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PSYCH205: Clinical Psychology

Unit 2: The Fundamentals of Mental Health and Mental Illness   This unit will provide you with an overview of mental illness, its manifestations, and its diagnoses. It will also cover the topic of etiology (the causes or origin of mental illness) and identify the factors that may influence and contribute to the development of mental illness. You will study methods of mental illness prevention and treatment—two primary concerns in the clinical psychology practice. Next, this unit will address the current state of the mental health services delivery system in the United States, as it is important to understand the context within which treatment delivery takes place. Finally, this unit will work to define recovery, the goal of intervention. What constitutes recovery? How do you know when it has been achieved?

Unit 2 Time Advisory
Completing this unit should take you approximately 4 hours.

☐    Introduction: 1.5 hours

☐    Subunit 2.1: 0.5 minutes

☐    Subunit 2.2: 2 hours

Unit2 Learning Outcomes
Upon successful completion of this unit, you will be able to:
- - define the criteria for what is considered abnormal versus normal, and explain how these definitions fit into the notion that psychopathology exists on a continuum; - identify the clusters of symptoms that manifest in mental illness; - describe the components of the biopsychosocial model of disease; and - describe the state of mental health service utilization in the United States, including its historical context, current patterns, and outcomes of interest.

  • Lecture: iTunesU: "What Is Abnormal?” and “What Is Abnormal?” The Saylor Foundation does not yet have materials for this portion of the course. If you are interested in contributing your content to fill this gap or aware of a resource that could be used here, please submit it here.

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2.1 Abnormal Psychology   - Reading: University of Central Oklahoma: Professor Caleb Lack’s Abnormal Psychology: An e-text!: “The Nature of Psychopathology and Abnormal Psychology” Link: University of Central Oklahoma: Professor Caleb Lack’s Abnormal Psychology: An e-text!:  "The Nature of Psychopathology and Abnormal Psychology"
 
Instructions: Please click on the link above, select the link to “The Nature of Psychopathology and Abnormal Psychology,” and read this article. This reading will clarify the factors that clinical psychologist use to address the question of “what is abnormal?” This reading will cover all topics outlined for Subunits 2.1.1–2.1.6.
 
Reading this text and taking notes should take approximately 30 minutes.
 
Terms of Use: This material is licensed under a Creative Commons Attribution Share-Alike Non-Commercial 3.0 License.

2.1.1 The Nature of Mental Disorders   *The nature of mental disorders can be difficult to ascertain. Scientific vs. socially constructed aspects indicate multiple components of mental disorder development. As such, there is no single, agreed upon operational definition of mental disorder etiology.

Refer to the “Nature of Psychopathology and Abnormal Psychology” article for additional information.*

2.1.2 Mental Disorders as Statistical Deviance   *Mental disorders as statistical deviance involve comparing an individual’s behavior to the frequency of occurrence of the same behavior in the general population. However, there are issues with this definition, specifically social norms, subjectivity, and extreme sides of a normal curve.

Refer to the “Nature of Psychopathology and Abnormal Psychology” article for additional information.*

2.1.3 Mental Disorders as Social Deviance   *Mental disorders as social deviance states behavior is deemed abnormal if it deviates from social standards, values, and the norms of an individual’s culture. However, there are issues with this definition, specifically little to no objective validity, the timeframe of acceptable behavior can change, and there are different morals/standards among disparate culture groups.

Refer to the “Nature of Psychopathology and Abnormal Psychology” article for additional information.*

2.1.4 Mental Disorders as Maladaptive Behavior   *Mental disorders as maladaptive behavior attempts to classify as mental disorders those behaviors that are dysfunctional (i.e., effectiveness/ineffectiveness of a behavior in dealing with challenges or accomplishing goals). However, there are issues with this definition since there are four different types of maladaptive behaviors and each type has inherent issues.

Refer to the “Nature of Psychopathology and Abnormal Psychology” article for additional information.*

2.1.5 Dimensional versus Categorical Models of Mental Disorders   *Mental disorders can be compared using dimensional (i.e., continuum) or categorical (i.e., polarized) models. That is, mental disorders are just extreme variations of normal psychological phenomena/problems. However, there are issues with this definition, such as there is large scientific support but it doesn’t mesh with real world instances.

Refer to the “Nature of Psychopathology and Abnormal Psychology” article for additional information. *

2.1.6 Mental Disorders as Social Constructions   *Mental disorders as social constructions state disorders are products of history and culture and should be defined in a universal, scientific construct. However, there are issues with this definition such that it implies the construct is fake or unimportant.

Refer to the “Nature of Psychopathology and Abnormal Psychology” article for additional information.*

2.2 Manifestations of Mental Illness   - Reading: United States Department of Health and Human Services’ MentalHealth: A Report of the Surgeon General (1999): “Chapter 2: The Fundamentals of Mental Health and Mental Illness” Link: United States Department of Health and Human Services’ MentalHealth: A Report of the Surgeon General (1999): “Chapter 2: The Fundamentals of Mental Health and Mental Illness” (PDF)
 
Instructions: Read the “Overview of Mental Illness” through the “Overview of Mental Health Services,” excluding “Overview of Treatment.” Next, read the “Overview of Recovery” and “Conclusions” sections. Please note that the pages in the PDF bar at the top of the document do not match the pages in the table of contents section on the first page. This reading will cover all of the remaining topics in unit 2 (subunits 2.2–2.7). 
 
Reading this text and taking notes should take approximately 2 hours.
 
Terms of Use: Please respect the copyright and terms of use displayed on the webpage above.

2.2.1 Anxiety   *Anxiety is the most readily accessible and easily understood of all mental disorders, since it is a vitally important physiological response to dangerous situations. There are seven common signs of acute anxiety, and anxiety can also manifest in more severe mental disorders such as OCD or PTSD.

Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 2: The Fundamentals of Mental Health and Mental Illness,” pages 40–41 for additional information.*

2.2.2 Psychosis   *Psychosis can be described as disturbances of perception and thought process. Determining if an individual suffers from psychosis varies with cultural context. A more prominent type of psychosis is schizophrenia whereby individuals suffer from hallucinations and/or delusions, in addition to other various positive and negative symptoms.

Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999):  “Chapter 2: The Fundamentals of Mental Health and Mental Illness,” pages 41–42 for additional information.*

2.2.3 Disturbance of Mood   *Mood disturbances can be difficult to define due to scientific problems in quantifiable measurement as well as cultural differences. There are many common signs of mood disorders with those signs characteristically manifesting as either a sustained feeling of sadness or sustained elevation of mood.

Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 2: The Fundamentals of Mental Health and Mental Illness,” pages 42–43 for additional information.*

2.2.4 Disturbance of Cognition   *Disturbances of cognition refer to difficulties in the ability to organize, process, and recall information. This can occur in a variety of disorders such as dementia, depression, or schizophrenia.

Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999):  “Chapter 2: The Fundamentals of Mental Health and Mental Illness,” pages 43 for additional information.*

2.2.5 Other Symptoms   *Although anxiety, psychosis, mood disturbances, and cognitive impairments are the most common of mental disorders, other somatic and/or physical symptoms or impairment of impulse control can manifest in an individual.

Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999):  “Chapter 2: The Fundamentals of Mental Health and Mental Illness,” pg. 43 for additional information.*

2.3 Diagnosis and Epidemiology of Mental Illness   2.3.1 Diagnosis of Mental Illness   *Diagnosing mental illness can be difficult due to categories being broad, heterogeneous, and overlapping. Given these issues, a systematic approach (i.e., DSM IV) has been developed to standardize mental illness classification.

Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 2: The Fundamentals of Mental Health and Mental Illness,” pages 43–45 for additional information.*

2.3.2 Overview of Etiology   *The precise cause of mental disorders is not known but broad etiological aspects have been identified (e.g., biological, psychological, social/cultural factors). The manifestation of mental disorders is an interaction amongst these broad aspects.

Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 2: The Fundamentals of Mental Health and Mental Illness,” pages 49–50 for additional information.*

2.3.3 Biopsychosocial Model of Disease   *The Biopsychosocial Model of Disease is a framework developed by George L. Engle that states biopsychosocial factors are involved in the causes, manifestation, course, and outcome of health and disease. However, there are issues with this model including degree of factorial influence, degree of interaction, and variation across individuals and life spans.

Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 2: The Fundamentals of Mental Health and Mental Illness,” pages 50–51 for additional information.*

2.3.4 Understanding Correlation, Causation, and Consequences   *Correlation determines mental illness risk factors but does not mean causation. The consequences of mental illness are considered later outcomes of a disorder.

Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 2: The Fundamentals of Mental Health and Mental Illness,” pages 51–52 for additional information.*

2.3.5 Biological Influences on Mental Health and Mental Illness   *The biological influences on mental health and mental illness are varied, including genetics, infections, physical trauma, nutrition, hormones, and toxins.

Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 2: The Fundamentals of Mental Health and Mental Illness,” pages 52–53 for additional information.*

2.4 Psychosocial Influences on Mental Health and Mental Illness   2.4.1 Psychodynamic Theories   Psychodynamic theories assert that behavior is the product of underlying conflicts over which people are not aware, and these deviant behaviors influence mental health and mental illness. Note especially how Sigmund Freud’s work contributes to a historical perspective of mental health theory and treatment approaches.
 
Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): Chapter 2: The Fundamentals of Mental Health and Mental Illness,” pages 55–56 for additional information.

2.4.2 Behavior and Social Learning Theories   *Behavior and social learning theories assert that personality is the sum of an individual’s observable responses to the outside world. Note especially, views from Watson and Skinner (i.e., rejection of the existence of underlying conflicts and unconscious, operant conditioning), Pavlov (i.e., classical conditioning), and Bandura (i.e., social learning theory).

Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 2: The Fundamentals of Mental Health and Mental Illness,” pages 56–57 for additional information.*

2.4.3 The Integrative Science of Mental Illness and Health   *The integrative science of mental illness and health focuses on understanding how findings from different mental health field disciplines have many common threads. There has been a progressive movement to promote linkages between various areas and principles.

Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 2: The Fundamentals of Mental Health and Mental Illness,” pg. 57 for additional information.*

2.5 Overview of Development, Temperament, and Risk Factors   2.5.1 Physical Development   *The physical development of our nervous system provides the foundation for mental function (i.e., cognition, mood, and intentional behavior). Note the four overarching findings/organizing principles extrapolated from research that categorize neuronal development and the implications these findings have on mental health and mental illness.

Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999):  “Chapter 2: The Fundamentals of Mental Health and Mental Illness,” pages 57–59 for additional information. *

2.5.2 Psychological Development: Piaget   *Jean Piaget’s theory on psychological development focuses on cognitive development as a process, where each stage of development precedes a previous stage in a fixed pattern.

Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999):  “Chapter 2: The Fundamentals of Mental Health and Mental Illness,” pg.59 for additional information.*

2.5.3 Psychological Development: Erik Erikson   *Erik Erikson’s psychoanalytic developmental theory is an expansion of Freud’s original theory of psychosexual development. Erikson supports the notion that development unfolds throughout the lifespan whereby each life stage presents its own challenges and opportunities for growth.

Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 2:  The Fundamentals of Mental Health and Mental Illness,” pages 59–60 for additional information.*

2.5.4 John Bowlby   *John Bowlby’s attachment theory of development is a reinterpretation of Freud’s original theory of psychosexual development. Bowlby theorized that attachment has a biological basis in need for survival.

Refer to The United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 2:  The Fundamentals of Mental Health and Mental Illness,” pg. 60 for additional information.*

2.6 Overview of Prevention   2.6.1 Definition of Prevention   *Preventing an illness from occurring is better than treating an illness after onset, and this notion has been the foundation in multiple fields, including those specific to mental health and mental illness. Note that there are varying levels of prevention from primary, secondary, and tertiary and there are also issues with these definitions (e.g., different meanings to different people and different fields of health).

Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 2: The Fundamentals of Mental Health and Mental Illness,” pages 62–63 for additional information.*

2.6.2 Risk Factors and Protective Factors   *Understanding the concepts of risk and protective factors is central to many prevention programs. Risk factors increase an individual’s likelihood of illness or disease development whereas protective factors increase an individual’s likelihood of not developing an illness or disease. Note the differentiation and interaction of these factors and how they affect the identifications and treatment in a population.

Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 2: The Fundamentals of Mental Health and Mental Illness,” pages 63–64 for additional information.*

2.7 Mental Health Services   2.7.1 Patterns of Use   *The settings for individuals using mental health services include institutional, community-based, and home-based options. Note the percentage of people who use mental health services and where received (e.g., general sector, specialty sector).

Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999):  “Chapter 2: The Fundamentals of Mental Health and Mental Illness,” pages 73–75 for additional information.*

2.7.2 History of Mental Health Services   *The origins of mental health services in the United States can be traced back to colonial America and has progressed through the years, influenced by national and international wars, urbanization, and health care reform. Examine the historical origins of mental health services systems, the origins of treatment, and policy interventions/measures.            

Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 2: The Fundamentals of Mental Health and Mental Illness,” pages 75–80 for additional information.*

2.7.3 Overview of Recovery   *Recovery from mental illness has a substantial impact on various populations, including consumers and families, mental health research, and service delivery. Note how the promotion of recovery process impacts each section and issues with the recovery process, such as problems with definitions and measurements.

Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999):  “Chapter 2: The Fundamentals of Mental Health and Mental Illness,” pages 97–100 for additional information.*

2.7.4 Mental Health and Mental Illness across the Lifespan   *Mental health and mental illness should be considered as continuing across the lifespan, since they are dynamic, ever-changing phenomena influenced by developmental stages and society.

Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999):  “Chapter 2: The Fundamentals of Mental Health and Mental Illness,” pages 102–104 for additional information.*

Assessment: The Saylor Foundation’s “Unit 2 Assessment”   - Assessment: The Saylor Foundation’s “Unit 2 Assessment” Link: The Saylor Foundation’s “Unit 2 Assessment”

 Instructions: Complete this unit assessment. For each question,
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