Oltmanns Chapter 1

By : Oltmanns and Emery

ABNORMAL PSYCHOLOGYABNORMAL PSYCHOLOGYSIXTH EDITIONSIXTH EDITION

Chapter OneChapter OneExamples and Definitions of Abnormal

Behavior

Recognizing the Presence of a DisorderDefining Abnormal Behavior

Who Experiences Abnormal Behavior?The Mental Health Professions **

Psychopathology in Historical Context **Methods for the Scientific Study of Mental

Disorders **

DO YOU THINK ANY OF THESE DO YOU THINK ANY OF THESE BEHAVIORS ARE ABNORMAL?BEHAVIORS ARE ABNORMAL?

Having a “lucky” seat in an exam? Being unable to eat, sleep, or study for days after

the breakup of a relationship? Breaking into a cold sweat at the thought of being

trapped in an elevator? Refusing to eat solid food for days to stay thin? Thorough hand-washing after riding a bus? Believing government agents monitor your phone

calls? Drinking a 6-pack daily to be “sociable”?

OVERVIEWOVERVIEW

Symptoms and signs of mental disorders are known as psychopathology.◦Pathology of the mind

Abnormal Psychology is the application of psychological science to the study of mental disorders.

The line dividing normal from abnormal is not always clear.

RECOGNIZING THE PRESENCE RECOGNIZING THE PRESENCE OF A DISORDEROF A DISORDER

Mental disorders are typically defined by a set of characteristics.

One symptom by itself is seldom sufficient to make a diagnosis.

Syndrome:◦A group of symptoms that appear together

and are assumed to represent a specific type of disorder.

RECOGNIZING THE PRESENCE RECOGNIZING THE PRESENCE OF A DISORDEROF A DISORDER

Mental disorders are defined in terms of:◦Duration or persistence of maladaptive

behaviors◦Impairment in the ability to perform social and

occupational roles

DEFINING ABNORMAL BEHAVIORDEFINING ABNORMAL BEHAVIOR

By what criteria do we decide whether a particular set of behaviors or emotional reactions should be viewed as a mental disorder?◦Individual experience of personal distress

DEFINING ABNORMAL BEHAVIORDEFINING ABNORMAL BEHAVIOR

Insight—the ability to appreciate the extent of one’s problems or the impact one’s behavior has on other people.

Interpersonal vs intrapersonal judgments

DEFINING ABNORMAL BEHAVIORDEFINING ABNORMAL BEHAVIOR

◦Statistical norms—how common or rare it is in the general population

Defining AbnormalityDefining Abnormality

H— Help Seeking

I — Irrational

D — Deviant

E — Emotional Distress

S — Significant Impairment

DEFINING ABNORMAL BEHAVIORDEFINING ABNORMAL BEHAVIOR

Harmful dysfunction—Jerome Wakefield

◦The condition results from the inability of some internal mechanism to perform its natural function.

◦The condition causes some harm to the person as judged by the standards of the person’s culture.

◦Not every dysfunction leads to a disorder.

DDEFINING ABNORMAL BEHAVIOREFINING ABNORMAL BEHAVIOR

Harmful Dysfunction (continued)◦The DSM-IV-TR (APA, 2000) definitions

places primary emphasis on the consequences of certain behavioral syndromes.Mental disorders are defined by clusters of persistent, maladaptive behaviors that are associated with personal distress (ex: anxiety or depression, impairment in social or occupational functioning).

DEFINING ABNORMAL BEHAVIORDEFINING ABNORMAL BEHAVIOR

◦Culture is defined in terms of values, beliefs, and practices that are shared by a specific community or group of people. Culture has a profound influence on opinions regarding the difference between normal and abnormal.

Culture Culture

◦Relativism --- the conceptions of truth and moral values are not absolute but are relative to the persons or groups holding them. What is considered normal and abnormal differs widely across cultures and over time.

◦Cultural relativism

◦Historical relativism

◦Voodoo Drapetomania

CultureCulture

There have been many instances in which groups representing particular social values have brought pressure to bear on decisions shaping the diagnostic manual.

What is the difference between normal and What is the difference between normal and abnormal behavior?abnormal behavior?

The differences between abnormal and normal behavior are essentially differences in degree, (quantitative differences).

abnormal normal normal abnormal

Diagnostic Criteria for Diagnostic Criteria for Premenstrual Dysphoric DisorderPremenstrual Dysphoric Disorder

Depressed mood or dysphoria (a feeling of low mood, irritability,anxiety and/or despair)

Anxiety or tension Affective lability Irritability Decreased interest in usual activities Concentration difficulties Marked lack of energy Marked change in appetite, overeating or food cravings Hyperinsomnia or insomnia Feeling overwhelmed Other physical symptoms, i.e. breast tenderness, bloating To be considered as PMDD, symptoms must occur during the week before

menstruation and remit a few days after onset of menses. B. Symptoms must interfere with work, school, usual activities or

relationships. Symptoms must not merely be an exacerbation of another disorder..

WHO EXPERIENCES WHO EXPERIENCES ABNORMAL BEHAVIOR?ABNORMAL BEHAVIOR?

Cross-Cultural Comparisons◦All mental disorders are shaped, to some extent, by cultural

factors.

◦ Do we see eating disorders in countries where there is famine? ◦ Have depression and anxiety increased recently?

◦No mental disorders are entirely due to cultural or social factors.

◦Psychotic disorders are less influenced by culture than are nonpsychotic disorders.

◦The symptoms of certain disorders are more likely to vary across cultures than are the disorders themselves.

Who Experiences Abnormal Who Experiences Abnormal Behavior?Behavior?

Frequency in and Impact on Community Populations◦Epidemiology: the scientific study of the

frequency and distribution of disorders within a population. Have there been increases/decreases in the diagnosis of disorders? Which ones? In specific areas? What role did gender, SES, race play?

◦Incidence: the number of new cases of a disorder that appear in a population during a specific period of time.

◦Lifetime prevalence: total proportion of people in a given population who have been affected by the disorder at some point during their lives.

WHO EXPERIENCES WHO EXPERIENCES ABNORMAL BEHAVIOR?ABNORMAL BEHAVIOR?

Frequency in and Impact on Community Populations◦Lifetime Prevalence and Gender DifferenceThe National Comorbidity Survey Replication (NCS-R) found that 46% of the surveyed people received at least one lifetime diagnosis. See page 12 Figure 1-1See page 12 Figure 1-1

Epidemiological studies consistently find gender differences for many types of mental disorders.

FIGURE 1-1 Lifetime prevalence FIGURE 1-1 Lifetime prevalence rates for various mental disorders rates for various mental disorders (NCS-R data)(NCS-R data)

Who Experiences Abnormal Who Experiences Abnormal Behavior?Behavior?

Frequency in and Impact on Community Populations

◦Comorbidity and Disease Burden The presence of more than one condition within the same period of time. 23 percent of the people in the NCS sample had three or more lifetime disorders, and 50% were rated as being severe.

How does the impact of mental How does the impact of mental disorders compare with that of disorders compare with that of other health problems?other health problems?

Epidemiologists measure disease burden by combining factors of mortality and disability.

Although mental disorders are responsible for only 1% of all deaths, they produce 47% of all disability in developed countries and 28% of all disability worldwide.

THE MENTAL HEALTH THE MENTAL HEALTH PROFESSIONSPROFESSIONS

Psychiatry: branch of medicine concerned with the study and treatment of mental disorders.◦Licensed to practice medicine◦Prescribe psychotropic medication

Clinical Psychology: concerned with the application of psychological science to the assessment and treatment of mental disorders.

Social Work: concerned with helping people achieve an effective level of psychosocial functioning.

Insanity and the Mental Health Insanity and the Mental Health FieldField

InsanityInsanity is a legal term that refers to is a legal term that refers to judgments about whether a person should judgments about whether a person should be held responsible for criminal behavior if be held responsible for criminal behavior if he or she is also mentally disturbed.he or she is also mentally disturbed.

Is the person legally responsible for Is the person legally responsible for his/her crimes because of mental illness?his/her crimes because of mental illness?