1Abnormal PsychologyDouglas A.HckerAdjunct Professor of Social and Behavioral SciencesChapter 1Abnormal Psychology: Past and PresentMental IllnessWho are we talking about?NIMH StudySurveyed 20,000 people to determine how mental illness affects lives.Found that 1 in 5 people will suffer from some form of mental disorder in their lifetime.Impact of Mental DisordersIf you include families of mentally ill people, 50% of us will be affected by mental disorder, either our own or someone we love.Common TermsMental disturbanceNervous Breakdown(psychotic episode)Abnormal Psychology: Past and PresentWhat is abnormal psychology?The field devoted to the scientific study of abnormal behavior to describe, predict, explain, and change abnormal patterns of functioningWorkers may be:Clinical scientists Clinical practitioners Types of Mental Health Care WorkersFamily and marriage counselors2Types of Clinical PsychologistsCognitive psychologists:behavioral modification therapyPositive PsychologistsOther Mental Health Workers?What Is Psychological Abnormality?Although many definitions have been proposed, none is universally acceptedMost definitions share some common featuresThe Four DsDeviance Different, extreme, unusualDistress Unpleasant & upsettingDysfunction Causes interference with lifeDanger Poses risk of harmDevianceFrom what?From behaviors, thoughts, and emotions considered normal in a specific place and time and by specific peopleFrom social norms Stated and unstated rules for proper conduct in a given society or cultureExamples?Judgments of deviance also depend on specific circumstances (i.e., social context, cultural norms)DistressAccording to many clinical guidelines, behavior must be personally distressing before it can be labeled abnormalNot always the caseExamples?DysfunctionAbnormal behavior tends to be dysfunctional it interferes with daily functioningCulture has an influence on determinations of dysfunction, as wellDysfunction alone does not necessarily indicate psychological abnormalityDanger Abnormal behavior may become dangerous to oneself or othersBehavior may be careless, hostile, or confusedAlthough cited as a feature of psychological abnormality, being dangerous is the exception rather than the ruleThe Elusive Nature of AbnormalityUltimately, a society selects the general criteria for defining abnormality and then uses those criteria to judge particular casesSzasz argues that, because of the influence of society, the whole concept of mental illness is invalidDeviations called abnormalare only problems of livingSocieties use the concept of mental illness to control those whothreaten social orderThe Elusive Nature of AbnormalityEven if we agree with the concept of abnormality, it is often applied inconsistentlyExamples:Diagnosis of alcohol problems in collegesIssue of abnormality versus eccentricityThe Elusive Nature of AbnormalityIn short, although abnormality generally is defined as behavior that is deviant, distressful, dysfunctional, and dangerous, these criteria often are vagueWhat Is Treatment?Once abnormality is determined, clinicians attempt to treat itTreatment (or therapy) is a procedure designed to change abnormal behavior into more normal behaviorIt, too, requires careful definitionWhat Is Treatment?According to Frank, all forms of therapy have three essential features:1.A sufferer who hopes the healer can provide relief2.A trained, socially accepted healer whose expertise is accepted by the sufferer and his or her social group3.A series of contacts between the healer and the sufferer, through which the healer tries to produce certain changes in the sufferers emotional state, attitudes, and behavior What Is Treatment?Despite the clarity of the definition, clinical therapy is surrounded by confusion and conflict:Lack of agreement about goals or aimsLack of agreement about successful outcomesLack of agreement about failureAre clinicians seeking to cure? To teach?Are sufferers patients (ill) or clients (having difficulty)?What Is Treatment?Despite these disagreements, most clinicians agree that large numbers of people need therapyResearch indicates that therapy often is helpfulHow Was Abnormality Viewed and Treated in the Past?Much of todays thinking about abnormal psychology is built on past approaches and ideas, rather than being a rejection of these ideas Theories and themes about abnormal psychology occur again and again; progress has not been a steady movement forwardAncient Views and TreatmentMost historians believe that prehistoric societies regarded abnormal behavior as the work of evil spiritsMay have begun as far back as the Stone AgeThe cure for abnormality was to force the demons from the body through trephination and exorcismHow Was Abnormality Viewed and Treated in the Past?In any given year in the US, 30% of adults and 19% of children display serious psychological disturbances and are in need of treatmentIn addition, most people have difficulty coping at various timesin their livesIs this the fault of modern society?Not entirely; historical records demonstrate that every society has witnessed psychological abnormality and had its own form of treatmentGreek and Roman Views and Treatments500 B.C.to A.D.500 A.D.Many psychological disorders were identifiedHippocrates believed that abnormality was a disease arising frominternal physical problemsHe looked to an unbalance of the four humorsHis suggested treatment that attempted to rebalanceEurope in the Middle Ages: Demonology ReturnsA.D.500 1350With the rise of clergy came the downplay of scienceAbnormality was again seen as a conflict between good & evilThe incidence of abnormality increased dramatically as outbreaksof mass madness occurred Earlier (largely discarded) treatments such as exorcism re-emerged At the close of the Middle Ages, demonology began to lose favor again5The Renaissance and the Rise of AsylumsA.D
.1400 1700German physician Johann Weyer believed that the mind was as susceptible to sickness as th
Chapter 1 - Abnormal Behavior in Historical ContextAbnormal Psychology (PS265)Class Notes GuideShoshana SlomanDEFINING "PSYCHOLOGICAL DISORDER"A psychological dysfunction within an individual associated with distress or impairment in functioningand a resonse that is not typical or culturally expected.Each criterion contributes something to the definition.
Any one element, alone, would not constitute a psychological for judging)Psychological Dysfunction:Breakdown of cognitive, emotional, or behavioral do we draw the line?
Considered a continuum or dimension, rather than being present orabsent.(dys = Greek for bad, abnormal, difficult)(ab = Latin for off, away from; norma = rule -- abnormal = deviating from the norm, from the rule)Personal Distress or Impairment:Distress: The individual is usually extremely upset about the dysfunction.This is not ALWAYS the case, however, as is often true with with normal activities, with achieving things that the person wants to.But not always.
Depends on the severity.
(Some simple phobias, for example.)Illustrates how most psychological disorders are extreme expressions of otherwise normal behavior.Atypical or Not Culturally Expected:Deviates from the average, the greater the deviation, the more abnormal, but that doesnt automatically imply a disorder.
(Pro athletes, talented artists.)
More productive, more
tolerated.To use this criterion alone has led to abuses--political prisoners in Soviet Union, DSM-IV-TR Definition:(Diagnostic and Statistical Manual of Mental Disorders-fourth edition-text rev)Behavioral, emotional, or cognitive dysfunctions that are unexpected in their cultural context and associated with personal distress or substantial impairment in functioning.When using this definition, we need to take culture and subculture into account, to determine whatwould be functional for a given society.
(More in Chapter 3.)THE SCIENCE OF PSYCHOPATHOLOGYScientific study of pscyhological disorders.Specially trained professionals--clinical & counseling psych (5-year training for PhD, PsyD, EdD)Psychiatrists (MD, then special psychiatric training during their 3-4 year residency) tend to biologicalPsychiatric social workers (MSW, expertise in collecting info about social and family situation ofpeople with psych disorders, also treat problems (often concentrating on family problems ass.w/dis)Psychiatric nurses (w/master's or doctoral degrees); therapists and counselors with masters degreesScientist-Practitioner Model:Mental health professionals who take a scientific approach are up with scientific developments in their field (consumers of science)*Evaluate their own assement/treatment procedures
(evaluators of science)*Conduct research (clinics or hospitals) that produces new info about disorders and treatment(Creators of science)Chapter 1 - Abnormal Behavior in Historical ContextAbnormal Psychology (PS265)Class Notes GuideShoshana Slomanpage 2Basic Categories for Research into Psychopathology (and associated terms):Clinical Description:
(Clinical = types of problems and activities of assessment/treatment)*Presenting problem--"presents"Statistical data:*Prevalence--how many people in a given population have the disorder*Incidence--how many new cases of the disorder occur during a given time period *sex ration
*age of onset*Course--the pattern of dev and change of the disorder--chronic, episodic, time-limited*Onset--acute (sudden), or insidious (gradually over a period of time)*Prognosis--anticipated courseCausation:Etiology (Greek roots--study of causes), including biological, psychological, and social dimensions.Treatment & Outcomes:Studying what kinds of treatments help which disorders.
Can also provide clues to causes, but itis not always as simple as that--(book--aspirin to relieve headache doesn't imply a lack of aspirin).However, it can give hints.Always agents outside ourselves, depend on pop theories of the time.HISTORICAL CONCEPTIONS OF ABNORMAL BEHAVIOR Supernatural:*Demons and witches*Paracelsus (Swiss dr early 1500's--lunatic, stars, etc)*Result of sinful behaviorTried to exorcise the demons, if that didn't work make body uninhabitable (by torture), scare themout (snake pit), other forms of "shock" treatments (dunking in icy water)SOMETIMES SHOCK OR EXORCISM WORKS.Biological:Hippocrates (Greek physician 460-377 BCE), considered father of modern medicine.understood brain to be seat of wisdom, consciousness, intelligence, and emotion.
Disorders resultfrom injuries, disease, genetics, psychological factors (stressful family life).Galen (Roman physician 129-128 CE) adopted and developed Hippocrates' ideas.Humors--blood (heart), black bile (spleen), yellow bile or choler (liver), and plegm (brain).
Too much black bile (melancholer) caused depression, etc.
First theory of "chemical imbalance".Treatment=rest, good diet, remove sources of stress, and bleeding (or bloodletting).
Also inductionof uterus causing somatoform symptoms.
Thought restricted to fem.Syphilis General paresis comes 15-20 years after intial syphlis infection.Causes delusions of persecution,delusions of grandeur, personality changes, mood changes, psychotic,but deterioriated and died w/in 5 years.
Pasteur's germ theory (1870) helped identify the fact thatall symptoms of the disease were caused by a germ.
Initially discovered that contraction ofthe malaria infection cured the disease (because of the fever) and used infected blood to treat.John P.
Grey was influential in the 19th century in advocating for the biological approach.
Treatmental patients the same as any physically ill person--rest, nutrition, hospitalization.
(Invented fan)Hospitals became large and impersonal, leaders called for downsizing.
(100 years later deinstitution-alization)Chapter 1 - Abnormal Behavior in Historical ContextAbnormal Psychology (P
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