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Abnormal psyche mid term study notes
Chapter 1
Key Points
- A variety of factors play a part in defining behaviours as abnormal. These include statistical rarity, personal distress, dysfunction, violations of social norms, and diagnosis by an expert.
- The early history of psychopathology reveals a struggle between supernatural and naturalistic explanations, and between harsh and sympathetic treatments.
- After the end of the Middle Ages in Europe, naturalistic approaches took over. By the late 19th century, both biological and psychological treatments based on research evidence became established as the preferred approaches.
- In Canada, the development of asylums in the 19th century marked the first steps in the mental health movement. Gradually, as elsewhere, biological and psychological interventions came to dominate, with Canadians contributing to these developments
Psychological abnormality: Behaviour, speech or thought that impairs a person’s ability to function in a way expected
Mental Illness, Psychological abnormality: implies a medical cause rather than a psychological cause
Psychological Disorder: Manifestation of the impairment of functioning (the abnormality) as described by a set of criteria
The Elements of Abnormality using depression as an example:
Statistical concept: occurs infrequently, how infrequently enough? Geniuses
Personal distress: but sometimes people with mental illness are not distressed, they may distress others
Personal dysfunction: behaviour that is so maladaptive it interferes with appropriate functioning, appropriate function is defined to a great by the context
Violation of norms: norms are contextual, can violate norms and not have a psych disorder– criminals, homosexuality as a disorder because of violation
Elements of abnormality: no one element is sufficient to define or determine abnormality. The definition of deviant changes as society changes.
How we define abnormality is culturally relative.
Clinical psychologists: are initially trained in general psychology and then receive graduate training in the application of this knowledge to the understanding, diagnosis, and amelioration of disorders of thinking and behaviour.
Psychiatrists are trained in medicine prior to doing specialized training in dealing with mental disorders, emphasis on pharmacological agents.
The DSM-5 definition
Historical views of abnormal behaviour
Stone Age trephining involved chipping away a circular section of skull
The Edwin Smith and Ebers papyri indicate that the Egyptians used surgery and prayers. Edward Smith describes brain as site of mental function
Ackernect, E pg 7 quote: the criterion by which a person in any society is judged to be mentally ill is not primarily the presence of certain unvarying and universally occurring symptoms. It depends rather on
Views of Abnormality during the middle ages:
First mental hospital in Baghdad in 792 A.D.–used humane treatment
Mass madness: group behavior disorders. Ex: lycanthropy: people thought they were possessed by wolves
Mass madness occasionally appears in modern times: 1983 Palestinian girls
Witches not all thought to be mentally ill but poor women with bad temper. Some were spiritually possessed
In the Arab world, treatment was humane and environmental and psychological factors were emphasized
The 16th^ century:
Establishment of early asylums
Prisons or storage places with filthy conditions and cruel patient treatment
Paradoxical: the intention was good but it turned out to be bad
Humanitarian reform: brought on moral therapy: France: Philippe Pinel. England: William Tuke. America: Benjamin Rush Dorothy Dix
Philippe Pinel unchained patients, placed them in sunny rooms and treated them with exercise and kindness. This was very successful.
William Tuke established the York Retreat, a country house for the mentally ill. He treated with kindness and acceptance
In 1845, the Country Asylums Act was passed in England. Required every county to provide asylum to “paupers and lunatics”
Benjamin Rush pushed moral management in America (emphasized spiritual and moral development)
From 1841 to 1881, Dorothy Dix lobbied for better treatment for the mentally ill in asylums. The caused the growth of the mental hygiene movement. Suitable hospitals were built
Paracelsus: used earl version of hypnotism to treat mentally ill
Weyers views: reflect a characteristic of renaissance thought—that is the mixture of traditional ideas (possession) theological concerns and original observations which represented a move towards a more scientific and naturalistic attitude about the insane.
The Emergence of Contemporary Views of Abnormal Behavior:
Recent changes: Biological discoveries
Nervous system and genetics (late 1700s into 1800s) pg 15
Development of mental disorders classification system: late 1800s
Krapelin (mental d/o resulted from biological problem, for which at the time there were no treatments for.) published a book called clinical psychiatry, which attempted to classify mental illness. Focused on diagnosis and classification, called groupings of symptoms syndromes. Kraepelin : Compendium der Psychiatrie, published in 1883. Certain symptoms occur together frequently enough to be considered separate mental disorders, features onset and prognosis. Course of each disorder predictable and therefore outcome can be predicted. He believed everything was biological and thus there were no treatments
Emergence of physical causation views
neuroSyphilis (GPI) lead to dementia and paralysis, resulted from untreated infections by the syphilis spirochete.
Emergence of psychological causation views
Late 18th century, messmer (hypnotist)
Somatogenesis: the idea that psychopathology is caused by biological factors
Shock therapy was a treatment method
Sakel: developed insulin coma
Electroconvulsive therapy (ECT) developed by Carletti
In the 1950s pharmacological agents targeting neurotransmitters for the treatment of psychiatric disorders became widely available, the view of this period and what continues to this day is that mental disorders are caused by disordered brain chemistry.
Mesmerism : Diseases treated by “animal magnetism, source of heated discussion in early nineteenth century. All people possessed magnetic forces that could be used to influence the distribution of the magnetic fluid in other people, thus effecting cure. Discredited in Europe, but mesmerism was popular in
Chapter 2 Theoretical perspectives on abnormal behaviour
Chapter 2 - Key Points
- The purpose theories play in science is they integrate most of what is currently known about the phenomena in the simplest way possible. They make testable predictions about aspects of the phenomena that were not previously thought of and they make it possible to specify what evidence would deny the theory. The null hypothesis essentially proposes that the prediction made from the theory is false. When a theory is supported the null hypothesis is rejected.
- Biological theories propose roles in the etiology (causes or origins) of disorders for: damage to the CNS; over or under-active neurotransmitters; too much or too little of one of the hormones; over or under-reaction of the ANS; and the contribution of genetics.
- Freudian theory considers unconscious conflicts to be the basis of psychological disorders. Important concepts are: levels of consciousness, role of the id, ego, and superego, psychosexual stages of development, and defence mechanisms.
- Behavioural theories invoke classical and operant conditioning, or social learning processes, as the causes of abnormal behaviour, which is theorized to result from the same conditioning processes as normal behaviour.
- Cognitive theories indicate that it is the person’s perceptions of events, irrational beliefs, and distorted schemata that generate dysfunction.
- Humanistic and existential theories similarly consider each person’s idiosyncratic perceptions and experiences to be crucial. From these perceptions and experiences, the person develops a sense of self, others, and of meaning to their life. They also generate their choices and develop, or fail to develop, responsibility for their actions.
- Socio-cultural influences include stereotypes of gender, race and poverty, and the effects of an expert labelling a person as disordered.
- Integrative theories see the interaction of biology, social and personal experience, and stress, as causing disorders.
Case studies:
Hailey: major depressive d/o
Biological would say: mom had depression so hailey has depression and psychodynamic would say parent child interaction
Behavioural : some system that she was rewarded or punished for environmental effects and cognitive would say schemas dictate behaviour
Humanistic: it’s the self
Sociocultural would say: the society and culture
Little Hans
Was brought to the attention of Freud, he was so scared of being bitten by a horse that he would NOT leave the house, this may be due to an incidence when the boy and his father were in a street car which was being pulled by horses and became out of control pulling the car uncontrollably for a few miles, and Hans appeared to be frightened and distressed. Freud dismissed the experience with the bolting horses as a cause, considering the fear to have hidden, unconscious origins.
Psychodynamic theorists, like Freud have suggested that behaviour is motivated by unconscious processes acquired during the formative years of life. Regarding the case of hans frued believed that the fear of being bitten by a horse was a symbolic representation of the boys hidden fear of being casturated by his father,
Though behavioural theorists believe that behaviours are learned in responses to environmental stimuli, dictating that Hans is afraid of being bitten by horses now because of his prior experience with the bolting horses that conditioned him into this fear.
Clara Hughes
Why would she suffer from depression
Levels of Theories
Single factor explanation: to state that a genetic defect or a single traumatic experience causes a mental disorder is to accept a single factor explanation, which attempts to trace the origins of a particular disorder to one factor.
Interactionist explanations: view behaviour as the product of the interaction of a variety of factors, generally make more satisfactory theories in describing mental disorders. take into account the biology and behaviour of the individual, as well as cognitive, social, and cultural environment
Testing hypotheses: experiments are NOT set up to prove the worth of a theory but rather to reject (or fail to reject) what is called the null hypothesis. Theories gain strength not just because the evidence supports their predictions, but primarily because alternative explanations are rejected.
The general aims of theories are to explain:
The etiology (causes or origins) of the problem behaviour
Maintenance: identify the factors that maintain the behaviour
Prediction: predict the course of the disorder
Treatments: design effective treatments
Biological Models
Brain plasticity: the incredible capacity of the brain to reorganize its circuitry
The role of the peripheral system:
The peripheral system includes the somatic nervous system, which controls the muscles. As well as the autonomic nervous system (ANS) which has two parts the sympathetic nervous system and the parasympathetic nervous system. These two system work together to produce homeostatic activity in a variety of bodily functions ex heart rate, digestive and eliminatory processes, sexual arousal, breathing etc. however during stressful situations the sympathetic system readies the body for action (fight or flight), at the same time the parasympathetic system shuts down digestive processes to allow all energy to be devoted to the fight or flight response.
Hans seyle = stress physiology
ANS (sympathetic system) is involved in fear and anxiety reactions, thus an overactive ANS may increase readiness to acquire phobias or other anxiety disorders. worry is associated with decreased parasympathetic regulation
Autonomic and somatic inflexibility may be particularly important to generalized anxiety disorder.
The role of the endocrine system:
Aspects of the CNS interact with the endocrine system in a feedback loop that maintains appropriate levels of hormones circulating in the bloodstream. Hormones are chemical messengers that are secreted by various glands. Theses secretions maintain adequate bodily functioning, and play an important role in the development of the organism; they also appear to be involved in the activation of some behaviour.
The relationship of the endocrine glands both to each other and to the CNS is complex. For example in a response to feedback indicating a specific hormone is low, the CNS will activate a CNS structure to release a certain hormone that will in turn activate an endocrine gland and then possibly another endocrine gland in order to regulate the initial imbalance.
Two disorders known to be related to the endocrine gland malfunctioning are Cretinism (dwarfism and mental retardation), and hypoglycemia (pancreas failing to produce balanced levels of insulin or glycogen)
One system that has been studied extensively in regards to depression and anxiety is the hypothalamic- pituitary-adrenal (HPA) axis. The HPA axis is chronically activated in many individuals diagnosed with major depression as well as some with anxiety disorders.
Genetics and behaviour:
Behavioural genetics offers an insight into the biological bases of abnormal functioning, more recent research emphasizes genotype-environment interaction
Behavioural research into the genetic bases of psychiatric disorders typically take one of three forms: family (pedigree studies), twin studies and adoption studies. In these cases there are comparisons made between the index case (person with the disorder) and another family or non-family member. If there is a match between them, the two are said to be concordant or to display concordance for the problem. The degree of concordance is thought to reveal the influence of genetics.
Genetic linkage studies: researchers examine families that have a high incidence of a particular psychiatric disorder. And within these extended families researchers look for the presence of particular traits (genetic markers) that can be linked to the disorder. Genetic markers can include hair or eye colour, colour blindness etc. genetic linkage studies have provided strong evidence of genetic basis for bipolar disorder and schizophrenia.
Psychodynamic theories:
Sigmund Freud was the founder of the psychodynamic school of thought. Psychodynamic theories claim that behaviour is controlled by unconscious forces, of which a person is unaware, see the person as having little control of their actions, however they believe that the origins of the unconscious controls to reside in the individuals personal experience.
Freuds studies on Anna O provided him with the insights he needed to develop his theory. She had paralysis, deafness, and disturbances of vision. During hypnosis she revealed traumatic past experiences, with deep emotional responses. She had repressed them and could not recall them in a wake state. Freud further assumed that these repressed or unconscious memories influence current functioning. In freuds theory four features together determine current behaviour and thinking, both normal and abnormal. The different levels of consciousness determine the accessibility of thoughts and desires. The structures of personality represent the embodiment of the various controlling forces; the stages of psychosexual development indicate the points in experience where problems can arise and defence mechanisms are the means by which people channel their psychic energy in functional or dysfunctional ways.
Levels of consciousness:
Conscious: which contains information of which we are currently aware
The ego uses defence mechanisms to allow the expression of libidinal desires in a distorted or symbolic form. The id hover does its best to break through these defences
Behavioural theories:
Early behaviourists believed that almost if not all behaviour was learned, Watson took the view that classical conditioning as described by Russian physiologist Ivan Pavlov was the basis for learning.
What is learned in classical conditioning then, is the transfer of a response from one stimulus to another, called stimulus- stimulus learning. Watsons famous application of this type of analysis was to the acquisition of phobias, ex little hans.
Two factor theory: developed by Mowrer, suggested that two types of learning take place in the acquisition and maintenance of phobas. 1. Classical conditioning establishes the aversive response to a previously neutral stimulus (the CS) 2. And thereafter, the organism avoids the CS in order to prevent feeling afraid. Avoiding the CS then prevents extinction from occurring. The latter part of Mowrer’s theory is derived from B.F skinners work whom developed operant conditioning. Explains the persistence of phobias, in a way that classical conditioning cannot it adds a negative reinforcement to the process.
Operant conditioning: in this theory consequences of behaviour are important, either reinforcement which is when behaviour increases in frequency as a result of consistent consequences. And punishment occurs when a behaviour decreases in frequency as a result of its consequences. There is positive reinforcement and negative reinforcement as well as positive punishment and negative punishment. “positive” and “negative” are not used to mean good or bad; rather positive refers to the presence of something and negative to the absence of something.
- Changing your thoughts can bring about behavioural and emotional change.
Rational emotive behaviour therapy: developed by Albert Ellis more than 4 decades ago, argued that, when faced with unfavourable life circumstances, human beings tend to make themselves feel frustrated, disappointed and miserable and behave in self-defeating ways, mainly because they construct irrational beliefs about themselves and their situations. Adaptive feelings behaviours stem from rational and functional thoughts.
ABC Model of human disturbance A= activating event B= beliefs C= consequences
Cognitive theory and therapy:
Aaron Beck’s cognitive model states that emotions and behaviours are heavily influences by individual perceptions or cognitive appraisals of events. Three main levels of cognition are emphasized 1. Schemas: internal representations of stored information and experiences. 2. Information processing and intermediate beliefs (if- then statements and inaccurate causal attributions) 3. Automatic thoughts: frequent thoughts that pop into our minds that are not accompanied by conscious appraisal, stem directly from a person’s core beliefs. Early maladaptive schemas : set of core beliefs, which originate from repetitious, aversive experiences in childhood.
Content specificity: different types of beliefs are considered to be related to different kinds of abnormal behaviour.
Cognitive therapy aims to help clients shift from unhealthy appraisals to more realistic and adaptive ones. Treatment is highly collaborative and involves designing specific learning experiences to teach clients how to monitor automatic thoughts, understand the relationships among cognition, affect and behaviour, examine the validity of automatic thoughts, develop more realistic and adaptive cognitions and alter underlying beliefs, assumptions, and schemas.
Humanistic and existential theories:
Considered to be variants on the phenomenological approach to understanding human behaviour. Husserl was the first to clearly formulate this viewpoint. According to this view, it is through experience that people form their sense of themselves and of the world, more specifically the accumulation of perceptions of the world.
The two most eminent advocates of humanistic psychology were Carl Rogers and Abraham Maslow, both emphasized the dignity and potential of humans and saw experience (as perceived by the individual) as providing the basis for improving ones self.
Rogers’ s position has been called a person centered theory of personality because he considered the person to be of central importance in understanding behaviour. He believed that self-fulfillment is achieved through self-acceptance and you have within you all the skills and resources to heal yourself, the farther apart your ideal self and your real self the more psychological disturbance.
The diathesis-stress perspective: a predisposition to developing a disorder (the diathesis) interacting with the experience of stress causes mental disorders. ex the role genetics plays in schizophrenia, mood disorders and alcoholism.
The biopsychosocial model: declares that disorders cannot be understood as resulting from the influence of one factor, biological, psychological and social factors must all be taken into account.
Chapter 3 classification and diagnosis
- The endeavour of diagnosing mental disorders has been criticized for its adherence to the medical model, unfairly stigmatizing an individual, and the information lost through the use of classification labels.
- The DSM, in particular, has been criticized for its gender bias and cultural bias.
- In terms of the DSM, inter-rater reliability refers to the extent to which two clinicians agree on the diagnosis of a particular patient and is an important requirement of any diagnostic system.
- Validity refers to the degree to which a classification system, for example, measures what it purports to measure. The two most important types of validity for diagnostic systems are concurrent validity and predictive validity.
- The DSM-5 is the latest of an ongoing attempt to improve reliability and validity by employing more specific criteria based on empirical findings.
Inter rater reliability: refers to the extent to which two clinicians agree on the diagnosis of a particular patient.
Categories of Disorders in DSM-5:
Sexual d/o and gender dysphoria
