ABNORMAL PSYCHOLOGY Ronald J.

Comer

Questions:
Whats the difference between Pavlov’s Clasical conditioning and Skinners Operant
Conditioning?
What is the MMPI?

Interesting Dates
1973 – DSM stops listing homossexuality as mental disorder

Acronyms (Sigla)
EEC = Eletroencefalograma/grafia
CAT scan = Tomografia
MRI = Ressonância Magnética
FDA = Food and Drug Administration
APA = American Psychological Association
PTSD = Post Traumatic Stress Disorder
WHO = World Health Organization (OMS)

CHAPTER 1
Defining “Psychological Abnormality”
The Four D’s / Patterns of psychological abnormality are typically:
Deviance / Different, extreme, unusual
Distress / Unpleasant and upsetting to the person
Dysfunction / Interfering with person’s ability to conduct daily activities in constructive way
Danger / Possibly dangerous

DEVIANCE
Behaviours, thoughts and emotions that deviate significantly from a SOCIETY’S IDEAS ABOUT
PROPER FUNCTIONING – Norms/stated and unstated rules of proper conduct
Consider: SPECIFIC CIRCUMSTANCES AND CULTURAL NORMS
Ex: extreme circumstances will trigger extreme behavior

DISTRESS
Even functioning that is considered unusual does not necessarily qualify as “abnormal” – have
to CAUSE DISTRESS before being considered so.
BUT: even if not causing distress must not be rulled out (paranoia, for instance… person can
feel special about being chosen by the “voices”/aliens/ etc)

DYSFUNCTION
Interferes with daily functioning: people cannot take care of themselves properly, participate
in social interactions, work productively.

DANGER
Ultimate psychological dysfunction is behavior that becomes DANGEROUS to oneself or to
others: consistently carless, hostile or confused.
It’s the exception rather than the rule (depression, anxiety, bizarre thinking often pose no
immediate danger)
ALSO: in the ABSENCE OF DISTRESS AND DYSFUNCTION, dangerous behavior alone does not
signify psychological abnormality. (ex.: parachute jumpers, fireman)

ELUSIVE NATURE OF ABNORMALITY

Thomas Szasz (1920 – 2012) – found the whole concept of mental illness to be invalid (because
he placed so much emphasis on societies role: deviations are simply “problems in living”, not
sign of something wrong with the person. Clinicians who de-emphasize the role of “illness” or
“disorder” – look instead at circumstances and coping challenges that bring them to
treatment.

Even then, we have plenty of BEHAVIOURS THAT ARE DEVIANT, DISTRESSFUL, DYSFUNCTIONAL
OR DANGEROUS and we don’t treat as “ABNORMAL”:

Drinking amongst College students

High numbers of aesthetic Plastic Surgery (silicone implants)
Indebting choices (mortgages – crisis of 2008… happening all over again)
High use of social media (addictions overlooked: series, exercises/gym,

Difficult to separate an abnormality that is simple ECCENTRIC X ILLNESS (requires intervention)

David Weeks (2015) studied ECCENTRICS and elected 15 common characteristics:
nonconformity, creativity, strong curiosity, idealism, extreme interests and hobbies, lifelong
awareness of being different,
- Eccentrics do not typically suffer from mental disorders.
- They choose freely to be different (the behavior does not “impose itself upon them),
and take pleasure in it;
- Their thought processes are not severely disrupted; does not leave them dysfunctional
IN THE STUDY, ECCENTRICS HAD FEWER EMOTIONAL PROBLEMS THAN THE “normals”.
ORIGINALITY, SENSE OF SELF – GOOD FOR MENTAL HEALTH

THERAPY / TREATMENT

Special systematic procedures to help people overcome their psychological difficulties

Jerome Frank (clinician) defines 3 essential features of therapy:
1. Sufferer who seeks relief from the healer
2. Trained, socialy accepted healer, whose expertise is accepted by the sufferer and its
social group
3. Series of contacts between healer and sufferer, through which

ANCIENT VIEWS AND TREATMENTS FOR ABNORMALITY

Possesion/Demonology
(idea of human beings as “territory” over which Divine and Evil forces fought).
Form of treatment: exorcism; trephination (as old as neolithic period!)
QUESTION: Shaman’s work… Jung/J. Campbell not so much to “expel” demons/voices, BUT TO
ACCOMMODATE the person to them and vice versa…
What demonological explanations or treatments, besides exorcism, are still around today, and why do they
persist?

Brasil: terreiro de Umbanda… espiritismo...;

GREEK AND ROMAN VIEWS AND TREATMENT

Hyppocrates (460 - ) ILLNESSES HAD NATURAL CAUSES. Abnormal behavior arising from
physical internal causes: “humors” (yellow bile, black bile, blood and phleugm)

Middle Ages – Demonology returns

Towards the end, medical treatment in hospitals

RENAISSANCE (1400 – 1700)

Johan Weyer (1515 – 1588) – doctor to specialize in mental illness – considered mind as
succeptible to diseases as the body.

First mental health colonies (parishes, monasteries, cities that welcomed mentally ill)

16th century: Asylums appear (first with intention of care – start overflowing… degrading
condotions… in England one even became touristic attraction… people screaming bound in
chains…

DEALING WITH MENTAL ILLNESS ALWAYS GETS US TO QUESTION HUMAN OVERALL

CRAZYNESS…

NINETEENTH CENTURY – REFORM AND MORAL TREATMENT

PINEL - 1793 (during French revolution) Philippe Pinel named chief physician at La Bicêtre
(asylum for male): unchained them, allowed to move freely around hospital, advocated
kindness and respect, replaced dungeons with well ventilated rooms; did same at female
facility;

TUKE, William – a quaker, north England – 1796, York Retreat, a rural estate; 30 mental
patients lived as guests in quiet country houses and were treated with a combination of rest,
talk, prayer, and manual work

These methods were called Moral Treatment

In US – Benjamin Rush (1745 – 1813) responsible for spreading it (Pensylvania hospital) –

considered Father of American Psychiatry

DOROTHEA DIX – Boston – made humane care a public and political concern; campaigned to
reform asylums;

DECLINE OF MORAL TREATMENT

By 1850… overflowing hospitals, money and staffing shortages… realizing this form of
treatment was not sufficient for recovery of all patients, some needed other forms of
treatment that hadn’t been developed (more severe illnesses)
EARLY TWENTIETH CENTURY

Emergence of two perspectives:

Somatogenic: attributes physical causes for mental illnesses (Hippocrates had already thought
of… 2.400 years ago)

German Researcher Kraepeling – associates physical causes (ex fatigue) to mental disorders;
develops first modern system for classifying abnormal behavior
Biological discoveries: syphilis led to general paresis (with physical symptoms, as paralysis,
and also with mental symptoms such as dillusion of grandeur)

HOWEVER: DISAPPOINTING AND DANGEROUS COURSES OF ACTIONS

- Tonsil extraction
- lobotomy
- Eugenic sterilization

Only in 1950 with development of drugs will the somatogenic view pay off

Psychogenic: attributes psychological causes to mental illness

Hypnotism
1st with Friedrich Mesmer (17…
2nd France and Vienna studies with hypnotism and hysteria: BREUER AND FREUD
From hypnosis to psychotherapy

TREATMENTS TODAY

Severe mental disturbances:

Deinstitutionalization – outpatient care: receive treatment in public or private psychiatric
hospitals and live at their own home (receiving outpatient psychotherapy and medication)
HOWEVER, usually go back and forth from hospitals OR end up living on the streets

Less Severe Disturbances

Private Psychotherapy (health insurances today cover)
Community mental health centers, crisis intervention centers, family service centers
Specific psychological problems: suicide prevention centers, substance abuse
programs, eating disorder programs, phobia clinics, and sexual dysfunction programs.

PREVENTIVE

Correction of social conditions

Help individuals at risk for developing emotional problems (ex pregnant teenagers,
children refugees)
Utilizing positive psychology to teach coping skills

POSITIVE PSYCHOLOGY: While researchers study and learn more about positive
psychology in the laboratory, clinical practitioners with this orientation are teaching
people coping skills that may help protect them from stress and adversity and
encouraging them to become more involved in personally meaningful activities and
relationships — thus helping to prevent mental disorders

Why do you think it has taken psychologists so long to start studying positive
behaviors?

MULTICULTURAL PSYCHOLOGY: seek to understand how culture, race, ethnicity,

gender, and similar factors affect behavior and thought and how people of different
cultures, races, and genders may differ psychologically

HEALTH INSURANCE:
Managed care programs is dominant form — programs in which the insurance
company determines such key issues as which therapists its clients may choose, the
cost of sessions, and the number of sessions for which a client may be reimbursed:
results often in shortened sessions, less effective therapy – reimburse less for therapy
than physical care.

TODAYS LEADING THEORIES AND PROFESSIONS

Before the 1950s, the psychoanalytic perspective, with its emphasis on unconscious
psychological problems as the cause of abnormal behavior, was dominant. Today we
have, as schools of thought.
biological,
cognitive-behavioral,
humanistic-existential,
sociocultural,
developmental psychopathology

PROFESSIONALS
clinical psychologists — professionals who earn a doctorate in clinical psychology
counseling psychologists,
educational and school psychologists,
mental health counselors,
psychiatric nurses,
marriage therapists,
family therapists,
clinical social workers (LARGEST GROUP)

VOCABULARY

Psychotropics: drugs that act mainly on the brain (antipsychotic, antidepressant, anxiety
drugs)
Deinstitutionalization: The practice, begun in the 1960s, of releasing hundreds of thousands of
patients from public mental hospitals.
Community Mental Health Approach:
STATISTICS TODAY:
30% of adult population and 17% of children and teens in US display dangerous psychological
disturbances and need clinical treatment
Around 140,000 people with severe mental disturbances are homeless on any given day;
another 440,000 are inmates of jails and prisons

Surveys suggest that around 43 percent of people with psychological disorders in the United
States receive treatment in the course of a year

Members of racial and ethnic minority groups in the United States collectively make up 40
percent of the population, a percentage that is expected to grow to 52 percent by the year
2055