PSY353 Lecture : PSY353 Notes
12 May 2018
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CHAPTER 1: Abnormal Behaviour in Historical Context
UNDERSTANDING PSYCHOPATHOLOGY
Psychological Disorder (Problematic Abnormal Behaviour) – a psychological dysfunction within an individual associated
with distress or impairment in functioning and a response that is not typical or culturally expected
• Phobia – psychological disorder characterised by marked and persistent fear of an object or situation → can be
disabling
3 Criteria for Psychological Disorder:
1. Psychological Dysfunction – a breakdown in cognitive, emotional, or behavioural functioning
• i.e. severe fear all evening during a date even though there is nothing to be afraid of
• fainting at the sight of blood → feeling queasy (mild version of this reaction) → doesn’t meet the criteria for the
disorder
• knowing where to draw the line between normal and abnormal dysfunction is often difficult
• so problems are often considered to be on a continuum or a dimension → rather than to be categories that are
either present or absent
• reason why just having a dysfunction is not enough to meet the criteria for a psychological disorder
2. Distress or Impairment
• Concept of distress → criterion is satisfied if the individual is extremely upset → adds an important component →
contributes to a good definition
• By itself, this criterion does not define problematic abnormal behaviour → because it is normal to be distressed →
suffering and distress are part of life
• By definition, suffering and distress are absent for some disorders → i.e. person who feels extremely elated and
may act impulsively as a part of a manic episode
• May enjoy the manic state so much that they are reluctant to begin treatment or stay long in treatment
Concept of impairment → useful, although not entirely satisfactory
• i.e. many people consider themselves shy or lazy → doesn’t mean they are abnormal
• but if you are so shy that you find it impossible to date or even interact with people and you make every attempt
to avoid interactions even though you would like to have friends → social functioning is impaired
• differences in severity of reaction → not all are impaired → most psychological disorders are simply extreme
expressions of otherwise normal emotions, behaviours, and cognitive processes
3. Atypical or Not Culturally Expected
• Sometimes, something is considered abnormal because it occurs infrequently → deviates from the average
• The greater the deviation → the more abnormal it is
Talented or eccentric → people who are far from average in their behaviour → but few would be considered
disordered → artists, movie stars, athletes → i.e. Lady Gaga (meat dress), J. D. Salinger (The Catcher in the Rye), rock
singers (wear makeup)
• The more productive you are in the eyes of society → the more eccentricities society will tolerate
• Deviating from the average → does not work well as a definition for problematic behaviour
Behaviour is disordered if you are violating social norms → even if a number of people are sympathetic to your point
of view
• Definition is useful in considering important cultural differences in psychological disorders
• i.e. entering a trance state and believing ne is possessed → psychological disorder in most Western cultures → but
not in many other societies where it is accepted and expected
• Robert Sapolsky (2002) → neuroscientist who worked with Masai people in East Africa → Rhoda thinks that the
woman is crazy because she killed a goat (only men kill goats) and she heard voices at the wrong time
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• Social standard of normal has been misused → i.e. committing political dissidents to mental institutions because
they protest the policies of their government (Iraq, before the fall of Saddam Hussein; now occurs in Iran)
Jerome Wakefield (1999, 2009) → used shorthand definition of harmful dysfunction
• Related concept → determine whether the behaviour is out of the individual’s control
• Variants of these approaches are most often used in current diagnostic practice → DSM-5 → contains current
listing of criteria for psychological disorders
AN ACCEPTED DEFINITION
Psychological Disorder (DSM-5) – behavioural, psychological, or biological dysfunctions that are unexpected in their
cultural context and associated with present distress and impairment in functioning , or increased risk of suffering, death,
pain, or impairment
• Most widely used definition → can be useful across cultures and subcultures if we pay careful attention to what is
functional or dysfunctional (or out of control) in a given society
It is never too easy to decide what represents dysfunction → scholars have argued that health professions will never be
able to satisfactorily define disease or disorder
• Prototype – a typical profile of a disorder when most or all of the symptoms that experts would agree are part of
the disorder are present
• Patient may have only some features or symptoms of the disorder (minimum number) and still meet the criteria
→ because set of symptoms is close to the prototype
Difference between DSM-5 and DSM-IV → additional dimensional estimates of the severity of specific disorders in DSM-5
• i.e. anxiety disorders → intensity and frequency of anxiety within a given disorder such as panic disorder is rated
on 0 to 4 scale → rating of 1 would indicate mild or occasional symptom → rating of 4 would indicate continual
and severe symptoms
THE SCIENCE OF PSYCHOPATHOLOGY
Psychopathology – scientific study of psychological disorders
• specially trained professionals → clinical and counselling psychologists, psychiatrists, psychiatric social workers,
psychiatric nurses, marriage and family therapists, mental health counsellors
Clinical psychologists and counselling psychologists → receive the Ph.D, Ed.D., or Psy.D.
• follow a course of graduate-level study lasting approximately 5 years → prepares them to conduct research into
causes and treatment of psychological disorders and to diagnose, assess, and treat thee disorders
• Counselling Psychologists → study and treat adjustment and vocational issues encountered by relatively healthy
individuals
• Clinical Psychologists → concentrate on more severe psychological disorders
• Programs in professional schools of psychology (Psy.D) → focus on clinical training → de-emphasise or eliminate
research training
• Ph.D. programs → integrate clinical and research training
• Psychologists with other specialty training → i.e. experimental and social psychologists → concentrate on
investigating the basic determinants of behaviour → but do not assess or treat psychological disorders
Psychiatrists → earn an M.D. degree in medical school → specialise in psychiatry during residency training (3-4 years)
• Investigate the nature and causes of psychological disorders → biological point of view
• Make diagnoses → offer treatments
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• Emphasise drugs or other biological treatments → but most use psychosocial treatments
Psychiatric Social Workers → earn a master’s degree in social work → as they develop expertise in collecting information
relevant to the social and family situation of the individual with a psychological disorder
• Also treat disorders → concentrating on family problems associated with them
Psychiatric Nurses → have advanced degrees → Master’s or Ph.D. → specialise in the care and treatment of patients with
psychological disorders in hospitals as part of a treatment team
Marriage and Family Therapists and Mental Health Counsellors → spend 1- years earning a master’s degree → employed
to provide clinical services by hospitals or clinics → supervised by a doctoral-level clinician
THE SCIENTIST-PRACTITIONER
Adoption of scientific methods to learn more about the nature of psychological disorders, their causes, and their treatment
→ most important development in the recent history of psychopathology
Scientist-practitioners → mental health professionals who take a scientific approach to their clinical work
May function in 3 ways:
1. Consumer of Science
• Keep up with latest scientific developments in their field
• Use the most current diagnostic and treatment procedures
• Consumers of the science of psychopathology to the advantage of their patients
2. Evaluator of Science
• Evaluate their own assessments or treatment procedures to see whether they work
• Accountable not only to their patients, but also to the government agencies and insurance companies that pay for
the treatments
• Must demonstrate clearly whether their treatments are effective or not
3. Creator of Science
• Conduct research that produces new information about disorders or their treatment → in clinics or hospitals
• Become immune to the fads that plague the field → often at the expense of patients and their families
• i.e. new miracle cures reported several times a year in popluar media → would not be used by a scientist-
practitioner if there were no sound scientific data showing that they work
Data flow from research attempts 3 basic things:
1. describe psychological disorders
2. determine their causes
3. treat them
CLINICAL DESCRIPTION
Presents – traditional shorthand way of indicating why the person came to the clinic → presenting problem
• describing the presenting problem → first step in determining the clinical description
Clinical description → represents the unique combination of behaviours, thoughts and feelings that make up a specific
disorder
• Clinical → refers both to the types of problems or disorders that you would find in a clinic or hospital and to the
activities connected with assessment and treatment
• Used to specify what makes the disorder different from normal behaviour or from other disorders
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