Abnormal Psychology: Understanding and Treating Disorders

Posted on Sep 15, 2024 in Psychology and Sociology

Defining and Explaining Abnormal Behavior

What is Abnormal Behavior?

Abnormal behavior is defined as behavior that is deviant (atypical), maladaptive (dysfunctional), or personally distressful.

Theoretical Perspectives on the Causes of Psychological Disorders

Several theoretical perspectives offer explanations for the causes of psychological disorders:

• Biological approaches: These approaches describe psychological disorders as diseases with origins in structural, biochemical, and genetic factors.
• Psychological approaches: These include the behavioral, social cognitive, and trait perspectives.
• Sociocultural approaches: These approaches emphasize the larger social context in which a person lives, including factors such as marriage, socioeconomic status, ethnicity, gender, and culture.
• Biopsychosocial approaches: These approaches view the interactions among biological, psychological, and social factors as significant forces in producing both normal and abnormal behavior.

Classification of Disorders

The classification of disorders provides a shorthand for communication among professionals, allows clinicians to make predictions about disorders, and helps them to decide on appropriate treatment. The Diagnostic and Statistical Manual of Mental Disorders (DSM) is the classification system clinicians use to diagnose psychological disorders. Some psychologists contend that the DSM-IV perpetuates the medical model of psychological disorders, labels everyday problems as psychological disorders, and fails to address strengths.

Anxiety Disorders

• Generalized Anxiety Disorder: Anxiety that persists for at least six months with no specific reason for the anxiety.
• Panic Disorder: Involves attacks marked by the sudden onset of intense terror. Biological, psychological, and sociocultural factors may contribute to its development.
• Phobic Disorders: Involve an irrational, overwhelming fear of a particular object (e.g., snakes) or situation (e.g., flying).
• Obsessive-Compulsive Disorder (OCD): An anxiety disorder characterized by anxiety-provoking thoughts that will not go away (obsessions) and/or urges to perform repetitive, ritualistic behaviors to prevent or produce some future situation (compulsions).
• Post-Traumatic Stress Disorder (PTSD): An anxiety disorder that develops through exposure to traumatic events, such as sexual abuse and assault, and natural and unnatural disasters. Symptoms include flashbacks, emotional avoidance, emotional numbing, and excessive arousal.

A variety of experiential, psychological, and genetic factors have been shown to relate to these disorders.

Mood Disorders

Two main types of mood disorders are depressive disorders and bipolar disorder.

Depressive Disorders

• Major Depressive Disorder: The individual experiences a serious depressive episode and depressed characteristics such as lethargy and hopelessness.
• Dysthymic Disorder: Generally more chronic and has fewer symptoms than major depressive disorder.

Biological explanations of depressive disorders focus on heredity, neurophysiological abnormalities, and neurotransmitter deregulation. Psychological explanations include behavioral and cognitive perspectives. Sociocultural explanations emphasize socioeconomic and ethnic factors, as well as gender.

Bipolar Disorder

Characterized by extreme mood swings that include one or more episodes of mania (an overexcited, unrealistic, optimistic state). Most individuals with bipolar disorder go through multiple cycles of depression interspersed with mania. Genetic influences are stronger predictors of bipolar disorder than depressive disorder, and biological processes are also a factor.

Suicide

Severe depression and other psychological disorders can cause individuals to want to end their lives. Theorists have proposed biological, psychological, and sociocultural explanations of suicide.

Eating Disorders

Three main eating disorders are anorexia nervosa, bulimia nervosa, and binge eating disorder.

• Anorexia Nervosa: Characterized by extreme underweight and starvation. The disorder is related to perfectionism and obsessive-compulsive tendencies.
• Bulimia Nervosa: Involves a pattern of binge eating followed by purging through self-induced vomiting.
• Binge Eating Disorder: Involves binge eating without purging.

Anorexia nervosa and bulimia nervosa are much more common in women than men, but there is no gender difference in binge eating disorder. Although sociocultural factors were once thought to be primary in explaining eating disorders, more recent evidence points to the role of biological factors.

Dissociative Disorders

• Dissociative Amnesia: Involves memory loss caused by extensive psychological stress.
• Dissociative Fugue: Also involves memory loss, but individuals with this disorder unexpectedly travel away from home or work, sometimes assume a new identity, and do not remember their old one.
• Dissociative Identity Disorder (DID): Formerly called multiple personality disorder, two or more distinct personalities are present in the same individual; this disorder is rare.

Schizophrenia

Schizophrenia is a severe psychological disorder characterized by highly disordered thought processes.

• Positive Symptoms: Behaviors and experiences that are present in individuals with schizophrenia but absent in healthy people; they include hallucinations and delusions.
• Negative Symptoms: Behaviors and experiences that are part of healthy human life that are absent for those with this disorder; they include flat affect and an inability to plan or engage in goal-directed behavior.

Biological factors (heredity, structural brain abnormalities, and problems in neurotransmitter regulation, especially dopamine), psychological factors (diathesis-stress model), and sociocultural factors may be involved in schizophrenia.

Biological Therapies

Biological approaches to therapy include drugs, electroconvulsive therapy (ECT), and psychosurgery.

• Psychotherapeutic Drugs: Treat psychological disorders and fall into three main categories: antianxiety drugs, antidepressant drugs, and antipsychotic drugs. Benzodiazepines are the most commonly used antianxiety drugs. Antidepressant drugs regulate mood; the three main classes are tricyclics, MAO inhibitors, and SSRI drugs. Lithium is used to treat bipolar disorder. Antipsychotic drugs are administered to treat severe psychological disorders, especially schizophrenia.
• Electroconvulsive Therapy (ECT): Used to alleviate severe depression when other interventions have failed.
• Psychosurgery: An irreversible procedure in which brain tissue is destroyed. Though rarely used anymore, psychosurgery is more precise today than in the days of prefrontal lobotomies.

Psychotherapy

Psychotherapy is the process that mental health professionals use to help individuals recognize, define, and overcome their disorders and improve their adjustment.

Psychodynamic Therapies

In Freudian psychoanalysis, psychological disorders stem from unresolved unconscious conflicts, believed to originate in early family experiences. A therapist’s interpretation of free association, dreams, transference, and resistance provides paths for understanding the client’s unconscious conflicts. Although psychodynamic therapy has changed, many contemporary psychodynamic therapists still probe the unconscious mind for early family experiences that might provide clues to clients’ current problems.

Humanistic Therapies

In humanistic therapies, the analyst encourages clients to understand themselves and to grow personally. Client-centered therapy, developed by Rogers, is a type of humanistic therapy that includes active listening, reflective speech, unconditional positive regard, empathy, and genuineness.

Behavior Therapies

Behavior therapies use learning principles to reduce or eliminate maladaptive behavior. They are based on the behavioral and social cognitive theories of personality. Behavior therapies seek to eliminate symptoms or behaviors rather than to help individuals gain insight into their problems. The two main behavior therapy techniques based on classical conditioning are systematic desensitization and aversive conditioning. In systematic desensitization, anxiety is treated by getting the individual to associate deep relaxation with increasingly intense anxiety-producing situations. In aversive conditioning, repeated pairings of the undesirable behavior with aversive stimuli decrease the behavior’s pleasant associations. In operant conditioning approaches to behavior therapy, an analysis of the person’s environment determines which factors need modification. Applied behavior analysis is the application of operant conditioning to change behavior. Its main goal is to replace maladaptive behaviors with adaptive ones.

Cognitive Therapies

Cognitive therapies emphasize that the individual’s cognitions (thoughts) are the root of abnormal behavior. Cognitive therapies attempt to change the person’s feelings and behaviors by changing cognitions. Three main forms of cognitive therapy are Ellis’s rational-emotive behavior therapy (REBT), Beck’s cognitive therapy, and cognitive-behavior therapy. Ellis’s approach is based on the idea that individuals develop psychological disorders because of their beliefs, especially irrational beliefs. In Beck’s cognitive therapy, the therapist assists the client in learning about logical errors in thinking and guides the client in challenging these thinking errors. Cognitive-behavior therapy combines cognitive and behavior therapy techniques and emphasizes self-efficacy and self-instructional methods.

The Effectiveness of Psychotherapy

Meta-analysis has found that psychotherapies are successful in treating psychological disorders. Psychotherapy has been shown to help individuals cope with serious physical diseases as well. Psychotherapy can aid individuals by alleviating physical symptoms directly or by reducing psychological problems that are related to physical illness. Brief psychotherapy may be a cost-effective way to prevent serious disorders before they occur. Psychotherapy can also enhance wellness. Individuals who gain in wellness are less likely to fall prey to recurrent problems. The therapeutic alliance and specific client factors are important variables influencing therapeutic success. The key to successful therapy may lie in the quality of participation of the client. Although an individual may come into the therapeutic situation in distress, it may be that his or her internal resources and strengths are brought forth by therapy, as a result of which the individual can experience positive change.

Sociocultural Approaches and Issues in Treatment

Group Therapies

Group therapies emphasize that relationships can hold the key to successful therapy. Family therapy is group therapy with family members. Four widely used family therapy techniques are validation, reframing, structural change, and detriangulation. Couples therapy is group therapy with married or unmarried couples whose major problem is within their relationship. Self-help support groups are voluntary organizations of individuals who get together on a regular basis to discuss topics of common interest. They are conducted without a professional therapist.

Community Mental Health

The community mental health movement was born out of the belief that the mental healthcare system was not adequately reaching people in poverty and deinstitutionalized individuals. Empowerment is a common goal of community mental health.

Cultural and Gender Considerations in Therapy

Psychotherapies’ traditional focus on the individual may be successful in individualist cultures, but individual-centered psychotherapies may not work as well in collectivist cultures. Therapy is often more effective when there is an ethnic match between the therapist and the client, although culturally sensitive therapy can be provided by a therapist from a different ethnic background. The emphasis on autonomy in psychotherapies may produce a problem for many women, who place a strong emphasis on connectedness in relationships. Some feminist-based therapies have emerged. As many as 50 percent of practicing therapists refer to themselves as “integrative” or “eclectic.” Integrative therapy combines techniques from different therapies based on the therapist’s judgment of which methods will provide the greatest benefit.

Health Psychology and Behavioral Medicine

Health psychology emphasizes biological, psychological, and social factors in human health. Closely aligned with health psychology is behavioral medicine, which combines medical and behavioral knowledge to reduce illness and promote health. These approaches demonstrate the biopsychosocial model by examining the interaction of biological, psychological, and social variables as they relate to health and illness. Stress is an example of a biological, psychological, and social construct. Health psychology and behavioral medicine bring the relationship of the mind and body to the forefront. These approaches examine the reciprocal mind-body relationship: how the body is influenced by psychological states and how mental life is influenced by physical health.

Making Positive Life Changes

Theories of Change

The theory of reasoned action suggests that we can make changes by devising specific intentions for behavioral change. We are more likely to follow through on our intentions if we feel good about the change and if we believe that others around us also support the change. The theory of planned behavior incorporates these factors as well as our perceptions of control over the behavior. The stages of change model posits that personal change occurs in a series of five steps: precontemplation, contemplation, preparation/determination, action/willpower, and maintenance. Each stage has its own challenges. Relapse is a natural part of the journey toward change.

Resources for Effective Life Change

Motivation is an important part of sustaining behavioral change. Change is more effective when the person does it for intrinsic reasons (because he or she wants to) rather than extrinsic reasons (to gain rewards). Implementation intentions are the specific ways individuals plan to institute changes. Social relationships are strongly associated with health and survival. Social support refers to the aid provided by others to a person in need. Support can take the form of tangible assistance, information, or emotional support. Social support is strongly related to functioning and coping with stress. Religious faith is associated with enhanced health. One reason for this connection is that religions often frown on excess and promote healthy behavior. In addition, religious participation allows individuals to benefit from a social group, and religion provides a meaning system on which to rely in times of difficulty. Personality characteristics related to positive health behaviors include conscientiousness, personal control, self-efficacy, and optimism. Conscientious individuals are likely to engage in healthy behaviors and live longer. Personal control is associated with better coping with stress. Self-efficacy is the person’s belief in his or her own ability to master a situation and produce positive outcomes. Optimism refers to a particular explanatory style as well as to the inclination to have positive expectations for the future. Studies have shown that both of these types of optimism relate to positive health outcomes.

Toward a Healthier Mind (and Body): Controlling Stress

Stress is the response of individuals when life circumstances threaten them and tax their ability to cope. Selye characterized the stress response with his concept of a general adaptation syndrome (GAS), which has three stages: alarm, resistance, and exhaustion. Chronic stress takes a toll on the body’s natural disease-fighting abilities. Stress is also related to cardiovascular disease and cancer. To “kick the stress habit” means remembering that stress is a product of how we think about events in our lives. Taking control of our appraisals allows us to see potentially threatening events as challenges. Hardiness is associated with thriving during stressful times. The Type A behavior pattern, particularly the hostility component, is associated with stressing out angrily when things are going poorly. This hostility leads to poor health outcomes. When a person is unable to manage stress alone, stress management programs provide a viable option for help.

Toward a Healthier Body (and Mind): Behaving as if Your Life Depends Upon It

Exercise has many positive psychological and physical benefits. Tips for increasing one’s activity level include starting small by making changes in one’s routine to incorporate physical activity and keeping track of progress. Overweight and obesity pose the greatest health risks to Americans today. They can be largely avoided by eating right, which means selecting nutritious foods and maintaining healthy eating habits for a lifetime, not just while on a diet.

Social Cognition

The face conveys information to social perceivers, including attractiveness. Self-fulfilling prophecy means that our expectations of others can have a powerful impact on their behavior. Attributions are our thoughts about why people behave as they do and about who or what is responsible for the outcome of events. Attribution theory views people as motivated to discover the causes of behavior as part of their effort to make sense of it. The dimensions used to make sense of the causes of human behavior include internal/external, stable/unstable, and controllable/uncontrollable. The fundamental attribution error is observers’ tendency to overestimate traits and to underestimate situations when they explain an actor’s behavior. Self-serving bias means attributing our successes to internal causes and blaming our failures on external causes. Heuristics are used as shortcuts in social information processing. One such heuristic is a stereotype—a generalization about a group’s characteristics that does not consider any variations among individuals in the group. The self is our mental representation of our own characteristics. Self-esteem is important and is related to holding unrealistically positive views of ourselves. Stereotype threat is an individual’s fast-acting, self-fulfilling fear of being judged based on a negative stereotype about his or her group. In order to understand ourselves better, we might engage in social comparison, evaluating ourselves by comparison with others. Attitudes are our feelings—about people, objects, and ideas. We are better able to predict behavior on the basis of attitudes when an individual’s attitudes are strong, when the person is aware of his or her attitudes and expresses them often, and when the attitudes are specifically relevant to the behavior. Sometimes changes in behavior precede changes in attitude. According to cognitive dissonance theory, our strong need for cognitive consistency causes us to change our behavior to fit our attitudes or to change our attitudes to fit our behavior. Self-perception theory stresses the importance of making inferences about attitudes by observing our own behavior, especially when our attitudes are not clear.

Social Behavior

Altruism

Altruism is an unselfish interest in helping someone else. Reciprocity often is involved in altruism. Individuals who are in a good mood are more helpful. Empathy is also linked to helping. The bystander effect means that individuals who observe an emergency help less when someone else is present than when they are alone. Women are more likely to help in situations that are not dangerous and involve caregiving. Men are more likely to help in situations that involve danger or in which they feel competent.

Aggression

One view of the biological basis of aggression is that early in human evolution, the most aggressive individuals were likely to be the survivors. Neurobiological factors involved in aggressive behavior include the neurotransmitter serotonin and the hormone testosterone. Psychological factors in aggression include frustrating and aversive circumstances. Sociocultural factors include cross-cultural variations, the culture of honor, and violence in the media. Males are consistently more physically aggressive than females.

Social Influence

Conformity and Obedience

Conformity involves a change in behavior to coincide with a group standard. Factors that influence conformity include informational social influence (going along to be right) and normative social influence (going along to be liked). Obedience is behavior that complies with the explicit demands of an authority. Milgram’s classic experiment demonstrated the power of obedience.

Group Behavior

People often change their behaviors when they are in a group. Deindividuation refers to the lack of inhibition and diffusion of responsibility that can occur in groups. Social contagion refers to imitative behaviors involving the spread of behavior, emotions, and ideas. Our performance in groups can be improved through social facilitation and lowered because of social loafing. Risky shift refers to the tendency for a group decision to be riskier than the average decision made by the individual group members. The group polarization effect is the solidification and further strengthening of a position as a consequence of group discussion. Groupthink involves impaired decision making and avoidance of realistic appraisal to maintain harmony in the group.

Intergroup Relations

Social Identity

Social identity is our definition of ourselves in terms of our group memberships. Social identity theory states that when individuals are assigned to a group, they invariably think of it as the in-group. Identifying with the group allows the person to have a positive self-image. Ethnocentrism is the tendency to favor one’s own ethnic group over others.

Prejudice and Discrimination

Prejudice is an unjustified negative attitude toward an individual based on membership in a group. The underlying reasons for prejudice include the presence of competition between groups over scarce resources, a person’s motivation to enhance his or her self-esteem, cognitive processes that tend to categorize and stereotype others, and cultural learning. Prejudice is also based on stereotypes. The cognitive process of stereotyping can lead to discrimination, an unjustified negative or harmful action toward a member of a group simply because he or she belongs to that group. Discrimination results when negative emotional reactions combine with prejudicial beliefs and are translated into behavior. An effective strategy for enhancing the effects of intergroup contact is to set up task-oriented cooperation among individuals from different groups.