MODULE 1

INTRODUCTION TO
ABNORMAL
PSYCHOLOGY
 Which of these behaviors do you regard as abnormal?
■ Finding a “lucky” seat in an exam
■ Being unable to sleep, eat, study, or talk to anyone else
for days after a lover says, “It’s over between us”
■ Breaking into a cold sweat at the thought of being
trapped in an elevator
■ Swearing, throwing pillows, and pounding fists on the
wall in the middle of an argument with a roommate
■ Refusing to eat solid food for days at a time in
order to stay thin
❑ Having to engage in a thorough hand-washing
after coming home from a ride on a bus
 Believing that the government has agents who are
listening in on telephone conversations
 Drinking a six-pack of beer a day in order to be
“sociable” with friends after work
Importance of the Definition
•Ensures mental disorders are identified based
on standardized clinical criteria.

•Helps differentiate psychiatric conditions from

transient psychological reactions.

•Guides clinicians in making accurate and

culturally sensitive diagnoses.
DSM 5 DEFINITION
A mental disorder is a syndrome characterized by clinically
significant disturbance in an individual’s cognition, emotion
regulation, or behavior that reflects a dysfunction in the
psychological, biological, or developmental processes
underlying mental functioning. Mental disorders are usually
associated with significant distress or disability in social,
occupational, or other important activities. An expectable
or culturally approved response to a common stressor or loss,
such as the death of a loved one, is not a mental disorder.
Socially deviant behavior (e.g., political, religious, or sexual)
and conflicts that are primarily between the individual and
society are not mental disorders unless the deviance or
conflict results from a dysfunction individual, as described
above.
(APA, 2013a, p. 20)
DSM 5 TR
 The Diagnostic and Statistical Manual of Mental Disorders Text
Revision (DSM-5 TR)
 The disorder occurs within the individual.
 It involves clinically significant difficulties in thinking, feeling, or
behaving.
 It causes significant distress in personal, social/relationship,
academic or occupation functioning.
 It is not a culturally specific reaction to an event (e.g., death of a
loved one).
 It is not primarily a result of social deviance or conflict with society.
 Symptoms must meet specific duration criteria for different
disorders.
ICD 11 DEFINITION
A mental, behavioral, and neurodevelopmental
disorder is defined as a condition characterized by a
clinically significant disturbance in an individual's
cognition, emotional regulation, or behavior. This
disturbance reflects a dysfunction in the underlying
psychological, biological, or developmental
processes that influence mental and behavioral
functioning. It is usually associated with distress or
impairment in important areas of functioning, such as
personal, family, social, educational, occupational, or
other significant life areas.

(WHO, 2024)
Criteria of Abnormal Behavior
 Suffering: One indicative of abnormality is
considered when people suffer
psychologically But it is neither a sufficient
condition (all that is needed) nor a necessary
condition (that all cases of abnormality must
show).
Criteria of Abnormal Behavior
Maladaptiveness: Maladaptive
behavior interferes with our well-being
& with our ability to enjoy work &
relationships. But not all disorders
involve maladaptive behavior. E.g.,
antisocial personalities.
Criteria of Abnormal Behavior
 Statistical Deviancy: Statistically rare and
undesirable by the society is considered as
abnormal. E.g., a person with low IQ would be
considered as abnormal because low IQ is
statistically rare and undesirable.

 Violation of the standards of society: When

people fail, to follow the conventional norms &
moral standards, we may consider their
behavior abnormal. But it depends on the
magnitude of violation & its commonality. E.g.,
Behavior is abnormal when a mother drowns
her children because of depression
Criteria of Abnormal Behavior
 Social discomfort: when a person violates
a social rule because of psychopathology,
people around him/her may experience a
sense of discomfort. Such a behavior can
be considered as abnormal.
 Irrationality & unpredictability: behavior
which is irrational & unpredictable can be
considered as abnormal. E.g., the
disorganized behavior & disordered speech
of people with schizophrenia.
Classificatory System
DSM
o The Diagnostic and Statistical Manual of
Mental Disorders, often known as the “DSM,” is
a reference book on mental health and brain-
related conditions and disorders.
o The American Psychiatric Association (APA) is
responsible for the writing, editing, reviewing
and publishing of this book.
Classificatory System
DSM 5 & DSM 5 TR
 The DSM-5’s original release date was in
May 2013.
 The latest version, the DSM-5-TR, was
published in 2022.
 The main goal of DSM-5-TR is to
comprehensively update the descriptive
text that is provided for each DSM disorder
based on reviews of the literature since the
release of the prior version.
Classificatory System
DSM 5 TR
 These changes include the addition of diagnostic entities,
and modifications and updated terminology in diagnostic
criteria and specifier definitions.
Examples:
 PROLONGED GRIEF DISORDER is characterized by the continued
presence, for at least 12 months after the death of a loved one, of
intense yearning for the deceased and/or persistent preoccupation
with thoughts of the deceased, along with other grief-related
symptoms such as emotional numbness, intense emotional pain and
avoidance of reminders that the person is deceased, that are
sufficiently severe to cause impairment in functioning.
Classificatory System
DSM 5 TR
Examples:
 UNSPECIFIED MOOD DISORDER is a residual category for
presentations of mood symptoms which do not meet the full criteria
for any of the disorders in either the bipolar or the depressive
disorders diagnostic classes, and for which it is difficult to choose
between Unspecified Bipolar and Related Disorder and Unspecified
Depressive Disorder (e.g., acute agitation).

 STIMULANT-INDUCED MILD NEUROCOGNITIVE DISORDER has

been added to the existing types of substance-induced mild
neurocognitive disorders (alcohol, inhalants, and sedative, hypnotics
or anxiolytic substances), in recognition of the fact that
neurocognitive symptoms, such as difficulties with learning and
memory and executive function, can be associated with stimulant
use
Classificatory System
ICD-11
 ICD–11 is the international standard for
systematic recording, reporting, analysis,
interpretation and comparison of mortality
and morbidity data.
 The ICD is developed and annually
updated by the World Health Organization.
Classificatory System
ICD-11
 Changes in coding structure (simple coding structure
that makes it easier to record various conditions with
specificity)
 International Applicability (The ICD-11 offers guidance
for its use with different cultures as well as translations into
43 different languages)
 Dimensional Approach (helps to reduce artificial
comorbidity, which refers to a person being diagnosed with
more than one illness when in fact their symptoms are all part
of the same illness)
Distinction between DSM (Diagnostic and Statistical
Manual of Mental Disorders) and ICD (International
Classification of Diseases)

Development of the DSM and ICD

represents two parallel yet distinct
approaches to psychiatric classification,
each reflecting different philosophical
orientations, cultural contexts, and
scientific paradigms
 Differences DSM ICD

Foundation The DSM emerged from The ICD, originated from the
Differences and American psychiatry's need for World Health Organization's
Origins standardized diagnostic criteria, broader mandate to classify all
beginning with DSM-I (1952) as a diseases globally.
relatively brief manual heavily
influenced by psychoanalytic ICD-1 (1948) included mental
theory (Sigmund Freud and disorders as one section within
Adolf Meyer). a comprehensive medical
classification system covering
Categorized mental disorders as all diseases rather than
"reactions" to psychological, focusing solely on psychiatric
social, and biological factors, conditions (understanding
(concepts were inherently physiological and public health
subjective and diagnostic concerns).
reliability inconsistent)
Facilitates international
epidemiological tracking.
Differences DSM ICD
Paradigmatic The most dramatic transformation The ICD's evolution has been
Shifts and occurred with DSM-III (1980), which more gradual building on previous
Scientific represented a revolutionary editions (disorders are grouped more
Evolution departure from psychoanalytic logically prevents overlap). While
frameworks toward descriptive, ICD-10 (1992) significantly
atheoretical criteria (operational expanded mental health
definition, multi-axial diagnosis, classifications and ICD-11 (2022)
and explicit diagnostic criteria) introduced important innovations
like Gaming Disorder and revised
The DSM became increasingly trauma-related categories
detailed and expansive, with (introduced complex PTSD), the
DSM-5 (2013) and DSM-5-TR ICD has maintained greater
(2022) incorporating dimensional continuity in its basic structure
approaches (existence of and approach.
psychiatric symptoms as
spectrum) alongside categorical The ICD-11's emphasis on clinical
diagnoses and integrating genetic, utility, global applicability, and
neurobiological, and socio-cultural cultural sensitivity reflects its
factors shaping expression of a international mandate (make
disorder. diagnosis and treatment more
accessible and adaptable across
regions).
 Differences DSM ICD
Methodological The DSM's emphasis on explicit The ICD's approach reflects
and criteria has enhanced different priorities: international
Philosophical diagnostic reliability (consistency consensus, cultural
Tensions in diagnosing by using standardized adaptability, and integration with
guidelines) but has been criticized broader health systems.
for potentially creating artificial
categorical distinctions ICD-11's development involved
(disorders manifest gradually and extensive global field testing
vary in severity) that don't reflect and emphasized practical clinical
the dimensional nature of mental utility over research precision,
phenomena capturing varying resulting in a system that may be
intensities of mental condition. less detailed than the DSM but
potentially more universally
The proliferation of diagnostic applicable across regions,
categories—from 106 in DSM-I to accounting for differences in
over 400 in DSM-5—raises healthcare resources, cultural
questions about diagnostic perspectives, and contextual
inflation and the medicalization factors.
of normal human experiences.
Differences DSM ICD
Cultural and The ICD's international scope
Economic The DSM's development has necessitates accommodation of
Influences been significantly shaped by diverse cultural expressions of
American and Canadian distress and varying healthcare
healthcare systems, resources globally. International
pharmaceutical industry interests, applicability is a requirement
and research funding structures. because of ICD being official
WHO classification system.
The detailed categorical system
facilitates insurance This has led to more flexible
reimbursement and diagnostic guidelines and greater
pharmaceutical development but attention to cultural variability in
may inadvertently promote mental health influenced by belief
overdiagnosis in contexts where system, social norms, coping
specific diagnoses are required mechanism, particularly evident in
for treatment access ICD-11's emphasis on cultural
factors in diagnosis (cultural
expression of distress).
 Challenges DSM and ICD
Self-diagnosis The proliferation of self-diagnosis facilitated by digital access to
as a challenge diagnostic criteria presents new challenges for both systems. The
detailed criteria originally designed for clinical training are now widely
accessible, potentially contributing to diagnostic inflation and
complicating the clinical diagnostic process.

Tensions DSM inadvertently contributed to categorical thinking that obscures

inherent in the complexity of mental phenomena.
psychiatric ICD's broader, more flexible approach better accommodates cultural
classification diversity and practical constraints but may sacrifice diagnostic
precision.

Need for an
integrated There is a need for integration of biological markers, cultural
approach considerations, and dimensional approaches while maintaining
practical clinical utility—a challenge that will require continued
refinement of both systems
Self-reading

History of Abnormal Psychology you

need to read on your own. Not part of
Syllabus
HISTORICAL BACKGROUND
 Demonology: Chinese, Egyptians, Hebrews &
Greeks often attributed abnormal behavior to a
demon or God who had taken possession of a
person.
 The primary type of treatment was exorcism
which included various techniques for casting
an evil spirit out of an afflicted person.
 Exorcism was the task of shamans or persons
regarded as having healing powers, who used
techniques like magic, prayer, incantation,
noise making & the use of purgatives.
 The Greek physician Hippocrates, insisted that
mental disorders have natural causes & required
treatment like other diseases.
 He emphasized the importance of heredity &
predisposition & said that brain pathology could
cause mental diseases.
 He classified mental diseases into 3 general
categories: mania, melancholia & phrenitis (brain
fever).
 Greek physician Galen divided the causes of
mental disorders into physical & mental
categories.
 Plato, the Greek philosopher believed that
mental patients should be treated humanely &
should not be held responsible for their actions.
 Aristotle, believed that various agents or
humors within the body when imbalanced, were
responsible for mental disorders.
 He rejected the notion of psychological factors
as causes of mental disorders.
 During middle ages, the first mental hospital
was established in Baghdad in AD 792.
 Avicenna, an Islamic physician adopted
principles of humane treatment for the mentally
ill unknown to Western medical practitioners of
the time.
 Martin Luther, a German theologian, held the
belief that the mentally disturbed were
possessed by the devil.
 Paracelsus, a Swiss physician rejected
demonology as a cause of abnormal behavior.
 He believed in Psychic causes of mental
illness.
 Minister Barred from Exorcisms
(Milwaukee Journal Sentinel)--A self-
described minister facing a criminal charge
in the death of an autistic child during a
prayer session was ordered not to perform
exorcisms as a bail condition during a
Wednesday court appearance.

Crimenews2000.com
Measured amount of blood
removed from the body,
typically with leeches
Induction of Vomiting

Eating tobacco or half-boiled cabbage

to induce vomiting (Burton, 1621)
THE WITCH HUNTS

Witches are causes of

madness
 EARLY ASYLUMS

Middle Ages or “Dark

Ages”

Very Poor Conditions

Example: Bedlam
(Hospital of St. Mary of
Bethlehem in London)
 Mass madness: During the last half of the
middle ages, in Europe, a particular trend
emerged. It was the widespread occurrence of
group behavior disorders that were apparently
cases of hysteria. Dancing manias were
reported.
 Tarantism: occurred in Italy which included an
uncontrollable impulse to dance that was
attributed to the bite of the Southern European
tarantula or wolf spider.
 Saint Vitus’s dance: dancing mania which was
spread to Germany & the rest of Europe.
 Lycanthropy: a condition in which people
believed themselves to be possessed by
wolves occurred throughout Europe.
 During the early part of the Medieval period,
the mentally disturbed were treated with
considerable kindness.
 Treatment consisted of prayer, holy water,
sanctified ointments, the touching of relics,
visits to holy places & mild forms of
exorcism
 From the 16thCentury on, special institutions
called assylums for the care of the mentally ill
grew in number.
 By the late 18th century, the humanitarian
treatment of patients began with the work of
Philippe Pinel.
 At the same time in England, William Tuke
established asylums where mental patients lived
in humane surroundings.
 Benjamin Rush, an American physician used
moral management to treat the mentally
disturbed.
The 19th & early 20th centuries
Dorothea Dix’s Mental Hygiene
movement focused on physical well
being of the hospitalized mental patients.
 She also directed the opening of two
large institutions in Canada and
completely reformed the asylum system
in Scotland and several other countries
Dorothea Dix (1802–1887) was a
tireless reformer who made great
strides in changing public attitudes
toward the mentally ill.
In 20th century ,Clifford Beers made
attempts to change general public’s
attitude toward mental patients.
In the first half of the twentieth century, hospital
care for the mentally ill afforded very little in
the way of effective treatment. In many cases,
the care was considered to be harsh, punitive,
and inhumane
 During the latter decades of the 20th
century, efforts were made to close down
mental hospitals & return psychiatrically
disturbed people to the community as a
means of providing more integrated &
humane treatment than was available in
the “isolated” environment of the
psychiatric hospital
 This movement is referred to as
deinstitutionalization
 Modern scientific views of abnormal behavior are
divided into 4 lines of development.
1. Biological discoveries: A major biomedical
breakthrough came with the discovery of the
organic factors underlying general paresis-
syphilis of the brain, one of the most serious
mental illness of the day.
 In 18th & 19th century, advancements in the field
of physiology, anatomy, neurology, etc led to
the identification of the biological or organic
pathology underlying many physical ailments.
Emil Kraepelin (1856–1926) was a
German psychiatrist who developed an
early synthesis and classification system
of the hundreds of mental disorders by
grouping diseases together based on
common patterns of symptoms.
2. The development of a classification
system for mental disorders: Psychiatric
classification system by Kraepelin played a
dominant role in the early development of the
biological viewpoint.
 Kraepelin’s work helped to establish the
importance of brain pathology in mental
disorders & became the forerunner of today’s
DSM-IV.
 3. The emergence of psychological
causation views: the first major step
towards understanding psychological
factors in mental disorders was taken by
Sigmund Freud(1856-1939).
 He developed a theory of psychopathology
known as Psychoanalysis that emphasized
the inner dynamics of unconscious
motives.
 Franz Anton Mesmer (1734–1815), an Austrian
physician developed the ideas about the influence
of the planets on the human body.
 Mesmer believed that the planets affected a
universal magnetic fluid in the body, the
distribution of which determined health or disease
& he treated all kinds of diseases by using “animal
magnetism
 Nancy school: Bernheim and Liébeault worked
together to develop the hypothesis that hypnotism
and hysteria were related and that both were due
to suggestion
 A neurologist in Paris, Jean-Martin Charcot (1825–
1893),believed that hypnotizability was actually a
symptom of a neurological disorder and that only
people who suffered from this disorder could be
treated by hypnosis
French neurologist Jean-Marti
Charcot is shown demonstrating
a hypnotic technique during a
medical lecture.
4. Experimental psychological research
developments: In 1879, Wilhelm Wundt
established the first psychological laboratory
at the University of Leipzig.
 The end of the 19th & the early 20th centuries
saw experimental psychology evolve into
clinical psychology with the development of
clinics to study as well as intervene in
abnormal behavior.
Behaviorism organized around a central
theme: the role of learning in human
behavior.
The origins of the behavioral view of
abnormal behavior & its treatments are
tied to experimental works on the form of
learning known as classical
conditioning developed by Ivan Pavlov
& Operant conditioning by Skinner.
Classification
 It is to improve treatment and prevention
efforts.
 Ideally, a classification of disorders is
based on knowledge of etiology or
pathophysiology because this increases
the likelihood of improving treatment and
prevention efforts.
Purposes
 To distinguish one psychiatric diagnosis
from another, so that clinicians can
o􀊃 er the most effective treatment;
 to provide a common language among
health care professionals;
 and to explore the still unknown causes
of many mental disorders.
Classification of abnormal
behavior
 Classification involves the attempt to delineate
meaningful sub varieties of maladaptive behavior.
 It is intended to enable communication about
particular clusters of abnormal behavior in
agreed-upon & relatively precise ways.
 Krapelin’s first classification system in 1883
formed the basis of the classification system
which is now used by the WHO & is known as the
International Classification of Diseases(ICD).
 The system is now in its tenth revision & so it is
known as ICD-10.
 What the ICD-10 does is to ask the person making
the diagnosis to identify the client’s symptoms from
one of 11 groups, & then to refine or focus the
diagnosis using a more detailed subcategory.
 ICD-10: 1.Organic 2.Schizophrenia 3.Psychoactive
substance use. 4.Mood /affective disorders.
5.Neurotic behavior 6.Behavioral/emotional
problems 7.Developmental 8.Mental retardation
9.Adult personality
10.Behavioral/physiological/psychological
11.Unspecified other disorders.
ICD-10 & DSM-5 share the goals of
providing a common short hand
language(L), understanding the
origins(O), of mental disorders, &
identifying appropriate treatment
plans(LOT).
ICD-10 gives more prominence to the
etiology(cause) of disorders within its
various categories.
 The classification system devised by the
American Psychiatric Association is
presented in the Diagnostic & Statistical
Manual of Mental Disorders(DSM, 1952).
 The DSM fourth edition(DSM-IV-TR)
published in 2000.
 DSM-5 published in 2013 (the roman
numerals are no longer used).
 The DSM presents comprehensive &
relatively precise definition for more than
200 diagnostic categories.
 The DSM-5 lists 22 major categories of
mental disorders, comprising more than
150 discrete illnesses.
 Descriptive approach: DSM-5 attempts to
describe the manifestations of the mental
disorders and only rarely attempts to
account for how the disturbances come
about.
 The definitions of the disorders usually
consist of descriptions of clinical features.
 Diagnostic Criteria. Specified diagnostic
criteria are provided for each specific mental
disorder.
 These criteria include a list of features that
must be present for the diagnosis to be made.
 Systematic Description. DSM-5
systematically describes each disorder in
terms of its associated features: specific age-,
culture-, and gender-related features;
prevalence, incidence, and risk; course;
complications; predisposing factors; familial
pattern; and differential diagnosis.
The disadvantages of
classification
 There can be some stigma attached to
receiving a psychiatric diagnosis.
 Stereotypes of abnormal behavior make us
automatically & incorrectly infer that our
knowledge about mental disorder will be
true for any person we meet who has a
psychiatric diagnosis.
 Stigma can be perpetuated by the problem
of labeling.
 A person’s self-concept may be directly
affected by being given a diagnosis of.
ex: schizophrenia.