Chapter 1

Abnormal Behavior in Historical Context

Myths and Misconceptions About Abnormal Behavior

y No Single Definition of Psychological Normality
y No Single Definition of Psychological Abnormality
ƒ Differences across time
ƒ Cross-cultural differences
ƒ Involves multiple dimensions/areas of functioning
y Many Myths Are Associated With Mental Illness
ƒ Weak in character
ƒ Dangerous to self or others
ƒ Mental illness is a hopeless situation

Approaches to Defining Abnormal Behavior

y Does Infrequency Define Abnormality?
y Does Suffering Define Abnormality?
y Does Strangeness Define Abnormality?
y Does the Behavior Itself Define Abnormality?
y Should Normality Serve as a Guide?

Toward a Definition of Abnormal Behavior

y Psychological Dysfunction
ƒ Breakdown in cognitive, emotional, or behavioral functioning
y Distress or Impairment
ƒ Difficulty performing appropriate and expected roles
ƒ Impairment is set in the context of a person’s background
y Atypical or Unexpected Cultural Response
ƒ Reaction is outside cultural norms

Definition of Abnormal Behavior (cont.)

Figure 1.1
The criteria defining a psychological disorder
 The Diagnostic and Statistical Manual (DSM-IV)
y Widely Accepted System for Classifying Psychological Problems and Disorders
y DSM Contains Diagnostic Criteria for Behaviors That
ƒ Fit a pattern
ƒ Cause dysfunction or subjective distress
ƒ Are present for a specified duration
ƒ And for behaviors that are not otherwise explainable

Approaches to the Scientific Study of

Psychological Disorders
y Mental Health Professionals
ƒ The Ph.D.’s: Clinical and counseling psychologists
ƒ The Psy.D.’s: Clinical and counseling “Doctors of Psychology”
ƒ M.D.’s: Psychiatrists
ƒ M.S.W.’s: Psychiatric and non-psychiatric social workers
ƒ MN/MSN’s: Psychiatric nurses
ƒ The lay public and community groups
y United by the Scientist-Practitioner Framework

Dimensions of the Scientist-Practitioner Model

y Producers of Research

y Consumers of Research

y Evaluators of Their Work Using Empirical Methods

Dimensions of the Scientist-Practitioner Model (cont.)

Figure 1.3
Three major categories make up the study and discussion of psychological disorders.

Scientist-Practitioner and
Clinical Description of Abnormality
y Description Aims to Distinguish Clinically Significant Dysfunction from Common Human
Experience
y Describe Prevalence and Incidence of Disorders
y Describe Onset of Disorders
ƒ Acute vs. insidious onset
y Describe Course of Disorders
ƒ Episodic, time-limited, or chronic course
 Causation, Treatment, and Outcome in Psychopathology
y What Factors Contribute to the Development of Psychopathology?
ƒ Study of etiology

y How Can We Best Improve the Lives of People Suffering From Psychopathology?
ƒ Pharmacologic, Psychosocial, and/or Combined Treatment Development

y How Do We Know That We Have Alleviated Psychological Suffering?

ƒ Study of treatment outcome

The Past: Historical Conceptions of Abnormal Behavior

y Major Psychological Disorders Have Existed
ƒ In all cultures
ƒ Across all time periods

y The Causes and Treatment of Abnormal Behavior Varied Widely

y Three Dominant Traditions Include: Supernatural, Biological, and Psychological

The Past: Abnormal Behavior and the Supernatural Tradition

y Deviant Behavior as a Battle of “Good” vs. “Evil”
ƒ Deviant behavior was believed to be caused by demonic possession, witchcraft,
sorcery
ƒ Treatments included exorcism, torture, beatings, and crude surgeries

y “Outer Force” Views Were Popular During the Middle Ages

y Few Believed That Abnormality Was an Illness on Par With Physical Disease

The Past: Abnormal Behavior and the Biological Tradition

y Hippocrates’: Abnormal Behavior as a Physical Disease
ƒ Hysteria “The Wander Uterus”
y Galen Extends Hippocrates Work
ƒ Humoral theory of mental illness
y Blood - Sanguine; Black Bile - Melancholy; Phlegm - Sluggishness; Yellow Bile –
choleric/hot tempered
ƒ Treatments remained crude
ƒ Foreshadowed modern views linking abnormality with brain chemical imbalances

The Past: Consequences of the Biological Tradition

y Mental Illness = Physical Illness
y The 1930’s: Biological Treatments Were Standard Practice
ƒ Insulin shock therapy, ECT, and brain surgery (i.e., lobotomy)
y By the 1950’s Several Medications Were Established
ƒ Examples include neuroleptics (i.e., reserpine) and minor tranquilizers

The Past: Abnormal Behavior and

the Psychological Tradition
y The Rise of Moral Therapy: The practice of allowing institutionalized patients to be treated
as normal as possible and to encourage and reinforce social interaction (Philippe Pinel,
Benjamin Rush, and others)
y Reasons for the Falling Out of Moral Therapy: Immigration and Mental Hygiene
movement led to an influx of patients

y Emergence of Competing Alternative Psychological Models

The Past: Abnormal Behavior and

the Psychoanalytic Tradition
y Freudian Theory of the Structure and Function of the Mind
y The Mind’s Structure
ƒ Id (pleasure principle; illogical, emotional, irrational)
ƒ Ego (reality principle; logical and rational)
ƒ Superego (moral principles; keeps Id and Ego in balance)
y Defense Mechanisms: When the Ego Loses the Battle with the Id and Superego
ƒ Displacement: transferring a feeling onto a less threatening object
ƒ Denial: refusal to acknowledge some aspect of experience
ƒ Rationalization: conceals true motivation through elaborate explanations
ƒ Reaction formation: substitutes feelings, behaviors, for the exact opposite of the unacceptable ones
ƒ Projection: falsely attributing one’s unacceptable feelings to another
ƒ Repression: blocks disturbing wishes, thoughts, etc. from conscious experience
ƒ Sublimation: directs potentially maladaptive feelings into socially acceptable behavior
y Freudian Stages of Psychosexual Development
ƒ Oral, anal, phallic, latency, and genital stages

The Past: Abnormal Behavior and

the Psychoanalytic Tradition (cont.)

Figure 1.4
Freud’s structure of the mind
Later Neo-Freudian Developments
in Psychoanalytic Thought

y Anna Freud and Self-Psychology

ƒ Emphasized the influence of the ego in defining behavior
y Melanie Klein, Otto Kernberg, and Object Relations Theory
ƒ Emphasized how children incorporate (introject) objects
ƒ Examples include images, memories, and values of significant others (objects)
y Others Developed Concepts Different from Those of Freud
ƒ Carl Jung, Alfred Adler, and Erik Erickson
y The Neo-Freudians Generally De-emphasized the Sexual Core of Freud’s Theory
 From Psychoanalytic Thought to
Psychoanalysis in Therapy
y Unearth the Hidden Intrapsychic Conflicts (“The Real Problems”)
y Therapy Is Often Long Term
y Techniques Include Free Association and Dream Analysis
y Examine Transference and Counter-Transference Issues
y Little Evidence for Efficacy

Humanistic Theory and the Psychological Tradition

y Carl Rogers, Abraham Maslow, and Fritz Perls
y Major Theme
ƒ That people are basically good
ƒ Humans strive toward self-actualization
y Treatment
ƒ Therapist conveys empathy and unconditional positive regard
ƒ Minimal therapist interpretation
y No Strong Evidence That Humanistic Therapies Work

The Behavioral Model and the Psychological Tradition

y Derived from a Scientific Approach to the Study of Psychopathology
y Ivan Pavlov, John B. Watson, and Classical Conditioning
ƒ Classical conditioning is a ubiquitous form of learning
ƒ Conditioning involves correlation between neutral stimuli and unconditioned stimuli
ƒ Conditioning was extended to the acquisition of fear
y Edward Thorndike, B. F. Skinner, and Operant Conditioning
ƒ Another ubiquitous form of learning
ƒ Most voluntary behavior is controlled by the consequences that follow behavior
y Both Learning Traditions Greatly Influenced the Development of Behavior Therapy

From Behaviorism to Behavior Therapy

y Reactionary Movement Against Psychoanalysis and Non-Scientific Approaches
y Early Pioneers
ƒ Joseph Wolpe – Systematic desensitization
ƒ Arnold Lazarus – Multi-modal behavior therapy
ƒ Aaron Beck – Cognitive therapy
ƒ Albert Bandura – Social learning or cognitive-behavior therapy
y Behavior Therapy Tends to be Time-Limited and Direct
y Strong Evidence Supporting the Efficacy of Behavior Therapy

Discussion Group 1 - Questions

y How are mental disorders defined by the DSM framework? That is, what 3 aspects/characteristics of
abnormal behavior represent the main criteria for defining a psychological disorder?

y Identify and explain two of Freud’s defense mechanisms.

y Define classical and operant conditioning principals.