Abnormal psychology

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Abnormal psychology is a part of psychology. Psychologists (scientists who practice psychology) who are in this area of psychology study thoughts and behaviours that is abnormal (not normal). They then use their knowledge to correct these behaviours in people who have them. Cultures tend to have different thresholds of what makes a behaviour 'abnormal'. The threshold for abnormal behaviour usually changes over time.

Abnormal psychology is often linked to mental disorders. This is because abnormal behaviour is often defined as when someone is not able to change to fit different settings. This is often also used to define some mental disorders. When someone cannot change to fit their environment it can cause suffering and the person may be uncomfortable when around people. Their behaviour can be unreasonable and hard to judge. Their behaviour can be dangerous.[1]

People who can change to fit their environment more easily than most people can have abnormal behaviour.

History[change | edit source]

Supernatural traditions[change | edit source]

A supernatural belief is a belief in a force that is beyond scientific understanding. There are a lot of cultures that believe in supernatural events. These cultures include religious cultures. As well as the Ancient Chinese, Ancient Egyptians, Hebrews and Ancient Greeks. These cultures have writings that say abnormal behaviour in the form of supernatural events created demons or Gods that would take over a person and act through those people. This was called possession and in the Roman Catholic Church exorcisms were done to make these demons leave the body of the individuals they possessed. Exorcism involved prayer, noises and potions.[2] People who had abnormal behaviour were often told they were possessed. In some cultures trepanation was often used. This was when a hole was made in someone's head to release the "bad spirit".

Asylums[change | edit source]

Lunatic asylums were buildings that kept patients that had abnormal behaviour. They became popular in Europe with the Madhouse Act of 1774.[3] Although they did exist before the act. Asylums were meant to look after people who could not take care of themselves. But they were known for being cruel and abusive to their patients. The buildings were often dirty and not looked after very well. Today the 18th century lunatic asylum doesn't exist as most of the asylums were closed in the late 1900's because of the invention of anti psychotic drugs. Some do exist now though. Although known as hospitals, there are many in-patient hospitals. This included Broadmoor hospital which houses some of Britain's the most dangerous criminals with mental illnesses. During the late 1700's, William Tuke made a religious retreat for patients. This was a turn away from the horrors of mental asylums.[4] Also in the late 1700's Philippe Pinel started to encourage better treatment of the mentally insane.

Asylums in America[change | edit source]

In the 1800s Dorothea Dix fought against the bad treatment of patients in mental asylums. She started a "mental hygiene" group to encourage politics to change the mental patient treatment in the United States. When people became aware of the wrong doing in mental asylums, money was raised to improve the treatment of patients and the asylums. She is thought to have helped to create 32 mental hospitals. By 1940 there were more than 400,000 patients living in mental asylums. Although there were more patients that were around before, treatments were needing to get better. Most treatments were still cruel to patients and were not effective. The asylums were quickly becoming overcrowded. Mary Jane Ward wrote a book in 1946 called "The Snake Pit" that raised awareness of the inhumane treatment of mental patients. The National Institute of Mental Health was created the same year. The organisation provided training and support for mental patients and workers that cared for them. The Hill-Burton Act was passed to give money to the mental health hospitals and the Community Health Services Act of 1963 was passed which created out-patient buildings for patients to live at home rather than in asylums. Rehabilitation and community care centers were also built under this act.[5]

Deinstitutionalisation[change | edit source]

During the late 1900's mental asylums were less accepted. The cruel treatment of patients and the overcrowding and ways of living were seen as not needed. Less money was being given to asylums. So many closed all around the world. The closing down of mental hospitals became known as deinstitutionalization. The movement from asylum to community was meant to help patients' development and recovery. The lack of good support programs meant that patients felt abandoned and found it hard to fit into normal life. This led to many becoming homeless.[6]

Explaining abnormal behaviour[change | edit source]

In the past there were three ways to explain abnormal behaviour. These were supernatural, biological, and psychological explanations. We no longer use supernatural explanations. Instead we use biological and psychological explanations. Biological explanations use genetics and neuroscience to explain abnormal behaviours. The biological explanation is based on how the brain works and how genes change the way it works. Psychological explanations uses how the mind works to explain abnormal behaviours.

Supernatural explanations[change | edit source]

Early cultures believed that abnormal behaviour was from demons, spirits and astrology. Trepanation was when a hole was drilled in a person's head. This was done to let the spirits or demons out of the person's head. Exorcism was practiced mainly by the Catholic Church. Exorcism was believed to ward the spirits out of the person that they possessed. These practices were normal during the Middle Ages. This was when abnormal behaviour was thought to be a religious issue rather than a psychological one. Some abnormal behaviour was thought to be witchcraft. People accused of witchcraft were almost always punished for the acts. The punishments are well known for killing the accused.

Biological explanations[change | edit source]

The Biological approach to explaining abnormal behaviour assumes that the behaviour can be explained by physical factors. Hippocrates was a man who lived during the 5th century and is thought to be the father of modern medicine. He did not accept that evil spirits or astronomy were the causes of psychological disorders. Hippocrates believed that there were natural causes for the disorders and appropriate treatments could be found. He focused on the "four humors" of the brain. He believed that these four humors must be balanced for healthy mental states and when one humor was dominant, various disorders would appear. To balance the humors, Hippocrates would prescribe lifestyles to his patients.[7] While new theories now exist, Hippocrates' focus on mental processes and clinical practice was a revolutionary concept.

Another Greek physician called Galen also took a scientific approach to the causes of psychological disorders. He divided them into physical and mental categories. Among Galen's causes were head injuries, alcohol abuse, and life experiences. During the 18th century, Galen's concepts influenced the medical industry. Galen's focus was on the biological causes for mental disorders.[8]

Psychological explanations[change | edit source]

Psychological explanations for abnormal behavior take a behavioral approach in which the positive behaviors are reinforced and negative ones are not. This approach is more focused on changing the actual behavior of a person than the true cause of it. Sigmund Freud was one of the most popular psychological theorists of the 20th century. The method he used to study and treat patients was known as psychoanalysis. Methods of hypnosis by were used by Freud, but also by Franz Mesmer and physicians in the Nancy School. However Freud attempted to have his patients confess their deepest, truest emotions which was referred to as a catharsis. He would have his patients speak freely about themselves, in free association. Also he would conduct dream analysis where patients would record and discuss their dreams. Freud's work led to other great psychoanalytic theorists such as Carl Jung, Alfred Adler, and Harry Stack Sullivan. Wilhelm Wundt and William James were credited for opening up the first experimental psychology laboratories. This led to many studies and psychological methods such as classical conditioning led by Ivan Pavlov and John B. Skinner, while Edward Thorndike and B. F. Skinner were the leaders of the study of operant conditioning.[9].

Classification[change | edit source]

DSM[change | edit source]

The North American reference book used by psychiatrists and psychologists to diagnose and treat psychological disorders is known as the Diagnostic and Statistical Manual of Mental Disorders (DSM). It is produced by the American Psychiatric Association (APA); the most recent version was released in May of 2013 and known as the DSM-5. The DSM is relied upon by clinicians, health insurance companies, pharmaceutical companies, and the legal system as a reference for understanding and identifying mental disorders.[10]The DSM divides mental disorders into groups and provides descriptive symptoms that defines each disorder. In addition, it lists statistics for each disorder ranging from its frequency in the general population to the most effective form of treatment.

Before diagnosing an individual with a specific mental disorder, a professional must first determine whether that individual does in fact suffer from a mental disorder. The DSM defines a mental disorder as a condition that:

  • Is primarily psychological and alters behavior, personality, or motivation,
  • When in its full blown state, causes stress, impairment in social functioning, or behavior that one would like to stop voluntarily because it poses a threat to physical health, and
  • Is distinct from other conditions, and is considered treatable.[11].

When using the DSM, a complete psychiatric diagnosis is split up into five dimensions, called "axes", that relate to different characteristics of disability or disorder:

  • Axis I contains all categories of mental disorder except mental retardation and personality disorders. A disorder within this axis is similar to an illness or disease in general medicine, and includes depression, anxiety disorder, autism spectrum disorder, bipolar disorder, and anorexia.
  • Axis II contains mental retardation and personality disorders such as paranoid personality disorder, antisocial personality disorder, and obsessive-compulsive personality disorder. This axis contains a large number of disorders, all of which relate to how a person thinks and acts with the world.
  • Axis III contains the general medical condition, minor medical conditions and any physical disorders of the individual. When the first three axes are used, relationships can be seen and it becomes easier for professionals to find the cause for mental disorder and treat a person effectively.
  • Axis IV contains any environmental or social factors that could play a role in diagnosing an individual. Poor social relationships, the death of a loved one, or being fired from work are all stressful factors that may aid in the development of mental disorder.[12]
  • Axis V is used by professionals for individuals under the age of 18. Children are graded on how well they currently handling their situation. The Global Assessment of Functioning used a scale of 0-100, but has been replaced in the DSM-5 by a survey and check box that is less subjective. [13]

The separate axes of the DSM are often linked together in the development of mental disorders. An individual with a

ICD-10[change | edit source]

The International Statistical Classification of Diseases and Related Health Problems (ICD) was created by the World Health Organization (WHO) and is the universal diagnostic system for mental disorders. The ICD is approved by health officials from 193 WHO member countries, and is available for free on the internet. Its purpose is to help countries reduce the problems associated with mental disorders. The coding system used in the DSM is designed to be compatible with the system used in the ICD; however, some codes may not match because the two publications get revised at different times. [14] The ICD-10 was made public in 1994; its most recent update occurred in 2010. Chapter 5 of the ICD-10 covers over 300 mental and behavioral disorders which are divided into the following categories:

  • F00-F09 Organic mental disorders
  • F10-F19 Mental and behavioral disorders caused by drug use
  • F20-F29 Schizophrenia and delusional disorders
  • F30-39 Mood disorders
  • F40-49 Neurotic, stress related disorders
  • F50-59 Behavioral disorders linked with bodily disturbances and physical factors
  • F60-F69 Disorders of adult personality and behavior
  • F70-F79 Mental retardation
  • F80-F89 Disorders of psychological development
  • F90-F98 Behavioral and emotional disorders that develop during childhood
  • F99 Unspecified mental disorders [15]

The Online ICD-10 can be found in its entirety here

Treatment[change | edit source]

Psychoanalysis[change | edit source]

Psychoanalysis is a form of therapy based on Psychoanalytic theory. This theory states that human behavior is controlled by unconscious forces such as instinct and that there is no such thing as free will. Many ideas found in the Psychoanalytic theory can be traced back to the famous psychologist Sigmund Freud. Freud believed mental disorders are a result of repressed memories and emotions from childhood; psychoanalysis is designed to search for these hidden memories and emotions and bring them to the patient's attention. Techniques such as hypnosis are used to tap into the unconscious mind with the hopes that the source of the disturbance is found. Freud also believed dreams had hidden meanings, and often asked patients to record their dreams for analysis. [16]. Because of the lack of scientific evidence supporting most Freudian ideas, psychoanalysis is rarely used by clinical psychologists and has been replaced by more effective forms of therapy.

Behavioral therapy[change | edit source]

Behavior Therapy is based on the theory of behaviorism, which states that all human behavior is a result of a stimulus and reinforcement. Famous behaviorists include James Watson, B.F. Skinner, and Joseph Wolpe. The goal of this therapy is to increase one's positive or socially reinforcing behavior.[17] Behavior therapy can be broken down into three areas:

  1. Applied Behavior Analysis(ABA)uses a form of operant conditioning where positive reinforcement is used to modify behavior.
  2. Cognitive Behavior Therapy(CBT) focuses on conditioning the negative thoughts and feelings behind patients with mental disorders in order to alter behavior.
  3. Social Learning Theory is used in the treatment and understanding of anxiety disorders. It goes beyond the traditional classical conditioning assumption that fear and anxiety must be learned directly; Social Learning Theory suggests that a child could acquire a fear of snakes, for example, by observing a family member show fear in response to snakes. [18].

Humanistic therapy[change | edit source]

Humanistic therapy is a method taken from Carl Rogers's "humanistic approach" which aims to focus on a client as a human rather than the problem that they have. A therapist can adjust the environment and mood of a session in a way that mimics normal conversation. This often helps the patient realize the issues they have, and share them with the therapist more successfully than in a traditional counseling session. Humanistic Therapy creates an effective means of getting to the source of a problem and treating it properly. [19]

References[change | edit source]

  1. Hewstone, Miles., Fincham, Frank D., Foster, Johnathan. Psychology. 2005. pg316
  2. Butcher, James., Mineka, Susan., Hooley, Jill. Abnormal Psychology. 2010. pg11
  3. History of the Asylum; The History Photographer
  4. Butcher, James., Mineka, Susan., Hooley, Jill. Abnormal Psychology. 2010. pg14
  5. Butcher, James., Mineka, Susan., Hooley, Jill. Abnormal Psychology. 2010. pg14
  6. Butcher, James., Mineka, Susan., Hooley, Jill. Abnormal Psychology. 2010. pg16
  7. Butcher, James., Mineka, Susan., Hooley, Jill. Abnormal Psychology. 2010. pg11
  8. Beidel, Deborah C., Bulik, Cynthia M., Stanley, Melinda A. Abnormal Psychology. 2014. pg13
  9. Beidel, Deborah C., Bulik, Cynthia M., Stanley, Melinda A. Abnormal Psychology. 2014. pg18
  10. "Insurance and Parity". http://www.psychiatry.org/mental-health/more-topics/insurance-and-parity. Retrieved 2013-12-4.
  11. Cockerham, William. Sociology of Mental Disorder. 1992
  12. "DSM-IV TR: A Thumbnail Sketch". http://www.psychpage.com/learning/library/counseling/dsm4.html. Retrieved 2013-12-4.
  13. [\http://www.dsm5.org/Documents/FAQ%20for%20Clinicians%208-1-13.pdf "FAQ about DSM-5 for Clinicians"]. \http://www.dsm5.org/Documents/FAQ%20for%20Clinicians%208-1-13.pdf. Retrieved 2013-12-4.
  14. "ICD vs. DSM". http://www.apa.org/monitor/2009/10/icd-dsm.aspx. Retrieved 2013-12-4.
  15. "ICD-10 Version:2010". http://apps.who.int/classifications/icd10/browse/2010/en#/V. Retrieved 2013-12-4.
  16. Freud, Sigmund. Studies on Hysteria (1895).Standard Edition, vol.2, Hogarth Press, 1955.
  17. "About Behavior Therapy". http://psychcentral.com/lib/about-behavior-therapy. Retrieved 2013-12-4.
  18. Mineka, S. & Zinbarg, R. A Contemporary Learning Theory Perspective on the Etiology of Anxiety Disorders: It's not what you thought it was.American Psychologist, 10-26, 61. 2006
  19. "Humanistic Therapies". http://www.counselling-directory.org.uk/humanistic.html. Retrieved 2013-12-4.