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Psychopathology - Summary, Tilburg University (8,5)

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Using the lectures of professor Mertens as a guide in combination with the relevant information out of the book from the ninth edition of "Fundamentals of Abnormal Psychology" you can be assured that all important information is included. If you have any questions, you can message me :)

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  • June 1, 2021
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  • 2020/2021
  • Summary

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Chapter 1 Abnormal Psychology: Past and Present
Abnormality definition has four D’s:
 Deviance – abnormal behaviors, thoughts and emotions are those that differ from a society’s
ideas (norms, culture) about proper functioning.
 Distress – behaviors, thoughts and emotions have to cause distress before they can be
labelled abnormal.
 Dysfunction – abnormal behavior tends to interfere with daily functioning.
 Danger – behavior becomes danger to oneself or others.
Szasz posits that societal involvement may invalidate the concept of mental illness.

Eccentric = a person who deviates from common behavior patterns or displays odd behavior, out of
pleasure and not mental disorder.

Treatment/therapy = systematic procedure designed to change abnormal behavior into more normal
behavior, has three essential features:
 Sufferer who seeks relief from healer.
 Trained, socially accepted healer, whose expertise is accepted by sufferer and social group.
 Series of contacts between healer and sufferer, through which healer tries to produce
changes in sufferer’s emotional state and behavior.

History
 Abnormal behavior was the doing of evil spirits.
o During stone age, trephination (= circular sections of skull were cut out with a stone
(trephine) to let evil spirits out) was conducted.
o Egyptian, Chinese and Hebrew societies practiced forms of exorcism, in which evil
spirits were expelled out of the body
 Hippocrates came up with the theory about humors (=bodily chemicals) and when imbalance
resulting in illness. Treatment was changing your life, diet, or letting blood out.
 During the Middles Ages, mental disorders had demonic causes. At the close of Middle Ages,
demonology and methods began to lose favor again.
 During the Renaissance demonological views continued to decline. Johann Weyer believed
that the mind could get sick just as the body.
 In sixteenth century, people with mental disorders would go to asylums.
 In nineteenth century, moral treatment emerged, respectful and humane techniques.
Benjamin Rush is the most influential person in spreading this and is founder of American
psychiatry. Dorothea Dix made humane care a political concern which led to state hospitals.

Two perspectives in twentieth century:
 Somatogenic perspective = abnormal functioning has physical causes.
 Psychogenic perspective = abnormal functioning has psychological causes.
o Freud: psychoanalysis = treatment of abnormal mental functioning that emphasizes
unconscious psychological forces.

Different trends in modern psychology:
 Psychotropic medications = drugs mainly affect brain and reduce mental dysfunctioning.
Three types:
o Antipsychotic drugs – correct distorted thinking
o Antidepressant drugs.
o Antianxiety drugs.
 Development of these drugs led to treatment outside hospitals, leading to patients being
releases (= deinstitutionalization).

,  Before 1950s private psychotherapy = arrangement in which person directly pays therapist.
 Today’s focus lies on prevention rather than healing, this has been influenced by positive
psychology.
o Multicultural psychology = filed that examines impact of culture, race, ethnicity and
gender on behaviors and thoughts, and focuses om how such factors may influence
origin, nature and treatment of abnormal behavior.
o Managed care program = health care coverage in which insurance company largely
controls nature, scope and cost of medical or psychological services.
o Telemental health = use of digital technologies to deliver mental health services
without therapist being physically present.

Clinical research
 Nomothetic understanding = understanding in terms of natural laws/principles. Researchers
want to develop a general nomothetic understanding by finding nature of abnormality.
 Using scientific method = collecting and evaluating information through observations.

Three types of investigation:
 Case study – single individual in detail.
o Strength: helpful for new ideas or techniques and or supporting/challenging new
ideas, and for unusual problems.
o Limitations: biased observers, subjective evidence – low internal validity, little basis
for generalization – low external validity.
 Correlational method – correlation for many individuals.
o Strength: high external validity.
o Limitations: low internal validity, it does not explain the correlation.
o Epidemiological study = form of correlational study that investigates the incidence
(new cases) and prevalence (total cases) of a disorder in a population.
o Longitudinal study = form of correlational study in which researchers observe and
follow the same individuals for a long period of time.
 Experimental method – causal relationship for many individuals.
o Independent and dependent variable, confounds, random assignment, placebo
therapy, control group.
o Masked design = experiment in which participants do not know whether they are in
experimental or control condition.
 Alternative experimental designs
o Quasi-experiment/mixed design = experiment without random assignment, existing
groups.
o Matched design = design that matches experimental participants with control
participants who are similar on key characteristics.
o Natural experiment = natural causes are used as independent variables and
researchers observe effects.
o Analogue experiment = experimenters produce real life environment conduct
experiments.
o Single-subject experiment = one single participant is observed before and after
certain manipulation.

Ethics:
 Institutional Review Boards (IRBs) = committees that review studies based on ethics and
human rights, following the next guidelines:
o Participants must enlist voluntarily.
o Participants must be informed before enlisting.

, o Participants can end their participation at any time.
o Benefits outweigh costs.
o Participants are protected from harm.
o Participants must have access to information about study.
o Privacy of participants is protected.

Chapter 2 Models of Abnormality
Models/paradigms = perspectives in science that are used to explain events and assumptions, guide
treatment techniques and principles.

The biological model
 Someone’s thoughts, emotions and behavior can be explained by biological means.
 Considers illness to be brought about by malfunctioning parts of the organism.
 Brain anatomy and chemistry: neurons communicate via neurotransmitters at synapses. The
body can also communicate with hormones.
o Disorders have been linked to certain brain regions, neurotransmitters or hormones.
 Three factors that cause abnormalities:
o Genetics = heritable information that is passed down from parents to siblings that is
stored in genes (mutation or result of evolution).
o Evolution: mental disorders might have been adaptive; they have helped individuals
to survive and reproduce in the past.
o Viral infection: exposure to viruses may cause psychological disorders.
 Biological treatments try to find physical source of dysfunctioning.
o Drug therapy:
 Psychotropic medications = drugs that affect emotions and thoughts.
 Antianxiety drugs
 Antidepressant drugs
 Antibipolar drugs – stabilize mood.
 Antipsychotic drugs – reduce delusions and hallucinations.
o Psychosurgery = brain surgery to reduce mental disorders.
o Brain stimulation: electroconvulsive therapy (ECT), transcranial magnetic stimulation
(TMS), deep brain stimulation (DBS).
 Strengths: produces new information, treatments bring relief.
 Weaknesses: limits understanding of abnormalities by excluding nonbiological factors,
produce undesirable effects.

The psychodynamic model (Freud)
 Behavior is influence by unconscious forces, and abnormal behavior is a result of conflict
between these forces.
 Psychoanalysis with three central forces:
o Id = unconscious instinctual needs, pleasure principle.
o Ego = unconscious reason, reality principle.
o Superego = conscious morality, morality principle.
 New events and pressures require adjustment in id, ego, and superego at developmental
stages.
o If adjustment unsuccessful, a person might become fixated (= stuck in that
developmental stage).
 Other theories are self-theory (= emphasize unified personality), object-relations theory (=
emphasize relationships with others)
 Psychodynamic therapies:
o Free association = naming any thought that comes to mind.

, o Therapist interpretation – drawing conclusions from patients behavior.
 Resistance = unconscious refusal.
 Transference = redirection toward psychotherapist of feelings associated
with important figures in patient’s life.
o Catharsis = relieving repressed feelings.
o Working through = examining same issue multiple times to gain insight.
 Current trends in therapy:
o Short-term psychodynamic therapies = patient chooses single problem to focus on
for the short-term.
o Relational psychoanalytic therapy = therapist and patient must have a personal
relationship, therapist tells things about themselves.
 Strengths: first to recognize importance of psychological theories and treatment and saw
abnormal functioning nested in same processes as normal functioning.
 Weaknesses: unsupported ideas, difficult to research, non-observable concepts, inaccessible
to human subjects.

The cognitive-behavioral model
 Focuses on maladaptive behavior and cognitions in understanding and treating psychological
abnormality.
 Behavioral dimension:
o Using conditioning: classical and operant conditioning, modelling.
o Therapists seek to help replace problematic behaviors with more appropriate
behaviors.
 Cognitive dimension:
o Focuses on maladaptive thinking processes: inaccurate assumptions and attitudes,
illogical thinking.
o Therapists help clients recognize, challenge and change problematic thinking.
 Exposure therapy = behavior-focused intervention in which fearful people are repeatedly
exposed to objects or situations they dread.
 Strengths: powerful force, very broad appeal, clinically useful, focuses on a human process,
theories lend themselves to research, therapies are effective.
 Weaknesses: precise role of cognition in abnormality has to be determined, therapies do not
help everyone, some changes may not be possible to achieve.

The humanistic-existential model
 Psychological health depends on ability to pursue goals and have a free and meaningful life.
 It consists of humanistic view, which believes humans are driven to self-actualize (= fulfil full
potential).
 And of existential view, which states that humans must have accurate self-awareness and
live a meaningful life in order to be psychologically healthy.
 Carl Roger
o Humanistic theory – basic human need for unconditional positive regard.
 If not received, then you get conditions of worth.
o Client-centered therapy = therapist creates supportive climate with unconditional
positive regard, accurate empathy and genuineness.
 Gestalt therapy = achieve self-acceptance through challenging and frustrating client.
 Existential therapy = focuses on client’s acceptance of responsibility for their own life.
 Spiritual views
o Role of religion is an important factor in mental health and treatment.
 Strengths: uses domains missing from other models, emphasizes individual and health,
optimistic.

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