Chapter 1 Abnormal Behavior in Historical Context Abnormal Behavior : Myths and Misconceptions What’s psychologically normal? What’s not? How do we describe people with mental illness? Lazy, crazy, dumb? Weak in character? Dangerous? Hopeless? What is a Psychological Disorder? Psychological dysfunction Breakdown in function Cognitive Behavioral Emotional What is a Psychological Disorder? Distress or impairment Individual versus others Example: mania Appropriateness to situation Example: death Degree of impairment What is a Psychological Disorder? Response is not typical or culturally expected More or less frequent Deviations from “average” Eccentricity Violation of social norms What is a Psychological Disorder? Accepted DSM-IV-TR definition: Behavioral, cognitive, emotional dysfunctions Unexpected in cultural context Personal distress Substantial impairment in function How Do We Classify Psychological Disorders? Diagnostic and Statistical Manual DSM-IV-TR Outlines criteria for disorders Prototypes/typical profiles Constant revision and modification DSM-V What is a Psychological Disorder? New areas of interest for the DSM-V: Reevaluating underlying concepts Surveys of mental health professionals Commonalities in disorders Discerning differences in degree The Science of Psychopathology Study of psychological disorders Conducted by Clinical and counseling psychologists (PhD, PsyD) Psychiatrists (MD) Psychiatric social workers (MSW) Psychiatric nurses (MN, MSN, PhD) Marriage and family therapists (MA, MS, MFT) Mental health counselors (MA, MS) The Scientist-Practitioner Framework Interaction of clinical work and science Consumer of science Informs practice Evaluator of practice Utilizes science Creator of science Synthesizes both Historical Conceptions of Abnormal Behavior Major psychological disorders have existed across time and cultures Causes and treatment of abnormal behavior varied widely, depending on context 3 DOMINANT TRADITIONS Supernatural Biological Psychological The Supernatural Tradition Deviance = Battle of “Good” vs. “Evil” Etiology- devil, witchcraft, sorcery Treatments- exorcism, torture, and crude surgeries The Supernatural Tradition Mass hysteria St. Vitus’ dance Tarantism Lycanthropy Modern examples? Emotion contagion “Mob psychology” The Supernatural Tradition Other Worldly Causes Moon and stars Paracelsus lunacy Modern examples? Astrology The Biological Tradition Hippocrates (460-377 BC) Father of modern Western medicine Etiology = physical disease Brain pathology Head trauma Genetics Psychosocial factors Stress, family Precursor to somatoform disorders Hysteria The Biological Tradition Galen (129-198 AD) Hippocratic foundation Galenic-Hippocratic Tradition Humoral theory of mental illness Etiology = brain chemical imbalances Treatments = Environmental regulation Heat, dryness, moisture, cold Bloodletting, induced vomiting The Biological Tradition and the 19th Century Syphilis and General Paresis STD with psychosis-like symptoms Delusions Hallucinations Etiology = bacterial microorganism Louis Pasteur’s germ theory Biological basis for madness The Biological Tradition and the 19th Century John Grey (1850s) American proponent of the biological tradition Etiology = always physical Treatments = treat as if the person is physically ill Rest Diet Room temperature Improved hospital conditions Dorothea Dix The Development of Biological Treatments Mental Illness = Physical Illness The 1920’s Insulin shock therapy –Manfred Sakel ECT--Joseph von Meduna The Development of Biological Treatments The 1950’s Psychotropic medications Increasingly available Systematically developed Neuroleptics Reserpine and psychosis Tranquilizers Benzodiazepines and anxiety The Development of Biological Treatments The cons of medications Unwanted physical side effects Addiction/dependence Effectiveness Emil Kraeplin Importance of brain pathology Developed system of classification Mental illness has a “lifecourse” just like a physical illness Consequences of the Biological Tradition Increased hospitalization “Untreatable” conditions Improved diagnosis and classification Emil Kraepelin Increased role of science in psychopathology The Psychological Tradition: Ancient Contributions Plato more humane treatment relatives should care for the person If someone committed a crime when they were insane, then they shouldn’t be punished like a normal person. The Psychological Tradition: Moral Therapy Key figures in humanistic reform: France Philippe Pinel (1745 – 1826) Jean-Baptiste Pussin England William Tuke (1732 – 1822) United States Benjamin Rush (1745 – 1813) Dorothea Dix (1802-1887) The Psychological Tradition Moral Therapy “Moral” = emotional or psychological Treating patients normally Encouraging social interaction Focus on relationships Individual attention Education Modern Perspectives to Abnormal Psychology Psychoanalytic Perspective or Psychodynamic Model Behaviorism Cognitive Perspective The Psychoanalytic Tradition- Background Freudian Theory – Overview and Development Work with patients suffering from hysteria Jean Charcot and hypnosis Free association Resistance Repression Psychodynamic Theory Psychodynamic Theory Freud’s theory: Human behavior is ruled by irrational instincts such as aggression and sex. The major influence on our behavior is the unconscious. 3 Layers of Consciousness Layers of Consciousness Conscious Preconscious Unconscious Freud’s Psychodynamic Theory Structure and Function of the Mind Id (pleasure principle) Ego (reality principle) Superego (conscience) Defense Mechanisms Occur when Ego Loses Battle with Id and Superego Examples: Displacement & Denial Rationalization & Reaction Formation Projection & Repression Psychosexual Stages Stages Age Oral 0-18 months Anal 18 months to three years Phallic Three to six years Latent Six years to puberty Genital Puberty to adulthood Behavioral Theories of Abnormality Classical Conditioning Operant Conditioning (Also two more theories, but we’re not talking about them today) Modeling and Observational Learning Observational Learning The Behavioral Model and the Psychological Tradition Classical Conditioning (Pavlov; Watson) Ubiquitous form of learning Pairing neutral stimuli and unconditioned stimuli Conditioning was extended to explain fear acquisition Classical Conditioning Before Conditioning: CS (bell) US (meat powder) No CR (no salivation) During Conditioning: CS signals UR (salivation) US UR produces After Conditioning: CS (bell) CR (salivation) produces Behavioral Model Operant Conditioning (Thorndike; Skinner) Another ubiquitous form of learning Voluntary behavior is controlled by consequences Operant Conditioning: R S Classical Conditioning: S R Operant Conditioning Positive Reinforcement Negative Reinforcement Punishment Cognitive Theories of Abnormality Types of cognition Causal attributions Control beliefs Learned helplessness Dysfunctional assumptions Some Common Global Dysfunctional Assumptions I should be loved by everyone for everything I do. I must have perfect self control. Once something affects my life, it will affect it forever. It is better to avoid problems than to face them. I should be terribly upset by certain situations. The Behavioral Model Classical Conditioning Ivan Pavlov (1849-1936) Ubiquitous form of learning Unconditioned stimulus (UCS) Unconditioned response (UCR) Conditioned stimulus (CS) Conditioned response (CR) The Behavioral Model Classical Conditioning – Concepts Stimulus generalization Extinction Introspection The Behavioral Model Behaviorism John B. Watson (1878 - 1958) Scientific emphasis Objective Radical empiricism “Little Albert” experiment The Behavioral Model and Behavior Therapy Mary Cover Jones Preexisting phobia extinguished by exposure and modeling Joseph Wolpe (1915 -1997) Systematic desensitization Relaxation The Behavioral Model - Operant Conditioning E.L. Thorndike (1874 – 1949) Law of effect: consequences shape behavior B.F. Skinner (1904 - 1990) Behavior “operates” on environment Reinforcements Punishments Behavior “shaping” The Scientific Method and an Integrative Approach Defining and studying psychopathology Requires a broad approach Multiple, interactive influences Biological, psychological, social factors Scientific emphasis Neuroscience Cognitive, behavioral sciences