An Introduction to Abnormal Psychology
Origins and Historical Perspectives of Abnormal Psychology
Over the years, doctors and scientists around the world have developed diagnostic criteria and treatments for psychological disorders. In ancient Greece, for example, the Greek philosopher Hippocrates took the biological approach by concluding that mental illness was due to an imbalance of bodily fluids (Hansell & Damour, 2008). Other ancient scientists and physicians believed that hysteria was responsible for such conditions. Hysteria was described as “the development of various symptoms that are usually caused by neurological (brain) damage or disease" (Hansell & Damour, 2008, p. 29).
For those unfortunate enough to be institutionalized for treatment of psychological disorders around the time of the Renaissance, treatment was less than adequate. In fact, treatment was either non-existent or involved being restrained, abused, and ridiculed, while being forced to live in disgusting, unsanitary conditions. In addition, patients were often publicly humiliated as they were viewed by tourists who possessed a morbid fascination with such institutions. It was not until the 18th and 19th centuries that reformers bravely challenged authorities about the treatment of patients, although efforts to improve conditions for the mentally ill were initially met with resistance.
Defining and Classifying Normal and Abnormal Behavior
Although there is currently no specific definition of abnormal behavior, there are several variables to consider in determining what constitutes abnormal behavior. Looking at cultural significance, some behaviors may be considered normal for an individual according to the culture. However, an individual residing in the country other than his country of origin may consider some behaviors abnormal compared to those derived from his country of birth. Other variables to consider are the context in which the behavior occurs, the age, religious beliefs, or political views of the individual, and the gender of the individual. Similarly, if behavior deviates from social norms, is dangerous, deviant, or causes significant and impairment in functioning, the behavior is considered abnormal.
Abnormal Psychology has Evolved into a Scientific Discipline
It was Freud who initially determined that a link existed between the mind and body. When informed about a client whose symptoms disappeared after a hypnotic session, Freud declared that if memories were brought into awareness from another part of the mind, those thoughts could be analyzed and dealt with by the client, and could lead to a successful recovery. Pioneers in diagnostics, Philippe Pinel, a French psychiatrist, and German physician Emile Kraeplin can be credited with the development of some of the earliest diagnostic systems, and more recently, “the DSM-II (published in 1968) listed 182 disorders, the DSM-III (1980) included 265, and the DSM-IV-TR (2000), the current edition, has almost 300 separate disorders” (Hansell & Damour, 2008, p. 76).
Theoretical Models of Abnormal Psychology
Scientific research involves the study of several theoretical perspectives. The biological theories rely on research into brain structure, the nervous system, the role of genetics, disease, physical injury, and chemical processes within the body which are directly related to behavior. The psychodynamic theories focus on inner conflict, the influence of early life on the adult, and the inner workings of the unconscious mind. Sigmund Freud first proposed the psychodynamic theories, although much of his work has been expanded upon and is still evolving in modern psychology (Hansell & Damour, 2008). During the mid 1900s, the humanist and existential theories became increasingly popular. These perspectives focus on lifestyle, free will, choice and emotional wellbeing. The goal of self-actualization is sought by dealing with emotional turmoil, and fulfilling basic needs such as love, safety, self-esteem, and physiological needs.
Sociocultural perspectives describe the influence of society and lifestyle where behavior is concerned. Incarceration is an example of how cause stress and unusual or stressful living conditions can cause behavioral changes. Similarly, psychosocial theories identify numerous environmental stressors such as the lack of social support, and natural disasters when studying behavior.
Countless variables exist and require consideration when attempting to define abnormal behavior. Over the years, startling progress has been made in the field of psychology, thanks to the various theoretical perspectives, and the advancement of research methods. During the early years of psychology, individuals were mistreated due to a lack of knowledge surrounding psychological illness. However, the development and ever-evolving theoretic perspectives continue to contribute invaluable knowledge to the understanding, diagnosis, and treatment of psychological illness.
What Is The Definition of Normal and Abnormal Behavior?
When trying to define what abnormal behavior is, one must take several determining factors into consideration. For example, “Different also suggests behavior that varies significantly, at least statistically, from the accepted norm, but it does not usually have negative connotations” (Myer, Chapman & Weaver, 2009, p. 2). So, when I see someone whose behavior is a little odd, perhaps in a humorous way, or if they are dressed in weird clothing. It is because I don’t usually encounter people who behave or dress that way, on a regular basis. This type of behavior I would consider eccentric, but not abnormal.
Other terms such as bizarre and deviant suggest some negativity, according to Myers, Chapman & Weaver (2009). However, bizarre might also be a word that I would use to describe eccentricity, depending on the circumstances at a particular moment. Yet another term, disordered, can only mean one thing when considering what is and what is not abnormal behavior, and that is, the person is so disturbed in some way that it causes them significant disruption to the extent that it interferes with day to day living and their sense of safety and wellbeing.
Factors Influencing Definitions of Abnormal Behavior
If I were to observe odd behavior that persisted over time and completely out of context, I think I would be sure the behavior was abnormal. For example, when grieving for a lost loved one, the process is through stages which gradually settle as time passes and the individual comes to terms with his loss. However, when the grief persists for long enough that it disrupts an individual’s capacity to function then I would consider it abnormal and hope the individual seeks help, or someone else makes the suggestion if he believes person A is not capable of recognizing that a problem exists. Some telltale signs would be a lack of care about hygiene, poor attendance, or no attendance at work, and persisting feelings of sadness that are not able to be explained except for the primary cause which was the death of a loved one.
Anxiety, Mood Affective, Dissociative, and Somatoform Disorders
Researchers and clinicians often refer to different theories to help explain the cause of various psychological disorders. The various perspectives such as biological, cognitive, and behavioral all have components which can be applied for treatment of psychological disorders. While some clinicians rely more heavily on one theory, most psychologists and research scientists draw on each of the components for research purposes and for designing effective treatment plans. According to Hansell & Damour (2008), "family studies have found that both the first and second degree relatives of people who are depressed are significantly more likely to suffer from major depressive disorder" (p. 181) .
From a biological standpoint, psychological disorders can be explained by various bodily processes that cause physiological responses to stress. Stress can be detrimental to healthy bodily functioning and when the disruption is caused due to the presence of a psychological disorder, bodily functions fail to work correctly which can cause a perpetual cycle of maladaptive mind – body interactions. Chemical processes in the brain control bodily functions, so the release of, or the lack of necessary chemicals to maintain homeostasis will cause the physical imbalances in addition to impaired mental processing and function. Medications are often prescribed to help maintain the healthy chemical production and balance.
Behavioral theories can also be used to explain possible causes of psychological disorders. Treatment plans such as behavior modification are designed and used in interventions, face-to-face, or as part of group therapy. Helping a patient to become aware of certain unwanted behaviors is vital to the success of therapy. For example, maladaptive thought processes can be disabled when the patient is aware of, and takes a proactive approach to replacing unwanted behaviors with more desirable, positive behaviors. In the case of the traumatic experience which continually causes extreme anxiety, the association between circumstance and an unwanted behavior is more likely to be rectified in the cycle broken the patient is aware of why he behaves poorly in response to certain stressors.
Because of the existence of faulty thought processes known as cognitive distortions which accompany psychological disorders, researchers and clinicians often rely heavily on cognitive theories to explain unwanted behaviors and the onset of a particular disorder. Cognitive distortions cause exaggeration, overly emotional responses to otherwise normal situations. Continual justification and exaggeration lead to prolonged states of hypervigilance which is detrimental to the physical and mental well-being of an individual. An example of cognitive distortion is fortune telling were the patient automatically assumes a worst-case scenario in anticipation of an upcoming event or circumstance.
Clinicians and theorists often draw on research findings relevant to other theories to draw conclusions and understand behaviors associated with various disorders. In circumstances where biological cognitive and behavioral explanations failed to provide clues about the possible underlying cause of the disorder, the psychodynamic perspective may be helpful in providing an explanation. In the case of dissociative disorders, the psychodynamic theory points to avoidant behavior being present for the purpose of keeping emotional turmoil suppressed. Rather than finding a solution to a problem that possibly occurred in childhood, an individual may continue living with underlying disturbances rather than confront them proactively to resolve anxiety.
Referring to several theoretical perspectives when searching for answers about psychological illness has its obvious advantages. Rather than relying on just one theory to understand, diagnose and treat psychological disorders, clinicians are able to gather as much information as possible to help them in their quest. When understood completely the theories seem more complementary than not, and provide researchers and clinicians with the tools necessary for identifying underlying causes, reasons for abnormal behavior, and for the development and application of successful interventions. Thanks to the contributions of researchers, each perspective continues to evolve providing more insight and understanding into the development, management, and possible extinction of countless psychological disorders and their symptoms.
What is Agoraphobia? Do I have it?
Among the numerous phobia, Agoraphobia is relatively common. Agoraphobia can cause significant distress and influence day-to-day functioning in a significant and negative manner. The individual with agoraphobia will harbor a fear of public places, or being in a crowd of people. Ironically, those who suffer with agoraphobia will also be alarmed if they find themselves alone, because they fear they will need help and nobody will be close by to offer assistance. Agoraphobics often feel panicky and fall into a vicious cycle of fearing panic will disable them if they leave the safety of their home, but at the same time, they feel stress because they are unable to do so.
How could a person develop this fear? Could this fear arise in some other way?
Agoraphobia can exist in conjunction with Panic Disorder, among other things. Anyone who has experienced a panic attack will know the feeling of apprehension and sheer terror when they think about having a panic attack in a public place. Because attacks often occur in open or public places, and especially in crowded spaces (while in the supermarket or out driving), an individual will be inclined to stay at home rather than risk a possibly humiliating and debilitating experience in the presence of others. This type of behavior is known as avoidant behavior.
In addition, agoraphobia can also exist with Post Traumatic Stress Disorder (PTSD). When a combination of the three problems exist together, and perhaps with additional disorders present, the daily routine can be severely disrupted leading to a multitude of other life issues. Behavior modification is available, and much research has recently been conducted on this very problem, particularly with an increased incidence of PTSD with returning military personnel.
Can such fears be explained through principles of classic conditioning?
Conditioning can explain how phobias develop, and how the cycles of perpetual fear is fed by fear itself. When an individual is apprehensive about going on an outing in case something dreadful happens to them while they are out of their ‘safe place’, they can experience physiological responses which are unpleasant, and it is these responses they associate with previous incidences where they have become fearful. This cycle gathers its own momentum, and unfortunately it is difficult to break without professional assistance. The anticipation of having an episode is a response bought about through conditioning, just as conditioning describes how the association with a situation or circumstance can also trigger a fear response.
Drug Treatment: Anxiety Disorder and Tourette Syndrome
Like depression, anxiety is common in today’s society, however, when it becomes intolerable and lingers for inexplicable reasons; it is classed as an anxiety disorder. Physiological symptoms of anxiety disorders are rapid heartbeat, high blood pressure and sleeping issues such as insomnia. Coping with symptoms of anxiety disorder can be extremely distressing and exhausting, so a suitable drug treatment in conjunction with psychological therapy is often necessary to maintain some sense of stability.
Different types of anxiety disorders exist; some are generalized, meaning there is no obvious reason for the feelings of anxiousness, and phobic disorder which is a more specified anxiety and produces a fear of certain things or situations. For example, someone which arachnophobia has an extreme fear of spiders, more so than the usual apprehension most people feel.
Panic Disorder is also relatively common, and can occur with either generalized or phobic disorders. Panic attacks cause the overwhelming fear that something drastic may happen, despite no evidence of any threat. Coping mechanisms can be developed to help ease the severity of panic attacks. Episodes often manifest without warning and can have debilitating effects.
People who suffer from panic attacks have been known to leave full grocery carts in the aisle of a supermarket and promptly leave, for fear that something terrible will happen to them and nobody will know how to provide the help they need. Although this is a coping mechanism, it is maladaptive, and has been known to cause the onset of agoraphobia, another anxiety disorder. The agoraphobic sufferer will eventually become housebound for fear of leaving and entering an unsafe environment. Like other disorders, anxiety disorders are also thought to have genetic links. Oftentimes, no genetic predisposition is evident, and panic disorder may seem to be triggered by a traumatic event. It could however, be a combination of both factors.
There are two suitable drug treatments for anxiety disorders; benzodiazepines and serotonin agonists (Pinel, 2007, p.495). Benzodiazepines are effective, although they produce a sedative effect and are not recommended for the long term. Buspirone is a serotonin agonist and does not produce the sedative effect, although it has been known to cause sleeping problems and nausea (Pinel, 2007, p.495). Interestingly, the SSRIs used to treat depression are commonly used for treating anxiety disorders, and are found to be very effective.
Tourette syndrome is said to develop in childhood and is recognizable by the demonstration of repetitious ticks, gestures, or sounds produced by the sufferer. There seems to be no control over these tics, and they can and do occur at inappropriate times. According to the National Institute of Mental Health (NIMH) Tourette is also known to co-exist with other disorders, and can also affect children with ADHD (NIMH, n.d., para 6). The repetitious behavior displayed in Tourette patients is also similar to obsessive compulsive disorder, and is often co-existent.
Tourette syndrome is a brain disorder, and as it develops over time, it usually becomes more pronounced. Even though Tourette resembles other disorders, not much is known about its cause. It is difficult to test a patient via imaging studies because involuntary tics make research problematic (Pinel, 2007, p.499).
Fortunately, some Tourette patients can suppress their tics, but trying to do so for extended periods of time produces anxiety. Like schizophrenia, D2 receptor blockers are also used to alleviate the tics associated with Tourette. According to Pinel (2007), “The current hypothesis is that Tourette syndrome is a neurodevelopmental disorder that results from excessive dopaminergic innervation of the striatum and the associated limbic cortex (p.499).
Although research is extensive, there is still much to be learned about the causes and developmental aspects of many psychological disorders. Animals do not always present with symptoms similar to a disorder, and so testing for treatments can sometimes be impossible. Ironically, some of the causes of disorders, and the drugs used to treat them have been discovered accidentally. Fortunately, when such wonderful accidents occur, links are often discovered which can help in the development and treatment of various other disorders and diseases.
Schizophrenia, Depression and Mania
While scientists scramble to find the specific causes and suitable treatments for psychological disorders, some of the treatments are born by accident while investigating the causes of other diseases. Science has afforded sufferers of many psychological disorders, an effective program of drug therapy, despite the origin and development of the disorder being unclear.
Although schizophrenia has many common symptoms, diagnosis is often difficult because the symptoms can be diverse, suggesting the presence of one or more disorders. Common symptoms of schizophrenia are; delusions, hallucinations and odd behavior (Pinel, 2007, p.482). Odd behaviors are often seen as periods where there an individual does not move, or where they repeat words they have spoken or just heard in a conversation. This repetitious chatter is known as echolalia.
Schizophrenia can be a genetic predisposition, although studies have shown that identical twins do not always have the disorder, and both parents may be healthy and show no signs of the disorder. This finding would show that experiential factors must also contribute to the onset and development, although some may have the predisposition in the first instance, and it is activated at some point in time by an experience.
Drug therapy for schizophrenia has evolved over many years, with one of the first major breakthroughs happening in the 1950s. Chlorpromazine was found to calm agitated schizophrenia, and brighten to outlook of otherwise depressed sufferers. Reserpine was another drug which acted similarly, however it was withdrawn from use after it was found to lower blood pressure to dangerous levels.
In the 1960s, the dopamine theory was developed, suggesting the excessive levels of dopamine cause schizophrenic symptoms. The antischizophrenic drug, chlorpromazine was found to block the activity at the dopamine receptors, thus alleviating the symptoms of schizophrenia. Spiroperidol is another drug which is considered extremely potent, and is also found to bind to the D2 dopamine receptors. Although D2 receptors appear to be a common denominator in schizophrenic episodes, it is now known that it is not the major cause, and underlying factors must also be contributing to the disorder. Some people who have suffered trauma during birth for example, may develop the disorder later in life, regardless of the presence of any condition with the parents.
Depression and Mania
Depression can affect anyone at any time; however, clinical depression is more severe than the usual bout of sadness. Depression is an affective disorder and is found to linger in some people more than others, until it disrupts daily life and becomes overwhelming. Sometimes depression is a reaction to an unpleasant event, however, endogenous depression can be present for no apparent reason. Mania also affects many people, causing polar opposite behavior to an individual who is depressed. Unfortunately, some people experience both extremes, and this disorder is known as bipolar disorder. There is a high suicide rate for sufferers, around 10%, so drug therapy is important in helping to ease the symptoms of the disorder (Pinel, 2007, p.489).
Antidepressants, lithium, and inhibitors are known to help relieve the symptoms of affective disorders; Tricyclic antidepressants block the reuptake of both serotonin and nor epinephrine, thus increasing their levels in the brain (Pinel, 2007, p.490). Prozac is another drug used for depression, it is known as a selective serotonin-reuptake inhibitor (SSRI), meaning that it stops serotonin from being received by receptors, which induces a more pleasant mood for the usually depressed patient. SSRIs are popular because they have few side effects.
The diathesis–stress model is one theory of depression and suggests that, similar to schizophrenia, some people are genetically predisposed to depression, although there is another contributing factor that triggers its onset.
What is Obsessive Compulsive Disorder (OCD)?
Obsessive-Compulsive Disorder (OCD) is an anxiety disorder which causes considerable distress and impairment in functioning. Those who suffer with the distress of OCD engage in ritualistic behaviors believed to reduce anxiety caused by obsessive thoughts. The obsessive thoughts can range from disturbing images that enter the mind, or the fear something terrible will happen to oneself or a loved one if the rituals are not performed. OCD usually develops during the teen years, or before the age of 30. Children can develop OCD, however, and males will generally develop OCD at a younger age than females (4th ed., DSM-IV-TR; American Psychiatric Association, 2000).
A little known fact about some of the typical behaviors associated with these types of disorders, is that another similar disorder classified as a personality disorder, also exists. Obsessive Compulsive Personality Disorder is often confused with OCD. There are some distinct differences. OCD is an anxiety disorder, whereas Obsessive Compulsive Personality Disorder, as the name suggests, is classified as a personality disorder. In recent times, some of the stigma associated with these disorders in particular, have been alleviated due to celebrity disclosure. One celebrity who openly speaks of his OCD is comedian and game show host, Howie Mandell. The behaviors of those with OCD are varied, although one of the most common problems is an irrational fear of contamination. OCD sufferers with this specific fear will calm anxiety by performing ritualistic behaviors such as excessive cleaning, sterilizing, disinfecting, and/or constant hand-washing or showering (this type commonly referred to as germophobe)
Those with Obsessive Compulsive Personality Disorder are often overly concerned with organization. These individuals will be perfectionists at home and at work, and can be difficult to live with, or to associate with as a co-worker or boss. In general, the person with this disorder will insist on doing everything personally, just to make sure a task is done correctly. Correctly, in this case, refers to the manner in which the symptoms will be alleviated, so watching another individual complete a task is not likely to be any help. Individuals with this type of personality disorder are also known to be morally and ethically above board in every situation, and will have zero tolerance for anyone who is not the same way.
Many of us have some of these tendencies, although unless they become disruptive to the normal daily routine, they are not usually problematic and would not qualify for a diagnosis. Unfortunately, it is often the case that these problems are not seen as problems by the sufferer for such a long period that help is usually refused, initially, or behavior modification is difficult to implement. With that said, help is available and is known to be very effective in the long-term.
How can OCD be managed?
OCD can be managed by purposely avoiding performing the ritualistic behaviors thought to be the only way to reduce the anxiety. Professional help is necessary for successful treatment. Medication such as antidepressants can be helpful, although like most treatments, it is more successful if taken in conjunction with regular cognitive behavioral therapy where progress can be monitored, and side possible side negative side-effects of medication can be addressed.
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders , Fourth Edition. Washington, DC, American Psychiatric Association, 1994.
Hansell, J., & Damour, L. (2008). Abnormal psychology (2nd ed.). Hoboken, NJ: Wiley.
Meyer, R., Chapman, L. K., & Weaver, C. M. (2009). Case studies in abnormal behavior. (8th ed.). Boston: Pearson/Allyn & Bacon.
National Institute of Mental Health. (n.d.). What conditions can coexist with ADHD? Retrieved April 2009, from National Institute of Mental Health (NIMH): http://www.nimh.nih.gov/health/publications/attention-deficit-hyperactivity-disorder/what-conditions-can-coexist-with-adhd.shtml
Pinel, J. P. J. (2007). Basics of biopsychology. Boston, MA: Allyn and Bacon.