Test Bank For Abnormal Psychology 7th edition by Oltmanns and Emery

Chapter 1 Examples and Definitions of Abnormal Behavior

Chapter-at-a-Glance
DETAILED INSTRUCTOR OUTLINE RESOURCES

PROFESSOR NOTES

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Clinical Research Methods

CHAPTER OUTLINE

I.

An overview of abnormal psychology

1. Psychopathology (pathology of the mind): the symptoms and signs of mental disorders including such phenomena as depressed mood, panic attacks, and bizarre beliefs
2. Abnormal psychology is defined as the application of psychological science to the study of mental disorders
3. Mental disorders are defined by a set of features (symptoms)
4. Terms: psychosis, delusion, insanity, nervous breakdown, syndrome

Defining abnormal behavior

1. Personal distress—subjective experience of suffering; misses cases in which individual does not identify own thoughts/behaviors as problematic
2. Statistical norms—how common or rare it is in the general population
   1. By definition people with usually high levels of anxiety or depression would be

      considered to be abnormal because their experience deviates from the expected norms

   2. Another weakness of the statistical approach is that it does not distinguish between deviations that are harmful and those that are not
3. Maladaptiveness—Wakefield’s harmful dysfunction concept
   1. The condition results from inability of some internal mechanism on the part of the person
   2. The condition causes harm to the person
   3. Mental illness is defined as harmful dysfunction in terms of a product of disruptions of thought, feeling, communication, perception, and motivation.
   4. The harmful dysfunction view of mental disorder recognizes that every type of dysfunction does not lead to a disorder; only dysfunction that results in significant harm to the person are considered to be disorders.
4. DSM-IV-TR (APA, 2000) defines mental disorders associated with: (any or all)
   1. Present distress
   2. Disability (impairment in one or more areas of functioning)

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II.

3. Significant risk of suffering death, pain, disability, or an important loss of freedom

5. Mental health means more than the absence of mental illness
   1. Healthy people can be described as ‘flourishing’
   2. Flourishing people have more positive emotions, are calm and peaceful, have positive attitudes, and possess a sense of meaning and purpose
6. Culture and Diagnostic Practice: DSM-IV-TR defines pathologies in terms of our particular culture and cultural values

   1. Culture is defined in terms of the values, beliefs, and practices that are shared by a specific community or group of people

   2. Cultural values influence the opinions regarding normal and abnormal behavior

III. Epidemiology

1. The scientific study of the frequency and distribution of disorders within a population
2. Incidence—number of new cases of a disorder that appear in a population during a specific period of time
3. Prevalence—total number of active cases that are present in a population during a specific period of time (lifetime prevalence—proportion of people in a given population affected by the disorder at some point during their lives)
4. Gender differences are found in many but not all mental disorders; most prominent differences include: anxiety disorders and depression (more common in women), and substance abuse and antisocial personality disorder (more common in men)
5. Comorbidity—the presence of more than one condition at one time in an individual
6. Global Burden of Disease and Injury (Sponsored by World Health Organization WHO)—assessed impact of conditions; mental disorders are responsible for 1% of death but 47% of disability in the U.S. and developed nations
7. Cross-Cultural Comparisons: 90% percent of individuals with Bulimia nervosa are women, usually university students, in the Western society
8. Draguns and Tanaka-Matsumi (2003) reported that mental disorders are shaped by culture, no mental disorder is caused entirely due to cultural factors, psychotic disorders are less influenced by culture, and that the symptoms of disorders vary across cultures

IV. Mental health professions

A. Psychiatrists are physicians (medical doctors) who specialize in treating mental disorders

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(often prescribe medication)

2. Clinical psychologists complete a Ph.D. or a Psy.D. (about 4 years plus internship) and are trained in assessment, psychotherapy, and applying scientific principles to the study of abnormal psychology
3. Social workers generally hold an M.S.W. and are committed to action that may be socially based or individually based
4. Masters-level professional counselors, marriage and family therapists, and psychiatric nurses also provide individual and family psychotherapy; non-graduate trained staff often provide psychosocial rehabilitation
5. Currently, dramatic changes in the provision of mental health care services are being driven by managed care companies, which place emphasis on cost containment
6. Individuals receive treatment in many different types of settings and from a variety of professionals, with only 40% of those whom receive treatment have this provided by a specialized mental health professional such as the above listed
7. However, 34% of individuals receive treatment for psychiatric problems from their primary care physician that does not have specialized training

V. Historical perspective on psychopathology

1. The Greek tradition: Hippocrates
   1. Assumed mental disorders had natural causes, not demonological sources
   2. Believed health depended on maintaining a balance of four bodily fluids: blood, phlegm, black bile, and yellow bile
2. The Asylum: Middle Ages
   1. Established to house the mentally disturbed
   2. Moral treatment emphasized support and respect for human dignity
   3. Dorothea Dix was a prominent and effective advocate for humane treatment of the mentally ill in hospitals
   4. Profession of psychiatry emerged from the development of large institutions
   5. Woodward’s Worcester Hospital (mid-1800s in U.S.) as a “model institution” employing moral and physical treatment approaches—based on protestant values; reported recovery rates from 82 to 91 percent between 1833 and 1845
   6. Created to serve heavily populated cities and to assume responsibilities that had previously been performed by individual families

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C. Lessons from the history of psychopathology

1. Cultural bias often, perhaps always, influences current thinking and treatment approaches
2. Scientific research is crucial to identify and understand effective treatment

VI. The scientific study of mental disorders

1. Basis is the “open-minded skepticism” of the scientific method
   1. Formulation of hypotheses
   2. Collection and analysis of empirical data
   3. Refinement of hypotheses based on findings
2. Case studies can provide a wealth of information about a particular pathology and can help generate research questions and hypotheses, but are limited because they can be interpreted in many ways and may not be reliable or generalizable
   1. Important sources of information
   2. Case studies can be viewed from many different perspectives
   3. Risky to draw conclusions
3. Clinical Research Methods

1. It is pivotal to understand how it is important to conduct research related to each disorder

LEARNING OBJECTIVES

Students should be able to:

1. Define abnormal psychology and psychopathology.
2. Consider the three primary criteria of abnormality (personal distress, statistical rarity, and maladaptiveness) in terms of their strengths and weaknesses.
3. Understand how the DSM-IV-TR defines mental disorders.
4. Distinguish incidence from prevalence and discuss epidemiology as it relates to psychopathology.
5. Identify and describe the roles of those in the major mental health professions.
6. Know the historical development of institutional treatment of mental disorders.

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7. Understand the importance of recognizing cultural bias and using scientific research to establish the validity of approaches to understanding and treating psychopathology.
8. Define the scientific method and understand the rationale for its use in the study of abnormal behavior.

LECTURE SUGGESTIONS

Cultural bias and labeling: Thomas Szasz’s approach:

Describe Thomas Szasz’s approach to diagnosis. Szasz argues that, since we cannot actually look inside another person, we should not use diagnostic categories to label them. He asserts that abnormal behavior is a social phenomenon and may be a perfectly normal response to an abnormal environment. Thus, involuntary civil commitment should not be allowed since it requires a judgment that we’re not capable of making. Further, if a person commits a crime, we should certainly prosecute and enforce the law against that person, and the fact that s/he may be “abnormal” in the eyes of a “professional” should not mitigate criminal responsibility. Some possible questions for discussion include: “If Szasz is right, how should we define what we now call abnormal psychology?” and “What are the benefits and drawbacks of identifying and labeling mental disorders?”

Szasz, T.S. (1961). The myth of mental illness: Foundations of a theory of personal conduct. New York: Hoeber-Harper.

Causality:

Biological reductionism assumes that biological factors cause abnormalities. For example, some mental health professionals and others suggest that “chemical imbalances” are the source of the emotional and behavioral problems. This suggestion assumes that because certain biological states are associated with psychological disorders, the biological state causes the disorder. However, causality can move in the opposite direction. Use the following argument to illustrate this point: If a teacher insults a student, the student is likely to feel some powerful emotion, perhaps anger or embarrassment. If he/she does feel this emotion, some physiological changes will therefore occur. For example, if the student becomes angry, norepinephrine will be released into the bloodstream. Does this mean that the cause of the student’s anger is the flow of norepinephrine? Not at all; we would still say that the cause of the student’s anger (and accompanying physiological changes) is feeling insulted. Similarly, the cause of a person’s depression is probably not simply, a chemical imbalance although a chemical imbalance may occur when a person is depressed. This does not mean that the biological approach is not important or valuable. Balance the lecture with an emphasis on the value of the biological approach to psychopathology.

Popularity of Abnormal Psychology:

Connor-Greene (2001) reported that on average students are exposed to at least five different psychiatric diagnoses among their friends and family. Starting class by exploring the different reasons for registering for the class may be an opportunity to address the stereotypes, stigma, and labels associated with mental illness. Halonen (2005) stated that there are three primary ways to teach abnormal psychology “lecture-centered, diagnosis-centered, and outcome-centered” (p. 42). The ultimate goal is to try to find a balance utilizing all three approaches. A good lecturer can capture the attention of the students with stories and animation, but frequently students can get lost in the stories while using real-life clinical examples can potentially violate confidentiality (Halonen, 2005). The diagnostic approach offers

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real-life application of the assessment of signs and symptoms as they pertain to a particular diagnosis. However, as Halonen (2005) mentioned most students, “will not become clinicians so this finely tuned practice misses the mark for most of them as well as providing opportunities for students to complicate interpersonal relationships due to ‘trying to diagnose’ everyone” (p. 43). The outcome-centered approach provides a happy medium integrating both the lecture-centered approach with the diagnosis-centered approach (Halonen, 2005). This discussion can also be a segue into the discussion of the syllabus, assignments, and expectations on both the professor’s part and the student’s part. In Halonen’s article, she outlines ways that professors can integrate both the lecture and diagnosis approach to teaching the course.

Connor-Green, P. A. (2001). Family, friends, and self: The real-life context of an abnormal psychology class. Teaching of Psychology, 28, 210-212.

Halonen, J. S. (2005). Abnormal psychology as liberating as art and science. Journal of Social and Clinical Psychology, 24(1), 41-50.