Chapter 1 Abnormal Behavior in Historical Context

1. Chapter 1Abnormal Behavior in Historical Context

2. Myths and Misconceptions About Abnormal Behavior • No Single Definition of Psychological Abnormality • No Single Definition of Psychological Normality

3. What is a Psychological Disorder? • Psychological Dysfunction • Breakdown in cognitive, emotional, or behavioral functioning • Personal Distress • Difficulty performing appropriate and expected roles • Impairment is set in the context of a person’s background • Atypical or Not Culturally Expected Response • Reaction is outside cultural norms

4. Definition of Abnormal Behavior (cont.) Figure 1.1 The criteria defining a psychological disorder

5. Abnormal Behavior Defined • A Psychological Dysfunction Associated With Distress or Impairment in Functioning That is not a Typical or Culturally Expected Response • The Diagnostic and Statistical Manual (DSM-IV) • DSM Contains Diagnostic Criteria • Psychopathology is the Scientific Study of Psychological Disorders

6. The Science of Psychopathology • Mental Health Professionals • Ph.D. : Clinical and counseling psychologists • Psy.D: Clinical and counseling “Doctors of Psychology” • M.D. : Psychiatrists • M.S.W. : Psychiatric and non-psychiatric social workers • MN/MSN: Psychiatric nurses • United by the Scientist-Practitioner Framework

7. Dimensions of the Scientist-Practitioner Model Figure 1.2 Functioning as a scientist-practitioner

8. Dimensions of the Scientist-Practitioner Model (cont.) Figure 1.3 Three major categories make up the study and discussion of psychological disorders.

9. Clinical Description • Begins with the Presenting Problem • Description Aims to • Distinguish clinically significant dysfunction from common human experience • Describe Prevalence and Incidence of Disorders • Describe Onset of Disorders • Acute vs. insidious onset • Describe Course of Disorders • Episodic, time-limited, or chronic course

10. Causation, Treatment, and Outcome • What Factors Contribute to the Development of Psychopathology? • Study of etiology: biopsychosocial model • How Can We Best Improve the Lives of People Suffering From Psychopathology? • Study of treatment development • Includes pharmacologic, psychosocial, and/or combined treatments • How Do We Know That We Have Alleviated Psychological Suffering? • Study of treatment outcome • Limited in specifying actual causes of disorders

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 • As particularly as a function of prevailing paradigms or world views • Three Dominant Traditions Include: Supernatural, Biological, and Psychological

12. The Supernatural Tradition • Deviant Behavior as a Battle of “Good” vs. Evil • Deviant behavior was believed to be caused by demonic possession, witchcraft, sorcery • Treatments included exorcism, torture, beatings, and crude surgeries • The Moon and the Stars • Paracelsus and lunacy

13. The Biological Tradition • Hippocrates: Abnormal Behavior as a Physical Disease • Hysteria “The Wander Uterus” • Galen Extends Hippocrates Work • Treatments remained crude • Galenic-Hippocratic Tradition • Foreshadowed modern views linking abnormality with brain chemical imbalances

14. The 19th Century • 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 and the Reformers • Consequences of the biological movement: • Mental Illness = Physical Illness

15. The Psychological Tradition • The Rise of Moral Therapy • Involved more humane treatment of institutionalized patients • Encouraged and reinforced social interaction • Reasons for the Falling Out of Moral Therapy • Population of mentally ill increased rapidly with immigration • Labor/resource intensive • Emergence of Competing Alternative Psychological Models

16. Psychoanalytic Theory • Freudian Theory • The Structure of the Mind • Id (pleasure principle; illogical, emotional, irrational) • Ego (reality principle; logical and rational) • Superego (moral principles; keeps Id and Ego in balance) • Defense Mechanisms: When the Ego Loses the Battle with the Id and Superego • Displacement & denial • Rationalization & reaction formation • Projection, repression, and sublimation • Psychosexual Stages of Development • Oral, anal, phallic, latency, and genital stages

17. The Past: Abnormal Behavior andthe Psychoanalytic Tradition (cont.) Figure 1.4 Freud’s structure of the mind

18. Psychoanalytic Psychotherapy: The “Talking” Cure • Unearth the hidden intrapsychic conflicts (“The Real Problems”) • Therapy is often long-term • Techniques include free association and dream analysis • Examine transference and counter-transference issues • Little evidence for efficacy

19. Humanistic Theory • Abraham Maslow and Carl Rogers • Major Themes • That people are basically good • Humans strive toward self-actualization • Humanistic Therapy • Therapist conveys empathy and unconditional positive regard • Minimal therapist interpretation

20. The Behavioral Model • Derived from a scientific approach to the study of psychopathology • Ivan Pavlov, John B. Watson, and Classical Conditioning • Classical conditioning is a ubiquitous form of learning • Conditioning involves a contingency between neutral and unconditioned stimuli • Conditioning was extended to the acquisition of fear and other emotional responses

21. The Beginnings of Behavior Therapy • Reactionary movement against psychoanalysis and non-scientific Approaches • Early Pioneers • Joseph Wolpe – Systematic desensitization • Edward Thorndike, B. F. Skinner, and Operant Conditioning • Another ubiquitous form of learning • Most voluntary behavior is controlled by the consequences that follow behavior • Learning traditions greatly influenced the development of behavior therapy • Behavior therapy tends to be time-limited and direct • Strong evidence supporting the efficacy of behavior therapies

22. The Present: An Integrative Approach • Psychopathology Is multiply determined • Unidimensional accounts of psychopathology are incomplete • Must consider reciprocal relations between • Biological, psychological, social, and experiential factors • Defining abnormal behavior is also complex, multifaceted, and has evolved • The supernatural tradition has no place in a science of abnormal behavior