WEEK 1: BACKGROUND AND THEORIES OF ABNORMAL PSYCHOLOGY
What is a Psychological Disorder?
- According to the DSM-5: “A mental disorder is a syndrome characterised by clinically
significant disturbance in an individual’s cognition, emotion regulation, or behaviour that
reflects a dysfunction in the psychological, biological, or developmental processes
underlying mental functioning. Mental disorders are usually associated with significant
distress or disability in social, occupational, or other important activities. An expectable
or culturally approved response to a common stressor or loss, such as the death of a loved
one, is not a mental disorder. Socially deviant behaviour (e.g., political, religious, or
sexual) and conflicts that are between the individual and society are not mental disorders
unless the deviance or conflict results from a dysfunction in the individual, as described
above.”
- This is to say that people are looked at from a holistic perspective (i.e., that it is
important to view the mind as a unit, rather than trying to break it down into its
individual parts), in terms of their cognitive abilities and how they are thinking
about different things, whether us as therapists can see cognitive errors in ones
functioning, one’s ability or inability to regulate their emotions or behaviour;
looking at psychological, biological or developmental processes that underlie this
functioning, as well as, social functioning/impacts (how the biopsychosocial
model influences individuals behaviours). These various areas of functioning are
usually associated with significant distress or disability, but not always the case
(tricky at times to diagnose [such as personality disorders]). Psychopathology
aims to rule out disorders that may be expectable (e.g., not wanting to diagnose
someone with feelings of sadness/distress after the death of a loved one with a
disorder, unless these emotions continue on longer than what is culturally deemed
acceptable).
- Based on a practitioner’s belief a person should be better functioning by a certain
time period (something that can cause a lot of debate).
How to Define Abnormal?
Looking at three main things:
1. Psychological dysfunction: some sort of break down in cognitive, emotional or
behavioural functioning (this may be in one or multiple of these areas. In terms of what is
considered normal and abnormal, problems are considered on a continuum opposed to
categorically present or absent.
- Personal distress or impairment:
, - Distress is typically an important component when diagnosing a disorder,
however, it is not necessarily present. Sometimes the person themselves might not
be distressed by their disorder, however are distressing other people.
- Often despite people having issues they may function perfectly fine meaning little
to no impairment.
- To diagnose a disorder either distress or impairment needs to be present.
- Most psychological disorders are extreme expressions of otherwise normal
emotions, behaviours, and cognitive processes
- Atypical or not culturally expected: does deviating from the cultural norm make someone
disordered? (e.g., atypical in terms of being the best cyclist in the world or of
extraordinary high intellect [these would be more considered statistically abnormal]).
- Violation of cultural/social norms: does the person experience their behaviours as
out of control? Is the dysfunction a harmful dysfunction? Does the disorder affect
the person’s ability to live functionally?
- Moving toward an accepted definition DSM 5: behavioural, psychological, or biological
dysfunctions that are unexpected in their cultural context and associated with present
distress and/or impairment in functioning or increased risk of suffering death, pain or
impairment.
The Science of Psychopathology
- Psychopathology: essentially the scientific study of psychological disorders (knowledge
about psychological disorders, how they are categorised, how they are conceptualised,
and how they are studied).
- Who works in this field? clinical psychologists (tend to focus on the more severe
psychological disorders), counselling psychologists, psychiatrists ([physicians medical
doctors], psychiatric social workers (typically working with psychosis and suicide
ideation), mental health counsellors and psychiatric nurses (typically working with
psychosis and suicide ideation).
Scientist-Practitioner Model
Scientific approach to clinical work:
- Keep abreast of latest developments (keeping up to date on readings of what is being
published on different disorders, using the most current diagnostic treatment procedures,
- Evaluate assessments and treatment procedures (to see if assessments and procedures:
have efficacy [i.e., the ability to produce their desired result]
- Conduct research (to produce new information about disorders and treatments [more
academically inclined clinical psychologists opposed to those working in private
practice])
,Goals of scientist-practitioner approach:
- Describe psychological disorders
- Determine causes/aetiology
- Treatment disorders
Important Terminology
- Presenting problem: the concerns or the issues the client presents with for assessment or
treatment.
- Clinical description: includes the unique combination of behaviours, thoughts and
feelings that make up a certain disorder (can differ greatly from person to person).
- Prevalence: how many people in a population as a whole have a particular disorder (e.g.,
lifetime or one year).
- Incidence: how many new cases occur during a given period of time (e.g., the space of a
year incidence would be, how many people in 2016 developed…).
- Course: typically pattern of a particular disorder (This will be important to understand for
the assignment). Is the course chronic (meaning once present the symptoms do not
relieve), episodic (meaning fluctuations can be seen in clinical presentation or symptom
severity [i.e., symptoms are worse at specific times], or time-limited (meaning the
symptoms are going to resolve on their own [potentially regardless of what the person
does or whether it is treated or not]).
- Onset: can be either acute (onset is quick, happens all at once) or insidious (onset
is slower, symptoms collect over time, often outside of conscious awareness).
- Prognosis: anticipated course or outcome of the disorder can be either poor (disorders
will not remit e.g., schizophrenia disorders), good (individual is likely to do well once
symptoms remit) or guarded (is in the middle; could be good or poor meaning
practitioners are not wanting to make an assessment either way).
- Aetiology: the study of the origins of a disorder (looking at the biological, social, and
psychological dimensions of disorders [how did x disorder develop and what contributed
to it).
Conceptualisations of Abnormal Behaviour
- Supernatural tradition
- Biological tradition
- Psychological tradition
- Integrative approach
Magic, Witches, and Hysterias
- Often throughout history, bizarre behaviours were believed to be caused by “evil”
- Work of demons and witches.
, - Treatment was often revolved around supernatural explanations such as exorcism,
hanging people over pits of snakes, shaving crosses into peoples heads,
confinement and torture continued into the 15th century.
- More enlightened perspective - insanity natural and caused by mental or emotional stress
and was natural (treated with rest, sleep and potions).
- Hysterias
- Mass hysteria (or large scale outbreak [large groups of people running out onto
the streets and dancing]).
- Modern-day explanations (emotions can spread from person to person).
- Astrology (moving of moon and stars affects behaviour [no scientific evidence to support
this claim]).
Early Biological Explanations
- Hippocrates (Hippocratic Corpus, 450-350BC): Mental illness is physical and can be
treated.
- Galen further developed theory of humour imbalance; four different types of humours in
one’s body and imbalances cause particular presentations of personality or behaviour:
- Blood (coming from the heart)
- Black bile (melancholer)
- Yellow bile (choler)
- Phlegm (which was believed to have come from the brain)
- Treatment for humour imbalance - regulate the heat of the environment and ensure the
person has good nutrition.
- Hysteria (what we now call somatic symptom disorders [i.e., presenting with physical
symptoms despite no evidence being found]). Only diagnosable in women, treatments
included marriage, having a baby and the moving of the uterus.
- 19th century
- Causes of insanity are physical and should be treated as physical.
What is a Psychological Disorder?
- According to the DSM-5: “A mental disorder is a syndrome characterised by clinically
significant disturbance in an individual’s cognition, emotion regulation, or behaviour that
reflects a dysfunction in the psychological, biological, or developmental processes
underlying mental functioning. Mental disorders are usually associated with significant
distress or disability in social, occupational, or other important activities. An expectable
or culturally approved response to a common stressor or loss, such as the death of a loved
one, is not a mental disorder. Socially deviant behaviour (e.g., political, religious, or
sexual) and conflicts that are between the individual and society are not mental disorders
unless the deviance or conflict results from a dysfunction in the individual, as described
above.”
- This is to say that people are looked at from a holistic perspective (i.e., that it is
important to view the mind as a unit, rather than trying to break it down into its
individual parts), in terms of their cognitive abilities and how they are thinking
about different things, whether us as therapists can see cognitive errors in ones
functioning, one’s ability or inability to regulate their emotions or behaviour;
looking at psychological, biological or developmental processes that underlie this
functioning, as well as, social functioning/impacts (how the biopsychosocial
model influences individuals behaviours). These various areas of functioning are
usually associated with significant distress or disability, but not always the case
(tricky at times to diagnose [such as personality disorders]). Psychopathology
aims to rule out disorders that may be expectable (e.g., not wanting to diagnose
someone with feelings of sadness/distress after the death of a loved one with a
disorder, unless these emotions continue on longer than what is culturally deemed
acceptable).
- Based on a practitioner’s belief a person should be better functioning by a certain
time period (something that can cause a lot of debate).
How to Define Abnormal?
Looking at three main things:
1. Psychological dysfunction: some sort of break down in cognitive, emotional or
behavioural functioning (this may be in one or multiple of these areas. In terms of what is
considered normal and abnormal, problems are considered on a continuum opposed to
categorically present or absent.
- Personal distress or impairment:
, - Distress is typically an important component when diagnosing a disorder,
however, it is not necessarily present. Sometimes the person themselves might not
be distressed by their disorder, however are distressing other people.
- Often despite people having issues they may function perfectly fine meaning little
to no impairment.
- To diagnose a disorder either distress or impairment needs to be present.
- Most psychological disorders are extreme expressions of otherwise normal
emotions, behaviours, and cognitive processes
- Atypical or not culturally expected: does deviating from the cultural norm make someone
disordered? (e.g., atypical in terms of being the best cyclist in the world or of
extraordinary high intellect [these would be more considered statistically abnormal]).
- Violation of cultural/social norms: does the person experience their behaviours as
out of control? Is the dysfunction a harmful dysfunction? Does the disorder affect
the person’s ability to live functionally?
- Moving toward an accepted definition DSM 5: behavioural, psychological, or biological
dysfunctions that are unexpected in their cultural context and associated with present
distress and/or impairment in functioning or increased risk of suffering death, pain or
impairment.
The Science of Psychopathology
- Psychopathology: essentially the scientific study of psychological disorders (knowledge
about psychological disorders, how they are categorised, how they are conceptualised,
and how they are studied).
- Who works in this field? clinical psychologists (tend to focus on the more severe
psychological disorders), counselling psychologists, psychiatrists ([physicians medical
doctors], psychiatric social workers (typically working with psychosis and suicide
ideation), mental health counsellors and psychiatric nurses (typically working with
psychosis and suicide ideation).
Scientist-Practitioner Model
Scientific approach to clinical work:
- Keep abreast of latest developments (keeping up to date on readings of what is being
published on different disorders, using the most current diagnostic treatment procedures,
- Evaluate assessments and treatment procedures (to see if assessments and procedures:
have efficacy [i.e., the ability to produce their desired result]
- Conduct research (to produce new information about disorders and treatments [more
academically inclined clinical psychologists opposed to those working in private
practice])
,Goals of scientist-practitioner approach:
- Describe psychological disorders
- Determine causes/aetiology
- Treatment disorders
Important Terminology
- Presenting problem: the concerns or the issues the client presents with for assessment or
treatment.
- Clinical description: includes the unique combination of behaviours, thoughts and
feelings that make up a certain disorder (can differ greatly from person to person).
- Prevalence: how many people in a population as a whole have a particular disorder (e.g.,
lifetime or one year).
- Incidence: how many new cases occur during a given period of time (e.g., the space of a
year incidence would be, how many people in 2016 developed…).
- Course: typically pattern of a particular disorder (This will be important to understand for
the assignment). Is the course chronic (meaning once present the symptoms do not
relieve), episodic (meaning fluctuations can be seen in clinical presentation or symptom
severity [i.e., symptoms are worse at specific times], or time-limited (meaning the
symptoms are going to resolve on their own [potentially regardless of what the person
does or whether it is treated or not]).
- Onset: can be either acute (onset is quick, happens all at once) or insidious (onset
is slower, symptoms collect over time, often outside of conscious awareness).
- Prognosis: anticipated course or outcome of the disorder can be either poor (disorders
will not remit e.g., schizophrenia disorders), good (individual is likely to do well once
symptoms remit) or guarded (is in the middle; could be good or poor meaning
practitioners are not wanting to make an assessment either way).
- Aetiology: the study of the origins of a disorder (looking at the biological, social, and
psychological dimensions of disorders [how did x disorder develop and what contributed
to it).
Conceptualisations of Abnormal Behaviour
- Supernatural tradition
- Biological tradition
- Psychological tradition
- Integrative approach
Magic, Witches, and Hysterias
- Often throughout history, bizarre behaviours were believed to be caused by “evil”
- Work of demons and witches.
, - Treatment was often revolved around supernatural explanations such as exorcism,
hanging people over pits of snakes, shaving crosses into peoples heads,
confinement and torture continued into the 15th century.
- More enlightened perspective - insanity natural and caused by mental or emotional stress
and was natural (treated with rest, sleep and potions).
- Hysterias
- Mass hysteria (or large scale outbreak [large groups of people running out onto
the streets and dancing]).
- Modern-day explanations (emotions can spread from person to person).
- Astrology (moving of moon and stars affects behaviour [no scientific evidence to support
this claim]).
Early Biological Explanations
- Hippocrates (Hippocratic Corpus, 450-350BC): Mental illness is physical and can be
treated.
- Galen further developed theory of humour imbalance; four different types of humours in
one’s body and imbalances cause particular presentations of personality or behaviour:
- Blood (coming from the heart)
- Black bile (melancholer)
- Yellow bile (choler)
- Phlegm (which was believed to have come from the brain)
- Treatment for humour imbalance - regulate the heat of the environment and ensure the
person has good nutrition.
- Hysteria (what we now call somatic symptom disorders [i.e., presenting with physical
symptoms despite no evidence being found]). Only diagnosable in women, treatments
included marriage, having a baby and the moving of the uterus.
- 19th century
- Causes of insanity are physical and should be treated as physical.
