Introduction to abnormal Psychology | Study notes Abnormal Psychology

MODULE 1

ABNORMAL PSYCH-

the branch of psychology devoted to the study, assessment, treatment, and prevention of

maladaptive behavior. (apa dictionary)

Within DSM-5, a MENTAL DISORDER is defined as a syndrome that is present in an

individual and that involves clinically significant disturbance in behavior, emotion regulation,

or cognitive functioning. These disturbances are thought to reflect a dysfunction in biological,

psychological, or developmental processes that are necessary for mental functioning

CRITERIAS FOR NORMALITY

● Suffering:

○ If people suffer or experience psychological pain we are inclined to consider

this as indicative of abnormality. Depressed people clearly suffer, as do

people with anxiety disorders.

○ But what of the patient who is manic and whose mood is one of elation? He

or she may not be suffering. In fact, many such patients dislike taking

medications because they do not want to lose their manic “highs.”

○ You may have a test tomorrow and be suffering with worry. But we would

hardly label your suffering abnormal.

○ Although suffering is an element of abnormality in many cases, it is neither a

sufficient condition (all that is needed) nor even a necessary condition (a

feature that all cases of abnormality must show) for us to consider something

as abnormal.

● Maladaptiveness:

○ Maladaptive behavior is often an indicator of abnormality. The person with

anorexia may restrict her intake of food to the point where she becomes so

emaciated that she needs to be hospitalized.

○ The person with depression may withdraw from friends and family and may

be unable to work for weeks or months. Maladaptive behavior interferes with

our well-being and with our ability to enjoy our work and our relationships.

● Statistical Deviancy:

○ The word abnormal literally means “away from the normal.” But simply

considering statistically rare behavior to be abnormal does not provide us with

a solution to our problem of defining abnormality.

○ Genius is statistically rare, as is perfect pitch. However, we do not consider

people with such uncommon talents to be abnormal in any way.

○ Also, just because something is statistically common doesn’t make it normal.

The common cold is certainly very common, but it is regarded as an illness

nonetheless. On the other hand, intellectual disability (which is statistically

rare and represents a deviation from normal) is considered to reflect

abnormality.

○ This tells us that in defining abnormality we make value judgments. If

something is statistically rare and undesirable (as is severely diminished

intellectual functioning), we are more likely to consider it abnormal than

something that is statistically rare and highly desirable (such as genius) or

something that is undesirable but statistically common (such as rudeness).

● Violation of the Standards of Society:

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MODULE 1

ABNORMAL PSYCH -

the branch of psychology devoted to the study, assessment, treatment, and prevention of maladaptive behavior. (apa dictionary) Within DSM-5, a MENTAL DISORDER is defined as a syndrome that is present in an individual and that involves clinically significant disturbance in behavior, emotion regulation, or cognitive functioning. These disturbances are thought to reflect a dysfunction in biological, psychological, or developmental processes that are necessary for mental functioning CRITERIAS FOR NORMALITY ● Suffering: ○ If people suffer or experience psychological pain we are inclined to consider this as indicative of abnormality. Depressed people clearly suffer, as do people with anxiety disorders. ○ But what of the patient who is manic and whose mood is one of elation? He or she may not be suffering. In fact, many such patients dislike taking medications because they do not want to lose their manic “highs.” ○ You may have a test tomorrow and be suffering with worry. But we would hardly label your suffering abnormal. ○ Although suffering is an element of abnormality in many cases, it is neither a sufficient condition (all that is needed) nor even a necessary condition (a feature that all cases of abnormality must show) for us to consider something as abnormal. ● Maladaptiveness: ○ Maladaptive behavior is often an indicator of abnormality. The person with anorexia may restrict her intake of food to the point where she becomes so emaciated that she needs to be hospitalized. ○ The person with depression may withdraw from friends and family and may be unable to work for weeks or months. Maladaptive behavior interferes with our well-being and with our ability to enjoy our work and our relationships. ● Statistical Deviancy: ○ The word abnormal literally means “away from the normal.” But simply considering statistically rare behavior to be abnormal does not provide us with a solution to our problem of defining abnormality. ○ Genius is statistically rare, as is perfect pitch. However, we do not consider people with such uncommon talents to be abnormal in any way. ○ Also, just because something is statistically common doesn’t make it normal. The common cold is certainly very common, but it is regarded as an illness nonetheless. On the other hand, intellectual disability (which is statistically rare and represents a deviation from normal) is considered to reflect abnormality. ○ This tells us that in defining abnormality we make value judgments. If something is statistically rare and undesirable (as is severely diminished intellectual functioning), we are more likely to consider it abnormal than something that is statistically rare and highly desirable (such as genius) or something that is undesirable but statistically common (such as rudeness). ● Violation of the Standards of Society:

○ All cultures have rules. Some of these are formalized as laws. Others form the norms and moral standards that we are taught to follow. ○ when people fail to follow the conventional social and moral rules of their cultural group we may consider their behavior abnormal. For example, driving a car or watching television would be considered highly abnormal for the Amish of Pennsylvania. However, both of these activities reflect normal everyday behavior for most other Pennsylvania residents. Of course, much depends on the magnitude of the violation and on how commonly the rule is violated by others. As illustrated in the example above, a behavior is most likely to be viewed as abnormal when it violates the standards of society and is statistically deviant or rare. ○ In contrast, most of us have parked illegally at some point. This failure to follow the rules is so statistically common that we tend not to think of it as abnormal. Yet when a mother drowns her children there is instant recognition that this is abnormal behavior. ● Social Discomfort: ○ When someone violates a social rule, those around him or her may experience a sense of discomfort or unease. ○ how do you feel when someone you met only 4 minutes ago begins to chat about her suicide attempt? Unless you are a therapist working in a crisis intervention center, you would probably consider this an example of abnormal behavior. ● Irrationality and Unpredictability: ○ If a person sitting next to you suddenly began to scream and yell obscenities at nothing, you would probably regard that behavior as abnormal. It would be unpredictable, and it would make no sense to you. ○ The disordered speech and the disorganized behavior of patients with schizophrenia are often irrational. Such behaviors are also a hallmark of the manic phases of bipolar disorder. ○ Perhaps the most important factor, however, is our evaluation of whether the person can control his or her behavior. Few of us would consider a roommate who began to recite speeches from King Lear to be abnormal if we knew that he was playing Lear in the next campus Shakespeare production—or even if he was a dramatic person given to extravagant outbursts. On the other hand, if we discovered our roommate lying on the floor, flailing wildly, and reciting Shakespeare, we might consider calling for assistance if this was entirely out of character and we knew of no reason why he should be behaving in such a manner. ● Dangerousness: ○ It seems quite reasonable to think that someone who is a danger to him- or herself or to another person must be psychologically abnormal. Indeed, therapists are required to hospitalize suicidal clients or contact the police (as well as the person who is the target of the threat) if they have a client who makes an explicit threat to harm another person. But, as with all of the other elements of abnormality, if we rely only on dangerousness as our sole feature of abnormality, we will run into problems. Is a soldier in combat mentally ill? What about someone who is an extremely bad driver? Both of these people may be a danger to others. Yet we would not consider them to be mentally ill.

illness. Once a group of symtoms in given a name and identified by means of a diagnosis, this diagnosis label can be hard to shake even if bthe person later makes a full recovery. ○ It is important to keep in mind, however, that diagnostic classification systems do not classify people. Rather, they classify the disorders that people have. When we note that someone has an illness, we should take care not to define him or her by that illness. Respectful and appropriate language should instead be used. At one time, it was quite common for mental health professionals to describe a given patient as “a schizophrenic” or “a manic-depressive.” Now, however, it is widely acknowledged that it is more accurate (not to mention more considerate) to say, “a person with schizophrenia,” or “a person with manic depression.” Simply put, the person is not the diagnosis. DSM INTRODUCTION The Diagnostic and Statistical Manual of Mental Disorders (DSM) is the handbook widely used by clinicians and psychiatrists in United States to diagnose psychiatric illnesses. Published by American Psychiatric Association(APA), the dsm covers all categories of mental disorders for both adults and children. It contains description , 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, risk and prognostic factors and other related diagnostic issues. ● Dsm history ○ DSM 1 - 1952 (102) ○ DSM 2- 1968 (182) ○ DSM 3 - 1982 (265) ○ DSM 4 - (297) ○ DSM ● Multi axial system [dsm 3] ○ DSM III introduced a multi axial or multidimentional approach for diagnosing mental disorders. It was supposed to help clinicians and psychiatrists make comprehensive evaluations of a client’s level of functioning because mental illnesses often impact many different life areas. ○ It describes disorders using five DSM axes or dimensions to ensure that all factors - psychological , biological and enviromental- were considered when making a mental health diagnosis. ○ AXIAL I- clinical syndromes Mental health and substance use disorders causing significant impairment. Disorders were grouped into different catergorires such as mood disorders, anxiety disorders and eating disorders. ○ AXIAL II- personality disorders and mental retardation Intellectual development disorders and personality disorders (antisocial and histrionic personality disorder) Personality disorders cause significant problems in how a person relates to the world

Intellectual dveelopement disorders are characterised by intellectual impairment and deficits in other areas such as self care and interpersonal skills. ○ AXIAL III- general medical conditions Medical conditions that influence or worsen axis I axis II disorders. Like HIV/AIDS and brain injuries. ○ AXIAL IV- psychosocial and environmental problems Social or enviromental probelms that may impact axis I or axis II disorders were accounted for in this axis. Includes, unemployment, relocation, divorce or the death of a loved one. ○ AXIAL V- global assessment of functioning Clinician gives their impression of the client’s overall level of functioning. Based on this assessment, clinicians could better understand how the other four axes interacted and the effect on the individual’s life. Upto and including the DSM-IV-TR , the multiaxial systems was used to help clinicians fully evaluate the biological, environmental and psychological factors that can play a role in a mental health condition. CHANGES IN DSM- 5 ● Shift from using roman numerals to arabic numbers in the name (dsm- 5 not dsm-v) ● Eliminated the multiaxialn system. Instead, DSM 5 lists categories of disorders along with a number of different related disorders. Example, include DSM 5 include anxiety disorders, bipolar and related disorders, depressive disorders , feeding and eating disorders, obsessive-compulsive and related disorders and personality disorders. ● Asperger’s syndrome was eliminated as a diagnosis and instead , incorporated under the category of autism spectrum disorder. ● Disruptive mood dysregulation disorder were added , to decrease the over diagnosis of childhood bipolar disorder. ● Several diagnosis were officially added to the manual like binge eating, hoarding, premenstrual dysphoric disorder (PMDD) CHANGES IN DSM- 5 - TR ● Revised criteria for more than 70 disorders. ● Addition of new diagnosis called prolonged grief disorder. ● Use more specific language to avoid confusion. For example, it revised the wording of criterion A in autism spectrum disorder from “as manifested by the following” to “as manifested by all of the following” to indicate that all symptoms must be present in order for a diagnosis to be made. ● Parenthetical (social phobia) next to social anxiety disorder was removed. ● Intellectual diability to intellectual development disorder ● Revised terms surrounding gender dysphoria ○ Desired gender —> experienced gender ○ Cross sex medical procedure —-> gender affirming medical procedure ○ Natal male/ female —-> indiviualassigned male/female at birth ● Reducing racial and cultural biases ○ race—> racialized (to call out that race is socially constructed) ○ Ethenoracial for categories like hispanic, white and african american

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MODULE 1

ABNORMAL PSYCH -