Psychopathology: concepts and clinical applications

Abnormal Psychology

Psychopathology

Discuss the criteria for abnormality and the meanings of psychological disorders, psychological dysfunction and "culturally expected" behaviors.

Abnormal psychology is the area devoted to the study of causes of mental dysfunction such as mental illness, psychopathology, maladjustment, emotional disturbance. Abnormal behavior brought about because of psychological dysfunction can have features of deviance depending on the culture, distress, and possible injury to self or others (Abnormal Psychology, 2010). The criterion that often defines abnormality includes: unusual behavior, socially unacceptable behavior, faulty perception of reality, significant personal distress, and behavior is maladaptive or self-defeating and behavior is dangerous to self or others (Criteria for Abnormality, n.d.)

A psychological disorder, which is also known as a mental disorder, is a pattern of behavioral or psychological symptoms that impact multiple life areas and/or create distress for the person who is experiencing these symptoms. Psychological disorders generate a maladaptive pattern of thoughts, feelings, and behaviors that lead to detriments in relationships and other life areas (Cherry, 2010). A person who has a psychological disorder often exhibits one or more of the criterion that defines abnormality.

Culturally expected behaviors are the behaviors or ways in which people are expected to act by the generally public. These are the behaviors that are generally accepted as normal behavior throughout society. If a person deviates from these normal behaviors then they are said to have a psychological dysfunction. It is the deviation from the normal standards that society has set down that result in a person being known as having an abnormality or psychological dysfunction. It is then this psychological dysfunction that leads to a person being diagnosed with a psychological disorder. These people exhibit symptoms that are not accepted by society and that is the reason they are considered abnormal and labeled as having a physiological disorder.

2. The DSM-IV is based on a multiaxial system. Explain the content of each axis and its contribution to understanding the patient.

Mental disorders are identified according to a manual published by the American Psychiatric Association called the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). A DSM-IV diagnosis has five parts. Each part, called an axis, which gives a different type of information about the diagnosis.

Axis I contains information about clinical disorders. Any mental health conditions besides personality disorders or mental retardation would be included here.

Axis II presents information about personality disorders and mental retardation.

Axis III provides information about medical conditions that are present.

Axis IV is used to explain psychosocial and environmental factors affecting the person.

Axis V is a ranking scale called the Global Assessment of Functioning. The GAF goes from 0 to 100 and provides a way to sum up in a single number just how well the person is functioning overall (Schimelpfening, 2010).

The DSM -- IV is used by professionals to diagnose psychiatric illnesses. The DSM-IV TR is put out by the American Psychiatric Association and includes all categories of mental health disorders for both adults and children. The manual is non-theoretical and focuses mostly on describing symptoms as well as statistics that concern which gender is most affected by the illness, the typical age of onset, the effects of treatment, and common treatment approaches. This multiaxial approach helps clinicians and psychiatrists to make a more comprehensive evaluation of a client's level of functioning, because mental illnesses often impact many different areas of life. The DSM-IV was first published in 1994 and listed more than 250 mental disorders. An updated version, called the DSM-IV TR, was in print in 2000 and contains minor text revision in the descriptions of each disorder (Cherry, 2010).

3. Describe the major objectives and typical activities and the intended outcomes of the process.

A mental health diagnosis consists of many steps that begin with an evaluation by a doctor to see if symptoms of mental illness are present. The assessment will begin with the doctor asking questions about your symptoms, medical history, and performing a physical exam. Even though there are no laboratory tests to specifically diagnose mental illness, the doctor may use various tests to make sure something else isn't causing the symptoms. If no other illness is present, then a person may be referred to a psychiatrist or psychologist, mental health professionals who are specially trained to diagnose and treat mental illnesses (Diagnosing Mental Illness, 2010).

Psychiatrists and psychologists use particularly designed interview and assessment tools to evaluate a person for a mental illness. The doctor bases their diagnosis on the person's report of symptoms including any social or functional problems caused by the symptoms and his or her observation of the person's attitudes and behavior. The doctor then decides if the person's symptoms and degree of disability point to a diagnosis of a specific disorder. The standard tool that is used by experts for the diagnosis of recognized mental illness is the Diagnostic and Statistical Manual of Mental Disorder (DSM), which is assembled by the American Psychiatric Association (Diagnosing Mental Illness, 2010).

The outcome of this process is for the psychiatrist or psychologist to be able to determine the best diagnosis for the patient. This will allow the patient to be treated with the best possible tools in order to work towards recovery. The overall point is to treat the patient so that they can once again become a functioning and productive member of society.

4. Describe each of the four components of informed consent for research participants. Explain why it may be difficult to satisfy informed consent when the research participants are mentally retarded adults.

An informed consent is a self-directed authorization by an individual regarding a medical intervention or involvement in research. A person must do more than articulate agreement or comply with a proposal for this to be considered informed consent. Informed consent is a process between physician or researcher and patient that must contain an information component and a consent component. The information element refers to the disclosure of information and comprehension of what is disclosed. The consent component refers to a voluntary choice and agreement to undergo a recommended procedure. Legal, regulatory, philosophical, medical, and psychological literature tends to favor the following elements as the necessary components of informed consent: (1) competence, (2) disclosure, (3) understanding, (4) voluntariness and (5) consent (Informed Consent, 2010).

If a person is competent to act, receives thorough disclosure, has an understanding, and is voluntary in their consent, then informed consent has occurred. This is where a problem comes in to play when the research participants are mentally retarded adults. Many people argue that mentally retarded adults are not capable of understanding and may lack competence and thus would not be able to give viable consent. They would more than likely not able to understand both the informed consent process as well as the research process so could not be expected to consent voluntarily.

Because of this there are several issues that arise when research containing mentally retarded adults is trying to be preformed. Using this people as subjects can lead to great advances within the field but obtaining voluntary informed consent if often very hard to do. This makes this area of research a very sensitive one as well as often very hard to do at all.

5. Name the important neurotransmitters and describe what impact each one is thought to have on human experience.

Electrical signals that occur within neurons are converted at synapses into chemical signals which then extract electrical signals on the other side of the synapse. These chemical signals are called neurotransmitters. There are two chief kinds of molecules that serve the function of neurotransmitters: small molecules, some quite well-known, with names such as dopamine, serotonin, or norepinephrine, and larger molecules, which are essentially protein chains, called peptides. These consist of the endogenous opiates, Substance P, and corticotropin releasing factor (CRF), among others. Altogether there appear to be more than 100 different neurotransmitters in the brain (Diagnosis and Treatment of Mental Disorders, n.d.).

A neurotransmitter can bring out a biological effect in the postsynaptic neuron by binding to a protein called a neurotransmitter receptor. Its function is to pass the information contained in the neurotransmitter message from the synapse to the inside of the receiving cell. It is thought that almost every known neurotransmitter has more than one different kind of receptor that can confer rather different signals on the receiving neuron (Diagnosis and Treatment of Mental Disorders, n.d.).

If neurotransmitters of either type are in small supply, or if they are blocked from reaching their proper receptors cell function tends to be abnormal. The lack of neurotransmitter function often results in maladaptive behavior. The human brain is very able of automatically manufacturing the quantity of chemicals it needs if it is given the raw materials such as nutrients from foods to do so. but, a person's normal diet does not supply enough of the raw materials the brain needs to manufacture the needed level of neurotransmitters. In addition, stress, worry, chemical use, poor nutrition, pollution and other factors of modern life are known to deplete neurotransmitter levels (What Are Neurotransmitters, 2010).

6. Describe some of research findings that demonstrate the importance of relationships to our psychological well-being.

A group of researchers from the University of Georgia and the University of Kansas have found that attractive people do tend to have more social relationships and therefore an increased sense of psychological well-being. The significance of attractiveness in everyday life is not fixed, or simply a matter of human nature. The force of our attractiveness on our social lives depends on the social environment where we live. Attractiveness does mean something in more socially mobile, urban areas and from a woman's point-of-view actually indicates psychological well-being, but it is far less important in rural areas. In urban areas people experience a high level of social choice, and associating with attractive people is one of those choices. In other words, in urban areas there is a free market of relationships which makes attractiveness more important for securing social connections and consequently for feeling good. In rural areas, relationships are not as much about choice and more about who is already living in the community. Consequently, attractiveness is less likely to be associated with making friends and feeling good (Research says importance of attractiveness varies with socio-cultural environments, 2009).

Recent research has discovered that the effects of sport on well-being are mediated by psychological characteristics such as physical self-concept, instrumentality and positive body images. In addition, sports were found to be greatly related to these psychological benefits for high school girls. Nevertheless, physical self-concept played a central role by mediating the sport -body image and sport instrumentality relationships. Positive body image is thought to be great predictor of psychological well-being among athletes (Psychological benefits of sport participation and physical activity for adolescent females, 2010).

7. Describe the diathesis-stress model. Use the model to explain how one identical twin suffers from clinical depression while other does not.

The diathesis-stress model discusses the relationship between potential causes of depression, and the degree to which a person may be vulnerable to react to those sources. The diathesis-stress model suggests that people have, to varying degrees, vulnerabilities or predispositions for developing depression. These vulnerabilities are referred to as diatheses. Diatheses include both biological and psychological factors. Some people often have more of these diatheses for developing depression than other people. This model proposes that having a propensity towards developing depression alone is not enough to trigger the illness. A person's individual diathesis must interact with stressful life events which are social, psychological or biological in nature in order to prompt the onset of the illness (Nemade, Staats Reiss and Dombeck, 2007).

The force of particular stressors varies across different people. Death or other losses such as job layoffs, relationship difficulties like divorce, normal milestones such as puberty, marriage, or retirement, alcoholism or drug abuse, neurochemical and hormonal imbalances and infections can all be powerful enough to cause depressive symptoms in someone with a diathesis for an illness. Each of these events will impact individuals in a distinctive manner. A significant loss may be enough to generate depression in one person, while a very similar loss experienced by another person might not faze them all that much (Nemade, Staats Reiss and Dombeck, 2007).

This is the factor that explains how one identical twin can suffer from clinical depression while the other does not. Even though they are identical twins and may be pre-disposed to depression it is how each of them deals with the stressors in life that determines the outcome. It has been shown that each person deals with stressors differently, so if one twin deals with stressors well and the others does not then this explains the difference.

8. Describe the symptoms, causes and treatment of panic disorder and the three categories of panic attack.

A panic attack is a sudden event of intense fear that develops for no apparent reason and that triggers severe physical reactions. Panic attacks can be very terrifying. When panic attacks occur, one might think they are losing control, having a heart attack or even dying. A person may only have one or two panic attacks in their lifetime, but they may have many more. If a person has panic attacks frequently, it could mean that they have panic disorder, a type of chronic anxiety disorder. Panic attacks were once thought to be nerves or stress, but they're now recognized as a real medical condition. Although panic attacks can considerably affect your quality of life, treatment including medications, psychotherapy and relaxation techniques to help prevent or control panic attacks is very effective (Panic attacks and panic disorder, 2008).