Chapter 1: Abnormal Psychology - Past and Present
= scientific study of abnormal behavior toward describing, predicting, explaining and changing
abnormal patterns of functioning
- Lots of slang were used to describe mental disorders
- Common feature across definitions
- 4 Ds: Deviance, Distress, Dysfunction and Danger
- 4 ds are influenced by norms, culture and context - especially deviance
- Sometimes deviant behavior is an appropriate reaction to extraordinarily bad
circumstances
- Sometimes deviant behavior is not accompanied by distress
- Dysfunctionality is defined dep on culture and context - see hunger strikes for ex
- Danger to themselves and others is rarely manifested in mental health patients
- Abnormality - general criteria in society to judge particular cases
- Szasz posits that societal involvement may invalidate the concept of mental
illness
- That mental illness is a concept invented by societies to control unusual patterns
of functioning that threaten the social order - see eccentrics (unusual patter with
which others have no right to interfere)
- Any definition of abnormality may be unable to be applied consistently
- Behaviors may be deviant, distressful and dysfunctional or dangerous but are not
necessarily considered abnormal
What is Treatment?
- Treatment or therapy = procedure designed to change behavior of sufferer or
patient
- Trained, socially accepted healer or therapist
- Therapeutic contacts between healer and sufferrer
- Rogers: therapy is a completely chaotic and divided field
- Clinicians agree that many people need a kind of therapy or another
- In the past:
- All societies witnessed psychological abnormality, many present ideas are rooted
in the past
- Evil possession may have been treated with trephination and exorcism
- Ancient Period: Philosophers and physicians; hippocrates believed that illnesses
have natural causes - treat with quiet life, veggie diet, temperance, exercise,
celibacy, bleeding;
- Middle Ages - Demonology; church rejected scientific forms of investigation and
controlled all education
- Mental disorders = demonic causes; mass madness;
- Treat with exorcism, torture, gradually hospitalization
- Renaissance: rise of asylums, care at religious shrines
- Demonological views declined
, - Weyer - first mental health physician would thought that the mind is just
as susceptible to disease as the body
- Asylums became overcrowded and horrible see Bedlam - Bethlehem
Hospital
- 19th century: reform and Moral treatment
- Mental disorders became more prevalent
- Pinel (france - La Salpetriere asylum was renovated to be good for
women) and Tuke (england) advocated moral treatment - humane,
respectful techniques
- Movement ended by early 20th century
- Benjamin Rush and Dorothea Dix - moral treatment, but it was expensive
- 20th century - Dual perspectives
- Moral treatment was on the decline due to shortage of resources;
assumption that all treatment could be humanity and dignity; prejudice
against mental illness
- Physical factors in abnormal functioning
- Emil Kraepelin - physical causes (untreated syphilis leads to
general paresis)
- But results were generally not great, medication was ineffective (see also
eugenic sterilisation and rise of discriminating laws)
- Psychogenic perspective - abnormality is due to psychological causes
- Mesmer, freud; based on work with hypnotism;
- Psychoanalysis became widely accepted as a theory and
treatment
- Recently,
- Negative public attitudes are on the decline, major breakthroughs in the
last 60 years
- Severe disturbances are treated with
- New psychotropic medication - antipsychotics, antidepressants,
antianxiety
- Led to mass deinstitutionalization and outpatient care (which is
today, the primary mode of treatment) → community mental health
care for severe disturbances; private psychotherapy for less
severe disturbances
- Prevention programs are increasing, positive psychology has
grown - coping skills, promoting positive values
- Targeted programs on one kind of psychological problem
- Multicultural psychology - in response to growing demographic
diversity
- Multicultural psychologists focus on culture, race, ethnicity,
gender affect behavior and cause diff in abnormality
- Insurance coverage for managed care programs
- Reimbursements for mental disorders tend to be lower
than for medical disorders
, - Manage care programs - kinda suck, may be too short,
favor treatments that don’t have lasting effects, hard for
those struggling with sever disorders
- Affordable care act (2008) in US, which was made better in
2013 improved the situation
- Today there are numerous theoretical perspectives, none
dominating the clinical field
Technology and Mental Health
- New triggers and vehicles for expression of abnormality
- Digital distractions → shorter attention spans
- Tele-mental health services increasing
- Mental health apps are more available
- Lots of web-based misinformation
Clinical researchers
- Systematic search for facts, observations in investigation
- Case studies
- Detailed interpretative description of a person’s life and psychological
problems
- Can originate new ideas
- Tentative support for theory or challenge theoretical assumptions
- Introduction to new therapeutic techniques, especially for very particular
problems - see HM, CW, JK
- Limited by:
- Biased observers
- Subjective evidence (low int validity)
- Not much generalization possible (low external validity
- Correlational method
- Degree to which events very with each other - positive corr +1, negative
-1, or unrelated 0
- Co-relationship between variables
- Subjects or participants:
- People in a study = sample
- Sample should not be biased = representative of population
- Trusted on statistical analysis of probability = statistical significance
- Confidence increases with size of the sample and magnitude of
correlation
- High external validity (can generalize), can repeat (replicability) studies
with other samples
- Lack internal validity (third variable problem), Describe but not explain a
relationship or causation
, -
- Experimental method - indep variable is manipulated and the effect is observed
on the dep variable
- Confound = other variables that may be affecting the dep variable
- Use control groups (maybe matched), random assignment,
masked (blind) design - especially in medical drug trials
- Control group = participants not exposed to IV but have similar
experience to experimental group
- Statistical significance applied
- Clinicians may evaluate clinical significance
- Masked design = participants do not know which assigned gorup
they are in - placebo therapy
- Double mask = participants and experimenters are unaware of the
groups to which participants are assigned
- Alternative research designs
- Matched (mixed designs) - participants are placed in existing groups to
address confounds based on demographic and other variables
- natural (quasi) experiments - IV is manipulated by external factors and
experimenter observes effects
- Events cannot be replicated, so broad generalizations cannot be
drawn from one study
- analogue experiment - IV are freely manipulated, ethical and practical
limitations are avoided
- Laboratory subjects are induced to behave in ways that resemble real life
- Stanford prison experiment
- Cannot be sure if setting is genuine
- single subject experiments etx
- Single subject observed before and after manipulation of IV
- Baseline data required for comparison
- Higher internal validity than case study because IV is manipulated
- Reversal designs
- Longitudinal studies (high-risk or developmental studies)
- Long period of observation, many occasions
- IV manipulation or random assignment is not possible
- Causes cannot be pinpointed, but correlations poitned out - see
personality research, life outcome data
- Epidemiological studies
= scientific study of abnormal behavior toward describing, predicting, explaining and changing
abnormal patterns of functioning
- Lots of slang were used to describe mental disorders
- Common feature across definitions
- 4 Ds: Deviance, Distress, Dysfunction and Danger
- 4 ds are influenced by norms, culture and context - especially deviance
- Sometimes deviant behavior is an appropriate reaction to extraordinarily bad
circumstances
- Sometimes deviant behavior is not accompanied by distress
- Dysfunctionality is defined dep on culture and context - see hunger strikes for ex
- Danger to themselves and others is rarely manifested in mental health patients
- Abnormality - general criteria in society to judge particular cases
- Szasz posits that societal involvement may invalidate the concept of mental
illness
- That mental illness is a concept invented by societies to control unusual patterns
of functioning that threaten the social order - see eccentrics (unusual patter with
which others have no right to interfere)
- Any definition of abnormality may be unable to be applied consistently
- Behaviors may be deviant, distressful and dysfunctional or dangerous but are not
necessarily considered abnormal
What is Treatment?
- Treatment or therapy = procedure designed to change behavior of sufferer or
patient
- Trained, socially accepted healer or therapist
- Therapeutic contacts between healer and sufferrer
- Rogers: therapy is a completely chaotic and divided field
- Clinicians agree that many people need a kind of therapy or another
- In the past:
- All societies witnessed psychological abnormality, many present ideas are rooted
in the past
- Evil possession may have been treated with trephination and exorcism
- Ancient Period: Philosophers and physicians; hippocrates believed that illnesses
have natural causes - treat with quiet life, veggie diet, temperance, exercise,
celibacy, bleeding;
- Middle Ages - Demonology; church rejected scientific forms of investigation and
controlled all education
- Mental disorders = demonic causes; mass madness;
- Treat with exorcism, torture, gradually hospitalization
- Renaissance: rise of asylums, care at religious shrines
- Demonological views declined
, - Weyer - first mental health physician would thought that the mind is just
as susceptible to disease as the body
- Asylums became overcrowded and horrible see Bedlam - Bethlehem
Hospital
- 19th century: reform and Moral treatment
- Mental disorders became more prevalent
- Pinel (france - La Salpetriere asylum was renovated to be good for
women) and Tuke (england) advocated moral treatment - humane,
respectful techniques
- Movement ended by early 20th century
- Benjamin Rush and Dorothea Dix - moral treatment, but it was expensive
- 20th century - Dual perspectives
- Moral treatment was on the decline due to shortage of resources;
assumption that all treatment could be humanity and dignity; prejudice
against mental illness
- Physical factors in abnormal functioning
- Emil Kraepelin - physical causes (untreated syphilis leads to
general paresis)
- But results were generally not great, medication was ineffective (see also
eugenic sterilisation and rise of discriminating laws)
- Psychogenic perspective - abnormality is due to psychological causes
- Mesmer, freud; based on work with hypnotism;
- Psychoanalysis became widely accepted as a theory and
treatment
- Recently,
- Negative public attitudes are on the decline, major breakthroughs in the
last 60 years
- Severe disturbances are treated with
- New psychotropic medication - antipsychotics, antidepressants,
antianxiety
- Led to mass deinstitutionalization and outpatient care (which is
today, the primary mode of treatment) → community mental health
care for severe disturbances; private psychotherapy for less
severe disturbances
- Prevention programs are increasing, positive psychology has
grown - coping skills, promoting positive values
- Targeted programs on one kind of psychological problem
- Multicultural psychology - in response to growing demographic
diversity
- Multicultural psychologists focus on culture, race, ethnicity,
gender affect behavior and cause diff in abnormality
- Insurance coverage for managed care programs
- Reimbursements for mental disorders tend to be lower
than for medical disorders
, - Manage care programs - kinda suck, may be too short,
favor treatments that don’t have lasting effects, hard for
those struggling with sever disorders
- Affordable care act (2008) in US, which was made better in
2013 improved the situation
- Today there are numerous theoretical perspectives, none
dominating the clinical field
Technology and Mental Health
- New triggers and vehicles for expression of abnormality
- Digital distractions → shorter attention spans
- Tele-mental health services increasing
- Mental health apps are more available
- Lots of web-based misinformation
Clinical researchers
- Systematic search for facts, observations in investigation
- Case studies
- Detailed interpretative description of a person’s life and psychological
problems
- Can originate new ideas
- Tentative support for theory or challenge theoretical assumptions
- Introduction to new therapeutic techniques, especially for very particular
problems - see HM, CW, JK
- Limited by:
- Biased observers
- Subjective evidence (low int validity)
- Not much generalization possible (low external validity
- Correlational method
- Degree to which events very with each other - positive corr +1, negative
-1, or unrelated 0
- Co-relationship between variables
- Subjects or participants:
- People in a study = sample
- Sample should not be biased = representative of population
- Trusted on statistical analysis of probability = statistical significance
- Confidence increases with size of the sample and magnitude of
correlation
- High external validity (can generalize), can repeat (replicability) studies
with other samples
- Lack internal validity (third variable problem), Describe but not explain a
relationship or causation
, -
- Experimental method - indep variable is manipulated and the effect is observed
on the dep variable
- Confound = other variables that may be affecting the dep variable
- Use control groups (maybe matched), random assignment,
masked (blind) design - especially in medical drug trials
- Control group = participants not exposed to IV but have similar
experience to experimental group
- Statistical significance applied
- Clinicians may evaluate clinical significance
- Masked design = participants do not know which assigned gorup
they are in - placebo therapy
- Double mask = participants and experimenters are unaware of the
groups to which participants are assigned
- Alternative research designs
- Matched (mixed designs) - participants are placed in existing groups to
address confounds based on demographic and other variables
- natural (quasi) experiments - IV is manipulated by external factors and
experimenter observes effects
- Events cannot be replicated, so broad generalizations cannot be
drawn from one study
- analogue experiment - IV are freely manipulated, ethical and practical
limitations are avoided
- Laboratory subjects are induced to behave in ways that resemble real life
- Stanford prison experiment
- Cannot be sure if setting is genuine
- single subject experiments etx
- Single subject observed before and after manipulation of IV
- Baseline data required for comparison
- Higher internal validity than case study because IV is manipulated
- Reversal designs
- Longitudinal studies (high-risk or developmental studies)
- Long period of observation, many occasions
- IV manipulation or random assignment is not possible
- Causes cannot be pinpointed, but correlations poitned out - see
personality research, life outcome data
- Epidemiological studies
