chapter 1 looking at abnormal - ulsanocw.ulsan.ac.kr/ocwdata/2014/02/c01069-02/lecturenotes/1... ·...

Chapter 1

Looking at Abnormal

Abnormality Along the Continuum

As humans, we think, feel and behave. In our life, our thoughts, feeling and behaviors help us to step to our goals.

However, sometimes, our thoughts, feeling, or behaviors may be interfering with our function in everyday life.

Problems in thoughts, feeling and behaviors vary from normal to abnormal.

Abnormality Along the Continuum

The study of abnormal psychology is the study of people who suffer mental, emotional, and often physical pain, often referred to as psychopathology.

Sometimes the experiences of people with psychopathology are as unusual, however, sometimes that re familiar to many people but more extreme.

Defining Abnormality

Mental Illness

The modern conceptualizations of mental disorders view them not as singular diseases with a common pathology that can be identified in all people with disorder.

But, a person diagnosed with mental illness has a collection of problems in rational thinking and in responding emotionally and behaviorally in everyday life.


Cultural Norms

Some behaviors are accepted in some circumstances, but some are abnormal in all circumstances. Therefore, cultural norms play a large role in defining abnormality.

Cultural relativism is the view that there are no universal standards or rules for labeling a behavior abnormal; instead, behaviors can be labeled abnormal only relative to cultural norms.


Cultural relativism

There are no universalstandards or rules for labeling a behavior abnormal; instead, behaviors can be labeled abnormal only relative to cultural norms. There are the way that behaviors are treated. First, culture and gener can influence the ways people express symptoms. Second, culture and gender can influence prople’s willingness to admit to certain types of behaviors or feelings. Third, culture and gender can influence the types of treatments deemed acceptable or helpful for people exhibiting abnormal behaviors.


The Four Ds of Abnormality

Modern judgments of abnormality are influenced by the interplay four dimensions, often called “the four Ds”: dysfunction, distress, deviance, and dangerousness.

Dysfunction: behaviors, thougts, and feeling are dysfunctional when they interfere with the person’s ablility to function in daily life, to hold a job, or to form close relationships.

Distress: behaviors and feelings that cause distress to the individaul or to others around him or her also likely to be considered abnormal.


The Four Ds of Abnormality

Deviant: highly deviant behaviors lead to judgments of abnormality. What is deviant is influence by clutural norm.

Dangerous: some behaviors and feelings are of poteneial harm to the individual, such as suicidal gesture or excessive aggression. Such dangerous behaviors and feelings are often seen as abnormor.

The four Ds together make up mental health proession’s definition of behaviors or feeling as abnormal or maladaptive.

A person’s vehaviors and feelings can be more or less dysfunctional, distressing, deviant, or dangerous. Thus, there is no sharp line between what is normal and what is abnormal.

Historical Perspectives on Abnormality

Across history, three types of theories have been used to explanin abnormal behavior. These three types of theories have influenced how people acting abnormally have been regarded in the society.

The biological theories have viewed abnormal behavior as similar to physical diseases, caused by the breakdown o systems in the body.

The supernatural theories have viewed abnormal behavior as a result of divine intervention, curses, demonic possession, and personal sin.

The psychological theories have viewed abnormal behavior as a result of traumas, auch as bereavement, or of chronic stress.


Ancient Theories

Humans have always viewed abnormality as some thing needing special explanation.

Driving away evil spirits

Historians speculate that even presistoric people had a concept of insanity, probably one rooted in supernatural beliefs. A person who acted oddly was suspected of being possessed by evil spirits. The typical treatment for abnormality was exorcism which driving the evil spirits from the body of the suffering person. At the other time, the person thought to be possessed by evil spirits would simply be killed.


Ancient China: Balancing Yin and Yang

There are some source on abnormalily in ancient Chinese medical texts. Ancient Chinese medicine was based on the concept of yin and yang. The human body was siad to contain a positive force (yang) and a negative force (yin), which confronted and complemented each other. If the two forces were in balance, the individual was healthy. If not, illness, including insanity, could result. Chinese medical philosophy also held that human emotions were controlled by internal organs. This theory encouraged people to live in an orderly and harmonious way so as to maintain the proper movement of vital air.


Ancient Egypt, Greece, and Rome: Biological Theories Dominate

Other ancient writing on abnormal behavior are found in the papyri of Egypt and Mesopotamia. A document known as the Kahun Papyrus lists a number of disorders, each folowed by a physician’s judgment of the cause of the disorder and the appropriate treatment.

The Egyptians believed that the uterus could become dislodged and wander throughout a woman’s body, interfering with her other organs.


Ancient Egypt, Greece, and Rome: Biological Theories Dominate

The greeks wrote frequently of people actine abnormally. Most Greeks and Romans saw abnormal behavior as an affliction from the gods. However, for the most part of Greek physicians rejected supernatural explanations of abnormal behavior. Hippocrates argued that abnormal behavior was like ther diseases of the body which caused by imbalances in the body’s essential humors. The treatments were intended to restore the balance on humors. The relatives of people considered insane were encouraged to confine their afflicted family members to the home.


Medieval Views

The Middle Ages are often described as a time of backward thinking dominated by an obsession with supernatural forces. Europe supernatural theories of abnormal behavior did not dominate until the late Middle Ages. Severe emotional shock and physical illness or injury most often were seen as the causes of bizarre behaviors. While laypeople probably did believe in demons and curses as causes of abnormal behavior, there is strong evidence that physicians and government officials attributed abnormal behavior to physical causes or traumas.


Witchcraft

When the power of the Catholic Church in Europe was threatened by the breakdown of feudalism and by rebellions, the church interpreted these threats in terms of heresy and Satanism. The witch hunts continued long after the reformation. Some psychiatric historians have argued that persons accused of witchcraft must have been mentally ill. Accused withches sometimes confessed to engaging in the unusual behaviors. However, confessions of such experiences may have been extracted through torture. The distinction between madness and witchcraft continues to this day in cultures that believe in witchcraft.


Psychic Epidemics

Psychic epidemics are defined as a phenomenon in which large number of people engage in unusual behaviors that appear to have a psychological origin. During the Middle Ages, reports o dance frenzies or manias were frequent. At the time, many people interpreted dance frenzies and tarantism as the results of possession by the devil.

Psychic epidemics are no longer viewed as the result of spirit possession or the bite of a tarantula. Rather, psychologists attempt to understand them through research from social psychology on the influence of others on individuals’ self-perceptions.


The spread of asylums

In about the eleventh or twelfth century, general hospitals began to include facilities for people exhibiting abnormal behavior. The mentally ill were little more than inmates in these early hospitals, housed against their will, often in extremely harsh conditions.

The law regarding the confinement of the mentally ill in Europe and United States were concerned with the protection of the public and the ill person’s relatives. The first act for regulating madhouses in England was passed in 1774, provisions applied only paying patients in private madhouses, not to the poor people confined to workhouses.


Moral treatment in Eighteenth and Nineteenth

The eighteenth and nineteenth centuries saw the growth of a more humane treatment of people with mental health problem. A period known as the mental hygiene movement. This new treatment was based on the psychological view that people developed problems because they had become seperated from nature and had succumbed to the stresses imposed by the rapid social changes of the period. The prescribed treatment, including prayers and incantations, was rest and relaxation in a serene and physically appealing place.


Moral treatment in Eighteenth and Nineteenth

Between 1841 – 1881, hundreds of more public hospitals for the insane established during this period by others were run according to humanitarian perspective. The moral treatment movement grew too fast. As more asylums were built and more people went into them. After that, the government reduced funding led to even greather declines in the quality of care. Effective treatments for most major mental health problems were not developed until well into the twentieth century. Until then, patients who could not afford private care were warehoused in large, overcrowded, physically isolated state institutions that did not offer treatment.

The Emergence of Modern Perspectives

The beginn of modern biological perspectives

Basic knowledge of the anatomy, physiology, neurology, and chemistry of the body increase repidly in the late nineteenth century. With the advancement of this basic knowledge of this basic knowledge came an increase focus on biological causes of abnomality. One of most important discoveries was the discovery of the cause of general paresis, a disease that leads to paralysis, insanity, and eventually death. The discovery that syphilis is the cause of one form of insanity lent great weight to the idea that biological factors can cause abnormal behaviors.


The psychoanalytic perspective

The developmen of psychoanalytic theory began with work of Franz Anton Mesmer. It grew as Jean Charcot. After that, Sigmund Freud worked with Josef Breuer and collaborated on a paper as On the Psychical Mechanisms of Hysterical Phenomena, which laid out their discoveries about hypnosis, the unconscious, and the therapeutic value of catharsis. This paper proved to be a foundation stone in the development of psychoanalysis, the study of the unconscious. Freud became the best known figure in psychiatry and psychology. The impact of Freud’s theories on the development of psychology over the next century cannot be overstated.


The roots of behaviorism

Behaviorist views on abnormal behavior began with John Watson and B.F.Skinner. John Watson studied in important human behaviors and rejected psychoanalytic and biological theories of abnormal behaviors. B.F.Skinner and E.L.Thorndike studied how the consequences of behaviors shape their likelihood of recurrence.

Behaviorism is the study of impact of reinforcements and punishments on behavior which has had as profound an impact on psychology and on our common knowledge of psychology as has psychoanalytic theory. Behavioral theories have led to many of the effective psychological treatments for disorders.


The cognitive Revolution

In 1970, psychology shifted its focus substantially to the study of cognitions, thought precesses that influence behavior and emotion. Albert Bandura contributed a great deal to the application of behaviorism to psychopathology. He argued that peoples’s beliefs about their ability to execute the behaviors necessary to control important events which called self-efficacy beliefs that are crucial in determining people’s well-being. Other key figure in cognitive perspectives was Albert Ellis who developed a retional-emotive therapy, and Aaron Beck who focused on the irrational thoughts of people with psychological problems. Beck’s cognitive therapy has become one of the most widely used therapies for many disorders.

Modern Mental Health Care

Halfway through the twentieth century, major breakthroughs were made in drug treatments for some of the major forms of abnomality. In particular, the dicovery of a class of drugs that can reduce hallucinations and delusions, known as the phenothiazines, made it possible for many people who had been institutionalized for years to be released from asylums and hospital.

There are still significant problems in the delivery of mental health care, some of which began with the deinstitutionalization movement of the mid-twentieth century.


Deinstitutionalization

Patients’ right advocates argued that mental patients can recover more fully or live more satisfying lives if they are integrated into the community, with the support of community-based treatment facilities which a process known as deinstitutionalization. The movement attempted to provide coordinated mental health services to people in community mental health centers. The deinstitutionalization movement had a massive effect on the lives of people with serious psychological problems. There are several types of community-based treatment facilities such as halfway houses and day treatment centers.


Deinstitutionalization

Unfortunately, community-besed mental health centers have never been fully funded or supported. Meanwhile, the state psychiatric hospitals to which former patients would have retreated were closed down by the hundred. The patients who was released from mental institutions began living in nursing homes and other types of group homes, some began living on the street. In emergencies, these people end up in general or private hospitals that are not equipped to treat them appropriately. Many end up in jail.


Managed Care

Managed care systems are meant to provide coordinated, comprehensive medical care to patients. They can be a great asset to people with long-term, serious psychological disorders. Manage care is a collection of methods for coordinating care that ranges from simple monitoring to tatal control over what care can be provided and paid for. Managed care can solve some of the problems created by deinstitutionalization.

For people with less severe psychological problems, the availability of mental health care through managed care systems and other private insurance systems has led to a large increase in the number of people seeking psychotherapy and other types of mental health care.


Managed Care

Mental health care often is not covred fully by health inurance. Also, many people do not have any health insurance. Laws have been passed in recent years that are intended to increase the availability of coverage for mental health services, but these laws are being hotly contested. Mental health services are expensive. Because mental health problems are sometimes chronic, mental health treatment can take a long time. The medical program which covers one quarter of all mental health care spending in US. However, many states have reduced or restricted eligibility and benefits for mental health care, increased co-payments, controlled drug costs and reduced or frozen payments to providers.


Professions within abnormal psychology

A number of professions are concerned with abnormal or maladaptive behavior. The professions withing abnormal psychology include psychiatrists, clinical psychologists, marriage and family therapists, clinical social workers, licensed mental health counselors, and psychiatric nurses. Each of these profession has its rewards and limitations. Many mental health professionals of all types combine clinical practice and research in their careers.

Chapter Intergration

Although the biological, psychological, and social theories of abnormality have traditionally been viewed as competing with one another to explain psychological disorders, many clinicians and researchers now believe that theories that integrate biological, psychological, and social perspectives on abnormality will prove most useful.

Reference

Susan, N. H. (2014). Abnormal Psychology. Connecticut: Yale.

Thank You !!!

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