Abnormal Psych

Defining Abnormal Behavior

• What comes to mind when you think of abnormal behavior?

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Abnormal Behavior

• Consider multiple perspectives

• A single ‘odd or eccentric’ behavior will not equate to our definition of abnormal behavior

• Abnormal behavior = clinically significant behavior that impairs an individual’s ability to adequately cope with the demands of his/her environment• The behavior is maladaptive and it’s often

the person’s ‘best’ attempt to cope with the emotional turmoil being experienced.

Let’s name some behaviors that people engage in, in an attempt to cope with their emotional pain:

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Abnormal Behavior

• Maladaptive Behavior• Measurable (frequency, severity)

• Observable

• Behavior is either:• Ego syntonic – behaviors, values, feelings that are

in harmony with or acceptable to the needs and goals of the ego, or consistent with one’s ideal self-image

• Ego dystonic – refers to thoughts and behaviors (e.g. dreams, impulses, compulsions, desires, etc) that are in conflict with a person’s ideal self-image

Abnormal Behavior

• Most often the maladaptive behavior impairs other areas (domains) of functioning too:• Social-Emotional

• Academic / Vocational

• Example: A person abused alcohol in response to feeling depressed; the person stops going to work and loses his/her job; family members begin to distance themselves and the person withdraws from friends & social encounters, etc.

Case Conceptualization:3 Domains of Impairment

• Must consider how the client is functioning in the 3 domains…

Behavioral

Academic/

Vocational

Social/Emotional

Case Conceptualization

• Psychologists asked themselves these questions:• 1. What are the maladaptive behaviors the client is

exhibiting?

• 2. How do these behaviors impact the individuals ability to adequately function in the other two domains?

• 3. Is the behavior ego dystonic OR ego syntonic?

• 4. What is the degree of severity of the impairment caused by the maladaptive behavior• Is the client a little upset or so distraught that he/she is

suicidal?• Does the client like a neat home or do they clean to the

point where they don’t want to leave the house or have company over?

Case Conceptualization:Symptom Profile

• Symptom• an indication of a disease or disorder

• A sign or indication of the existence of something undesirable

• Symptoms can be physiological or psychological• Ex: depressed mood, excessive worrying, trouble

sleeping, crying, hallucinations, delusions, etc. • Symptoms results from the clients inability to effectively

cope with the demands of the environments and manifest as maladaptive behaviors which impair functioning

The Symptom Profile

Maladaptive Behaviors

Cognitive Disturbance

?Poor Reality

Testing?

Affective Instability?

Mood disturbance

? Physiological

Disturbance?

Social/ Emotiona

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Academic/

Vocational

Case Conceptualization

• Step 1: List client’s symptoms

• Step 2: List the client’s maladaptive behaviors• Domain 1

• Step 3: List impairment in functioning in other two domains• Social/emotional

• Academic/vocational

Cognitive Symptoms

• Maladaptive thoughts

• Excessive worrying

• Hallucinations

• Delusions

• Poor reality testing

• Memory Loss

• Racing Thoughts

Affective Symptoms

• Mood disturbance

• Depression

• Anxiety

• Sadness

• Irritability

• Mania

Physiological Symptoms

• Excessive sleeping

• Crying

• Rapid Heartbeat

• Sweating

• Weight Loss

• Weight Gain

• Clenched Jaw/Fists

Case Conceptualization

Treatment

Long term goals Short term goals Strategies

DiagnosisSpecific, observable, measurable

behavior & Symptoms Five Axis Diagnosis

AssessmentWhat are the symptoms? How do symptoms impair

functioning?

Case Conceptualization Assessment

Are there Cognitive Symptoms? Affective Symptoms? Physiological

Symptoms?•STEP 1

How do the symptoms impair functioning the three domains (behavioral, social/emotional,

academic/vocational)

•STEP 2

Does the impairment in functioning result in clinically

significant inability to cope/adapt that warrants a

diagnosis

• STEP 3