1. Chapter 1 Abnormal Behavior in Historical Context

3. Myths and Misconceptions About Abnormal Behavior
No Single Definition of Psychological Abnormality
No Single Definition of Psychological Normality
Psychology Disorder v. Mental illness
Many Myths Are Associated With Mental Illness
Lazy, crazy, dumb
Weak in character
Dangerous to self or others
Mental illness is a hopeless situation

4. 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

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

6. 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-5)
DSM Contains Diagnostic Criteria plus Subtypes and Specifiers
Psychopathology is the Scientific Study of Psychological Disorders

7. DSM - 5 Definition
A mental disorder is a syndrome characterized by clinically significant disturbance in an individual’s cognition, emotional regulation or behavior that reflects a dysfunction in the psychological, biological, or developmental processes underlying mental functioning. Mental disorders are usually associated with significant distress or disability in social, occupational, or other important activities. An expectable or culturally appropriate response to a common stress or loss, such as death of a loved one, is not a mental disorder. Socially deviant behavior (e.g., political, religious, or sexual) and conflicts that are primarily between individuals and society are not mental disorders unless the deviance or conflict results from a dysfunction in the individual, as described above.
DSM-5, p. 20.

8. The Science of Psychopathology
Mental Health Professionals
The Ph.D.: Clinical, counseling, and school psychologists
The Psy.D.: Clinical, counseling, and school psychologists
“Doctors of Psychology”
M.D.’s: Psychiatrists (medications)
Child or Adult Board Certified – extra training
M.S.W.’s: Psychiatric and non-psychiatric social workers
MN/MSN’s: Psychiatric nurses
LPC - Licensed Mental Health/Professional Counselor
United by the Scientist-Practitioner Framework

9. Psychology Training Models
Boulder Model – 1948
Ph.D. – Scientist –Practitioner (4-5+ years of training)
Producers of Research
Consumers of Research
Evaluators of Their Work Using Empirical Methods
Teachers/Faculty
Vail Model
Psy.D. – Professional Practitioner (4-5+ years of training)
Practice focus
Consumer of research
Empirical validated methods

10. Dimensions of the Scientist-Practitioner Model (cont.)
Figure 1.2
Functioning as a scientist-practitioner

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

12. 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
Other features (e.g. age, developmental stage, ethnicity, race)
Add: Subtypes and Specifiers – DSM 5

13. Causation, Treatment, and Outcome
What Factors Contribute to the Development of Psychopathology?
Study of etiology
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 - “Evidence Based Treatment”
Limited in specifying actual causes of disorders

14. 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

15. 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

16. 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

17. 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

18. Consequences of the Biological Tradition
Mental Illness = Physical Illness, such as “nerves” or “chemical imbalance”

19. The Psychological Tradition
The Rise of Moral Therapy
Involved more humane treatment of institutionalized patients
Encourage and reinforced social interaction
Proponents of Moral Therapy
Dorothea Dix
Philippe Pinel and Jean-Baptiste Pussin
William Tuke followed Pinel’s lead in England
Reasons for the Falling Out of Moral Therapy
Emergence of Competing Alternative Psychological Models

20. Psychoanalytic Theory
Freudian Theory of the Structure and Function of the Mind
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

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

22. Later Developments in Psychoanalytic Thought
Anna Freud and Self-Psychology
Emphasized the influence of the ego in defining behavior
Melanie Klein, Otto Kernberg, and Object Relations Theory
Emphasized how children incorporate (introject) objects
Examples include images, memories, and values of significant others (objects)
The Neo-Freudians: Departures From Freudian Thought
Carl Jung, Alfred Adler, Karen Horney, Erich Fromm, and Erik Erickson
De-emphasized the sexual core of Freud’s theory

23. 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

24. 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

25. 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

26. 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

27. Behavioral-Cognitive
Albert Ellis – Rational Emotive Behavior Therapy – RET/REBT – 1950’s - It is what we think that causes us to be disturbed
Albert Bandura – Social Learning Theory – 1960 (vicarious learning) & Social Modeling
Aaron (Tim) Beck MD – Cognitive Therapy (1960 & 70); David Burns, MD - Cognitive distortions
Arnold Lazarus – Multimodal Therapy – 1970’s – 7 domains to address in assessment and treatment
BASIC- ID; Behavior, Affect, Sensation, Imagery, Cognitive, Interpersonal, and Drug (physical)

28. 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

29. Warning Signs – Adults Confused thinking
Prolonged depression (sadness or irritability)
Feelings of extreme highs and lows
Excessive fears, worries, and anxieties
Social withdrawal
Dramatic changes in eating and sleeping habits
Strong feelings of anger
Delusions or hallucinations
Growing inability to cope with daily problems and activities
Suicidal thoughts
Denial of obvious problems
Numerous unexplained physical ailments
Substance abuse

30. Warning Signs – Younger Children
Changes in school performance
Poor grades despite strong efforts
Excessive worry or anxiety ( i.e. refusal to go to bed/school)
Hyperactivity – excessive
Persistent nightmares
Persistent disobedience or aggression
Frequent temper tantrums

31. Warning Signs – Older Children & Pre-Adolescents
Substance abuse
Inability to cope with problems and daily activities
Change in sleeping and/or eating habits
Excessive complaints for physical ailments
Defiance of authority, truancy, theft, and/or vandalism
Intense fear of gaining weight
Prolonged negative mood, often accompanied by poor appetite or thoughts of death
Frequent outbursts of anger