Chapter 1 - Abnormal Behavior in Historical Context

Question 1

Psychological Disorder

Answer 1

Psychological dysfunction within an individual associated with distress or impairment in functioning and a response that is not typical or culturally expected.

Question 2

Phobia

Answer 2

A psychological disorder characterized by marked and persistent fear of an object or situation.

[Example: blood-injection - injury phobia]

Question 3

Abnormal Behavior [aka Psychological Disorder]

Answer 3

Three criteria:
1. Psychological Dysfunction
2. Distress or Impairment
3. Atypical or not culturally expected response

Question 4

Psychological Dysfunction

Answer 4

Breakdown in cognitive, emotional, or behavioral functioning.

[EXAMPLE: If you are out on a date, it should be fun. But if you experience severe fear all evening and just want to go home, even though there is nothing to be afraid of, and the severe fear happens on every date, your emotions are not functioning properly.]

PROBLEM: Knowing where to draw the line between normal and abnormal dysfunction is often difficult. Often leading to these problems being considered as a continuum or dimension rather than categories that are either present or absent.

Therefore, having a dysfunction is not enough to meet the criteria for a psychological disorder.

Question 5

Distress or Impairment

Answer 5

Distress is considered a very much important aspect of life and not likely to change. However, in cases of someone with a manic episode suffering and distress are absent.

Impairment is a case of someone who may so shy that it is nearly impossible to date or interact with people causing their social functioning to be impaired.

Question 6

Atypical or Not Culturally Expected

Answer 6

At times, something is considered abnormal because it occurs infrequently; deviating from the average. The greater the deviation, the more abnormal it is.

Question 7

Social Standard of Normal

Answer 7

Has been misused, for example, the practice of committing political dissidents to mental health institutions because they protest the policies of their government, which was common in Iraq before the fall of Saddam Hussein and now is occurring in Iraq. Although such dissident behavior clearly violated social norms, it should not alone be cause for commitment.

Question 8

Harmful Dysfunction

Answer 8

A related concept that is also useful to determine whether the behavior is out of the individual’s control (something that the person doesn’t want to do)

Variants of this approach are most often used in current diagnostic practice, as outlined in the 5th edition of the Diagnostic and Statistical Manual, which contains the current listing of criteria for psychological disorders.

Question 9

Most Widely Accepted Definition of Psychological Disorders

Answer 9

The Diagnostic and Statistical Manual of Mental Disorders describes behavioral, psychological, or biological dysfunctions that are unexpected in their cultural context and associated with present distress and impairment in functioning or increased risk of suffering, death, pain, or impairment.

Definition can be used across cultures and subcultures if we pay attention to what is functional or dysfunctional (or out of control) in a given society.

Question 10

Psychopathology

Answer 10

The scientific study of psychological disorders.

Within the field are specifically trained professionals including; clinical and counseling psychologists, psychiatrists, psychiatric social workers, and psychiatric nurses, as well as marriage and family therapists and mental health counselors.

Question 11

Clinical and Counseling Psychologists

Answer 11

Receive the Ph.D., doctor of philosophy degree (or sometimes an Ed.D., doctor of education, or Psy.D., doctor of psychology) and follow a course of graduate-level study lasting approximately 5 years, which prepares them to conduct research into the causes and treatment of psychological disorders and to diagnose, assess, and treat these disorders.

Question 12

Difference between Ph.D. and Psy.D.

Answer 12

Psy.D focuses on clinical training and de-emphasizes or eliminates research training.
Ph.D integrates clinical and research training.

Question 13

Psychiatrists

Answer 13

Earn an M.D. degree in medical school and then specialize in psychiatry during residency training for about 3 to 4 years.
They investigate the nature and causes of psychological disorders from a biological point of view, making diagnoses and offering treatment. (most often prescribed drugs or other biological treatments)

Question 14

Psychiatric Social Workers

Answer 14

Earn a master’s degree in social work as they develop expertise in collecting information relevant to the social and family situation of the individual with a psychological disorder. Most often treat the disorder, often concentrating on family problems associated with them.

Question 15

Psychiatric Nurses

Answer 15

Have advanced degrees, such as a master’s or even a Ph.D., and specialize in the care and treatment of patients with psychological disorders, usually in hospitals as part of a treatment team.

Question 16

Marriage and Family Therapists and
Mental Health Counselors

Answer 16

Spend about 1 to 2 years earning a master’s degree and employed to provide clinical services by hospitals or clinics, usually under the supervision of a doctoral-level clinician.

Question 17

Scientist-Practitioners

Answer 17

The scientific approach that many health professionals take in their clinical work.

Question 18

Mental Health Practitioners function as scientist-practitioners in three ways:

Answer 18

1. Keeping up with the latest scientific developments in their field using the most current diagnostic and treatment procedures
2. Evaluate their assessments or treatment procedures to determine whether they work. [Being accountable not only to their patients but also to the government agencies and insurance companies paying for the treatments, so they must demonstrate whether their treatments are effective.]
3. May conduct research in clinics or hospitals that produce new information about disorders or their treatment, becoming immune to the fads that plague our field, often at the expense of patients and their family.

Question 19

Presenting Problem

Answer 19

The patient “presents” with a specific problem or set of problems. [Presents is a traditional shorthand way of indicating why the person came to the clinic.

Question 20

Clinical Description

Answer 20

Represent the unique combination of behaviors, thoughts, and feelings that make up a specific disorder..

Specifying what makes the disorder different from normal behavior or from other disorders.(statistical data may also be relevant)

Question 21

Prevalence

Answer 21

For example, how many people in the population as a whole have the disorder? The figure would be the prevalence of the disorder.

Question 22

Incidence

Answer 22

For example, statistics on how many new cases occur during a given period, such as a year, represent the incidence of the disorder.

Question 23

Sex Ratio

Answer 23

What percentage of males and females have the disorder?

Question 24

Typical age of onset

Answer 24

Which often differs from one disorder to another

Question 25

Types of courses

Answer 25

1. Chronic course - Some disorders, such as schizophrenia, tend to last a long time, sometimes a lifetime. 2. Episodic course - Some disorders, like mood disorders, are likely to recover within a few months, only to suffer a reoccurrence of the disorder at a later time. [ a pattern that may repeat itself throughout a person's life.] 3. Time-limited course - The disorder will improve without treatment or in a relatively short period with little or no risk of reoccurrence.

Question 26

Differences in onset

Answer 26

a.) Acute onset - They begin suddenly b.) Insidious onset - They develop gradually over an extended period.

Question 27

Prognosis

Answer 27

The anticipated course of a disorder. "Prognosis is good," meaning the individual will probably recover. "Progonis is guarded," meaning the probable outcome doesn't look good.

Question 28

Patients age (an important aspect of clinical description)

Answer 28

Specific psychological disorders in childhood may present differently from those in adulthood or old age. Example: Children experiencing anxiety or panic attacks often assume that they are physically ill because they have difficulty understanding that there is nothing physically wrong. This often leads to misdiagnosis in children and they end up getting treated for a medical disorder.

Question 29

Different Studies

Answer 29

a.) Developmental Psychology b.) Developmental Psychopathology c.) Life-span developmental psychopathology

Question 30

Developmental Psychology

Answer 30

Study in changes of behavior over time

Question 31

Developmental Psychopathology

Answer 31

Study of changes in abnormal behavior

Question 32

Life-span Developmental Psychopathology

Answer 32

Study of abnormal behavior across the entire age span

Question 33

Etiology

Answer 33

The study of origins having to do with why a disorder begins (what causes it) and includes biological, psychological, and social dimensions

Question 34

Treatment

Answer 34

If a new drug or psychological treatment is successful in treating the disorder, it may give us some insight into the nature of the disorder and its causes. Example: A drug with a known specific effect within the nervous system alleviates a certain disorder, we know that something in part of the nervous system might either be causing the disorder or helping maintain it.

Question 35

Historical Conceptions of Abnormal Behavior

Answer 35

For thousands of years, humans have always tried to explain and control problematic behavior.However, our efforts always derived from the theories or models of behavior popular at the time.

Question 36

Three major models that have guided us back to the beginning of civilization

Answer 36

1. Supernatural model 2. Biological model 3. Psychological model

Question 37

Supernatural model

Answer 37

The model is that supposed agents outside our bodies and environment influence our behavior. These agents might be divinities, demons, spirits, or other phenomena such as magnetic fields, the moon, or stars.

Question 38

Soul or the Psyche

Answer 38

Referred to the mind being separate from the body since the era of ancient Greece

Question 39

Biological model & Psychological model

Answer 39

Thought that the mind can influence the body and, in turn, the body can influence the mind. Most philosophers looked for causes of abnormal behavior in one or the other. This spilt gave rise to the two traditions of thought of abnormal behavior as either being biological or psychological.

Question 40

Supernatural Tradition

Answer 40

For much of recorded history, deviant behavior has been considered a reflection of the battle of good and evil.

Question 41

Demons and Witches

Answer 41

During the last quarter of the 14th century, the Catholic church split into two with another center in South France competing with the Catholic church of Rome. In reaction to this split, the Roman Church fought hard against evil in the world. People increasingly turned to magic and sorcery to solve their problems. During these times, the bizarre behavior of people afflicted with psychological disorders was seen as the work of the devil and witches.

Question 42

Treatments during the last quarter of the 14th century

Answer 42

a.) Exorcisms - various religious rituals were performed in an effort to rid the victim of evil spirits. b.) Shaving the pattern of a cross in the hair of the victim's head c.) securing sufferers to a wall near the front of a church so that they might benefit from hearing Mass. ***Led to the witch trials of the late 17th century, which resulted in 20 women being hung to death***

Question 43

Stress and Melancholy

Answer 43

During the 14th and 15th century there was an enlightened view that insanity was a natural phenomenon caused by mental and emotional stress and that it was curable. Mental depression and anxiety ware recognized as illnesses, however the symptoms were identified by churches with the sin of acedia or sloth.

Question 44

Odd treatments for possession

Answer 44

a.) Hanging people over a pit full of poisonous snakes b.) The hypothesized therapeutic element of shock c.) Hydrotherapy where patients were had applications of ice cold water

Question 45

Mass Hysteria

Answer 45

Fascinating Phenomenon characterized by large-scale outbreaks of bizarre behavior. *Puzzled historians and mental health practitioners were leading support to the notion of possession by the devil during the Middle Ages.*

Question 46

Examples of Mass Hysteria

Answer 46

a.) Saint Vitus's Dance (aka tarantism) in Europe whole groups of people simultaneously compelled to run, dance, shout, rave, and jump around in patterns all through the streets. Two attempted reasons were; possession or reaction to insect bites b.) Local school reported 17 students and 4 teachers having dizziness, headaches, nausea, and stomach pain for no apparent reason that all stemmed from one student reporting a smell and crying in pain.

Question 47

Emotion Contagion

Answer 47

The experience of an emotion seems to spread to those around creating a mass hysteria. If someone nearby becomes frightened or sad, chances are that, for the moment, you also will feel fear or sadness.

Question 48

Mob Psychology

Answer 48

When emotion contagion escalates into full blown panic attacks affecting the whole community. When emotions are in a high state and one person identifies a "cause' for the problem, others will probably assume that their own reactions have the same source.

Question 49

The Moon and Stars

Answer 49

Swiss Physician Paracelsus suggested that the moon and stars' movements profoundly affected people's psychological functioning. Speculating that the moon's gravitational effect on bodily fluids might be a possible cause of mental disorders. ***Inspiring the word "lunatic," which is derived from the Latin word luna meaning "moon"*** Belief is still followed by astrologers, however, there has been no serious evidence confirming a connection.

Question 50

Humoral Theory of Disorders

Answer 50

Created by the Greek physician Hippocrates and Roman physician Galen (Hippocratic-Galenic approach) Normal brain functioning related to four bodily fluids or humors: a.) Blood - Heart c.) Yellow bile (or choler) - Liver b.) Black bile - Spleen d.) Phlegm - Brain The first example of associating psychological disorders with a "chemical imbalance."

Question 51

Four Basic Qualities related to the four humors

Answer 51

1. Heat 2. Dryness 3. Moisture 4. Cold Excess of one or more humors was treated by regulating the environment to increase or decrease heat, dryness, moisture, or cold depending on which humor was out of balance.

Question 52

Two additional treatments during King Charles VI's reign

Answer 52

a.) Bleeding or bloodletting - carefully measure the amount of blood that was removed from the body often with leeches. b.) Induced vomiting - 1621, Anatomy of Melancholy, Robert Burton recommended eating tobacco and a half-boiled cabbage to induce vomiting.

Question 53

Chinese Yin and Yang

Answer 53

It focused on the movement of air or "wind" throughout the body and that unexplained mental disorders were caused by blockages of wind or the presence of cold, dark wind (yin) as opposed to warm, life-sustaining wind (yang). Treatment involved restoring the proper flow of wind through various methods, including acupuncture.

Question 54

Psychosocial Treatment

Answer 54

Approaches the causation of psychopathology, which focuses on psychological, social, and cultural factors.

Question 55

Moral Therapy

Answer 55

The term moral refers to more emotional or psychological factors rather than to a code of conduct. Treated institutionalized patients as normally as possible in a setting that encouraged and reinforced normal social interaction providing them with many opportunities for appropriate social and interpersonal contact. ***Horace Mann at Worcester State Hospital treated 100 patients who were assaultive before treatment, and no more than 12 continued to be violent a year after beginning treatment***

Question 56

Mental Hygiene Movement

Answer 56

Schoolteacher Dorothea Dix was aware of the deplorable conditions imposed on patients with insanity, and made it her life's work to inform the American public and their leaders of the abuse.

Question 57

Psychoanalysis

Answer 57

Based on Sigmond Freud's elaborate theory of the structure of the mind and the role of unconscious processes in determining behavior.

Question 58

Behaviorism

Answer 58

John B. Watson, Ivan Pavlov, and B. F. Skinner focused on how learning and adaptation affect the development of psychopathology.

Question 59

Unconscious

Answer 59

Discovered by Josef Breuer and Sigmund Freud and its apparent influence on the production of psychological disorders.

Question 60

Catharsis

Answer 60

Recalling and reliving emotional trauma that has been made unconscious and releasing the accompanying tension.

Question 61

Insight

Answer 61

The relationship between current emotions and earlier events

Question 62

Psychoanalytic Model

Answer 62

Three Major Facets: 1. The structure of the mind and the distinct functions of personality that sometimes clash with one another 2. The defense mechanisms with which the mind defends itself from these clashes or conflicts 3. The stages of early psychosexual development provide a grist for the mill of our inner conflicts.

Question 63

Structure of the Mind 3 Major Parts (or functions)

Answer 63

1. the id 2. the ego 3. the superego

Question 64

id

Answer 64

The source of our strong sexual and aggressive feelings or energies.

Question 65

Libido

Answer 65

The energy or drive within the id (drives toward life and fulfillment)

Question 66

Thanatos

Answer 66

A less important source of energy (death instinct drives toward death and destruction)

Question 67

Pleasure Principle

Answer 67

Id operates according to this principle with an overriding goal of maximizing pleasure and eliminating any associated tension or conflicts.

Question 68

Primary Focus

Answer 68

Id's characteristical way of processing information is emotional, irrational, illogical, filled with fantasies, and preoccupied with sex, aggression, selfishness, and envy.

Question 69

Ego

Answer 69

The part of the mind that ensures that we act realistically

Question 70

Reality Principle

Answer 70

The ego operates according to this principle, which are characterized by logic and reason.

Question 71

Secondary Process

Answer 71

The cognitive operations or thinking styles of the ego

Question 72

Superego

Answer 72

The third important structure of th*e mind that represents your conscience *Purpose it to counteract the potentially dangerous aggressive and sexual drives of the id. *And mediate conflict between the id and the superego

Question 73

Moral Principles

Answer 73

The superego operates according to this principle that has been instilled in us by our parents and our culture.

Question 74

Intrapsychic Conflicts

Answer 74

Conflicts with the mind between the id and ego. a.) If mediates are successful, we can go on to the higher intellectuals and pursuits in life. b.) If unsuccessful, and the id or the ego becomes too strong, conflict will overtake us, and psychological disorders will develop.

Question 75

Defense Mechanism

Answer 75

Unconscious protection processes that keep primitive emotions associated with conflicts in check so that the ego can continue its coordinating function signaled by anxiety.

Question 76

Examples of defense mechanisms:

Answer 76

1. Denial 2. Displacement 3. Projection 4. Rationalization 5. Reaction Formation 6. Repression 7. Sublimination

Question 77

Denial

Answer 77

Refuses to acknowledge some aspect of objective reality or subjective experience that is apparent to others.

Question 78

Displacement

Answer 78

Transfers a feeling about, or a response to, an object that causes discomfort onto another, usually less threatening, object or person.

Question 79

Projection

Answer 79

Falsely attributes own unacceptable feelings, impulses, or thoughts to another individual or object.

Question 80

Rationalization

Answer 80

Conceals the true motivations for actions, thoughts, or feelings through elaborate reassuring or self-serving but incorrect explanations

Question 81

Reaction Formation

Answer 81

Substitute behavior, thoughts, or feelings that are the direct opposite of unacceptable ones

Question 82

Repression

Answer 82

Blocks disturbing wishes, thoughts, or experiences from the conscious awareness

Question 83

Sublimination

Answer 83

Directs potentially maladaptive feelings or impulses into socially acceptable behavior

Question 84

Psychosexual stages of development

Answer 84

Freud's theory is that during infancy and early childhood, we pass through a number of stages that have a profound, lasting impact. 1. Oral 2. Phallic 3. Latency 4. Genital Freud hypothesized that if we did not receive appropriate gratification during a specific stage or if a specific stage left a particularly strong impression (fixation), an individual's personality would reflect the stage throughout adult life.

Question 85

Castration Anxiety

Answer 85

The phenomenon is that intense fears developed by a father may punish a little boy's lust for their mother by removing the son's penis.

Question 86

Neuroses

Answer 86

Term Freud had used to label neurotic disorders that referred to disorders of the nervous system. ***Term previously used as the psychoanalytical view of the causes of psychological disorders had been dropped from the DSM in 1980***

Question 87

Ego Psychology

Answer 87

It was developed by Freud's daughter, Anna Freud. The theory is that an individual slowly accumulates adaptional capacities, skills in reality testing, and defenses. Abnormal behavior develops when the ego is deficient in regulating such functions as delaying and controlling impulses or in marshaling appropriate normal defenses to strong internal conflicts. ***Defense reactions of the ego determines our behavior***

Question 88

Self-psychology

Answer 88

Developed by Heinz Kohut on the formation of self-concept and the progress toward health, or conversely, the development of neurosis.

Question 89

Object Relations

Answer 89

The study of how children incorporate the images, the memories, and sometimes the values of a person who was important to them and to whom they were (or are) emotionally attached.

Question 90

Object

Answer 90

Refers to these important people

Question 91

Introjection

Answer 91

The process of incorporation Introjected objects can become an integrated part of the ego or may assume conflicting roles in determining the identity or self.

Question 92

Collective Unconcious

Answer 92

Developed by Freud's student Carl Jung. A theory in which wisdom accumulated by society and culture is stored deep in individual memories and passed down from generation to generation. Emphasizing: a.) Spiritual and religious drives are much a part of human nature as sexual drives b.) Importance of enduring personality traits such as introversion (the tendency to be shy and withdrawn) and extroversion (the tendency to be friendly and outgoing)

Question 93

Inferiority Complex

Answer 93

Developed by Freud's student Alfred Adler. Focused on feelings of inferiority and the striving for superiority.

Question 94

Free Association

Answer 94

Developed by Freud, in which patients were instructed to say whatever comes to mind without the usual socially required censoring. (intended to be emotionally charged material that may be repressed because it is too painful or threatening to bring into consciousness.)

Question 95

Dream Analysis

Answer 95

Therapists interpret the content of dreams, supposedly reflecting the primary-process thinking of the id, and systematically relate the dreams to symbolic aspects of unconscious conflicts.

Question 96

Transference

Answer 96

A phenomenon where the patient comes to relate to the therapist much as they did to important figures in their childhood, particularly their parents.

Question 97

Countertransference

Answer 97

Therapists project some of their own personal issues and feelings, usually positive, onto the patient.

Question 98

Psychodynamic Psychotherapy

Answer 98

Conflicts and unconscious processes are emphasized. Efforts are made to identify trauma and active defense mechanisms; however, therapists use an eclectic mixture of tactics with a social and interpersonal focus.

Question 99

Therapeutic Alliance

Answer 99

The relationship of the therapist and the patient.

Question 100

Humanistic Psychology

Answer 100

The philosophies of Carl Jung and Alfred Adler emphasized the positive, optimistic side of human nature adopted by personality theorists.

Question 101

Self-actualizing

Answer 101

The assumption is that all of us could reach our highest potential in all areas of functioning if only we had the freedom to grow.

Question 102

Person-centered therapy (Client-centered therapy)

Answer 102

The therapist takes a passive role, making as few interpretations as possible.

Question 103

Unconditional postive regard

Answer 103

The complete and almost unqualified acceptance of most of the client's feelings and actions

Question 104

Behavioral Model

Answer 104

Also known as: Cognitive-behavioral model OR Social learning model Brought the systematic development of more scientific approach to psychological aspects of psychopathology

Question 105

Classical Conditioning

Answer 105

A type of learning in which a neutral stimulus is paired with a response until it elicits that response.

Question 106

Extinction

Answer 106

Presentation of a Conditioned Stimulus (CS) like chemotherapy without the Unconditional Stimulus (UCS), like the nurse or medical equipment for a long period of time would eventually eliminate the Conditioned Response (CR) like nausea and vomiting.

Question 107

Introspection

Answer 107

A study developed by Edward Titchener in which subjects simply reported on their inner thoughts and feelings after experiencing certain stimuli.

Question 108

Systematic Desensitization (Behavior Therapy)

Answer 108

Individuals were gradually introduced to the objects or situations they feared so that their fear could be extinguished; that is they could test reality and see that nothing bad happened in the presence of the phobic object or scene.

Question 109

Reinforcement (B.F. Skinner)

Answer 109

"Reward" connotes the effect of the behavior.

Question 110

Shaping (B.F. Skinner)

Answer 110

A process of reinforcing successive approximation to a final behavior or set of behaviors