Transcript a PowerPoint Presentation of Chapter One

Essentials of Understanding Abnormal
Behavior
Chapter One
Abnormal Behavior
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 individual’s psychological disorder
The Concerns of Abnormal Psychology
(cont’d.)
• Modifying abnormal behavior
– Therapy: program of systematic intervention
aimed at improving a person’s behavioral,
affective (emotional), or cognitive state
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)
Determining Abnormality (cont’d.)
• 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?
Determining Abnormality (cont’d.)
• Four major factors in judging psychopathology
– Distress
– Deviance (bizarreness)
– Dysfunction (inefficiency in behavioral, affective,
or cognitive domains)
– Dangerousness
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?
Cultural Considerations in Abnormality
(cont’d.)
• 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
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
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
The Frequency and Burden
of Mental Disorders (cont’d.)
• 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
The Frequency and Burden
of Mental Disorders (cont’d.)
Figure 1-1 1-year prevalence of mental disorders in adult Americans and lifetime
prevalence of mental disorders in American adolescents
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
Stereotypes (myths) about the Mentally
Disturbed (cont’d.)
• 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
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
Historical Perspectives on Abnormal
Behavior (cont’d.)
• Mass Madness (13th century): Group of people
exhibit similar symptoms with no apparent cause.
– Tarantism: wild dancing and convulsions
assumed to be caused by spider’s 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”
Historical Perspectives on Abnormal
Behavior (cont’d.)
• 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.
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
Causes: Early Viewpoints (cont’d.)
• 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.
Causes: Early Viewpoints (cont’d.)
• 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
Contemporary Trends
• Multicultural psychology:
– Culture, race, ethnicity, gender, age, and socioeconomic 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
Contemporary Trends (cont’d.)
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
Contemporary Trends (cont’d.)
• 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
Contemporary Trends (cont’d.)
• 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
Contemporary Trends (cont’d.)
– 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
Contemporary Trends (cont’d.)
• 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
Contemporary Trends (cont’d.)
• 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