Chapter 1
Psychopathy = The field concerned with the nature,
development and treatment of psychological disorders.
- What constitutes a disorder? It is a demarcation of
the definition of abnormal behavior. There is no
clear answer. The clinical community and society
will have to make an informed weighted decision on
what is severe enough, where to draw the line.
- There is no clear set of behaviors that make a
person abnormal.
Stigma = The destructive beliefs and attitudes held by a society that are ascribed to groups
considered different in some manner, such as people with psychological disorders.
1. A label is applied to a group of people that distinguishes them from others (e.g., “crazy”).
2. The label is linked to deviant or undesirable attributes by society (e.g., crazy people are
dangerous).
3. People with the label are seen as essentially different from those without the label,
contributing to an “us” versus “them” mentality (e.g., we are not like those crazy people).
4. People with the label are discriminated against unfairly (e.g., a clinic for crazy people can’t be
built in our neighborhood).
Battling stigma
1. Community strategies
a. Housing options
b. Education
c. Personal contact
2. Mental health and Health Profession strategies
a. Mental health evaluations
b. Education, training and support
3. Individual and family strategies
a. Education for individuals and families
b. Support and advocacy groups
Knowing more about the causes or available treatments of psychological disorders like schizophrenia
or depression does not decrease stigma, according to studies in 13 different countries around the
world. Two factors that can reduce stigma are contact and familiarity. Stigma can be reduced through
celebrities as rolemodels, podcasts and social media has been used to spread the message that
psychological disorders are common and affect many of us.
Psychological disorder
1. Personal distress - It causes the person great distress. Not all psychological disorders cause
distress and not all behavior that causes distress is disordered.
2. Violation of social norms
Social norms = Widely held standards (beliefs and attitudes) that people use consciously or
intuitively to make judgments about where behaviors are situated on such scales as
good-bad, right-wrong, justified-unjustified and acceptable-unacceptable.
Of course, social norms vary a great deal across cultures and ethnic groups, so behavior that
clearly violates a social norm in one group may not do so at all in another.
3. Disability and dysfunction
Disability = Impairment in some important area of life (e.g. work or personal relationships)
Dysfunction = Something has gone wrong and is not working as it should
1
,Early history of psychopathology
Supernatural explanations
Many philosophers believed that disturbed behavior reflected the displeasure of the gods or
possession by demons.
Exorcism = The ritualistic casting out of evil spirits
Early biological explanations
Hippocrates regarded the brain as the organ of consciousness, intellectual life, and emotion; thus, he
thought that disordered thinking and behavior were indications of some kind of brain pathology.
Hippocrates classified psychological disorders into three categories: mania, melancholia, and
phrenitis, or brain fever. He believed that healthy brain functioning, and therefore mental health,
depended on a delicate balance among four humors, or fluids of the body—namely, blood, black bile,
yellow bile, and phlegm. An imbalance of these humors produced disorders.
The dark age: back to the supernatural
Historians have often pointed to the death of Galen (ce 130–200), the second-century Greek who is
regarded as the last great physician of the classical era, as the beginning of the so-called Dark Ages
in western European medicine and in the treatment and investigation of psychological disorders.
Christian monasteries, through their missionary and educational work, replaced physicians as healers
and as authorities on psychological disorder. Many people with psychological disorders roamed the
countryside, destitute and progressively becoming worse. During this period, there was a return to a
belief in supernatural causes of psychological disorders.
Beginning in the 13th century, lunacy trials to determine a person’s mental health were held in
England. The defendant’s orientation, memory, intellect, daily life, and habits were at issue in the trial.
Notably, the people who were hospitalized were not described as being possessed.
Development of asylums
Asylums = Refuges for the housing and care of people with psychological disorders.
- The Priory of St. Mary of Bethlehem was founded in 1243. Records indicate that in 1403 it
housed six men with psychological disorders. Bethlehem eventually became one of London’s
great tourist attractions, viewing the people housed was considered entertainment.
Unfortunately, housing people with psychological disorders in hospitals and placing their care
in the domain of medicine did not necessarily lead to more humane and effective treat- ment.
In fact, the medical treatments were often crude and painful.
- Philippe Pinel (1745–1826) has often been considered a primary figure in the movement for
more humane treatment of people with psychological disorders in asylums. Pinel came to
believe that people in his care were first and foremost human beings, and thus these people
should be approached with compassion and understanding and treated with dignity. He
surmised that if their reason had left them because of severe personal and social problems, it
might be restored to them through comforting counsel and purposeful activity. He reserved
the more humanitarian treatment for the upper classes; people of the lower classes were still
subjected to terror and coercion as a means of control, with straitjackets replacing chains.
- Moral treatment = People had close contact with attendants, who talked and read to them
and encouraged them to engage in purposeful activity; residents led lives as close to normal
as possible and in general took responsibility for themselves within the constraints of their
disorders. No more than 250 people in any given hospital. Moral treatment was largely
abandoned in the latter part of the 19th century because mental hospitals became
overcrowded and understaffed.
2
,Biological approaches
1. Discovering Biological origins in general paresis and syphilis
Since the late 1700s, it had been known that a number of people with psychological disorders
manifested a syndrome characterized by a steady deterioration of both mental and physical abilities
and progressive paralysis; the presumed disease associated with this syndrome was given the name
general paresis. By the mid-1800s, it had been established that some people with general paresis
also had syphilis, but a connection between the two conditions had not yet been made. Finally, in
1905, the specific microorganism that causes syphilis was discovered. For the first time, a causal link
had been established between infection, damage to certain areas of the brain, and a form of
psychopathology (general paresis). If one type of psychopathology had a biological cause, so could
others. Biological approaches gained credibility, and searches for more biological causes were off and
running.
2. Genetics
Francis Galton (1822–1911), often considered the originator of genetic research because of his study
of twins in the late 1800s in England, attributed many behavioral characteristics to heredity. He is
credited with coining the terms nature and nurture to talk about differences in genetics (nature) and
environment (nurture). Unfortunately, Galton is also credited with creating the eugenics movement in
1883. Advocates of this movement sought to eliminate undesirable characteristics from the population
by restricting the ability of certain people to have children.
3. Biological treatment
The general warehousing of people in mental hospitals in the early part of the 20th century, coupled
with the shortage of professional staff, created a climate that allowed, perhaps even subtly
encouraged, experimentation with radical interventions. (Such as insulin-coma therapy).
Early in the 20th century, electroconvulsive therapy (ECT) was originated by two Italian physicians,
Ugo Cerletti and Lucino Bini. Cerletti was interested in epilepsy and was seeking a way to induce
seizures experimentally. He found that by applying electric shocks to the sides of the human head he
could produce full epileptic seizures. In the decades that followed, ECT was administered to people
with schizophrenia and severe depression, usually in hospital settings.
In 1935, Egas Moniz, a Portuguese psychiatrist, introduced the prefrontal lobotomy, a surgical
procedure that destroys the tracts connecting the frontal lobes to other areas of the brain. The
procedure was used especially for those whose behavior was violent. Many people did indeed quiet
down and could even be discharged from hospitals, but largely because their brains were damaged.
Psychological approaches
Mesmer and Charcot
Hysteria = Physical incapacities, such as blindness or paralysis for which no physical cause could be
found.
Mesmer believed that hysteria was caused by a distribution of a universal magnetic fluid in the body.
Moreover, he thought that one person could influence the fluid of another to bring about a change in
the other’s behavior. He originally developed a technique that used rods to influence a person’s
alleged magnetic fields. Later, Mesmer perfected his routines so that he would simply look at people
rather than using rods. He was one of the earlier practitioners of modern-day hypnotism.
Charcot also studied hysterical states. Although Charcot believed that hysteria was a problem with the
nervous system and had a biological cause, he was also persuaded by psychological explanations.
Given Charcot’s prominence in Parisian society, his support of hypnosis as a worthy treatment for
hysteria helped to legitimize this form of treatment among medical professionals of the time
Breuer and Freud
Breuer's method became known as the cathartic method.
Catharsis = Reliving an earlier emotional trauma and releasing emotional tension by expressing
previously forgotten thoughts about the event. Later investigation revealed that they reported the case
of Anna O. incorrectly as she was only cured temporarily.
3
, The central assumption of Freud’s theorizing was that psychopathology results from unconscious
conflicts in the individual. Although he was very much influenced by his teacher Charcot, he believed
that hysteria could be explained more often by psychological causes than by neurological causes.
Freud divided the mind into three principal parts: id, ego, and superego. The id seeks immediate
gratification of its urges. Unlike the contents of the id, those of the ego are primarily conscious. The
task of the ego is to deal with reality, and it mediates between the demands of reality and the id’s
demands for immediate gratification. The superego can be roughly conceived of as a person's
conscience.
Defense mechanism = A strategy used by the ego to protect itself from anxiety, it attempts to resolve
conflicts and satisfy the demands of the id and superego.
Psychotherapy/analysis = The goal of the therapist is to understand the person’s early childhood
experiences, the nature of key relationships, and the patterns in current relationships. The therapist is
listening for core emotional and relationship themes that surface again and again. A component is the
analysis of transference.
Transference = Transference refers to the person’s responses to his or her analyst that seem to
reflect attitudes and ways of behaving toward important people in the person’s past.
Freud’s ideas and methods have been heavily criticized over the years. One of the main criticisms has
to do with the lack of research to support them.
Continuing influences of Freud
1. Childhood experiences help shape adult personality
2. There are unconscious influences on behavior
3. The causes and purposes of human behavior are not always obvious
The rise of behaviorism
Behaviorism focuses on observable behavior rather than on
consciousness or mental functioning.
Classical conditioning
In this experiment, because the meat powder automatically elicits
salivation with no prior learning, the powder is termed an unconditioned
stimulus (UCS) and the response of salivation an unconditioned response
(UCR).
When the offering of meat powder is preceded several times by a neutral
stimulus, the ringing of a bell, the sound of the bell alone (the conditioned
stimulus, or CS) can elicit the salivary response (the conditioned
response, or CR).
4
Psychopathy = The field concerned with the nature,
development and treatment of psychological disorders.
- What constitutes a disorder? It is a demarcation of
the definition of abnormal behavior. There is no
clear answer. The clinical community and society
will have to make an informed weighted decision on
what is severe enough, where to draw the line.
- There is no clear set of behaviors that make a
person abnormal.
Stigma = The destructive beliefs and attitudes held by a society that are ascribed to groups
considered different in some manner, such as people with psychological disorders.
1. A label is applied to a group of people that distinguishes them from others (e.g., “crazy”).
2. The label is linked to deviant or undesirable attributes by society (e.g., crazy people are
dangerous).
3. People with the label are seen as essentially different from those without the label,
contributing to an “us” versus “them” mentality (e.g., we are not like those crazy people).
4. People with the label are discriminated against unfairly (e.g., a clinic for crazy people can’t be
built in our neighborhood).
Battling stigma
1. Community strategies
a. Housing options
b. Education
c. Personal contact
2. Mental health and Health Profession strategies
a. Mental health evaluations
b. Education, training and support
3. Individual and family strategies
a. Education for individuals and families
b. Support and advocacy groups
Knowing more about the causes or available treatments of psychological disorders like schizophrenia
or depression does not decrease stigma, according to studies in 13 different countries around the
world. Two factors that can reduce stigma are contact and familiarity. Stigma can be reduced through
celebrities as rolemodels, podcasts and social media has been used to spread the message that
psychological disorders are common and affect many of us.
Psychological disorder
1. Personal distress - It causes the person great distress. Not all psychological disorders cause
distress and not all behavior that causes distress is disordered.
2. Violation of social norms
Social norms = Widely held standards (beliefs and attitudes) that people use consciously or
intuitively to make judgments about where behaviors are situated on such scales as
good-bad, right-wrong, justified-unjustified and acceptable-unacceptable.
Of course, social norms vary a great deal across cultures and ethnic groups, so behavior that
clearly violates a social norm in one group may not do so at all in another.
3. Disability and dysfunction
Disability = Impairment in some important area of life (e.g. work or personal relationships)
Dysfunction = Something has gone wrong and is not working as it should
1
,Early history of psychopathology
Supernatural explanations
Many philosophers believed that disturbed behavior reflected the displeasure of the gods or
possession by demons.
Exorcism = The ritualistic casting out of evil spirits
Early biological explanations
Hippocrates regarded the brain as the organ of consciousness, intellectual life, and emotion; thus, he
thought that disordered thinking and behavior were indications of some kind of brain pathology.
Hippocrates classified psychological disorders into three categories: mania, melancholia, and
phrenitis, or brain fever. He believed that healthy brain functioning, and therefore mental health,
depended on a delicate balance among four humors, or fluids of the body—namely, blood, black bile,
yellow bile, and phlegm. An imbalance of these humors produced disorders.
The dark age: back to the supernatural
Historians have often pointed to the death of Galen (ce 130–200), the second-century Greek who is
regarded as the last great physician of the classical era, as the beginning of the so-called Dark Ages
in western European medicine and in the treatment and investigation of psychological disorders.
Christian monasteries, through their missionary and educational work, replaced physicians as healers
and as authorities on psychological disorder. Many people with psychological disorders roamed the
countryside, destitute and progressively becoming worse. During this period, there was a return to a
belief in supernatural causes of psychological disorders.
Beginning in the 13th century, lunacy trials to determine a person’s mental health were held in
England. The defendant’s orientation, memory, intellect, daily life, and habits were at issue in the trial.
Notably, the people who were hospitalized were not described as being possessed.
Development of asylums
Asylums = Refuges for the housing and care of people with psychological disorders.
- The Priory of St. Mary of Bethlehem was founded in 1243. Records indicate that in 1403 it
housed six men with psychological disorders. Bethlehem eventually became one of London’s
great tourist attractions, viewing the people housed was considered entertainment.
Unfortunately, housing people with psychological disorders in hospitals and placing their care
in the domain of medicine did not necessarily lead to more humane and effective treat- ment.
In fact, the medical treatments were often crude and painful.
- Philippe Pinel (1745–1826) has often been considered a primary figure in the movement for
more humane treatment of people with psychological disorders in asylums. Pinel came to
believe that people in his care were first and foremost human beings, and thus these people
should be approached with compassion and understanding and treated with dignity. He
surmised that if their reason had left them because of severe personal and social problems, it
might be restored to them through comforting counsel and purposeful activity. He reserved
the more humanitarian treatment for the upper classes; people of the lower classes were still
subjected to terror and coercion as a means of control, with straitjackets replacing chains.
- Moral treatment = People had close contact with attendants, who talked and read to them
and encouraged them to engage in purposeful activity; residents led lives as close to normal
as possible and in general took responsibility for themselves within the constraints of their
disorders. No more than 250 people in any given hospital. Moral treatment was largely
abandoned in the latter part of the 19th century because mental hospitals became
overcrowded and understaffed.
2
,Biological approaches
1. Discovering Biological origins in general paresis and syphilis
Since the late 1700s, it had been known that a number of people with psychological disorders
manifested a syndrome characterized by a steady deterioration of both mental and physical abilities
and progressive paralysis; the presumed disease associated with this syndrome was given the name
general paresis. By the mid-1800s, it had been established that some people with general paresis
also had syphilis, but a connection between the two conditions had not yet been made. Finally, in
1905, the specific microorganism that causes syphilis was discovered. For the first time, a causal link
had been established between infection, damage to certain areas of the brain, and a form of
psychopathology (general paresis). If one type of psychopathology had a biological cause, so could
others. Biological approaches gained credibility, and searches for more biological causes were off and
running.
2. Genetics
Francis Galton (1822–1911), often considered the originator of genetic research because of his study
of twins in the late 1800s in England, attributed many behavioral characteristics to heredity. He is
credited with coining the terms nature and nurture to talk about differences in genetics (nature) and
environment (nurture). Unfortunately, Galton is also credited with creating the eugenics movement in
1883. Advocates of this movement sought to eliminate undesirable characteristics from the population
by restricting the ability of certain people to have children.
3. Biological treatment
The general warehousing of people in mental hospitals in the early part of the 20th century, coupled
with the shortage of professional staff, created a climate that allowed, perhaps even subtly
encouraged, experimentation with radical interventions. (Such as insulin-coma therapy).
Early in the 20th century, electroconvulsive therapy (ECT) was originated by two Italian physicians,
Ugo Cerletti and Lucino Bini. Cerletti was interested in epilepsy and was seeking a way to induce
seizures experimentally. He found that by applying electric shocks to the sides of the human head he
could produce full epileptic seizures. In the decades that followed, ECT was administered to people
with schizophrenia and severe depression, usually in hospital settings.
In 1935, Egas Moniz, a Portuguese psychiatrist, introduced the prefrontal lobotomy, a surgical
procedure that destroys the tracts connecting the frontal lobes to other areas of the brain. The
procedure was used especially for those whose behavior was violent. Many people did indeed quiet
down and could even be discharged from hospitals, but largely because their brains were damaged.
Psychological approaches
Mesmer and Charcot
Hysteria = Physical incapacities, such as blindness or paralysis for which no physical cause could be
found.
Mesmer believed that hysteria was caused by a distribution of a universal magnetic fluid in the body.
Moreover, he thought that one person could influence the fluid of another to bring about a change in
the other’s behavior. He originally developed a technique that used rods to influence a person’s
alleged magnetic fields. Later, Mesmer perfected his routines so that he would simply look at people
rather than using rods. He was one of the earlier practitioners of modern-day hypnotism.
Charcot also studied hysterical states. Although Charcot believed that hysteria was a problem with the
nervous system and had a biological cause, he was also persuaded by psychological explanations.
Given Charcot’s prominence in Parisian society, his support of hypnosis as a worthy treatment for
hysteria helped to legitimize this form of treatment among medical professionals of the time
Breuer and Freud
Breuer's method became known as the cathartic method.
Catharsis = Reliving an earlier emotional trauma and releasing emotional tension by expressing
previously forgotten thoughts about the event. Later investigation revealed that they reported the case
of Anna O. incorrectly as she was only cured temporarily.
3
, The central assumption of Freud’s theorizing was that psychopathology results from unconscious
conflicts in the individual. Although he was very much influenced by his teacher Charcot, he believed
that hysteria could be explained more often by psychological causes than by neurological causes.
Freud divided the mind into three principal parts: id, ego, and superego. The id seeks immediate
gratification of its urges. Unlike the contents of the id, those of the ego are primarily conscious. The
task of the ego is to deal with reality, and it mediates between the demands of reality and the id’s
demands for immediate gratification. The superego can be roughly conceived of as a person's
conscience.
Defense mechanism = A strategy used by the ego to protect itself from anxiety, it attempts to resolve
conflicts and satisfy the demands of the id and superego.
Psychotherapy/analysis = The goal of the therapist is to understand the person’s early childhood
experiences, the nature of key relationships, and the patterns in current relationships. The therapist is
listening for core emotional and relationship themes that surface again and again. A component is the
analysis of transference.
Transference = Transference refers to the person’s responses to his or her analyst that seem to
reflect attitudes and ways of behaving toward important people in the person’s past.
Freud’s ideas and methods have been heavily criticized over the years. One of the main criticisms has
to do with the lack of research to support them.
Continuing influences of Freud
1. Childhood experiences help shape adult personality
2. There are unconscious influences on behavior
3. The causes and purposes of human behavior are not always obvious
The rise of behaviorism
Behaviorism focuses on observable behavior rather than on
consciousness or mental functioning.
Classical conditioning
In this experiment, because the meat powder automatically elicits
salivation with no prior learning, the powder is termed an unconditioned
stimulus (UCS) and the response of salivation an unconditioned response
(UCR).
When the offering of meat powder is preceded several times by a neutral
stimulus, the ringing of a bell, the sound of the bell alone (the conditioned
stimulus, or CS) can elicit the salivary response (the conditioned
response, or CR).
4
