Lichtman Fundamentals of Abnormal Psychology, 7e Abnormal Psychology: Past and Present Chapter 1

2 Abnormal Psychology: Past and Present  What is abnormal psychology?  The scientific study of abnormal behavior in an effort to describe, predict, explain, and change abnormal patterns of functioning  Most definitions, however, have certain features in common:  “The Four Ds”  Deviance – Different, extreme, unusual, perhaps even bizarre  Distress – Unpleasant and upsetting to the person  Dysfunction – Interfering with the person’s ability to conduct daily activities in a constructive way  Danger – Posing risk of harm Lichtman, Fundamentals of Abnormal Psychology, 7e

3 Deviance  From what?  From behaviors, thoughts, and emotions that differ markedly from a society’s ideas about proper functioning  From social norms  Stated and unstated rules for proper conduct  Examples? Lichtman, Fundamentals of Abnormal Psychology, 7e

4 Distress  According to many clinical theorists, behavior, ideas, or emotions usually have to cause distress before they can be labeled abnormal Lichtman, Fundamentals of Abnormal Psychology, 7e

5 Dysfunction  Abnormal behavior tends to be dysfunctional – it interferes with daily functioning Lichtman, Fundamentals of Abnormal Psychology, 7e

6 Danger  Abnormal behavior may become dangerous to oneself or others  Behavior may be consistently careless, hostile, or confused Lichtman, Fundamentals of Abnormal Psychology, 7e

7 The Elusive Nature of Abnormality  In short, although abnormality generally is defined as behavior that is deviant, distressful, dysfunctional, and sometimes dangerous, these criteria often are vague and subjective Lichtman, Fundamentals of Abnormal Psychology, 7e

8 What Is Treatment?  Treatment, or therapy, is a procedure designed to change abnormal behavior into more normal behavior Lichtman, Fundamentals of Abnormal Psychology, 7e

9 What Is Treatment? According to Jerome Frank, all forms of therapy have three essential features: 1. A sufferer who seeks relief from the healer 2. A trained, socially accepted healer, whose expertise is accepted by the sufferer and his or her social group 3. A series of contacts between the healer and the sufferer, through which the healer… tries to produce certain changes in the sufferer’s emotional state, attitudes, and behavior Lichtman, Fundamentals of Abnormal Psychology, 7e

10 What Is Treatment?  Despite this straightforward definition, clinical treatment is surrounded by conflict and confusion:  Lack of agreement about goals or aims  Lack of agreement about successful outcome  Lack of agreement about failure Lichtman, Fundamentals of Abnormal Psychology, 7e

11 How Was Abnormality Viewed and Treated in the Past?  Many present-day ideas and treatments have roots in the past Lichtman, Fundamentals of Abnormal Psychology, 7e

12 Ancient Views and Treatments  Historians have concluded that ancient societies probably regarded abnormal behavior as the work of evil spirits  This view may have begun as far back as the Stone Age  The treatment for severe abnormality was to force the demons from the body through trephination and exorcism Lichtman, Fundamentals of Abnormal Psychology, 7e

13 Greek and Roman Views and Treatments  500 B.C. to 500 A.D.  Hippocrates believed and taught that illnesses had natural causes i.e. The work of God  He looked to an unbalance of the four fluids, or humors  To treat psychological dysfunctioning, Hippocrates sought to correct the underlying physical pathology Lichtman, Fundamentals of Abnormal Psychology, 7e

14 Europe in the Middle Ages: Demonology Returns  500 – 1350 A.D.  The church rejected scientific forms of investigation, and it controlled all education  Religious beliefs came to dominate all aspects of life  Once again, abnormality was seen as a conflict between good and evil  Mentally ill were treated for demonic possession. Lichtman, Fundamentals of Abnormal Psychology, 7e

15 The Renaissance and the Rise of Asylums  1400 – 1700 A.D.  German physician Johann Weyer believed that the mind was as susceptible to sickness as the body  The care of people with mental disorders needed to be provided by community and by family. Lichtman, Fundamentals of Abnormal Psychology, 7e

16 The Renaissance and the Rise of Asylums  Across Europe, religious shrines were devoted to the humane and loving treatment of people with mental disorders  One, at Gheel, became a community mental health program of sorts  Unfortunately, this time also saw a rise of asylums – institutions whose primary purpose was care of the mentally ill  The intention was good care, but because of overcrowding they became virtual prisons Video: Rush Restraint Chair Lichtman, Fundamentals of Abnormal Psychology, 7e

The Nineteenth Century: Reform and Moral Treatment  As 1800 approached, the treatment of people with mental disorders began to improve once again  Pinel (France) and Tuke (England) advocated moral treatment – care that emphasized moral guidance and humane and respectful techniques  In the U.S., Benjamin Rush (father of American psychiatry) and Dorothea Dix (Boston schoolteacher) were the primary proponents of moral treatment  Dix’s work led to the creation of state hospitals 17 Lichtman, Fundamentals of Abnormal Psychology, 7e

18 The Nineteenth Century: Reform and Moral Treatment  By the end of the nineteenth century, several factors led to a reversal of the moral treatment movement:  Money and staff shortages  Declining recovery rates  Overcrowding  Emergence of prejudice  By the early years of the twentieth century, the moral treatment movement had ground to a halt; long-term hospitalization became the rule once again Lichtman, Fundamentals of Abnormal Psychology, 7e

19 The Early Twentieth Century: Dual Perspectives  As the moral movement was declining in the late 1800s, two opposing perspectives emerged:  The Somatogenic Perspective  Abnormal functioning has physical causes  The Psychogenic Perspective  Abnormal functioning has psychological causes Lichtman, Fundamentals of Abnormal Psychology, 7e

The Early Twentieth Century: The Psychogenic Perspective  The rise in popularity of this  perspective was based on work with hypnotism:  Sigmund Freud’ s theory of psychoanalysis  Freud and his followers offered psychoanalytic treatment primarily to patients who did not require hospitalization – now known as outpatient therapy  By the early 20th century, psychoanalytic theory and treatment were widely accepted 20 Video: Early Medical Prodecures Lichtman, Fundamentals of Abnormal Psychology, 7e

21 How Are People with Severe Disturbances Cared For?  In the 1950s, researchers discovered a number of new psychotropic medications:  Antipsychotic drugs  Antidepressant drugs  Antianxiety drugs  These discoveries led to deinstitutionalization and a rise in outpatient care  This change in care was not without problems Lichtman, Fundamentals of Abnormal Psychology, 7e

22 Lichtman, Fundamentals of Abnormal Psychology, 7e

How Are People with Less Severe Disturbances Treated?  Surveys suggest that nearly 1 in 6 adults in the US receives treatment for psychological disorders in the course of a year, the majority for fewer than 5 sessions  Outpatient treatments are also becoming available for more and more kinds of problems.  Yet another change in outpatient care has been the development of programs devoted exclusively to one kind of psychological problem 23 Lichtman, Fundamentals of Abnormal Psychology, 7e

24 A Growing Emphasis on Preventing Disorders and Promoting Mental Health  The community mental health approach has given rise to the prevention movement  Many of today’s programs are trying to:  Correct the social conditions that underlie psychological problems  Help individuals at risk for developing disorders  Prevention programs have been further energized by the growing interest in positive psychology – the study and enhancement of positive feelings, traits, and abilities Lichtman, Fundamentals of Abnormal Psychology, 7e

The Growing Influence of Insurance Coverage  Today the dominant form of insurance coverage is the managed care program – a program in which the insurance company determines key care issues  At least 75% of all privately insured persons in the U.S. are enrolled in managed care programs  A key problem is that reimbursements for mental disorders tend to be lower than those for medical disorders 25 Lichtman, Fundamentals of Abnormal Psychology, 7e

What Are Today’s Leading Theories and Professions?  One of the most important developments in the field of abnormal psychology has been the growth of numerous theoretical perspectives, including:  Psychoanalytic  Biological  Behavioral  Cognitive  Humanistic-existential  Sociocultural  At present, no single perspective dominates the clinical field 26 Lichtman, Fundamentals of Abnormal Psychology, 7e

What Do Clinical Researchers Do?  Research is the systematic search for facts through the use of careful observations and investigations  It is the key to accuracy in all fields but it is particularly important in the field of abnormal psychology 27 Lichtman, Fundamentals of Abnormal Psychology, 7e

28 What Do Clinical Researchers Do?  Use three methods of investigation to form and test hypotheses and to draw broad conclusions… Lichtman, Fundamentals of Abnormal Psychology, 7e

29 The Case Study  ***Provides a detailed, interpretative description of a person’s life and psychological problems  Can be a source of new ideas about behavior  Freud’s theories based mainly on case studies  May offer tentative support for a theory  May challenge a theory’s assumptions  May inspire new therapeutic techniques  May offer opportunities to study unusual problems Lichtman, Fundamentals of Abnormal Psychology, 7e

30 The Case Study  Has limitations:  Is reported by biased observers  Relies on subjective evidence  Provides little basis for generalization  These limitations are addressed by the two other methods of investigation… Lichtman, Fundamentals of Abnormal Psychology, 7e

The Correlational Method and The Experimental Method  Preferred method of clinical investigation  Typically involve observing many individuals  Researchers apply procedures uniformly  Studies can be replicated  Researchers use statistical tests to analyze results 31 Lichtman, Fundamentals of Abnormal Psychology, 7e

The Correlational Method  Correlation is the degree to which events or characteristics vary with each other  The correlational method is a research procedure used to determine the “co- relationship” between variables 32 Lichtman, Fundamentals of Abnormal Psychology, 7e

33 Most Investigated Correlational Questions in Clinical Research  Are stress and onset of mental disorders related?  Is culture (or gender or race) generally linked to mental disorders?  Are income and mental disorders related?  Are social skills tied to mental disorders?  Is social support tied to mental disorders?  Are family conflict and mental disorders related?  Is treatment responsiveness tied to culture?  Which symptoms of a disorder disappear altogether?  How common is a disorder in a particular population? Lichtman, Fundamentals of Abnormal Psychology, 7e

34 Describing a Correlation  When variable change the same way, their correlation is said to have a positive direction  In a negative correlation, the value of one variable increases as the value of the other variable decreases  Variables also may be unrelated, meaning there is no consistent relationship between them Lichtman, Fundamentals of Abnormal Psychology, 7e

35 Describing a Correlation  The magnitude (strength) of a correlation is also important  High magnitude = variables which vary closely together  Low magnitude = variables which do not vary as closely together Lichtman, Fundamentals of Abnormal Psychology, 7e

36 What Are the Merits of the Correlational Method?  Advantages of the correlational method:  Because researchers measure their variables, observe many participants, and apply statistical analyses, they can generalize findings  Can repeat (replicate) studies on other samples  Difficulties with correlational studies:  Results describe but do not explain a relationship  Results say nothing about causation Lichtman, Fundamentals of Abnormal Psychology, 7e

37 Special Forms of Correlational Research  There are two special forms of correlational study:  Epidemiological studies  Reveal the incidence and prevalence of a disorder in a particular population  Incidence = number of new cases that emerge in a given period  Prevalence = total number of cases in a given period  Longitudinal studies  Researchers observe the same individuals on many occasions over a long period Lichtman, Fundamentals of Abnormal Psychology, 7e

38 The Experimental Method  An experiment is a research procedure in which a variable is manipulated and the manipulation’s effect on another variable is observed  Manipulated variable = independent variable  Variable being observed = dependent variable  Allows researchers to ask questions such as: Does a particular therapy relieve the symptoms of a particular disorder?”  Questions about causal relationships can only be answered by an experiment Lichtman, Fundamentals of Abnormal Psychology, 7e

39 Most Investigated Causal Questions in Clinical Research  Does factor X cause a disorder?  Is cause A more influential than cause B?  How does family communication and structure affect family members?  How does a disorder affect the quality of a person’s life?  Does treatment X alleviate a disorder?  Is treatment X more helpful than no treatment at all?  Is treatment A more helpful than treatment B?  Why does treatment X work?  Can an intervention prevent abnormal functioning? Lichtman, Fundamentals of Abnormal Psychology, 7e

40 The Experimental Method  Statistics and research design are very important  Researchers must try to eliminate all confounds – variables other than the independent variable that may also be affecting the dependent variable  Three features are included in experiments to guard against confounds:  A control group  Random assignment  Blind design Video: Ethics Lichtman, Fundamentals of Abnormal Psychology, 7e