History of Abnormal Psychology

1
History of Abnormal Psychology
2
Connecting Treatment to Etiology

• Attitudes about a disorder influence how we
  attempt to treat it.
• Consider how you would treat a mental disorder
  due to
• Weakness of character
• Sinfulness
• Heredity
• Physical environment
• Social environment

3
Historical Views of Abnormal Behavior

• Demonology, Gods, Magic
• Abnormal behavior often attributed to possession
• Good or Bad possession depended on the
  persons symptoms
• Treatment
• Trephining allowed the evil spirit to escape the
  head
• Exorcisms used to cast demons out of the body

4
Hippocrates Early Medical Concepts

• Hippocrates (460-377 B.C.)
• Mental disorders due to natural causes
• Brain
• Mental disorders
• Pointed out that head injuries could lead to
  sensory and motor disorders
• Emphasized the importance of heredity and
  predisposition

5
Hippocrates Early Medical Concepts

• Classification Three categories
• Treatment do no harm
• Misconceptions

6
Early Philosophical Conceptions

• Plato (427-347 B.C.)
• Aristotle (384-322 B.C.)

7
Alexandria, Egypt

• Center of Roman Culture (c. 300-30 B.C.)
• Therapies used for mental patients
• Why were these therapies used to treat mental
  illness?

8
Middle Ages Europe(A.D. 500-1300)

• Mental disorders were prevalent
• Etiology of Mental Illnesses
• Treatment of Mental Illness

9
Middle Ages Middle EastTreatment and
Classification

• First mental hospital established in Baghdad in
  A.D. 792
• Avicenna (Arabia A.D. 980-1037)

10
Reformation Europe (16th Century) Treatment -
Establishment of Asylums

• Places to warehouse troublesome people, used
  harsh tactics to control unruly or excited
  patients
• Bedlam Monastery of St. Mary of Bethlehem in
• London commissioned by King Henry VIII (1547)

11
Age of Enlightenment Humanitarian Reform Key
People

• Pinel (Paris 1745-1826)
• Tuke (England 1732-1822)
• Dix (America 1802-1887)

12
Twentieth CenturyTreatment

• Asylums viewed by public as eerie, strange, and
  frightening

13
Twentieth CenturyTreatment

• 1946 1963 Changing views of mental health
  services
• National Institute of Mental Health is organized
• DSM-I published
• Mary Jane Ward published The Snake Pit
• Goffman published Asylums
• Hill-Burton Act is passed
• Community Health Services Act of 1963

14
Twentieth CenturyDeinstitutionalization

• 1970s Deinstitutionalization and Community
  Mental Health Care
• Forces that initiated/shaped the movement
• Miracle drugs
• Reconceptualization of Mental Illness
• Recognition of Institutional Hazards
• Economic Incentives

15
Twentieth CenturyDeinstitutionalization
Evaluating it

• Fewer patients spend time in inpatient hospitals
• Patients spend less time in inpatient hospitals
• More patients are re-hospitalized
• Where are they instead?

16
Twentieth CenturyDeinstitutionalization
Evaluating it

• Large focus on medication
• Still more stigma than physical illness
• Little economic or social support for mental
  health programs
• Deinstitutionalization paid more attention to
  negative rights than positive rights
• Negative Rights
• Positive Rights

17
Causal Factors
18
Causes and Risk FactorsDefinitions

• Etiology is the causal pattern of abnormal
  behavior
• Necessary cause
• Sufficient cause
• Contributory cause
• Distal causal factors
• Proximal causal factors
• Reinforcing contributory cause

19
Causes and Risk FactorsFeedback and Circularity

• When more than one causal factor is involved, a
  causal pattern is found
• Simple cause and effect sequences are rare in
  abnormal psychology
• Complex systems of feedback produce patterns of
  interaction and circularity

20
Causes and Risk FactorsDiathesis-Stress Models

• Diathesis
• Stress

21
Causes and Risk FactorsDiathesis-Stress Models

• Diathesis-Stress Models
• Multi-causal development models
• Additive model
• Interactive model
• These models emphasize that we must know what is
  normal development to understand what constitutes
  abnormal development

22
Causes and Risk FactorsProtective Factors

• Protective factors
• Resilience
• Examples

23
Viewpoints

• Biological Causes
• Environmental Causes
• Psychosocial
• Sociocultural
• Theoretical Perspectives (Counseling Perspective)
• Psychodynamic
• Behavioral
• Cognitive-Behavioral

24
Biological Viewpoint

• The cause of mental disorders is due (at least in
  part) to biological processes
• One of the main contributors to the biological
  viewpoint was the finding that syphilis could
  cause psychosis

25
Biological ViewpointNeurotransmitters

• Imbalances of Neurotransmitters
• May be excessive production and release of the
  neurotransmitter substances into the synapses
• May be a dysfunction in how neurotransmitters are
  deactivated
• May be a problem with receptors in the
  postsynaptic neuron

http//www.tvdsb.on.ca/westmin/science/sbioac/home
o/synapse.htm
26
Biological ViewpointGenetic Vulnerabilities

• Mental illness may be due to
• Single vs. Multiple Genes
• Genotype-Environment Interaction

27
Biological ViewpointsGenetic and Environmental
Influences

• Genetic influences
• Shared environmental influences
• Nonshared environmental influences
• Studying genetic and environmental influences

28
Environmental CausesPsychosocial Viewpoint

• The cause of mental disorders is due (at least in
  part) to a persons social environment
• Early Deprivation
• Trauma
• Marital Discord/Divorce
• Parenting Styles
• Parental Psychopathology

29
Psychosocial ViewpointsEarly Deprivation

• Institutionalization
• Many children institutionalized in infancy or
  early childhood show severe emotional,
  behavioral, and learning problems and are at risk
  for disturbed attachment relationships and
  psychopathology
• Adoption can lead to significant improvement
• Children, ages 4-6, showed increases in IQ points
  after adoption
• Low SES increase of 8 IQ points
• Middle SES increase of 13.5 IQ points
• High SES increase of 19 IQ points

30
Psychosocial ViewpointsTrauma

• Neglect and Abuse in the home
• Among infants, gross neglect may be worse than
  abuse
• Abused children may be overly aggressive, have
  communication or language difficulties, and
  significant impairment in behavioral, emotional,
  and social functioning
• Improvements may be seen when the caregiving
  environment changes, but for some, these early
  experiences may never be overcome

31
Psychosocial ViewpointsParenting Styles

• Parenting Styles Warmth and Control
• Styles of parenting vary in warmth and control
• Authoritative parenting
• Authoritarian parenting
• Permissive-indulgent parenting
• Neglectful-uninvolved parenting
• Exception

32
Psychosocial ViewpointsParental Psychopathology

• Parental psychopathology
• Parents suffering from schizophrenia, depression,
  antisocial PD, and alcoholism tend to have
  children at heightened risk for a variety of
  developmental difficulties
• Effects do not seem to be due simply to genetic
  variables
• Protective factors can buffer these effects
  warm/nurturing relationship with an adult, high
  intellect, social/academic competence, etc.

33
Psychosocial ViewpointsMarital Discord/Divorce

• Marital Discord
• Divorced Families

34
Environmental CausesSociocultural Viewpoints

• The cause of mental disorders is due (at least in
  part) to a persons societal or cultural context
• Low SES and Unemployment
• Prejudice and Discrimination
• Social Change and Uncertainty
• Urban Stressors

35
Sociocultural ViewpointsPathogenic Societal
Influences

• Low SES status and unemployment
• Correlation between psychopathology and low SES
  strength of correlation varies by disorder
• Lower SES families tend to have more
  problems/dysfunction because of the stressors
  associated with low SES
• Relationship between psychopathology and
  unemployment
• Underemployed people show rates of depression
  comparable to those seen in unemployed
  individuals

36
Sociocultural ViewpointsPathogenic Societal
Influences

• Prejudice and discrimination in race, gender, and
  ethnicity
• Stereotypes are demoralizing
• Types of Discrimination
• Access
• Treatment
• In addition to discrimination, women have also
  suffered from sexual harassment in the workplace

37
Sociocultural ViewpointsPathogenic Societal
Influences

• Social change and uncertainty
• Urban stressors Violence and homelessness

38
Theoretical Viewpoints (Counseling Perspective)

• The Psychodynamic Perspective
• The Behavioral Perspective
• The Cognitive Perspective

39
Theoretical ViewpointsThe Psychodynamic
Perspective

• Sigmund Freud founded the psychoanalytic school,
  which emphasizes the role of unconscious motives
  and thoughts
• Structure of personality
• Id
• Ego
• Superego

40
Theoretical ViewpointsThe Psychodynamic
Perspective

• Anxiety, defense mechanisms, and the unconscious
• Freud believed that anxiety played a key causal
  role in most forms of psychopathology
• Distress is experienced as a result of desires
  (often sexual) that are viewed as inappropriate
  by the person
• These desires are so distressing that they cant
  be dealt with rationally
• Ego resorts to irrational defense mechanisms
• These unconscious conflicts continue to cause
  problems for the person, resulting in the
  symptoms of mental illness
• Treatment involves uncovering the unconscious
  desires and dealing with them in a more rational
  way

41
Theoretical ViewpointsThe Psychodynamic
Perspective

• Newer psychodynamic perspectives
• Object relations theory
• Interpersonal perspective
• Attachment theory

42
Theoretical ViewpointsThe Psychodynamic
Perspective

• Impact of the Psychodynamic Perspective
• Development of therapeutic techniques (eg. free
  association, dream analysis, etc.)
• Recognition of the influence of the unconscious,
  early childhood experiences, and sexual factors
• Theory that problems develop as failed coping
  strategies
• Two important criticisms

43
Theoretical ViewpointsThe Behavioral Perspective

• The Behavioral Perspective emphasizes the role of
  learning in the development of psychopathology
• Classical Conditioning
• Operant Conditioning

44
Theoretical ViewpointsThe Behavioral Perspective

• Operant conditioning response to a behavior
  will increase or decrease the frequency of that
  behavior

Add Something to Environment
Take Something out of Environment
POSITIVE REINFORCEMENT
NEGATIVE REINFORCEMENT
Increase Occurrence of Behavior
Decrease Occurrence of Behavior
POSITIVE PUNISHMENT
NEGATIVE PUNISHMENT
45
Operant Conditioning

• Schedules of reinforcement
• Fixed ratio
• Fixed interval
• Variable ratio
• Variable interval
• Extinction

46
Theoretical ViewpointsThe Behavioral Perspective

• Impact of the Behavioral Perspective
• Maladaptive behavior is viewed essentially as the
  result of
• Hailed for precision and objectivity, wealth of
  research, and for its demonstrated effectiveness
  in changing specific behaviors
• Criticized for being unemotional or lacking
  empathy, focusing on specific behaviors, and for
  the misconception that it simplifies behavior
• Treatment is focused on changing specific
  behaviors and ultimately, emotional responses to
  those behaviors

47
Theoretical ViewpointsThe Cognitive Perspective

• The Cognitive perspective focuses on how thoughts
  and information processing can become distorted
  and lead to maladaptive emotions and behavior

48
Theoretical ViewpointsThe Cognitive-Behavioral
Perspective

• Schemas and Cognitive Distortions
• Beck developed the concept of a schema or
  underlying representative of knowledge that
  guides the current processing of information and
  often leads to distortions in attention, memory,
  and comprehension
• Self-schemas include our views about who we are,
  what we might become, and what is important to us
• Different forms of psychopathology are
  characterized by different maladaptive schemas
  that have developed as a function of adverse
  early learning experiences

49
Theoretical ViewpointsThe Cognitive-Behavioral
Perspective

• Cognitive Distortions
• Black and White/All or None thinking
• Overgeneralization
• Mental filter
• Disqualifying the positive
• Personalization
• Jumping to Conclusions
• Treatment focuses on identifying and challenging
  cognitive distortions as well as developing more
  realistic self-talk

50
In sum

• Advantages of having a theoretical viewpoint
• Disadvantages of having a theoretical viewpoint
• Remember