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Abnormal Psychology

Chapter 1: Historical & Modern Perspectives

I.

NORMAL VS. ABNORMAL BEHAVIOR 1. Definition of Abnormal Behavior Abnormal Behavior is behavior that is inconsistent with the individual’s developmental, cultural, and social norms and creates emotional distress or interferes with daily functioning. a. Is Being Different Abnormal? Being different is not the same as being psychologically abnormal. b. Is Behaving Deviantly (Differently) Abnormal? Deviant behaviors differ from prevailing societal standards. Understanding Behavior within a specific context is known as goodness of fit. A behavior can be problematic or not problematic depending on the environment in which it occurs. To understand behavior it is critical to consider the context in which the behavior occurs. Family norms, cultural traditions and practices affect behavior in various ways. Culture refers to shared behavioral patterns and lifestyles differentiating one group of people from another. Culture-bound Syndrome is a term

that originally described abnormal behaviors that were specific to a particular location or group. Age is another context that must be taken into consideration for abnormality. As a child matures physically, mentally, and emotionally, behaviors previously considered developmentally appropriate and normal can become abnormal. Eccentric behavior is not necessarily abnormal behavior. It may violate social norms, but is not always negative or harmful to others. Most people with psychological disorders do not engage in dangerous behavior. c. Is Behaving Dysfunctionally Abnormal? In defining abnormal behavior, it is important to consider if a certain behavior causes distress or dysfunction for the person or others. If a behavior causes occupational and social dysfunctions, the presence of a psychological disorder is considered. d. Defining Abnormal Behavior The definition presented before was based on the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders by American Psychiatric Association [APA, 2013]). This definition is based on diagnosis (labeling a behavior),

symptoms (signs of abnormality), and etiology (causes). Psychological disorders are common in the general population. The most commonly reported disorders in the United States are anxiety and depressive disorders. Women are more likely to suffer from anxiety and mood disorders while men are more likely to suffer from alcohol and drug abuse. Culture influences how symptoms are expressed. Psychological disorders occur most frequently among lower income and lesser educated persons. Developmental trajectory refers to the idea that the common symptoms of a disorder change according to a person’s age. For example, the symptoms of depression may change as a child matures. Different disorders may appear at various ages.

II.

THE HISTORY OF ABNORMAL BEHAVIOR & ITS TREATMENT 1. Ancient Theories Certain behavior has been recognized as abnormal throughout history, which are almost the same today. As far back to the cave man, the practice trephining has been noted, which involved using a circular instrument to cut sections of the skull. It was assumed that opening the skull would allow evil spirits to escape. Ancient Egyptians believed that spirits controlled the environment and person’s behavior. 2. Classical Greek and Roman Periods Ancient Greeks believed that gods controlled abnormal behavior. Hippocrates, considered the father of medicine (440 B.C.) provided both a diagnostic classification system and a model to explain abnormal behavior. He identified common psychological symptoms such as hallucinations (hearing or seeing things not noted by others), delusions (beliefs with no basis in reality), melancholia (severe sadness), and mania (hyper arousal). All these symptoms are recognized today. He also discussed hysteria, now called conversion disorder. This illness was used to describe patients who seemed to be blind and paralyzed with no medical (organic) causes. Hippocrates also

believed in four body humors which include yellow bile, black bile, blood, and phlegm. He related them to different personalities. He suggested removal of patients from their families, good rest, good food, and exercise to deal with their illnesses. Another famous Greek physician was Galen who was an expert in many fields of medicine. 3. The Middle Ages Through the Renaissance After the fall of the Roman Empire, demonology dominated theories of mental illness in Europe. Demons were considered the source of all evil in medieval Europe. According to church officials, negative behavior was the work of the devil or witchcraft, which became an important theory to explain abnormal behavior. People were accused of witchcraft and put to death, the majority being women. The Renaissance brought new attitudes towards science. Witches were also executed in the USA during the 17th century. Nevertheless, belief in the supernatural and paranormal still exists in today’s world. Mass hysteria was also noted during the Middle Ages. Tarantism (bite of tarantula) would cause death and lycanthropy (belief that a person was possessed by a wolf) were types of mass madness. Mass hysteria might be caused by emotional contagion which was automatic mimicry of other persons’

emotions and expressions. The Renaissance period (14th – 17th centuries) enlightened the treatment of mental illness in Europe. In the 16th century, mentally ill people were placed in asylums, which were referred to as “madhouses”. Treatment consisted of confinement, torture, and other “medical” treatments. 4. The 19th Century & the Beginning of Modern Thought During the late 18th century, the French physician Philippe Pinel and William Tuke in England radically changed the approach to treatment of mental illness. Pinel believed mental illness was curable. He removed the chains from patients and created daytime activities for them. Moral treatment of patients included kindness and occupation. Moral treatment in USA is commonly associated with Benjamin Rush and Dorothea Dix. During the late 17th century in Europe, the German physician Franz Anton Mesmer proposed that the body was a magnet and using the physician’s body as a second magnet could cure the mental illness. He believed a substance called animal magnetism existed in the body. The German psychiatrist Emil Kraeplin in the 19th century provided the first classification of mental illness and provided the somatogenic view of mental illness, believing that all mental illnesses had a physical (organic or biological) cause.

Another physician interested in the brain was Jean-Martin Charcot who established a school of neurology in Paris. He was interested in hysteria. The Nancy School in France established that hysteria was a form of self-hypnosis. The Viennese physician, Josef Breuer studied the effects of hypnotism and used it to treat patients with hysteria. One of his patients, known as Anna O. developed physical problems and under hypnosis, while discussing her problems, her symptoms disappeared. Breuer called his treatment the talking cure, a new approach to the treatment of mental illness. 5. The Twentieth Century Two psychological models of abnormal behavior dominated the early part of the 20th century. They were the psychoanalytic theory and behaviorism. a. Psychoanalysis Sigmund Freud (1856-1939) introduced psychoanalysis and presented the psychogenic view of mental illness. He first practiced hypnosis with Joseph Breuer in Vienna, Austria, but gave up the practice and introduced psychoanalysis, a comprehensive theory that attempts to explain both normal and abnormal behavior. i. In psychoanalytic theory, the mind consists of three regions: the id, ego and superego.

1. Basic instinctual drives and the source of psychic energy called libido is located in the id, which is totally unconscious and seeks pleasure via the pleasure principle. 2. The ego develops when the id comes in contact with reality. Ego copes with reality and follows the reality principle. 3. Superego is the third region of the mind. It places moral restraints on id's impulses (particularly sexual and aggressive ones). When moral rules are violated, the superego punishes with feelings of guilt. These three intrapsychic forces are always competing, causing conflict and anxiety, creating a psychodynamic system. Freud also forwarded defense mechanisms, ways of dealing with anxiety and conflict. Stages Psychosexual Development- According to this theory, each person passes through these stages between infancy and five years of age. Coping with each stage has important effects on psychological development.

i.

The oral stage (oral phase) occurs during the first 1.5 years of life. The mouth becomes the center of gratification and pleasure.

ii.

The anal stage (anal phase) from 1.5 to 3 years emphasizes toilet training and involves discipline and control issues.

iii.

During the phallic stage (phallic phase), psychosexual energy centers on the genital area and the child gets pleasure by touching or rubbing the genitals.

iv.

The latency stage from six to twelve years is the period of socialization for the child.

v.

The genital stage (from 12 to 18) prepares the adolescent for mature adult sexuality. Anxiety and depression are caused by negative experiences.

Depending on the age at which the experience occurs, a person can become fixated at a stage of psychosexual development. According to Freud, the goal of psychoanalysis was to "make conscious what is unconscious". This was called insight. b. Behaviorism In 1904, Ivan Pavlov presented classical conditioning in dogs. He placed food powder in the dog's mouth (unconditioned stimulus) which brought about saliva (unconditioned response). He then paired light with food

and, gradually, light, which was a neutral stimulus, gained the properties of food and when presented alone caused saliva. The light was then called conditioned stimulus and saliva given to it conditioned response. i.

In 1908, John B. Watson stated that only observable behavior and not inner thoughts or feelings was appropriate in psychology. This view, known as behaviorism, considered all behavior as a result of learning.

ii.

In 1920 he published the case of "little Albert" which showed that emotional responses such as fear could be learned through classical conditioning. He paired a white rat (neutral stimulus) with loud noise (unconditioned stimulus) and after few trials, showing the white rat (which now became conditioned stimulus) brought about fear, which was now conditioned response. This fear was also generalized to other white objects.

iii.

Mary Cover Jones used counter-conditioning to eliminate fear brought about by conditioning. Today we know that many fears and phobias (irrational fears) are learned through conditioning.

III. CURRENT VIEWS OF ABNORMAL BEHAVIOR & TREATMENT A model is used to describe something that cannot be observed directly, e.g. a pump to illustrate the function of a heart. No true model for abnormal behavior is available. An eclectic model using a variety of perspectives is employed by an eclectic psychologist to describe, explain, predict, and control abnormal behavior. i.

The Biological Models These models state that abnormal behavior results from biological processes of the body, particularly the brain. Mental illness and disorders are correlated with brain dysfunctions and can be treated with medication and/or other bio-medical techniques. a. The Human Brain i. The human brain is a very complex organ. About 100 billion neurons (nerve cells that transmit messages) make up the brain. Synapses are spaces between neurons. Neurons communicate when neurotransmitters (chemical substances) are released into the synapse. The neuron sends electrical impulses down the axon, releasing neurotransmitters into the next synapse and the process continues.

ii. Neurotransmitter activity is the basis for brain activity (thinking, feeling, and motor activity) and is related to many physical and mental disorders. Imaging tests such as the CAT scan and MRI examine the structure of the brain to study the abnormalities. iii. In the 19th century, Sir Francis Galton worked on behavioral genetics. This field has explored the role of both genes and environment in transmission of behavioral traits. Based on animal models that have found links between early vital infection and later behavioral changes, some researchers have proposed a viral infection theory. During prenatal period or shortly after birth, viral infections might cause brain abnormalities and later lead to behavioral abnormalities. ii.

Psychological Models As stated, the biological model seeks the causes of abnormal behavior in the workings of the brain or body. Psychological approaches emphasize how environmental factors, such as family and cultural factors, may influence the development and maintenance of abnormal behavior. a. Modern Psychoanalytic Models

i. Modern psychoanalysts believe that personality patterns begin to form in childhood. Freud's ideas have influenced many theorists. Contemporary models of psychoanalysis such as ego psychology focus on conscious motivations and emphasize ego autonomy. b. Behavioral Models i. Learning theory stresses the importance of external events in the onset of abnormal behavior. According to this theory, abnormal behavior is the result of maladaptive learning experiences. They state that biology interacts with the environment to influence behavior. Behaviorists focus on observable and measurable behavior. They feel significant experiences can occur at any point in life. ii. A behavior is repeated if it is rewarded. This is the work of Skinner in operant conditioning. Whereas reinforcement (reward) increases the frequency of a behavior, punishment has the opposite effect. It decreases or eliminates a behavior. iii. Albert Bandura proposed another type of learning, which he called modeling. Learning occurs when a person watches a model’s behavior. For example,

children learn aggression by watching aggressive models. c. The Cognitive Model i. The cognitive model proposes that abnormal behavior results from distorted cognitive processes, not internal forces or external events. Cognition includes thinking, reasoning and problem-solving. The way we perceive or think about a situation or an event affects our emotions and behavior. d. The Humanistic Model i. Humanists believe that people are basically good and motivated to self-actualize (reach their highest potentials). Abnormal behavior occurs when the person fails to reach self-actualization. iii.

Sociocultural Models Followers of this model study how psychological disorders may express themselves differently in different cultures. They also state that abnormal behavior must be understood within the context of social and cultural forces such as gender roles, social class, etc. Thus, behavior that is considered abnormal in one culture might be called normal in another.

iv.

The Biopsychosocial Model

Currently most mental health professionals accept the biopsychosocial model of mental illness. The model states that biological, psychological and social factors are closely related in causing abnormal behavior. In other words, the combination of biological or psychological pre disposition (diathesis) and the presence of environmental stress creates psychological disorders. The diathesis-stress model integrates biological and psychological and sociocultural systems to provide explanations for human behavior....