1-1PPTs t/a Abnormal Psychology 1e by Rieger - Copyright 2009 McGraw-Hill Australia Pty Ltd

CHAPTER 1

CONCEPTUAL ISSUES IN ABNORMAL PSYCHOLOGY

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AIMS AND OBJECTIVES Discuss how we define “abnormal”

How do we know who has a psychological disorder and needs treatment?

Provide overview of biological and psychological perspectives on classification, causation, and treatment of mental disorders

Describe the prominent classification system for mental disorders

Preview future directions in the field of psychiatric classification

1-3PPTs t/a Abnormal Psychology 1e by Rieger - Copyright 2009 McGraw-Hill Australia Pty Ltd

DEFINING ABNORMAL

Statistical rarity

Any deviation from the norm = abnormal

But lots of positive characteristics are rare,

e.g., very talented or highly intelligent people

Norm violation

Behavior is abnormal if it is socially unacceptable

Must be careful not to use this criterion to oppress

non-conformist behaviour

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DEFINING ABNORMAL

Distress If a person is bothered by a certain behaviour, it may be

classified as abnormal In some situations, however, an individual may not be bothered

by a maladaptive behaviour

Dysfunction Behaviours that interfere with a person’s life are classified as

abnormal This criterion is limited because how functional an individual is

depends on societal expectations

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DEFINING ABNORMAL

Independently, rarity, norm violation, distress and dysfunction are neither necessary nor sufficient to define abnormal behaviour

Cumulatively, they help to clarify what we think is “normal” vs. “abnormal”

Another approach to this issue is Wakefield’s (1992, 1999) harmful dysfunction analysis A disorder involves a factual component (dysfunction) and a

value component (harmful)

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THE BIOLOGICAL PERSPECTIVE

Classification Emil Kraepelin (1856-1926) was the first to classify types of

mental disorders based on systematic empirical observations

Before then, there was little agreement on what constituted mental illness Some believed “insanity” was a single disease, others classified

symptom clusters based on hypothesized causes (e.g., balance of the four humours: blood, yellow bile, black bile, and phlegm)

Kraeplin used a descriptive approach and offered diagnostic categories defined by common patterns of symptoms

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THE BIOLOGICAL PERSPECTIVE

Causation In the late 19th century, a German neurologist discovered

that general paresis, a type of “insanity” characterised by bizarre behaviours, hallucinations, and delusions, was caused by a biological disease (syphilis)

Other researchers began identifying associations between certain syndromes, such as difficulty producing or understanding speech, and localised brain damage

These types of discoveries led to increasing acceptance of the idea that mental disturbances have a biological cause, such as infection, toxins, or structural brain abnormality

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THE BIOLOGICAL PERSPECTIVE

Treatment Early biological treatments included electroconvulsive

therapy (ECT) and psychosurgery

Contemporary approaches focus on two causes of mental disorders: structural brain abnormalities and neurochemical imbalances

Since the discovery of effective medications in the 1950s, they are commonly used to treat mental disorders. Some argue that there are drawbacks to psychopharmacological approaches: Psychiatric medications may be overused - not a universal cure High risk of relapse and possible side effects

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THE PSYCHOLOGICAL PERSPECTIVE

Psychoanalytic Approach Developed by Sigmund Freud in the late 19th Century

Reasons for human behaviour are hidden in the unconscious and involve complex interactions between: the Id - driven by instincts the Ego - conscious, realistic, logical, aims to balance pressures

of Id with external world the Superego - internalised influences of parents and societal

moral standards, seeks perfection and control

Failure to manage conflict can lead to anxiety/neuroses, which may be treated by psychoanalysis

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THE PSYCHOLOGICAL PERSPECTIVE

Psychoanalytic Approach

History of activities and objects to which the libido (psychic energy of Id) attaches itself: Oral stage, 0 to 2 years Anal stage, 2 to 3 years Phallic stage, 3 to 6 years Latency Period, 6 to 12 years Genital stage, 12 and beyond

Criticisms of the psychoanalytic movement are that it is: untestable unfalsifiable unable to meet societal demands for accountability

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THE PSYCHOLOGICAL PERSPECTIVE

The Behavioural Approach

Emphasises examining observable causes of behaviour in

the immediate environment Classical conditioning

Operant conditioning

Avoidance learning

Treatment from the behavioural perspective includes: Functional analysis

Extinction

Aversion therapy

Token economies

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The Cognitive Approach

Emphasises dysfunctional cognitive processes cause

emotional and behavioral disturbances

ABC model – Albert Ellis

Cognitive distortions – Aaron Beck

e.g., black and white thinking, over-generalising,

personalising

THE PSYCHOLOGICAL PERSPECTIVE

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THE PSYCHOLOGICAL PERSPECTIVE

The Cognitive Approach Recent research has also focused on the ways in which individuals

process information, including Selective attention Memory patterns, e.g., negative bias in depressed individuals

Cognitive therapy techniques include: Thought diaries Cognitive restructuring Behavioural experiments

Important features of the cognitive-behavioural perspective: Scientist-practitioner model Emphasis reliable and valid assessment, clear goals, and basing

treatments on empirical evidence

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THE PSYCHOLOGICAL PERSPECTIVE

Humanistic & Sociocultural Approaches Humanistic perspective emphasises:

Uniqueness of individuals

Potential for positive human growth

Freedom and responsibility to make choices

Carl Rogers – founder of client centred therapy and concept of

unconditional positive regard

Sociocultural perspective argues that abnormal behaviours are best understood in terms of the social environment of the individual e.g., eating disorders a result of Western culture’s emphasis on

thinness

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DIAGNOSIS OF MENTAL DISORDERS

Advantages Improved communication Collaboration among mental health professionals

Disadvantages Reification of diagnostic categories – mental disorders are

hypothetical concepts, not independent of societal values Stigma – applying diagnoses may sometimes be harmful to

people

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THE DEVELOPMENT OF THE DSM SYSTEM DSM-I published in 1952 by the American Psychiatric

Association, followed by DSM-II in 1968

DSM I and II did not have much influence on mental health Lacked reliability and validity

DSM-III was a radical departure Atheoretical, topographical approach

- precise descriptions rather than etiology Specificity – improved reliability and validity Multiaxial assessment

DSM-IV (1994) and DSM-IV-TR (2000) retained principal features but more research-based

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CURRENT CONTROVERSIES FOR DSM-V (PROJECTED RELEASE 2010)

Categorical versus dimensional approach?

More etiologically-based diagnostic system?

Ascertaining the applicability of diagnostic criteria across cultures

Proposed rating system to indicate the extent and quality of empirical support for diagnostic criteria

1-18PPTs t/a Abnormal Psychology 1e by Rieger - Copyright 2009 McGraw-Hill Australia Pty Ltd

SUMMARY

Defining Abnormal The Biological Perspective

Classification Causation Treatment

The Psychological Perspective Psychoanalytic Approach Behavioural Approach Cognitive Approach Humanistic/Sociocultural Approach

Diagnosis of Mental Disorders Advantages and Disadvantages Development of the DSM system Current Controversies for DSM-V