality
  • Some characteristics are regarded as abnormal even if frequent
    • Depression may affect 27% of elderly people, making it common but still a problem
• Abnormality can be defined by violation of social norms
  • Thinking or behavior is classified as abnormal if it violates unwritten rules about expected behavior
  • Behavior may be incomprehensible or make others feel threatened
  • Social behavior varies markedly across cultures
  • Social norms change over time
    • Behavior once seen as abnormal may become acceptable
  • Considering drinking & driving / homosexuality
    • Until 1980, homosexuality was considered a psychological disorder by WHO, but is now accepted
• Failure to function adequately defines abnormality
  • Abnormal if unable to cope with everyday life demands
  • May be unable to perform necessary behaviors for day-to-day living
• Characteristics that define failure to function adequately include exhibiting
  • Suffering
  • Maladaptiveness
  • Vividness & unconventionality
  • Unpredictability & loss of control
  • Irrationality/incomprehensibility
  • Causing observer discomfort
  • Violating moral/social standards
• Limitations: Abnormal behavior may actually be helpful, functional, and adaptive
  • e.g., Hand-washing may make an individuals who suffers from OCD cheerful
  • Many engage in harmful behavior but are not classified as abnormal
    • e.g., adrenaline sports, smoking, drinking alcohol
• Deviation from ideal mental health defines abnormality
  • It defines what is normal/ideal and anything deviating from this is regarded as abnormal
  • Includes characteristics of
    • Positive view of self
    • Capability for growth and development
    • Autonomy and independence
• Limitations: It is practically impossible for any individual to achieve all ideal characteristics all the time
  • For example, a person may not be the "master of his environment" but is happy
  • Absence of ideal mental health criterion hardly suggests suffering from mental disorder

Universal Agreement

• There is no universal agreement on what abnormality means
• The following concepts are still universal to the study
  • Suffering
  • Maladaptiveness
  • Deviancy
  • Violation of standards of society
  • Social discomfort
  • Irrationality & unpredictability
  • Subjective to social judgments

DSM's Definition of Mental Disorder

• A clinically significant behavioral or psychological syndrome or pattern
• Associated with distress or disability
  • Impairment in one or more areas of functioning
• Not simply a predictable or culturally sanctioned response to a particular event
• Considered to reflect behavioral, psychological, or biological dysfunction in an individual

DSM 5 Definition

• Syndrome characterized by clinically significant disturbance in cognition, emotion regulation, or behavior
• Reflects a dysfunction in underlying psychological, biological, or developmental processes
• Usually associated with significant distress and disability in social, occupational, or other activities
• Not an expectable, culturally approved response to an event, nor socially deviant behavior
• Conflicts between individual and society unless it results from a dysfunction

Classification System

• Includes a multiaxial assessment
• Diagnostic and Statistical Manual of Mental Disorders (DSM) developed by APA
• International Classification of Diseases (ICD) developed by WHO
• Purposes of classifying mental disorders:
  • Distinguish one psychiatric diagnosis to offer effective treatment
  • Provide a common language among health care professionals
  • Explore still unknown causes of mental disorders

Multiaxial Evaluation

• DSM-IV-TR is a multi-axial system evaluating patients along several variables, containing 5 axes
• Axes I and II make up mental disorder classification: 17 major & 300 specific
• Axis I is clinical disorders and conditions that may be focus of clinical attention
  • Includes diagnoses of;
    • Disorders first diganosed in infancy; childhood; or adolescence
    • Delirium, dementia, amnestic and other cognitive disorders
    • Mental Disorder due to medical reasons
    • Substance-related disorders
    • Schizophrenia & psychotic disorders
    • Anxiety Disorders
    • Somatoform Disorder
    • Dissociative Disorders
    • Sexual & Gender Identity Disorders
    • Eating Disorders
    • Sleep Disorders
    • Impulse-control disorders
    • Adjustment disorders
    • Clinical attentions
• Axis II consists of personality disorders and mental retardation
  • Habitual use of a defense mechanism can be found here
  • Paranoid Personality Disorder
  • Schizoid Personality Disorder
  • Schizotypal Personality Disorder
  • Antisocial Personality Disorder
  • Borderline Personality Disorder
  • Histrionic Personality Disorder
  • Narcissistic Personality Disorder
  • Avoidant Personality Disorder
  • Dependent Personality Disorder
  • Obsessive Compulsive Personality Disorder
  • Personality Disorder
  • Mental Retardation
• Axis III lists any physical disorder or general medical condition present with the mental disorder
  • It may be a cause, result, or unrelated to the mental disorder
  • If causative, it is listed in both Axis I & III
• Axis IV is used to code psychosocial and environmental problems that contribute significantly to the development / exacerbation of current disorder
  • Problems with primary support group or in related to social environment
  • Educational, occupational, or housing problems
  • Economic problems or problems with access to health care services
  • Problems related to interaction with the legal system or environmental factors
• Axis V is a global assessment of functioning - scale judging a patients overall time in a particular time
  • Functioning includes social, occupational & psychological
  • Axis V GAF scale
    • Score 91-100: means superior functioning where there are no symptoms
    • Score 81-90: Absent limited symptoms with good functioning in all areas, is socially effective, generally satisfied with life
    • Score 71-80: transient present, and expectable reactions to psychosocial stressors
    • Score 61-70: mild conditions with mild difficulty in working as a individual leading to good interpersonal ship
    • Score 51-60: Moderate symptoms OR moderate difficulty with small group as they confront peers
    • Score 41-50: Major symptoms such as suicide
    • Score 31-40: Impairment in reality testing to communicate
    • Score 21-30: A Delusional state along with no judgement leading as a individual
    • Score 11-20: some that damage as self or gross
    • Score 1-10: severely hurt as self
    • Score 0: inadequate

Biopsychosocial Model of Mental Illness

• George Engel & John Romano are best known for this
• Involves complex interplay of three major dimensions in psychiatric disorders development
• Provides a holistic approach to psychiatric illnesses
• A person does not suffer as isolated organs, but rather as a whole
• Biological includes causal factors from genetics to neuroscience
  • The Nature are attribute from the individual
    • Our genetics determine the behavior, physical appearance, & personality characteristics
  • Nutrition
    • Vulnerabilities of the disorder
    • The upbringing, and life experiences determine our behavior
    • We are "nurtured" to behave in certain ways
  • Neuroscience Paradigm:
    • Mental disorders are linked to aberrant processes in the brain
    • Neurotransmitter:
    • A biochemical messenger that sends signals from one neuron to another
    • Brain Structure & Function:
    • Is related to mental disorder
    • Failure to undergo processes lead to the development of disorders
    • Cortisol levels of a person with depression are elevated
• Psychological includes causal factors from behavioral and cognitive processes
  • Behavioral contributes to the development of psychopathology
  • Therapy reinforcement
  • Children with autism develop language and children with mental retardation develop life skills
  • Cognitive Science is the role of unconscious in people
    • People believe that situations are uncontrollable so they do not try to change the situation
    • Concepts are highly taught for learning
• Social/Emotional factors are enviromental interactions
  • Ex. Gender influences influence, role in society. influences to challenges of the enviroment.
    • Culture & Ethnicity influences psychopathy