1. Chapter 1 Abnormal Psychology
Jill M. Hooley | James N. Butcher
Matthew K. Nock | Susan Mineka
Seventeenth Edition, Global Edition
Chapter 1
Abnormal Psychology: Overview and Research Approaches

2. Learning Objectives (1 of 3)
1.1 Explain how we define abnormality and classify mental disorders. 1.2 Describe the advantages and disadvantages of classification. 1.3 Explain how culture affects what is considered abnormal and describe two different culture-specific disorders.

3. Learning Objectives (2 of 3)
1.4 Distinguish between incidence and prevalence and identify the most common and prevalent mental disorders.
1.5 Discuss why abnormal psychology research can be conducted in almost any setting.
1.6 Describe three different approaches used to gather information about mental disorders.

4. Learning Objectives (3 of 3)
1.7 Explain why a control (or comparison group) is necessary to adequately test a hypothesis. 1.8 Discuss why correlational research designs are valuable, even though they cannot be used to make causal inferences. 1.9 Explain the key features of an experimental design.

5. What Do We Mean by Abnormality?
There is no consensus definition
There are some clear indicators of abnormality
ABNORMALITY

6. Indicators of Abnormality
Indicators of abnormality include:
Subjective Distress
Maladaptiveness
Statistical Deviancy
Violation of the Standards of Society
Social Discomfort
Irrationality and Unpredictability
Dangerousness

7. Indicators of Abnormality
Points to remember!
No one element is sufficient to define or determine abnormality
Culture plays a role in determining what is/is not abnormal

8. The DSM-5 Definition of Mental Disorder
Clinically significant disturbance in behavior, emotional regulation, or cognitive function
Associated with distress or disability
Biological, psychological, or developmental dysfunction in individual
MENTAL
DISORDER
Clinically significant disturbance in behavior, emotional regulation or cognitive function
Associated with distress or disability (i.e., impairment in one or more important areas of functioning)
Not simply a predictable and culturally sanctioned response to a particular event (e.g., the death of a loved one)
Considered to reflect biological, psychological, or developmental dysfunction in the individual

9. The DSM-5 Definition of Mental Disorder
Another psychiatric classification system
Has similarities and differences with DSM-5
Used in U.S. and other countries
ICD-10
Diagnostic classification systems classify disorders, not people

10. Classification and Diagnosis
Provide nomenclature and common language Allow information structuring
Facilitate research Establish the range of problems to address
Classification Systems
Diagnostic classification systems classify disorders, not people

11. Classification and Diagnosis
Loss of individual’s information Stigma and stereotyping associated with diagnosis Self-concept impacted by diagnostic labeling
Disadvantages of Classification
Loss of information regarding individual Stigma associated with diagnosis Stereotypes based on diagnosis Labeling can negatively impact self-concept

12. Understanding of neurobiological basis does not lessen stigma
How Can We Reduce Prejudicial Attitudes Toward People Who Are Mentally Ill?
Understanding of neurobiological basis does not lessen stigma
Contact with individuals does not lessen stigma
Negative reactions are widespread global phenomena
Loss of information regarding individual Stigma associated with diagnosis Stereotypes based on diagnosis Labeling can negatively impact self-concept

13. Culture and Abnormality
Cultural factors influence
Presentation of disorders found worldwide
Certain forms of highly culture-specific psychopathology
Some unconventional actions and behaviors are universally considered the product of mental disorder

14. Culture-Specific Disorders
Certain forms of psychopathology highly specific to certain cultures
Examples
Taijin kyofusho in Japan
Ataque de nervios in Latinos and Latinas especially from the Caribbean
Certain forms of psychopathology appear to be highly specific to certain cultures
Examples
Taijin kyofusho—in Japan
Anxiety about body or bodily functions offending others
Ataque de nervios—in Latinos and Latinas especially from the Caribbean
Loss of control including crying, trembling, screaming often after a stressful event

15. How Common Are Mental Disorders?
Significant question for many reasons
Planning, establishing, and funding mental health services for specific disorders
Providing clues to causes of mental disorders
For example, schizophrenia is more common in some populations than others, so factors related to those populations may play a causal role

16. Prevalence and Incidence
Epidemiology
Study of distribution of diseases, disorders, or health-related behaviors in a given population

17. Prevalence and Incidence
Number of active cases in population during any given period of time
Typically expressed as percentages
Different types of prevalence estimates (point, 1-year, lifetime)
Different types of prevalence estimates include point prevalence, one-year prevalence, and lifetime prevalence

18. Prevalence and Incidence
Number of new cases in population over given period of time
Incidence figures are typically lower than prevalence figures
Incidence figures are typically lower than prevalence figures because they exclude already existing cases

19. Prevalence Estimates for Mental Disorders
Lifetime prevalence
Most prevalent category
Most common individual disorders
Comorbidity
Lifetime prevalence of having any DSM disorder is 46.4% but does not include all disorders
Most prevalent category is anxiety disorders, followed by mood disorders
Most common individual disorders are major depressive disorder, alcohol abuse, phobias, and conduct disorder
Comorbidity—two or more disorders in the same person—is high, especially when a person has one serious disorder

20. Figure 1. 1 Prevalence of Serious Mental Illness Among U. S
Figure Prevalence of Serious Mental Illness Among U.S. Adults (2012) Rates of severe mental illness are higher in women, people ages 26 to 49, and some minority groups. (Data courtesy of SAMHSA)

21. Figure 1.2 The Burden of Mental Illness for Different Disorders Across the Lifespan Disability adjusted life years (DALYs) for various mental and substance use disorders are shown according to age. DALYs represent the total (worldwide) number of otherwise healthy years of life that are lost or profoundly impacted because of the disorder. Depression causes the greatest total disability. This is because depression is a relatively common disorder. (Adapted from Whiteford et al., Global burden of disease attributable to mental and substance use disorders: findings from the Global Burden of Disease Study Lancet, 382, 1580.)

22. Treatment Inpatient hospitalization typically in psychiatric units
Not all people receive treatment
Vast majority of treatment is done on outpatient basis
Inpatient hospitalization typically in psychiatric units
Surveys indicate that admission to mental hospitals has decreased substantially during the past 45 years. The development of medications that control the symptoms of the most severe disorders is one reason for this change.
Patients who need inpatient hospitalization are now typically admitted to psychiatric units of general hospitals or to private hospitals, with stays shorter than in the past.
The number of prison inmates being treated for severe mental illness has increased dramatically.

23. Mental Health Professionals
Play differing roles in the process
Gather comprehensive evaluation patient data
Diagnosis and assessment involves participants who
Gather data germane to a comprehensive evaluation of the patient’s situation

24. Types of Mental Health Professionals
How many can you name?
Clinical Psychologist
Counseling Psychologist
School Psychologist
Psychiatrist
Psychoanalyst
Clinical Social Worker
Psychiatric Nurse
Occupational Therapist
Pastoral Counselor
Community Mental Health Worker
Alcohol- or Drug-Abuse Counselor

25. Research Approaches in Abnormal Psychology
Benefits of Research
Learn about a disorder’s symptoms, prevalence, duration (acute, chronic), and accompanying problems
Understand etiology and nature of disorder
Discover how to provide the best patient care
To avoid misconception and error we must adopt a scientific attitude and approach to the study of abnormal behavior
Abnormal psychology research can take place in clinics, hospitals, schools, prisons, and even highly unstructured contexts such as naturalistic observations of the
homeless on the street.
Research methodology (the scientific processes and procedures we use to conduct research) is constantly evolving.

26. Sources of Information
Case studies
Self-report data
Observational approaches
In practice, much clinical research involves a mix of self-report and observational methods.

27. Case Studies Specific individual observed and described in detail
Subject to bias of author of case study
Conclusion have low generalizability
Case studies are an excellent way to illustrate clinical material.
They can also provide some limited support for a particular theory or provide some negative evidence that can challenge a prevailing idea or assumption.
Case studies can be a valuable source of new ideas and serve as a stimulus for research, and they may provide insight into unusual clinical conditions that
are too rare to be studied in a more systematic way.

28. Self-Report Data
Participants asked to provide information about themselves
Interviews and Questionnaires
May be inaccurate
People may not know why they do something or may intentionally be misleading

29. Observational Approaches
Collecting information without asking participants directly for it
Outward behavior can be observed directly
Biological variables can be observed via technologically advanced methods
Biological variables (e.g., heart rate) can be observed via technologically advanced methods
Functional magnetic resonance imaging (fMRI) is now routinely used to study the working brain, such as blood flow to various parts of the brain during memory tasks and brain areas influence imagination.
Transcranial magnetic stimulation (TMS) generates a magnetic field on the surface of the head, allowing the stimulation of underlying brain tissue.

30. Forming and Testing Hypotheses
An effort to explain, predict, or explore something
Often sparked by anecdotal accounts and unusual research findings
Must be tested in well-designed research studies
Frequently determine therapeutic approaches used to treat a particular clinical problem
Working hypotheses regarding the causes of different disorders very much shape the approaches we use when we study and treat the disorders.

31. Sampling and Generalization
Who should researchers include in a study?
Individuals who are similar in their behavioral abnormalities (representative)
Study group should mirror underlying population in all important ways
Large, randomly selected groups are ideal
Match population on severity and duration of disorder and in demographics such as age, gender, and marital status

32. Sampling and Generalization
Finding research participants
Samples of convenience (using subjects who are easily accessible)
Online recruitment of subjects (Amazon’s Mturk)
Disadvantages
Not a representative sample of the population as a whole

33. Internal and External Validity
Internal validity = methodologically sound
External validity = generalizability
Internal validity is the extent to which a study is methodologically sound
Internally valid studies are free of confounds and lead to valid conclusions
External validity is the extent to which a study’s findings can be generalized beyond the study itself
Externally valid studies typically use samples representative of the population

34. Criterion and Comparison Groups
Complete the following sentence: To test hypotheses, researchers use a comparison (control) group of people who ________.
Do not exhibit the disorder
Are comparable in other major respects to criterion group (people with the disorder)

35. Correlational Research Designs
Measuring Correlation
Statistical Significance
Effect Size
Meta-analysis
Correlational research studies the world as it is
It does not involve any manipulation of variables, but rather, the researcher selects certain groups of interest and compares the groups on a variety of different measures.

36. Figure Correlational Research Designs In correlational research, data are collected from two different samples or groups and are then compared. (Adapted from Petrie & Sabin, Medical Statistics at a Glance. Oxford, UK: Blackwell Science Ltd.)

37. Measuring Correlation
Negative correlation (-)
Positive correlation (+)
Correlation of zero
Correlation coefficient is a numerical representation of the strength of a correlation
Ranges from -1.0 to +1.0
Positive correlation indicates that two measures vary together in a direct, corresponding manner
Negative correlation indicates that two measures vary inversely
Correlation of zero indicates the measures do not predict each other at all
Correlation coefficient (r)

38. Figure Scatterplots of data illustrating positive, negative, and no correlation between two variables. Dots indicate a given person’s score on the two variables of interest. A strong positive correlation (r − + 1.0) means that high scores on one variable are associated with high scores on the second variable, creating a forward-sloping straight line. For example, we would expect there to be a positive correlation between weight and the number of calories eaten per day. When there is a strong negative correlation (r − −1.0), high scores on the first variable are associated with low scores on the second variable, creating a backward-sloping straight line. A relevant example here would be the association between weight and time spent exercising per day. When there is no correlation (r = 0), scores on the independent variable tell us nothing about scores on the dependent variable. An example here might involve weight and astrological sign.

39. Statistical Significance
p < .05
Less than 5 in 100 chance that correlation would happen by chance
Both strength of correlation and size of sample influence statistical significance
Research articles often identify correlations as significant by noting p < .05
This means there is less than a 5 in 100 chance that the correlation would happen by chance
Both the strength of the correlation and the size of the sample influence statistical significance

40. Effect Size
Reflects the size of association of variables
Independent of sample size
Used to compare the strength of findings from different studies
Can’t use significance to compare findings if sample sizes were different
Effect size is a stable measure used to compare across studies
An effect size of zero means there is no association between the variables

41. Meta-Analysis Combines effect sizes from all included studies
Summarizes research findings
Statistical approach
Combines effect sizes from all included studies
More effective than literature review summary
Calculates effect sizes and then combines them for all studies included in analysis
Each study is equivalent to one individual participant

42. Correlations and Causality
If two variables are correlated, there are multiple possible reasons for this.
How many reasons can you identify?
Variable A could cause variable B
Variable B could cause variable A
Variable A and variable B could both be caused by variable C
Variables A and B could both be involved in a complex pattern of variables influencing A and B in similar ways

43. Correlations and Causality
Correlation does NOT mean causation!

44. Retrospective versus Prospective Strategies
Retrospective research strategies involve looking back in time
Prospective research strategies involve looking ahead in time
Retrospective research strategies involve looking back in time, often to a point before the participant developed a disorder
Prospective research strategies involve looking ahead in time, usually with participants with a high likelihood of becoming disordered
A study that follows people over time and that tries to identify factors that predate the onset of a disorder employs a longitudinal design.

45. The Experimental Method in Abnormal Psychology
Studying the Efficacy of Therapy
Single-Case Experimental Designs
Animal Research
Observational research studies things as they are
It is an excellent way to determine correlation

46. The Experimental Method in Abnormal Psychology
To draw conclusions about causality, resolve questions of directionality
Scientists control all factors except independent variable
Actively manipulate independent variable
If dependent variable changes as independent variable changes, it is regarded as a cause of the outcome

47. Figure Experimental Research Designs In experimental research, participants are assessed at baseline and then randomly assigned to different groups (e.g., a treatment and a control condition). After the experiment or treatment is completed, data collected from the two different groups are then compared. (Adapted from Petrie & Sabin, Medical Statistics at a Glance. Oxford, UK: Blackwell Science Ltd.)

48. Studying the Efficacy of Therapy
Confidence in treatment’s efficacy
Equivalency in treated and untreated groups (random assignment)
Standard treatment as comparison group
Should a treated group show significantly more improvement than an untreated group, one can have confidence in the treatment’s efficacy
It is important to make the treated and untreated groups as equivalent as possible
As an alternative to no treatment, standard treatment can be used as a comparison group

49. Single-Case Experimental Designs
Single-case research designs
Make causal inferences in individual cases
Involve alternating baseline condition and treatment condition
Single-case experimental designs (e.g., ABAB designs) can also be used to make causal inferences in individual cases
ABAB designs involve alternating baseline condition (no treatment) with treatment condition

50. Figure An ABAB Experimental Design: Kris’s Treatment In the A phase, baseline data are collected. In the B phase, a treatment is introduced. This treatment is then withdrawn (second A phase) and then reinstated (second B phase). In this example, hair manipulation declines with use of wrist weights, returns to pretreatment (baseline) levels when they are withdrawn, and declines again when they are reintroduced. (Data adapted from Rapp et al., Treatment of hair pulling and hair manipulation maintained by digital-tactile stimulation. Behavior Therapy, 31, pp. 381–93.)

51. Animal Research Factors to consider Ethical issues Advantages
Generalizability (analogue studies)

52. Unresolved Issues
Categorization of increasing numbers of people as mentally ill
Financial interests of mental health professionals benefit from inclusive definitions
How broadly should abnormality be defined?
For example, “Internet gaming disorder” and “caffeine-use disorder” are in DSM-5 for special consideration
Expanding horizons of mental disorder are categorizing increasing numbers of people as mentally ill
Financial interests of mental health professionals benefit from inclusive definitions