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Chapter 1

PSYC 561 Chapter 1: Abnormal Behavior in Historical Context

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PSYC 561

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PSYC 561 Chapter 1- Abnormal Behavior in Historical Context
What is a Psychological disorder?
Breakdown in function;
o Functioning in an abnormal, unusual way, usually affecting all 3 elements of
the ‘ABC Model’
ABC Model:
o Affect way that we feel at any given time (feeling-part)
o Behaviors what we are doing at any given moment (doing-part)
o Cognitions way that we think at any given moment (thinking-part)
o Most questions asked to patients concern these 3 areas (for example, someone
hearing voices in their head has a disorder predominantly affecting the
cognitions part)
Personal distress or impairment determining diagnosis
o How is it affecting the individual?
For example, major depressive disorder heavily affects the individual
o How is it affecting others?
For example, personality disorders may have a significant impact on
the people around a patient
o Is it appropriate to the situation?
Yes: less likely to yield diagnosis
No: more likely to yield diagnosis
Example of an appropriate ‘disorder’: depression after the death
of a loved one, or after a bad break up
o Degree of impairment (‘‘Diagnostic Threshold’’)
More difficult to judge, largely subjective
More so: more likely to yield diagnosis
Less so: less likely to yield diagnosis
o Note: A condition does not have to affect a person in the moment for them to
be diagnosed!
More gray areas surrounding psychological disorders
o Deviation from ‘‘average’’ means culture can play a role
o Violation of social norms may result in a diagnosis, however these do change
For example, homosexuality used to be a mental disorder but this is no
longer the case
o In order for something to be diagnostic, it must impact one’s social,
interpersonal, and/or occupational functioning. Try to judge: ‘‘is it changing
one’s ability to?’’
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The DSM-5
Diagnostic and statistical manual, is divided into chapters where each chapter
constitutes a ‘‘group’’ or ‘‘family’’ of related disorders
For each diagnosis the DSM includes:
o Clinical description (usually 1-3 sentences) which contains:
Course: what is the course the disorder takes? As in: first, then… ,
afterwards…, in the final stages… etc.
Onset: typical age that it comes to show symptoms. Can be acute
(=sudden) or insidious (=gradual)
Prognosis: ‘‘treatability’’ of the disease. For example, mild depression
has a relatively good prognosis while Alzheimer’s has a relatively bad
A ‘‘prototype’’ is what a typical diagnosis looks like
o Symptom guidelines and requirements, in a very specific sentence, with
different words on the blanks depending on the diagnosis:
‘‘The individual must demonstrate --- of the following --- symptoms
for a period of at least ---.
In case of a differential diagnosis (=multiple diagnosis) one must be
chosen that best fits the individual
o Causation (etiology)
Contains the biological, psychological and social factors associated
with the disease, providing some insight to the possible causes of the
o Treatment and outcome statistics
To aid in providing the most suitable therapy and for what time period
Brief historical perspective
Supernatural tradition
o Religious/mystical component: people attributed mental illness to demonic
possession, witchcraft, or a visitation from God. Possible ‘‘cures’’ included
exorcisms and torture
Biological Tradition
o Hippocrates (460-377 BC)
Thought psychological disorders have both biological and
psychological causes. Bottom line: mental illness is a physical disease.
o Galen (129-198 AD)
First to say that there are different types of people which can be
categorized (precursor to personality tests)
Humoral theory: there are 4 humors. One’s mental health is determined
by the color of their bile. 1= Choleric (blue bile), which explains anger,
high stress and anxiety. 2= Melancholic (black bile), explains
depression. 3= Phlegmatic (green bile), explains laziness. 4= Sanguine
(yellow bile), these are the only happy people. Galen’s humoral theory
is far from accurate.
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