Chapter 1

The History of Abnormal Psychology

Understanding Psychopathology What is a psychological disorder?

Whats 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 Harmful dysfunction

What is a Psychological Disorder? Distress or impairment Individual versus others Appropriateness to situation Degree of impairment

What is a Psychological Disorder? Response is atypical or culturally expected Deviations from average 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

What is a Psychological Disorder? Diagnostic and Statistical Manual DSM-IV-TR Outlines criteria for disorders Prototypes/typical profiles Constant revision and modification DSM-5

What is a Psychological Disorder? New areas of interest for the DSM-5: Reevaluating underlying concepts Surveys of mental health professionals Commonalities in disorders Discerning differences in degree

The Science of Psychopathology Psychopathology is the scientific study 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 Interaction of clinical work and science Consumer of science Informs practice Evaluator of practice Utilizes science Creator of science Synthesizes both

The Scientist-Practitioner

Clinical Description Presenting Problem

Clinical Description Dysfunction vs. common experience

Statistics Prevalence Incidence

Clinical Description Course Episodic Time-limited Chronic Onset Acute vs. insidious Prognosis Good vs. guarded

Clinical Description Age of onset may shape presentation Developmental psychology Developmental psychopathology Life-span developmental psychopathology

Clinical Description

Causation, Treatment, and Outcomes Etiology Cause or development of psychopathology Treatment Pharmacologic and/or psychosocial

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

The Supernatural Tradition Deviance = Battle of Good vs. Evil Etiologydevil, witchcraft, sorcery Great Persian Empire (900 to 600 BC) 14th and 15th century Europe Salem witch trials in U.S. Demons and witches Treatmentsexorcism, torture, and crude surgeries

The Supernatural Tradition Stress and melancholy in the 14th century Etiologynatural, curable phenomenon Illness model Still connected with sin Treatments for possession

The Supernatural Tradition Mass hysteria St. Vituss dance Tarantism Modern Mass hysteria Emotion contagion Mob psychology

The Supernatural Tradition The moon and the stars Moon and stars Paracelsus Lunacy Modern examples? Astrology

The Biological Tradition Hippocrates (460-377 BC) Father of modern Western medicine Etiology = physical disease Precursor to somatoform disorders Hysteria

The Biological Tradition Galen (129-198 AD) Hippocratic foundation Galenic-Hippocratic Tradition Humoral theory of mental illness Black, blue, yellow and phlegm biles Etiology = brain chemical imbalances Treatments = environmental regulation Heat, dryness, moisture, cold Bloodletting, induced vomiting

19th Century Syphilis and General Paresis STD with psychosis-like symptoms Delusions Hallucinations Etiology = bacterial microorganism Louis Pasteurs germ theory Biological basis for madness

19th Century John Grey (1850s) American proponent of the biological tradition Etiology = always physical Treatments = as is physically ill Rest Diet Room temperature Improved hospital conditions

The Development of Biological Treatments Mental Illness = Physical Illness The 1930s Insulin shock therapy Brain surgery ECT Benjamin Franklin (1750s) Treatment for depression?

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

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

The Psychological Tradition Plato, Aristotle, and Greece Etiology Social and environmental factors Treatment Reeducation via discussion Therapeutic environments Similar practices in ancient Muslim countries

Moral Therapy
Moral Therapy Moral = emotional or psychological Treating patients normally Encouraging social interaction Focus on relationships Individual attention Education

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) Horace Mann (1833)

Asylum Reform and the Decline of Moral Therapy Declines in the Mid-19th Century Increased numbers of patients Immigrants Homeless Mental Hygiene Movement Dorothea Dix (1802-1887) Staffing problems Outcome = decreased treatment efficacy

Psychoanalytic Theory Anton Mesmer (1734 1815) Mesmerism and hypnosis Suggestibility Jean Charcot (1825-1893) Hypnosis as treatment Mentor to Freud

Josef Breuer (1842-1925) Furthered hypnosis treatments Collaborator with Freud

Psychoanalytic Theory Conscious versus unconscious: Id Pleasure principle Illogical, emotional, irrational Ego Reality principle Logical and rational Superego Moral principles Balances Id and Ego

Psychoanalytic Theory

Psychoanalytic Theory Defense mechanisms Ego fights to stay on top of the Id and Superego Loss = anxiety Coping strategies include: Displacement Denial Rationalization Reaction formation Projection Repression Sublimation

Psychoanalytic Theory Stages of Psychosexual Development Patterns of gratifying basic needs Infancy to early childhood Oral Anal Phallic Latency Genital Conflicts at each stage must be resolved i.e., Oedipus complex in the phallic stage Adult personality reflects childhood experience

Psychoanalytic Theory Later Developments in Psychoanalytic Thought Self-Psychology Anna Freud (1895-1982) Ego defines behavior Object Relations Theory Melanie Klein and Otto Kernberg Children incorporation of objects Images Memories Values of significant others

Psychoanalytic Theory Freuds students de-emphasize sexuality Carl Jung (1875-1961) Collective unconscious Enduring personality traits Introversion vs. extroversion Alfred Adler (1870-1937) Birth order Inferiority complex Striving for superiority Self-actualization

Psychoanalytic Theory Emphasis on life-span development Influence of society and culture on personality Key figures: Karen Horney (1885-1952) Erich Fromm (1900-1980) Erik Erickson (1902-1994)

Psychoanalytic Theory Psychoanalytic Psychotherapy Unearth intrapsychic conflicts Long-term treatment model

Techniques Free Association Dream Analysis

Transference/Counter-Transference

Efficacy Data are Limited

Psychoanalytic Psychotherapy Emphasizes conflicts and unconscious Trauma and active defense mechanisms Focus on: Affect Avoidance Patterns Past experience Interpersonal experience Therapeutic relationship Wishes, dreams, fantasies

Psychoanalytic Psychotherapy
Criticisms Pejorative terms (e.g., neurosis) Unscientific Untested

Contributions Unconscious processes Emotions triggered by cues Therapeutic alliance Defense mechanisms

Humanistic Theory Theoretical constructs Intrinsic goodness Striving for self-actualization Blocked growth

Person-centered therapy Carl Rogers (19021987) Hierarchy of Needs Abraham Maslow (19081970)

The Behavioral Model Classical Conditioning Ivan Pavlov (18491936) 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 (18781958) Scientific emphasis Objective Little Albert experiment

The Behavioral Model and Behavior Therapy Mary Cover Jones Preexisting phobia extinguished by exposure and modeling Joseph Wolpe (19151997) Systematic desensitization Relaxation

The Behavioral Model - Operant Conditioning E.L. Thorndike (18741949) Law of effect: consequences shape behavior B.F. Skinner (19041990) Behavior operates on environment Reinforcements Punishments Behavior shaping

The Present: 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