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Individual Differences and Abnormal Psychology: Coursework – Second semester 2007/8
1. Classification Systems in Abnormal Psychology

Classification systems are valuable first in determining whether certain behaviors are abnormal and second in ascertaining what type of abnormal behavior a certain behavioral disorder is. Using a classification system efficient in diagnosing a person’s psychological state and subsequently prescribing appropriate therapy or treatment for the identified disorders, and has practical benefits for insurance companies requiring diagnoses in the processing claims.

This system being universal, it guarantees a similar diagnosis for the same symptoms in a person no matter who performs the diagnosis. This consistency allows the immediate application of necessary interventions than if there are differing diagnoses and suggested treatments. It also guarantees that a clinician diagnosing a client/patient will be able to successfully do so because the classification system includes all known types of abnormalities.

Classification systems prove the existence of a certain disorder and also highlight the similarities and differences as well as general and particular characteristics of various disorders. This is done through the uniform and unambiguous definition of a general classification of a disorder by the identification of the range of symptoms for it as well as the independent and more precise symptoms for its different sub-types. The common terminology and definitions constitute a common language for communication among clinicians (Maddux and Winstead, 2005, p.67).

Classification makes it easy for researchers to define the scope and limitations of their study based for instance on how the homogeneity of control or experimental groups involving people with certain abnormal behaviors are determined. The same is equally important in the development of theory as generalizations from the study of abnormal psychology are construed only to hold true to a disorder that actually exists and is specifically defined and also applies only to the wider group of people who actually display the symptoms defined for this disorder (Boeree, 2003).

However, using classification systems has its disadvantages because one assumes that all people fill fit into the available molds set for abnormal behavior. The diversity in economic, social and cultural environments of people and their unique sets of traits make it quite difficult to simplify behaviors into one classification system (Maddux and Winstead, 2005, p.68). It should also recognize the particular impact of gender, ethnicity and economic status on behavior during the diagnosis itself.

This brings to the fore the issue of defining psychological disorder. Can we say that abused women, who have developed attitudes of powerlessness in their predicament, be considered abnormal or should this behavior be viewed as a product of the socially defined unequal power relations between men and women?

Another disadvantage is treating abnormal behavior as a disease much like physiological diseases are. The latter at least is based on the actual physical condition of a person. Disorders, on the other hand, are not based on a physical state but are determined from their deviation from acceptable, normal or average set of behaviors in society. Thus, a point of contention with the DMR classification system is that although it helps us organize different abnormal behaviors, what if the disorders exist only because we construct certain sets of behaviors as disorders (Boeree, 2003)?

Another downside of using classification systems is that the words used have a wide range of definitions or meanings for different people. If for instance a physiological disease such as rhinitis simply means the allergic reaction to inhaled allergens, different people define anxiety in different ways – through its biological manifestations, as an emotion relating to fear or worry or to the psychological anticipation of the negative outcome of events.  Similarly, general depression, obsession, frustration and aptitude can not be captured in just one definition but depends on which point of view one is coming from.

Advances in scientific study also point to the role of biological make-up (e.g. hormone levels) in determining why certain behaviors are displayed and also the effects of drugs/medication on behavior. Maddux and Winstead (2005, p.69) have proposed that laboratory tests should also be conducted during diagnosis in order to include these factors.

Classification systems also pose a problem with regards to reification. When we use terms used to refer to a specific abnormal behavior in order to describe the psychological state of individuals, the possibility of equally using these terms in explaining the behavior itself is great (Boeree, 2003). For instance, a person diagnosed as schizophrenic hears voices that no other person hears. His condition is then used to explain why he hears voices instead of the more precise explanation of auditory hallucination as a symptom of his disorder as the cause.

List of References:

Boeree, G. (2003) Abnormal Psychology: Lecture 2 on Classification. Retrieved 27 February     2008 from ccvillage.buffalo.edu/Abpsy/lecture2.html – 21k

Maddux, J.E. and Winstead, B.A. (eds.)(2005) Psychopathology: Foundations for a       Contemporary Understanding. New Jersey: Lawrence Erlbaum Associates, p. 67-69

2. The Different Treatments Used for Anorexia Nervosa

Current treatments for anorexia nervosa involve physical treatment to mitigate the physiological effects of the disorder such as malnutrition and weight loss while there are also interventions in the form of psychotherapy to deal with the mental/emotional/psychological causes of such behavior which includes cognitive behavioral therapy, family and group therapy or behavioral counseling (Lucas, 2004).

Physical treatment entails the strict monitoring of the patient’s diet in terms of nutrition and amount of intake in order to slowly but progressively bring his/her weight to acceptable levels and guarantee the normal functioning of the different parts of the body. The goal is to stabilize the declining physical condition of persons suffering from anorexia and may necessitate hospitalization (Levitt and Sansone, 2003).

The different kinds of psychotherapy serve to help patients identify the reasons why they deny themselves food or why they are obsessed with losing weight and ways in which to overcome these by changing the negative attitudes developed with regards to food and weight. Psychotherapy also helps those with anorexia in positively countering the negative assessments of others regarding their physical appearance instead of resorting to life-threatening means.

Specifically, the cognitive behavioral therapy focuses on changing the negative thoughts associated with food and the positive thoughts attached with weight loss. The patient is taught to be conscious about these thoughts through self assessment and correct them. The particular circumstances that led to the person’s resorting to weight loss techniques are taken into account through food journals and for the person to try to avoid these circumstances in the future. Other activities that promote the positive value of the normal body in terms of weight and the part that food plays in it are encouraged. Appropriate coping mechanisms in the advent of the resurgence of negative feelings are also laid out.

Individual behavioral counseling meanwhile uses positive reinforcement to effect positive changes in eating patterns (Lucas, 2004). Particular situations, thoughts or events that lead to food refusal and engagement in weight loss are recognized and non-destructive activities are substituted for these, such as massage and other relaxation techniques as alternatives.

Family therapy is employed for anorexia in teenagers and children. This recognizes the role that the family might have played in bringing about the phobia for food and the role that it can play in the patient’s recovery as well (Lucas, 2004). The family, because it is the most intimate social group to which the person belongs to, it has both the capacity and responsibility to support and monitor the person in his/her efforts at overcoming the eating disorder especially because they lack the greater maturity that adults have in facing the same eating problem.

The other method, group therapy in an organized setting, is used to promote a supportive environment for individuals suffering the same disorder, for them to learn from each other and may also initiate and encourage discussions on the social and cultural context of dieting as a way of widening the perspectives of anorexia nervosa patients in understanding their situations (Levitt and Sansone, 2003).

Based on evidence, there seems to be no sole treatment for anorexia nervosa that works for most people. However, effectiveness depends on using the treatment that best suits the age, gender and the severity of the physical effects of starvation in patients. It is also widely accepted that a multidisciplinary approach and a combination of various treatments will increase the chances for recovery. This means the involvement of psychologists, physicians and nutritionists and combining both physical treatments and psychotherapy to address the most urgent problems faced by patients of this disorder.

The cognitive behavioral therapy usually works best for adults who have the maturity for conscious processing of emotions and thinking that bring about a negative attitude to food and weight which involves a strong resolve to overcome the disorder. Group and family therapy are seen to be the best treatment for children and teenagers while behavioral counseling may work for older teenagers or young adults.

Some also propose a community-based and integrated approach to treating eating disorders: community-based because it focuses on people with eating disorders in particular communities and taking into account the prevailing local culture as well as economic conditions within the community to determine cost effectiveness of treatments (Levitt and Sansone, 2003).

List of references:

Levitt, J.L. and Sansone, R.L. (2003) The Treatment of Eating Disorder Clients in a Community-         Based             Partial Hospitalization Program. Journal of Mental Health Counseling, 25, p.1

Lucas, A.R. (2004) Demystifying Anorexia Nervosa: An Optimistic Guide to Understanding and             Healing. New York: Oxford University Press, p. 102-106

3. Depression and Anxiety Among the Elderly

Older people are more prone to anxiety and depression because there are more events that lead to feelings of loss and grief later in life. The inability to be totally independent, the decline in one’s ability to perform things that one could easily do during younger days, the loss of youth itself, illness or the death of one’s spouse and friends all contribute to an uncertain future and sadness. These feelings are reinforced by the decrease in coping skills so that depression and anxiety occupies longer periods of older people’s lives such that it now constitutes a behavioral disorder (Mcfarland, 2005).

In a study by Mcfarland (2005), cognitive behavioral therapy that changes thinking, promote coping mechanisms and alter emotions together with the use of the anti-depressant desipramine was shown to significantly treat mild to moderate depression among a group of elderly patients, more than using the drug alone or psychotherapy alone.

This implies the need for constant medication for depressive older people. This may not be appropriate if it becomes the primary treatment because it fosters dependence on medication and long term use may bring about adverse reactions especially since older bodies become more sensitive. The human capacity to cope should still be fostered as a primary treatment, albeit with more difficulty. However, medication may be the primary treatment option for the severely depressed or those with suicidal tendencies.

Interpersonal therapy has also been proven to result in positive outcomes with regards to depressed elderly. The anxiety and negative feelings associated with changing roles and emotional loss is handled by improving the status of personal relationships with remaining loved ones into ones that are supportive and caring (Mcfarland, 2005). There are also some studies that detail this type of therapy together with antidepressant medication as equally successful treatments.

Life review and reminiscence therapy is yet another treatment that is apt for elderly people. It involves a guided assessment of one’s personal history which aims to settle feelings of guilt, remorse and loss over past events and to cultivate a positive outlook and purpose for the remaining, maybe few, years of life (Hanaoka and Okamura as cited in Mcfarland 2005, p.1).  It has also been reported to enhance life-satisfaction specifically for patients who suffered a stroke.

The problem solving therapy, on the other hand, is based on a step-by-step process beginning with problem identification and setting attainable objectives where answers to problems are outlined and the individual chooses that which he/she most prefers though when compared to the placebo group and another group that used the drug paroxetin only, the latter had the most effective results (Mcfarland, 2005).

There are also various intervention programs developed and subjected to scientific study. One is the Program to Encourage Active, Rewarding Lives for Seniors (PEARLS) – a home based program incorporating 8 50-minute therapy sessions for dysthymia and minor depression followed by regular telephone communication with patients. It has proved effective especially when stress is given to pleasant activities during problem solving and if they engage in more physical and social activities in between therapy (Ciechanowski et al.as cited in Mcfarland 2005, p.1).

Another is the Improving Mood–Promoting Access to Collaborative Treatment (IMPACT) for the same disorder but also takes into consideration arthritis in patients (Lin et. al. as cited in Mcfarland 2003, p.1). The IMPACT treatment included the combination of collaborative/team care involving a nurse, psychologist and physician, anti-depressant medication and interpersonal therapy. The overall results were positive in that the symptoms of depression decreased in the patients along with lowered pain and limiting effects of arthritis to daily functioning.

These studies conducted between 2000 and 2005 are proof to the effectiveness of using medication and various forms of established and newly developed treatment programs in addressing the combination of depression, anxiety as well as other physiological illnesses. What seems to be common among the treatments or programs is how they develop a sense of vitality, sense of purpose and how individual capacities of the elderly are utilized for maximum functioning. These are appropriate because they take into full consideration the effects of ageing on individuals

What needs to be done should be the conduct of more studies to determine the broader range of effectiveness of these treatments among the elderly using different variables. The elderly should not be taken in disregard because they are past the prime of life but recognize instead what they can still contribute to society.

List of References:

Mcfarland, K. (2005) Battling Late-Life Depression: Short Term Psychotheraphy for Depression          in Older Adults-A Review of Evidence-Based Studies since 2000. Annals of the     American Psychotherapy Association, 8, p.1

 

List of References

Boeree, G. (2003) Abnormal Psychology: Lecture 2 on Classification. Retrieved 27 February     2008 from ccvillage.buffalo.edu/Abpsy/lecture2.html – 21k

Levitt, J.L. and Sansone, R.L. (2003) The Treatment of Eating Disorder Clients in a Community-         Based             Partial Hospitalization Program. Journal of Mental Health Counseling, 25, p.1

Lucas, A.R. (2004) Demystifying Anorexia Nervosa: An Optimistic Guide to Understanding and             Healing. New York: Oxford University Press, p. 102-106

Maddux, J.E. and Winstead, B.A. (eds.)(2005) Psychopathology: Foundations for a       Contemporary Understanding. New Jersey: Lawrence Erlbaum Associates, p. 67-69

Mcfarland, K. (2005) Battling Late-Life Depression: Short Term Psychotheraphy for Depression          in Older Adults-A Review of Evidence-Based Studies since 2000. Annals of the     American Psychotherapy Association, 8, p.1

 

 

 

 

 

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