FAP5_Lecture_Ch01 - Chapter 1 Abnormal Psychology Past and...

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Unformatted text preview: Chapter 1 Abnormal Psychology: Past and Present Comer, Fundamentals of Abnormal Psychology, 5e – Chapter 1 Slides & Handouts by Karen Clay Rhines, Ph.D. 1 Abnormal Psychology: Past and Present What is abnormal psychology? The field devoted to the scientific study of abnormal behavior to describe, predict, explain, and change abnormal patterns of functioning Workers may be: Clinical scientists Clinical practitioners Comer, Fundamentals of Abnormal Psychology, 5e – Chapter 1 2 What Is Psychological Abnormality? Although many definitions have been proposed, none is universally accepted Most definitions share some common features… “The Four Ds” Deviance – Different, extreme, unusual Distress – Unpleasant & upsetting Dysfunction – Causes interference with life Danger – Poses risk of harm Comer, Fundamentals of Abnormal Psychology, 5e – Chapter 1 3 Deviance From what? From behaviors, thoughts, and emotions considered normal in a specific place and time and by specific people From social norms Stated and unstated rules for proper conduct in a given society or culture Examples? Judgments of deviance also depend on specific circumstances (i.e., social context, cultural norms) 4 Comer, Fundamentals of Abnormal Psychology, 5e – Chapter 1 Distress According to many clinical guidelines, behavior must be personally distressing before it can be labeled abnormal Not always the case Examples? Comer, Fundamentals of Abnormal Psychology, 5e – Chapter 1 5 Dysfunction Abnormal behavior tends to be dysfunctional – it interferes with daily functioning Culture has an influence on determinations of dysfunction, as well Dysfunction alone does not necessarily indicate psychological abnormality Comer, Fundamentals of Abnormal Psychology, 5e – Chapter 1 6 Danger Abnormal behavior may become dangerous to oneself or others Behavior may be careless, hostile, or confused Although cited as a feature of psychological abnormality, being dangerous is the exception rather than the rule Comer, Fundamentals of Abnormal Psychology, 5e – Chapter 1 7 The Elusive Nature of Abnormality Ultimately, a society selects the general criteria for defining abnormality and then uses those criteria to judge particular cases Szasz argues that, because of the influence of society, the whole concept of mental illness is invalid Deviations called “abnormal” are only “problems of living” Societies use the concept of mental illness to control those who threaten social order 8 Comer, Fundamentals of Abnormal Psychology, 5e – Chapter 1 The Elusive Nature of Abnormality Even if we agree with the concept of abnormality, it is often applied inconsistently Examples: Diagnosis of alcohol problems in colleges Issue of abnormality versus eccentricity Comer, Fundamentals of Abnormal Psychology, 5e – Chapter 1 9 The Elusive Nature of Abnormality In short, although abnormality generally is defined as behavior that is deviant, distressful, dysfunctional, and dangerous, these criteria often are vague Comer, Fundamentals of Abnormal Psychology, 5e – Chapter 1 10 What Is Treatment? Once abnormality is determined, clinicians attempt to treat it Treatment (or therapy) is a procedure designed to change abnormal behavior into more normal behavior It, too, requires careful definition… Comer, Fundamentals of Abnormal Psychology, 5e – Chapter 1 11 What Is Treatment? • According to Frank, all forms of therapy have three essential features: 1. 2. A sufferer who hopes the healer can provide relief A trained, socially accepted healer whose expertise is accepted by the sufferer and his or her social group A series of contacts between the healer and the sufferer, through which the healer tries to produce certain changes in the sufferer’s emotional state, attitudes, and behavior 3. Comer, Fundamentals of Abnormal Psychology, 5e – Chapter 1 12 What Is Treatment? Despite the clarity of the definition, clinical therapy is surrounded by confusion and conflict: Lack of agreement about goals or aims Lack of agreement about successful outcomes Lack of agreement about failure Are clinicians seeking to cure? To teach? Are sufferers patients (ill) or clients (having difficulty)? 13 Comer, Fundamentals of Abnormal Psychology, 5e – Chapter 1 What Is Treatment? Despite these disagreements, most clinicians agree that large numbers of people need therapy Research indicates that therapy often is helpful Comer, Fundamentals of Abnormal Psychology, 5e – Chapter 1 14 How Was Abnormality Viewed and Treated in the Past? In any given year in the US, 30% of adults and 19% of children display serious psychological disturbances and are in need of treatment In addition, most people have difficulty coping at various times in their lives Is this the fault of modern society? Not entirely; historical records demonstrate that every society has witnessed psychological abnormality and had its own form of treatment… 15 Comer, Fundamentals of Abnormal Psychology, 5e – Chapter 1 How Was Abnormality Viewed and Treated in the Past? Much of today’s thinking about abnormal psychology is built on past approaches and ideas, rather than being a rejection of these ideas Theories and themes about abnormal psychology occur again and again; progress has not been a steady movement forward 16 Comer, Fundamentals of Abnormal Psychology, 5e – Chapter 1 Ancient Views and Treatment Most historians believe that prehistoric societies regarded abnormal behavior as the work of evil spirits May have begun as far back as the Stone Age The cure for abnormality was to force the demons from the body through trephination and exorcism 17 Comer, Fundamentals of Abnormal Psychology, 5e – Chapter 1 Ancient skull with holes from trephination Greek and Roman Views and Treatments 500 B.C. to A.D. 500 A.D. Many psychological disorders were identified Hippocrates believed that abnormality was a disease arising from internal physical problems He looked to an unbalance of the four humors His suggested treatment that attempted to “rebalance” 19 Comer, Fundamentals of Abnormal Psychology, 5e – Chapter 1 Europe in the Middle Ages: Demonology Returns A.D. 500 – 1350 With the rise of clergy came the downplay of science Abnormality was again seen as a conflict between good & evil The incidence of abnormality increased dramatically as outbreaks of mass madness occurred Earlier (largely discarded) treatments such as exorcism re­ emerged At the close of the Middle Ages, demonology began to lose favor again 20 Comer, Fundamentals of Abnormal Psychology, 5e – Chapter 1 The Renaissance and the Rise of Asylums A.D. 1400 – 1700 German physician Johann Weyer believed that the mind was as susceptible to sickness as the body Weyer is considered the founder of modernstudy of psychopathology Patient care improved as demonological views declined 21 Comer, Fundamentals of Abnormal Psychology, 5e – Chapter 1 The Renaissance and the Rise of Asylums Shrines devoted to loving care of the mentally ill were established and one, at Gheel, became a community mental health program of sorts This time also saw a rise of asylums – institutions whose primary purpose was care of the mentally ill The intention was good care, but because of overcrowding they became virtual prisons 22 Comer, Fundamentals of Abnormal Psychology, 5e – Chapter 1 The Nineteenth Century: Reform and Moral Treatment As 1800 approached, asylums were reformed into places of care Pinel (France) and Tuke (England) advocated moral treatment – care that emphasized humane and respectful treatment In the US, Benjamin Rush (father of American psychiatry) and Dorothea Dix (Boston schoolteacher) were the primary proponents of moral treatment Comer, Fundamentals of Abnormal Psychology, 5e – Chapter 1 23 The Nineteenth Century: Reform and Moral Treatment By the end of the nineteenth century, there was a reversal of the moral treatment movement because of several factors: Money and staff shortages Declining recovery rates Lack of more effective treatment for severely mentally ill Long­term hospitalization became the rule once again Comer, Fundamentals of Abnormal Psychology, 5e – Chapter 1 24 The Early Twentieth Century: Dual Perspectives As the moral movement was declining in the late 1800s, two opposing perspectives emerged: The Somatogenic Perspective Abnormal functioning has physical causes Abnormal functioning has psychological causes The Psychogenic Perspective Comer, Fundamentals of Abnormal Psychology, 5e – Chapter 1 25 The Early Twentieth Century: The Somatogenic Perspective Two factors responsible for rebirth of this perspective: Emil Kraepelin’s textbook argued that physical factors (like fatigue) are responsible for mental dysfunction Several biological discoveries were made, such as the link between untreated syphilis & general paresis This approach, while creating optimism, lead to few positive results until the 1950s, when a number of effective medications were discovered 26 Comer, Fundamentals of Abnormal Psychology, 5e – Chapter 1 The Early Twentieth Century: The Psychogenic Perspective Rise in popularity of this perspective was based on work with hypnotism: Friedrich Mesmer and hysterical disorders Sigmund Freud: father of psychoanalysis Unconscious processes at the root of abnormality The psychoanalytic approach had little effect on the treatment of severely disturbed patients in mental hospitals 27 Comer, Fundamentals of Abnormal Psychology, 5e – Chapter 1 Current Trends Have we come a long way? 43% of people interviewed believe that people bring mental health disorders upon themselves 35% consider mental health disorders to be caused by sinful behavior However, the past 50 years have brought major changes in the ways clinicians understand and treat abnormal functioning 28 Comer, Fundamentals of Abnormal Psychology, 5e – Chapter 1 How Are People with Severe Disturbances Treated? 1950s – Psychotropic medications discovered Antipsychotic drugs Antidepressant drugs Antianxiety drugs These discoveries led to deinstitutionalization and a rise in outpatient care This change in care was not without problems 29 Comer, Fundamentals ofAbnormal Psychology, 5e – Chapter 1 How Are People with Severe Disturbances Treated? Outpatient care is now the primary mode of treatment When patients need greater care, they are usually given short­term hospitalizations or outpatient psychotherapy and medication in community settings Unfortunately, there are too few community programs available; only 40% of those with severe disturbances receive treatment of any kind 31 Comer, Fundamentals of Abnormal Psychology, 5e – Chapter 1 How Are People with Less Severe Disturbances Treated? Since the 1950s, there has been an increase in outpatient care Although this type of care was once exclusively private psychotherapy, it now includes various settings, as well as specialty care In any given year, 1 in 5 adults receive some type of mental health care 32 Comer, Fundamentals of Abnormal Psychology, 5e – Chapter 1 A Growing Emphasis on Preventing Disorders and Promoting Mental Health The community mental health approach has given rise to the prevention movement Many of today’s programs are trying to: Correct the social conditions associated with psychological problems Identify and help those at risk for developing disorders Prevention programs have also been energized by the rise of positive psychology – the study and promotion of positive feelings, traits, and abilities 33 Comer, Fundamentals of Abnormal Psychology, 5e – Chapter 1 The Growing Influence of Insurance Companies Today the dominant form of insurance coverage is the managed care program – a program in which the insurance company determines key care issues Approximately 75% of all privately insured persons in the U.S. are enrolled in managed care programs At issue are the duration of therapy, the push for medication treatment, and the relatively low rates of reimbursement for care Comer, Fundamentals of Abnormal Psychology, 5e – Chapter 1 34 What Are Today’s Leading Theories and Professions? One important development in the field of abnormal psychology is the growth of theoretical perspectives, including: Psychoanalytic Biological Behavioral Cognitive Humanistic­existential Sociocultural No single perspective dominates 35 Comer, Fundamentals of Abnormal Psychology, 5e – Chapter 1 What Are Today’s Leading Theories and Professions? In addition to multiple perspectives, there also are a variety of professionals now available to offer help to people with psychological problems Comer, Fundamentals of Abnormal Psychology, 5e – Chapter 1 36 Comer, Fundamentals of Abnormal Psychology, 5e – Chapter 1 37 What Are Today’s Leading Theories and Professions? One final development in the study and treatment of mental disorders is a growing appreciation for effective research Clinical researchers attempt to examine which concepts and theories best explain and predict abnormal behavior, which treatments are most effective, and what kinds of changes may be required 38 Comer, Fundamentals of Abnormal Psychology, 5e – Chapter 1 What Do Clinical Researchers Do? Research is the key to accuracy in all fields Particularly important (and challenging) in the field of abnormal psychology Comer, Fundamentals of Abnormal Psychology, 5e – Chapter 1 39 What Do Clinical Researchers Do? Clinical researchers face certain challenges that make their investigations particularly difficult: Measuring unconscious motives Assessing private thoughts Monitoring mood changes Clinical researchers must consider the cultural backgrounds, races, and genders of those they study Clinical researchers must follow the code of ethics to ensure that their subjects are not harmed 40 Comer, Fundamentals of Abnormal Psychology, 5e – Chapter 1 What Do Clinical Researchers Do? Clinical researchers try to discover laws and principles of abnormal psychological functioning: Search for nomothetic understanding General or universal laws Generally do not assess, diagnose, or treat individual clients Use the scientific method to pinpoint relationships among variables They systematically collect and evaluate information through careful observation Use three methods of investigation to form and test hypotheses… 41 Comer, Fundamentals of Abnormal Psychology, 5e – Chapter 1 The Case Study Provides a detailed, interpretative description of a person’s life & psychological problems Can serve as a source of new ideas about behavior Freud’s theories based entirely on case studies May offer tentative support for a theory May challenge a theory’s assumptions May inspire new therapeutic techniques May offer opportunities to study unusual problems 42 Comer, Fundamentals of Abnormal Psychology, 5e – Chapter 1 The Case Study Has limitations: Observers are biased Relies on subjective evidence Has low internal validity Has low external validity Provides little basis for generalization These limitations are addressed by the two other methods of investigation… 43 Comer, Fundamentals of Abnormal Psychology, 5e – Chapter 1 The Correlational Method & The Experimental Method Do not offer richness of detail Do allow researchers to draw broad conclusions Typically involve observing many individuals Researchers apply procedures uniformly Studies can be replicated Researchers use statistical tests to analyze results 44 Comer, Fundamentals of Abnormal Psychology, 5e – Chapter 1 The Correlational Method Correlation is the degree to which events or characteristics vary with each other Measures the strength of a relationship Does not imply cause and effect The people chosen for a study are its subjects or participants Comer, Fundamentals of Abnormal Psychology, 5e – Chapter 1 45 The Correlational Method The direction of a correlation (relationship) is important Positive correlation = variables change in the same direction Negative correlation = variables change in the opposite direction Unrelated = no consistent relationship Comer, Fundamentals of Abnormal Psychology, 5e – Chapter 1 46 The Correlational Method The magnitude (strength) of a correlation is also important High magnitude = variables that vary closely together Low magnitude = variables that do not vary as closely together Comer, Fundamentals of Abnormal Psychology, 5e – Chapter 1 47 The Correlational Method Direction and magnitude of a correlation are often calculated statistically Called the “correlation coefficient” Sign (+ or ­) indicates direction Number (from 0.00 to 1.00) indicates magnitude 0.00 = no consistent relationship +1.00 = perfect positive correlation ­1.00 = perfect negative correlation Most correlations found in psychological research fall far short of “perfect” 48 Comer, Fundamentals of Abnormal Psychology, 5e – Chapter 1 The Correlational Method Correlations can be trusted based on statistical probability How likely is it that the observed correlation occurred by chance? Comer, Fundamentals of Abnormal Psychology, 5e – Chapter 1 49 The Correlational Method Advantages of correlational studies: Can generalize results Can repeat studies Do not explain a relationship Difficulties with correlational studies: Comer, Fundamentals of Abnormal Psychology, 5e – Chapter 1 50 Comer, Fundamentals of Abnormal Psychology, 5e – Chapter 1 51 The Correlational Method Two special forms of correlational study: Epidemiological studies Reveal the incidence and prevalence of a disorder in a particular population Incidence = number of new cases in a given period Prevalence = total number of cases in a given period Longitudinal studies Observe one sample of participants on many occasions over a long period 52 Comer, Fundamentals of Abnormal Psychology, 5e – Chapter 1 The Experimental Method An experiment is a research procedure in which a variable is manipulated, and the manipulation’s effect on another variable is observed Manipulated variable = independent variable Variable being observed = dependent variable Allows researchers to ask questions such as: Does therapy X reduce symptoms of disorder Y? Causal relationships can only be determined through experiments 53 Comer, Fundamentals of Abnormal Psychology, 5e – Chapter 1 The Experimental Method Statistics and research design are very important Researchers must eliminate all confounds – those variables other than the independent variable that may also be affecting the dependent variable Three features are included in experiments to guard against confounds: The control group Random assignment Blind design Comer, Fundamentals of Abnormal Psychology, 5e – Chapter 1 54 The Experimental Method A control group is a group of participants who are not exposed to the independent variable, but whose experience is similar to that of the experimental group By comparing the groups, researchers can better determine the effect of the independent variable Rules of statistical significance are applied 55 Comer, Fundamentals of Abnormal Psychology, 5e – Chapter 1 The Experimental Method Researchers must also watch out for differences in the makeup of the experimental and control groups To do so, researchers use random assignment – any one of a number of selection procedures that ensures that every participant in the experiment is as likely to be placed in one group as another Examples: coin flip; drawing names from a hat 56 Comer, Fundamentals of Abnormal Psychology, 5e – Chapter 1 The Experimental Method A final confound problem is bias To avoid bias by the participant, experimenters employ a “blind design,” in which participants are kept from knowing which condition of the study (experimental or control) they are in One strategy for this is providing a placebo – something that simulates real therapy but has no key ingredient To avoid bias by the experimenter, experimenters employ a “double­blind design,” in which both experimenters and participants are kept from knowing which condition of the study participants are in Often used in medication trials Comer, Fundamentals of Abnormal Psychology, 5e – Chapter 1 57 Alternative Experimental Designs Clinical researchers often must settle for designs that are less than ideal and include: Quasi­experimental designs Natural experiments Analogue experiments Single­subject experiments Comer, Fundamentals of Abnormal Psychology, 5e – Chapter 1 58 Alternative Experimental Designs In quasi­experimental designs, investigators do not randomly assign subjects to groups, but make use of group that already exist Example: children with a history of child abuse To address the problem of confounds, researchers use matched control groups These groups are “matched” to the experimental group based on demographic and other variables 59 Comer, Fundamentals of Abnormal Psychology, 5e – Chapter 1 Alternative Experimental Designs In natural experiments, nature manipulates the independent variable and the experimenter observes the effects Example: psychological impact of flooding Cannot be replicated at will Broad generalizations cannot be made Comer, Fundamentals of Abnormal Psychology, 5e – Chapter 1 60 Alternative Experimental Designs Analogue experiments allow investigators to freely manipulate independent variables while avoiding ethical and practical limitations They induce laboratory subjects to behave in ways that seem to resemble real life Example: animal subjects Comer, Fundamentals of Abnormal Psychology, 5e – Chapter 1 61 Alternative Experimental Designs In a single­subject experiment, a single participant is observed both before and after manipulation of an independent variable Example: ABAB design Comer, Fundamentals of Abnormal Psychology, 5e – Chapter 1 62 What Are the Limits of Clinical Investigations? Each method addresses some of the problems of studying human behavior but no single approach overcomes them all Best to view each method as part of a team of approaches Comer, Fundamentals of Abnormal Psychology, 5e – Chapter 1 63 ...
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FAP5_Lecture_Ch01 - Chapter 1 Abnormal Psychology Past and...

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