Human behaviour has many complexities, and several specialists and philosophers have done extensive research to look for the causes of abnormal behavior in certain humans. In the times of ancient Greek, the mind has often been called ‘soul’ or the ‘psyche’ and was considered to be a separate entity from body. However many have thought that mind can influence the body and as a result the body can influence mind and most philosophers have looked for causes in one or the other.
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This book: Abnormal psychology, by David H. Barlow and V. Mark Durand is an integrative narration of various aspects of human behaviour. It covers nearly all the abnormalities of behavior and mental illness that a person can suffer from. The book deals with the historical overview of abnormal behaviour and brings forth many insights into the cause and effect of psychological disorders.
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However at the heading of the first chapter there is a saying by Scopenhauer, which says: “ A clear and complete insight into the nature of madness, a correct and distinct conception of what constitutes the difference between the sane and the insane has, as far as I know, not been found.” This is a way sums up the entire study of abnormal behavior and psychological disorders found in human beings; although there is still much left to be known. It goes on to explain how psychological dysfunction within an inpidual is associated with distress and impairment in functioning and is a response that is not typically associated with cultural or characteristic behavior norms. Such as in the case of a girl Judy, who suffered from ‘blood –injury- injection -phobia’, and fainted at the sight of blood. The book explains how such fears of injections and blood is found in many of us, but in cases of severe fear, such as Judy’s, it is called ‘phobia’. phobias are abnormal behaviors and calls for medical intervention by psychiatrists and psychotherapists. This book also deals with the various cross cultural and atypical or not culturally accepted behaviors that may have different connotations in different cultures.
For example, to get into a trance like state and believe that one is possessed is accepted in some cultures, but in western society it is rendered abnormal behaviour. The science of psychopathology, treatment of hysteria, psychoanalytical psychotherapy, dream analysis, behavioral model, Freud’s structure of mind etc. is also discussed in the first chapter. It deals with the various psychosexual stages of development and humanistic theory. It tells the readers how efforts are made to identify trauma active defense mechanisms, and how the specialists use an electric mixture of tactics along with a social and interpersonal focus.
The integrative approach to psychopathology is well discussed in the book. It goes into details as to what causes phobias? It explains how the biological influences, social influences, developmental influences and emotional influences are responsible for the phobias and abnormal behaviors in humans. We come to know that Genes are what decides the physical and mental attributes of a person, and how genes play a great role in a person’s behavior. Scientists have now identified that there are genetic contributions to psychological disorders and related behaviour patterns. Half of our cognitive abilities and enduring personality traits are due to genes.
In 1983, the distinguished neuroscientist and Nobel prize winner Eric Kandel speculated that the process of learning affects more than behavior. He suggested that the very genetic structure of cells might actually change as a result of learning, if genes that are inactive or dormant interact with the environment in such a way that they become active.
‘The Reciprocal Gene- Environment Model’ explains the factor that genetic endowment may actually increase the probability that an inpidual will experience stressful life events. As we come to know about the physiognomy of central nervous system and brain structure, we learn details about the neurotransmitters, the psychological influences on brain structure and function, and the implications for psychopathology and various personality disorders. Scientists have made important discoveries about the familiar emotion of anger. It has been known for years that negative emotions like anger and hostility increase a person’s risk of developing heart disease. In fact more than smoking, drinking, high blood pressure or high cholesterol levels, it is the sustained hostility and angry outbursts that contribute to the risk of heart attacks. There is an integral relation between emotions and psychopathology. Suppressing any kind of emotions such as anger or fear may contribute to psychopathology.
There are also cultural, social and interpersonal factors that have dangerous affects on the mental state of an inpidual. These effects consist of voodoo, the evil eye and other factors. A large number of studies have demonstrated that social effects on mental health and behavior is quite strong. Gender also plays an important role the puzzling effect on psychopathology. Life span developmental psychopathologists point out that we intend to look at psychological disorders from a snapshot perspective. We focus on particular point in a person’s life and assume that it represents the whole person. This book states that important development change occur at all stages of life and one can develop abnormal behavior sometime later due to many factors, that have influence on a person’s life as they grow older.
There are key concepts in assessment such as: Reliability, which is the degree to which a measurement is consistent. Validity is whether something measures what it is designed to measure, or whether a technique assesses what it is supposed to. Standardization is the process by which certain set of standards or norms is determined fro a technique in order to make its use consistent across different measurements. The standard applied to assessments based n age, race, gender, socio economic status and diagnosis. Most psychologists, psychiatrists and other mental health professionals use clinical interviews to gather information on current and past behavior of a patient.
Clinicians determine when a specific problem has first started and identify the problem, the behavior pattern and the diagnosis on such observations. Mental Status Exam is based upon the systematic observation of someone’s behaviour. We all are capable of pseudo-mental status exam; whether we are clinicians or Laymen, it doesn’t matter. Most of the observations are based upon the appearances, or general behaviour of the inpidual. However such assessments and observations are superficial, with little knowledge about the cause and effect. But the therapist or the specialist makes his assessment by organizing the behaviour.
The clinician notes the abnormal or overt physical movements, like twitching, manner of dressing, general appearance, posture and facial expressions. For example very slow and effortful motor behaviour indicates severe depression. The speech also gives a good idea of a person’s thought processes. In some patients of schizophrenia, there is a marked pattern of disorganized speech. The speech has ‘looseness of association’ or ‘derailment’ off thought process that is quite noticeable in the schizophrenics. There are many hypotheses surrounding abnormal behavior. What causes distress and impair functioning? Behavioral scientists have explored human behaviour the same way as other scientists have studied the path of the comet or about the AIDS virus.
Abnormal behavior is a challenging subject and invites many researches due to its biological and psychological dimensions. Complexity of anxiety disorders is one of the basic studies of abnormal behaviour. Anxiety is a complex and mysterious subject, as Sigmund Freud realised many years ago. Most of us have felt anxiety at some point or the other. Anxiety is basically a negative mood that is characterized by bodily sensations of apprehensions and physical tensions. It results in elevated heart rate and muscle tension.
Biological contributions are one such factor indicative of anxiety disorders as every one of us has different responses to anxiety filled moments and situations. Some inpiduals are more prone to disorder than others due to genetic and biological factors. psychologists observe the various factors to determine the severity of anxiety and when and how it becomes a psychopathological case. Studies show that we inherit a tendency to be tense or uptight. However no single gene is responsible for causing anxiety. The tendency to panic also runs in the family and may have a genetic component. Some evidences indicates that genetic contribution to anxiety and panic differ; but in both situations genetic vulnerability, particularly in a person who is under stress, may create the condition for panic but does not cause it directly. Generalized anxiety disorder is a very common factor and can be effectively treated by drug and psychological treatments. The book comprehensibly covers the study of somatoform and dissociative disorders.
There are many people who have a tendency towards hypochondria. The popular image of hypochondriac is of a person who is perpetually under the threat of illness. One who exaggerates even minor symptoms and thinks that he is suffering from some deadly diseases. Most of the times they are the butt of jokes amongst their family and friends but this kind of anxiety and fear is a psychological disorder that needs medical attentions and intervention. This comes under the general heading of somatoform disorders. There are instances when people feel dissociated from themselves. In general terms it is called an ‘out of body experience’ where the victim feels absolutely cut off from their real self. Some people lose their identity entirely due to such conditions and become psychopathological case. Somatoform and dissociative disorders have a very strong historical link, and there are increasing evidences to indicate that they share common features.
As with anxiety disorders, hypochondria too have cultural specifics. Such as Chinese and Indians, who are known to have more anxiety related to health problems. Most Indians are obsessed with losing semen, and even feel physical weakness and dizziness after the ejaculation. Most Chinese have this fear that their genitals are retracting into their abdomen and continuously obsess about it. Treatments often comprises of focusing on identifying and challenging the illness related misinterpretations of physical sensations and showing patients how to create symptoms by focusing attention on certain body areas. Dissociative disorder often happens after a very stressful situation or event, such as an accident. It is body’s own self defense mechanism, which blocks the mind from certain painful reactions. It may also happen when a person is very tired or under physical or mental pressure. These sensations of unreality and derealization happen when the sense of reality of the external world is lost. It is serious set of conditions where reality, experience, and even one’s identity begin to disintegrate.
This can be a very dangerous situation, which seemingly appears harmless in initial stages. In the study of psychology eating and sleep disorder is the most common ones. The most famous bulimic was princess Diana who was suffering from the severe eating disorder called bulimia, where the patient develops a negative body image and grows an extreme aversion to food. This is categorized into two parts. Bulimia Nervosa, where the person has out of control eating binges followed by self induced vomiting, and anorexia nervosa where the person eats nothing beyond minimal amount of food. Their body weight drops to dangerously low proportions and often these disorder results in death.
Anorexia nervosa is less common than bulimia, but there is great deal of overlap. With this disorder anxiety and mood disorders too follow the person and in women it is cessation of menstruation. Dry skin, brittle hair or nails, and low tolerance to cold temperatures occurs. Low blood pressure and low heart rate also are the prominent features of anorexics. Just as eating is essential to our health, sleep is also an integral part of a healthy existence. A sleep deprived person is low in energy, with slow reflexes, memory lapses and fatigue being other common symptoms. The studies of sleep ahs long influenced concepts of abnormal psychology. Most treatments used in 19th century for people with severe mental illness included encouraging patients to get adequate amount of sleep
A number of disorders covered in the book are frequently associated with sleep complaints, including schizophrenia, major depression, bipolar disorders and anxiety related disorders. Insomnia is the most common sleep disorder. Almost a third of general population complaints of lack of sleep at one time or the other. A number of psychological disorders are associated with sleep disorder. Another sleep disorder is Hypersomnia, where a person suffers from sleeping too much. They can sleep all night and yet find themselves falling asleep during daytime, finding it difficult to keep their eyes open.
Other sleep disorders are Narcolepsy, breathing related sleep disorders, Circadian rhythm sleep disorders. Sleep walkers or parasomnia is another dangerous condition where a person may get up in state of sleep and walk about, not knowing or being conscious of it the next day. Sleep terror, or nightmare in general terms is also an abnormal psychological disorder, where the person has terrible dreams that keep him awake and extremely anxious, resulting in lack of sleep. Talking of personality disorders; we all know that personality is the characteristic way a person behaves or thinks. Any person deviating from the accepted way of thinking would stand out, by the oddness of their behavior, and would be termed as abnormal.
We often term people as ‘shy’, ‘outgoing’, ‘reticent’, ‘talkative’, ‘sensitive silent type’, ‘moody type’ etc. We term people with these types on the basis of their apparent behavior and thoughts. These are what we call personality types. However there are various aspects to personality disorders. If a person’s behavior causes distress to self and to another person, if a person is not happy and is unable to change his behavior or relate to the world in a normal way, he is suffering form personality disorder. Like much other psychological disease, personality disorder is also chronic; it originates in childhood and continues unto adulthood.
There are many types of personality disorders. Schizoid, paranoid, schizotypal, anti- social, narcissistic, dependant, obsessive compulsive disorder, avoidant; and in severe cases the disorder becomes psychotic. A person suffering from paranoid personality disorder is likely to be extremely mistrustful of others, and is always suspicious of others intentions and motives, without any justification. It hampers in their ability to make friends or have a congenial working relation with another person. A schizoid personality type would be someone who many times over version of a seemingly harmless looking ‘loner type’. Such a personality appears, cold detached, and unemotional. Nothing affects them actually. Neither do they feel love, hate, romance, and sex; nor do they have any kind of normal human responses to such things. The term ‘schizoid’ is used to describe people who have a tendency to turn inwards.
Generally termed as a state that veers in to schizophrenia later. So a schizoid type is often a potential candidate of schizophrenia. Coming to Schizophrenia, this is another dangerous mental condition, which is form of bipolar psychiatric disorder caused by lesion in brain. psychosis is a general term used to describe psychotic symptoms. Schizophrenia is a kind of psychosis. Several braindisorders can lead to psychotic symptoms, including lesions in the brain resulting fromhead traumas strokes, tumors, or the use of illegal drugs.
A form of personality disorder, schizophrenia is also genetically acquired and worsens as a person grows older. There is no cure, only treatment for schizophrenia. Most patients are guilty of not continuing with the medicine due to its prolonged and adverse side effects of the psychotropic medicines. It is almost invariably accepted that patients suffering form schizophrenia are notorious for abrupt cessation of medication.
However, it is not easy to define one thing that makes a person schizophrenic. Inpiduals who have schizophrenia have varying symptoms. Schizophrenia is actually a number of behaviors and symptoms, that aren’t shared by all the people who are given this diagnosis. But most of the time, seeing and hearing things are invariably a part of the schizophrenic’s world. Hallucinations, disorganized speech, and inappropriate affect ; that is laughing and crying at the wrong moment are the common traits of a schizophrenic. Schizophrenia has many subtypes that can be broadly categorized into three types:
paranoid type, disorganized type, catatonic type. The paranoid types suffer from delusions, or hallucinations but do not have disorganized speech and their cognitive skills are also relatively intact. Disorganized types have marked disruption in their speech and behavior and they show inappropriate affect, such as laughing in a silly way at inappropriate times.
In Catatonia, there is alternate movement of immobility and excited agitation. They have the tendency to remain in fixed positions, engage in excessive activity and stay oppositional by remaining rigid. They also display odd mannerisms with their body and faces, including grimacing. There are people who have borderline personality disorders. Those suffering from borderline personality disorder have unstable moods and relationships. They have a very poor self-image and they often feel empty and are at a great risk of having suicidal tendencies. It is one of the most common personality disorder and such people suffer from a great deal of paranoia regarding themselves and their relationships.
This type of disorder is observed in every culture. These people severely suffer from fear of abandonment; they indulge in self-mutilation and have turbulent relationships throughout their lives. Other common types are Histrionic and Narcissistic types. These two have one thing in common and that is being egomaniacs. They love to be the centre of attraction and attention and the histrionic types often get into exaggerated motions and actions like hugging someone they have just met, and crying uncontrollably while watching a sad movie. Narcissistic types are preoccupied with getting the attention spot on themselves, and are preoccupied with receiving all the attention that they can.
Burlow, H. David. Durand, Mark.V. Abnormal psychology: An Integrative Approach. Wadsworth: United States (2005).
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