"Abnormal" Psychology Think about it... 450 million peopleworldwide suffer frompsychologicaldisorders A US governmentsurvey estimates that15% of the populationare in need ofpsychological therapy. From NIMH TRUE or FALSE? 1. Very few people are actually affected by psychological disorders. 2. People sometimes forget a very traumatic event as a way of copingwith the psychological stress of the trauma. 3. People whose illnesses are all in their heads do not really havesymptoms of disease. 4. Depression is the most common type of psychological disorder. 5. Some people never feel guilty, even when they commit seriouscrimes. What is "normal"? Are psychological disorders genuine illnesses or socially defined categories? What is Abnormal Behavior??? Is abnormal behavior treatable? Can we prevent abnormality? Whats Normal? Whats Abnormal? How do we decide between these two terms? Finding a lucky seat in an exam.
Being unable to sleep, eat, study, or talk to anyone else for days after a break-up. Breaking into cold sweat at the thought of being trapped in an elevator. Swearing, throwing pillows, and pounding fists on the wall in the middle of an argument with a friend or parent. Refusing to eat solid food for days at a time in order to stay thin. Having to engage in a thorough hand-washing after coming home from a ride on a bus or train. Believing that the government has agents who are listening in on telephone conversations. Drinking a six-pack of beer a day in order to be sociable with friends. - 50% of ppl use the bathroom 6x/day
DEVIANCENOT DEVIANT - 50% of ppl use the bathroom 6x/day - 97% write own name when trying out a new pen - 50% regularly sneak food into movie theaters - 57% report having experienced dj vu Kanner, 1995 - 39% of ppl who confess to snooping in their hosts medicine cabinets - 30% of ppl who refuse to sit on a public toilet seat - 23% confess to not flushing all the time - 10% believe theyve seen a ghost Kanner, 1995 Questions to consider
How typical is the behavior of people in general? Is the behavior maladaptive? Does the behavior cause the individual emotionaldiscomfort? Is the behavior socially unacceptable? Abnormal is... Any behavior that differs much from the average
Any behavior that leads to distress (pain), disability(impaired functioning), or an increased risk of death,pain, or loss of freedom (DSM definition) Let people decide for themselves whether they aretroubled? TYPICALITY MALADAPIVITY the behavior impairs an individualsability to function adequately in everyday life; behavior thatis hazardous to the individual or others EMOTIONAL DISCOMFORT feelings of helplessness,hopelessness, suicidal thoughts SOCIALLY UNACCEPTABLE BEHAVIOR culture mustbe considered (culture-bound syndromes) *Unjustifiable/disturbing to other people 4 Approaches to Abnormality
The following can occur alone or an interaction cancontribute towards abnormality 1) Distress 2) Impairment 3) Risk to Self or Other People 4) Socially and Culturally Unacceptable Behavior Norms: A societys stated and unstated rules for proper conduct.
Norms vs. Culture Norms: A societys stated and unstated rules for proper conduct. Culture: Peoples common history, values, institutions, habits, skills, technology and arts. Would you consider this normal? Abnormal?
Along the Niger River, menof the Wodaabe tribe puton elaborate makeup andcostumes to attract women. In Western society, thesame behavior would breakbehavioral norms andprobably be judgedabnormal Causes of Abnormality? Biological Psychological Socio-cultural The Two Models Medical - psychological disorders are sickness/diseases
- etiology/prognosis Bio-psycho-social Model - abnormal behavior has 3major aspects: biological, psychological, sociological Biopsychosocial Perspective
Refers to the interaction in which biological, psychological,and sociocultural factors play a role in the development ofan individual Diathesis Stress Model - People are born with a predisposition (or diathesis) thatplaces them at risk for developing a psychologicaldisorder. - This vulnerability could be genetic or due to earlier lifeexperience. Table 1.1 Causes of Abnormality
Biological Genetic Inheritance Medical Conditions Brain Damage Exposure to environmental stimuli Psycho- logical Traumatic life experiences Learned associations Distorted Perceptions Faulty ways of thinking Socio-cultural Disturbances in intimate relationships Problems in extended relationships Political of social unrest Discrimination toward ones social group Biological Causes Biological determinants? Use of Medication
Brain damage; exposure to toxins Genetics PDs do sometimes run in families E.g., MDD Medical Ailments Environmental Contributor Psychological Causes Disturbances often arise from an emotional,distressing or troubling life experience Interpersonal experience Events that take place in interactions w/ otherpeople Intrapsychic Those that take place w/in thoughts and feelings Sociocultural Causes What does sociocultural mean? R.D. Laing (1964)
people who refuse to abide by the norms of thissociety are psychologically healthier than thosewho blindly accept and live by such restrictivesocial norms Thomas Szasz (1961) Problems with living vs. sick Trouble stems from a mismatch b/w personalneeds and societys ability to meet those needs The Human Experience of Psychological Disorders Myths of Mental Illness
Creative people are a little crazy Ppl w/ mental disorders are dangerous Most older ppl are senile Criminals are born bad Asthma is caused by emotional problems Suicidal individuals rarely talk about suicide People wilth Schizophrenia have multiple personalities The Human Experience of Psychological Disorders
Stigma, social reactions - People treat individuals suffering from apsychological disorder differently Why is stigma around PDs and treatment aproblem?? Social Cognitive Processes
Cues 1) Psychiatric symptoms 2) Social Skill Deficits3)Physical appearance 4) Labels Stereotypes Prejudice Discrimination Why do some psychologists criticize diagnostic labels? Classification DSM- IV- TR DSM V Diagnostic and Statistical Manual of Mental Disorders (DSM)
First developed in 1952 by American PsychiatricAssociation Many revisions, movement away from theconceptualization of psychological disorders asemotional reactions History of DSM DSM-IV (the 4th ed.) 1994
DSM-IV-TR (4th ed., text revision) 2000 - Includes editorial revisions Diagnostic and Statistical Manual of Mental Disorders - Provides both clinicians and researchers with acommon language for delineating disorders - This helps professionals with differing backgroundsunderstand one another - This helps create confidence in labeling a ct or pt Published by the American Psychiatric Assoc. DSM Concerns in developing the DSM-IV Reliability Validity Base Rates
Social Context Mental Disorder What does this term mean to you?
Clinically Significant Consistently present over time Dramatically affects daily life Syndrome Collection of symptoms (observable actions) thatform a definable pattern. Based on client report of thoughts and feelings Assumptions of the DSM Medical Model Disorders are viewed as diseases
MDs usually use term patient and mental disorder.The latter = neg conotation Atheoretical Orientation Descriptive, rather than explanatory Describes Sx, not causes Categorical Approach Multiaxial System (described next!!!) NOTE: Neurosis: Psychosis:
Term referring tobehavior that involvesdistressing,unacceptable symptomsthat are enduring andlack any physical basis. Not a moderndiagnostic term Psychosis: Term referring tovarious forms ofbehavior involving aloss of contact withreality, such asdelusions (falsebeliefs) andhallucinations (falseperceptions) The 5 Axes of the DSM - V Axis I: Clinical Disorders
Axis II: PersonalityDisorders and MentalRetardation Axis III: General MedicalConditions Axis IV: Psychosocial andEnvironmental Problems Axis V: Global Assessment ofFunctioning Axis I To be listed on Axis I
Must be primary focus of clinical attention Typically, an overlay of an otherwise healthypersonality E.g., substance related disorders; anxietydisorders, schizophrenia, depression Axis II Personality traits that are inflexible and maladaptive
Usually a long standing condition E.g., Narcissism, OCPD, Borderline Can an individual have a diagnosis on Axis I and AxisII? Example?? Axis III Physical conditions can be the basis of psychologicalproblems and should be documented. E.g., Lymes/Bells & Dep Ct. Also important b/c of medication interaction andcausality Axis IV Negative life events E.g., problem with primary support group
Details: parent died OR falling out with family All areas of this Axis are stressors which cancontribute towards a dx on Axis I or II Axis V An overall judgment of functioning
Consider psychological status, social functioning(including personal and work relationships) Whats normal? 65 and Up is generally high functioning Review 1. Define each of the following terms: phobia, dissociation,depersonalization, and mania. 2. What are obsessions and compulsions, and how are theyrelated? 3. What fears are associated with each of the followingphobias: agoraphobia, claustrophobia, and zoophobia? 4. What must occur before a psychologist will make adiagnosis of major depression? Adapted from Kessler et al., 2005 Who Seeks Therapy? This chart is based on U.S. Surveys Percentages represent individuals who have been in therapy at some point in their life -(Adapted from Fetto, 2002) Anxiety Disorders Generalized Anxiety Disorder Panic disorder Phobias
OCD PTSD Mood Disorders Major Depressive Disorder Dysthymic disorder
Bipolar Disorder Other categories Substance-related
Developmental-related Disorders - mental retardation, pervasive disorders,ADHD Age-related and Cognitive Disorders - Dementia, Alzheimer's Personality Disorders - Histronic, Narcissistic, Paranoid, Schizoid, Schizotypal,Avoidant, Antisocial, Borderline Schizophrenia Somatoform Disorders - Conversion, Body Dysmorphic, Hypchondrias Dissociative Disorders - Dissociative Amnesia, Diss. Fugue, Depersonalization Eating Disorders/Impulse Control Disorders - Anorexia, Bulimia, Kleptomania Sexual Disorders - Pedophilia, Exhibitionism, Fetishism, Sadism/Masochism