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Chapter 1

Abnormal Behavior in

Historical Context

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Myths and MisconceptionsAbout Abnormal Behavior

No single definition ofpsychologicalabnormality

No single definition ofpsychologicalnormality

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What is a PsychologicalDisorder?

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 persons

background Atypical or not culturally expected

response Reaction is outside cultural norms

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Abnormal Behavior Defined

Working definition

A psychological dysfunction associated withdistress or impairment in functioning that is

not typical or culturally expected The Diagnostic and Statistical Manual

(DSM-IV-TR)

DSM Contains diagnostic criteria

The field of psychopathology The scientific study of psychological disorders

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The Science ofPsychopathology

Mental health professionals

The Ph.D.: Clinical and counseling psychologist

The Psy.D.: Clinical and counseling Doctor of

Psychology M.D.: Psychiatrist

M.S.W.: Psychiatric or non-psychiatric socialworker

MN/MSN: Psychiatric nurse Lay public and community groups

United by the scientist-practitionerframework

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The Scientist-Practitioner

Producers of research

Consumers of research

Evaluators of their work using empirical

methods

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Clinical Description

Begins with the presenting problem

Description aims to

Distinguish clinically significant dysfunction

from common human experience

Describe prevalence and incidence ofdisorders

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Causation, Treatment,and Outcome

Etiology

What contributes to the development ofpsychopathology?

Treatment development How can we help alleviate psychological

suffering?

Includes pharmacologic, psychosocial, and/or

combined treatments

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Causation, Treatment,and Outcome (continued)

Treatment outcome research

How do we know that we have helped?

Limited in specifying actual causes of disorders

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Historical Conceptions ofAbnormal Behavior

Major psychological disorders have existed

In all cultures

Across all time periods

Causes and treatment of abnormalbehavior

Varies widely across cultures, time periods,world views

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Historical Conceptions ofAbnormal Behavior (continued)

Three dominant traditions

Supernatural

Biological

Psychological

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The Supernatural Tradition

Deviant behavior as a battle ofGood vs. Evil

Caused by demonic possession, witchcraft,

sorcery Treatments included exorcism, torture,

beatings, and crude surgeries

The moon and the stars

Paracelsus and lunacy

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The Biological Tradition

Hippocrates: Abnormal behavior as aphysical disease

Hysteria the wandering uterus

Galen extends Hippocrates work Humoral theory of mental illness

Treatments remained crude

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The Biological Tradition(continued)

Galenic-Hippocratic tradition

Linked abnormality with brain chemicalimbalances

Foreshadowed modern views

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The 19th Century

General paresis (syphilis) and thebiological link with madness

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

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The 19th Century(continued)

John Grey and the reformers

Championed biological tradition in the U.S.

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Consequences of theBiological Tradition

Mental illness = physical illness

Emil Kraepelin

Diagnosis and classification

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The Psychological Tradition

The rise of moral therapy

More humane treatment of institutionalizedpatients

Encouraged and reinforced social interaction

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The Psychological Tradition(continued)

Proponents of moral therapy

Philippe Pinel and Jean-Baptiste Pussin

Benjamin Rush led reforms in U.S.

Dorothea Dix mental hygiene movement William Tuke followed Pinels lead in England

The falling out of moral therapy

Emergence of competing alternativepsychological models

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Psychoanalytic Theory

Freudian theory of the structure andfunction of the mind

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)

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Psychoanalytic Theory(continued)

Defense mechanisms: Ego loses the battlewith the id and superego

Displacement & denial

Rationalization & reaction formation

Projection, repression, and sublimation

Psychosexual stages of development

Oral, anal, phallic, latency, and genital stages

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Later Developments inPsychoanalytic Thought

Anna Freud and self-psychology

Emphasized influence of the ego in definingbehavior

Melanie Klein, Otto Kernberg, and objectrelations theory

Emphasized how children incorporate(introject) objects

Objects images, memories, and values ofsignificant others

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Later Developments inPsychoanalytic Thought

(continued)

The neo-Freudians: Departures fromFreudian thought

De-emphasized the sexual core of Freudstheory

Jung, Adler, Horney, Fromm, and Erickson

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Psychoanalytic Psychotherapy:The Talking Cure

Unearth the hidden intrapsychic conflicts

The real problems

Therapy is often long term

Techniques Free association

Dream analysis

Examine transference and counter-transference issues

Little evidence for efficacy

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Humanistic Theory

Major players

Abraham Maslow and Carl Rogers

Major themes

That people are basically good Humans strive toward self-actualization

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Humanistic Theory(continued)

Humanistic therapy

Therapist conveys empathy and unconditionalpositive regard

Minimal therapist interpretation No strong evidence that humanistic

therapies work

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The Behavioral Model

Derived from a scientific approach to thestudy of psychopathology

Classical conditioning (Pavlov; Watson)

Ubiquitous form of learning Contingency between neutral and

unconditioned stimuli

Conditioning was extended to the acquisition

of fear

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The Beginnings ofBehavior Therapy

Challenged psychoanalysis andnon-scientific approaches

Early pioneers

Joseph Wolpe systematic desensitization

Operant conditioning (Thorndike; Skinner)

Another ubiquitous form of learning

Voluntary behavior is controlled byconsequences

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The Beginnings ofBehavior Therapy (continued)

Learning traditions influenced thedevelopment of behavior therapy

Behavior therapy tends to be time-limited and

direct Strong evidence supporting the efficacy of

behavior therapies

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The Present:An Integrative Approach

Psychopathology is multiply determined

Unidimensional accounts of

psychopathology are incomplete

h

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The Present:An Integrative Approach

(continued)

Must consider reciprocal relations between

Biological, psychological, social, and

experiential factors Defining abnormal behavior

Complex, multifaceted, and has evolved

The supernatural tradition

Has no place in a science of abnormal behavior