Abnormal Psychology

What is a psychological Disorder?

• Psychological disorders are persistently harmful thoughts, feelings and actions.– When behavior is deviant, distressful and

dysfunctional, psychologists label it a disorder.

• The more extreme a disorder is, the more easily it is detected. When trying to diagnose a patient, doctors look for three classic symptoms of sever psychopathology:

• Hallucinations-false sensory experiences.• Delusions-extreme disorders that involve persistent false

beliefs. • Affect (emotion)-characteristically depressed, anxious,

manic, or no emotional response.

What was once believed to cause mental disorders?

Perceived Causes movements of sun or moon

lunacy--full moon evil spirits

Ancient Treatments exorcism, caged like animals, beaten,

burned, castrated, mutilated, blood replaced with animal’s blood

Early Theories

• Music or singing was often used to chase away spirits.

• In some cases trephening was used:– Cutting a hole in the

head of the afflicted to let out the evil spirit.

Psychological Disorders as a Continuum

No Disorder Mild DisorderModerate Disorder

Severe Disorder

Absence of signs of psychological disorder

Few signs of distress or other indicators of psychological disorder

Indicators of disorders are more pronounced and occur more frequently

Clear signs of psychological disorder, which dominate the person’s life

Absence of behavioral problems

Few behavior problems; responses usually appropriate to the situation

More distinct behavior is often inappropriate to the situation

Severe and frequent behavior problems; behavior is usually inappropriate to the situation

No problems with interpersonal relationships

Few difficulties with relationships

More frequent difficulties with relationships

Many poor relationships or lack of relationships

Disorders are exaggerations of normal behavior and responses.

DSM- Diagnostic and Statistic Manual of Mental Disorders.

-Primary reference for making diagnostic judgments

Indicators of Abnormality

• While psychologists look for the three classical symptoms, not all disorders have such sever symptoms. A few others are:– Distress: Does the individual show unusual or

prolonged levels of anxiety?– Maladaptiveness: Does the person act in ways that

make others fearful?– Irrationality: Does the person act or talk in ways that

are irrational or incomprehensible to others?– Unpredictability: Does the individual behave erratically

and inconsistently at different times?– Unconventional/undesirable behavior: Does the

person act in ways that are statistically rare and violate social norms?

The More the Better

• Clinicians are more confident in labeling behavior as “abnormal” when two or more of the indicators are present. – Extremes and prevalence = greater confidence in

diagnosis

Rates of Psychological Disorders

The Medical Model• In the late 18th century, the “disease view” reemerged.

• The result was the medical model, a view that mental disorders are diseases of the mind that, like ordinary physical diseases, have objective causes and require specific treatment.

**butt

Medical Model in Practice

• The medical model led to mental hospitals or “asylums.” In this supportive atmosphere, many patients actually improved, even thrived, on rest, contemplation and simple but useful work.

Problems with the Medical Model• Despite its success, modern psychologists find fault

with relying solely on the medical model.

• They suggest that treating the disorder as a “disease” leads to a doctor-knows-best approach in which the therapist takes all the responsibility for diagnosing and correcting the problem.

• In this model, the patient becomes a passive recipient of medication and advice.

Psychologists vs. Psychiatrists

• The other problem psychologists have with the medical model (doctor-knows-best), is that it takes responsibility away from psychologists and gives it to psychiatrists. – According to our authors, it assigns psychologists

to second-class professional status.

The Cognitive Approach

• The cognitive approach to depression points out that negative thinking styles are learned and modifiable. *Think classical and operant conditioning.

Social-Cognitive-Behavioral Approach• As psychology has evolved, theories which were

originally at odds, have now been combined to offer more thorough explanations, for example, cognitive psychology and behaviorism.

• Cognitive psychology looks inward, emphasizing mental processes. Behaviorism looks outward and emphasizes the influences of the environment.

• Psychologist from these perspectives see these two as complementary, and add that cognitions and behavior usually happen in social context, requiring social perspective.

Combining Perspectives

• The behavioral perspective tells us that abnormal behaviors can be acquired in the same fashion as healthy behaviors-- through behavioral learning.

• The cognitive perspective suggests that we must consider how people think about themselves and their relations with other people.

• Social-cognitive-behavioral approach, then, is an alternative to the medical model combining all three of psychology’s major perspectives.

Rosenhan Experiment• Rosenhan suspected that some strange

behaviors seen in mental patients might originate in the abnormal atmosphere mental hospitals, rather than in the patients themselves.

• To test these theories, Rosenhan and seven collogues conducted the Rosenhan Experiment in the early 1970s.

David Rosenhan

Explaining Rosenhan

• Rosenhan said that the mistaken diagnosis were most likely a result of the lack of time the doctors spent with the patients.

• Surprisingly, the other hospital patients readily detected the experiment. The pseudo-patients reported that the other patients regularly voiced their suspicions.

– Watch Rosenhan discuss his experiment – http://www.youtube.com/watch?v=j6bmZ8cVB4o

After the Experiment

• All of the people who served in the original study were eventually discharged from the hospital with the label of "schizophrenic in remission."

• To put it another way, they were still considered schizophrenic, but they were temporarily free of symptoms.

Psychological Disorders and Courtrooms

The Insanity Plea: Breaking the myths– Does not mean a person gets away

with a crime without circumstance– Not easy to be considered not

guilty by reason of insanity; less than 1%

– If deemed not guilty by reason of insanity individuals don’t go home, they are assigned to go to a mental institution until they are deemed mentally stable; could be longer than a prison sentence.

Court Confidentiality Problem- Psychologist are required to maintain patient

confidentiality and not expose what they a patient told them in private.

However, a judge may require that a psychologist give a testimony as to the psychological state of an individual, divulging confidential details.

In a court of law, a judge may issue a subpoena that requires a psychologists full cooperation.