History of Mental Health Discussion

Discuss your thoughts ( in 300 words or more) on the history and treatment of individuals suffering from mental illness. You may include your beliefs on exorcism, trepanation, witchcraft, and/or thoughts on the reform of mental institutions.

https://www.pbs.org/video/a-history-of-mental-illness-huv9lo/

https://www.coursehero.com/study-guides/abnormalpsychology/history-of-abnormal-behavior/

Chapter 2: Historical Perspectives

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Learning Objectives

Three characteristics commonly considered in defining abnormal behavior:

Cultural inappropriateness

Subjective distress

Psychological impairment

Do diseased brains cause abnormal behavior?

Abnormality does not generally lend itself to precise definition. The emphasis here will be on understanding the current diagnostic system for identifying mental disorders.

Do diseased brains cause abnormal behavior?

Do ideas, emotional conflicts, and upsetting experiences cause abnormal behavior?

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The Witch Trials of Salem (Slide 1 of 2)

In the summer and early fall of 1693, 17 women and 2 men were taken to Gallows Hill near Salem, Massachusetts and hanged as witches.

Principal accusers were a group of young girls.

Betty (9) and her cousin Abigail (11) were the first to show symptoms of a strange malady.

They sat motionlessly and stared fixedly at an invisible object.

They had convulsions—writhing and screaming.

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The Witch Trials of Salem (Slide 2 of 2)

Common pattern: One girl, in her fits and convulsions, claimed to see the spectral form of a villager tormenting her.

This was enough for a guilty verdict.

Rebecca Nurse (71) demonstrated her “witchcraft” when a group of girls imitated moves made at her trial.

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Models and Metaphors (Slide 1 of 2)

To understand new phenomena, we tend to apply ideas that are useful in another familiar domain.

As a science progresses, it moves through a series of models (paradigms) about how its subject matter should be viewed. A paradigm provides the following:

A viewing framework

Vocabulary to discuss

A “recipe” to conduct research

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Figure 2-1 Is it a Rabbit, or a Duck?

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Models and Metaphors (Slide 2 of 2)

Mature sciences, like physics, have moved through a series of paradigms, each one more powerful than its predecessor.

Psychology is a relatively new science in which no single ruling paradigm has yet emerged.

Competing viewpoints exist in psychology.

Each viewpoint offers a different model or metaphor to explain observations and predict events.

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Models and Metaphors for Abnormal Behaviors

Demonology

Spirit possession

Witchcraft

Naturalistic explanations

Organic view

Medical model

Psychological view

Understanding hysteria

Learning and behavior

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Early Demonology

Diverse people developed a remarkably similar theory or metaphor to explain abnormal behavior: possession by some god, spirit, or demon.

Exorcism is the practice of expelling demons from bodies they possess.

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Early Greek and Roman Views of Abnormal Behavior (Slide 1 of 2)

Not everyone subscribed to the prevailing belief in spirit possession.

Many physicians and philosophers held modern viewpoint, essentially modern in their denial of supernatural explanations for both physical and mental disorders.

Hippocrates, Galen, Asclepiades, Aretaeus

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Early Greek and Roman Views of Abnormal Behavior (Slide 2 of 2)

Hippocrates: behavioral abnormalities were sicknesses in the same sense as physical disorders.

Advocated medical approaches to treatment, such as moderate exercise and physical tranquility.

Galen: strongly influenced by the earlier work of Hippocrates; psychological abnormalities caused by imbalances of important bodily fluids called the four humors:

Yellow bile, black bile, blood, and phlegm

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The Middle Ages: Dance Manias

Episodes of mass madness in which groups of people dance in the streets

In Italy, similar episodes were called tarantism because they were believed to be caused by the bite of a tarantula.

In other parts of Europe, they were known as St. Vitus' dance after a 1518 episode in which dancers were sent to a chapel of St. Vitus.

In some areas, the dance mania became institutionalized as an annual ritual.

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The Middle Ages: Witchcraft

From the end of the 15th century and continuing for some 200 years, there was a widespread preoccupation with witches, their identification, and destruction.

Flogging, starving, immersion in hot water, and more refined forms of torture were used.

Initially, witches were thought to have signed a pact with the devil, but the distinction between voluntary and involuntary demonic possession became blurred over time.

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Voices of Reason

Johann Weyer (1515 – 1588)

Believed that many witches were mentally disturbed individuals who needed care and treatment

Reginald Scott (1538 – 1599)

Published The Discovery of Witchcraft (1584) in which he especially denied the role of demons in producing mental disorders

St. Vincent de Paul (1576 – 1660)

Argued that mental diseases were similar in kind to bodily disease

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Demonology Today: Alive and Well in the U.S.A.? (Slide 1 of 2)

Belief in occult phenomena, such as witchcraft and astrology, has enjoyed a revival that began in the second half of the twentieth century.

Over half of individuals in a random telephone survey of southern states believe that people are sometimes possessed by the devil (Rice, 2003).

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Demonology Today: Alive and Well in the U.S.A.? (Slide 2 of 2)

Ritualistic abuse by Satan worshipers became a popular explanation for multiple personality disorder (now, dissociative identity disorder) featured in many television programs and magazines in the 1970s and 1980s.

A 1992 FBI report concluded there is little or no evidence of allegations of Satanic ritualistic abuse.

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Humanitarian Reforms (Slide 1 of 2)

Although asylums usually began as havens where the mentally disturbed could find food, shelter, and some kindly attention; as time went by, they tended to become overcrowded, noisy, unsanitary repositories.

Living conditions at London asylum Bethlehem Hospital (opened in 1547) became so noisy and chaotic that the word bedlam was derived from its name.

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Humanitarian Reforms (Slide 2 of 2)

In the 18th and 19th centuries, several reformers began improving the care of the mentally disturbed.

Philippe Pinel (1745-1826), France

William Tuke (1732 – 1822), England

Dorothea Dix (1802-1887), United States

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The Organic View

Based on the belief that mental disorders have their origin in some biological malfunctioning transmitted through heredity or are caused by a disease, injury, lesion, or more subtle biochemical disturbance in the brain

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The Organic View: Rene Descartes

Philosopher Rene Descartes (1596-1650) proposed that humans and animals worked much as machines did.

Humans were different from the purely mechanistic animals, according to Descartes, because they have a soul and could act voluntarily.

Dualism: the separation of mind and body

Led to the scientific exploration of the mechanisms of the physical body

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The Organic View: Emil Kraepelin

Emil Kraepelin (1855-1926) created a classification system that continues to influence psychiatric thinking.

Kraepelin looked for individuals with patterns of symptoms (symptom complexes) which showed a similar onset, course, and outcome.

He combined symptom patterns into two major syntheses:

Manic-depressive psychosis

Dementia praecox

A third category was created which occurred more rarely and only had one symptom: paranoia

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Manic-Depressive Psychosis

Kraepelin linked mania (excited, elated reactions) with depression to form the manic-depressive category because the psychiatric records demonstrated the following:

Symptoms sometimes alternated with each other in the same person.

Both mania and melancholia showed an abrupt onset and a periodic course in which the person tended to show spontaneous recovery but a high likelihood of future recurrences.

In neither case was there progressive mental deterioration or physical symptoms such as paralysis.

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Dementia Praecox

Kraeplin created this category based on symptoms which had in two common characteristics:

Early onset, usually in adolescence or young adulthood (thus praecox or precocious)

A progressive downhill course toward an incurable dementia (mental incompetence)

While irreversible, the outcome was not death, but rather stabilization at a reduced level of mental and social capacity.

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The Organic View: Emil Kraepelin

Kraepelin's two major classifications accounted for about two-thirds of all the patients in mental hospitals at that time.

Established the possibility that categories of mental disorders reflected distinct disease processes.

The cause and cure of these types of disorders could proceed more rationally if they were investigated as organic diseases.

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The Organic View: An Example of Organic Causation

General paresis involved a symptom-complex, consisting of delusions of grandeur, dementia, and progressive paralysis. The paralysis and mental deterioration progressed rapidly to a fatal outcome.

In 1884, Fournier provided highly suggestive evidence that the symptoms of general paresis were related to and perhaps part of the sexually transmitted disease, syphilis.

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Organic Causation: General Paresis

Fournier found that 65% of patients with general paresis had a history of syphilis, compared with only 10% of patients with other mental disorders.

In 1897, Krafft-Ebing inoculated nine paretic patients, (who had denied having a prior syphilitic infection) with matter from syphilitic sores.

None of these patients developed symptoms of syphilis.

In 1905, Schaudinn identified a spirochete called Treponema pallidum, which was the cause of general paresis.

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Organic Cure: General Paresis

In 1917, malarial fever therapy was successfully used to treat syphilis, avoiding the development of general paresis.

In Vienna, Wagner-Juaregg used blood from a soldier with malaria to infect patients with general paresis.

The resulting malarial infection caused a high fever, which in turn, killed off the syphilis spirochete.

A much more effective therapy was developed decades later with the discovery of penicillin.

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Organic View: Current Status

After a century of organically oriented research, the foundation of the disease model of mental illness remains surprisingly incomplete.

With very few exceptions, there are no laboratory tests that can be conducted to detect the presence (or absence) of a mental disorder, or even any biochemical findings that are specific to particular disorders.

A precise physical cause has never been found for most DSM-V diagnoses.

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The Psychological View

The view that psychological events—personal experiences, beliefs, emotions, and ideas—might cause abnormal behavior developed along two very different lines of work:

The study of hysteria and hypnosis

The study of animal learning

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The Psychological View: Hysteria

Hysteria includes the following:

Uncontrolled emotional outbursts of weeping, laughter, or other inappropriate behaviors

Certain altered states of consciousness

A host of changeable bodily symptoms, such as paralyses, muscular contractions, and defects in hearing and vision

These symptoms have no identifiable organic basis.

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Healing by Suggestion: Anton Mesmer

Healing produced by permitting a flow of the magnetic fluid into or from the person by the "magnetizer" or healer

Developed a theatrical style of treatment which was discredited in 1784 by a group of scientific thinkers that said:

“Imagination without magnetism produces convulsions and that magnetism without imagination produces nothing."

Mesmerism became a popular term for procedures used to induce trances and other altered states of consciousness.

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The Scientific Study of Hysteria: Jean-Martin Charcot (Slide 1 of 3)

A puzzling but significant fact about hysteria was the almost unlimited variety of symptoms it encompassed:

Grande hysterie

Disturbances in sensory perception

Anesthesia, hemianesthesia, glove anesthesia, blindness, deafness

Hysterical pains

Paralysis

Abasia (inability to walk), selective defects

La belle indifférence

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The Scientific Study of Hysteria: Jean-Martin Charcot (Slide 2 of 3)

As a neurologist, Charcot recognized that many of the symptoms of hysteria differed from similar symptoms which arose from known organic causes.

Individuals with hysteria rarely hurt themselves when their symptoms overtook them.

There was a disappearance of the affliction under chloroform, but not in ordinary sleep.

Individuals with hysteria had normal reflexes, sudden onset, and occasionally, sudden disappearance.

No known organic lesion or disease process could produce the effects on the body.

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The Scientific Study of Hysteria: Jean-Martin Charcot (Slide 3 of 3)

Charcot wondered if hysterical symptoms could be produced through autosuggestion in a process similar to self-hypnosis.

He could put hysterical patients under hypnosis, produce new symptoms at will, and relieve the existing symptoms of at least some patients.

Others found hysterical symptoms could be induced through hypnosis in subjects with no previous history of hysteria.

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The Psychological View: Animal Learning

The second path of investigation which provided insight into the psychological causes of abnormal behavior was derived from animal experiments on how behavior was affected by experience.

Ivan Pavlov (1849 – 1936)

Edward Thorndike (1874 – 1949)

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Figure 2-2 Pavlov’s Conditioning Apparatus

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The Study of Animal Learning: Ivan Pavlov

In his work on digestion, Pavlov noted that his dogs soon came to salivate before meat powder was delivered into the mouth, apparently at the sight of the laboratory workers engaged in the study.

He undertook a series of experiments to understand the nature of this “psychic” reflex, and this work had a profound effect on psychology.

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The Study of Animal Learning: Pavlovian Conditioning (Slide 1 of 4)

Terminology:

Unconditioned stimulus (US): a stimulus that is naturally capable of eliciting the unconditioned response

Unconditioned response (UR): a response that occurs naturally or innately to an unconditioned stimulus

Conditioned stimulus (CS): an originally neutral stimulus that becomes capable of eliciting a conditioned response after repeated pairing with an unconditioned stimulus

Conditioned response (CR): a response that is elicited by a conditioned stimulus after repeated pairing with an unconditioned stimulus

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The Study of Animal Learning: Pavlovian Conditioning (Slide 2 of 4)

In Pavlov’s studies:

The meat powder was called the unconditioned stimulus (or US).

Salivation produced by the meat powder was called the unconditioned response (or UR).

The neutral stimulus (such as a bell or light) was called the conditioned stimulus (or CS).

The response of salivation to the conditioned stimulus was called the conditioned response (or CR).

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The Study of Animal Learning: Pavlovian Conditioning (Slide 3 of 4)

Learning is the acquisition of the association between the CS and the US.

Extinction is a process in which repeated presentations of the conditioned stimulus occur without the unconditioned stimulus. The association between the CS and US weakens.

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Figure 2-3 Typical Learning and Extinction Curve in a Conditioning Experiment

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The Study of Animal Learning: Pavlovian Conditioning (Slide 4 of 4)

Two other processes were evident as a result of conditioning:

Stimuli that were increasingly similar to the CS also exerted some control over the CR.

With continued conditioning, discrimination occurs, narrowing the range of controlling stimuli to those closest to the CS.

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Figure 2-4 Discrimination of (A) From (D) Produced “Neurosis”

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The Study of Animal Learning: Shenger-Krestovnikova (Slide 1 of 2)

Pavlov believed human behavior could be analyzed and explained in terms of innate and acquired (conditioned) reflexes.

Shenger-Krestovnikova, a student of Pavlov, created “symptoms of acute neurosis” in dogs in a discrimination experiment.

She trained dogs to salivate when presented with a circle drawn on a card.

She then found that the dogs also salivated if an ellipse, rather than a circle, was shown on the card (generalization).

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The Study of Animal Learning: Shenger-Krestovnikova (Slide 2 of 2)

The dogs were then trained to discriminate the circle from the ellipse by pairing food only with the circle, and then she refined the discrimination to more similar stimuli.

When faced with the discrimination between (A) and (D), Pavlov reported that one dog “began to squeal in its stand, kept wriggling about, tore off with its teeth the apparatus… a behaviour which never happened before. On being taken into the experimental room the dog now barked violently…”

In other words, the dog appeared to develop a neurosis.

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Figure 2-5 Thorndike’s “Puzzle Box”

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The Study of Animal Learning: Edward Thorndike (Slide 1 of 3)

Thorndike studied the process whereby animals escaped from a “puzzle box.”

Hungry cats learned by trial and error how to escape to get food.

Cats slowly became more adept at the required response, taking less and less time to get out of the puzzle box on succeeding trials.

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The Study of Animal Learning: Edward Thorndike (Slide 2 of 3)

In 1911. Thorndike formulated the "law of effect.”

When a behavior is followed by a satisfying consequence, it is more likely to be repeated; when followed by a punishing or annoying consequence, it is less likely to recur. In other words, whether a given behavior is strengthened or weakened depends upon its consequences or effects.

This learning process emphasized the consequence that followed the response.

This would come to be called instrumental learning, or operant conditioning, to distinguish it from classical, or Pavlovian, conditioning.

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The Study of Animal Learning: Edward Thorndike (Slide 3 of 3)

Thorndike viewed the law of effect as a process of selection:

The environment “selected” effective responses by the positive outcomes those responses produced.

Thorndike saw the similarity between Darwin’s concept of natural selection of physical attributes and his view of learning as environmental selection of behavior.

Since consequences changed behavior, neural connections in the brain were also changed, a foreshadowing of behavioral neuroscience.

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Chapter Summary (Slide 1 of 5)

Attempts to explain strange phenomena are usually couched in familiar metaphors.

Demon possession has been a popular, but scientifically unsupportable explanation for abnormal behavior in many times and places.

Some ancient Greeks and Romans, such as Hippocrates and Galen, proposed more naturalistic explanations, including the ideas that fluid imbalances or disordered brains caused disordered behavior.

FINAL THOUGHTS

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Chapter Summary (Slide 2 of 5)

In the late Middle Ages and afterward, many individuals, some of whom were probably suffering from mental disorder, were convicted and put to death as witches.

Some courageous individuals, including Johann Weyer and Reginald Scott, spoke against prevailing beliefs and argued that mental illnesses resulted from natural causes, not from demon possession.

FINAL THOUGHTS

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Chapter Summary (Slide 3 of 5)

Humanitarian reforms in the treatment of the mentally ill have waxed and waned throughout history. Especially important landmarks were the reforms instituted by Phillippe Pinel in Paris in 1792 and Dorothea Dix in the United States in the mid-19th century.

The organic view of abnormal behavior experienced a revival in the 19th century, especially in the work and writings of men such as Wilhelm Greisinger and Emil Kraepelin.

FINAL THOUGHTS

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Chapter Summary (Slide 4 of 5)

The discovery that a syphilitic infection produced the symptom pattern known as general paresis was particularly important in strengthening the organic view.

One psychological view of abnormal behavior arose largely from the study of hysteria, developing from the views of Anton Mesmer to the carefully documented work of Jean-Martin Charcot. Clinical observations strongly suggested that hysterical symptoms arose from strong emotional conflicts and the social context in which the person lived.

FINAL THOUGHTS

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Chapter Summary (Slide 5 of 5)

A second psychological perspective of abnormal behavior developed from laboratory studies on animal conditioning and learning. The work of Ivan Pavlov and Edward Thorndike set the stage for behavioral theories of how both normal and abnormal behavior can be acquired and modified through learning processes.

FINAL THOUGHTS

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Chapter 3: Contemporary Frameworks

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Learning Objectives

How does psychodynamic theory explain and treat psychological problems?

What treatments have developed from the behavioral model?

What is the biological perspective of abnormality?

How does the humanistic approach differ from other perspectives?

Can assessment of treatment outcomes contribute to a more unified framework?

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Contemporary Frameworks in Psychology

Current models or frameworks of psychopathology

Psychoanalytic theory

Behavioral approaches

Biological approaches

Humanistic-experiential approaches

Each model views the source of abnormal behavior differently; as such, each model presents different types of treatments.

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Freud’s Psychoanalytic (or Psychodynamic) Theory

The dynamic interplay of intrapsychic events—motives, drives, emotions, fantasies, and conflicts—that underlie the surface manifestations of symptoms must be understood to comprehend abnormal behavior.

Psychological symptoms are seen as analogous to physical symptoms, such as fever, only to be understood and treated if the underlying disease process, such as an infection, is identified.

The underlying disease is not physical, but rather a pathological condition, existing among the intrapsychic processes of the mind.

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Basics of Psychoanalytic Theory

The unconscious

The sexual basis of psychological symptoms

Libido, Oedipal conflict

Anxiety and defense mechanisms

The structure of the mind

Id, ego, superego

Stages of psychosexual development

Childhood origins of neurotic symptoms

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Unconscious Motivation

Freud: the mind consists of different levels of activity, with most action occurring outside of conscious awareness

The largest part of the mind is the unconscious: we are unaware and material is normally unavailable.

Unconscious motivation: the basic theme of unacceptable impulses struggling to find expression in various disguises

The basis for all irrational human behavior.

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Figure 3-1 The Iceberg Metaphor of the Mind

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The Sexual Basis of Psychological Symptoms

As patients explored the hidden and disguised bases of their symptoms, it seemed that the trail inevitably led to a sexual conflict.

Initially Freud felt his patients had actually experienced some kind of sexual attack, but he came to believe the patient as a young child had imagined that such events had occurred.

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The Oedipal Conflict

The Oedipal conflict is sexual attraction to the opposite-sex parent, accompanied by competition and antagonism toward the same-sex parent, as in the Greek myth of Oedipus.

Castration anxiety; penis envy

If children have dealt with an especially intense Oedipal conflict, they are vulnerable to re-arousals of the conflict and ineffective repressive defenses in adolescence.

The result can become symptoms of psychological disorders.

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Anxiety and the Mechanisms of Defense (Slide 1 of 3)

Anxiety: a powerful and unpleasant emotion which serves as a signals some impending danger

The danger may be internal

Disturbing, instinctual impulse threatening to break into awareness and be expressed in overt behavior

The danger may be external

A perceived threat of loss of love or physical injury from significant people in the child's life

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Anxiety and the Mechanisms of Defense (Slide 2 of 3)

Defense mechanisms: strategies to prevent anxiety-arousing impulses from entering awareness or being overtly expressed in ways that might evoke retaliation.

There are any number of defense mechanisms

Repression

Reaction formation

Isolation

Projection

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Anxiety and the Mechanisms of Defense (Slide 3 of 3)

Repression: unconsciously but intentionally forgetting memories associated with anxiety-arousing impulses and conflicts

Reaction formation: behaving in a way directly opposite from some underlying impulse

Isolation: separating emotions from intellectual content

Projection: shifting a reaction from an original target to some other target.

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Figure 3-2 The Purpose of Defense Mechanisms

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The Structure of the Mind

Three primary parts of the mind according to Freud:

Id: the source of basic instinctual drives seeking immediate gratification

Ego: mediates between the urgings of the id and the demands of external reality

Superego: an internalized and partially irrational representation of parental or cultural values

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Libido

The sexual instinct is the libido.

All motivation (other than few simple drives, such as hunger and thirst) arise from the libido.

Freud considered many forms of behavior that do not seem related to sex, as sublimated expressions of the libidinal instinct.

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Stages of Psychosexual Development (Slide 1 of 2)

There are biologically determined stages of psychosexual development in which the libido seeks gratification through different zones of the body.

Oral

Anal

Genital (divided thus):

Phallic

Latency

Adult genital

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Stages of Psychosexual Development (Slide 2 of 2)

Fixations at and regressions to these various stages of development influence later personality traits, including features of abnormal behavior.

Fixations: an unusual investment of libidinal energy at a certain psychosexual stage

Regressions: a return to some earlier stage of psychosexual development in the face of some current frustration

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Childhood Origination of Neurotic Symptoms

Little Hans

Neurotic (anxiety-driven) symptoms result from the interplay between instinctual impulses, striving for expression, and defensive strategies.

Crucial feature: a re-arousal of urges, fantasies, and fears from early childhood, a time when loss of parental love or threats of punishment were experienced as catastrophic events.

The responses evoked are not adult modes of problem resolutions. They arise from a child’s view.

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Psychodynamic Treatment

Goal: to make the unconscious conscious, as a way to facilitate greater understanding and insight into the self.

To reach this goal the following techniques are used:

Free association

Resistance

Transference

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Psychodynamic Treatment: Free Association

Patient is instructed to express whatever comes to mind, no matter how seemingly irrelevant, trivial, or embarrassing.

Patient is encouraged to adopt a passive attitude—reporting ideas, feelings, and images that come into awareness.

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Psychodynamic Treatment: Resistance

Patients unconsciously attempting to block insight into unconscious motives and conflicts

Since the way a patient resists is likely to reflect styles of ego defenses used in other situations, insight about these resistances is considered an important therapeutic benefit.

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Psychodynamic Treatment: Transference

The projection of thoughts and feelings from important persons in one’s childhood or later life to the therapist

Transference and counter-transference (the therapist’s reaction to the patient’s projections) become important tools for insight therapy.

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Variations in Psychodynamic Approaches

Students of Freud went on to form their own interpretations of the approach:

Alfred Alder (1870 – 1937)

Inferiority complex

Carl Jung (1875 – 1961)

Collective unconscious

Karen Horney (1885 – 1952)

Basic anxiety

Object-relations theory

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Abnormal Psychology, 5th Edition

Behavioral Approaches

Behaviorism: An approach to understanding behavior that emphasizes the relation between observable behavior and specifiable environmental events or stimuli

An underlying assumption is that the principles of conditioning could explain all behavior, both normal and abnormal.

Two schools of behaviorism

Classical (Pavlovian) conditioning

Operant Conditioning

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Abnormal Psychology, 5th Edition

Behavioral Approaches: Operant Conditioning

A form of learning in which the consequences of a response influence its later probability

Operant conditioning involves “voluntary” or emitted behaviors.

Classical or Pavlovian conditioning involves reflexive or elicited behaviors.

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Terms in Operant Conditioning

Reinforcement: a consequence that strengthens or increases the likelihood that a response will be repeated

Primary reinforcers: events, usually biological in nature, which almost always provide reinforcement

Punishment: a consequence that weakens or decreases the likelihood that a response will be repeated

Punishers: types of consequences that weaken or suppress the behaviors that produce them

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Terms in Operant Conditioning: Reinforcement

Consequences can be further organized as to whether the behavioral contingency involves the presentation or removal of something.

Positive: a stimulus added as the consequence of behavior

Negative: a stimulus is removed as the consequence of behavior

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Terms in Operant Conditioning: Discriminative Stimulus

Discriminative stimulus: serves as a signal that a certain response will lead to a reinforcer or a punisher

The organism learns to not only make a response, but to only make it under certain circumstances.

Stop the car in the presence of a red light on the traffic signal; continue forward in the presence of a green light.

Discriminative stimuli serve to guide our actions.

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Operant Conditioning: Three Levels of Selection

Selection by consequences

Skinner: operant conditioning and natural selection were the same process—operating over different time spans and on different aspects of the organism.

Units of selection and units of time

Genes = Generations

Individual behaviors = Moments

Cultural selection = Decades or centuries

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Operant Conditioning and Abnormal Behavior

Shaped because it produces reinforcing consequences

Should be subject to unlearning if the setting conditions and consequences are appropriately changed

The contingencies that maintain a behavior can be shown through the use of a reversal design.

Reversal design: an experimental design in which reinforcement contingencies are changed, reinstated, and changed again—demonstrates the contingencies that maintain a behavior

Modifying Ann’s shyness

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Figure 3-3 Ann’s Shyness

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Behavioral Approaches: Treatment

Contingency management: demonstrated in Ann’s case

Modeling: teaching a behavior by performing the behavior and having the learner imitate it

Systematic desensitization: counter-conditioning procedure in which subjects are gradually exposed to stronger anxiety-producing stimuli while maintaining a state of relaxation

Covert sensitization: form of behavior therapy in which the person is asked to imagine an upsetting scene in order to produce a form of aversion conditioning

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Variations in Behavioral Approaches

Behavioral techniques have been combined with other approaches to produce hybrid treatment options.

Cognitive-behavioral therapies (CBTs) apply behavioral treatment principles to attitudes, beliefs, and thought processes.

Acceptance and commitment therapy (ACT): Patients are taught to recognize the presence of certain bothersome emotions, such as depression or anxiety, and accept their occurrence, often termed mindfulness. Patients also make a commitment to engage in the important behaviors of normal life.

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Biological Approaches

Biological science has made great progress in understanding the physical bases for behavior.

Research into the anatomy and neurochemistry of the brain provides insights into their role in emotions, emotional disorders, and avenues for treatment.

Although behavior is not possible without biology, it is less clear whether a particular biological state results in any specific behavior.

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Biological Approaches: Major Concepts

Heredity

Chromosomes and genes

Twin and adoption studies

Estimates of genetic influences

The brain and nervous system

Cortical function

Neurotransmission and neurotransmitters

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Biological Approaches: Heredity

Chromosomes are elongated bodies in cells that carry genetic information.

23 pairs of chromosomes in human body cells

Genes are units of hereditary information carried in a chromosome by DNA.

Alleles are alternate forms of genes.

Genotype: the total set of inherited characteristics, determined by a person’s genetic makeup

Phenotype: the observable characteristics that result from the interaction between genotype and environmental influences

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Figure 3-4 Male Chromosomes

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Figure 3-5 Chromosomes Consist of Strands of DNA

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Figure 3-6 DNA Replication Prior to Cell Division

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Research Methods for Studying Hereditary Influences

Mental disorders are not inherited in a direct manner, but there is evidence that heredity plays an important role in psychopathology.

By collecting information from studies about family members who have mental disorders, the distribution of the disorder in the family pedigree can provide information about the genetic involvement in the disorder.

Linkage studies

Twin studies

Adoption studies

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Research Methods: Linkage Studies

These studies suggest modes of inheritance by examining whether the disorder appears in certain patterns—on one side of a family or in a line from mother to son.

Large pedigree studies remain particularly useful for the study of rare gene variants, which provide investigators with a focus for subsequent sequencing.

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Figure 3-7 Example of a Family Pedigree of Alzheimer’s Disease

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Research Methods: Twin Studies

There are two types of twins:

Identical (monozygotic – MZ): results from the splitting of a single fertilized ovum—the twins have the same genetics

Fraternal (dizygotic – DZ): results from the simultaneous fertilization of two separate ova—the twins are as genetically alike as any sibling pair

It is assumed the differences in degree of behavioral similarity between identical and fraternal twins will be largely due to the greater genetic similarity of the identical twins, given that both MZ and DZ twins share roughly equal environments.

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Research Methods: Adoption Studies

Another method of assessing genetic influence is to compare children who have been removed from their biological parents at or shortly after birth and adopted or raised by foster parents.

If an adoptee is more like the adopting parents than the biological parents, we infer environmental influences.

If the adoptee is more like the biological parent than the adoptive parents, we infer genetic influences.

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Estimates of Genetic Influences

For most behavioral traits, genes may account for about half of the variability between people, while environmental factors account for the other half.

Calculations of heritability do not tell us to what extent either genetics or environment “causes” a trait, nor whether any individual will develop the trait, because biological traits are influenced by both genetic and environmental factors.

Phenylketonuria (PKU)

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Figure 3-8 Process Involved in Producing Behavior

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The Human Brain: Divisions

Hindbrain: the oldest part of the brain; controls the basic physical functioning, such as heartbeat, respiration, blood pressure, and balance.

Midbrain: controls sleep, waking, and many basic reflexes.

Cerebral cortex: involved with seeing, hearing, fine motor control, speech and language, learning, and other higher functions

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Figure 3-9 Localization of Cortical Functions in the Brain

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The Human Brain: Neurotransmission

Neurons: individual nerve cells

Dendrites: a neuron’s branching fibers that receive input

Axon: part of the neuron that carries neutral impulses to other cells

Synapse: a tiny gap separating neurons, across which neurotransmitters provide chemical communication between cells

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Figure 3-10 Neuronal Communication

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Biological Treatments

The attempt to address assumed underlying biological causes

Convulsive therapies

Psychosurgery

Pharmacology

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Biological Treatments: Convulsive Therapies (Slide 1 of 2)

Early in the 1900s, observations were noted that mentally disturbed people showed improvement in their symptoms after recovering from a convulsion.

In recent decades, electroconvulsive therapy (ECT) has been restricted almost entirely to serious mood disorders.

ECT is more effective in the short term than antidepressant medications in the treatment of severe depression.

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Biological Treatments: Convulsive Therapies (Slide 2 of 2)

Magnetic seizure therapy: stimulation of brain regions by magnetic fields at sufficient strength to result in convulsions

Repetitive transcranial magnetic stimulation (rTMS): repeated magnetic pulses at subseizure levels of intensity; promising but not as effective as ECT

Vagus nerve stimulation: approved by the FDA for use with treatment-resistant depression; uses implanted electrodes in specific brain areas.

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Biological Treatments: Psychosurgery

Frontal lobotomy: a procedure (about 1935) separating the frontal lobes from the deeper parts of the brain as a treatment for violent, agitated, depressed, or dangerous patients

Although only about one-third of his subjects improved, Antonio Moniz was awarded the Nobel Prize in Medicine in 1949 for developing the procedure.

Psychosurgery remains an experimental practice and is not a part of standard biological treatment at the present.

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Biological Treatments: Pharmacology (Slide 1 of 3)

The focus is the use of drugs, which impact neurotransmission in the brain.

Over 11% of American adults received psychotropic medications in 2002.

The drug revolution has resulted in symptom relief, but none of the medications correct or resolve the biological condition presumed to underlie the symptoms.

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Biological Treatments: Pharmacology (Slide 2 of 3)

Before 1900, alcohol, heroin, cocaine, and various other sedative/hypnotic and stimulant substances were used as treatments for mental disorders.

By 1950, benzedrine (an amphetamine) had been used for hyperactivity, and lithium salts had been used to treat mania.

Anti-psychotic and anti-depressant drugs were developed in the 1950s, when reductions in psychological symptoms were noted after the use of antihistamine and tuberculosis medications, respectively.

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Biological Treatments: Pharmacology (Slide 3 of 3)

The revolutionary development of antipsychotic and antidepressant medications also led to the development of biological theories of the disorders they treat.

Dopamine hypothesis of schizophrenia: the disorder is caused by excessive dopamine activity in the brain

Catecholamine hypothesis of depression: the mood disorder resulted from a relative depletion of norepinephrine in the brain

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Biological Treatments: Pharmacology and Potential Complications

Significant concerns about medication side effects

Tardive dyskinesia: the occasional long-term side effect of phenothiazine treatment of schizophrenia, involving rhythmical, stereotyped movements and lip smacking

Agranulocytosis: a potentially fatal blood disease associated with the use of newer antipsychotic medications.

Additional medications are frequently prescribed to help patients control the side effects of psychotropic medications; relapse is high once medications are discontinued

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Humanistic-Experiential Approaches (Slide 1 of 2)

Psychological symptoms explained as the existential anxiety produced by blockage of growth or the result of inauthentic subjective experiences.

People are seen as valued human beings who struggle with the problems of their existence, and who are free to make their own choices.

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Humanistic-Experiential Approaches (Slide 2 for 2)

Various humanistic writers disagree in regards to the question of whether people are basically good, bad, or neither.

Abraham Maslow and Carl Rogers argue that people are basically motivated toward self-fulfillment and constructive personality growth.

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Approaching an Integrated Model

Increased reliance on outcome assessment has resulted in efforts to empirically identify effective treatments

That trend may combine with the tendency within science to refine a paradigm and move the study of psychopathology toward a more unified model.

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Chapter Summary (Slide 1 of 4)

The psychodynamic framework explains the psychological symptoms in terms of intrapsychic events, such as motives, fantasies, and conflicts.

Freud held that conflicts about sexuality play an important role in all neurotic disorders.

Other investigators differed with Freud and proposed psychodynamic theories of their own, renouncing the idea that sexual conflicts lay behind all neurotic disorders. They suggested that other factors, such as strivings for superiority and basic anxiety arising from a conflict between needs for affection and hostility, should be the targets of therapy.

FINAL THOUGHTS

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Chapter Summary (Slide 2 of 4)

The behavioral framework explains psychological symptoms as the result of personal experiences and learning histories, interacting with the current set of prevailing contingencies of reinforcement and punishment. It proposes that symptoms are treated by providing new learning experiences and altering contingencies to favor the development of more adaptive behaviors.

FINAL THOUGHTS

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Chapter Summary (Slide 3 of 4)

The cognitive approach modifies the behavioral perspective to include beliefs, expectations, attitudes, and thought patterns as sources of problems and targets to modify.

The biological approach explains psychological symptoms as the result of underlying biological or chemical abnormalities. It proposes that symptoms are treated medically, usually with psychotropic medication.

FINAL THOUGHTS

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Chapter Summary (Slide 4 of 4)

Humanistic-experiential approaches explain psychological symptoms as the existential anxiety produced by blockage of growth or the results of inauthentic subjective experiences. Treatment involves the freely-chosen acceptance of responsibility for one’s own life experience.

Increased reliance on outcome assessment has resulted in efforts to empirically identify effective treatments. That trend may combine with the tendency within science to refine a paradigm, moving the study of psychopathology toward a more unified model.

History of Mental Health Discussion

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