Abnormal

psychology

Abnormal psychology is the branch of

psychology that studies unusual patterns
of behavior, emotion, and thought, which
could possibly be understood as a mental
disorder. Although many behaviors could
be considered as abnormal, this branch of
psychology typically deals with behavior in
a clinical context.[1][2]: 1–4 There is a long
history of attempts to understand and
control behavior deemed to be aberrant or
deviant (statistically, functionally, morally,
or in some other sense), and there is often
cultural variation in the approach taken.
The field of abnormal psychology
identifies multiple causes for different
conditions, employing diverse theories
from the general field of psychology and
elsewhere, and much still hinges on what
exactly is meant by "abnormal". There has
traditionally been a divide between
psychological and biological explanations,
reflecting a philosophical dualism in regard
to the mind-body problem. There have also
been different approaches in trying to
classify mental disorders. Abnormal
includes three different categories; they
are subnormal, supernormal and
paranormal.[3]

The science of abnormal psychology

studies two types of behaviors: adaptive
and maladaptive behaviors. Behaviors that
are maladaptive suggest that some
problem(s) exist, and can also imply that
the individual is vulnerable and cannot
cope with environmental stress, which is
leading them to have problems functioning
in daily life in their emotions, mental
thinking, physical actions and talks.
Behaviors that are adaptive are ones that
are well-suited to the nature of people,
their lifestyles and surroundings, and to
the people that they communicate with,
allowing them to understand each other.[4]

Clinical psychology is the applied field of

psychology that seeks to assess,
understand, and treat psychological
conditions in clinical practice. The
theoretical field known as abnormal
psychology may form a backdrop to such
work, but clinical psychologists in the
current field are unlikely to use the term
abnormal in reference to their practice.
Psychopathology is a similar term to
abnormal psychology, but has more of an
implication of an underlying pathology
(disease process), and as such, is a term
more commonly used in the medical
specialty known as psychiatry.[5]

History

Humors

Hippocrates (460-377 B.C.E.),

hypothesized that the body and mind
become unwell when the so-called
humors, vital fluids in the body, become
unbalanced. The four temperaments
theory posits four such humors: black bile,
yellow bile, phlegm, and blood. Each
humor was associated with a particular
temperament: too much phlegm causes a
person to be fatigued, too much black bile
causes melancholia, yellow bile causes a
quick temper, and too much blood causes
optimism, cheerfulness, and confidence.[6]

Asylums

The act of placing individuals with mental

illness in a separate facility known as an
asylum dates to 1547, when King Henry VIII
of England established the St. Mary of
Bethlehem asylum in London. This
hospital, nicknamed Bedlam, was famous
for its deplorable conditions.[7] Asylums
remained popular throughout the Middle
Ages and the Renaissance era. These early
asylums were often in miserable
conditions. Patients were seen as a
"burden" to society, locked away and
treated almost like beasts to be dealt with,
rather than patients needing treatment.
However, many of the patients received
helpful medical treatment. There was
scientific curiosity into abnormal behavior,
although it was rarely investigated in the
early asylums. Inmates in these early
asylums were often put on display for
profit, as they were viewed as less than
human. The early asylums were basically
modifications of the existing criminal
institutions.[8]
In the late 18th century, the idea of
humanitarian treatment for the patients
gained much favor, due to the work of
Philippe Pinel in France. He pushed for the
idea that the patients should be treated
with kindness, and not the cruelty inflicted
on them, as if they were animals or
criminals. His experimental ideas, such as
removing the chains from the patients,
were met with reluctance. The experiments
in kindness proved to be a great success,
which helped to bring about a reform in the
way mental institutions would be run.[8]

Institutionalization would continue to

improve throughout the 19th and 20th
century, as a result of the work of many
humanitarians such as Dorothea Dix, and
the mental hygiene movement which
promoted the physical well-being of the
mental patients. "Dix, more than any other
figure in the nineteenth century, made
people in America and virtually all of
Europe aware that the insane were being
subjected to incredible abuses."[9] Through
this movement, millions of dollars were
raised to build new institutions to house
the mentally ill. Mental hospitals began to
grow substantially in numbers during the
20th century, as care for the mentally ill
increased in them.
By 1939, there were over 400,000 patients
in state mental hospitals in the US.[10]
Hospital stays were normally quite long for
the patients, with some individuals being
treated for many years. These hospitals,
while better than the asylums of the past,
were still lacking in the means of effective
treatment for the patients. Even though the
reform movement had occurred, patients
were often still met with cruel and
inhumane treatment.

Things began to change in the year 1946,

when Mary Jane Ward published the
influential novel titled The Snake Pit, which
was made into a popular movie of the
same name. The book called attention to
the conditions which mental patients
faced, and helped to spark concern in the
general public to create more humane
mental health care in these overcrowded
hospitals.[10]

That same year, the National Institute of

Mental Health was also created, which
provided support for the training of
hospital employees, and research into the
conditions of the patients. During this
period, the Hill-Burton Acts was also
passed, which was a program that funded
mental health hospitals. Along with the
Community Health Services Act of 1963,
the Hill-Burton Acts helped with the
creation of outpatient psychiatric clinics,
inpatient general hospitals, and
rehabilitation and community consultation
centers.[8]

Deinstitutionalisation

In the late twentieth century, however, a

large number of mental hospitals were
closed in many countries. In England, for
example, only 14 of the 130 psychiatric
institutions that had been created in the
early 20th century remained open at the
start of the 21st century.[10] In 1963,
President John F. Kennedy launched the
community health movement in the United
States as a "bold new approach" to mental
health care, aimed at coordinating mental
health services for citizens in mental
health centers. In the span of 40 years, the
United States was able to see an about 90
percent drop in the number of patients in
psychiatric hospitals.[7]

Deinstitutionalisation ended the long-term

confinement of patients in isolating mental
hospitals, which could and did cause long-
term negative adaptations. For instance,
institutionalizing people with schizophrenia
worsens negative symptoms.[11] However,
the practice is sometimes criticised for a
perceived rise in homelessness amongst
people who were previously
institutionalized, or are presumed that they
would have been in the institution
era.[12][13]

Explaining abnormal
behaviour

People have tried to explain and control

abnormal behavior for thousands of years.
Historically, there have been three main
approaches to abnormal behavior: the
supernatural, biological, and psychological
traditions.[2]: 7 Abnormal psychology
revolves around two major paradigms for
explaining mental disorders, the
psychological paradigm and the biological
paradigm. The psychological paradigm
focuses more on the humanistic, cognitive,
and behavioral causes and effects of
psychopathology. The biological paradigm
includes theories that focus more on
physical factors, such as genetics and
neurochemistry.

Supernatural explanations

In the first supernatural tradition, also

called the demonological method,
abnormal behaviors are attributed to
agents outside human bodies. According
to this model, abnormal behaviors are
caused by demons, aliens, or spirits, or the
influences of the Moon, planets, and stars.
During the Stone Age, trepanning was
performed on those who had mental
illness, to literally cut the evil spirits out of
the victim's head. Conversely, Ancient
Chinese, Ancient Egyptians, and Hebrews
believed that these were evil demons or
spirits and advocated exorcism. By the
time of the Greeks and Romans, mental
illnesses were thought to be caused by an
imbalance of the four humors, leading to
draining of fluids from the brain. During the
Medieval period, many Europeans believed
that the power of witches, demons, and
spirits caused abnormal behaviors. People
with psychological disorders were thought
to be possessed by evil spirits that had to
be exorcised through religious rituals. If
exorcism failed, some authorities
advocated steps such as confinement,
beating, and other types of torture to make
the body uninhabitable to witches,
demons, and spirits. The belief that
witches, demons, and spirits are
responsible for the abnormal behavior
continued into the 15th century.[2]: 8 Swiss
alchemist, astrologer, and physician
Paracelsus (1493–1541), on the other
hand, rejected the idea that abnormal
behaviors were caused by witches,
demons, and spirits and suggested that
people's mind and behaviors were
influenced by the movements of the moon
and stars.[2]: 11 This tradition is still alive
today. Some people, especially in the
developing countries, as well as some
followers of religious sects in the
developed countries, continue to believe
that supernatural powers influence human
behaviors. In Western academia, the
supernatural tradition has been largely
replaced by the biological and
psychological traditions.[2]: 26

Supernatural traditions
Throughout time, societies have proposed
several explanations of abnormal behavior
within human beings. Beginning in some
hunter-gatherer societies, animists have
believed that people demonstrating
abnormal behavior are possessed by
malevolent spirits. This idea has been
associated with trepanation, the practice
of cutting a hole into the individual's skull
in order to release the malevolent
spirits.[14] Although it has been difficult to
define abnormal psychology, one definition
includes characteristics such as statistical
infrequency.[15]
A more formalized response to spiritual
beliefs about abnormality is the practice of
exorcism. Performed by religious
authorities, exorcism is thought of as
another way to release evil spirits who
cause pathological behavior within the
person. In some instances, individuals
exhibiting unusual thoughts or behaviors
have been exiled from society, or worse.
Perceived witchcraft, for example, has
been punished by death. Two Catholic
Inquisitors wrote the Malleus Maleficarum
(Latin for "The Hammer Against Witches"),
which was used by many Inquisitors and
witch-hunters. It contained an early
taxonomy of perceived deviant behavior,
and proposed guidelines for prosecuting
deviant individuals.[16]

Biological explanations

In the biological tradition, psychological

disorders are attributed to biological
causes. In the psychological tradition,
disorders are attributed to faulty
psychological development, and to social
context.[2]: 26 The medical or biological
perspective holds the belief that most or
all abnormal behavior can be attributed to
a medical factor; assuming all
psychological disorders are diseases.[17]
The Greek physician Hippocrates, who is
considered to be the father of Western
medicine, played a major role in the
biological tradition. Hippocrates and his
associates wrote the Hippocratic Corpus
between 450 and 350 BC, in which they
suggested that abnormal behaviors can be
treated like any other disease. Hippocrates
viewed the brain as the seat of
consciousness, emotion, intelligence, and
wisdom and believed that disorders
involving these functions would logically
be located in the brain.[2]: 11

These ideas of Hippocrates and his

associates were later adopted by Galen,
the Roman physician. Galen extended
these ideas and developed a strong and
influential school of thought within the
biological tradition that extended well into
the 18th century.

Medical: Kendra Cherry states: "The

medical approach to abnormal psychology
focuses on the biological causes of
mental illness. This perspective
emphasizes understanding the underlying
cause of disorders, which might include
genetic inheritance, related physical
disorders, infections, and chemical
imbalances. Medical treatments are often
pharmacological in nature, although
medication is often used in conjunction
with some other type of psychotherapy."[18]

Psychological explanations

According to Sigmund Freud's structural

model, the id, ego, and superego are three
theoretical constructs that define the way
an individual interacts with the external
world, as well as responding to internal
forces[19] 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. Finally, the ego serves to
realistically integrate the drives of the id
with the prohibitions of the super-ego.
Lack of development in the Superego, or
an incoherently developed Superego within
an individual, will result in thoughts and
actions that are irrational and abnormal,
contrary to the norms and beliefs of
society.[19]

Irrational beliefs

Irrational beliefs that are driven by

unconscious fears, can result in abnormal
behavior.[20] Rational emotive behavior
therapy helps to drive irrational and
maladaptive beliefs out of one's mind.[20]
Sociocultural influences

The term sociocultural refers to the

various circles of influence on the
individual, ranging from close friends and
family, to the institutions and policies of a
country, or the world as a whole.
Discriminations, whether based on social
class, income, race and ethnicity, or
gender, can influence the development of
abnormal behaviour.[21]

Multiple causality

The number of different theoretical

perspectives in the field of psychological
abnormality has made it difficult to
properly explain psychopathology. The
attempt to explain all mental disorders
with the same theory leads to
reductionism (explaining a disorder or
other complex phenomena using only a
single idea or perspective).[22] Most
mental disorders are composed of several
factors, which is why one must take into
account several theoretical perspectives,
when attempting to diagnose or explain a
particular behavioral abnormality or mental
disorder. Explaining mental disorders with
a combination of theoretical perspectives
is known as multiple causality.
The diathesis–stress model[23]
emphasizes the importance of applying
multiple causality to psychopathology, by
stressing that disorders are caused by
both precipitating causes, and
predisposing causes. A precipitating cause
is an immediate trigger that instigates a
person's action or behavior. A predisposing
cause is an underlying factor that interacts
with the immediate factors to result in a
disorder. Both causes play a key role in the
development of a psychological
disorder.[22] For example, high neuroticism
antedates most types of
psychopathology.[24]
Recent concepts of abnormality

Statistical abnormality[25] – when a

certain behavior/characteristic is
relevant to a low percentage of the
population. However, this does not
necessarily mean that such individuals
have mental illness (for example,
statistical abnormalities such as
extreme wealth/attractiveness)
Psychometric abnormality –
Psychometric abnormality implicates
abnormality as a deviation from a
statistically determined norm, such as
the population average IQ of 100. In this
case, an IQ score less than about 70–75
may define someone as having a
learning disability, and suggests they will
have some difficulties coping with life.
However, the problems associated with
a low IQ differ widely across individuals
depending on their life circumstances.
So, even when an individual is defined as
psycho-metrically 'abnormal', this tells
us little about their actual condition or
problems. Furthermore, if one takes the
other end of the IQ spectrum, a deviation
of 30 points above the mean is generally
not considered to be abnormal, or to
indicate the presence of mental health
problems.
 Deviant behavior – this is not always a
sign of mental illness, as mental illness
can occur without deviant behavior, and
such behavior may occur in the absence
of mental illness.
Combinations – including distress,
dysfunction, distorted psychological
processes, inappropriate responses in
given situations, and causing/risking
harm to oneself.[26]

Examples

There is a wide range of mental disorders

that are considered to be forms of
Abnormal Psychology. These include, but
are not limited to:
Schizophrenia

Schizophrenia can be described as a

disorder that causes extreme loss of
touch with reality. The Psychotic nature of
schizophrenia manifests itself through
delusions, as well as auditory and visual
hallucinations. Schizophrenia is known to
have a genetic etiology, as well as other
biological components, such as brain
disruptions in the prenatal development
period.[27]: 323–326

Attention deficit hyperactivity disorder

Attention deficit hyperactivity disorder

(ADHD) is characterized by high amounts
of inattention and hyperactive
impulsiveness. Inattentive symptoms
include not listening, careless errors,
disorganization, losing personal
belongings, becoming easily distracted,
and forgetfulness. Symptoms of
hyperactive impulsiveness include
fidgeting, talking excessively, and
interrupting others.[27]: 225–253

Antisocial personality disorder

Antisocial personality disorder can be

described as a cluster of personality traits
that lead to specific outcomes, and violate
the rights of other people. These
personality traits include callousness,
deceitfulness, lack of remorse, apathy,
manipulation of others, impulsiveness, and
grandiosity.[28] Additional traits may
include superficial charm, sexual
promiscuity, and pathological lying.[28]

Dissociative identity disorder

Dissociative identity disorder (DID)

involves one individual having multiple
personalities. Those with DID are
described as having multiple selves that
each have their own consciousness and
awareness.[29]
DID has two main etiologies, which are the
post-traumatic and socio-cognitive
models.[29] The post-traumatic model
states that DID is caused by inescapable
past trauma, such as child abuse. The
child dissociates and forms alternate
personalities, as a coping mechanism in
response to the current trauma. Even when
the trauma ends, the personalities
continue to disrupt the person's life
longterm. The socio-cognitive model
states that people implicitly act as if they
have multiple personalities, and this is
done to align with cultural norms.[29]

Social anxiety disorder

Those with social anxiety disorder (SAD)
have a very intense fear of social
situations. This fear stems from the belief
that the person will be evaluated
negatively, or embarrass themselves.[30]

SAD is also considered to be one of the

more disabling mental disorders.
Symptoms of this disorder include fear in
most, if not all social situations.[30] SAD
can develop after a traumatic and/or
embarrassing experience has occurred
while the person was being observed by
other people.[27]: 200–202

Generalized anxiety disorder

Generalized anxiety disorder is
characterized by a constant, chronic state
of worry and anxiety that is related to a
large variety of situations, and is difficult
to control. Additional symptoms may
include irritability, fatigue, concentration
difficulties, and restlessness.[31]

Specific phobia

Individuals with specific phobias have an

extreme fear and avoidance of various
objects or situations.[32] Specifically, fears
become phobias when there is excessive
and unreasonable fear that is
disproportionate to the culture that the
individual is in.[27]: 199–200 Examples of
specific phobias include, but are not
limited to, phobias of school, blood, injury,
needles, small animals, and heights.[32]

Post-traumatic stress disorder

Post-traumatic stress disorder (PTSD) is

described as physical and mental distress
related to past traumatic experiences.
PTSD can manifest a large variety of
symptoms, including, but not limited to,
nightmares, flashbacks, avoidance and/or
physiological reactions related to stimuli
regarding the trauma, shame, guilt, anger,
hypervigilance, and social withdrawal.[33]
PTSD symptoms can arise due to various
experiences that involve actual or
threatened violence, injury, or death.
Firsthand experience, witnessing, or
learning about traumatic experiences can
possibly lead to the development of
PTSD.[33]

Approaches

Somatogenic – abnormality is seen as a

result of biological disorders in the
brain.[34] This approach has led to the
development of radical biological
treatments, e.g. lobotomy.
Psychogenic – abnormality is caused by
psychological problems. Psychoanalytic
(Freud), Cathartic, Hypnotic and
Humanistic Psychology (Carl Rogers,
Abraham Maslow)[35] treatments were
all derived from this paradigm. This
approach has, as well, led to some
esoteric treatments: Franz Mesmer used
to place his patients in a darkened room
with music playing, then enter it wearing
a flamboyant outfit and poke the
"infected" body areas with a stick.
Classification

DSM-5

The standard abnormal psychology and

psychiatry reference book in North
America is the Diagnostic and Statistical
Manual of the American Psychiatric
Association. The current version of the
book is known as the DSM-5. It lists a set
of disorders and provides detailed
descriptions on what constitutes a mental
disorder.[36]

The DSM-5 identifies three key elements

that must be present to constitute a
mental disorder. These elements
include:[36]

Symptoms that involve disturbances in

behavior, thoughts, or emotions.
Symptoms associated with personal
distress or impairment.
Symptoms that stem from internal
dysfunctions (i.e. specifically having
biological and/or psychological
roots).[37]

The DSM-5 uses three main sections to

organize its contents. These sections
include I, II, and III. Section I includes the
introduction, use, and basics of the DSM-5.
Section II includes diagnostic criteria and
codes. Section III includes emerging
measures and models.[36]

Section I (DSM-5 Basics)

Section I of the DSM-5 briefly prefaces

purpose, content, structure, and use.[36]
This includes basics, introductions and
cautionary statements for forensic use.[36]
Information is also given about the revision
and review processes as well as the DSM-
5's goals to harmonize with the ICD-11. An
explanation regarding the change from the
previous multi-axial classification system
to the current three section system is also
included here.[36]

Section II (Diagnostic Criteria and

Codes)

Section II of the DSM-5 Contains a wide

range of diagnostic criteria and codes
used for establishing, and diagnosing the
vast amount of abnormal psychological
constructs.[36] This sections replaced the
bulk of the axis system in the previous
DSM versions and includes the following
categories:[36]

Diagnostic Criteria and codes[36]

Neurodevelopmental Disorders[36]
Schizophrenia Spectrum and Other
Psychotic Disorders[36]
Bipolar and related Disorders[36]
Depressive Disorders[36]
Anxiety Disorders[36]
Obsessive-Compulsive and related
Disorders[36]
Trauma and Stressor related
disorders[36]
Dissociative Disorders[36]
Somatic Symptom and Related
Disorders[36]
Feeding and Eating Disorders[36]
Elimination Disorders[36]
Sleep Wake Disorders[36]
Sexual Dysfunctions[36]
Gender Dysphoria[36]
Disruptive, Impulse Control, and Conduct
Disorders[36]
Substance Related and Addictive
Disorders[36]
Neurocognitive Disorders[36]
Personality Disorders[36]
Paraphilic Disorders[36]
Medication induced movement
disorders and effects of medication.[36]
 Other Mental disorders and additional
Codes[36]

These categories are used to organize the

various Abnormal psychological concepts
based on their similarity.[36]

Section III (Emerging Measures and

Models)

Section III of the DSM-5 contains the

various methods and strategies that are
used to make clinical decisions,
understand culture, and explore emerging
diagnoses.[36]
ICD-10

The major international nosologic system

for the classification of mental disorders
can be found in the International
Classification of Diseases, 10th revision
(ICD-10). The ICD-10 has been used by
World Health Organization (WHO) Member
States since 1994. Chapter five covers
some 300 mental and behavioral
disorders. The ICD-10's chapter five has
been influenced by APA's DSM-IV and there
is a great deal of concordance between
the two. Beginning in January 2022, the
ICD-11 will replace the ICD-10 in WHO
member states.[38] WHO maintains free
access to the ICD-10 Online (https://www.
who.int/classifications/icd/en/) . Below
are the main categories of disorders:

F00–F09 Organic, including

symptomatic, mental disorders[39]
F10–F19 Mental and behavioral
disorders due to psychoactive
substance use[39]
F20–F29 Schizophrenia, schizotypal and
delusional disorders[39]
F30–F39 Mood [affective] disorders[39]
F40–F48 Neurotic, stress-related and
somatoform disorders[39]
F50–F59 Behavioral syndromes
associated with physiological
disturbances and physical factors[39]
F60–F69 Disorders of adult personality
and behavior[39]
F70–F79 Mental retardation[39]
F80–F89 Disorders of psychological
development[39]
F90–F98 Behavioral and emotional
disorders with onset usually occurring in
childhood and adolescence[39]
F99 Unspecified mental disorder[39]
ICD-11

The ICD-11 is the most recent version of

the International Classification of
Diseases. The Mental, behavioral, or
Neurodevelopmental disorders section
highlights forms of abnormal
psychology.[40]

Mental, behavioral, or
Neurodevelopmental disorders

6A00-6A0Z Neurodevelopmental
disorders[40]
6A20-6A2Z Schizophrenia or other
primary psychotic disorders[40]
6A40-6A4Z Catatonia[40]
6A60-6A8Z Mood Disorders[40]
6B00-6B0Z Anxiety or fear related
disorders[40]
6B20-6B2Z Obsessive-compulsive or
related disorders[40]
6B40-6B4Z Disorders specifically
associated with stress[40]
6B60-6B6Z Dissociative disorders[40]
6B80-6B8Z Feeding or eating
disorders[40]
6C00-6C0Z Elimination Disorders[40]
6C20-6C2Z Disorders of bodily distress
or bodily experience[40]
Disorders due to substance use or
addictive behaviors[40]
6C70-6C7Z Impulse control
disorders[40]
6C90-6C9Z Disruptive behavior or
dissocial disorders[40]
6D10-6E68 personality disorders and
related traits[40]
6D30-6D3Z Paraphilic disorders[40]
6D50-6D5Z Factitious disorders[40]
6D70-6E0Z Neurocognitive disorders[40]
6E20-6E2Z Mental or behavioral
disorders associated with pregnancy,
childbirth or the puerperium[40]
 6E40.0-6E40.Z (6E40) Psychological or
behavioral factors affecting disorders or
diseases classified elsewhere[40]
6E60-6E6Z secondary mental or
behavioral syndromes associated with
disorders or diseases classified
elsewhere[40]

Perspectives of abnormal
psychology

Psychologists may use different

perspectives to try to get better
understanding on abnormal psychology.
Some of them may just concentrate on a
single perspective. But the professionals
prefer to combine two or three
perspectives together in order to get
significant information for better
treatments.

Behavioral – the perspective focus on

observable behaviors
Medical – the perspective focus on
biological causes on mental illness
Cognitive – the perspective focus on
how internal thoughts, perceptions and
reasoning contribute to psychological
disorders
Cause

Genetics

Investigated through family studies,

mainly of monozygotic (identical) and
dizygotic (fraternal) twins, often in the
context of adoption. Monozygotic twins
should be more likely than dizygotic
twins to have the same disorder
because they share 100% of their
genetic material, whereas dizygotic
twins share only 50%. For many
disorders, this is exactly what research
shows. But given that monozygotic
 twins share 100% of their genetic
material, it may be expected of them to
have the same disorders 100% of the
time, but in fact they have the same
disorders only about 50% of the time[41]
These studies allow calculation of a
heritability coefficient.
Genetic vulnerabilities (Diathesis stress
Model)[27]: 290–291

Biological causal factors

Neurotransmitter [imbalances of
neurotransmitters like norepinephrine,
dopamine, serotonin and GABA (Gamma
 aminobutyric acid)] and hormonal
imbalances in the brain[42]
Constitutional liabilities [physical
handicaps and temperament]
Brain dysfunction and neural plasticity
Physical deprivation or disruption
[deprivation of basic physiological
needs]

Socio-cultural factors

Effects of urban/rural dwelling, gender

and minority status on state of mind[43]
Generalizations about cultural practices
and beliefs may fail to capture the
diversity that exists within and across
 cultural groups, so we must be
extremely careful not to stereotype
individuals of any cultural group[44]
Experiences with child physical and or
sexual abuse.[33]
Encounters with environments that
involve actual or threatened death[33]

Systemic factors

Family systems[45]
Negatively Expressed Emotion playing a
part in schizophrenic relapse and
anorexia nervosa.
Biopsychosocial factors

Illness dependent on stress "triggers".[46]

Therapies

Psychoanalysis (Freud)

Psychoanalytic theory is heavily based on

the theory of the neurologist Sigmund
Freud. These ideas often represented
repressed emotions and memories from a
patient's childhood. According to
psychoanalytic theory, these repressions
cause the disturbances that people
experience in their daily lives, and by
finding the source of these disturbances,
one should be able to eliminate the
disturbance itself. This is accomplished by
a variety of methods, with some popular
ones being free association, hypnosis, and
insight. The goal of these methods is to
induce a catharsis, or emotional release in
the patient, which should indicate that the
source of the problem has been tapped,
and it can then be treated. Freud's
psychosexual stages also played a key
role in this form of therapy, as he would
often believe that the problems the patient
was experiencing were due to them
becoming stuck, or "fixated", in a particular
stage. Dreams also played a major role in
this form of therapy, as Freud viewed
dreams as a way to gain insight into the
unconscious mind. Patients were often
asked to keep dream journals to bring in
for discussion during the next therapy
session. There are many potential
problems associated with this style of
therapy, including resistance to the
repressed memory or feeling, and negative
transference onto the therapist.
Psychoanalysis was carried on by many
after Freud, including his daughter Anna
Freud, and Jacques Lacan. Many others
have also gone on to elaborate on Freud's
original theory, and to add their own take
on defense mechanisms or dream
analysis.[47] While psychoanalysis has
fallen out of favor to more modern forms
of therapy, it is still used by some clinical
psychologists to varying degrees.[48]

Behavioral therapy (Wolpe)

Behavior therapy relies on the principles of

behaviorism, such as involving classical
and operant conditioning. Behaviorism
arose in the early 20th century, from the
work of psychologists such as James
Watson and B. F. Skinner. Behaviorism
states that all behaviors humans do is
because of a stimulus and reinforcement.
While this reinforcement is normally for
good behavior, it can also occur for
maladaptive behavior. In this therapeutic
view, the patients maladaptive behavior
has been reinforced, which will cause the
maladaptive behavior to be repeated. The
goal of the therapy is to reinforce less
maladaptive behaviors, so that with time,
these adaptive behaviors will become the
primary ones in the patient.[49]

Humanistic therapy (Rogers)

Humanistic therapy aims to achieve self-

actualization (Carl Rogers, 1961). In this
style of therapy, the therapist will focus on
the patient themselves, as opposed to the
patient's problem. The goal of this therapy
is, by treating the patient as "human", rather
than "client", to get to the source of the
problem, and to resolve the problem in an
effective manner. Humanistic therapy has
been on the rise in recent years, and has
been associated with numerous positive
benefits. It is considered to be one of the
core elements needed for therapeutic
effectiveness, and a significant contributor
to not only the well-being of the patient,
but society as a whole. Some say that all
of the therapeutic approaches today draw
from the humanistic approach in some
regard, and that humanistic therapy is the
best way for treat a patient.[50] Humanistic
therapy can be used on people of all ages;
it is very popular among children in its
variant known as "play therapy".[51]

Cognitive behavioural therapy (Ellis

and Beck)

Cognitive behavioural therapy (CBT) aims

to influence thought and cognition (Beck,
1977). This form of therapy relies on not
only the components of behavioral therapy
as mentioned before, but also the
elements of cognitive
psychology.[27]: 101–102 This relies on not
only the clients behavioral problems that
could have arisen from conditioning, but
also their negative schemas and distorted
perceptions of the world around them.
These negative schemas may cause
distress in the life of the patient; for
example, the schemas may give them
unrealistic expectations for how well they
should perform at their job, or how they
should look physically. When these
expectations are not met, it will often
result in maladaptive behaviors, such as
depression, obsessive compulsions, and
anxiety. With CBT, the goal is to change the
schemas that are causing the stress in the
patients life, and replace them with more
realistic ones. Once the negative schemas
have been replaced, it will hopefully cause
a remission of the patients symptoms.
CBT is considered particularly effective in
the treatment of depression, and has even
been used in recent years in group
settings. It is felt that using CBT in a group
setting aids in giving its members a sense
of support, and decreasing the likelihood
of them dropping out of therapy before the
treatment has had time to work
properly.[52] CBT has been found to be an
effective treatment for many patients, even
those who do not have diseases and
disorders typically thought of as
psychiatric ones. For example, patients
with the disease multiple sclerosis have
found a lot of help using CBT. The
treatment often helps the patients cope
with the disorder they have, and how they
can adapt to their new lives without
developing new problems, such as
depression, or negative schemas about
themselves.[53]

According to RAND, therapies are difficult

to provide to all patients in need. A lack of
funding and understanding of symptoms
provides a major roadblock that is not
easily avoided. Individual symptoms and
responses to treatments vary, which
creates a disconnect between patient,
society, and care givers/professionals.[54]
Play therapy (Humanistic)

Children are often sent to therapy due to

outbursts that they have in a school or
home setting; the theory is that by treating
the child in a setting that is similar to the
area that they are having their disruptive
behavior, the child will be more likely to
learn from the therapy, and have an
effective outcome. In play therapy, the
clinicians will "play" with their client, usually
with toys, or a tea party. Playing is the
typical behavior of a child, and therefore,
playing with the therapist will come as a
natural response to the child. In playing
together, the clinician will ask the patient
questions, and due to the setting, the
questions seem less intrusive, more
therapeutic, and more like a normal
conversation. This should help the patient
realize issues they have, and confess them
to the therapist with less difficulty than
they may experience in a traditional
counselling setting.[55]

Play therapy involves a therapist observing

a child, as the child plays with toys and
interacts with their surrounding
environment. The therapist plays an
observational as well as an interactional
role in the intervention. This process
allows for the child to enact their problems
through play, and speak more comfortably
with the therapist.[27]: 102–103 Although
somewhat controversial, due to data that
suggests a lack of effectiveness in
children older than 10 years old, play
therapy has been shown to be a valuable
treatment. This therapy is particularly
useful for younger children under the age
of 10, who are consciously aware of their
environment. Play therapy is important,
seeing as many therapeutic interventions
that are effective for adults have shown to
be less effective for children.[51]
Family systems therapies

Family systems therapies are based on the

belief that children's problems revolve
around problems that occur within the
family. Family systems therapy attempts
to improve the relations between multiple
people involved in specific families via
therapeutic intervention. For the best
effect, it is recommended that the entire
family be included in the therapy. The
treatments include family management
skill development, and child-parent
attachment development. These
interventions help to improve family
functioning.[27]: 102–103
Family management skill
development (Family systems
therapy)

Family management skills can be taught

by family therapists, and include methods
such as improving supervision, disciplinary
practices, and creating environments that
allow for positive interactions between
parents and children.[27]: 102–103

Child-parent attachment development

(Family systems therapy)

Child-parent attachment development

involves altering or creating relationships
between parents and children, in attempts
to create secure bases for the child, and to
facilitate trust, independence, and positive
perceptions of family relationships. We
see these situations a lot more than we
think which makes some spectrums of
abnormal psychology more normal, and
more common. [45] These goals are often
achieved by creating understanding
regarding behaviors, creating opportunities
for attachment, and increasing the family's
ability to think about their history and
relationships.[45]

See also

Abuse
Cognitive behavioral therapy
International Classification of Diseases
Insanity defense
Mental Health Act 1983
Mental Health Act 2007
M'Naghten Rules
Models of abnormality
Outline of psychology
Parapsychology
Seasonal affective disorder
Zero stroke
Society of Clinical Child & Adolescent
Psychology
List of organizations in psychology
Notes

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w.ncbi.nlm.nih.gov/pmc/articles/PMC438236
8) . Clinical Psychology Review. 33 (5): 686–
697. doi:10.1016/j.cpr.2013.04.003 (https://d
oi.org/10.1016%2Fj.cpr.2013.04.003) .
PMC 4382368 (https://www.ncbi.nlm.nih.gov/
 pmc/articles/PMC4382368) .
PMID 23702592 (https://pubmed.ncbi.nlm.ni
h.gov/23702592) .

Further reading

Ahn WK, Novick LR, Kim NS (September

2003). "Understanding behavior makes it
more normal" (https://ahnthinkinglab.yale.ed
u/sites/default/files/files/Papers/ahnnovickki
m2003-1.pdf) (PDF). Psychonomic Bulletin &
Review. 10 (3): 746–52.
doi:10.3758/bf03196541 (https://doi.org/10.
3758%2Fbf03196541) . PMC 2654343 (http
s://www.ncbi.nlm.nih.gov/pmc/articles/PMC2
654343) . PMID 14620373 (https://pubmed.n
cbi.nlm.nih.gov/14620373) .
 Zvolensky MJ, Kotov R, Antipova AV, Schmidt
NB (April 2005). "Diathesis stress model for
panic-related distress: a test in a Russian
epidemiological sample". Behaviour Research
and Therapy. 43 (4): 521–32.
doi:10.1016/j.brat.2004.09.001 (https://doi.or
g/10.1016%2Fj.brat.2004.09.001) .
PMID 15701361 (https://pubmed.ncbi.nlm.ni
h.gov/15701361) . S2CID 2979875 (https://a
pi.semanticscholar.org/CorpusID:2979875) .

External links

Abnormal Psychology Students Practice

Resources (https://web.archive.org/we
b/20080108152418/http://minnay.com/
products/)
 Psychology Terms – a 600-page
dictionary pdf (https://web.archive.org/
web/20170712233214/http://english4su
ccess.ru/Upload/books/1278.pdf)
A Course in Abnormal Psychology (http
s://web.archive.org/web/200912020228
10/http://ccvillage.buffalo.edu/Abpsy/)

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