Chapter 1 & 2 Abnormal Behavior in Historical Context & The Causes of Psychopathology

1. Chapter 1 & 2Abnormal Behavior in Historical Context & The Causes of Psychopathology

2. Myths and Misconceptions About Abnormal Behavior • Many Myths Are Associated With Mental Illness • Lazy, crazy, dumb • Weak in character • Dangerous to self or others • Mental illness is a hopeless situation

3. The Myth of Mental Illness • Thomas Szasz - outspoken critic • Abnormal Behavior = Unpleasant Behavior • Psychiatric Dx - Tells us nothing meaningful about person (unlike medical dxs) • Dx. used to control people and keep “undesirables” out of the way

4. Mental Illness - More than a Myth • Most believe mental illnesses are objective, and there is little to distinguish between mental and physical illnesses. Research supports this. This whole class will support this point. • However, Szasz raises two important points: • (1) What impact does a society have on mental illness? Homosexuality, masturbation were once dxs • (2) For a Dx to be given, let’s make sure it does tell us something meaningful about a person

5. Approaches to Defining Abnormal Behavior • No Single Definition of Psychological Abnormality • No Single Definition of Psychological Normality • Does Infrequency Define Abnormality? • Does Suffering Define Abnormality? • Does Strangeness Define Abnormality? • Does the Behavior Itself Define Abnormality? • Should Normality Serve as a Guide?

6. Toward a Definition of Abnormal Behavior • Psychological Dysfunction • Breakdown in cognitive, emotional, or behavioral functioning • Distress or Impairment • Difficulty performing appropriate and expected roles • Impairment is set in the context of a person’s background • Atypical or Unexpected Cultural Response • Reaction is outside cultural norms

7. Why We Do This Clinical Description (phenomenology) • Describing the Problem • Description Aims to • Distinguish clinically significant dysfunction from common human experience • Describe Cluster of Symptoms • Describe Epidemiology • Prevalence/incidence • Onset of Disorders (Acute vs. insidious) • Course (Episodic, time-limited, or chronic course)

8. Why We Do This Causation, Treatment, and Outcome • What Factors Contribute to the Development of Psychopathology? • Study of etiology • How Can We Best Improve the Lives of People Suffering From Psychopathology? • Study of treatment development

9. Who deals with Psychopathology Currently? • Mental Health Professionals • The Ph.D.’s: Clinical and counseling psychologists • The Psy.D.’s: Clinical and counseling “Doctors of Psychology” • M.D.’s: Psychiatrists • M.S.W.’s: Psychiatric and non-psychiatric social workers • MN/MSN’s: Psychiatric nurses • LPC: Licensed Clinical Counselors

10. Historical Conception and Causes of Psychopathlogy

11. Historical Conceptions of Abnormal Behavior • Major Psychological Disorders Have Existed • In all cultures • Across all time periods • The Causes and Treatment of Abnormal Behavior Varied Widely • Across cultures • Across time periods • Particularly as a function of prevailing paradigms or world views

12. The Past: Abnormal Behavior and the Supernatural Tradition • Deviant Behavior as a Battle of “Good” vs. “Evil” • Deviant behavior was believed to be caused by demonic possession, witchcraft, sorcery • Mass hysteria (St. Vitus’dance or Tartanism) and the church • Treatments included exorcism, torture, beatings, and crude surgeries • Movement of the Moon and Stars as a Cause of Deviant Behavior • Paracelsus and lunacy • Both “Outer Force” Views Were Popular During the Middle Ages • Few Believed That Abnormality Was an Illness on Par With Physical Disease

13. Trephination – A Treatment in Line with the Hypothesized Cause

14. The Past: Abnormal Behavior and the Biological Tradition • Hippocrates’: Abnormal Behavior as a Physical Disease • Hysteria “The Wander Uterus” • Galen Extends Hippocrates Work • Humoral theory of mental illness • Treatments remained crude • Galenic-Hippocratic Tradition • Foreshadowed modern views linking abnormality with brain chemical imbalances

15. The Past: The Biological Tradition • Mental Illness = Physical Illness • The 1930’s: Biological Treatments Were Standard Practice • Insulin shock therapy, ECT, and brain surgery (i.e., lobotomy) • By the 1950’s Several Medications Were Established • Examples include neuroleptics (i.e., reserpine) and major tranquilizers

16. The Past: The Biological Tradition Comes of Age • General Paresis (Syphilis) and the Biological Link With Madness • Associated with several unusual psychological and behavioral symptoms • Pasteur discovered the cause – A bacterial microorganism • Led to penicillin as a successful treatment • Bolstered the view that mental illness = physical illness and should be treated as such • John Grey, Dorothea Dix, and the Reformers

17. The Past: Abnormal Behavior andthe Psychological Tradition • The Rise of Moral Therapy • The practice of allowing institutionalized patients to be treated as normal as possible and to encourage and reinforce social interaction • Philippe Pinel and Jean-Baptiste Pussin • William Tuke followed Pinel’s lead in England • Benjamin Rush led reforms in the United States • Reasons for the Falling Out of Moral Therapy • Emergence of Competing Alternative Psychological Models

18. The Past: Abnormal Behavior andthe Psychoanalytic Tradition • Freudian Theory of the Structure and Function of the Mind • The Mind’s Structure • Id (pleasure principle; illogical, emotional, irrational) • Ego (reality principle; logical and rational) • Superego (moral principles; keeps Id and Ego in balance)

19. Freud and Psychopathology • Freudian Stages of Psychosexual Development • Oral, anal, phallic, latency, and genital stages • Defense Mechanisms: When the Ego Loses the Battle with the Id and Superego • Displacement & denial, rationalization, reaction formation, projection, repression, and sublimation

20. Behavioral Perspectives • Classical conditioning • Operant conditioning • Modeling/Social Learning • Behavioral treatment interventions

21. The Behavioral Tradition The Behavioral Tradition • Classical Conditioning (Pavlov; Watson) • Learning ELICITED responses • Pairing neutral stimuli and unconditioned stimuli • Conditioning was extended to explain fear acquisition • Operant Conditioning (Thorndike; Skinner) • Learning EMITTED responses • Voluntary behavior is controlled by consequences • Positive reinforcement • Negative reinforcement • Punishment • Both Learning Traditions • Greatly influenced the development of behavior therapy

22. The Behavioral Tradition • Social Learning Theory (Bandura) • Learning through observation of modeling • Bobo doll studies

23. Cognitive Perspectives • Cognitive explanations • Cognitive treatment interventions • Integrated cognitive-behavioral approaches

24. The Cognitive Perspective • Expanded upon behaviorism • Thoughts, attitudes, beliefs interact with stimuli in the environment to produce emotion and behavior • Attributions • Cognitive Distortions • Negative Automatic Thoughts

25. Cognitive-Behavioral Tradition • A merging of these two traditions and the dominant paradigm currently. • Stimulus-response relationships are important as well as cognitive processing • Most empirically validated treatments stem from this tradition Cognitive Processing Stimulus Response Emotions Behaviors

26. Biological Perspectives • The central nervous system • The neuron • Neurotransmission • The Brain • The peripheral nervous system • The endocrine system • Genetics

27. Division of the Nervous System

28. The Central Nervous System • The Neuron • Soma – Cell body • Dendrites – Branches that receive messages from other neurons • Axon – Trunk of neuron that sends messages to other neurons • Axon terminals – Buds at end of axon from which chemical messages are sent • Synapses – Small gaps that separate neurons • Neurons Function Electrically, but Communicate Chemically • Neurotransmitters are the chemical messengers

29. Dendrites Diagram of a Neuron Soma Axon Direction of impulse Axon Terminals Synapse

30. The Synapse & Neurotransmitters Information from one neuron flows to another neuron across a synapse. The synapse is a small gap separating 2 neurons. The synapse consists of: • a presynaptic ending that contains neurotransmitters, mitochondria and other cell organelles, • a postsynaptic ending that contains receptor sites for neurotransmitters and, • the synaptic cleft: a space between the presynaptic and postsynaptic endings.

31. Neurotransmitter ReleaseDiffusion The neurotransmitter molecules diffuse across the synaptic cleft where they can bind with receptor sites on the postsynaptic ending to influence the electrical response in the postsynaptic neuron. In the figure on the left, the postsynaptic ending is a dendrite (axodendritic synapse), but synapses can occur on axons (axoaxonic synapse) and cell bodies (axosomatic synapse).

32. Functions of MainTypes of Neurotransmitters Figure 2.12 Manipulating serotonin in the brain.

33. Functions of MainTypes of Neurotransmitters • Neurotransmitters have two basic function • Excitation • Inhibition • Main Types and Functions of Neurotransmitters • Acetylcholine • Dopamine • Norepinephrine and beta blockers • Serotonin (5HT) • Endorphins • Gamma aminobutyric acid (GABA) and benzodiazepines

34. Cholinergic system (Acetylcholine)

35. ACETYLCHOLINE (ACh) • Acetylcholine (ACh) is a neurotransmitter substance that is found both in the CNS and in the PNS. • In the PNS it is the NT released at synapses on skeletal muscle and is also found in the ganglia of the autonomic nervous system. • In the brain it appears to be involved in learning and memory and in sleeping and dreaming.

36. Dopaminergic system (Dopamine)

37. DOPAMINE (DA) • Dopamine (DA) is an inhibitory neurotransmitter • It is implicated in movement, attention and learning. • Dopamine excess may be involved in Schizophrenia. • Most importantly it is involved in the “reward system of the brain.”

38. Noradrenergic system (Norepinephrine)

39. NORADRENALINE (NA) • Noradrenalin (NA) is not synthesised in the cell body but the dopamine synthesised there is converted into NA inside the synaptic vessicles. • Like ACh, NA is found in the autonomic nervous system. Here it has an excitatory role. • In the brain, NA is inhibitory and is primarily involved in control of alertness and wakefulness. • The release of NA from the neuron is more complicated than for other neurotransmitters. • NA stimulates the release of Adrenalin (a hormone) from the adrenal medulla.

40. Serotonergic system (Serotonin)

41. SEROTONIN • At most synapses Serotonin (5-HT) is an inhibitory neurotransmitter. • It plays a role in the regulation of mood, producing sedation or relaxation. • It also has a role in the control of eating, sleep and arousal. In addition, it can regulate pain.

42. Endorphins • Generally inhibitory • Modulate the experience of pain • Involved in feelings of euphoria and reward

43. GABA • Most prevalent inhibitory neurotransmitter in the brain • Implicated in relaxation/antianxiety • Many drugs target this system

44. The Brain Forebrain Midbrain Hindbrain Telencephalon Diencephalon Mesencephalon Metencephalon Myelencephalon

45. Divisions of the Brain A review of this method of dividing the brain. Forebrain Midbrain Hindbrain Telencephalon Diencephalon Mesencephalon Metencephalon Myelencephalon Cerebral Cortex Basal Ganglia Hippocampus Amygdala Thalamus Hypothalamus Tectum Tegmentum Pons Cerebellum Medulla

46. Cerebral CortexAnatomical Divisions- 4 lobes The average human brain weighs about 1,400 grams (3 lb). The brain can be divided down the middle lengthwise into two halves called the cerebral hemispheres. Each hemisphere of the cerebral cortex is divided into four lobes … Although most people have the same patterns of gyri and sulci on the cerebral cortex, no two brains are exactly alike.

47. Neuroscience and the Brain Structure • Lobes of Cerebral Cortex • Frontal – Thinking and reasoning abilities, memory • Parietal – Touch recognition • Occipital – Integrates visual input • Temporal – Recognition of sights and sounds and long-term memory storage • Limbic System-”emotion center” • Thalamus – Receives and integrates sensory information • Hypothalamus – Eating, drinking, aggression, sexual activity

48. Major Structures of the Brain

49. Division of the Nervous System Figure 2.7b Major Structures of the Brain.

50. Neuroscience: Peripheral Nervous and Endocrine Systems • Somatic Branch of PNS • Controls voluntary muscles and movement • Autonomic Branch of the PNS-involuntary muscles • Sympathetic and parasympathetic branches of the ANS • Regulates cardiovascular system & body temperature • Regulates the endocrine system and aids in digestion