DSM-MOD-1

INTRODUCTION Meaning and

Concept of
Meaning and concept of abnormality
Models of understanding abnormal behavior
Abnormality
Society and mental illness: stigma, crime and mental illness, caregiving,
changes in attitude towards mental illness PSYCHOLOGY WITH SAARA

Understanding the The Four Ds of Abnormality

Meaning and Concept
of Abnormality Statistical Rarity:
Behaviors or traits that
Violation of Social
Norms: Actions that defy
are uncommon within a the unwritten rules of Distress: This involves behaviors or feelings
given population. For societal conduct. An that cause significant discomfort, suffering, or
instance, experiencing example is speaking Deviance: This criterion pertains to behaviors,
thoughts, or emotions that significantly differ anguish to the individual or those around
hallucinations is loudly to oneself in
statistically rare in the public without using a from societal or cultural norms. For instance, in them. For example, someone experiencing
general populace.​ communication device.​ many cultures, hearing voices (hallucinations) is severe anxiety may feel overwhelming
considered deviant because it deviates from distress that interferes with daily activities. It's
Abnormality in psychology refers to typical experiences. However, it's essential to important to note that not all deviant
recognize that what is deemed deviant can vary behaviors cause distress; some individuals
behavioral, emotional, or cognitive across different societies and cultural contexts. ​ may engage in atypical behaviors without
patterns that deviate significantly from experiencing any personal discomfort. ​
Personal Distress:
societal norms and expectations. These Experiences causing Maladaptive Behavior:
significant anguish or Behaviors hindering an
deviations can manifest in various ways discomfort to the individual's ability to Dysfunction: This criterion assesses
and are often assessed using specific individual, such as
persistent feelings of
function effectively in
daily life, like substance
whether a behavior interferes with an Danger: This pertains to behaviors that
individual's ability to perform necessary pose a risk of harm to the individual or
criteria to determine their impact on an sadness or anxiety.​ abuse leading to job loss. daily functions, such as maintaining others. For instance, suicidal behaviors
individual's functioning and well-being. personal hygiene, holding a job, or or aggressive actions towards others are
forming relationships. For example, considered dangerous. While danger is a
chronic substance abuse might lead to critical factor, it's not always present in
job loss and relationship problems, all cases of abnormality.
indicating dysfunction.
 Integrating the Four Cultural and Contextual Models of Understanding Abnormal Behaviour
Ds Considerations
While each of the Four Ds provides a lens
for assessing abnormality, they are most Abnormal behavior has been interpreted through various models, each offering unique perspectives on its origins and
effective when considered collectively. A Cultural norms and societal values play a treatments. These models guide professionals in diagnosing and intervening in mental health issues.
comprehensive evaluation typically significant role in defining what is
examines multiple criteria to determine the
presence and severity of a psychological considered abnormal. Behaviors deemed
disorder.​ acceptable in one culture might be viewed 4.
as deviant in another. For example, certain Psychological 3. Sociocultural
Biological Model Biopsychosocial
religious or spiritual practices may involve Models Model
approach
Conclusion behaviors that, outside of that cultural
Abnormality is a multifaceted concept that cannot be
encapsulated by a single definition. The Four Ds—
context, could be misinterpreted as signs of
Deviance, Distress, Dysfunction, and Danger—offer a mental illness. Therefore, it's crucial for
comprehensive framework for understanding and mental health professionals to consider Psychodynamic Behavioural
Cognitive Model
assessing abnormal behavior. However, these criteria cultural and contextual factors when Model Model
should be applied with consideration of cultural, societal,
assessing and diagnosing abnormal
and individual nuances to ensure accurate and
empathetic evaluations. behavior.

Biological Model (Medical Model)

The biological model sees abnormal behavior as a result of physical or physiological factors such as
brain structure, genetics, and neurochemistry. According to this approach, mental disorders are Biological Model (Medical Model)
caused by dysfunctions in the body, just like physical illnesses.
Key Aspects of the Biological Model:
a) Genetic Influence c) Brain Structure and Functioning
• Mental disorders can be hereditary. Studies show that disorders like schizophrenia, bipolar disorder, • Abnormalities in brain structure can lead to mental disorders.
and major depressive disorder tend to run in families. • Example: Brain scans of people with schizophrenia often show larger
ventricles (fluid-filled spaces in the brain), which suggests brain tissue loss.
• Example: If a person has a close relative (like a parent or sibling) with schizophrenia, their chances of
developing the disorder increase compared to someone with no family history. Treatment Based on Biological Model:
b) Neurotransmitter Imbalances • Medications: Antidepressants (like SSRIs), antipsychotics, and mood
stabilizers are prescribed to correct chemical imbalances.
• Neurotransmitters (brain chemicals) play a major role in regulating mood, emotions, and thoughts.
• Brain stimulation therapies: ECT (Electroconvulsive Therapy) is used for
• Example: severe depression.
• Low serotonin levels are linked to depression. • Neurosurgery (rarely used today, but lobotomies were performed in the
• High dopamine levels are associated with schizophrenia. past).
• Imbalances in GABA (gamma-aminobutyric acid) may cause anxiety disorders.
 Psychodynamic Model (Freudian Approach) Behavioural Model (Learning Theory)
This model was introduced by Sigmund Freud and focuses on the unconscious mind and early childhood The behavioral model suggests that abnormal behavior is learned through experience and the environment, rather than
experiences as the root cause of abnormal behavior. being a result of unconscious conflicts or biological issues.
Key Concepts of the Psychodynamic Model: Key Concepts of the Behavioral Model:
a) Unconscious Conflicts a) Classical Conditioning (Pavlov’s Experiment)
• According to Freud, the human mind has three parts: • People can develop abnormal behaviors due to associations between stimuli.
• Id (instinctual desires) • Example: A person bitten by a dog in childhood may develop a lifelong phobia of dogs.
• Ego (rational thinking)
• Superego (moral conscience)
b) Operant Conditioning (B.F. Skinner)
• If there is a conflict between these parts, it can lead to anxiety and abnormal behavior. • Behavior is shaped through rewards and punishments.
Example: Someone who constantly feels guilty for doing something harmless may have an overactive superego. • Example: A child who throws tantrums and gets attention may continue this behavior into adulthood to gain sympathy.
c) Observational Learning (Bandura’s Social Learning Theory)
b) Repressed Childhood Trauma
• People learn behaviors by watching others.
• Freud believed that traumatic childhood experiences (such as abuse, neglect, or loss of a parent) get buried in the
unconscious and later manifest as mental disorders. • Example: A child who grows up in a violent household may learn that aggression is an acceptable way to handle
conflicts.
• Example: A person with a fear of relationships might have experienced emotional neglect as a child but is unaware
of how it still affects them. Treatment Based on the Behavioral Model:
Treatment Based on the Psychodynamic Model: • Systematic Desensitization: Used to treat phobias by gradually exposing a person to their fear.
• Psychoanalysis (Talk Therapy): The therapist helps the patient uncover repressed memories and emotions. • Behavior Modification: Rewards desirable behavior and discourages unwanted behavior.
• Dream Analysis & Free Association: Freud used these techniques to explore the unconscious mind. • Aversion Therapy: Uses unpleasant consequences to eliminate harmful behaviors (e.g., using a bitter nail polish to stop
nail-biting).

Cognitive Model (Thinking Patterns & Perception) Sociocultural Model

The sociocultural model looks at how society and culture impact mental health. It argues that abnormal behavior cannot
The cognitive model, introduced by Aaron Beck and Albert Ellis, focuses on how thought patterns influence be understood in isolation from a person’s social and cultural environment.
emotions and behavior. Key Concepts of the Sociocultural Model:
Key Concepts of the Cognitive Model: a) Cultural Influence on Disorders
• Some disorders are culture-specific (only found in certain societies).
a) Cognitive Distortions
• Example: "Koro" is a disorder found in some Asian cultures where men irrationally fear that their genitals will shrink and
• People with mental disorders often have irrational and negative thought patterns. disappear.
b) Social Factors
• Example: A person with social anxiety may think, “Everyone is judging me,” even when no one is paying
attention. • Poverty, discrimination, and lack of social support increase the risk of mental illness.
• Example: Someone living in extreme poverty may develop depression due to chronic stress and hopelessness.
b) Schemas (Mental Frameworks)
c) Stigma and Mental Illness
• A person’s past experiences shape how they view the world. • In many cultures, mental illness is stigmatized, preventing people from seeking treatment.
• Example: If someone grew up in a highly critical household, they may develop a self-defeating schema, • Example: In some communities, depression is seen as a "weakness" rather than a legitimate health condition.
believing that they are never good enough. Treatment Based on the Sociocultural Model:
Treatment Based on the Cognitive Model: • Community-based therapies: Support groups, peer counseling.
• Awareness programs: Reducing stigma around mental illness.
• Cognitive Behavioral Therapy (CBT): Helps people identify and change negative thought patterns.
• Addressing social issues: Providing better mental health care in low-income areas.
• Rational Emotive Behavior Therapy (REBT): Focuses on challenging irrational beliefs
 Biopsychosocial Model (Integrated Approach)
Mental illness does not exist in
• This is the modern, holistic approach that combines all the previous
models. Society isolation—it is shaped by society,
culture, and social attitudes. How
society views, treats, and responds
• It suggests that abnormal behavior is caused by a combination of
biological, psychological, and social factors. and to mental illness has a profound
impact on individuals with
Example: psychological disorders. This section
• A person with depression may have a biological predisposition (low
serotonin levels), psychological issues (negative thought patterns), and
Mental explores stigma, crime and mental
illness, caregiving, and changing
societal attitudes towards mental
social stressors (job loss or lack of support).
Treatment Based on Biopsychosocial Model: Illness health.

• A combination of medication (biological), therapy (psychological), and

social interventions (sociocultural).

Stigma and Mental Illness

Stigma refers to negative beliefs, attitudes, and stereotypes that society holds about people with mental
Crime and Mental Illness
disorders. It leads to discrimination, social exclusion, and difficulty in accessing care.
Types of Stigma: The relationship between mental illness and crime is complex. While mental illness is not a direct cause of
crime, there are some important interactions between the two.
a) Public Stigma (Social Stigma)
• When society holds negative stereotypes about mentally ill individuals, considering them dangerous, weak,
or incapable.
• Example: Someone with schizophrenia may be seen as violent, even though most individuals with
schizophrenia are not aggressive. Myth: People with mental illness Myth: Mental illness directly
b) Self-Stigma are violent and dangerous. causes criminal behavior.
• When a person internalizes negative societal beliefs, leading to low self-esteem and shame. Reality: Most individuals with Reality: Criminal behavior is
• Example: A person with depression might believe they are a burden, avoiding treatment due to guilt or fear mental illness are not violent. In influenced by multiple factors,
of judgment. fact, they are more likely to be including poverty, substance
c) Institutional Stigma victims of violence than abuse, lack of social support, and
• When laws, policies, and systems discriminate against those with mental illness. perpetrators. childhood trauma.
• Example:
• Many insurance policies do not cover mental health treatment as comprehensively as physical illnesses.
• Job applications often ask about mental health history, leading to workplace discrimination.
 Types of Crimes Associated with Mental
Crimes Due to Untreated Symptoms
Illness
Types of • Severe disorders like schizophrenia, bipolar disorder,
and psychosis can lead to impulsive actions, especially
Crimes if untreated.
• Example: A person experiencing delusions may act 3. Crimes of Neglect or Self-Harm

Associated out based on false beliefs (e.g., harming someone

they believe is trying to hurt them).
• Severe depression and psychotic disorders can lead to
suicidal behavior or neglect of dependents (e.g., child
neglect by a depressed parent).
with Crimes Linked to Substance Abuse
4. Personality Disorders and Criminality

Mental • Many people with mental disorders self-medicate

with alcohol or drugs, increasing the risk of criminal • Antisocial Personality Disorder (ASPD) is linked to criminal
behavior, as it involves lack of empathy, impulsivity, and
behavior.
Illness • Example: A person with untreated PTSD might use
drugs and commit theft to support their addiction.
disregard for societal rules.
• Example: Serial offenders like Ted Bundy exhibited traits of
ASPD.

The Role of Forensic Improving the Criminal Justice Caregiving for People with Mental Illness
Psychology System for the Mentally Ill
• Mental health courts provide Family members and caregivers play a crucial role in supporting,
Forensic psychologists assess criminal alternatives to imprisonment. managing, and advocating for individuals with mental disorders.
responsibility, fitness to stand trial, • Crisis intervention teams (CITs) However, caregiving comes with significant challenges.
and rehabilitation needs. train police to handle psychiatric
crises. Who Are the Caregivers?
Some individuals with severe mental
• Rehabilitation over punishment • Family members (parents, spouses, siblings, children)
illness may be declared “Not Guilty by – Therapy and treatment in
• Professional caregivers (psychiatric nurses, social workers,
Reason of Insanity” (NGRI) and sent correctional facilities reduce
to psychiatric institutions instead of reoffending. therapists)
prison. • Community support groups
 Challenges Faced by Caregivers Support for Caregivers

Emotional and Physical Financial Burden – Long-

Stigma and Social
Exhaustion – Constantly term treatment, Respite Care Services –
Isolation – Families may Psychoeducation Programs
caring for someone with medication, and
feel ashamed or isolated – Teaching families about Providing temporary relief
severe mental illness can hospitalization can be mental disorders. to caregivers.
due to societal stigma.
cause burnout. expensive.

Lack of Knowledge – Balancing Personal Life – Support Groups – Financial and Legal
Many caregivers struggle Managing personal Connecting caregivers with Assistance – Government
with understanding the responsibilities while others facing similar programs that help cover
illness and providing caregiving can be challenges. treatment costs.
appropriate care. overwhelming.

Scientific Advancements

Changes in • Research in neurobiology, genetics, and psychology has proven that mental
illness is not a "choice" but a medical condition.

Media Representation

Attitude Factors • More movies, books, and celebrities talk openly about mental health (e.g.,
Deepika Padukone discussing depression).

That Led to
Towards
Policy Changes

• Many countries now have Mental Health Acts ensuring legal protection for

Changing people with mental disorders.

Mental Attitudes
Technology and Teletherapy

• The rise of online therapy and mental health apps has made treatment more
accessible.

Illness Workplace Mental Health Initiatives

• Companies now offer mental health days, employee counseling, and stress
management programs.