January 13th, 2012

Abnormal Psychology Chapter 1 + Lecture 1

- The study of Abnormal psychology is the study of people who suffer mental, emotional, and physical pain as a result of some form of psychological or mental disorder referred to as psychopathology Psychological Disorder=Some kind of psychological dysfunction occurring with in the individual caused by a distress or impairment resulting in an atypical response (not typical from a cultural stand point) - Refers to a change or break down in cognition or emotional functioning, or a break down in behavioral functioning - Regular functions have an extreme impact on their life like driving over a bridge - When depressed they withdraw, and when in anxiety they try to escape ( mall you look for exits when so you can leave when anxious) - Dysfunction can occur in a daily situation or just certain situation -- also depends on our day such as diet, or how you slept - Psychological dysfunction ranges from 0-100 - Some people function very well though in spite of their problems Scientist Practitioner Model - Introduced 1949 - People should be trained scientists, and practitioners - Keep track of scientic developments and make sure patients are getting upto date scientic help 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 Methods to Study the Disorders Studying the clinical description - The presenting of the problem - What are the unique combination that make the disorder - What is the change that tells you its depression VS. Schizo. Causation - What are the factors of causation? Is it biological, neurotransmitter irregularity? Or is there psychological or social factors? - How many people in the society have the same problem - How many new cases are occurring in a certain period of time - What are the gender relations? Treatment + Outcome - Studying the prognosis - Is the person likely to get better with the condition? Dening Abnormality The context or circumstances surrounding a behavior, inuences wether a behavior is abnormal Another perspective argues that behaviors can be categorized as abnormal if they violate a cultures gender roles -- expectation for the behavior of an individual based on their gender. - Ex. A man crying in public vs. a woman crying in public Another perspective focuses on the unusualness of the behavior, the discomfort of the person exhibiting the behavior, and the presence of the metal illness and the maladaptiveness (not providing adequate or appropriate adjustment to the environment or situation) of the behavior

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Cultural Relativism - This perspective says that there is no universal standard or rules for labeling a behavior as abnormal - Behaviors can be abnormal only in comparison to cultural norms - Cultural relatives believe that different denitions of abnormality are used across different cultures --- ex. Bereavement practices: In western countries bereaved people are expected to mourn their dead loved ones for a time (a few weeks- months) then to let go and move on with their lives. The norm is to break emotional bonds with the dead and these who dont or unable to are labelled as abnormal - Opponents of cultural relativism argue that dangers arise when societal norms are allowed to dictate what is normal and abnormal. - Scientists Thomas Szasz says through history societies have labelled individuals/ groups as abnormal in order to silence them. --- ex. Hitler branded the Jews abnormal, and used this as justication for the Holocaust, also during the slave trade in the US slaves who tried to escape were diagnosed with drapetomania- sickness that caused them to desire freedom. - In modern day gender roles inuence our perspective of whether a behavior is abnormal vs. normal. A stay at home husband, and a working wife could seem abnormal but a depressed wife, and an aggressive husband would seem normal because they dont violate the gender roles. * Most psychologists dont take an extreme relativist view on abnormality seeing the dangers of accepting societies denitions of what is normal vs. abnormal Unusualness - A second standard that has been used for designating behaviors as abnormal - Behaviors that are unusual or rare are considered abnormal where as behaviors that are typical are considered normal - The unusualness of any behavior depends in part on a cultures norms for that behavior - The unusualness criterion for abnormality has 2 problems: 1) All thought the standard can seem unbiased someone still has to decide how rare a behavior must be to call it abnormal 2) Many rare behaviors are positive for the individual and for society and most people would object to labeling such behaviors as abnormal. These activities are rare but are a source of great joy for them and do not harm others. These people are referred to as eccentrics --- ex. we dont label a piano virtuoso as abnormal but gifted Discomfort - Supporters of the discomfort theory believe a person would be considered abnormal if they suffer discomfort and want to be rid of the behaviors. - If a persons behaviors violate societal norms but do not cause any harm or discomfort then the behavior should not be considered abnormal - This viewpoint help change the view psychiatrists had upon homosexuality-- Gay and Lesbians have argued their sexual orientation is a natural part of themselves and it is a characteristic that does not cause them discomfort hence homosexuality was removed as a mental disorder. Problems: 1) Some therapists disagreed to the discomfort criterion because people are not always aware of the problems their behaviors create for themselves or for others --- ex. people who loose touch with reality and ignore their human needs ( food, not taking care of themselves), are not fully aware of their problem 2) If we require a person to know they have a problem and seek help for their problem before we label them as abnormal some people who could really improve would never get the help. 3) The behaviors of some people cause discomfort in others if not in themselves --- ex. people who are antisocial, lie, cheat, and even violent towards other people may suffer no discomfort and even may experience pleasure at causing other people pain.

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Mental Illness - This criterion implies that there is a clear physical process that differs from health and leads to specic behaviors or symptoms. --- ex. when people say someone has schizo. they imply as though the symptoms should show up in a biological test such as a blood pressure test. - To date there are no biological tests to diagnose abnormalities, when we give a persons psychological symptoms a diagnose it is simply a label for that set of symptoms Maladaptiveness - Behaviors and feelings that are maladaptive-- cause people to suffer distress (extreme anxiety, sorrow,pain) and that prevent them from functioning in daily life are abnormal and should be the focus of research and intervention - The 3 Ds of maladaptiveness: dysfunction, distress, and deviance - The maladaptive criteria has attracted widespread support among mental health professionals b.c it captures what it means to be abnormal while avoiding the problems involved in cultural relativism, unusualness, discomfort and illness criteria's Harmful Dysfunction - Is another approach to dening abnormality by Jerome Wakeeld - He suggested that mental disorder can be dened as harmful dysfunctions because they involve a harmful failure of internal mechanisms to perform their naturally selected functions --- ex. a personality disorder can be said to exist when a dysfunction occurs in the normal adaptive functions of the personality system - But Wakeeld says not all dysfunction leads to disorder; a dysfunction is a mental disorder only when the dysfunction causes some harm to the person as determined by the standards of that persons culture. Categorical Vs. Dimensional Ratings of Mental Illness - The American Psychiatric Associations Diagnostic and Statistical Manual of Mental Disorders (DSM-IVTR) represents the categorical perspective that disorders are qualitatively distinct syndromes. - An alternative approach is the dimensional perspective which views mental functioning as a continuum form normality to abnormality with psychopathology representing exaggerations of normal functioning. - A dimensional system classies clinical presentation based on the quantications of attributes rather than assignment to categories Positive Psychology Positive Psychology= Is the study of positive emotion, positive character, and positive institutions as well as the study of conditions and processes that contribute to the ourishing or optimal functioning of people, groups and institutions - Instead of studying and treating abnormalities, some clinical psychologists have begun to study happiness - These people want to help others achieve high levels of functioning or what they call full functioning. Diathesis- Stress Models - Views disorder as being made of two parts Diathesis= Is a vulnerability or a predisposition to developing a mental disorder is thought to be a necessary component in the development of a disorder. - Various factors such as genetics, neurobiological, psychological and sociocultural aspects can play a role in a persons diathesis. - But a diathesis alone cant cause a disorder, it needs a trigger which is the stress components of the model - A mental disorder occurs when an individual with a vulnerability experiences some stressful life events. - Individuals with higher diathesis may need only a small amount of stress to activate a disorder, compared to people with low diathesis levels. 3

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Historical Perspectives on Abnormality - Three types of theories of the causes of abnormal behaviors have competed for dominance across time Biological Theories= Saw abnormal behavior as similar to physical diseases caused by the breakdown of systems in the body. According to this theory the appropriate cure was the restoration of the body to good health Supernatural Theories= Saw abnormal behavior as a result of divine interventions, curses, demonic possessions, and personal sin. To rid the person of the disorder they used religious rituals, exorcisms, confessions and atonement. Pathological Theories= saw abnormal behavior as a result of traumas such as bereavement or chronic stress. According to these theories, rest, relaxation, a change of environment, and certain herbal medicines were sometimes helpful. * These three theories inuenced how people with disorders were seen in society. Ancient Theories Evil Spirits of The Stone Age - Demons and ghosts were the cause of abnormal behavior; when a person acted oddly they were suspected of people possessed by evil spirits - The typical treatment was exorcism where shamans and healers would say prayers and try to talk to the spirits out of the body or make the body an uncomfortable place for the spirit to reside in through starvation or beating the person , and other times the person was just killed Trephination=One treatment in the stone ages was to drill holes into the skulls of people so that the abnormal spirits could leave. The drilling was done by a tool called a Trephine - It was believed that if the person survived this surgery the evil spirits would be released and his or her abnormal behavior would decline. - Some historians say this procedure was used to remove blood clots caused by stone weapons during warfare and for other medical purposes Ancient China: Yin & Yang - Ancient chinese medicine was based on the concept of the yin an yang. The human body is said to contain a positive force (yang) and a negative force (yin) that confronted and complemented each other. - If the two forces were in balance the individual was healthy and if not illness, including insanity were the result. - Another theory was that the emotions were controlled by the internal organs; when the vital air ew onto one of the organs an individual experience a particular emotion --- ex. air on the heart meant joy, and air of the lungs meant sorrow. - The theory encouraged people to live in an better lifestyle so that they could maintain the proper movement of air. - The rise of Taoism and Buddhism led to some religious interpretations of abnormal behavior where evil winds and ghosts were blamed for bewitching people and for peoples erratic emotional displays and uncontrolled behavior

Ancient Egypt, Greece, & Rome: Biological Theories Dominate -Kahun Papyrus an ancient papyrus found that lists a number of disorders each with a physicians judgment on the cause of the disorder and the appropriate treatment - Many disorders supposedly left people with aches an pains, or extreme sadness - These disorders were said to only occur on women and were attributed with the wandering uterus - The Egyptians believed the uterus could become dislodged and wander throughout a womans body and interfere with her other organs causing these symptoms - Later the Greeks took this theory and named it hysteria - In the Egyptian papyri the cure for this illness was a strong smelling substance that would drive the uterus back into its place

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- The ancient Egyptian perspective on abnormal behavior was vainly driven by biological theories of these disorders but they also believed that supernatural powers could intervene in the cure - The Old Testament makes several references to madness, and thus the hebrew saw madness as a punishment from god - People who were stuck with madness were to confess their sins and repent to achieve relief - Even the greeks thought people were mad; The physician Hippocrates described a common phobia of a man who could not walk alongside a cliff - Another physician named Aretaeus described an artisan who appears to have had symptoms of what we now call agoraphobia - The tradition interpretation for this madness was an afiction from god, but for the most part the greek physicians rejected supernatural explanations - Hippocrates, the father or medicine argued that the body was made of 4 basic humours: blood, phlegm, yellow bile, and black bile; all diseases including abnormal behavior was caused by imbalances in the bodys essential humours. Hippocrates classied abnormal behavior into epilepsy,mania,melancholia, and brain fever. - Throughout ancient times relatives of a person considered to be sick were encored to conne the person at home and the state claimed no responsibility, there were no asylums other than religious temples to care for them. - People who were mad couldnt marry, or dispose of their own property, poor people who were mad were beggars, and if violent they were locked up * The general public was greatly afraid of the mad of any form even if you were mad in a divine form you were shunned and stoned. Treatments: - They believed restoring the balance of the humours would work or through extensive procedures like bloodletting where you bleed the patient from an excess of blood. - Other treatments were rest, relaxation, and a change of climate or scenery, a change of diet and a temperate life. - Hippocrates also believed in modern treatments of today like removing a patient from a difcult family Medieval Views - This time is often described as the time of backward thinking where thoughts were dominated with witchcraft and supernatural theories of abnormal behavior. - Before the 11th C. witchcraft was accepted as real but was just a nuisance - Severe emotional shock and physical illness and injury were most often seen as the cause of bizarre behaviors. - Strong evidence shows that physicians and government ofcials attributed abnormal behavior to physical causes or traumas. Witchcraft - Starting in the 11th C. the power of the church was threatened by the break down of feudalism ( a dominate social system) and rebellions caused by the economic and political inequality of times - The church took these as signs of Satanism, and the questioning began to get rid of the heretics but eventually those practicing witchcraft or Satanism were also the focus of the hunts - Some psychiatric historians believe that those who were accused of witchcraft must have been mentally ill. - Accused witches sometimes confessed to speaking with the devil, ying on the back of animals, and other unusual behavior -- such people must of been experiencing delusions, or hallucinations - Accused witches were said to have a devils mark on their bodies, which were areas that were insensitive to pain -- psychologists say this was either a sense of self-hypnosis or a hysteria - There were professional witch pickers who would poke around to nd the devils mark and accuse. These professionals wold also known to use techniques to make it falsely appear that a person is insensitive to pain. - Accusations of witchcraft was also used as a means of social punishment or control

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----ex. a man was accused of witchcraft after he had lent the mayor money and then asked for him to pay it back - People who were usually accused were older women, unmarried and poor who often begged for food and money and were considered by their neighbor to be foul-mouthed and disgusting - Physicians risked being condemned to death by arguing that accused witches had mental illness - It is also believed that some people who truly believed they were withes were not suffering from mental disorders-- the culture in which they lived in completely accepted the existence of witchcraft that these people may simply have used these cultural beliefs to explain their own feelings and behaviors Psychic Epidemics Psychic Epidemics= phenomenon in which large numbers of people begin to engage in unusual behaviors that appear to have a psychological origin - During the middle ages reports of dance frenzies or mania were frequent - A similar phenomena was tarantism which was seen in Italy where people developed an acute pain which they attributed to the bite of a tarantula - But now these epidemics are no longer viewed as the result of spirit possession or the bite of a tarantula - Psychologists try to understand them by using research from social psychology about the inuence of others on individuals self-perceptions Asylums During the Renaissance - As early as the 12th century many towns in Europe would take in the mentally ill, and care for them in their homes such as a town called Gheel in Belgium where they received humane treatment. - Then about the 11th or 12th century general hospitals started to include special rooms or facilities for people with abnormal behavior -- such as the Dollhaus (madhouse), and Tollkiste (made cell) - In these places the abnormal people were treated far from humane; they were little more than inmates hosed against their will often in extreme conditions - One of the most famous hospitals was the Hospital of Saint Mary of Bethlehem, later nicknamed Bedlem in London - At Bedlem the conditions were lthy and were conned to chains or walls and locked in small boxes,; the patients were also exhibited to the public for free - The Act for Regulating Madhouses was passed later with the intentions of cleaning up the horric conditions in hospitals and madhouses and protecting people from being unjustly jailed for insanity - The act made sure people were examined throughly by a physician and a certicate be signed before a patient could be admitted. - The conditions of the Asylums in America were not that much better; the public hospital in Wiliamsburg, Virginia became the rst hospital exclusively for the mentally ill; the treatments which were designed to restore health and balance to the mind included powerful electric shocks, plunging of the person into ice water or hot water, starvation, and a heavy use of restraints Moral Treatment - The 18th and 19th century moved towards a more humane treatment of the mentally ill; It was based on the psychological view that people became mad because they were separated from nature and forced to the stresses imposed by the social changes of the period - Quaker William Tuke opened an asylum in England called the Retreat, in response to the brutal treatments he saw was being inicted on the abnormal - His intent was to prove a mild system of treatment which he called moral treatment Moral treatment= A treatment designed to restore a patients self-restraint by treating them with respect and dignity and encouraging them to exercise self-control Dorothea Dix -- a retired schoolteacher who visited a jail to teach women inmates seeing the brutality of the lifestyle she was on a quest to improve the treatment of people with abnormal behavior, she went from state to state talking to people about the conditions - Her efforts led to the passing of laws and the funding to clean-up the psychiatric hospitals and the training of mental health professional dedicated to mental health - She helped establish many institutions even in Canada 6

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Philippe Pinel -- Another leader of moral treatment, and a french physician who ordered that patients be released from chains and be allowed to walk freely around the asylum; they were provided with clean, sunny rooms,comfortable sleeping quarters, and good food; Many other physicians thought Pinel was mad for releasing them, his approach was really successful - Unfortunately the moral treatment grew too fast, because so many patients were being given the moral treatment the number of patients who failed to benet from it increased and questions about the effectiveness of moral treatment grew louder - In Canada the rst Asylum opened in Beauport Quebec; the conditions mirrored those in Europe & America. - Across Canada Asylums developed and remained segregated from the community, and over crowded; by the turn of the 20th century asylums became inhumane all over again Modern Perspectives - Huge advances in the scientic study of disorders took place in the early 20th century - The basic knowledge of anatomy, physiology, neurology and chemistry of the body rapidly increased in the late 19th century - One of the most important discoveries of modern biological theories f abnormality was the discovery of the cause of general paresis General Paresis= A disease that leads to paralysis, insanity, and eventually death; patients with paresis also had a history of syphilis, which led to the doubt that syphilis might be the cause of Paresis Psychoanalytic Perspective Started with Franz Anton Mesmer an austrian physician who thought that people had a magnetic uid in the body that must be distributed in a particular pattern to maintain health. The distribution of this magnetic uid in one person could be inuenced by the magnetic forces of other people as well as by the alignments of the planets, called Psychogenesis - The psychological disorders that were the focus of much of Mesmers treatment were the hysterical disorders in which people lose functioning or feeling in some part of the body for no apparent physiological reason - His methods were known as Mesmerism - The cures Mesmer caused in his psychiatric patients was said to be a trancelike state that Mesmer seemed to induce on his patients-- later this state was called Hypnosis - Under hypnosis, Mesmers patients appeared suggestible, and the suggestion that their ailments would disappear seemed enough to actually make them disappear Jean Charcot, head of a hospital in Paris, and the leading neurologist of his time argued that hysteria was caused by the degeneration in the brain and had nothing to do with hypnosis. Bernheim & Liebault, two physician from a french town proved to Charcot that they could induce the symptoms of hysteria, such as paralysis in an arm or the loss of feeling in a leg by suggesting these symptoms to patients who were hypnotized --- Charcot was so impressed he became a leading researcher of the psychological cause of abnormal behavior One of Charcots students was Sigmund Freud a Viennese neurologist; he went to study with Charcot and became convinced that much of the mental life of an individual remains hidden from consciousness Freud started working with Josef Breuer had discovered that encouraging patients to talk about their problems while under hypnosis led to a great release of emotion (patient, Anna O) which was eventually called Catharsis - They both ended up writing a paper about hypnosis, the unconscious, and the therapeutic value of catharsis. The paper became the foundation of psychoanalysis = the study of the unconscious The Roots of Behaviorism Behaviorism= The study of the effect of reinforcements and punishments on behavior has had a profound impact on psychology and on our common knowledge of psychology as has psychoanalytical theory Wilhelm Wundt = established the rst experimental psychology laboratory in Germany; his work focused on memory and sensation. 7

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James Mark Baldwin= One of Wundts students established the rst Psychology Lab in Canada at the University of Toronto Ivan Pavlov= A russian physiologist was developing theories and methods in order to understand behavior in terms of stimuli and responses-- discovered that dogs could be conditioned to salivate to stimuli other than food if the food was paired with the other stimuli, a process called Classical Conditioning John Watson= American who was inspired by Pavlov to study important human behaviors such as phobias. Watson rejected psychoanalytic and biological theories of abnormal behaviors such as phobias and explained them as entirely on the basis of the individuals history of conditioning B.F. Skinner & E.L. Thorndike= studied how the consequences of behaviors shape the likelihood of their reoccurrence. They argued that behaviors that are followed by positive consequences are more likely to be repeated than behaviors followed by negative consequences. This process came to be known as operant or instrumental conditioning Cognitive Revolution Cognition= Thought processes that inuence behavior and emotion Albert Bandura= Was trained in behaviorism and contributed a a great deal to the application of behaviorism to psych-pathology Self-efcacy Beliefs= Bandura argued that peoples beliefs about their ability to execute the behaviors necessary to control important events are crucial in determining well being Albert Ellis= Argued that people prone to psychological disorders are plagued by irrational negative assumptions about themselves and the world - He developed a therapy for emotional problems based on his rational-emotive therapy, which was controversial because it required therapists to challenge, sometimes quite harshly their patients irrational belief system Modern Mental Health Care Patients Rights Movements = argued that people with mental disorders could recover more fully or live more satisfying lives if they were to integrate into the community with the support of community based treatment facilities-- a process known as deinstitutionalization Professions Related to Abnormal Psychology Psychiatrists= Have an M.D. degree and have specialized training in the treatment of psychological problems , they can prescribe medicine Clinical Psychologists= Usually have a Ph.D in psychology with a specialization is psychological problems, they can conduct psychotherapy but in most provinces they do not prescribe Marriage and family Therapists= Specialize in helping families, couples and children overcome problems that are interfering in wellbeing Clinical social Worker= Masters in social working focus in helping people with psychological problems overcome the social conditions contributing to their problems such as joblessness Psychiatric Nurses= degree in nursing with specialization in the treatment of people with severe psychological problems Occupational Therapists= Masters degree with skills in helping individuals overcome obstacles and barrier caused by injury and illness that affect productivity Counseling Psychologist (Ph.D) -- at schools,work ; they dont deal with major psychological problems, treat problems in 5-6 sessions ** Other than social workers, they all can legally diagnose a person.