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01:830:340 (47)
Chapter 1


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Sara Campbell

Chapter 1: Abnormal Behavior in Historical Context I. What is a Psychological Disorder? psychological disorder: psychological dysfunction associated with distress or impairment in functioning that is not a typical or culturally expected response. phobia: a psychological disorder characterized by marked and persistent fear of an object or situation. abnormal behavior: actions that are unexpected and often evaluated negatively because they differ from typical/usual behavior. psychological dysfunction associated with distress or impairment in functioning and a response that is not typical or culturally expected three criteria for determining abnormal behavior: 1. psychological dysfunction-a breakdown in cognitive, emotional, or behavioral functioning a. drawing the line btwn normal and abnormal is difficult ex fear of blood is common among people but at what point is it dysfunctional 2. personal distress- the behavior must be associated with distress for the individual which is severe enough to impair normal functioning a. some disorders (ex mania) are not associated with distress (may actually enjoy it) b. some level impairment in normal functioning must be present c. extreme expressions of normal emotions, behaviors, and cognitive processes 3. atypical/not culturally expected- a behavior is abnormal is you are violating social norms. abnormal does not necessarily mean deviating from the average (ex being smarter than avg isn't bad its talented) social standards of normal can be misused. accepted definition of abnormal: ■ difficult to define and must have all three criteria present ■ most widely accepted definition describes behavioral, psychological, or biological dysfunctions that are unexpected in their cultural context and associated with present distress and impairment in functioning or inc risk of suffering, death, pain, or impairment. * to determine if someone’s behavior is normal prototypes of disorders are created. prototypes: diagnostic criteria which create a typical profile for a disorder, and used in comparison with a patient's behavior to determine if they are abnormal. II. The Science of Psychopathology psychopathology: the scientific study of psychological disorders. ■ clinical & counseling psychologists- receive a PhD in a five year graduate program of study preparing them to conduct research, diagnose, and treat disorders. ○ counseling: study and treat adjustment and vocational issues encountered by relatively healthy individuals. ○ clinical: concentrate on more severe psychological disorders ■ psychiatrists- first earn a MD in med school then specialize in psychiatry during residency training (3-4 years). investigate cause, diagnose, and treat disorders. emphasize drugs or other biomedical treatments and psychosocial treatment. ■ psychiatric social workers-earn a masters degree in social work (learn about the family situation of individual with psychological disorder). treat disorders associated with family problems. ■ psychiatric nurses-specialize in treatment of of patients with psychological disorders usually in hospitals as part of the treatment team. ■ marriage and family therapists and mental health counselors- spend one to two years earning a masters degree and are employed to provide clinical services by hospitals or clinics. scientist practitioner: mental health professional expected to apply scientific methods to their work (in three ways) 1. keep up with the latest developments in their field and therefore use the most current diagnostic and treatment procedures 2. evaluate their own treatment procedures to see whether they are effective a. accountable not only to patients but to insurance companies/ government so must demonstrate that their treatments work 3. conduct research that provides new information about disorders or their treatment (research attempts three things) a. describe psychological disorders b. determine their causes c. treat them clinical description- presenting problem: original complaint reported by the client to the therapist, the actual treated problem may be a modification derived from the presenting problem. (used to determine a clinical description) clinical description: details of the combination of behaviors, thoughts, and feelings of an individual that make up a particular disorder. (specify what makes certain behavior different from abnormal uses prevalence) prevalence: number of people displaying a disorder in a total pop at any given time. incidence: number of new cases of a disorder appearing during a specific period. (onset and total number of cases are compared in a ratio) course: pattern of development and change of a disorder over time. chronic course- tend to last a long time (ex. schizophrenia) ■ episodic course- individual is likely to recover within a few months only to suffer recurrence of disorder at a later time (ex. mood disorders) ■ time-limited course- will improve without treatment over a relatively short time period. onset: how quickly a disorder develops/ progresses ■ acute onset- disorder begins suddenly ■ insidious onset-disorder develops gradually over an extended time period prognosis: predicted development/ anticipated course of a disorder over time *important to know typical course of a disorder and onset to know what can be expected and so it can be treated effectively developmental psychology: the study of changes in behavior over time *age is an important part of clinical description (a disorder occurring in a child may present differently than the same disorder in an adult bc of different thought processes, children are often misdiagnosed and treated for mental disorder) developmental psychopathology: the study of changes in abnormal behavior life-span developmental psychopathology: the study of an abnormal behavior throughout an entire age span causation, treatment, and etiology outcomes- Etiology: the study of the cause or source of a disorder including biological, social, and psychological dimensions. ■ effective treatments can provide information about the cause of a disorder however the effect does not necessarily imply the cause ○ ex when you have a headache and take aspirin to cure it does not mean that the cause of the headache was lack of aspirin III.Historical Conceptions of Abnormal Behavior ■ humans have tried to explain problematic behavior since beginning of existence ■ three major models have been developed 1. supernatural model: agents outside our bodies influence our behaviors (divinities, demons, spirits, moos, etc) developed ideas of the soul/psyche and thought either the soul or body controlled the other and was responsible for abnormal behavior, this thinking led to two more models: 2. biological model 3. psychological model: The Supernatural Model: A. demons and witches ■ 14th-15th century supported by religions and lay authorities ■ people possessed by the devil were responsible for misfortune ■ exorcism: religious ritual that attributes disordered behavior to possession by demons and seeks to treat the individual by driving the demons from the body ■ other treatments included shaving cross on victims head and hearing mass B. stress and melancholy ■ reflected that insanity was a natural phenomenon caused by mental or emotional stress and was curable ■ church identified symptoms of anxiety and depression with the sin of acedia (sloth) ■ common treatments were sleep and a healthy enviro ■ other treatments included baths, ointments, potions ■ would transfer from villages where people took turns caring for them (we now know that keeping individuals within their own community is beneficial) C. Treatments for possession ■ middle ages were subject to beating, confinement, other tortures ■ hang over snakes to scare evil spirits out of the body ■ early shock treatments: dumping in cold water (hydrotherapy) D. mass hysteria ■ large scale outbreaks of bizarre behavior ■ in europe when large groups of people would run out into streets ance and shout for no reason ■ emotion contagion: the experience of an emotion of one person spreads to those around us. ■ mob psychology: if one person identifies the source of an emotion other people will assume that their reactions are coming from the same source (school example p. 9) E. the moon and the stars ■ Paracelsus (swiss physician) rejected possession and said that the moon and stars has effect on people's psychological functioning ■ derived word lunatic (root luna) The Biological Model: A. Hippocrates and Galen a. hippocrates- greek physician suggested psychological disorders could be treated like any other disease b. believed caused by brain pathology or head trauma or heredity c. believed the brain was responsible for intelligence and emotion therefore disorder source is located within the brain d. Galen expanded his ideas in the 19th century e. Hippocrates-Galen humoral theory- normal brain functioning was related to four bodily fluids (humors) and either too much or too little of them and applied to personality traits blood black bile (melancholy) yellow bile (choler) phlegm heart spleen liver brain sanguine (red)- describes melancholic- depression, cholic- hot tempered phlegmatic- apathy and someone red in caused by black bile sluggishness, calm under complexion cheerful and flooding brain stress optimistic insomnia/delirium - caused by too much blood in brain f. treatments i. regulating the environment (inc/dec heat, dryness, moisture, cold) ii. rest, nutrition, exercise iii.bleeding (bloodletting)- blood removed from the body often with leeches iv. induced vomiting B. somatoform disorders a. blindness and paralysis (disorders which could not find a physical cause) were hysteria disorders they thought were restricted to women because of uterus displacement looking for conception *hippocrates C. 19th century a. two strong influences: i. discover of the nature and cause of syphilis ii. american psychiatrist John P Grey b. syphilis i. sexually transmitted bacteria invade the brain and cause delusions ii. discovered by Louis Pasteur c. John P Grey i. cause of mental conditions were physica therefore could be treated as a physical condition D. development of biological treatments a. many drug uses were discovered by accident (ex insulin shock therapy) b. electroconvulsive therapy- used to treat people who are schizophrenic (modified and still used today) c. rauwolfia serpentine (reserpine) and neuroleptics (major tranquilizers) were used to make patients less aggressive and decrease hallucinations d. benzodiazepines (minor tranquilizers) reduced anxiety *widely used E. consequences of the biological tradition a. in late 19th century grey dec interest in treating mental illness bc thought they were a result of some unknown brain discovery and incurable (only option was to hospitalize patients) b. centered on diagnosis and study of brain pathology c. emil kraepelin- influential, first to see that certain mental disorders present a set of symptoms and age of onset d. treatment was widely eliminated The Psychological Model: A. psychosocial treatment: focus on the social and cultural factors (ex family experience) as well as psychological influences. these approaches include cognitive, behavioral, and interpersonal methods. a. plato and aristotle thought cause of disorder were the social and cultural influences in ones life b. cognitive science was developed- studied dreams, fantasies, cognition c. more humane approach to treatment B. moral therapy: psychosocial approach in the 19th century that involved treating patients as normally as possible in normal environments a. moral meaning emotional and psychological b. encouraged social interactions and relationships (eliminated seclusiveness) c. type of treatment started with plato and even earlier with the greeks d. developed by french psychiatrist Philippe Pinel and Jean-Baptiste Pussian e. william tuke (english) and benjamin rush (american) followed their ideas f. asylums which a
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