Chapter 1 – Abnormal Behavior:  Historical and Modern Perspectives

 

I.  What Is Abnormality?

        A.  Statistical Infrequency (Statistical Deviance)

        B.  Violation of Societal Norms

                1.  Norms can differ by age, culture, environment, time, etc

                2.  “goodness-of-fit”

        C.  Dangerousness?

        D.  Personal Distress

        E.  Disability or Dysfunction (Functional Impairment)

 

II.  What Is a Paradigm?

        A.  Perspectives, views, filters

        B.  Helps in organizing data

        C.  Risks narrowing of observations and interpretations

                1.  “If all you have is a hammer, everything looks like a nail.”

        D.  Error of assuming cause via successful treatment

        E.  More interactions than single-paradigm theories would suggest

        F.  So, focus on factors involved, rather than single paradigms?

        G.  Importance of “Scientist-Practitioner Approach” (here and elsewhere)

 

 

III.  History of Psychopathology and Its Treatment

        A.  Spirits, demonology, witchcraft, and other supernatural explanations

                1.  Early history/Biblical times, 14th -18th centuries

                2.  tx = trephination, exorcisms, snakepits, witch trials

       

        B.  Earliest Biological Views

                1.  Hippocrates (5th century BCE), later expanded by Galen (2nd century)

                2.  Four humours

                3.  Also coined term “hysteria”

                4.  One of first to look at physical causes

                5.  tx = rest, nutrition, etc.

 

C.  Asylum Care and Moral Treatment (18th /19th centuries)

        1.  Pinel and Pussin’s reforms in France

        2.  “kindness and occupation,”  “calm and order”

        2.  Brought to and implemented in America by people like Benjamin Rush, Dorothea Dix, Jane Addams

 

        D.  Early Contemporary Biological Views (18th century toward present day)

                1.  Classification of symptoms into syndromes – Kraeplin

                        a. based on covariation of symptoms; etiology; prognosis

                2.  The role of syphilis and general paresis

                3.  Mesmer and Charcot:  hysteria, 18th and 19th centuries

                        a.  caused by impeded animal magnetism (M); brain deformity (C)

                        b.  as new data countered Charcot’s view, abandoned brain deformity for self-hypnosis

                4.  tx = medical/physical methods (lobotomy, ECT, penicillin, “magnetic passes over body”)

 

        E.  Early Contemporary and Modern Psychological Views:  Psychoanalysis

                1.  Charcot’s newly revised views of hysteria as self-hypnosis

                2.  Breuer and Freud:  hysteria and catharsis, beg. of psychoanalysis

a.  Late 19th and early 20th century

                        b.  Structure of mind:  id, ego, superego

                        c.  Psychosexual development and fixation

                        d.  Conflict à Neurotic anxiety à Defense mechanisms

                                i.     ex:  repression, projection, displacement

                                ii.    see chart on pg 26

                        e.  Tx = “make the unconscious conscious”

                                i.  free association

                                ii. interpretation of resistance, transference, dreams, behaviors

                                iii.  leads to insight and catharsis

                        f.  Later developments:  ego psychology, object relations, Jungian/Adlerian approaches

                3.  Modern-Day Psychoanalysis

                        a.  Traditional psychoanalysis

                        b.  Modern psychodynamic perspectives

                                i.  continued emphasis on unconscious, defenses, intrapsychic dynamics

                                ii.  less emphasis on psychosexual stages, earliest childhood

                                iii.  tends to be briefer and more focused

                        c.  Evaluation:  Much criticism of Freudian theory (very little scientific support, based on very narrow sample, largely unfalsifiable, and when tested, often is disproven).  But is important in emphasizing that childhood plays a role in adulthood, there are unconscious/nonconscious influences on us, not everything is obvious.

 

       

        F.  Early Contemporary and Modern Psychological Views:  Behaviorism

                1.  Beginning early 20th century

                2.  Based in animal learning models, applied to human situations

3.  Classical conditioning (Pavlovian conditioning)

a.  Watson and Rayner:  Applied classical conditioning to cause fear (Little Albert)

b.  Mary Cover Jones:  Used classical conditioning to reduce fear, via extinction

c.  later, Joe Wolpe:  used counter-conditioning in systematic desensitization

4.  Operant conditioning 

        a.  Thorndike’s Law of Effect

b.  Skinner:  adapted Law of Effect to develop operant conditioning

        i.   reinforcement and punishment

        ii.  schedules of reinforcement

        iii.  shaping, generalization, etc

                5.  Modeling (observational learning, social learning, vicarious conditioning):  Bandura

6.  Mediational Learning

a.  Mowrer’s two-factor theory

7.  Cognitive theory

        a.  interpretations of events, not events themselves, are what matter

        b.  Beck:  negative cognitive triad of schemas à cognitive distortions

8.  Tx =  break maladaptive learned behaviors (or distorted thoughts), replace with new

a.  counterconditioning (systematic desensitization, aversive conditioning)

b.  rearrange contingencies (token economies, reward/punishment, etc)

c.  modeling, role-playing, behavioral rehearsal

d.  exposure

e.  cognitive challenging and behavioral experiments

 

                9.  Evaluation:  CBT treatment methods are amongst best-studied, and most effective.  Criticisms:  can’t always find relevant learning history to explain problem, ignores individual differences (e.g., in temperament), difficult to measure cognition, or show where it comes from; little focus on historical factors?

               

        G.  Modern Psychological Views:  Humanism

1.  Mid-20th century

2.  Emphasized role of free will, innate striving

3.  Not very comprehensive description of causes; focus on treatment

        a.  problems arise via failure to self-actualize

        b.  Rogers:  due to discrepancy between self-image and actual self

4.  Tx = help person strive toward self-actualization

                i.   Rogers:  client-centered therapy

ii.  unconditional positive regard, genuineness, empathy

iii. use of reflective listening

           

        H.  Modern Biological Views:  Genetics and Neuroscience (see chpt 2 for basics)

                1.   Genes vs gene expression, polygenic etiology

                2.  How do we determine extent of genetic component?

                        a.  will be covered in chapter 2 (research methods)

                3.  Role of neurotransmitters

        a.  too many or too few receptors

                        b.  receptors too easily or not easily enough excited

                        c.  problems in reuptake process

                        d.  neurotransmitter functioning affected by agonists/antagonists

                4.   Neuroendocrine system

                        a.  stress hormones

                5.  Structural abnormalities

                        a.  cause vs effect?

                6.   Tx = adjust brain chemistry via medication; awareness of vulnerabilities à better prevention/identification?

                7.   Evaluation:  Much evidence for roles of both genetics and neuroscience, but reductionistic?  May ignore environment.

 

        I.  Sociocultural Factors

                1.  Includes impact of gender and gender roles, SES, social support, culture, subculture, etc

        2.  Culture-bound syndromes

                3.  Socioculturally influenced expressions of emotions/behaviors/thoughts

                4.  Sociocultural differences in prevalence, treatment-seeking, outcome

       

        J.  BioPsychoSocial Model

                1.  Integrative approaches in which many factors above are seen as important

                2.  Diathesis-stress model

                3.  Can include other gene/environment interactions