Chapter 1 - Abnormal Behavior in Historical Context Flashcards
Psychological Disorder
Psychological dysfunction within an individual associated with distress or impairment in functioning and a response that is not typical or culturally expected.
Phobia
A psychological disorder characterized by marked and persistent fear of an object or situation.
[Example: blood-injection - injury phobia]
Abnormal Behavior [aka Psychological Disorder]
Three criteria:
1. Psychological Dysfunction
2. Distress or Impairment
3. Atypical or not culturally expected response
Psychological Dysfunction
Breakdown in cognitive, emotional, or behavioral functioning.
[EXAMPLE: If you are out on a date, it should be fun. But if you experience severe fear all evening and just want to go home, even though there is nothing to be afraid of, and the severe fear happens on every date, your emotions are not functioning properly.]
PROBLEM: Knowing where to draw the line between normal and abnormal dysfunction is often difficult. Often leading to these problems being considered as a continuum or dimension rather than categories that are either present or absent.
Therefore, having a dysfunction is not enough to meet the criteria for a psychological disorder.
Distress or Impairment
Distress is considered a very much important aspect of life and not likely to change. However, in cases of someone with a manic episode suffering and distress are absent.
Impairment is a case of someone who may so shy that it is nearly impossible to date or interact with people causing their social functioning to be impaired.
Atypical or Not Culturally Expected
At times, something is considered abnormal because it occurs infrequently; deviating from the average. The greater the deviation, the more abnormal it is.
Social Standard of Normal
Has been misused, for example, the practice of committing political dissidents to mental health institutions because they protest the policies of their government, which was common in Iraq before the fall of Saddam Hussein and now is occurring in Iraq. Although such dissident behavior clearly violated social norms, it should not alone be cause for commitment.
Harmful Dysfunction
A related concept that is also useful to determine whether the behavior is out of the individual’s control (something that the person doesn’t want to do)
Variants of this approach are most often used in current diagnostic practice, as outlined in the 5th edition of the Diagnostic and Statistical Manual, which contains the current listing of criteria for psychological disorders.
Most Widely Accepted Definition of Psychological Disorders
The Diagnostic and Statistical Manual of Mental Disorders describes behavioral, psychological, or biological dysfunctions that are unexpected in their cultural context and associated with present distress and impairment in functioning or increased risk of suffering, death, pain, or impairment.
Definition can be used across cultures and subcultures if we pay attention to what is functional or dysfunctional (or out of control) in a given society.
Psychopathology
The scientific study of psychological disorders.
Within the field are specifically trained professionals including; clinical and counseling psychologists, psychiatrists, psychiatric social workers, and psychiatric nurses, as well as marriage and family therapists and mental health counselors.
Clinical and Counseling Psychologists
Receive the Ph.D., doctor of philosophy degree (or sometimes an Ed.D., doctor of education, or Psy.D., doctor of psychology) and follow a course of graduate-level study lasting approximately 5 years, which prepares them to conduct research into the causes and treatment of psychological disorders and to diagnose, assess, and treat these disorders.
Difference between Ph.D. and Psy.D.
Psy.D focuses on clinical training and de-emphasizes or eliminates research training.
Ph.D integrates clinical and research training.
Psychiatrists
Earn an M.D. degree in medical school and then specialize in psychiatry during residency training for about 3 to 4 years.
They investigate the nature and causes of psychological disorders from a biological point of view, making diagnoses and offering treatment. (most often prescribed drugs or other biological treatments)
Psychiatric Social Workers
Earn a master’s degree in social work as they develop expertise in collecting information relevant to the social and family situation of the individual with a psychological disorder. Most often treat the disorder, often concentrating on family problems associated with them.
Psychiatric Nurses
Have advanced degrees, such as a master’s or even a Ph.D., and specialize in the care and treatment of patients with psychological disorders, usually in hospitals as part of a treatment team.
Marriage and Family Therapists and
Mental Health Counselors
Spend about 1 to 2 years earning a master’s degree and employed to provide clinical services by hospitals or clinics, usually under the supervision of a doctoral-level clinician.
Scientist-Practitioners
The scientific approach that many health professionals take in their clinical work.
Mental Health Practitioners function as scientist-practitioners in three ways:
- Keeping up with the latest scientific developments in their field using the most current diagnostic and treatment procedures
- Evaluate their assessments or treatment procedures to determine whether they work. [Being accountable not only to their patients but also to the government agencies and insurance companies paying for the treatments, so they must demonstrate whether their treatments are effective.]
- May conduct research in clinics or hospitals that produce new information about disorders or their treatment, becoming immune to the fads that plague our field, often at the expense of patients and their family.
Presenting Problem
The patient “presents” with a specific problem or set of problems. [Presents is a traditional shorthand way of indicating why the person came to the clinic.
Clinical Description
Represent the unique combination of behaviors, thoughts, and feelings that make up a specific disorder..
Specifying what makes the disorder different from normal behavior or from other disorders.(statistical data may also be relevant)
Prevalence
For example, how many people in the population as a whole have the disorder? The figure would be the prevalence of the disorder.
Incidence
For example, statistics on how many new cases occur during a given period, such as a year, represent the incidence of the disorder.
Sex Ratio
What percentage of males and females have the disorder?
Typical age of onset
Which often differs from one disorder to another
Types of courses
- Chronic course - Some disorders, such as schizophrenia, tend to last a long time, sometimes a lifetime.
- Episodic course - Some disorders, like mood disorders, are likely to recover within a few months, only to suffer a reoccurrence of the disorder at a later time. [ a pattern that may repeat itself throughout a person’s life.]
- Time-limited course - The disorder will improve without treatment or in a relatively short period with little or no risk of reoccurrence.
Differences in onset
a.) Acute onset - They begin suddenly
b.) Insidious onset - They develop gradually over an extended period.
Prognosis
The anticipated course of a disorder. “Prognosis is good,” meaning the individual will probably recover.
“Progonis is guarded,” meaning the probable outcome doesn’t look good.
Patients age (an important aspect of clinical description)
Specific psychological disorders in childhood may present differently from those in adulthood or old age.
Example: Children experiencing anxiety or panic attacks often assume that they are physically ill because they have difficulty understanding that there is nothing physically wrong. This often leads to misdiagnosis in children and they end up getting treated for a medical disorder.
Different Studies
a.) Developmental Psychology
b.) Developmental Psychopathology
c.) Life-span developmental psychopathology
Developmental Psychology
Study in changes of behavior over time
Developmental Psychopathology
Study of changes in abnormal behavior
Life-span Developmental Psychopathology
Study of abnormal behavior across the entire age span
Etiology
The study of origins having to do with why a disorder begins (what causes it) and includes biological, psychological, and social dimensions
Treatment
If a new drug or psychological treatment is successful in treating the disorder, it may give us some insight into the nature of the disorder and its causes.
Example: A drug with a known specific effect within the nervous system alleviates a certain disorder, we know that something in part of the nervous system might either be causing the disorder or helping maintain it.
Historical Conceptions of Abnormal Behavior
For thousands of years, humans have always tried to explain and control problematic behavior.However, our efforts always derived from the theories or models of behavior popular at the time.
Three major models that have guided us back to the beginning of civilization
- Supernatural model
- Biological model
- Psychological model
Supernatural model
The model is that supposed agents outside our bodies and environment influence our behavior. These agents might be divinities, demons, spirits, or other phenomena such as magnetic fields, the moon, or stars.
Soul or the Psyche
Referred to the mind being separate from the body since the era of ancient Greece
Biological model & Psychological model
Thought that the mind can influence the body and, in turn, the body can influence the mind. Most philosophers looked for causes of abnormal behavior in one or the other. This spilt gave rise to the two traditions of thought of abnormal behavior as either being biological or psychological.
Supernatural Tradition
For much of recorded history, deviant behavior has been considered a reflection of the battle of good and evil.
Demons and Witches
During the last quarter of the 14th century, the Catholic church split into two with another center in South France competing with the Catholic church of Rome. In reaction to this split, the Roman Church fought hard against evil in the world.
People increasingly turned to magic and sorcery to solve their problems. During these times, the bizarre behavior of people afflicted with psychological disorders was seen as the work of the devil and witches.
Treatments during the last quarter of the 14th century
a.) Exorcisms - various religious rituals were performed in an effort to rid the victim of evil spirits.
b.) Shaving the pattern of a cross in the hair of the victim’s head
c.) securing sufferers to a wall near the front of a church so that they might benefit from hearing Mass.
Led to the witch trials of the late 17th century, which resulted in 20 women being hung to death
Stress and Melancholy
During the 14th and 15th century there was an enlightened view that insanity was a natural phenomenon caused by mental and emotional stress and that it was curable.
Mental depression and anxiety ware recognized as illnesses, however the symptoms were identified by churches with the sin of acedia or sloth.
Odd treatments for possession
a.) Hanging people over a pit full of poisonous snakes
b.) The hypothesized therapeutic element of shock
c.) Hydrotherapy where patients were had applications of ice cold water
