Last Page Update: Tue, 05-Feb-2002 3:42 PM

How can we distinguish normal from abnormal behavior?

Deviation from the Average - follows a statistical definition. In order to determine abnormality, we simply observe what behaviors are rare or infrequent in a given society or culture and label these deviations from the norm as abnormal

Deviation from the Ideal / culture- takes into account not what most people do (the average), but the standard toward which most people are striving—the ideal. Behavior is considered abnormal if it deviates enough from some kind of ideal or standard.

Abnormality as a Sense of Subjective Discomfort- concentrates on the psychological consequences of the behavior for the individual. Behavior is considered abnormal if it produces a sense of distress, anxiety or guilt in an individual—or if it is harmful to others in some way.

Abnormality as the Inability to Function Effectively/ control - considers the ability of the person to be in control and adjust to the demands of society or to function effectively like feed themselves, hold a job, get along with others and in general live as productive members of society.

The continuum between abnormality and normality- Probably the best way to deal with the imprecision in comprehensively defining abnormality is not to consider abnormality and normal behavior as absolute states. Rather, they should be viewed as marking the two ends of a continuum or scale of behavior, with completely normal functioning at one end and totally abnormal behavior at the other. Behavior obviously falls somewhere between these two extremes.

What are the major models of abnormal behavior used by mental health professionals, and how are they applied to specific cases?

The medical model - the model that suggests that when an individual displays symptoms of abnormal behavior, the cause is physiological, such as a hormonal imbalance, a chemical deficiency, or an injury to the part of the body.

The psychoanalytic model- the model that suggests that abnormality stems from childhood conflicts over opposing desires regarding sex and aggression. According to Freud, if the conflicts of childhood are not successfully dealt with, they remain unresolved in the unconscious and eventually bring about abnormal behavior or neurotic symptoms during adulthood. In order to understand, the roots of a person’s disordered behavior, the psychoanalytic model scrutinizes his or her early life history.

The behavioral model - The model that suggests that abnormal behavior itself is the problem to be treated, rather than viewing behavior as a symptom of some underlying medical or psychological problem. Both normal and abnormal behaviors are seen as responses to a set of stimuli., responses that have been learned through past experience and are guided in the present by stimuli that one finds in the environment.

The cognitive model-The model that suggests that people’s thoughts and beliefs are a central component to abnormal behavior. A primary goal of treatment using cognitive model is to explicitly teach new cognitions.

The humanistic model- The model that suggests that people are basically rational and that abnormal behavior results from an inability to fulfill human needs and capabilities. Humanistic approaches to abnormal behavior focus on the relationship of the individual to the world, on the ways in which people view themselves in relation to others and see their place in the world in a philosophical sense. Rather than assuming there is something wrong with an individual, humanistic theorists view abnormal behavior as an understandable reaction to circumstances arising in the person’s daily life.

 

The sociocultural model-The model that suggests that people’s behavior, both normal and abnormal, is shaped by family, society and cultural influences. The kinds of stresses and conflicts people experience—not in terms of unconscious processes, but as part of their daily interactions with the environment—can promote and maintain abnormal behavior.

 

What is the classification system used to categorize abnormal behavior, and what are the major mental health disorders?

Diagnostic and Statistical Manual for Mental Disorders, Fourth Edition (DSM-IV) -. In order for mental health professionals of diverse backgrounds and approaches to communicate, it is designed to be primarily descriptive and devoid of suggestions as to the underlying causes of an individual’ s behavior and problems. It has a listing of 200 disorders grouped into categories.

Five Axes or Dimensions

· axis I - major clinical syndrome or particular maladaptive behavior being exhibited

· axis II- the nature of any long-standing personality problems in adults or any developmental problems in children and adolescents that may be relevant to treatment

· axis III- any physical disorders or illnesses that may also be present

· axis IV - identifying and severity of psychosocial stressors present

· axis V- the general level of functioning over the past year in social relationships, work and use of leisure time

* Medical student’s disease - the feeling that symptoms and illnesses one studies are characteristic of oneself

Major Diagnostic Categories

Anxiety Disorder- Anxiety is a nervous feeling of apprehension accompanied by physical symptoms, such as a pounding heart and trembling hands. The occurrence of anxiety without obvious external cause, intruding on daily function is a possible sign of a disorder. Generalized Anxiety Disorders- the experience of long term anxiety with no explanation or linked to an identifiable source. Panic disorder- Anxiety that manifests itself in the form of panic attacks. It is characterized by frequent, sudden, intense rush of anxiety for no apparent reason— is often accompanied by agoraphobia, a fear of public places. Post traumatic stress disorder-Reexperiencing a stressful event that can occur months or years after the event. Phobic disorders- A disorder characterized by an intense, irrational fear that may keep people from carrying out routine daily behaviors. Obsessive-Compulsive disorder- A disorder characterized by obsessions or compulsions, people are plagued with unwanted thoughts, called obsessions, or feel that they must carry out some actions, termed compulsions, against their will.

Somatoform Disorders - People with somatoform disorders have bodily symptoms that are psychological rather than medical in origin. Hypochondriasis- a constant preoccupation with one’s physical health , fear of illness and misinterpretation of normal aches and pains. Conversion disorders- a temporary loss of a bodily function without a phyical cause. Psychological disturbances characterized by actual physical disturbances, such as the inability to speak or move one’s arm.

Dissociative Disorders- Psychological dysfunction characterized by the splitting apart of critical personality facets that are normally integrated, allowing stress avoidance by escape. Dissociative identity disorder (multiple personality) - a disorder in which a person displays characteristics of two or more distinct personalities. Dissociative amnesia- a failure to remember past experience, the "forgotten" material is still present in memory—it simply cannot be recalled. Dissociative fugue - an amnesiac condition in which people take sudden, impulsive trips, sometimes assuming a new identity

Mood Disorders- Affective disturbance severe enough to interfere with normal living. Major depression- a widespread mood disorder, brings feelings of deep sadness and despair that occure without discernible cause and last two weeks or more. It is a severe form of depression that interferes with concentration, decision making, and sociability. Mania - An extended state of intense euphoria and elation. Bipolar disorders-a disorder in which a person alternates between euphoric feelings of mania and bouts of depression.

Psychotic Disorders (Schizophrenia)- a class of disorders characterized by a severe distortion of reality, resulting in antisocial behavior, silly or obscene behavior, hallucinations, and disturbances in movement. DSM-IV lists five major types of schizophrenia: disorganized, catatonic, paranoid, undiffereniated and residual.

Characteristics of Schizophrenia

· Decline from a previous level of functioning

· Disturbances of thought and language

· Delusions.

· Perceptual disorders

· Emotional disturbances

· Withdrawal

Personality Disorders -a mental disorder characterized by a set of inflexible, maladaptive personality traits that keep a person from functioning properly in society. Antisocial or sociopathic personality disorder- a disorder in which individuals display no regard for moral and ethical rules or for the rights of others. Of those who have antisocial personality disorder, 80 percent are men. The condition produces a chronic pattern of self-centered, manipulative and destructive behavior towards others.

Narcissistic personality disorder- a personality disorder characterized by an exaggerated sense of self and an inability to experience empathy for others.

Characteristics of personality disorders

· a lack of conscience, guilt or anxiety over transgressions

· impulsive behavior and an inability to withstand frustration

· manipulation of others

What are the major indicators that signal a need for the help of a mental health practitioner?

· Long term feelings of psychological distress that interferes with your sense of well being, competence, and ability to function effectively in daily routines

· Occasions in which you experience overwhelmingly high stress, accompanied by feelings of inability to cope with the situation

· Prolonged depressions or feelings of hopelessness, particularly when they do not have any clear cause (such as the death of someone close)

· Withdrawal from other people

· A chronic physical problem for which no physical cause can be determined

· A fear or phobia that prevents you from engaging in normal everyday activities

· Feelings that other people are out to get you or are talking about and plotting against you

· The inability to interact effectively with others, preventing the development of friendships and loving relationships

What are the goals of psychologically based and biologically based treatment approaches ?

Psychotherapy- is the use of psychological techniques by professionally trained individual to help a client change unwanted behavior and adjust to his or her environment. Biomedical therapy, which may be used together with psychotherapy, includes the use of drugs, surgery and electric shock to induce behavior change. Therapies can be divided into two categories. Insight therapies are aimed towards helping individuals become aware of the motives, often repressed or denied, that are shaping their behaviors. Action therapies do not focus on digging deeply into the individual’s personality. Action-oriented direct their attention to the presenting symptoms and attempt to change the specific problematic behaviors or beliefs.

Insight Therapies

Psychodynamic treatment- is based on the notion that the basic sources of abnormal behavior are unresolved past conflicts and anxiety over the possibility that unacceptable unconscious impulses will enter the conscious part of a person’s mind. To Freud, the answer was to confront the conflicts and impulses by bringing them out of the unconscious part of the mind and into the conscious part.

Psychoanalysis- A major aim of psychoanalysis is to peel away defenses in order to bring repressed thoughts into consciousness so individuals can deal with them. Psychodynamic therapy that involves frequent sessions and often lasts for many years. Free association- a Freudian therapeutic technique in which a patient says everything that comes to mind to give the therapist a clue to the workings of the patient’s unconscious. Dream interpretation- An examination of a patient’s dreams to find clues to the unconscious conflicts and problems being experienced; involves helping clients understand the latent content of their dreams, which are expressions of repressed feelings.

Humanistic therapy- therapy in which the underlying assumption is that people have control of their behavior, can make choices about their lives, and are essentially responsible for solving their own problems. However, as children we often learn that other people have expectations about how we should behave and we learn that the way to get rewards is to live up to others’ expectations. If we follow this pattern, we may lose touch with our own desires and feelings. When this happens, we become unhappy and experience anxiety. Client-Centered therapy - A therapeutic technique in which the therapist creates a warm, supportive environment to allow the client to better understand and work out his or her problems. The proper setting is one in which people do not fear social rejection for expressing themselves. Existential Therapy- an approach that addresses the meaning of life, allowing a client to devise a system of values that gives purpose to his or her life. Gestalt therapy- This approach to therapy attempts to integrate a client’s thoughts, feelings, and behavior into a whole, developed by Fritz Perls, proposed that unconscious thoughts and emotions (background) may lead to behaviors (figure) that are inappropriate to the situation. This therapy encourages people to take responsibility for their actions in the present, while understanding the emotions that are influencing them.

Action Therapies

Behavioral approaches to Treatment - Approaches to treating abnormal behavior that assume that both normal and abnormal behaviors are learned and that appropriate treatment consists of learning new behavior or unlearning maladaptive behavior. aversive conditioning- a technique used to help break unwanted habits by associating the habits with very unpleasant stimuli. Systematic desensitization- a procedure in which a stimulus that evokes pleasant feelings is repeatedly paired with a stimulus that evokes anxiety in the hope that the anxiety will be alleviated. Token system- a procedure whereby a person is given tokens for good performance or behavior which they can exchange for treats or other primary enforcers. Modeling therapies - used as a therapeutic technique to teach new behaviors or strengthen existing ones. Also used to reduce a number of phobias by showing the model interacting with the treated object.

Cognitive Approaches- a process by which people’s faulty cognitions about themselves and the world are changed to a more accurate ones. Rational emotive therapy- psychotherapy based on Ellis’s suggestion that the goal of therapy should be to restructure one’s beliefs into a more realistic, rational and logical system. Our problems are not the result of how we feel; rather, how we think and believe determines how well we will adjust to our environment.

Family therapy- Type of psychotherapy that involves the whole family, rather than just one member of it, since the family system as a whole can often create stress and contribute to the development of psychological disorders.

Biological based therapy

An approach to therapy that uses drugs and other medical procedures to improve psychological functioning. Clinical psychopharmacology - is the use of drugs (antipsychotic drugs, antidepressant drugs, lithium, antianxiety drugs) to treat psychological disorders. Although these drugs are being used successfully in treating mental illness, they all have undesirable side effects; clients must be constantly monitored. Electroconvulsive Therapy- Treatment involving the administration of an electric current to a patient’s head to treat depression. It is given to most often to people who are suffering from severe depression, have not responded to drug treatment, and who may attempt suicide if not relieved of their depression. Psychosurgery- (Prefrontal lobotomy)- the surgical destruction of certain areas of a patient’s frontal lobes to improve the control of emotionality.

Community psychology- involves developing community-based centers to prevent or give early attention to emotional, social and behavioral problems. One program in this effort is the shelter for battered and abused women where women can receive guidance and a safe haven in their own community. The programs can help women protect themselves from suffering further abuse, and develop productive, independent lives of their own.

Therapy can be very useful for treating many psychological disorders, but everyone will not be helped by therapy. The factors that determine therapy effectiveness are characteristics of the client, characteristics of the therapist, the nature of the problem, and the type of therapy. Some therapies are useful for a very specific type of client whereas others have broader application. Consequently, many therapists adopt the eclectic approach which bases the choice of therapy technique on the demands of the individual client.