PSYC31222 Clinical Psychology

Question:

1 Discuss the concepts of abnormality (nomiality) and provide examples.

2 Discuss two major classification systems that are used by health professionals for mental disorders.

3 Discuss and evaluate the following models for atypical behavior

A. biomedical

b behaviorist c. psychoanalytical.

4 Choose one treatment/treatment for mental health that you like from each of these perspectives.

A. biomedical

b Behaviourist

Answer:

1.Concept Of Normality & Abnormality

These are the two key concepts that help to distinguish between normal and abnormal behavior.

Normality refers to the common occurrence of a particular behavior.

Its definition can be different depending on social context and what is normal.

Normality can be described as positive behavior. Atypical behavior is considered abnormal.

However, abnormality can be defined as a person’s unhonorable behavior or psychological disorder (Bassett-Baker 2015).

While the diagnostic manual of mental diseases clearly defines various types of mental disorderes, there isn’t a clear definition of normality and abnormality.

This is due to the fact that psychological disorders can vary between individuals and among different socio-cultural groups.

The criteria used to define abnormality are statistical infrequency, violation of social norms and harming others.

2.Main Systems for Classification Of Mental Disorders

The two main systems used by health professionals to classify mental disorders are:

These include:

ICD 10 (The International Classification of Diseases): This is the standard diagnostic classification that covers 10 major categories of mental disorders.

These include symptoms of mental disorder, mental or behavioral disorders caused by psychoactive substance, schizophrenia and mood disorders, neurotic disorders, personality disorders and mental retardation.

ICD-10 offers both diagnostic and clinical guidelines for health care professionals (WHO

DSM-IV: This is the Diagnostic and Statistical Manual of Mental Disorders. Published by the American Psychiatric Association, it categorizes and describes all types of mental disorders in adults and children.

DSM-IV manual can be used by health care professionals to take a multi-dimensional approach to diagnosing mental illness.

This manual offers a holistic diagnosis of mental illness that takes into consideration all contributing factors. (Proctor Kopa and Hoffmann 2014).

These five dimensions are used to determine the type of mental illness.

Axis 1: This is the highest level in the multiaxial system of diagnosis. It gives an idea about acute symptoms and how they can be treated.

These symptoms include panic attack, major depression episode, schizophrenia, and even panic attack.

Axis II – This dimension is used to assess personality and developmental disorders.

One example of a personality disorder is paranoid or borderline personality disorder. Autism is an example of a developmental disorder.

These mental disorders can last a lifetime and are often present in childhood.

This disorder is associated with social stigma because it causes patients to struggle to adapt to society demands.

Axis 3: This dimension is concerned with the evaluation of physical conditions which can be used to determine the cause of disorder as described in axis II and I.

Axis IV – It includes psychosocial stressors. This has a significant impact upon diagnosis and prognosis.

The review of patient’s life events records allows health care professionals to identify psychosocial stressesors that can lead to medical illness.

Axis V – This is the final level at which the health professional assesses the current level of functioning and compares it with the previous year (Proctor Kopa and Hoffmann 2014).

1.Biological (medical). The medical model of mental illness is used in mental health care to diagnose and treat disease. It involves observation, description, assessment, diagnostic test, and observation of symptoms.

Psychopathology is based on the assumption that mental disorders can also be caused by the physical structure or functioning of the brain.

In determining the root cause of mental illness, we can use the modern DSM and ICD classifications.

The biological approach is based on the belief that behavioral dysfunction is due to changes in physical factors, such as neurotransmitter levels, or hormone levels.

There are some strengths and weaknesses in the biological model.

Research has demonstrated that psychological disturbance can be caused by biological factors, such as neurotransmitters or hormones.

Sperner, Kohl, and Fuchs (2014) presented evidence on the relationship between neurotransmitters in depression and immune changes.

The study showed that mood disorder and depression can be caused by an impaired metabolism of catecholamines, neurotransmitters, and Sperner-Unterweger and Kohl (2014).

The model also addresses patients’ experience with social stigma. They are more inclined to accept the fact that their psychological disorder is caused biologically and is not due to patient’s ability.

The biomedical model favors the implementation of drug therapies for mental ill patients. This provides immediate relief from severe symptoms.

It focuses too much on illness as a result of nature.

It doesn’t take into consideration individual differences that may contribute to illness.

Behaviorist model: The main idea behind the behaviorist model is that abnormal or normal behavior is learned from the environment, and how it interacts with it.

Therefore, the environment plays an important role in diagnosing mental disorder.

The behaviorism approach states that people can learn new behavior through either operant or classical conditioning.

Classical conditioning involves the acquisition of positive or negative behavior using environmental stimuli. Operant conditioning is the learning process through reward and punishment (Horowitz, 2014).

This model has the advantage of helping mental health professionals understand behavioral changes caused by environmental factors.

Its simplistic approach has led to criticism.

The model is too simplified and has neglected the role of the unconscious mind in behavior.

Mental illness cannot therefore be assessed by only observing external behavior.

Mohr and colleagues (2013) suggest that there may be biological or psychological causes of mental illness.

This model was found to be ineffective because it focuses too much on the internal influences (thoughts and feelings about abnormal behavior) and is one-dimensional.

Psychoanalytical models: Sigmund Fréud created the psychoanalytical psychology model. This model posits that people can heal themselves by changing their motivation and thinking.

This model assumes that all mental disorders and mental illness can be traced back to the unconscious mind.

Unusual behavior can result from traumas or issues during a person’s childhood.

The model’s focus on the unconscious mind has been widely applied clinically to assist patients with anxiety disorders and depression (Stolorow Brandchaft & Atwood 2014).

This model has led to the creation of problem-based therapies, such as cognitive and behavioral therapies. These treatments focus on identifying client’s maladaptive thinking patterns and helping them develop healthy thoughts.

There are ethical issues that can arise from the application of this model.

For mentally ill patients, treatment can be either by antipsychotics or drug treatment.

Research has provided insights into the effectiveness and safety of antipsychotics in treating depressive disorder.

Leucht et. al. found that these drugs helped to alleviate severe depressive symptoms.

However, side-effects can lead to more complications for patients.

To minimize the complications, it is possible to combine other medications with antipsychotics for mental disorder.

Patients also have to be aware of the efficacy and tolerance of drugs (Spielmans et. al.

According to behaviorism, one treatment given to mentally ill people is behavioral therapy.

Behavioral therapy aims to correct maladaptive behavior and is based on the belief that every behavior can be learned.

Patients suffering from depression, anxiety disorder, and anger problems have found behavioral therapy to be effective.

Cognitive behavioral therapy is another part of behavioral treatment. Although it has been shown to be effective in reducing symptoms, the dropout rate for this therapy has been high (Hans & Hiller 2013).

To maximize the therapy’s effectiveness, it is important to address these issues.

Psychodynamic therapy is one example of the treatment options available under the psychodynamic approach.

It is designed to help people explore their emotions and feelings.

The therapy’s main purpose is to find any traumas or unresolved issues which have led to maladaptive thoughts and behaviors in patients.

Psychodynamic therapy has the advantage of allowing patients to explore their feelings freely.

It can help patients to improve their social, work and personal functioning as well as help them to cope with mental issues (Driessen et. al.

Refer to

Bassett A.M. and Baker C. (2015)

Normal or abnormal? “Normative uncertainty” in Psychiatric Practice.

Journal of Medical Humanities, 36(2) pp.89-111.

A clinical trial that randomized cognitive-behavioral therapy to psychodynamic therapy in outpatient treatment for major depression.

American Journal of Psychiatry. 170(9). pp. 1041-1050.

Hans, E., and Hiller W. (2013).

The effectiveness and dropout rates of outpatient cognitive behavior therapy for adult unipolar disorder: a meta-analysis nonrandomized effectiveness studies. DOI 10.1037/a0031080

Psychology Press.

Comparative effectiveness and tolerability 15 antipsychotic drugs for schizophrenia: a meta-analysis of multiple treatments.

The Lancet 382(9896), 951-962.

Mohr D.C. Burns M.N. Schueller S.M. Schueller G. Clarke M. Klinkman M.

Behavioral intervention technology: evidence review and future recommendations in mental health research.

Proctor S.L., Kopak A.M., and Hoffmann N.G.

Prevalence of cocaine abuse disorder: Current DSM-IV and proposed DSM-5 diagnostic criteria. There are two and three severity levels.

Psychology of Addictive Behaviors. 28(2). p. 563.

Potential interactions between immunological changes and neurotransmitters in depression

Adjunctive antipsychotic treatment for major depression: A meta-analysis on depression, quality and safety.

Psychoanalytic Treatment: An Intersubjective Approach.

Sue D., Sue D.W. Sue S. and Sue D.M. (2015)

Crawford, M.J.

Classification, assessment and prevalence of personality disorder.

The Lancet 385(9969), 717-726.

WHO