Abnormal Psychology lesson 3 and samples.pdf

CHAPTER 1 – INTRODUCTION TO ABNORMAL PSYCHOLOGY
PSY 109: Abnormal Psychology | TTh 9:00-10:30 | Kristina Camille V. Pacris-Quitevis, RPsy, RPm, LPT, CHRA
Psychopathology — scientific study of psychological
disorders.
● Etiology — has to do with why a disorder
begins (what causes it) and includes
biological, psychological, and social
dimensions.
● Symptoms — observations reported by the
client/significant people around the client.
● Signs — observations from the clinician or
psychiatrist.
● Onset — when did the symptoms start to
show.
○ Acute — abrupt; less than 6 months.
○ Insidious — symptoms started slowly
and did not have obvious symptoms at
first.
○ Chronic — more than 6 months.
● Prognosis —anticipated course of disorder.
○ The prognosis is good — the
individual will probably recover.
○ The prognosis is guarded — the
probable outcome doesn’t look good;
condition is irreversible (e.g.
dementia)
● Comorbid — a person is experiencing two or
more symptoms at the same time.
● Course — individual pattern the disease
follows; pattern of the presence of the
symptoms (how long does the symptoms
occurred)
○ Episodic —returning symptoms; the
individual is likely to recover within a
few months only to suffer a recurrence
of the disorder at a later time.
○ Time-limited course — the disorder
will improve without treatment in a
relatively short period.
○ Chronic — tend to last a long time,
sometimes a lifetime.
Considerations:
● Prevalence — how many people in the
population as a whole have the same disorder
(coverage, case, date range/inclusive, place).
● Incidence — how many new cases occurred
during a given period (e.g. COVID updates).
Different Professionals Involved in Psychopathology
1. Psychologist
a. Counseling — problems on
adaptation and other less severe cases.
b. Clinical — work closely with
psychiatrists to handle patients with
severe disorders, as they cannot
prescribe medications but can help
mitigate the severity of symptoms.
2. Psychiatrist — prescribe medications
3. Psychometricians — develops tests and
interprets results; responsible also for
administering and scoring psychological tests.
4. Psychiatric Nurses — provide support in the
clinical setting to assist psychiatrists in
ordering medications and to support
psychologists.
5. Social Workers — more inclined to provide
services to the community, such as
Psychological First Aid.
6. RGCs
Mental Health — state of mental well-being that
enables people to cope with stress.
Mental Health Continuum — mental health is not
fixed.
longer time spent in excelling = negative emotions
longer time spent in thriving = low stress tolerance
Strategies: RACSS GO Model
● Relaxation
● Activity
● Cognitive — evaluating irrational thoughts
● Social — social support
● Spiritual — connecting with spirits that can be
helpful for you
● Gratitude — listing down the things that
you’re grateful for
● Optimism
Psychological Disorders — psychological dysfunction
within an individual that is associated with distress or
impairment in functioning and a response that is not
typical or culturally expected.
5 D’s
1. Dysfunction — breakdown in cognitive,
emotional, or behavioral functioning.
2. Distress — “extreme” emotions; comes with
impairment in functioning.
a. Impairment in Functioning — unable
to perform basic tasks.
3. Deviance — atypical response or not culturally
expected; behaviors that violate social norms.
4. Danger — presence or inflicting harm/pain
towards oneself, others, and property.
5. Duration — how long the symptoms are
present; indicates how different two disorders
are.
Diagnostic and Statistical Manual of Mental Disorders
(DSM)
- It is created by the American Psychiatric
Association (APA) as an assessment system for
mental illness.
- It was published in 2013 and includes
identifiable criteria that mental health
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professionals use to arrive at a specific
diagnosis.
- The DSM-5 TR is the current edition of the
DSM, which was released in March 2022. It
features a new disorder called Prolonged Grief
Disorder and codes of suicidal and
non-suicidal self-injury.
International Classification of Diseases (ICD)
- Produced by the World Health Organization,
which includes medical as mental health
diagnosis.
- It is the foundation for the identification of
health trends and statistics globally. It is the
international standard for defining and
reporting diseases and health conditions. It
allows the world to compare and share health
information using a common language,
- It defines the universe of diseases, disorders,
injuries and other related health conditions.
These entities are listed in a comprehensive
way so that everything is covered. It organizes
information into standard groupings of
diseases.
Historical Conceptions of Abnormal Behavior
A. The Supernatural Tradition
- Agents outside our bodies and
environment influence behavior,
thinking and emotions.
- Spirits, demons, magnetic fields,
stars, moon, etc.
● 14th
Century — devils and witches
○ Treatments: religious rituals and/or
exorcism
● Depression & Anxiety — identified by the
church as sin of acedia or sloth or laziness.
○ Treatments: rest, sleep, and happy
environment; baths, ointments,
various potions
Mass hysteria may simply demonstrate the
phenomenon of emotion contagion, in which the
experience of an emotion seems to spread to those
around you.
● Nicolas Oresme — suggested that the disease
of melancholy was the source of some
behavior, rather than demons.
● Charles VI of France — was under a great deal
of stress, partly because of the division of the
catholic church.
● Paracelsus — Swiss physician who suggested
that movements of the moon and stras had
profound effects on people’s psychological
functioning.
● Roman Catholic Church —requires that all
healthcare resources can be exhausted first
before spiritual solutions such as exorcism can
be considered.
B. The Biological Tradition
- Psychological disorders were believed
to be biologically caused.
● Hippocrates
- Hippocratic Corpus — collection of
medical writings.
- “Disorders involving consciousness,
emotion, wisdom and intelligence can
be located in the brain.”
- He coined the term hysteria.
- Father of western medicine.
● Hippocrates & Galen — humoral theory of
disorders (blood, black bile, yellow bile,
phlegm).
● Louis Pasteur — germ theory of disease
● Emil Kraepelin — one of the fathers of
modern psychiatry, known in the area of
diagnosis and classification.
● John P. Grey — believed that insanity is
always physical, and therefore should be given
rest, diet, and proper room temperature and
ventilation.
● Benjamin Franklin — physical interventions
such as electric shock and brain surgery can be
effective to create brief convulsion.
C. The Psychological Tradition
- During the 1st
half of the 19th
century, a
strong psychosocial approach to
mental disorders called Moral Therapy
became influential. Its basic tenets
included treating institutionalized
patients as possible in a setting that
reinforced normal social interaction.
● Philippe Pinel & Jean-Baptiste Pussin —
originated Moral Therapy.
● Benjamin Rush — Moral Therapy in USA
● Dorothea Dix — Mental Hygiene Movement
● Franz Mesmer — Animal Magnetism; father
of hypnosis
● Jean-Martin Charcot — legitimized fledging
practice of hypnosis
● Sigmund Freud & Joseph Breuer — hypnosis;
catharsis
Psychological Theories
A. Psychoanalytic Theory — holds that
behaviors are influenced by unconscious
processes. According to this approach, we are
victims of unconscious sexual and aggressive
instincts that constantly influence our
behavior. Likewise, this approach assumes
that childhood experiences shape our
personality later in life.
Psychoanalytic Therapy
● Catharsis — the purging release of emotional
tension.
● Hypnosis — a trance-like mental state in
which people experience increased attention,
concentration, and suggestibility.
● Free Association — spend a few minutes to
clear your mind of thoughts. Then allow
whatever comes into your mind to enter. Say
whatever you feel like saying, even if it is not
what you have expected.
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● Dream Analysis — Freud said that dreams
provide the id impulses with a stage for
expression. They are a type of wish
fulfillment, that is, a representation of what
the individual would like to have.
B. Behavioral Model — holds that behaviors are
influenced by rewards, punishments, and
models by means of imitation. According to
this approach, we act the way we do because of
our environment, not because of our personal
choice or direction.
C. Humanistic Theories — people are assumed
to have a great deal of responsibility for their
actions. This approach explained that a
behavior is in response to the frustration of
some basic needs.
D. Cognitive Theories — describes differences in
personality as differences in the way people
process information.
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CHAPTER 2 – CONTEMPORARY MODELS OF ABNORMAL BEHAVIOR
Model — an analogy used by scientists, usually to
describe or explain a phenomenon or process they
cannot directly observe.
One Dimensional Model
This uses a single approach to explain the occurrence
of a certain phenomenon; unitary in nature.
A. Medical/Biological Model
- disorders have an organic or physical cause.
Assumptions:
1. Characteristics that make us who we are are
embedded in the genetic material of our cells.
And many of our personal qualities result from
complex interactions between our biological
makeup and the environment.
2. Thoughts, emotions, and behaviors involve
physiological activity occurring within the
brain; changes in the way we think, feel, or
behave affect these biological processes, and
over time, can change brain structure.
3. Many mental disorders are associated with
inherited biological vulnerability and/or some
form of brain abnormality.
4. Medications and other biological
interventions used to treat mental disorders
influence various physiological processes
within the brain.
The Human Brain
Alcohol produces pleasurable effects by increasing
brain activity in reward processing areas. It activates
opioid receptors in the nucleus accumbens, adding to
the pleasure of intoxication. Alcohol addiction involves
the ventral tegmental area sending dopamine signals
to the nucleus accumbens. Dopamine plays a key role
in learning the association between alcohol and its
rewarding effects. This learning leads to "incentive
salience," a strong motivation for alcohol influenced by
physiological state and learned cues. People may be
drawn to alcohol for its rewarding effects or to
alleviate physical or emotional discomfort.
Neurotransmitters
● Chemical substances that are released into the
synapse by the presynaptic neuron when a
nerve impulse occurs.
● There may be excessive production and release
of the neurotransmitter substance into the
synapse, causing a functional excess in levels
of that neurotransmitter.
● There may be a problem with the receptors in
the postsynaptic neuron, which may be either
abnormally sensitive or abnormally
insensitive.
Genes and Genetic Vulnerabilities
● Genes — basic physical and functional units of
heredity; made up of DNA and located in
chromosomes.
● Most of our behavior, personality and
intelligence are determined by many genes.
● Most mental disorders are not caused by a
single gene. Rather, they are polygenic —
caused by more than one gene.
● Most people wrongly believe that a
psychological disorder is inevitable if it has a
genetic component, but this is not the case.
● Nature interacts with nurture
B. Psychodynamic Model
- A person’s behavior is determined largely by
underlying psychological forces of which
he/she is not consciously aware.
- A person with abnormal behavior has
personality forces that have poor working
relationships.
- Fixation at an early stage of development
causes subsequent development to suffer and
the individual may have abnormal functioning
in the future.
C. Behavioral Model
- People are controlled by their environment.
- We are the result of what we have learned
from our environment (environmental
experiences). Behaviorism is concerned with
how environmental factors (stimuli) affect
observable behavior (response).
- Two processes: classical and operant
conditioning.
Maladaptive Behavior — faulty or ineffective learning
and conditioning.
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D. Humanistic/Existential Model
Humanistic Perspective:
- Anxiety, depression, and other problems occur
when society blocks a person’s innate
tendency for growth by imposing conditions
on whether one has personal value.
- Furthermore, psychological disorders may
develop from poor coping mechanisms to the
frustration of some basic needs.
Existential Perspective:
- Psychological dysfunction is caused by self
deception in which people hide from life’s
responsibilities and fail to recognize that it is
up to them to give meaning to their lives.
E. Cognitive Model
- Focuses on how internal thoughts,
perceptions, and reasoning contribute to
psychological disorders.
- People engage in abnormal behavior because
of particular thoughts and behaviors that are
often based upon their false assumptions.
Assumptions:
1. Abnormal behavior is caused by faulty and
irrational thoughts(cognitions).
2. It is the way you think about a problem, not
the problem itself that causes mental
disorders.
3. Changing faulty thinking will lead to a change
in behavior.
F. Sociocultural Model
- Abnormal behavior is best understood in light
of the broad forces that influence an
individual.
Two Major Perspectives
● Family-social perspective — broad factors
that operate directly on an individual as
he/she moves through life.
○ Social labels and roles, social
networks, family structure and
communication.
● Multicultural perspective — an individual's
behavior is best understood when examined in
the light of that individual’s unique cultural
context, from the values of that culture to the
special external pressures faced by members
of the culture.
Multi-dimensional Model
This model uses a combination of the various models /
approaches to explain the etiology of a certain
psychological disorder.
Multipath Model — provides an organizational
framework for understanding the numerous
influences the development of mental disorders, the
complexity of their interacting components, and the
need to view disorders from a holistic framework.
G. Nature/Nurture Interaction
Diathesis-Stress Model
- believes that people develop a psychological
disorder in response to stress because they
have an underlying predisposition (diathesis)
to the disease.
Reciprocal Gene Environment Model
- people with a genetic predisposition toa
disorder may also have a genetic tendency to
create environmental risk factors that
promote the disorder.
Non-genetic Inheritance Model
- genes are not the whole story. Early learning
(such as Parenting Styles and Nurturance)
may override genetic predisposition.
H. Biopsychosocial Model
- combines biological, psychological, and social
factors to understand a patient, and uses this
to guide both treatment and prognosis.
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Abnormality results from interaction of genetic,
biological, developmental, emotional,
behavioral, cognitive, social, cultural, and
societal influences.
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CHAPTER 3 – CLINICAL ASSESSMENT, DIAGNOSIS, AND TREATMENT
Assessment — collecting of relevant information in an
effort to reach a conclusion.
Clinical Assessment
- gathering information and drawing
conclusions about the traits, skills, abilities,
emotional functioning, and psychological
problems of an individual.
- systematic evaluation and measurement of
psychological, biological, and social factors in
an individual presenting with a possible
psychological disorder.
Psychodiagnosis
- process of determining whether the particular
problem afflicting the individual meets all
criteria for a psychological disorder.
- assessment and description of an individual’s
psychological symptoms, including inferences
about what might be causing the psychological
distress.
Characteristics of Assessment Tools
● Reliability — degree to which a procedure or
test yields consistent results.
○ Test-retest reliability — assessment
tool yields similar results every time it
is given to the same people.
○ Internal consistency reliability —
various parts of a test yield similar or
consistent results.
○ Interrater (or interjudge) reliability
— different judges independently
agree on how to score and interpret an
assessment tool.
● Validity — extent to which a test or procedure
actually measures what it was designed to
measure.
○ Predictive validity — how well a test
or measure predicts or forecasts a
person’s behavior, response, or
performance.
○ Concurrent or descriptive validity —
degree to which the measures
gathered from one tool agree with the
measures gathered from other
assessment techniques.
○ Construct validity — how well a test
or measure relates to the
characteristics of disorder in question.
○ Content validity — how well a test
measures what it is intended to
measure.
● Standardization — process by which a certain
set of standards or norms is determined for a
technique to make its use consistent across
different situations.
- standards apply to the procedures of
testing, scoring, and evaluating of
data.
Assessment Tools
● Clinical Interview
○ Mental Status Exam (MSE) — a set of
questions and observations that
systematically evaluate the client’s
awareness, orientation with regard to
time and place, attention span,
memory, judgment and insight,
thought content and processes, mood,
and appearance.
○ Semi Structured Clinical Interviews
— made up of questions that have
been carefully phrased and tested to
elicit useful information in a
consistent manner so that clinicians
can be sure they have inquired about
the most important aspects of
particular disorders.
- Clinicians may also depart
from set questions to follow
up on specific issues.
○ Structured Clinical Interviews —
standardized questions that are
worded the same way for all clients.
● Physical Examination
○ Behavioral Assessment — using
direct observation to formally assess
an individual’s thoughts, feelings, and
behavior in specific situations or
contexts.
The ABCs of Observation
❖ Antecedent — before
❖ Behavior — during
❖ Consequence — after
○ Self-Monitoring — self-observation;
observation of own behavior to find
patterns.
● Psychological Testing
○ Projective Testing — variety of
methods in which ambiguous stimuli
are presented to people who are asked
to describe what they see.
○ Personality Inventories — self-report
questionnaires that assess personal
traits.
○ Intelligence Tests — assesses an
individual's intellectual strengths and
weaknesses, particularly when mental
retardation or brain damage is
suspected.
● Neuropsychological Testing
○ Neuropsychological Tests — measure
abilities in areas such as receptive and
expressive language, attention and
concentration, memory, motor skills,
perceptual abilities, and learning and
abstraction in such a way that the
clinician can make educated guesses
about the person’s performance and
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the possible existence of brain
impairment.
○ Neuroimaging
■ Images of brain structure
● Computerized axial
tomography (CAT)
● Magnetic resonance
imaging (MRI)
■ Images of brain functioning
● Positron emission
tomography (PET)
● Single photon
emission computed
tomography (SPECT)
● Functional MRI
(fMRI) – BOLD-fMRI
(Blood-Oxygen-Level
-Dependent fMRI)
● Psychophysiological Assessment
- assessing measurable changes in the nervous
system that reflect emotional or psychological
events.
- measurement may be taken directly from the
brain or peripherally from other parts of the
body.
- Electroencephalogram (EEG)
- Electrodermal responding (formerly
galvanic skin response or GSR)
Classification Systems
● When certain symptoms occur together
regularly – a cluster of symptoms is called a
syndrome – and follow a particular course,
clinicians agree that those symptoms make up
a particular mental disorder.
● A list of disorders, along with descriptions of
symptoms and guidelines for making
appropriate diagnoses.
● Emil Kraepelin developed the first modern
classification system .
● A classification system for abnormal behaviors
aims to provide distinct categories and
indicators for atypical behaviors, thought
processes, and emotional disturbances.
Five Purposes of Classification
1. As a nomenclature
2. As a basis of information retrieval
3. As a descriptive system
4. As a predictive system
5. As a basis for a theory of psychopathology
● Classical (or pure) Categorical Approach
- Assumes that every diagnosis has a clear
underlying pathophysiological cause and that
each disorder is unique.
- It is useful in medicine but is inappropriate to
the complexity of psychological disorders.
● Dimensional Approach
- The variety of cognitions, moods, and
behaviors with which the patient presents is
noted and quantified on a scale.
- Describes the objects of classification in terms
of continuous dimensions.
- Based on an ordered sequence or on
quantitative measurements.
● Prototypical Approach
- Identifies certain essential characteristics of
an entity so that others can classify it but it
also allows certain nonessential variations
that do not necessarily change the
classification.
Functions of a Good Classification System
1. Organization of clinical information —
provides the essentials of a patient’s condition
coherently and concisely.
2. Shorthand communication — enhances the
effective interchange of information, by
clearly transmitting important features of a
disorder and ignoring unimportant features.
3. Prediction of natural development — allows
accurate short-term and long-term prediction
of an individual’s development.
4. Treatment and recommendations — allows
accurate predictions of the most effective
interventions.
5. Heuristic value — allows the investigation and
clarification of issues related to a problem
area. It also enhances theory-building.
6. Guidelines for financial support — provides
guidelines to services needed, including
payment of caregivers.
Diagnostic and Statistical Manual of Mental Disorders
- A widely used classification system for
psychiatric disorders.
- Lists all officially designated mental disorders
and the characteristics or symptoms needed to
confirm a diagnosis.
- Diagnostic criteria include physical,
behavioral, and emotional characteristics
associated with a disorder.
- Symptoms must cause significant distress or
impairment in social, occupational, or other
important areas of functioning .
- All DSMs are based on the classification
system developed by Emil Kraepelin in around
1850.
- DSM, 1952 – 106 mental disorders
- DSM-II, 1968 – 182 mental disorders
- DSM-III, 1980 – 265 mental disorders
- DSM-III-R – 292 mental disorders
- DSM-IV, 1994 – 297 mental disorders
- DSM-5, 2013 – 500+ mental disorders
Exceptions to the categorical nature of DSM-5:
1. Autism categories are replaced with one
disorder called “autism spectrum disorder,”
and an alternative dimensional model for the
diagnosis of personality disorders is added.
2. Risk syndromes are added that represent
milder forms of well-established disorders.
3. Assessment procedures are enhanced to
permit more than a simple “yes-or-no”
option.
● Subtypes — mutually exclusive subgrouping
within a diagnosis.
● Specifiers — specific features associated with
a diagnostic category.
○ Remission — a diminution in the
seriousness of an illness.
8

○ Prognosis — prediction of the
probable outcome of a disorder,
including the chances of full recovery.
● Cross-cutting measure — assesses common
symptoms that are not specific to one
disorder.
○ Comorbid — the presence of two or
more disorders in the same person.
○ Comorbidity — co-occurrence of
different disorders.
● Course — usual pattern that a disorder
follows.
Issues in Assessment of Mental Disorders
Challenges in Assessment
● Resistance to providing information
● Evaluating children
● Evaluating individuals across cultures
Ethical Issues in Assessment
1. Potential cultural bias of the instrument of the
clinician
2. Theoretical orientation of the clinician
3. Underemphasis on the external situation
4. Insufficient validation
5. Inaccurate data or premature evaluation
Culture and the Development of Mental Disorders
1. Culture may cause stress and psychological
problems.
2. Culture may influence a person’s reaction to
stress.
3. Culture may influence which symptoms of a
disorder are expressed and the content of the
symptoms.
4. Culture may reinforce certain forms of mental
disorder.
Four Main Areas to be Considered
1. Clinicians must overcome a language barrier if
one exists.
2. Clinicians must obtain information about the
cultural background of a client.
3. Clinicians must be culturally sensitive.
4. Clinicians must be knowledgeable about
cultural variations in psychological problems.
Social and Cultural Considerations in DSM-5
● Includes a plan for integrating important
social and cultural influences on diagnosis.
● Culture — values, knowledge, and practices
that individuals derive from membership in
different ethnic groups, religious groups, or
other social groups, as well as how
membership in these groups may affect the
individual’s perspective on their experience
with psychological disorders.
● Cultural formulation — description of a
disorder from the perspective of the patient’s
personal experience and in terms of his or her
primary social and cultural group.
Five Domains of the CFI
1. Cultural identity of the client
2. Cultural ideas of distress
3. Cultural factors related to the social
environment
4. Cultural influences on the relationship
between the client and the mental health
professional
5. Overall cultural assessment
Disadvantages of Classification
● Labeling a person as having a mental disorder
can result in overgeneralization, stigma, and
stereotypes.
● A label may lead those who are labeled to
believe that they do indeed possess
characteristics associated with the label or
may cause them to behave in accordance with
the label.
Treatment Options and Decisions
Factors that influence treatment decisions:
● Assessment information
● Diagnosis
● Clinician’s theoretical orientation and
familiarity with research
● State of knowledge in the field
General conclusions in therapy outcome studies:
1. People in therapy are usually better off than
people with similar problems who receive no
treatment.
2. The various therapies do not appear to differ
dramatically in their general effectiveness.
3. Certain therapies or combinations of therapies
do appear to be more effective than others for
certain disorders.
Empirically supported treatment
● The active identification, promotion, and
teaching of those interventions that have
received clear research support.
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