Understanding Psychopathology

Understanding Psychopathology

• Distinguishes abnormal psychology and the study of mental disorders

Who Studies Abnormal Psychology

• Butcher defines abnormal psychology as understanding the nature and treatment of mental disorders
• The APA defines abnormal psychology as the study, assessment, treatment, & prevention of maladaptive behavior
• Barlow defines it as "problematic abnormal behavior"

Signs of Psychological Disorders

• A psychological dysfunction includes distress or impairment in functioning accompanied by a response
• The 4 D's of Abnormality are deviance, dysfunction, distress, and danger

Deviance in Mental Health

• Deviance involves deviating from the average, occurring infrequently, being atypical, and violating social norms
• Cultural awareness is important when considering deviance, and examples include eating dirt/mud
• What is considered normal in some places, such as Africa and South America, differs in others
• In those regions, dirt is normal for medication purposes

Dysfunction

• Dysfunction is a breakdown in cognitive, mental, or behavioral functioning
• Cognition involves thinking, memory, decision making, judgment, and language development
• Emotions involve adapting to the environment, connecting socially, and self-awareness
• Not all of the criteria needs to be satisfied to indicate a psychological disorder
• Some behaviors are normal with respect to duration, intensity, frequency, or symptoms

Determining Danger and Distress

• If people suffer or experience psychological pain, they are experiencing distress
• Danger involves putting oneself or others at risk, including inflicting danger to oneself and others
• The presence of the 4 D's does not guarantee a disorder.
• Lawyers may claim mental disorder to reduce sentencing
• Intention should be checked to see if there is a pattern

Harmful Dysfunction Simplified

• Jerome Wakefield simplified the 4 D's of abnormality down to one key concept.
• Harmful dysfunction must be present for the 4 D's to apply
• Harmful means that dysfunction must cause significant distress or impairment in life
• Dysfunction: failure in a biological or psychological function

Limitations of Harmful Dysfunction

• Fully understanding the evolutionary function of a behavior is necessary
• This can often be unclear.
• An alternative perspective is if the behavior is out of the individual's control

Diagnosing a Metal Disorder

• A mental disorder presents as a syndrome
• It is characterized by clinically significant disturbances in cognition, emotion regulation, or behavior
• It reflects a dysfunction in the psychological, biological, or developmental processes
• It is usually associated with significant distress or disability in social, occupational, or other activities
• It is not an expectable or culturally approved response to a common stressor or loss, like the death of a loved one
• Socially deviant behavior, such as political, religious, or sexual expression, and conflicts between individuals are not considered mental disorders

Psychological Disorder and Abnormal Behavior

• They involve psychological dysfunction within an individual
• They are associated with distress or impairment in functioning
• Response must not be typical or culturally expected
• 4 criteria include harmful psychological dysfunction, a breakdown in cognitive, emotional, or behavioral functioning, a value judgment component

Psychological Dysfunction Criteria

• Dysfunctions occur when an internal mechanism cannot perform its natural, evolved function, according to Wakefield
• Judgement of behavior's harm and the belief a dysfunction causes it form part of our diagnosis
• This component is objective & scientific
• Dysfunction in behavior, psychology, or biology are interrelated
• Dysfunction in the brain and behavior are interrelated
• Determining the line between normal and abnormal is difficult
• Problems are a continuum/dimension, not a dichotomy of present or absent

Distress & Impairment

• Distress becomes the criteria if the individual is extremely upset
• By itself, this criteria fails to define problematic abnormal behavior
• Disorders represent extreme expressions of normal emotions
• Mental disorders aren't always distressing, like antisocial personality disorder
• Some disorders lack definitions of suffering and distress
• Someone in a manic episode who feels elated and impulsive may not seek treatment

Impairment

• Not all disorders involve impairment
• Those with bulimia nervosa may binge and purge in private without impairment

Atypical Response

• Many are far from average but not disordered, simply talented or eccentric
• "Deviating from average" isn't a good definition for problematic behavior

Violation of Social Norms

• Social norms are standards people use to judge behaviors as good/bad, right/wrong, etc.
• Behaviors are abnormal if they occur infrequently and deviate from the average
• The greater the deviation, the more abnormal it is to be violating social norms, even if others are sympathetic

DSM-5 Definition of Mental Disorders

• Behavioral, psychological, or biological dysfunctions are unexpected in a cultural context
• Associated with distress/impairment or increased risk of suffering/death/pain/impairment
• Consider how a disease or disorder matches a "typical" disorder profile or prototype
• When all symptoms experts agree are part of the disorder are present in an individual

Statistical Data & Psychopathology

• This means patients only need some symptoms to meet disorder criteria if their symptom set is close to the prototype
• Concerns the scientific study of mental disorders, their nature, development, and treatment
• It is the same with abnormal psychology

Professionals

• Clinical/counseling psychologists receive a Ph.D., Ed.D., or Psy.D. after five years of graduate study
• They conduct research, diagnose, assess, and treat disorders
• Counseling psychologists study and treat adjustment and vocational issues experienced by relatively healthy individuals and normal populations
• Clinical psychologists concentrate on severe psychological disorders

Types of Clinical Psychologists

• A Ph.D path follows a graduate level study
• Clinical cases are diagnosed, assessed, and treated
• Ph.D is focused on clinical training and eliminates research training
• Can use pharmacology and prescribe psychoactive medications, but is not the only aspect of medical practice
• Referrals are given to this professional if a client needs to stabilize their functioning before psychology interventions is required

Further Types of Professionals

• Psychiatric social workers have master's degrees in social work
• They collect information and treat disorders with family problems
• Psychiatric nurses, holding master's degrees or Ph.Ds, specialize in caring for patients with disorders in hospitals
• Marriage and family therapists and mental health counselors earn master's degrees in 1-2 years
• They provide services in hospitals/clinics under doctoral supervision

The Scientist-Practitioner Model

• In psychopathology, scientific methods are adopted to study disorders
• Scientist-practitioners may function as consumers, evaluators, or creators of science
• As consumers, they enhance practice by staying current on research
• As evaluators, they determine the effectiveness of practices
• As creators, they conduct research, often in clinics/hospitals
• This provides new information regarding disorders and treatment

Studying Psychological Disorders

• Study disorders through clinical description, causation (etiology), and treatment and outcome
• Clinical descriptions are unique combinations of behaviors, thoughts, and feelings
• "Clinical" refers to clinic/hospital problems & connected assessment/treatment activities
• Also look at strengths, thought processes, coping mechanisms in patients
• Predisposing = factors increasing susceptibility that includes genetic family history
• Precipitating = events or stressors that trigger onset such as traumatic experience or stressful events
• Perpetuating = conditions/behaviors that maintain or worsen the issued such as maladaptive coping

Statistical Data

• There are 4 components: Presenting problems, clinical descriptions, statistical data, course
• Presenting problems explain help seeking behavior and help with the treatment plan
• Clinical descriptions define the disorder
• Statistical data includes prevalence (disorder rate in the population), incidence (new cases in a period), and sex ratio
• Sex ratio helps us understand why some disorders are gender focused, and helps point to genetic, social, or hormone causes
• Gender identity isn't considered here
• Typical age of onset is an important factor
• High prevalence but low incidence = chronic disorders for which there is a low rate of new cases and slow rates of improvement in general

Course

• Includes individual patterns followed by disorders
• Chronic disorders last a long time, like schizophrenia
• Doesn't necessarily mean a cure is impossible
• However, treatments & therapeutic interventions are used to manage the symptoms
• Disorders with an episodic course recur after a few months
• Time-limited disorders improve without treatment
• Onset describes how the disorder started, such as acute vs insidious

Prognosis

• Prognosis = anticipated course of a disorder and what can be expected in a disorder based on assessment
• A good prognosis means the individual recovers
• A guarded prognosis has a bad outcome
• Early diagnosis = opportune time sensitive treatment, which could prevent the disorder from worsening
• Focus on treatment sometimes instead of the diagnosis
• A patient's age influences the clinical approach
• An environmental case history is needed if abuse or neglect is involved

Psychosocial and Development Theories

• If one stage isn't satisfied, they can't proceed
• We would go back to the start to resolve the issue
• Note that this type of thinking is not applicable in every case
• Developmental psychology refers to the study of behavioral changes over time
• It does not focus in the developmental level
• Developmental psychopathology is a study of how behavior changes and deviates when a disorder is diagnosed
• Life-span is if it has been occuring across the whole age range of the client

Causation

• Concerns the origins of a disorder, what causes it, and which factors affect it largely
• Depression may stem from biological (genetic predisposition), psychological (trauma/negative thoughts), or social components (cultural pressures/family dynamics)

CBT

• CBT addresses these negative thoughts
• Causation is biological, psychological, and social
• A Granger causality describes when a series of events predicts another events temporally
• However, events can be hard to understand and pinpoint
• A challenge when determining causality is seeing that two events occuring together doesn't always mean the other directly causes the other

Medication

• Medicine targeting neurotransmitters can treat schizophrenia, but doesn't equate to causation
• Treatment is important for psychological and disorder studies
• If new psychosocial of drug treatment works, it may give hints about the disorders nature