Abnormal Psychology Phase 1: Introduction Source: Barlow, Durand & Hofmann (2018), Comer & Comer (2017), DSM-V, DSM-V-TR Introduction ▪ To specify what makes the disorder different o Psychological Disorder – psychological from normal behavior dysfunction within an individual associated with o Prevalence – How many people in the distress or impairment in functioning and a population as a who have/had the disorder? response that is not typical or culturally o Incidence – how many new cases occurring expected during a given period ▪ Psychological Dysfunction – refers to a o Course – individual pattern of symptoms breakdown in cognitive, emotional, or ▪ Chronic – last a long time behavioral functioning ▪ Episodic – likely to recover a few months ▪ Distress or Impairment – individual is only to suffer re-occurrence extremely upset and cannot function ▪ Time-Limited – disorder will improve properly without treatment in a relatively short period ▪ Atypical or Not Culturally Expected – with little or no risk or recurrence deviates from the average or the norm of o Onset – beginning of the disorder the culture ▪ Acute – sudden o Psychopathology – scientific study of ▪ Insidious – gradually over an extended psychological disorders period of time o Clinical/Counseling Psychologist – received o Prognosis – anticipated course of the disorder Ph.D. and follow a course of graduate-level o Etiology – study of origins, why the disorder study lasting approx. 5 years begins o Psy.D. – focus on clinical training and History de-emphasize or eliminates research training Supernatural o Ph.D. – integrate clinical and research training o During the last quarter of the 14th century, o Psychiatrists – first earn an M.D. in med Roman Catholic Church fought back against school, then specialize in Psychiatry evil in the world that is believed must have o Psychiatric Social Workers – earns master’s been behind these disorders in social work as they develop expertise in o People turned to magic and sorcery to solve collecting information relevant to the social and their problems because they also believed that family situation of the individual psych disorders were the works of the devil o Scientist-Practitioners – they may keep up and witches with the latest scientific developments in their o Treatments include exorcisms, shaving the field and utilize the knowledge in their practice pattern of a cross in the hair of the victim’s ▪ Evaluate their own assessments and head and securing sufferers to a wall near the treatment procedures to see whether they church are effective o Mental depression and anxiety were ▪ Conduct research that produces new recognized as illness, although symptoms such information about disorders or their as despair and lethargy were often identified by treatments, thus becoming immune to the the church as a sin of acedia, or sloth fads that plague our field, often at the o Common treatments was rest, sleep, and expense of patients and their families health and happy environment (baths, o Presenting Problem or Present – traditional ointments, and happy environment) shorthand way of indicating why the person o Nicholas Oresme – suggested that came to the clinic melancholy (depression) was the source of o Clinical Description – represents the unique some bizarre behavior, rather than demons combination of behaviors, thoughts, and o Possession is not always connected with sin feelings that make up a specific disorder but may be seen as an involuntary and the ▪ Clinical – refers both to the types of possessed individuals as blameless problems or disorders that you would find in o In the middle ages, if exorcism failed, some a clinic or hospital and to the activities authorities resorted to confinement, beatings, connected with assessment and treatment and other forms of torture as treatment Abnormal Psychology Phase 1: Introduction Source: Barlow, Durand & Hofmann (2018), Comer & Comer (2017), DSM-V, DSM-V-TR (hanging people over a pit full of poisonous o General Paresis – psychotic patients snakes deteriorated steadily, becoming paralyzed and o Mass Hysteria – whole groups of people were dying within 5 years of onset simultaneously compelled to run out in the o John P. Grey – believed that the causes of streets, dance, shout, rave, and jump around in insanity were always physical patterns as if they were a particularly wild party ▪ Invented rotary fan (Saint Vitus’s Dance and Tarantism) ▪ Conditions in hospitals greatly improved o Paracelsus – rejected the notions of o In the 1930s, the physical interventions of possession and suggested that the movement electric shocks and brain surgeries were often of moon and starts had profound effects on used people’s psychological functioning o Manfred Sakel – used large doses of insulin to Biological convulse and temporarily comatose patients o Hippocrates – Father of Modern Medicine (Insulin Shock Therapy) ▪ Hippocratic Corpus (Hippocratic Oath) o Benjamin Franklin – discovered that mild and ▪ Suggested that psych disorders should be modest electric shock to the head produced treated like any other disease brief convulsion and memory loss but ▪ Psych disorders might also be caused by otherwise did little harm brain pathology or head trauma and could o Joseph von Meduna – schizophrenia is rarely be influenced by heredity observed to individuals with epilepsy ▪ Brain is the seat of wisdom, consciousness, o Emil Kraepelin – founding fathers of modern intelligence, and emotion psychiatry ▪ Also coined the word Hysteria to describe a ▪ Contributed to the diagnosis and concept he learned about from the classification of disorders Egyptians (now Somatic Symptoms ▪ Dementia Praecox Disorders) Psychological ▪ Wandering Uterus o Aristotle – emphasized the influence of social o Galen – adopted the ideas of Hippocrates and environment and early learning on later developed Humoral Theory of Disorders psychopathology a. Blood – heart; sanguine – cheerful and o Moral Therapy – basic tenets included treated optimistic institutionalized patients as normally as b. Black Bile – liver; melancholic – depressed possible in a setting that encouraged and and sentimental reinforced normal social interaction c. Yellow Bile – spleen; choleric – apathetic ▪ Philippe Pinel and Jean-Baptiste Pussin and chill – Moral Therapy in Framce d. Phlegm – brain; phlegmatic – hot-tempered ▪ William Tuke – Moral Therapy in England ▪ Two treatments: Bloodletting and induced ▪ Benjamin Rush – Moral therapy in US vomiting ▪ Dorothea Dix – mental health movement ▪ Robert Burton – recommended eating o Franz Anton Mesmer – suggested to his tobacco and half-boiled cabbage to induced patients that their problem was caused by an vomiting undetectable fluid found in all living organisms o Chinese focused on the movement of air or called animal magnetism “wind” throughout the body o Jean-Martin Charcot – demonstrated some ▪ Unexplained mental disorders were caused techniques of mesmerism were effective with a by blockages of wind or the presence of number of psychological disorders, and he did cold, dark wind (yin) as opposed to warm, much to legitimize the fledgling practice of life-sustaining (yang) hypnosis ▪ Treatment: acupuncture o Freud partnered with Josef Breuer to o Advanced Syphilis – sexually transmitted experiment different hypnotic procedure and disease caused by a bacterial microorganism discovered “Unconscious” mind entering the brain, include delusions o Catharsis – release of emotional material Abnormal Psychology Phase 1: Introduction o o o o o o o o o o o Source: Barlow, Durand & Hofmann (2018), Comer & Comer (2017), DSM-V, DSM-V-TR Structure of Mind: o Carl Jung – introduced the concept of ▪ Id - pleasure collective unconscious, which is wisdom ▪ Ego - reality accumulated by society and culture that is ▪ Superego – morality stored deep in individual memories and passed Defense Mechanisms – unconscious down from generation to generation protective processes that keep primitive o Alfred Adler – created the term Inferiority emotions associated with conflicts in check so Complex that the ego can continue its coordinating o Free Association – patients are instructed to function say whatever comes to mind without the usual socially required censoring o Dream Analysis – therapist interprets the content of dreams o Transference – patients come to relate to the therapist much as they did to important figures in their childhood o Countertransference – therapist project some of their own personal issues and feelings, usually positive, onto the patient Humanistic o Self-Actualizing – highest potential, in all areas of functioning o Abraham Maslow – postulated Hierarchy of Needs o Carl Rogers – originated Person-Centered Therapy o Unconditional Positive Regard – the complete and almost unqualified acceptance of most of the client’s feelings and actions o Empathy – sympathetic understanding of the Psychosocial Stages: Oral, Anal, Phallic, individual’s particular view of the world Latency, Genitals Behavioral Fixation – if we did not receive appropriate o Classical Conditioning – type of learning in gratification during a specific stage which neutral stimulus is paired with response Castration Anxiety – fear of losing penis until it elicits that response Oedipus Complex – battle of lustful impulses ▪ Unconditioned Stimulus – natural stimulus towards his mother and castration anxiety on ▪ Unconditioned Response – natural or other unlearned response Electra Complex – young girl wanting to ▪ Conditioned Stimulus – newly conditioned replace her mother and possess her father event introduced (penis envy) ▪ Conditioned Response – response from Neuroses – disorders of the nervous systems the conditioned stimulus Anna Freud – Ego Psychology (defensive ▪ Extinction – without CS showed long reactions of ego, determines our behavior) enough, the behavior could be eliminated Heinz Kohut – focused on a theory of o Stimulus Generalization – strength of the formation of self-concept and the crucial response to similar objects or people is usually attributes of the self that allow individual to a function of how similar these objects or progress toward health (Self-Psychology) people are Object Relations – study of how children o Introspection – Edward Titchener; subjects incorporate the images, the memories, and report their inner thoughts and feelings after sometimes the values of a person who was experiencing certain stimuli important to them (introjection) Abnormal Psychology Phase 1: Introduction Source: Barlow, Durand & Hofmann (2018), Comer & Comer (2017), DSM-V, DSM-V-TR John B. Watson – founder of behaviorism o Neurons – nerve cells that transmit information ▪ Little Albert throughout the NS o Systematic Desensitization – patients were o Dendrites – receive messages from other gradually introduced to the objects or situations nerve cells they feared so that their fear could extinguish o Axon – transmit impulses to other neurons o Operant Conditioning – behavior changes as o Synapses – connections to other neurons a function of what follows the behavior o Action Potentials – electric impulses where (rewards or punishment) information is transmitted ▪ B.F. Skinner o Terminal button – end of axon ▪ Edward Thorndike – Law of effect (behavior o Synaptic Cleft – space between terminal can be strengthened or weakened) button of one neuron and the dendrite of ▪ Reinforcement – reward another ▪ Shaping – process of reinforcing o Neurotransmitters – biochemicals that are successive approximations to a final released from the axon of one neuron and behavior or set of behaviors transmit the impulse to the dendrite receptors Genes of another neuron o Genes – long molecules of DNA at various ▪ Excitatory – increase the likelihood that the locations on chromosomes, within cell nucleus connecting neuron will fire o 46 Chromosomes, 23 Pairs, 22 Pairs of ▪ Inhibitory – decrease the likelihood that the Autosomes, 1 pair Sex Chromosomes connecting neurons will fire o XX – female, XY – male o Glial Cells – modulate neurotransmitter activity o Dominant and Recessive Brain o Adverse life events can overwhelm the o Brain Stem – lower and more ancient part of influence of genes the brain; essential for autonomic functioning o Erik Kandel – speculated that the process of such as breathing, heartbeat, etc. learning affects more than behavior; ▪ Hindbrain – contains the medulla, pons, environment may occasionally turn on certain and cerebellum; regulates many autonomic genes activities such as breathing, heartbeat, and o Diathesis-Stress Model – individuals inherit digestion tendencies to express certain traits or ▪ Cerebellum – controls motor coordination behaviors, which may then be activated under abnormalities associated with autism conditions of stress ▪ Midbrain – coordinates movements with ▪ Diathesis – a condition that makes sensory input and contains parts of reticular someone susceptible to developing disorder activating system (contributes to sleep, (vulnerability) arousal and tension) o Gene-Environment Correlation Model – ▪ Thalamus and Hypothalamus – involves people might have genetically determined in regulating behavior, emotions, and tendency to create the environment risk factors hormones that trigger a genetic vulnerability o Limbic System – located around the edge of o Epigenetics – study how your behavior and the center of the brain environment can cause changes that affect ▪ Hippocampus, Cingulate Gyrus, Septum, your genes work and Amygdala Neuroscience ▪ Regulate emotional experiences and o Neuroscience – how the nervous system and expressions and, to some extent, our ability the brain works towards understanding our to learn and to control impulses behavior, emotions, and cognitive processes ▪ Also involved with the basic drives of sex, o Central Nervous System – processes all aggression, hunger and thirst information received from our sense organs o Basal Ganglia – base of the forebrain, and reacts as necessary includes caudate nucleus o Abnormal Psychology Phase 1: Introduction Source: Barlow, Durand & Hofmann (2018), Comer & Comer (2017), DSM-V, DSM-V-TR Damage involved changing our posture or ▪ High levels is linked to Parkinson’s, twitching or shaking Alzheimer’s, and Huntington’s o Cerebral Cortex – provides us with our ▪ Low levels is linked to learning and memory distinctly human qualities, allowing us to look to issues the future and plan, to reason, and to create o Gamma-Aminobutyric Acid/GABA – ▪ Left Hemisphere – responsible for verbal inhibitory neurotransmitter and other cognitive processes ▪ Inhibit the transmission of information and ▪ Right Hemisphere – perceiving the world action potential around us and creating images ▪ Benzodiazepines – make it easier for ▪ Lobes: Frontal, Parietal, Occipital, GABA to attach themselves to the Temporal receptors of specialized neurons ▪ Prefrontal Cortex – area responsible for ▪ Reduces levels of anger, hostility, higher cognitive functions aggression, and perhaps even more Peripheral Nervous System positive emotional states o Somatic Nervous System – controls the ▪ Decreased GABA activity = mood muscles disorders, anxiety, schizophrenia, ASD o Autonomic Nervous System – regulate o Serotonin – regulates our behavior, moods cardiovascular system and endocrine system and thought processes ▪ Sympathetic – fight or flight responses ▪ Low levels = less inhibition and with ▪ Parasympathetic – calms the sympathetic instability, impulsivity and the tendency to nervous system; rest and digest functions overreact, aggression, suicide, and o Endocrine System – glands produce excessive sexual behavior hormones that is released to the blood streams ▪ High levels = interact with GABA to ▪ Pituitary – master gland counteract glutamate ▪ Thyroid – controls metabolism and growth ▪ Selective-Serotonin Reuptake Inhibitors (thyroxine) (SSRIs) – affects serotonin more directly ▪ Parathyroid – controls the levels of calcium and are used to treat number of ▪ Adrenal – controls metabolism, blood psychological disorder pressure, sex development, stress o Norepinephrine – stimulate at least two (epinephrine) groups of receptors called alpha-adrenergic ▪ Pineal – releases melatonin and beta-adrenergic receptors ▪ Pancreas – creates insulin ▪ High levels = high blood pressure, ▪ Testes – makes sperm and release arrythmia, etc. testosterone ▪ Low levels = anxiety, depression, ADHD, ▪ Ovaries – releases estrogen, progesterone, headaches, memory problems, etc. and testosterone o Dopamine – implicated in the pathophysiology Neurotransmitters of schizophrenia and disorders of addiction o Agonist – effectively increase the activity of ▪ Low levels = less motivated the neurotransmitters ▪ High levels = more competitive, aggressive o Antagonist – decrease or block and poor impulse control neurotransmitter DSM-V o Inverse Agonists – produces effects opposite o Idiographic Strategy – tailoring the treatment to those produced by the neurotransmitters based on the information of the client o Reuptake – neurotransmitter is released, o Nomothetic Strategy – determining the quickly broken down and brought back to the general class of problems to which the synaptic cleft presenting problem belongs (classifying the o Glutamate – excitatory neurotransmitters that problem) turns on many different neurons leading to o Classification – any effort to construct groups action or categories and to assign objects or people to ▪ Abnormal Psychology Phase 1: Introduction o o o o o o o o o Source: Barlow, Durand & Hofmann (2018), Comer & Comer (2017), DSM-V, DSM-V-TR categories on the basis of their shared ▪ Strives to be evidence-based attributes or relations ▪ Attempt to eliminate the category Not Taxonomy – classification of entities for Otherwise Specified (NOS) scientific purposes o 2022: DSM-V-TR Nosology – taxonomy of psychological or ▪ Prolonged Grief Disorder medical phenomena o Other Specified disorders – applied when Nomenclature – describes the names or symptoms do not meet the full criteria, but the labels of the disorders that make up the clinician stated the specific reason why it is not nosology met 1952: APA first published DSM-I o Unspecified disorders – applied when ▪ Includes 106 mental disorders symptoms do not meet the full criteria and the ▪ Distinguished personality disturbance from clinician chose to not specify the reason to neurosis make more specific diagnosis 1968: DSM-II end ▪ 182 mental disorders ▪ Strived toward an “atheoretical” approach ▪ Homosexuality was referred as Scythians Disease 1980: DSM-III attempted to take an atheoretical approach to diagnosis, relying on precise descriptions of the disorders as they presented to clinicians rather than on psychoanalytic or biological theories of etiology ▪ DSM-III also specified and written in detailed manner the criteria for identifying disorder ▪ Precise descriptive format ▪ Multiaxial format (5 Axis) ▪ Clear shift from psychodynamic approach ▪ 265 diseases ▪ DSM-III-R – 292 mental disorders 1994: DSM-IV ▪ Distinction between organically based disorders and psychologically based disorders ▪ 297 disorders ▪ 5 Axes 2000: DSM-IV-TR ▪ TR = Text Revision ▪ Corrected minor errors and improved the supportive educational material ▪ Mental retardation (now called IDD) ▪ Used to have Autism (now ASD), Asperger’s Syndrome and Childhood Disintegrative Disorder 2013: DSM-V ▪ Removed the Axial System ▪ Designed to usher in a system of classification wherein mental disorders exist along spectrum