Durand%20and%20Barlow%20Chapter%201:%20%20Abnormal%20Behavior%20in%20Historical%20Context

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Chapter 1Abnormal Behavior in Historical Context
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Myths and Misconceptions About Abnormal Behavior

• No Single Definition of Psychological Abnormality
• No Single Definition of Psychological Normality

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

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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

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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

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The Science of Psychopathology (continued)

• M.S.W.s Psychiatric and non-psychiatric social
  workers
• MN/MSNs Psychiatric nurses
• Lay public and community groups
• United by the Scientist-Practitioner Framework

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The Scientist-Practitioner

• Producers of Research
• Consumers of Research
• Evaluators of Their Work Using Empirical Methods

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Functioning as a Scientist-Practitioner
Fig. 1.2, p. 6
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Clinical Description

• Begins with the Presenting Problem
• Description Aims to
• Distinguish clinically significant dysfunction
  from common human experience
• Describe Prevalence and Incidence of Disorders

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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

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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

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Causation, Treatment, and Outcome (continued)

• Treatment Outcome Research
• How do we know that we have helped?
• Limited in specifying actual causes of disorders

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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

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Historical Conceptions of Abnormal Behavior
(continued)

• Three Dominant Traditions
• Supernatural
• Biological
• Psychological

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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

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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

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The Biological Tradition (continued)

• Galenic-Hippocratic Tradition
• Linked abnormality with brain chemical imbalances
• Foreshadowed modern views

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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

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The 19th Century (continued)

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

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Consequences of the Biological Tradition

• Mental Illness Physical Illness
• Emil Kraeplin
• Diagnosis and Classification

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The Psychological Tradition

• The Rise of Moral Therapy
• More humane treatment of institutionalized
  patients
• Encourage and reinforced social interaction

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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 Pinels lead in England
• The Falling Out of Moral Therapy
• Emergence of Competing Alternative Psychological
  Models

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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)

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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

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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

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Later Developments in Psychoanalytic Thought
(continued)

• The Neo-Freudians Departures From Freudian
  Thought
• De-emphasized the sexual core of Freuds theory
• Jung, Adler, Horney, Fromm, and Erickson

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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

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Humanistic Theory

• Major Players
• Abraham Maslow and Carl Rogers
• Major Themes
• That people are basically good
• Humans strive toward self-actualization

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Humanistic Theory (continued)

• Humanistic Therapy
• Therapist conveys empathy and unconditional
  positive regard
• Minimal therapist interpretation
• No strong evidence that humanistic therapies work

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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

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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

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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

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The Present An Integrative Approach

• Psychopathology Is Multiply Determined
• Unidimensional Accounts of Psychopathology Are
  Incomplete

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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