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What is Abnormal Psychology?

Scientific study of psych disorders/mental disorders/abnormal behaviour
- can be abnormal without pathology


What entails the empirical method of studying abnormal psychology?

1. Description of symptoms (classification, diagnosis)
But: Problematic.
- E.g. Doctors associated some symptoms to the "Fevers": however, this symptom was also part of other different diseases (poor differentiation)
- Also difficulty in distinguishing the different diseases as distinct from each other, or if they are describing the same disease
2. Identify Causation of symptoms
3. Identify what Maintains symptoms
4. Treatment of "abnormality"/psych/mental disorders


What is the history behind the definition of "Mental Disorder"?

Olden days: Mental illness - madness, insanity
- Gross distortions of reality (hallucinations, delusions, etc.)
- Disorganisation of speech/affect/behav (confusion, memory loss)
- Similar to today's psychosis, schizophrenia, dementia
18-19C: small number of patients treated in mental asylums/hospitals by "mad doctors/alienists" - forerunners of psychiatrists
- Anxiety, sadness, angst etc. were just problems with living, and were overcome with help from priests/friends/family


What are mental disorders like today?

>400 categories of mental disorder, as listed in DSM (Diagnostic and Statistical Manual of Mental Disorders) and ICD (International Classification of Diseases and health related problems)
- Contain descriptions of symptom clusters: symptoms of abnormal behav that tend to cluster/appear together
e.g. schizophrenia, MDD, phobia etc treated by psychiatrists, psychologists, clin psy, social workers etc


What are the problems surrounding the estimation of the prevalence of a mental disorder?

- Not sufficient to record data merely from those seeking/receiving treatment - only a minority seek help
- Help-seeking influenced by cultural/financial reasons, education, knowledge, beliefs etc.


Name 3 ways that data is collected to assess psychiatric epidemiology?

- Community studies using large representative samples (10,000's of people)
- Internationally: National comorbidity survey; Epidemiologic Catchment Area Survey
- Aus: National survey of Mental Healthy & Wellbeing (ABS)


What does the Prevalence of mental disorder refer to?

Prevalence: Number of cases
What proportion of the population has a diagnosable disorder, within a specific time-period?


What is point-prevalence?

Point prevalence:
"Right now, X% of Australians have Y disease"


What is one-year prevalence?

One-year prevalence:
"In 2007, X% of Australians have Y disease"


What is lifetime prevalence?

Lifetime prevalence:
"During their lifetimes, X% of Australians have Y disease"


What does the Incidence of mental disorder refer to?

Incidence: Number of new cases
What proportion of healthy individuals will develop the disorder within a specified time period?
"Every year, X% of Australians develop Y disease for the first time"
- Gives info about behaviour of disorder


Other questions that help inform us about a mental disorder?

What proportion of indiv with diagnosis seek help? (Perception of help-seeking)
What proportion receive help? (do we cater for them)

Prevalence/incidence in various subpopulations (men/women, age, ethnic groups, etc.)
- helps us target these groups


What is the lifetime prevalence of mental disorders?

Adults: 32-48%
Before 21: 35-49%

National survey of Mental health and wellbeing:
Lifetime prev = 45%
7.3mil Australians (16-85y.o.) experienced anxiety, affective or substance use disorder in life
Only a third of people received help
- Highest: Schizophrenia (48% of patients)


What is the main concern of clinicians/public health in regards to mental health? But why may this not reflect reality?

Large of number people with mental disorders receive no treatment.

But, more likely it is due to overestimation of mental disorder prevalence.
- Due to classification of illnesses: increased % of diagnoses, or easy to meet criteria


What is the DSM Definition of Mental Disorder? (4)

1. A clinically significant behavioural/psychological syndrome or pattern
- Clin sig: sig enough for you to go and seek help
2. ...Associated with present distress or disability or with sig increased risk of suffering death, pain, disability, or an important loss of freedom
- hurts now, or hurts later
3. ...must not be merely an expectable and culturally sanctioned response to a particular event, for example, the death of a loved one.
4. ...whatever its original cause, it must be currently considered a manifestation of a behav/psycho/biological dysfunction in the individual (e.g. anxiety: good in face of danger, but dysfunctional when in non-threatening situations)

+ Social judgement of what is acceptable behav (e.g. seeing spirits: seen as gift in some cultures, not so in others)


What is the most serious flaw in psychiatric thinking?

Failure to consider whether or not symptoms of psychiatric disorders are actually harmful internal dysfunctions

--> overdiagnosis