CHAPTER 1: INTRODUCTION & HISTORICAL OVERVIEW
Psychopathology: the field concerned with the nature, development and treatment of psychological
disorders. The field is continually developing and adding new things.
Stigma: destructive beliefs and attitudes held by a society that are ascribed to groups considered
different in some manner, such as people with psychological disorders.
Four characteristics:
1. A label is applied to a group of people that distinguished them from others (they are crazy)
2. The label is linked to deviant or undesirable attributes by society (crazy people are dangerous)
3. People with the label are seen as different, us vs them (we are not like those crazy people)
4. People with the label are discriminated against unfairly (clinic for those crazy people)
How to reduce stigma:
insurance coverage for mental illness / ban discriminatory laws / employ mentally ill people /
decriminalization (send people to hospitals, not jail) / housing options / more personal contacts /
educate people about disorders / mental health evaluation (prevent it) / education and training for
professionals to recogniz e stigmas / education for individuals and families / online support groups
Defining Psychological Disorder
DSM-5 says it includes a number of characteristics:
It says that developmental, psychological and biological dysfunctions are all irrelated; brain impacts
behaviour, behaviour impacts brain.
- The disorder occurs with the individual
- It includes clinically significant difficulties in thinking, feeling or behaving
- It involves personal distress
- It involves dysfunction in psychological/neurobiological/developmental processes
- It is not a culturally specific reaction to an event (e.g. death of a loved one)
- It is not primarily a result of social deviance or conflict with society
Four characteristics that should be part of any comprehensive psychological disorder
Personal distress: a person’s behaviour may be classified as disordered if it causes him or her
great distress.
Not all psychological disorders cause distress / not all behaviour is disordered that cause it
Disability: impairment in some important area of life
Some behaviours do not cause disability, nor are they unexpected.
Violation of social norms: behaviour that violate these are seen as disordered.
Not all such behaviour is seen as a disorder, some disorders to not violate norms
Harmful dysfunction: a value judgement (harmful) and an objective, scientific component
(dysfunction). Dysfunction occurs when an internal mechanism is unable to perform its
natural function (= that it is evolved to perform).
It cannot fully account: many internal mechanisms involved in disorders are unknown.
History of Psychopathology
Before the age of scientific inquiry, good and bad manifestations of power beyond human control were
regarded as supernatural.
Demonology: an evil being or spirit can dwell within a person and control his mind and body.
Exorcism: the ritualistic casting out of evil spirits, because odd behaviour is caused by possession.
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,Early biological explanations were made by Hippocrates (5th century b.c.), saying that psychological
disorders are diseases of the brain. The brain is the organ of consciousness, intellectual life and
emotion.
After the fall of Greco-Roman civilization, the biological perspectives became less prominent in
western Europe, and demonological thinking gained ascendancy.
- Witchcraft; people blame disorders on those regarded as witches, who where regarded as witches,
who were persecuted with great zeal.
From the 13th century on, lunacy trials determine a person’s health
From the 15th century, old leprosy hospitals were converted to asylums, refuges for the housing and
care of people with psychological disorders in Europe. Treatment was poor or non-existent until
various humanitarian reforms (Pinel & Pussin) were instituted in the 18th century.
Mental hospitals established in Europa and the States. Moral treatment, people had close contact
with attendants, who talked, read and encouraged them to engage in purposeful activity. Dorothea Dix
improved the conditions for people with psychological disorders. But these became overcrowded and
understaffed. Deinstitutionalization: release from hospital because of large number of sick people.
Contemporary developments in biological and psychological approaches to the causes and treatments
of psychological disorders were heavily influenced by scientists in late 19 th – 20th century.
Biological approaches
- Louis Pasteur established in the 1860-70s the germ theory of disease, which posited that disease is
caused by infection of the body by minute organisms.
- Galton considered the originator of genetic research with twins, attributing many behavioural
characteristics to heredity.
- In the early 20th century, electroconvulsive therapy (ECT) was originated to treat schizophrenia and
severe depression.
Psychological approaches
- In 18th century, many people were observed to be subject to hysteria (blindness/paralysis), for which
no physical cause could be found. Mesmer said it was biological, but he is generally considered one of
the earlier practitioners of hyptonism, what’s also called mesmerism.
- Cathartic method (Breuer): reliving an earlier trauma and releasing emotional tension by expressing
previously forgotten thoughts about the event.
- Psychoanalytic theory (Freud): psychopathology results from unconscious conflicts in the
individual. He divided the mind (psyche) into 3 parts:
1. Id: present at birth, all energy needed to run the psyche so basic needs (food, water). The
source of its energy is biological and called libido. You are unconscious of this energy.
Id seeks immediate gratification of its urges = pleasure principle.
2. Ego: develops during second 6 months of life, contents are conscious. The task is to deal with
reality = reality principle, it mediates between demands and reality.
3. Superego: develops throughout childhood, person’s conscience. Children incorporate parental
values as their own to receive pleasure of parental approval.
Stages of psychosexual development
1. Oral stage (0-18 months): feeding and sucking and biting with lips, month and tongue
2. Anal stage (18-3 years): pleasure via anus
3. Phallic stage (3-6): maximum gratification of the id is obtained through genital stimulation
4. Latency period (6-12): id impulses do not play a major role in motivating behaviour
5. Genital stage (adult): heterosexual interests predominate.
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, Defense mechanism: strategy used by the ego to protect itself from anxiety, for example:
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 acceptable 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 behavioural patterns of an earlier stage of development
Rationalization: offering acceptable reasons for an unacceptable action or attitude
Sublimation: converting unacceptable impulses into socially valued behaviours
Psychoanalysis: understand the person’s early-childhood experiences, the nature of key relationships,
and the patterns of current relationships. There are 3 techniques:
1. Free association: a person tries to say whatever comes to mind without censoring anything
2. Interpretation: the analyst points out the meaning of certain of a person’s behaviour
3. Analysis of transference: the person responds to the analyst in ways that the person has
previously responded to other important figures in his life, and the analyst helps the person
understand and interpret these responses.
Neo-Freudian Psychodynamic Perspectives:
- Jung: analytical psychology: in addition to the personal unconscious, there is a collective
unconscious, the part of the unconscious that is common to all human beings, like spiritual/religion
urges, gender traits.
- Adler, individual psychology: regarded people as inextricably tied to their society, because
fulfilment is found in doing things for social good. Feeling and behaving better depend on thinking
more rationally = cognitive behaviour therapy
Freud’s work still has influence: 3 commonly held assumptions:
- childhood experiences help shape adult personality
- there are unconscious influences on behaviour
- the causes and purposes of human behaviour are not always obvious.
After some years, people lose faith in Freud’s approach
Behaviourism (Watson): observable behaviour rather than on consciousness or mental functioning
3 forms that influenced this approach in the early and middle parts of the 20 th century:
Classical Conditioning: Pavlov
- unconditioned stimulus: powder - unconditioned response: response of salvation
- conditioned stimulus: ringing of bell - conditioned response: salvation
extinction: when an established CR of the CS is no longer followed by UCS, the CR
disappears.
Operant conditioning Thorndike
Law of effect: behaviour that has good consequences will be repeated
Positive reinforcement: strengthening of a response by GIVING something
Negative reinforcement: strengthening of a response by REMOVING something
Modelling: witnessing someone perform certain activities can increase / decrease diverse
kinds of behaviour, like sharing, aggression and fear. [to cure phobias]
Behaviour therapy: change behaviour, thoughts and feelings with conditioning.
Systematic desensitization: treat phobias / anxiety, muscles are relaxed and you are exposed to feared
situations.
Cognitive therapy (Beck), became popular in beginning of 1960, people do think and feel the same
Rational-emotive behaviour therapy (Ellis), focus on beliefs that people think about themselves, the
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