Abnormal
Psychology
21PSY 312 Sem III
Prof Aiswarya Menon
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What will you learn in Abnormal Psychology
■ Defining abnormal behaviour
■ History of classifications
■ Approaches to etiology
■ Introduction to Psychotic, Anxiety and Stress Related Disorders
■ Case history & MSE - Clinical Assessment
■ Basic treatment plan
Defining Abnormal Behaviour - 4Ds
❖ Deviation from average : statistical frequency perspective
❖ Deviation from social norms
❖ Dysfunction - cognitive, emotional & behavioural
❖ Distress
❖ Danger
“.. behavioral, psychological, or biological dysfunctions that are unexpected in their
cultural context and associated with present distress and impairment in functioning, or
increased risk of suffering, death, pain, or impairment”
History
■ Three general theories of etiology : Supernatural, Somatogenic and Psychogenic
■ Stone Age - possession of evil spirits, trephination
■ Hippocrates (400 B.C.) : -imbalance of humors - blood, yellow bile, black bile, phlegm - 4
categories: epilepsy, mania, melancholia and brain fever
■ Middle Ages ( 5th to 15th century ) - natural disasters like plagues and famines, supernatural
forces
■ 13th to 18th century : ‘witch- hunting’ - Approx 100,000 women were burned at stake
■ 16th century: Renaissance period- establishment of mental hospitals and asylums- terrible
conditions
■ 19th Century: Pinel (France) & Dorothy Dix (US) - institutional reforms
■ 20th Century : Sigmund Freud and Josef Breuer - hypnosis, birth of psychoanalysis
Diagnostic and Statistical Manual of Mental Disorders (DSM)
Pre DSM : - most mental illnesses were treated like physiological problems - no clear classification
- need for classification arose for use at asylums - Statistical Manual for the Use of Institutions for the
Insane
- second major need arose during World War II - cases of “shell shock” - Military 203
➔ (1949) ICD - 6 included section for mental illnesses for the first time
DSM- I (1952)
➔ 102 categories
➔ Disorders were seen as ‘reactions’ to stressors
➔ Broad categories : organic brain syndromes(epilepsy etc - impairments in brain) & functional
disorders(psychotic vs neurotic vs character - difficulties in individual adaptation to the
environment)
DSM- II (1968)
➔ Expanded the major categories
➔ Added a child/ adolescent section
➔ lack of empirical data, no consensus, low reliability
DSM - III (1980)
➔ Specific and detailed criteria
➔ Multi-axial system
➔ Less influence of psychodynamic factors
➔ Personality disorders
DSM-III-R (1987)
➔ Revision of multiaxial system
DSM III Multiaxial System
AXIS I : Clinical Disorders (schizophrenia,
depression etc)
AXIS II : Personality disorders & Mental
retardation ( more chronic conditions,
developmental disorders etc)
AXIS II : General medical conditions
AXIS IV : Rating of psychosocial stress
DSM-IV (1994) and DSM-IV-TR (2002)
➔ Pervasive developmental disorders, learning disorders etc moved from Axis II to Axis I
➔ Axis II only for Personality disorders and Intellectual Disability
➔ Axis IV rating of stressors and severity changed into checklist
➔ Axis V changed to Global Assessment of Functioning (GAF)
➔ DSM IV-TR only made some minor changes in descriptions of disorders and diagnostic criteria
Multi Axial System for DSM IV
AXIS I : Clinical Disorders (schizophrenia,
depression etc)
AXIS II : Personality disorders & Intellectual
Disability
AXIS II : General medical conditions
AXIS IV : Psychosocial and environmental
problems
AXIS V : Global Assessment of Functioning
DSM V (2013)
➔ Removal of axial system
➔ Removed the Global Assessment of Functioning (GAF score)
➔ Reclassifies certain disorders,
➔ Addition of disorders (for ex; social communication disorder (or SCD) and disruptive mood
dysregulation disorder (or DMDD) (previously understood as childhood bipolar disorder)
➔ Autism Spectrum Disorder (ASD) now encompasses the previous DSM-IV autistic disorder
(autism), Asperger’s disorder, childhood disintegrative disorder, and pervasive developmental
disorder not otherwise specified.
➔ Cross-cutting dimensional symptom measures
DSM - 5 Categories of Disorders
■ Neurodevelopmental Disorders
■ Schizophrenia Spectrum and Other Psychotic Disorders
■ Bipolar and Related Disorders
■ Depressive Disorders
■ Anxiety Disorders
■ Obsessive - Compulsive and Related Disorders
■ Trauma or Stressor Related Disorder
■ Dissociative Disorders
■ Somatic Symptom and Related disorders
■ Feeding and Eating Disorders
■ Elimination Disorders
■ Sleep wake Disorders
■ Sexual Dysfunctions
■ Gender Dysphoria
■ Disruptive, Impulse-Control, and Conduct Disorders
■ Substance Related Disorders
■ Neurocognitive Disorder
■ Personality Disorder
■ Paraphilic Disorder
Issues with Diagnoses
■ Labelling
■ Stigma
■ Self Stigma
■ Misdiagnoses
■ Lack of consensus- subjectivity
■ Cultural considerations
Scope of Abnormal Psychology
■ Clinical Psychologist
■ Counsellors
■ School Counsellors
■ Psychiatric Social Worker
■ Rehabilitation
■ Psychological Assessment
Important Terms
■ Clinical Description
■ Prevalence
■ Incidence
■ Etiology
■ Onset
■ Presenting Problem
■ Necessary, Sufficient, and Contributory Causes
■ Course
■ Prognosis
■ Predisposition
■ Stressor
■ Intervention
■ Comorbidity
Models of Abnormal Behaviour
■ Psychodynamic
■ Biological
■ Behavioural
■ Cognitive
■ Socio-Cultural
■ Humanistic/Existential
■ Integrative Approaches / Multidimensional
