Chapter One Questions

Discuss what is meant by the "elusive nature of abnormality."

- Society selects general criteria for defining abnormality and then those particular cases. - Thomas Szaz place such emphasis on society roles that he found the whole concept of mental illness to be invalid, a myth of sorts. Deviations that society calls abnormal are simply "problems in living" not signs of something wrong within the person. - Society may have trouble separating an abnormality that requires interventions from eccentricity. - The power point refers to abnormal as Scientific study of abnormal behavior in an effort to describe, predict, explain, and change abnormal patterns of functioning

Describe moral treatment.

Phillipe Pinel believed patients needed to be treated with sympathy and kindness, rather than "beaten out of them". Patients were allowed to roam around, airy and sunny rooms. The text says: "19th century approach...treating people with mental dysfunction that emphasized moral guidance and humane respectful treatment"

Discuss the development and foci of (a) prevention programs and (b) positive psychology. How are they related to the community mental health approach?

(a) Rather than wait for psychological disorders to occur, many of today's community programs try to correct the social conditions that underlie psychological problems (poverty or violence in the community, for example) and to help individuals who are at risk for developing emotional problems (for example, teenage mothers or the children of people with severe psychological disorders) Thus preventing disorders from ever forming. These programs are not always successful though. (b) Positive psychology is the study and promotion of positive feelings such as optimism and happiness, positive traits like hard work and wisdom, positive abilities, and group-directed virtues, including altruism and tolerance. The purpose of positive psychology is to teach people coping skills that may help protect them from stress and encouraging them to pursue psychological wellness, meaningful activities, and enriching relationships—thus preventing mental disorders. Community prevention programs are not always successful, but they have grown in number, offering great promise as the ultimate form of intervention.

Describe the ways that ancient peoples, Greeks, Romans, and persons in the age of the Renaissance viewed and treated abnormal behavior.

- Ancient societies have concluded that these societies probably regarded abnormal behavior as the work of evil spirits. There is evidence from the stone as of an operation called a trephination, a trephine, was used to cut away a circular section of the skill. - The Egyptian, Chinese and Hebrews = possession of demons, "perform" exorcism, pray, plead with evil spirit. If that didn't work - extreme forms of exorcism, such as whipping or starving the person. - Greeks and Romans, bodily chemicals, Called humors, that influence mental and physical functioning: Yellow bile (caused frenzied activity), black bile (source of unshakable sadness), blood, and phlegm (p.8). Hippocrates believed and taught that illness had natural causes. - During the renaissance - getting rid of demons became less popular and asylums were being built to treat the mentally ill. At first the asylums were there to provide good care to patients, but once they started overflowing with the mentally ill, they became more like prisons (patients lived in filthy conditions and were treated horribly).

Describe the influence of managed care programs on the treatment of psychological abnormality. What is parity?

- Managed care programs: health care coverage in which the insurance company largely controls the nature, scope, and cost of medical or psychological services (the insurance chooses which therapists clients can see, the cost of a session, and the number of sessions the client will be reimbursed). - U.S. Congress passed a federal parity law (2008) that directed insurance companies to provide equal coverage for mental and medical problems, and in 2014 the mental health provisions of the Affordable Care Act (ACA) ("Obamacare"). - Parity is defined as: the state or condition of being equal, especially regarding status or pay.

Define multicultural psychology. How does it enhance the clinical practice?

- Multicultural psychology seeks to understand how culture, race, ethnicity, gender, and similar factor affect behavior and thoughts and how people of different cultures, races and genders may differ psychologically. This has powerful effect on our understanding and treatment of abnormal behavior. - Since society sets what abnormal is we have to understand other's cultures to identify what is true abnormal behavior and cultural behavior.

Describe the somatogenic and psychogenic perspectives of the early 1900s.

- Somatogenic perspectives: The view that abnormal psychological functioning has physical causes. - Two factors responsible for rebirth of somatogenic perspective Researcher Emil Kraepelin argued that physical factors (ex. fatigue) can cause mental dysfunction. - New biological discoveries (p.11). - Psychogenic perspectives: The view that the chief causes of abnormal functioning are psychological. - Hypnotism: Friedrich Mesmer (his hypnosis clinic in Paris for those with hysterical disorders). He took away people's disorders using hypnosis. - Breuer used hypnosis - discovered that patients would sometimes "wake up" free of hysterical symptoms after being under hypnosis and talking about previous upsetting events. - Psychoanalysis: Either the theory or the treatment of abnormal mental functioning that emphasizes unconscious psychological forces as the cause of psychopathology. - Freud developed the technique of psychoanalysis - a form of discussion in which clinicians help troubled people gain insight into their unconscious psychological processes.

Discuss some of the difficulties of defining a person's behavior as abnormal.

- Very hard to define. Judgement of abnormality vary from society to society. - Abnormal behavior is called psychopathology, maladjustment, emotional disturbance or mental illness. - Many definitions have been proposed but none have won total acceptance. - Society values may also change over time, causing its views of what is psychologically abnormal to change as well.

Compare and contrast the professions that study and treat abnormal behavior.

Before the 1950s, psychotherapy was offered only by psychiatrists, physicians who complete three to four additional years of training after medical school (a residency) in the treatment of abnormal mental functioning. After World War II the demand for mental health services expanded so rapidly that other professional groups had to step in to fill the need. Among those other groups are clinical psychologists— professionals who earn a doctorate in clinical psychology by completing four to five years of graduate training in abnormal functioning and its treatment and also complete a one-year internship in a mental health setting. Psychotherapy is also provided by counseling psychologists, educational and school psychologists, psychiatric nurses, marriage therapists, family therapists, and—the largest group—psychiatric social workers (see Table 1-2). Each of these specialties has its own graduate training program. Theoretically, each conducts therapy in a distinctive way, but in reality clinicians from the various specialties often use similar techniques.

Compare and contrast the different clinical research methods used in studying abnormal behavior. What are the advantages and limitations of each method?

Case Study- provides a detailed, interpretative description of a person's life and psychological problems Advantages: source for new ideas, tentative support for a theory, challenge a theory's assumptions, inspire new therapeutic techniques, and offer opportunities to study unusual problems Limitations: may include reports by biased observers, relies on subjective evidence, provides little basis for generalization Correlational - research procedure used to determine the co-relationship between variables Advantages- can be trusted based on statistical analysis of probability, determine co-relationships between variables, measures variables, observes participants, can repeat studies with new samples to check earlier study results and generalize findings Limitations- does not explain the relationship or the cause Experimental- research procedure in which a variable is manipulated and the manipulation's effect on another variable is observed. Independent variable (manipulated variable) and dependent variable (variable being observed). Advantages- Allows researchers to ask questions about causal relationships and then study them out and test them to answer their questions Limitations- Researchers must try to eliminate all confounds which is very difficult, bias, making sure that all parts of the experiment are probable and take every aspect into account

Describe the different ways of defining abnormality from the perspectives of deviance, distress, dysfunction, and danger (the 4 D's).

Deviance - differ from social norms. Society's values change so what is abnormal can change too. Distress - Before they can be labeled abnormal behaviors, ideas, or emotions must cause distress. Dysfunction - Abnormal behavior tends to be so upsetting, distracting, or confusing that people can not care for themselves properly, have social interactions or work productively. Danger - behavior is consistently careless, hostile, or confused may be placed themselves or those around them at risk.

Describe the current treatment of severely disturbed individuals. Contrast this to the current treatment of less severely disturbed individuals.

Outpatient care has now become the primary mode of treatment for people with severe psychological disturbances as well as for those with more moderate problems. When severely disturbed people do need institutionalization these days, they are usually hospitalized for a short period of time. Ideally, they are then provided with outpatient psychotherapy and medication in community programs and residence. The treatment picture for people with moderate psychological disturbances has been more positive than that for people with severe disorders. Before the 1950s, outpatient care exclusively took the form of private psychotherapy, Insurance companies have started to pay for these sessions on a limited basis. Many companies now employ a managed care plan to help deal with mental illness. Outpatient therapy is also offered in a number of less expensive settings, such as community mental health centers, crisis intervention centers, family service centers, and other social service agencies. Surveys suggest that nearly one of every six adults in the United States receives outpatient treatment for psychological disorders in the course of a year

Discuss the positive and negative influences of technology on mental health and its treatment.

POSITIVE: Allows for individuals who are struggling with mental health to be able to receive cybertherapy. This is done with skype, social media, etc... Social networking also has had an impact on psychological dysfunction by being supporters of those who are struggling and helping them. Social media users are likely to have more close relationships, receive social support, are more trusting, and lead more active lives. NEGATIVE: With technology there are many new triggers and vehicles for the expression of abnormal behavior. Violent video games may have a contribution to the development of antisocial behavior and perhaps to the onset of conduct disorder. Constant texting, tweeting, etc. may cause shorter attention spans causing attention problems. Social networking can increase social anxiety and peer pressure.

List the current dominant theories in abnormal psychology.

Psychoanalytic (talk therapy) Biological (also called biomedical, usually involves medication) Behavioral (focuses on changing behavior and environment) Cognitive (focus is on changing thoughts to change behavior) Humanistic-existential (holistic and focus is on self-actualization and authentic life) Sociocultural (focus is on society and culture of individual, also includes family systems model)

8. Discuss the impact of deinstitutionalization on the care and treatment of the severely mentally ill.

There are community programs in place to help the severely mentally ill once they leave the institution, but there are too few to help everyone. hundreds of thousands of persons with severe disturbances fail to make lasting recoveries, and they shuttle back and forth between the mental hospital and the community. After release from the hospital, they at best receive minimal care and often wind up living in decrepit rooming houses or on the streets. At least 100,000 people with such disturbances are homeless on any given day; another 135,000 or more are inmates of jails and prisons