Abnormal Psychology, Kring et al., 13th Edition
Chapter 4, 9-15 Clinical Psychology
Oefenvragen Klinische Psychologie Part 1
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Psychologie
Klinische Psychologie
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Chapter 1
Introduction and historical overview
Psychopathology: Study of the nature, development, treatment of psychological disorders.
● Challenging to remain objective.
● Closeness to subjects adds to its intrinsic fascination.
● Need to confront and work to change stigma → destructive beliefs and attitudes held
by a society that are ascribed to groups considered different in some manner.
○ Label is applied to group → refers to undesirable attributes → people with the
label seen as different → discriminated against → stigma.
Defining psychological disorder
Occurs within an individual, is not culturally specific reaction to an event and is not primarily
a result of social deviance or conflict with society.
Personal distress: A person’s behavior may be classified as disordered if it causes him or
her great distress.
● Not all mental disorders cause distress, not all behavior that causes distress is
disordered.
Disability: Impairment in some important area of life → work or personal relationships.
● Disability alone cannot be used to define mental disorders, some not all mental
disorders involve disability.
Violations of social norms: Behavior that violates social norms (standards, beliefs and
attitudes) might be classified as disordered.
● This way of defining mental disorders is both too broad and to narrow → also vary a
great deal across cultures and ethnic groups.
Dysfunction: Wakefield: When an internal mechanism is unable to perform its natural
function → function that it evolved to perform. DSM: Behavioral, psychological and biological
dysfunctions are all interrelated.
● Internal mechanisms involved are largely unknown.
History of psychopathology
Early demonology: The doctrine that an evil being or spirit can dwell within a person and
control his or her mind and body. Exorcism: Ritualistic casting out of evil spirits.
Early biological explanations: Hippocrates separated medicine from religion, magic and
superstition → he thought that disordered thinking and consciousness were indications of
some kind of brain pathology.
The dark ages and demonology: After death of Galen, physician who followed
Hippocrates’ ideas, belief in supernatural causes of psychological disorders returned.
● The persecution of witches: Those accused of witchcraft should be tortured if they
did not confess → those convicted were to be imprisoned for life.
○ Initial belief people accused of being witches were mentally ill → but analysis
reveals more healthy than ill people were accused.
● Lunacy trials: Attribution of odd behavior to a misalignment of the moon and stars →
welcome alternative to explanations involving demons or witches.
Development of asylums: Housing and care of people with psychological disorders.
, ● Bethlehem and other early asylums: Viewing people housed in Bethlehem was
considered entertainment, and people bought tickets to see them.
● Pinel’s reforms: He believed that people in his care were first and foremost human
beings and thus these people should be approached with compassion and
understanding and treated with dignity.
● Moral treatment: People had close contact with attendants → residents led lives as
close to normal as possible and in general took responsibility for themselves within
the constraints of their disorders.
The evolution of contemporary thought
Biological approaches:
● Discovering biological origins in general paresis and syphilis: If one type of
psychopathology had a biological cause, so could others.
● Genetics: Idea that psychological disorders may run in families.
● Biological treatments:
○ Insulin: Used to induce a coma → people with schizophrenia showed
“improvement”.
○ ECT: Electroconvulsive therapy → two shocks to the sides of the head →
epileptic seizures → used to treat schizophrenia and severe depression.
○ Prefrontal lobotomy: Surgical procedure that destroys the tracts connecting
the frontal lobes to other areas of the brain → used for people with
psychological disorders → unable to carry coherent conversation.
Psychological approaches:
● Mesmer and Charcot: Mesmer was the earlier practitioner of modern-day
mesmerism, hypnotism. While Mesmer believed it was biological, Charcot became
interested in the psychological explanations.
● Breuer and the cathartic method: Reliving an earlier emotional trauma and
releasing emotional tension by expressing previously forgotten thoughts about the
event → later investigation revealed this didn’t really cure hysteria.
● Freud and psychoanalysis: Psychopathology results from unconscious conflicts in
the individual.
○ Id: Present at birth and is the repository of all the energy needed to run the
mind → basic urges for food, water, warmth, affection and sex.
■ Pleasure principle: When id not satisfied → tension produced →
impels a person to eliminate this tension as quickly as possible.
○ Ego: The ego is primarily conscious and deals with reality.
■ Reality principle: Ego mediates between the demands of reality and
the id’s demands for immediate gratification.
○ Superego: A person’s conscience → incorporating values to receive pleasure
of approval and avoid the pain of disapproval.
● Defence mechanisms: Strategy used by the ego to protect itself from anxiety.
○ Repression: Keeping unacceptable impulses or wishes from conscious
awareness.
○ Denial: Not accepting a painful reality into conscious awareness.
○ Projection: Attributing to someone else one’s own unacceptable thoughts or
feelings.
○ Displacement: Redirecting emotional responses from their real target to
someone else.
, ○ Reaction formation: Converting an unacceptable feeling into its opposite.
○ Regression: Retreating to the behavioral patterns of an earlier stage of
development.
○ Rationalization: Offering acceptable reasons for an unacceptable action or
attitude.
○ Sublimation: Converting an unacceptable aggressive or sexual Someone
who has aggressive feelings toward impulses into socially valued behaviors
● Psychoanalytic therapy: Therapy where the goal of the therapist is to understand
the person’s early-childhood experiences, the nature of key relationship and the
patterns in current relationships.
● Neo-Freudian psychodynamic perspectives:
○ Analytical psychology (Jung): Proposed there is a collective unconscious
→ part of the unconscious that is common to all human beings and that
consists primarily of what Jung called archetypes → basic categories that all
human beings use in conceptualizing about the world.
○ Individual psychology (Adler): Regards people as inextricably tied to their
society because he believed that fulfilment was found in doing things for the
social good. He focused on helping people change their illogical and mistaken
ideas and expectations.
● Continuing influences of Freud and his followers: Freud’s influence is most
evident in the following three commonly held assumptions:
○ Childhood experiences help shape adult personality.
○ There are unconscious influences on behavior:
○ The causes of purposes of human behavior are not always obvious.
● The rise of behaviourism (Watson): Focuses on observable behavior rather than
on consciousness or mental functioning.
○ Classical conditioning (Pavlov): First a bell was
rung behind the dog and then the meat powder was
placed in its mouth → after repeating this the dog
began salivating as soon as it heard the bell and
before it received the meat powder.
■ CS; Conditioned Stimulus, CR; Conditioned
Response, UCS; Unconditioned Stimulus,
UCR; Unconditioned Response.
○ Law of effect (Thorndike): Behavior followed by
consequences satisfying organism will be repeated
→ behavior followed by unpleasant consequences will be discouraged.
○ Operant conditioning (Skinner):
■ Positive reinforcement: Strengthening of a tendency to respond by
virtue of the presentation of a pleasant event.
■ Negative reinforcement: Strengthening of a tendency to respond by
removal of an aversive event.
○ Modelling: We all learn by watching others → children fearing dogs →
witness fearless model engages in activities with a dog → children show
increased willingness to approach and touch a dog.
● Behavior therapy: Applies procedures based on classical and operant conditioning.
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