Psychopathology 1: What is abnormal? "
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46 terms
Terms | Definitions |
|---|---|
 People with psychological disorders are not: | Lazy and should just pull themselves together -Crazy -Dumb -Weak in character -Dangerous to self and others -Hopeless and impossible to help |
| Facts about Psychological Disorders | Most psychological disorders are not flamboyant You can't necessarily tell someone has a disorder Many people suffer in private with their problems, although friends and families may realise something is wrong Psychological treatment can make a real difference to these people |
| Defining Abnormal | To know what is "abnormal", we have to agree on what is "normal" We need to be able to reliably tell who has a disorder and needs treatment |
| Defining Abnormal; Deviation from the norm: | Characteristics of majority, "normal" .Any deviation from the norm, "abnormal" .But lots of characteristics are rare, not "average" .Very talented people, highly intelligent .Wouldn't treat these to make them "average" |
| Defining Abnormal; Culturally unacceptable: | Some deviations are acceptable, others are not .Definitions of "abnormal" are influenced by culture .Until 1973, homosexuality was classed as a psychological disorder .Wouldn't treat people simply because they are socially unacceptable |
| Defining Abnormal Causes distress or impairment: | Perhaps distress/dysfunction determines disorder? -But distress is often a part of everyday life -Bereavement or trauma -Being distressed is normal -In some disorders, the "sufferer" is not distressed |
| Problems in classifying behavior as "abnormal", The myth of mental illness (Szasz, 1960): | -mental illness "is a myth, whose function it is to disguise and thus render more palatable the bitter pill of moral conflicts in human relations" |
| Problems in classifying behavior as "abnormal", Labelling sane as insane (Rosenhan, 1973): | 8 well-adjusted people acted as patients -Presented for admission at psychiatric hospitals -Reported they were hearing noises/voices, otherwise told truth about themselves -All but 1 diagnosed as schizophrenic, hospitalised, prescribed medication -Psychiatric staff interpreted their behaviour as insane |
| Problems in classifying behavior as "abnormal"; Stigma of "mentally ill" label (Lamy, 1966): - | College students asked to decide whether they would prefer to employ: a)an ex-convict with an offence, or b)a psychiatric patient who was hospitalised for 30 different jobs -Ex-convict chosen over psychiatric patient as more reliable -Ex-convict considered preferable to mind a child |
| 3 Aims of Psychopathology | To describe abnormal behaviour -To explain what causes abnormal behaviour -To treat abnormal behaviour |
| First task is to describe the nature of psychological disorders | Hard to explain cause or effectively treat without a clear description of disorder Need to agree on the signs and symptoms that characterise (diagnose) specific disorders |
| Kraepelin (1856-1926) first to classify types of mental disorders based on systematic empirical observations | Before then, little agreement on what constitutes mental illness: -„Mad. vs. each symptom = separate disorder |
| Kraeplin offered diagnostic categories defined by | common patterns of symptoms |
| Kraepelin.s system and current diagnostic systems | imply that mental disorders are separate entities: You have a disorder OR you do not |
| Diagnostic Systems | This is often the case in medicine But is it the case in psychopathology? |
| This is where a dimension becomes a category | Most psychological disorders are extreme versions of normal behaviour: We all feel anxious and depressed some times Clinical anxiety differs from normal anxiety in severity, duration, impairment NOT quality But it is important to draw the line somewhere |
| Diagnostic and Statistical Manual of Mental Disorders (DSM) | One major system used by psychologists: Draws the line between normal and abnormal feelings and behaviours Focuses on signs and symptoms of mental disorders |
| Diagnosis and the DSM | First published by American Psychiatric Association in 1952 5 revisions reflecting time & culture: DSM-II (1968), DSM-III (1980), DSM-III-R (1987), DSM-IV (1994), DSM-IV-TR (2000) Categorical disorders diagnosed by set lists of signs and symptoms Uses a multiaxial approach |
| Wider clinical assessment of overall functioning on Axes III-V: | Medical, social, family, economic problems |
| Diagnostic information on Axes I-II: | Presently known psychiatric disorders -long-standing problems |
| DSM designed to | provide complete picture of client |
| Axis I: | most major disorders |
| Axis II: | stable, enduring problems (e.g., personality disorders, mental retardation) |
| Axis III: | medical conditions relevant to each disorder |
| Axis IV: | psychosocial and environmental factors including specific sources (e.g., stress) |
| Axis V: | global assessment of current functioning |
| Diagnostic Criteria: Bulimia Nervosa (a) (1) | eating, in a discreet period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances. |
| Diagnostic Criteria: Bulimia Nervosa (a)(2) | a sense of lack of control over eating during the episode (e.g., a feeling that one can not stop eating or control what or how much one is eating). |
| Diagnostic Criteria: Bulimia Nervosa (B) | Recurrent inappropriate compensatory behaviour in order to prevent weight gain, such as self-induced vomiting; misuse of laxatives, diuretics, enemas, or other medications; fasting; or excessive exercise. |
| Diagnostic Criteria: Bulimia Nervosa (a) | Recurrent episodes of binge eating. An episode of binge eating is characterised by both of the following: |
| Diagnostic Criteria: Bulimia Nervosa (C) | The binge eating and inappropriate compensatory behaviours occur, on average, at least twice a week for 3 months. |
| Diagnostic Criteria: Bulimia Nervosa (D) | Self-evaluation is unduly influenced by body shape and weight. |
| Diagnostic Criteria: Bulimia Nervosa (E) | The disturbance does not occur exclusively during episodes of Anorexia Nervosa. |
| Bulimia Nervosa Purging Type: | during the current episode of Bulimia Nervosa, the person has regularly engaged in self-induced vomiting or the misuse of laxatives, diuretics, or enemas. |
| Bulimia Nervosa Non-purging Type: | during the current episode of Bulimia Nervosa, the person has used other inappropriate compensatory behaviours, such as fasting or excessive exercise, but has not regularly engaged in self-induced vomiting or the misuse of laxatives, diuretics, or enemas. |
| Examples of DSM-V revisions | Clinical characteristics of individuals reporting a frequency of once/week were similar to those meeting the current criterion. Therefore, the required minimum frequency will be reduced to once/week. |
| Examples of DSM-V revisions subtype | A literature review indicated that the non-purging subtype had received relatively little attention, and that these individuals more closely resemble individuals with Binge Eating Disorder. In addition, how to define non-purging inappropriate behaviors (e.g., fasting or excessive exercise) is unclear. Deletion of this subtype is recommended. |
| Assessment Techniques | Structured diagnostic interviews Self-report questionnaires Reports by significant others Behavioural observation Psychophysiological assessment |
| "Abnormal" | is hard to define; does not have one necessary or sufficient characteristic |
| Psychopathology | is the empirical study of description, causes and treatment of abnormal psychology |
| Psychologists describe disorders in terms of | signs & symptoms |
| DSM-IV | is the clinical psychologist.s main diagnostic system |
| Value of assessment: | reliability, validity, standardisation |
| Reliability | Do we all agree? |
| Validity | Just because we all agree, does not mean that we are right! |
| Standardisation | What is normal? |
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