A. History, Classification Systems and Models

Abnormal Behavior:
Psychological Disorders

A. History, Classification Systems and Models

¡ No one absolute definition of psychological disorders.

¡ Continuum between mental health on one hand and pathology on the other.

B. History, Classification Systems and Models

¡ Proposed definitions include:

¡ A pattern of ________or psychological symptoms that causes significant personal stress and impairs the ability to function in one or more important areas of life, or both. (APA, 1994)

¡ A psychological disorder may exist when behavior is _________, disturbing, ___________ (types of behaviors that inhibit a person’s ability to adjust to particular situations.) and unjustifiable. (Myers, 1998)

¡ A psychological abnormality involves the presence of at least two of the following:

ž Distress

ž ____________

ž Irrationality

ž Unpredictability

ž Unconventional and statistical rarity

ž Observer discomfort

¡ Sanity and insanity are legal rather than ___________ terms.

¡ Insanity

ž The ability of the defendant to distinguish right from wrong.

ž Historical Perspectives on Abnormal behavior

C. The ancient world

§ Greece

§ Hippocrates (460-377 BC) believed ________________ was the result of natural, as opposed to supernatural, causes.

§ Galen (130-200 AD) divided the causes of mental disorders into physical and psychological explanations.

§ In China in 200 AD, Chung Ching stated that both organ pathologies and stressful psychological situations were causes of_________________.

D. Historical Perspectives on Abnormal behavior

¡ The Middle Ages (500-1500 AD)

¡ In Europe, abnormal behavior viewed as ______________possession.

¢ Treatment involved prayer, laying on of hands, and exorcism by a clergy member.

¡ Islamic countries

¢ Humane mental hospitals were established (Baghdad 792 AD)

¢ Persian physician Ibn Sina (Avicenna, 980-1037) established principals for testing the _________________of new drugs.

¢ Still form the basis modern clinical drug trials.

E. Historical Perspectives on Abnormal behavior

¡ The Renaissance

¡ Led to re-emergence of the scientific approach in Europe.

¢ Spanish num Teresa of Avila (1515-1582) established the conceptual framework that the mind can be sick.

¢ Weyer (1515-1588) of Germany and Scot (1538-1599) of England used scientific skepticism to refute the concept of demonic possession.

¡ Humanitarian reforms of the 18th and 19th century.

¢ In the U.S., Benjamin Rush(1745-1813), the founder of American psychiatry, encouraged human treatment of mentally ill and the establishment of hospitals for their care.

¢ Historical Perspectives on Abnormal behavior

F. Scientific advances of the 20th century.

¡ Developments in technology such as MRI and PET scans have added to our knowledge of biological bases of psychological disorders.

¡ Development of psychopharmacology has provided effective treatments for many psychological disorders.

G. Models (or perspectives) of psychological disorders

¡ The_____________ model

¡ Emphasizes that mental illness needs to be diagnosed on the basis of its symptoms

¡ Cured only through therapy based on medical intervention.

¡ Recent discoveries______________ influenced abnormalities in brain structure and biochemistry contribute to wide range of disorders.

¢ Schizophrenia

¢ ____________

¢ Anxiety disorders

— Medications influence many disorders and symptoms

— Schizophrenia, depression and_____________disorders are often successfully treated medically.

H. Models (or perspectives) of psychological disorders

¡ The ______________ model

¡ Inspired by Freud

¢ Emphasizes the role of unconscious conflicts over aggressive and sexual impulses.

¢ Psychoanalytic therapy (the “talking cure”) dominated mid-20th century approaches.

¢ Currently practiced to a lesser extent.

¡ The behavioral model

¡ Emphasizes that psychological disorders have___________ as their basis.

¢ Ex. Inappropriate behaviors might have been reinforced and the punishment or extinction of appropriate behaviors may have occurred.

¡ Therapy relies on learning_____________ to change maladaptive behaviors.

I. Models (or perspectives) of psychological disorders

¡ The _____________ model

¢ Grew out of dissatisfaction with behaviorism’s limits.

¢ Emphasizes that irrational or maladaptive thought processes are the cause of psychological disorders.

¢ The greatest numbers of__________________ in psychology today use this model.

¡ The Biopsychosocial model

¢ Eclectic____________ model.

¢ Assumes that biological, psychological, and sociocultural factors interact to produce or exacerbate_________________ disorders.

¢ Therapists who subscribe to this view may recommend drugs as well as behavioral and cognitive therapies.

J. The Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV)

¡ Published by the American ________________Association, (APA), the DSM-IV, as it is known, is a widely used diagnostic classification system.

¡ Provides a set of criteria which allows______________ to make assessments.

¡ System based on five axes used by_________________ to provide a complete diagnosis.

¡ The Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV)

K. Axis 1

¡ 16 major categories of________psychological disorders.

¢ Mood disorders

¢ Schizophrenic disorders

L. Axis 2

¡ Includes personality disorders and developmental disorders

M. Axis 3

¡ Includes medical conditions that might affect or interact with the client’s psychological disorder

¢ _______________

¢ Headaches

N. Axis 4

¡ A rating of recent social and____________ sources of stress,

¢ Death in the family

¢ Chronic unemployment

O. Axis 5

¡ Global_______________ of Functioning (GAF) made on a scale that ranges from 1 to 100, where 100 represents unimpaired function and 1 represents severe dysfunction.

P. The Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV)

¢ Example of therapists multiaxial diagnosis:

— Axis 1: __________ dependence

— Axis 2: dependent ___________ disorder

— Axis 3: diabetes

— Axis 4: death of spouse; unemployment

— GAF= 60 (moderate symptoms, e.g., occasional panic attacks or moderate difficulty in social, occupational, or school functioning)

Q. Criticisms of classification

¡ System relies heavily on the medical perspective.

¡ Reliability in diagnosis remains a problem; psychological disorders have “fuzzy borders.”

¡ Different disorders share certain characteristics.

¢ Example

¢ A person might exhibit some, but not all, characteristics of a particular disorder.

¡ Controversy exists regarding the existence of some disorders:

¡ Dissociative identity disorder

¡ Premenstrual syndrome