Introduction

Identifying, classifying, and describing abnormal behaviour

Unisa study Guide

Free resources and links

Diagnostic and statistical manual of mental disorders _ DSM-5 ( PDFDrive ).pdf

Essentials of Understanding Abnormal Behavior 3rd Edition – PDF Room

PYC3702-Abnormal-Behaviour-and-Mental-Health-Exams.pdf

Key Vocabulary

There is a lot of important terminology to get familiar with in abnormal psychology, so let’s get through a good chunk of it straight away.

Assignment 1: a. Prevention

How prevalent are mental disorders

Mental disorders are extremely common. Some studies show that about half the population being studied has had symptoms of a mental disorder at some point in their lifetime. (+/- 50% lifetime prevalence)

There is a lot of social stigma associated with mental illness, due to stereotyping, prejudice and discrimination. This then causes self-stigma, as people internalize these social judgements, and incorporate them into their self-image.

A negative self-image then harms their self-esteem and self-efficacy.

Causes of mental disorders

1. Biological
   • symptoms occur in clusters called syndromes
   • The first DSM system of classification classified mental illnesses based on their physiological causes
   • General paresis was proven to be caused by late stage syphilis

2. Psychological

• many mental illnesses arise from stress, conflict or other psychological, cognitive and emotional factors
• Mesmer’s work with hypnotism showed that suggestion could both cause and treat symptoms
• Thus that the mind can be a causal factor.

Contemporary trends

Research and evidence-based medicine

This is an exciting time for neuroscience and evidence-based research. New understandings of the causes of mental illness and potential treatments are being developed across the scientific community.

So contemporary models of abnormal behavior include these aspects:

• biological
  • organic
  • biochemical
  • physiological
  • genetic
• psychological
  • emotional
  • behavioral
  • cognitive
  • in the context of social and cultural specifics

Prevention of Abnormal Behavior

Community Psychology

Community psychology is directed at helping ordinary people who cannot afford to access clinical psychology.

It focusses on how psychology professionals can intervene in the social system to help people who are not having their basic needs for food, shelter and safety met.

And it brings attention to widespread problems associated with poverty such as:

• substance abuse
• crime
• violence
• domestic violence

Community psychologists look at collective social solutions such as creating or improving organizations so that they help people better and meet their needs.

They intervene to improve people’s situations, quality of life and emotional wellbeing.

Community psychology looks for the strengths of a community and then works to build those strengths.

4 theoretical models of community psychology

1. Mental health model: goal is to prevent mental illness & its negative effects on people’s lives
2. Social action model: Helps the poor meet their needs and move up in live. Works on the problem of social inequality
3. Ecological model: Sees the community as a network of interrelationships, like an ecology
4. Organisational model: Studies and prevents the incidence of mental disorders within organizations. Facilitates change and development.

Community intervention is usually fairly public, and works with non-professionals, volunteer and self-help support networks.

Prevention of Psychopathology

Community psychology aims to keep people well.

1. primary prevention: less new cases
2. secondary prevention: shorten the duration
3. tertiary prevention: minimize the effects

Primary Prevention

How to reduce the incidence of new cases of mental disorders?

By increasing support for people. For example by creating a housing program for the homeless

and decreasing threats to mental wellbeing. For example by reducing crime in a community.

As we South Africans know, primary prevention is heavy lifting. It is not easy to implement. In fact it is even resisted. Why is this?

1. Big investment with unknown future rewards: Only through prospective and longitudinal research can you identify successes, failures and how these arose from the process. It takes time to know if a primary prevention program works. When it is actually rolling out, you don’t know if it is working or not, because the results are still in the future.
2. Competes with traditional programs that treat mental illness
3. Prevention is often only possible with broader changes in society, and this is a big ask for mental health workers. It requires a lot of networking and organisational support.
4. How to get funding for prevention, which was funneled for treatment before?
5. There is a lot of work: planning, work and long-term evaluation.

Secondary Prevention

Shorten duration. Reduce impact.

So how to reduce duration and impact?

• Early detection
• Effective treatment

Problems include:

1. Unreliable diagnosis
2. treatment is very patient-specific
3. Public health treatment takes ages because it is under-funded. There is usually a waiting list. There are not enough mental health employees or public health facilities.

“Walk-in” clinics, crisis intervention facilities, and emergency telephone lines do help, and are often run by Non-Governmental Organizations. (NGOs)

Tertiary Prevention

Tertiary prevention is often about the release from mental hospitals and institutions.

• Transition back to normal life.
• It is not always easy for patients to feel welcomed back into the community and family

Assignment 1 b: Models of psychopathology

Models of Abnormal Behavior

There are three categories of model:

Assumptions of the multipath model

• No single perspective is enough to explain mental disorders on its own
• There are multiple influences on the development of a disorder, so explanations must include all four dimensions – biological, psychological, social and sociocultural.
• Not all dimensions are equally significant in any disorder
• Causality is complex and reciprocal
• Each dimension may offer potential strengths and assets to help prevent, reduce or remove symptoms.
• Permeable boundaries between dimensions

Dimension 1: Biological Factors

Dimension 2: Psychological factors

There are 4 very different psychological perspectives for understanding abnormal psychology.

Dimension 3: Social Factors

So the social relational models look at family, couple and group perspectives.

1. The family systems model
   1. One person’s behavior affects the entire family
   2. The family strongly influences our personalities and behaviors. So a person’s mental illness often reflects unhealthy family dynamics, especially poor communication. ie the cause is the family system.
   3. Therapy must focus on the family system rather than the individual.
2. The conjoint family therapeutic approach teaches families to communicate clearly and constructively instead of dysfunctionally.
3. Strategic family approaches look at and intervene to develop healthier power distribution within the family.
4. Structural family approaches reorganize family relationships that may be too enmeshed or too distant.
5. Couples therapy
6. Group therapy is between strangers that share similar challenges.

Dimension 4: Sociocultural factors

Gender Factors

Socioeconomic Class

Immigration and acculturative stress

Race and ethnicity

Assignment 1: c Classifying

Criteria for a problem to be a mental disorder

A mental disorder is a syndrome characterized by clinically significant disturbance in an individual’s cognition, emotion regulation, or behavior that reflects a dysfunction in the psychological, biological, or developmental processes underlying mental functioning. Mental disorders are usually associated with significant distress or disability in social, occupational, or other important activities. An expectable or culturally approved response to a common stressor or loss, such as the death of a loved one, is not a mental disorder. Socially deviant behavior (e.g., political, religious, or sexual) and conflicts that are primarily between the individual and society are not mental disorders unless the deviance or conflict results from a dysfunction in the individual, as described above.”

Diagnostic and statistical manual of mental disorders DSM-5

So in short a mental disorder has 3 positive qualities

1. involves a significant disturbance in thinking, emotional regulation and/or behavior
2. caused by psychological, biological, or developmental dysfunction.
3. Causes significant distress or disability in day to day functioning

And it has two exclusions:

1. Is not merely a culturally expected response to common stressors or losses
2. or deviance in conflict with social norms.

Assessment and Classification

Based on scientific method.

4 steps of the scientific method in research

1. formulating a question
2. stating a hypothesis
3. testing the hypothesis
4. concluding that the hypothesis is true or false, and to what extent.

Possible research methods

What is abnormal psychology?

Key vocabulary

WTF

Categories of Disorders

We all know most of these, but having a shopping list in the head is a very important tool for the rest of the course, and for the future.

Assignment 1 d: African

Psychopathology from an African Perspective

Why do we need an African understanding?

1. Western Psychology collaborated in the oppression of blacks and Africans, through prejudice, stereotyping and discrimination.
2. Western psychology does not speak well to the lived experience of black and poor people, and is not open and available to them.
3. Western Psychology does not accurately represent and therefore is not easily applicable to African life and mentality.

3 Levels of acculturation

1. Traditional
2. Transitional
3. Modern

The role of culture in psychopathology

• Culturally specific stressors eg: racial discrimination
• some syndromes are more common in some cultures eg: Foetal alcohol syndrome in the Cape Wineland’s rural poor
• Some cultures may be more or less psychopathologic
• Some mental disorders are universal, but their cultural content is culture specific eg: hearing Jesus or hearing the Prophet Mohammed in schizophrenia
• Different cultures tolerate mental illness to a different extent
• And interpret mental illness differently
• Cultural transitions can also cause psychopathology, such as an increase in suicide, aggression or drug addictions

African World view

People choose between their worldviews based on what is available and many other factors to understand and treat mental illness as it arises.

Ubuntu: Strong emphasis on the social, on community, and on humanity as the centre of the universe.

Everything is filled with spirit. There are both natural and supernatural causes for illness.

Everybody is interconnected. Success is about contributing to, and being part of, the community and extended family.

The past is important, and needs to be understood. The future has not yet happened and is less emphasized.

African healing	Western healing
natural & spiritual causes	scientific causes
supernatural, holistic	fear of supernatural
magical	positivistic
harmony with nature	mastery of
harmony with universe	mastery of
present-oriented	future-oriented
desire to follow tradition	desire to succeed
respect for elderly/ancestors	disregard
group over individual	personal success over group
cooperative	competitive
self-depreciation	individualist & aggressive
holistic	analytical
home and family	migratory, upward mobility
intuitive, spiritual	consciousness & intelligence
subjective	objective
natural & humanistic	technological & scientific
intuitively logical	empirically logical

Paraphrased from Stricken, 1990, p14

Traditional African Perspective on Psychopathology

Mind, body and spirit are seen holistically. In unity and interconnection.

There is also a strong emphasis on being part of the group and on relationships, not only with the tangible world of people and nature, but also with the intangible world and the ancestors.

Mental problems arise because of the failure of human relations and disruption of social equilibrium and behaviors such as being selfish, aggressive or envious are seen as pathological. So harmony is encouraged.

Why rather than how is the question, and the supernatural realm is often seen as the cause.

Supernatural possible causes for mental illness: Ukufa kwabantu 

• sorcery
• disharmony between a person and their ancestors
• Punishment from God/Gods
• A curse
• offense against God/Gods
• Disruption of harmony in the past
• natural causes – Umkhuhlane 
• breaking of taboos or traditional customs
• disruption in social relationships
• angry ancestors
• possession by evil spirit

The illness lies in the collective, not in the individual. It is all about interpersonal relationships.

Traditional norms and rituals are an important part of healing.

The ancestors are angry if traditional social rites around birth, marriage, death and initiation are not performed, or if offerings of animal sacrifice and beer are not given. If the ancestors are not informed of developments in the family, they are displeased. Finally, the ancestors and God can decide whether or not to cure an illness.

Key terminology

Culture-specific syndromes