normalcy, or what is psycholoically normal, is the degree to which _____

Defining "Normal" and "Abnormal"

Ideas of "normal" and "abnormal" are largely shaped by social standards and tin have profound social ramifications.

Learning Objectives

Clarify the challenges inherent in trying to ascertain "normal" and "abnormal"

Central Takeaways

Key Points

• What is considered "normal" changes with changing societal standards.
• Despite the challenges inherent in defining "normal," information technology is still of import to plant guidelines so as to be able to identify and help people who are suffering. This is the goal of the Diagnostic and Statistical Manual of Mental Disorders (known equally the DSM-five), a publication in the field of clinical psychology.
• The DSM-5 attempts to explicitly distinguish normality from abnormality based on specific symptoms.
• In very crude terms, order by and large sees normality equally good and aberration equally bad. Being labeled as "normal" or "abnormal" can have profound ramifications for an individual, such as exclusion or stigmatization past society.
• Stigma and discrimination tin add to the suffering and disability of those who are diagnosed with (or perceived to have) a mental disorder.
• In order to reduce stigma, a recent move has been fabricated toward the adoption of person-centered language: referring to people as "individuals with mental disease" rather than "mentally ill individuals" (e.chiliad., a "person with bipolar disorder," rather than a "bipolar person").

Cardinal Terms

• etiology: The establishment of a cause, origin, or reason for something.
• pathology: Any deviation from a salubrious or normal status; abnormality.
• social norms: Grouping-held beliefs nigh how members of that grouping should bear in a given situation.
• stressor: An environmental condition or influence that causes distress for an organism.
• stigma: The societal disapproval and judgment of a person or group of people because they do not fit their community's social norms.

Challenges in Defining "Normal"

A psychological disorder is a status characterized by abnormal thoughts, feelings, and behaviors. However, defining what is "normal" and "abnormal" is a subject field of much debate. Definitions of normality vary widely by person, time, identify, civilization, and situation. "Normal" is, later all, a subjective perception, and also an baggy one—it is often easier to describe what is not normal than what is normal.

In simple terms, however, society at large oftentimes perceives or labels "normal" equally "adept," and "abnormal" as "bad." Being labeled as "normal" or "abnormal" can therefore have profound ramifications for an individual, such equally exclusion or stigmatization by lodge.

Although it is difficult to define "normal," it is still important to establish guidelines in social club to exist able to identify and aid people who are suffering. To this end, the fields of psychology and psychiatry have developed the Diagnostic and Statistical Transmission of Mental Disorders (known as the DSM-five), a standardized hierarchy of diagnostic criteria to help discriminate among normal and abnormal (i.e. "pathological") behaviors and symptoms. The 5th edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (the DSM-5) lays out explicit and specific guidelines for identifying and categorizing symptoms and diagnoses.

Clinical Definitions of Abnormal: The DSM

The DSM is a central chemical element of the debate around defining normality, and it continues to change and evolve. Currently, in the DSM-5 (the fifth edition), abnormal beliefs is mostly divers as behavior that violates a norm in society, is maladaptive, is rare given the context of the culture and environs, and is causing the person distress in their daily life. Specifically, the goal of the DSM-5 is to identify abnormal behavior that is indicative of some kind of psychological disorder. The DSM identifies the specific criteria used when diagnosing patients; information technology represents the industry standard for psychologists and psychiatrists, who ofttimes work together to diagnose and care for psychological disorders.

Equally the DSM has evolved over time, in that location take been a number of conflicts surrounding the categorization of abnormal versus normal mental functioning. Much of this difficulty comes from distinguishing betwixt an expected stress reaction (a reaction to stressful life events that could be considered "normal") and individual dysfunction (symptoms or stress reactions that are beyond what a "normal" or expected reaction might be). As a issue, the DSM explicitly distinguishes mental disorders and not-disordered weather. A non-matted condition results from, or is perpetuated by, social stressors. To this end, the DSM requires that to run across the diagnostic criteria for a mental disorder, an private'southward symptoms "must not be simply an expectable and culturally sanctioned response to a detail issue; for example, the death of a loved ane. Whatever [the design of symptoms'] original cause, information technology must currently be considered a manifestation of a behavioral, psychological, or biological dysfunction in the individual."

That said, if an individual's response to a item situation is causing significant impairment in more than than 1 surface area of the individual's life (such equally work, home, school environment, or relationships), information technology may be considered abnormal or an indicator of a psychological disorder regardless of its etiology.

Stigma

It is important to analyze the societal consequences of diagnosis because so many people experience mental illness at some point in their lives. Co-ordinate to the World Wellness Organization (WHO), more than a third of people globally meet the criteria for at least one diagnosable mental disorder at some indicate in their lives. Unfortunately, stigma and discrimination tin can add to their suffering and disability. This has led various social movements to work to increase societal awareness and understanding of mental illness and challenge social exclusion.

A stigma is the societal disapproval and judgment of a person or grouping of people because they do not fit their community's social norms. In the context of mental disease, social stigma is characterized equally prejudiced attitudes and discriminatory beliefs directed toward individuals with mental illness as a upshot of the characterization they accept been given. In the Us, people are often pressured to be "normal"—or at least perceived as such—in order to gain acceptance by lodge. Society tends to be uncomfortable with "abnormality"—then if someone does not conform to what is perceived as normal, they might exist given a number of negative labels, such equally "sick", "crazy", or "psycho." These labels lead to discrimination, marginalization, and isolation of—fifty-fifty violence against—the individual.

Self-Stigma

In a related issue, self-stigmatization is when someone internalizes society'southward negative perceptions of them or of people they retrieve are like them: they begin to believe, or fear that others will believe, that the negative labels and perceptions are true.

NAMI logo: The National Brotherhood on Mental Disease aims to reduce societal stigma and shaming of various mental illnesses.

Effects of Stigma and Self-Stigma

This internalization contributes to feelings of shame and usually leads to poorer treatment outcomes. Experience of stigma or cocky-stigma can also lead to the following:

• Refusal to receive treatment. An individual'southward fear of stigmatization and breach may lead them to decline treatment altogether. Anxiety about others' perceptions and the social consequences that come forth with a label of mental affliction oft deter people from seeking assistance in any therapeutic, familial, social, or pharmacological context.
• Social isolation. An individual with mental illness may avoid social settings altogether; for example, an private struggling with depression may choose not to see or speak with friends and family for fear of "bringing them down" or "existence a burden." This is especially dangerous in light of the knowledge that social connectedness is ane of the central factors in recovery from mental illness.
• Distorted perception of the incidence of mental illness. Although approximately one in three people volition experience mental illness at some point in their life, at that place are still many people who do not acknowledge mental affliction every bit a public health concern. By causing people to non seek out treatment, society's stigma of mental illness leads to fewer diagnoses and fewer people getting aid. This means that mental illness seems far less common than it actually is.

Combating Stigma

Stigmas are usually deeply ingrained in gild over many years and and then cannot exist eradicated instantly. But with the ascent awareness that mental illness affects and so many people in the United States and globally, more and more is beingness done to reduce the stigma associated with such illnesses.

Person-Centered Language

For example, the field of psychology has recently moved toward using deliberate person-centered language—referring to people as individuals with mental illness rather than mentally sick individuals. In this manner, the language emphasizes the individual's humanity and defines them as a person first, rather than defining them by their illness.

For case, referring to someone as "the anorexic girl" has a different bear upon than "the girl with anorexia." In the first case, the individual is entirely divers by the disorder; in the second, anorexia is a characteristic, simply non a defining one. The aforementioned goes for "the student with ADHD," "the child with autism," and "the mother with depression"—each of these is far less stigmatizing than "the ADHD educatee," "the autistic child," and "the depressed mother."

Classifying Abnormal Behavior: The DSM

The DSM guides the diagnoses of psychological disorders; information technology has been revised many times and is both praised and criticized.

Learning Objectives

Evaluate the pros and cons of the DSM system of classifying mental disorders

Key Takeaways

Key Points

• The Diagnostic and Statistical Transmission of Mental Disorders (DSM) is the standard classification manual used by mental health professionals in the United States.
• The DSM contains a hierarchy of diagnostic criteria for every mental-health disorder recognized by the American Psychiatric Association.
• The DSM has been revised multiple times since the initial writing of the DSM-I (including the DSM-II, DSM-III, DSM-III-Revised, DSM-IV, DSM-4-TR, and DSM-v).
• Some of the strengths of the DSM are that it helps develop evidence-based treatments and information technology affords consistency among clinicians, insurance companies, and other healthcare providers.
• The DSM has been criticized for its lack of reliability and validity in its diagnoses; basing its diagnoses on superficial symptoms rather than underlying causes; its distinct cultural bias; and a conflict of interest related to its relationship with pharmaceutical companies.

Cardinal Terms

• comorbidity: The presence of 1 or more disorders (or diseases) in addition to a chief disease or disorder.
• neurosis: A mental disorder, less severe than psychosis, marked by anxiety or fear.
• psychodynamic: Of an arroyo to psychology that emphasizes the systematic study of psychological forces that underlie man behavior, feelings, and emotions, as well as how these might relate to early on experience.
• psychosis: A severe mental disorder, sometimes with physical impairment to the brain, marked by a distorted view of reality.

What Is the DSM?

Although a number of classification systems take been developed over time for the diagnosis of mental disorders, the i that is used past virtually mental health professionals in the United States is the Diagnostic and Statistical Manual of Mental Disorders (DSM), published most recently in its 5th edition (known equally the "DSM-5") past the American Psychiatric Clan in 2013.

The DSM is the standard classification manual of mental disorders and contains a hierarchy of diagnostic criteria for every mental-health disorder recognized by the American Psychiatric Clan. The DSM is used past psychiatrists and psychologists, doctors and nurses, and therapists and counselors. Information technology is used for individual clinical diagnoses, but its codes and criteria are too used in the collection of data almost the incidence of different disorders.

The DSM is ofttimes considered a "necessary evil"—it has many flaws, but it is also the merely widely accustomed method of diagnosing mental disorders.

History of the DSM

The initial impetus for developing a classification of mental disorders in the United States was the need to collect statistical information. Research and changing cultural norms have contributed to the DSM's evolution over fourth dimension.

DSM-I (1952)

The first version of the DSM was created in response to the large-scale involvement of psychiatrists in the treatment, processing, and assessment of World War II soldiers. The DSM-I was 130 pages long and listed 106 mental disorders, many of which accept since been abased.

DSM-2 (1968)

The DSM-I and the DSM-II are articulate reflections of the strongly psychodynamic slant the field of psychology had at the time of their publication. Symptoms were non specified in item for specific disorders, and many were seen as reflections of broad underlying conflicts or maladaptive reactions to life problems, rooted in a distinction between neurosis and psychosis. Sociological and biological knowledge was incorporated in a model that did non emphasize a clear purlieus between normality and abnormality.

DSM-III (1980)

Effectually this fourth dimension, a controversy emerged regarding the deletion of the concept of neurosis. Faced with enormous political opposition, the DSM-Iii was in serious danger of not being approved past the American Psychological Association's (APA's) board of trustees unless "neurosis" was included in some capacity; a political compromise reinserted the term in parentheses after the word "disorder," in some cases. The DSM-Three included more than than twice as many diagnoses (265) as the original DSM-i and was nigh vii times its size (886 total pages).

DSM-IV (1994)

In this version, a clinical significance criterion was added to nigh half of all the categories. This criterion required that symptoms cause "clinically significant distress or impairment in social, occupational, or other important areas of operation."

A "text revision" of the DSM-IV, known as the DSM-IV-TR, was published in 2000. The DSM-Four-TR was organized into a five-role axial system.

• Axis I: Clinical disorders, such every bit depression and anxiety.
• Axis Two: Personality disorders and/or developmental disorders (such as intellectual disabilities, formerly called mental retardation).
• Axis III: Physical issues that may bear on mental wellness, such every bit diabetes.
• Centrality Iv: Psychosocial stressors, such as occupational issues.
• Centrality V: A global cess of performance score (GAF), which provides a score of the person's overall functioning from ane to 100.

DSM-5 (2013)

Perhaps the most controversial version nevertheless, the DSM-5 contains extensively revised diagnoses; it broadens diagnostic definitions in some cases while narrowing definitions in other cases. Notable changes include the change from autism and Asperger syndrome to a combined autism spectrum disorder; dropping the subtype classifications for variant forms of schizophrenia; dropping the "bereavement exclusion" for depressive disorders; a revised handling and naming of gender -identity disorder to gender dysphoria; and changes to the benchmark for post-traumatic stress disorder (PTSD). The DSM-five has discarded the multiaxial organisation of diagnosis of the DSM-4, listing all disorders on a unmarried centrality. It has replaced Axis IV with meaning psychosocial and contextual features and dropped Centrality V (the GAF) entirely. Although DSM-5 is longer than DSM-IV, the volume includes only 237 disorders, a decrease from the 297 disorders that were listed in DSM-IV.

DSM-v: The latest edition of the Diagnostic and Statistical Transmission of Mental Disorders, the DSM-v, published in 2013.

Strengths of the DSM

Testify-Based Treatment

Ane of the strengths of the DSM is its utilise in researching and developing evidence-based treatments. Researchers employ the DSM diagnoses to carry studies and trials on patients, and this research determines which handling approaches provide the about effective results. As studies become published, mental-wellness service providers learn how to contain the almost show-based treatments into their practice.

Consistency and Insurance Coverage

The DSM also provides a common language for physicians, social workers, nurses, psychologists, marriage and family therapists, and psychiatrists to communicate near mental affliction. In addition to providing a common language amongst practitioners, hospitals, clinics, and insurance companies in the US besides generally require a DSM diagnosis for all patients treated. Providers must often apply the DSM in order to get coverage for their clients from insurance companies, which crave certain DSM diagnoses for treatment.

Weaknesses of the DSM

Reliability and Validity Concerns

The revisions of the DSM from the 3rd edition forward take been mainly concerned with diagnostic reliability—the degree to which unlike diagnosticians agree on a diagnosis. Many diagnoses are so similar that in that location is a loftier rate of comorbidity betwixt disorders.

Diagnoses Based on Superficial Symptoms

The DSM is primarily concerned with the signs and symptoms of mental disorders, rather than their underlying causes. It claims to collect them together based on statistical or clinical patterns. Furthermore, diagnostic labels tin be stigmatizing for patients by creating stereotypes about certain diagnoses.

Cultural Bias

Electric current diagnostic guidelines take been criticized as having a fundamentally Euro-American outlook. Common criticisms include both disappointment over the big number of documented not-Western mental disorders still left out and frustration that fifty-fifty those included are often misinterpreted or misrepresented.

Medicalization and Financial Conflicts of Interest

It has been alleged that the way the categories of the DSM are structured and the substantial expansion of the number of categories are representative of an increasing medicalization of homo nature. This has been attributed by many to the expanding ability and influence of pharmaceutical companies over the last several decades. Of the authors who selected and divers the DSM-IV psychiatric disorders, roughly one-half have had fiscal relationships with the pharmaceutical industry at 1 fourth dimension, raising the prospect of a direct conflict of interest.

Stigma

Because the DSM is a system of labeling, it is often criticized for contributing to the creation of social stigma confronting those with mental illnesses. In the context of mental illness, social stigma is characterized as prejudiced attitudes and discriminating behavior directed toward individuals with mental illness every bit a consequence of the characterization they have been given. Stigma and discrimination tin add to the suffering and disability of those who are diagnosed with a mental disorder.

Preventing Psychological Disorders

Focusing on the prevention of mental illness, rather than only on treating existing mental illness, has numerous health and economic benefits.

Learning Objectives

Give examples of primary, secondary, and tertiary approaches to preventing psychological disorders

Primal Takeaways

Cardinal Points

• Prevention of mental illness has a number of benefits, ranging from improvements in individuals' well-existence to positive economic and social changes.
• Hazard factors for mental illness include both genetic and environmental influences.
• Prevention efforts involve assessing take chances factors for mental disease. There are iii levels of prevention: master, secondary, and tertiary.
• Main prevention targets individuals who are at loftier take a chance for developing a disorder based on biological, social, or psychological risk factors (e.g., teaching emotion-regulation skills to teens).
• Secondary prevention seeks to diagnose and treat a disorder in its early stages (e.g., rape crisis counseling).
• Tertiary prevention targets individuals who already have a disorder past seeking to reduce or eliminate the negative impact of the disorder (due east.g., Alcoholics Anonymous, or AA).

Key Terms

• predisposition: The state of being susceptible to something, especially to a affliction or other health trouble.
• stressor: An environmental status or influence that causes distress for an organism.
• intervention: The activeness of interfering in a course of events.
• main prevention: Efforts to avert occurrence of disease either through eliminating illness agents or through increasing resistance to disease. Examples in the context of physical health include immunization against illness, maintaining a good for you diet and practise regimen, and fugitive smoking.

Prevention of mental disease has a number of benefits, ranging from improvements in individuals' well-being to positive economic and social changes. The 2004 written report of the World Health Organization (WHO) Prevention of Mental Disorders stated that "prevention of these disorders is obviously i of the most constructive means to reduce the [disease] burden." Similarly, the 2011 European Psychiatric Association (EPA) guidance on prevention of mental disorders states that "At that place is considerable show that various psychiatric conditions can be prevented through the implementation of effective bear witness-based interventions."

Run a risk Assessment

Gamble factors for mental illness include both genetic and environmental influences. Environmental influences include early childhood relationships and experiences (such equally corruption or neglect), poverty, the furnishings of race and racism, and major life stressors (such every bit a breakup, the loss of a task, or the decease of a loved one). Other risk factors may include family unit history of mental affliction (such equally depression or feet ), temperament, and attitudes (due east.g., pessimism).

Some mental disorders have a genetic link. Usually this link is a predisposition to developing the disorder, which means that while an individual may exist more likely than other individuals to develop information technology, at that place is no guarantee that they will. Main prevention (discussed beneath) can help reduce the likelihood that a genetically predisposed individual will develop a given disorder.

Risk factors and genetics: A person's take a chance of developing schizophrenia increases if a relative has schizophrenia—the closer the genetic relationship, the higher the run a risk.

3 Levels of Prevention

Prevention falls into three levels: primary, secondary, and tertiary. Main prevention targets individuals who are at a loftier adventure for developing a disorder; secondary prevention targets those who are in the early stages of a disorder; and tertiary prevention targets individuals who already take a disorder by seeking to reduce or eliminate its negative impact.

Primary Prevention

Chief prevention includes methods to avoid the occurrence of a disorder or disease altogether. Most population-based health promotion efforts are of this type. This method targets individuals and groups who accept a high risk of developing a mental illness based on biological, social, or psychological take chances factors. Primary prevention programs might include teaching parents effective parenting skills, distributing condoms to students who are at high hazard for STIs or teen pregnancy, or providing social support to children of divorce. Research has found such programs to exist highly effective, and financially speaking the cost of implementing such primary prevention programs is often much lower than the ultimate cost of caring for individuals after they have been diagnosed with the disorder or disease.

Secondary Prevention

Secondary prevention includes methods to diagnose and treat a disorder or disease in its early stages before it causes meaning distress. This approach also aims to lower the rate of established cases. An example of a secondary prevention program is rape crisis counseling. Afterwards beingness raped, an private may develop or be in the early on stages of developing a number of disorders such as low, feet, or post-traumatic stress disorder (PTSD). Early intervention through counseling can help minimize the progression of ane or more of these mental wellness issues.

Tertiary Prevention

Tertiary prevention includes methods to reduce the negative touch on of existing disorders or diseases by reducing complications and restoring lost function. These methods include interventions that forestall relapse, promote rehabilitation, and reduce the nature of the disorder. Examples of third prevention programs include Alcoholics Anonymous (AA), diabetes control programs, and dwelling house visits to those who are chronically ill.

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Source: https://courses.lumenlearning.com/boundless-psychology/chapter/introduction-to-abnormal-psychology/

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