Type:
Solution Manual
Resource:
Abnormal Psychology
Edition:
14th Edition
Author(s):
James N. Butcher Susan Mineka Jill M. Hooley
CHAPTER 1: Abnormal Psychology: An Overview Teaching Objectives 1. Explain the authors’ approach to the study of abnormal psychology. 2. Discuss common topics and issues relevant to abnormal psychology. 3. Explain why we need to classify mental disorders and the advantages and disadvantages of classification. 4. Summarize the DSM-IV definition of mental disorders illustrating several problems with this approach. 5. Identify how cultural issues can influence the definition of abnormal psychology. 6. Identify the professionals responsible for working on the mental health “team.” 7. Explain the difference between the prevalence and the incidences of mental disorders. 8. Discuss the prevalence rates for mental disorders. 9. Summarize current trends in patient care including inpatient and outpatient treatment. 10. Describe the scientific inquiry process. 11. Describe the importance of hypotheses in the research process. 12. Identify the critical elements of sampling and generalization. 13. Compare and contrast observational research strategies, experimental research designs, and single-case experimental designs. 14. Illustrate how research designs allow psychologists to make statements about the efficacy of treatment. 15. Discuss the importance of animal research to understanding abnormal behavior. 16. Identify the basic principles behind the text’s study of abnormal psychology.
Chapter Overview/Summary Encountering instances of abnormal behavior is a common experience for all of us. This is not surprising given the high prevalence of many forms of mental disorder. A precise definition of abnormality is still elusive. Even though we lack consensus on the precise definition of abnormality, there are clear elements of abnormality: suffering, maladaptiveness, deviancy, violations of society’s standards, causing discomfort in others, and irrationality or unpredictability. These elements allow for the adoption of a prototype model of abnormality. Although this model is helpful, we have the additional problem of changing values and expectations in society at large. Despite these difficulties, psychologists continue to classify mental disorders for several reasons: classification systems provide a nomenclature that allows us to structure information in a more helpful way, research on etiological factors, treatment decisions, social and political implications, and insurance reimbursement. There are also many disadvantages to classifying mental disorders: loss of information, stigma, stereotyping, and labeling. The DSM-IV definition is atheoretical, focusing on a clinically significant behavioral or psychological syndrome or pattern that is associated with distress or disability (impairment in one or more areas of functioning), and not simply a predictable or culturally sanctioned response to a particular event. Mental disorders, then, are the product of ‘dysfunctions’ within the individual. As might be expected, there are many criticisms of this definition. For example, what is meant by the term “clinically significant,” which determines what is culturally sanctioned, and how much impairment is necessary for a diagnosis to be made? Wakefield has proposed a definition that describes a mental disorder as a “harmful dysfunction.” His approach focuses on social values in defining abnormality as well as an evolutionary model to determine what is functional, creating potential new difficulties. This current text utilizes the prototype model adopted by the DSM classification system. Culture shapes the presentation of clinical disorders in some cases. There are also certain disorders, such as taijin kyofusho, that appear to be highly culture specific. DSM opts for a categorical classification system similar to that used in medicine. Disorders are regarded as discrete clinical entities, although not all clinical disorders are best considered in this way. Even though it is not without problems, the DSM provides us with a working set of criteria that help clinicians and researchers to identify and study specific and important problems that affect people’s lives. Although it is far from a “finished product,” knowledge of the DSM is essential to a serious study of the field. The extent of mental disorders may be surprising. Several epidemiological studies have been conducted in recent years. The lifetime prevalence of having a DSM-IV disorder is 46.7%. In addition, there is significant comorbidity, especially among those individuals who have severe disorders. Unfortunately not all people with mental disorders receive treatment. Some may deny or minimize their problems and others try to cope with their problems on their own. Even when the problems are recognized, many delay seeking treatment or seek assistance from a primary health care provider such as a physician. Most treatment is conducted in outpatient settings and
inpatient care is typically brief and provided only for those who need more intensive care. In an ideal case, the mental health team, composed of professional and paraprofessionals, may gather information from a variety of sources, process and integrate all the available information, arrive at a consensus diagnosis, and plan the initial phase of treatment. To avoid misconception and error, we must adopt a scientific attitude and approach to the study of abnormal behavior. This requires a focus on research and research methods, including an appreciation of the distinction between what is observable and what is hypothetical or inferred. To produce valid results, research must be done on people who are truly representative of the diagnostic groups to which they purportedly belong. Research in abnormal psychology may be observational or experimental. Observational research studies things as they are. Experimental research involves manipulating one variable (the independent variable) and seeing what impact this has on another variable (the dependent variable). Mere correlation between variables does not allow us to conclude that there is a causal relationship between them. Simply put, correlation does not imply causation. Although most experiments involve studies of groups, single case experimental designs (e.g. ABAB designs) can also be used to make causal inferences in individual cases. Analogue studies are studies that provide an approximation to the human disorders of interest (e.g. animal research). Although generalization can be a problem, animal research in particular has been very informative.
MyPsychLab Resources The current edition offers yet more assets and resources to aid you in teaching with this text. The new edition of MyPsychLab offers many videos, activities, and even short PowerPoint-like clips to clarify points in the text. Go to www.MyPsychLab.com—you can register for access to my lab assets. Contact your book rep for the access codes for this text. Your students will also need to register using their e-mail address, Course ID, and a Student Access Code (provided with student’s textbook or in a student access card/kit available from your campus bookstore). If you assign any of the simulations or activities, students will have to have access to the site. If you would like to show videos, only you will need access. To select videos, log in to MyPsychLab, select the front cover of this textbook, then click on the “Multimedia Library” button on the next page in the left-hand column. A new page will appear with search criteria. You can select a particular chapter or “All Chapters,” and then select “Watch” in the Media Type field to bring up a list of video offerings.
Detailed Lecture Outline Lecture Launcher 1.1: Why Are You Taking this Course? Students taking abnormal psychology often have a variety of reasons for doing so. These range from satisfying a degree requirement to a desire for enhanced personal insight. The expectations of the students regarding the course and what they may or may not get out of it are interesting issues to explore at the very outset. Students should be encouraged to volunteer their reasons for enrolling in the course. Common answers that usually arise include: to learn more about my own behavior, to understand others, and to learn about the different mental health professions. Hearing other peoples’ answers to this question can also help students expand their ambitions in the course beyond the ones they originally held. This discussion can also provide a good opportunity to present the rationale behind studying abnormal psychology and how the scientific tradition assists in increasing our understanding of behavior and its determinants. After this discussion students should have a clear understanding of the demands and expectations of this course and how their expectations fit into the course design. Teaching Tip 1.1: General Tips for Students on Studying Teaching Abnormal poses some interesting issues as it attracts a wide variety of students. Often I’ll have both freshman and seniors in the class as well as majors from all different areas. Because of this I often spend a little more time discussing the qualifications of different areas of the fields. I also spend time on studying. Many students seem to erroneously feel that they know much of the material from TV and movies and thus may not study enough.
I.
What Do We Mean by Abnormality?
The first discussion is about the way in which abnormal behavior is defined and classified so that researchers and mental health professionals can communicate with each other about the people they see
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Handout 1.1: Begin this discussion by having students take a few minutes to fill out handout 1.1 “Is it Abnormal?” You then want to discuss some of their answers in relation to how difficult it is to define “abnormal” behaviors. Both 1 and 6 involve similar behaviors but one would be far more acceptable than the other –why? Students should point out that gender may play a role, or maybe the situation or context of the behavior Both 2 and 9 are both about persons talking to themselves. Again, the context makes all the difference Both 3 and 7 further highlight the issue of culture and context in how we interpret behaviors. This is also a good time to discuss religion and religious behaviors (the APA steers clear of most religious behaviors because it gives rise to issues of religious freedom). Ask students what behaviors done in a religious context would seem “abnormal” outside of one. Both 4 and 10 are in reference to hearing voices. Again, it continues the discussion above as #10 again involves a religious freedom. You can also use this one to discuss the perhaps “adaptive value” of schizophrenia. E.g., even today in a remote non-industrialized setting (for example the Amazon) if you think you are talking to god it is most likely a plus. Here in the states, not so much. Both 5 and 8 have to do with superstitious behaviors. Ask students what superstitious behaviors they perform, or know of behaviors that others do. How different is that from some of the rituals you see in OCD? It is important to point out to students that there are many issues to defining abnormal behavior. What’s appropriate for one gender, or in one context, or in one culture, may be profoundly “abnormal” in another. Activity 1.1: Defining Abnormality Students can be introduced to the numerous definitions of abnormality described in The World around Us 1.2: The Elements of Abnormality by trying to formulate their own definition of what is abnormal. The question “How would you define abnormal behavior?” can be used to initiate the discussion. A number of different answers will be generated, and these should be recorded on the blackboard. The instructor will have to challenge each of the answers in order to illustrate the concepts expressed in the text. The responses generated by the students can then be categorized into the different areas identified in chapter 1—for example, the view that abnormality is always dangerous or that mental disorder is something to be scorned. Through the course of the discussion, students should come to appreciate the problem in defining abnormal behavior and gain an insight into factors affecting the labeling of abnormality. There are several elements in a comprehensive definition of abnormality. A.
The Elements of Abnormality 1. Suffering: this is personally defined psychological suffering. E.g., you can’t leave your house because you need to wash your hands 1,000 times. This is one of the most important aspects according to the APA. 2. Maladaptive behavior: any behavior that is maladaptive for the individual OR towards society. E.g., anorexia: starving oneself is maladaptive.
Lecture Launcher1.2: Evolutionary Psychology If you have a background that includes evolutionary psychology you may want to discuss adaptive value and ask students to generate possible reasons why we would see maladaptive behaviors not die out. As one of the main tenets of Evolutionary Psychology is that behaviors that persist must in some way be or have been adaptive, how does this explain the disorders we see today? One example can be built on the example above on the “adaptive value” of schizophrenia. Ask students if someone lived in a remote tribe in South America or Africa and they reported talking to God, how would their village receive them? Could there be other situations with other disorders where some of these behaviors are actually adaptive in some way? 3.
Deviancy: statistically unusual behaviors. Again, point out this is not comprehensive, e.g., depression is in no way statistically unusual.
4.
Violation of the standards of society. This gets at failure to follow the conventional social and moral codes of an individual society. E.g., taking ones clothes off in public.
Lecture Launcher 1.3: Evolving Conceptualizations of Homosexuality Prior to the publication of DSM-III in 1980, homosexuality was considered a mental illness. In DSM-III it was considered a disorder only if the homosexual person was emotionally troubled by it—that is, only if it was egodystonic. In DSM-IIIR (1987) it moved into a general category of sexual disorders “not otherwise specified,” where it was recast as “persistent and marked distress about one’s sexual orientation,” for ego-dystonic heterosexuality as well as homosexuality. These transitions were not driven by scientific research but by evolving societal norms and political pressure. Evolving conceptualizations of homosexuality provide interesting material for discussing diagnosis, science, and politics. It is also sometimes quite interesting to discuss the kinds of research that could be conducted to establish the diagnostic status of behaviors, including homosexuality. Are there data that would certify behaviors as abnormal, or are societal values absolutely necessary? 5.
B.
Causing social discomfort: This is related to the above violation of social norms but results in others discomfort. 6. Irrationality and unpredictability: This is related to behavior that cannot be expected and/or behaviors that appear to be irrational. E.g., washing one’s hands 500 times. The DSM-IV Definition of Mental Disorder (See table 1.1) 1. Mental disorder as clinically significant distressing or disabling syndrome in the individual. 2. DSM utilizes “prototype” approach. 3. Atheoretical—causal mechanisms are not described. 4. Rules out culturally sanctioned behaviors. 5. DSM definition still problematic—what is “clinically significant?” 6. Wakefield—“harmful dysfunction” as alternative to DSM definition. a. Classifies “harm” in terms of social value b. “Dysfunction” determined according to evolutionary theory
Lecture Launcher 1.4: Abnormality as “Harmful Dysfunction” An interesting article that can be used for a brief lecture and discussion session is one by J. Wakefield published in 1998 (“Diagnosing DSM-IV: DSM-IV and the concept of disorder.” Behavior Research and Therapy, 35, 633-649). The author suggests that the DSM-IV is over inclusive of its diagnostic criteria. The DSM does not distinguish harmful conditions due to internal dysfunction from harmful conditions that are not disordered or problems in living. The author recommends a dimensional approach to diagnosing mental disorder. Students can be asked about the value of having a diagnostic system, such as the DSM-IV, that does not examine the context of the individual’s life. The events that trigger mental disorder would have a more meaningful place in the dimensional approach than in the DSM classification system. Students can be asked to discuss the events that may lead to problems in living conditions that are harmful to the individual, yet don’t cause internal dysfunction. Would there be different outcomes for the different situations? Have students list the problems of living that may cause dysfunction in life. Should a person be diagnosed with a mental disorder if experiencing these situations?
C.
7. DSM is a work-in-progress Why Do We Need to Classify Mental Disorders? 1. Advantages—overall, you are looking at 5 main advantages: a. Nomenclature helps structure information b. Promotes research c. Directs treatment d. Delimits domain of professional expertise e. Delineates insurance reimbursement