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Chapter 1

Abnormal psychology Chapter 1.docx

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York University
PSYC 3140
Jennifer Lewin

Abnormal psychology Chapter 1 What is Psychological disorder? Psychological disorder: a psychological dysfunction within an individual associated with distress or impairment in functioning and a response that is not typical or culturally expected Psychological dysfunction Psychological dysfunction: breakdown in cognitive, emotional, or behavioral functioning - it exists on a continuum -it is either present of absent Personal Distress -disorder or behavior must be associated with distress adds an important component and seems clear: the criterion is satisfied if the individual is extremely upset -normal to be distressed -psychological disorders are simply extreme expressions of otherwise normal emotions, behaviours, and cognitive processes Atypical or Not Culturally Expected -the criterion that the response be atypical or not culturally expected is important but also insufficient to determine abnormality -something is considered abnormal because it occurs infrequently -your behavior is abnormal if you are violating social norms, even if some people are sympathetic to your point of view -Diagnostic and Statistical Manual (DSM-IV-TR) contains the current listing of criteria for psychological disorders -it is difficult to define normal and abnormal -DSM-IV-TR describes behavioral, psychological, or biological dysfunctions that are unexpected in their cultural context and associated with present distress and impairment in functioning, or increased risk of suffering, death, pain, or impairment -Szasz advanced his position that mental illness is a myth and that the practice of labeling mental illnesses should be abolished. He argued that a fundamental difference exists between the use of diagnoses for physical diseases and their use in mental illnesses -Albee argued that the biggest mistake made by clinical psychology profession was uncritically accepting the concept of mental disease and using the medical model and associated diagnoses in conceptualizing abnormal behavior The science of Psychopathology Psychopathology: is the scientific study of psychological disorders -trained professionals include: clinical/counseling psychologists, psychiatrists, psychiatric social workers/nurses, marriage and family therapists, and mental health counselors -PH.D (Doctor of Philosophy) prepares them to conduct research into the causes and treatment of psychological disorders and to diagnose, assess, and treat these disorders -Psy. D (Doctor of psychology) more emphasis on on clinical practice and less on research and training -only those who are licensed or registered with their provincial board or college are permitted to call themselves psychologists -the label of psychologist conveys information about the training and qualifications of the professional, whereas the label of psychotherapist are not specific to a particular profession -experimental and social psychologists, concentrate on investigating the basic determinants of behavior but do not assess or treat psychological disorders - counseling psychologists study and treat adjustment and vocational issues encountered by relatively healthy individuals, whereas clinical psychologists concentrate on more severe psychological disorders -psychiatrists also investigate the nature and causes of psychological disorders, often from a biological point of view, make diagnoses, and offer treatments -social workers treat disorders concentrating on family problems associated with them -psychiatric nurses specialize in the care and treatment of patients with psychological disorders usually in hospitals as part of a treatment team -Marriage and family therapists and mental health counselors provide clinical services in hospitals or clinics, under the supervision of a doctoral- level clinician The Scientist- Practitioner -development in the history of psychopathology is the adoption of scientific methods to learn more about the nature of psychological disorders, their causes, and their treatment -Mental health professionals take a scientific approach to their clinical work and are referred to scientists- practitioners -Mental health practitioners may function as scientists practitioners at least one of three ways:  Consumer of science  enhancing the practice  Evaluator of science  determining the effectiveness of the practice  Creator of science  conducting research that leads to new procedures useful in practice -Three major categories compose the study and discussion of psychological disorders  Clinical description  Causation (etiology)  Treatment and outcome Clinical Description -Presents: indicating why the person came to the clinic -clinical description represents unique combination of behaviors, thoughts, and feelings that make up a specific disorder. Important function of clinical description is to specify what makes the disorder different from normal behavior or from other disorders Clinical: types of problems or disorders you would find in a clinic or hospital and to the activities connected with assessment and treatment. -Prevalence: how many people in the population as a whole have the disorder -Incidence: how many cases occur during a given period -most disorders follow an individual pattern (course) -chronic course: last long time -episodic course: likely to recover within a few months -acute onset: begin suddenly -insidious onset: gradually over an extended time -prognosis: anticipated course of a disorder Causation, Treatment, and Outcomes -Etiology: has to do with why a disorder begins (what causes it) and includes biological, psychological and social dimensions -treatment is often important to the study of psychological disorders The Supernatural Tradition Demons and Witches -society as a whole began to believe in the reality and power of demons and witches. People turned to magic and sorcery to solve their problems -individuals possessed by evil spirits were responsible for misfortune experienced by townspeople -treatments included exorcism (religious rituals performed), shaving the cross in victim’s hair, tying them to a church wall so they hear the mass Stress and Melancholy -insanity was a natural phenomenon caused by mental or emotional stress, and that it was curable -mental depression and anxiety were recognized as illnesses -treatments were rest, sleep, and a healthy and happy environment, baths, ointments, and potions -Nicholas Oresme suggested that the disease of melancholy (depression) rather than demons, was the source of some bizarre behavior Treatments for Possession -HIV/AIDS some people believe it is a divine punishment for what they consider abhorrent behavior -Possession is not always connected with sin and may be seen as involuntary and the possessed individual as blameless -use exorcism painful...sometimes works… if it failed some other steps are taken to make the body uninhabitable by evil spirits, many people were subjected to confinement, beatings and torture The Moon and the Stars -Paracelsus rejected notions of possession by the devil, suggested that the movements of the moon and stars had profound effects on people’s psychological functioning -millions of people around the world are convinced that their behavior is influenced by the stages of the moon or the position of the stars. This belief is most noticeable today in followers of astrology, who hold that their behavior and the major events in their lives can be predicted by their day-to-day relationship to the position of the planets The Biological Tradition Hippocrates and Galen - Greek physician Hippocrates father of modern medicine. He and his associates left a body of work called the Hippocratic Corpus which suggests that psychological disorders could be treated like any other disease. They believed psychological disorders might also be caused by brain pathology or head trauma and could be influenced by heredity (genetics) -Hippocrates considered the brain to be the seat of wisdom, consciousness, intelligence, and emotion. Disorders involving these functions would logically be located in the brain -Hippocrates recognized the importance of psychological and interpersonal contributions to psychopathology -physician Galen adopted the ideas of Hippocrates -influential legacies of the Hippocratic-Galenic approach is the humoral theory of disorders. -Hippocrates assumed that normal brain functioning was related to four bodily fluids, or humors: blood, black bile, yellow bile, and phlegm -blood came from the heart, black bile from the spleen, phlegm from the brain, and choler or yellow bile from the liver -physicians believed that disease resulted from too much or too little of one of the humors -four humors were related to the Greeks’ conception of the four basic qualities: heat, dryness, moisture, and cold -excesses of one or more humors were treated by regulating the environment to increase or decrease heat, dryness, moisture or cold, depending on which humor was out of balance Syphilis -behavioral and cognitive symptoms of what we now know as advanced syphilis include believing that everyone is plotting against you or that you are God as well as other odd behaviors -Pasteur stated that all the symptoms of a disease were caused by a germ that had invaded the body -a cure for general paresis: physicians observed recovery in patients who had contracted malaria and injected others with blood from a soldier who was ill with malaria. High fever burned out the syphilis bacteria -clinical investigators discovered that penicillin cures syphilis John P. Grey -psychiatrist named John P.Grey appointed superintendent of a hospital in New York -Grey’s position was that insanity always has physical causes -the mentally ill patient should be treated as physically ill. Emphasis on rest, diet, and proper room temperature and ventilation -Grey even invented the rotary fan in order to ventilate his large hospital -Under Grey’s leadership, hospitals improved -deinstitutionalization: patients were released into their communities The Development of Biological Treatments -physical interventions of electric shock and brain surgery were often used, new drugs, insulin given to stimulate appetite in psychotic patients who were not eating and calmed them down -insulin shock therapy is giving higher doses of insulin until patients convulsed and became temporarily comatose. This was abandoned because it was too dangerous resulting in prolonged coma or death -Joseph von Meduna observed schizophrenia rarely found in epileptics. His followers concluded that induced brain seizures might cure schizophrenia -opium had been used as sedatives, along with herbs and folk remedies. Serpentina and neuroleptics drugs can diminish hallucinatory and delusion thought processes but controlled agitation and aggressiveness -benzodiazepines reduced anxiety -Neuroleptics had side effects, such as tremors and shaking Consequences of the Biological Tradition -John p. Grey and his colleagues reduced interest in treating patients with mental illnesses. They thought mental disorders were due to brain pathology therefore incurable. -in place of treatment, interest centered on diagnosis, legal questions concerning the responsibility of patients for their actions during periods of insanity, and the study of brain pathology itself -Emil Kraepelin involved in treatment, reflecting the belief that disorders were due to brain pathology. His lasting contribution was in the area of diagnosis and classification -Kraepelin was one of the first to distinguish among various psychological disorders, seeing that each may have a different age of onset and course, with somewhat different cluster of presenting symptoms and probably a different cause -treatment based on humane principles The Psychological Tradition -Plato thought that the two causes of maladaptive behavior were the social and cultural influences in a person’s life and learning that took place in that environment -psychosocial approaches, focus not only on psychological factors but also on social and cultural ones -Aristotle emphasized the influence of the social environment and early learning on later psychopathology -these philosophers wrote about the importance of fantasies, dreams, and cognitions and thus anticipated, to some extent, later developments in psychoanalytic thought and cognitive science Moral Therapy - a strong psychosocial approach to mental disorders called moral therapy -moral therapy meant emotional or psychological rather than a code of conduct -basic tenets included treating institutionalized patients as normally as possible in a setting that encouraged and reinforced normal social interaction, providing them with many opportunities for appropriate social and interpersonal contact -Pinel’s where a humane, socially facilitative atmosphere produced miraculous results -Benjamin Rush introduced moral therapy to New World -asylums provided places of refuge for the confinement and care of people with mental illnesses -Sussman notes institutionalizing people wit
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