LOOKING AT
ABNORMALITY
CHAPTER 1
ABNORMAL PSYCHOLOGY
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Study of people who suffer mental,
emotional, and often physical pain
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Otherwise known as
psychopathology
WHY IS ABNORMAL PSYCHOLOGY
IMPORTANT?
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In our future practice of psychology, we will be working with individuals to help
scientifically recognize the following associated with mental disorders
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Problematic emotions
Cognitions
Behaviors
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It helps us understand how an abnormal mind works, diagnose the disease, and
predict the progress of the disease
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A correct understanding of abnormality can check, prevent, and cure the disease
RELATED ISSUES
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What are the characteristics of various mental disorders?
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What factors cause mental disorders or are otherwise related to their
development?
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How can we best measure and diagnose mental disorders and related problems?
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How can we best prevent mental disorders from occurring to those at risk?
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How can we best treat mental disorders once they have developed?
WHAT TO YOU IS ABNORMALITY?
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What words do we use to describe
abnormal behavior?
MENTAL ILLNESS
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Behaviors, thoughts, or feelings
viewed as pathological or abnormal if
they are symptoms of this
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Implication of a disease that should
show up on some sort of
psychological test
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Are there any biological tests that
would detect mental illness?
CULTURAL NORMS
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Fasting: normal in certain religions,
common ritual of cleansing and
penitence
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Play a large role in defining
abnormality
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How people treat the dead differs
•
Stay-at-home Dads?
CULTURAL RELATIVISM
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There are no universal standards or
rules for labeling a behavior abnormal
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Behaviors can be labeled abnormal
only relative to cultural norms
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Honors norms and traditions of
different cultures
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HOWEVER: These shouldn’t be used
to justify controlling them or
silencing them
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Culture must not be the sole basis of
abnormal behavior
HOW MUCH INFLUENCE DOES CULTURE
HAVE ON INDIVIDUALS?
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The way people express emotions
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Willingness to admit certain types of
behaviors or feelings
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Types of treatments deemed
acceptable or helpful for people
exhibiting abnormal behaviors
4 D’S OF ABNORMALITY
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Dysfunction
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Distress
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Deviance
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Dangerousness
DYSFUNCTIONAL BEHAVIOR
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Behaviors, thoughts and feelings
become dysfunctional when they
interfere with the person’s
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•
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Ability to function in daily life
Ability to hold a job
Ability to form close relationships
DISTRESS
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Behaviors and feelings cause distress
to the individual or to others around
him/her
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Tremendous emotional and even
physical pain
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Person with disorder is not in distress
but causes others distress
DEVIANT BEHAVIORS
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Influenced by cultural norms
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Hearing voices
Trying to conform to socially defined
norms (thinness)
Religious fanatics?
Talking to oneself in public?
Man wearing women’s clothing
DANGEROUS
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Behaviors and feelings which are of
potential harm to the individual
•
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Suicidal gestures
Excessive aggression
MALADAPTIVE BEHAVIOR
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Interfere with daily functioning
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Cause suffering
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Highly unusual
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Potentially dangerous
LET’S THINK FOR A MOMENT
THE 4 D’S OF ABNORMAL BEHAVIOR
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Dysfunctional: behaviors and feelings are dysfunctional when they interfere with
a person’s ability to function in daily life, to hold a job, or form relationships
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Distress: Behaviors and feelings that cause distress to the individual or to others
around him or her are considered abnormal
•
Deviant: Highly deviant behaviors like chronic lying or stealing lead to judgments
of abnormality
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Dangerous: Behaviors and feelings that are potentially harmful to an individual or
the individuals around them are seen as abnormal
HISTORICAL
PERSPECTIVES ON
ABNORMALITY
Biological Theories
Supernatural Theories
Psychological Theories
BIOLOGICAL THEORIES
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Viewed abnormal behavior as similar
to physical diseases
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Caused by a breakdown of systems in
the body
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Appropriate cure is restoration of
bodily health
SUPERNATURAL THEORIES
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Abnormal behaviors as a results of
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Divine intervention
Curses
Demonic possession
Personal Sin
To rid a person of perceived affliction
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Religious rituals
Exorcisms
Confessions
Atonement
PSYCHOLOGICAL THEORIES
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Abnormal behavior is a result of
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Traumas (bereavement or chronic
stress)
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Rest and relaxation
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Change of environment
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Certain types of herbal medicine
ANCIENT
THEORIANCIENT
THEORIESES
Drive away Evil Spirits
Ancient China: Balancing Yin and Yang
Ancient Egypt, Greece, and Rome
DRIVING AWAY EVIL SPIRITS
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Possession of evil spirits thought to
be the cause of abnormal behavior
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Typical treatment: Exorcism
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Shamans/healers:
recite prayers or incantations,
• try to talk spirits out of the body or
• make the body an uncomfortable place
for spirits to reside
• Kill the person
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STONE AND MIDDLE AGES
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Trephination: used to drill holes in the
skull to allow evil spirits to depart;
still in question another theory is that
it was used to remove blood clots
(stone weapons or other medical
purposes)
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Trephine: tool used for drilling
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People who were seeing or hearing
things that were not real
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People who were chronically sad
ANCIENT CHINA: BALANCING YIN AND
YANG
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Nei Ching (Classic of Internal
Medicine) written around 2674 BCE
by Huang Ti (legendary third emperor
of China)
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Known as the Yellow Emperor, yellow
denoting earth
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People began to live in wooden
houses, built walled towns, travelled
in boats and carts, and made pottery.
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Ministers taught art of divination by
art and moon, established calendar,
invented writing.
YIN AND YANG
YIN AND YANG
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When two forces were in balance, the
individual was healthy
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If not, illness included insanity could
occur
CHINESE MEDICAL PHILOSOPHY
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Human emotions were controlled by
internal organs
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When vital air flowed on one of these
organs, an individual experienced a
particular emotion.
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Air flowed on heart: joy
Air flowed on lungs: sorrow
Air flowed on liver: anger
Air flowed on spleen: worry
Air flowed on kidney: fear
ANCIENT EGYPT
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Papyri of Egypt and Mesopotamia
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Kahun Papyrus: oldest one dates
from about 1900 BCE
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Lists number of disorders, each
followed by a physician’s judgment of
the cause of the disorder and the
appropriate treatment
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Treatment included use of strongsmelling substances to drive uterus
back into its proper place
WANDERING UTERUS
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A woman who loves bed; she does
not rise and she does not shake it
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Uterus could become dislodged and
wander throughout a woman’s body,
interfering with her organs
GREEKS
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Named the disorder hysteria: from
the Greek word hystera, which means
uterus
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Hysteria used to refer to
psychological symptoms that
probably are the result of
psychological processes
WRITINGS ON PEOPLE ACTING
ABNORMALLY
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Hippocrates: described the case of
the common phobia
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Man could not walk alongside a cliff,
pass over a bridge, or jump over even a
shallow ditch without feeling unable to
control his limbs and having his vision
impaired
ABNORMAL BEHAVIOR AS AFFLICTION
FROM THE GODS
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Roman God of healing and medicine
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Those afflicted retreated to temples
honoring the god where priests held
healing ceremonies
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Socrates and Plato argued that some
forms abnormal behavior were divine
and could be the source of great
literary and prophetic gifts
HIPPOCRATES
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Often regarded as the father of
medicine
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Argued abnormal behavior was like
other diseases of the body
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Body was composed of 4 humors.
HUMORS
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Yellow Bile
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Black bile
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Blood
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Phlegm
ABNORMAL BEHAVIOR AS CLASSIFIED
BY HIPPOCRATES
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Epilepsy
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Mania
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Melancholia
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Brain fever
DISEASES INCLUDING ABNORMAL
BEHAVIOR
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Caused by imbalances in the body’s
essential humors
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Observation included listening to
their dreams
TREATMENT OF ABNORMAL BEHAVIOR
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Physiological and intrusive
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Bleed a patient to rid them of excess
blood
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Rest, relaxation, change of climate or
scenery, change of diet, living a
temperate life
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Confine relative to home
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State could take rights away from people
declared insane
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Cannot get married
Cannot own property or sell property
If poor, roam the streets if not violent
If violent, locked away
MEDIEVAL VIEWS
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Middle Ages (around 400 to 1400 CE):
backward thinking, dominated by
obsession with supernatural forces
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Witchcraft and witches accepted as
read but considered nuisances
Severe shock: causes of bizarre
behaviors
WITCHCRAFT
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Catholic church threatened by
breakdown in feudalism and
rebellions
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Church interpreted threats in terms
of heresy and Satanism
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Inquisition: established originally to
rid Earth of religious heretics; Those
practicing witchcraft or satanism
became focus of these hunts
ACCUSED WITCHES
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Must have been mentally ill
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Confessed to speaking with the devil
Flying on the backs of animals
Engaging in other unusual behaviors
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They may have been experiencing
delusions (false beliefs) or
hallucinations (unreal perceptual
experiences)
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Mental illness symptoms or a result of
torture or in exchange of a stay in
execution
JOHANN WEYER (1563)
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Published The Deception of Dreams
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Those accused of being witches
suffered from melancholy
(depression) and senility
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His writings were banned by the
church
REGINALD SCOT
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Discovery of Witchcraft (1584)
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Supported Weyer’s beliefs
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Women were diseased wretches
suffering from melancholy
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Words, actions, reasoning, and
gestures show that sickness has
affected their brains and impaired
their powers against judgment
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Church refuted arguments and
banned Scot’s writings
CHANGE CAME FROM WITHIN
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St. Therese of Avila (16th century)
explained that mass hysteria that had
broken out among a group of nuns was
not the work of the devil but was the
result of infirmities or sickness.
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These nuns were ‘comas enfermas’ or as
if sick.
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She sought out natural causes for their
strange behaviors and concluded they
were due to
Weak imagination
• Melancholy
• Drowsiness or sleepiness
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PSYCHIC EPIDEMICS
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Phenomenon in which large numbers
of people engage in unusual
behaviors that appear to have a
psychological origin
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Peter of Herental: reported dance
frenzies that broke out over a 4month period in Germany in 1374
TARANTISM
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Noted in Italy as early as the 14th
century and became prominent in the
17th century
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Remnants of ancient rituals
performed by people worshipping the
Greek god Dionysus
SPEAD OF ASYLUMS
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Many towns in Europe took some
responsibility for housing and caring
for people considered mentally ill
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General hospitals began to include
special rooms or facilities for people
exhibiting abnormal behavior
HOSPITAL OF SAINT MARY OF
BETHLEHEM
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London
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Officially became a mental hospital in
1547
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Nicknamed Bedlam, famous for its
deplorable conditions
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Patients were exhibited to the public
for a fee
DALTON’S COMON LAW 1618 EDITION
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Lawful for parents, kinsmen, or other
friends of a man that is mad or frantic
to
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Take him and put him into a house
Bind or chain him
Beat him with rods
Do any other forcible act to reclaim
him
Keep him so he shall do no hurt
ACT FOR REGULATING MADHOUSES
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Passed in 1774
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Intention was to clean up deplorable
conditions in hospitals and
madhouses
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Protect people from being unjustly
jailed for insanity
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Provided for licensing and inspection
of madhouses
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Required that a physician, surgeon, or
apothecary sign a certificate before a
patient is admitted
BENJAMIN RUSH
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One of the founders of American
Psychiatry
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Thought that abnormal behaviors
were medical illnesses
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Believed that abnormal behavior was
caused by excessive blood in the
brain
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Prescribed bleeding the patient or
drawing huge amounts of blood in
the body
MORAL TREATMENT 18TH AND 19TH
CENTURIES
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Mental Hygiene Movement: new
treatment based on the psychological
view that people developed problems
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Separation from nature
Succumbed to stress imposed by rapid
social changes
PHILIPPE PINEL
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Leader of the movement
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Took charge of La Bicetre in Paris in
1793
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Believed that many forms of
abnormality could be cured by
restoring patients’ dignity and
tranquility
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Ordered that patients be allowed to
walk freely around the assylum
WILLIAM TUKE
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Opened an asylum in England called
The Retreat
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Treatment was designed more to
restore patients’ self-restraint by
treating them with respect and
dignity, encouraging them to exercise
self control
DOROTHEA DIX
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Retired school teacher from Boston
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Discovered negligence and brutality
that characterized treatment of poor
people exhibiting abnormal behavior,
many were warehoused in jailed
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Helped establish more than 30
mental institutions in the US, Canada,
Newfoundland, and Scotland
EMERGENCE OF
MODERN
PERSPECTIVES
Beginnings of Modern Biological perspectives
Psychoanalytic Perspective
Roots of Behaviorism
Cognitive Revolution
BEGINNINGS OF MODERN BIOLOGICAL
PERSPECTIVES
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Wilhelm Griesinger published The
Pathology and Therapy of Psychic
Disorders
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All psychological disorders can be
explained in brain pathology
Emil Kraepelin: Also published a text
emphasizing the importance of brain
pathology in psychological disorders
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Developed a scheme for classifying
symptoms into discrete disorders that
is the basis for our modern
classification systems
GENERAL PARESIS
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One of the most important
discoveries underpinning modern
biological theories of abnormality
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Disease that leads to paralysis,
insanity, and eventually death
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Reports that patients with paresis
also had history of syphillis led to the
suspicion that syphilis might be the
cause of paresis
RICHARD KRAFFT-EBING
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Viennese psychiatrist who injected
paretic patients with matter from
syphylitic sores
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None developed syphilis
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He concluded they must already be
infected with it
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This discovery gave weight to the
idea that biological factors can cause
abnormal behaviors
PSYCHOANALYTIC PERSPECTIVE
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Franz Anton Mesmer: Austrian
physician who believed people have
magnetic fluid in the body that must
be distributed in a particular pattern
to maintain health
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Focused on hysterical disorders:
people lose functioning or feeling in
some part of the body for no
apparent reason
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Mesmerism continued to fuel debate
long after he faded into obscurity
JEAN-MARTIN CHARCOT
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Head of La Salpertriere Hospital
(Paris)
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Leading neurologist
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Argued that hysteria was caused by
degeneration of the brain
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Worked with Nancy Hippolyte-Marie
Bernheim and Ambroise-Aguguste
Liebault, who showed they could
induce symptoms of hysteria by
suggesting these symptoms to
patients who were hypnotized
SIGMUND FREUD
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Viennese neurologist who went to
study with Charcot (1885)
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Became convinced that much of the
mental life on an individual remains
hidden from consciousness
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Janet at that time, investigating
multiple personality disorder
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He then worked with Josef Breuer
JOSEF BREUER
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Another physician interested in
hypnosis and in the unconscious
processes behind psychological
problems
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Discovered that encouraging patients
to talk about their problems under
hypnosis led to a great upwelling and
release of emotion, which eventually
was called catharsis
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Wrote On the Physchical Mechanisms
of Hysterical Phenomena with Freud
PSYCHOANALYSIS
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Study of the unconscious
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Was introduced in the US in 1909 in a
series of lectures at Clark University,
at the invitation of G. Stanley Hall
ROOTS OF BEHAVIORISM
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Ivan Pavlov
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John B. Watson
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Developed methods and theories for
understanding behavior in terms of
stimuli and responses (Classical
Conditioning)
Studied phobias in terms of classical
conditioning
E.L. Thorndike & B.F. Skinner: studied
how consequences of behaviors
shape their likelihood for recurrence
(Operant Conditioning)
BEHAVIORISM
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Study of the impact of
reinforcements and punishments on
behavior
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Has led to many of the effective
psychological treatments for
disorders
COGNITIVE REVOLUTION
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Cognitions: thought processes that
influence behavior and emotion
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Albert Bandura: argued that people’s
beliefs about their ability to execute
behaviors necessary to control
important events (self-efficacy
beliefs) are crucial in determining
people’s well-being
ALBERT ELLIS
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Argued that people prone to
psychological disorders are plagued
by irrational negative assumptions
about themselves and the world
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Developed Rational Emotive Therapy
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Required therapists to challenge their
patients’ irrational belief systems
AARON BECK
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Focused on irrational thoughts of
people
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One of the most widely used
therapies for many disorders
MODERN MENTAL HEALTH CARE
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Discovery of a class of drugs that can
reduce hallucinations and delusions
(phenothiazines) made it possible for
patients to be released from hospitals
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New drug therapies
DEINSTITUTIONALIZATION
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Patients’ right movement: mental
patients can recover more fully or live
more satisfying lives if integrated into
the community with support of
community-based treatment
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1955 to 1998: number of patients in
state psychiatric hospitals decreased
by 90%
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Dramatic increases in their quality of
life on their release
COMMUNITY MENTAL HEALTH
CENTERS
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Include teams of social workers,
therapists, and physicians who
coordinate care
HALFWAY HOUSE
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Offer people with long-term mental
health problems the opportunity to
live in a structured, supportive
environment as they try to
reestablish working relationships and
ties to family and friends
DAY TREATMENT CENTERS
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Allow people to obtain treatment
during the day, along with
occupational and rehabilitative
therapies
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Live at home at night
MANAGED CARE
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Collection of methods for
coordinating care that ranges from
simple monitoring to total control
over what care can be provided and
paid for.
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Goals are to coordinate services for
an existing medical problem and to
prevent future medical problems
PROFESSIONS WITHIN ABNORMAL
PSYCHOLOGY
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Psychiatrists
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Clinical Psychologists: PhD in Psychology with a
specialization in treating and researching
psychological problems
•
Marriage and Family Therapists: help families,
couples, and children overcome problems
•
Clinical social workers: Masters in social work
and often focus on helping people with
psychological problems overcome social
conditions
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Licensed Mental Health counselors: graduate
training in counseling without PhD
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Psychiatric Nurses: have degree in nursing,
specialization in treatment of people with severe
psychological problems
BIOPSYCHOSOCIAL APPROACH
(INTEGRATIONIST APPROACH)
Biological
Factors
Social Factors
Psychological
Factors