Chapter 1 Abnormal Behavior in Historical Context

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

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

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

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

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

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

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

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

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

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

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

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

The 19 th 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

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

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

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

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

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

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

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

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