ABNOPSYCH: Chapter 1: Abnormal Behavior in Historical Context

KMEN

Psychological Disorder

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

DSM 5 (2013) Definition

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

How the apparent disease or disorder matches a “typical” profile of a disorder. A patient may have only some features or symptoms (a minimum number) and still meet criteria for the disorder because his or her set of symptoms is close to the prototype.

Psychological Dysfunction

A breakdown in cognitive, emotional, or behavioral functioning.

Distress

The behavior must be associated with distress to be classified as a disorder. The criterion is satisfied if the individual is extremely upset.

Impairment

If functioning is impossible, such as being so shy that you find it impossible to date or even interact with people and you make every attempt to avoid interactions even though you would like to have friends.

Psychopathology

The scientific study of psychological disorders.

Counseling Psychologists

Tend to study and treat adjustment and vocational issues encountered by relatively healthy individuals.

Clinical Psychologists

Concentrate on more severe psychological disorders.

Psy.D.

Doctoral degree that focuses on clinical training and de-emphasizes or eliminates research training.

Ph.D.

Doctoral degree that integrates clinical and research training.

Psychiatrists

First earn an M.D. degree in medical school and then specialize in psychiatry during residency training that lasts 3 to 4 years.

Psychiatric Social Workers

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 Nurses

Have advanced degrees (master’s or Ph.D.) and 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

Spend 1 to 2 years earning a master’s degree and are employed to provide clinical services by hospitals or clinics, usually under the supervision of a doctoral-level clinician.

Scientist-Practitioner (Role 1)

Keep up with the latest scientific developments in their field and therefore use the most current diagnostic and treatment procedures.

Scientist-Practitioner (Role 2)

Evaluate their own assessments or treatment procedures to see whether they work.

Scientist-Practitioner (Role 3)

Might conduct research that produces new information about disorders or their treatment.

Presenting Problem

Traditional shorthand way of indicating why the person came to the clinic.

Prevalence

How many people in the population as a whole have the disorder.

Incidence

How many new cases occur during a given period.

Chronic Course

Disorders that tend to last a long time, sometimes a lifetime.

Episodic Course

The individual is likely to recover within a few months only to suffer a recurrence of the disorder at a later time.

Acute Onset

Disorders that begin suddenly.

Insidious Onset

Disorders that develop gradually over an extended period.

Prognosis

The anticipated course of a disorder.

Developmental Psychopathology

Study of changes in abnormal behavior.

Life-Span Developmental Psychopathology

Study of abnormal behavior across the entire age span.

Etiology

The study of origins and has to do with why a disorder begins (what causes it) and includes biological, psychological, and social dimensions.

Supernatural Tradition (14th Century)

Psychological disorders were seen as the work of the devil and witches.

Supernatural Tradition Treatment

Included magic, sorcery, exorcism, shaving the pattern of a cross in the hair of the victim’s head, and securing sufferers to a wall near a church. If exorcism failed, people were subjected to confinement, beatings, and other forms of torture.

Nicholas Oresme

A chief adviser to the king of France (14th century) who believed the disease of melancholy (depression) was the source of some bizarre behavior, rather than demons.

Mass Hysteria

Characterized by large-scale outbreaks of bizarre behavior.

Saint Vitus’s Dance / Tarantism

A form of mass hysteria where whole groups of people were simultaneously compelled to run out in the streets, dance, shout, rave, and jump around in patterns.

Emotion Contagion

The experience of an emotion seems to spread to those around us.

Mob Psychology

A shared response where if one person identifies a “cause” of the problem, others will probably assume that their own reactions have the same source.

Paracelsus (1493–1541)

Swiss physician who believed the movements of the moon and stars had profound effects on people’s psychological functioning due to the gravitational effects of the moon on bodily fluids, inspiring the word lunatic.

Hippocrates (Father of Modern Western Medicine)

Believed psychological disorders might be caused by brain pathology or head trauma, influenced by heredity (genetics), and considered the brain to be the seat of wisdom, consciousness, intelligence, and emotion.

Hysteria (Hippocrates)

A term he coined for somatic symptom disorders, restricted to women, where physical symptoms appear with no physical cause, presumed caused by the empty uterus wandering to various parts of the body in search of conception.

Humoral Theory of Disorders (Galen)

Adopted from Hippocrates, suggesting disease resulted from too much or too little of four humors

Humoral Theory Treatment

Included regulating the environment, bleeding or bloodletting, or inducing vomiting (e.g., Robert Burton recommended eating tobacco and a half-boiled cabbage).

General Paresis

A sexually transmitted disease caused by a bacterial microorganism entering the brain, resulting in symptoms like delusions of persecution or grandeur.

General Paresis (Cure)

Physicians observed a surprising recovery in patients with general paresis who had contracted malaria, leading to the deliberate injection of other patients with malaria.

John P. Grey (American Psychiatrist)

Asserted that causes of insanity were always physical, advocating for mentally ill patients to be treated as physically ill, promoting rest, diet, and proper room temperature and ventilation.

Insulin Shock Therapy

Discovered when insulin was given to stimulate appetite in psychotic patients but also seemed to calm them down; Manfred Sakel began using higher dosages until patients convulsed and became temporarily comatose, attributing recovery to the convulsions.

Electroconvulsive Therapy (ECT) Origin

Benjamin Franklin (1750s) discovered a mild electric shock to the head produced a brief convulsion and memory loss (amnesia). Joseph von Meduna (1920s) observed schizophrenia was rarely found in individuals with epilepsy and concluded induced brain seizures might cure schizophrenia.

Neuroleptics (Major Tranquilizers)

Drugs that diminished hallucinatory and delusional thought processes and controlled agitation and aggressiveness.

Benzodiazepines (Minor Tranquilizers)

Used to reduce anxiety.

Emil Kraepelin (1856–1926)

Major contributor to diagnosis and classification; one of the first to distinguish among various psychological disorders based on age of onset, time course, and symptom clusters.

Plato (Psychological Tradition)

Thought the causes of maladaptive behavior were social and cultural influences and the learning that took place in that environment; suggested reeducation through rational discussion as the best treatment.

Moral Therapy

A 19th-century psychosocial approach emphasizing humane and positive psychological interventions, providing care, massage, and soothing music. Worked best when patient numbers were low (200 or fewer).

Philippe Pinel and Jean-Baptiste Pussin

French reformers who removed all chains used to restrain patients and instituted humane and positive psychological interventions.

Benjamin Rush

Considered the founder of U.S. psychiatry; introduced moral therapy at Pennsylvania Hospital.

Dorothea Dix (Mental Hygiene Movement)

Schoolteacher who campaigned endlessly for reform in the treatment of insanity for the homeless and mentally ill.

Franz Anton Mesmer

Believed problems were caused by blocked "animal magnetism," using rods and suggestion in a dark room to "cure" patients.

Jean-Martin Charcot

Head of the Salpétrière Hospital who helped legitimize the practice of hypnosis.

Catharsis (Breuer and Freud)

The release of emotional material, discovered by asking patients to describe problems while under hypnosis.

Insight (Breuer and Freud)

A fuller understanding of the relationship between current emotions and earlier events.

Case of Anna O

Patient of Breuer and Freud who developed hysterical symptoms (blurry vision, paralysis, difficulty speaking) after her father became ill.

ID (Freud)

Source of strong sexual and aggressive feelings or energies; operates on the Pleasure Principle, seeking to maximize pleasure and eliminate tension.

Primary Process (ID)

Type of thinking that is emotional, irrational, illogical, filled with fantasies, and preoccupied with sex, aggression, selfishness, and envy.

Libido

The energy or drive within the id.

Thanatos

The death instinct.

EGO (Freud)

Executive or manager of our minds; operates on the Reality Principle, mediating conflict between the id and the superego.

Secondary Process (EGO)

Thinking styles characterized by logic and reason.

SUPEREGO (Freud)

Conscience; operates on Moral Principles, instilled by parents and culture.

Intrapsychic Conflicts

All conflicts within the mind due to the opposing demands of id and superego.

Repression

Defense mechanism where the individual blocks disturbing wishes, thoughts, or experiences from conscious awareness.

Sublimation

Defense mechanism where the individual directs potentially maladaptive feelings or impulses into socially acceptable behavior.

Oral Stage (Freud)

Focuses on the need for food (age 0–2); fixation results in dependency and passivity in adult personality.

Phallic Stage (Freud)

Characterized by early genital self-stimulation (age 3–5 or 6).

Oedipus Complex (Freud)

Conflict in young boys involving lustful impulses toward the mother and castration anxiety (fear of punishment) by the father.

Electra Complex (Freud)

The young girl wanting to replace her mother and possess her father, driven by penis envy.

Ego Psychology (Anna Freud)

Focuses on how the individual accumulates adaptational capacities and defenses; abnormal behavior develops when the ego is deficient.

Object Relations

The study of how children incorporate the images, memories, and values of important people (objects) in their lives.

Introjection

The process of incorporating images, memories, and values of important people.

Collective Unconscious (Jung)

A wisdom accumulated by society and culture that is stored deep in individual memories and passed down from generation to generation.

Inferiority Complex (Adler)

Term created by Alfred Adler focusing on feelings of inferiority and the striving for superiority.

Free Association

Psychoanalytic technique where patients are instructed to say whatever comes to mind without censoring.

Dream Analysis

Psychoanalytic technique where the therapist interprets the content of dreams, relating them to symbolic aspects of unconscious conflicts.

Transference

Patients come to relate to the therapist much as they did to important figures in their childhood (e.g., parents).

Countertransference

Therapists project some of their own personal issues and feelings onto the patient.

Classical Conditioning (Pavlov)

A type of learning in which a neutral stimulus is paired with a response until it elicits that response.

Systematic Desensitization (Joseph Wolpe)

Behavior therapy technique where individuals are gradually introduced to the objects or situations they feared so that their fear could extinguish.

Operant Conditioning (B. F. Skinner)

A type of learning in which behavior changes as a function of what follows the behavior.

Law of Effect (Thorndike)

Behavior is either strengthened or weakened depending on the consequences of that behavior.

Shaping

A process of reinforcing successive approximations to a final behavior or set of behaviors.