Module 1

ABNORMAL PSYCHOLOGY: PAST AND PRESENT

What is Abnormal Psychology?

Abnormal Psychology is concerned with the understanding the nature, causes and treatment
of mental disorders. A branch of Psychology that studies about various psychological
disorders, its etiology (causes) and symptoms. Abnormal psychology is a branch which
studies usual patterns of behaviour, emotions, thoughts which may or may not be
precipitating.

We are familiar with the topics and problems within the field of abnormal psychology in our
daily life surroundings. These issues captures our attention, trigger our concern and compel
us to ask questions which is an important aspect of being a Psychologist.

The concept of normality and abnormality.

Normality refers to behavior that is typical or expected within a given population. It is the
state of being within the range of what is considered usual or standard. Normal behavior is
characterized by being adaptive, functional, and socially acceptable. It is behavior that
allows individuals to function effectively within their environment and to meet the demands
of their everyday life.

• Appropriate perception of reality

• Ability to exercise voluntary control over behaviour

• Self-esteem and acceptance

• Ability to form affectionate relationships

• Productivity

The WHO considers normality to be a state of complete physical, mental and social
well-being.

There is still no agreement regarding what is abnormality or disorder. No one behaviour

makes someone abnormal but still there are some clear indicators of abnormality. But no
single indicator is sufficient enough to define or determine what is abnormality. ANYTHING
THAT DEVIATES FROM THE NORMAL OR DIFFERS FROM THE USUAL OR
TYPICAL IS CALLED ABNORMAL. However, certain unusual behaviours can be
considered normal in certain cultures.

The current diagnostic procedures used in mental health community rely on four important
ways in which abnormality can be defined.
 • DEVIANCE

• DISTRESS

• DYSFUNCTION

• DANGER

4 D’s of Abnormality

Deviance

Substantial deviation from the statiscally calculated average. Those who fall within the
“GOLDEN MEAN”(it refers to the range where most people belong to) or who do what most
other people do- are normal. Those who exhibit behaviours which differ from the majority
are abnormal.(even of it is harmless eccentricity).

This criterion is used in some evaluations of psychological abnormality. For example,

diagnosis of Mental Retardation, it is strictly based on statistical accounting done by
intelligence testing.

Statistical criteria of defining abnormality is a simple task. One has to just measure the
person’s performance against the average performance. If it falls outside the average range, it
is abnormal.

It lacks value, there is no difference between desirable and undesirable behaviour, it

discourages valuable deviation.

It ignores the concept of individual differences.

Distress

Behaviours should be considered abnormal if the individual suffers discomfort as a result of

the behaviours and wish to get rid of them. The experience of distress-emotional and physical
pain is common in life. However here the intensity of pain is so high that it affects the
individuals daily functioning. For example, a victim of an extremely traumatic event may
experience unrelenting pain or emotional turmoil and may not be able to cope in daily life.
Although subjective distress is an element of abnormality is many cases, it is not a sufficient
condition or a necessary condition to consider something as abnormal.

Dysfunction

Dysfunction means cognitive, emotional and behavioral breakdown. It’s an inability to

perform daily functioning or everyday activities. In other words, a behavior is considered
abnormal if it impairs functionality. It is important to determine the presence of a problem
large enough to be considered a diagnosis. This can also be Maladaptive behaviours that
interfere with our well-being and with our ability to enjoy our work and our relationships. For
example, a person with Anorexia restricts food intake to the point where she needs to get
hospitalised, a person with depression may withdraw from friends and family and may be
unable to work for weeks or months.

Danger

In some situations, a persons thoughts and behaviours threaten the physical or psychological
wellbeing of others. When an individuals actions pose threat to one’s own life or to the life of
others, the behaviour is considered to be abnormal. A severely depressed individual is at risk
for committing suicide, a person suffering from schizophrenia is out of touch with reality and
may put oneself or others at risk and is therefore the condition is referred to as abnormal.
Research suggest that in people with mental illness, dangerousness is more exception than the
rule. (Corrigan&Watson,2005).

CURRENT CLASSIFICATION- DSM 5 AND ICD 11

Diagnostic Statistical Manual of Mental Disorders.

The standard for defining various types of mental disorders is American Psychiatric
Association’s DSM. Diagnostic and Statistical Manual of Mental Disorders provides all the
information necessary (descriptions, lists of symptoms) to diagnose mental disorders. It
provides clinicians with specific diagnostic criteria for each disorder. It provides descriptive
information about the type and number of symptoms needed for each diagnosis which
ensures diagnostic accuracy and consistency. DSM does not include information about
treatment but is important for the clinicians to have an accurate diagnosis in order to select
the most appropriate treatment plan for their patients.

DSM has been used by clinicians and researchers from different orientations (biological,
psychodynamic, cognitive, behavioural, interpersonal, family/systems), to communicate the
essential characteristics of mental disorders presented by their patients. The information is of
value to all professionals associated with various aspects of mental health care, including
psychiatrists, other physicians, psychologists, social workers, nurses, counsellors, forensic
and legal specialists, occupational and rehabilitation therapists, and other health
professionals. The criteria facilitate an objective assessment of symptom presentations

in a variety of clinical settings as well in general community epidemiological studies of

mental disorders. DSM-5 is also a tool for collecting and communicating accurate public
health statistics on mental disorder morbidity and mortality rates.

• The Diagnostic and Statistical Manual was first published in 1952. Since then, there
have been several updates issued.

• DSM-I®: 1952. (102 categories of diagnosis)

• DSM-II®: 1968.(182 categories of diagnosis)

 • DSM-III®: 1980. The APA published a revised version, the DSM-III-R®, in 1987.
(265 categories of diagnosis)

• DSM-IV®: 1994. The APA published a text revision version, the DSM-IV-TR®, in
2000. (297 categories of diagnosis)

• DSM-5: 2013. The APA published a text revision version, (541 categories)

• the DSM-5-TR, in 2022.

The DSM-III introduced a multiaxial or multidimensional approach for diagnosing mental

disorders. The multiaxial approach was intended to help clinicians and psychiatrists make
comprehensive evaluations of a client's level of functioning because mental illnesses often
impact many different life areas. It described disorders using five DSM "axes" or dimensions
to ensure that all factors—psychological, biological, and environmental—were considered
when making a mental health diagnosis.

• Axis I – Clinical Syndromes

• Axis II – Personality Disorders and Mental Retardation

• Axis III – General Medical Conditions

• Axis IV – Psychosocial and Environmental Problems

• Axis V – Global Assessment of Functioning

DSM 5

The DSM-5 is the fifth edition of this handbook. DSM-5-TR (text revision) is the latest
version used.

In DSM 5, a Mental Disorder is defined as a syndrome that is present within an individual.

It involves clinically significant disturbance in behaviour, emotion regulation or cognitive
functioning. These disturbances are thought to reflect a dysfunction in biological,
psychological or developmental processes that are necessary for mental functioning. It
recognizes that mental disorders are associated with significant distress or disability in key
areas of functioning such as social, occupational or other activities.

Predictable or culturally approved responses to common stressors or losses (such as death of

loved ones) are excluded. Dysfunctional pattern of behaviour stems from social deviance or
conflicts that the person has with society or has a whole.

A fifth edition of the American Psychiatric Association Diagnostic and Statistical Manual of
Mental Disorders was published in 2013 called DSM-5. It contains the social nomenclature
used by psychiatrists and other mental health professionals in the United States
DSM-5 lists more than 500 mental disorders. Each entry describes the criteria for diagnosing
the disorder and the key clinical features of the disorder. The system also describes features
that are often but not always related to the disorder. The classification system is further

accompanied by background information such as research findings; age, culture, or gender

trends; and each disorder’s prevalence, risk, course, complications, predisposing factors, and
family patterns.

DSM-5 requires clinicians to provide both categorical and dimensional information as part of
a proper diagnosis. Categorical information refers to the name of the distinct category
(disorder) indicated by the client’s symptoms. Dimensional information is a rating of how
severe a client’s symptoms are and how dysfunctional the client is across various dimensions
of personality and behavior.

Major changes from DSM IV TR to DSM 5

● The chapters of the DSM have been reorganized to reflect a consideration of

developmental and lifespan issues. Disorders that are thought to reflect developmental
perturbations or that manifest early in life (e.g., neurodevelopmental disorders and
disorders such as schizophrenia) are listed before disorders that occur later in life.

● The multiaxial system has been abandoned. No distinction is now made between Axis
I and Axis II disorders.

● DSM-5 allows for more gender-related differences to be taken into consideration for
mental health problems.

● DSM-5 contains a structured interview that focuses on the patient’s cultural

background and characteristic approach to problems.

● The term intellectual disability is now used instead of the term mental retardation.

ICD 11

ICD stands for the International Classification of Disease. The ICD provides a method of
classifying diseases, injuries, and causes of death. Chapter 5 of ICD 10 covers various Mental
and Behavioural Disorders. The World Health Organization (WHO) publishes the ICDs to
standardize the methods of recording and tracking instances of diagnosed disease all over the
world, making it possible to conduct research on diseases, their causes, and their treatments.
The first International Classification of Diseases, Adapted for Indexing of Hospital records
and Operation Classification (ICDA) was published in 1962 by the U.S Public Health
Services. The International Classification of Diseases (ICD-11) is the 11th edition of a global
categorization system for physical and mental illnesses published by the World Health
Organization (WHO). The ICD-11 is a revised version of the ICD-10 and the first update to
be developed and published in two decades.
The 11th version of the ICD was released on June 18, 2018, as a preliminary version. It was
officially presented at the World Health Assembly in May 2019 and began to be used as the
official reporting system by member states beginning January 1, 2022. Total 26 chapters, 2
supplementary sections– chapter 6- Mental, Behavioural and Neurodevelopmental disorders.

• Coding structure: A key feature of the revised system is that it provides a simple
coding structure that makes it easier to record various conditions with specificity.

• International Applicability: The ICD-11 offers guidance for its use with different
cultures as well as translations into 43 different languages.

• Digital-Ready and User-Friendly: The new ICD-11 was designed to be electronic

and user-friendly for use by a global audience. It runs on a central platform and can
connect to any software. In addition, it can be a machine-readable format, expanding
its potential uses in the digital age.

• Dimensional Approach: Another enhancement of the ICD-11 is that it's based on a

dimensional approach that makes it better at capturing change over time, is consistent
with research evidence, and will improve recovery from illness.

Fundamental differences among ICD and DSM

ICD

• Produced by global health agency of UN

• Free and open resource for public health benefit

• For countries and frontline service providers

• Global, multidisciplinary, multilingual development

• Approved by WHO

DSM

• Produced by American Psychiatric Association

• Intellectual property of APA

• Primarily for psychiatrists and psychologists

• Dominated by US, Anglophone perspective

• Approved by APA Board of Trustees and APA Assembly

CONCEPT OF HEALTHY PERSONALITY

1. Effective functioning: works well and produces the results that were intended.
 2. Positive emotional balance: the ability to remain calm and clear-headed during a
stressful situation or crisis.

3. Life satisfaction: a person's cognitive and affective evaluations of his or her life”

4. Self esteem: Self-esteem is how we value and perceive ourselves.

5. Self acceptance: an individual's acceptance of all of their attributes, positive or

negative

6. Goal oriented

7. Rational thoughts- Rational thinking is defined as thinking that is consistent with

known facts. They have more realistic thinking.

8. Resilience: Resilience is the process and outcome of successfully adapting to difficult

or challenging life experiences, especially through mental, emotional, and behavioral
flexibility and adjustment to external and internal demands.

9. Socio-emotional intelligence: ability to perceive and accurately express emotion, to

use emotion to facilitate thought, to understand emotions, and to manage emotions for
emotional growth.

HISTORICAL VIEW OF ABNORMAL BEHAVIOUR

Supernatural model
Historians of ancient societies have concluded that these societies regarded abnormal
behavior as the work of evil spirits. People in prehistoric societies apparently believed that
all events around and within them resulted from the actions of magical, sometimes sinister,
beings who controlled the world. In particular, they viewed the human body and mind as a
battleground between external forces of good and evil. Abnormal behavior was typically
interpreted as a victory by evil spirits, and the cure for such behavior was to force the demons
from a victim’s body.

This supernatural view of abnormality may have begun as far back as the Stone Age. Some
skulls from that period show evidence of an operation called trephination- An ancient
operation in which a stone instrument was used to cut away a circular section of the skull to
treat abnormal behaviour. The purpose of opening the skull is as a treatment for severe
abnormal behaviour that is to release the evil spirits that were supposedly causing the
problem.

Later societies also explained abnormal behavior by pointing to possession by demons.

Egyptian, Chinese, and Hebrew writings all account for psychological deviance this way.

The treatment for abnormality in these early societies was often exorcism. The idea was to
coax the evil spirits to leave or to make the person’s body an uncomfortable place in which to
live. A shaman, or priest, might recite prayers, plead with the evil spirits, insult the spirits,
perform magic, make loud noises, or have the person drink bitter potions. If these techniques
failed, the shaman performed a more extreme form of exorcism, such as whipping or starving
the person.

Biological model (Greeks and Romans)

Hippocrates, the father of modern medicine, taught that illnesses had natural causes. He saw
abnormal behavior as a disease arising from internal physical problems. he believed that all
other forms of disease, in his view resulted —from an imbalance of four fluids, or humors,
that flowed through the body:

yellow bile, black bile, blood, and phlegm

The best-known of the earlier paradigms for explaining personality or temperament is the
doctrine of the four humors, associated with the name of Hippocrates and later with the
Roman physician Galen. The four elements of the material world were thought to be the
earth, air, fire, and water, which had attributes of heat, cold, moistness, and dryness. These
elements combined to form the four essential fluids of the body-blood (sanguis), phlegm, bile
(choler), and the black bile (melancholic). The fluids combined in different proportions
within different individuals, and a persons’s temperament was determined by which of the
humors was dominant. From this view came one of the earliest and longest-lasting typologies
of human behaviour: the sanguine, the phlegmatic, the choleric, and the melancholic.

Hippocrates considered dreams to be important in understanding a patient’s personality.

500 to 1350 AD: In Middle Ages, Religious beliefs, which were highly superstitious and
demonological, came to dominate all aspects of life. There were outbreaks of mass madness,
delusions (absurd false beliefs) and hallucinations (imagined sights or sounds). Exorcisms
were revived.

1400 to 1700: Renaissance, a period of flourishing cultural and scientific activity.

demonological views of abnormality continued to decline. German physician Johann Weyer,
the founder of the modern study of psychopathology, the first physician to specialize in
mental illness, believed that the mind was as susceptible to sickness as the body was. Across
Europe, religious shrines were devoted to the humane and loving treatment of people with
mental disorders.

These improvements in care began to fade by the mid sixteenth century. Asylum : A type of
institution that became popular in the sixteenth century to provide care for persons with
mental disorders. Most asylums became virtual prisons.

THE NINETEENTH CENTURY: Care of those with mental disorders started to improve
again in the nineteenth century. In Paris, Philippe Pinel started the movement toward moral
treatment. In the United States, Dorothea Dix spearheaded a movement to ensure legal rights
and protection for people with mental disorders and to establish state hospitals for their care.

Unfortunately, the moral treatment movement disintegrated by the late nineteenth century,
and mental hospitals again became warehouses where inmates received minimal care.

20th CENTURY: As the moral movement was declining two opposing perspectives emerged
and began to compete for the attention of clinicians:

The somatogenic perspective, the view that abnormal psychological functioning has
physical causes. Two factors were responsible for this rebirth. One was the work of a
distinguished German researcher, Emil Kraepelin. In 1883, Kraepelin published an
influential textbook arguing that physical factors, such as fatigue, are responsible for mental
dysfunction. Secondly, One of the most important discoveries, that an organic disease,
syphilis, led to general paresis, an irreversible disorder with both mental symptoms such as
delusions of grandeur and physical ones like paralysis.

The psychogenic perspective, the view that the chief causes of abnormal functioning are
psychological. These perspectives came into full bloom during the twentieth century.
Hypnotism is a procedure in which a person is placed in a trance like mental state during
which he or she becomes extremely suggestible. It was used to help treat psychological
disorders as far back as 1778, when an Austrian physician, Friedrich Anton Mesmer
established a clinic in Paris. His patients suffered from hysterical disorders, mysterious
bodily ailments that had no apparent physical basis. Mesmer had his patients sit in a darkened
room filled with music; then he appeared, dressed in a colorful costume, and touched the
troubled area of each patient’s body with a special rod.

Psychological model:

According to Sigmund Freud’s structural model, the Id, Ego, and Super-ego are three
theoretical constructs that define the way an individual interacts with the external world, as
well as responds to internal forces. The Id represents the instinctual drives of an individual
that remain unconscious. The Super-ego represents a person’s conscience and their
internalization of societal norms and morality. The Ego serves to realistically integrate the
drives of the id with the prohibitions of the super-ego. Lack of development in the Super-ego,
or an incoherently developed super-ego within an individual, will result in thoughts and
actions that are irrational and abnormal, contrary to the norms and the beliefs of the society.

Behavioural model:

Although psychoanalysis dominated thought about abnormal behavior at the end of the
nineteenth century and in the early twentieth century, another
school—behaviorism—emerged out of experimental psychology to challenge its supremacy.
Behavioral psychologists believed that the study of subjective experience—through the
techniques of free association and dream analysis—did not provide acceptable scientific data
because such observations were not open to verification by other investigators. In their view,
only the study of directly observable behavior—and the stimuli and reinforcing conditions
that “control” it—could serve as a basis for formulating scientific principles of human
behavior.

The behavioral perspective is organized around a central theme: the role of learning in
human behavior.

Although this perspective was initially developed through research in the laboratory rather
than through clinical practice, its implications for explaining and treating maladaptive
behaviour soon became evident.

Classical Conditioning. The origins of the behavioral view of abnormal behavior and its
treatment are tied to experimental work on the type of learning known as classical
conditioning—a form of learning in which a neutral stimulus is paired repeatedly with an
unconditioned stimulus that naturally elicits an unconditioned behavior. After repeated
pairings, the neutral stimulus becomes a conditioned stimulus that elicits a conditioned
response. This work began with the discovery of the conditioned reflex by Russian
physiologist Ivan Pavlov.

John B. Watson reasoned that if psychology was to become a true science, it would have to
abandon the subjectivity of inner sensations and other “mental” events and limit itself to what
could be objectively observed. Watson thus changed the focus of psychology to the study of
overt behavior rather than the study of theoretical mentalistic constructs, an approach he
called behaviorism. He also challenged the psychoanalysts and the more biologically
oriented psychologists of his day by suggesting that abnormal behavior was the product of
unfortunate, inadvertent earlier conditioning and could be modified through reconditioning.

Operant Conditioning

E. L. Thorndike and subsequently B. F. Skinner were exploring a different kind of

conditioning, one in which the consequences of behavior influence behavior. Behavior that
operates on the environment may be instrumental in producing certain outcomes, and those
outcomes, in turn, determine the likelihood that the behavior will be repeated on similar
occasions. For example, Thorndike studied how cats could learn a particular response, such
as pulling a chain, if that response was followed by food reinforcement. This type of learning
came to be called instrumental conditioning and was later renamed operant conditioning by
Skinner. Both terms are still used today. In Skinner’s view, behavior is “shaped”

when something reinforces a particular activity of an organism—which makes it possible “to

shape an animal’s behavior almost as a sculptor shapes a lump of clay”.

CAUSES AND RISK FACTORS FOR ABNORMAL BEHAVIOUR

One of the primary goal of clinical Psychology is to understand the nature of relationships.
In considering the causes of abnormal behaviour, it is important to distinguish among
necessary, sufficient, and contributory causal factors, as well as between relatively distal
causal factors and those that are more proximal.

● Distal causal factors: Causal factors occurring relatively early in life that may not
show their effects for many years. Eg: loss of parents, bullying.

● Proximal risk factors: Immediate causes. Factors that operate shortly before the
occurance of symptoms of disorder. Eg: divorce.

● Reinforcing contributory cause: This can lead to a maladaptive behaviour that is

already occurring. Eg: Stressful environment.

Feedback and bi-directionality in abnormal behaviour

The case of perceived hostility

The task of determining cause-and-effect relationships has focused on isolating the condition
X (cause) that can be demonstrated to lead to condition Y (effect). For example, when the
alcohol content of the blood reaches a certain level, alcoholic intoxication occurs.

Behavioural sciences deal with a multitude of interacting causes, because effects can serve as
feedback that can in turn influence the causes. In other words, the effects of feedback and the
existence of mutual, two-way (bidirectional) influences must be taken into account. Concepts
of causal relationships must take into account the complex factors of bidirectionality of
feedback.

Diathesis stress model

Many mental disorders are believed to develop when someone who has a pre existing
vulnerability for that disorder experiences a major stressor. Models describing this kind of
situation are commonly known as diathesis–stress models of abnormal behaviour.

A vulnerability, or diathesis, is a predisposition toward developing a disorder that can derive

from biological, psychological, or sociocultural causal factors.
Stress, the response or experience of an individual to demands that he or she perceives as
taxing or

exceeding his or her personal resources. Stress often occurs when an individual experiences
chronic or episodic events that are undesirable and lead to behavioural, physiological, and
cognitive accommodations.

The diathesis results from one or more relatively distal necessary or contributory causes, but
is generally not sufficient to cause the disorder. Instead, there must be a more proximal factor
(the stressor), which may also be contributory or necessary but is generally not sufficient by
itself to cause the disorder except in someone with the diathesis. Factors contributing to the
development of a diathesis are themselves sometimes highly potent stressors, as when a child
experiences the death of a parent and may thereby acquire a predisposition or diathesis for
becoming depressed later in life.

Additive model, the diathesis and the stress sum together, and when one is high the other can
be low, and vice versa. Thus, a person with no diathesis or a very low level of diathesis could
still develop a disorder when faced with truly severe stress. In other words, individuals who
have a high level of a diathesis may need only a small amount of stress before a disorder
develops, but those who have a very low level of a diathesis may need to experience a large
amount of stress for a disorder to develop.

Interactive model, some amount of diathesis must be present before stress will have any
effect. Thus, someone with no diathesis will never develop the disorder, no matter how much
stress he or she experiences, whereas someone with the diathesis will demonstrate an
increasing likelihood of developing the disorder with increasing levels of stress. More
complex models are also possible because diatheses often exist on a continuum, ranging from
zero to high levels.
Biological Causal factors

In examining biologically based vulnerabilities, we must consider abnormalities in genetics,

brain dysfunction and neural plasticity, neurotransmitter and hormonal abnormalities in the
brain or other parts of the central nervous system, and temperament.

• Genetic vulnerabilities can affect the development of mental disorders through multiple
mechanisms, including ways in which the genotype may affect the phenotype
(genotype–environment correlations) and ways in which they affect an individual’s
susceptibility to environmental influences (genotype–environment interactions).

• Methods for studying the extent of genetic versus environmental influences include the
family history method, the twin method, and the adoption method. More recently, linkage
analysis and association studies are beginning to contribute knowledge about the exact
location of genes contributing to mental disorders.

• Studies of neural plasticity have shown that genetic programs for brain development are
not as fixed as once believed and that existing neural circuits can often be modified based on
experience.
• Many different neurotransmitter and hormonal abnormalities contribute to the
development of mental disorders because of the effects they exert on different relevant brain
and body areas for different disorders.

• Temperament is strongly influenced by genetic factors and refers to a baby’s characteristic

ways of reacting to the environment and his or her ways of self-regulation. It forms the basis
of our adult personality, which in turn influences our vulnerability to different disorders.

Psychological causal factors

In examining psychologically based vulnerabilities, three primary perspectives have

developed since the end of the nineteenth century: psychodynamic, behavioural, and
cognitive-behavioural.

• The oldest psychological viewpoint on abnormal behaviour is Freudian psychoanalytic

theory. For many years this view was preoccupied with questions about libidinal (id) energies
and their containment. More recently, four second-generation psychodynamic theories
departed in significant ways from Freud’s original ideas.

• Anna Freud’s ego psychology focused on the important role of the ego in normal and
abnormal behaviour, with special attention focused on ego-defense reactions.

• Object-relations theorists focused on the role of the quality of very early (pre-Oedipal)
mother–infant relationships for normal development.

• The originators of the interpersonal perspective took exception to the Freudian emphasis
on the internal determinants of motivation and behaviour and instead emphasized the social
and cultural forces that shape behaviour.

• Attachment theory, which has roots in both the interpersonal and object-relations
perspectives, emphasizes the importance of early experiences with attachment relationships
for laying the foundation for later child, adolescent, and adult development.

• Psychoanalysis and closely related therapeutic approaches are termed psychodynamic in

recognition of their attention to inner, often unconscious forces.

• The behavioral perspective focuses on the role of learning in human behaviour and
attributes maladaptive behaviour either to a failure to learn appropriate behaviours or to the
learning of maladaptive behaviours.

• The primary forms of learning studied are classical conditioning and operant
(instrumental) conditioning. The effects of each are modified by principles of generalization
and discrimination. Observational learning is also important.

• Adherents of the behavioural viewpoint attempt to alter maladaptive behaviour by

extinguishing it or providing training in new, more adaptive behaviours.
 ● The cognitive-behavioral viewpoint attempts to incorporate the complexities of
human cognition, and how it can become distorted, into an understanding of the
causes of psychopathology.

• People’s schemas and self-schemas play a central role in the way they process information,
in how they attribute outcomes to causes, and in their values. The efficiency, accuracy, and
coherence of a person’s schemas and self-schemas and attributions appear to provide an
important protection against breakdown.

• Treatments developed from the cognitive-behavioral perspective attempt to alter

maladaptive thinking and improve a person’s abilities to solve problems and to achieve goals.

Sociocultural factors

Sources of psychologically determined vulnerability include early deprivation or trauma,

problems in

● parenting style

● marital discord and divorce

● low socioeconomic status and unemployment

● maladaptive peer relationships

● prejudice and discrimination.

CURRENT TRENDS IN ABNORMAL PSYCHOLOGY

1.Growing Awareness and a Focus on Prevention

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).

Prevention programs have been further energized in the past few decades by the field of
psychology’s ever-growing interest in positive psychology. Positive psychology is the study
and enhancement of positive feelings such as optimism and happiness, positive traits like
hard work and wisdom, positive abilities such as social skills and other talents, and
group-directed virtues, including altruism and tolerance.\

While researchers study and learn more about positive psychology in the laboratory, clinical
practitioners with this orientation are teaching people coping skills that may help to protect
them from stress and adversity and encouraging them to become more involved in personally
meaningful activities and relationships—thus helping to prevent mental disorders.
Government and non-government agencies are campaigning for better awareness.

• GROW

• ASP

• PMHA's Lusog Isip ng Kabataan

2.The Development and Use of Psychotropic Drugs

In 1950s research discovered drugs that primarily affect the brain and alleviate many
symptoms of mental dysfunctioning antipsychotic drugs, which correct extremely confused
and distorted thinking antidepressant drugs, which lift the mood of depressed people
antianxiety drugs, which reduce tension and worry. A process where patients are integrated
into the community, with the support of community-based treatment facilities.

3.Types of Community-Based Treatment Facilities

Since the discovery of medications, mental health professionals in most of the developed
nations of the world have followed a policy of deinstitutionalization, releasing hundreds of
thousands of patients from public mental hospitals. 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. Ideally, they are then provided with outpatient
psychotherapy and medication in community programs and residences.

Community mental health approach.

Community Mental Health Centers that provide community care for people with severe
psychological disturbances— often include teams of social workers, therapists, and
physicians who coordinate care.

4. Halfway Houses

The effect of the Deinstitutionalization Movement in Europe offer people with long-term
mental health problems the opportunity to live in a structured, supportive environment as they
try to re establish a job and ties to family and friends.

5. Day Treatment Centers

The treatment picture for people with moderate psychological disturbances has been more
positive than that for people with severe disorders. Since the 1950s, outpatient care has
continued to be the preferred mode of treatment for them, and the number and types of
facilities that offer such care have expanded to meet the need.

Private psychotherapy : An arrangement in which a person directly pays a therapist for

counselling services. Today, 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. Outpatient treatments are also becoming available
for more and more kinds of problems and clients enter therapy because of milder problems in
living—problems with marital, family, job, peer, school, or community relationships.

Since the 1950s has been the development of programs devoted exclusively to specific
psychological problems. For example, suicide prevention centers, substance abuse programs,
eating disorder programs, phobia clinics, and sexual dysfunction programs. Clinicians in
these programs have the kind of expertise that can be acquired only by concentration in a
single area.

6. Multicultural psychology

In response to this growing diversity, an area of study called multicultural psychology has
emerged. Multicultural psychologists seek to understand how culture, race, ethnicity, gender,
and similar factors affect behavior and thought and how people of different cultures, races,
and genders may differ psychologically. The field of multicultural psychology has begun to
have a powerful effect on our understanding and treatment of abnormal behavior.

7. Leading theories and professions

Additional influential perspectives have emerged, particularly the biological,

cognitive-behavioral, humanistic-existential, sociocultural, and developmental
psychopathology schools of thought. At present, no single viewpoint dominates the clinical
field.

Demand for mental health services has brought in scope for other mental health professionals
other than psychiatrists and physicians. Psychotherapy and related services are also provided
by counseling psychologists, educational and school psychologists, psychiatric nurses,
marriage therapists, family therapists, and —the largest group—clinical social workers (see .
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.

Well-trained clinical researchers conduct studies in universities, medical schools,

laboratories, mental hospitals, mental health centers, and other clinical settings throughout the
world. Their work has produced important discoveries and has changed many of our ideas
about abnormal psychological functioning.

8. Technological advancements

Telemental health, the use of various technologies to deliver mental health services without
the therapist being physically present, is growing by leaps and bounds. Telemental health
takes such forms as long-distance therapy between clients and therapists using
videoconferencing, therapy offered by computer programs, and Internet-based support
groups.
And literally thousands of smartphone apps are devoted to relaxing people, cheering them up,
giving them feel-good advice, helping them track their shifting moods and thoughts, or
otherwise improving their psychological states. Similarly, countless Web sites offer mental
health information.