PSY 8- ABNORMAL PSYCH
 Decriminalization
CHAPTER 1
 Psychopathology- the field concerned
with the nature, development, and
treatment of mental disorders, keep in
mind that the field is continually
developing and adding new findings.
 Stigma-refers to the destructive beliefs
and attitudes held by a society that are
ascribed to groups considered different
in some manner, such as people with
mental illness.
The Four Characteristics of Stigma
1. A label is applied to a group of people that
distinguishes them from others (e.g., “crazy”).
2. The label is linked to deviant or undesirable
attributes by society (e.g., crazy people are
dangerous).
3. People with the label are seen as essentially
different from those without the label,
contributing to
an “us” versus “them” mentality (e.g., we are
not
like those crazy people).
4. People with the label are discriminated
against
unfairly (e.g., a clinic for crazy people can’t be
built in our neighborhood)
Fighting against Stigma: A Strategic Approach
Policy and Legislative Strategies
 Parity in Insurance Coverage
 Discriminatory Laws
 Employment
Community Strategies
 Housing Options
 Personal Contact
 Education
Mental Health and Health Profession
Strategies
 Mental Health Evaluations
 Education and Training
Individual and Family Strategies
 Education for Individuals and Families
 Support and Advocacy Groups
Personal Distress
One characteristic used to define mental
disorder is personal distress—that is, a person’s
behavior may be classified as disordered if it
causes him or her great distress.
Disability—that is, impairment in some
important area of life (e.g., work or personal
relationships)—can also characterize mental
disorder. For example, substance use disorders
are defined in part by the social or occupational
disability
Phobias can produce both distress and disability
Violation of Social Norms-social norms are
widely held standards (beliefs and attitudes)
that people use consciously or intuitively to
make judgments about where behaviors are
situated on such scales as good–bad, right–
wrong, justified–unjustified, and acceptable–
unacceptable.
Dysfunction- In an influential and widely
discussed paper, Wakefield (1992) proposed
that mental disorders could be defined as
harmful dysfunction.
 A judgment that a behavior is harmful
requires some standard, and this
standard is likely to depend on social
norms and values, the characteristic just
described.
  Dysfunctions are said to occur when an
internal mechanism is unable to
perform its natural function—that is,
the function that it evolved to perform.
By grounding this part of the definition
of mental disorder in evolutionary
theory, Wakefield hoped to give the
definition scientific objectivity
History of Psychopathology
Early Demonology
The doctrine that an evil being or spirit can
dwell within a person and control his or her
mind and body is called demonology
The belief that odd behavior was caused by
possession led to treating it by exorcism, the
ritualistic casting out of evil spirits.
Early Biological Explanations
In the fifth century b.c., Hippocrates (460?–377?
b.c.), often called the father of modern
medicine, separated medicine from religion,
magic, and superstition.
 Hippocrates regarded the brain as the
organ of consciousness, intellectual life,
and emotion; thus, he thought that
disordered thinking and behavior were
indications of some kind of brain
pathology.
 Hippocrates is often considered one of
the earliest proponents of the notion
that something wrong with the brain
disturbs thought and action
Hippocrates classified mental disorders
into three categories:
 mania,
 melancholia,
 and phrenitis, or brain fever
Hippocrates believed that normal brain
functioning, and therefore mental health,
depended on a delicate balance among four
humors, or fluids of the body, namely, blood,
black bile, yellow bile, and phlegm
The Dark Ages and Demonology
Historians have often pointed to the death of
Galen (a.d. 130–200), the second-century Greek
who is regarded as the last great physician of
the classical era, as the beginning of the so-
called Dark Ages in western European medicine
and in the treatment and investigation of
mental disorders.
The Persecution of Witches Beginning in the
thirteenth century, in response to widespread
social unrest and recurrent famines and
plagues, people in Europe turned to
demonology to explain these disasters.
In the dunking test, if the woman did not
drown, she was considered to be in league with
the devil (and punished accordingly); this is the
ultimate nowin situation.
Lunacy Trials Evaluations of other sources of
information also indicate that mental illness
was not primarily ascribed to witchcraft.
Beginning in the thirteenth century, lunacy trials
to determine a person’s mental health were
held in England.
Moral Treatment
patients had close contact with attendants, who
talked and read to them and encouraged them
to engage in purposeful activity; residents led
lives as close to normal as possible and in
general took responsibility for themselves
within the constraints of their disorders
The Evolution of Contemporary Thought
Discovering Biological Origins in General
Paresis and Syphilis The anatomy and workings
of the nervous system were partially
understood by the mid-1800s, but not enough
was known to let investigators conclude
whether the structural brain abnormalities
presumed to cause various mental disorders
were present or not.
Genetics Francis Galton (1822–1911), often
considered the originator of genetic research
with twins, because of his study of twins in the
late 1800s in England, attributed many
behavioral characteristics to heredity. He is
credited with coining the terms nature and
nurture to talk about differences in genetics
(nature) and environment (nurture).
Francis Galton is considered the originator of
genetics research. (
Biological Treatments The general warehousing
of patients in mental hospitals earlier in the
twentieth century, coupled with the shortage of
professional staff, created a climate that
allowed, perhaps even subtly encouraged,
experimentation with radical interventions.
In the early 1930s, the practice of inducing a
coma with large dosages of insulin was
introduced by Sakel (1938), who claimed that
up to three-quarters of the people with
schizophrenia whom he treated showed
significant improvement. Later findings by
others were less encouraging, and insulin-coma
therapy—which presented serious risks to
health, including irreversible coma and death—
was gradually abandoned.
electroconvulsive therapy (ECT) was originated
by two Italian physicians, Ugo Cerletti and
Lucino Bini.
Prefrontal lobotomy
 Moniz 1935
 Often used to control violent behaviors;
led to
Mesmer and Charcot During the eighteenth
century in western Europe, many people were
observed to be subject to hysteria, which
referred to physical incapacities, such as
blindness or paralysis.
Breuer and the Cathartic Method
Breuer hypnotized her, and while hypnotized,
she began talking more freely and, ultimately,
with considerable emotion about upsetting
events from her past.
Reliving an earlier emotional trauma and
releasing emotional tension by expressing
previously forgotten thoughts about the event
was called catharsis, and Breuer’s method
became known as the cathartic method. In
1895, Breuer and a younger colleague, Sigmund
Freud (1856–1939), jointly published Studies in
Hysteria, partly based on the case of Anna O
Freud and Psychoanalysis
The central assumption of Freud’s theorizing,
often referred to as psychoanalytic theory, is
that psychopathology results from unconscious
conflicts in the individual.
Structure of the Mind Freud divided the mind,
or the psyche, into three principal parts: id, ego,
and superego.
According to Freud,
 the id is present at birth and is the
repository of all of the energy needed
to run the psyche, including the basic
urges for food, water, elimination,
warmth, affection, and sex. Trained as a
neurologist, Freud saw the source of
the id’s energy as biological, and he
called this energy libido. The individual
cannot consciously perceive this energy
—it is unconscious, below the level of
awareness.
 id seeks immediate gratification of its
urges, operating on what Freud called
the pleasure principle.
 the ego begins to develop from the id
during the second 6 months of life.
Unlike the contents of the id, those of
the ego are primarily conscious.
 The superego—the third part of the
psyche in Freud’s theory—can be
roughly conceived of as a person’s
conscience. Freud believed that the
superego develops throughout
childhood, arising from the ego much as
the ego arises from the id
A defense mechanism is a strategy used by the
ego to protect itself from anxiety
Psychoanalytic Therapy Psychotherapy based
on Freud’s theory is called psychoanalysis or
psychoanalytic therapy. It is still practiced
today, although not as commonly as it once
was.
Freud's Structures of the Mind
 Id
- Unconscious
• Pleasure principle
Immediate gratification
• Tibido
Energy of ID
• Ego
• Primarily conscious
• Reality principle
- Attempt to satisfy ID's demands within reality's
constraints
• Superego
• The conscience
• Develops as we incorporate parental and
society values
Goals of Psychoanalytic Therapy or
Psychoanalysis Importance of Cognitions
• Understand early-childhood experiences,
particularly key (parental) relationships Limitations of Behavior Therapy
• Understand patterns in current relationships • How we think or appraise a situation
influences our
Psychoanalytic Techniques
feelings and behaviors
• Free Association
Cognitive Therapy
• Analysis of Transference
Emphasize how people think about themselves
• Interpretation and
their experiences can be a major determinant of
NEO-FREUDIANS psychopathology
• Focus on understanding maladaptive thoughts
Jung (1875-1961) • Change cognitions to change feelings and
•Analytical psychology behaviors

• Collective unconscious Ellis (1913-2007)

Archetypes • REBT (Rational-Emotive Behavior Therapy)

• Catalogued personality characteristics

Extraversion vs. Introversion Mental Health Professions

Adler (1870-1937) Psychologists (RPsy)

• Individual psychology • Recognized by PAP as Clinical or Counseling

Psychologist
Fulfillment derived from working for the social
good • Acquired through Ph. D. or Psy. D.

They maintained that the ego energies of its
own that are
Just as important as id energies and that it is
important to
focus on a person's current living situation as
well as
his/her social interactions.
The Evolution of Contemporary Thought:
Rise of Behaviorism
• Passed the Board Exam for Psychologist (PRC)
• Grandfather Clause (Approved by PRB/PRC)
Psychometrician (RPm)
Psychiatric Nurses (RN)
Psychiatrists
M.D.'s can prescribe medications
Social Workers
- Not trained in psychological assessment

John Watson (1878-1958) Chapter Outline

Behaviorism Chapter 2: Current Paradigms in
• Focus on observable behavior Psychopathology
• Emphasis on learning rather than thinking or I. The Genetic Paradigm
innate tendencies I. The Neuroscience Paradigm
Three types of learning: I. The Cognitive Behavioral Paradigm
• Classical Conditioning IV. Factors That Cut Across the Paradigms
• Operant Conditioning V. Diathesis-Stress: An Integrative Paradigm
• Modeling
Current Paradigms: 1.Cenetic • Events and experiences that are unique to
each
Heredity plays a role in most behavior
family member
Genes
• Carriers of genetic information (DNA)
• Impacted by environmental influences
Current Paradigms: 2.
e.g., stress, relationships, culture,
maltreatment, poverty Neuroscience
and IQ, depression) Examines the contribution of brain structure
Relationship between genes and and function to psychopathology
environment is bidirectional (interaction • Mental disorders are linked to aberrant
between processes in
all levels of biological and experiential variables, the brain.
from the
Three major components:
genetic through the cultural)
- Neurons and neurotransmitters
• Nature via nurture (Ridley, 2003)
• Brain structure and function
• Neuroendocrine system

IMPORTANT GENETIC TERMS

Current Paradigms:
3. Cognitive Behavioral
Gene expression (genes produce protein)
Roots in learning principles and cognitive
Proteins influence whether the action of a science
specific gene will occur. Learning
Behavior is reinforced by consequences
Polygenic transmission
To alter behavior, modify consequences
Multiple gene pairs vs. single gene
Systematic desensitization
development, turning themselves on and off as
• Relaxation plus exposure
they interact with a person's
environment is the essence of genetie • Important treatment for anxiety disorders
vulnerability.
Heritability Cognitive Science
Extent to which variability in behavior is due to Behaviorism criticized for ignoring thoughts and
genetic factors
emotions
Beritability estimate
Cognition
from 0.00 to 1.00
• A mental process that includes:
Group rather than individual indicator
Perceiving, recognizing, conceiving, judging, and
-a population stat, not metric of likelihood a reasoning
particular person will inherit a Disorder
Schema
• Organized network of previously accumulated
knowledge
Environmental Effects
• We actively interpret new information
Shared environment
Role of attention in psychopathology
• Events and experiences that family members
have • Anxious individuals more likely to attend to
threat or
in common
danger
Nonshared environment
 Affect vs. Mood
Role of the Unconscious Emotion
Contemporary theorists have attempted to • Components
study the unconscious scientifically Expressive
Implicit memory • Experiential
• The unconscious may reflect efficient Physiological
information
• Most psychopathology includes disturbances
processing rather than being a repository for of one or
troubling material more component
• e.g., flat affect in schizophrenia
Cognitive Behavior Therapy (CBT) What is your Ideal Affect?
Attends to thoughts, perceptions, judgments, • Happiness vs. Calmness
self-statements, and unconscious
assumptions Factors That Cut Across the Paradigms
Cognitive Restructuring
• Change a pattern of thinking Sociocultural Factors
• Changes in thinking can change feelings, • Gender, race, culture, ethnicity, and
behaviors, socioeconomic
and symptoms status
• May increase vulnerability to psychopathology
Beck's Cognitive Therapy e.g., women more likely to experience
depression than
Initially developed for depression
men
Depression caused by distorted thoughts
• Some disorders specific to certain cultures
•Nothing ever goes right for me!
- Hilikomori in Japanese culture
Information-Processing Bias
• Attention, interpretation, and recall of
negative and Current Paradigms:
positive information biased in depression Diathesis-Stress
-Help patients recognize and change Integrative model that incorporates multiple
maladaptive thought patterns causal
factors
PSYCHODYNAMIC Genetic, neurobiological, psychological, and
environmenta
Freud
Diathesis
-Ego Analysis-pathogenic beliefs; object
- Underlying predisposition
relations
May be biological or psychological
-Attachment Theory
• Increases one's risk of developing disorder
-Implicit Memory, Rational Self
-Stress
-Brief Psychodynamic Therapy &
• Environmental events
Interpersonal Therapy
May occur at any point after conception
A
Current Paradigms:
Factors That Cut Across the Paradigms
•Psychopathology unlikely to result from one
single