Download Basic Statistics for the Behavioral Sciences

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
• An accepted definition
– A psychological dysfunction associated with
distress or impairment in functioning that is not
typical or culturally expected
• The Diagnostic and Statistical Manual (DSMIV-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.: Clinical and counseling psychologist
– The Psy.D.: Clinical and counseling “Doctor of
Psychology”
– The Ed.D.: Clinical and counseling “Doctor of
Education
– M.D.: Psychiatrist
– Psychiatric social worker
– Psychiatric nurse
– Family therapists
The Scientist-Practitioner
• Stays current with research in field
• Evaluates own assessment and treatment
• Conducts research
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
• 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
• 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 and across all time periods.
• Causes and treatment of abnormal behavior
vary widely across cultures, time periods,
world views.
Historical Conceptions of Abnormal
Behavior
• 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 Supernatural Tradition
• Mass hysteria
– Saint Vitus’s Dance and Tarantism
• Modern mass hysteria
– Emotion contagion
– Mob psychology
• 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
• Galenic-Hippocratic tradition
– Linked abnormality with brain chemical
imbalances
– Foreshadowed modern views
The 19th 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 19th Century
• John P. Grey and the reformers
– Championed biological tradition in the U.S.
Consequences of the
Biological Tradition
• Mental illness = physical illness
• Emil Kraepelin
– Diagnosis and classification
The Psychological Tradition
• The rise of moral therapy
– More humane treatment of institutionalized
patients
– Encouraged and reinforced social interaction
The Psychological Tradition
• 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
• Asylum reform and the decline of moral
therapy
• Emergence of competing alternative
psychological models
Psychoanalytic Theory
• Freudian theory of the structure and function
of the mind
– Unconscious
– Catharsis
– Psychoanalytic model
• 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
• 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 countertransference issues
• Psychodynamic psychotherapy
• Little evidence for efficacy
Humanistic Theory
• Major players
– Abraham Maslow and Carl Rogers
• Major themes
– People are basically good
– Humans strive toward self-actualization
Humanistic Theory
• Person-centered therapy
– Therapist conveys empathy and unconditional
positive regard
– Minimal therapist interpretation
• There is 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)
– Reinforcement
– Another ubiquitous form of learning
– Voluntary behavior is controlled by consequences
The Beginnings of
Behavior Therapy
• 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
An Integrative Approach
• Psychopathology is multiply determined.
• Unidimensional accounts of psychopathology
are incomplete.
An Integrative Approach
• Must consider reciprocal relations among:
– 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