Define Psychopathology.
-What are the criteria that separate disorders from normal behavior?
- Statistical deviance
- Maladaptiveness
- Personal Distress
Statistical Deviance as a criterion to separate disorders from normal behavior.
One way of defining psychopathology is to use statistical norms of behavior and experience to determine what is supposedly normal.
-What might be considered normal may not always be considered healthy or appropriate behavior (hearing
voices or nudity)
-Abnormality and statistical deviance cannot always be equated, and the context in which the individual lives
needs consideration
- A more accurate way of understanding deviance is the extent to which cultural norms or ideological perspectives are breached
- However, even within a particular cultural context, equating deviance with an abnormality is problematic because such a criterion fails to distinguish between positive and negative behaviors (e.g. eccentricity, genius, or some form of outstanding achievement)
The Bell curve.
The bell curve is the most common type of distribution for a variable, and due to this fact, it is known as a normal distribution. The term “bell curve” comes from the fact that the graph used to depict a normal distribution consists of a bell-shaped line.
The highest point on the curve, or the
top of the bell represents the most probable event in a series of data, while all other possible occurrences are equally distributed around the most probable event, creating a downward-sloping line on each side of the peak.
Maladaptiveness as a criterion to separate disorders from normal behavior.
The extent to which certain behaviors or experiences are maladaptive to the self or others is also used as a means of defining psychopathology.
- Common signs of psychopathology such as suicide, depression, and fatigue would fit this criterion because they stand in the way of an individual’s personal growth and actualization.
- Maladaptiveness is also relative to the particular cultural perspective.
- The practices of some cultures are viewed as adaptive and are practiced for the purpose of instilling cultural beliefs.
Personal distress as a criterion to separate disorders from normal behavior.
- Suffering often accompanies psychological disorders
- In cases where anxiety and depression are the prominent symptoms, people often struggle with unbearable negative thoughts about themselves and their world.
- Personal distress is associated with what constitutes a mental disorder
- Individuals who suffer from an antisocial personality disorder (APD) often do not feel appropriate forms of distress
- Individuals with APD are likely to find pleasure in inflicting pain on others and they are often violent and abusive in
their relationships with others
Context-dependent
- As has been shown in using criteria of
Statistical deviance, Maladaptiveness and
Personal distress, there is no clear-cut answer to the problem of what is normal and what is not - Homosexuality, for instance, used to be a diagnosable mental disorder in many parts of the world; but since 1973, homosexuality has no longer been regarded as a mental disorder because there are no clear links to be found between mental disorders, abnormality, and homosexuality.
A brief history of mental illness
The Ancient Era The Early Era The Renaissance The Asylum The ScientificEra
The Early era
- Problems with madness and insanity have always been a part of the human condition (Porter, 2002)
- The dominant understanding of mental illness from 5000 BC was informed by a belief that individuals who became psychologically disturbed were possessed by evil, supernatural forces.
The Ancient Era
The first evidence of a shift to a naturalistic view of mental illness
can be found in the work of a Greek physician named Hippocrates (460 – 377 BC)
- He believed that psychological disorders were the result of imbalances in four essential fluids or humors in the body: blood, phlegm, yellow bile and black bile
- Mental illness was seen as a punishment for sins committed, or as a form of demonic possession
- The church became the main vehicle through which such so-called possessions could be exorcised
- Formal segregation of mentally disturbed individuals began in the
late Middle Ages when the Church, supposedly out of charity, began locking up the so-called insane. - The best-known institution for the insane was established in the religious house of St Mary of Bethlehem (often called Bedlam)
The Renaissance Era
1400-1600
- Patients were treated more humanely.
- Ideas related to witchcraft were openly challenged.
- Physicians argued that so-called demonic possessions were medical illnesses and people could not be held responsible for their actions.
The Asylum Era
- Although the scientific understanding of mental illness began to increase, the institutionalization of the mentally ill also increased
- Common treatments included restraining patients for long periods of time, placing them in dark cells, and subjecting them to torture-like treatments
- Inmates were often subjected to electric shocks, bleeding in order to rid the body of supposedly dangerous fluids, powerful drugs, and starvation.
- In France, Philippe Pinel (1745 – 1826) put forward the idea that mental patients needed to be treated with kindness and consideration if they were to recover.
- In England, William and Henry Tuke established a country retreat where
patients could rest peacefully and work in a caring and supportive atmosphere - Despite these developments, mental patients in some places around the
world are still subjected to extreme forms of restraint such as being chained.
The Scientific Era
- Towards the end of the 19th century, scientific discoveries related to mental disturbance began to increase
- In 1883, Emil Kraepelin observed that certain symptoms occurred with specific types of mental disease
- From this, he developed a classification system for a number of disorders, most notable dementia praecox (known today as schizophrenia)
- Sigmund Freud devised a means of treating patients who suffered from hysterical and neurotic conditions
- His treatment, known as psychoanalysis, was based on his theory that psychopathology is largely caused
by the repression of forbidden wishes or instinctual drives.
Treatments for psychopathology
emerging in the scientific era.
Many forms of psychological treatments have emerged in the past 50 years, all claiming to have a better understanding of the human condition and abnormal behavior.
- Existential psychotherapy, primal therapy, cognitive-behavior therapy, gestalt psychotherapy, logo-therapy and
neurolinguistics programming are but a few of the treatments developed during this era.
Modern conceptualization and Medications
The introduction of psychotropic (mood influencing) drugs in the 1950s has also been seen as an important landmark in the history of mental illness
- Drugs such as lithium, chloropromazine, and imipramine were hailed as miracle drugs because, for the first time, symptoms associated with mania,
psychosis and depression could be controlled through the use of medication - Currently, the status of applied psychology appears to be shifting away from adopting a single theoretical or disciplinary approach for understanding, managing, and treating psychological problems
- There is a growing awareness that our understanding of psychopathology is always context-dependent.
Alternative understandings of psychopathology
- There are other views of psychopathology, and other histories of psychopathology that differ from
the dominant Western approach - In southern Africa, alongside the biomedical or Western view of psychopathology there are other
important traditions - Indigenous theories of illness, including theories of psychopathology, will commonly locate the cause of personal problems in difficulties in social relationships
Classification of mental illness
The most widely used classification system is the Diagnostic and Statistical
Manual of Mental Disorders (DSM)
- The DSM system has been under development since 1952 (DSM-I) and has undergone a number of changes since its inception (Austin, 2014)
- As for the DSM-III, the DSM-5 is derived from the biomedical model, where signs and symptoms are grouped together to identify an underlying pathological cause or syndrome.
A selection of some of the disorders found in DSM-5:
- Intellectual disability
- Autistics spectrum disorder
- Pica
- Neurocognitive disorder
- Substance use disorders
- Bipolar I disorder
- Panic disorder
- Obsessive-compulsive disorder
4 Current perspectives on
psychopathology
Biomedical
Psychodynamic
Cognitive Behavioural
Community
Current perspectives on
psychopathology - Biomedical perspective
The biomedical model claims that all mental illnesses have a biological cause
- Biological abnormalities are understood to occur mainly in three different areas: genetic predisposition, abnormal functioning of neurotransmitters, and structural abnormalities in the brain
Current perspectives on psychopathology- Psychodynamic perspective
- Contemporary psychodynamic perspectives are derived from Freud’s development of psychoanalysis.
- This perspective believes that the way we relate to others and ourselves is largely influenced by internal forces that exist outside of our consciousness.
Current perspectives on
psychopathology- Cognitive-Behavior perspective
Central to the cognitive-behavior perspective is the idea that cognition, or learned ways of thinking, directly impact the individual’s emotions and behaviors
- Cognitive therapists believe that irrational beliefs and automatic thoughts are principally responsible for the
development of psychopathology (Beck, 1972; Ellis, 1995; Glasser, 1984).
Current perspectives on
psychopathology- Community psychology perspective
- Community psychology is most interested in understanding
psychopathology from within the context of the community. - The emphasis here lies on the importance of the social, political, and cultural contexts in understanding, identifying, and treating the psychological problem.
Integrated approaches to psychopathology
- The above perspectives are often used in an integrated way to gain a fuller understanding of psychopathology and its precipitating causes
-Two approaches are particularly
useful in this regard:
1. The diathesis-stress model: first introduced by Meehl (1962) who suggested that some people inherit or develop predispositions (diathesis) to psychopathology
- The biopsychosocial approach: attempts to integrate biological, psychological, and social factors to gain a better understanding of why mental disorders occur
Common disorders in SA.
- Post-traumatic stress disorder
2. Schizophrenia
