CHAPTER 1:
Abnormal Behaviour in Historical Context
OUTLINE
Defining psychological disorders
Defining psychopathology
History of psychopathology
Biomedical model
WHAT IS PSYCHOPATHOLOGY
“The scientific study of psychological dysfunction”
Focus on the behaviour/cognitive manifestations of a mental disorder
Includes: Aetiology, Progression, Symptomatology, Diagnosis, Treatment
WHAT IS A PSYCHOLOGICAL DISORDER
“Psychological dysfunction associated with distress or
impairment in functioning that is not typical or
culturally expected response”
May include cognitive, behavioural or
emotional elements
“Behavioural, psychological or biological dysfunctions that are unexpected in their cultural context
and associated with present distress and/or impairment in functioning or increased risk of suffering,
death, pain or impairment”
DISTRESS, IMPAIRMENT AND CULTURAL CONTEXT
Distress: normal in some situations
Dysfunctional distress occurs when a person is MUCH more distressed than others would be
Impairment: must be pervasive/significant
o Mental disorders = often exaggerations of normal processes
Culture: Consider ‘normalcy’ relative to behaviour of others in same cultural context
“Rule of thumb: Mental disorder = harmful dysfunction”
1
,STUDYING PSYCHOLOGICAL DISORDERS
– CLINICAL DESCRIPTION
Begin with presenting problem: SYMPTOMS
o Original complaint reported by client to therapist
Description aims to: distinguish clinically significant dysfunction from common human
experience
o Specify what makes it ABNORMAL
Describe prevalence & incidence of disorders
o Prevalence: how many people in population have the disorder
o Incidence: number of new cases over a period of time (i.e. per year)
Details of combination of behaviours, thoughts and feelings of individual that make up
particular disorder
DESCRIBE:
1. Onset of disorder
a. Acute: began suddenly
b. Insidious: develop gradually over extended period of time
2. Course of disorder (pattern of development & change of disorder over time)
a. Episodic: recover within few months, suffer recurrence at a later time
b. Time-limited: improve without treatment in a relatively short period
c. Chronic: lasts a long time, sometimes lifetime
3. Prognosis (predicted future development of disorder over time)
a. Good: will probably recover
b. Guarded: probable outcome does not look good
4. Age of onset – may shape presentation
5. Sex ratio
2
,CAUSATION, TREATMENT, OUTCOME
1. Aetiology: what contributes to the development of psychopathology
Cause/source of disorder
2. Treatment development
How to help alleviate psychological suffering?
Pharmacological, psychosocial or combined treatments
HISTORICAL CONCEPTIONS OF ABNORMAL BEHAVIOUR
Major psychological disorders have existed across time and cultures
Perceived causes and treatment of abnormal behaviour varied widely, depending on context.
3 DOMINANT TRADITIONS (explain abnormal behaviour):
Supernatural
Biological (mental illness have physical roots)
PSYCHOLOGICAL (FREUD, PSYCHOANALYSIS, MORAL THEORY)
1. Rise of moral (psychological/emotional factors) therapy
Popular in first half of 19th century
Main idea: treat patients as normally as possible in normal environment
(PSYCHOSOCIAL APPROACH)
More humane treatment of institutionalised patients (e.g. remove chains)
Encouraged & reinforced social interaction
Psychosocial treatment: focus on social & cultural factors, as well as psychological
influences. Approaches include cognitive, behavioural & interpersonal methods
Proponents of moral therapy
Philippe Pinel & Jean-Baptiste Pussin: no restraints
Benjamin Rush: led reforms in USA
Dorothea Dix: mental hygiene movement – effort to improve care of mentally
disordered by informing public of mistreatment
3
, 2. Asylum reform
More patients getting care
Moral therapy declined because – more difficult with large groups of patients
Soon followed by emergence of competing alternative psychological models
3. Psychoanalytic theory
Freudian theory of structure & function of the mind
PSYCHOANALYTIC THEORY
“Freudian theory of structure & function of the mind”
▫ Unconscious: part of psychic makeup that is outside awareness of person
▫ Catharsis: rapid/sudden release of emotional tension thought to be an NB factor in
psychoanalytic therapy
▫ Psychoanalytic model sought to explain development & personality
STRUCTURE OF THE MIND
1. Id
- pleasure principle: maximising pleasure & eliminate associated tension/conflicts
- illogical, emotional, irrational
- libido vs Thanatos
- primary process
2. Superego
- Moral principles
3. Ego
- Rational
- Mediates conflict between Id & Superego
- Reality principle
- Secondary process (logic & reason)
4
Abnormal Behaviour in Historical Context
OUTLINE
Defining psychological disorders
Defining psychopathology
History of psychopathology
Biomedical model
WHAT IS PSYCHOPATHOLOGY
“The scientific study of psychological dysfunction”
Focus on the behaviour/cognitive manifestations of a mental disorder
Includes: Aetiology, Progression, Symptomatology, Diagnosis, Treatment
WHAT IS A PSYCHOLOGICAL DISORDER
“Psychological dysfunction associated with distress or
impairment in functioning that is not typical or
culturally expected response”
May include cognitive, behavioural or
emotional elements
“Behavioural, psychological or biological dysfunctions that are unexpected in their cultural context
and associated with present distress and/or impairment in functioning or increased risk of suffering,
death, pain or impairment”
DISTRESS, IMPAIRMENT AND CULTURAL CONTEXT
Distress: normal in some situations
Dysfunctional distress occurs when a person is MUCH more distressed than others would be
Impairment: must be pervasive/significant
o Mental disorders = often exaggerations of normal processes
Culture: Consider ‘normalcy’ relative to behaviour of others in same cultural context
“Rule of thumb: Mental disorder = harmful dysfunction”
1
,STUDYING PSYCHOLOGICAL DISORDERS
– CLINICAL DESCRIPTION
Begin with presenting problem: SYMPTOMS
o Original complaint reported by client to therapist
Description aims to: distinguish clinically significant dysfunction from common human
experience
o Specify what makes it ABNORMAL
Describe prevalence & incidence of disorders
o Prevalence: how many people in population have the disorder
o Incidence: number of new cases over a period of time (i.e. per year)
Details of combination of behaviours, thoughts and feelings of individual that make up
particular disorder
DESCRIBE:
1. Onset of disorder
a. Acute: began suddenly
b. Insidious: develop gradually over extended period of time
2. Course of disorder (pattern of development & change of disorder over time)
a. Episodic: recover within few months, suffer recurrence at a later time
b. Time-limited: improve without treatment in a relatively short period
c. Chronic: lasts a long time, sometimes lifetime
3. Prognosis (predicted future development of disorder over time)
a. Good: will probably recover
b. Guarded: probable outcome does not look good
4. Age of onset – may shape presentation
5. Sex ratio
2
,CAUSATION, TREATMENT, OUTCOME
1. Aetiology: what contributes to the development of psychopathology
Cause/source of disorder
2. Treatment development
How to help alleviate psychological suffering?
Pharmacological, psychosocial or combined treatments
HISTORICAL CONCEPTIONS OF ABNORMAL BEHAVIOUR
Major psychological disorders have existed across time and cultures
Perceived causes and treatment of abnormal behaviour varied widely, depending on context.
3 DOMINANT TRADITIONS (explain abnormal behaviour):
Supernatural
Biological (mental illness have physical roots)
PSYCHOLOGICAL (FREUD, PSYCHOANALYSIS, MORAL THEORY)
1. Rise of moral (psychological/emotional factors) therapy
Popular in first half of 19th century
Main idea: treat patients as normally as possible in normal environment
(PSYCHOSOCIAL APPROACH)
More humane treatment of institutionalised patients (e.g. remove chains)
Encouraged & reinforced social interaction
Psychosocial treatment: focus on social & cultural factors, as well as psychological
influences. Approaches include cognitive, behavioural & interpersonal methods
Proponents of moral therapy
Philippe Pinel & Jean-Baptiste Pussin: no restraints
Benjamin Rush: led reforms in USA
Dorothea Dix: mental hygiene movement – effort to improve care of mentally
disordered by informing public of mistreatment
3
, 2. Asylum reform
More patients getting care
Moral therapy declined because – more difficult with large groups of patients
Soon followed by emergence of competing alternative psychological models
3. Psychoanalytic theory
Freudian theory of structure & function of the mind
PSYCHOANALYTIC THEORY
“Freudian theory of structure & function of the mind”
▫ Unconscious: part of psychic makeup that is outside awareness of person
▫ Catharsis: rapid/sudden release of emotional tension thought to be an NB factor in
psychoanalytic therapy
▫ Psychoanalytic model sought to explain development & personality
STRUCTURE OF THE MIND
1. Id
- pleasure principle: maximising pleasure & eliminate associated tension/conflicts
- illogical, emotional, irrational
- libido vs Thanatos
- primary process
2. Superego
- Moral principles
3. Ego
- Rational
- Mediates conflict between Id & Superego
- Reality principle
- Secondary process (logic & reason)
4
