Abnormal Behavior in Historical Context

The following are common myths about 2. Distress or Impairment

those suffering from mental illness:  Impairment means that you are not
able to function properly as human
 Easily recognized as deviant being because of the symptoms
 Disorder due to inheritance  If the symptoms/ situation extremely
 Incurable upsets a person, this criterion is
 Weak willed satisfied.
 Never contribute to society  But remember, by itself this criterion
 Always dangerous does not define abnormal behavior.
Understanding Psychopathology It is often quite normal to be
Psychological Disorder distressed— for example, if
-a psychological dysfunction within an someone close to you dies.
individual associated with distress or  The human condition is such that
impairment in functioning and a response suffering and distress are very much
that is not typical or culturally expected. part of life. This is not likely to
Criteria for Abnormality change.
Psychological Dysfunction 3. Deviant or Atypical
-the behavior interferes with the person's -At times, something is considered
ability to function. abnormal because it occurs infrequently; it
Distress or Impairment deviates from the average.
-the behavior is troubling in the individual  How about eccentrics?
Deviant or Atypical  How about “Artists”?
-the behavior is significantly different from  Political Dissidents?
what society deems acceptable. 4. Danger
Dangerous -the symptoms bring danger to the person
-the behavior may cause threat or other people, then that is a a sign of
1. Psychological Dysfunction psychological disorder.
-breakdown in cognitive, emotional, or The 4Ds of diagnosis
behavioral functioning. Deviance Rare within society,
Abnormal behavior, therefore, has the different from
capacity to make well-being difficult to norms.
obtain and can be assessed by looking at Dysfunction Significantly
an individual’s current performance and interferes with a
comparing it to what is expected in general person’s life
or how the person has performed in the Distress How much upset
past. does it cause.
1. Psychological Dysfunction- breakdown Danger Either to
in cognitive, emotional, or behavioral themselves or to
functioning. other people.
 Being happy in situations that Science of Psychopathology
should not be a cause for the scientific study of mental disorders,
happiness. including their symptoms, causes, and
 Being sad for no reason in effects. It involves understanding abnormal
particular. behavior patterns, emotional disturbances,
 Being afraid of things that are and cognitive dysfunctions that can lead to
relatively harmless. psychological disorders.
Pathology from “pathos”= suffering and ACUTE ONSET: they begin suddenly
“logos” = study INSIDIOUS ONSET: develop gradually over
Science of Psychopathology an extended period.
 Psychiatrists first earn an M.D. Prognosis -a forecast of the likely course
degree in medical school and then of a disease or ailment.
specialize in psychiatry during ETIOLOGY- the study of origins, has to do
residency training that lasts 3 to 4 with why a disorder begins (what causes it)
years. and includes biological, psychological, and
 Psychologist- with a Master's in social dimensions.
Clinical Psychology and having Historical Conceptions of Abnormal
passed the board exam, you can Behavior
practice as a licensed psychologist in Supernatural Tradition
the Philippines. A Ph.D. is optional  12th- 17th Century - Medieval Ages
and typically pursued for academic  deviant behavior has been
or advanced clinical practice considered a reflection of the battle
purposes. between good and evil.
Phase 1-Presenting Problem Demons and Witches
-specific problem or set of problems, why During the last quarter of the 14th century,
the person came to the clinic. religious and lay authorities supported
Ex. I have a trouble sleeping. these popular superstitions and society as a
Clinical Description whole began to believe more strongly in the
-Represents the unique combination of existence and power of demons and
behaviors, thoughts, and feelings that witches.
make up a specific disorder.  EXORCISM
Incidence  TORTURE
How many new cases occur during a given  EXECUTION
period, (such as year), represent the Biological Tradition
incidence of the disorder. Physical causes of mental disorders have
Prevalence been sought since early in history.
How many people in the population as a Hippocrates and Galen
whole have the disorder? They suggested that psychological disorders
Course could be treated like any other disease.
the development of the disease in a They
patient, including the sequence and speed did not limit their search for the causes of
of the stages and forms they take. psychopathology to the general area of
1. Chronic course: “disease,” because they believed that
tend to last a long time or sometimes psychological disorders might also be
lifetime. (Ex. Schizophrenia) caused
2. Episodic course: by brain pathology or head trauma and
likely to recover within a few months only could be influenced by heredity (genetics).
to suffer a recurrence of the disorder at a Humoral Theory
later time. (Mood Disorder) Hippocrates assumed that normal brain
3. Time-limited course: functioning was related to four bodily fluids
the disorder will improve without or humors: blood, black bile, yellow bile,
treatment in a relatively short period. and phlegm.
Onset -beginning of a disorder Blood = Sanguine (Too energetic)
-how the disorder develops Phlegm= Phlegmatic (Cold/dry personality)
Yellow = Choleric (Quick toAnger)
Black = Melancholic (low mood/sadness)
Syphilis-a sexually transmitted disease Abnormal Behavior in Historical
caused by a bacterial microorganism Context
entering the brain, include believing that Three Major Models-that have guided us
everyone is plotting against you (delusion of date back to the beginnings of
perse cution) or that you are God (delusion civilization.
of grandeur), as well as other bizarre Supernatural Model
behaviors. Supernatural Model
John P. Grey Psychological Model
Grey’s position was that the causes of Psychological Tradition
insanity were always physical. Focus not only on psychological factors but
Therefore, the mentally ill patient should be also on social and cultural ones as well.
treated as physically ill. Plato thought that the two causes of
Insulin Shock Therapy maladaptive behavior were the social and
Insulin was occasionally given to stimulate cultural influences in one’s life and the
appetite in psychotic patients who were not learning that took place in that
eating, but it also seemed to calm them environment.
down. Aristotle, also emphasized the influence
The therapy induced coma-like states, of social environment and early learning
which could cause patients to experience on later psychopathology.
seizures, brain damage, or even death if the They also advocated humane and
hypoglycemia became too severe or was responsible care for individuals with
not properly managed. psychological disturbances.
Electroconvulsive Therapy (ECT) Moral Therapy
-Benjamin Franklin During the first half of the 19th century, a
-a mild and modest electric shock to the strong psychosocial approach to mental
head produced a brief convulsion and disorders called moral therapy became
memory loss (amnesia) but otherwise did influential.
little harm. The term moral actually referred more to
Medications emotional or psychological factors rather
Delusion= false beliefs than to a code of conduct.
Hallucinations= seeing/hearing things that Philippe Pinel
doesn't exist. Treating people with abnormal behavior, as
Neuroleptics (major tranquilizers) human as possible.
- hallucinatory and delusional thought 19th Century, started by Philippe Pinel
processes could be diminished in some WI LL IAM TUKE of England
patients; these drugs also controlled BENJAMIN RUSH started in US. The
agitation and aggressiveness founder of US Psychiatry
Benzodiazepines (minor tranquilizers) Asylums-The place that often gave refuge
- which seemed to reduce anxiety. to
Consequences of Biological Tradition the mentally disturbed and conditions were
1.Decreased interest in curing appaling.
psychopathology Psychoanalysis
2. Presentation by Became more scientific  Sigmund Freud
in our approach to psychological disorders.  Neurologist
 Father of Psychoanalysis
 Theory of the structure of the mind
and the role of unconscious
processes in determining behavior.
Hypnotism HUMANISTIC THEORY
Anna O -Freud's Patient Humanistic psychology is a perspective that
Josef Breuer- worked on the celebrated emphasizes looking at the whole individual
case of Anna O. and, with Sigmund Freud, and stresses concepts such as free will, self-
developed the theory of psychoanalysis. efficacy, and self-actualization. Rather than
Jean Charcot- Started the work on hypnosis concentrating on dysfunction, humanistic
and hysteria. psychology strives to help people fulfill their
Ana O. potential and maximize their well-being.
 Partial blindness BEHAVIORISM- theory that psychology can
 Numbness of some body parts be objectively studied through observable
 Catharsis- the process of releasing, action.
and thereby providing relief from, Operant Classical
strong or repressed emotions. Conditioning Conditioning
ID= Instincts Subject learns Subject learns to
EGO= Reality behavior by associate two
SUPEREGO= Morality associating it with unrelated stimuli
DEFENSE MECHANISM consequences. with each other.
Unconscious protective processes that keep BEHAVIORAL THERAPY
primitive emotions associated with conflict Behavioral therapy suggests that since old
in check so that the ego can continue its learning led to the development of a
coordinating function. problem, then new learning can fix it.
Psychoanalytic Psychotherapy Psychological Tradition
FREE ASSOCIATION- patients are instructed The Present: Scientific Method
to say whatever comes to mind without the and Integrative Approach
usual socially required censoring. AN INTEGRATIVE
DREAM ANALYSIS- therapist interprets the APPROACH TO
content of dreams, supposedly reflecting PSYCHOPATHOLOGY
the primary-process thinking of the id, and History of Psychopathology
systematically relates the dreams to  Supernatural
symbolic aspects of unconscious conflicts.  Biological
Psychodynamic Therapy  Psychological
Psychodynamic therapy can help people One-Dimensional versus Multidimensional
improve their quality of life by helping Models
them ONE-DIMENSIONAL- proposes a single
gain a better understanding of the way they factor as the cause of psychopathology.
think and feel. The idea is that this will MULTIDEMNSIONAL-integrates multiple
improve their ability to make choices, causes of psychopathology and affirms that
relate to others, and forge the kind of life each cause comes to affect other causes
they would like to live. over time.
In simple terms, Sigmund Freud's theory
suggests that human behavior is influenced
by unconscious memories, thoughts, and
urges. This theory also proposes that the
psyche comprises three aspects: the id,
ego, and superego
Genetic Contributions to Psychopathology Epigenetics and the Nongenomic
 Genes are long molecules of “Inheritance” of Behavior
deoxyribonucleic acid (DNA) at Epigenetics- the tendency of genes to be
various locations on chromosomes, expressed differently depending on the
within the cell nucleus. environment (stress, nutrition, or other
 Everyone has a unique set of genes. factors)
 23 pairs of chromosomes 23rd pair There are some behaviors that does not
are Sex chromosomes (x for females, need to be passed down by genes.
y for males) (Ex. Violence, Drug Addiction)
DNA (DEOXYRIBONUCLEIC ACID) It's not only genes but also the society.
Faulty DNA can lead to abnormal outcomes Neuroscience and its contribution to
from physical to psychological. Psychopathology
o Genetic factors usually determine Knowing how the nervous system and,
half of our personality traits and especially, how the brain works is central to
cognitive abilities. any understanding of our behavior,
o Genetic studies estimates that genes emotions, and cognitive processes.
account less than half of the
explanation to all disorders.
The Diathesis–Stress Model
-Individuals inherit tendencies to express
certain traits or behaviors, which may then
be activated under conditions of stress.
-Proposed by Eric Kandel: a medical doctor
who specialized in psychiatry, a
neuroscientist and a professor of
biochemistry and biophysics.
Diathesis and Stress
Diathesis refers to a predisposition or Genetic contributions might lead to
vulnerability to developing a mental patterns of neurotransmitter activity that
disorder. This can be due to genetic factors, influence personality. Thus, some impulsive
early life experiences, or other biological risk takers may have low serotonergic
susceptibilities. activity and high dopaminergic activity.
Stress refers to the environmental factors Psychosocial Influence on Brain Structure
that trigger the onset of mental illness or and Function
exacerbate existing conditions. These can Treatment usually requires a theoretical
include significant life events, trauma, and cause of the disorder (biological or
daily stressors. cognitive behavioral) and trying out which
Genes and Environment one works with the patient.
-The greater the underlying vulnerability, Initiating Factors - why the disorder
the less stress is needed to trigger a developed in the first place.
disorder. Maintaining Factors - why the problem still
The Gene–Environment Correlation Model persists.
Genetic endowment may increase the
probability that an individual will
experience stressful life events.
 Interaction of Psychosocial Factors and SHADOW OF INTELLIGENCE
Neurotransmitter Systems He thought the human ability to plan in
Not everyone has the same response to some detail for the future was connected to
neurotransmitters, it depends on the that gnawing feeling that things could go
psychosocial factors of the person. wrong and we had better be prepared for
Rhesus Monkey Experiment: Scientists them. This is why anxiety is a future
have discovered that a particular class of oriented mood state.
drugs, the benzodiazepines, or minor IT BECOMES BAD WHEN...
tranquilizers, makes it easier for GABA Anxiety becomes bad if you have too much
molecules to attach themselves to the of it and if it becomes irrational.
receptors of specialized neurons. FEAR
Thus, the higher the level of Unlike anxiety, fear is not vague. Anxiety
benzodiazepine, the more GABA becomes comes from uncertainty while fear comes
attached to neuron receptors and the from certainty that danger will come upon
calmer we become. us.
Same with anxiety, fear is a good thing. Too
ANXIETY DISORDER much of it, it becomes bothersome. If you
suddenly feel fear with no immediate
Anxiety is complex and mysterious, as danger, this is known as panic.
Sigmund Freud realized many years ago. In This sudden overwhelming reaction came
some ways, the more we learn about it, the to
more baffling it seems. be known as panic, after the Greek god Pan
“Anxiety” is a specific type of disorder, but who terrified travelers with bloodcurdling
it is more than that. screams.
THE COMPLEXITY PANIC ATTACK
OF ANXIETY DISORDERS Abrupt experience of intense fear or acute
Anxiety is a human condition brought by discomfort, accompanied by physical
self-awareness and our ability to predict symptoms that usually include heart
the future. palpitations, chest pain, shortness of
The self-awareness that we are now alive breath, and, possibly dizziness.
and sooner or later, we will die. 2 types of Panic Attack
Anxiety as an EMOTION that allowed us to EXPECTED (CUED) PANIC ATTACK
survive the harsh environment. If you have a clue when or where the next
ANXIETY- is a negative mood state attack will occur.
characterized by bodily symptoms of UNEXPECTED (UNCUED) PANIC ATTACK
physical tension and by apprehension about If you don’t have a clue when or where the
the future. next attack will occur.
ANXIETY -is a negative mood state CAUSES OF ANXIETY AND RELATED
characterized by bodily symptoms of DISORDERS
physical tension and by apprehension Biological, Psychological and Social causes
about the future. BIOLOGICAL CONTRIBUTIONS
In humans’ physiological symptoms include: The tendency to panic also seems to run in
fidgeting, increase heart rate, families and probably has a genetic
muscle tension component that differs somewhat from
Anxiety the “Shadow of Intelligence” genetic contributions to anxiety.
HOWARD LIDDELL (1949)
Anxiety is also associated with specific PSYCHOLOGICAL CONTRIBUTIONS
brain circuits and neurotransmitters. Parents have a big role in anxiety disorders
 Depleted levels of gamma- of their children
aminobutyric acid (GABA) are  Parents who are responsive to their
associated with increased anxiety children's needs build a sense of
 The noradrenergic system has also control for their children
been implicated in anxiety.  Parents who allow their children to
 Corticotropin-releasing factor (CRF) explore their world and develop the
may have a role in the expression of necessary skills to cope with
anxiety and depression. unexpected occurences enable their
 emotional brain (the limbic system), children to develop a healthy sense
(hippocampus and the amygdala; of control
the locus coeruleus in the brain  Parents who are overprotective and
stem; the prefrontal cortex; and the over intrusive are more likely to
dopaminergic neurotransmitter raise children with anxiety disorders.
system.)
ANXIETY SENSITIVITY
 The behavioral inhibition system the general tendency to respond fearfully
(BIS) is activated by signals from the to anxiety symptoms.
brain stem of unexpected events, Conditioning and Cognitive explanations:
such as major changes in body  Associating panic to neutral stimulus
functioning that might signal danger.  This creates "triggers"
 When the BIS is activated by signals Stressful life events trigger our biological
that arise from the brain stem or and psychological vulnerabilities to anxiety.
descend from the cortex, our Most are social and interpersonal in nature
tendency is to freeze, experience —marriage, divorce, difficulties at work,
anxiety, and apprehensively death of a loved one, pressures to excel in
evaluate the situation to confirm school, and so on.
that danger is present. Some might be physical, such as an injury
 The Fight/Flight System (FFS) - or illness.
circuit originates in the brain stem TRIPLE VULNERABILITY THEORY
and travels through several midbrain
structures, including the amygdala,
the ventromedial nucleus of the
hypothalamus, and the central gray
matter.
 When stimulated in animals, this
circuit produces an immediate
alarm-and-escape response that
looks very much like panic in
humans META-STRESS it happens when you stress in
 Deficiences in serotonin can trigger advance about something that has not even
FFS taken place yet.
 Specific brain circuits is overactive COMORBIDITY OF ANXIETY AND RELATED
 BIS is very slow/ poor DISORDERS
 Fight/ Flight system is high Comorbidity is the co-occurrence of two or
 Brain over reacts and generates more disorders in a single individual
fear
The high rates of comorbidity among PANIC DISORDER & AGORAPHOBIA
anxiety and related disorders (and  Intense fear/ anxiety towards being
depression) emphasize how all of these outside of home
disorders share the common features of  Fear is out of proportion about the
anxiety and panic described here. actual danger posed by the object
COMORBIDITY WITH PHYSICAL DISORDERS or situation
The presence of any anxiety disorder was SPECIFIC PHOBIA
uniquely and significantly associated with  Intense fear/anxiety towards an
thyroid disease, respiratory disease, object or situation
gastrointestinal disease, arthritis, migraine  Fear is out of proportion about the
headaches, and allergic conditions. actual danger posed by the
The anxiety disorder most often begins object/situation
before the physical disorder, suggesting SOCIAL ANXIETY DISORDER
(but not proving) that something about Social Anxiety Disorder can be specified if it
having an anxiety disorder might cause, or is performance only
contribute to the cause of, the physical Ex. Stage Fright
disorder CAUSES & TREATMENT
SUICIDE 1. Generalized Anxiety Disorder (GAD)
Based on epidemiological data, Weissman Integrative Approach
and colleagues found that 20% of patients
with panic disorder had attempted suicide.
They also concluded that the risk of
someone with panic disorder attempting
suicide is comparable to that for
individuals with major depression.
 The relationship is strongest with
panic disorder and posttraumatic
stress disorder
 People with generalized anxiety
disorder and social anxiety disorder
who engaged in deliberate self-harm
were especially more likely to
engage in this behavior multiple
times, and at least one of those
times was a suicide attempt.
ANXIETY DISORDERS
 Generalized Anxiety Disorder
 Panic Disorder TREATMENT (Generalized Anxiety Disorder)
 Agoraphobia Medication:
 Specific Phobia Anti-anxiety or anti-depressant
 Social Anxiety Phobia Psychological Treatment
GENERALIZED ANXIETY DISORDER Cognitive Behavioral Treatment (CBT)
 Excessive, uncontrollable anxiety in  Socratic Method- to refute irrational
every aspect of a person's life beliefs
 Causes distress and impairment Psychosocial Education- to help client deal
with everyday life
TREATMENT (Panic and Phobia)
Medication:
Anti-anxiety
Psychological Treatment
Cognitive Behavioral Treatment (CBT)
 Systematic Desensitization
 Exposure Therapy
Psychosocial Education- to help client deal
with everyday life