Abnormal psychology
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Abnormal psychology is the scientific study of abnormal behavior in order to describe, predict, explain, and change abnormal patterns of functioning. Abnormal functioning is almost always a result of a mental disorder. According to the DSM-IV, a mental disorder can be defined as 'a pattern of behavioral and psychological symptoms that causes significant personal distress, impairs the ability to function in one or more important areas of daily life, or both.' [1]. Abnormal psychology in clinical psychology studies the nature of psychopathology, its causes, and its treatments. Of course, the definition of what constitutes 'abnormal' has varied across time and across cultures. Individuals also vary in what they regard as normal or abnormal behavior. In general, abnormal psychology can be described as an area of psychology that studies people who are consistently unable to adapt and function effectively in a variety of conditions. The four main contributing factors to how well an individual is able to adapt include their genetic makeup, physical condition, learning and reasoning, and socialization.
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[edit] History
The history of abnormal psychology began with the research of the famous ancient Greek philosopher Plato in the fourth century B.C. During his time, most believed that the strange behaviors and actions that psychologists study today were caused by evil spirits. Plato believed this to be false and spoke his ideas of these behaviors being caused by a "natural madness, usually caused by a disease". Unfortunately his words had no affect on the common people of his age. During the Dark Ages, the idea of the behaviors being caused by evil spirits escalated to the idea that people were being possessed by demons. Many people were exorcised by the churches or burned at the stake for possessing these "demons". Over approximately one hundred thousand innocent people were killed for the same reasons by the Inquisition. It wasn't until early 19th century that the idea of evil spirits and demons was tossed aside, and the idea of these behaviors being caused by illnesses in the mind was finally embraced.
[edit] Core concepts: explaining abnormal behavior
Abnormal psychology consists of three core concepts; cultural and historical relativism, the principle of multiple causality and the connection between mind and body.
[edit] Cultural and historical relativism
Throughout time, societies have proposed several explanations in hopes of understanding abnormal behavior within human beings. Throughout "pre-modern" societies, people firmly believed that abnormal behavior was a direct result of animism, the belief in the existence and power of a spiritual world. The idea that people demonstrating abnormal behavior were possessed by malevolent spirits led to a practice known as trephination. The process of trephination involved cutting a hole into the individual's skull in order to release the malevolent spirits.[2]
A more religious approach to the animistic beliefs of abnormality is the practice known as exorcism. Performed by religious authorities, exorcism was thought of as another way to release evil spirits whom were causing the pathological behavior within the person. Most patients or individuals with mental disorders, were exhiled or banned from society. Witchcraft, (communicating with evil spirits or ghosts) currently viewed at as a psychosis or state of delirium was punished by death. Most witches ended up on the pile. The church made a manual that told the people what to do with witchcraft and abnormal behavior. That manual is known as the witchhammer, official Latin name: Malleus Maleficarum. Witch was one the first books actually published in Germany that held a taxonomy of the abnormal or deviant behavior, of course that work is revised by now and banned by the church in late 15th century.
The act of placing mentally ill individuals in a separate facility known as an asylum dates back to 1547 when King Henry VIII of England established the St. Mary of Bethlehem asylum. Asylums continued to be a popular approach for the mentally ill throughout the Middle Ages and the Renaissance era.
[edit] Multiple causality
The amount of different theoretical perspectives in the field of psychological abnormality has made it difficult to properly explain psychopathology. The attempt to explain all mental disorders with the same theory leads to reductionism (explaining a disorder or other complex phenomena using only a single idea or perspective)[3]. Most mental disorders are composed of several factors, which is why one must take into account several theoretical perspectives when attempting to diagnose or explain a particular behavioral abnormality or mental disorder. Explaining mental disorders with a combination of theretical perspectives is known as multiple causality.[1]
The diathesis-stress model [2] emphasizes the importance of applying multiple causality to psychopathology by stressing that disorders are caused by both precipitating causes and predisposing causes. A precipitating cause is an immediate trigger that instigates a person's action or behavior. A predisposing cause is an underlying factor that interacts with the immediate factors to result in a disorder. Both causes play a key role in the development of a psychological disorder. [4]
[edit] Mind and body
A paradigm is a general viewpoint on the world and is much broader than a theory. Today's field of psychology revolves around two major paradigms for explaining mental disorders, the psychological paradigm and the biological paradigm. The psychological paradigm focuses more on the humanistic, cognitive and behavioral perspectives. The biological paradigm includes the theories that rely more on physical causes such as genetics and neurochemistry.
[edit] Modern concepts of abnormality
- Statistical abnormality - when a certain behaviour/characteristic is relevant to a low percentage of the population. However, this does not necessarily mean that such individuals are suffering from mental illness (for example, statistical abnormalities such as extreme wealth/attractiveness)
- Psychometric abnormality - when a certain behaviour/characteristic differs from the population's normal dispersion e.g. having an IQ of 35 could be classified as abnormal, as the population average is 100. However, this does not specify a particular mental illness.
- Deviant behaviour - this is not always a sign of mental illness, as it can occur without deviant behaviour, and such behaviour may occur in the absence of mental illness.
- Combinations - including distress, dysfunction, distorted psychological processes, inappropriate responses in given situations and causing/risking harm to oneself. .[5]
[edit] Approaches
- Somatogenic - abnormality is seen as a result of biological disorders in the brain (Kraeplin, 1883). However, this approach has led to the development of radical biological treatments e.g. lobotomy.
- Psychogenic - abnormality is caused by psychological problems. This has led to slightly bizarre treatments. Mesmer used to put his patients in a darkened room with music playing, then entered wearing a flamboyant outfit and pressed the 'infected' body areas with a stick. It has also led to the development of hypnosis, psychoanalysis (Freud) and carthasis as psychological treatments, as well as humanism (Carl Rogers, Abraham Maslow). [6]
[edit] Nosology
[edit] DSM-IV TR
The standard abnormal psychology and psychiatry reference book in North America is the Diagnostic and Statistical Manual of the American Psychiatric Association. The current version of the book is known as DSM IV-TR. It lists a set of disorders and provides detailed descriptions on what constitutes a disorder such as Major Depressive Disorder or anxiety disorder. It also gives general descriptions of how frequent the disorder occurs in the general population, whether it is more common in males or females and other such facts. The diagnostic process uses five dimensions called 'axes' to ascertain symptoms and overall functioning of the individual. These axes are as follows
- Axis I - Particular clinical syndromes
- Axis II - Permanent Problems (Personality Disorders, Mental Retardation)
- Axis III - General medical conditions
- Axis IV - Psychosocial/environmental problems
- Axis V - Global assessment of functioning (often referred to as GAF)
[edit] ICD-10
The major international nosologic system for the classification of mental disorders can be found in the most recent version of the International Classification of Diseases, 10th revision (ICD-10). The ICD-10 has been used by World Health Organization (WHO) Member States since 1994. Chapter five covers some 300 "Mental and behavioural disorders." The ICD-10's chapter five has been influenced by APA's DSM-IV and there is a great deal of concordance between the two. WHO maintains free access to the ICD-10 Online . Below are the main categories of disorders:
- F00-F09 Organic, including symptomatic, mental disorders
- F10-F19 Mental and behavioural disorders due to psychoactive substance use
- F20-F29 Schizophrenia, schizotypal and delusional disorders
- F30-F39 Mood [affective] disorders
- F40-F48 Neurotic, stress-related and somatoform disorders
- F50-F59 Behavioural syndromes associated with physiological disturbances and physical factors
- F60-F69 Disorders of adult personality and behaviour
- F70-F79 Mental retardation
- F80-F89 Disorders of psychological development
- F90-F98 Behavioural and emotional disorders with onset usually occurring in childhood and adolescence
- F99 Unspecified mental disorder
[edit] Etiology
[edit] Genetics
- Investigated through family studies, mainly of monozygotic (identical) and dizygotic (fraternal) twins, often in the context of adoption.
- These studies allow calculation of a heritability coefficient.
- However, this tends to ignore prenatal experience, and has possible negative consequences, such as eugenics, assumptions of determinism and the ethics of medical screeing (as it may have knockon effects for medical insurance and emotional state).
[edit] Biological factors
- Investigates effects of hormones, neurotransmitters and neuron damage in mental illness, for example Alzheimer's Disease (neuronal degeneration), Seasonal Affective Disorder (hormonal imbalance) and depression/anxiety.
- Different theories focus on structural, biochemical and genetic theories.
[edit] Psychological factors
- Psychoanalysis (Freud)
- Behavioural therapy (Wolpe) based on behaviourism, and involving classical and operant conditioning.
- Humanistic therapy aiming to achieve self-actualisation (Carl Rogers, 1961)
- Cognitive Behavioural Therapy aims to influence thought and cognition (Beck, 1977).
[edit] Socio-cultural factors
- Affects of urban/rural dwelling, gender and minority status on state of mind.
- British Psychiatric Morbidity Survey conducted by Jenkins (1998) [7]
[edit] See also
- DSM-IV Codes
- Structured Clinical Interview for DSM-IV (SCID)
- Insanity Defense
- M'Naghten Rules
- International Classification of Diseases
- Cognitive Behavioural Therapy
- British Psychiatric Morbidity Survey
- Seasonal Affective Disorder
- Mental Health Act 1983
- Mental Health Act 2007
- Mental Health Alliance
[edit] References
- ^ Psychology. Hockenbury and Hockenbury. Third edition.ch 14, pg 574.
- ^ James Hansell and Lisa Damour. Abnormal Psychology. Ch 3. pg 30-33.
- ^ James Hansell and Lisa Damour. Abnormal Psychology ch 3. pg 37
- ^ Abnormal Psychology. James Hansell and Lisa Damour. Ch 3. pg 37.
- ^ Paul Bennett, Abnormal and Clinical Psychology, (ISBN 978-0335212361), pp. 3-5. Open University Press (Great Britain, 2003)
- ^ Paul Bennett, Abnormal and Clinical Psychology, (ISBN 978-0335212361), pp. 7-10. Open University Press (Great Britain, 2003)
- ^ British Psychiatric Morbidity Survey, Jenkins et al. (1998), The British Journal of Psychiatry 173: 4-7.
[edit] Systemic factors
- Family systems
- Negatively Expressed Emotion playing a part in schizophrenic relapse and anorexia nervosa.
[edit] Biopsychosocial factors
- Holistic causal model
- Illness dependent on stress 'triggers'. <ref>[[Paul Bennett]], [[Abnormal and Clinical Psychology]], (ISBN 978-0335212361), pp. 17-26. Open University Press (Great Britain, 2003)</li></ol></ref>
[edit] Bibliography
- James Hansell, Lisa Damour, Abnormal Psychology, ISBN 0-471-38982-X, Von Hoffman Press (2005)
- Don Hockenbury, Sandra Hockenbury, Psychology,ISBN 0-7167-5129-1, Worth Publishing, 3rd Edition (2003)
[edit] External links
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