08.
06 Abnormal Psychology-Revised Notes
Sir Eric Amion, RPsy, RPm
Introduction to Abnormal Psychology and Historical
Review
Table of Specifications
Psychopathology
 Study of the nature, symptomatology,
development, and treatment of psychological
disorders.
o Symptomatology – basic features and
manifestations; used as basis in coming
up with a diagnosis as assessments rely
on symptoms (medical condition), but in
psychopathology, hindi lang sa symptoms
nagre-rely ang assessments.
o Development = etiology, causes
 Challenges to the study of psychopathology:
o Maintaining objectivity
o Avoiding preconceived notions
o Reducing stigma
Key Characteristics in the DSM Definition of Mental
Disorder (Defining Mental Disorder)
1. Distress
2. Disability
3. Deviance (violation of social norms)
4. Dysfunction
- These are only partial, not applicable to all
disorders/conditions
- There is no universal definition of mental disorder
Psychological Dysfunction
 Breakdown in cognitive, emotional, or behavioral
functioning
 Internal mechanism is unable to perform its usual
function
o not doing their function well
o thought process is distorted/irrational
o more of internal, the way the person
processes thoughts, emotions, etc.
Personal Distress
 a person’s behavior may be classified as
disordered if it causes them great distress.
 The term is subjective (needs clinical judgment)
 Makes the condition clinically significant
o Experiences out of proportion reaction
 Psychologically suffering
 It’s important to consider the intensity, quality,
duration, culture
Disability
 Impairment in some important area of life (e.g.,
work/personal relationships) – can also
characterize mental disorder
 Impairment is set in the context of a person’s
background
 No longer able to fulfill responsibilities as a person
 Impairment
 obligations, responsibility, functioning, context is
important, externalizing functioning
Nuggets:
 2 Generic Indicators of a Disorder:
 Distress
 Dysfunction
 Might not still be an indicator to all diagnosis (e.g.,
antisocial personality disorder – because they are
less likely to experience remorse. Hence, less likely
to experience distress)
 Partial definitions, not applicable to all conditions
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 Criterion A, B, C: inclusionary criteria (ruling in)
 “Clinically causes impairment/distress”;
 Exclusionary criteria: should be eliminated (ex.
“should not be better explained by other
conditions”) – ruling out
Violation of Social Norms
 Reaction is outside cultural norms
 Something is considered abnormal because it
occurs infrequently
 It deviates from the average
 Consider: Culture Specific – ex. “mali-mali”
(madaling ma-startle, mimic words after being
startled)
The Diagnostic and Statistical Manual (DSM)
 Widely Accepted System
o Used to classify psychological problems
and disorders
 DSM Contains Diagnostic Criteria for Behaviors
that
o Fit a pattern
o Cause dysfunction or subjective distress
o are present for a specified duration
 Duration allows us to
differentiate one disorder from
the other
o and for behaviors that are not otherwise
explainable
Nuggets:
 Diagnostic threshold – minimum requirement
 Subthreshold – below minimum requirement, diagnosis
should not be made
o If in need of treatment = provisional diagnosis
is given (when someone exhibits symptoms,
but diagnostic threshold is not met, there’s
 only a presumption that the diagnostic criteria
will be eventually met)
 Other Specified Disorder (OSD): person did not fall in
any categories; symptoms are not enough to meet the
criteria, but clinician chooses to explain why
Abnormality
 A mental disorder is a syndrome characterized by
clinically significant disturbance in an individual’s
cognition, emotion regulation, or behavior that
reflects a dysfunction in the psychological,
biological, or development processes underlying
mental functioning.
o Syndrome = constellation of symptoms
that co-occur; combination of many
symptoms that occur together
 Mental disorders are usually associated with
significant distress or disability in social,
occupational, or other important activities
 An expectable or culturally approved response to a
common stressor/loss, such as death of a loved
one, is not amental disorder
 Socially deviant behavior and conflicts that are
primarily between the individual and society are
not mental disorders unless the deviance/conflict
results from a dysfunction in the individual
Approaches to the Scientific Study of Psychological
Disorders
 Mental Health Professionals
o The Ph.D.’s: Clinical and counseling
psychologists
o The Psy.D.’s: Clinical and counseling
“Doctor of Psychology”
o The RPsy’s Registered Psychologists
o M.D.’s: Psychiatrists
o M.S.W.’s: Psychiatric and non-psychiatric
social workers
o MN/MSN’s: Psychiatric nurses
o The lay public and community groups
 United by the Scientist-Practitioner Framework
Dimensions of the Scientist-Practitioner Model
Mental Health Professional:
 Consumer of science
o Enhancing the practice
 Evaluator of Science
o Determining the effectiveness of the
practice
 Creator of Science
o Conducting research that leads to new
procedures useful in practice
Clinical Description, Etiology, Treatment, and Outcome in
Psychopathology
 Clinical Description
o Presents – presenting problem
o Prevalence – number of people in the
population
o Incidence – number of new cases occur
during a given period
o Onset – beginning of the disorder
 Acute – begins suddenly
 Insidious – develop gradually
o Course – pattern
 Chronic – lasts a long time
 Episodic – likely to recover and
suffer a recurrence
 Time-limited – will improve
without treatment in a relatively
short period
 Etiology – contributions to the development of
psychopathology; allow us to know possible
treatment
 Treatment Development
o to alleviate psychological suffering
o includes pharmacologic, psychosocial,
and/or combined treatments
 Prognosis – anticipated course of a disorder (good
or guarded)
 Treatment Outcome Research
o How do we know that we have helped?
o Limited in specifying actual causes of
disorders
History of Psychopathology
 Before the age of scientific inquiry
 The evolution of contemporary thought
o Early foundations on biological
approaches, genetic and biological
treatments
o Psychological approaches
Demonology
 The doctrine that an evil being/spirit can dwell
within a person and control their mind and body
thereby can be treated by Exorcism the ritualistic
casting our of evil spirits
 Trephination – cutting holes to the skull in the
belief that evil spirits may come out
 Hydrotherapy – patients were shocked back to
their senses by being submerged in ice-cold water
Early Biological Explanations
 Hippocrates - Mental disturbances have natural
(not supernatural) causes
o 4 humors: blood, black bile, yellow bile,
and phlegm (sanguine, melancholia,
choleric, phlegmatic)
o 3 categories: mania, melancholia, and
phrenitis
Dark Ages
 Church gained influence, and the papacy was
declared independent of the state
 Christian monasteries, through their missionary
and educational work replaced physicians as
healers and as authorities on mental disorder
 Monks cared and prayed for mentally ill,
concocted potions
 Galen – Greek physician who followed
Hippocrates’ ideas and is regarded as the last great
physician of the classical era
 The Persecution of the Witches (Beginning 13 th
century)
o Witchcraft – viewed as instigated by
Satan, was seen as a hearsay and a denial
of God
 o Those accused of witchcraft should be
tortured
o Historians concluded many of the accused
were mentally ill
 Lunacy Trials (Began in 13th century England)
o Municipal authorities assumed
responsibility for care of mentally ill
o Trials held to determine sanity
o Trials were conducted under the Crown’s
right to protect the people with mental
illness
o The defendant’s orientation, memory,
intellect, daily life, and habits were at
issue in the trial
 Lunacy (Paracelsus) – attributes insanity to
misalignment of moon and stars
 Mass Hysteria
o Large-scale outbreaks of bizarre behavior
o In Europe, whole groups of people were
simultaneously compelled to run out in
the streets, dance, shout, rave, and jump
around in patterns as if they were at a
particularly wild party late at night (still
called a “rave”), but without the music
o The behavior was known by several
names, including Saint Vitus’s Dance and
tarantism
Renaissance and the Rise of Asylums
 Characterized as a time of extreme cultural and
scientific growth, and a decline of religious
influence
 Rise of asylums and specializations in mental
health
 Johan Weyer – first physician to specialize in
illnesses of the mind
 Gheel Belgium – first religious mental health
facility
 Bethlehem Hospital, Spain – first medical mental
asylum
 Asylum – establishments for the confinement and
care of mentally ill
o Priory of St. Mary of Bethlehem (1243)
 One of the first mental
institutions
 Origin of the term “bedlam”
 Eventually became one of
London’s great tourist attractions
 St. Mary of Bethlehem
o Treatment non-existent or harmful at
asylum
o Early medical treatment could be harmful
o Benjamin Rush – recommended copious
amounts of blood and believed that they
could be cured by being frightened.
o Treatment is either nonexistent or not
humane
The 19th Century: Reform and Moral Treatment
 Philippe Pinel and Jean-Baptise Pussin (18th – 19th
Century)
o Pioneered humanitarian treatment at
LaBicetre
o Pinel is said to have begun to treat the
patients as sick human beings rather than
as beasts
o He unchained the patients and allowed
them to move freely about the hospital
grounds
 Moral Treatment
o Small, privately funded, humanitarian
mental hospitals
 Friends Asylum (1817) and
Hartford Retreat (1924)
 Patients engaged in purposeful
calming activities
 Talked with attendants
 William Tuke (1732-1819) was bringing similar
reforms to northern England
 He founded the York Retreat – rural estate where
about 30 mental patients lived as guests in quiet
country houses and were treated with a
combination of rest, talk, prayer, and manual work
Dorothea Dix (1802-1887)
 Crusader for prisoners and mentally ill
 Urged improvement of institutions
 Worked to establish 32 new, public hospitals
 Unfortunately, the small staffs of these new
hospitals were unable to provide the individual
attention
 Known as “mental hygiene movement”
Early Foundations: Biological Approaches
 Mid-1800s not enough information is known about
the biological basis of mental illness
 Louis Pasteur (1860s) established the germ theory
of disease, which set forth the view that disease is
caused by infection of the body by minute
organisms
 General paresis (GP)
o Degenerative disorder with psychological
symptoms and individuals with GP also
has syphilis
o 1905 discovery of microorganism that
causes syphilis
o Since general paresis had biological cause
other mental illness
Early Foundations: Genetics
 Galton’s work (late 1800s) lead to notion that
mental illness can be inherited
 Behavioral genetics
o Extent to which behavioral differences are
due to genetics
 Eugenics
o Promotion of enforced sterilization to
eliminate undesirable characteristics from
the population
o Many state laws (late 1800s and early
1900s) prohibited marriage and required
mentally ill to be sterilized
o Such laws were upheld by the US
Supreme Court in 1927
o By 1945, more than 45,000 people with
mental illness in the US had been forcibly
 sterilized
Nuggets:
 Predisposition doesn’t follow progression of a condition
Early Biological treatments
 Insulin-coma therapy (Manfred Sakel) – inducing a
coma with large dosages of insulin
 Electroconvulsive Therapy (ECT) (Cerletti and Bini)
– applying electric shocks that produce epileptic
seizures to the sides of the head
 Prefrontal lobotomy (Egas Moniz)
o A surgical procedure that destroys the
tracts connecting the frontal lobes to
other areas of the brain
o Often led to listlessness, apathy, and lack
of some cognitive abilities
Early Foundations: Emil Kraeplin
 Pioneered classification of mental illness based on
biological causes
 Published 1st psychiatry text
o Precursor of DSM
 Mental illness as “syndrome” – cluster of
symptoms that co-occur
 Proposed two major syndromes:
o Dementia praecox = “schizophrenia”
o Manic-depressive psychosis = “MDD”
Nuggets:
 Emil Kraeplin: Father of DSM
Early Foundations: Psychological Approaches
 Mesmer
o Treated patients with hysteria using
“animal magnetism”
o Early practitioner of hypnosis
(mesmerism)
 Jean Martin Charcot
o Hysteric symptoms could be removed
through hypnosis
o Problem with the nervous system and had
biological cause, he was also persuaded
by psychological explanations.
 Josef Breuer
o Used hypnosis to facilitate catharsis (case
of Anna O.)
o Catharsis – release of emotional tension
triggered by reliving and talking about
event
o Together with Sigmund Freud, they jointly
published Studies in Hysteria, partly
based on the case of Anna O.
Early Foundations: Freud and Psychoanalysis
 Psychoanalytic Theory
o Human behavior determined by
unconscious forces
o Psychopathology results from conflicts
among these unconscious forces.
Overview of Freud’s Psychoanalytic Theory
 The structure of the mind
 The structure of personality
 Theory of psychosexual stages development
 Defense mechanisms
 Techniques of psychoanalysis
Later Developments in Psychoanalytic Thought
 Anna Freud
o Freud’s daughter, concentrated on the
way in which the defensive reaction of
the ego determines our behavior
o The first proponent of the modern field of
ego psychology
 Heinz Kohut
o Focused on a theory of the formation of
self-concept and the crucial attributes of
the self that allow an individual to
progress toward health, or conversely, to
develop neurosis (Self-Psychology)
Neo-Freudians
 Jung
o Broke up with Freud
o Analytical Psychology
 Hypothesized that in addition to
the personal unconscious
postulated by Freud, there is a
collective unconscious
 Also catalogued various
personality characteristics
Nuggets:
 Crowned prince of Freud
 NEO-PI
 Adler
o Individual Psychology – regarded people
as inextricably tied to their society
because he believed that fulfillment was
found in doing things for the social good.
o Focused on feelings of inferiority and the
striving for superiority
o Created the term “inferiority complex”
Nuggets:
 We do something for the society
 Theory is simplistic
Other Psychoanalytic Theories
 Karen Horney and Erich Fromm
o Others took psychoanalytical theorizing in
different directions, emphasizing
development over the life span and the
influence of culture and society on
personality
o Focused on psychopathology; functional
for understanding personality disorders
 Erik Erikson
o Theory of development across the life
span (Psychosocial Development
The Behavioral Model
 Pavlov (Classical Conditioning)
o A type of learning in which a neutral
stimulus is paired with a response until it
elicits that response
 o Pavlov’s experiment was published
 Elements of learning
o Unconditioned Stimulus (UCS)
o Conditioned Stimulus (CS)
o Unconditioned Response (UR)
o Conditioned Response (CR)
Nuggets: the theory is said to be a revolutionary psychology
Watson and the Rise of Behaviorism
 John Watson
o Revolutionized psychology
o Strongly influenced by the work of Pavlov
o Emphasis on learning rather than innate
tendencies
o Focused on observable behavior
o He and a student, Rosalie Rayner
experiment on “Little Albert”
 Mary Cover – was one of the first psychologists to
use behavioral techniques to free a patient from
phobia
o Individuals were gradually introduced to
the objects or situations they feared so
that their fear could extinguish (Case of
Little Peter)
The Beginnings of Behavior Therapy
 Joseph Wolpe – his best-known technique was
termed “systematic desensitization”
o In principle, it was like the treatment of
little Peter
o Wolpe added another element by having
his patients do something that was
incompatible with fear while they were in
the presence of the dreaded object or
situation
B.F. Skinner and Operant Conditioning
 E. Thorndike
o Learning through consequences
o Law of Effect
o consequences
 B.F. Skinner (Principle of Reinforcement)
o Positive Reinforcement – behaviors
followed by pleasant stimuli are
strengthened
o Negative Reinforcement – behaviors that
terminate a negative stimulus are
strengthened
o Reinforcement
Nuggets:
Anorexia Nervosa
 Restriction of food intake
 Fear of becoming fat/gaining weight
 Self-starvation is reinforcing
o Brain is capable of releasing opioid-like
chemicals, reward center is activated in the
brain
Obsessive Compulsive Disorder
 Obsession: repetitive images
 Compulsion: clearly excessive behaviors
o Compulsion is maintained because of
negative reinforcement
 Obsessive thoughts lead to anxiety (a negative
emotion/experience), results to reducing these
obsessive thoughts by performing compulsive
behavior (allows them to reduce/get rid of this
anxiety, a negative reinforcement)
 Treatment: “exposure and response prevention”
– expose the person that cause their obsessive
thoughts (leads to high anxiety causes compulsion)
then therapist will stop the client from doing a
compulsion.
Modeling
 Learning by imitating others’ behavior – can occur
without reinforcement
 Bandura & Menlove
o Modeling reduced children’s fear of dogs
 After witnessing a fearless model
engage in various activities with
a dog, initially fearful children
showed an increase in their
willingness to approach and
touch a dog.
Humanistic Theory
 Keyword: Self-actualizing – all of us could reach
our highest potential, in all areas of functioning, of
only we had the freedom to grow
 Variety of conditions may block our actualization
 difficult living conditions/stressful
life/interpersonal experiences may move you away
from your true self.
Abraham Maslow
 Most systematic in describing the structure of
personality
 Postulated a hierarchy of needs
Carl Rogers
 Originated client-centered therapy, later known as
person-centered therapy
 The therapist takes a passive role, making as few
interpretations as possible
 Empathetic, genuineness, UPR are necessary and
sufficient in therapy
The Importance of Cognition
 Aaron Beck – developed a cognitive therapy for
depression based on the idea that depressed
mood is caused by distortions in the way people
perceive life experiences
o Father of cognitive therapy
 Albert Ellis
o Principal thesis was that sustained
emotional reactions are caused by
internal sentences that people repeat to
themselves, these self-statements reflect
sometimes unspoken assumptions –
irrational beliefs
o Developed rational-emotive behavior
therapy (REBT) in 1993
o Activating evet – belief ng person and
makakapagpabago sa pagtingin niya sa
event
The Present: The Scientific Method and an Integrative
Approach
 2 developments that shed light on the nature of
psychopathology:
1. Increasing sophistication of scientific tools and
methodology, and
2. Realization that no one influence – biological,
behavioral, cognitive, emotional, or social –
ever occurs in isolation.

Nuggets:
 Biomarkers – ano yung isang way na objective para
malaman na may diagnosis yung isang tao (e.g.,
laboratories)
 Sociogenic hypothesis – poor people highly develop
psychological disorder due to their socioeconomic status
Timeline of Events
 1848: Dorothea Dix – campaigns more humane
treatments
 1854: John Grey – insanity is the result of physical
causes, thus de-emphasizing psychological
treatments
 1870: Louis Pasteur – germ theory of disease,
which helps identify the bacterium that causes
syphilis
 1895: Josef Breuer treats the “hysterical” anna O.,
leading to Freud’s development of psychoanalytic
theory.
 1900: S. Freud’s Interpretation of Dreams
 1904: I. Pavlov (conditioned reflexes in dogs)
 1913: E. Kraeplin classifies carious psychological
disorders from a biological point of view and
published work on diagnosis
 1920: J. Watson (Little Albert)
 1930: Insulin shock therapy, electric shock
treatments, and brain surgery for psychopathology
 1938: B.F. Skinner (The Behavior of Organisms and
operant conditioning)
 1943: MMPI
 1946: Anna Freud (Ego and the Mechanisms of
Defense)
 1950: first effective drugs for severe disorders.
Humanistic psychology gains some acceptance.
 1952: DSM-I is published
 1958: J. Wolpe (Systematic Desensitization for
treating phobia)
 1968: DSM-II is published
 1980: DSM-III is published
 1987: DSM-III-TR is published
 1990s: more research methods are developed; no
one influence – biological or environmental – is
found to cause psychological disorders in isolation
from the other.
 1994: DSM-IV is published
 2000: DSM-IV-TR is published
 2013: DSM-5 is published
 2022: DSM-5-TR is published
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