PSY 223 - Abnormal Psychology: Chapters 1, 2, 3

Disease model

• The model that psychology worked with for over 60 years, from about the late 1800s into the middle part of the 20th century

• Focused on curing mental disorders

• Included pioneers such as Freud, Adler, Klein, Jung, and Erickson

Positive psychology

• Psychology that had a more positive conception of human potential and nature

• Established by Martin Seligman, who became president of the American Psychological Association in 1996

• Scientific study of topics such as happiness, love, hope, optimism, life satisfaction, goal setting, leisure, and subjective well-being

• Utilizes a quantitative approach and aims to help people make the most out of life’s setbacks, relate well to others, find fulfillment in creativity, and find lasting meaning and satisfaction

Abnormal behavior

A combination of personal distress, psychological dysfunction, deviance from social norms, dangerousness to self and others, and costliness to society

Dysfunction

Clinically significant disturbance in an individual’s cognition, emotion, regulation, or behavior that reflects a dysfunction in the psychological, biological, or developmental processes underlying mental functioning

Distress

• When the person experiences a disabling condition in social, occupational, or other important activities

• Can take the form os psychological or physical pain, or both concurrently

• When alone, it is not sufficient enough to describe behavior as abnormal

Deviance

• A move away from what is normal or the mean

• When a person fails to follow the stated and unstated rules of society

• Not necessarily negative

Dangerousness

When behavior represents a threat to the safety of the person or others

Culture

The totality of socially transmitted behaviors, customs, values, technology, attitudes, beliefs, art, and other products that are particular to a group

Social norms

• The stated and unstated rules of society

• Change over time due to shifts in accepted values and expectations

Cost of mental illness on society

• Mental illness affects a person’s life, which then ripples out to the family, community, and world

• In terms of worldwide impact, data from 2010 estimates $2.5 million in global costs

• Cost is greater than the combined costs of somatic diseases such as cancer, diabetes, and respiratory disorders

• Mental disorders are a substantial economic burden for societies and that certain groups of mental disorders are more costly than others

Abnormal psychology

The scientific study of abnormal behavior, with the intent to be able to predict reliably, explain, diagnose, identify the causes of, and treat maladaptive behavior

Psychopathology

The scientific study of psychological disorders

Mental disorders

Characterized by psychological dysfunction, which causes physical and/or psychological distress or impaired functioning, and is not an expected behavior according to societal or cultural standards

Classification

How we organize or categorize things

Nomenclature

Naming system

Epidemiology

The scientific study of the frequency and causes of diseases and other health-related states in specific populations such as a school, neighborhood, a city, country, and the world

Psychiatric or mental health epidemiology

The occurrence of mental disorders in a population

Presenting problem

A specific problem that a patient presents

Clinical description

• A description given for a presenting problem

• Includes information about the thoughts, feelings, and behaviors that constitute that mental disorder

Prevalence

The percentage of people in a population that has a mental disorder or can be viewed as the number of cases divided by the total number of people in the sample

Point prevalence

• The proportion of a population that has the characteristic at a specific point in time

• The number of active cases

Period prevalence

The proportion of a population that has the characteristic at any point during a given period of time, typically the past year

Lifetime prevalence

The proportion of a population that has had the characteristic at any time during their lives

Incidence

The number of new cases in a population over a specific period

Comorbidity

When two or more mental disorders are occurring at the same time and in the same person

Etiology

The cause of the disorder

Course

• The particular pattern of the disorder

• May be acute, chronic, or time-limited

Acute

Lasts a short time

Chronic

Persists for a long time

Time-limited

Recovery will occur after some time regardless of whether any treatment occurs

Prognosis

The anticipated course the mental disorder will take

Treatment

Any procedure intended to modify abnormal behavior into normal behavior

Social cognition

The process through which we collect information from the world around us and then nterpret it

Sensation

• Detecting physical energy emitted or reflected by physical objects

• Occurs courtesy of our eyes (vision), ears (hearing), nose (smell), skin (touch), and mouth (taste)

Perception

• Meaning is added to raw sensory data

• Information is relayed to the brain through the neural impulse where it is processed and interpreted

Categories

Groups that people are assigned to based on the information we detect

Schema

A set of beliefs and expectations about a group of people, believed to apply to all members of the group, and based on experience

Primacy effect

First impressions

Perseverance effect/belief perseverance

Even if we obtain new information that should override an incorrect initial assessment, the initial impression is unlikely to change

Stereotypes

Special types of schemas that are very simplistic, very strongly held, and not based on firsthand experience

Heuristics

Mental shortcuts

Social identity theory

• States that people categorize their social world into meaningfully simplistic representations of groups of people

• These representations are then organized as prototypes

Prototypes

Fuzzy sets of a relatively limited number of category-defining features that not only define one category but serve to distinguish it from other categories

Out-group homogeneity

Occurs when we see all members of an outside group as the same

In-group/out-group bias

A tendency to show favoritism to, and exclude or hold a negative view of, members outside of one’s immediate group

Prejudice

The negative view or set of beliefs about a group of people

Discrimination

Acting in a way that is negative against a group of people

Implicit attitudes

Attitudes that we are unaware of

Explicit attitudes

The views within our conscious awareness

Stigma

• Overlapping with prejudice and discrimination in terms of how people with mental disorders are treated

• When negative stereotyping, labeling, rejection, and loss of status occur

Public stigma

• When members of a society endorse negative stereotypes of people with a mental disorder and discriminate against them

• They might avoid them altogether, resulting in social isolation

Label avoidance

To avoid being labeled as “crazy” or “nuts”, people needing care may avoid seeking it altogether or stop care once started

Self-stigma

• When people with mental illnesses internalize the negative stereotypes and prejudice, and in turn, discriminate against themselves

• They may experience shame, reduced self-esteem, hopelessness, low self-efficacy, and a reduction in coping mechanisms

Courtesy stigma

Public disapproval and social devaluation that an individual experiences simply by being connected to a stigmatized person or group

Mental illness today

• Nearly 46% of participants in the National Comorbidity Study Replication of 2001-2003 had a psychiatric disorder at some time in their lives

• About 80% of the sample reported seeking treatment for their disorder

• Women were more likely than men to seek help

• Whites were more likely than African and Hispanic Americans to seek help

• The use of mental health services has increased by over 50% during this decade

• Stigma has reduced over time, diagnosis is more effective, community outreach programs have increased, and general practitioners have been more willing to prescribe psychoactive medications

Psychiatric/psychotrophic drugs

• Used for the treatment of mental illness and made an immediate impact

• Cannot cure mental illness alone, but they can improve symptoms and increase the effectiveness of treatments

• Classes: Antidepressants, mood-stabilizing medications, anti-psychotic drugs, anti-anxiety drugs

• Used in 77% of mental health cases by 1996

• Spending grew from $2.8 billion in 1987 to about $18 billion in 2001

• Its usage is influenced by the expansion of insurance coverage for prescription drugs, the introduction and diffusion of managed behavioral health care techniques, and the conduct of the pharmaceutical industry in promoting their products

Deinstitutionalization

• The release of patients from mental health facilities

• A result of the use of psychiatric drugs

Managed health care

• A term used to describe a type of health insurance in which the insurance company determines the cost of services, possible providers, and the number of visits a subscriber can have within a year

• Regulated through contracts with providers and medical facilities

• Three forms: Health Maintenance Organizations (HMO), Preferred Provider Organizations (PPO), Point of Service (POS)

• Developed in the 1980s to combat the rising cost of mental health care and took responsibility away from single practitioners or small groups who could charge what they felt was appropriate

• Actual impact on mental health services is still questionable at best

Health Maintenance Organizations (HMO)

• Typically only pay for care within the network

• The subscriber chooses a primary care physician (PCP) who coordinates most of their care

• The PCP refers the subscriber to specialists or other health care providers as is necessary

• The most restrictive option

Preferred Provider Organizations (PPO)

• Usually pay more if the subscriber obtains care within the network

• If care outside the network is sought, they cover part of the cost

Point of Service (POS)

Plans that provide the most flexibility and allow the subscriber to choose between an HMO or a PPO each time care is needed

Multicultural psychology

• Approach that takes into account a person’s gender, age, race, ethnicity, socioeconomic status (SES), and culture, and how these factors shape the individual’s thoughts, feelings, and behaviors

• Understands how the various groups, whether defined by race, culture, or gender, differ from one another

Prescription rights for psychologists

• The proposal to allow appropriately trained psychologists the right to prescribe to reduce inappropriate prescribing

• Measures in some states have been opposed by the American Medical Association and American Psychiatric Association over concerns that inadequate training of psychologists could jeopardize patient safety

Prevention science

The science of identifying the factors that cause specific mental health issues and implementing interventions to stop them from happening, or at least minimize their deleterious effects

Scientific method

• A systematic method for gathering knowledge about the world around us

• Steps

  • Step 0: Ask questions and be willing to wonder.

  • Step 1: Generate a research question or identify a problem to investigate.

  • Step 2: Attempt to explain the phenomena we wish to study.

  • Step 3: Test the hypothesis.

  • Step 4: Interpret the results.

  • Step 5: Draw conclusions carefully.

  • Step 6: Communicate our findings to the broader scientific community.

Critical thinking

Our ability to assess claims made by others and make objective judgments that are independent of emotion and anecdote and based on hard evidence

Literature review

When we conduct a literature search through our university library or a search engine to see what questions have been investigated already and what answers have been found so we can identify gaps or holes in this body of work

Theory

A systematic explanation of a phenomenon

Hypothesis

A specific, testable prediction

Research design

The plan of action for how to test the hypothesis

Descriptive statistics

Provide a means of summarizing or describing data and presenting the data in a usable form

Inferential statistics

Allow for the analysis of two or more sets of numerical data to determine the statistical significance of the results

Statistical significance

An indication of how confident we are that our results are due to our manipulation or design and not chance

Replication

Repeating the study

Three cardinal features of science

• Observation (to know about the world around us, we have to be able to see it firsthand)

• Experimentation (to be able to make causal or cause-and-effect statements, we must isolate variables and manipulate one variable and see the effect of doing so on another variable)

• Measurement (to know if the experiment has worked)

Naturalistic observation

• The scientist studies human or animal behavior in its natural environment

• Advantages: You see behavior as it happens, the experimenter does not taint the data

• Disadvantages: It could take a long time for the behavior to occur, behavior of those being observed may be influenced if the researcher is detected

Laboratory observation

• Observing people or animals in a laboratory setting

• Advantages: The experimenter can use sophisticated equipment to record the session and examine it later

• Disadvantages: The behavior of subjects could become artificial since the subjects know the experimenter is watching them

Case study

• A detailed study and description of one person or a small group

• Advantages: You arrive at a detailed description of the investigated behavior, can lead us to novel ideas about the cause of abnormal behavior and help us to study unusual conditions that occur too infrequently to analyze with larger sample sizes and in a systematic way

• Disadvantages: The findings may be unrepresentative of the larger population (lacking generalizability), the study is subject to researcher bias in terms of what is included in the final narrative and what is left out

Generalizability

The degree to which research findings can be applied to broader populations beyond the original study sample

Surveys/Self-report data

• A questionnaire consisting of at least one scale with some questions used to assess a psychological construct of interest

• Advantages: Allow for the collection of large amounts of data quickly

• Disadvantages: Could be tedious for the participant, social desirability

Social desirability

When a participant answers questions dishonestly so that they are seen in a more favorable light

Correlational research

• Research method that examines the relationship between two variables or two groups of variables

• Advantages: You can correlate anything

• Disadvantages: You can correlate anything including variables that do not have any relationship with one another, does not allow you to make a causal statement

Correlation coefficient

• A numerical measure of the strength of this relationship is derived

• Can range from -1.00 (perfect inverse relationship) to 0 (no relationship) to +1.00 (perfect relationship)

Epidemiological study

A special form of correlational research in which the prevalence and incidence of a disorder in a specific population are measured

Experiment

• A controlled test of a hypothesis in which a researcher manipulates one variable and measures its effect on another variable

Independent variable (IV)

The manipulated variable

Dependent variable (DV)

The variable that is measured

Control group

The group that does not receive the treatment or is not manipulated

Experimental group

The group that does receive the treatment or manipulation

Random assignment

Participants have an equal chance of being placed in the control or experimental group

Placebo

A sugar pill made to look exactly like the pill given to the experimental group

Single-subject experimental design

An experimental design that focuses on one individual when a study does not afford a large sample of participants

Confounding variables

Variables not originally part of the research design but contribute to the results in a meaningful way

Reversal/ABAB design

A type of single-subject experimental design

Multimethod research

• When several research approaches are employed at different stages of the research study

• Used to provide the psychologist with the most precise picture of what is affecting behavior or mental processes

Clinical psychologist

• Degree Required: Ph.D./PsyD

• Function/Training: Trained to make diagnoses and can provide individual and group therapy

• Can they prescribe medications? Yes (in 6 states)

School psychologist

• Degree Required: Masters or Ph.D.

• Function/Training: Trained to make diagnoses and can provide individual and group therapy but also works with school staff

• Can they prescribe medications? No

Counseling psychologist

• Degree Required: Ph.D.

• Function/Training: Trained to make diagnoses and can provide individual and group therapy

• Can they prescribe medications? Yes (in 6 states)

Clinical social worker

• Degree Required: M.S.W. or Ph.D.

• Function/Training: Trained to make diagnoses and can provide individual and group therapy and is involved in advocacy and case management. Usually in hospital settings.

• Can they prescribe medications? No

Psychiatrist

• Degree Required: M.D.

• Function/Training: Has specialized training in the diagnosis and treatment of psychiatric patients

• Can they prescribe medications? Yes