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CHAPTER OUTLINE Understanding Psychopathology What Is a Psychological Disorder? The Science of Psychopathology Historical Conceptions of Abnormal Behavior The Supernatural Tradition Demons and Witches Stress and Melancholy Treatments for Possession Mass Hysteria Modern Mass Hysteria The Moon and the Stars Comments The Biological Tradition Hippocrates and Galen The 19th Century The Development of Biological Treatments Consequences of the Biological Tradition The Psychological Tradition Moral Ther
Typology: Summaries
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a. Socioeconomic status (SES) b. Downward drift c. Developmental trajectory- the idea that common symptoms of a disorder may vary depending on a person’s age. d. Trephination- the process in which a circular instrument was used to cut away sections of the skull, possibly in an attempt to release demons from the brain. CONCEPT CHECK
Throughout history, certain behaviors have been recognized as abnormal—often the same ones we recognize today. However, the explanations for these abnormal behaviors have evolved, ranging from an imbalance of bodily fluids to possession by demons, genetic abnormalities, and traumatic learning experiences. Today, new technologies allow us to watch the brain as it processes sights, smells, and sounds; solves problems; and experiences emotions. As this knowledge has increased, some of the earlier ideas about abnormal behavior seem outlandish or quaint. ANCIENT THEORIES ➢ Ancient Egyptians believed that spirits controlled much of the environment as well as aspects of a person’s behavior. ➢ Even before the Egyptians, some cultures engaged in a practice called trephination, using a circular instrument to cut away sections of the skull. ➢ One interpretation of trephination is that it was a treatment for abnormal behaviors. Opening up the skull, it may have been thought, released the evil spirits that had assumed control of the person (Selling, 1940). ➢ This is only an assumption. Trephination might simply have been used to treat head wounds received in battles (Maher & Maher, 1985). Even today, we are not sure why ancient peoples practiced it. *Trephination involved making a hole in the skull. It may have been a way that ancient peoples tried to release evil spirits from the body of an afflicted person.
*** Mass hysteria** a situation in which a group of people share and sometimes even act upon a belief that is not based in fact (for example, tarantism and lycanthropy) ➢ There is a scientific basis for mass hysteria. Emotional contagion is defined as the automatic mimicry and synchronization of expressions, vocalizations, postures, and movements of one person by another. ➢ When these overt behaviors converge, emotions come together as well. These mimicking behaviors are not under voluntary control but nevertheless serve to influence behavior. *** Emotional contagion** the automatic mimicry and synchronization of expressions, vocalizations, postures, and movements of one person by another. ➢ Although many people may no longer believe that wolves or spider bites are responsible for abnormal behaviors, the process of emotional contagion remains a powerful influence on behavior (see the feature “Examining the Evidence: Modern- Day Mass Hysteria”) ➢ The Renaissance period (14th to 17th Century) marked a second time of enlightenment in the treatment of mental illnesses in Europe. ➢ Europe. Much of this transformation can be traced back to the Dutch physician Johann Weyer (1515–1588) and the Swiss physician Paracelsus (1493–1541). ➢ Weyer was the first physician to specialize in the treatment of mental illness , and Paracelsus refuted the idea that abnormal behaviors were linked to demonic possession ➢ Paracelsus b elieved that mental disorders could be hereditary and that some physical illnesses had a psychological origin ➢ These changing views toward mental illness altered treatment approaches as well. A movement that was genuinely concerned with providing help arose , and its goal was to separate those with mental illness from those who engaged in criminal behavior (Sussman, 1998). ➢ Beginning in the sixteenth century, people with mental illness were housed in asylums—separate facilities designed to isolate them from the general public.
Philippe Pinel, a French physician, released mental patients from their chains and advocated a more humane form of treatment. ❖ The Retreat was built on a hill, and although it contained a hidden ditch and a wall to ensure confinement, the barriers could not be seen from the buildings; this gave the illusion of a home rather than an institution. ❖ The work of both Pinel and Tuke heralded moral treatment , “ summed up in two words, kindness and occupation ” (W.A.F. Browne, 1837, cited in Geller & Morrissey, 2004). ❖ Moral treatment was quite comprehensive. In the United States, it included removal of the patient from the home and former associates as well as respectful and kind treatment that included “manual labor , religious services on Sunday , the establishment of regular habits and of self- contro l, and diversion of the mind from morbid trains of thought ” (Brigham, 1847, p. 1, cited in Luchins, 2001). ❖ Moral treatment in the United States is most commonly associated with Benjamin Rush (1745–1813) and Dorothea Dix (1802– 1887). Rush was a well-known physician at Pennsylvania Hospital and a signer of the Declaration of Independence. ❖ He limited his practice to mental illness, which he believed had its causes in the blood vessels of the brain (Farr, 1994). Although this theory was later disproved, Rush believed that the human mind was the most important area of study , and he became known as the father of American psychiatry (Haas, 1993) ❖ In the United States, perhaps no name is more closely associated with humane care than that of Dorothea Dix, the Boston schoolteacher who devoted her life to the plight of the mentally ill and the need for treatment reform Dorothea Dix of Massachusetts was a tireless reformer who brought the poor treatment of the mentally ill to public attention. ❖ Through her efforts, 32 institutions that included programs in psychiatric treatment, research, and education were established (Gold, 2005 ). Dix believed that asylums, correctly designed and operated, would allow for treatment and perhaps even cure. ❖ Although Dix brought the plight of the mentally ill to public attention, moral treatment alone did not cure most forms of mental illness. In fact, mental hospitals became associated with permanent institutionalization, custodial care, isolation, and very little hope.
❖ During the late 1700s in Europe, the treatment of mental disorders went beyond providing rest and humane care. ❖ The German physician Franz Anton Mesmer (1734–1815) hardly followed the conventional medical establishment. His academic thesis explored the clinical implications of astrology (McNally, 1999). ❖ Mesmer proposed that the body was a magnet and that using the physician’s body as a second magnet could achieve a cure for mental illnes s (Crabtree, 2000). Mesmer believed that a substance called animal magnetism existed within the body. ❖ When it flowed freely, the body was in a healthy state; however, when the flow of this energy force was impeded, disease resulted. The cure involved “magnetic passes” of the physician’s hands over the body (McNally, 1999). Mesmerism was roundly criticized by a committee of scientists and physicians that included Benjamin Franklin and the noted French chemist Antoine Lavoisier. o Animal magnetism a force that Mesmer believed flowed within the body and, when impeded, resulted in disease o Placebo effect a condition in which symptoms of illness diminish or disappear not because of any specific treatment but because the patient believes that a treatment is effective. ❖ A placebo can be in the form of pills with inert ingredients such as cornstarch. It can also be in the form of a therapist or physician who displays an attitude of caring about the patient. However, it is important to add that although placebos may change how patients feel, the effect is usually temporary. Placebos are not the same as actual treatment. ❖ A significant event for establishing a biological basis for some psychological disorders occurred in the latter part of the nineteenth century. Scientists discovered that syphilis (a sexually transmitted disease caused by a bacterium) led to the chronic condition called general paresis manifested as physical paralysis and mental illness and eventually death. ❖ The work of the German psychiatrist Emil Kraepelin (1856–1926) was another important chapter in the history of abnormal behavior. ❖ During medical school, Kraepelin attended lectures in the laboratory of Wilhelm Wundt , the founder of modern scientific psychology (Decker, 2004). He applied Wundt’s scientific methods to measure behavioral deviations, hoping to provide the theoretical foundations
✓ Psychoanalysis Sigmund Freud (1856–
✓ Some defense mechanisms prevented the onset of abnormal behavior. Other defense mechanisms (such as regression) may result in abnormal or age-inappropriate behaviors. ✓ Almost as well known as the id, ego, and superego are Freud’s stages of psychosexual development ✓ According to the theory, each person passes through these stages between infancy and 5 years of age. How a child copes with each stage has important effects on psychological development ✓ The oral phase occurs during the 0- 18 months of life. Sucking and chewing are pleasurable experiences; aggressive impulses emerge after the development of teeth. The anal phase (from age 18 months to 3 years) coincides with toilet training. During this time, parents emphasize discipline and control issues, and power struggles develop. ✓ Aggressive impulses on the part of the child could lead to personality traits of negativism and stubbornness as well as the emergence of hostile, destructive, or sadistic behaviors. During the phallic phase (ages 3 to 5), psychosexual energy centers on the genital area and children derive pleasure from touching or rubbing the genitals. During this phase, children may develop romantic fantasies or attachments toward their opposite-sex parent. ✓ The two additional stages, the latency phase (the formant stage of psychosexual development when children are disinterested in the opposite sex) and the genital phase (the mature stage of psychosexual development), are considered to play a more limited role in abnormal behavior. ✓ In psychoanalytic theory, anxiety and depression are caused by negative experiences. Depending on the age at which the experience occurs, individuals become fixated (stalled) at a stage of psychosexual development. This leaves a psychological mark on unconscious. ✓ In psychoanalytic theory, even though the individual is unaware of the early experience, it still influences daily functioning. In short, the individual behaves psychologically at the stage of development when the fixation occurred. ✓ The goals of psychoanalysis, the treatment Freud developed, include insight , bringing the troubling material to consciousness, and catharsis, releasing psychic energy. ✓ Several techniques are used to achieve these goals. In free association , the person minimizes conscious control and without selection or censorship, tells the analyst everything that comes to mind, allowing the analyst to draw out information regarding unconscious conflicts. ✓ In dream analysis , individuals are encouraged to recall and recount their
✓ Watson believed that the only appropriate objects of scientific study were observable behaviors, not inner thoughts or feelings. ✓ This view, known as behaviorism, is based on principles that consider all behavior (normal or abnormal) to be learned as a result of experiences or interactions with the environment. ✓ Watson is most famous for his work with his student. Rosalie Rayner. In 1920, they published the case of Little Albert , which demonstrated that emotional responses such as fear could be acquired through classical conditioning. In this case, Little Albert’s fear of a white rat was established by pairing the white rat with a loud, aversive noise (Watson & Rayner, 1920). ✓ Unfortunately, Little Albert and his mother left Johns Hopkins soon after the experiments were completed and for many years, psychologists were unsure about his fate. We now know that Little Albert’s real name was Douglas Merritte, and unfortunately, he died in 1925 from a condition known as acquired hydrocephalus, the condition in which the cavities of the brain have an excess of cerebrospinal fluid. o John Watson introduced behaviorism, which in its strictest form asserts that all behavior is learned. With his student, Rosalie Rayner, he studied infants’ emotional responses, showing that emotions could be acquired by classical conditioning.
First, scientific advances lead to new and more sophisticated approaches to understanding human behavior Research findings allow unsupported theories to be discarded and provide new hypotheses to be tested and evaluated. This is the core of a scientific approach to abnormal behavior. Scientists form hypotheses and conduct controlled experiments to determine whether their hypotheses are supported. If empirical evidence supports the hypotheses, then those theories continue. If the evidence does not provide support, the theory is discarded or changed, and the process begins again. Second, scientific discoveries in areas other than psychology may later provide insight into abnormal behavior. For example, the Human Genome Project is mapping all of the genetic material in the human body. As our understanding of this map develops, new techniques (see Chapter
activity (thinking, feeling, and motor activity) and is related to many physical and mental disorders. ❖ Until recently, the activity of neurotransmitters in the brain had to be assessed indirectly from their presence in other parts of the body (blood or spinal fluid). However, it was always unclear how accurately chemicals in blood or spinal fluid really reflected neurotransmitter activity in the brain. ❖ Through advances in neuroscience, we now rely less on assumptions and indirect measures to understand the structure and function of the nervous system and its interaction with behavior. ❖ Imaging tests such as the CAT scan and MRI examine the morphology (structure) of the brain and are used to determine whether parts of the brain are structurally different in those with and without psychological disorders. ❖ For example, the brains of patients with Alzheimer’s disease have two structural abnormalities, plaques and tangles, which exist in greater number than among older people without Alzheimer’s disease. ❖ For other psychological disorders, the evidence is less definitive. ❖ In some disorders, such as post- traumatic stress disorder (PTSD, an anxiety disorder that occurs after a traumatic event), changes in the brain appear to be the result of, not the cause of, the disorder (Bellis, 2004). In other words, years of living with the disorder cause changes in the brain, a process sometimes known as biological scarring. ❖ In other instances, when compared to people with no disorder, the brains of people with schizophrenia show structural brain abnormalities that could have occurred before birth (Malla et al., 2002; Sallet et al., 2003; see Chapter 10). o neuron a nerve cell found throughout the body, including the brain o synapse a space between neurons o neurotransmitter a chemical substance that is released into the synapse and transmits information from one neuron to another o neuroscience the study of the structure and function of the nervous system and the interaction of that system and behavior o biological scarring the process by which years of living with a disorder cause changes in the brain ❖ Advanced neuroimaging techniques such as positron emission tomography (PET) and functional magnetic resonance imaging (fMRI; see Chapter
that might be associated with various disorders. ❖ Differences in brain functioning have been reported for adults with schizophrenia (Holmes et al., 2005), depression (Holmes et al., 2005; Milak et al.,2005), adults and children with anxiety disorders (Baxter et al., 1992; Bellis, 2004), eating disorders (van Kuyck et al., 2009), and many other psychiatric disorders. ❖ Although neuroscience data provide exciting new avenues for further research, it is still too soon to conclude that brain abnormalities cause psychological disorders. o First, not all studies that compare people with and without a disorder find differences in brain structure or function. Furthermore, even when differences are detected, the abnormalities are not always found in a second trial, meaning that the abnormalities are not consistent. o Second, to date, when differences exist, they are sometimes found in several different disorders. This means that whatever difference exists probably does not cause a specific disorder. Just like a fever that may be associated with many different physical illnesses, abnormal brain functioning may indicate that something is wrong, but not specifically what is wrong. o Third, in most instances, few data indicate that these structural or functional abnormalities existed before the disorder occurred (schizophrenia and autism may be exceptions). It is just as likely that some disorders, such as PTSD, may cause changes in brain functioning, if not necessarily brain structure. ❖ Over the next decade, continued research in these areas coupled with the development of even more sophisticated assessment devices and strategies may help clarify some of these issues. ❖ The field of behavioral genetics emerged with works by Sir Francis Galton (1822–1911) and his 1869 publication, Hereditary Genius o behavioral genetics the field of study that explores the role of genes and environment in the transmission of behavioral traits o viral infection theory the theory that during the prenatal period or shortly after birth, viral infections could cause some psychological disorders