ABNORMAL AND CLINICAL PSYCHOLOGY

OVERVIEW
Abnormal = away from the normal = deviation from some specified norm

Abnormal behavior = is behavior that deviates from the norms of the society in which it is enacted.

Norm = is the structural and functional integrity of the body as a workable biological system ( the boundary lines between normality and pathologic ---which are usually, but not always, clear). = for psychological disorder, we have no ideal nor a universal normal model of human mental and behavioral functioning to use as a base of comparison.

Thus we find considerable confusion and disagreement as to just what is or is not normal, a confusion aggravated by changing values and expectations in society. = virtually a requirement for social acceptance is needed for being considered normal.

In short, virtually all what we regard as abnormal in behavior we also regard as undesirable, although in a strict and literal sense undesirability is not a necessary attribute of behaviors that may deviate from some normative expectation.

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.

Syndrome = refers to a group of clinical observations or symptoms that tend to co-occur. e.g. Feelings of despondency, lowered self-esteem, and suicidal preoccupation constitute important parts of a depressive syndrome.

* DSM (Diagnostic and Statistical Manual of Mental Disorder) is careful in asserting that mental disorders are always products of dysfunctions.

ABNORMAL BEHAVIOR IS A MALADAPTIVE BEHAVIOR

Behavior is abnormal, a manifestation of mental disorder, if it is both persistent and in serious degree contrary to the continued well-being of the individual and/or that of the human community of which the individual is a member.

This working definition contains, of course, an explicit value judgment that ties the definition of mental disorder to the persistent enactment of behavior that produces harmful consequences for self and/or others.

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 the maladaptive behavior.

TERMINOLOGIES:

Abnormal Psychology or Psychopathology = referred to as that part of the field of psychology concerned with the understanding, treatment, and prevention of abnormal behavior.

Clinical Psychology = is the discipline concerned with the study, assessment, treatment, and prevention of abnormal behavior in areas of applied psychology.

Psychiatry = is the corresponding field of medicine; which is closely related to clinical psychology, the chief difference being that psychiatrist tend to conceptualize abnormal behavior and its treatment in medical rather than behavioral and cognitive 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.

DSM-IV (DIAGNOSTIC AND STATISTICAL MANUAL) CLASSIFICATION OF MENTAL DISORDER:

Axis I. The particular clinical syndromes or other conditions that may be a focus of clinical attention, such as schizophrenia. Axis II. Personality disorders. Any longstanding personality problems that meet diagnostic criteria for one or more of these problematic ways of relating to the world, such as antisocial personality disorder. The latter diagnosis, for example, refers to an earlydeveloping and persistent pattern of disregard for accepted standards of conduct, including legal ones;

Axis III. General medical conditions. Listed in here are any general medical conditions potentially relevant to understanding or management of the case. Axis IV. Psychological and environmental problems. Axis V. Global assessment of functioning.

The last two DSM-IV axes are used to access broader aspects of an individuals situation, one dealing with the stressors that may have contributed to the current disorder and the other dealing with how well the individual is coping at the present time.

PROBLEM OF LABELING:

Epidemiology is the study of the distribution of diseases, disorders, or health-related behaviors in a given population. Mental health epidemiology refers to the study of the distribution of mental disorders. A key component of an epidemiological survey is determining the magnitude of the problem being studied.

Prevalence refers to the relative proportion of active cases that can be identified at a given point in, or during a given period of time. Incidence is the occurrence (onset) rate of a given disorder in a given population, often expressed as a cumulative ratio of onsets per unit population over some time period say one year.

OBSERVATION OF BEHAVIOR:

The bedrock of psychological knowledge is observation and what psychologists observe is the behavior of organisms. The focus of such observations is variable and includes the overt actions of an organism and the human verbal reports about inner processes or events (which is quite troublesome but often interesting and may be potentially useful).

In addition, mental events are in their fundamental nature private events, forever inaccessible to confirmation by anyone else. But science normally demands such confirmation by others as a means of assuring in the observations made. This constraint has been a source of considerable difficulty for the discipline of psychology throughout history.

Scientific observational methods employ systematic techniques by which observers are trained to watch and record behavior without bias. Such methods have helped to ensure the scientific integrity of observational research, but obstacles still remain.

To make sense of observed behavior, researchers generate hypotheses, more or less plausible ideas to explain something in this case, behavior.

These hypotheses are important because they frequently determine the therapeutic approaches used to treat an abnormality.

SOME POPULAR MISCONCEPTIONS ABOUT ABNORMAL BEHAVIOR

1. The belief that abnormal behavior is always bizarre. 2. The view that normal and abnormal behavior are different in kind.

3. The view of former mental patients as unstable and dangerous.

4. The belief that mental disorder is something to be ashamed of. 5. The belief that mental disorder is something magical or awe-inspiring.

HISTORICAL VIEWS OF ABNORMAL BEHAVIOR

DEMONOLOGY, GODS, AND MAGIC

Abnormal behavior was attributed to a demon or god who had taken possession of a person. good and bad spirits were widely used to explain lightning, thunder, earthquakes, storms, fires, sickness and many other events that otherwise seemed incomprehensible.

Primary type of treatment for demonic possession was ---exorcism --- to cast out evil spirits of an afflicted person.

HIPPOCRATES

Denied that deities and demons intervened in the development of illness and insisted that mental disorders had natural causes and require treatments. Believed that the brain was the central organ of intellectual activity and that mental disorders were due to brain pathology.

Emphasized the importance of heredity and predisposition. He pointed out that injuries to the head could cause sensory and motor disorders.

Classified all mental disorders into 3 categories:

1. 2. 3.

Mania Melancholia Phrenitis (brain fever)

He relied heavily on clinical observations. Advocated treatments which were far in advance of the exorcistic practices. Believed in the importance of the environment and often removed his patients from their families.

Therefore, Hippocrates emphasis on the natural causes of diseases, clinical observation, and brain pathology as the root of mental disorders.

PLATO AND ARISTOTLE

Plato believe that the disturbed person is not responsible for his acts and should not be punished. Emphasizes on the humane treatment of the mentally disturbed. Aristotle believed the Hippocratic theory of disturbances of the person.

LATER GREEKS AND ROMAN PHYSICIANS

Medical practice developed to a high level, and built temples as sanitoriums. Pleasant surroundings were considered of great therapeutic value for mental patients, who were provided with constant activities. Physicians of this time used a wide range of therapeutic measures.

Roman physicians made use of medicines that make their patients comfortable by using pleasant physical therapies (warm baths and massage). They also follow the principle of contraiis contrarius (patients drink chilled wine while they were in a warm tub)

GALEN (A.D. 130-200)

One of the most influential Greek physicians, who practice in Rome. Elaborated on Hippocratic tradition. Made a number of original contributions concerning the anatomy of the nervous system.

Maintained a scientific approach to the field by dividing the causes of psychological disorders into physical and mental categories.

With Galens death in A.D. 200 ---- fall of Rome at the end of the 5th century ---- Dark Ages in the history of abnormal psychology. Contributions of Hippocrates and the later Greek and Roman physician were soon lost --returned to superstitions and belief in demonology returned.

MIDDLE AGES

More scientific aspects of Greek medicine survived. 1st mental hospital was established in Baghdad in 792 A.D.; then at Damascus and Aleppo. In these hospitals, the mentally disturbed individuals received humane treatment.

The outstanding figure in Islamic medicine was Avicenna, called the Prince of Physicians, authored The Canon of Medicine. He established a unique approach to treatment of mental disorder. Madness was caused by Satanic possession and that exorcism was the treatment of

16TH CENTURY

Viewed that the mind can also be sick like the body. Psychological and emotional torture or stress cause the sick mind of individuals.

But still believed that witchcraft, demonology causes the mental disorders of individuals.

Asylums were begun as a way of removing the mentally disturbed from society, thus labeling them as madhouses.

17TH & 18TH CENTURIES

Benjamin Rush institutes and encouraged a more humane treatment of the mentally ill. Wrote a systematic way of treating psychiatric patients and organized the course of Psychiatry as a subject.

19TH & 20TH CENTURY

Mental illness was better classified, and treatment used more accurate drugs or medicines in alleviating and controlling undesirable behaviors. Wage a campaign of public awareness about the need for changes in attitudes towards and treatment of mental patients.