{"id":4179,"date":"2018-09-18T17:06:23","date_gmt":"2018-09-18T21:06:23","guid":{"rendered":"https:\/\/www.amyork.ca\/academic\/zz\/?p=4179"},"modified":"2018-09-18T17:27:47","modified_gmt":"2018-09-18T21:27:47","slug":"introduction-and-historical-overview","status":"publish","type":"post","link":"https:\/\/www.amyork.ca\/academic\/zz\/abnormal-psychology\/introduction-and-historical-overview\/","title":{"rendered":"Introduction and Historical Overview"},"content":{"rendered":"<ul>\n<li><strong>Psychopathology<\/strong> = the field concerned with the nature, development and treatment of psychological disorders<\/li>\n<li>Challenge: remaining objective, avoiding preconceived notions, reduce stigma<\/li>\n<li><strong>Stigma<\/strong> = destructive beliefs and attitudes held by society that are ascribed to groups considered different in some manner (people with psychological disorders) o 1) Label is applied to a group of people that distinguishes them from others o 2) Label is linked to deviant\/undesirable attributes by society (crazy people are dangerous) o 3) People w\/label are seen as essentially different from those without the label, contributing to an \u201cus\u201d versus \u201cthem\u201d mentality (we are not like those crazy people)\n<ul>\n<li>4) People w\/label are discriminated against unfairly (clinic for crazy people can\u2019t be built in our neighborhood)<\/li>\n<\/ul>\n<\/li>\n<li>Nearly half of US citizens will experience some type of psychological disorder during some point of their lifetime<\/li>\n<\/ul>\n<p><strong>Defining Psychological Disorder<\/strong><\/p>\n<ul>\n<li>Definition of mental disorder is found in the 5<sup>th<\/sup> edition of the American diagnostic manual, the <strong>Diagnostic and Statistical Manual of Mental Disorders<\/strong> (DSM-5) *May 2013 \uf0b7 Psychological disorder:\n<ul>\n<li>Occurs within the individual<\/li>\n<li>Involves clinically significant difficulties in thinking, feeling, or behaving<\/li>\n<li>Usually involves personal distress of some sort, such as in social relationships or occupational functioning<\/li>\n<li>Involves dysfunction in psychological, developmental, and\/or neurobiological processes that support mental functioning<\/li>\n<li>Is not a culturally specific reaction to an event (e.g. death of a loved one) o Is not primarily a result of social deviance or conflict with society<\/li>\n<\/ul>\n<\/li>\n<li>4 key characteristics: personal distress, disability, violation of social norms, dysfunction<\/li>\n<li>Personal Distress\n<ul>\n<li>A person\u2019s behaviour may be classified as abnormal if it causes him\/her great distress<\/li>\n<li>Not all psychological disorders cause distress *e.g. antisocial\/personality disorder<\/li>\n<li>Not all behaviour that causes distress is disordered *e.g. hunger due to religious fasting<\/li>\n<\/ul>\n<\/li>\n<li>Disability\n<ul>\n<li><strong>Disability<\/strong> = impairment in some important area of life<\/li>\n<li>g. substance use disorders defined in part by social or occupational disability<\/li>\n<\/ul>\n<\/li>\n<li>Violation of Social Norms\n<ul>\n<li><strong>Social norms<\/strong> = widely held standards that people use consciously or intuitively to make judgments about where behaviours are situated on such scales as good-bad, right-wrong, etc.<\/li>\n<li>Social norms vary a great deal across cultures and ethnic groups<\/li>\n<li>Make others uncomfortable or causes problems (e.g. antisocial behaviour of psychopath)<\/li>\n<\/ul>\n<\/li>\n<li>Dysfunction\n<ul>\n<li><strong>Harmful dysfunction<\/strong> = failure of internal mechanisms in the mind to function properly o 1) Value judgment (harmful), 2) objective, scientific component (dysfunction)<\/li>\n<li>Standard of comparison as to what is harmful depends on social norms and values<\/li>\n<li><strong>Dysfunction<\/strong> = occurs when an internal mechanism is unable to perform its natural function \uf0b7 Developmental, psychological, and biological dysfunctions are all interrelated<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p><strong>History of Psychopathology<\/strong><\/p>\n<p>Early Demonology<\/p>\n<ul>\n<li>Before advances in scientific discovery, all good\/bad manifestations of power beyond human control were regarded as supernatural<\/li>\n<li>It was thought that disturbed behaviour reflected the displeasure of the gods or possession by demons<\/li>\n<li><strong>Demonology<\/strong> = the doctrine that an evil being or spirit can dwell within a person and control his\/her mind and body<\/li>\n<li><strong>Exorcism<\/strong> = the ritualistic casting out of evil spirits o Rites of prayer, noisemaking, forcing the afflicted to drink terrible-tasting brews, flogging, starvation<\/li>\n<\/ul>\n<p>Early Biological Explanations<\/p>\n<ul>\n<li>Hippocrates (father of modern medicine) separated medicine from religion, magic and superstition<\/li>\n<li>Insisted that illness had natural causes and should be treated like other more common maladies<\/li>\n<li>Regarded the brain as the organ of consciousness, intellectual life, and emotion<\/li>\n<li>Disordered thinking\/behaviour indicate brain pathology<\/li>\n<li>3 categories of psychological disorders: mania, melancholia, and phrentis (brain fever)<\/li>\n<li>Mental health depends on a balance among <strong>4 humors<\/strong> (fluids of the body) o Blood, black bile, yellow bile, and phlegm *imbalance produces disorders<\/li>\n<li>Predominance of phlegm = sluggish\/dull, black bile = melancholia, yellow bile = irritability\/anxiousness, blood = changeable temperament<\/li>\n<\/ul>\n<p>The Dark Ages and Demonology<\/p>\n<ul>\n<li>Death of Galen said to be the start of the Dark Ages in western European medicine \uf0b7 Monks in the monasteries cared for and nursed the sick (prayed, touched w\/relics, potions) \uf0b7 The Persecution of Witches:\n<ul>\n<li>13<sup>th<\/sup> century, recurrent famines and plagues *demonological explanations for disasters o Witchcraft (instigated by Satan) viewed as heresy and a denial of God o Torture sometimes led to bizarre delusional sounding confessions o Pope Innocent VIII mandated witch hunts o Burning used as method of driving out the demon<\/li>\n<li>Turns out more healthy individuals than mentally ill individuals were tried and\/or prosecuted as witches \uf0b7 Lunacy Trials:<\/li>\n<li>Municipal authorities took over some activities of the church, one being care of mentally ill o 1 purpose of the hospital: mad are kept safe until they are restored of reason\n<ul>\n<li>Not described as being possessed o Trials conducted under the Crown\u2019s right to protect the people with psychological disorders<\/li>\n<li>Trials were to determine a person\u2019s mental health\/sanity (13<sup>th<\/sup> century, England)<\/li>\n<li>Judgment of insanity allowed the Crown to become guardian of the lunatic\u2019s estate o Strange behaviour was attributed to physical illness\/injury, or emotional shock<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>o \u201cLunacy\u201d comes from Swiss physician, attributed odd behaviour to misalignment of the moon and stars<\/p>\n<p>Development of Asylums<\/p>\n<ul>\n<li>Very few hospitals for people with psychological disorders until the 15<sup>th<\/sup> century<\/li>\n<li>Many hospitals for people with leprosy o As leprosy disappeared, these buildings were no longer used, converted to asylums \uf0b7 <strong>Asylums<\/strong> = establishments for the confinement and care of mentally ill \uf0b7 Bethlehem and Other Early Asylums:<\/li>\n<\/ul>\n<p>o Priory of St. Mary and Bethlehem founded in 1243 *one of first mental institutions<\/p>\n<p>1547 Henry VIII devoted the hospital to confinement of people with psychological disorders o Became a tourist attraction *bought tickets to enter o Origin of term bedlam (wild uproar or confusion)\u00a0 o Similar to the Lunatics Tower in Vienna o Medical treatments were crude and painful<\/p>\n<p>o Benjamin Rush (father of American psychiatry) \u2013 believed psyc disorders were caused by excess blood in the brain, would treat by drawing large quantities of blood from disordered individuals<\/p>\n<p>\uf0a7 Believed he could cure people by frightening them *convince them death is near \uf0b7 Pinel\u2019s Reforms:<\/p>\n<p>o Figure for more humane treatment of people with psychological disorders in asylums o Pinel was thought to have removed the confining chains worn by patients at La Bicetre<\/p>\n<p>\uf0a7 Was really a former patient (Jean-Baptiste Pussin), became an orderly o Pinel believed that if reason had left a patient because of severe social\/personal problems, it might be restored through comforting counsel and purposeful activity \uf0b7 Moral Treatment:<\/p>\n<ul>\n<li>Friend\u2019s Asylum (1817 Pennsylvania), Hartford Retreat (1824 Connecticut)<\/li>\n<li><strong>Mental treatment<\/strong> = people had close contact with attendants, who talked and read to them and encouraged them to engage in purposeful activity<\/li>\n<li>Residents lead lives as close to normal as possible o Engage in purposeful, calming activities (e.g. gardening) o Talked with attendants<\/li>\n<li>In general, took responsibility for themselves<\/li>\n<li>Dorthea Dix \u2013 crusader for improved conditions for people with psychological disorders\n<ul>\n<li>Campaigned to improve the lives of people with psychological disorders<\/li>\n<li>Efforts lead to 32 public hospitals being built<\/li>\n<li>Staff unable to provide individual attention, ran by physicians not interested in psychological well-being, only interested in biological aspects of illness <strong>The Evolution of Contemporary Thought <\/strong><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>Biological Approaches<\/p>\n<ul>\n<li>Biological Origins in General Paresis and Syphilis:\n<ul>\n<li>By mid 1800s, partially understood anatomy and workings of the nervous system o Not enough to know if structural brain abnormalities that cause psychological disorders were present<\/li>\n<li>Many people with psyc disorders had a syndrome of steady deterioration of mental and physical abilities and progressive paralysis = <strong>general paresis <\/strong>\n<ul>\n<li>= Degenerative disorder with psyc symptoms (delusions of grandeur) &amp; physical symptoms (progressive paralysis)<\/li>\n<li>Established that some people with general paresis also had syphilis <strong>o <\/strong>Louis Pasteur \u2013 <strong>germ theory of disease<\/strong> = disease is caused by infection of the body by minute organisms<\/li>\n<li>Demonstrated relation between syphilis and general paresis<\/li>\n<li>Causal link established between infection, damage to certain areas of the brain, and a form of psychopathology (paresis) \uf0b7 Genetics:<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>o Galton \u2013 originator of genetic research with twins, attributed many behavioural characteristics to heredity<\/p>\n<ul>\n<li>Coined the terms nature and nurture (genetics vs. environment)<\/li>\n<li>Mental illness can be inherited (internal trait)<\/li>\n<li>Also created the<strong> eugenics<\/strong> <strong>movement<\/strong>, sought to eliminate undesirable characteristics from the population by restricting the ability of certain people to have children (= <strong>enforced sterilization<\/strong>) \uf0b7 Biological Treatments:<\/li>\n<\/ul>\n<ul>\n<li>Experimentation with radical interventions began on those with psychological disorders o <strong>Insulin induced coma<\/strong> (Sakel) to treat schizophrenia **serious risks of treatment<\/li>\n<li><strong>Electroconvulsive therapy<\/strong> = applying electric shocks to the sides of the human head, used to produce epileptic seizures (used as a technique on patients with schizophrenia &amp; severe depression)<\/li>\n<li><strong>Prefrontal lobotomy<\/strong> = a surgical procedure that destroys the tracts connecting the frontal lobes to other areas of the brain (Moniz) *used especially for violent behaviour<\/li>\n<\/ul>\n<p>\uf0a7 Recipients became dull and listless, suffered serious losses in cognitive capacities<\/p>\n<p>Psychological Approaches<\/p>\n<ul>\n<li>Search for biological causes dominated until well into the 20<sup>th<\/sup> century \uf0b7 Mesmer and Charcot:<\/li>\n<\/ul>\n<p>o Mesmer was a physician with an interest in astronomy who theorized that there was a natural energetic transference that occurred between all animate &amp; inanimate objects that he called ANIMAL MAGNETISM, sometimes later referred to as MESMERISM<\/p>\n<p>\uf0a7 Treated patients w\/hysteria using animal magnetism (early practitioner of hypnosis) o Many people were observed to be subject to hysteria in 18<sup>th<\/sup> century western Europe o <strong>Hysteria<\/strong> = physical incapacities, such as blindness or paralysis, for which no physical cause could be found<\/p>\n<p>o Mesmer believed hysteria was caused by a distribution of a universal magnetic fluid in the body<\/p>\n<ul>\n<li>One person could influence the fluid of another to bring about change in the other\u2019s behaviour<\/li>\n<li>Conducted meeting involving mystery and mysticism, trying to transmit animal magnetism and adjust universal magnetic fluid in individuals to remove the hysterical disorder (first using rods, then just by looking)<\/li>\n<li>Viewed hysteria of having strictly biological causes<\/li>\n<li>Early practitioner of modern-day hypnosis o Charcot believed hysteria was a problem of the nervous system, also persuaded by psychological explanations \uf0b7 Breuer and the Cathartic Method:<\/li>\n<\/ul>\n<ul>\n<li>Anna O had a number of hysteria symptoms: partial paralysis, impairment of sight and hearing, and difficulty speaking, sometimes went into a dream-like state<\/li>\n<li>Breuer hypnotized her and she spoke freely about upsetting events from her past o Felt much better upon being awakened after hypnotic session<\/li>\n<li><strong>Cathartic <\/strong><strong>method<\/strong> = reliving an earlier emotional trauma and releasing emotional tension by expressing previously forgotten thoughts about the event<\/li>\n<li>Published \u201cStudies in Hysteria\u201d with Sigmund Freud \uf0b7 Freud and Psychoanalysis:<\/li>\n<li>Much of human behaviour is determined by forces that are inaccessible to awareness o <strong>Psychoanalytic theory<\/strong> = psychopathology results from unconscious conflicts in the individual \uf0b7 Structure of the Mind (Freud):<\/li>\n<\/ul>\n<p><strong>Psyche<\/strong> = the mind, divided into 3 principle parts: id, ego and superego o <strong>Id<\/strong> = present at birth, repository of all energy needed to run the psyche, includes basic urges<\/p>\n<p>*aka limbic system<\/p>\n<ul>\n<li><strong>Libido<\/strong> = biological source of the id\u2019s energy (unconscious)<\/li>\n<li>Id seeks immediate gratification = <strong>pleasure principle<\/strong> (tension is produced if not satisfied)<\/li>\n<\/ul>\n<ul>\n<li><strong>Ego<\/strong> = begins to develop from the id during the second 6 months of life, conscious, deals with reality<\/li>\n<\/ul>\n<p>\uf0a7 Operates on the <strong>reality principle<\/strong> = mediates between the demands of reality and the id\u2019s demands for immediate gratification<\/p>\n<ul>\n<li><strong>Superego<\/strong> = a person\u2019s conscience, develops throughout childhood, arising from the ego\n<ul>\n<li>Incorporate parental values as their own<\/li>\n<li>Ego and Superego aka frontal lobe \uf0b7 Defense Mechanisms:<\/li>\n<\/ul>\n<\/li>\n<li>Discomforts experienced by the ego as it attempts to resolve conflicts and satisfy demands of the id and superego can be reduced in several ways<\/li>\n<li><strong>Defense mechanism<\/strong> = a strategy used by the ego to protect itself from anxiety (repression, denial, projection, regression, rationalization) \uf0b7 Psychoanalytic Therapy:<\/li>\n<li>Goal of the therapist is to understand the person\u2019s early-childhood experiences, the nature of key relationships, and the patterns in current relationships<\/li>\n<li>Therapist listens for core emotional and relationship themes that surface again and again o <strong>Free association<\/strong> = a person reclines on a couch, facing away from the analyst, and is encouraged to give free rein to his or her thoughts, verbalizing whatever comes to mind, without censoring anything<\/li>\n<li><strong>Transference<\/strong> = the person\u2019s responses to his\/her analyst that seem to reflect attitudes and ways of behaving toward important people in the person\u2019s past\n<ul>\n<li>Analyst could gain insight into childhood origins of a person\u2019s repressed conflicts o <strong>Interpretation<\/strong> = the analyst points out to the patient the meanings of certain of a person\u2019s behaviour<\/li>\n<li>Defense mechanisms are a principle focus \uf0b7 Jung and Analytical Psychology:<\/li>\n<\/ul>\n<\/li>\n<li><strong>Collective unconscious<\/strong> = part of the unconscious that s common to all human beings and that consists primarily of <strong>archetypes<\/strong> = basic categories that all human beings use in conceptualizing about the world<\/li>\n<li>Each of us has masculine and feminine traits that are blended o People\u2019s spiritual and religious urges are as basic as the id urges o Extraversion vs. introversion \uf0b7 Adler and Individual Psychology:<\/li>\n<li><strong>Individual psychology<\/strong> = regarded people as inextricably tied to their society, fulfillment is found in doing things for the social good<\/li>\n<li>Stressed the importance of working toward goals o Focus on helping people change their illogical and mistaken ideas and expectations o Feeling and behaving better depend on thinking more rationally (lead to CBT) \uf0b7 Continuing Influences of Freud and His Followers:<\/li>\n<li>&#8211; Freud conducted no formal research on causes\/treatments of psychological disorders o &#8211; Based on anecdotal evidence, not grounded in objectivity<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p>1) Childhood experiences help shape adult personality (don\u2019t focus on his psychosexual stages as much)<\/p>\n<ul>\n<li>2) There are unconscious influences on behaviour *people can be unaware of the cause of their behaviour<\/li>\n<li>3) The causes and purposes of human behaviour are not always obvious \uf0b7 The Rise of Behaviourism:<\/li>\n<li>Dissatisfaction in Freud\u2019s theories bright to a head by John Watson<\/li>\n<li><strong>Behaviourism<\/strong> = focuses on observable behaviour rather than on consciousness or mental functioning<\/li>\n<li>Focus shifted from thinking to learning o 1) Classical Conditioning:\n<ul>\n<li>Ivan Pavlov<\/li>\n<li><strong>Unconditioned stimulus<\/strong> = automatically elicits a response without prior learning<\/li>\n<li><strong>Unconditioned response<\/strong> = response elicited by UCS<\/li>\n<li><strong>Conditioned stimulus<\/strong> = previously neutral stimulus that elicits a conditioned response after multiple pairings with UCS<\/li>\n<li><strong>Conditioned response<\/strong> = response elicited by CS<\/li>\n<li><strong>Extinction<\/strong> = CR gradually disappears if the CS is no longer followed by the UCS<\/li>\n<li>John Watson and Little Albert o 2) Operant Conditioning:<\/li>\n<li>Thorndike studied the effects of consequences on behaviour<\/li>\n<li><strong>Law of effect<\/strong> = behaviour that is followed by consequences satisfying to the organism will be repeated, and behaviour followed by unpleasant consequences will be discouraged<\/li>\n<li>Skinner \u2013 operant conditioning \u201cPrinciple of reinforcement\u201d<\/li>\n<li><strong>Positive reinforcement<\/strong> = strengthening of a tendency to respond by virtue of the presentation of a pleasant event called a positive reinforcer<\/li>\n<li><strong>Negative reinforcement<\/strong> = strengthens a response but does so with the removal of an aversive event<\/li>\n<li>Operant conditioning principles may contribute to persistence of aggressive behaviour of conduct disorder o 3) Modeling:<\/li>\n<li>We learn by watching and imitating others (even without reinforcement)<\/li>\n<li>Witnessing someone perform certain activities can increase\/decrease diverse kinds of behaviours (Bandura &amp; Menlove) \uf0b7 Behaviour Therapy:<\/li>\n<\/ul>\n<\/li>\n<li>Emerged in 1950s \u2013 applied procedures base don classical and operant conditioning to alter clinical problems = <strong>behaviour modification<\/strong><\/li>\n<li><strong>Systematic desensitization<\/strong> = includes deep muscle relaxation and gradual exposure to a list of feared situations, starting with those that arouse minimal anxiety and progressing to these that are the most frightening (used to treat anxiety &amp; phobias)<\/li>\n<li>A state opposite to anxiety is substituted for anxiety as the person is exposed gradually to stronger and stronger doses of what he\/she fears<\/li>\n<li>Modeling also included in behaviour therapy<\/li>\n<li>Operant techniques using rewards have been particularly successful with treating childhood problems<\/li>\n<\/ul>\n<p>Intermittent reinforcement (only rewarding some instances of target behaviour) makes new behaviour more enduring \uf0b7 The Importance of Cognition:<\/p>\n<ul>\n<li>Humans don\u2019t just behave, we think and feel too<\/li>\n<li>The way in which people think about situations can influence behaviour in dramatic ways \uf0b7 Cognitive Therapy:<\/li>\n<li>Based on the idea that people not only behave, they also think and feel<\/li>\n<li>Emphasize how people construe themselves and the world is a major determinant of psychological disorders<\/li>\n<li>Therapist begins by helping clients become more aware of their maladaptive thoughts o Change cognition to change feelings and behaviour<\/li>\n<li>Roots in Beck\u2019s cognitive therapy and Ellis\u2019s Rational Emotive Behavioural Therapy o <strong>REBT<\/strong> = sustained emotional reactions are caused by internal sentences that people repeat to themselves; these self-statements reflect sometimes unspoken assumptions \u2013 irrational beliefs \u2013 about what is necessary to lead a meaningful life<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>Psychopathology = the field concerned with the nature, development and treatment of psychological disorders Challenge: remaining objective, avoiding preconceived notions, reduce stigma Stigma = destructive beliefs and attitudes held&hellip; <a class=\"continue\" href=\"https:\/\/www.amyork.ca\/academic\/zz\/abnormal-psychology\/introduction-and-historical-overview\/\">Continue Reading<span> Introduction and Historical Overview<\/span><\/a><\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[104],"tags":[],"_links":{"self":[{"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/posts\/4179"}],"collection":[{"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/comments?post=4179"}],"version-history":[{"count":0,"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/posts\/4179\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/media?parent=4179"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/categories?post=4179"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/tags?post=4179"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}