Abnormal Psychology Chapter 1-2 PDF

ABNORMAL PSYCHOLOGY CHAPTER 1: ABNORMAL BEHAVIOR IN Thus, defining psychological disorder by HISTORY CONTEXT distress alone doesn’t work, although concepts of distress...

ABNORMAL PSYCHOLOGY CHAPTER 1: ABNORMAL BEHAVIOR IN Thus, defining psychological disorder by HISTORY CONTEXT distress alone doesn’t work, although concepts of distress contribute to a good Abnormality – “abnormal” refers to being definition above/below the norm - Most psychological disorders are simply - In abnormal psychology, if behavior extreme expressions of otherwise normal creates problem and becomes disruptive to emotions, behaviors, and cognitive himself or other, then this would be processes considered abnormal 3) Atypical/Not Culturally Expected – important but also insufficient to Psychopathology – study of mental disorders; determine if a disorder is present by itself focusing on the disorders - Ex: talented/eccentric – people that are - Theoretical basis far from the average behavior, but few - Etiology (nature and cause) would be considered disorder (such as - Symptomatology (manifestations of the Lady Gaga wearing meat clothing) symptoms) - The more productive you are in the eyes - Diagnosis of society; the more eccentricities society - Treatment will tolerate. Therefore, “deviating from the average” doesn’t work well as a Psychological Disorder – a psychological definition for problematic abnormal dysfunction within an individual associated with behavior distress/impairment in functioning and a response - View that your behavior is disordered if that is not typical or culturally expected you are violating social norms, even if a number of people are sympathetic to your Criteria defining a psychological disorder: point of view. This definition is useful in  Dysfunction considering important cultural differences  Distress in psychological disorders  Deviant - Harmful dysfunction – behavior is out of  Dangerous individual’s control Abnormal Behavior – a psychological Accepted Definition dysfunction within an individual that is associated Psychological Disorder (DSM-5) – behavioral, with distress/impairment in functioning and a psychological, or biological dysfunctions that are response that is not typical/culturally expected unexpected in their cultural context and 1) Psychological Dysfunction – a associated with present distress and impairment breakdown in cognitive, emotional, or in functioning, or increased risk of suffering, behavioral functioning death, pain, or impairment - Ex: experience severe fear all evening - Consider how the apparent when on a date or your emotions are not disease/disorder matches a “typical” functioning properly profile disorder 2) Distress/Impairment – criterion is - Prototype – patient may have only had satisfied if the individual is extremely some features/symptoms of the disorder (a upset minimum number) and still meet the - Criterion itself does not define criteria for the disorder because his/her problematic abnormal behavior. It is quite symptoms is close to the prototype normal to be distressed - Some disorders, by definition, suffering Science of Psychopathology and distress are absent Psychopathology – scientific study of - One of the major difficulties with this psychological disorder problem is that some people enjoy the manic state so much they are reluctant to - Counseling psychologist – study and begin treatment or stay long in treatment. treat adjustment and vocational issues 1  ABNORMAL PSYCHOLOGY encountered by relatively healthy - Data flow from research that attempts individuals three basic things: - Clinical psychologist – concentrate more o To describe psychological on sever psychological disorders disorders - Experimental and social psychologists – o To determine their causes concentrate on investigating the basic o To treat them determinants of behaviors but do not assess or treat psychological disorders - Psychiatrists – investigate the nature and Clinical Description cause of psychological disorders, often from a biological point of view; make Presenting problem – patient “presents” with a diagnoses; and offer treatments. They specific problem emphasize drugs/other biological Presents – traditional shorthand ways of treatments, although most use indicating why the person came to the clinic psychosocial treatment - Psychiatric Social Workers – develop Clinical description – represents the unique expertise in collecting information combination of behaviors, thoughts, and feelings relevant to the social and family situation that make up a specific disorder of the individual with psychological disorder; concentrating on family Clinical – refers both the types of problems or problems disorders that you would find in a clinic/hospital - Psychiatric Nurses – specialize in the and to the activities connected with assessment care and treatment of patients with and treatment psychological disorders - One important function of the clinical - Marriage and Family Therapists and description is to specify what makes the Mental Health Counselors – provide disorder different from normal behavior or clinical services by hospitals/clinics, from other disorders. Statistical data may usually under the supervision of a also be relevant doctoral-level clinician - Prevalence of the disorder (how many Scientist-Practitioner people in the population as a whole has a disorder?) - Mental health professionals take a - Incidence of the disorder (how many new scientific approach to their clinical work cases occur during a given period, such as - They may function as scientist- a year) practitioners in three ways: o They may keep up with the latest Course – most disorders follow a somewhat scientific developments in their different pattern field and therefore use the most - Chronic course – they tend to last a long current diagnostic and treatment time, sometimes a lifetime procedures. They are consumers of - Episodic course – the individual is likely the science of psychopathology to to recover within a few months only to the advantage of their patients suffer a recurrence of the disorder at a o Scientist-practitioners evaluate later time. This may repeat through a their own assessments/treatment person’s life procedures to see whether they - Time-limited course – disorder will work. They must demonstrate improve without treatment in a relatively clearly whether their treatments short period with little or no risk of are effective or not recurrence o They might conduct research, often in clinics and hospitals, that Differences in the course of disorders are produces new information about differences in onset disorders or their treatment - Acute onset – they begin suddenly 2  ABNORMAL PSYCHOLOGY - Insidious onset – others develop - The bizarre behavior of people afflicted gradually over an extended period with psychological disorders was seen as - It is important to know the typical course the work of the devil and witches of a disorder so that we can know what to - Individuals possessed by evil spirits were expect in the future and how best to deal probably responsible for any misfortune with the problem. This is an important of experienced by people in the local the clinical description community, which inspired drastic action against possessed Prognosis – anticipated course of a disorder. We - Treatment included exorcism, in which may say, “the prognosis is good,” meaning the various religious rituals were performed in individual will probably recover, or “the an effort to rid the victim of evil spirits prognosis is guarded,” meaning the probable - Evil continued to be blamed for outcome doesn’t look good unexplainable behavior - The patients age may be an important part Stress and Melancholy of the clinical description (specific psychological disorder in childhood may - Reflected the enlightened view that present differently from the same disorder insanity was a natural phenomenon, in adulthood/old age) caused by mental or emotional stress, and - Children are often misdiagnosed and that it was curable treated for a medical disorder - Mental depression and anxiety were recognized as illnesses, although Developmental psychology – study in behavior symptoms such as despair and lethargy Developmental psychopathology – study of were often identified by the church with changes in abnormal behavior the sin of acedia/sloth - Common treatments were rest, sleep, and Life-span developmental psychopathology – a healthy and happy environment + baths, study of abnormal behavior across life span ointments and various potions Causation, Treatment and Etiology Outcomes - (14th – 15th centuries) people with physical deformities/disabilities, were often moved Etiology – the study of origins, has to do with from house to house in medieval villages why a disorder begins (what causes it) and as neighbors took turns in caring them includes biological, psychological, and social - Medieval practice of keeping people who dimensions have psychological disturbances in their own community is beneficial - Treatment is also, often important to the - Nicholas Oresme – suggested that the study of psychological disorders. If a new disease of melancholy (depression) was drug/psychosocial treatment is successful the source of some bizarre behavior, in treating a disorder, it may give us some rather than demons hints about the nature of the disorder and its causes Treatment and Possession - Psychopathology is rarely simple because the effect does not necessarily imply the - The sufferer is largely responsible for the cause disorder, which might well be a punishment for evil deeds Historical Conceptions of Abnormal Behavior - Acquired immune deficiency syndrome (AIDS) epidemic was associated with a - Purpose of the models is to explain why similar belief among some people someone is “acting like that” - Human immunodeficiency virus (HIV) – many people believed it was a divine 1) SUPERNATURAL TRADITION punishment for what they considered Demons and Witches (14th – 15th century) immoral behavior - Possession is not always connected with - People increasingly turned to magic and sin but may be seen as involuntary and the sorcery to solve their problems possessed individual is blameless 3  ABNORMAL PSYCHOLOGY - If exorcism failed, authorities take emotion. Disorders involving these necessary steps to make the body functions would logically be located in the unhabitable by evil spirits through beating brain. He also recognized the importance and other forms of torture of psychological and interpersonal - Strangely the torture approach sometimes contributions of psychopathology worked; the most disturbed, oddly - Galen – adopted the ideas of Hippocrates behaving individuals would suddenly and further developed, creating a powerful come to their senses and experience relief and influential school of thought within from their symptoms the biological tradition - Therapeutic shock treatment was developed (dunking in ice-cold water) Humoral theory Mass Hysteria - 1st example of associating disorders with a “chemical imbalance” - Characterized by large-scale outbreaks of - Hippocratic-Galenic approach assuming bizarre behavior the normal brain functioning was related - Emotion contagion – if someone is to four bodily fluids/humors: sad/frightened, you will also feel the same o Blood – came from the heart way as them. When this situation o Black bile – from spleen escalates, whole community is affected. o Yellow bile – from the liver People are also suggestible when they are o Phlegm – from the brain in a state of high emotion - Physicians believed that disease resulted - Mob psychology from too much/too little of one of the - Emotion contagion occurring across social humors; ex: networks, raising the possibility that o Melancholer means “black bile” – episodes of mass hysteria may increase derivative from melancholy to Moon and Stars refer aspects of depression - Four humors are related to Greeks’ Paracelsus – suggests that movements of the conception of the four basic qualities: moon and stars had profound effects on people’s o Heat psychological functioning; gravitational effects of o Dryness the moon on bodily fluids might be possible o Moisture cause of mental disorders o Cold - Lunatic – derived from “luna” which is - Sometimes connected to personality traits moon o Sanguine – “red, like blood”; - No scientific/serious evidence ruddy in complexion, presumably - This belief is most noticeable today in from copious blood flowing followers of astrology, who hold that their through the body, and cheerful behavior and the events in their lives can optimistic, although insomnia and be predicted by their day-to-day delirium were thought to be caused relationship to the position of the planets by excessive blood in the brain o Melancholic – depressive (depression was thought to be 2) BIOLOGICAL TRADITION caused by black bile flooding in the brain) Hippocrates and Galen o Phlegmatic – personality (from - Hippocrates – father of modern Western the humor phlegm) indicates medicine; he suggested that psychological apathy and sluggishness but can disorders might also be caused by brain also mean being calm under stress pathology/head trauma and could be o Choleric – from yellow bile, is hot influenced by heredity (genetics) tempered - He considered the brain to be the seat of wisdom, consciousness, intelligence, and 4  ABNORMAL PSYCHOLOGY - Excess of one or more humors were John P. Grey – champion of the biological treated by regulating the environment to tradition in the US and was the most influential increase/decrease heat, dryness, American psychiatrist of the time moisture/cold, depending on which humor was out of balance - His position was that the cause of insanity - Bleeding/bloodletting – carefully was always physical. Therefore, the measured amount of blood was removed mentally ill patient should be treated as from the body, often with leeches. Other physically ill was induce vomiting (eating tobacco and - He also invented the rotary fan to ventilate a half-boiled cabbage to induce vomiting) the hospital - Chinese focused on the movement of air/ The Developmental of Biological Treatments “wind” throughout the body o Unexplained mental disorders - 1930s – physical interventions of electric were caused by blockages of shock and brain surgery were often used. wind/the presence of the cold, dark Their effects of new drugs, were wind (yin) as opposed to warm, discovered quite by accident life-sustaining wind (yang) o Insulin – stimulate appetite and o Treatment involved restoring also seemed to calm the patients proper flow of wind through down; higher dosage resulted in various methods, including convulsion that leads to temporary acupuncture comatose - Hysteria – somatic symptom disorder o Insulin shock therapy – was also (Hippocrates) – physical symptoms abandoned because it was too appear to be the result of a medical dangerous, often resulted to problem for which no physical cause can prolonged coma and even death be found, such as paralysis and some kind - 1970s – mild and modest electric shock to of blindness the head produced a brief convulsion and memory loss (amnesia) but otherwise did 19th Century – discovery of the nature and a little harm cause of syphilis and strong support form o Electroconvulsive therapy John P. Grey - 1950s – first effective drugs for severe Syphilis – sexually transmitted disease caused psychotic disorders were developed in a by a bacterial organism entering the brain, systematic way include believing everyone is plotting against o Opium (derived from poppies) – you (delusion of persecution) or that you are used as sedatives along with other God (delusion of grandeur) herbs and folk remedies o Rauwolfia serpentine (reserpine) - Although these symptoms are similar to and neuroleptics (major those of psychosis – psychological tranquilizers) – for the first time disorders characterized in part by beliefs hallucinatory and delusional that are not based on reality (delusions), thought processes could be perceptions that are not based on reality diminished in some patients; these (hallucinations) drugs also controlled agitation and - The condition was designated a disease, aggressiveness general paresis, because it had consistent o Benzodiazepines (minor symptoms (presentation) and a consistent tranquilizers) – reduce anxiety course that resulted in death o Benzodiazepines (valium and - Louis Pasteur – germ theory of disease, Librium) – most widely prescribed facilitated the identification of the specific drugs in the world bacterial microorganism that caused o Bromides – class of sedating syphilis drugs, they were reported as being - Penicillin cures syphilis effective for many serious psychological and emotional 5  ABNORMAL PSYCHOLOGY symptoms (eventually disappeared - Its basic tenets include treating due to its effectivity being modest) institutionalized patients as normally as - Neuroleptics have also been used less possible in a setting that encouraged and since it has many side effects such as reinforced normal social interaction thus chronic tremors and shaking, providing them with many opportunities hallucinations, delusions, and agitation for appropriate social and interpersonal contact Consequences of the Biological Tradition - Relationships were carefully nurtured - Grey and his colleagues reduced/eliminate - Individual attention clearly emphasized interest in treating mental patients, positive consequences for appropriate because they thought that mental disorders interactions and behaviors were the result of some as-yet- Asylum Reform and the Decline of Moral undiscovered brain pathology and were Therapy therefore incurable. The only available course of action was to hospitalize these - Human treatment declined because of a patients convergence of factors (mid-19th century): - Emil Kraepelin – one of the founding o It was widely recognized that fathers of modern psychiatry. He was moral therapy worked best when extremely influential in advocating the the number of patients in an major ideas of the biological tradition, but institution was 200 or fewer, he was little involved in treatment allowing for a great deal of - He was one of the first to distinguish individual attention among various psychological disorders, o Has an unlikely source. The great seeing that each may have a different age crusader Dorothea Dix of onset and time course, with different campaigned endlessly for reform clusters of presenting symptoms and in the treatment of insanity (her different cause work became known as the mental - Treatment was based on humane hygiene movement) principles o Through her efforts, humane treatment became more widely 3) PSYCHOLOGICAL TRADITION available in the US institutions – Plato – thought that the two causes of she was acknowledged as a hero in maladaptive behavior were the social and cultural the 19th century influences in one’s life and the learning that took - Increase in patients: this led to a rapid place in that environment transition from moral therapy to custodial care because hospitals were inadequately - The best treatment was to reeducate the staffed individual through rational discussion so - Dix reformed asylums and single- that the power of reason would handedly inspired the construction of predominate numerous new institutions here and - Psychosocial treatment approaches to the abroad causation of psychopathology, which - 19th century – final blow to the practice of focus not only on psychological factors moral therapy was the decision, that but also on social and cultural ones mental illness was caused by brain pathology and was therefore incurable Aristotle – emphasized the influence of social - 20th century environment and early learning on later o Psychoanalysis – elaborate theory psychopathology of the structure of the mind and the Moral Therapy role of unconscious processes in determining behavior Moral – referred more to o Behaviorism – associated with emotional/psychological factors rather than to a John B. Watson, Ivan Pavlov and code of conduct 6  ABNORMAL PSYCHOLOGY B.F Skinner, which focuses on - Breuer and Freud had discovered the how learning and adaptation affect unconscious mind and its apparent the development of influence on the production of psychopathology psychological disorders Psychoanalytic Theory Catharsis – therapeutic to recall and relieve emotional trauma that has been made Franz Anton Mesmer – unconscious and to release the accompanying (hypnotized/mesmerized by someone) he tension; release of emotional material suggested that the problem of his patients was caused by an undetectable fluid found in all living - Fuller understanding of the relationship organisms called “animal magnetism” which between current emotions and earlier could become blocked events is referred to as insight - Freud and Breuer’s theories were based - Regarded as father of hypnosis, a state on case observations, some of which were which extremely suggestible subjects made in a systematic way appear to be in trance - Breuer dealt with one symptom at a time Benjamin Franklin – put animal magnetism to through hypnosis and subsequent “talking test; patients receive either magnetized water/non through,” tracing each symptom to its magnetized water with strong suggestions that hypothetical causation in circumstances they would get better - The process of treating one behavior at a time fulfills a basic requirement for - Neither the patient nor the therapist knew drawing scientific conclusions about the which water was has magnetism which effects of treatment in an individual case makes it a double-blind experiment study - Animal magnetism was only a strong - Freud’s basic principles of mental suggestion functioning that he originally proposed Jean-Martin Charcot – demonstrated that some remained constant through his writings techniques of mesmerism were effective with a and are still applied by psychoanalysts number of psychological disorders, and he did today much to legitimize the fledging practice of Three major facets of psychoanalytic theory: hypnosis (hysteria) 1) Structure of the mind and the distinct Josef Breuer – experimented with a somewhat functions of personality that sometimes different hypnotic procedure clash with another - While patients are in highly suggestible 2) Defense mechanisms with which the mind state of hypnosis, Breuer asked his defends itself from these clashes/conflicts patients to describe their problems, 3) Stages of early psychosexual development conflicts, and fears in as much detail as that provides grist for the mill of our inner they could conflicts - Observed important phenomenon during The Structure of the Mind the process: o Patients often became extremely 1) Id (pleasure principle) emotional as they talked and felt - Source of our strong sexual and quite relieved and improved after aggressive feelings or energies emerging from the hypnotic state - Libido – energy/drive within the id o Seldom would they have gained an - Thanatos – death instinct understanding of the relationship - Two basic drives, toward life and between the emotional problems fulfillment on the one hand and death and and their psychological disorder destruction on the other, are continually in o Material seemed to be beyond the opposition awareness of the patient 7  ABNORMAL PSYCHOLOGY - Overriding goal of maximizing pleasure discomfort onto another, usually less and eliminating any associated threatening, object or person tension/conflicts o Ego adaptively decides that - Goal of pleasure, which is prominent in expressing primitive anger to childhood, often conflicts with social rules someone and regulations 3) Projection – falsely attributes own - Primary process – this type of thinking is unacceptable feelings, impulses, or emotional, irrational, illogical, filled with thoughts to another individual/object fantasies, and preoccupied with sex, 4) Rationalization – conceals the true aggression, selfishness, and envy motivations for actions, thoughts/feelings 2) Ego (reality principle) through elaborate reassuring/self-serving - We must find ways to meet our basic but incorrect explanations needs without offending everyone around 5) Reaction formation – substitutes us behavior, thoughts/feelings that are the - Cognitive operations/thinking styles of the direct opposite of unacceptable ones ego are characterized by logic and reason 6) Sublimation – directs potentially and are referred to as the secondary maladaptive feelings/impulses into process, as opposed to the primary socially acceptable behavior process o More constructive outlet - Role: mediate conflict between the id and the superego, juggling their demands with Phobic and obsessive symptoms are especially the realities of the world common self-defeating defensive reactions that - Executive/manager of our minds reflect an inadequate attempt to deal with an - Intrapsychic conflicts – conflicts within internally dangerous situation. the mind, if the id and superego is strong - Phobic symptoms typically incorporate 3) Superego elements of danger - Counteract the potentially dangerous - Defense mechanisms may be of potential aggressive and sexual drives of the id, the import in the study of psychopathology basis for conflict is readily apparent - Coping styles – contemporary Freud conceptualized the mental structures terminology of defense mechanisms described in this section to explain unconscious Psychosexual Stages of Development processes. He believed that the id and the superego are almost entirely unconscious. - Have a profound and lasting impact - Freud as one of the first to take a Defense Mechanisms developmental perspective on the study - Conflicts produce anxiety that threatens to abnormal behavior overwhelm the ego - Oral, anal, phallic, latency and genital - Unconscious protective processes that period – represents distinctive patterns of keep primitive emotions associated with gratifying our basic needs and satisfying conflicts in check so that the ego can our drive for physical pleasure continue its coordinating function - If we did not receive appropriate - Anna Freud further conceptualized it gratification during a specific stage/if a - They are sometimes adaptive and specific stage left a particularly strong maladaptive impression (fixation), an individual’s personality would reflect throughout adult life o Adult personality characteristic 1) Denial – refuses to acknowledge some aspects of objective reality/subjective (oral) – dependency, passivity, experience that is apparent to others rebellious and cynicism 2) Displacement – transfers a feeling about, - Early genital stimulation (phallic stage) or a response to, an object that causes o Oedipus complex o Electra complex 8  ABNORMAL PSYCHOLOGY o Castration anxiety Carl Jung and Alfred Adler – rejected Freud’s o Penis envy – conflict is resolved ideas and form their own school of thought when females develop healthy - Jung introduced collective unconscious – heterosexual relationships and wisdom accumulated by society and look forward to having a baby, culture that is stored deep in individual which he viewed as healthy memories and passed down from substitute for having a penis generation to generation Neuroses – disorders of the nervous system o He also suggested the spiritual and religious drives are as much as a Later Developments in Psychoanalytic part of human nature as are sexual Thought drives Ana Freud – concentrated on the defensive o Continues to draw attention to reactions of the ego determine our behavior mystics - Emphasized the importance of enduring - Ego psychology personality traits such as introversion - Individual slowly accumulates (shy and withdrawn) and extroversion adaptational capacities, skill in reality (tendency to be friendly and outgoing) testing, and defenses - Adler – created the term inferiority - Abnormal behavior develops when the complex ego is deficient in regulating such - Both believed the basic quality of human functions as delaying and controlling nature is positive and that there is a strong impulses/in marshaling appropriate drive toward self- actualization (realizing normal defenses to strong internal one’s own potential) conflicts - They also believed that by removing Heinz Kohut – focused on the theory of the barriers to both internal and external formation of self-concept and the crucial growth the individual would improve and attributes of the self that allow an individual to flourish progress toward health/conversely, to develop Others took psychoanalytical theorizing in neurosis different directions, emphasizing development - Psychoanalytic approach in known as self- over the life span and the influence of culture and psychology society on personality. Object relation – the study how children Erik Erikson – greatest contribution was his incorporate the images, memories and sometimes theory of development across the life span, in the values of a person who was important to them which he described in some detail the crises and and to whom they are (or are) emotionally conflicts that accompany eight specific stages attached to (stages of psychosocial development) - Object – refers to the important people Psychoanalytic Psychotherapy - Introjection – process of incorporation - Designed to reveal the nature of - Introjected objects can become an unconscious process and conflict through integrated part of the ego/may assume catharsis and insight conflicting roles in determining the - Free association – patients are instructed identity/self to say whatever comes to mind without - In this theory, you tend to see the world the usual socially required censoring through the eyes of the person o Intended to reveal emotionally incorporated into your self charged material that may be - It focuses on how these disparate images repressed because of too come together to make up a person’s painful/threatening to bring into identity and on the conflicts that may consciousness emerge - Couch is the symbol for psychotherapy 9  ABNORMAL PSYCHOLOGY - Dream analysis – therapist interprets the o Exploration of patients’ wishes, contents of the dreams, supposedly dreams or fantasies reflecting the primary process thinking of - Two additional features characterize the id psychodynamic psychotherapy: o Often difficult because the patient o It is significantly briefer than may resist the efforts of the classical psychoanalysis therapist to uncover repressed and o Psychodynamic therapists sensitive conflicts deemphasize the goal of o Goal: help patients gain insight personality reconstruction, into the nature of the conflicts focusing instead on relieving the - Psychoanalyst – relationship of the suffering associated with therapist and the patient psychological disorders o Transference – patients come to relate to the therapist much as they Comments did to important figures in the - Psychoanalysis is of historical interest childhood, particularly parents more than current interest, and classical o Patients who resent therapist but psychoanalysis as a treatment has been can verbalize no good reason for it diminishing in popularity for years may be reenacting childhood - Major criticism: basically unscientific, resentment toward a parent relying on reports by the patient of events o Countertransference – therapist that happened years ago project some of their own personal - Events have been filtered out through issues and feelings, usually experiences of the observer and then positive to the patient interpreted in ways that certainly could be - Therapist are trained to deal with their questioned and might differ from one own feelings as well as those of their analyst to another patients, it is strictly against all ethical - No careful measurement of any of these cannons of the mental health professions psychological phenomena and no obvious to accept overtures from patients that way to prove/disprove the basic might lead to relationship outside therapy hypotheses of psychoanalysis - Symptom substitution – eliminating - Measurement and the ability to phobia/depressive episode would be little prove/disprove a theory are the use unless the underlying conflict was foundations of the scientific approach dealt with adequately, because another symptom may emerge Humanistic Theory - Therapist use an eclectic mixture of - Jung and Adler emphasized the positive, tactics, with a social and interpersonal optimistic side of human nature focus. Tactics that characterize - Adler believed that we all strive to reach psychodynamic psychotherapy includes: superior levels of intellectual and moral o Focus on affect and the expression development of patients’ emotions o Exploration of patients’ attempts Self-actualizing – assumption that all of us could to avoid topics/engage in activities reach our highest potential, in all areas of that hinder the progress of therapy functioning, if only we had the freedom to grow; o Identification of patterns in every person is basically good and whole, most blocks originated outside the individual patients’ actions, thoughts, feelings, experiences, and Abraham Maslow – postulated the hierarchy of relationships needs. He hypothesized that we cannot progress o Emphasis on past experiences up the hierarchy until we have satisfied the needs o Patients’ interpersonal experiences at lower levels o Emphasis on therapeutic Carl Rogers – originated person-centered relationship therapy (the therapist takes a passive role, 10  ABNORMAL PSYCHOLOGY making as few interpretations as possible, giving Classical conditioning – type of learning in the individual a chance to develop during the which a neutral stimulus is paired with a response course of therapy, unfettered by threats to the until it elicits that response self) - Conditioning (conditioned response) – a - Humanistic theorists have the faith in the response that occurred only on the ability of human relations to foster this condition of the presence of a particular growth event/situation (stimulus) - Unconditional positive regard – - Conditioning is one way we acquire new complete and almost unqualified information, particularly information that acceptance of most of the client’s feelings is somewhat emotional in nature and actions, is critical to the humanistic approach Stimulus generalization – responses generalize - Empathy – sympathetic understanding of to similar stimuli; this particular reaction is the individual’s particular view of the distressing and uncomfortable, particularly if it world associated with a variety of objects/situations - Result of the therapy is that clients will be - Classical conditioning process begins with more straight-forward and honest with a stimulus that would elicit a response in themselves and will access their innate almost anyone and requires no learning; tendencies toward growth no conditions must be present for the Humanistic approach has had a substantial effect response to occur on theories of interpersonal relationships. o Unconditioned stimulus (UCS) – food and chemotherapy - This also emphasized the importance of o Unconditioned response (UCR) – the therapeutic relationship in a way quite natural/unlearned response different from Freud’s approach o Conditioned stimulus (CS) and - Humanistic therapists believed that conditioned response (CR) relationships, including the therapeutic - CR can be learned in one trial. Most relationship, were the single most positive learning of this type requires repeated influence in facilitating human growth pairing of the UCS and the CS The humanistic model contributed little new - Presentation of the CS without a stimulus information to the field of psychopathology. for a long period of time would eventually eliminate the CR. This process is called - They had little interest in doing research extinction that would discover/create new knowledge Edward Titchener – emphasized the study of - They stressed unique, nonquantifiable introspection experiences of the individual, - Subjects simply reported on their inner emphasizing that people are more thoughts and feelings after experiencing different than alike certain stimuli, but the results of this - This model found its greatest application “armchair” psychology were inconsistent among individuals without psychological and discouraging to many experimental disorders psychologists Watson and the Rise of Behaviorism Behavioral Model John B. Watson – founder of behaviorism - Also known as the cognitive-behavioral - He decided to base psychology on model/social learning model introspection Pavlov and Classical Conditioning o “Psychology, as the behaviorist views it, is a purely objective experimental branch of natural science. Its theoretical goal is 11  ABNORMAL PSYCHOLOGY prediction and control of behavior. which behavior changes as a function of Introspection forms no essential what follows the behavior) part of this methods” - Walden Two – depicts a fictional society - Little Albert experiment – considered run on the principles of operant unethical in today’s standards, and it turns conditioning out Albert may have also had some - Beyond Freedom and Dignity – he lays neurological impairment that could out a broader statement of problems contribute to developing fear facing our culture and suggests solutions based on his own view of a science of Mary Cover Jones – thought that if fear could be behavior learned/classically conditioned in this way, perhaps it could also be unlearned/extinguished Edward L. Thorndike The Beginnings of Behavior Therapy - Law of effect – behavior is either strengthened (likely to be repeated more Joseph Wolpe – became dissatisfied with frequently) or weakened (likely to occur prevailing psychoanalytic interpretations of less frequently) depending on the psychopathology and began looking for consequences of that behavior something else Skinner coined the term operant conditioning - Systematic desensitization – similar to because behavior operates on the environment treatment of little Peter (fear is gradually and changes it in some ways. unlearned): individuals were gradually introduced to objects/situations they - Most things that we do socially provide feared so that their fear could extinguish; the context for other people to respond to they could test reality and see that nothing us in one way or another, thereby bad happened in the presence of the providing consequences for our behavior. phobic object/scene The same is true of our physical o Also added another element by environment, although consequences may having patients do something that be long term was incompatible with fear while - Reinforcement – “reward” because it they were in the presence of the connotes the effect of behavior dread object/situation o All our behavior is governed to o Because he could not always some degree of reinforcement, reproduce the phobic object in his which can be arranged in an office, he had his patients carefully endless variety of ways, in and systematically imagine the schedules of reinforcements phobic scene, and the response he o Using punishment as a chose was relaxation because it consequence is relatively was convenient ineffective in the long run and that - Wolpe, Eysenck, and Stanley Rachman – the primary way to develop new called the approach behavior therapy (use behavior is to positively reinforce of desensitization and the wide-scale desired behavior applications of the new science of - Skinner did not see the need to go beyond behaviorism of psychopathology) the observable behavior and quantifiable - Wolpe’s procedures are seldom used to establish a satisfactory science of today, they paved way for modern-day behavior fear and anxiety reduction procedures in - Skinner did not deny the influence of which severe phobias can be eliminated as biology or the existence of subjective little as 1 day states of emotion/cognition; he simply explained these phenomena as relatively B.F Skinner and Operant Conditioning inconsequential side effects of a particular - The Behavior of Organisms (principles of history of reinforcement operant conditioning, a type of learning in 12  ABNORMAL PSYCHOLOGY - Shaping – a process of reinforcing o Realization that no one influence successive approximations to a final —biological, behavioral, behavior or set of behaviors cognitive, emotional/social—even occurs in isolation Pavlov, Watson, and Skinner contributed - Our behavior, both normal and abnormal, significantly to behavior therapy, in which is the product of a continual interaction of scientific principles of psychology are applied to psychological, biological, and social clinical problems. influences Comments - Adolf Meyer – considered the dean of American psychiatry - Behavioral model is incomplete and o He emphasized the equal inadequate to account for what we know contributions of biological, about psychopathology psychological, and sociocultural - Disorders were considered determinism environmentally determined reactions - This model also accounts for development of psychopathology across the lifespan CHAPTER 2: AN INTEGRATIVE APPROACH TO PSYCHOPATHOLOGY The Present: The Scientific Method and an - Biological dimensions include causal Integrative Approach factors from the fields of genetics and neuroscience - Supernatural explanations have little - Psychological dimensions include causal influence on scientists and other factors from the behavioral and cognitive professionals processes, including learned helplessness, - Biological, psychoanalytic, and behavioral social learning, prepared learning, and models continue to further our knowledge even unconscious process of psychopathology - Emotional influences contribute in a - Each tradition fails in many ways: variety of ways to psychopathology, as do o Scientific methods were not often social and interpersonal influences applied to the theories and - Developmental influences figure in any treatments within a tradition, discussion of causes of psychological mostly because methods would disorders have produced evidence necessary - No influence operates in isolation. Each to confirm/disprove the theories dimension, biological or psychological, is and treatments had not been strongly influenced by the others and by developed (this leads to people development, and they weave together in believing to various fads and various complex and intricate ways to superstitions that proved to be create a psychological disorder untrue/useless) o Health professionals tend to look One Dimensional vs. Multidimensional Models as psychological disorders One dimensional Model narrowly, from their own point of view alone - Attempts to trace the origin of behavior to - Watson assumed that all behaviors, a single cause including disordered behavior, were the - Ex: schizophrenia/phobia is caused by result of psychological and social chemical imbalance/by growing up influences and that the contribution of surrounded by overwhelming conflicts biological factors was inconsequential among family members - Developments that shed light to the nature of psychopathology Multidimensional Model o Increasing sophistication of scientific tools and methodology 13  ABNORMAL PSYCHOLOGY - Most scientists and clinicians believe similar condition, although somewhat abnormal behavior results from multiple milder in most cases influences - Many people rather severe syncope - Systemic – system; any particular reaction tendencies do not develop influence contributing to psychopathology phobias. They cope with their reaction cannot be considered out of context in various ways, including tensing - Context – biology and behavior of the their muscles whenever they are individual, as well as cognitive, confronted with blood emotional, social and cultural - The cause of blood-injection-injury- environment, because any component of phobia is caused by a biological the system inevitably affects the other dysfunction (an overactive vasovagal components, forming a complex network mechanism) or a traumatic experience (seeing a gruesome film) What Caused Judy’s Phobia? and seeing a subsequent conditioning - In adopting a one-dimensional causal model, we would miss the important point: to cause blood-injection-injury- phobia, a complex interaction must occur between emotional, cognitive, social, biological, and behavioral factors. Inheriting a strong syncope reaction definitely puts a person at risk for developing this phobia, but other influences are at work as well  Emotional Influences - What role did Judy’s fear and anxiety play in the development of her phobia,  Behavioral Influences and where did it come from? - Unconditioned response to the - Emotions can affect physiological stimulus responses such as blood pressure, - Classical conditioning is also heart rate, and respiration, particularly considered if we know rationally there is nothing - Stimulus generalization also to fear, as Judy did contributes - Rapid increases in heart rate caused by  Biological Influences her emotions may have triggered a - Vasovagal syncope – a common stronger and more intense baroreflex. cause of fainting Emotions also changed the way she - Syncope – means “sinking feeling” or thought about situations involving “swoon” caused by low blood pressure blood and injury and motivated her to in the head behave in ways she didn’t want to, - The amount of blood reaching her avoiding all situations connected with brain diminished until she lost blood and injury, even if it was consciousness important not to avoid them - Sinoaortic baroreflex arc – sudden - Emotions play a substantial role in the increase in blood pressure by lowering development of many disorders it  Developmental Influences - The tendency to overcompensate - Life span development seems to be inherited, a trait that may - As time passes, many things about account for the high rate of blood- ourselves and our environments injection-injury phobia in families change in important ways, causing us - 61% of the family members of to react differently at different ages individuals with the phobia has a - Developmental critical period – when we are more or less reactive to a 14  ABNORMAL PSYCHOLOGY given situation or influence than other o Concern of the individual, a times knowledgeable informant, or - Why did this problem develop when the clinician that there has she was 16 years old and not before? been a significant decline in Is it possible that her susceptibility to cognitive function having a vasovagal reaction was o Substantial impairment in highest in her teenage years? cognitive performance, - The timing of her physiological preferably documented by reaction, along with viewing the standardized disturbing biology film, provided the neuropsychological testing, or combination to initiate her severe in its absence, another phobic response quantified clinical assessment (psychological test comes in Genetics and Psychopathology handy; intelligence test) Genes – long molecules of deoxyribonucleic acid o Also applicable to mild (DNA) at various locations on chromosomes, neurocognitive disorders within the cell nucleus o Others also experience agnosia, or remember the - Gene endowment; other factors in the names of other people environment influence our physical o Amnesia is not the same as the appearance. To some extent, our weight and even our height are neurocognitive disorder, affected by nutritional, social, and because they are not limited to cultural factors memory (it includes a lot of - Our genes seldom determine our domains) physical development in any absolute o Mental statue examination way. Exactly where we go within (in clinical and industrial; very these boundaries depends on important) environmental influences Mild Neurocognitive Disorder Huntington’s Disease – causes involuntary - Evidence of modest cognitive decline shaking or jerkiness through the body from a previous level of performance - Degenerative brain disease that in one or more cognitive domains appears in early to middle age, usually o Concern of the individual, a the early 40s knowledgeable informant, or - Causes mild or major neurocognitive the clinician that there has disorder (early onset is ranging from been a mild decline in 40-50s; occur during the older age) cognitive function - Traced as a genetic defect that causes o Modest impairment in deterioration in the basal ganglia cognitive performance, - It causes broad changes in personality, preferably documented by cognitive functioning, and motor standardized behavior neuropsychological testing, or in its absence, another Major Neurocognitive Disorder quantified clinical assessment - Evidence of significant cognitive Phenylketonuria (PKU) – can result in mental decline from a previous level of retardation performance (such as complex attention, executive function - This disorder, present at birth is (planning), learning and memory, caused by the inability of the body to language, perceptual motor or social metabolize (breakdown) cognition) in one or more cognitive phenylalanine, a chemical compound domains found in many foods 15  ABNORMAL PSYCHOLOGY - Present at birth, and is passed on when Polygenic – influenced by many genes, each both parents are carriers of the gene contributing only a tiny effect, all of which, may - Causes intellectual disability be influenced by the environment - Possible correction through proper diet management – prevention rather Recessive gene – must be paired with another than cure (restriction of phenylalanine recessive gene to determine a trait in the diet as early as possible, or until Genome – an individual’s complete set of genes the diet no longer affects the brain —consists of more than 20,000 genes, polygenic usually 6-7 of age) interactions can be quite complex - Way to correct the disorder: change the way the environment interacts with Quantitative genetics – sums up all the tiny and affects the genetic expression of effects across many genes without necessarily this disorder telling us which genes are responsible for which effects The Nature of Genes Molecular genetics – focuses on examining the - Each normal human cell has 46 actual structure of genes with increasingly chromosomes arranged in 23 pairs advanced technologies such as DNA (one chromosome in each pair comes microarrays (allow scientists to analyze from the mother and also from the thousands of genes at once and identify broad father) networks of genes that may be contributing to a - first 22 pairs of chromosomes provide particular trait) programs or direction for the development of the body and brain - Genes exert their influences on our bodies and our behavior through a Sex chromosome – determine an individual’s sex series of steps that produces proteins X chromosomes – in females, both chromosomes - Only a small portion of our genes in in the 23rd pair any one cell are “turned on” or expressed Y chromosomes – in males, the mother - Environmental factors, in the form of contributes an x chromosome while the mother is social and cultural influences, can the y chromosome determine whether genes are “turned on” - X and Y chromosomes is responsible for variance in biological sex Genes and Behavior - 160 million parts in the X chromosome. The ordering of these - According to research, about half of base influences how the body one’s enduring personality traits are develops and works cognitive abilities are attributed to genetic influence Dominant gene – one pair of genes that strongly - Adverse environmental influence can influences a particular trait, and we need only one affect the influence of genes of them to determine such as the eye or hair color - Genetic factors determined stability in cognitive abilities, whereas - Occurs when one member of a gene environmental factors were pair is consistently expressed over the responsible for any changes other - Adverse life events such as a - Mendelian laws of genetics – predict “chaotic” childhood can overwhelm fairly accurately how many offspring the influence of genes will develop at a certain trat, - Study showed marked variability or characteristics, or disorders depending change in cognitive abilities if his or on whether one or both of the parents her environment changed dramatically carry the dominant gene from the other twins because of some stressful events such as death of a loved one 16  ABNORMAL PSYCHOLOGY - For psychological disorders, the may lead to changes in the number of evidence indicates that genetic factors receptors at the end of a neuron, which make some contribution to all in turn would affect biochemical disorders but account for less than half functioning in the brain of the explanation - The brain, like any other parts of the o If one pair of identical twins body, may well be influenced by has schizophrenia, there is a environmental changes during less-than-50% likelihood that development. But we also assume that the other twin will also have once maturity is reached, the structure schizophrenia and function of out internal organs and - Behavioral genetics have reached most of our physiology are set or hard- general conclusions: wired o Specific genes or small groups - The brain is subject to continual of genes may ultimately be change in response to the found to be associated with environment, even at the level of certain psychological genetic structure disorders, as suggested in Diathesis-Stress Model – indicates that several important studies. tendencies for certain traits or behaviors to be Contributions to psychological activated certain conditions disorders come from many genes, each having a relatively - Diathesis – condition that makes small effect someone susceptible to developing a o Linkage studies – scientists disorder. When the right kind of life study individuals who have the event, such as a certain type of same disorders, such as bipolar stressor, comes along, the disorder disorders, and also share the develops same features, such as eye - Vulnerability – would not become color; because the location of prominent until certain environmental the gene for eye color is events occurred (emotional exposure known, this allows scientists to that comes with the degree of attempt to “link” known gene uncertainty) locations with the possible - Diathesis is genetically based and the location of a gene contributing stress is environmental but that they to the disorder must interact to produce a disorder o It has become increasingly - The smaller the vulnerability, the clear that genetic contributions greater the life stress required to cannot be studied in the produce the disorder; conversely, with absence of interactions with greater vulnerability, less life stress is events in the environment that required trigger genetic vulnerability or - Chemical transporter study by Caspi “turn on” specific genes et. Al o Short and long alleles Gene and Environment Interaction o Chemical transporter and the Eric Kandel – speculated the process of learning 5-HTT gene affects more than behavior o Demonstrated that neither genes nor life experiences - Suggested that very genetic structure (environmental events) can of cells may change as a result of solely explain the onset of a learning if genes that were inactive or disorder such as depression. It dormant interact with the environment takes a complex interaction of in such a way that they become active the two factors - The environment may occasionally turn on certain genes. This mechanism 17  ABNORMAL PSYCHOLOGY - Predisposition factors and the precipitating factors Epigenetics and the Nongenomic Gene-environment Correlational Model – “Inheritance” of Behavior indicated that certain genes may increase the - Epigenetics refers to the idea that probability that an individual will experience there are factors beyond genetics that stressful life events influence the individual - Reciprocal gene-environment Model - Factors beyond genetics that influence - Genetic endowment may increase the behavior probability that an individual will - There are instances that our experience stressful life events experiences allow us to combat or be - Ex: people with a genetic vulnerability resilient in developing psychological phobia, may also have a personality disorders trait—impulsiveness, that makes them - Nature and nurture develops resilience more likely to be involved in minor in developmental disorder accidents that would result them in o Lab rat study by Francis et al. seeing blood (1999) o They are accident prone - Stress reactivity and because they are continually how it passes through rushing to complete things or generations to get to places without regard - Cross-fostering – rat for their physical safety pup born to one mother o These people might have a is assigned to another genetically determined mother tendency to create the very - Maternal behavior environment risk factors that affected how the young trigger a genetic vulnerability rats tolerated stress to blood-injury-injection - Calm and supportive phobia behavior by mothers - Ex: individuals with depressive could be passed down predispositions, these individuals through generations of might seek out difficult relationships rats independent of leading to more stress, circumstances genetic influence and more environmental instances that o Primate study by Suomi (1999) lead to severe or worse depression - Environmental effects - Some evidence indicates that it applies of early parenting seem to the development of depression, to override any genetic because some people may tend to seek contribution to be out difficult relationships or other anxious, emotional or circumstances that lead to depression reactive to stress - Nonreactive surrogates 18  ABNORMAL PSYCHOLOGY o Adoption study by Tiernari et al. (1994) - Found that children whose parents have schizophrenia and were adopted away as babies demonstrated a tendency to develop psychiatric disorders (including schizophrenia) themselves only if they were adopted into - Sympathetic NS primarily responsible for dysfunction families mobilizing the body during times of stress - We can talk of or danger by rapidly activating the organs heritable (genetic) and glands under its control. Three things contribution only in the happen: context of the o Heat beats faster, increasing individual’s past and the flow of blood to the present environment muscles o Respiration increases, allowing Despite genetic influences we cannot discount more oxygen to get into the environmental support toward the individual. blood and brain; and the A complex interaction between genes and adrenal glands are stimulated environment plays an important role in every o All three changes mobilize us psychological disorders. for action (it mediates a substantial part of our - The earlier the intervention/therapy the “emergency” or “alarm” better for the children that have reaction) developmental/psychological disorder - Parasympathetic NS’s function is to - To establish a positive relationship with balance the sympathetic NS. the parents of the child being assessed, o It takes over after the sympathetic reassure them that it is for the nervous system that has been development of their child and not for active for a while, normalizing the other people (teach them proper social arousal and facilitating the storage skills and socialization etc., allowing them of energy by helping the digestive to develop) process Central and Peripheral Nervous System Neuroscience and Psychopathology - CNS processes all information received Neuroscience – knowing how the nervous from our sense organs and reacts as system, how the brain works is central to any necessary understanding of our behavior, emotions and - Spinal cord is part of the CNS, but its cognitive processes primary function is to facilitate the sending of messages to and from the brain, which is the other major component of the CNS an the most complex organ in the body - Neurons – 140 billion nerve cells, that control our thoughts and emotions. They also transmit information throughout the nervous system 19  ABNORMAL PSYCHOLOGY - Typical neurons contain a central cell body with two kinds of branches o Dendrites – have numerous receptors that receive messages in the form of chemical impulses from other nerve cells, which are converted into electrical impulses o Axon – transmits these impulses to other neurons o Synapses – any one nerve cell may have multiple connections to other neurons - Within each neuron, information is transmitted through electrical impulses, called action potentials, traveling along the axon of a neuron o Terminal button – end of a neuron o Synaptic cleft – space between the terminal button of one neuron and the dendrite of another o Neurotransmitters – biochemicals that are released from the axon of one neuron and transmit the impulse to the dendrite receptors of another neuron; these are chemical stored in vesicles in the terminal buttons (basic/fundamental units of the brain/nervous system) Glia/Glial cells - Cells outnumber neurons by a ratio of about 10 to 1, for many years they were little studied because scientists believed that they were passive cells that merely served to connect and insulate neurons - Electrical impulses are action potential - Glial cells actually play active roles in neural activity; it is now known that there are different types of glial cells with several specific functions, some of which serve to modulate neurotransmitter activity Excitatory – increase the likelihood that the connecting neurons will fire 20  ABNORMAL PSYCHOLOGY Inhibitory – increase the likelihood that the - Thalamus and hypothalamus – involved connecting neurons will fire broadly with regulating behavior and emotions. These structures function The Structure of the Brain primarily as a relay between the forebrain and the remaining lower areas of the brain stem - Limbic system – limbic means border, so named because it is located around the edge of the center of the brain; regulates emotion memory o Hippocampus – sea horse o Cingulate gyrus – girdle o Septum