PSYC 435 Abnormal Psychology Notes Plus Trial Exam PART ONE [2023/2024]

PSYC 435 Abnormal Psychology Notes Plus Trial Exam PART ONE [2023/2024]. Psychology 435: Abnormal Psychology has eleven major learning outcomes. When you have completed this course, you should be able to: 1. Describe the historical emergence of abnormal psychology as a concept and as an area of clinical practice. 2. Identify and compare several theories about the causes of abnormal behaviour. 3. Discuss issues in the assessment and diagnosis of mental disorders. 4. Describe the wide variety of treatment approaches available to modern clinicians. 5. Identify and describe several common and relatively easily treated disorders, such as adjustment, anxiety, phobias, and somatoform disorders. 6. Identify and describe the more difficult-to-treat disorders, such as schizophrenia, paranoia, and the affective disorders. 7. Describe and discuss disorders that involve some violation of legal or social standards, including sexual variations, alcohol and drug abuse patterns, impulse control, and violence. 8. Recognize relationships between various central nervous system impairments and abnormal behaviour patterns. 9. Explain the aspects and implications of various types and levels of neurodevelopmental disorders. 10. Identify, describe, and discuss special disorders of childhood, adolescence, adulthood, and aging. Abnormal Psychology (PSYC 435) Athabasca University PART ONE 11. Discuss the major ethical and legal considerations associated with abnormal behaviour. Unit 1 Overview Unit 1 explores the definition of abnormal psychology and looks at the prevalence and incidence of mental disorders. Further, it looks at the research approaches in abnormal psychology. Learning Objectives 1. Discuss common topics and issues relevant to Abnormal Psychology. - Abnormal psychology is concerned with understanding the nature, causes, and treatment of mental disorders. - Family aggregation: whether a disorder runs in families. - No single thing can define or determine abnormality, but someone might struggle in these areas: Subjective distress Maladaptiveness Statistical Deviancy Violation of the standards of society Social discomfort Irrationality and unpredictability Dangerousness 2. Explain why we need to classify mental disorders. - We need to classify mental disorders so that there are specific diagnostic criteria for each disorder that creates a common language so that a specific diagnosis means the same thing to one clinician as it does to another. In addition, it provides descriptive information about the type and number of symptoms needed for each diagnosis which helps to ensure diagnostic accuracy, consistency and reliability. - Most sciences rely on classifications, provides us with nomenclature (naming system), common language and shorthand terms, help to structure information in a more helpful manner. CLASSIFICATION FACILITATES RESEARCH 3. Explain the DSM definition of mental disorders. - DSM: Diagnostic and Statistical Manual of Mental Disorders - A mental disorder is defined as a syndrome that is present in an individual and that involves clinically significant disturbance in behaviour, emotion regulation, or cognitive functioning. These disturbances are thought to reflect a dysfunction in biological, psychological, or developmental processes that are necessary for mental functioning. DSM-5 also recognizes that mental disorders are usually associated with significant distress or disability in key areas of functioning such as social, occupational, or other activities. Predictable or culturally approved responses to common stressors or losses (such as death of a loved one) are Abnormal Psychology (PSYC 435) Athabasca University PART ONE excluded. It is also important that this dysfunctional pattern of behavior not stem from social deviance or conflicts that the person has with society as a whole. - Within a given culture, many shared beliefs and behaviors exist that are widely accepted and that may constitute one or more customary practices. 4. Identify how culture can influence the definition of Abnormal Psychology. - Labeling, stigma and stereotyping - Number 13 in Christian countries vs Number 4 in Japan - Culture can shape the clinical presentation of disorders like depression, which are present in cultures around the world. Cultural interpretation and expression of abnormal psychology is not known well. - A case in point is taijin kyofusho. This syndrome, which is an anxiety disorder, is quite prevalent in Japan. It involves a marked fear that one’s body, body parts, or body functions may offend, embarrass, or otherwise make others feel uncomfortable. Often, people with this dis-order are afraid of blushing or upsetting others by their gaze, facial expression, or body odor. - Latino descent, ataque de nervios or an “attack of nerves” is a clinical syndrome that does not seem to correspond to any specific diagnosis within the DSM. Triggered by stressful event, symptoms are crying, trembling and uncontrollable screaming, sense of being out of control, can be physically or verbally aggressive, faint or have a seizure-like fit but then can return to normal as if nothing happened. 5. Identify the professionals responsible for working on the mental health “team.” - Psychiatrist: prescribe medications and monitors for side effects - Clinical Psychologist: individual therapy meeting with patient several times a week - Clinical Social Worker: helps patient resolve family problems. - Psychiatric Nurse: checks daily to provide support and help cope better in hospital setting. - Team of professionals can be different in outpatient. Can be just the psychiatrist (medication and psychotherapy) but some receive meds from the psychiatrist but go see a psychologist or a clinical social worker for therapy. Some see a counseling psychologist, a psychoanalyst, or a counsellor. 6. Explain the difference between the prevalence and the incidence of mental disorders. - Epidemiology: the study of the distribution of diseases, disorders, or healthrelated behaviours in a given population. Mental health epidemiology is the study of the distribution of mental disorders. - Prevalence: the number of active cases in a population during any given period of time. Percentages of the population that has the disorder, etc. - Point prevalence: the estimated proportion of actual, active cases of a disorder in a given population at a given point in time. For example, if we were to conduct a Abnormal Psychology (PSYC 435) Athabasca University PART ONE study and count the number of people who have major depressive disorder (i.e., clinical depression) on January 1 of next year, this would provide us with a point prevalence estimate of active cases of depression. - 1-year prevalence figure: count everyone who experienced the disorder at any point in time throughout the entire year. - Lifetime prevalence: an estimate of the number of people who have had a particular disorder at anytime in their lives (even if recovered). - Incidence: the number of new cases that occur over a given period of time (typically one year). 7. Discuss the prevalent rates of mental disorders. - - - - Comorbidity: presence of two or more disorders in the same person, higher in severe disorders. Abnormal Psychology (PSYC 435) Athabasca University PART ONE 8. Explain inpatient and outpatient treatment. - Outpatient treatment requires that a patient visit a mental health facility practitioner, but the patient does not have to be admitted or stay overnight. A patient may attend a community mental health center, see a private therapist, or receive treatment through the outpatient department of a hospital. - Hospitalization and inpatient care are preferred for those needing more intensive care. Deinstitutionalization. 9. Describe and explain the benefits and dimensions of the various research approaches. - Acute: short in duration - Chronic: long in duration - Etiology: causes of disorders - Case Studies: can be subject to bias because the writer decides what they include. Low generalizability: they cannot be used to draw conclusions about other cases even if it is similar. Conclusions can be narrow and mistaken. Can illustrate clinical material. Limited support for a particular theory or provide some negative evidence that can challenge a prevailing idea or assumption. - Self-Report Data: This might involve having our research participants complete questionnaires of various types. Another way of collecting self-report data is from interviews. The researcher asks a series of questions and then records what the person says. Misleading, people might not report themselves well, lying, misinterpreting the question, desire to present themselves as favorable, not always accurate or truthful. - Observational Approaches: depends on what we are trying to see. We can use direct observation, for example having trained observers record the number of times children who are classified as being aggressive hit, bite, push, punch or kick playmates. Might also look at biological variants (heart rate) as well as hormones etc. Functional Magnetic Resonance Imagining (fMRI) used to study the working brain and can study blood flow to various parts. There is also Transcranial Magnetic Stimulation (TMS) which generates a magnetic field on the surface of the head where we can stimulate underlying brain tissue. Painless and noninvasive while a person is sitting. Using TMS, we can even take a particular area of the brain “off-line” for a few seconds and measure the behavioral consequences. In short, we can now collect observational data that would have been impossible to obtain in the past. 10. Describe the process of doing research. - Generate a hypothesis (an effort to explain, predict or explore something), which is normally tested. Design studies to help them approach an understanding of this. - Sampling: try to select people who are representative of the much larger group of individuals with panic disorder for example. Abnormal Psychology (PSYC 435) Athabasca University PART ONE - Samples of convenience: study groups of people who are easily accessible to them and are readily available. - External validity: the extent to which we can generalize our findings beyond the study. - Internal Validity: reflects how confident we can be in the results of a particular given study; is the extent to which a study is methodologically sound, free of confounds, or other sources of error, and able to be used to draw valid conclusions. - Comparison group (control group) is used to test hypotheses, group of people who do not exhibit the disorder being studies but who are comparable in other major respects to the criterion group (people with the disorder being studied). - Correlational research: involves studying the world as it is, does not involve manipulation of variables. Researcher selects certain groups of interest and compares the groups on a variety of different measures. - Positive correlation vs negative correlation (inverse correlation) vs uncorrelation - Correlation coefficient: denoted by symbol r. Correlation runs from 0-1. + and – represents the direction of association. Positive means higher scores on one variable are associated with higher scores on another. Negative means as scores on one go up, the other goes down. - Statistical significance: the probability that the correlation would occur purely by chance is less than 5 out of 100 (p.05) - Effect size: reflects the size of the association between the variables. - Meta-analysis: a statistical approach that calculate and then combines the effect sizes from all the studies. - CORRELATION DOES NOT MEAN CAUSATION. - Third variable problem: To use an example from abnormal psychology, it was once thought that masturbation caused insanity. This hypothesis no doubt arose from the fact that, historically, patients in mental asylums could often be seen masturbating in full view of others. Of course, we now know that masturbation and insanity were correlated not because masturbation caused insanity but because sane people are much more likely to masturbate in private than in public. In other words, the key factor linking the insanity and masturbation (and the unmeasured third variable) was that of impaired social awareness. - Retrospective research: looking back in time, collect info about how patients lived before which could be associated with what went wrong later. - Prospective research: looking ahead in time, focus on people before the disorder manifests. - Longitudinal design: study that follows people over time and that tries to identify factors that predate the onset of a disorder. - Direction of effect problem: correlational research does not allow us to draw any conclusions about directionality. - Experimental research: - Independent variable: one manipulated Abnormal Psychology (PSYC 435) Athabasca University PART ONE - Dependent variable: one that changes. - Random assignment: every research participant has an equal chance of being placed on treatment or no-treatment condition. - Standard treatment comparison study - Single-case research designs: case studies used to develop and test therapy techniques within a scientific framework. - Double-blind study: neither subjects nor experimenter knew who got magnets (placebo vs not placebo). - ABAB design: A (baseline condition, collect data), B (introduce treatment), A (withdraw and collect data), B (reinstate treatment). - Analogue studies: study not the true item of interest but an approximation of it. Unit 2 Overview Unit 2 explores the historical views of abnormal behaviour, with attention to the emergence of humanitarian approaches and the development of contemporary views. Learning Objectives 1. Explain why, in ancient times, abnormal behaviour was attributed to possession by a demon or god and describe how exorcism was administered by shamans and priests as the primary type of treatment for demonic possession. - The behavioral problems were dealt with not through medicine but through religious rites or incantations that were made by people who sought exorcism from antisocial traits and behaviors by repeating explicit phrases. - They thought that abnormal behaviours were from a demon or god who had taken possession of a person (good or evil spirits). Mystical or religious significance was thought to be a good spirit or god, treated with awe, supernatural powers. - Most others were considered an angry god or evil spirit. Thought to represent wrath and punishment of God. Exorcisms were used for demonic possession and included a variety of techniques. These techniques varied but typically included magic, prayer, incantation, noisemaking, and the use of horrible-tasting concoctions made from sheep’s dung and wine. 2. Describe the important contributions from 460 BCE to 200 CE made by Hippocrates, Plato, Aristotle, and Galen about the conceptualization of the nature and causes of abnormal behaviour. Hippocrates - During this period the Greek physician Hippocrates (460–377 b.c.), often referred to as the father of modern medicine, received his training and made substantial contributions to the field. He denied that deities and demons intervened in development of illnesses and instead insisted that mental disorders, like other diseases, had natural causes and appropriate treatments. Brain was central organ Abnormal Psychology (PSYC 435) Athabasca University PART ONE of intellectual activity and mental disorders were due to brain pathology. Emphasizes brain injuries can cause sensory and motor disorders. 3 mental disorder categories: mania, melancholia, and phrenitis (brain fever) Four elements were earth, air, fire and water which contribute to head, cold, moistness and dryness. These elements combined to form four essential fluids of the body: blood (sanguis), phlegm, bile (choler), and black bile (melancholic). This brought one of the earliest and longest lasting typologies of the human behaviour: the sanguine, the phlegmatic, the choleric and the melancholic. Dreams were important. Basic concept of modern psychodynamic psychotherapy. Melancholia treatment: regular and tranquil life, sobriety and abstinence from all excesses, a vegetable diet, celibacy, exercise short of fatigue, and bleeding if indicated, removal of patients from family. Plato - Plato shared the belief that mental disorders were in part divinely caused. - Asclepiages - Theory of disease based on the flow of atoms through the pores in the body and came up with treatments such as massage, special diets, bathing, exercise, listening to music, and rest and quiet, to restore to the body. - Galen - Anatomy of the nervous system. Scientific approach to the field, dividing the causes of psychological disorders into physical and mental categories. Among the causes he named were injuries to the head, excessive use of alcohol, shock, fear, adolescence, menstrual changes, economic reversals, and disappointment in love. - Contrariis contrarius: opposite by opposite (ex. Chilled wine while in a warm tub) 3. Discuss how mental disorders were viewed during the Middle Ages. - First mental hospital in Baghdad in A.D 792 and in these hospitals, the patients were treated humanely. Avincenna referred to hysteria, epilepsy, manic reactions and melancholia most (ex. Prince thinking he was a cow). - During the Middle Ages in Europe, scientific inquiry into abnormal behavior was limited, and the treatment of individuals who were psychologically disturbed was characterized more often by ritual or superstition than by attempts to understand an individual’s condition. - Mass Madness: the widespread occurrence of group behaviour disorders that were apparently cases of hysteria, this was simultaneous (dancing etc.) - Tarantism: a disorder that included an uncontrollable impulse to dance was often attributed to the bite of the southern European tarantula or wolf spider. Also known as Saint Vitus’s Dance in Europe - Lycanthropy: a condition in which people believed themselves to be possessed by wolves and imitated their behaviour. - Koro: southeast Asia, dear of genital retraction accompanied by a fear of death. - Exorcism and Witchcraft: treatment consisted of prayer, holy water, sanctified ointments, visits to holy places and mild forms of exorcism. “For a fiend-sick Abnormal Psychology (PSYC 435) Athabasca University PART ONE man: When a devil possesses a man, or controls him from within with disease, a spewdrink of lupin, bishopswort, henbane, garlic. Pound these together, add ale and holy water.” Those physically possessed were considered mad, whereas those spiritually possessed were likely to be considered witches. - Humanism: a movement emphasizing the importance of specifically human interests and concerns. 4. Give examples of mass madness or mass hysteria, and summarize the explanations offered for this unusual phenomenon. - See number 3. 5. Outline the contributions in the late Middle Ages and early Renaissance of Paracelsus, Teresa of Ávila, Johann Weyer, Reginald Scot, and St. Vincent de Paul, all of whom argued that those showing abnormal behaviour should be seen as mentally ill and treated with humane care. - Paracelsus: superstitious beliefs about possession. He also postulated a conflict between the instinctual and spiritual natures of human beings, formulated the idea of psychic causes for mental illness, and advocated treatment by “bodily magnetism,” later called hypnosis. Moon had supernatural influence over the brain. - Johann Weyer (Joannus Wierus): disturbed by imprisonment, torture, and burning of people accused of witchcraft that he made a careful study of the entire problem. He made a book that rebutted the church’s witch-hunting handbook. Work was banned by the church. - St. Vincent de Paul said “mental disease is no different than bodily disease and Christianity demands of the humane and powerful to protect, and the skillful to relieve the one as well as the other.” 6. Describe the inhumane treatment that mental patients received in early “insane asylums” in Europe and the United States. - Asylums: sanctuaries or places of refuge meant solely for the care of people with mental illness. Most asylums were known as madhouses and basically stored people who were insane. - St. Mary of Bedlam: Violent patients exhibited to public for one penny a look, and more harmless were forced to seek charity. Lunatics Tower was also similar. - Pennsylvania Hospital in Philadelphia: followed the idea that patients needed to choose rationality over insanity. Aggressive treatments aimed at restoring a physical balance in the body and the brain, designed to intimidate patients. Included: powerful drugs, water treatments, bleeding and blistering, electrical shocks, and physical restraints. 7. Describe the humanitarian reforms in the treatment of mental patients that were instigated by Philippe Pinel, William Tuke, Benjamin Rush, and Dorothea Dix. Abnormal Psychology (PSYC 435) Athabasca University PART ONE - Philippe Pinel: La Bicetre in France. Allowed to take chains of patients to test his views that patients with mental illness should be treated with kindness and consideration, as sick people not beasts or criminals. Results were order and peace. - William Tuke: York Retreat. A pleasant country house where people with mental illnesses lived, worked, and rested in a kindly, religious atmosphere. In 1842 the Lunacy Inquiry Act was passed: included a requirement that asylyms and houses be effectively inspected every 4 months to ensure proper diet and the elimination of the use of restraints. In 1845 the Country Asylums Act was passed in England which required every county to provide asylum to paupers and lunatics and the Britain policy was expanded to colonies. - In Kingston, people were dealt by “tanking” which meant lunatics were routinely held under water in a bathing tank by nurses and sometimes other patients until near death