Theories of Psychopathology

Introduction
This unit presents current definitions of abnormality and describes how these perspectives have evolved over time. Ideas about normal and abnormal are socially constructed; behaviors that are considered normal or adaptive in one culture or at a certain time in history can be viewed as abnormal or pathological in another place or time.
The Abnormal Psychology text describes four components of abnormality: “Dysfunction, distress, deviance, and dangerousness” (Nolen-Hoeksema, 2014, p. 6). In The Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM–5; American Psychiatric Association, 2013), you will find the following definition of mental disorder:
A syndrome characterized by clinically significant disturbance in an individual’s cognition, emotion regulation, or behavior that reflects a dysfunction in the psychological, biological, or developmental processes underlying mental functioning. Mental disorders are usually associated with significant distress or disability in social, occupational, or other important activities. An expectable or culturally approved response to a common stressor or loss, such as the death of a loved one, is not a mental disorder. Socially deviant behavior (e.g., political, religious, or sexual) and conflicts that are primarily between the individual and society are not mental disorders unless the deviance or conflict results from a dysfunction in the individual, as described above (p. 20.)
Our own values and personal belief systems also have an impact on the ways in which we define concepts like mental disorder. It is important to be aware of the assumptions and biases that we hold and how they affect the ways in which we assess and diagnose the presenting issues of our clients.
There are three key theoretical models used for understanding psychopathology: biological, psychological, and social or interpersonal approaches. Each approach considers the factors important to the etiology of abnormal behavior, describes the processes that maintain these behaviors in people, and provides specific treatment approaches that can be used to effect positive change. Current approaches to diagnosis and treatment incorporate an integrated perspective that draws from several models in explaining the causes of psychological distress in people.
One of the criticisms of diagnosing in general, and of the DSM-5 in particular, is that it reflects a medicalization of behaviors. Clinicians who are drawn to a systemic perspective, such as many marriage and family counselors and therapists, understand disordered behavior as reflecting interactions within the context of a relational system, rather than being a mental disorder within the context of the individual. All clinicians are responsible for understanding current diagnostic systems which guide insurance reimbursement, provide a common language between professionals, and can be used to facilitate the delivery of counseling services.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author.
Nolen-Hoeksema, S. (2014). Abnormal psychology (6th ed.). New York, NY: McGraw-Hill.
Objectives
To successfully complete this learning unit, you will be expected to:
1. Define the concepts of abnormality and mental disorder.
2. Discuss the impact of historical, sociocultural, and political forces on definitions of normal and abnormal.
3. Explore personal values or beliefs that may impact views of abnormal behavior or mental disorders when working with clients from diverse backgrounds.
4. Discuss theoretical models used for describing psychopathology.
5. Apply an integrated model (biological, psychological, and sociocultural) of psychopathology.

Readings
Use your Abnormal Psychology text to complete the following:
• Read Chapter 1, “Looking at Abnormality,” pages 2–21.
• Read Chapter 2, “Theories and Treatment of Abnormality,” pages 22–57.
Use the DSM-5 to read “Use of the Manual,” pages 19–24, from Section 1.
Use the Library to select and read one of the following articles:
• Strong and Bursch’s 2013 article, “DSM-5 and Evidence-Based Family Therapy?” from Australian & New Zealand Journal of Family Therapy, volume 34, issue 2, pages 90–103.
• Eriksen and Kress’s 2008 article, “Gender and Diagnosis: Struggles and Suggestions for Counselors,” from Journal of Counseling and Development, volume 86, issue 2, pages 152–162.
• Guinson, Green, and Hanna’s 2003 article, “Intolerance and Psychopathology: Toward a General Diagnosis for Racism, Sexism, and Homophobia,” from American Journal of Orthopsychiatry, volume 73, issue 2, pages 167–176.
• Miller and Prosek’s 2013 article, “Trends and Implications of Proposed Changes to the DSM-5 for Vulnerable Populations,” from Journal of Counseling and Development, volume 91, issue 3, pages 359–366.
• Strong’s 2015 article, “Diagnoses, Relational Processes and Resourceful Dialogs: Tensions for Families and Family Therapy,” from Family Process, volume 54, issue 3, pages 518–532.
• Mendelson’s 2003 article, “Homosexuality and Psychiatric Nosology,” from Australian and New Zealand Journal of Psychiatry, volume 37, issue 6, pages 678–683.
These articles provide a variety of perspectives and historical context related to the changing DSM.
Optional – Readings
You may choose to complete the following:
• Read the Introduction, pages 5–17, from Section I of the DSM-5 to gain more familiarity with the manual.
• Review Optional Readings for Principles of Psychopathology. Each learning unit in this course includes a link to the document. This document contains a list of additional articles about the mental disorders you are studying in the unit and current issues regarding assessment, diagnosis, and treatment. You can draw from these articles (or any others you find in the library) to support the ideas you present in your discussion posts.

Discussion 1:1 page needed with 250 words, not including references and citations and 2 references needed.
Definitions of Psychopathology
The unit readings present several definitions of mental disorder and describe the ways in which concepts of abnormality have changed over time. For this discussion:
1. What criteria would you use to evaluate whether a person’s behavior is normal or abnormal? Please consider both individual and systemic perspectives.
2. Select one behavior you might see in a client you are working with and describe how that behavior might be perceived differently in the following contexts:
o Different time periods (for example, 1900 A.D. and 2000 A.D.).
o Different cultures or social groups.
3. Explain how your own values and personal beliefs will impact the way in which you view some of a client’s behaviors, thoughts, or emotions as being normal or abnormal. Use examples to illustrate your ideas.
Support your ideas with references to the course texts, articles from this learning unit, articles from the Optional Readings for Principles of Psychopathology list, or articles from peer-reviewed journals that you locate in the library.
Discussion 2: 1 page needed with 250 words, not including references and citations and 2 references needed.
Models of Psychopathology
Chapter 2 of the Abnormal Psychology text presents three main theories of abnormality: biological, psychological, and sociocultural. Figure 2.12 on page 54 demonstrates how these perspectives can be integrated to explain symptoms of depression.

For this discussion, consider the following case vignette:
Susie is an 8-year-old Asian American girl; the youngest child in a family of four older siblings. Her parents are both high school teachers. When Susie was 5 years old, she was hospitalized for three weeks for a serious illness. Since that time, she has been in good health.
Susie is extremely shy and avoids situations in which she needs to interact with new people or large groups. She worries about making mistakes in her schoolwork and becomes extremely anxious when taking tests. Sometimes, she becomes so nervous that her heart races; she begins to tremble and has difficulty breathing. Susie is also afraid of the dark and does not want to be alone in her room at night. She often requires the presence of one of her parents or older sisters until she falls asleep.

In your discussion post:
1. Take the perspective of a theorist from each of the three models of abnormality—biological, psychological, and sociocultural—and briefly explain how you would view the factors leading to Susie’s presenting behaviors.
2. Describe an integrated approach for understanding Susie’s symptoms of anxiety (avoidance, worry, nervousness, and fearfulness) using Figure 2.12 as a model. Consider how biological, psychological, developmental, systems, and social factors would interact to cause anxiety in Susie.
Support your ideas with references to the course texts, articles from this learning unit, articles from the Optional Readings for Principles of Psychopathology list, or articles from peer-reviewed journals that you locate in the library.
Reference
Nolen-Hoeksema, S. (2014). Abnormal psychology (6th ed.). New York, NY: McGraw-Hill.

 

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