Transcript Basic Statistics for the Behavioral Sciences

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
Determining Abnormality (cont’d.)
• DSM-V 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
• Clinical significance- The behavior involves
measurable degrees of impairment- e.g.
inability to fulfill personal, professional
functions
• Distress
• Risk to self or others
• Behavior cannot be a socially expectable
response to a particular event- such as death
of a friend
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
Cultural Considerations in Abnormality
(cont’d.)
• Two key questions to consider:
– What is universal in human behavior that is also
relevant to understanding psychopathology?
– What is the relationship between cultural norms,
values, and attitudes, and the incidence and
manifestations of behavior disorders?
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
The Frequency and Burden
of Mental Disorders (cont’d.)
• The cost and burden to society is great
– At least 25% of adult Americans and almost 50%
of American children suffer from diagnosable
disorder
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 about the Mentally
Disturbed (cont’d.)
• More common myths:
– Mental illness is incurable
– People become mentally disturbed because they
are weak willed
– Mental illness is always a deficit
– 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.)
• The Middle Ages:
– Reverted to supernatural explanations
• Mass madness, or group hysteria
• Tarantism, or St. Vitus’s dance
– Witchcraft
• The Renaissance:
– The rise of humanism
• Humanism: emphasizes human welfare and the worth
and uniqueness of the individual
Historical Perspectives on Abnormal
Behavior (cont’d.)
• The Reform Movement:
– Moral treatment movement: shift to more
humane treatment of people who were mentally
disturbed
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Philippe Pinel
William Tuke
Benjamin Rush
Dorothea Dix
Clifford Beers
Historical Perspectives on Abnormal
Behavior (cont’d.)
• What role should spirituality and religion play
in mental health care?
– Spiritual being: a person’s animating life force that
speaks to the thoughts, feelings, and behaviors
related to a transcendent state or one’s capacity
for creativity, growth, and love
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
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
– Cultural values and influences
– Sociopolitical influences
– Cultural and ethnic bias in diagnosis
Contemporary Trends (cont’d.)
• Positive psychology:
– Study of positive human functioning, and the
strengths and assets of individuals, families, and
communities
• Optimal human functioning:
– Subjective well-being, happiness, optimism,
resilience, hope, courage, ability to cope with
stress, self-actualization, and self-determinism
Contemporary Trends (cont’d.)
• Spirituality:
– Animating life force or energy of the human
condition that is broader than but inclusive of
religion
• Focus on resilience:
– Positive aspects of resilience, strengths, assets in
successful mental health coping
Contemporary Trends (cont’d.)
• Changes in therapeutic landscape:
– The drug revolution (1950s):
• Rapidly and dramatically decreased or eliminated
troublesome symptoms
• 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