Chapter 1 Abnormal Behavior in Historical Context

Abnormal Behavior : Myths and Misconceptions  What’s psychologically normal?  What’s not?  How do we describe people with mental illness?  Lazy, crazy, dumb?  Weak in character?  Dangerous?  Hopeless?

What is a Psychological Disorder?  Psychological dysfunction  Breakdown in function  Cognitive  Behavioral  Emotional

What is a Psychological Disorder?  Distress or impairment  Individual versus others  Example: mania  Appropriateness to situation  Example: death  Degree of impairment

What is a Psychological Disorder?  Response is not typical or culturally expected  More or less frequent  Deviations from “average”  Eccentricity  Violation of social norms

What is a Psychological Disorder?  Accepted DSM-IV-TR definition:  Behavioral, cognitive, emotional dysfunctions  Unexpected in cultural context  Personal distress  Substantial impairment in function

How Do We Classify Psychological Disorders?  Diagnostic and Statistical Manual  DSM-IV-TR  Outlines criteria for disorders  Prototypes/typical profiles  Constant revision and modification  DSM-V

What is a Psychological Disorder?  New areas of interest for the DSM-V:  Reevaluating underlying concepts  Surveys of mental health professionals  Commonalities in disorders  Discerning differences in degree

The Science of Psychopathology  Study of psychological disorders  Conducted by  Clinical and counseling psychologists (PhD, PsyD)  Psychiatrists (MD)  Psychiatric social workers (MSW)  Psychiatric nurses (MN, MSN, PhD)  Marriage and family therapists (MA, MS, MFT)  Mental health counselors (MA, MS)

The Scientist-Practitioner Framework  Interaction of clinical work and science  Consumer of science  Informs practice  Evaluator of practice  Utilizes science  Creator of science  Synthesizes both

Historical Conceptions of Abnormal Behavior  Major psychological disorders have existed across time and cultures  Causes and treatment of abnormal behavior varied widely, depending on context

3 DOMINANT TRADITIONS  Supernatural  Biological  Psychological

The Supernatural Tradition  Deviance = Battle of “Good” vs. “Evil”  Etiology- devil, witchcraft, sorcery  Treatments- exorcism, torture, and crude surgeries

The Supernatural Tradition  Mass hysteria  St. Vitus’ dance  Tarantism  Lycanthropy  Modern examples?  Emotion contagion  “Mob psychology”

The Supernatural Tradition  Other Worldly Causes  Moon and stars  Paracelsus  lunacy  Modern examples?  Astrology

The Biological Tradition  Hippocrates ( BC)  Father of modern Western medicine  Etiology = physical disease  Brain pathology  Head trauma  Genetics  Psychosocial factors  Stress, family  Precursor to somatoform disorders  Hysteria

The Biological Tradition  Galen ( AD)  Hippocratic foundation  Galenic-Hippocratic Tradition  Humoral theory of mental illness  Etiology = brain chemical imbalances  Treatments = Environmental regulation  Heat, dryness, moisture, cold  Bloodletting, induced vomiting

The Biological Tradition and the 19 th Century  Syphilis and General Paresis  STD with psychosis-like symptoms  Delusions  Hallucinations  Etiology = bacterial microorganism  Louis Pasteur’s germ theory  Biological basis for madness

The Biological Tradition and the 19 th Century  John Grey (1850s)  American proponent of the biological tradition  Etiology = always physical  Treatments = treat as if the person is physically ill  Rest  Diet  Room temperature  Improved hospital conditions  Dorothea Dix

The Development of Biological Treatments  Mental Illness = Physical Illness  The 1920’s  Insulin shock therapy –Manfred Sakel  ECT--Joseph von Meduna

The Development of Biological Treatments  The 1950’s  Psychotropic medications  Increasingly available  Systematically developed  Neuroleptics  Reserpine and psychosis  Tranquilizers  Benzodiazepines and anxiety

The Development of Biological Treatments  The cons of medications  Unwanted physical side effects  Addiction/dependence  Effectiveness

Emil Kraeplin  Importance of brain pathology  Developed system of classification  Mental illness has a “lifecourse” just like a physical illness

Consequences of the Biological Tradition  Increased hospitalization  “Untreatable” conditions  Improved diagnosis and classification  Emil Kraepelin  Increased role of science in psychopathology

The Psychological Tradition: Ancient Contributions  Plato  more humane treatment  relatives should care for the person  If someone committed a crime when they were insane, then they shouldn’t be punished like a normal person.

The Psychological Tradition: Moral Therapy  Key figures in humanistic reform:  France  Philippe Pinel (1745 – 1826)  Jean-Baptiste Pussin  England  William Tuke (1732 – 1822)  United States  Benjamin Rush (1745 – 1813)  Dorothea Dix ( )

The Psychological Tradition  Moral Therapy  “Moral” = emotional or psychological  Treating patients normally  Encouraging social interaction  Focus on relationships  Individual attention  Education

Modern Perspectives to Abnormal Psychology  Psychoanalytic Perspective or Psychodynamic Model  Behaviorism  Cognitive Perspective

The Psychoanalytic Tradition- Background  Freudian Theory – Overview and Development  Work with patients suffering from hysteria  Jean Charcot and hypnosis  Free association  Resistance  Repression  Psychodynamic Theory

Psychodynamic Theory  Freud’s theory: Human behavior is ruled by irrational instincts such as aggression and sex. The major influence on our behavior is the unconscious.

3 Layers of Consciousness Layers of Consciousness Conscious Preconscious Unconscious

Freud’s Psychodynamic Theory  Structure and Function of the Mind  Id (pleasure principle)  Ego (reality principle)  Superego (conscience)

Defense Mechanisms  Occur when Ego Loses Battle with Id and Superego  Examples:  Displacement & Denial  Rationalization & Reaction Formation  Projection & Repression

Psychosexual Stages StagesAge Oral 0-18 months Anal 18 months to three years Phallic Three to six years Latent Six years to puberty Genital Puberty to adulthood

Behavioral Theories of Abnormality  Classical Conditioning  Operant Conditioning (Also two more theories, but we’re not talking about them today)  Modeling and Observational Learning  Observational Learning

The Behavioral Model and the Psychological Tradition  Classical Conditioning (Pavlov; Watson)  Ubiquitous form of learning  Pairing neutral stimuli and unconditioned stimuli  Conditioning was extended to explain fear acquisition

 Before Conditioning: CS (bell)US (meat powder) No CR (no salivation) UR (salivation)  During Conditioning: CS USUR signals produces  After Conditioning: CS (bell) CR (salivation) produces Classical Conditioning

Behavioral Model  Operant Conditioning (Thorndike; Skinner)  Another ubiquitous form of learning  Voluntary behavior is controlled by consequences  Operant Conditioning: R  S  Classical Conditioning: S  R

Operant Conditioning  Positive Reinforcement  Negative Reinforcement  Punishment

Cognitive Theories of Abnormality  Types of cognition  Causal attributions  Control beliefs  Learned helplessness  Dysfunctional assumptions

Some Common Global Dysfunctional Assumptions I should be loved by everyone for everything I do. Once something affects my life, it will affect it forever. I must have perfect self control. It is better to avoid problems than to face them. I should be terribly upset by certain situations.

The Behavioral Model  Classical Conditioning  Ivan Pavlov ( )  Ubiquitous form of learning  Unconditioned stimulus (UCS)  Unconditioned response (UCR)  Conditioned stimulus (CS)  Conditioned response (CR)

The Behavioral Model  Classical Conditioning – Concepts  Stimulus generalization  Extinction  Introspection

The Behavioral Model  Behaviorism  John B. Watson ( )  Scientific emphasis  Objective  Radical empiricism  “Little Albert” experiment

The Behavioral Model and Behavior Therapy  Mary Cover Jones  Preexisting phobia extinguished by exposure and modeling  Joseph Wolpe ( )  Systematic desensitization  Relaxation

The Behavioral Model - Operant Conditioning  E.L. Thorndike (1874 – 1949)  Law of effect: consequences shape behavior  B.F. Skinner ( )  Behavior “operates” on environment  Reinforcements  Punishments  Behavior “shaping”

The Scientific Method and an Integrative Approach  Defining and studying psychopathology  Requires a broad approach  Multiple, interactive influences  Biological, psychological, social factors  Scientific emphasis  Neuroscience  Cognitive, behavioral sciences