PSYCH 239- Abnormal PSYCH Larissa Predy FALL 2024

Units 1, 2, 3

what are the Four D’s of Abnormality

Distressing, Dysfunctional, Deviates, and Dangerous

dysfunctional

when behavioural thoughts and feelings interfere with a person’s ability to function in daily life, to hold a job, or to form close relationship

Distress

considered abnormal when it affects the individual and those around them

Deviates

considered abnormal when different from social norms, since behaviours are influenced by cultural norms and practices within our community

Psychopathology

field of study devoted to understanding, treating and preventing psychological dysfunction

disease model of mental illness

a belief that behaviors, thoughts or feelings can be viewed as pathological or abnormal if they are symptoms of mental illness

• the belief that there has to be biological proof to the illness to diagnose an individual

stigmas

influence how we view those with psychological disorders and how they can see themselves

disorders

a group of symptoms that disrupts typical body functions but does not have a known cause

• no biological test is available to diagnose any types of abnormality

Mental Illnesses are characterized by:

• alterations in thinking

• mood or behaviour associated with significant distress - distressing to self/others

• and impaired functioning

cultural relativism

there are no universal standards or rules for labelling a behaviour normal

• what is considered abnormal in one culture may be considered normal in another

• honors the norms and traditions of different cultures, rather than imposing the standards of one culture on judgements of abnormality

culture and gender influence

• ways people expirees symptoms of abnormality

• people’s willingness to admit to certain types of behaviors or feelings

• types of treatments deemed acceptable or helpful for people exhibiting abnormal behaviors

biological theories

abnormal behaviour is similar to physical disease and is caused by the breakdown of systems in the body

• cured by the restoration of bodily health

supernatural theories

abnormal behaviour results from divine intervention, curses, demonic possession, or personal sin

• cured through religious rituals, exorcisms, confessions, and atonement to rid the person of perceived affliction

psychological theories

viewed abnormal behaviour results from trauma, bereavement, chronic stress, , and life events

• cured through rest, relaxation, or change of environment to improve psychological health

Ancient China: Balancing Yin and Yang

• abnormal behaviour caused by an imbalance by positive and negative forces in body

• emotions controlled by internal organs

  • evil winds bewitched people influencing their behviour

Ancient Egypt, Greece, and Rome: Biological Theories Dominate

• rejection of supernatural causes

• ex. hysteria referred to psychological symptoms caused by physical processes

• resembles modern day mindfulness and self-care prescriptions

• Instituonalization and removal of rights were common, leading to fear, silence, and stigmatization

psychic epidemics

large numbers of people engaing in unusual behvaiours that appear to have a psychological origin

• uncommon today but still occurs

• treatment was to confine people to asylums where they were often mistreated

understood as the influence of others on individual self-perceptions

mental hygeine movement

proposed more humane treatment of mental illness

• people become ill when they are separated from nature

• rapid social changes create enough stress in some people that their mental illness results

treatment in form of prayers, and incantations, rest and relaxation in a serene and physically appealing place

moral treatment

patients should be provided with humane conditions to live in- forms of abnormality could be cured by restoring a patients dignity and tranquility

• failed to happen because there were not enough mental health workers to staff the growing number of hospitals

• patients remained impaired or their condition worsened

what are the causes of abnormality according to biological approach

brain dysfunction, biochemical imbalances, and genetic abnormalities

Brain dysfunction

people whose brains do not function properly often show problems in psychological functioning

Endocrine System

system of glands produces chemicals called hormones, which are released directly into the blood

hormones

carries messages throughout the body, potentially affecting a person’s mood, level of energy, and reaction to stress

behavioural genetics

study of the gentics of personality and abnormality, is concerned with the extent to which behaviours or behavioral tendencies inherited and identifying the processes by which genes affect behaviour

behavioral therapies

focus on identifying those reinforcements and punishments that contribute to a person’s maladaptive behaviours and on changing specific behaviours

• foundation is the behavioural assessment of the client’s problem- identies specific circumstances that elicit the client’s unwanted behaviour or emotional responses

systematic desensitization therapy

a gradual method for extinguishing anxiety responses to stimuli and the maladaptive behaviour that often accompanies this anxiety

• teaches client to remain deeply relaxed while visualizing a series of increasingly fearsome scenes- develops hierarchy of feared stimuli

Franz Mesmer

Mesmerism (magnetic fluid flow and affected interpersonally)- eiscredited and debunked

• the hypnotic trace-like state was used to induce symptoms of hysteria suggesting it could also be a cure

Sigmund Freud

believed the mental life of individuals is hidden from consciousness and could be explored under hypnosis allowing for greater insight by the therapist

classical conditioning

stimuli can become associated with fears and thereby produce abnormal responses- signal different responses to occur instead of fear-induced response

• explains seemingly irrational responses to a host of neutral stimuli

• targets associations made between emotions and stimuli

behaviourism

abnormal behaviour can be caused by patterns of reinforcement and punishment

• Thorndike and Skinner studied how consequences shape likelihood of recurrence- how consequence shape every behaviour

cognitions

abnormal behaviour caused by distorted thinking that leads to negative emotions and self-defeating actions

• thoughts influence actions

cognitive therapies

help clients identify and challenge their negative thoughts and dysfunctional belief systems

• goal is to collaborate with clients to define problems and teach them more efective ptoblem -solving techniques for dealing eith concrete ptoblems in their lives

Self-efficacy Beliefs

people have beliefs about their ability to control their actions. A negative sense of self-efficacy can impair functioning

• ex. self-defeatist beliefs- lead to low effect and motivation due to those beliefs

patients’ right movement

argued patients recover better or live more satisfying lives, if they are integrated into the community with the support of community-based treatment facilities a process known as deinstitutionaliztion

deinstituionalization

integrating patients into the community with the support of community-based treatment facilities

community mental health movement (1963)

provide coordinated mental health services to people in community mental health centers

• promoted the release of psychiatric patients from long-term care facilities to short-term and community mental health centres

• the goal was to offer less restrictive, more humane treatment options and provide coordinated mental health services

halfway houses

offer people with long-term mental health problems the opportunity to live in a structured, supportive environment

day-treatment centers

allow people to obtain treatment during the day, along with occupational and rehabilitative therapies

• less intensive than inpatient or residential programs

managed care

a collection of methods for coordinating care that ranges from simple monitoring to total control over what care can be provided and paid for

• goal is to coordinate services for an existing medical problem and to prevent future medical problems

• address some of the problems created by deinstitionalization

healthcare provider stigma

prejudice and discrimination voiced or exercised consciously or unconcisouly, by occupational groups designated to provide assistance to stigmatized groups

social stigma

opinions, language, and phrasing that may be societally accepted or be outdated and result in reduced likelihood of access to support or services, and understanding

family stigma

blame, shame, and contamination that falls to family members based on some aspect of one member’s experience

cultural stigma

myths about mental health symptoms and mental health treatment that act as an obstacle to obtaining professional help- misunderstanding about mental health

self-stigma

internalization of public attitudes leading to negative consequences such as to preclude self-acceptance and/or help seeking, or increase helplessness/hopelessness

• own internalizations of these attitudes often resulting in negative drawbacks

theory

set of ideas that provides a framework for questioning, gathering, and interpreting information about a phenomenon

• describes causes or contributing factors to mental disorders

  • the way we approach research

therapy

treatments that target the causal factors of psychological disorders

• generally based on a theory that addresses those factors the theory says cause the phenomenon

• different for each theory of abnormal behaviour

  • actual treatment

sociocultural approach

view that disorders are a result of environmental conditions and cultural norms

• view psychological disorders as falling along a continuum because they don’t view these disorders as vastly different from normal functioning

• labels society assigns to individuals that deviate from social and cultural norms

• looks beyond the individual or even the family to larger society to understand the needs of the individual

• social norms and policies that stigmatize and marginalize certain groups and put them at a risk for mental health problems

bological approach

view that disorders are a result of abnormal genes or neurobiological dysfunction

• sees disorders as collections of deficits in fundamental neurobiological processes

• these problems with cognition and emotional processing range from mild to severe

psychological approach

view that disorders are a result of thinking processes, persoanlity styles, emotions, and conditioning

biopsychological approach

considers mental health symptoms as resulting from the interaction of biological, psychological, and social factors

endocrine system

system of glands that produces chemicals called hormones released directly into the blood

hormones

carry messages throughout the body and affects: mood, energy, and reactions to stress

pituitary gland

master gland controlling the secretion of hormones from the other endocrine glands

• works in conjunciton with the hypothlamus and adrenal glands regulate response to stress

• malfunctioning of the hypothalamic-pituitary adrenal axis (HPA axis) cause anxiety and depression

chronic stress can cause dysregulation in neurotrasmitter and endocrine systems

polygenic

many genes come together to create disorders

• process which means that it takes multiple genetic abnormalities coming together in one individual to create a specific disorder

epigenetics

interactions between genes and the environment

• indicates the environmental conditions can affect the expression of genes- study heritable changes in the expression of genes without change in gene sequence

• DNA can be chemically modified by different environmental conditions resulting in genes being turned on or off- cells, tissues, and organs are altered in their development

drug therapies

medications that alter the functioning of neurotrasnmitter systems

• often have both therapeutic effects and adverse effects called sife effects

psychosurgery

a neurosurgeon attempts to destroy small areas of the brainthought to be involved in patient’s symptoms

• used rarely, and only with people who severe disorders that do not respond to other forms of treatment

Biochemical imbalnces

neurotransmitters, reuptake, degradation, serotonin, dopamine, norepinephrine

classical conditioning

• explains seemingly irrational responses to a host of neutral stimuli

• targets associations made between emotions and stimuli

operant conditioning

shape new behaviors by rewarding desired behaviors and punishing undesired behaviors

• continuous reinforcement schedule

• partial reinforcement schedule

• extinction

modeling

new behaviours are learned by imitating the behaviours modeled by important people

• likely to occur when the person modelling the behaviour is seen as an authority figure or perceived to be similar to oneself

observational learning

person observes the rewards and punishments that another person receives and then behaves accordingly

behavioural therapies

focuses on identifying those reinforceents and punishments that contribute to a person’s maladaptive behaviours and on changing specifi behaviours

Cognitive theories

emphasize role of cognition (thoughts), our thoughts or beliefs shape our behaviour and the emotions

• a belief how something will go influences the person

• ex. worldview impacts how you respond to situations

cognitive-behavioral therapy (CBT)

cognitive techniques combined with behavioral techniques- focuses on the problem with emphasis on the present

• rather than focusing on the causes of distress or experiences in the past, it looks for ways to improve a client’s current state of mind

• designed to be short-term

psychodynamic theories

suggests that all behaviours, thoughts, and emotions, whether normal or abnormal, are influenced to a large extent by unconcsicous processes

• interpersonal therapy (IPT)

• short-term, skill focused, theraist guides the discussion-more about relationships

psychoanalysis

refers to a theory of personality and psychopathology, a method of investigating the mind, and a form of treatment for psychopathology

repression

the motivated forgetting of a difficult experience

• does not dissolve the emotion associated with the memory

ego psychology

emphasizes the importance of the individual’s ability to regulate defences in ways that allow healthy functioning within the realities of society

object relation

perspective that integrated significant aspects of Freud’s drive theory with the role of early relationships in the development of self-concept and personality

• we carry these mental representations throughout adulthood, and they affect subsequent relationships

self psychology and relational psychoanalysis

emphasizes the unconscious dimensions of our relationships with one another from pregnancy and infancy throughout all of life

• goal is less about how the past affects the present than to show how current unconscious forces influence the relationship between the therapist and client

collective unconscious

the wisdom accumulated by a society over hundreds of years of human existence and stored in memories of individuals

• Carl Jung

psychodynamic therapies

the goal is to help clients recognize their maladaptive coping strategies and the sources of their unconscious conflicts

• resulting insights free clients from the grip of the past and give them a sense of agency in making changes in the present

interpersonal therapy

emerged out of modern psychodynamic theories of psychopathology, whichhh isch shifted focus form the unconcious conflicts of the individual to the client’s pattern of relationships with important people in their lives

humanistic

• self-actualization

• client centred

  • helps clients reach their full potential- therapists acts as a less authoritative power, shows positive regard

humanistic theories

are humanistic therapybased on the assumption that humans have an innate capacity for goodness and for a living a full life

• recognized that the environment can play a large tole in our happiness and unhappiness

• once we recognize these forces we become freer to direct our own lives, they would naturlly make good choices and be happier

family systems

attribute problems to the society (the family) rather than the individual

• more geared towards children

• you cannot help an individual without treating the entire family system that created and is maintaining the individual’s problems

emotion-focused/ third-wave approaches

• dialectic behaviour therapy (DBT)

• Acceptance and Commitment Therapy (ACT)

  • focus on people’s ability to regulate their own emotions

  • face distressing emotions rather than avoiding it (challenging maladaptive thoughts)

transdiagnostic risk factors

increase the risk of multiple types of psychological problems

• ex. children from abusive household we move likely to develop psychological problem, but not specific

diathesis-stress model

when risk factor and trigger/stress come together in same individual, a full-blown disorder emerges

• specific stress has to occur for disorder to emerge

third wave approaches

(the first wave was behavioural approaches, and the second wave was cognitive approaches) has become prominent in the theory and treatment of psychological disorders.

• Modern psychotherapeutic techniques that combine elements of the first and second wave approaches- behavioural therapy and cognitive therapy, respectively- with mindfulness meditation practices derived from Zen Buddhism to help people accept, understand, and better regulate their emotions

primary prevention

• prevention of the development of psychological disorders before they start

  • Some primary prevention strategies for reducing drug abuse and delinquency might include changing neighbourhood characteristics that seem to contribute to drug use or delinquency

goal is to stop psychological disorder form developing. ex. mental health awareness

secondary prevention

• focused on detecting a disorder at its earliest stages and thereby preventing the development of the full-blown disorder

  • Goal is early identification through screening as well as providing interventions to prevent the illness from advancing- especially those of higher risk experiencing mental health problmes

ex. screening tools to detect mild symptoms of depreesion

tertiary prevention

•  focuses on people who already have a disorder and these are implemented after symptoms are established

  • Seeks to prevent relapse and reduce the impact of the disorder on the person's quality of life

goal is to prevent relapse and reduce symptoms of psychological disorders, and improve quality of life- ex. community-based treatment delivered

assessment

the process of evaluating psychological, social, and emotional functioning through a variety of clinical method

• often includes interviews, observations, psychological and neurological tests to determine the client’s prsenting problem and clinical description

presenting problem

typically refers to the specific problem that brought the person in for help

syndrome

symptoms that cluster together

diagnosis

label given to a set of symptoms that tend to occur together, and meet thresholds for frequency, duration, intensity, and impairment

abnormality

indication that something is not typical, normal, or expected, an indication that development is atypical or there has been a significant unexpected changes in behaviour

assessment

the process of gathering information about an individuals symptoms and possible causes

• ex. screening measure, clinical interviewing, testing, history

social factors

support networks, work relationships, social skills

biological factors

major illnesses, possible genetic vulnerabilities, brain functioning

psychological factors

personality, coping skills, intellectual strengths, symmptoms

validity

the accuracy of a test in assessing what it is supposed to measure, accuracy of a test, measurement, or instrument

• face, predictive, content, concurrent and construct

concurrent (or convergent) validity

the extent to which a test yields the same reuslt as other, established measure of the same behaviour, thoughts or feelings

• ex. compare the new test to an existing proven test

Face validity

when on face value, the items seem to measure what the test is intended to measure

content validity

is how well an instrument (ex. a test or questionnaire) appropriately measures the content, theory, or phenomenon being studied- test assesses important aspects of a phenomenon

predictive validity

addresses how well an instrument that is used for assessment like a survey, can predict future behaviour

construct validity

the extent to which a test measures what it is supposed to measure and not something else altogether

reliability

indicates consistency of a test in measuring what it is supposed to measure