Intro to abnormal psych

Question 1

How can we define statistical “abnormality”?

Answer 1

Also called gifted/eccentric, abnormality occurs within one or two standard deviations away from the mean
Socioculturally this labelling has justified how society controlled/silenced these individuals

Question 2

What is important to consider aside from simply where someone falls on a bell curve?

Answer 2

Consider the individual - are they experiencing discomfort/wish to be rid of the abnormality?
Is there a clear physical process leading to specific symptoms or behaviours e.g. a mental health condition?
Does the person have difficulty with everyday function?

Question 3

What is meant by maladaptiveness?

Answer 3

Lack of normal functioning
Most widely used term for defining abnormalities, combining both statistical abnormality and the experience of distress for a person
It is commonly a symptom WITHIN mental health conditions - DISTRESS, DEVIANCE, DYSFUNCTION

Question 4

What are 3 historical perspectives on abnormality?

Answer 4

Biological - something wrong in the body e.g. Ancient Greeks believed hysteria caused by a wandering uterus
Psychological - abnormal behaviour ultimately stemming from stress and childhood trauma etc.
Supernatural - possessed by spirits, trephination to let spirits out

Question 5

What did people in Ancient China believe?

Answer 5

Balance of Yin and Yang - human emotions controlled by internal organs through “vital air” (joy in heart, sorrow on lungs, anger on liver)

Question 6

What was Hippocrates’s view on abnormality?

Answer 6

Medical perspective - result of abnormalities and imbalances in the four main humours

Question 7

Who were two key players in redefining how asylum inmates were treated, and what was the ultimate result of their actions?

Answer 7

Dorothea Dix - crusaded for moral treatment
Phillippe Pinel - leader of moral treatment who ordered patients to be freed from chains, have access to windows, planned social activities etc.

Many patients actually regained control of their behaviour and re-engaged with their lives

Question 8

What did the biological perspective, originating in the last 19th century, suggest?

Answer 8

Basic anatomy, physiology, neurology knowledge was increasing around this time, and Wilhelm Griesinger published a text which systematically argued for the first time that all psych disorders could be explained in terms of brain pathology
Paralysis could be caused by general paresis for example, a severe neuropsych disorder caused by chronic meningoencephalitis leading to cerebral atrophy in late-stage syphilis

Question 9

Who were the 3 key players in the psychoanalytic movement?

Answer 9

Mesmer - magnetic fluid that must be maintained in a certain pattern to maintain health, focused on hysteria and technique was hypnosis
Charcot - hysteria caused by brain degeneration, nothing to do with hypnosis
Freud - study of the unconscious, dabbled in hypnosis

Question 10

Who were the 3 key players in the behaviourist perspective?

Answer 10

Wundt - first experimental lab
Pavlov - understanding behaviour in terms of stimuli and responses
Thorndike/skinner - how consequences of behaviour shape likelihood of recurrence

Question 11

What was the argument underpinning the cognitive revolution?

Answer 11

Behaviourism ignored internal thought processes that mediate relationships between stimuli and responses
Bandura - self-efficacy beliefs
Albert Ellis - people prone to psych disorders are plagued by IRRATIONAL NEGATIVE ASSUMPTIONS about themselves and the world

Question 12

What happened to modern mental health care in the 60s?

Answer 12

Deinstitutionalisation and the patients’ rights movement
Community mental health movement - 90% reduction from institutes and increased quality of life for patients who previously would have been regarded sub-human
(However resources not fully adequate and homelessness became a problem)

Question 13

What does the vulnerability-stress model suggest regarding the development of mental health disorders?

Answer 13

A person must carry an underlying vulnerability to a disorder in order to develop it, but the full disorder will only occur if this vulnerability combined with a TRIGGER

Question 14

What are examples of vulnerabilities according to the vulnerability-stress model?

Answer 14

Biological - genes, disordered biochemistry, brain anomalies
Social - maladaptive upbringing, chronic stress
Psychological - unconscious conflicts, poor skills, maladaptive cognitions

Question 15

What are some of the triggers in the VS model?

Answer 15

Biological - onset of disease, exposure to toxins
Social - traumatic event, major loss
Psychological - perceived loss of control, violation of a trust

Question 16

What followed from the case of Phineas Gage?

Answer 16

Left frontal lobe damage - structural changes led to behavioural changes
Ideas that specific regions of brain involved in specific behaviours and functions, and abnormalities in areas lead to specific abnormalities in behaviour

Question 17

What are the 4 psychological theories of mental disorders?

Answer 17

Psychodynamic - unconscious conflicts between primitive desires and constraints on desires cause symptoms
Cognitive - way of interpreting situations, assumptions about world, and self-concept cause negative feelings and behaviours
Behavioural - symptoms due to reinforcement and punishment for specific behaviours
Humanistic/existential - arise when people don’t pursue their own values and potentials and instead feel they need to conform to demands of others

Question 18

What are 3 social approaches to mental disorders?

Answer 18

Interpersonal theories - result from long-standing patterns of negative relationships, with roots in early experiences with caregivers
Social structural theories - societies create mental disorders in individuals by putting them under unbearable stress and by sanctioning abnormal behaviour
Family systems theories - Families create and maintain disorders in individual family members to maintain the status quo

Question 19

What does the social-structural model of mental health disorders look at?

Answer 19

Neighbourhood characteristics e.g. widespread poverty, discrimination, high residential turnover etc
Societal organisation - lack of common values, lack of social control, open conflict etc
Psychological stress - insufficient resources, chronic fear
Subcultural influences e.g. gangs and drugs
These factors combine to produce mental health outcomes such as child maltreatment, behavioural disorders, depression, substance abuse and juvenile delinquency

Question 20

What has been proposed to counter the original vulnerability-stress model?

Answer 20

The bio, psych and social factors involved in developing disorders are not so distinct - they all interact closely e.g. a problem with the HPA axis which produces genetic vulnerability may lead to a psychological problem with regulating stress and negative assumptions about oneself (e.g. “I can’t cope!”). These factors then lead into social withdrawal, reinforcing psych factors even more –> CYCLICAL

Question 21

What 3 types of studies can be conducted to obtaining info about mental health disorders?

Answer 21

Case studies - In-depth patient history, rich detail and ability to focus on rare problems but lacks generalisability and option for replication
Experimental studies - e.g. therapy outcome studies. using control groups; difficult to use to research abnormal behaviour because challenging to get right patients plus abnormalities often have multiple causes so would need multi-method approach
Correlational studies - No manipulation involved, cannot say that a variable causes another

Question 22

What can we do when it comes to actually assessing and diagnosing an individual presenting with symptoms of a mental disorder?

Answer 22

Use a number of tests and questionnaires e.g. Beck depression inventory

Question 23

What are the 5 types of validity to consider when administering diagnostic testing?

Answer 23

FACE - appears to measure what it is meant to
CONTENT - assesses all important aspects of phenomenon
PREDICTIVE - predicts the behaviour it is supposed to measure
CONCURRENT - yields same results as other measures of the same behaviour, thoughts or feelings
CONSTRUCT - measures what it is supposed to measure

Question 24

What are the 4 types of reliability to consider?

Answer 24

Test-retest reliability - produces similar results at two different points in time
Internal - different parts of same test produce similar results
Alternate form reliability - two versions of same test produce similar results
Inter-rater - two or more raters who administer and score test come to similar conclusions

Question 25

What is a key concept to remember in the diagnosis of mental disorders?

Answer 25

Clusters of symptoms are rarely specific to one condition, commonly some overlap making specific diagnoses trickier e.g. major depressive and generalise anxiety disorders may both present as fatigue, and we need more in-depth assessment to distinguish between them

Question 26

What is the stated purpose of the DSM?

Answer 26

Provide a helpful guide to clinical practice
Facilitate research and improve communication between clinicians and researchers
Educational tool for teaching psychopathology

Question 27

What does the DSM involve?

Answer 27

A series of AXES or dimensions for assessing all aspects of a patient’s mental and emotional health - comprehensive picture of complex or concurrent mental health disorders

Question 28

What are the 5 axes of the DSM?

Answer 28

Axis 1 - all psych diagnostic categories except mental retardation and personality disorders
Axis 2 - personality disorders and mental retardation
Axis 3 - General medical conditions
Axis 4 - Psychosocial and environmental factors contributing to the disorder e.g. family problems, educational issues, problems such as war etc
Axis 5 - Global assessment of functioning, rating general level of functioning to help doctor draw up a treatment plan and evaluate progress

Question 29

What is the most critically important thing to do when assessing and diagnosing mental health conditions?

Answer 29

Take an integrated perspective! Social, biological and psychological factors all combined