Abnormal Psychology - Module 1 Part 1 PDF

Module1 Part1: Introduction to Abnormal Psychology RMDEALA Module1 Part1: Introduction to Abnormal Psychology Course Learning Outcome CLO1. Establish the difference between pathological and non-pathological behavior by illustrating the nature of abnormal behaviors/mental o...

Module1 Part1: Introduction to Abnormal Psychology RMDEALA Module1 Part1: Introduction to Abnormal Psychology Course Learning Outcome CLO1. Establish the difference between pathological and non-pathological behavior by illustrating the nature of abnormal behaviors/mental or psychological disorders and looking into how the history of Abnormal Psychology has affected the different views of these disorders. Topic Learning Outcomes TLO1. Describe abnormal behavior/psychological disorder/ psychopathology in view of the different criteria of a pathological behavior. TLO2. Discuss highlights in the historical development/ perspectives of Abnormal Psychology in the Western and Filipino context. Stereotypes/ misconceptions/ stigma/ myth vs reality about the mentally disturbed/ mental illness My t h : Mentally disturbed people can always be recognized by their abnormal behavior. R e a l i t y: Mentally disturbed people are not always distinguishable from others on the basis of consistently unusual behavior. My t h : The mentally disturbed have inherited their disorders. If one member of a family has an emotional breakdown, other members will probably suffer a similar fate. R e a l i t y: The belief that insanity runs in certain families has caused misery and undue anxiety for many people.  My t h : Mentally disturbed people can never be cured and will never be able to function normally or hold jobs in the community. R e a l i t y: This erroneous belief has caused great distress to many people who have at some time been labeled mentally ill. Some have endured social discrimination and have been denied employment because of the public perception that “once insane, always insane.” My t h : People become mentally disturbed because they are weak willed. To avoid emotional disorders or cure oneself of them, one need to only exercise will power. R e a l i t y: Needing help to resolve difficulties does not indicate a lack of will power. In fact, recognizing one’s own need for help is a sign of strength rather than a sign of weakness. My t h : Mental illness is always a deficit, and the person suffering from it can never contribute anything of worth until cured. R e a l i t y: Many persons who suffered from mental illness were never “cured,” but they nevertheless made great contributions to humanity. My t h : Mental illness causes people to become unstable and potentially dangerous. Reality: The vast majority of individuals who are mentally ill do not commit crimes, do not harm others, and do not get into trouble with the law. However, there is a slightly increased risk of violence among individuals with a dual diagnosis (a mental disorder and substance abuse) and a prior history of violence (Elbogen & Johnson, 2009). Introductory Concepts Abnormal psychology focuses on psychopathology, the study of the symptoms and causes of mental distress and the various treatments for behavioral and mental disorders. Those who study psychopathology attempt to describe, explain, predict, and modify the behaviors, emotions or thoughts associated with various mental conditions. People who work in the field of psychopathology strive to alleviate the distress and life disruption experienced by those with mental disorders and the concerns of their friends and family members. Abnormal psychology is the scientific study whose objectives are to describe, explain, predict, and modify behaviors associated with mental disorders (Sue et al., 2016). Definition of a Mental Disorder A mental disorder is a syndrome characterized by clinically significant disturbance in an individual’s cognition, emotion regulation, or behavior that reflects a dysfunction in the psychological, biological, or developmental processes underlying mental functioning. Mental disorders are usually associated with significant distress or disability in social, occupational, or other important activities. An expectable or culturally approved response to a common stressor or loss, such as the death of a loved one, is NOT a mental disorder. Socially deviant behavior (e.g., political, religious, or sexual) and conflicts that are primarily between the individual and society are NOT mental disorders unless the deviance or conflict results from a dysfunction in the individual. APA (2022) The diagnosis of a mental disorder should have clinical utility: it should help clinicians to determine prognosis, treatment plans, and potential treatment outcomes for their patients. Barlow & Durand (2018) define abnormal behavior as actions that are unexpected and often evaluated negatively because they differ from typical or usual behavior. x Four major factors involved in judging psychopathology distress, deviance, dysfunction, and dangerousness Distress: extreme discomfort, pain or suffering Most people who seek the help of therapists are experiencing psychological distress that affects social, emotional, or physical functioning. Manifestations of distress: Social: an individual may become withdrawn and avoid interactions with others or, at the other extreme, may engage in inappropriate or dangerous social interactions. Emotional distress: might involve extreme or prolonged reactions such as anxiety and depression. Physical distress: can surface in conditions such as asthma or hypertension or with symptoms of fatigue, pain, or heart palpitations. Reactions which are so intense, exaggerated, or prolonged that it interferes with your ability to function adequately. For some disorders, by definition, suffering and distress are absent (Durand & Barlow, 2016). E.g. Consider the person who feels elated and may act impulsively as part of a manic episode. Deviance Abnormal behaviors deviate or represent a significant deviation from social norms. Some examples of unusual behavior include false perceptions of reality (such as hallucinations), an intense preoccupation with repetitively washing one’s hands, or demonstrating extreme panic in a social setting. Sue et al. (2016) identified certain behaviors that are considered abnormal in most situations. These behaviors include refusal to leave your house; depression so severe that you sleep most of the day; starving yourself because you are so fearful of gaining weight; experiencing frequent nightmares involving a trauma you experienced; forgetting your own identity; feeling overwhelmed with fear at the sight of a spider, etc. Dangerousness- violence risk Only a small minority of acts of violence involve someone with a severe mental illness (Frazel & Grann, 2006). Drug and alcohol abuse is much more likely to result in violent behavior than are other kinds of mental illness (Friedman & Michels, 2013). Dysfunction refers to a breakdown in cognitive, emotional, or behavioral functioning. The behaviors or feelings prevent the person from functioning in daily life. Emotional problems sometimes interfere with the performance of one’s roles. How to assess dysfunction: 1. compare someone’s performance with the requirements of a role. 2. compare an individual’s performance with his or her potential.  Define: 1. clinical description 2. presenting problem 3. prevalence 4. etiology 5. incidence 6. course 7. prognosis 8. onset of the disorder 1. Clinical description: the unique combination of behaviors, thoughts, and feelings that make up a specific disorder. Durand and Barlow (2016) Function of clinical description: To specify what makes the disorder different from normal behavior or from other disorders. 2. Presenting problem: Original complaint reported by the client to the therapist. -initial symptom motivating the patient / client to consult a practitioner. -the chief complaint in the medical field (or CC) The actual treated problem may be a modification derived from the presenting problem. 3. prevalence – Number of people displaying a disorder in the total population at any given time -the percentage of individuals in a targeted population who have a particular disorder during a specific period of time Intellectual developmental disorder (IDD) has an overall general population prevalence of approximately 10 per 1,000 APA (2022) 4. etiology - the study of origins, has to do with why a disorder begins and includes biological, psychological, and social dimensions. - the cause or causes for a condition 5. Incidence : Number of new cases of a disorder appearing during a specific period. Difference between prevalence and incidence: Prevalence is a measurement of all individuals affected by the disease at a particular time (% of individuals in a targeted population). e.g. 12-month prevalence Incidence is a measurement of the number of new individuals who contract a disease during a particular period of time. 6. course: pattern of development and change of a disorder over time. Most disorders follow a particular pattern, or course. E.g. Schizophrenia follow a chronic course, meaning that they tend to last a long time. Mood disorders follow an episodic course, in that the individual is likely to recover within a few months only to suffer a recurrence of the disorder at a later time. Other disorders may have a time-limited course, meaning they will improve without treatment in a relatively short period. 7. prognosis: predicted development of a disorder over time. A prognosis is a prediction of the future course, duration, severity and likely outcome of a condition. 8. onset of the disorder - the first appearance of the signs or symptoms of an illness Some disorders have an acute onset, meaning they begin suddenly; others develop gradually over an extended period, which is called an insidious onset. Age of onset: the common age which an illness initially begins in susceptible people - childhood, adolescence, etc. References: APA (2022). Diagnostic statistical manual of mental disorders: DSM-5 TR (5th ed.). American Psychiatric Association. Barlow, D.H., Durand, V. M., & Hofman, S.G. (2018). Abnormal psychology: an integrative approach. (8th ed.). Cengage Learning. Sue, D., Sue, D. W., Sue, D., & Sue, S. (2016). Understanding abnormal behavior. (11th ed.). Cengage Learning. M1: Part 2 Historical Perspectives of Abnormal Psychology RMDEALA Gospel – Luke 5:1-11 1 While the crowd was pressing in on Jesus and listening to the word of God, he was standing by the Lake of Gennesaret. 2 He saw two boats there alongside the lake; the fishermen had disembarked and were washing their nets. 3 Getting into one of the boats, the one belonging to Simon, he asked him to put out a short distance from the shore. Then he sat down and taught the crowds from the boat. 4 After he had finished speaking, he said to Simon, “Put out into deep water and lower your nets for a catch.” 5 Simon said in reply, “Master, we have worked hard all night and have caught nothing, but at your command I will lower the nets.” 6 When they had done this, they caught a great number of fish and their nets were tearing. 7 They signaled to their partners in the other boat to come to help them. They came and filled both boats so that the boats were in danger of sinking. 8 When Simon Peter saw this, he fell at the knees of Jesus and said, “Depart from me, Lord, for I am a sinful man.” 9 For astonishment at the catch of fish they had made seized him and all those with him, 10 and likewise James and John, the sons of Zebedee, who were partners of Simon. Jesus said to Simon, “Do not be afraid; from now on you will be catching men.” 11 When they brought their boats to the shore, they left everything and followed him. The gospel of the Lord. All: Praise to You, O Lord, Jesus Christ. Reflection: Today, let us take some time to reflect on our willingness to follow the voice of the Savior. Are we open to saying “Yes” to Him in all things? Are we willing to radically follow the direction He gives us, even if it may seem risky or unfamiliar? Remember that if we do so, we will be amazed at the ways in which He works in our lives. Let us trust in His guidance and remain open to His direction, and we will find ourselves blessed beyond measure. Let us pray: Dear Lord, we long to step out of our comfort zone, then put out into deep water, and wholeheartedly engage in evangelization as You have called us to. Please guide us to be obedient in all circumstances. Amen. St. John Baptist de la Salle, All: Pray for us. Live Jesus in our hearts. All: Forever. Learning Outcomes: CLO1. Establish the difference between pathological and non- pathological behavior by illustrating the nature of abnormal behaviors/mental or psychological disorders and looking into how the history of Abnormal Psychology has affected the different views of these disorders. TLO2. Discuss highlights in the historical development/ perspectives of Abnormal Psychology in the Western and Filipino context. Historical Perspectives on Abnormal Behavior Prehistoric and Ancient Beliefs What was the prevailing belief during this time about abnormal behavior? Where do people attribute mental illness? What treatments were practiced? Historical Perspectives on Abnormal Behavior Prehistoric and Ancient Beliefs Ancient people attributed many forms of illness to demonic possession, sorcery, or retribution from an offended ancestral spirit. Certain symptoms and behaviors, from simple headaches to convulsions, were ascribed to evil spirits residing within a person’s body demonology Treatment: trephination -part of the skull was chipped away to provide an opening through which the evil spirits could escape, in hopes that the person would return to his or her normal state. Another treatment: exorcism Elaborate prayers, noises, emetics (drugs that induce vomiting), and extreme measures such as flogging and starvation were used to cast evil spirits out of an afflicted person’s body.  Naturalistic Explanations: Greco-Roman Thought What were the contributions by Hippocrates, Plato and Galen in providing a shift on how people look at mental disorder? What view prevailed during this time; how was mental disorder seen? What theory was proposed by Hippocrates and Galen in looking at mental illnesses? What treatments did they offer to sufferer? Naturalistic Explanations: Greco-Roman Thought Hippocrates He believed that, because the brain was the central organ of intellectual activity, deviant behavior was caused by brain pathology, that is, a dysfunction or disease of the brain.  He also considered heredity and the environment important factors in psychopathology. He classified mental illnesses into three categories— mania, melancholia (sadness or depression), and phrenitis (brain fever)—and provided detailed clinical descriptions of symptoms such as paranoia, alcoholic delirium, and epilepsy.  To treat melancholia, Hippocrates recommended tranquility, moderate exercise, a careful diet, abstinence from sexual activity, and bloodletting when necessary. His belief in environmental influences on behavior sometimes led him to separate disturbed individuals from their families. Philosopher Plato and the Greek physician Galen Plato (429–347 B.C.) insisted that people who were mentally disturbed were the responsibility of their families and that they should not be punished for their behavior.  Galen (A.D. 129–199) made major contributions through his scientific examination of the nervous system and his explanation of the role of the brain and central nervous system in mental functioning. Hippocratic Galenic approach: Humoral theory Hippocrates believed that all diseases including abnormal behavior was caused by imbalances of 4 basic humors or elements: Blood - heart Phlegm - brain Yellow bile - liver Black bile –spleen Treatment: restoration of the balance of the humors through 1. Bleeding a patient 2. Rest, relaxation, change of climate or scenery 3. Change of diet 4. Temperate life  Reversion to Supernatural Explanations: The Middle Ages What happened to the natural causes or beliefs as propagated by Hippocrates, Plato and Galen? How were mentally ill people viewed and consequently, treated during this time? Reversion to Supernatural Explanations: The Middle Ages With the collapse of the Roman Empire and the rise of Christianity, rational and scientific thought gave way to a reemphasis on the supernatural. Religious truths were viewed as sacred and those who challenged these ideas were denounced as heretics. Natural and supernatural explanations of illness were once again fused. The Dark Ages (Fifth through Tenth Centuries) People once again believed that many illnesses were the result of supernatural forces. Religious monks treated the mentally ill with compassion, allowing them to rest and receive prayer in monasteries and at shrines. In other cases, treatment was quite brutal, particularly when the illness was seen as resulting from God’s wrath or possession by the devil. When the illness was perceived to be punishment for sin, the sick person was assumed to be guilty of wrongdoing; relief could only come through atonement or repentance.  Treatment consisted of torturous exorcism procedures designed to combat Satan and eject him from the possessed person’s body. Prayers, curses, obscene epithets, and the sprinkling of holy water—as well as such drastic and painful “therapies” as flogging, starving, and immersion in cold water—were used to drive out the devil.  Mass Madness (Thirteenth Century) What is mass madness or group hysteria? How did this come about? What about tarantism? Where did this spread? What did people do (those who were said to be part of this) do to cure themselves of the symptoms? Mass Madness (Thirteenth Century) Italy - Early in the 13th century, large numbers of people were affected by various forms of mass madness, or group hysteria, involving the sudden appearance of unusual symptoms that had no apparent physical cause. One of the better-known manifestations of this condition was tarantism, characterized by agitation and frenzied dancing. People would leap up, believing they were bitten by a spider. They would then run out into the street or marketplace, jumping and dancing about, joined by others who also believed that they had been bitten. The mania soon spread throughout the rest of Europe, where it became known as Saint Vitus’s dance. How can these phenomena be explained? Outbreaks of mass hysteria are often associated with stress and fear. There was enormous social unrest during the 13th century. The bubonic plague had decimated one third of the population of Europe. War, famine, and pestilence were rampant, and the social order of the times was crumbling.  Witchcraft: 15th Through 17th Centuries Why was the church attacked during this time? How did the church fight against these attacks? What is your idea of witchcraft? Is this belief still in existence during our current time? Witchcraft: 15th Through 17th Centuries Social and religious reformers increasingly challenged the authority of the Catholic Church. Accordingly, Satan himself fostered the attacks on church practices. In effect, the church actively endorsed an already popular belief in demonic possession and witches.  People whose actions were interpreted as peculiar were often suspected of witchcraft. It was acceptable to use torture to obtain confessions from suspected witches, and many victims confessed because they preferred death to prolonged agony. Thousands of innocent men, women, and even children were beheaded, burned alive, or mutilated during the period of the witch hunts. The Rise of Humanism RECAP of the prevailing treatment. What changes happened in the way people look at mental illness/ sufferer with the rise of humanism? Who were responsible in the shift of paradigm? What were their contributions?  Most asylums were at best custodial centers in which people who were mentally disturbed were chained, caged, starved, whipped, and even exhibited to the public for a small fee, much like animals in a zoo (Dreher, 2013).  The term bedlam, which has become synonymous with chaos and disorder, was the shortened name of Bethlehem Hospital, an asylum in London that has come to symbolize the cruel treatment of people experiencing severe mental illness. Patients were bound by chains, left untreated, and exhibited to the public in the courtyard. The Rise of Humanism The new way of thinking held that if people were “mentally ill” and not possessed, then they should be treated as though they were sick. A number of new methods for treating the mentally ill reflected this humanistic spirit. Humanism: a philosophical movement that emphasizes human welfare and the worth and uniqueness of the individual.  Johann Weyer (1515–1588), a German physician, published a revolutionary book that challenged the prevailing beliefs about witchcraft. He personally investigated many cases of possession and asserted that many people who were tortured, imprisoned, and burned as witches were mentally disturbed, not possessed by demons (Metzger, 2013).  Although both the church and state severely criticized and banned his book, it helped pave the way for the humanistic perspective on mental illness. With the rise of humanism, a new way of thinking developed—if people were “mentally ill” and not possessed, they should be treated as though they were sick. The Moral Treatment Movement: 18th and 19th Centuries Philippe Pinel instituted what came to be known as the moral treatment movement—a shift to more humane treatment of people who were mentally disturbed. He removed patients’ chains, replaced dungeons with sunny rooms, encouraged exercise outdoors on the hospital grounds, and treated patients with kindness and reason.  In England, William Tuke (1732–1822), a prominent Quaker tea merchant, established a retreat at York for the “moral treatment” of mental patients. At this pleasant country estate, the patients worked, prayed, rested, and talked out their problems—all in an atmosphere of kindness.  In the United States, three individuals— Benjamin Rush, Dorothea Dix, and Clifford Beers—made important contributions to the moral treatment movement. Rush (1745–1813), widely acclaimed as the father of U.S. psychiatry, encouraged humane treatment of those residing in mental hospitals. He insisted that patients be treated with respect and dignity and that they be gainfully employed while hospitalized, an idea still evident in the modern concept of work therapy.  Dorothea Dix (1802–1887), a New England schoolteacher, was a leader in 19th century social reform in the United States. Dix worked tirelessly on behalf of those experiencing mental disorders. She campaigned for reform legislation and funds to establish suitable mental hospitals.  The moral treatment movement was energized in 1908 with the publication of A Mind That Found Itself, a book by Clifford Beers (1876–1943) about his own mental collapse. His book describes the terrible treatment he and other patients experienced in three mental institutions, where they were beaten, choked, spat on, and restrained with straitjackets. Now the early viewpoints, divided into: 1. Biological 2. Psychological Who were those famous people who propagated these views on mental illness? What were their contributions? Causes of Mental Illness: Early Viewpoints 1. biological viewpoint holds that mental disorders are the result of physiological damage or disease, 2. psychological viewpoint which stresses an emotional basis for mental illness. The Biological Viewpoint The ideas of Wilhelm Griesinger (1817–1868), a German psychiatrist who believed that all mental disorders had physiological causes, received considerable attention.  Emil Kraepelin (1856–1926), a follower of Griesinger, observed that certain symptoms tend to occur regularly in clusters, called syndromes. In his Textbook of Psychiatry (1883/1923), Emil Kraepelin outlined a system for classifying mental illnesses based on their physiological causes.  The acceptance of an organic or biological cause for mental disorders was enhanced by medical breakthroughs such as Louis Pasteur’s (1822–1895) germ theory of disease. The biological viewpoint gained even greater strength with the discovery of the biological basis of general paresis, a degenerative physical and mental disorder associated with late-stage syphilis (a sexually transmitted infection). In 1897, Richard von Krafft-Ebing, a German neurologist, proved conclusively that the serious mental symptoms associated with general paresis resulted from syphilis bacteria invading the brain. Finally, in 1905, a German zoologist, Fritz Schaudinn, isolated the microorganism that causes syphilis and develops into general paresis. These events strengthened the search for biological explanations for mental disorders. As medical breakthroughs in the study of the nervous system occurred, many scientists became hopeful that they would discover a biological basis for all mental disorders. The Psychological Viewpoint Psychological viewpoint—the belief that mental disorders are caused by psychological and emotional factors. For example, personal challenges or interpersonal conflicts can lead to intense feelings of frustration, depression, and anger, which may consequently lead to deteriorating mental health. Mesmerism and Hypnotism Mesmer developed a theory of “animal magnetism” contending that disruptions in the flow of magnetic forces in the body could produce physical problems and that the use of magnetism could restore the flow to normal. He developed a highly controversial treatment referred to as mesmerism, a technique that evolved into the modern practice of hypnotism. Used to treat hysteria Breuer and Freud The idea that psychological processes could produce mental and physical dysfunction soon gained credence among physicians who were using hypnosis. Viennese doctor Josef Breuer (1842–1925) discovered that after one of his female patients spoke quite freely about her past traumatic experiences while in a trance, many of her physical symptoms disappeared. cathartic method, the therapeutic use of verbal expression to release pent- up emotional conflicts. It foreshadowed the practice of psychoanalysis initiated by Sigmund Freud (1856–1939)— techniques that have had a lasting influence in the field of abnormal psychology.  Behaviorism The behavioristic perspective stressed the importance of directly observable behaviors and the conditions that evoked, reinforced, and extinguished them. It not only provided an alternative explanation regarding the development of both normal and abnormal behaviors but also offered successful procedures for treating some psychological conditions. Reflect on these: All through out these different eras/ time, how do our own people view mental illness? Is there any difference at all on how we Filipinos treat people with mental illnesses? What practices/ beliefs were/ are very much part of our culture? What about in our current time now, how do Filipinos look at mental disorder? Reference: Sue, D., Sue, D. W., Sue, D., & Sue, S. (2016). Understanding abnormal behavior. (11th ed.). Cengage Learning