Psychological Disorders
|Meaning of Abnormal Behavior
The 'gold standard' for defining mental disorder and its subclasses in the United States as well as
many other parts of the world has become the American Psychiatric Association's Diagnostic and
Statistica1 Manual of Mental Disorders (DSM) whose fourth edition was published in 1994, and
is being currently referred to. Here is how the DSM-IV defines mental disorder: “[a mental
disorder] is conceptualized as a clinically significant behavioral or psychological syndrome or
pattern that occurs in an individual and that is associated with present distress (a painful
symptom) or disability (impairment in one or more areas of functioning) or with a significantly
increased risk of suffering death, pain, disability or an important loss of freedom". Whatever it’s
original causes, it must currently be considered a manifestation of a behavioral, psychological or
biological dysfunction in the individual. Neither deviant behavior (political, religious or sexual)
nor conflicts that are primarily between the individual and society are mental disorders ur1less
the deviance or conflict is a symptom of a dysfunction in the individual as described above."
Note: The term syndrome refers to a group of clinical observations or symptoms that end to
co-occur. For example, feelings of despondency, lowered self-esteem and suicidal preoccupation
constitute important parts of a depressive syndrome.
Although some measure of social conformity is essential to group life, we suggest that the
best criterion for determining the normality of behavior is not whether society accepts it but
rather whether it is inimical to individual and group well-being. According to this perspective,
abnormal behavior is maladaptive behavior. Even behavior that conforms to the norms of society
is considered abnormal if it seriously interferes with functioning and is self-defeating in its
consequences. As a result, we hold that behavior is abnormal, a manifestation of a mental
disorder, if it is both persistent and in serious' degree contrary to the well being of the individual
and/or that of the human community of which the individual is a member. In simple terms,
psychological disorders share some if not all of the following characteristics:
First, these disorders usually generate distress-anxiety, internal conflict, depression,
confusion and other negative feelings-in the 'persons who experience them. Second,
psychological disorders involve patterns of behavior or thought that are judged to be unusual or
atypical. People with these disorders don't behave or think like most others in their society, and
this fact is noticed- often with discomfort-by persons around them. Third, psychological disorders
involve behaviors that are maladaptive - ones that interfere with individuals' ability to function
normally and to meet the demands of daily life. People suffering from such disorders find it
difficult to carry out their work, to interact with friends or strangers, to meet family obligations,
or to accomplish the countless small tasks of daily life. Finally, psychological disorders are
associated with behavior that is evaluated negatively by the members of a particular society. In
other words, persons suffering from such disorders often behave in ways that are viewed as
objectionable or unacceptable by the people around them. Of course, ideas about what forms of
behavior are acceptable and what forms are unacceptable can and often do vary between cultures,
and can also change greatly within the same culture over time.
, Taking these points into account, we can define psychological disorders as patterns of
behavior and thought that are atypical, that are viewed as undesirable or unacceptable within a
given culture, that are maladaptive, and that usually (although not always ) cause the persons
who demonstrate them considerable distress.
In assessing, treating and preventing abnormal behavior, mental health personnel are
concerned not only with the maladaptive behavior itself, but also with the family, community and
society in which it occurs. From this perspective, therapy is defined not solely in terms of helping
individuals adjust to their personal situations-no matter how frustrating or abnormal in
themselves-but also in terms of alleviating group and societal conditions that may be causing or
maintaining maladaptive behavior.
Before we move on, you should have some introduction to the main personnel who labor
in this rather complex mental health arena. Represented here are several distinct but closely
related professional fields involved in the study of abnormal behavior and mental health.
Abnormal psychology or psychopathology has long been referred to as that part of the
field of psychology concerned with the understanding, treatment and prevention of abnormal
behavior. Within the area of applied psychology, clinical psychology is the discipline broadly
concerned with the study, assessment, treatment and prevention of abnormal behavior.
Psychiatry is the corresponding field of medicine, the chief difference being that psychiatrists
tend to conceptualize abnormal behavior and its treatment in biological rather than in cognitive
and behavioral terms. Psychiatric social work is concerned with the analysis of social
environments and with providing services that help individuals adjust in both family and
community settings. Psychiatric nursing is a specialized branch of the nursing profession whose
work setting is typically that of hospital wards devoted to the care of mental patients, thus
demanding skills that are quite different from those required of the nurse caring for medical and
surgical patients.
Perspectives of Abnormal Psychology
A number of theorists and researchers have tried to understand the causes of abnormal behavior.
Existing evidence suggests that, in fact, such disorders existed long before the dawn of
civilization, at which time they were thought to be a result of evil spirits. The Greeks developed a
different perspective believing that, such abnormal behavior was the result of natural factors like
brain injury, heredity etc. This was replaced by the idea that abnormal patterns of behavior had
supernatural causes such as demonic possession and witchcraft. Gradually however, the scientific
approach remerged and nowadays, various perspectives to psychological disorders have been
established after careful study and research. Some of them are presented below.
Diathesis-Stress Model
A predisposition towards developing a disorder is termed a diathesis. It can derive from biologic
psychosocial and /or sociocultural causal factors. Most mental disorders are conceived of as the
result of stress operating on a person with a diathesis for the type of disorder that emerges. Hence
we will discuss what are commonly known as diathesis-stress models of abnormal behavior.
This diathesis is a relatively necessary or contributory cause but it is not sufficient to cause the
, disorder. Instead there must be a more proximal cause (the stressor) that may also be contributory
or necessary but it is generally not sufficient by itself to cause the disorder either. Thus, what
usually results in a disorder is a diathesis caused by any number of factors (biological,
psychological or social) and other stressors that enhance the diathesis and make it more likely for
the individual to develop a syndrome. For example, when a child experiences the death of a
parent and may thereby acquire a predisposition or diathesis for becoming depressed later in life.
If this diathesis is added to other stressors like neglect by other parent, improper interpersonal
relationships etc. it will be more likely to develop into major depression.
The diathesis-stress model is the basis upon which we must understand other
perspectives of abnormal behavior. We will now look at several viewpoints that dominate today's
approaches to understanding the causes of abnormal behavior, although no one approach provides
a complete understanding of abnormal behavior.
Biological/Medical Approach
This approach focuses on factors that may cause disorders-biochemical imbalances in the brain,
genetic defects, brain dysfunctions, physical deprivation etc. Prior to the eighteenth century,
persons suffering from mental disorders were often subjected to harsh treatment. Patients in
so-called mental hospitals were shackled to walls in dark, unlighted cells that they were never
permitted to leave. Sanitation was primitive and nonexistent and little if any attention was paid to
diet.
But change was in the wind. Disturbed by these conditions, Jean-Baptiste Pussin,
superintendent of a large hospital of Paris, established new and more human rules for the
treatment of inmates. No beatings were allowed and patients who had been chained for years
were freed from their shackles in the hope that they would become more manageable. Many did
respond favorably to this treatment, so the reforms were continued by Philippe Pinel, who
became chief physician of the hospital's ward for the mentally ill in 1793. Like Pussin, Pinel
believe that psychologically disturbed persons were suffering from a form of illness, and that
moving them from dungeons to bright, sunny rooms and treating them with kindness rather than
violence would help them recover. The results were impressive: many patients, especially those
less seriously disturbed responded to this treatment with rapid improvements.
The view that abnormal behavior is the result of mental illness gradually gained in
strength until it was, at least in Western nations, the dominant approach. This medical perspective
remains highly influential today and is the basis of psychiatry, a branch of modern medicine
specializing in the treatment of mental disorders.
Within psychology there is less emphasis on abnormal .behavior as a disease and more on
its potential biological or biochemical causes. Evidence suggests that changes in the structure or
functioning of the brain may play an important role in several forms of abnormal behavior. For
example, one of the main causes of schizophrenia is said to be an excess of the neurotransmitter
dopamine. It also appears that some psychological disorders may be inherited and therefore
stresses upon the importance of genetics. This has in fact been proved by numerous genetic
studies comparing identical twins with fraternal twins etc. Hormones are also said to playa role in
certain mental disorders like sexual dysfunctions. Physical deprivation during birth caused by a
mother's improper nourishment and care has also been found to cause conditions like mental
retardation.
|Meaning of Abnormal Behavior
The 'gold standard' for defining mental disorder and its subclasses in the United States as well as
many other parts of the world has become the American Psychiatric Association's Diagnostic and
Statistica1 Manual of Mental Disorders (DSM) whose fourth edition was published in 1994, and
is being currently referred to. Here is how the DSM-IV defines mental disorder: “[a mental
disorder] is conceptualized as a clinically significant behavioral or psychological syndrome or
pattern that occurs in an individual and that is associated with present distress (a painful
symptom) or disability (impairment in one or more areas of functioning) or with a significantly
increased risk of suffering death, pain, disability or an important loss of freedom". Whatever it’s
original causes, it must currently be considered a manifestation of a behavioral, psychological or
biological dysfunction in the individual. Neither deviant behavior (political, religious or sexual)
nor conflicts that are primarily between the individual and society are mental disorders ur1less
the deviance or conflict is a symptom of a dysfunction in the individual as described above."
Note: The term syndrome refers to a group of clinical observations or symptoms that end to
co-occur. For example, feelings of despondency, lowered self-esteem and suicidal preoccupation
constitute important parts of a depressive syndrome.
Although some measure of social conformity is essential to group life, we suggest that the
best criterion for determining the normality of behavior is not whether society accepts it but
rather whether it is inimical to individual and group well-being. According to this perspective,
abnormal behavior is maladaptive behavior. Even behavior that conforms to the norms of society
is considered abnormal if it seriously interferes with functioning and is self-defeating in its
consequences. As a result, we hold that behavior is abnormal, a manifestation of a mental
disorder, if it is both persistent and in serious' degree contrary to the well being of the individual
and/or that of the human community of which the individual is a member. In simple terms,
psychological disorders share some if not all of the following characteristics:
First, these disorders usually generate distress-anxiety, internal conflict, depression,
confusion and other negative feelings-in the 'persons who experience them. Second,
psychological disorders involve patterns of behavior or thought that are judged to be unusual or
atypical. People with these disorders don't behave or think like most others in their society, and
this fact is noticed- often with discomfort-by persons around them. Third, psychological disorders
involve behaviors that are maladaptive - ones that interfere with individuals' ability to function
normally and to meet the demands of daily life. People suffering from such disorders find it
difficult to carry out their work, to interact with friends or strangers, to meet family obligations,
or to accomplish the countless small tasks of daily life. Finally, psychological disorders are
associated with behavior that is evaluated negatively by the members of a particular society. In
other words, persons suffering from such disorders often behave in ways that are viewed as
objectionable or unacceptable by the people around them. Of course, ideas about what forms of
behavior are acceptable and what forms are unacceptable can and often do vary between cultures,
and can also change greatly within the same culture over time.
, Taking these points into account, we can define psychological disorders as patterns of
behavior and thought that are atypical, that are viewed as undesirable or unacceptable within a
given culture, that are maladaptive, and that usually (although not always ) cause the persons
who demonstrate them considerable distress.
In assessing, treating and preventing abnormal behavior, mental health personnel are
concerned not only with the maladaptive behavior itself, but also with the family, community and
society in which it occurs. From this perspective, therapy is defined not solely in terms of helping
individuals adjust to their personal situations-no matter how frustrating or abnormal in
themselves-but also in terms of alleviating group and societal conditions that may be causing or
maintaining maladaptive behavior.
Before we move on, you should have some introduction to the main personnel who labor
in this rather complex mental health arena. Represented here are several distinct but closely
related professional fields involved in the study of abnormal behavior and mental health.
Abnormal psychology or psychopathology has long been referred to as that part of the
field of psychology concerned with the understanding, treatment and prevention of abnormal
behavior. Within the area of applied psychology, clinical psychology is the discipline broadly
concerned with the study, assessment, treatment and prevention of abnormal behavior.
Psychiatry is the corresponding field of medicine, the chief difference being that psychiatrists
tend to conceptualize abnormal behavior and its treatment in biological rather than in cognitive
and behavioral terms. Psychiatric social work is concerned with the analysis of social
environments and with providing services that help individuals adjust in both family and
community settings. Psychiatric nursing is a specialized branch of the nursing profession whose
work setting is typically that of hospital wards devoted to the care of mental patients, thus
demanding skills that are quite different from those required of the nurse caring for medical and
surgical patients.
Perspectives of Abnormal Psychology
A number of theorists and researchers have tried to understand the causes of abnormal behavior.
Existing evidence suggests that, in fact, such disorders existed long before the dawn of
civilization, at which time they were thought to be a result of evil spirits. The Greeks developed a
different perspective believing that, such abnormal behavior was the result of natural factors like
brain injury, heredity etc. This was replaced by the idea that abnormal patterns of behavior had
supernatural causes such as demonic possession and witchcraft. Gradually however, the scientific
approach remerged and nowadays, various perspectives to psychological disorders have been
established after careful study and research. Some of them are presented below.
Diathesis-Stress Model
A predisposition towards developing a disorder is termed a diathesis. It can derive from biologic
psychosocial and /or sociocultural causal factors. Most mental disorders are conceived of as the
result of stress operating on a person with a diathesis for the type of disorder that emerges. Hence
we will discuss what are commonly known as diathesis-stress models of abnormal behavior.
This diathesis is a relatively necessary or contributory cause but it is not sufficient to cause the
, disorder. Instead there must be a more proximal cause (the stressor) that may also be contributory
or necessary but it is generally not sufficient by itself to cause the disorder either. Thus, what
usually results in a disorder is a diathesis caused by any number of factors (biological,
psychological or social) and other stressors that enhance the diathesis and make it more likely for
the individual to develop a syndrome. For example, when a child experiences the death of a
parent and may thereby acquire a predisposition or diathesis for becoming depressed later in life.
If this diathesis is added to other stressors like neglect by other parent, improper interpersonal
relationships etc. it will be more likely to develop into major depression.
The diathesis-stress model is the basis upon which we must understand other
perspectives of abnormal behavior. We will now look at several viewpoints that dominate today's
approaches to understanding the causes of abnormal behavior, although no one approach provides
a complete understanding of abnormal behavior.
Biological/Medical Approach
This approach focuses on factors that may cause disorders-biochemical imbalances in the brain,
genetic defects, brain dysfunctions, physical deprivation etc. Prior to the eighteenth century,
persons suffering from mental disorders were often subjected to harsh treatment. Patients in
so-called mental hospitals were shackled to walls in dark, unlighted cells that they were never
permitted to leave. Sanitation was primitive and nonexistent and little if any attention was paid to
diet.
But change was in the wind. Disturbed by these conditions, Jean-Baptiste Pussin,
superintendent of a large hospital of Paris, established new and more human rules for the
treatment of inmates. No beatings were allowed and patients who had been chained for years
were freed from their shackles in the hope that they would become more manageable. Many did
respond favorably to this treatment, so the reforms were continued by Philippe Pinel, who
became chief physician of the hospital's ward for the mentally ill in 1793. Like Pussin, Pinel
believe that psychologically disturbed persons were suffering from a form of illness, and that
moving them from dungeons to bright, sunny rooms and treating them with kindness rather than
violence would help them recover. The results were impressive: many patients, especially those
less seriously disturbed responded to this treatment with rapid improvements.
The view that abnormal behavior is the result of mental illness gradually gained in
strength until it was, at least in Western nations, the dominant approach. This medical perspective
remains highly influential today and is the basis of psychiatry, a branch of modern medicine
specializing in the treatment of mental disorders.
Within psychology there is less emphasis on abnormal .behavior as a disease and more on
its potential biological or biochemical causes. Evidence suggests that changes in the structure or
functioning of the brain may play an important role in several forms of abnormal behavior. For
example, one of the main causes of schizophrenia is said to be an excess of the neurotransmitter
dopamine. It also appears that some psychological disorders may be inherited and therefore
stresses upon the importance of genetics. This has in fact been proved by numerous genetic
studies comparing identical twins with fraternal twins etc. Hormones are also said to playa role in
certain mental disorders like sexual dysfunctions. Physical deprivation during birth caused by a
mother's improper nourishment and care has also been found to cause conditions like mental
retardation.
