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Samenvatting Custom Psychopathology, ISBN: 9781119922490 Klinische Psychologie (PSBA2-22)
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- Rijksuniversiteit Groningen (RuG)
Samenvatting Custom psychopathology
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1Psychopathology – Graham Davey
Psychopathology: Research, Assessment and Treatment in Clinical Psychology - 2nd Edition.
Custom for University of Groningen.
Chapter 1 - An Introduction to Psychopathology: Concepts, Paradigms and Stigma………..2
Chapter 2 – Classification and Assessment in Clinical Psychology……………………………….……5
Chapter 3 – Research Methods in Clinical Psychology……………………………………………………..8
Chapter 4 – Treating Psychopathology……………………………………………………………………………10
Chapter 6 – Anxiety and Stressor-Related Problems………………………………………………….……14
Chapter 7 – Depression and Mood Disorders…………………………………………………………….……21
Chapter 8 – Experiencing Psychosis: Schizophrenia Spectrum Problems………………………...26
Chapter 9 – Substance Use Disorders…………………………………………………………………………..…32
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Chapter 1 - An Introduction to Psychopathology: Concepts, Paradigms and Stigma
Psychopathology is the study of deviations from normal or everyday psychological or
behavioural functioning. The branch of psychology responsible for understanding and
treating psychopathology is known as clinical psychology. We tend to use the words crazy,
madness and insanity regularly in different circumstances:
1. When someone’s behaviour deviates from expected norms
2. When we are unclear about the reasons for someone’s actions
3. When a behaviour seems to be irrational
4. When a behaviour or action appears to be maladaptive or harmful to the individual
or others.
We cannot attempt to define psychopathology on the basis that some ‘normal’ functioning
has gone wrong. This is because we are still some way from understanding the various
processes that contribute to psychopathology, and many forms of behaviour that require
treatment by clinical psychologists are merely extreme forms of what we would call ‘normal’
or ‘adaptive’ behaviour.
1.1 A Brief History of Psychopathology
A historical perspective on psychopathology and ‘madness’ is important because it helps us
to understand how our views of the causes of mental health problems have changed and
developed over time, and it also helps us to understand how approaches to treating and
dealing with mental health problems have changed. Demonic possession are historical
explanations of psychopathology such as ‘demonic possession’ often alluded to the fact that
the individual has been ‘possessed’ in some way. The medical model is an explanation of
psychopathology in terms of underlying biological or medical causes. In the 19 th century
there was an discovery that syphilis had a biological cause, and was also an important
contributor to the mental disorder known as general paresis, implied that many other
examples of mental or psychological illness might also have medical or biological
explanations. This became known as the somatogenic hypothesis, which advocated that the
causes or explanations of psychological problems could be found in physical or biological
impairments. The medical model has given rise to large body of scientific knowledge about
psychopathology that is based on medicine, and this profession is known as psychiatry. The
medical model has some implications. Firstly, it implies that medical or biological causes
underlie psychopathology. This is by no means always the case, and bizarre behaviour can be
developed by perfectly normal learning processes. Secondly, 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. Finally there is an implicit
assumption in the medical model that psychopathology is caused by ‘something not working
properly’.
In previous centuries asylums were hospices converted for the confinement of individuals
with mental health problems. The moral treatment is an 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. Between 1950 and 1970, the limitations of hospitalization were being
recognized and there was some attempt to structure the hospital environment for patients.
The first attempts were known as milieu therapies, which were the first attempts to create a
therapeutic community on the ward which would develop productivity, independence,
responsibility, and feelings of self-respect. Later the token economy programs developed, a
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reward system which involves participants receiving tokens engaging in certain behaviours,
which at a later time can be exchanged for a variety of reinforcing or desired items.
1.2 Defining Psychopathology
The problems of defining psychopathology not only revolve around what criteria we use, but
also what terminology we use. There are still numerous psychopathology courses and
textbooks that use the title abnormal psychology. Merely using this title implies that people
suffering from mental health problems are in some way ‘abnormal’ either in the statistical or
the functional sense. We can use statistical definitions to decide whether an activity or a
psychological attribute deviates substantially form the statistical norm, and in some areas of
clinical psychology this has been used as means of deciding whether a particular disorder
meets diagnostic criteria.
It is very difficult to use deviation from social norms, or even violations of social norms, as a
way of defining psychopathology. First, different cultures often differ significantly in what
they consider to be socially normal and acceptable. Second, it is difficult to use cultural
norms to define psychopathology because cultural factors seem to significantly affect how
psychopathology manifests itself.
- Social and cultural factors will affect the 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 an depression
manifest themselves.
- Society or culture can influence the course of psychopathology.
1.3 Explanatory Approaches to Psychopathology
Genetics and neuroscience are two of the most important biological paradigms through
which researchers attempt to understand psychopathology. Genetics is the study of heredity
and the variation of inherited characteristics. The way in which genetics might influence
psychopathology can be studies in a variety of ways: concordance studies and twin studies.
The diathesis-stress model is a model that suggests a mental health problem develops
because of an interaction between a genetic predisposition and our interaction with the
environment.
The neuroscience paradigm seeks an understanding of psychopathology by identifying
aspects of the individual’s biology that may contribute to symptoms. The main focus of this
paradigm is on brain structure and function.
The psychoanalytical model is an approach first formulated by Sigmund Freud. Freud made
an influential theory called psychoanalysis, which was an attempt to explain both normal
and abnormal psychological functioning in terms of how various psychological mechanisms
help to defend against anxiety and depression by repressing memories and thoughts that
may cause conflict and stress. ID, ego, and superego.
The behavioural model adopts the broad view that many examples of psychopathology
reflect our learnt reactions to life experiences. There became an area of psychology known
as learning theory and argued that just as adaptive behaviour can be acquired through
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learning, then so can many forms of dysfunctional behaviour. classical conditioning and
operant conditioning.
The cognitive behaviour therapy (CBT) is an intervention for changing both thoughts and
behaviour. CBT represents an umbrella term for many different therapies that share the
common aim of changing both cognitions and behaviour.
The human-existentialist approach is a model of psychopathology which aims to resolve
psychological problems through insight, personal development, and self-actualization. An
influential example is the client-centered therapy. An approach to psychopathology
stressing the goodness of human nature, assuming that if individuals are unrestricted by
fears and conflicts, they will develop into well-adjusted, happy individuals.
1.4 Mental Health and Stigma
Mental health stigma can be divided into two distinct types:
- Social stigma is characterized by prejudicial attitudes and discriminating behaviour
directed towards individuals with mental health problems as a result of the
psychiatric label they have been given.
- Perceived stigma/self-stigma is the internalizing by the mental health sufferer of
their perceptions of discrimination, and perceived stigma can significantly affect
feelings of shame and lead to poorer treatment outcomes.
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