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Chapter One Abnormal Behavior SHOOTING STUNS NATION Arizona Republic, January 9, 2011 6 killed at public event, including staffer, federal judge; 13 wounded Shooter: Jerod Loughner Definition Abnormal Psychology is the Scientific study of strange or unusual behavior in order to describe, explain, predict, & control them. Shooter: Jerod Loughner Describe A psychological or psychiatric evaluation determines whether a person has: – Lost contact with reality – Experiences hallucinations or delusions – Is a danger to himself or others *** Shooter: Jerod Loughner Explain A psychological or psychiatric evaluation looks for causes of the behavior: – Drugs/alcohol – Biological problems (brain tumor or chemicals) – Social adjustment (friends, cultural differences) Shooter: Jerod Loughner Prediction A psychological or psychiatric evaluation tries to predict the behavior in the: – Individual, using his background information. – Others, who have similar backgrounds. Shooter: Jerod Loughner Control Psychologists can control abnormal behavior through: –Therapy –Hospitalization Shooter: Jerod Loughner Determining Abnormality • Psychologists use the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) – Most widely used classification system • DSM-IV defines abnormal behavior as: – “clinically significant behavioral or psychological syndrome or pattern that is associated with present distress or disability or with a significantly increased risk of suffering death, pain, disability or loss of freedom” (APA, 2000) Definition simplified: A behavior that departs from some norm and that harms the affected individual or others. Determining Abnormality • Important questions to ask: – Distress? -- affect ability to function? – Deviance? -- rare? Culture? Situation? – Dysfunction? -- sudden? Living up to abilities? – Dangerous? – to herself or others? Contextual and Cultural Limitations • Culture: – Shared learned behavior transmitted from generation to generation – Culture is a powerful determinant of how behavior is defined and treated Debate: • Cultural Universality vs. Cultural Relativism: Origins, processes, and manifestation of disorders are the same across cultures What is universal in human behavior? What is normal/abnormal may vary from culture to culture How do cultural norms, values, & attitudes relate to behavior disorders? Man charged with murder in 'honor killing' The Arizona Republic, Dec. 22, 2009 An Iraqi immigrant accused of slaying his daughter in an "honor killing" has been charged with first-degree murder and could face the death penalty, Maricopa County Attorney Andrew Thomas said Monday. Faleh Hassan Almaleki, 48, of Glendale, is accused of using his Jeep Cherokee to run over his daughter, 20year-old Noor Almaleki, and another woman in a Peoria parking lot on Oct. 20. His daughter died of her injuries. Almaleki was reportedly furious with his daughter for becoming "too Westernized," police said. Psychiatric Epidemiology Study of Abnormal Behaviors and factors that contribute to them. …which includes… • Prevalence: – Percentage of people in a population with a disorder at a given time -- statistics • Lifetime Prevalence: – Total proportion of people in a population who have ever had a disorder • Incidence: – Onset or occurrence of a disorder over a period of time Mental Disorders in America Establishment of National Institute of Mental Health EXCELLENT resource for “Disorders Workbook” information… Gender Differences in Mental Disorders – Major depression is twice as common in – women. – Lifetime prevalence of alcohol dependence : twice as high in… – men – Antisocial personality dis: 3 times as high in – men. – Gender differences in schizophrenia and bipolar disorder – none. Burden of Mental Disorders • Cost and burden to society is great: – At least 30% of adult Americans and 20% of American children suffer from diagnosable disorder. – By 2020, neuropsychiatric disorders in children will increase 50% – Mental illness ranks higher than cancer and other malignant diseases in how in affects individual health and productivity. Costs of Mental Illness The direct costs of mental health services in the United States in 1996 totaled $69.0 billion. This figure represents 7.3 percent of total health spending. An additional $17.7 billion was spent on Alzheimer’s disease and $12.6 billion on substance abuse treatment. Direct costs correspond to spending for treatment and rehabilitation nationwide. When economists calculate the costs of an illness, they also strive to identify indirect costs which refer to lost productivity at the workplace, school, and home due to premature death or disability. The indirect costs of mental illness were estimated in 1990 at $78.6 billion (Rice & Miller, 1996). More than 80 percent of these costs stemmed from disability rather than death because mortality from mental disorders is relatively low. Mental Health: A Report of the Surgeon General Stereotypes Common Myths about the mentally ill. They… …are always recognizable by their deviant behavior. …have inherited their disorder. …are incurable. …are weak. …suffer from a deficit. …are unstable and potentially dangerous. Historical Perspectives • Prehistoric and Ancient Beliefs: – Demonology treated by trephining or exorcism Historical Perspectives • Greco-Roman: Naturalistic Explanations – Hippocrates believed deviant behavior caused by brain pathology, the dysfunction of brain Hippocrates first introduced the concept of disturbed physiology (organic processes or functions) as the basis for all illnesses, mental and physical. Historical Perspectives • Middle Ages: – Back to supernatural explanations – Witchcraft: • A group of young girls in Salem Village, Massachusetts began to display unusual behaviors: convulsive seizures, blasphemous screaming, and trance-like states. The physicians could find no physiological cause for the disturbing behaviors so the community reasoned that it must be the work of Satan and the girls must be witches. (Source: Eyewitnesstohistory.com) Salem, Massachusetts Historical Perspectives • The Renaissance: In 1492, St. Mary of Bethlem, aka "Bedlam", opened to receive mental patients in England and was famous for it's inhumane treatment of the mentally ill. "The Rakes Progress", by William Hogarh Historical Perspectives – The rise of humanism • 1793 Philippe Pinel/William Tuke removed the chains from patients to promote more humane treatment of the mentally ill. • 1808 Franz Gall wrote about phrenology (the idea that a person's skull shape and placement of bumps on the head can reveal personality traits. • 1834 Ernst Heinrich Weber published his perception theory of 'Just Noticeable Difference,' now known as Weber's Law (sensory research.) Dorothea Dix • Instrumental in lobbying for and helping establish: • first state mental hospital in Illinois (1847) • First mental institution in Raleigh, NC, (1849). • first public mental hospital in Pennsylvania (1853). • …to name a few… Early Causes/Treatments • Biological Viewpoint (physical basis) – Kraepelin • Symptoms occur in clusters (syndromes) to represent mental disorders, each with a unique cause, course, and outcome. • Classified mental disorders based on organic causes: metabolic disturbance, endocrine difficulty, brain disease, heredity • Evolved into DSM (now Version IV-TR) of the APA Early Causes/Treatments • Psychological: – Mesmerism, Charcot (The Nancy School) , Josef Breuer and Sigmund Freud all used mesmerism/hypnotism for the treatment of hysteria. Freud gave it up quickly. – Josef Breuer and Sigmund Freud: Relief by talking about traumatic experiences • Cathartic method: Therapeutic use of verbal expression to release pent-up emotional conflicts Causes: Early Viewpoints • Behavioral: – Stressed conditions that evoke, reinforce, extinguish directly observable behaviors – Rooted in laboratory science – Remember John Watson? B. F. Skinner? Albert Bandura? Contemporary Trends • The Drug Revolution: – “one of the great medical advances of the 20th century” (Sue, et al.) (Generation Rx) – Started with lithium (1949), then Thorazine. – Reduces symptoms so therapy would work. – Only Psychologists in AZ – NM, LA, OR allow psychologists to prescribe. – Success of psychopharmacology spawned new interest in brain-behavior relationship Implications • The study of abnormal psychology is complex and influenced by historical time • No single explanation fits all situations • Multipath model is necessary in attempting to understand such complex processes • Multipath model consists of following factors: – Biological – Psychological – Psychodynamic, behavioral, cognitive, humanism – Social – families, environment – Sociocultural