The term abnormal psychology refers to the scientific study of people who are atypical or unusual, with the intent to be able to reliably predict, explain, diagnose, identify the causes of, and treat maladaptive behavior. A more sensitive and less stigmatizing term that is used to refer to the scientific study of psychological disorders is psychopathology. These definitions beg the questions of, what is considered abnormal and what is a psychological or mental disorder? It may be surprising to you, but the concept of mental or psychological disorders has proven very difficult to define and even the American Psychiatric Association (APA, 2013), in its publication, the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5 for short), states that though “no definition can capture all aspects of all disorders in the range contained in the DSM-5” certain aspects are required. While the concept of mental or psychological disorders is difficult to define, and no definition will ever be perfect, it is recognized as an extremely important concept and therefore psychological disorders (aka mental disorders) have been defined as a psychological dysfunction which causes distress or impaired functioning and deviates from typical or expected behavior according to societal or cultural standards. This definition includes three components (3 Ds). Let’s break these down now:
Though not part of the DSM 5’s conceptualization of what abnormal behavior is, many clinicians add a 4th D – dangerousness to this list. Dangerousness refers to when behavior represents a threat to the safety of the person or others. Individuals expressing suicidal intent, those experiencing acute paranoid ideation combined with aggressive impulses (e.g., wanting to harm people who are perceived as “being out to get them”), and many individuals with antisocial personality disorder may be considered dangerous. Mental health professionals (and many other professionals including researchers) have a duty to report to law enforcement when an individual expresses an intent to harm themselves or others. Nevertheless, individuals with depression, anxiety, and obsessive-compulsive disorder are typically no more a threat to others than individuals without these disorders. As such, it is important to note that having a mental disorder does not automatically deem one to be dangerous and most dangerous individuals are not mentally ill. Indeed, a review of the literature (Matthias & Angermeyer, 2002) found that only a small proportion of crimes are committed by individuals with severe mental disorders, that strangers are at a lower risk of being attacked by a person with a severe mental disorder than by someone who is mentally healthy, and that elevated risks to behave violently are limited to a small number of symptom constellations. Similarly, Hiday and Burns (2010) showed that dangerousness is more the exception than the rule. This leads us to consider the cost of mental illness to society. The National Alliance on Mental Illness (NAMI) indicates that depression is the number one cause of disability across the world “and is a major contributor to the global burden of disease.” Serious mental illness costs the United States an estimated $193 billion in lost earnings each year. They also point out that suicide is the 10th leading cause of death in the U.S. and 90% of those who die from suicide have an underlying mental illness. In relation to children and teens, 37% of students with a mental disorder age 14 and older drop out of school which is the highest dropout rate of any disability group, and 70% of youth in state and local juvenile justice systems have at least one mental disorder. Source: https://www.nami.org/Learn-More/Mental-Health-By-the-Numbers. In terms of worldwide impact, the World Economic Forum used 2010 data to estimate $2.5 trillion in global costs in 2010 and projected costs of $6 trillion by 2030. The costs for mental illness are greater than the combined costs of cancer, diabetes, and respiratory disorders (Whiteford et al., 2013). And finally, “The Social Security Administration reports that in 2012, 2.6 and 2.7 million people under age 65 with mental illness-related disability received SSI and SSDI payments, respectively, which represents 43 and 27 percent of the total number of people receiving such support, respectively” (Source: https://www.nimh.nih.gov/about/directors/thomas-insel/blog/2015/mental-health-awareness-month-by-the-numbers.shtml). So as you can see the cost of mental illness is quite staggering for the United States and other countries.
Check this out: Seven Facts about America’s Mental Health-Care System https://www.washingtonpost.com/news/wonk/wp/2012/12/17/seven-facts-about-americas-mental-health-care-system/?utm_term=.12de8bc56941 In conclusion, though there is no one behavior that we can use to classify people as abnormal, most clinical practitioners agree that any behavior that strays from what is considered the norm or is unexpected within the confines of one’s culture, that causes dysfunction in cognition, emotion, and/or behavior, and that causes distress and/or impairment in functioning, is abnormal behavior. Armed with this understanding, let’s discuss what mental disorders are. There are many types of mental health professionals that people may seek out for assistance. They include: Table 1: Types of Mental Health Professionals
1.1.4.1. Prescription Rights for PsychologistsTo reduce inappropriate and over-prescribing it has been proposed to allow appropriately trained psychologists the right to prescribe. Psychologists are more likely to choose between therapy and medications, and so can make the best choice for their patient. The right has already been granted in New Mexico, Louisiana, Guam, the military, the Indian Health Services, and the U.S. Public Health Services. Measures in other states “have been opposed by the American Medical Association and American Psychiatric Association over concerns that inadequate training of psychologists could jeopardize patient safety. Supporters of prescriptive authority for psychologists are quick to point out that there is no evidence to support these concerns (Smith, 2012).” For more information on types of mental health professionals, please visit: http://www.mentalhealthamerica.net/types-mental-health-professionals |