Essentials of Understanding Abnormal Behavior Chapter One

1
Essentials of Understanding Abnormal
BehaviorChapter One

• Abnormal Behavior

2
The Concerns of Abnormal Psychology

• What is abnormal psychology?
• An area of scientific study aimed at describing,
  explaining, predicting, and modifying behaviors
  that are considered unusual or strange
• Uses psychodiagnosis attempts to describe,
  assess, and systematically draw inferences about
  an individuals psychological disorder

3
The Concerns of Abnormal Psychology (contd.)

• Modifying abnormal behavior
• Therapy program of systematic intervention aimed
  at improving a persons behavioral, affective
  (emotional), or cognitive state

4
Determining Abnormality

• Psychologists use the Diagnostic and Statistical
  Manual of Mental Disorders (DSM)
• Most widely used classification system of mental
  disorders
• Currently in its 5th Version DSM V (May 2013)
• Defines abnormal behavior as a behavioral or
  psychological syndrome or pattern that reflects
  an underlying psychobiological dysfunction, is
  associated with distress or disability, and is
  not merely an expectable response to common
  stressors or losses. (www.dsm5.org)

5
Determining Abnormality (contd.)

• Limitations of DSM-V definition
• DSM definition is quite broad and raises
  questions
• When is a syndrome or pattern of behavior
  significant enough to have meaning?
• Is it possible to have a mental disorder without
  any signs of distress or discomfort?
• What criteria are to be used in assessing
  symptoms?

6
Determining Abnormality (contd.)

• Four major factors in judging psychopathology
• Distress
• Deviance (bizarreness)
• Dysfunction (inefficiency in behavioral,
  affective, or cognitive domains)
• Dangerousness

7
Cultural Considerations in Abnormality

• Culture
• Shared values, beliefs, attitudes and behaviors
  transmitted from generation to generation
• Powerful determinant of how behavior is defined
  and treated
• Multicultural limitations
• How does culture affect our understanding of
  human behavior?

8
Cultural Considerations in Abnormality (contd.)

• Cultural universality
• Assumption that origins, processes, and
  manifestations of mental disorders are the same
  across cultures
• Cultural relativism
• Belief that lifestyles, cultural values, and
  worldviews affect expression and determination of
  abnormal behavior

9
Sociopolitical Considerations in Abnormality

• Mental illness as a sociopolitical construction
• Thomas Szasz
• Problems in living versus mental illness
• Must be sensitive to individual value systems,
  societal norms and values, and potential
  sociopolitical ramifications

10
The Frequency and Burden of Mental Disorders

• Psychiatric epidemiology
• Study of the prevalence of mental illness in a
  society
• Prevalence
• Percentage of individuals in a targeted
  population who have a particular disorder during
  a specific period of time

11
The Frequency and Burden of Mental Disorders
(contd.)

• Incidence
• Number of new cases of a disorder that appear in
  an identified population within a specified time
  period
• Lifetime prevalence
• The percentage of people in the population who
  have had a disorder at some point in their life

12
The Frequency and Burden of Mental Disorders
(contd.)

• Figure 1-1 1-year prevalence of mental disorders
  in adult Americans and lifetime prevalence of
  mental disorders in American adolescents

13
Stereotypes about People Who are Mentally
Disturbed

• Americans tend to be suspicious of people with
  mental disorders
• Common myths
• People who are mentally disturbed can always be
  recognized by their abnormal behavior
• People who are mentally disturbed have inherited
  their disorders

14
Stereotypes (myths) about the Mentally Disturbed
(contd.)

• Mental illness is incurable Nearly
  three-fourths of people who are hospitalized with
  severe mental disorders will improve and go on to
  lead productive lives.
• People become mentally disturbed because they are
  weak willed
• Mental illness is always a deficit Many people
  with mental illness were never cured, but they
  nevertheless made great contributions to
  humanity.
• Mentally disturbed people are unstable and
  potentially dangerous

15
Historical Perspectives on Abnormal Behavior

• Prehistoric and ancient beliefs
• Demonology treated by trephining or exorcism
• Naturalistic explanations (Greco-Roman)
• Naturalistic explanations supplanted supernatural
• Hippocrates believed deviant behavior was caused
  by brain pathology, dysfunction or disease of
  the brain

16
Historical Perspectives on Abnormal Behavior
(contd.)

• Mass Madness (13th century) Group of people
  exhibit similar symptoms with no apparent cause.
• Tarantism wild dancing and convulsions assumed
  to be caused by spiders bite
• Lycanthropy imitating wolves and imagining
  themselves as wolves
• Witchcraft (15th-17th centuries)
• The Hammer of Witches (1484) Pope Innocent VIII
  approved the persecution of witches. Two
  priests, Heinrich Kramer and James Sprenger wrote
  Malleus Maleficarum

17
Historical Perspectives on Abnormal Behavior
(contd.)

• The Reform Movement
• Philippe Pinel began the moral treatment
  movement, treated patients with kindness and
  reason rather than chains and torture.
• William Tuke created the York retreat, also
  subscribing to the moral treatment movement.
• Benjamin Rush (1745-1813) considered the father
  of US psychiatry, trained physicians to treat
  patients with mental disorders and to practice
  humane treatment.
• Dorothea Dix (1802-1887) Spent 40 years working
  for humane treatment of the mentally ill and
  raised millions of dollars.
• Clifford Beers (1876-1943) wrote A Mind that
  Found Itself about his own battle with mental
  illness and the treatment he and others
  experienced in 3 mental institutions.

18
Causes Early Viewpoints

• Biological (organic) view
• Belief that mental disorders have a physical or
  physiological basis (Griesinger)
• Kraepelin
• Symptoms occur in clusters (syndromes) to
  represent mental disorders, each with unique
  cause, course, and outcome
• Classified mental illness based on organic causes
• Original basis for Diagnostic Statistical Manual
  of American Psychiatric Association

19
Causes Early Viewpoints (contd.)

• Biological view gained greater strength with
  discovery of general paresis, a progressively
  degenerative and irreversible physical and mental
  disorder related to late-stage syphallis
• Fritz Schaudinn (1905) discovered the
  micororganism that actually causes syphilis and
  the resulting neurological deterioration, the
  first definite evidence for medical cause in
  psych. disorder was discovered.

20
Causes Early Viewpoints (contd.)

• Psychological view
• Mental disorders are caused by psychological and
  emotional (not biological/organic) factors
• Mesmerism and hypnotism
• Josef Breuer
• Relief by talking about traumatic experiences
• Cathartic method therapeutic use of verbal
  expression to release pent-up emotional conflicts
  
• Sigmund Freud psychoanalysis

21
Contemporary Trends

• Multicultural psychology
• Culture, race, ethnicity, gender, age, and
  socio-economic class relevant to understand and
  treat abnormal behavior
• Mental health professionals need to
• Increase cultural sensitivity
• Acquire knowledge of diversity
• Develop culturally relevant therapy approaches

22
Contemporary Trends (contd.)

• Figure 1-2 Census 2010 Racial and Ethnic
  Composition of the United States The rapid
• demographic transformation of the United States
  is illustrated by the fact that minorities
• now constitute an increasing proportion of the
  population. Several trends are evident.
• First, within several short decades, people of
  color will constitute a numerical majority.
• Second, the number of Latino/Hispanic Americans
  has surpassed the number of African Americans.
  Third, mental health providers will increasingly
  be coming into contact with clients who differ
  from them in race, ethnicity, and culture.
• Source http//www.census.gov/newsroom/release/
  archives/2010_census/cb11-cn125htm

23
Contemporary Trends (contd.)

• Dimensions related to cultural diversity
• Social conditioning How we are raised, what
  values are instilled in us, and how we are
  expected to behave in fulfilling our roles
• Cultural values and influences types of mental
  disorders differ from country to country and
  differences in cultural traditions may influence
  susceptibility to certain emotional disorders.
• Sociopolitical influences In response to a
  history of prejudice, discrimination, and racism,
  many minorities adopted behaviors important for
  their survival
• Cultural and ethnic bias in diagnosis Mental
  health professionals are not immune to inheriting
  the prejudicial attitudes

24
Contemporary Trends (contd.)

• Positive psychology
• Study of positive human functioning, and the
  strengths and assets of individuals, families,
  and communities
• Focuses on strengths and assets of people in
  preventing psychological disorders

25
Contemporary Trends (contd.)

• The drug revolution (1950s)
• Rapidly and dramatically decreased or eliminated
  troublesome symptoms
• the drug chlorpromazine (brand name Thorazine)
  was extremely effective in treating agitated
  people with schizophrenia
• Deinstitutionalization
• Prescription privileges for psychologists
• Managed health care
• Industrialization of health care, whereby large
  organizations in the private sector control the
  delivery of services

26
Contemporary Trends (contd.)

• Industrialization of health care has brought
  about major trends
• Business interests are exerting increasing
  control over psychotherapy
• Current business practices are depressing income
  of practitioners
• Psychologists are being asked to justify use of
  their therapies
• Enactment of mental health and substance abuse
  parity legislation

27
Contemporary Trends (contd.)

• Appreciation for research
• Breakthroughs in neuroscience
• Role of neurotransmitters in mental disorders
• Renewed interest in brain-behavior relationship
  with success of psychopharmacology
• Increasing exploration of biological bases of
  abnormal behavior
• Integration of drug therapy with psychotherapy
• Move toward empirically-based treatments