Persoonlijkheids-, Klinische en Gezondheidspsychologie
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Universiteit Leiden (UL)
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PERSOONLIJKHEIDS, KLINISCHE EN GEZONDHEIDS-PSYCHOLOGIE
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Abnormal psychology
Looking at abnormality
The study of abnormal psychology is the study of people who suffer mental, emotional, and often
physical pain, often referred to as psychopathology
A common belief is that behaviors, thoughts, or feelings can be viewed as pathological or abnormal if
they are symptoms of mental illness (this implies that a disease process is present)
Cultural relativists argue that the norms of a society must be used to determine the normality of a
behavior (there are no universal standards or rules for labeling a behavior abnormal, this can be done
only relative to cultural norms)
Behaviors that cause distress, prevent people from functioning in daily life (dysfunction), are unusual
or deviant, and pose a threat to the person or others (dangerousness) are abnormal (the four D’s)
Abnormal behaviors fall along a continuum (from adaptive to maladaptive) and the location of the
line designating behaviors as disordered is based on a subjective decision
Historically, theories of abnormality have fallen into one of three categories:
1. Biological theories saw psychological disorders as like physical diseases, caused by the
breakdown of a system of the body
a. Ancient Chinese: balancing ying (negative forces) and yang (positive forces)
b. Egyptian and Greek texts suggest that these cultures took this view as dominant
2. Supernatural theories saw abnormal behavior because of divine intervention, curses,
demonic possession and personal sin
a. Prehistoric times: attributing it to demons or ghosts
b. Stone Age (treatment): trephination (drilling holes in the skull to allow demons to
depart)
c. Middle Ages: witchcraft
3. Psychological theories saw abnormal behavior as being a result of stress
In psychic epidemics and mass hysterias, groups of people show similar psychological and behavioral
symptoms (usually attributed to common stresses or beliefs)
Nineteenth/twentieth century: abnormal people were shut away in prisonlike conditions, tortured,
starved, or ignored (in asylums)
Mental hygiene movement: moral management (moral treatment) of mental hospitals became
more widespread (patients treated with kindness, given best biological treatment available (not until
mid-twentieth century))
- A leader of the movement of moral treatment was Philippe Pinel
- William Tuke opened an asylum in England in direct response to the brutal treatment he saw
being delivered at other facilities
- Dorothea Dix: fought for the moral treatment of mental patients
Modern biological perspectives: advanced by Kraeplin’s development of a classification system (and
the discovery that general paresis is caused by a syphilis infection)
,Psychoanalytic perspective began with Anton Mesmer (mesmerism; using hypnosis) -> Jean Charcot
(hysteria was caused by degeneration in the brain) -> Sigmund Freud (interested in the role of the
unconscious in producing abnormality) -> Pierre Janet (investigating multiple personality disorder) ->
Josef Breuer (hypnosis/unconscious processes)
- Psychoanalysis is the study of the unconscious
Behaviorist views began with John Watson and B. F. Skinner (E. L. Thorndike) (used principles of
classical (Pavlov) and operant conditioning to explain normal and abnormal behavior)
- Behaviorism is the study of the impact of reinforcement and punishments on behavior
Cognitive theorists such as Albert Ellis, Albert Bandura and Aaron Beck focused on the role of
thinking processes in abnormality
- Cognitions are thought processes that influence behavior and emotion
- Self-efficacy beliefs are people’s beliefs about their ability to execute the behaviors
necessary to control important events
The deinstitutionalization movement attempted to move mental patients form mental health
facilities to community-based mental health centers (but: not fully funded/supported -> few
resources, for example halfway houses or day treatment centers): patient’s rights movement
Managed care systems are meant to provide coordinated, comprehensive medical care to patients
(great asset to people with long-term, serious psychological disorders)
The professions within abnormal psychology include psychiatrists, psychologists, marriage and
family therapists, clinical social workers, licensed mental health counselors, and psychiatric nurses
, Theories and treatment of abnormality
A theory is a set of ideas that provides a framework for asking questions about a phenomenon and
for gathering and interpreting information about that phenomenon. A therapy is a treatment,
usually based on a theory of a phenomenon, that addresses those factors the theory says cause the
phenomenon
It is often a combination of factors (risk factors) that causes disorders: biopsychosocial approach
- Factors that increase risk for multiple types of psychological problems are referred to as
transdiagnostic risk factors
- A diathesis-stress model shows that only when the risk factor and the trigger or stress come
together in the same individual does he full-blown disorder emerge
Biological theories of psychopathology typically attribute symptoms to structural abnormalities in
the brain, disordered chemistry or faulty genes
- Structural abnormalities (brain dysfunction) in the brain can be caused by faulty genes, by
disease, or by injury. Which particular area of the brain is damaged influences the symptoms
individuals show (Phineas Gage)
o Brain has three main regions: hindbrain (medulla, pons, reticular formation,
cerebellum), midbrain (superior and inferior colliculus, substantia nigra) and the
forebrain (thalamus, hypothalamus, pituitary gland, limbic system, cerebrum)
o Medulla: helps control breathing and reflexes
o Pons: important for attentiveness and the timing of sleep
o Reticular formation: a network of neurons that control arousal and attention to
stimuli
o Cerebellum: concerned primarily with the coordination of movements
o Superior and inferior colliculus: relay sensory information and control movement
o Substantia nigra: a crucial part of the pathway that regulates responses to reward
o Outer layer of the cerebrum is the cerebral cortex: involved in many of our most
advanced thinking processes (two hemispheres connected by the corpus callosum)
Each hemisphere is divided into four lobes (frontal, parietal, occipital and
temporal lobes)
o Other structures of the forebrain are called subcortical structures
Thalamus: directs incoming information from sense receptors to the
cerebrum
Hypothalamus: regulates eating, drinking and sexual behavior – involved in
processing basic emotions
Limbic system: set of structures that regulate many instinctive behaviors
Amygdala: structure of the limbic system that is critical in emotions
such as fear
Hippocampus: structure of the limbic system that plays a role in
memory
- Many biological theories attribute psychopathology to imbalances in neurotransmitters or to
the functioning of receptors for neurotransmitters (disordered chemistry)
o Neurotransmitters are biochemicals that act as messengers carrying impulses from
one neuron, or nerve cell, to another in the brain and in other parts of the nervous
system
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