Abnormal Psychology - Essay Example

?Abnormal Psychology Abnormal psychology is a complex topic. There are different models of abnormality, and different ifications. The models of abnormality are medical, cognitive, behavioural and psychodynamic. The medical model assumes that abnormality may be treated like a physical disease. The cognitive model aims to change one’s thoughts. The behavioural model aims to change one’s behaviours. Moreover, there are classifications of abnormality, which is dictated in Britain by the ICD. These are all explained further in this essay. Also, there are singular ideas put forth by Szasz and Rosenhand regarding abnormalities. Rosenhand believes that mental illness is over diagnosed, and he “proved” this point with his now-famous study. Szasz is a firm believer in autonomy over one’s body, therefore one should not be committed to a mental health facility unless one has openly approved of this. These two theorists will also be briefly analyzed and critiqued. Models of Abnormality There are four basic models of abnormality – biological, which is the medical model; behavioural; cognitive; and psychodynamic. The medical model is what will be discussed first. According to Gross (2000), if a patient has a psychological illness which is associated with a physical illness, then this patient should be treated as any other patient that has a physical illness. The psychological illness might come from infection, pathology of the brain, neurochemical imbalances or genetic issues. Just as one would be treated for a broken arm in a purely physical way, if a patient has a psychological issue that is the result of a medical issue, then the physicality abnormality is what is treated. The way that biological factors are treated as that the doctor may look at family history – what percentage of first-degree relatives have the disorder? Brain-imaging techniques may also be used, such as PET scans, CAT scans, MRIs and MEG techniques. Genetics are also an issue with the medical model – within identical twins, if one twin has an abnormality, then the other twin has a 50% chance of having it as well. Alternatively, there could be a gene mutation that would cause an abnormality. An example of this would be the mutation of the G protein receptor kinase 3, which may cause hypersensitivity to dopamine, which would, in turn, lead to extreme moods that mark bi-polar disorder. As for chemical imbalances in the brain, the brain relies upon different chemicals that must be in balance in order for there to be a normally functioning brain. These chemicals are used to send and receive messages, and, when these chemicals are out of balance, depression, anxiety or OCD may result. Moreover, hormonal levels may also be out of balance, and this, too, can affect a person’s feeling of well-being and mood (Gross, 2000). Infections is another medical risk factor – the patient may be suffering from syphilis, HIV, herpes or Prion diseases, and all of these are medical conditions which might lead to abnormal psychology. There can be other abnormalities in the brain that can lead to atypical psychology. One kind of abnormality may come from brain injury. For instance, as Gross (2000) notes, if the Hippocampus is damaged, there may be behavioural problems that are associated with memory loss. Other times, if the brain is structurally damaged in the areas that control self-awareness, the patient may suffer from what is known as “anosognosia” – this means that the patient does not realize that he or she has an illness. These brain injuries are environmental, in that they do not originate in illness or within the body itself, but, rather, are the result of external trauma. There are other environmental risk factors as well – toxins, such as mercury and lead, may cause irrational behaviour or might slow development (Gross, 2000). The behavioural model is another model of abnormality. According to Gross (2000), the environment is the cause of maladaptive behaviour. The psychiatrists who adhere to the behavioural model, therefore believe that the key to curing the abnormal psychological illness is to change the person’s dysfunctional behaviour. One way of treating abnormal psychology through behavioural means is through aversion therapy – the stimulus that is the cause of the abnormal behaviour is coupled with another stimulus that is negative. Systematic desensitization is also used, which means that the behaviour that is dysfunctional is coupled with a stimulus that produces an even more dysfunctional response – a fear of spiders may mean that that patient is exposed to the spiders, and is then exposed to poisonous snakes. The spiders seem less fearsome than the snakes, so the phobia is extinguished this way (Gross, 2000). The cognitive model is the third model. The patient is not thought to behave differently, but, rather, is taught to think differently (Gross, 2000). The psychiatrist may use a method called the Rational Emotive Therapy (RET), which his designed to activate an emotional event, in the hopes of effecting change in the way that the patient thinks about that event. Aaron Beck also formulated a cognitive model that included the notion of negative schemas – the schemas are a set of rules and ideas that the patient may use to make sense of another person’s behaviour. If the schema is somehow incorrect – say that the schema is built around a prejudice or a bias, then situations may have incorrect interpretations. This is because, since the person has a schema, then they have to interpret behaviour or situations that fit into that schema, as opposed to trying to adapt or change their schema. Such cognitive errors that might result from faulty schema include catastrophizing – feeling that the worst case scenario will become a reality, and that there is nothing to prevent this; all or nothing, in which the patient may think that he or she cannot do a job perfectly, therefore they might as well not even attempt at starting it; and overgeneralization - for instance, one might think that he or she cannot do one thing right, which means that he or she cannot do anything right (Gross, 2000). The psychodynamic model is the last model that will be discussed (Gross, 2000). This model, which was pioneered by Sigmund Freud, states that abnormal psychological processes come from repressed emotions and thoughts. When something is repressed, alternative behaviour forms that takes the place of that which is repressed. The main therapy for this kind of model is free association – the patient tells the psychiatrist freely what is on his or her mind, and the psychiatrist jots down what the patient says, and tries to pinpoint the trouble areas. Three classifications of abnormality According to the International Statistical Classification of Diseases and Related Health Problems (2010), there are three different Axes, which means domains of information. These groups are what help a clinician make an accurate diagnosis and plan treatment, as well as predict outcomes. The first level is group I, which are the clinical disorders. These disorders are the disorders which encompass all disorders and conditions, with the exception of personality disorders and mental retardation. These disorders include delirium, mental disorders due to a general medical condition, substance-related disorders, schizophrenia, mood disorders, anxiety disorders, somatoform disorders, factitious disorders, sexual and gender identity disorders, eating disorders, sleep disorders, impulse-control disorders and adjustment disorders. Group 2 is the next Axis of disorders. The Group 2 disorders are personality disorders and mental retardation. Included in this are paranoid personality disorder; schizoid personality disorder; schizotypal personality disorder; antisocial personality disorder; borderline personality disorder; histrionic personality disorder; narcissistic personality disorder; avoidant personality disorder; dependent personality disorder; obsessive-compulsive personality disorder; and personality disorder not otherwise specified. Mental retardation is also in this group Group 3 and this for the behavioural disorders associated with physiological disturbance factors. This refers to medical conditions, which are conditions that might contribute to how one understands or manages the individual’s particular disorder. These medical conditions are important to diagnosing a psychological disorder, for a variety of reasons (ICD, 2010). For instance, some medical conditions may lead to psychological conditions worsening or developing. As an example of this, hypothyroidism may cause depressive symptoms. As another example, depression may due to be diagnosed with cancer. Examples of medical conditions include infectious diseases; neoplasms; endocrine, nutritional and metabolic diseases; diseases of the blood, nervous system, circulatory system, respiratory system, digestive system, genitourinary system, skin, and musculoskeletal system and connective tissue. Also, complications of pregnancy, childbirth and puerperium are considered Group 3 conditions. An excellent example, then, of behavioural syndrome associated with physiological disturbances and physical factors would be post-partum psychological disorders. The ICD (2010) states that in the case of these particular mood disorders, the symptomology would be the same as if the disorders are non post-partum. For instance, a woman may have delusions that her child is possessed by the devil. Or she might be severely depressed. She might also have panic attacks. She might develop signs of obsessive-compulsive disorder. She might have psychotic features. What is different about the particular disorders that the woman is diagnosed with, compared to women who have not recently given birth, is that the symptoms occur within 4 weeks of postpartum. Group 3 definition of a general medical condition, because her general medical condition of pregnancy is what would help her doctors understand her condition, as well as help her doctors to manage the condition. The Rosenhan Study There is a difficulty in proper diagnosis of mental illness or psychiatric disorders, and D.L Rosenhan (1973) did a study to illustrate these difficulties. He set out to prove that diagnoses of mental disorders are not as substantive as we have always assumed. His hypothesis was that the characteristics of mental disorders may not be in the patients, but, rather, are in the environment and context of the observation. In other words, mental disorders may in the eye of the beholder. To prove this, he hired 8 people to present themselves to various psychiatric institutions with symptoms that would suggest schizophrenia. They would arrive at the hospital and complain of hearing voices. These were the only lies that they told, however, as the personnel in these hospitals asked them other questions about their history, and they answered these questions honestly. When they were admitted into the hospital, all of these pseudopatients stopped have any symptoms. They behaved as they would normally behave, although some of them experienced nervousness because they were afraid of being called a fraud. They would engage in conversation, and would tell the staff that they no longer were hearing voices. Yet, each of these pseudopatients were deemed to be schizophrenic. Rosenhand (1973) believes that there is a bias at work. The bias is that doctors are more likely to call a healthy person sick, then they are to call a sick person healthy. This is because it is better to err in the side of caution – if a doctor calls a sick person healthy, then, according to Rosenhand (1973), there are less consequences than there are for calling a healthy person sick. Rosenhand (1973) then followed up his study with other hospitals. He told each of these hospitals that they could expect that up to three pseudopatients would be sent to them. These hospitals reported that forty-one different patients were the pseudopatients. In actuality, Rosenhand (1973) did not send any pseudopatients to any hospitals during this period of time. He states that the reason for this is because the stakes were high for these hospitals, the stakes being prestige and diagnosis acumen. This relates to classification because, presumably, Rosenhand (1973) states that there would be a number of false positives in diagnosing patients with Group 1 and 2 disorders. In other words, patients may have nothing wrong with them, at all, yet they are affixed with a psychiatric disorder label that they probably would never be able to get rid of. However, in the analysis of this experiment, it seems that the Rosenhand (1973) experiment shows nothing of the kind. The fact is that Rosenhand set up an artificial scenario that would probably never play out in real life. People are just not likely to fake psychiatric disorders in real life. They wouldn’t have the motivation to do so. Rosenhand provided them with artificial motivation, which was that he wanted them to prove his point. In real life, however, a clinician would be remiss if he or she did not take a patient seriously if that patient were hearing voices, because an actual patient is not likely to be lying about this. Also, Rosenhand incorrectly stated that the medical profession has more of a motivation to diagnose a healthy person sick, then a sick person healthy, on the assumption that a doctor would be in more trouble if he misdiagnoses a healthy person with a sickness than a sick person with health. That is not true – if a doctor misses a life-threatening illness, and the person dies from it, than that doctor could be facing a lawsuit. Telling a healthy person that he or she is sick, when that person really isn’t sick, necessitating pointless treatment, would also subject the doctor to a lawsuit. So, it seems that the reality is directly opposite to what Rosenhand proclaims – doctors have more motivation to make sure that they catch illness, than they would to create an illness where there is none. So, the explanation that Rosenhand uses for why a medical establishment would diagnosis sickness where there is none is not sound. Benefits of Labeling Verses Stigma Rosenhand’s study aside, there are clearly benefits to giving a person a proper psychiatric diagnosis. Again, people are not likely to fake psychiatric symptoms in real life, unless they are doing it to get attention. If that is the case, then they still would have a psychiatric illness, although not necessarily the one with the symptoms they are faking – histrionic personality disorder would probably be the diagnosis for somebody who is creating psychiatric symptoms just to get attention, as that disorder is marked by attention-seeking behaviour (ICD, 2010). Therefore, if a person is experiencing dysfunction, and this dysfunction is impairing their life, which are the two major criteria for psychological disorders, than that person would benefit from treatment for his or her disorder. Just like one would never want a chronic illness like diabetes be neglected, and one would want to be treated for this illness, the same holds for mental illnesses. There are medicines that the individual can take, and therapy. While there is no doubt that there are also stigmas that are associated with having a psychological illness, this should never be a reason for declining to diagnosis somebody. And, although Thomas Szasz famously believes that people should be free to accept mental health or not, therefore people should not be held in mental facilities against their will (Szasz, 1960), this is inherently problematic as well. A mentally ill person may not know that he or she needs treatment, because, well, the mentally ill person might be delusional. Therefore, there are clearly instances where people should be treated against their will. One need only look at the mass shootings in America, which were perpetrated by mentally ill people who should have been treated against their will, to see the danger in letting mentally ill people decide for themselves to get treatment. Szasz may mean well, but his theories do not take into account that a person’s mental illness, by its very nature, would prevent the person from ever seeking help, therefore the person continues to suffer, when that person has the chance to actually get better if they are treated against their will. Conclusion Abnormal psychology, or psychological disorders, means that somebody has a dysfunction that impairs his or her life. There are various ways to diagnose somebody, and the Bible for clinicians is the ICD. Moreover, they might have medical problems or social problems that cause these disorders, which would mean that they would have an ICD group 3 diagnosis. There is certainly some controversy, however, in the diagnosing of these illnesses. Rosenhand (1973) would state that people are over-diagnosed, and he sent in healthy people to act sick to prove a point. However, since his study was so clearly artificial, and would not be duplicated in real life, unless the person wants attention (therefore probably has histrionic personality disorder), his study does not really hold up in the light of day. Szasz (1960) has a similar liberal view, only his view is that people should be able to refuse treatment. However, if a person is truly mentally ill, than that person will not seek treatment on his or her own. Therefore, the person remains sick, when he or she has a chance to get well. While there are controversies, it can be said that it is better that a sick person get treatment, and that, really, is the bottom line. Bibliography American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. Washington, DC: American Psychiatric Association. Gross, R. (2000) Psychology – A New Introduction for A Level. International Classification of Diseases (2010) Available at: www.who.int/classificaitons/icd/en Nolen-Hoeksema, S. (1998) Clashing Views on Abnormal Psychology. New York: Dushkin/McGraw-Hill. Rosenhand, D. (1973) On being sane in insane places. In Nolen-Hoeksema, S. (1998) Clashing Views on Abnormal Psychology. New York: Dushkin/McGraw-Hill. Szasz, T. (1960) The Myth of Mental Illness: Foundations of a Theory of Personal Conduct. New York: Harper and Row. Read More