CLASS

INTRODUCTION

• Full Name & Nickname

• Where do you come
from
• You goal for this class
• One WORD in DSM-5
that can relate to you

Ice Breaker: Introduction to Psychopathology NORMAL VERSUS ABNORMAL

• Break into pairs or small groups of students.
• Most people are pretty quick to label some behaviors as abnormal or even sick,
but how?
• How do you know whether behavior is abnormal or not? What criteria do you
use? Remember to be as specific as possible.
• Do the members of your group have the same criteria or different criteria?
• Discuss the criteria in your group and in the class.

A woman wears a
colourful shirt to
a social event

A girl cries with

no reasons for
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more than 3 1
pa rt. months
 Psychopathology: What Is a
An Integrative Psychological
Approach (9th Ed.) Disorder*?
4 D’s of
Chapter 1: Abnormality
Psychopathology in
Historical Context DEVIAN
DANGER
Barlow & Durand, Psychopathology: An Integrative Approach, 9th Edition. © 2023 Cengage. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.

Distress, Impairment, and Cultural Context

• Distress is normal in some situations
Discussion Activity 1
• Dysfunctional distress occurs when person is
much more distressed than others would be • Think back to the definition of “abnormal” you suggested in the Icebreaker.
• Impairment: Must be pervasive and/or significant • Did you mention the idea of dysfunction?
• Culture: Consider “normalcy” relative to behavior • What about whether distress or impairment resulted?
of others in same cultural context
• Did you consider whether the behavior was somehow atypical?
• Accepted definition:
• Behavioral, psychological, or biological • Why do you think psychologists insist on all three of these criteria?
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 Three Categories Make up the Study of

Psychological Disorders
• Psychopathology*: Scientific study of psychological dysfunction
• Mental health professionals
• Ph.D.: Clinical and counseling psychologist (trained in research and
delivering treatment)
• Psy.D.: Clinical and counseling “Doctor of Psychology” (trained in delivering
treatment)
• M.D.: Psychiatrist
• Psychiatric nurses
• Licensed clinical social worker & Clinical Mental Health Counselor (trained in
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delivering treatment) 2
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 Clinical Description Causation, Treatment and
• Clinical description* begins with the presenting problem Outcome
• Symptoms (e.g., chronic worry, panic attacks)
• Description aims to distinguish clinically significant dysfunction from • Etiology*
common human experience • What contributes to the development of psychopathology?
• May also describe other factors: • Treatment development
• Prevalence* and incidence* of disorders • How can we help alleviate psychological suffering?
• Onset of disorders: acute vs. insidious onset
• Includes pharmacological, psychosocial, and combined
• Course* of disorders: episodic, time-limited, or chronic course treatments
• Prognosis*: good vs. guarded

Historical Conceptions of Abnormal The Supernatural Tradition (1 of 2)

Behavior HYSTERIA
• Deviant behavior as a battle of “Good” vs. “Evil”
• Major psychological disorders have existed across time and cultures • Believed to be caused by demonic possession,
witchcraft, sorcery
• Perceived causes and treatment of abnormal behavior varied widely, depending
on context • Treatments included exorcism*, torture, religious
rituals
• Three dominant traditions have existed in the past to explain abnormal behavior
• Competing view that coexisted with supernatural
• Supernatural
tradition: “insanity” is caused by emotional stress,
• Biological not supernatural forces
• Psychological • Treatments: Rest, sleep, healthy environment,
baths, potions

The Supernatural Tradition (2 of 2) The Biological Tradition

• Mass hysteria • Hippocrates (460-377 BC)
• Saint Vitus’s Dance/Tarantism • Father of modern Western medicine

• Modern mass hysteria • Mental disorders understood as physical

disease
• Emotion contagion
• Hysteria “the wandering uterus” –
• Mob psychology psychological symptoms were a result of
• The moon and the stars the uterus moving around in the body

• Paracelsus: Swiss physician suggested that • Linked abnormality with brain chemical
mental health problems are affected by pull imbalances
of moon and stars • Foreshadowed modern views
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 Hippocratic-Galenic Tradition Later Biological Advances

• Humoral theory of disorders: Functioning • General paresis (late stage syphilis) and the biological link with madness
is related to having too much or too little • Includes psychological and behavioral symptoms
of four key bodily fluids (humors)
• Caused by a bacterium
• Blood, phlegm, black bile, yellow bile
• Bolstered the view that mental illness = physical illness
• Example: Depression caused by too
• John P. Grey and the reformers
much black bile
• Psychiatrist who believed mental illness had physical roots
• Treated by changing environmental
conditions (e.g., reducing heat) or • Championed biological tradition in the U.S.
bloodletting/vomiting • Led to reforms of hospitals to give psychiatric patients better care

The Development of Biological Treatments Consequences of the Biological Tradition

• Insulin shock therapy • Overall, mental illness understood to have physical roots
• Electric shock • Increased hospitalization
• Crude surgery • Mental illness often seen as “untreatable” condition
• Medication became increasingly available starting in • Improved diagnosis and classification
the mid-20th century
• Emil Kraepelin was father of classification
• Neuroleptics (major tranquilizers) now called
antipsychotics • Increased role of science in psychopathology

• Minor tranquilizers prescribed for anxiety and

related disorders

Knowledge Check Activity Knowledge Check Activity: Answers

Is each statement true or false? 1. According to the supernatural tradition, mental disorders may be a result of possession or the influence
of evil spirits.
1. According to the supernatural tradition, mental disorders may be a result of True: The supernatural tradition views mental disorders as a matter of “Good” vs. “Evil,” and resulting
from supernatural forces like possession or the influence of evil spirits.
possession or the influence of evil spirits.
2. In the supernatural tradition, treatment usually involved rest and relaxation, coupled with healthy
socialization.
2. In the supernatural tradition, treatment usually involved rest and relaxation,
False: The supernatural tradition relied on religious rituals such as exorcism and even torture to drive out
coupled with healthy socialization. the evil influences that caused the disorders.
3. According to Kraepelin, mental disorders were the result of imbalances in bodily humors.
3. According to Kraepelin, mental disorders were the result of imbalances in False. Kraepelin is associated with the classification of mental disorders while Hippocrates is associated
bodily humors. with the idea that mental disorders are the result of humoral imbalances.
4. The syndrome known as general paresis bolstered the idea mental illnesses had a physical cause.
4. The syndrome known as general paresis bolstered the idea that mental True: General paresis, the late stage of syphilis, has psychological symptoms and is caused by infection
illnesses had a physical cause. with Treponema pallidum. This association bolstered the idea that mental illness has a physical cause.
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 The Psychological Tradition Figure 01.04 Freud’s Structure of the Mind

• Moral therapy*
• Treated institutionalized patients as normally as possible in a setting that
encouraged and reinforced normal social interaction
• Declined in use due to the size and composition of the institutionalized
population
• Large numbers of people were immigrating to the U.S. and, if
institutionalized, thought not to “deserve” moral therapy
• Mental hygiene movement* focused on providing care to everyone who
needed it, causing a large influx in patients

Psychoanalytic Theory Later Developments in Psychoanalytic

Thought
• Defense mechanisms*: Ego’s attempt to
manage anxiety resulting from id/superego • Ego psychology* (Anna Freud): defensive
conflict reactions of the ego determine behavior

• Displacement & denial • Self-psychology* (Heinz Kohut): focused on

the formation of self-concept and the crucial
• Rationalization & reaction formation attributes of the self that allow an individual to
progress toward health or neurosis*
• Projection, repression, and sublimation
• Carl Jung: rejected focus on sexual drives;
• Psychosexual stages of development* emphasized spiritual and religious drives;
introduced collective unconscious*
• Oral, anal, phallic, latency, and genital stages
• Alfred Adler: focused on feelings of inferiority
• Theory: conflicts arise at each stage and and the striving for superiority
must be resolved

Psychoanalytic Psychotherapy Psychodynamic Psychotherapy*

• Designed to reveal the nature of unconscious mental processes and conflicts • Derived from psychoanalytic approach
through catharsis* and insight • Focus on affect and the expression of emotions

• Techniques include free association*, dream analysis*, and analysis of • Exploration of attempts to avoid topics or engage in activities that hinder the progress of
therapy
transference*
• Identification of patterns in actions, thoughts, feelings, experiences, and relationships
• Very time consuming and costly
• Emphasis on past experiences
• Little evidence of effectiveness • Focus on interpersonal experiences
• Emphasis on the therapeutic relationship
• Exploration of wishes, dreams, or fantasies
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 Role Play Activity Humanistic Theory
Freud had a number of patients made famous by his writing about them including
one known as Rat Man, believed to be a lawyer named Ernst Lanzer. Lanzer • Abraham Maslow
experienced what might now be termed obsessive-compulsive disorder, and he was
• Hierarchy of needs, beginning with our most basic physical needs and
terribly fearful that some harm might come to close friends or family members (his
ranging upward to needs for self-actualization*, love, and self-esteem
primary obsessions) if he did not carry out certain rituals (his compulsions). He was
particularly fearful that his loved ones would be subjected to a particularly horrible • Carl Rogers
form of torture involving being eaten alive by rats, hence the name Rat Man.
• Humanistic therapy emphasizing unconditional positive regard*, empathy,
• Form small groups and ask one student to assume the role of Freud while the and innate tendency towards growth
other assumes the role of Rat Man. Act out part of a psychoanalytic session using
the Freudian concepts and methods you have learned. • Most useful among individuals without psychological disorders who are dealing
with stresses of life
• Discuss your ideas and impressions in the group and class. What seems to be
helpful about Freudian methods? What seems less so?

The Cognitive-Behavioral Model (1 of 2) The Cognitive-Behavioral Model* (2 of 2)

• Pavlov and classical conditioning* • B. F. Skinner and operant conditioning

• Learning in which a neutral stimulus is paired with a response until it elicits • Learning in which behavior changes as a function of what follows the
that response behavior (reinforcement*)
• Watson and the rise of behaviorism • Influenced by Watson and Thorndike (law of effect)
• Psychology is a purely objective experimental branch of natural science with • Behavioral model has contributed greatly to the understanding and treatment of
goals of prediction and control of behavior psychopathology
• Joseph Wolpe and behavior therapy* • Incomplete and inadequate to account for what we now know about
psychopathology
• Systematic desensitization*

The Present: The Scientific Method

Breakout Group Activity 2 and an Integrative Approach

• Break into pairs or small groups for this activity.
• Although the three traditions discussed in the text are often viewed as “historic,”
their influences continue to be felt today in popular culture.
• Consider the three traditions: supernatural, biological, and psychological.
• Give at least one example of how each tradition is represented in popular
understanding or portrayal of mental disorders.
• Discuss your examples with the class.
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pa rt.
• Scientific methods were not often applied to the theories and treatments within a
tradition
• Mental health professionals tend to look at psychological disorders narrowly,
from their own theoretical orientation
• Two crucial developments in the 1990s:
• The increasing sophistication of scientific tools and methodology
• The realization that no one influence—biological, behavioral, cognitive,
emotional, or social—ever occurs in isolation
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 Discussion Activity 2 Self-Assessment
• Consider the case of Janelle, described in your text. Janelle was a 16 year-old referred to an
anxiety disorders clinic because of repeated episodes of fainting. She became queasy after • Consider your own beliefs about psychopathology and its causes and
seeing a particularly graphic video of a frog being dissected and began avoiding materials and treatments.
situations she feared might expose her to images of blood or gore. She initially fainted after
encountering something that was bloody, and her fainting increased to five to ten episodes per
• What have you learned about how “abnormality” is defined by
week. Physicians could find no organic reason for the fainting, which had become increasingly psychologists? Do you think the definition is a useful one? Does it capture
disruptive in Janelle’s classes and which was distressing to Janelle. what you think abnormality is?
• According to Alfred Meyer, biological, psychological, and sociocultural factors are equally • What do you think causes psychopathology?
important in understanding the causes of psychopathology.
• What about the treatment of psychopathology? What do you think the best
• What kinds of biological factors might play a role in Janelle’s fainting?
approaches are?
• What sorts of psychological factors?
• What about sociocultural factors?

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