Understanding Abnormality

• Unusualness is one criterion for determining abnormality
• Social deviance is another criterion for determining abnormality
• Faulty perceptions or interpretations of reality is a third for determining abnormality
• Significant personal distress is also considered for determining abnormality
• Maladaptive or self-defeating behavior is an indicator of abnormality
• Dangerousness is a factor for determining abnormality

Cultural Factors

• Cultural norms affect judgements about behavior

Demonological Model

• The demonological model views abnormal behavior as invasion by evil spirits or demons
• The demonological model was prominent in ancient Greece
• Under the demonological model, individuals were sometimes "fixed" by trephination or stoning

Trephination

• Trephination is a prehistoric practice of cutting a hole in a person's skull
• Trephination was possibly done to release demons

Origins of the Medical Model (Ill Humor)

• Ancient Hippocratic belief tied health to balance of humors
• Humors are vital bodily fluids

Hippocratic Belief System

• Abnormal behavior was attributed to an imbalance of humors

Ancient Hippocratic Beliefs on Lethargy

• Lethargy or sluggishness was thought to be caused by an excess of phlegm

Ancient Hippocratic Belief System on Depression

• Depression or melancholia was thought to be caused by an overabundance of black bile

Hippocratic Beliefs on Personality

• An excess of blood was associated with a sanguine disposition, marked by cheerfulness, confidence, and optimism

Ancient Hippocratic Beliefs on Excess Yellow Bile

• An excess of yellow bile was believed to make people 'bilious' and choleric, or quick-tempered

Medieval Times

• During medieval times, abnormal behaviors were seen as a sign of possession by evil spirits or the devil
• The Roman Catholic Church was influential during medieval times
• Exorcism was practiced during medieval times

Witchcraft

• The late 15th-17th centuries saw massive persecutions, especially of women accused of witchcraft
• Church officials believed witches made pacts with the devil
• Diagnostic tests like the water-float test were used to detect witchcraft

Asylums

• Asylums, or madhouses, began to appear throughout Europe in the late 15th and early 16th centuries
• Asylums gave refuge to beggars and the mentally disturbed, but conditions were appalling

St. Mary's of Bethlehem Hospital

• The public could buy tickets to observe the inmates, similar to a circus sideshow or zoo

Jean-Baptiste Pussin & Pinel

• Argued that people who behave abnormally suffer from diseases
• Argued that such people should be treated humanely (late 18th, early 19th century)

Dorothea Dix

• Decried the deplorable conditions in jails and almshouses where mentally disturbed people were placed
• Responsible for the establishment of more than 30 mental hospitals

Deinstitutionalization

• Late-1950s policy of shifting care from state hospitals to community settings
• Done to reform the mental health system

Phenothiazines

• Reduced the need for indefinite hospital stays

The Community Mental Health Movement

• Launched in 1963
• Attempted to provide coordinated mental health services in community-based treatment centers

The Biological Perspective

• Explained abnormal behavior based on underlying biological defects or abnormalities.

Wilhelm Griesinger

• Believed in diseases of the brain

Emil Kraepelin

• Linked mental disorders to physical diseases

Influential Discoveries Supporting the Medical Model

• Syphilis: general paresis (Greek for 'to relax') in late stage
• Alzheimer's disease: major cause of dementia

Jean-Martin Charcot (1825-1893)

• Experimented with hypnosis in treating hysteria

Sigmund Freud (1856-1939)

• Influenced by Charcot
• Developed the psychodynamic model, the first major psychological model of abnormal behavior

Leaning Models

• Explained how pathological behaviors were learned and reinforced

Cognitive Models

• Focused on faulty thinking (style, beliefs, interpretation) and its effects on mental health

Humanistic Models

• Focus on understanding obstacles preventing self-awareness, self-acceptance, and reaching potential

Sociocultural Perspective

• Causes of abnormal behavior may be found in societal failures, not just the individual
• Psychological problems may stem from societal ills
• Focus on relationships between mental health and social factors

Biopsychosocial Model

• An integrative model explaining abnormal behavior through interactions of biological, psychological, and sociocultural factors

Epigenetics

• The field focusing on how environmental factors influence gene expression

Nature vs Nurture

• Explores whether heredity or environment most impacts psychological development

Psychoanalytic Theory

• Developed by Sigmund Freud
• States roots of psychological problems are in unconscious motives and conflicts from childhood

Conscious

• It is the part of the mind corresponding to present awareness

Preconscious

• Part of the mind containing memories not in awareness
• Can be brought into awareness by focusing attention

Unconscious

• Part of the mind outside ordinary awareness
• Contains instinctual urges

Id

• Unconscious psychic structure present at birth containing primitive instincts
• Regulated by the pleasure principle

Pleasure Principle (Id)

• It is the governing principle involving demands for immediate gratification of needs

Ego

• Psychic structure governed by the reality principle
• Organizes reasonable ways of coping with frustration and seeks to curb the demands of the id

Reality Principle (Ego)

• The governing principle of the ego
• Involves considerations of social acceptability and practicality

Super Ego

• Psychic structure incorporating values of parents and others
• Functions as a moral conscience

Defense Mechanisms

• Reality-distorting strategies used by the ego
• Shields the self from awareness of anxiety-provoking impulses

Carl Jung (1875-1961)

• Developed analytical psychology
• Involved personal and collective unconscious

Archetypes

• Primitive images or concepts residing in the collective unconscious

Alfred Adler (1870-1937)

• Developed individual psychology
• States people are driven by an inferiority complex, and self-awareness is important

Karen Horny (1885-1952)

• Stressed importance of child-parent relationships in the development of emotional problems

Heinz Hartmann (1894-1970)

• Originator of ego psychology
• Focused on conscious strivings of the ego more than unconscious functions of the id

Erik Erikson (1902-1994)

• Focused on psychosocial development
• Attributed more importance to social relationships + formation of personal identity than to unconscious processes

Margaret Mahler (1897-1985)

• An object-relations theorist
• Focused on the influences of internalized representations of the personalities of parents and other strong attachment figures

Freudian Model

• Mental health is a function of the dynamic balance among the psychic structures of id, ego, and superego
• Freud believed underlying conflicts causing psychological disorders originate in childhood and are buried in the unconscious

Psychosis

• A severe form of disturbed behavior
• Characterized by impaired ability to interpret reality and difficulty meeting demands of daily life

Behaviorism

• The study of observable behavior that focuses on the role of learning in explaining behavior

Classical Conditioning

• Response to one stimulus becomes linked to another through pairing

Unconditioned Stimulus

• A stimulus that elicits an unlearned response

Unconditioned Response

• An unlearned response

Conditioned Response

• A learned response to a previously neutral stimulus

Operant Conditioning

• Behavior is acquired and strengthened when it is reinforced

Reinforcement

• Changes in the environment (stimuli) that increase the frequency of the preceding behavior

Positive Reinforcers

• Reinforcers that, when introduced increase the frequency of the preceding behavior

Negative Reinforcers

• Reinforcers that, when removed, increase the frequency of the preceding behavior

Punishment

• Application of aversive or painful stimuli that reduces the frequency of the behavior it follows

Social-Cognitive Theory

• Learning-based theory
• Emphasizes observational learning
• Incorporates cognitive factors into understanding behavior

Modeling

• Learning by observing and imitating the behavior of others

Expectancies

• Beliefs about expected outcomes

Carl Rogers (1902-1987) and Abraham Maslow (1908-1970)

• Principle forces

Self-Actualization

• The motive that drives one to reach one's full potential

Unconditional Positive Regard

• Valuing people as having worth regardless of their behavior

Conditional Positive Regard

• Valuing people based on whether their behavior meets one's approval

Conditional Models

• Study of the thoughts, beliefs, expectations, and attitudes that may underlie abnormal behavior

Aaron Beck (1921-)

• Cognitive theorist who proposed four basic types of cognitive distortions that contribute to emotional distress

Social Causation Model

• Belief that social stressors, like poverty increases the risk of disorder

Downward Drift Hypothesis

• The theory says that problems lead people to drift downward in social status

Diathesis

• A vulnerability or predisposition to a particular disorder

Diathesis-Stress Model

• Abnormal behavior arises from the interaction of vulnerability and stressful life events

Three Major Groups of Helping Professions

• Clinical psychologists (Doctoral degree in psychology)
• Psychiatrists (Medical degree and completion of a residency program in psychiatry)
• Clinical social workers (Master's degree in social work (M.S.W.)
• Psychotherapy (A structured form of treatment derived from a psychological framework that consists of one or more verbal interactions or treatment sessions between a client and a therapist)
• Countertransference (Transfer of feelings or attitudes that the analyst holds toward other persons in her or his life onto the client)
• Transference relationship (Transfer to the analyst of feelings and attitudes the client holds toward important figures in his or her life)
• Dream analysis (Freud believed dreams represented the "royal road to the unconscious.")
• Free association (The method of verbalizing thoughts as they occur without a conscious attempt to edit or censure them.)
• Psychoanalysis (The first method of psychotherapy developed by Sigmund Freud.)
• Modern psychodynamic therapists: Focus more on the client's present relationships / Focus less on sexual issues / Encourage the client to make adaptive behavior changes
• Systematic desensitization (-- A behavior therapy technique for overcoming phobias by means of expo.)
• Gradual exposure (--A behavior therapy technique for overcoming fears through direct exposure to increasingly fearful stimuli)
• Token economy (Behavioral treatment program in which a controlled environment is con:)
• Humanistic therapy (Focus on clients' subjective, conscious experiences. :)/ the client's present
• Person centered therapy (Person-centered therapy:) nondirective/ reflection
• Cognitive therapy (,therapy that teaches people new, more adaptive ways of thinking and acting:) encourages new thoughts
• Aaron beck cognitive (Encourage clients to recognize and change errors in their thinking :) record thoughts prompted by events
• Cognitive distor-(Tendencies to magnify negative events and minimize personal accomplish :) effects mood
• Eclectic therapy (An approach to psychotherapy that incorporates principles or techniques :) uses various systems of theories
• Technical eclectics (uses techniques but not theoretical positions)
• Integrative eclectic (synthesize and integrate diverse theoretical approaches)

Barriers that Exist for Ethnic Minorities

• Cultural mistrust
• Mental health literacy
• Institutional barriers
• Cultural barriers
• Language barriers
• Economic and accessibility barriers

Biomedical Therapies

• Growing emphasis in American psychiatry on biomedical therapies
• Currently, about one in five adult Americans takes psychotropic drugs
• Psychopharmacology

Drug Therapy

• Psychotropic drugs are used in treating many types of psychological disorders

Major Classes of Psychotropic Drugs

• Antianxiety drugs
• Antipsychotic drugs
• Antidepressants
• Lithium and other drugs are used to treat mania and mood swings in people with bipolar disorder

Electroconvulsive Therapy (ECT)

• Electric shock is sent through the patient's brain and is sufficient to induce convulsions
• Generally considered a treatment of last resort

Psychosurgery

• More controversial than ECT and is rarely practiced today
• Although no longer performed today, the most common form was the prefrontal lobotomy