Chapter 1: Psychopathology in Historical Context

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

Psychological dysfunction within an individual that is associated with distress or impairment in functioning and a response that is not typical or culturally expected.

What are the criteria for defining a psychological disorder?

Psychological dysfunction

Distress or impairment

Atypical response

breakdown in cognitive, emotional, or behavioral functioning

Psychological dysfunction

why is it important to distinguish normal/abnormal behaviors?

Behaviors exist on a spectrum and must be viewed in context

True or false: having a dysfunction is enough to meet the criteria for a psychological disorder

false

Should we consider cultures when evaluating dysfunction?

yes. different cultures have different norms that define how they view impairment, dyfunction, and normal/abnormal

psychological disorder definition used in the DSM-5

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.

prototype

typical’ profile of a disorder—for example, major depression or schizophrenia—when most or all symptoms that experts would agree are part of the disorder are present.

Psychopathology

Scientific study of psychological disorders.

_____ tend to study and treat adjustment and vocational issues encountered by relatively healthy individuals

counseling psychologists

____ usually concentrate on more severe psychological disorders

clinical psychologists

____ typically earn a master’s degree in social work as they develop expertise in collecting information relevant to the social and family situation of the individual with a psychological disorder

Psychiatric social workers

____ have advanced degrees, such as a master’s or even a Ph.D., and specialize in the care and treatment of patients with psychological disorders, usually in hospitals as part of a treatment team.

Psychiatric nurses

scientist-practitioners

Mental health professionals who are expected to apply scientific methods to their work. They must keep current in the latest research on diagnosis and treatment, they must evaluate their own methods for effectiveness, and they may generate their own research to discover new knowledge of disorders and their treatment.

“data flow from research attempts three basic things

to describe psychological disorders, to determine their causes, and to treat them

presenting problem

Original complaint reported by the client to the therapist. The actual treated problem may sometimes be a modification derived from the presenting problem.

clinical description

Details of the combination of behaviors, thoughts, and feelings of an individual that make up a particular disorder.

clinical description helps ____

distinguish between abnormal and normal behavior

prevalence

Number of people displaying a disorder in the total population at any given time

incidence

Number of new cases of a disorder appearing during a specific period

course

Pattern of development and change of a disorder over time.

3 main courses of a disorder

chronic course: last a long time

episodic course: likely to recover in a few months, possibly coming back at a later time

time-limited course: will improve without treatment with little risk of coming back

chronic course in a disorder:

last a long time

episodic course:

likely to recover in a few months, possibly coming back at a later time

time-limited course:

will improve without treatment with little risk of coming back

Two main Onsets of a disorder:

Acute onset: begin suddenly

insidious onset: gradually over time

prognosis

Predicted future development of a disorder over time.

We call the study of changes in behavior over time ___

developmental psychology

developmental psychopathology

the study of changes in abnormal behavior as

life-span developmental psychopathology

Study of abnormal behavior across the entire age span

Etiology

Cause or source of a disorder.

Three Etiologies

biological, social, psychological

Statisticians often use the ___ to describe when a series of events temporally predict another series of events

Granger causality

supernatural model

the belief that forces outside our body influence our emotions/behaviors

Three main models for origin of behaviors

Supernatural, biological, psychological

exorcism

Religious ritual that attributes disordered behavior to possession by demons and seeks to treat the individual by driving the demons from the body.

___, in which the experience of an emotion seems to spread to those around us

emotion contagion

who came up with the humoral theory of disorders?

Hippocrates

what is the humoral theory?

normal brain functioning was related to four bodily fluids or humors. disease happened when there was too much or too little

four bodily fluids (humors) and where they came from

Blood came from the heart, black bile from the spleen, phlegm from the brain, and choler or yellow bile from the liver.”

humors also related to Greek four basic qualities: …

heat, dryness, moisture, cold

what was the Chinese beliefs (similar to humoral theory)

wind moved through body

blockages of wind = bad

cold, dark wind = yin = bad

warm, life-sustaining wind = yang = good

Hippocrates also coined the word ___ to describe a concept he learned about from the Egyptians, who had identified what we now call the ___. In these disorders, the physical symptoms appear to be the result of a medical problem for which no physical cause can be found, such as paralysis and some kinds of blindness.

hysteria ; somatic symptom disorders

what early disease helped with the understanding of biology in psychology

syphilis

who was John P. Grey?

believed the cause was physical

treat the mentally ill as if they were physically ill

his hospitals were good, but became overcrowded

deinstitutionalization = good and bad

disorders were because of brain pathology = uncurable = hospital

main early biological treatments

electric shock, brain surgery, insulin causing dangerous convulsions, safe convulsions, shock the brain of the depressed, substances (opium, sedatives, herbs and folk remedies, major and minor tranquilizers, sedating drugs)

Who was … “one of the first to distinguish among various psychological disorders, seeing that each may have a different age of onset and time course, with somewhat different clusters of presenting symptoms, and probably a different cause”

Emil Kraepelin

psychosocial treatment

Treatment practices that focus on social and cultural factors (such as family experience), as well as psychological influences. These approaches include cognitive, behavioral, and interpersonal methods.

moral therapy

Psychosocial approach in the 19th century that involved treating patients as normally as possible in normal environments.

The term moral actually referred to …

emotional or psychological factors

what is the main point of moral therapy?

treat patients normal in a positive setting which reinforced/encouraged normal behaviors and interactions

Early moral therapy

Greek Asclepiad Temples of the 6th century BC, Muslim Middle east countries

Key moral therapy figures

Philippe Pinel and Jean-Baptiste Pussin : Parisian hospital La Bicêtre

William Tuke followed lead in England

“___, often considered the founder of U.S. psychiatry, introduced moral therapy in his early work at Pennsylvania Hospital”

Benjamin Rush

Benjamin Rush impact on Asylums

Asylums were like prisons before, but now better

Patients previously deemed incurable were treated and released

why did humane treatment decline?

it worked best with less patients, but there was an influx of patients.

mental hygiene movement

Mid-19th-century effort to improve care of the mentally disordered by informing the public of their mistreatment.

who led the mental hygiene movement

Dorothea Dix

psychoanalysis

Psychoanalytic assessment and therapy, which emphasizes exploration of, and insight into, unconscious processes and conflicts, pioneered by Sigmund Freud

behaviorism

Explanation of human behavior, including dysfunction, based on principles of learning and adaptation derived from experimental psychology.

key figures of behaviorism

John B. Watson, Ivan Pavlov, and B. F. Skinner

who is widely regarded as the father of hypnosis?

Franz Anton Mesmer

unconscious

Part of the psychic makeup that is outside the awareness of the person.

catharsis

Rapid or sudden release of emotional tension thought to be an important factor in psychoanalytic therapy.

psychoanalytic model

Complex and comprehensive theory originally advanced by Sigmund Freud that seeks to account for the development and structure of personality, as well as the origin of abnormal behavior, based primarily on inferred inner entities and forces.

Three major facets of psychoanalytic model

“the structure of the mind and the distinct functions of personality that sometimes clash with one another”

“the defense mechanisms with which the mind defends itself from these clashes, or conflicts”

“the stages of early psychosexual development that provide grist for the mill of our inner conflicts.”

The mind, according to Freud, has three major parts or functions: …

the id, the ego, and the superego

id

In psychoanalysis, the unconscious psychical entity present at birth representing basic sexual and aggressive drives.

The id was driven by which principle?

driven by pleasure principle: “…overriding goal of maximizing pleasure and eliminating any associated tension or conflicts.”

what is the pleasure principle

“…overriding goal of maximizing pleasure and eliminating any associated tension or conflicts.”

The id used ____ thinking

illogical, emotional, irrational

illogical, emotional, irrational thinking is known as …

the primary process

ego

In psychoanalysis, the psychical entity responsible for finding realistic and practical ways to satisfy id drives.

The ego is driven by ____ thinking (secondary process)

logical, rational

secondary process is …

logical, rational thinking

The ego is driven by which principle?

driven by reality principle

superego

In psychoanalysis, the psychical entity representing the internalized moral principles of parents and society.

The superego is driven by …

driven by moral principles

“The role of the ___ is to mediate conflict between the ___ and the ___, juggling their demands with the realities of the world.”

ego ; id ; superego

intrapsychic conflicts

In psychoanalysis, the struggles among the id, ego, and superego.

defense mechanisms

Common patterns of behavior, often adaptive coping styles when they occur in moderation, observed in response to particular situations. In psychoanalysis, these are thought to be unconscious processes originating in the ego.

list of defense mechanisms

Denial, Displacement, Projection, Rationalization, Reaction formation, Repression, Sublimation

Denial (defense mechanism):

Refuses to acknowledge some aspect of objective reality or subjective experience that is apparent to others

Displacement (defense mechanism):

Transfers a feeling about or a response to an object that causes discomfort onto another, usually less threatening, object or person

Projection (defense mechanism):

Falsely attributes own unacceptable feelings, impulses, or thoughts to another individual or object

Rationalization (defense mechanism):

Conceals the true motivations for actions, thoughts, or feelings through elaborate reassuring or self-serving but incorrect explanations

Reaction formation (defense mechanism):

Substitutes behavior, thoughts, or feelings that are the direct opposite of unacceptable ones

Repression (defense mechanism):

Blocks disturbing wishes, thoughts, or experiences from conscious awareness

Sublimation (defense mechanism):

Directs potentially maladaptive feelings or impulses into socially acceptable behavior

psychosexual stages of development

In psychoanalysis, the sequence of phases a person passes through during development. Each stage is named for the location on the body where id gratification is maximal at that time.

stages of psychosexual stages of development

oral, anal, phallic, latency, genital

castration anxiety

In psychoanalysis, the fear in young boys that they will be mutilated genitally because of their lust for their mothers.

oral phase

0 - 2 years

food, sucking, lips, tongue, and mouth = sources of pleasure

lack of … gratification = problems in adulthood (excessive thumb sucking, eating, chewing pencils, biting fingernails. dependency and passivity or rebelliousness and cynicism.)

phallic phase

3 - 5/6 years

characterized by early genital self-stimulation

Oedipus complex in boys

Electra complex and penis envy in girls

Oedipus complex

the idea that boys what to kill their dad to sleep with their mom

Electra complex and penis envy

“Freud viewed the young girl as wanting to replace her mother and possess her father. Central to this possession is the girl’s desire for a penis, so as to be more like her father and brothers—hence the term penis envy. According to Freud, the conflict is successfully resolved when females develop healthy heterosexual relationships and look forward to having a baby, which he viewed as a healthy substitute for having a penis.”

ego psychology

Derived from psychoanalysis, this theory emphasizes the role of the ego in development and attributes psychological disorders to failure of the ego to manage impulses and internal conflicts. Also known as self-psychology.

ego psychology developed by __

Anna Freud