Abnormal Psychology, Thirteenth Edition PowerPoint  Lecture Notes Presentation Chapter 1 Introduction and Historical Review Abnormal Psychology, Thirteenth Edition by Ann M. Kring, Sheri L. Johnson, Gerald C. Davison, & John M. Neale © 2015 John Wiley & Sons, Inc. All rights reserved.

Chapter Outline Chapter 1: Introduction and Historical Review 11/17/2018 Chapter Outline Chapter 1: Introduction and Historical Review I. Introduction to the Study of Mental Disorders II. History of Psychopathology III. The Evolution of Contemporary Thought IV. The Mental Health Professions © 2015 John Wiley & Sons, Inc. All rights reserved.

Psychopathology Study of the nature, development, and treatment of psychological disorders Challenges in the study of psychopathology: Maintain objectivity Avoid preconceived notions Reduce stigma © 2015 John Wiley & Sons, Inc. All rights reserved. © 2014 John Wiley & Sons, Inc. All rights reserved.

Figure 1.1: Four Characteristics of Stigma © 2015 John Wiley & Sons, Inc. All rights reserved.

Defining Mental Disorder, DSM-5 Definition The disorder occurs within the individual It involves clinically significant difficulties in thinking, feeling, or behaving It involves dysfunction in processes that support mental functioning It is not a culturally specific reaction to an event (e.g. death of a loved one) It is not primarily a result of social deviance or conflict with society © 2015 John Wiley & Sons, Inc. All rights reserved.

Defining Mental Disorder Personal Distress The condition causes the individual distress Emotional pain and suffering Helplessness and hopelessness of depression Disability Impairment in a key area (e.g., work, relationships) Chronic substance abuse results in job loss Violation of Social Norms Makes others uncomfortable or causes problems Antisocial behavior of the psychopath Dysfunction Wakefield's Harmful Dysfunction: failure of internal mechanisms in the mind to function properly Behavioral, psychological, and/or biological systems are impaired © 2015 John Wiley & Sons, Inc. All rights reserved.

Figure 1.2: Key Characteristics in the Definition of Mental Disorder © 2015 John Wiley & Sons, Inc. All rights reserved.

History of Psychopathology Early Demonology Possession by evil beings or spirits Exorcism Early Biological Explanations Hippocrates (5th century BC) Mental disturbances have natural (not supernatural) causes (problems with the brain) Three categories of mental disorders: mania, melancholia, & phrenitis (brain fever) Normal brain functioning depended on balance of four humors: blood, black bile, yellow bile, & phlegm © 2015 John Wiley & Sons, Inc. All rights reserved.

History of Psychopathology: Dark Ages Dark Ages (2nd century AD) Monks cared and prayed for mentally ill Witches (13th century AD) Torture sometimes led to bizarre delusional sounding confessions, e.g., concourse with demons. Initially, historians concluded many of the accused were mentally ill. Further research found little support for this conclusion. © 2015 John Wiley & Sons, Inc. All rights reserved.

History of Psychopathology: Lunacy Trials Trials held to determine sanity Began in 13th century England Municipal authorities assumed responsibility for care of mentally ill Lunacy attributes insanity to misalignment of moon (“luna”) and stars © 2015 John Wiley & Sons, Inc. All rights reserved.

History of Psychopathology: Asylums Asylums (15th century) Establishments for the confinement and care of mentally ill Priory of St. Mary of Bethlehem (founded in 1243) One of the first mental institutions The wealthy paid to gape at the insane Origin of the term bedlam (wild uproar or confusion) Treatment non-existent or harmful at asylums Benjamin Rush recommended drawing copious amounts of blood, to relieve brain pressure © 2015 John Wiley & Sons, Inc. All rights reserved.

History of Psychopathology: Pinel’s Reforms and Moral Treatment Philippe Pinel (1745–1826) Pioneered humanitarian treatment at LaBicetre Moral Treatment Small, privately funded, humanitarian mental hospitals Friends Asylum (1817) Patients engaged in purposeful, calming activities (e.g., gardening) Talked with attendants © 2015 John Wiley & Sons, Inc. All rights reserved.

History of Psychopathology: Dorothea Dix Crusader for prisoners and mentally ill Urged improvement of institutions Worked to establish 32 new, public hospitals Unfortunately, small staffs at these new public hospitals could not provide necessary individual attention Hospitals administered by physicians, who were more interested in biological rather than psychological aspects of mental illness © 2015 John Wiley & Sons, Inc. All rights reserved.

The Evolution of Contemporary Thought: Biological Approaches General paresis and Syphilis Degenerative disorder with psychological symptoms (delusions of grandeur) and physical symptoms (progressive paralysis) By mid-1800’s, it was known that general paresis and syphilis occurred together in some patients In 1905, biological cause of syphilis found Since general paresis had biological cause, other mental illness might also Biological causes of psychopathology gained credibility © 2015 John Wiley & Sons, Inc. All rights reserved.

The Evolution of Contemporary Thought : Genetics Galton’s (1822–1911) work lead to notion that mental illness can be inherited Nature (genetics) and nurture (environment) Eugenics Promotion of enforced sterilization to eliminate undesirable characteristics from the population Many state laws required mentally ill to be sterilized © 2015 John Wiley & Sons, Inc. All rights reserved.

Early Biological Treatments Insulin-coma therapy Sakel (1930’s) Electroconvulsive Therapy (ECT) Cerletti and Bini (1938) Induce epileptic seizures with electric shock Prefrontal lobotomy Moniz (1935) Often used to control violent behaviors; led to listlessness, apathy, and loss of cognitive abilities © 2015 John Wiley & Sons, Inc. All rights reserved.

The Evolution of Contemporary Thought: Psychological Approaches Mesmer (1734–1815) Treated patients with hysteria using “animal magnetism” Early practitioner of hypnosis Charcot (1825–1893) His support legitimizes hypnosis as treatment for hysteria Breuer (1842–1925) Used hypnosis to facilitate catharsis in Anna O. Cathartic Method Release of emotional tension triggered by reliving and talking about event © 2015 John Wiley & Sons, Inc. All rights reserved.

Freud Breuer and Freud (1856–1939) jointly publish “Studies in Hysteria” in 1895, which serves as the basis for Freud’s theory. Freudian or psychoanalytic theory Human behavior determined by unconscious forces. Psychopathology results from conflicts among these unconscious forces. © 2015 John Wiley & Sons, Inc. All rights reserved.

Freud’s Structures of the Mind Id Unconscious Pleasure principle Immediate gratification Libido Energy of id Ego Primarily conscious Reality principle Attempt to satisfy id’s demands within reality’s constraints Superego The conscience Develops as we incorporate parental and society values © 2015 John Wiley & Sons, Inc. All rights reserved.

Defense Mechanisms Id, Ego, & Superego continually in conflict Conflict generates anxiety Ego generates strategies to protect itself from anxiety Defense mechanisms Psychological maneuvers used to manage stress and anxiety © 2015 John Wiley & Sons, Inc. All rights reserved.

Table 1.2: Selected Defense Mechanisms © 2015 John Wiley & Sons, Inc. All rights reserved.

Psychoanalytic Therapy Goals of Psychoanalytic Therapy or Psychoanalysis Understand early-childhood experiences, particularly key (parental) relationships Understand patterns in current relationships Psychoanalytic Techniques Free Association Analysis of Transference Interpretation © 2015 John Wiley & Sons, Inc. All rights reserved. © 2014 John Wiley & Sons, Inc. All rights reserved.

Table 1.3: Major Techniques of Psychoanalysis © 2015 John Wiley & Sons, Inc. All rights reserved.

Neo-Freudians Jung (1875–1961) Adler (1870–1937) Analytical psychology Collective unconscious Archetypes Catalogued personality characteristics Extraversion vs. Introversion Adler (1870–1937) Individual psychology Fulfillment derived from working for the social good © 2015 John Wiley & Sons, Inc. All rights reserved.

Continuing Influences of Freud and His Followers Childhood experiences help shape adult personality There are unconscious influences on behavior © 2015 John Wiley & Sons, Inc. All rights reserved.

The Evolution of Contemporary Thought: Rise of Behaviorism John Watson (1878–1958) Behaviorism Focus on observable behavior Emphasis on learning rather than thinking or innate tendencies Three types of learning: Classical Conditioning Operant Conditioning Modeling © 2015 John Wiley & Sons, Inc. All rights reserved.

Classical Conditioning Discovered by Pavlov (1849–1936) Unconditioned Stimulus (UCS) Meat powder (automatically elicits salivation) Unconditioned Response (UR) Salivation (automatic response to meat powder) Neutral Stimulus (NS) Initial ringing of bell (does not automatically elicit salivation) Conditioned Stimulus (CS) After pairing the NS and the UCS, the NS becomes a CS (bell now automatically elicits salivation) Conditioned Response (CR) Salivation (automatic response to bell) Extinction CS (bell) not followed by UCS (meat powder) causes gradual disappearance of CR (salivation) © 2015 John Wiley & Sons, Inc. All rights reserved.

Figure 1.3: The process of classical conditioning © 2015 John Wiley & Sons, Inc. All rights reserved.

Operant Conditioning E. Thorndike (1874–1949) B.F. Skinner (1904–1990) Learning through consequences Law of Effect Behavior that is followed by satisfying consequences will be repeated; behavior that is followed by unpleasant consequences will be discouraged B.F. Skinner (1904–1990) Principle of Reinforcement Positive reinforcement Behaviors followed by pleasant stimuli are strengthened Negative reinforcement Behaviors that terminate a negative stimulus are strengthened © 2015 John Wiley & Sons, Inc. All rights reserved.

Modeling Learning by watching and imitating others’ behaviors Can occur without reinforcement Bandura & Menlove (1968) Modeling reduced children’s fear of dogs © 2015 John Wiley & Sons, Inc. All rights reserved.

Behavior Therapy Behavior Therapy or Behavior Modification Systematic Desensitization Used to treat phobias and anxiety Combines deep muscle relaxation and gradual exposure to the feared condition or object Starts with minimal anxiety producing condition and gradually progresses to most feared Intermittent Reinforcement Rewarding a behavior only occasionally more effective than continuous schedules of reinforcement © 2015 John Wiley & Sons, Inc. All rights reserved. © 2014 John Wiley & Sons, Inc. All rights reserved.

Importance of Cognitions Limitations of Behavior Therapy How we think or appraise a situation influences our feelings and behaviors Cognitive Therapy Emphasizes that how people think about themselves and their experiences can be a major determinant of psychopathology Focuses on understanding maladaptive thoughts Changes cognitions to change feelings and behaviors Ellis (1913–2007) REBT (Rational-Emotive Behavior Therapy) © 2015 John Wiley & Sons, Inc. All rights reserved.

Mental Health Professions Psychologists Clinical or Counseling Ph. D. or Psy. D. Psychiatrists M.D.s can prescribe psychotropic medications Psychiatric Nurses and Psychiatric Nurse Practitioners Nurse Practitioners can prescribe psychotropic medications Social Workers M.S.W. Not trained in psychological assessment Master’s Level Therapists & Counselors MFTs (Marriage and Family Therapists) © 2015 John Wiley & Sons, Inc. All rights reserved.

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