Abnormal Psychology, Thirteenth Edition by Ann M. Kring, Sheri L. Johnson, Gerald C. Davison, & John M. Neale © 2015 John Wiley & Sons, Inc. All rights reserved. Chapter 1: Introduction and Historical Review I. Introduction to the Study of Mental Disorders II. History of Psychopathology III. The Evolution of Contemporary Thought IV. The Mental Health Professions © 2015 John Wiley & Sons, Inc. All rights reserved. Study of the nature, development, and treatment of psychological disorders Challenges in the study of psychopathology: • Maintain objectivity • Avoid preconceived notions • Reduce stigma © ©2014 Inc.All Allrights rightsreserved. reserved. 2015John JohnWiley Wiley & & Sons, Sons, Inc. © 2015 John Wiley & Sons, Inc. All rights reserved. The disorder occurs within the individual It involves clinically significant difficulties in thinking, feeling, or behaving It involves dysfunction in processes that support mental functioning It is not a culturally specific reaction to an event (e.g. death of a loved one) It is not primarily a result of social deviance or conflict with society © 2015 John Wiley & Sons, Inc. All rights reserved. Personal Distress • The condition causes the individual distress • Emotional pain and suffering Helplessness and hopelessness of depression Disability • Impairment in a key area (e.g., work, relationships) Chronic substance abuse results in job loss Violation of Social Norms • Makes others uncomfortable or causes problems Antisocial behavior of the psychopath Dysfunction • Wakefield's Harmful Dysfunction: failure of internal mechanisms in the mind to function properly • Behavioral, psychological, and/or biological systems are impaired © 2015 John Wiley & Sons, Inc. All rights reserved. © 2015 John Wiley & Sons, Inc. All rights reserved. Early Demonology • Possession by evil beings or spirits Exorcism Early Biological Explanations • Hippocrates (5th century BC) Mental disturbances have natural (not supernatural) causes (problems with the brain) Three categories of mental disorders: mania, melancholia, & phrenitis (brain fever) Normal brain functioning depended on balance of four humors: blood, black bile, yellow bile, & phlegm © 2015 John Wiley & Sons, Inc. All rights reserved. Dark Ages (2nd century AD) • Monks cared and prayed for mentally ill Witches (13th century AD) • Torture sometimes led to bizarre delusional sounding confessions, e.g., concourse with demons. Initially, historians concluded many of the accused were mentally ill. Further research found little support for this conclusion. © 2015 John Wiley & Sons, Inc. All rights reserved. Lunacy Trials • Trials held to determine sanity Began in 13th century England • Municipal authorities assumed responsibility for care of mentally ill • Lunacy attributes insanity to misalignment of moon (“luna”) and stars © 2015 John Wiley & Sons, Inc. All rights reserved. Asylums (15th century) • Establishments for the confinement and care of mentally ill • Priory of St. Mary of Bethlehem (founded in 1243) One of the first mental institutions The wealthy paid to gape at the insane Origin of the term bedlam (wild uproar or confusion) • Treatment non-existent or harmful at asylums Benjamin Rush recommended drawing copious amounts of blood, to relieve brain pressure © 2015 John Wiley & Sons, Inc. All rights reserved. Philippe Pinel (1745–1826) • Pioneered humanitarian treatment at LaBicetre Moral Treatment • Small, privately funded, humanitarian mental hospitals Friends Asylum (1817) Patients engaged in purposeful, calming activities (e.g., gardening) Talked with attendants © 2015 John Wiley & Sons, Inc. All rights reserved. Dorothea Dix (1802–1887) • Crusader for prisoners and mentally ill • Urged improvement of institutions • Worked to establish 32 new, public hospitals • Unfortunately, small staffs at these new public hospitals could not provide necessary individual attention • Hospitals administered by physicians, who were more interested in biological rather than psychological aspects of mental illness © 2015 John Wiley & Sons, Inc. All rights reserved. General paresis and Syphilis • Degenerative disorder with psychological symptoms (delusions of grandeur) and physical symptoms (progressive paralysis) • By mid-1800’s, it was known that general paresis and syphilis occurred together in some patients • In 1905, biological cause of syphilis found • Since general paresis had biological cause, other mental illness might also Biological causes of psychopathology gained credibility © 2015 John Wiley & Sons, Inc. All rights reserved. Galton’s (1822–1911) work lead to notion that mental illness can be inherited • Nature (genetics) and nurture (environment) • Eugenics Promotion of enforced sterilization to eliminate undesirable characteristics from the population Many state laws required mentally ill to be sterilized © 2015 John Wiley & Sons, Inc. All rights reserved. Insulin-coma therapy • Sakel (1930’s) Electroconvulsive Therapy (ECT) • Cerletti and Bini (1938) • Induce epileptic seizures with electric shock Prefrontal lobotomy • Moniz (1935) • Often used to control violent behaviors; led to listlessness, apathy, and loss of cognitive abilities © 2015 John Wiley & Sons, Inc. All rights reserved. Mesmer (1734–1815) • Treated patients with hysteria using “animal magnetism” • Early practitioner of hypnosis Charcot (1825–1893) • His support legitimizes hypnosis as treatment for hysteria Breuer (1842–1925) • Used hypnosis to facilitate catharsis in Anna O. • Cathartic Method Release of emotional tension triggered by reliving and talking about event © 2015 John Wiley & Sons, Inc. All rights reserved. Breuer and Freud (1856–1939) jointly publish “Studies in Hysteria” in 1895, which serves as the basis for Freud’s theory. Freudian or psychoanalytic theory • Human behavior determined by unconscious forces. • Psychopathology results from conflicts among these unconscious forces. © 2015 John Wiley & Sons, Inc. All rights reserved. Id • Unconscious • Pleasure principle Immediate gratification • Libido Energy of id Ego • Primarily conscious • Reality principle Attempt to satisfy id’s demands within reality’s constraints Superego • The conscience • Develops as we incorporate parental and society values © 2015 John Wiley & Sons, Inc. All rights reserved. Id, Ego, & Superego continually in conflict • Conflict generates anxiety • Ego generates strategies to protect itself from anxiety Defense mechanisms Psychological maneuvers used to manage stress and anxiety © 2015 John Wiley & Sons, Inc. All rights reserved. © 2015 John Wiley & Sons, Inc. All rights reserved. Goals of Psychoanalytic Therapy or Psychoanalysis • Understand early-childhood experiences, particularly key (parental) relationships • Understand patterns in current relationships Psychoanalytic Techniques • Free Association • Analysis of Transference • Interpretation 2015John JohnWiley Wiley & & Sons, Sons, Inc. © ©2014 Inc.All Allrights rightsreserved. reserved. © 2015 John Wiley & Sons, Inc. All rights reserved. Jung (1875–1961) • Analytical psychology • Collective unconscious Archetypes • Catalogued personality characteristics Extraversion vs. Introversion Adler (1870–1937) • Individual psychology Fulfillment derived from working for the social good © 2015 John Wiley & Sons, Inc. All rights reserved. Childhood experiences help shape adult personality There are unconscious influences on behavior © 2015 John Wiley & Sons, Inc. All rights reserved. John Watson (1878–1958) Behaviorism • Focus on observable behavior • Emphasis on learning rather than thinking or innate tendencies Three types of learning: • Classical Conditioning • Operant Conditioning • Modeling © 2015 John Wiley & Sons, Inc. All rights reserved. Discovered by Pavlov (1849–1936) • Unconditioned Stimulus (UCS) • • • • • Meat powder (automatically elicits salivation) Unconditioned Response (UR) Salivation (automatic response to meat powder) Neutral Stimulus (NS) Initial ringing of bell (does not automatically elicit salivation) Conditioned Stimulus (CS) After pairing the NS and the UCS, the NS becomes a CS (bell now automatically elicits salivation) Conditioned Response (CR) Salivation (automatic response to bell) Extinction CS (bell) not followed by UCS (meat powder) causes gradual disappearance of CR (salivation) © 2015 John Wiley & Sons, Inc. All rights reserved. © 2015 John Wiley & Sons, Inc. All rights reserved. E. Thorndike (1874–1949) • Learning through consequences • Law of Effect Behavior that is followed by satisfying consequences will be repeated; behavior that is followed by unpleasant consequences will be discouraged B.F. Skinner (1904–1990) • Principle of Reinforcement Positive reinforcement Behaviors followed by pleasant stimuli are strengthened Negative reinforcement Behaviors that terminate a negative stimulus are strengthened © 2015 John Wiley & Sons, Inc. All rights reserved. Learning by watching and imitating others’ behaviors • Can occur without reinforcement Bandura & Menlove (1968) • Modeling reduced children’s fear of dogs © 2015 John Wiley & Sons, Inc. All rights reserved. Behavior Therapy or Behavior Modification • Systematic Desensitization Used to treat phobias and anxiety Combines deep muscle relaxation and gradual exposure to the feared condition or object Starts with minimal anxiety producing condition and gradually progresses to most feared • Intermittent Reinforcement Rewarding a behavior only occasionally more effective than continuous schedules of reinforcement © ©2014 Inc.All Allrights rightsreserved. reserved. 2015John JohnWiley Wiley & & Sons, Sons, Inc. Limitations of Behavior Therapy • How we think or appraise a situation influences our feelings and behaviors Cognitive Therapy • Emphasizes that how people think about themselves and their experiences can be a major determinant of psychopathology • Focuses on understanding maladaptive thoughts • Changes cognitions to change feelings and behaviors Ellis (1913–2007) • REBT (Rational-Emotive Behavior Therapy) © 2015 John Wiley & Sons, Inc. All rights reserved. Psychologists • Clinical or Counseling • Ph. D. or Psy. D. Psychiatrists • M.D.s can prescribe psychotropic medications Psychiatric Nurses and Psychiatric Nurse Practitioners • Nurse Practitioners can prescribe psychotropic medications Social Workers • M.S.W. • Not trained in psychological assessment Master’s Level Therapists & Counselors • MFTs (Marriage and Family Therapists) © 2015 John Wiley & Sons, Inc. All rights reserved. Copyright 2015 by John Wiley & Sons, New York, NY. All rights reserved. No part of the material protected by this copyright may be reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording or by any information storage and retrieval system, without written permission of the copyright owner. © 2015 John Wiley & Sons, Inc. All rights reserved.