ABNORMAL PSYCHOLOGY: AN INTEGRATIVE APPROACH 7TH EDITION
BY BARLOW AND DURAND
CHAPTER 1: ABNORMAL BEHAVIOR IN HISTORICAL CONTEXT
UNDERSTANDING
... [Show More] PSYCHOPATHOLOGY
A. What is Psychological Disorder
- Psychological Disorder is a psychological dysfunction within an individual associated with
distress or impairment in functioning and a response that is not typically or culturally expected
o Psychological Dysfunction
▪ Refers to a breakdown in cognitive, emotional or behavioral functioning
▪ Knowing where to draw the line between normal and abnormal dysfunction is
often difficult
o Personal Distress or Impairment
▪ That the behavior must be associated with distress to be classified as abnormal
adds and important component and seems clear: the criteria is satisfied if the
individual is extremely upset
▪ It is quite normal to be distressed, the human condition is such that suffering, and
distress are very much part of life, thus defining psychological disorder by distress
alone doesn’t work, although it contributes
▪ Psychological disorders are simply extreme expression of otherwise normal
emotions, behaviors, and cognitive process
o Atypical or Not Culturally Expected
▪ Something is considered abnormal because it occurs infrequently, it “deviates from
the average”, but doesn’t work well as a definition for abnormal behavior
▪ Behavior is abnormal if you are violating social norms, even if number if people
are sympathetic to your point of view
▪ A social standard of normal has been misused, however, a harmful dysfunction
- An accepted Definition
o The most widely accepted definition used in DSM describes behavioral, psychological, or
biological dysfunction that are unexpected in the cultural context and associated with
present distress and impairment in functioning, or increased risk of suffering, death, pain
or impairment
- Prototype – a typical profile of a disorder that best distinguished a dysfunction from a not
dysfunction
THE SCIENCE OF PSYCHOPATHOLOGY
- Psychopathology is the scientific study of psychological disorder
- Clinical Psychologist and counseling psychologist received the Ph.D. degree and follow a course
of graduate – level study, which prepares them to conduct research into the causes and treatment
of psychological disorders and to diagnose, assess and treat these disorders
- Psychologist first earn M.D. degree and then specialist in psychiatry
o Also investigate the nature and cause of psychological disorder, often from a biological
point of view, make diagnoses, and offer treatment
- Psychiatric social workers can earn a master’s degree in social work as they develop expertise in
collecting information relevant to the social and family situation of the individual with a
psychological disorder
- Psychiatric nurses have advanced degrees, such as a master’s or even Ph.D., and specialized in the
care and treatment of patients with psychological disorders
- Marriage and family therapist and mental health counselors typically spend 1 – 2 years earning a
master’s degree and are employed to provide clinical services under the supervision of a doctoral
– level clinician
A. The Scientist – Practitioner
- many mental health professionals take a scientific approach to their clinical work and therefore
called scientist – practitioners
- mental health practitioners may function as scientist – practitioners in one or more of the three
ways:
o they may keep up with the latest scientific development in their field and therefore use the
most current diagnostic and treatment procedures (consumer of science)
o evaluate their own assessments or treatment procedures to see whether they work
(evaluator of science)
o might conduct research, that produces new information about disorder or their treatment,
thus becoming immune to the fads that plaque our field (creator of science)
- scientific data attempts three basic things:
o to describe psychological disorder (clinical description)
o to determine their cause (causation or etiology)
o to treat them (treatment and outcome)
B. Clinical Description
- Clinical description is the unique combination of behaviors, thoughts, and feelings that make up
a scientific disorder
o Is to specify what makes the disorder different from normal behavior or from other disorder
o Statistical data may also be relevant
- Prevalence of the disorder – how many people in the population as a whole have the disorder
- Incidence of the disorder – how many new cases occur during a given period, such as a year
- Course – an individual pattern followed by a certain disorder
o Chronic course – tend to last for a long time
o Episodic course – recurrence of the disorder
o Time – limited course – disorder will improve without treatment in a relatively short
period
- Differences on onset:
o Acute onset – they begin suddenly
o Insidious onset – develop gradually over an extended period
- It is important to know thy typical course of a disorder so that we can know what to expect in the
future and how best to deal with the problem
- Prognosis – the anticipated course of a disorder
- A patient’s age may be an important part if the clinical description
- Developmental psychopathology is the study of the changes in abnormal psychology
- Life – span development psychopathology is the study of abnormal behaviors across the entire age
span
C. Causation, Treatment and Etiology Outcomes
- Etiology, or the study of origins, has to do with why a disorder begins (what causes it) and includes
biological, psychological, and social dimensions
- If a new drug or psychosocial treatment is successful in treating a disorder, it may give us some
hints about the nature of the disorder and its causes
- Psychopathology is rarely simple because the effect does not necessarily imply to a cause
HISTORICAL CONCEPTIONS OF ABNORMAL PSYCHOLOGY
A. The Supernatural Tradition
- Deviant behavior has been considered a reflection of the battle between good and evil
a. Demons and Witches
o In 14th century, one strong current of opinions put the causes and treatment of psychological
disorder squarely in the realm of the supernatural
o Bizarre behavior of the people afflicted with psychological disorder was seen as the work
of the devil and witches thus turned to magic and sorcery to solve the problem
o Exorcism – a treatment which various religious rituals were performed in an effort to rid
the victim of evil spirit
o Insanity was a natural, phenomenon, caused by mental or emotional stress, and that it was
curable
o With a perceived connection between evil deeds and sins on the one head and
psychological disorder on the other, it is logical to conclude that the sufferer is largely
responsible for the disorder, which might well be punished by evil deed
o If exorcism failed, some authorities thought that steps were necessary to make the body
uninhabitable by evil spirits, and many people were subjected to confinement, beatings,
and other forms of torture
o Hanging people over a pit full of poisonous snakes might scare the evil spirits right out
their bodies
o Many other treatments based in the hypothesized therapeutic element of shock were
developed, including dunking in ice – cold water
b. Mass Hysteria
o a large – scale outbreaks of bizarre behavior by many people at the same time and at once
o also called as Saint Vitus’ dance and Tarantism
o one reasonable guess was reaction to insect bites
c. Modern Mass Hysteria
o Mass hysteria may simply demonstrate the phenomenon of emotion contagion, in which
the experience of an emotion seems to spread to those around us
o Mob psychology – since people are suggestible when they are in states of high emotions,
therefore, if one person, identifies a cause of the problem, others will assume that their own
reactions have the same source
d. The Moon and the Stars
o The movements of the moon and stars had profound effects of people’s psychological
functioning
o The gravitational effects of the moon on the body fluids might be a possible cause of mental
disorder
o This belief is most noticeable today in the followers of astrology
e. Comments
o the supernatural tradition in psychopathology is alive and well, although it is relegated
o members of organized religions in most part of the world look to psychology and medical
science for help with major psychological disorders; in fact, the Roman Catholic Church
requires that all health care resources be exhausted before spiritual solutions such as
exorcism can be considered
B. The Biological Tradition
a. Hippocrates and Galen
o Hippocrates is the father of modern west medicine
▪ Suggested that psychological disorder could be treated like any other diseases,
causes by brain pathology or head trauma or heredity
▪ Considered the brain to be the seat of wisdom, consciousness, intelligence and
emotions
▪ Recognizes the importance of psychological and interpersonal contributions to
psychopathology
o Galen later adopted the ideas of Hippocrates and developed them further, creating a
powerful and influential school of thought within the biological tradition
o The Humoral Theory of disorder
▪ Normal brain functioning was related to four bodily fluids or humors
▪ Disease resulted from too much or too little of the humors
▪ The first example of associating psychological disorders with a “chemical
imbalance”
▪ Four humors and their personality traits:
• Blood from the Heart – cheerful, optimistic
• Black Bile from the Spleen – depressive
• Phlegm from the Brain – apathy and sluggish or calm
• Choler or Yellow Bile from the Liver – hot tempered
▪ Excess of one or more humors were treated by regulating the environment to
increase or decrease heat dryness, moisture, or cold (Greek’s concept), depending
on which humor was out of balance
▪ Bleeding or bloodletting – a carefully measured amount of blood was removed
from the body, often with leeches
▪ Other treatment include inducing vomiting through eating tobacco and half –
boiled cabbage
o A similar situation in ancient China, except that instead if humor, the Chinese focused on
the movement of the air or wind in the body
▪ Mental disorder were caused by blockages of wind or the presence of cold dark
wind (yin) as opposed to warm, life – sustaining wind (yang)
▪ Treatment involved restoring proper flow of wind through various methods,
including acupuncture
o Hippocrates also coined the word hysteria or known today as Somatic Symptom Disorder
▪ The physical symptoms appear to be the result of a medical problem for which no
physical cause can be found, such as paralysis and some kind of blindness
▪ Was assumed (by Egyptians) that the empty uterus wandered to various parts of
the body in search of conception
▪ Treatment includes marriage or fumigation of the vagina
▪ Called as the wandering uterus theory
b. The 19th Century
o The discovery of nature and cause of syphilis, and strong support from the well – respected
American Psychiatrist John P. Grey
o Syphilis
▪ Behavioral and cognitive symptoms of what we know as advance syphilis, a
sexually transmitted disease caused by a bacterial microorganism entering the
brain, including delusion of persecution, and grandeur, as well as other bizarre
behaviors
▪ Sufferers are a subgroup of apparently psychotic patients that deteriorated steadily,
becoming paralyzed, and dying within five years of onset
▪ The condition was designated a disease, called general paresis in 1825
▪ Treatment was deliberately injecting other patients with blood from a soldier with
malaria because physicians observed a surprising recovery in patients with general
paresis who had malaria
o John P. Grey
▪ The champion of the biological tradition in the US
▪ Grey’s position was that the causes of insanity were always physical, therefore,
mental ill patient should be treated as physically ill
c. The Development of Biological Treatments
o Renewed interest in the biological origin of psychological disorders led, ultimately, to
greatly increase understanding of biological contributions to psychopathology and the
development of new treatment
o Insulin Shock Therapy – insulin was occasionally given to stimulate appetite in psychotic
patients who were not eating, but it also served to calm them down
o Electroconvulsive Therapy – treatment wherein applying electric shock directly to the brain
o The first effective drug for severe psychotic disorder were developed; Rauwolfia serpentine
(resperine), neuroleptics (major tranquilizers), and Benzodiazepines (minor tranquilizers)
o Bromides, a class sedating drugs, was reported to treat anxiety and other psychological
disorder but later disappeared from the scene after side effects began to show
o Neuroleptics have also been used less as attention has focused on their many side effects
d. Consequences of the Biological Tradition
o Emil Kraepelin – one of two founding fathers of modern psychiatry
▪ Was one of the first to distinguish among various psychological disorders, seeing
that each may have a different age of onset and time course, with somewhat
different clusters of presenting symptoms and probably a different course
C. The Psychological Tradition
- Plato believed that the two causes of maladaptive behavior were the social and cultural influences
of one’s life and the learning that took place in the environment
- Advocate for human and responsible care for individuals with psychological disturbances
a. Moral Therapy
o Treating institutionalized patients as normally as possible in setting that encouraged and
reinforced normal social interaction, thus, provided them with many opportunities for
appropriate social and interpersonal contact
o Moral therapy as a system originated with the well – known French psychiatrist, Phillippe
Pinel and his close associate Jean Baptiste Pussin
o it was the rise of moral therapy that made asylum habitable and even therapeutic
b. Asylum Reform and the Decline of Moral Therapy
o Human treatment declined because of a convergence of factors:
▪ Moral therapy worked best when the number of patients in an institution was 200
fewer, allowing for great deal of individual attention
▪ Mental hygiene movement by Dorothea Div
▪ Reemerging in several different school of thought in the 20th century
c. Psychoanalytic Theory
o Fran Anton Mesmer – the father of hypnosis, a state in which extremely suggestible
subjects sometimes appear to be in a trance
o Jean Martin Charcot – demonstrated that some technique of mesmerism were effective
with a number of psychological disorders, and he did much legitimate the fledging practice
of hypnosis
o Breur and Freud had discovered the unconscious mind and its apparent influences on the
production if psychological disorder
o Catharsis – a therapeutic process to recall and relive emotional trauma that has been made
unconscious and to release the accompanying tensions
o Psychoanalytic Theory by Sigmund Freud
▪ The structure of the Mind
• Id – the source of strong sexual and aggressive feelings and energies
o Drives within the id are libido and Thanatos (sex and aggression)
o Pleasure principle – maximizing pleasure and eliminating any
associated conflicts or tension
o Emotional, irrational, illogical, filled with fantasies, preoccupied
with sex, aggression, selfishness and envy
• Ego – part of our mind that ensure that we act realistically
o Realistic principle
o Characterized by logic and reasoning
• Super ego – conscience, the moral principle
o Voice within that nags at us when we know we’re doing
something wrong
• If ego unsuccessfully manage the id and the superego into harmony,
psychological disorder will develop or intrapsychic conflicts
▪ Defense Mechanism
• Unconscious protective processes that keep primitive emotions associated
with conflicts in check so that the ego can continue its coordinating
function
• Phobic and obsessive symptoms are especially common self – defeating
defensive reactions that reflect an inadequate attempt to deal with an
internally dangerous situation
• Reduction in maladaptive defense mechanisms, and strengthening of
adaptive mechanisms such as humor and sublimation, correlated with
psychological health
• Examples of defense mechanism are denial, displacement, projection,
rationalization, reaction formation, repression, sublimation
▪ Psychosexual Stages of Development
• The stages represent distinctive patterns of gratifying our basic needs, and
satisfying our drive for physical pleasure
• If we did not receive appropriate gratification during a specific stage, on
that specific stage left a particular strong impression (which Freud termed
as Fixation), an individual’s personality would reflect on the stage
throughout adult life
o Oral stage might result in excessive thumb sucking, and emphasis
on oral stimulation through overeating, chewing pencils, biting
fingernails
▪ Dependency and passivity personality in reaction with
rebelliousness and cynicism
▪ Later Developments in Psychoanalytic Theory
• Ego Psychology by Anna Freud concentrated on the way in which the
defense reactions of the ego determine our behavior
• Self – Psychology by Heinz Kohut focused on a theory of the formation
of self – concept and the crucial attributes of the self that allow an
individual to progress towards health
• Object Relation is the study of how children incorporate the images, the
memories, and sometimes the values of a person who was important to
them and to whom they were emotionally attached
• Erick Erickson greatest contribution was his theory of development across
life span
▪ Psychoanalytic Psychotherapy
• Many techniques are designed to reveal the nature of unconscious mental
process and conflicts through catharsis and insight
• Free association – patients are instructed to say whatever comes to mind
without the usual socially required censoring
• Dream analysis – therapist interprets the content of dreams, supposedly
reflecting the primary process thinking of the id, and the systematically
relates the dreams to symbolic aspects of the unconscious conflicts
• Transference – patients come to relate to the therapist much as they did
to important figures in childhood
• Counter transference – therapist project some of their own personal
issues and feelings, usually positive, onto the patient
▪ Psychodynamic Psychotherapy
• Focus on affect and the expression of patient’s emotions
• An exploration of patients’ attempt to avoid topics or engage in activities
that hinder the progress of therapy
• The identification of patterns in patients’ actions, thoughts, feelings,
experiences and relationships
• An emphasis on past experiences
• A focus on patients’ interpersonal experience
• An emphasis on the therapeutic relationship
• An exploration of patients’ wish, dreams and fantasies
o Comments
▪ A major criticism of psychoanalysis is that it is basically unscientific, relying on
the reports by the patients of events that happened years ago
▪ Study of psychoanalytic events and observations have been valuable in both of
psychopathology and therapy and of history
d. Humanistic Theory
o Self – actualizing was the watchword for this movements
▪ All of us could reach our highest potential, in all areas of functioning, if only we
had the freedom to grow
o Because every person is basically good and whole, most blocks originate outside the
individual
o Abraham Maslow’s Hierarchy of Needs
▪ We cannot progress up the hierarchy until we have satisfied the needs at lower
level
o Carl Roger’s Person – Centered Therapy
▪ Most influential humanist
▪ The point is to give the individual a chance to develop during the course of therapy,
unfettered by threats to the self
▪ The hope for result of person – centered therapy is that clients will be more straight
– forwarded and honest with themselves and will access their innate tendencies
towards growth
▪ Rather than seeing the relationship as a mean to an end (transference), humanistic
therapists believed that relationships, including the therapeutic relationships, were
the single most positive influence in facilitating human growth
▪ The humanistic model found its greatest application among individuals without
psychological disorder
e. The Behavioral Model
o Also known as cognitive behavioral model or social learning model, brought the systematic
development of a more scientific approach to psychological aspects of psychopathology
o Pavlov and Classical Conditioning [Show Less]