Chapter 1Abnormal Behavior in

Historical Context

Myths and Misconceptions About Abnormal Behavior

• No Single Definition of Psychological Abnormality

• No Single Definition of Psychological Normality

What is a Psychological Disorder?

• Psychological Dysfunction– Breakdown in cognitive, emotional, or

behavioral functioning• Personal Distress

– Difficulty performing appropriate and expected roles

– Impairment is set in the context of a person’s background

• Atypical or Not Culturally Expected Response – Reaction is outside cultural norms

Abnormal Behavior Defined

• Working Definition– A psychological dysfunction associated

with distress or impairment in functioning that is not typical or culturally expected

• The Diagnostic and Statistical Manual (DSM-IV-TR)– DSM Contains Diagnostic Criteria

• The Field of Psychopathology – The scientific study of psychological

disorders

The Science of Psychopathology

• Mental Health Professionals

– The Ph.D.’s: Clinical and counseling psychologists

– The Psy.D.’s: Clinical and counseling “Doctors of Psychology”

– M.D.’s: Psychiatrists

The Science of Psychopathology (continued)

– M.S.W.’s: Psychiatric and non-psychiatric social workers

– MN/MSN’s: Psychiatric nurses

– Lay public and community groups

• United by the Scientist-Practitioner Framework

The Scientist-Practitioner

• Producers of Research

• Consumers of Research

• Evaluators of Their Work Using Empirical Methods

Fig. 1.2, p. 6

Functioning as a Scientist-Practitioner

Clinical Description

• Begins with the Presenting Problem

• Description Aims to

– Distinguish clinically significant dysfunction from common human experience

• Describe Prevalence and Incidence of Disorders

Clinical Description (continued)

• Describe Onset of Disorders

– Acute vs. insidious onset

• Describe Course of Disorders

– Episodic, time-limited, or chronic course• Prognosis

– Good vs. guarded

Causation, Treatment, and Outcome

• Etiology

– What contributes to the development of psychopathology?

• Treatment Development

– How can we help alleviate psychological suffering?

– Includes pharmacologic, psychosocial, and/or combined treatments

Causation, Treatment, and Outcome (continued)

• Treatment Outcome Research

– How do we know that we have helped?

– Limited in specifying actual causes of disorders

Historical Conceptions of Abnormal Behavior

• Major Psychological Disorders Have Existed

– In all cultures

– Across all time periods

• Causes and Treatment of Abnormal Behavior

– Varies Widely Across cultures, time periods, world views

Historical Conceptions of Abnormal Behavior (continued)

• Three Dominant Traditions

– Supernatural

– Biological

– Psychological

The Supernatural Tradition

• Deviant Behavior as a Battle of “Good” vs. Evil

– Caused by demonic possession, witchcraft, sorcery

– Treatments included exorcism, torture, beatings, and crude surgeries

• The Moon and the Stars

– Paracelsus and lunacy

The Biological Tradition

• Hippocrates: Abnormal Behavior as a Physical Disease

– Hysteria “The Wandering Uterus”

• Galen Extends Hippocrates Work

– Humoral theory of mental illness

– Treatments remained crude

The Biological Tradition (continued)

• Galenic-Hippocratic Tradition

– Linked abnormality with brain chemical imbalances

– Foreshadowed modern views

The 19th Century

• General Paresis (Syphilis) and the Biological Link With Madness

– Several unusual psychological and behavioral symptoms

– Pasteur discovered the cause – A bacterial microorganism

– Led to penicillin as a successful treatment

– Bolstered the view that mental illness = physical illness

The 19th Century (continued)

• John Grey and the Reformers– Championed biological tradition in the USA

Consequences of the Biological Tradition

• Mental Illness = Physical Illness

• Emil Kraeplin

– Diagnosis and Classification

The Psychological Tradition

• The Rise of Moral Therapy

– More humane treatment of institutionalized patients

– Encourage and reinforced social interaction

The Psychological Tradition (continued)

• Proponents of Moral Therapy– Philippe Pinel and Jean-Baptiste Pussin– Benjamin Rush – Led reforms in U.S.– Dorothea Dix – Mental hygiene movement– William Tuke - Followed Pinel’s lead in

England• The Falling Out of Moral Therapy• Emergence of Competing Alternative

Psychological Models

Psychoanalytic Theory

• Freudian Theory of the Structure and Function of the Mind

• Structure of the Mind

– Id (pleasure principle; illogical, emotional, irrational)

– Ego (reality principle; logical and rational)

– Superego (moral principles; keeps Id and Ego in balance)

Psychoanalytic Theory (continued)

• Defense Mechanisms: Ego Loses the Battle with the Id and Superego

– Displacement & denial

– Rationalization & reaction formation

– Projection, repression, and sublimation

• Psychosexual Stages of Development

– Oral, anal, phallic, latency, and genital stages

Later Developments in Psychoanalytic Thought

• Anna Freud and Self-Psychology

– Emphasized influence of the ego in defining behavior

• Melanie Klein, Otto Kernberg, and Object Relations Theory

– Emphasized how children incorporate (introject) objects

– Objects – images, memories, and values of significant others

Later Developments in Psychoanalytic Thought (continued)

• The Neo-Freudians: Departures From Freudian Thought

– De-emphasized the sexual core of Freud’s theory

– Jung, Adler, Horney, Fromm, and Erickson

Psychoanalytic Psychotherapy: The “Talking” Cure

• Unearth the Hidden Intrapsychic Conflicts – “The Real Problems”

• Therapy Is Often Long Term• Techniques

– Free Association– Dream Analysis

• Examine Transference and Counter-Transference Issues

• Little Evidence for Efficacy

Humanistic Theory

• Major Players

– Abraham Maslow and Carl Rogers

• Major Themes

– That people are basically good

– Humans strive toward self-actualization

Humanistic Theory (continued)

• Humanistic Therapy

– Therapist conveys empathy and unconditional positive regard

– Minimal therapist interpretation

• No strong evidence that humanistic therapies work

The Behavioral Model

• Derived from a Scientific Approach to the Study of Psychopathology

• Classical Conditioning (Pavlov; Watson)

– Ubiquitous form of learning

– Contingency between neutral and unconditioned stimuli

– Conditioning was extended to the acquisition of fear

The Beginnings of Behavior Therapy

• Challenged Psychoanalysis and Non-Scientific Approaches

• Early Pioneers– Joseph Wolpe – Systematic

desensitization• Operant Conditioning (Thorndike; Skinner)

– Another ubiquitous form of learning– Voluntary behavior is controlled by

consequences

The Beginnings of Behavior Therapy (continued)

• Learning Traditions Influenced the Development of Behavior Therapy– Behavior therapy tends to be time-limited

and direct– Strong evidence supporting the efficacy of

behavior therapies

The Present: An Integrative Approach

• Psychopathology Is Multiply Determined

• Unidimensional Accounts of Psychopathology Are Incomplete

The Present: An Integrative Approach (continued)

• Must Consider Reciprocal Relations Between

– Biological, psychological, social, and experiential factors

• Defining Abnormal Behavior

– Complex, multifaceted, and has evolved

• The Supernatural Tradition

– Has no place in a science of abnormal behavior