Durand and Barlow Chapter 1: Abnormal Behavior in Historical

advertisement

Chapter 1

Abnormal Behavior in

Historical Context

Myths and Misconceptions About Abnormal

Behavior

• No Single Definition of Psychological

Abnormality

• No Single Definition of Psychological

Normality

What is a Psychological Disorder?

• 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 person’s background

• Atypical or Not Culturally Expected Response

– Reaction is outside cultural norms

Abnormal Behavior Defined

• Working Definition

– A psychological dysfunction associated with distress 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

The Science of Psychopathology

• Mental Health Professionals

– The Ph.D.’s: Clinical and counseling psychologists

– The Psy.D.’s: Clinical and counseling

“Doctors of Psychology”

– M.D.’s: Psychiatrists

The Science of Psychopathology

(continued)

– M.S.W.’s: Psychiatric and non-psychiatric social workers

– LPC/MHSP: Licensed Professional

Counselors/Mental Health Service Provider

– LMFT: Licensed Marriage and Family

Therapist

– MN/MSN’s: Psychiatric nurses

– Lay public and community groups

The Scientist-Practitioner

• Producers of Research

• Consumers of Research

• Evaluators of Their Work Using Empirical

Methods

Functioning as a Scientist-Practitioner

Fig. 1.2, p. 6

Clinical Description

• Begins with the Presenting Problem

• Description Aims to

– Distinguish clinically significant dysfunction from common human experience

• Describe Prevalence and Incidence of

Disorders

Clinical Description (continued)

• Describe Onset of Disorders

– Acute vs. insidious onset

• Describe Course of Disorders

– Episodic, time-limited, or chronic course

• Prognosis

– Good vs. guarded

Causation, Treatment, and Outcome

• Etiology

– What contributes to the development of psychopathology?

• Treatment Development

– How can we help alleviate psychological suffering?

– Includes pharmacologic, psychosocial, and/or combined treatments

Causation, Treatment, and Outcome

(continued)

• Treatment Outcome Research

– How do we know that we have helped?

– Limited in specifying actual causes of disorders

Historical Conceptions of Abnormal

Behavior

• Major Psychological Disorders Have Existed

– In all cultures

– Across all time periods

• Causes and Treatment of Abnormal Behavior

– Varies Widely Across cultures, time periods, world views

Historical Conceptions of Abnormal

Behavior (continued)

• Three Dominant Traditions

– Supernatural

– Biological

– Psychological

The Supernatural Tradition

• Deviant Behavior as a Battle of “Good” vs.

Evil

– Caused by demonic possession, witchcraft, sorcery

– Treatments included exorcism, torture, beatings, and crude surgeries

• The Moon and the Stars

– Paracelsus and lunacy

The Biological Tradition

• Hippocrates: Abnormal Behavior as a

Physical Disease

– Hysteria “The Wandering Uterus”

• Galen Extends Hippocrates Work

– Humoral theory of mental illness

– Treatments remained crude

The Biological Tradition (continued)

• Galenic-Hippocratic Tradition

– Linked abnormality with brain chemical imbalances

– Foreshadowed modern views

The 19 th Century

• General Paresis (Syphilis) and the Biological

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

The 19 th Century (continued)

• John Grey and the Reformers

– Championed biological tradition in the USA

Consequences of the Biological Tradition

• Mental Illness = Physical Illness

• Emil Kraeplin

– Diagnosis and Classification

The Psychological Tradition

• The Rise of Moral Therapy

– More humane treatment of institutionalized patients

– Encourage and reinforced social interaction

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 Pinel’s lead in

England

• The Falling Out of Moral Therapy

• Emergence of Competing Alternative

Psychological Models

Psychoanalytic Theory

• Freudian Theory of the Structure and

Function 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)

Psychoanalytic Theory (continued)

• Defense Mechanisms: Ego Loses the Battle with the Id and Superego

– Displacement & denial

– Rationalization & reaction formation

– Projection, repression, and sublimation

• Psychosexual Stages of Development

– Oral, anal, phallic, latency, and genital stages

Later Developments in Psychoanalytic

Thought

• Anna Freud and Self-Psychology

– Emphasized influence of the ego in defining behavior

• Melanie Klein, Otto Kernberg, and Object

Relations Theory

– Emphasized how children incorporate

(introject) objects

– Objects – images, memories, and values of significant others

Later Developments in Psychoanalytic

Thought (continued)

• The Neo-Freudians: Departures From

Freudian Thought

– De-emphasized the sexual core of Freud’s theory

– Jung, Adler, Horney, Fromm, and Erickson

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

Humanistic Theory

• Major Players

– Abraham Maslow and Carl Rogers

• Major Themes

– That people are basically good

– Humans strive toward self-actualization

Humanistic Theory (continued)

• Humanistic Therapy

– Therapist conveys empathy and unconditional positive regard

– Minimal therapist interpretation

• No strong evidence that humanistic therapies work

The Behavioral Model

• Derived from a Scientific Approach to the

Study of Psychopathology

• Classical Conditioning (Pavlov; Watson)

– Ubiquitous form of learning

– Contingency between neutral and unconditioned stimuli

– Conditioning was extended to the acquisition of fear

The Beginnings of Behavior Therapy

• Challenged Psychoanalysis and Non-

Scientific Approaches

• Early Pioneers

– Joseph Wolpe – Systematic desensitization

• Operant Conditioning (Thorndike; Skinner)

– Another ubiquitous form of learning

– Voluntary behavior is controlled by consequences

The Beginnings of Behavior Therapy

(continued)

• Learning Traditions Influenced the

Development of Behavior Therapy

– Behavior therapy tends to be time-limited and direct

– Strong evidence supporting the efficacy of behavior therapies

The Present: An Integrative Approach

• Psychopathology Is Multiply Determined

• Unidimensional Accounts of Psychopathology

Are Incomplete

• Cognitive Behavioral Therapy (CBT)

– Aaron Beck

– Albert Ellis

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

Download
Study collections