1. Abnormal PsychAbnormal Psych

2. Defining Abnormal Behavior What comes to mind when you think of abnormal behavior?

3. Abnormal Behavior Consider multiple perspectives A single ‘odd or eccentric’ behavior will not equate to our definition of abnormal behavior Abnormal behavior = clinically significant behavior that impairs an individual’s ability to adequately cope with the demands of his/her environment The behavior is maladaptive and it’s often the person’s ‘best’ attempt to cope with the emotional turmoil being experienced.

4. Let’s name some behaviors that people engage in, in an attempt to cope with their emotional pain:

5. Abnormal Behavior Maladaptive Behavior Measurable (frequency, severity) Observable Behavior is either: Ego syntonic – behaviors, values, feelings that are in harmony with or acceptable to the needs and goals of the ego, or consistent with one’s ideal self-image Ego dystonic – refers to thoughts and behaviors (e.g. dreams, impulses, compulsions, desires, etc) that are in conflict with a person’s ideal self-image

6. Abnormal Behavior Most often the maladaptive behavior impairs other areas (domains) of functioning too: Social-Emotional Academic / Vocational Example : A person abused alcohol in response to feeling depressed; the person stops going to work and loses his/her job; family members begin to distance themselves and the person withdraws from friends & social encounters, etc.

7. Case Conceptualization: 3 Domains of Impairment Must consider how the client is functioning in the 3 domains… Behavioral Academic/ Vocational Social/ Emotional

8. Case Conceptualization Psychologists asked themselves these questions: 1. What are the maladaptive behaviors the client is exhibiting? 2. How do these behaviors impact the individuals ability to adequately function in the other two domains? 3. Is the behavior ego dystonic OR ego syntonic? 4. What is the degree of severity of the impairment caused by the maladaptive behavior Is the client a little upset or so distraught that he/she is suicidal? Does the client like a neat home or do they clean to the point where they don’t want to leave the house or have company over?

9. Case Conceptualization: Symptom Profile Symptom an indication of a disease or disorder A sign or indication of the existence of something undesirable Symptoms can be physiological or psychological Ex: depressed mood, excessive worrying, trouble sleeping, crying, hallucinations, delusions, etc. Symptoms results from the clients inability to effectively cope with the demands of the environments and manifest as maladaptive behaviors which impair functioning

10. The Symptom Profile Maladaptive Behaviors Cognitive Disturbance? Poor Reality Testing? Affective Instability? Mood disturbance? Physiological Disturbance? Social/ Emotional Academic/ Vocational

11. Case Conceptualization Step 1: List client’s symptoms Step 2: List the client’s maladaptive behaviors Domain 1 Step 3: List impairment in functioning in other two domains Social/emotional Academic/vocational

12. Cognitive Symptoms Maladaptive thoughts Excessive worrying Hallucinations Delusions Poor reality testing Memory Loss Racing Thoughts

13. Affective Symptoms Mood disturbance Depression Anxiety Sadness Irritability Mania

14. Physiological Symptoms Excessive sleeping Crying Rapid Heartbeat Sweating Weight Loss Weight Gain Clenched Jaw/Fists

15. Case Conceptualization Treatment Long term goalsShort term goalsStrategies Diagnosis Specific, observable, measurable behavior & Symptoms Five Axis Diagnosis Assessment What are the symptoms? How do symptoms impair functioning?

16. Case Conceptualization Assessment Are there Cognitive Symptoms? Affective Symptoms? Physiological Symptoms? STEP 1 How do the symptoms impair functioning the three domains (behavioral, social/emotional, academic/vocational) STEP 2 Does the impairment in functioning result in clinically significant inability to cope/adapt that warrants a diagnosis STEP 3