abnormal behavior
-Non-typical or uncommon
�Socially unacceptable
�Behavior that deviates from the norm
�Distressing to the person who exhibits it or to the people around them
�Maladaptive
Maladaptive
Behavior that limits the ability to function or fulfill life responsibilities
Psychological Behavior
�Abnormal behavior that involves disturbance of psychological function or behavior.
�Psychological dysfunction associated with distress or impairment that is not typical or culturally appropriate
Criteria for psychological disorder
�Clinical significance
�Distress
�Behavior cannot be a socially expectable response
�Psychological or biological disturbance
�Behavior cannot be defined in terms of social rebellion or deviance
Factors that create abnormal behavior
-biological
-psychological
-sociocultural
Biological factors
-genetics
-biochemistry
-brain structures
Psychological factors
-Personality traits
-coping ability
-perception
Sociocultural factors
-social policies
-discrimination
-stigma
Biopsychological perspective
Biological, psychological, and sociocultural factors are seen as influencing the development of the individual
Spiritual approach
This approach regarded psychological disorders as the product of possession by evil or demonic spirits
-trephening
-exorcism
-treatments recommended by the church
Humanitarian approach
�developed throughout history, in part as a reaction against the spiritual approach and its associated punishment of people with psychological disorders
�This approach regarded psychological disorders as the result of cruelty, stress, or poor living condi
Hippocrates
- (ca. 460-377 B.C)- Founder of modern medicine.
-Believed that there were four important bodily fluids that influenced physical and mental health, leading to four personality dispositions
Claudius Galen
-(A.D. 130-200)
�Developed a system of medical knowledge based on anatomical studies
Benjamin Rush
-(1745-1813)
- the founder of American psychiatry, rekindled interest in the scientific approach to psychological disorders
�placing patients in their own wards
�giving them occupational therapy
�prohibiting hospital visits from curiosity seekers looking for entertainment
Rush advocated for improvements such as?
Sigmund Freud
- (1856-1939)
-developed psychoanalysis
Ivan Pavlov
(1849-1936)
-discovered classical conditioning, which became the basis for the behaviorist movement
B. F. Skinner
(1904-1990)
-formulated a systematic approach to operant conditioning.
Positive psychology
-emphasizes the potential for growth and change throughout life.
-The movement views psychological disorders as difficulties that inhibit the individual's ability to achieve highly subjective well-being and feelings of fulfillment
�the process of testing ideas about the nature of psychological phenomena without bias before accepting these ideas as adequate explanations.
�The scientific method involves a progression of steps from posing questions of interest to sharing the results w
The essence of the scientific method is objectivity?
Independent variable (IV)
The variable manipulated by the experimenter
Dependent variable (DV)
The variable measured/observed by the experimenter
Quasi-experimental
�Participants receive a treatment similar to the experimental treatment
Randomized control trial
Research in which researchers randomly assign participants to conditions in which they receive different forms of intervention
RCT
�The use of randomization minimizes the chances that bias can enter into the decision of which participants receive which treatment.
�RCT is used as the foundation for evidence-based treatment, in which clients receive interventions based on the findings
Placebo condition
Participants receive a treatment similar to the experimental treatment.
Double-blind method
Neither the person giving the treatment nor the person receiving the treatment knows whether the participant is in the experimental or control group
Correlation design
-Involve tests of relationships between variables that researchers cannot experimentally manipulate
-Statistic (-1 and 1)
Positive correlations
scores move in the same direction between variables
Negative correlations
scores move in opposite directions between variables
Patient
A person who receives treatment
Client
A person seeking psychological services
Psychologist
-(PhD or PsyD)
-Healthcare professional offering psychological services
Clinician
The person providing treatment
Psychiatrists
�People with degrees in medicine (MDs)
�Receive specialized advanced training in diagnosing and treating people with psychological disorders
Clinical psychologist
-(PhD or PsyD)
-A mental health professional with training in the behavioral sciences who provides direct service to clients
�Doctor of philosophy (Ph.D.)
�Doctor of psychology (Psy.D.)
Two types of doctorates in psychology?
�Social workers, master's-level counselors, marriage and family therapists, nurse clinicians, and school psychologists
�Typically referred to as therapist or counselor
Professionals with master's degrees also provide psychological services and include?
Diagnostic and statistical manual of mental disorders (DSM)
�A book published by the American Psychiatric Association that contains standard terms and definitions of psychological disorders.
�First edition published in 1952
�Five axes in DSM-IV-TR changed to two axes in DSM-5
�Clinical Syndromes
�Psychosocial and Environmental Problems
Changes in multiaxial system
DSM-5
�Currently in the 5th edition (DSM-5)
�The DSM-5 is a non-axial diagnostic system that is divided into 22 chapters that include sets of related disorders
�DSM-IV-TR clusters diagnoses on similarity of symptoms
�DSM-5 diagnoses are reorganized to reflect new knowledge of comorbidity and shared etiology
�OCD moved from anxiety cluster to new cluster that also includes hoarding and body dysmorphic disorder
Changes in organization of diagnoses
�Remain Unchanged from DSM-IV
�Proposed revisions included in Section III
�For further study
DSM-5 personality disorder diagnosis
-Disruptive mood dysregulation
-Premenstrual Dysphoric Disorder, etc.
DSM-5 new diagnosis
DSM-5 renaming of diagnoses
�Mental Retardation to Intellectual Disability
�Dysthymia to Persistent Depressive Disorder
DSM-5 combining diagnosis
Substance use disorder replaces substance abuse and substance dependence
The International Classification of diseases
�Mental health professionals outside the U.S. and Canada use the World Health Organization's (WHO) diagnostic system, which is the International Classification of Diseases (ICD).
�The ICD-10 is the current edition
�The advantage of using the ICD is that it provides a common diagnostic system that the 110 member nations of WHO can use for epidemiological purposes.
�This provides increased consistency of diagnostic terminology among various countries.
Advantage of ICD
�Risk factors
�Types of symptoms experienced
�Willingness to seek help
�Availability of treatments
Culture can influence?
�Too many diagnoses
Criticism of DSM?
Comirbitity
Presence of a second diagnosis
Reliability
Consistency of measurement
Inter-rater reliability
Observer agreement
Test-retest reliability
Similarity of scores across repeated test administrations or observations
Alternate forms reliability
Similarity of scores on tests that are similar but not identical
Internal consistency
Extent to which test items are related to one another
Validity
How well does a test measure what it is supposed to measure
Content validity
-Extent to which a measure adequately samples the domain of interest
-e.g., all of the symptoms of a disorder
Criterion validity
Extent to which a measure is associated with another measure (the criterion)
Concurrent
Two measures administered at the same point in time
Predictive
�Ability of the measure to predict another variable measured at some future point in time
Construct validity
�A construct is an abstract concept or inferred attribute
�Method for evaluating diagnostic categories
-Stigma against mental illness.
�Treated differently by others
�Difficulty finding a job
-Categories do not capture the uniqueness of a person.
�The disorder does not define the person.
�She is an individual with schizophrenia, not a "schizophrenic"
-Clas
Criticism of classification
-principal diagnosis
-differential diagnosis
-comorbid
Steps in diagnosis
Principle diagnosis
The disorder that is considered to be the primary reason the individual seeks professional help
Differential Diagnosis
The process of systematically ruling out alternative diagnosis
Comorbid
�The situation that occurs when multiple diagnostic conditions occur simultaneously within the same individual.
�For example, major depression and OCD exist together
case formulation
�A clinician's analysis of the factors that might have influenced the client's current psychological status
Cultural formulation
�Includes the clinician's assessment of the client's degree of identification with the culture of origin
�The culture's beliefs about psychological disorders, the ways in which the culture interprets particular events, and the cultural supports available
Treatment plan
The outline for how therapy should take place
�Immediate goals
�Short-term goals
�Long-term goals
Goals of treatment
�Psychiatric hospitals
�Specialized inpatient treatment centers
�Outpatient treatment
�Halfway houses and day treatment programs
�Other treatment sites
treatment sites?
Modality
Form in which the clinician offers psychotherapy
� Individual psychotherapy
� Family therapy
� Group therapy
� Milieu therapy
Modalities of treatment
Evidence based practice
Clinical decision-making that integrates the best available research evidence and clinical expertise in the context of the cultural background, preferences, and characteristics of clients
The clinician's role in treatment
Quality of the relationship between the client and clinician is a crucial determinant of whether therapy will succeed or not.
The client's role in treatment
Psychotherapy is a joint enterprise in which the client plays an active role
-treatment runs its course
-shows improvement
-maintains this improved level of functioning
The client remains in treatment until?
Remission
�Occurs when the individual's symptoms no longer interfere with his or her behavior and are below those required for a DSM diagnosis
Psychological assessment
�is a procedure in which a clinician provides a formal evaluation of an individual's cognitive, personality, and psychosocial functioning.
�A broad range of measurement techniques, all of which involve having people provide scorable information about thei
-Reliability
-Validity
-Standardization
What Makes a Good Psychological Test?
Standardization
A psychometric criterion that clearly specifies a test's instructions for administration and scoring
-Relying on research findings and scientifically viable theories
-Using psychometrically strong measures
-Empirically evaluating the assessment process
principles of evidence-based assessment?
Unstructured interview
Involves a series of open-ended questions
�Reasons for being in treatment
�Symptoms
�Health status
�Family background
�Life history
Information sought through interviews?
Structured interview
Consists of a standardized series of questions with predetermined wording and order
Mental status examination
A method of objectively assessing a client's behavior and functioning in a number of spheres, with particular attention to the symptoms associated with psychological disturbance
Mini-Mental State Examination (MMSE)
�Structured tool that clinicians use as a brief screening device to assess neurocognitive disorders.
�The clinician administers a set of short memory tasks and compares the client's scores to established norms
�Overall cognitive evaluation
�Diagnosis of learning disabilities
�Determination of giftedness
�Prediction of future academic achievement
�Diagnosis of neurological and psychiatric disorders
�Evaluation of the potential of employees
Uses of intelligence testing?
Stanford-Binet intelligence test (5th ed.)
�Average deviation IQ score is set at 100 with a standard deviation of 15.
�SB5 yields scores on measures of scales labeled fluid reasoning, knowledge, quantitative reasoning, visual-spatial reasoning, and working memory.
Deviation intelligence (IQ)
An index of intelligence derived from comparing the individual's score on an intelligence test with the mean score for that individual's reference group.
Wechsler Adult Intelligence Scale (WAIS-IV)
�The first comprehensive individual test that researchers specifically designed to measure adult intelligence
�The WAIS can produce an overall IQ score based on an age-normed mean of 100 and standard deviation of 15.
�Scores on Verbal Comprehension, Perce
Personality testing
�Clinicians use tests of personality to understand a person's thoughts, behaviors, and emotions
most commonly used Self-report clinical inventory?
Minnesota Multiphasic Personality Inventory (MMPI-2)
Neo Personality Inventory (NEO-PI-R)
big 5 personality traits?
Personality Assessment Inventory (PAI)
-use with clients with lower reading and language skills
�Rorschach Inkblot Test
�Thematic Apperception Test (TAT)
Projective tests
behavioral assessments
�record actions rather than responses to rating scales or questions.
�A form of measurement based on objective recording of the individual's behavior
�Include descriptions of the events that precede or follow the target behavior
Neuropsychological assessment
Gathering information about a client's brain functioning on the basis of performance on psychological tests
Executive functioning
the ability to formulate goals, make plans, carry out those plans, and then complete the plans in an effective way
Adaptive Testing
clients responses to earlier questions determine subsequent questions presented to them
�Trail Making Tests
�Clock Drawing Test
�Wisconsin Card Sorting Test
All assess executive functioning
Types of neuropsychological assessments?
Computerized Axial Tomography (CT or CAT scan)
Reveals structural abnormalities by detecting differences in tissue density
�e.g., enlarged ventricles
Magnetic Resonance Imaging (MRI)
Similar to CT but higher quality
fMRI (functional MRI)
�Images reveal function as well as structure
�Measures blood flow in the brain
�(BOLD=blood oxygenation level dependent)
Positron Emission Tomography (PET scan)
Brain function
Psychophysiology
Study of bodily changes that accompany psychological characteristics or events
Electrocardiogram (EKG)
Heart rate measured by electrodes placed on chest
Electrodermal responding (skin conductance)
Sweat-gland activity measured by electrodes placed on hand
Electroencephalogram (EEG)
Brain's electrical activity measured by electrodes placed on scalp
Paradigm
-Thomas Kuhn
-Perspective or conceptual framework from within which a scientist operates
Biological perspective
Assumed that disturbances in emotions, behavior, and cognitive processes are caused by abnormalities in the functioning of the body
Neurotransmitter
Chemical substance released from a neuron into the synaptic cleft
-Inheritance of particular combinations of genes
-Faulty copying when cells reproduce
-Mutations that a person acquires over the course of life
Genetic abnormalities can come about through?
Genes
-Carriers of genetic information (DNA)
-Impacted by environmental influences
e.g., stress, relationships, culture
Bidirectional
Relationship between genes and environment is?
Endophenotypes
combo of genetic and environmental contributors to complex behaviors
Diathesis-stress model
People are born with predispositions that place them at risk if exposed to certain environmental factors.
Gene expression
Proteins influence whether the action of a specific gene will occur
Polygenic transmission
Multiple gene pairs vs. single gene
Heritability
-Extent to which variability in behavior is due to genetic factors
-Heritability estimate ranges from 0.00 to 1.00
-Group, rather than individual indicator
Behavior Genetics
Study of the degree to which genes and environmental factors influence behavior
Genotype
-Genetic material inherited by an individual
-Unobservable
Phenotype
-Expressed genetic material
-Observable behavior and characteristics
-Depends on interaction of genotype and environment
Gene-environment interaction
One's response to a specific environmental event is influenced by genes
Epigenetics
-Study of how the environment can alter gene expression or function
-Cross-fostering adoptee method
-Family inheritance studies
-Genome-wide linkage studies
-Genome-wide association studies
Genetics Research Methods
Family inheritance studies
Researchers compare the disorder rates across relatives who have varying degrees of genetic relatedness
Genome-wide linkage studies
Genetic method in which researchers study the families of people with specific psychological traits or disorders.
Genome-wide association studies
Researchers scan the entire genome of individuals who are not related to find the associated genetic variations with a particular disease.
Neuroscience
Examines the contribution of brain structure and function to psychopathology
-Neurons and neurotransmitters
-Brain structure and function
-Neuroendocrine system
Three major components of neuroscience?
Serotonin and Dopamine
-depression
-mania
-schizophrenia
Norepinephrine
-anxiety
-other stress-related disorders
Gamma-Aminobutyric Acid (GABA)
-Inhibits nerve impulses
-Implicated in anxiety
Agonist drugs
stimulate neurotransmitter receptor sites
Antagonist drugs
dampen neurotransmitter receptor sites
-Biological treatments
-Psychotherapeutic medications
-Psychosurgery
-Electroconvulsive therapy (ECT)
Treatments?
psychodynamic
gives greatest emphasis to the role of processes beneath the surface of awareness as influences on abnormality.
-Id contains the sexual and aggressive instincts
-Ego is the center of conscious awareness
-Superego is the personality's seat of morality
Freuds three mind structures
Defense mechanisms
Tactics that keep unacceptable thoughts, instincts, and feelings out of conscious awareness and thus protect the ego against anxiety
-Secure
-Anxious
-Avoidant
Infant attachment style(Ainsworth)
Behavioral perspective
A theoretical perspective in which it is assumed that abnormality is caused by faulty learning experiences
-Counterconditioning
-Contingency management
-Participant modeling
Behavioral perspective treatments?
Counterconditioning
-Process of replacing an undesired response to a stimulus with an acceptable response
-Systematic desensitization
Contingency management
-Principle of rewarding a client for desired behaviors and not providing rewards for undesired behaviors.
-Token economy
Humanistic perspective
The humanistic perspective believes that people are motivated to strive for self-fulfillment and meaning in life.
Sociocultural perspective
Emphasizes the ways that individuals are influenced by people, social institutions, social forces
Family perspective
Assumed that abnormality is caused by disturbances in the pattern of interactions and relationships within the family
Neurodevelopmental disorders
Disorders that begin early in life and remain with the individual throughout life
Intellectual disability
-This diagnosis is used to characterize individuals who have intellectual and adaptive deficits that first became evident when they were children.
-Significantly below average intellectual functioning, indicated by an IQ of 70 or below
-Examples include p
-Down syndrome
-Phenylketonuria (PKU)
-Fragile X syndrome
Causes of intellectual developmental disorders?
Down syndrome
-Caused by abnormal chromosomal formation during conception
-Extra copy of chromosome 21
-Have 47 instead of 46 chromosomes
-Trisomy 21
-Flattened nose, small ears, upward slanting eyes
PKU
-Missing an enzyme that breaks down an amino acid found in foods that contain protein
-Placed on a diet low in phenylalanine early in life
-Aviod milk, eggs, aspartame
Fragile X Syndrome
-Most common form of intellectual disability in males
-Caused by a change in the gene FMRI
-When in women causes trouble conceiving, premature menopause
-Teratogens- environmental hazards that affect the developing child
-Rubella (measles)
-Anoxia- oxygen deprivation
-Premature birth, and brain injury during delivery
-Fetal alcohol syndrome
Environmental causes of intellectual developmental disabilities?
Fetal alcohol syndrome (FAS)
A mother who consumes alcohol during pregnancy increases the risk that her child will be born with?
-Mainstreaming- integration into ordinary school, least restrictive environment
-Behavioral interventions involving family
-Friendship training
Treatment of intellectual developmental disorders?
Autism spectrum disorder
A neurodevelopmental disorder involving impairments in the domains of social communication and performance of restricted, repetitive behaviors.
-Autistic disorder
-Asperger's disorder
-Childhood disintegrative disorder
-Pervasive developmental disorder not otherwise specified
Four disorders previously considered to be separate are now a single condition with differing levels of severity?
-Social and communication disturbances. -Restricted range of interests and performance of repetitive behaviors and activities.
Children are evaluated along two domains for autism spectrum disorder?
-Lovaas treatment
-Self-control procedures
-Improve language and communication during the child's early years
-Teaching adaptive skills
-Interaction of peers rather than adults
Treatments for autism spectrum disorder?
Rett syndrome
-Normal development occurs in a child early in life (up to age 4) and then neurological and cognitive impairments develop.
-The syndrome occurs almost exclusively in females and can be used as a specifier for autism spectrum disorder
Dyscalculia
Specific learning disorder with impairment in mathematics?
childhood-onset fluency disorder (stuttering)
Children who are unable to produce fluent speech?
social (pragmatic) communication disorder
have deficits in the social use of verbal and nonverbal communication?
Attention-deficit/hyperactivity disorder
A neurodevelopmental disorder involving a persistent pattern of inattention and/or hyperactivity
developmental coordination disorder
-The primary form of motor disorder
-experience marked impairment in their abilities to coordinate the movements of their hands and feet.
tic
-rapid, recurring involuntary movement or vocalization.
Motor tics
include eye blinking, facial twitches, and shoulder shrugging.
Vocal tics
include coughing, grunting, snorting, coprolalia (the uttering of obscenities), and tongue clicking.
Tourette's disorder
-People with this disorder experience a combination of chronic movement and vocal tics
-Usually a lifelong condition
-Onset usually in childhood or adolescence
stereotypic movement disorder
-Waving, body rocking, head-banging, self-biting, and picking at their bodies.
-engage in repetitive, seemingly driven behaviors.