ABNORMAL BEHAVIOUR IN HISTORICAL CONTEXT
• Defining psychological disorders.
• Defining psychopathology.
• History of psychopathology.
• Biomedical model.
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PSYCHOPATHOLOGY
PSYCHOPATHOLOGY & PSYCHOLOGICAL DISORDERS
Behavioural, psychological or biological dysfunctions unexpected in a specific cultural context and is associated
with present distress and/or impairment in functioning or an increased risk of pain, suffering, impairment or death.
• Psychopathology: scientific study of psychological dysfunction.
• Psychological disorder (or abnormal behaviour):
Psychological dysfunction.
Associated with distress or impairment in functioning.
Atypical or a not a culturally expected response.
Can include behavioural, emotional and/or cognitive elements.
DISTRESS, IMPAIRMENT & CULTURAL CONTEXT
• Distress is normal in some situations → dysfunctional when distress is more than what is necessary.
• Impairment indicates that distress is pervasive/significant → disorder if it is harmful dysfunction.
• Defining a psychological disorder by distress alone does not work.
• Mental disorders are often extremes of normal processes e.g. extreme shyness.
• Certain things are considered normal in some cultures compared to others.
• Human behaviour is complex keep multiple perspectives in mind better understand suffering.
STUDYING PSYCHOLOGICAL DISORDERS: THE CLINICAL DESCRIPTION
• Begins with presenting the problem and its symptoms e.g. panic attacks, chronic worry.
• Goal: clinically distinguish between significant dysfunction from common human experience.
• Describe the prevalence and incidence of mental disorders.
Prevalence refers to how many people in a population have the disorder.
Incidence refers to how many new cases appear in a given period of time.
• Studying psychological disorders: clinical description, aetiology and treatment/outcome.
CLINICAL DESCRIPTION
• Represents the unique combination of behaviours, thoughts and feelings related to a disorder.
• Describe onset of disorders → acute (develop suddenly) versus insidious (develops over time).
• Describe course (or pattern) of disorders → chronic versus time-limited versus episodic.
• Prognosis (anticipated course) of the disorder → guarded versus good.
• Age of onset → can shape presentation of the disorder.
Notes by Jade Jensen (24688665)
, • Describe the presenting problem → original complaint reported to the therapist by the client.
• Studying changes in behaviour over time is known as developmental psychology.
• Studying changes in abnormal behaviour is known as developmental psychopathology.
CAUSATION, TREATMENT AND AETIOLOGY OUTCOMES
• Aetiology: how the disorder started → biological, social, and psychological dimensions.
• The effect of a disorder does not always imply the cause psychopathology is not simple.
• Need to figure out how to alleviate psychological suffering.
• Make use of pharmacological, psychosocial and/or combined treatments.
IMPORTANT FACTORS IN PSYCHOPATHOLOGY & ABNORMAL BEHAVIOUR
• Affect, behaviours, body, relationships, discourse and defences.
• Self, intersubjective space, context, emotional convictions, history and language.
ASSESSMENT & DIAGNOSIS
• Assessment and diagnosis involve complex and time-consuming procedures.
• Requires deductive reasoning, technical skills and sensitivity to cultural backgrounds.
• Training is essential for clinicians to avoid misdiagnosis.
• Diagnosis is there to provide a guide a treatment and to help understand prognosis.
• Ultimate goal of assessment is diagnosis need minimum number of symptoms and their duration.
• Often an overlap between symptoms in disorders.
• Differential diagnosis: list all possible disorders as well as comorbid disorders.
• The final diagnosis communicates information about the patient, treatment and prognosis.
CONTEXTUAL FACTORS TO CONSIDER
• Age (developmental disorders), gender, culture and what happened before (recent trauma).
• Pattern or once-off, explanation, how it affects others, medical factors and class.
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HISTORICAL CONCEPTIONS OF ABNORMAL BEHAVIOUR
HISTORY OF ABNORMAL BEHAVIOUR
• Major psychological disorders have existed across cultures and time.
• Perceived cause and treatment of abnormal behaviour has varied depending on context.
• 3 dominant traditions have existed in the past to explain abnormal behaviour:
1. Supernatural tradition:
What was considered as good and what was evil → blamed for abnormal behaviour.
Demons and witches → use of sorcery and magic to solve problems.
Use exorcisms to treat abnormal behaviour (specific rituals and behaviours).
Stress and melancholy → treated with sleep, rest and a healthy environment.
Mass hysteria → groups of people who were compelled to act in a wild way.
Cures through magic/exorcism/rituals have little connection with modern science.
2. Biological tradition:
Belief that psychological disorders are caused by biological roots.
Caused by brain pathology or head trauma or due to genetics (Hippocrates).
Development of medical treatments and pharmacology.
Notes by Jade Jensen (24688665)
, 3. Psychological tradition:
Psychosocial treatment practice on social and cultural factors.
Psychological influences e.g. cognition, behaviour and interpersonal methods.
Moral therapy: psychosocial approach → treat patients in ‘normal’ environments.
More humane treatment of institutionalised patients.
Encouraged and reinforced social interaction.
Popularised in the first half of the 19th century.
Patients should not be restrained (Pinel and Pussin).
Dorothea Dix became known for mental hygiene movement.
Asylum reform patients got more care moral therapy declined.
PSYCHOANALYTIC, HUMANISTIC & BEHAVIOURAL THEORY
PSYCHOANALYSIS & PSYCHOANALYTIC THEORY (FREUD)
• Psychoanalysis (Freud) → unconscious, catharsis → explain development and personality.
• Structure of the mind → id (pleasure/irrational), superego (morality) and ego (reality/rational).
• Defence mechanisms → attempts to manage anxiety from id/superego conflict in order to function.
Displacement and denial.
Reaction formation, rationalisation and repression.
Sublimation and projection.
• Psychosexual stages → oral, anal, phallic, latent and genital (solve a conflict at each stage).
• Anna Freud and self-psychology → emphasised the influence of the ego in defining behaviour.
• Melanie Klein and Otto Kleinberg emphasised how children incorporate/introject objects in play.
• Objects represent significant others and their memories, values and images.
• Neo-Freudians de-emphasised the sexual core of Freud’s theory.
• Alfred Adler focused on inferiority feelings and Carl Jung emphasised the collective unconscious.
Inferiority complex: feeling of being inferior to others strive for superiority.
Collective unconscious: accumulated wisdom of a culture collected across generations.
• ‘Talking’ cure: unearth hidden conflicts and ‘real problems’ requiring long-term therapy usually.
• Examine issues of transference and counter-transference.
Transference: relate to the therapist as an important figure they had during childhood.
Counter-transference: therapist projects own feelings onto the patient.
• Use techniques of dream analysis and free association → minimal evidence for its efficacy.
• Psychodynamic psychotherapy: shorter than psychoanalysis and more goal-directed.
Emphasises conflicts and unconscious to uncover trauma and active defence mechanisms.
Emotional expression, avoidance patterns, past experiences.
Interpersonal experience, therapeutic relationship, wishes, dreams and fantasies.
• Psychoanalysis is criticised for being unscientific and untested.
• Contributed to the understanding of the unconscious.
• Emotions can be triggered by things outside of conscious awareness use of defence mechanisms.
• Highlights the importance of ‘therapeutic alliance’.
HUMANISTIC THEORY (ROGERS & MASLOW)
• Self-actualisation: reaching highest potential in all areas of functioning by having freedom to grow.
• Difficult experiences can move you away from your true self.
• Based on intrinsic human goodness and striving towards self-actualisation.
Notes by Jade Jensen (24688665)
, • Person-centred therapy (Carl Rogers):
Therapist has a passive role and makes very few interpretations.
Give individual the chance to develop during the course of therapy.
Importance of unconditional positive regard from those surrounding the individual.
• Hierarchy of Needs (Abraham Maslow):
Humans need to fulfil their basic needs first such as the need for food and safety.
Can move onto fulfilling higher needs such as the need for love and self-esteem.
• Humanistic model did not contribute much new information to the field of psychopathology.
• More effective for people dealing with normal everyday stressors and not with psychopathology.
BEHAVIORAL MODEL (WATSON, PAVLOV & SKINNER)
• Explaining human behaviour based on principles of learning and adaption from experiences.
• Classical conditioning (Pavlov and Watson):
Neutral stimulus is paired with a (unconditioned stimulus) response until it elicits a response.
New response is a conditioned response and the neutral stimulus becomes conditioned.
Conditioning explains how some fears can be acquired.
Watson believed that psychology should be as scientific and objective as possible.
Mary Cover Jones → treated phobias with exposure and extinction in learned behaviour.
Stimulus generalisation: respond in the same way to stimuli that are similar.
Extinction: conditioned stimulus is presented continuously without the unconditioned
stimulus the response becomes weakened over time.
• Operant conditioning (Thorndike and Skinner):
Thorndike → law of effect in that behaviour is repeated if it is followed by good conseque-
nces and is decreased if it is followed by bad consequences.
Skinner → behaviour ‘operates’ according to the environment managed by consequences
such as rewards and punishment called behaviour ‘shaping’ through reinforcement.
Positive reinforcement: contingent delivery of desired consequences.
Negative reinforcement: contingent escape from an aversive consequence.
BEGINNINGS OF BEHAVIOUR THERAPY
• Creation of new associations through practicing new useful habits.
• Also through the reinforcement of behaviours with positive consequences.
• Time-limited and direct and involves systematic desensitisation.
• Paved the way for modern anxiety-reducing procedures where phobias can even be eliminated.
• Behavioural therapy has contributed greatly to understanding psychopathology.
THE SCIENTIFIC METHOD & INTEGRATIVE APPROACH (WHERE WE ARE NOW)
THE PRESENT APPROACH TO PSYCHOPATHOLOGY
• A broad approach is need in defining and studying psychopathology.
• There are multiple interactive influences in psychopathology → biology, psychology and social.
• Scientific emphasis is becoming increasingly more important in psychopathology.
• Supernatural explanations does not have a place in science in psychopathology.
• Neuroscience advancements and cognitive behavioural science contribute to our knowledge.
• Only current valid model of abnormal behaviour is multi-dimensional and integrative.
Notes by Jade Jensen (24688665)
