Introduction to Abnormal Psychology

1. Introduction to Abnormal Psychology Naomi Wagner, PhD Some slides are taken from Sue

2. What is Abnormality? • The prefix Ab means- away from • Norm means the typical, the average • “Away from the average behavior” • It is difficult to determine what is normal and what is abnormal in human behavior • Views about abnormality have changed throughout history

3. Terms • Abnormality • Psychopathology • Mental Illness • Mental Disorders • Psychological Disorders • Maladjustment • And more • These terms are used interchangeably

4. How do we Determine what is Abnormal? • In some instances it is easier to put the cut-off line between normal and abnormal • In psychosis one can easily draw the line • Psychosis involves breaking away from reality- having hallucinations for example • In other instances it is difficult to draw he line- e.g. anxiety- we all have the tendency to be anxious in some situations – where do you draw the line?

5. (Cont-d) • In depression- where do you draw the line between sadness that is part of life and sadness that becomes clinical depression? • In viewing child behavior- how can we tell that a given behavior reflects developmental immaturity and will subside, or is it the sign of a deeper clinical problem?

6. The Study 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 • Usespsychodiagnosis: attempts to describe, assess, and systematically draw inferences about an individual’s psychological disorder (sue)

7. Some of the Difficulties • Can we predict abnormal behavior? • Can we modify it? • Sometimes behavior that appears abnormal is an attempt to adjust to extreme life situations • Example: J.C. Duggart that was abducted at age 11 and was kept captive for 18 years • She could have escaped- why hasn’t she?

8. Therapy • Modifying abnormal behavior • Therapy: program of systematic intervention aimed at improving a person’s behavioral, affective (emotional), or cognitive state

9. Determining Abnormality • Psychologists use theDiagnostic and Statistical Manual of Mental Disorders (DSM • Most widely used classification system of mental disorders • We are currently using the new 5th edition ( 2013) • It lists all the currently agreed –upon mental disorders and criteria for diagnosis

10. DSM Definition of Abnromality • 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.”

11. The Limitations of the DSM 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? • Is it possible that a given behavior is a reaction to stressor rather than response to common stressor

12. For Major Factors Used to Determine abnormality • Most definitions of abnormality use some form of statistical average • The 4 factors: • Distress • Deviance • Dysfunction • Danger to self or others • Not all factors need to be present

13. Cont-d • Certain behaviors are judged abnormal in most situations • Examples: Hallucinations, delusions, disorientation • Certain behaviors were considered abnormal in previous historical times

14. Clinical Significance • The extent to which a given behavior is abnormal in terms is assessed by the 4 factors • 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

15. Cultural Considerations • 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

16. Psychiatric Epidemiology • The study of the prevalence of mental illness in a society • May provide insight as to why some mental illnesses occur in a given society • Prevalence: the % of people that have the disorder in a certain period • Incidence: The number of new cases in a specific period of time • Lifetime prevalence: The % of people who have had the disorder at one time during their lives

17. Historical Perspectives • Prehistory: Possessions by evil spirits • Trephining: Piercing a hole in the skull to release the spirit

18. History (cont-d) • Ancient people regarded mentally-ill people as being possessed by evil spirits, and apparently used “trephining”, piercing a hole in the skull of the afflicted person, in an attempt to “release” these spirits. • Later, in ancient Greece, Hippocrates viewed abnormality as the result of imbalance among 4 fluids, or biles, in the body. Excess in one of the biles caused the person to display some particular behaviors.

19. History (cont-d) • In the Middle Ages, the belief that abnormal behavior is caused by demonic possession was reflected in the “treatments” given to the mentally ill, these “treatments” were administered by the religious authorities, and included all types of procedures to purge the afflicted person of the demons. Exotcism

20. Middle Ages: Burning “witches” at the stake

21. Asylums- 16th-17th centuriesSt. Mary of Bethlehem in London

22. The Reform Movement 18th and 19th centuries • A reform Movement started in Europe and the US in the 1700’s Chiarugi, Pinel, Tuke, Rush, and Dorothea Dix are some of the names associated with this movement- who advocated humane treatment of the mentally ill.

23. The mental patients were treated like animals in the zoo

24. The Biological Viewpoint Late 19th century • Main models at the beginning of modern times (end of 19th century): The Somatic model, started with the work of Greisinger and Kraepelin, who saw mental disorders as disorders of the brain. Somatic (body) treatments such as psychosurgery and electro-convulsive therapy were used and abused as treatment methods for those institutionalized. • Kraepelin identified clusters of symptoms called syndromes –representing a unique disorder

25. The Psychological Viewpoint • The psychological model, viewing mental disorders as a product of the mind started with the interest in hypnosis, the early work of Mesmer, culminating with the work of Freud. • The main contention of this model was that mental disorders are caused by unconscious factors. Psychoanalysis had emerged as an attempt to understand a condition that got the name Hysteria

26. 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 • Biological view gained greater strength with discovery ofgeneral paresis, a progressively degenerative and irreversible physical and mental disorder

27. Cont-d • Sigmund Freud (1856-1939) was a neurologist in Vienna practicing with hypnosis to treat patients who suffered from hysteria: adisorder in which the patient displays a variety of physical symptoms without having any organic basis for them. He foundthat under hypnosis his patients uncovered early childhood memories, typically dealing with unpleasant events of sexualnature. He later used the technique of free associations instead of hypnosis. When his patients talked about their early memoriestheir symptoms have subsided. • There was no way to confirm the validity of these early memories.

28. The Deinstitutionalization Movement • With the advent of the anti-psychotic (psychotropic) drugs in the late1950’s, a belief that these drugs will cure mental illness brought about the movement toward empting the big mental hospitals, and sending the mental patients into the community, where, as it was hoped, they could function in semi-independent environments. The hope did not materialized, and many mental patients found themselves on the streets.

29. New Trends • 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

30. Resilience Current genetic findings • Focus on resilience: • Positive aspects of resilience, strengths, assets in successful mental health coping • The longer allele of the serotonin-transporter gene has been found related to resilience

31. Current Findings • 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