Chapter 1: Intro and Historical Review

09/22/2014

Psychopathology the field concerned with the nature

development, and treatment of mental disorders
Stigma the destructive beliefs and attitudes held by a society
that are ascribed to groups considered different in some manner
Distinguishing label is applied
Label refers to undesirable attributes
People with the label are seen as different
People with the label are discriminated against
Mental disorderthe disorder occurs within the individual, it
involves clinically significant difficulties in thinking, feeling, or
behaving, it involves dysfunction in processes that support mental
functioning , it is not a culturally specific reaction to an event, it is
not primarily a result of a social deviance or conflict with society
PERSONAL DISTRESS
VIOLATION OF SOCIAL NORMS
DISABILITY
DYSFUNCTION
Disability impairment in some important area of life
Harmful dysfunction a value judgment (harmful) and an
objective, scientific componentthe dysfunction
The History of Psychopathology
A. Early Demonology
i. All good and bad manifestations of power beyond human
controleclipses, earthquakes, storms, fire, diseases, the
changing seasons were seen as supernatural

1. Demonology an evil being or spirit that can

dwell within a person and control his or her mind
and body
2. Exorcismthe belief that odd behavior was
caused by possession led to the ritual of casting
out evil spirits
B. Early Biological Explanations
i. Hippocrates the father of modern medicine, separated
medicine from religion, magic and superstition
ii. Regarded the brain as the organ of consciousness,
intellectual life, and emotion
iii. Classified mental disorders into three categories
1. Mania
2. Melancholia
3. Phrenitis (brain fever)
C. The Dark Ages and Demonology
i. The death of Galen (130-200)
1. He was considered the last great physician of the
classical era
o His death was the beginning of the Dark Ages
ii. The Persecution of Witches
1. Beginning of the 13th century people blamed
demonology to explain disasters
2. Satan and deny God
3. In 1484 Pope Innocent VIII sent monks, clergy, and
inquisitors to search for witches
4. Later on in the middle ages it was declared that the
people who were seen as witches were mentally ill
iii. Lunacy trails were used to determine a persons
mental health
D. Development of Asylums
i. Bethlehem and Other Early Asylums

1. Asylums refuges for the confinement and care

of people with mental illness
ii. Pinels reforms
1. Philppe Pinel (1745-1826) primary figure in the
movement for humanitarian treatment of people
with mental illness in asylums
iii. Moral treatment
o Patients had close contact with attendants, who talked
and read to them and encouraged them to engage in
purposeful activity
E. Dorothea Dix (1802-1887)
o Crusader for prisoners and mentally ill
o Urged improvement of institutions
o Worked to establish 32 new, public hospitals
o Unfortunately, small staffs at these new public
hospitals could not provide necessary individual
attention
o Hospitals administered by physicians, who were more
interested in biological rather than psychological
aspects of mental illness
THE EVOLUTION OF CONTEMPORARY THOUGHT
A. BIOLOGICAL APPROACHES
i. Discovering biological origins in general paresis and syphilis
1. The anatomy and workings of the nervous system were
partially understood by the mid-1800s
General paresis a neuropsychiatric disorder affecting
the brain, caused by late-stage syphilis.
2. Germ theory of disease disease is caused by infection
of the body by multiple organisms
ii. Genetics
1. Francis Galtonthe originator of genetic research with
twin in the late 1800s

2. Coined the terms nature and nurture to talk about

vestigators became intrigued by the idea that mental
illness may run in the family
3. Eugenics movementprohibited people with mental
illness from marrying and having children
iii. Biological treatments
1. Electroconvulsive therapy Ugo Cerletti and Lucino
Bini the appliance of electric shock, epileptic seizures
2. Prefrontal lobotomy a surgical procedure that
destroys the tracts connecting the frontal lobs to other
areas of the brain
B. PSYCHOLOGICAL APPROACHES
i. Mesmer and Charcot
1. Franz Anton Mesmer believed that hysteria was
caused by a particular distribution of a universal
magnetic fluid in the body
2. Jean Martin Charcot neurologists , believed that
hysteria was problem with the nervous system
ii. Breuer and the cathartic method
1. Josef Breuer is a physician, treated a woman who had
a number of hysterical symptoms including partial
paralysis, impairment of sight and hearing and
difficulty speaking by hypnotizing her
2. Cathartic method relieving an earlier emotional
trauma and releasing emotional tensions by expressing
previously forgotten thoughts about the event
iii. Freud and psychoanalysis
1. Psychoanalytic theory psychopathology results
from unconscious conflicts in the individual
2. Structure of the Mind
a. Psyche (division of the mind) id, ego, superego
i. Id present at birth and is the repository of
all of the energy needed to run the psyche,
including the basic urges for food, water,
elimination, warmth, affection, and sex
1. Libidoenergy source of the id
2. Unconscious below the level of
awareness
3. Pleasure principlewhen the id is not
satisfied, tension is produced and the
id impels a person to eliminate this
tension as quickly as possible
ii. Ego primarily conscious

o May resort to fantasy when seeking

satisfaction but has to deal with
reality
o Reality principlemedicates btw the
demands reality and the ids demand
for immediate gratification
o Reality principle mediates between
the demands of reality and the ids
demands for immediate gratification
iii. Super-ego
1. The third part of the psyche,
conceived of as a persons conscious,
2. Freud believed that the super-ego
develops throughout childhood
Defense Mechanisms a strategy used by the ego to protect
itself from anxiety
o Repression: keeping unacceptable impulses or wished from
conscious awareness
o Denialnot accepting a painful reality into conscious
awareness
o Projectionattributing to someone else ones own
unacceptable thoughts or spirits
o Displacementredirecting emotional responses from their
real target to someone else
o Reaction formation converting an unacceptable feeling
into its opposite
o Regressionretreating to the behavioral patterns of an
earlier stage of development
o Rationalizationoffering acceptable reasons for an
unacceptable action or attitude
o Sublimationconverting unacceptable aggressive or sexual
impulses into socially valued behaviors
Psychoanalytic Therapy the goal of the therapist is to understand
the persons early childhood experiences, the nature of key relationships,
and the patterns in current relationships
Free Associationa patient reclines on a couch, facing away from
the analyst and is encouraged to give free rein to his or her thoughts,
verbalizing whatever comes to mind, without censoring anything
Transferencethe patiences response to his or her analyst that
seems to reflect attitudes and ways of behaving toward important people in
the patients past rather than reflecting actual aspects of the analyst-patient
relationship

Interpretationthe analyst points out to the patient the meanings on

certain of the patients behavior
iv. Neo-Freudian psychodynamic perspectives
1. Relative importance of id versus ego, of biological
versus sociocultural forces on psychological
development, of unconscious versus conscious
processes and of childhood versus adult
experiences; whether sexual urges drive
behaviors that are not obviously sexual and the
role of re-flexlike id impulses versus that of
purposive behavior governed primarily by
conscious ego deliberations
2. Jung and Analytical Psychology
a. Analytical psychology
Collective unconscious
Archetypes
Catalogued personality characteristics
Extraversion vs. Introversion
3. Adler (1870-1937)
Individual psychology
Fulfillment derived from working for the
social good
v. Continuing influences of Freud and His Followers
Childhood experiences help shape adult
personality
There are unconscious influences on behavior
There are unconscious influences on behavior
The Evolution of Contemporary Thought: The Rise of Behaviorism
A. John Watson (1878-1958)
Behaviorism Focus on observable behavior
Emphasis on learning rather than thinking or innate
tendencies
Three types of learning:

Classical Conditioning
Discovered by Pavlov (1849-1936)
Unconditioned Stimulus (UCS)
o Meat powder (automatically elicits
salivation)
Unconditioned Response (UR)
o Salivation (automatic response to
meat powder)
Neutral Stimulus (NS)
o Initial ringing of bell (does not
automatically elicit salivation)
Conditioned Stimulus (CS)
o After pairing the NS and the UCS, the
NS becomes a CS (bell now
automatically elicits salivation)
Conditioned Response (CR)
o Salivation (automatic response to
bell)
Extinction
o CS (bell) not followed by UCS (meat
powder) causes gradual
disappearance of CR (salivation)
Operant Conditioning
o E. Thorndike (1874-1949)
Learning through consequences
o Law of Effect
Behavior that is followed by satisfying
consequences will be repeated; behavior that is
followed by unpleasant consequences will be
discouraged
o B.F. Skinner (1904-1990)

Principle of Reinforcement
Positive reinforcement
Behaviors followed by pleasant stimuli
are strengthened
Negative reinforcement
Behaviors that terminate a negative
stimulus are strengthened

Modeling
o Albert Bandura
Learning by watching and imitating others
Bobo doll experiment
Modeling help children get rid of their fear of dogs
Behavior Therapy or Behavior Modification
Systematic Desensitization
o Used to treat phobias and anxiety
o Combines deep muscle relaxation and gradual exposure
to the feared condition or object
o Starts with minimal anxiety producing condition and
gradually progresses to most feared
Intermittent Reinforcement
o Rewarding a behavior only occasionally more effective
than continuous schedules of reinforcement
Behavior Therapy

Limitations of Behavior Therapy

o How we think or appraise a situation influences our
feelings and behaviors
Cognitive Therapy
o Emphasize how people think about themselves and
their experiences can be a major determinant of
psychopathology
o Focus on understanding maladaptive thoughts
o Change cognitions to change feelings and behaviors
Ellis (1913-2007)
REBT (Rational-Emotive Behavior Therapy)