Introduction to Abnormal Psychology PDF

UNIT I ABNORMAL PSYCHOLOGY- An Overview Abnormality: Meaning, Definition, Nature Historical Background of Abnormality. Criteria of abnormal behaviour (Biological, Psychological, Socio-cultural) Current Classification Systems: DSM-5 & ICD-10/11 an Overview NORMALITY...

UNIT I ABNORMAL PSYCHOLOGY- An Overview Abnormality: Meaning, Definition, Nature Historical Background of Abnormality. Criteria of abnormal behaviour (Biological, Psychological, Socio-cultural) Current Classification Systems: DSM-5 & ICD-10/11 an Overview NORMALITY - Normality is behavior that is consistent in a person’s usual way of behaving. It is conformity to societal standards as well as thinking and behaving similarly to the majority, and as such is generally seen as good in this context. Normality is also behavior that is expected and/or appropriate to the situation. It may also be just being average, as is the case in psychological statistics. It involves being able to adjust to the surroundings, manage or control emotions, being able to work satisfactorily as well as build relationships that are fulfilling or at least acceptable. Read more: Difference Between Normality and Abnormality Psychology | Difference Between http://www.differencebetween.net/science/difference-between-normality-and-abnormality-psychology/#ixzz 7cUfGzK1d WHAT IS ABNORMAL ? Deviating from what is normal or usual, typically in a way that is undesirable or worrying. "the illness is recognizable from the patient's abnormal behaviour" - Unusual, Rare, Atypical, Untypical, Deviating, Divergent, Unhealthy, Malformed, Unfamiliar, Out of the Ordinary, Bizarre, Irregular, Anomaly, Odd, Unconventional, Unnatural…etc.. - Behavior is considered to be abnormal when it is atypical or out of the ordinary, consists of undesirable behavior, and results in impairment in the individual's functioning. Abnormality in behavior, is that in which is considered deviant from specific societal, cultural and ethical expectations.(Wikipedia) Abnormality- Abnormality is any impairment in an individual’s functioning or maladaptation to changes in life or the surroundings. It is behavior that is unusual, bizarre, atypical or out of the ordinary. It is maladjustment to one’s society and culture, exaggeration, perversion or violation of a society’s prevailing standards, and is generally viewed as bad. It can be a lack or a deficit in a particular trait, like in limited intelligence, or just being a statistical rarity as in being above genius. It can also be a disorganization in personality or emotional instability. In abnormal psychology, abnormality is defined as behavior that is deviant from societal norms, distressing to the individual or to close relations, dysfunctional to everyday living, or dangerous to self or others. Read more: Difference Between Normality and Abnormality Psychology | Difference Between http://www.differencebetween.net/science/difference-between-normality-and-abnormality-psychology/#ixzz7cUgE7oQi ABNORMAL PSYCHOLOGY The branch of psychology devoted to the study, assessment, treatment and prevention of maladaptive behavior. - American Psychological Association The field of psychology consists of many sub-fields. Abnormal psychology is a subfield of psychology that focuses on studying behavior, emotion, thoughts that deviate from what is considered "normal." It is amongst the prominent clinical branches of psychology and focuses on abnormal human behaviour which is different from the normal curve of human behaviour and thus results in various implications on the individual’s mind. Abnormality can be observed in behaviour, personality, thoughts and emotion regulation. To summarize In psychology, normality and abnormality refer to behaviors, including thoughts and emotions, as well as biological and psychological traits. Normality and abnormality are subjective to individual perspectives and societal norms and the meanings of each may change depending on the times, culture and societal standards. In simplest terms, normality is conformity to norms and abnormality is deviance from the norms. Normality is good or correct adaptive behavior while abnormality is maladaptation or maladjustment. Normality usually leads to healthy state of mind and living while abnormalities may lead to mental or emotional distress. HISTORICAL BACKGROUND OF ABNORMALITY What is considered abnormal behavior is often dictated by the culture/society a person lives in ❏ Prehistoric and Ancient Beliefs Prehistoric cultures often held a supernatural view of abnormal behavior and saw it as the work of evil spirits, demons, gods, or witches who took control of the person. This form of demonic possession was believed to occur when the person engaged in behavior contrary to the religious teachings of the time. Treatment by cave dwellers included a technique called trephination, in which a stone instrument known as a trephine was used to remove part of the skull, creating an opening. They believed that evil spirits could escape through the hole in the skull, thereby ending the person’s mental affliction and returning them to normal behavior. Early Greek, Hebrew, Egyptian, and Chinese cultures used a treatment method called exorcism in which evil spirits were cast out through prayer, magic, flogging, starvation, noise-making, or having the person ingest horrible tasting drinks. ❏ Greco-Roman Thought- Rejecting the idea of demonic possession, Greek physician, Hippocrates (460-377 B.C.), said that mental disorders were akin to physical disorders and had natural causes. Specifically, he suggested that they arose from brain pathology, or head trauma/brain dysfunction or disease, and were also affected by heredity. Hippocrates classified mental disorders into three main categories – melancholia, mania, and phrenitis (brain fever) and gave detailed clinical descriptions of each. He also described four main fluids or humors that directed normal functioning and personality – blood which arose in the heart, black bile arising in the spleen, yellow bile or choler from the liver, and phlegm from the brain. Mental disorders occurred when the humors were in a state of imbalance such as an excess of yellow bile causing frenzy/mania and too much black bile causing melancholia/depression. Hippocrates believed mental illnesses could be treated as any other disorder and focused on the underlying pathology. Also important was Greek philosopher, Plato (429-347 B.C.), who said that the mentally ill were not responsible for their own actions and so should not be punished. He emphasized the role of social environment and early learning in the development of mental disorders and believed it was the responsibility of the community and their families to care for them in a humane manner using rational discussions. Greek physician, Galen (A.D. 129-199) said mental disorders had either physical or mental causes that included fear, shock, alcoholism, head injuries, adolescence, and changes in menstruation.  ❏ Roman physicians treated mental disorders with massage and warm baths, with the hope that their patients be as comfortable as possible. They practiced the concept of “contrariis contrarius”, meaning opposite by opposite, and introduced contrasting stimuli to bring about balance in the physical and mental domains. An example would be consuming a cold drink while in a warm bath. ❏ The Middle Ages – 500 AD to 1500 AD- The progress made during the time of the Greeks and Romans was quickly reversed during the Middle Ages with the increase in power of the Church and the fall of the Roman Empire. Mental illness was yet again explained as possession by the Devil and methods such as exorcism, flogging, prayer, the touching of relics, chanting, visiting holy sites, and holy water were used to rid the person of the Devil’s influence. In extreme cases, the afflicted were confined, beat, and even executed. Scientific and medical explanations, such as those proposed by Hippocrates, were discarded at this time. Group hysteria, or mass madness, was also seen in which large numbers of people displayed similar symptoms and false beliefs. This included the belief that one was possessed by wolves or other animals and imitated their behavior, called lycanthropy, and a mania in which large numbers of people had an uncontrollable desire to dance and jump, called tarantism. The latter was believed to have been caused by the bite of the wolf spider, now called the tarantula, and spread quickly from Italy to Germany and other parts of Europe where it was called Saint Vitus’s dance.  The study of abnormal behavior dates back to the time of the ancient Greeks. During the late 1800s and early 1900s, thinkers such as Sigmund Freud suggested that mental health conditions could be treated with methods including talk therapy. The 12th through 16th centuries saw a turn to cruelty in dealing with the mentally ill. Imprisonment, starvation, severe beating, and restraint with chains quickly became the preferred method of dealing with the mentally ill. Beginning in the 18th century, the psychological community made some advances in mental illness. The age of enlightenment was in full swing, and humanitarianism was the New Age reform during this time. Chains were removed from patients, as an experiment, and produced great results. Early psychologists of the time began training medical practitioners in the kind treatment of the mentally ill, which also bought excellent results. However, imprisonment and cruel, inhumane treatment of the mentally ill still prevailed across most of world, and commitment to asylums was largely the norm. The 19th century was dominated by a change in general opinion regarding mental illness. Dorothea Dix, a nurse and social reformer, began a revolution in the way people viewed the mentally ill. She gained worldwide recognition for bringing the inhumane treatment of mental patients to the attention of the general public. She established and enlarged 32 mental hospitals in America, Europe, and Japan, and changed treatment practices to those of a humanitarian nature. As with many other changes that were occurring in America, and the world, this century saw much bigger advances in the treatment of the mentally ill. The National Institute of Mental Health was established, the Hill-Burton Act, which provided funding for mental health agencies, was passed, and the age of "deinstitutionalization" began. This essentially meant that institutionalizing patients was used as a last resort, and a shift began toward out-patient care and the use of drugs to treat certain mental illnesses. Sigmund Freud's theories on mental and emotional disorders was gaining worldwide interest. Talk therapy and psychoanalysis became hugely popular for a large part of the population. Alcoholics Anonymous was founded in 1939. By the end of the 20th century, AA had gained an estimated 1 million members in the U.S. alone. Stigma was reduced to a large degree; this propelled more people who suffered in silence to come forward and seek help for mental problems, which ultimately led to the psychological community having a richer pool from which to perform research. Research, in turn, led to greater developments in therapies that would help millions of people suffering from a variety of mental disorders, as well as the development of numerous drugs that were prescribed in great excess during this century, often to the detriment of the patient. Early 21st century research has been heavily focused on the study of neurotransmitters, hormones, genetics, and brain matter. This research has, and will continue to, lead to alternative treatments that are geared to changing, or "fixing," brain chemistry, hormonal imbalances, and neurotransmission problems in the brain, without the use (or with minimal use), of prescription medications. There is a movement away from the heavy use of drugs that ultimately causes more problems to the patient; some can be highly addictive, and often very difficult to withdraw from. The latest research reveals that the use of Omega 3 and Omega 6 fatty acids has been found to decrease the onset of psychotic disorders, such as bi-polar and paranoid schizophrenia. These findings are very exciting, because large amounts of Omega 3 have no side effects, help alleviate depression, and actually produce benefits to the heart, skin, and eyes. The perspectives in Abnormal Psychology The medical perspective The psychodynamic perspective The behavioral perspective The cognitive perspective The social‐cultural perspective Criteria of abnormal behaviour (Biological, Psychological, Socio-cultural) Abnormal behavior is defined as ‘behavior that is atypical or statistically uncommon within a particular culture or that is maladaptive or detrimental to an individual or those around that individual. There are four major criteria for identifying abnormal behavior in individuals, according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V), which is the most important text used by mental health professionals in the United States today. These four criteria are: Violation of social norms Statistical rarity Personal distress Maladaptive behaviors None of these criteria is sufficient on its own; abnormal behavior is usually identified when it falls into several of these categories. Violation of Social Norms. Behavior that is in violation of social norms is often considered psychologically and culturally abnormal. There are many reasons why a person might perform such behaviors. They might be suffering from a mental illness, but they may also be responding rationally to unusual circumstances. They might be acting in an abnormal way as part of a performance or because of cultural ignorance if they are a traveler. Violation of social norms alone is not sufficient to diagnose abnormal behavior. Statistical Rarity. Behavior can be abnormal because it is statistically rare. Someone who is acting in a way that is very uncommon may be demonstrating abnormal behavior. However, cultural context is again important to take into consideration: some very rare behaviors are nonetheless considered normal within a given society, provided those witnessing the behavior can understand the rationale behind it. However, statistical rarity can be a helpful thing to consider when analyzing behavior. People with uncommon neurodevelopmental disorders may also behave in ways that are abnormal primarily because they are statistically rare. Personal Distress. An important thing to consider when determining whether a behavior is abnormal is whether it causes personal distress either to the person performing the behavior or to those around them. Personal distress alone is certainly not a sufficient marker of abnormality, as people behave in a wide variety of ways that distress them without stepping out of the bounds of normal behavior. But if an unusual behavior is causing or caused by personal distress, it is likely something that could and should be treated as, if not necessarily abnormal, at least potentially pathological. Maladaptive Behaviors. Maladaptive behaviors are defined as actions that inhibit appropriate personal growth. They are created to deal with challenging life circumstances and are usually a kind of survival mechanism. However, when carried outside of a particular context, maladaptive behaviors can become abnormal and can be harmful to an individual. Understanding the causes of behaviors and seeing if they are maladaptive in nature can help determine whether a behavior is abnormal. There is no individual model that completely explains human behavior, or in this case, abnormal behavior, and so each model contributes in its own way. Biological – includes genetics, chemical imbalances in the brain, the functioning of the nervous system, etc. Psychological – includes learning, personality, stress, cognition, self-efficacy, and early life experiences. Several perspectives that make up the psychological model to include psychodynamic, behavioral, cognitive, and humanistic-existential. Sociocultural – includes factors such as one’s gender, religious orientation, race, ethnicity, and culture. Classification Systems: DSM-5 & ICD-10/11 an Overview DSM - The Diagnostic and Statistical Manual of Mental Disorders (DSM) is the handbook widely used by clinicians and psychiatrists in the United States to diagnose psychiatric illnesses. Published by the American Psychiatric Association (APA), the DSM covers all categories of mental health disorders for both adults and children. It contains descriptions, symptoms, and other criteria necessary for diagnosing mental health disorders. It also contains statistics concerning who is most affected by different types of illnesses, the typical age of onset, the development and course of the disorders, risks and prognostic factors, and other related diagnostic issues. Just as with medical conditions, certain government agencies and many insurance carriers require a specific diagnosis in order to approve payment for support or treatment of mental health conditions. Therefore, in addition to being used for psychiatric diagnosis and treatment recommendations, mental health professionals also use the DSM to classify patients for billing purposes. The Diagnostic and Statistical Manual was first published in 1952. Since then, there have been several updates issued. In the DSM-I, there were 102 categories of diagnoses, increasing to 182 in the DSM-II, 265 in the DSM-III, and 297 in the DSM-IV. DSM- 5- TR Is the first published revision of DSM-5 since its original publication in 2013. Like the previous text revision (DSM-IV-TR), the main goal of DSM-5-TR is to comprehensively update the descriptive text that is provided for each DSM disorder based on reviews of the literature since the release of the prior version. A number of significant changes and improvements in DSM-5-TR that are of interest to practicing clinicians and researchers. These changes include the addition of diagnostic entities, and modifications and updated terminology in diagnostic criteria and specifier definitions. Diagnostic entities added to DSM-5-TR include Prolonged Grief Disorder, Unspecified Mood Disorder, and Stimulant-Induced Mild Neurocognitive Disorder. The DSM-5-TR revised criteria for 70 disorders as well as added a new diagnosis, prolonged grief disorder. This new edition of the DSM also revised language surrounding gender dysphoria and race.  International Statistical Classification of Diseases ICD-1 was used internationally starting in 1909 with The United Nations delegating ICD-based responsibility to WHO beginning in 1946. The American Hospital Association (AHA) Central Office on ICD-9 was established by the Memorandum of Understanding as a Clearinghouse for ICD-9-based issues nearly two decades later. ICD serves a broad range of uses globally and provides critical knowledge on the extent, causes and consequences of human disease and death worldwide via data that is reported and coded with the ICD. Clinical terms coded with ICD are the main basis for health recording and statistics on disease in primary, secondary and tertiary care, as well as on cause of death certificates. These data and statistics support payment systems, service planning, administration of quality and safety, and health services research. Diagnostic guidance linked to categories of ICD also standardised data collection and enables large scale research. For more than a century, the International Classification of Diseases (ICD) has been the basis for comparable statistics on causes of mortality and morbidity between places and over time. Originating in the 19th century, the latest version of the ICD, ICD-11, was adopted by the 72nd World Health Assembly in 2019 and came into effect on 1st January 2022. ICD purpose and uses - As a classification and terminology ICD-11: allows the systematic recording, analysis, interpretation and comparison of mortality and morbidity data collected in different countries or regions and at different times; ensures semantic interoperability and reusability of recorded data for the different use cases beyond mere health statistics, including decision support, resource allocation, reimbursement, guidelines and more ICD-11 Highlights Legally mandated health data standard (WHO Constitution and Nomenclature Regulations). In effect from January 2022. Conceptual framework independent of language and culture. Integration of terminology and classification. End-to-end digital solution (API, tools, online and offline). Up-to-date scientific knowledge. Comparable statistics and semantic interoperability - for 150 years. ICD-11 is accessible to everybody. ICD-11 is distributed under Creative Commons Attribution-NoDerivs 3.0 IGO license. ICD-11 enables, for the first time, the counting of traditional medicine services and encounters. The 11th revision is more extensive and has greater implications for what can be done with the ICD, and how, than any revision since the 6th, in 1948. Drawing differences between DSM-5 & ICD - 11 During the development of the ICD‐11 and DSM‐5, the World Health Organization (WHO) and the APA made efforts toward harmonizing the two systems, including the appointment of an ICD‐DSM Harmonization Group. The ICD and DSM are now closer than at any time since the ICD‐8 and DSM‐II. Differences are largely based on the differing priorities and uses of the two diagnostic systems and on differing interpretations of the evidence. Substantively divergent approaches allow for empirical comparisons of validity and utility and can contribute to advances in the field. There are significant differences between the ICD‐11 and DSM‐5 with regard to these sexual health conditions There are also some differences regarding the placement of certain disorders in diagnostic groupings, reflecting differences in perspectives and underlying organizational principles in the ICD‐11 and DSM‐5. The ICD‐11 also differs from the DSM‐5 in its placement of Secondary Mental or Behavioural Syndromes Associated with Disorders or Diseases Classified Elsewhere, which correspond to Mental Disorders Due to Another Medical Condition in the DSM‐5.