Abnormal psychology

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Abnormal psychology is the field devoted to the study of causes of mental dysfunction (mental illness, psychopathology, maladjustment, emotional disturbance). Abnormal behavior expressing the psychological dysfunction can have features of deviance (depending on the culture), distress, and possible injury to self or others. The primary source of research has been done with Western perspective and research methods. The field is beginning to expand to a worldwide level, broadening the scope of interpretation of causes of mental disorders to embrace Eastern perspectives as well.

Introduction

Abnormal psychology is the scientific study of abnormal behavior in order to describe, predict, explain, and change abnormal patterns of functioning. Abnormal psychology in clinical psychology studies the nature of psychopathology, its causes, and its treatments. Of course, the definition of what constitutes 'abnormal' has varied across time and across cultures. Individuals also vary in what they regard as normal or abnormal behavior. In general, abnormal psychology can be described as an area of psychology that studies people who are consistently unable to adapt and function effectively in a variety of conditions. The four main contributing factors to how well an individual is able to adapt include their genetic makeup, physical condition, learning and reasoning, and socialization.

Psychopathology is a term which refers to either the study of mental illness or mental distress, or the manifestation of behaviors and experiences which may be indicative of mental illness or psychological impairment. This kind of illness can happen to anyone though, in some cases, genetics or early childhood exposures can be an indicator of some disorders. Alzheimer's Disease occurs in populations of people who are aging. It can strike anyone. Ronald Reagan, president of the United States in the 1980s was diagnosed with Alzheimer's Disease at the end of his presidency. He died almost twenty years later.

History

Archaeological discoveries have helped historians recreate some aspects of the culture and beliefs of ancient societies. Most historians surmise that abnormal behavior was considered to be the work of evil spirits on the victim’s mind. Skulls have been found from the Stone Age (half-million years ago) with areas removed by s method of surgery. The procedure involved making holes in the skulls with stone tools called trephine. The purpose for this surgery was to release evil spirits from the mind. Exorcism by priests and shamans was also used to drive out the invading spirits.

During the Greek and Roman period, 500 B.C.E. to 500 C.E., some symptoms of mental disorders were classified into terms such as melancholia, dementia, hysteria, and hallucinations. Hippocrates (460 – 377 B.C.E.), considered to be the father of medicine, referred to brain pathologies as humors caused by yellow bile, black bile, blood, or phlegm. Plato (427 -347 B.C.E.) and Aristotle (384 – 322 B.C.E.) also believed that mental disturbances were generated from within the individual not from the influence of outside forces.

In the Middle Ages in Europe, 500 – 1350 C.E., the presence of Christian priests expanded across Europe. Deviant behavior or psychological dysfunction was viewed as created by the conflict between good and evil, God or Satan. Cruel methods of ridding the afflicted person of the devil’s influence were varied and often resulted in death or permanent disabilities. Hospitals to care for the mentally ill began to emerge at the end of the period.

The Renaissance period was a time when science flourished. The German physician, Johann Weyer (1515 – 1588 C.E.), was the first doctor to specialize in mental illness and is consider to be the founder of modern psychopathology. Some progress was made in England and Belgium to care for the sick but this deteriorated by the mid-sixteenth century when asylums began to replace hospitals. The first asylum was founded in Muslim Spain. In 1547, Henry VIII opened Betheleham Hospital (pronounced Bedlam by the locals.

Philosophy has played a large role in defining the science of psychology and should be mentioned in regard to abnormal psychology as well. Just as Plato and Aristotle influenced Greek philosophy other philosophers, like Descartes and Kant, expressed similar observations and concerns to their contemporaries. Both men had a belief in a higher being and were concerned with the way that good and evil effected human thoughts and actions. Following from Plato and religious tradition, the Western view has been one of mind and body dualism.

File:Descartes3.jpg

René Descartes at work.

At the time of the French Revolution, Philippe Pinet (1745 - 1826), became the chief physician at La Bicetre asylum in Paris. He believed the patients were sick people in need of kindness and care. The English Quaker, William Tuke (1773 – 1813), started similar reforms in the United States. Dorothea Dix (1802 – 1887) further championed the cause of human public care and took it to the level of political reform. She personally helped to establish 32 state hospitals.

Every time a wave of treatment improved it was followed by a period of decline usually due to over capacity and lack of funding. “By the early years of the twentieth century, the moral treatment movement had ground to a halt in the United States and Europe.” In the early twentieth century, two opposing perspectives emerged: somatogenic and psychogenic. The former held that abnormal behavior had physical origins and the latter held that the causes of such were psychological. Biological science found causes for illness such as syphilis. The study of hypnotism launched the psychological origin (psychogenic) perspective Friederich Mesmer (1734 – 1815) introduced the treatment of hysteria with hypnotherapy but it was not well regarded by doctors of his day. It was not seriously studied until the late 1800s in Vienna. This attracted Sigmund Freud (1856 – 1939) who later founded psychoanalysis.

Psychopathology as the study of mental illness

Many different professions may be involved in studying mental illness or distress. Most notably, psychiatrists and clinical psychologists are particularly interested in this area and may either be involved in clinical treatment of mental illness, or research into the origin, development and manifestations of such states, or often, both. More widely, many different specialties may be involved in the study of psychopathology. For example, a neuroscientist may focus on brain changes related to mental illness. Therefore, someone who is referred to as a psychopathologist, may be one of any number of professions who have specialized in studying this area.

Psychiatrists in particular are interested in descriptive psychopathology, which has the aim of describing the symptoms and syndromes of mental illness. This is both for the diagnosis of individual patients (to see whether the patient's experience fits any pre-existing classification), or for the creation of diagnostic systems (such as the Diagnostic and Statistical Manual of Mental Disorders) which define exactly which signs and symptoms should make up a diagnosis, and how experiences and behaviours should be grouped in particular diagnoses (e.g. clinical depression, schizophrenia).

Psychopathology should not be confused with psychopathy, which is a type of personality disorder.

Psychopathology as a descriptive term

The term psychopathology may also be used to denote behaviours or experiences which are indicative of mental illness, even if they do not constitute a formal diagnosis. For example, the presence of an hallucination may be considered as a psychopathological sign, even if there are not enough symptoms present to fulfill the criteria for one of the disorders listed in the DSM.

In a more general sense, any behaviour or experience which causes impairment, distress or disability, particularly if it is thought to arise from a functional breakdown in either the cognitive and neurocognitive systems in the brain, may be classified as psychopathology.

The academic journal Psychopathology

Originally founded in 1897 and named Psychiatria Clinica, the journal changed its name to Psychopathology in 1984. It bills itself as the 'International journal of experimental psychopathology, phenomenology and psychiatric diagnosis' and aims to 'elucidate the complex interrelationships of biology, subjective experience, behavior and therapies'.

Models of Abnormality

The Biological Model

This perspective is adopted from a medical approach and typically regards a malfunctioning brain as the cause of abnormal behavior. Many factors are considered to be potential causes to biological dysfunction from head injury to poor nutrition. Genetics, evolution, and viral infection are areas that have received a great deal of attention. Treatments by biological practitioners utilize psychotropic medications, electroconvulsive therapy (ECT), and neurosurgery.

The Psychodynamic Model

Sigmund Freud

This theory regards human behavior to be determined by underlying psychological influences that usually are unconscious. These influences (also called forces) are dynamic in that the relationship between them gives rise to behavior. Abnormal symptoms are created when conflicts arise in this relationship. This theory postulates that all behavior is determined by childhood events and past experience. Sigmund Freud (1856 – 1939) and Josef Brener (1842 – 1925) conducted experiments with hypnosis which put Freud on the path of formulating this theory. He contended that a person could become fixated or stuck at a stage where trauma occurred (usually childhood).

The Behavioral Model

This model originated in laboratories experimenting with learning. From this, the understanding of conditioning arose. In operant conditioning, for example, humans and animals learn to behave a certain way based on the rewards that they received for certain responses. Another example is classical conditioning which found that events occurring closely together whether positive or negative will be generalized and create the same response for either event at a later time. If one event produced happiness, the other event (even if it was negative) can be remembered as positive. [[Ivan Pavlov](1849 – 1946), a Russian physiologist, found classical conditioning while experimenting with dogs.

The Cognitive Model

File:Albert Ellis 2003 seated.jpg

Albert Ellis

Albert Ellis (1962) and Aaron Beck (1967) developed the cognitive model in the early 1960s. They proposed that cognitive processes are at the center of behavior, thought, and emotions. To understand abnormal behavior required the clinician to ask their client questions about their attitudes and assumptions.

Abnormal functioning according to cognitive theorists is explained by realizing that everyone creates their view of the world and comprises their reality. If the view created by an individual is flawed then unhealthy thoughts create dysfunctional behavior.

Some of the poorly adapted personal world views are the result of assumptions that are inaccurate. This leads to attitudes that are negative. Illogical thinking processes also are a source of destructive thinking patterns. One of these manifests as overgeneralization which draws a broad negative conclusion following a minor event.

The Humanistic – Existential Model

Humanists and existential theorists ate grouped together in this model because of their focus on the broader dimensions of human existence. There are also differences between them. Humanists maintain that human beings are naturally born with positive tendencies such as cooperation. The goal of people is to fulfill their potential for goodness and growth called self-actualization. Existentialists believe that from birth, each person has total freedom to face existence and find meaning or avoid taking responsibility.

Carl Rogers (1902 – 1987) is often considered the pioneer of the humanistic framework. He developed a warm approach to his work called client-centered therapy. The existential view derived from nineteenth-century European existential philosophers.

The Sociocultural Model

This model holds that abnormal behavior is caused by the role that society and culture play in an individual’s life. It considers societal norms, rolls in the social environment, cultural background, family structure, and views of others. Sociocultural theorists focus on societal labels and rules, social networks, family structure, and communication, cultural influences, and religious beliefs.

The Biopsychosocial Model

As understanding of how the genetic, chemical, electrical and molecular dimensions in bran function, many practitioners have taken on a more eclectic approach to treating their clients. In this approach abnormal behavior is studied form the viewpoint of the psychology, biological, and societal influences on behavior.

Allce Miller - Pioneer in Childhood Traumatic Disorders

Alice Miller (born January 12, 1923) is a psychologist noted for her work on child abuse and its effects upon society as well as the lives of individuals. She was born in Poland and in 1946 migrated to Switzerland. She gained her doctorate in philosophy, psychology and sociology in 1953 in Basel. In 1986, Alice Miller was awarded the Janusz Korczak Literary Award by the Anti-Defamation League. She has two adult children.

Miller became strongly disenchanted with her chosen field of psychoanalysis after many years spent in practice. Her first three books originated from research she took upon herself as a response to what she felt were major blind spots in her field. However, by the time her fourth book was published she no longer believed that psychoanalysis was viable at all.

Although Miller mentions child sexual abuse, her approach is more encompassing. Drawing upon the work of psychohistory, Miller has analyzed writers Virginia Woolf, Franz Kafka and others to find links between their childhood traumas and the outcome of their lives. She maintains that all instances of mental illness, crime and falling prey of religious cults are ultimately caused by childhood trauma and inner pain not processed by a helper which she has come to term an "enlightened witness". She extends this trauma model to include all forms of child abuse, including those that are commonly accepted (such as spanking) which she calls poisonous pedagogy (schwarze Pädagogik).

In the 1990s Miller strongly supported a new method from Konrad Stettbacher, who was later charged with incidents of sexual abuse. Since then she has refused to bring forward therapist or method recommendations. In open letters, Miller explained her decision and how she originally became Stettbacher's disciple but in the end distanced herself from him and his regressive therapies.

Miller blames abusive parents for the majority of neuroses and psychoses of mankind, however, while condemning their actions, she avoids any negative judgments of these parents, believing that their abusive behaviors are a result of unconscious forces -a result of abuses they endured at the hand of there own parents- over which they have little control. In our culture "Sparing the parents is our supreme law" wrote Miller. Even psychiatrists, psychoanalysts and clinical psychologists are unconsciously afraid to blame parents for the mental disorders of their clients. According to Miller mental health professionals are also creatures of the poisonous pedagogy internalized in their own childhood. This explains why the command "Honor your parents" has been one of the main targets in Miller's school of psychology.

Miller calls electroconvulsive therapy —a treatment occasionally used for severe cases of depression— "a campaign against the act of remembering". She also criticizes psychotherapists' advice to clients to forgive their abusive parents. For Miller this can only hinder the way to recovery: to remember and feel the pain of our childhood. "The majority of therapists fear this truth. They work under the influence of destructive interpretations culled from both Western and Oriental religions, which preach forgiveness to the once-mistreated child". Forgiveness does not resolve hatred but covers it in a very dangerous way in the outgrown adult: displacement on scapegoats, as she discussed in her psycho-biographies of Adolf Hitler and Jürgen Bartsch, both of whom she describes as having suffered atrocious parental abuse.

A common denominator in Miller's writings is to explain why human beings prefer not to know about their own victimization during childhood: to avoid unbearable pain. However, the unconscious command of the individual, not to be aware how he or she was treated in childhood, leads to displacement: the irresistible drive to repeat traumatogenic modes of parenting in the next generation of children.

The introduction of Miller's first book, The Drama of the Gifted Child, first published in 1979, contains a famous line that summarizes her views:

“

Experience has taught us that we have only one enduring weapon in our struggle against mental illness: the emotional discovery and emotional acceptance of the truth in the individual and unique history of our childhood.

”

Nosology

DSM-IV TR

In North America, the 'bible' of abnormal psychology and psychiatry is the Diagnostic and Statistical Manual of the American Psychiatric Association . The current version of the book is known as DSM IV-TR. It lists a set of disorders and provides detailed descriptions on what constitutes a disorder such as Major Depression or Anxiety Disorder. It also gives general descriptions of how frequent the disorder occurs in the general population, whether it is more common in males or females and other such facts. The diagnostic process uses five dimensions called 'axes' to ascertain symptoms and overall functioning of the individual. These axes are as follows

• Axis I - Particular clinical syndromes
• Axis II - Permanent Problems (Personality Disorders, Mental Retardation)
• Axis III - General medical conditions
• Axis IV - Psychosocial/environmental problems
• Axis V - Global assessment of functioning (often referred to as GAF)

Diagnosis of abnormal behavior generally fall into one or more of the following categories:

• Anxiety Disorders (Phobias, Panic Disorder, Obsessive-Cumpulive Disorder)
• Stress Disorders (Post-Traumatic Stress Disorder, Psychophysiological Disorders)
• Somatoform and Dissociatve Disorders (
• Mood Disorders (Unipolar Depression, Bipolar Disorders)
• Suicide
• Eating Disorders (Bulimia Nervosa)
• Substance-Related Disorders (Depressants, Stimulants, Hallucinogens)
• Sexual Disorders and Gender Identity Disorders (Sexual Dysfunction, Paraphilias)
• Schizophrenia
• Personality Disorders (Paranoid, Schizoid, Antisocial, Borderline, Some Anxiety Disorders)
• Disorders of Childhood and Adolescence (Oppositional Defiant Disorder, Attention-Deficit/Hyperactivity Disorder)
• Disorders of Aging and Cognition (Depression, Substance Abuse, Alzheimer's Disease)

ICD-10

The major international nosologic system for the classification of mental disorders can be found in the most recent version of the International Classification of Diseases, 10th revision (ICD-10). The ICD-10 has been used by (WHO) Member States since 1994. Chapter five covers some 300 "Mental and behavioural disorders." The ICD-10's chapter five has been influenced by APA's DSM-IV and there is a great deal of concordance between the two. WHO maintains free access to the Below are the main categories of disorders:

• F00-F09 Organic, including symptomatic, mental disorders
• F10-F19 Mental and behavioural disorders due to psychoactive substance use
• F20-F29 Schizophrenia, schizotypal and delusional disorders
• F30-F39 Mood [affective] disorders
• F40-F48 Neurotic, stress-related and somatoform disorders
• F50-F59 Behavioural syndromes associated with physiological disturbances and physical factors
• F60-F69 Disorders of adult personality and behaviour
• F70-F79 Mental retardation
• F80-F89 Disorders of psychological development
• F90-F98 Behavioural and emotional disorders with onset usually occurring in childhood and adolescence
• F99 Unspecified mental disorder

References

ISBN links support NWE through referral fees

• American Psychiatric Assocation. (1994). Diagnostic and Statistical Manual of Mental Disorders DSM -IV (4th ed.) Washington, DC: Author. ISBN 0890420610.
• Capps, D. (1995). The Child's Song: the religous abuse of children. Louiseville:Westminster Knox Press. ISBN 10-066425554x.
• Comer, R, (2006). Abnormal Psychology (6th ed.) Worth Publishers, NY. ISBN 0716769069
• Miller, A. (1991). Breaking Down the Walls of Silence. NY:Dutton/Penguin Books. ISBN 10-1860493475.
• Miller, A. 1990). For Your Own Good. Farrar, Straus,Giroux. ISBN 10-037452693.
• Miller, A. (1986). Though Shalt Not Be Aware. NY:New American Library. ASIN BOOOOIWAMGW.
• Sims, A. (2002) Symptoms in the Mind: An Introduction to Descriptive Psychopathology (3rd ed). Elsevier. ISBN 0-7020-2627-1

External links

• Psychopathology journal by Karger Publishers Retrieved on October 13, 2007.
• Psychopathology Research Master at the University of Maastricht Retrieved on October 13, 2007.

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