2. Defined: The scientific study of abnormal behavior in order to describe, predict, explain, and change abnormal patterns of functioning Abnormal = uncommon, deviating behavior

3. Therapy – Topics of Interest Do clients sometimes think that therapists can see right into them, or read their minds? Might a client worry that the therapist might treat lightly or carelessly something personal that the client reveals? What if the therapist told someone else about the client's disclosures (this raises the practical and ethical issues about confidentiality)? What if the therapist forgot something important the client told him/her, or confused that information with another client?

4. Mental Disorders “A clinically significant behavioral 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."— Diagnostic & Statistical Manual of Mental Disorders 4th Ed.

5. National Institute of Mental Health Statistics An estimated 26.2 percent of Americans ages 18 and older — about one in four adults — suffer from a diagnosable mental disorder in a given year. (57.7 million people) About 3-6 percent, or 1 in 18 —suffer from a serious mental illness. (13 million) In addition, mental disorders are the leading cause of disability in the U.S. and Canada for ages 15-44. Nearly half (45 percent) of those with any mental disorder meet criteria for 2 or more disorders, with severity strongly related to comorbidity. Most common disorders were anxiety, phobias, and mood disorders

8. Within this group, 4.6 million children received mental health services totaling $8.9 billion. The average expenditure per child was higher than that for the average American at $1,931.”

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12. What makes a Behavior a Psychological Disorder? Many definitions have been proposed, yet none are universally accepted ¨ Most definitions, however, share some common features… “The Four Ds” Deviance – Different, extreme, unusual Distress – Unpleasant & upsetting Dysfunction – Causes interference with life Danger – Poses risk of harm

13. Understanding Psychological Disorders Ancient Treatments of psychological disorders include trephination, exorcism, being caged like animals, being beaten, burned, castrated, mutilated, or transfused with animal’s blood.trephination Trephination (boring holes in the skull to remove evil forces)

14. Medical Perspective Philippe Pinel (1745-1826) from France, insisted that madness was not due to demonic possession, but an ailment of the mind. (moral treatment) Dance in the madhouse. (lunatic ball)

17. Models of the Causes of Psychological Disorders Biological model Physiological or biochemical basis Psychoanalytic model Disorders are the result of unconscious conflicts Cognitive-Behavioral model Disorders are the result of learning maladaptive ways of behaving and thinking Diathesis-Stress model Biological predisposition to disorder which is triggered by stress

18. Systems theory: Biopsychosocial Model Assumes that biological, socio-cultural, and psychological factors combine and interact to produce psychological disorders.

19. Medical Approach When physicians discovered that syphilis led to mental disorders, they started using medical models to review the physical causes of these disorders. 1913 – Hideyo Noguchi 1.Etiology: Cause and development of the disorder. 2.Diagnosis: Identifying (symptoms) and distinguishing one disease from another. 3.Treatment: Treating a disorder in a psychiatric hospital. 4.Prognosis: Forecast about the disorder.

20. Classifying Psychological Disorders The American Psychiatric Association rendered a Diagnostic and Statistical Manual of Mental Disorders (DSM) to describe psychological disorders. The most recent edition, DSM-V (Text Revision, 2013), describes est. 350+ psychological disorders compared to 60 in the 1950s. Universal authority in the US for classification Highly contested/criticised

21. The DSM spells out the specific diagnostic criteria An example of this can be seen in the diagnosis of a major depressive episode. A person must exhibit at least five or more of the listed nine characteristics and the symptoms must be evident for at least the last two weeks for that person to be diagnosed with this disorder. When diagnosing a client the American Psychological Association recommends that the clinician use a multiaxial Assessment System.

22. Multiaxial Classification Are Psychosocial or Environmental Problems (school or housing issues) also present? Axis IV What is the Global Assessment of the person’s functioning? (GAF Scale is out of 100 with the lower the school the more limited their functionioning. Axis V Is a General Medical Condition (diabetes, hypertension or arthritis etc) also present? Axis III Is a Personality Disorder or Mental Retardation present? Axis II Is a Clinical Syndrome (cognitive, anxiety, mood disorders [16 syndromes]) present? Axis I

23. Sample Axis I 296.21 Major Depressive Disorder 303.90 Alcohol Dependence Axis II 301.6 Dependent Personality Disorder Axis III None Axis IV Recent Divorce, unemployment Axis V 58

24. Multiaxial Classification Note 16 syndromes in Axis I

25. Multiaxial Classification

26. Goals of DSM 1. Describe (350+) disorders. 2. Determine how prevalent the disorder is. Disorders outlined by DSM-V are reliable. Therefore, diagnoses by different professionals are similar. Others criticize DSM-IV for “putting any kind of behavior within the compass of psychiatry.”

27. Labeling Psychological Disorders 1. Critics of the DSM-V argue that labels may stigmatize individuals. 2. Labels may be helpful for healthcare professionals when communicating with one another and establishing therapy. Asylum baseball team (labeling)

28. Labeling Psychological Disorders 3.“Insanity” labels raise moral and ethical questions about how society should treat people who have disorders and have committed crimes. Theodore Kaczynski (Unabomber)

29. Modern Psychotherapy

31. Psychodynamic Therapies (insight) Psychoanalysis – Developed by Freud to analyze an individuals unconscious. Free Association – Encourage individuals to say aloud whatever content comes to mind (no matter how embarrassing) Interpretation – Therapist role is to interpret the person’s talking for symbols, hidden meanings, and complexes. Resistance – Client’s often show defense mechanisms around sensitive content. Modern versions probe for childhood issues, have less emphasis on sex, and focus on the self in the environment.

33. Humanistic Therapy (insight) Client Centered Therapy – Carl Rogers developed a method where the therapist provides the most supportive atmosphere and places heavy emphasis on self-reflection. Client Centered Therapy Therapist will mimic, or reflect the speech, of the client back to them. “You sound upset” Therapist must act as a person trying to make a connection, not a probe for diagnoses. Must show unconditional positive regard to get to the highest levels of reflection

35. Behavior Therapies Uses reinforcement, conditioning, observational methods to eliminate maladaptive behavior. Treats the symptoms For example, for a depressed person, the treatment will focus on the reduction of sleep changes and feelings of helplessness. Uses tactics like systematic desensitization – stepping a client by developing relaxation techniques in ever increasing stressful situations. Flooding – exposing them in an excessive degree (remember the pickle girl)

37. Cognitive Therapies Stress that thoughts are the main source of problems. Work to cognitively restructure the thoughts, or patterns of thoughts, that persist in disorders. Rational Emotive Therapy (REBT) – Albert Ellis’ method of attacking irrational and self-defeating beliefs through rational examination. Aaron Beck – Extended this idea that establishing the goal of therapy as a method to allow people to recognize self-defeating thoughts.

40. Integration – Family, Group Most modern therapy is Eclectic, meaning it integrates components from the various perspectives. Other Modern Advances Group therapy – Introduces the socialcultural approach to other therapy forms, adapting them to therapy sessions with others involved. Family Therapy – From couples to parents, one of the quickest growing areas of therapy focuses on problematic situations within social relationships.

41. Somatic (biological) Treatments A. Drugs ("psychopharmacology") 1. Antipsychotic drugs (major tranquilizers - e.g., the phenothiazines) 2. Antidepressant drug (e.g., SSRIs) 3. Anti-anxiety drugs (minor tranquilizers: benzodiazipines like valium; barbiturates) 4. Mood swing drugs (e.g., lithium) B. Psychosurgery, e.g., the frontal lobotomy C. Electro-convulsive treatment ("ECT")

42. Drug Remedies for Various Disorders