PSYC303 NOTES FALL 2022
g g g
CHAPTERgI:gUNDERSTANDINGgPSYCHOPATHOLOGY
• psychologicalgdisorder,gagpsychologicalgdysfunctiongwithingangindividualgassociatedgwithgdistressgorgimp
airmentgingfunctioninggandgagresponsegthatgisgnotgtypicalgorgculturallygexpected.g
ggggggggggggggggg
- AgdysfunctiongwasgclearlygpresentgingJudy.gButgmanygpeoplegexperiencegagmildgversiongofgthisgreactiong
(feelinggqueasygatgthegsightgofgblood)gwithoutgmeetinggthegcriteriagforgthegdisorder.g
- WegcangcertainlygsaygthatgJudygwasgdistressed.gButgremember,gthisgcriteriongdoesgnotgdefinegproblemat
icgabnormalgbehavior.g
- Judygwasgclearlygimpairedgbyghergphobia,gbutgmanygpeoplegwithglessgseveregreactionsgaregnotgimpaired.
g
-
- WHATgISgAgPSYCHOLOGICALgDISORDER?
• Agpsychologicalgdisorder,gorgproblematicgabnormalgbehavior,gisgagpsychologicalgdysfunctiongthatgisgasso
ciatedgwithgdistressgorgimpairmentgingfunctioninggandgagresponsegthatgisgnotgtypicalgorgculturallygexpect
edg
• 3gcriteria:gpsychologicalgdysfunction,gdistress,gorgimpairment,gatypicalgorgnotgculturallygexpected
, ➢ PsychologicalgDysfunction:gItgrefersgtogagbreakdowngingcognitive,gemotional,gorgbehavioralgfunctioni
ng.gForgexample,gifgyougaregoutgongagdate,gitgshouldgbegfun.gButgifgyougexperiencegseveregfeargallge
vening,gevengthoughgtheregisgnothinggtogbegafraidgof,gandgthegfearghappensgongeverygdate,gyourge
motionsgaregnotgfunctioninggproperly.gHowever,gifgyourgfriendsgagreegthatgthegpersongwhogaskedgy
ougoutgisgunpredictablegandgdangerousgingsomegway,gitgwouldgnotgbegdysfunctionalgtogbegfearful.g
➢ DistressgorgImpairment:gbygitself,gthisgcriteriongdoesgnotgdefinegproblematicgabnormalgbehavior.gItgi
sgoftengnormalgtogbegdistressed—
forgexamplegifgsomeonegclosegtogyougdies.gSufferinggandgdistressgaregpartgofglife.gThegconceptgofgi
mpairmentgisguseful,galthoughgnotgentirelygsatisfactory.gForgexample,gmanygpeoplegconsidergthems
elvesgshygorglazy.gThisgdoesn’tgmeangthey’regabnormal.gButgifgyougaregsogshygthatgyougfindgitgimpos
siblegtoginteractgwithgpeoplegevengthoughgyougwouldglikegtoghavegfriends,gyourgsocialgfunctioninggis
gimpaired.g
➢ AtypicalgorgNotgCulturallygExpected:gAtgtimes,gsomethinggisgconsideredgabnormalgbecausegitgdeviat
esgfromgthegaverage.gTheggreatergthegdeviation,gthegmoregabnormalgitgis.gThisgdefinitiongisgusefulgi
ngconsideringgculturalgdifferencesgingpsychologicalgdisorders.gConsidergthegpracticegofgcommittinggp
oliticalgdissidentsgtogmentalginstitutionsgbecausegtheygprotestgthegpoliciesgofgtheirggovernment,gwhi
chgwasgcommongingIraqgbeforegthegfallgofgSaddamgHussein.g
- ANgACCEPTEDgDEFINITION
• It’sgbehavioral,gpsychological,gorgbiologicalgdysfunctionsgthatgaregunexpectedgingtheirgculturalgcontextga
ndgassociatedgwithgpresentgdistressgandgimpairmentgingfunctioning,gorgincreasedgriskgofgsuffering,gdeath
,gpain,gorgimpairment.g
• However,git’sgnotgeasygtoghavegagcertaingdefinitiongstill.gSogthegbestgwegmaygbegablegtogdogisgtogconsid
erghowgthegapparentgdiseasegorgdisordergmatchesgag‘’typical’’gprofilegofgagdisorderg–
gforgex:gmajorgdepression
- THEgSCIENCEgOFgPSYCHOPATHOLOGY
• Psychopathologygisgthegscientificgstudygofgpsychologicalgdisorders.g
• gmentalghealthgpract.gFunctionsgasgscientist-pract.gIngthreegways
➢ First,gtheygkeepgupgwithgtheglatestgdevelopmentsgingtheirgfieldgandgusegthegmostgcurrentgdiagnostic
gandgtreatmentgprocedures.gIngthisgsense,gtheygaregconsumersgofgthegsciencegofgpsychopathology.g
➢ Second,gtheygevaluategtheirgowngassessmentsgorgtreatmentgproceduresgtogseegwhethergtheygwork.g
Theygaregaccountablegnotgonlygtogtheirgpatientsgbutgalsogtoggovernmentgagenciesgandginsurancegco
mpaniesgthatgpaygforgthegtreatments,gsogtheygmustgdemonstrategwhethergtheirgtreatmentsgaregeff
ective.g
➢ Third,gscientist-
practitionersgconductgresearchgthatgproducesgnewginformationgaboutgdisordersgorgtheirgtreatment.g
, Suchgresearchgattemptsgthreegbasicgthings:gtogdescribegpsychologicalgdisorders,gtogdeterminegtheirg
causes,gandgtogtreatgthem.
•
- ClinicalgDescription
• PresentinggProblem:goriginalgcomplaintgreportedgbygthegclientgtogthegtherapist.gThegactualgtreatedgprob
lemgmaygbegagmodificationgderivedgfromgthegpresentinggproblem.
• ClinicalgDescription:gdetailsgofgthegcombinationgofgbehaviors,gthoughts,gandgfeelingsgofgangindividualgtha
tgmakegupgagparticulargdisorder.
• Prevalence:gthegnumbergofgpeoplegdisplayinggagdisordergingthegtotalgpopulationgatganyggivengtimeg
• Incidence:gnumbergofgnewgcasesgofgagdisordergappearinggduringgagspecificgperiod
• Course:gpatterngofgdevelopmentgandgchangegofgagdisordergovergtime.gForgexample,gsomegdisorders,gsuc
hgasgschizophrenia,gfollowgagchronicgcourse,gmeaninggtheygtendgtoglastgaglonggtime.gOthergdisorders,glik
egmoodgdisorders,gfollowgangepisodicgcourse,gingthatgthegindividualgisglikelygtogrecovergwithingagfewgmo
nthsgonlygtogsuffergagrecurrencegofgthegdisorder.g
• Prognosis:gPredictedgdevelopmentgofgagdisordergovergtime
• Etiology:gCausegorgsourcegofgagdisorder.
- HISTORICALgCONCEPTIONSgOFgABNORMALgBEHAVIOR
➢ ThegSupernaturalgTradition
• Forgmuchgofgourgrecordedghistory,gdeviantgbehaviorghasgbeengconsideredgagreflectiongofgthegbattlegbet
weenggoodgandgevil.gWhengconfrontedgwithgunexplainable,girrationalgbehaviorgandgsufferinggandguphea
val,gpeopleghavegperceivedgevil.
• DemonsgandgWitches:gDuringgtheglateg14thgcentury,gthegbizarregbehaviorgofgpeoplegafflictedgwithgpsych
ologicalgdisordersgweregseengasgthegworkgofgthegdevilgandgwitches.gTreatmentsgincludedgexorcism,gingw
hichgreligiousgritualsgweregperformedgtogridgthegvictimgofgevilgspirits.g
o THEgBIOLOGICALgTRADITION
• Hippocrates:gFathergofgmoderngWesterngmedicine.gHegandgothersgsuggestedgthatgpsychologicalgdisorder
sgcouldgbegtreatedglikeganygothergdisease.gTheygbelievedgthatgpsychologicalgdisordersgmightgalsogbegcau
sedgbygbraingpathologygorgheadgtraumagandgcouldgbeginfluencedgbygheredityg(genetics).gHegalsogrecogni
, zedgthegimportancegofginterpersonalgcontributionsgtogpsychopathologygsuchgasgthegnegativegeffectsgofgf
amilygstress.g
• Galen:gthegromangphysician,gadoptedgthesegideasgandgdevelopedgthemgfurther.g
• Hippocratic-
Galenicgapproachg=ghumoralgtheorygofgdisorders.gHippocratesgassumedgthatgnormalgbraingfunctioninggw
asgrelatedgtogfourgbodilygfluidsgorgHUMORS:gblood,gblackgbile,gyellowgbile,gandgphlegm.gPhysiciansgbelie
vedgthatgdiseasegresultedgfromgtoogmuchgorgtooglittlegofgonegofgtheghumors;gforgexample,gtoogmuchgbl
ackgbilegwasgthoughtgtogcausegmelancholiag(depression).g
➢ Theg19thgCentury
• Syphilis:gBehavioralgandgcognitivegsymptomsgofgwhatgwegnowgknowgasgadvancedgsyphilis,gagsexuallygtra
nsmittedgdiseasegcausedgbygagbacterialgmicroorganismgenteringgthegbrain,gincludinggbelievinggthatgever
yonegisgplottinggagainstgyoug(delusiongofgpersecution)gorgthatgyougaregGodg(delusiongofggrandeur).gPhys
iciansgobservedgagsurprisinggrecoverygingpatientsgwithggeneralgparesisgwhoghadgcontractedgmalaria,gsogt
heyginjectedgothergpatientsgwithgbloodgfromgagsoldiergwhogwasgillgwithgmalaria.gManygrecoveredgbecau
segtheghighgfeverg“burnedgout”gthegsyphilisgbacteria.gObviously,gthisgtypegofgexperimentgwouldgnotgbeg
ethicallygpossiblegtoday.gUltimately,ginvestigatorsgdiscoveredgthatgpenicillingcuresgsyphilis,gbutgwithgtheg
malariagcure,g“madness”gandgassociatedgsymptomsgforgthegfirstgtimegweregtracedgdirectlygtogagcurablegi
nfection.gManygmentalghealthgprofessionalsgassumedgthatgcomparablegcausesgandgcuresgmightgbegdisco
veredgforgallgpsychologicalgdisorders.g
• JohngP.gGrey:gThegchampiongofgthegbiologicalgtraditiongingthegUS.gGreygheldgthatgthegcausegofginsanityg
weregphysicalgsogmentallygillgpatientsgshouldgbegtreatedgasgphysicallygillgwithgthegtreatmentgincludinggre
st,gdiet,gandgpropergroomgtemperaturegandgventilation.g
➢ DevelopmentgofgbiologicalgTreatments
• Ingtheg1930s,gelectricgshockgandgbraingsurgerygweregoftengused.gTheirgeffects,gandgthegeffectsgofgnewgd
rugs,gweregdiscoveredgbygaccident.g
• ManfredgSakelg–ginsulingshockgtherapy
• JosephgvongMedunag–ginducedgbraingseizuresgmightgcuregschizophrenia
• Duringgtheg1950s,gthegfirstgeffectivegdrugsgforgseveregpsychoticgdisordersgweregdevelopedgingagsystemat
icgway.g
➢ ConsequencesgofgthegBiologicalgTradition
• EmilgKraepeling–
ghegwasginfluentialgingadvocatinggthegmajorgideasgofgthegbiologicalgtradition,gbutghegwasglittleginvolvedgi
ngtreatment.gHisglastinggcontributiongwasgingdiagnosisgandgclassification.g
o THEgPSYCHOLOGICALgTRADITION
o Howgdogthegpsychologicalgapproachesgofgpsychoanalysis,ghumanism,gandgbehaviorismg
explaingabnormalgbehavior?g
➢ Moralgtherapy
• Thegpsychosocialgapproachgingtheg19thgcenturyginvolvedgtreatinggpatientsgasgnormallygasgpossiblegingthe
genvironment
g g g
CHAPTERgI:gUNDERSTANDINGgPSYCHOPATHOLOGY
• psychologicalgdisorder,gagpsychologicalgdysfunctiongwithingangindividualgassociatedgwithgdistressgorgimp
airmentgingfunctioninggandgagresponsegthatgisgnotgtypicalgorgculturallygexpected.g
ggggggggggggggggg
- AgdysfunctiongwasgclearlygpresentgingJudy.gButgmanygpeoplegexperiencegagmildgversiongofgthisgreactiong
(feelinggqueasygatgthegsightgofgblood)gwithoutgmeetinggthegcriteriagforgthegdisorder.g
- WegcangcertainlygsaygthatgJudygwasgdistressed.gButgremember,gthisgcriteriongdoesgnotgdefinegproblemat
icgabnormalgbehavior.g
- Judygwasgclearlygimpairedgbyghergphobia,gbutgmanygpeoplegwithglessgseveregreactionsgaregnotgimpaired.
g
-
- WHATgISgAgPSYCHOLOGICALgDISORDER?
• Agpsychologicalgdisorder,gorgproblematicgabnormalgbehavior,gisgagpsychologicalgdysfunctiongthatgisgasso
ciatedgwithgdistressgorgimpairmentgingfunctioninggandgagresponsegthatgisgnotgtypicalgorgculturallygexpect
edg
• 3gcriteria:gpsychologicalgdysfunction,gdistress,gorgimpairment,gatypicalgorgnotgculturallygexpected
, ➢ PsychologicalgDysfunction:gItgrefersgtogagbreakdowngingcognitive,gemotional,gorgbehavioralgfunctioni
ng.gForgexample,gifgyougaregoutgongagdate,gitgshouldgbegfun.gButgifgyougexperiencegseveregfeargallge
vening,gevengthoughgtheregisgnothinggtogbegafraidgof,gandgthegfearghappensgongeverygdate,gyourge
motionsgaregnotgfunctioninggproperly.gHowever,gifgyourgfriendsgagreegthatgthegpersongwhogaskedgy
ougoutgisgunpredictablegandgdangerousgingsomegway,gitgwouldgnotgbegdysfunctionalgtogbegfearful.g
➢ DistressgorgImpairment:gbygitself,gthisgcriteriongdoesgnotgdefinegproblematicgabnormalgbehavior.gItgi
sgoftengnormalgtogbegdistressed—
forgexamplegifgsomeonegclosegtogyougdies.gSufferinggandgdistressgaregpartgofglife.gThegconceptgofgi
mpairmentgisguseful,galthoughgnotgentirelygsatisfactory.gForgexample,gmanygpeoplegconsidergthems
elvesgshygorglazy.gThisgdoesn’tgmeangthey’regabnormal.gButgifgyougaregsogshygthatgyougfindgitgimpos
siblegtoginteractgwithgpeoplegevengthoughgyougwouldglikegtoghavegfriends,gyourgsocialgfunctioninggis
gimpaired.g
➢ AtypicalgorgNotgCulturallygExpected:gAtgtimes,gsomethinggisgconsideredgabnormalgbecausegitgdeviat
esgfromgthegaverage.gTheggreatergthegdeviation,gthegmoregabnormalgitgis.gThisgdefinitiongisgusefulgi
ngconsideringgculturalgdifferencesgingpsychologicalgdisorders.gConsidergthegpracticegofgcommittinggp
oliticalgdissidentsgtogmentalginstitutionsgbecausegtheygprotestgthegpoliciesgofgtheirggovernment,gwhi
chgwasgcommongingIraqgbeforegthegfallgofgSaddamgHussein.g
- ANgACCEPTEDgDEFINITION
• It’sgbehavioral,gpsychological,gorgbiologicalgdysfunctionsgthatgaregunexpectedgingtheirgculturalgcontextga
ndgassociatedgwithgpresentgdistressgandgimpairmentgingfunctioning,gorgincreasedgriskgofgsuffering,gdeath
,gpain,gorgimpairment.g
• However,git’sgnotgeasygtoghavegagcertaingdefinitiongstill.gSogthegbestgwegmaygbegablegtogdogisgtogconsid
erghowgthegapparentgdiseasegorgdisordergmatchesgag‘’typical’’gprofilegofgagdisorderg–
gforgex:gmajorgdepression
- THEgSCIENCEgOFgPSYCHOPATHOLOGY
• Psychopathologygisgthegscientificgstudygofgpsychologicalgdisorders.g
• gmentalghealthgpract.gFunctionsgasgscientist-pract.gIngthreegways
➢ First,gtheygkeepgupgwithgtheglatestgdevelopmentsgingtheirgfieldgandgusegthegmostgcurrentgdiagnostic
gandgtreatmentgprocedures.gIngthisgsense,gtheygaregconsumersgofgthegsciencegofgpsychopathology.g
➢ Second,gtheygevaluategtheirgowngassessmentsgorgtreatmentgproceduresgtogseegwhethergtheygwork.g
Theygaregaccountablegnotgonlygtogtheirgpatientsgbutgalsogtoggovernmentgagenciesgandginsurancegco
mpaniesgthatgpaygforgthegtreatments,gsogtheygmustgdemonstrategwhethergtheirgtreatmentsgaregeff
ective.g
➢ Third,gscientist-
practitionersgconductgresearchgthatgproducesgnewginformationgaboutgdisordersgorgtheirgtreatment.g
, Suchgresearchgattemptsgthreegbasicgthings:gtogdescribegpsychologicalgdisorders,gtogdeterminegtheirg
causes,gandgtogtreatgthem.
•
- ClinicalgDescription
• PresentinggProblem:goriginalgcomplaintgreportedgbygthegclientgtogthegtherapist.gThegactualgtreatedgprob
lemgmaygbegagmodificationgderivedgfromgthegpresentinggproblem.
• ClinicalgDescription:gdetailsgofgthegcombinationgofgbehaviors,gthoughts,gandgfeelingsgofgangindividualgtha
tgmakegupgagparticulargdisorder.
• Prevalence:gthegnumbergofgpeoplegdisplayinggagdisordergingthegtotalgpopulationgatganyggivengtimeg
• Incidence:gnumbergofgnewgcasesgofgagdisordergappearinggduringgagspecificgperiod
• Course:gpatterngofgdevelopmentgandgchangegofgagdisordergovergtime.gForgexample,gsomegdisorders,gsuc
hgasgschizophrenia,gfollowgagchronicgcourse,gmeaninggtheygtendgtoglastgaglonggtime.gOthergdisorders,glik
egmoodgdisorders,gfollowgangepisodicgcourse,gingthatgthegindividualgisglikelygtogrecovergwithingagfewgmo
nthsgonlygtogsuffergagrecurrencegofgthegdisorder.g
• Prognosis:gPredictedgdevelopmentgofgagdisordergovergtime
• Etiology:gCausegorgsourcegofgagdisorder.
- HISTORICALgCONCEPTIONSgOFgABNORMALgBEHAVIOR
➢ ThegSupernaturalgTradition
• Forgmuchgofgourgrecordedghistory,gdeviantgbehaviorghasgbeengconsideredgagreflectiongofgthegbattlegbet
weenggoodgandgevil.gWhengconfrontedgwithgunexplainable,girrationalgbehaviorgandgsufferinggandguphea
val,gpeopleghavegperceivedgevil.
• DemonsgandgWitches:gDuringgtheglateg14thgcentury,gthegbizarregbehaviorgofgpeoplegafflictedgwithgpsych
ologicalgdisordersgweregseengasgthegworkgofgthegdevilgandgwitches.gTreatmentsgincludedgexorcism,gingw
hichgreligiousgritualsgweregperformedgtogridgthegvictimgofgevilgspirits.g
o THEgBIOLOGICALgTRADITION
• Hippocrates:gFathergofgmoderngWesterngmedicine.gHegandgothersgsuggestedgthatgpsychologicalgdisorder
sgcouldgbegtreatedglikeganygothergdisease.gTheygbelievedgthatgpsychologicalgdisordersgmightgalsogbegcau
sedgbygbraingpathologygorgheadgtraumagandgcouldgbeginfluencedgbygheredityg(genetics).gHegalsogrecogni
, zedgthegimportancegofginterpersonalgcontributionsgtogpsychopathologygsuchgasgthegnegativegeffectsgofgf
amilygstress.g
• Galen:gthegromangphysician,gadoptedgthesegideasgandgdevelopedgthemgfurther.g
• Hippocratic-
Galenicgapproachg=ghumoralgtheorygofgdisorders.gHippocratesgassumedgthatgnormalgbraingfunctioninggw
asgrelatedgtogfourgbodilygfluidsgorgHUMORS:gblood,gblackgbile,gyellowgbile,gandgphlegm.gPhysiciansgbelie
vedgthatgdiseasegresultedgfromgtoogmuchgorgtooglittlegofgonegofgtheghumors;gforgexample,gtoogmuchgbl
ackgbilegwasgthoughtgtogcausegmelancholiag(depression).g
➢ Theg19thgCentury
• Syphilis:gBehavioralgandgcognitivegsymptomsgofgwhatgwegnowgknowgasgadvancedgsyphilis,gagsexuallygtra
nsmittedgdiseasegcausedgbygagbacterialgmicroorganismgenteringgthegbrain,gincludinggbelievinggthatgever
yonegisgplottinggagainstgyoug(delusiongofgpersecution)gorgthatgyougaregGodg(delusiongofggrandeur).gPhys
iciansgobservedgagsurprisinggrecoverygingpatientsgwithggeneralgparesisgwhoghadgcontractedgmalaria,gsogt
heyginjectedgothergpatientsgwithgbloodgfromgagsoldiergwhogwasgillgwithgmalaria.gManygrecoveredgbecau
segtheghighgfeverg“burnedgout”gthegsyphilisgbacteria.gObviously,gthisgtypegofgexperimentgwouldgnotgbeg
ethicallygpossiblegtoday.gUltimately,ginvestigatorsgdiscoveredgthatgpenicillingcuresgsyphilis,gbutgwithgtheg
malariagcure,g“madness”gandgassociatedgsymptomsgforgthegfirstgtimegweregtracedgdirectlygtogagcurablegi
nfection.gManygmentalghealthgprofessionalsgassumedgthatgcomparablegcausesgandgcuresgmightgbegdisco
veredgforgallgpsychologicalgdisorders.g
• JohngP.gGrey:gThegchampiongofgthegbiologicalgtraditiongingthegUS.gGreygheldgthatgthegcausegofginsanityg
weregphysicalgsogmentallygillgpatientsgshouldgbegtreatedgasgphysicallygillgwithgthegtreatmentgincludinggre
st,gdiet,gandgpropergroomgtemperaturegandgventilation.g
➢ DevelopmentgofgbiologicalgTreatments
• Ingtheg1930s,gelectricgshockgandgbraingsurgerygweregoftengused.gTheirgeffects,gandgthegeffectsgofgnewgd
rugs,gweregdiscoveredgbygaccident.g
• ManfredgSakelg–ginsulingshockgtherapy
• JosephgvongMedunag–ginducedgbraingseizuresgmightgcuregschizophrenia
• Duringgtheg1950s,gthegfirstgeffectivegdrugsgforgseveregpsychoticgdisordersgweregdevelopedgingagsystemat
icgway.g
➢ ConsequencesgofgthegBiologicalgTradition
• EmilgKraepeling–
ghegwasginfluentialgingadvocatinggthegmajorgideasgofgthegbiologicalgtradition,gbutghegwasglittleginvolvedgi
ngtreatment.gHisglastinggcontributiongwasgingdiagnosisgandgclassification.g
o THEgPSYCHOLOGICALgTRADITION
o Howgdogthegpsychologicalgapproachesgofgpsychoanalysis,ghumanism,gandgbehaviorismg
explaingabnormalgbehavior?g
➢ Moralgtherapy
• Thegpsychosocialgapproachgingtheg19thgcenturyginvolvedgtreatinggpatientsgasgnormallygasgpossiblegingthe
genvironment
