LECTURE 1

Abnormal Behavior in Historical Context

Prepared by:
MISS NORZIHAN AYUB

Outline
Understanding Psychopathology
Historical Conceptions of Abnormal Behavior
The Supernatural Tradition
The Biological Tradition
The Psychological Tradition
The Present
The Scientific Method
An Integrative Approach

Focus Questions
How do psychologists define a psychological
disorder?
What is a scientist-practitioner?
What supernatural influences were formerly believed
to explain abnormal behavior?
How do psychological approaches including
psychoanalysis, humanism and behaviorism explain
abnormal behavior?

What is a Psychological Disorder?

Psychological dysfunction associated with distress
and/or impairment in functioning
Involves a response that is not typical or culturally
expected
May include cognitive, behavioral and/or emotional
elements

Distress, Impairment and Cultural

Context
Distress is normal in some situations
Dysfunctional distress occurs when person is much
more distressed than others would be
Impairment: Must be pervasive and/or significant
Mental disorders are often exaggerations of normal
processes (e.g., extreme shyness or sadness)
Culture: Consider normalcy relative to behavior of
others in same cultural context

Rule of thumb: Mental disorder = harmful dysfunction

What is a Psychological Disorder?

An Accepted Definition
Behavioral, psychological, or biological dysfunctions
that are unexpected in their cultural context and
associated with present distress and/or impairment
in functioning, or increased risk of suffering, death,
pain, or impairment

The Science of Psychopathology

Psychopathology: Scientific study of psychological
dysfunction
Mental health professionals
The Ph.D.: Clinical and counseling psychologist
(trained in research and delivering treatment)
The Psy.D.: Clinical and counseling Doctor of
Psychology (trained in delivering treatment)
M.D.: Psychiatrist
Psychiatric nurses
LICSW: Licensed clinical social worker (trained in
delivering treatment)

The Scientist-Practitioner
Practice (treatment delivery) and research mutually
influence each other
A scientist-practitioner:
Stays current with research in field
Evaluates own assessment and treatment
Conducts research

The Scientist-Practitioner

Clinical Description
Begins with the presenting problem
Symptoms (e.g., chronic worry, panic attacks)
Description aims to:
Distinguish clinically significant dysfunction from
common human experience
Describe prevalence and incidence of disorders

Clinical Description

Clinical Description
Describe onset of disorders
Acute vs. insidious onset
Describe course of disorders
Episodic, time-limited, or chronic course
Prognosis
Good vs. guarded
Consider age of onset, which may shape presentation

Causation, Treatment and Outcome

Etiology
What contributes to the development of
psychopathology?
Treatment development
How can we help alleviate psychological suffering?
Includes pharmacological, psychosocial, and/or
combined treatments

Historical Conceptions of Abnormal

Behavior
Major psychological disorders have existed across
time and cultures
Perceived causes and treatment of abnormal
behavior varied widely, depending on context

Historical Conceptions of Abnormal

Behavior
Three dominant traditions have existed in the past to
explain abnormal behavior
Supernatural
Biological
Psychological

The Supernatural Tradition

Deviant behavior as a battle of
Good vs. Evil
Believed to be caused by demonic possession,
witchcraft, sorcery
Treatments included exorcism, torture, religious
services

The Supernatural Tradition

Stress and melancholy = anxiety and depression
Competing view that coexisted with supernatural
tradition: insanity is caused by emotional stress,
not supernatural forces
Treatments: Rest, sleep, healthy environment,
baths, potions
Possession
Mental illness sometimes believed to reflect
possession by evil spirits
Treated by shocking/scaring out spirits (e.g.,
hang patient over snake pit)

The Supernatural Tradition

Mass hysteria
Saint Vituss Dance/Tarantism
Modern mass hysteria
Emotion contagion
Mob psychology
The moon and the stars
Paracelsus: Swiss physician suggested that mental
health problems are affected by pull of moon and
stars
Led to term lunatic

The Biological Tradition

Hippocrates (460-377 BC)
Father of modern Western medicine
Etiology of mental disorders = physical disease
Hysteria the wandering uterus psychological
symptoms were a result of the uterus moving
around in the body
Linked abnormality with brain chemical imbalances
Foreshadowed modern views
Galen (129-198 AD) extended Hippocrates work

Galenic-Hippocratic Tradition
Humoral theory of disorders: Functioning is related to
having two much or too little of four key bodily fluids
(humors)
Blood, phlegm, black bile, yellow bile
Example: Depression caused by too much black
bile
Treated by changing environmental conditions
(e.g., reducing heat) or bloodletting/vomiting

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

John P. Grey and the reformers
Psychiatrist who believed mental illness had physical
roots
Championed biological tradition in the U.S.
Led to reforms of hospitals to give psychiatric patients
better care

The Development of Biological

Treatments
Psychotropic medications became increasingly
available in 1950s
Electric shock
Crude surgery
Insulin (discovered by accident to calm psychotic
patients)
Major tranquilizers (discovered mid-20th C)
Minor tranquilizers (e.g., benzodiazepines)
commonly prescribed for anxiety today

Consequences of the Biological Tradition

Overall, mental illness understood to have physical
roots
Increased hospitalization
Mental illness often seen as untreatable condition
Improved diagnosis and classification
Emil Kraepelin was father of classification
Increased role of science in psychopathology

The Psychological Tradition

The rise of moral therapy
Became popular in first half of 19th century
Moral = referring to psychological/emotional
factors
Main idea: Treat patients as normally as possible
in normal environment
More humane treatment of institutionalized patients
Encouraged and reinforced social interaction

The Psychological Tradition

Proponents of moral therapy
Philippe Pinel and Jean-Baptiste Pussin patients
shouldnt be restrained
Benjamin Rush led reforms in U.S.
Dorothea Dix mental hygiene movement
Asylum reform > more patients getting care
Moral therapy declined because more difficult with
large groups of patients
Soon followed by emergence of competing alternative
psychological models

Psychoanalytic Theory
Freudian theory of the structure and function of the
mind
Unconscious
Catharsis
Psychoanalytic model sought to explain
development and personality)
Structure of the mind
Id (pleasure principle; illogical, emotional,
irrational)
Superego (moral principles)
Ego (rational; mediates between supergo/id)

Psychoanalytic Theory
Defense mechanisms: Egos attempt to manage
anxiety resulting from id/superego conflict
Displacement & denial
Rationalization & reaction formation
Projection, repression, and sublimation
Psychosexual stages of development
Oral, anal, phallic, latency, and genital stages
Theory: conflicts arise at each stage and must be
resolved

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 significant others and their images,
memories, and values

Later Developments in Psychoanalytic

Thought (continued)
The Neo-Freudians: Departures from Freudian
thought
De-emphasized the sexual core of Freuds theory
Examples:
Carl Jung emphasized the collective unconscious
Alfred Adler focused on feelings of inferiority,
invented inferiority complex

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

Psychodynamic Psychotherapy
Therapy with themes of psychoanalysis, but often
shorter and more goal-directed
Emphasizes conflicts and unconscious, may work to
uncover rauma and active defense mechanisms
Focus on:
Emotional expression
Avoidance and other cognitive or behavioral
patterns
Past experience
Interpersonal experience
Therapeutic relationship
Wishes, dreams, fantasies

Psychoanalytic Psychotherapy
Major criticism: Largely unscientific and untested
Contributions
Unconscious processes have been empirically
demonstrated
Emotions can be driggered by triggered by cues
outside of conscious awareness
Therapeutic alliance is important
Defense mechanisms

Humanistic Theory
Theoretical constructs
Intrinsic human goodness
Striving for self-actualization
Person-centered therapy
Carl Rogers (19021987)
Hierarchy of Needs
Abraham Maslow (19081970)
Humans fulfill basic needs first (e.g., food, safety)
before moving onto higher needs like self esteem

Humanistic Theory
Person-centered therapy
Therapist conveys empathy and unconditional
positive regard
Minimal therapist interpretation
No strong evidence that purely humanistic therapies
work to treat mental disorders
More effective for people dealing with normal life
stress, not suffering from psychopathology

The Behavioral Model

Derived from a scientific approach to the study of
psychopathology
Classical conditioning (Pavlov; Watson)
Ubiquitous form of learning
People learn associations between neutral stimuli
and stimuli that already have meaning
(unconditioned stimuli)
Conditioning explains the acquisition of some fears

The Behavioral Model

Classical conditioning concepts
Stimulus generalization
Start to respond in the same way to similar
stimuli. E.g., a child taught to fear the color red
(because it is paired with a loud, scary noise)
may also fear the color orange
Extinction
When the conditioned stimulus is repeatedly
presented without the unconditioned stimulus,
the association is weakened

The Behavioral Model

John B. Watson (18781958)
Believed that psychology should be as scientific
and objective as possible
Little Albert experiment: Baby Albert was taught
to fear a white rat when it was repeatedly paired
with a loud noise (classsical conditioning)
Mary Cover Jones
One of the first to treat phobias with exposure and
extinction of learned association

The Behavioral Model - Operant

Conditioning
E.L. Thorndike (18741949)
Law of effect: Behavior will repeated more often if it
is followed by good consequences and less often if
it is followed by bad consequences
B.F. Skinner (19041990)
Behavior operates on environment and is
managed by consequences (rewards and
punishments)
Behavior shaping: New behavior can be learned
by reinforcing successive approximations

The Beginnings of Behavior Therapy

Behavior therapy: Creating new associations by
practicing new behavioral habits, and/or reinforcing
useful behaviors with positive consequences
Behavior therapy tends to be time-limited and direct
Strong evidence supporting the efficacy of behavior
therapies
Example: Joseph Wolpe (19151997)
Systematic desensitization: Individuals gradually
exposed to fears (usually through imagination)
while practicing relaxation exercises

The Present: The Scientific Method and

an Integrative Approach
Defining and studying psychopathology
Requires a broad approach
Multiple, interactive influences
Biological, psychological, social factors
Scientific emphasis continues to be very important
The supernatural tradition no longer has a place
in a science of abnormal behavior
Advances in neuroscience and cognitive and
behavioral science will add to our knowledge