Introduction to

Abnormal Psychology
Chapter 1

R.Billones
 Objectives:

a.) Identify the term in Abnormal psychology define

in the course
b.) Evaluate the different factors that affects in
Psychological Disorders
c.) Explore the Clinical Diagnosis and Assessment
 Abnormal Psychology

The scientific study of abnormal behaviour, with the

objective to:
-Describe
-Explain
-Predict
-Control
 Abnormal Psychology

How are people with

psychological disorders
portrayed in our culture?
Abnormal Psychology
 Abnormal Psychology

Are all disorders

viewed the same?
 Abnormal Psychology

Are all disorders

viewed the same?
 Kdrama Series
It’s Okay To Not Be Okay (2020) Forest (2020) Her Private Life (2019) Mental Coach Jegal (2022)
Psychiatric Ward PTSD PTSD Depression
 Kdrama Series
My Liberation Notes (2022) Flower of Evil (2020) Extracurricular (2020) Itaewon Class (2020)
Alcoholism Antisocial Personality Psychopathic Tendencies Antisocial Personality
 Kdrama Series
Cheese In The Trap (2016) Hyde, Jekyll, Me (2015) Kill Me, Heal Me (2015) It’s Okay, That’s Love (2014)
Antisocial Personality Dissociative Identity Dissociative Identity Schizophrenia, Phobia
 Who’s Normal?
1. Your neighbor has physical complaints and sees several doctors
weekly.

2. A 22 years old college student smokes 4-5 marijuana joints per day,
has a 3.8 GPA, has a part-time job and a solid long-term relationship.

3. Rachel has been caught several times urinating in the corner.

4. A 35 years old very happily married man enjoys wearing women’s

clothes and underwear on the weekends when he and his wife go out
on the town.
 Abnormal Psychology

Who decides what’s

“NORMAL”?

WE do!
 Myths of Abnormal Behaviour

The following are common myths about those

suffering from mental illness:
Ø Easily recognized as deviant
Ø Disorder due to inheritance
Ø Incurable
Ø Weak willed
Ø Never contribute to society
Ø Always dangerous
 What is Abnormal Behaviour?

Abnormal behaviour characterized:

ü Non-typical
ü Socially unacceptable
ü Distressing to the person who exhibits it
or to the people around them.
 What is Abnormal Behaviour?

Abnormal behaviour departs from some

norm and harms the affected individual or
others
ü Conceptual Definitions
ü Practical Definitions
ü Surgeon General & DSM-V TR.
Definitions
 What is Abnormal Behaviour?

Criteria for abnormal behavior include

statistical infrequency, dysfunction,
personal distress, and violation of norms.
REMEMBER: None of these criteria alone is
adequate for classifying abnormal
behavior.
 DEFINITION OF ABNORMAL
BEHAVIOR

Deviation from Social

Norms
Behavior deviates from
acceptable standards,
norms or values
 DEFINITION OF ABNORMAL
BEHAVIOR

Maladaptive Behavior
Best definition where
behavior interferes with an
individual’s ability to
function in society
Practical Definitions

The 4 ‘D’s
Discomfort
Deviance
Dysfunction
Danger
 CAUSES OF ABNORMAL
BEHAVIOR

1. Biological/Genetic
2. View as mental disorder - similar
to physical disorders
3. Diagnosis and treatment -
Nervous system and the brain
 CAUSES OF ABNORMAL
BEHAVIOR

4. Cognitive –Emotional
Deficits in cognitive processes, thoughts and
beliefs
5. Environmental
-Unconscious conflicts
-Problems during Freudian psychosexual stages
-Childhood
 Surgeon General & DSM-V

“A clinically significant behavioural or

psychological syndrome or pattern that occurs in
an individual and that is associated with present
distress (e.g., a painful symptom) or disability
(i.e., impairment in one or more important areas
of functioning) or with a significantly increased
risk of suffering death, pain, disability, or an
important loss of freedom”
 History of Abnormal Psychology

Ancient Beliefs
Demonology
Exorcism
Trephining >

Naturalistic Explanations
Hippocrates (Four Humors)
Return to the Supernatural
Mass Madness (Tarantism) >
Witchcraft
 Reforms of Abnormal Psychology

Humanism
-People are sick; not possessed
-Need to be treated with dignity
Reform Movements
-Moral Treatment (Shift from prison to hospital)
Biological View
-Organic explanation for abnormal behaviour
-Drug revolution
 Frequency of Mental Disorders
14
12
10
Statistical Frequency
8
% 6
-Occurrence of behavior
4 compared to the behavior of
2
0
the general public
-What is abnormal compared
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 Psychology Students Syndrome

Many psychology students find that the various disorders apply

to them:
Ø Abnormal behaviour is not qualitatively different from
“normal” behaviour
Ø Many of us will exhibit similar symptoms
Ø Behaviours are only problematic when they harm or interfere
with your daily functioning
Ø Diagnosing friends and romantic partners may lead to
conflict
 Mental Health Professions

Who studies abnormal behaviour?

Ø Clinical Psychologist
-Ph.D. and internship
Ø Psychiatrist
-M.D. and internship
Ø School Psychologist
-M.A. or Ph.D.
Ø Social Worker
-M.S.W.
 Mental Health Professions

Psychiatrists
Clinical psychologists
Clinical social workers
Psychiatric nurses
Licensed mental health counselors
Marriage and family therapists
 Why do people go see?
70
60
50
40
% 30
20
10
0

an is
t
an i st er rse her
i r i g k t
sic iat sic lo or N
u O
o
y ch hy h lw
ph y p yc ia
ily Ps er Ps oc
m th S
Fa O
 Diversity and Multiculturalism

1. Social Conditioning
• e.g., gender stereotypes
2. Cultural Values
• Interpret complaints with culture in mind
3. Sociopolitical Influences
• Different experiences affect what is abnormal
4. Bias in diagnosis
 What do we call people
labeled as abnormal?

These word “Labeling”

are used to dismiss
and dehumanize Be CAREFUL!
people who we
consider
(March, 2022)
different.
 Clinical Psychology

Is the field of
psychology concerned
with assessment,
treatment, and
prevention
(March, 2022)
of
maladaptive behavior.
 Clinical Psychology

The American Psychiatric

Association (APA) has devised a
system for diagnosing
maladjusted behavior.

The Diagnostic and Statistical

Manual of Mental Disorders
(DSM)
(March, 2022)
 Diagnosing Abnormal Behavior

The Diagnostic and Statistical Manual of Mental Disorders, Fifth

Edition, Text Revision (DSM-5-TR) features the most current text
updates based on scientific literature with contributions from
more than 200 subject matter experts. The revised version
includes a new diagnosis (prolonged grief disorder), clarifying
modifications to the criteria sets for more than 70 disorders,
addition of International Classification of Diseases, Tenth
Revision, Clinical Modification (ICD-10-CM) symptom codes for
suicidal behavior and nonsuicidal self-injury, and updates to
descriptive text for most disorders based on extensive review of
the literature. In addition, DSM-5-TR includes a comprehensive
review of the impact of racism and discrimination on the
diagnosis and manifestations of mental disorders. The manual
(March, 2022) will help clinicians and researchers define and classify mental
disorders, which can improve diagnoses, treatment, and
research.
 Goals of DSM
• To provide a system for diagnosing
disorders

• To improve the reliability of

diagnoses

• To make diagnoses consistent with

(March, 2022) research evidence and clinical
experiences.
 DSM 4 vs DSM 5

(March, 2022)
 DSM 4 vs DSM 5 36

8 × 250

(March, 2022)
 Interrater Reliability

(March, 2022)
 DSM Classification
System
Elements of a Diagnosis
The DSM 5 states that the following make up the four (4) key
elements of a diagnosis (APA, 2013):
1. Diagnostic Criteria and Descriptors – Diagnostic criteria are the guidelines for
making a diagnosis. When the full criteria are met, mental health professionals can add
severity and course specifiers to indicate the patient’s current presentation. If the full
criteria are not met, designators such as “other specified” or “unspecified” can be
used. If applicable, an indication of severity (mild, moderate, severe, or extreme),
descriptive features, and course (type of remission – partial or full – or recurrent) can
be provided with the
(March, diagnosis. The final diagnosis is based on the clinical interview,
2022)
text descriptions, criteria, and clinical judgment.
 DSM Classification
System
2. Subtypes and Specifiers – Since the same disorder can be manifested in
different ways in different individuals the DSM uses subtypes and specifiers to
better characterize an individual’s disorder. Subtypes denote “mutually exclusive
and jointly exhaustive phenomenological subgroupings within a diagnosis” (APA,
2013). Specifiers are not mutually exclusive or jointly exhaustive and so more than
one specifier can be given. Major depressive disorder has a wide range of
specifiers that can be used to characterize the severity, course, or symptom
clusters. Again the fundamental distinction between subtypes and specifiers is
that there(March,
can be only
2022)one subtype but multiple specifiers.
 DSM Classification
System

3. Principle Diagnosis – A principal diagnosis is used when

more than one diagnosis is given for an individual (when an
individual has comorbid disorders). The principal diagnosis is
the reason for the admission in an inpatient setting or the
reason for a visit resulting in ambulatory care medical
services in outpatient settings. The principal diagnosis is
generally the 2022)
(March, main focus of treatment.
 DSM Classification
System

4. Provisional Diagnosis – If not enough

information is available for a mental health
professional to make a definitive diagnosis, but
there is a strong presumption that the full criteria
will be met with additional information or time,
then the provisional specifier can be used.
(March, 2022)
DSM Classification
System
DSM Classification
System
DSM Classification
System
 The ICD-11
In 1893, the International Statistical Institute adopted the International List of Causes of
Death which was the first edition of the ICD. The World Health Organization was entrusted with the
development of the ICD in 1948 and published the 6th version (ICD-6), which was the first version to
include mental disorders. The ICD-11 was published in June 2018 and adopted by member states of WHO
in June 2019. The WHO states:
ICD is the foundation for the identification of health trends and statistics globally, and the
international standard for reporting diseases and health conditions. It is the diagnostic classification
standard for all clinical and research purposes. ICD defines the universe of diseases, disorders, injuries
and other related health conditions, listed in a comprehensive, hierarchical fashion that allows for:
•easy storage, retrieval and analysis of health information for evidence-based decision-making;
•sharing and comparing health information between hospitals, regions, settings, and countries;
•and data comparisons in the same location across different time periods.
(March, 2022)
Source: http://www.who.int/classifications/icd/en/
 The ICD-11
The ICD lists many types of diseases and disorders and includes Mental and Behavioral
Disorders. The list of mental disorders is broken down as follows:
• Organic, including symptomatic, mental disorders
• Mental and behavioral disorders due to psychoactive substance use
• Schizophrenia, schizotypal and delusional disorders
• Mood (affective) disorders
• Neurotic, stress-related and somatoform disorders
• Behavioral syndromes associated with physiological disturbances and physical
factors
• Disorders of adult personality and behavior
• Mental retardation
• Disorders of psychological development
(March,
• Behavioral 2022)
and emotional disorders with onset usually occurring in childhood and
adolescence
• Unspecified mental disorder
 Harmonization of DSM 5
and ICD 11
According to the DSM-5, there is an effort to
harmonize the two classification systems so that there can
be a more accurate collection of national health statistics
and design of clinical trials, increased ability to replicate
scientific findings across national boundaries and to rectify
the lack of agreement between the DSM- V and ICD-11
diagnoses. (APA, 2013). At time of publication of this text,
however,(March,
this 2022)
had not yet occurred.
 Issues of Classification
Helps Hinders
Ø To making treatment Ø By stigmatizing patients
decisions Ø Because different labels can
Ø To communicate among mean different things to different
clinicians people
Ø Research Ø By biasing how we see the
Ø advancing knowledge of patient
disorders Ø By focusing on one point in the
Ø diagnosis as a first step to patient’s development
(March, 2022)
understanding mechanisms Ø Patient may outgrow the label
and developing treatments
 Assessment
Observation
Self-Report Inventories
Biological Measures
Psychophysiological Measures
Neuroimaging Techniques
Projective Tests
Rorschach
(March, 2022)Ink Blots
Thematic Apperception Test (TAT)
Questions?