Summary of the chapters selected by the University of Groningen for the subject Clinical Psychology. This subject is given in the second year of studying psychology.
Davey, G. (2015) Psychopathology: Research, Assessment and Treatment in Clinical Psychology - 2nd Edition. Custom for University of Groningen. Wiley & Sons Ltd.
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Bachelor Psychology
Klinische Psychologie (PSBA222/PSBE222)
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Psychopathology
Chapter 1; An introduction to psychopathology: concepts, paradigms
and stigma
Psychopathology The study of deviations from normal or everyday psychological or
behavioral functioning
Clinical psychology The branch of psychology responsible for understanding and treating
psychopathology.
Demonic possession Historical explanations of psychopathology such as demonic possession
often alluded to the fact that the individual had been possessed in some
way.
Medical model An explanation of psychopathology in terms of underlying biological or
medical causes.
Demonology Many ancient civilizations such as those in Egypt, China, Babylon and
Greece, believed that those exhibit symptoms of psychopathology were
possessed by bad spirits- known as demonology.
General paresis A brain disease occurring as a late consequence of syphilis, characterized
by dementia, progressive muscular weakness and paralysis.
Somatogenic The hypothesis that the causes or explanations of psychological problems
hypothesis can be found in physical or biological impairments.
Psychiatry A scientific method of treatment that is based on medicine, the primary
approach of which is to identify the biological causes of psychopathology
and treat them with medication or surgery.
Asylums In previous centuries asylums were hospices concerted for the
confinement of individuals with mental health problems.
Moral treatment Approach to the treatment of asylum inmates, developed by the Quaker
movement in the UK, which abandoned contemporary medical
approaches in favor of understanding, hope, moral responsibility and
occupational therapy.
Milieu therapies The first attempts to structure the hospital environment for patients,
which attempted to create a therapeutic community on the ward in
order to develop productivity, independence responsibility and feelings
of self-respect.
Token economy A reward system which involves participants receiving tokens for
engaging in certain behaviors, which at later time can be exchanged for a
variety reinforcing or desired items.
Many forms of psychopathology are accompanied by what appear to be changes in the individual’s
personality, and these changes in personality or behavior are some of the first symptoms that are
noticed. In the history, people tended to describe these changes in personality as the person being
possessed in some way. Their personality appeared to have been taken over and replaced by the
persona of someone or something else. demonology.
The medical model of psychopathology has some important implications for the way we conceive
mental health problems;
- Firstly, an obvious implication is that it implies that medical or biological causes underlie
psychopathology.
- Second, the medical model adopts what is basically a reductionist approach by attempting to
reduce the complex psychological and emotional features of psychopathology to simple
biology.
, - There is an implicit assumption in the medical model that psychopathology is cause by
something not working properly.
Cons of medical model;
- Psychopathology can be viewed as being on a dimension rather than being a discrete
phenomenon that is separate from normal experience
- By implying that psychopathology is caused by a normal process that is broken, imperfect or
dysfunctional, the medical model may have an important influence on how we view people
suffering from mental health problems and how they might view themselves.
Phillippe Pinel (1745-1826) is often considered to be the first to introduce more humane treatments
during his time as the superintendent of the Bicetre Hospital in Paris. He began by removing the
chains and restraints that previously had been the standard ways of shackling inmates, and started to
treat these inmates as sick human beings rather than animals. Further enlightened approaches to the
treatment of asylum inmates were pioneered in the USA by Benjamin Rush and by the Quaker
movement in the UK. The latter developed an approach known as moral treatment, which
abandoned contemporary medical approaches in favor of understanding, hope, moral responsibility
and occupational therapy.
Custodial care was neither economically viable nor was it providing an environment in which patients
has an opportunity to improve. Because of the growing numbers of in-patients diagnosed with
mental health problems, the burden of care came to rest more and more on nurses and attendants
who (because of a lack of experience and training) would resort simple to restraint as the main form
of intervention patients developing social breakdown syndrome; confrontational and challenging
behavior, physical aggressiveness and a lack of interest in personal welfare and hygiene.
1950-1970; Milieu therapies; first attempts to create a therapeutic community on the
ward which would develop productivity, independence, responsibility and feelings of
self-respect.
Token economy programs; based on operant reinforcement, where patients would
receive tokens (rewards) for exhibiting desired behaviors.
Abnormal psychology An alternative definition of psychopathology, albeit with stigmatizing
connotations relating to not being normal.
Service user groups Groups of individuals who are end users of the mental health services
provided by, for example, government agencies such as the NHS.
Statistical norm The mean, average or modal example of a behavior.
Ataque de Nervios A form of panic disorder found in Latinos from the Caribbean.
Seizisman A state of psychological paralysis fond in the Haitian community.
Harmful dysfunction Assumption that psychopathology is defined by the dysfunction of a
normal process that has the consequence of being in some way harmful.
The problems of defining psychopathology not only revolve around what criteria we use to define
psychopathology, but also what terminology we use. We must consider not only whether a definition
is useful in the scientific and professional sense, but also whether it provides a definition that will
minimize the stigma experienced by sufferers, and facilitate the support they need to function as
inclusive members of society.
Statistical norm; problems
- In the intellectual disability case, an IQ of less than 70 may be statistically rare, but rather
than simply forcing the individual into a diagnostic category, a better approach would be to
, evaluate the specific needs of individuals with intellectual disabilities in a way that allows us
to suggest strategies, services and supports that will optimize individual functioning
- Substantial deviation from the norm does not necessarily imply psychopathology because
individuals with exceptionally high IQs are also statistically rare, but don’t need a
psychological intervention
- Emotions such as anxiety and depression that underlie the most common mental health
problems are not statistically rare emotions. They are experienced almost daily by most
people.
Deviation from social and political norms; problems
- Different cultures often differ significantly in what they consider to be socially normal and
acceptable
- It is difficult to use cultural norms to define psychopathology because cultural factors seem
to significantly affect how psychopathology manifest itself
Social and cultural factors affect vulnerability of an individual to causal factors
Culture can produce culture-bound symptoms of psychopathology which seem confined
to specific cultures and can influence how stress, anxiety and depression manifest
themselves examples; Ataque de Nervios and Seizisman
- Society or culture can influence the course of psychopathology
The problem with defining psychopathology solely in terms of maladaptive behavior is also apparent
when we discuss forms of behavior that we might call maladaptive but we would not necessarily
want to label as psychopathology.
The problem with harmful dysfunction definition is that we still know very little about the brain
mechanisms that generate psychopathology symptoms, so it is very difficult to know what normal
process might be dysfunction.
Defining psychopathology in terms of the degree of distress and impairment expressed by the
sufferer is useful in a number of ways;
- It allows people to judge their own normality rather than subjecting them to judgements
about their normality made by others in society
- Defining psychopathology in terms of the degree of distress and impairment experienced can
be independent of the type of lifestyle chosen by the individuals
Difficulties with this approach;
- This approach does not provide any standards by which we should judge behavior itself
- Psychopathology classification schemes do include so-called disorders in which diagnosis
does not require that the sufferer necessarily reports any personal distress or impairment
Genetics The study of heredity and the variation of inherited characteristics.
Concordance studies Studies designed to investigate the probability with which family
members or relatives will develop a psychological disorder depending on
how closely they are related- or more specifically, how much genetic
material they have in common.
Twin studies Studies in which researchers have compared the probability with which
monozygotic (MZ) and dizygotic (DZ) twins both develop symptoms
indicative of a psychopathology in order to assess genetic contributions
to that psychopathology.
, Diathesis-stress model Model that suggests a mental health problem develops because of an
interaction between a genetic predisposition and our interactions with
the environment.
Heritability A measure of the degree to which symptoms can be accounted for by
genetic factors. It ranges from 0 to 1, and the nearer this figure is to, the
more important are genetic factors in explaining the symptoms.
Molecular genetics Genetic approach that seeks to identify individuals genes that may be
involved in transmitting psychopathology symptoms.
Genetic linkage A method of identifying individual genes by comparing the inheritance of
analysis characteristics for which with the inheritance of psychopathology
symptoms.
Epigenetics The study of changes in organisms caused by modification of expression
rather than alternation of the genetic code.
Corpus callosum A set of nerve fibers which connects the two mirror-image hemispheres
of the brain.
Cerebral cortex The outer, convoluted area of the brain.
Occipital lobe Brain area associated with visual perception.
Temporal lobe The areas of the brain that lie at the side of the head behind the temples
and which are involved in hearing, memory, emotion, language, illusions,
tastes and smells.
Parietal lobe Brain region associated with visuo-motor coordination.
Frontal lobe One of four parts of the cerebrum that control voluntary movement,
verbal expressions, problem solving, will power and planning.
Limbic system A brain system comprising the hippocampus, mammillary body,
amygdala, hypothalamus, fornix and thalamus, is situated beneath the
cerebral cortex and is thought to be critically involved in emotion and
learning.
Hippocampus A part of the brain which is involved in special learning.
Amygdala The region of the brain responsible for coordinating and initiating
responses to fear.
Brain Brain neurotransmitters are chemicals that help neurons to communicate
neurotransmitters with each other and are essential components of the mechanisms that
regulate efficient and effective brain functioning.
Dopamine A compound that exists in the body as a neurotransmitter and as a
precursor of other substance including adrenalin.
Serotonin An important brain neurotransmitter where low levels are associated
with depression.
Norepinephrine A neurotransmitter thought to play a role in anxiety symptoms.
Gamma-aminobutyric A neurotransmitter thought to play a role in anxiety symptoms.
acid (GABA)
Sigmund Freud An Austrian neurologist and psychiatrist who founded the psycho-
analytic school of psychology.
Psychoanalysis An influential psychological model of psychopathology based on the
theoretical work of Sigmund Freud.
id In psychoanalysis, the concept used to describe innate instinctual needs-
especially sexual needs.
Ego In psychoanalysis, a rational part of the psyche that attempts to control
the impulses of the id.
Ego defense Means by which the ego attempts to control unacceptable id impulses
mechanisms and reduce the anxiety that id impulses may arouse.
Superego Key concept in Sigmund Freud’s psychanalytic theory. The superego
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