2. ObjectivesObjectives
Define abnormality.
Review historical approaches to
abnormality.
Compare how different schools explain
abnormal behavior.
Identify how disorders are classified and
problems with system.
Discuss how society views mental illness.
3. What is normal?What is normal?
“Normal”
“Abnormal”
◦ Standard
◦ Socially acceptable behavior
w/in a culture
◦ Deviation from normality
◦ Maladaptive behavior
◦ Distress
4. ReviewReview: History of Abnormal Behaviors: History of Abnormal Behaviors
Earliest Explanation?
◦ Evil Spirits – Trephining
Ancient World
◦ Greeks – (Humors) Natural not supernatural forces
Middle Ages
◦ Demonic possession
Renaissance
◦ Scientific approach – mind can be sick
American Reform
◦ Benjamin Rush & Dorothea Dix – humane treatment, asylums
Scientific Advances
◦ Biological Basis, Imaging & Genetics, Psychopharmacology
http://www.youtube.com/watch?v=Bi-3LufJKVs&feature=related
5. TPS: Perspectives of DisordersTPS: Perspectives of Disorders
Illness is the
result of….
Can be treated
by…
Conceptual
Model
Psychoanalytic
Behavioral
Cognitive
Psychosocial
Neurobiology
6. Perspectives of DisordersPerspectives of Disorders
Illness is the
result of….
Can be treated
by…
Conceptual
Model
Psycho-
analytic
Unconscious conflicts over
aggressive & sexual
impulses.
Psychotherapy (“talking
cure”)
Psychodynamic Model
Behavioral Reinforcement of
inappropriate or extinction
of appropriate behaviors.
Behavior Therapy:
Apply principles of learning
to change/modify behavior
Learning Model
Cognitive Irrational or maladaptive
thought processes
Cognitive Therapy:
Change thought processes
Psychosocial Biological, psychological,
and sociocultural factors.
Medication, Behavioral ,
Cognitive Therapies
Vulnerability-Stress Model
Neurobiology Genetic abnormalities in
brain structure &
biochemistry.
Medication Medical Model
7. Conceptual ModelsConceptual Models
Medical Model: Diagnose, treat, and cure
mental illness.
◦ Diagnosis – distinguish among disorders
◦ Etiology – cause/origin of disorder
◦ Prognosis – course & outcome of disorder
11. Major DSM-IV DisordersMajor DSM-IV Disorders
Anxiety
Mood
Eating
Somatoform
Substance-Related
Schizophrenia
Dissociative
Personality
Impulse Control
Sleep Disorders
Sexual & Gender
Identity Disorders
Delirium, Dementia &
Amnesia Disorders
Disorders Diagnosed
in Childhood or
Adolescence
12. Criticisms of DSMCriticisms of DSM
Over diagnosis
◦ Normal behaviors classified as disease (hyperactivity
normal in kids = ADHD)
Huge spectrum
◦ Lump minor (caffeine-induced sleep disorder) with
major disorders (schizophrenia)
Labels Harmful
◦ Self-fulfilling prophecy
Reliability
◦ Diagnosis seems scientific but it’s not, subjective
Controversial Disorders
13. Mental Illness vs. InsanityMental Illness vs. Insanity
Sane and Insane are legal terms
Insanity – inability of defendant to
distinguish right from wrong at time of
crime
TPS - Should the insanity plea be allowed or
not?
14. Why Study Abnormal Psych?Why Study Abnormal Psych?
Prevalence
Stigma /
Misconceptions
http://www.youtube.
com/watch?
v=WUaXFlANojQ
15. Organizations & GoalsOrganizations & Goals
APA
National Mental
Health Assoc
NAMI – Family Org
for People w/ Brian
Disorders
Educate public
Confront discrimination
Challenge negative
stereotypes
Emphasize treatment
works
Achieve parity
w/physical diseases
16. ClosureClosure
What steps can high school students take
to lessen the stigma often associated with
psychological disorders?
Editor's Notes
Normal? Standard by which to measure socially acceptable behaviors within a culture (can vary culture to culture) What is abnormal? Deviation from normality – Behavior that is unlike that of the average or majority. MUST BE CAREFUL, behaving differently doesn’t necessarily indicate poor mental health! Person who believes he’s a prophet and stands on street corner may be…kid in class who dresses differently and stays quiet may not be! Maladaptive behavior – Behaviors disrupt every day life, may be harmful to self or others. Distress - Failing to adjust physically, emotionally, socially to get along in the world. Defense mechanisms have failed to protect us from anxiety…or…defense mechanisms work so well, reality is altered!
How does each major school of thought describe mental illness? How does each major school of thought think mental illness can be treated? Conceptual model – psychologists use different models for understanding, describing, and treating psych disorders.
Psychodynamic Model disorders result from maladaptive defenses against unconscious conflicts Learning Model disorders result from reinforcement of abnormal behavior Vulnerability-Stress Model Disorders result from interaction b/t biological and environmental factors. Biological vulnerability to certain disorder develops into disorder if certain environmental stressors present.
Neurobiology in particular emphasizes that mental illness needs to be diagnosed on the basis of its symptoms and cured through therapy based on medical intervention. Psychological illnesses can be diagnosed (based on symptoms), treated, and cured (hopefully).
Objective – pencil & paper standardized tests (MMPI) Projective – response to ambiguous stimuli, psychologist’s judgment (Rorschach, Association) See personality unit for more DSM allows for systematic classification of mental disorders into categories describe disorders, predict outcomes, consider treatments, encourage research into etiology (cause) Psychologist – Testing, research & therapy Psychiatrist – Medical degree, treats disorders, can prescribe medication
APA published first edition in 1952. DSM II based upon Freud’s psychoanalytic theory – most mental illness due to biological or psychological causes. Severe forms called psychoses; biologic = organic psychoses, others = functional psychoses Less severe disorders called neuroses DSM III moved away from Freudian psychology – used general term disorders rather than psycho/neurosis. Took view that mental disorders are caused by underlying psychological diseases; viewed psycholgical problems as medical ones DSM IV based on much research – enables scientists to differentiate many kinds of disorders. Some disorders have also been eliminated.
Multi-Axial system of Classification: Diagnoses made on several different dimensions or categories Axis 1 – Records patient’s primary diagnosis. 16 major categories of adult psychological disorders. Axis 2 – Records long-standing personality problems, developmental disorders, or mental retardation. Axis 3 – Records any medical conditions that might affect the patient psychologically (interact w/disorder). Axis 4 – Records any significant psychosocial or environmental problems experienced by the patient. Rating of recent stressors (death in family, unemployment) Axis 5 – Records an assessment of the patient’s level of functioning. Scale that ranges from 1 to 100 (1 represents severe dysfunction, 100 represents unimpaired function).
Anxiety – GAD, Phobia, Panic, OCD, PTSD Mood – Depression, Bipolar Eating – Anorexia, Bulimia Somatoform – Physical symptoms that can’t be explained by medical diagnosis – Conversion, Hypochondriasis Substance – Abuse, Dependence Schizophrenia- Dissociative – Amnesia, Fugue, Identity Disorder (multiple personalities) Personality - Paranoid, Schizoid, Antisocial (sociopathic), Histrionic, Narcissistic, Avoidant, Dependent Impulse Control - Explosive, Kleptomania, Pyromania, Trichotillomania Sleep – Dyssomnia & Parasomnia Sex - Dysfunctions, Paraphilias, Gender Identity Childhood - Mental Retardation, Learning, Motor Skills, Communication, Pervasive Dvpt (Autism, Aspergers), Attention Deficit and Disruptive Behavior, Tic, Elimination
British Law 1843 Used to be that prosecution had to prove defendant was sane…capacity to know act was wrong Now 75% of states say defense must prove insanity…show they didn’t understand wrongfulness of acts. Not guilty by reason of insanity - released Guilty but mentally ill – sent to treatment facility - if judged recovered before end of sentence, sent to prison Idaho, Montana, Utah don’t allow insanity pleas!
Prevalence – 1. WHO estimates 400 million people worldwide suffer from disorders (~6.8 billion total) No culture free of depression or schizophrenia. 2. In US, ~15% of population in need of therapy, 1.9 million admitted to mental hospitals & psychiatric units/year, 2.4 million seek out-patient help, and in any given year, about 5 million adults and 3 million children suffer from acute episode of one of 5 serious disorders (schizophrenia, bipolar, depression, OCD, and panic) Stigma Misconceptions leads to misunderstanding and discrimination
Some of many organizations making efforts to combat the misconceptions attached to disorders are APA, NMHA, specific organizations like Anxiety Disorders Association of America Goals Educate public about mental illness Confront discrimination in insurance coverage, housing, education, employment, and access to services Challenge negative stereotypes such as those portrayed in the media Emphasize that treatment works. Fact: current success rates 60% schizo, 65% bipolar, 80% depression. Achieve understnading that serious mental illnesses are no-fault, biologically based brain diseases which should receive the same attention, concern, and care dollars as other physical diseases.
