Whitbourne7e IM Ch01

CHAPTER 1
OVERVIEW TO UNDERSTANDING
ABNORMAL BEHAVIOR
CHAPTER AT A GLANCE
Abnormal Behavior
Prominent Themes in Abnormal

Psychology throughout History
Spiritual Approach
What Is Abnormal Humanitarian Approach
Behavior? Scientific Approach
The Social Impact of Research Methods in Abnormal

Psychological Disorders Psychology
Experimental Design
Defining Abnormality
Correlational Design
What Causes Abnormal

Behavior? Types of Research Studies
Biological Causes Survey
Psychological Causes Laboratory Studies
Sociocultural Causes The Case Study Method
The Biopsychosocial Perspective Single Case Experimental Design
Investigations in Behavioral Genetics
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Teaching Objectives
1.0 What Is Abnormal Behavior?

1.1 Recognize the difficulties to defining abnormal behavior because it overlaps with “normal” behavior.
1.2 Discuss how one must go beyond the “other people” syndrome and how psychological difficulties are
part of everybody’s lives.
2.0 The Social Impact of Psychological Disorders

2.1 Discuss how socially it affects the individual who is diagnosed with a psychological disorder and for
those around him.
3.0 Defining Abnormality

3.1 Contrast the view of abnormal behavior as deviation from the average with the view of abnormal
behavior as deviation from the optimal.
4.0 What Causes Abnormal Behavior?

4.1 Define abnormal behavior as a concept that incorporates biological, psychological, and sociocultural
perspective.
4.2 Discuss the importance of the biopsychosocial perspective.
5.0 Prominent Themes in Abnormal Psychology throughout History

5.1 Recognize the influence of beliefs about possession on prehistoric approaches to
psychological disorders.
5.2 Describe the spiritual approach which regarded abnormal behavior as the product of
possession by evil or demonic spirits.
5.3 Describe how the humanitarian explanations view psychological disorders as the result of
cruelty, stress, or poor living conditions.
5.4 Describe how scientific approach looks for causes that we can objectively measure, such as
biological alterations, faulty learning processes, or emotional stressors.
6.0 Research Methods in Abnormal Psychology

6.1 Describe the essential elements of the scientific research methods in abnormal psychology.
7.1 Experimental Design

7.2 Explain the experimental method and describe the concepts of independent and dependent variables,
placebos, treatment and control groups, double-blind techniques.
8.1 Correlational Design

8.2 Discuss the correlational method and define negative and positive correlations.
9.1 Types of Research Studies

9.2 Outline the survey method and distinguish prevalence from incidence.
9.3 Describe how laboratory studies are conducted.
9.4 Describe the case study method.
9.5 Indicate how the single-subject study is conducted and how the multiple baseline technique is used in
this type of research.
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9.6 Discuss how the field of behavioral genetics and psychopathology attempt to determine the extent to
which people inherit psychological disorders.
9.7 Discuss how complex it is to define abnormality without bringing in all the clinical perspectives.
10.0 Chapter Boxes

10.1 Describe the slight changes made in the DSM-5 as what is “clinically significant”.
10.2 Discuss the David Rosenhan’s groundbreaking study that shattered people’s assumptions
about the difference between “sane” and “insane.” Indicate the ethics of correct disgnosis.
10.3 Discuss some of the key ideas in the case of Vincent van Gogh.
Lecture Discussion Topics and Controversies
1. In the case of Rebecca Hasbrouck, what single factor do you think may have led to her breakdown?
2. How might the lack of support from Rebecca’s family and her boyfriend have contributed to
Rebecca’s mental state?
3. Mental disorders do not discriminate; however, there are many disparities when it comes to the
treatment of mental health. How might these disparities affect different cultures, races, and gender?
4. In the Western world, body piercing is a fad. In other countries it marks status and may be performed
as a ritualistic ceremony. Some research suggests that numerous body piercings may be a form of
self-mutilation. Is body piercing a form of self-expression? Can we use our bodies as a canvas to
express ourselves or is it an indicator to mental illness?
Roberti, Jonathan W., Storch, Eric A. (2005). Psychosocial adjustment of college students with tattoos and piercings.
Journal of College Counseling, 8 (1), p14-19.
5. According to NIMH (2008), mental disorders are common in the United States and internationally.
An estimated 26.2 percent of Americans aged 18 and older — about one in four adults — suffer from
a diagnosable mental disorder in a given year. When applied to the 2004 U.S. Census residential
population estimate for ages 18 and older, this figure translates to 57.7 million people. Even though
mental disorders are widespread in the population, the main burden of illness is concentrated in a
much smaller proportion — about 6 percent, or 1 in 17 — who suffer from a serious mental illness. In
addition, mental disorders are the leading cause of disability in the U.S. and Canada for ages 15-44.
Many people suffer from more than one mental disorder at a given time. Nearly half (45 percent) of
those with any mental disorder meet criteria for 2 or more disorders, with severity strongly related to
comorbidity.
http://www.nimh.nih.gov/health/topics/statistics/index.shtml
6. The burden of mental illness on health and productivity in the United States and throughout the world
has long been underestimated. Data developed by the massive Global Burden of Disease study
conducted by the World Health Organization, the World Bank, and Harvard University, reveal that
mental illness, including suicide, accounts for over 15 percent of the burden of disease in established
market economies, such as the United States. This is more than the disease burden caused by all
cancers.
http://www.nimh.nih.gov/health/topics/statistics/index.shtml
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7. The challenge in treating institutionalized individuals has been to strike a balance between depriving
them of their freedoms, and providing them with needed treatment. The 1963, Community Mental
Health Care Act, often thought of by many to have been the impetus for the deinstitutionalization
movement, removed the need to deprive patients of their freedom. Countless individuals previously
cared for in state institutions were released into communities because, when medicated, they were
thought to be functional enough to survive in the community. Where do deinstitutionalized
individuals go? Recent statistics indicate that they joined the ranks of the homeless. According to
Freshwater and Westwood (2006), there are many international differences apparent in the ways
reforms are being implemented; however, many of the reforms amplify government interest in mental
health. Most of the initiatives lead to deinstitutionalization and the decentralization of responsibility.
Some reforms reflect a strong orientation toward supporting and assisting people with mental illness
as citizens in the community.
Freshwater, D., Westwood, T. (2006). Risk, detention and evidence: humanizing mental health reform. Journal of
Psychiatric and Mental Health Nursing, 13 (3), 257-259.
8. Kendra Webdale was a young woman who died in January 1999. She was pushed in front of a New
York City subway train by Andrew Goldstein, who had countless hospitalizations for schizophrenia.
Goldstein had many documented attempts to get services without success. As a result of this tragedy,
New York State has recently enacted legislation that provides assisted outpatient treatment for clients
who in their view are unlikely to survive safely in the community without additional supervision.
These clients may be a potential risk to our safety. Therefore, this controversial law can force
mentally ill clients to take medication. Will this approach work? What are the ramifications of this
law?
Moran. Mark (2000) Coercion or caring?, AMNews staff. April 17, 2000.
Office of Counsel for the New York State office of Mental Health. November 1999.
Winerip, M. (1999, May 23). Bedlam on the streets: Increasingly, the mentally ill have nowhere to go. That’s their
problem--and ours. The New York Times Magazine, 42-49, 50, 65-68.
9. Jails and prisons are increasingly becoming the warehouses for the seriously mentally ill that were
formerly hospitalized. People with schizophrenia, severe depression, bipolar disorder, and other
serious mental illnesses, are more apt to be arrested for minor offenses and spend inordinate amounts
of time in jail because they are homeless and cannot make bond. There are now more seriously
mentally ill people in jails and prisons than in hospitals and mental institutions.
Cohen, F. (1996). Offenders with mental disorders in the criminal justice-correctional process. In B. D. Sales and D. W.
Shuman (Eds.). Law, mental health, and mental disorder (397-413). Pacific Grove, CA: Brooks/Cole Publishing Co.
Steadman, H. J., Barisiak, S., Dvoskin, J., & Holohean, E. J. (1987). A survey of mental disability among state prison
inmates. Hospital and Community Psychiatry, 28, 1086.
Teplin, L. A. (1990). The prevalence of severe mental disorder among male urban jail detainees: Comparison with the
epidemiological catchment area program. American Journal of Public Health, 80, 663.
Teplin, L. A. (1984). The criminalization of the mentally ill: Speculation in search of data. In L. A. Teplin (Ed.), Mental
health and criminal justice. Newbury Park, CA: Sage.
10. In the mid 1400s in Europe, tolerance for bizarre behavior waned. Individuals who acted strangely
were said to be in league with the devil. These individuals were often thought to be witches.
According to the authors of a 1486 witch-hunting manual, Malleus Maleficarum (or the Witches’
Hammer), most witches were women (Kramer & Sprenger, 1971, p. 41). The primary reasons for
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this, according to the authors, were that women were feeble of mind and body and more carnal than
men (p. 44). The Witches’ Hammer was written by two Dominican monks, and was considered a
religious document. Because of the prevailing societal attitudes at the time, it essentially legitimized
the mistreatment and murder of women.
Kramer, H. & Sprenger, J. (1971). The malleus maleficarum. New York: Dover Publications (TO 2.3)
11. Definitions of abnormality are in most cases inherently bound to social norms. Since norms vary from
culture to culture, one would expect that the definitions of abnormality also vary from culture to
culture. Consider the following description from our Western perspective:
The seance is opened by singing and drumming. After a time the

shaman falls down very hard on the floor. In a while, the tapping
of her fingers and toes is heard on the...floor. Slowly she gets up,
and already she is thought to “look awful, like a dog, very
scary.” She crawls back and forth across the floor making
growling sounds. In this state she begins to carry out the various
rites..., such as sucking the illness out of the body and blowing it
into the air... (Murphy, 1964; as cited in Murphy, 1976).
Seeing and hearing things that are not there, and believing in things that do not exist are signs of
disorder in our culture. In some other cultures, they are sometimes considered to be a part of insanity
and at other times not. The brief description above is a common ritual practiced by shamanesses in a
group of Inuit (Eskimos) in northwestern Alaska (Murphy, 1976). The Inuit note that during the
ritual, the shaman is “...out of mind, but not crazy.” (p. 1022). They contrast this state with
nuthkavihak, which is more in line with what the western world considers “being crazy.” The
individual that is nuthkavihak, “...is out of mind, and crazy.”
Murphy, J. M. (1976). Psychiatric labeling in cross-cultural perspective. Science, 191, 1019-1028.
Demonstrations and Classroom Exercises
1. James Carr and John Austin (1997) have developed a demonstration of the single-subject research
design. Students act as their own subjects in a brief study of the effects of exercise on pulse rate.
After instructing students on how to take their own pulse rate, they are required to take baseline
measures of their pulse rate (in beats per minute) for 5 one-minute intervals. Then the treatment phase
begins. Students are then instructed to stand up and do jumping jacks for 20 seconds, after which they
sit and record their pulse rate for 1 minute. They are to repeat this sequence for 4 more trials. The
final baseline phase then begins where students are required to record their resting pulse rate for 5
more minutes. Students can then graph their results and attempt to draw some conclusions regarding
how the treatment affected their heart rates. Carr and Austin (1997) report that student opinions of
this activity are very favorable in that it provides a concrete example of the use of the single-subject
design.
Carr, J. E. & Austin, J. (1997). A classroom demonstration of single-subject research designs. Teaching of Psychology, 24,
188-190.
2. You may want to describe some of your own research to reinforce your students’ understanding of
research methods and issues. Have students identify what type of research it is (i.e., experimental,
correlational), what variables were being studied, what procedures were used to select and assign
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subjects to conditions, and how extraneous variables were controlled. Students seem to retain the
information on research methods better if they have concrete examples.
3. Have students collect news items, either from newspapers, the Internet or from the television news,
where a person’s behavior in the case could potentially be construed as abnormal. Then have the
students consider the 4 criteria defined as abnormality provided by the text. Would most of the news
stories likely lead someone to label the person’s behavior as abnormal? Also have students review the
individual’s behavior described in the reports based on the biological, psychological, and
sociocultural criteria used to define abnormality.
4. Break students up in small groups. Have them arrive at a consensus of the definition of abnormality.
Have them discuss the difficulties and the influence of gender, age, culture, and religion.
5. Ask students to develop a hypothesis (real or imagined) about any abnormal behavior of their choice
(it need not be a DSM-IV –TR diagnosis, but some behavior they consider abnormal). Design research
testing the hypothesis using at least three methods and critique the pros and cons of each method.
Faces Interactive Classroom Exercises (www.mhhe.com/faces)

1. Major Depression: Referencing the assessment area of the Faces Interactive Guide for Major
Depression, direct students to form groups of 4-5 and develop a scenario of how Tara would have
been treated for her symptoms 300 years ago. Would she have been diagnosed with Major
Depression? What other diagnoses would she have potentially been diagnosed with?
2. Major Depression: Through Faces Interactive, have students access the case report for Tara. Ask
them to research current treatments that might be successful for Tara and develop a treatment plan
based on their research.
Videos and Films

Abnormal Psychology emphasizes the problems of distinguishing clearly between normal and abnormal
behavior within the context of the DSM. (Coast District Telecourses, 11460 Warner Avenue, Fountain
Valley, CA 92708).
Asylum is an excellent documentary that covers the history of St. Elizabeth’s hospital in Washington, our
nation’s first asylum. In addition to highlighting the ups and downs of this form of treatment, the film also
features commentary by two historians who highlight the pros and cons of deinstitutionalization. The
video also deals with the plight of the homeless mentally ill. It is available from: Direct Cinema Limited,
P.O. Box 69799, Los Angeles, CA 90069.
Back from Madness: The Struggle for Sanity (#CBK6299) documents the cases of four psychiatric
patients and their treatment at Massachusetts General Hospital. As a contrast to the current treatments
portrayed, archival footage of how mental illness was treated in the past is also included. It is available
from Films for the Humanities and the Social Sciences—1-800-257-5126 or http://www.films.com
Emotional Illness discusses abnormal behavior and distinguishes neurotic, psychotic, and psychosomatic
illnesses. (Audio Visual Center, Indian University, Bloomington, IN 47405).
Dr. Pinel Unchains the Insane enacts Pinel’s crusade for moral treatment. (McGraw-Hill Textfilms, 1221
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Avenue of the Americas, New York, NY 10020).
Mental Health Care Issues: Diverting the Mentally Ill from Jail (#CBK6444) examines the difficult
situation that arises when prison inmates also suffer from mental illnesses. The program also explores the
possible benefits of diverting offenders to mental health programs. It is available from Films for the
Humanities and the Social Sciences—1-800-257-5126 or http://www.films.com. The first three
programs in the PBS series Madness deal with several of the issues covered in chapter 1. Program 1
entitled, “To Define True Madness,” considers the issues involved in defining abnormality and some of
the past and present myths about mental illness. Program 2, “Out of Sight,” illustrates the history of
institutionalization and the reforms instituted by Pinel. Program 3, “Brainwaves,” chronicles the history
of medical discoveries pertaining to mental disorders.
One Flew Over the Cuckoo’s Nest, starring Jack Nicholson, presents some interesting questions about
abnormal behavior, as well as focusing on the inhumanity in some mental hospitals.
Nuts, starring Barbra Streisand and Richard Dreyfuss, depicts a woman who tries to convince the legal
system that she is not “crazy” and wants to be tried for murdering an assailant. Like One Flew over the
Cuckoo’s Nest, it poses questions about what is abnormal behavior and, more importantly, who decides
whether or not it is.
Girl Interrupted, starring Winona Ryder and Angelina Jolie, is based on a true story, set in 1967. Winona
Ryder depicts a young woman who is institutionalized and questions the differences between confinement
and freedom, madness and insanity. What starts out as a prescribed “short rest” becomes a remarkable
two-year personal journey of growth and inner awareness.
The Fisher King, starring Robin Williams and Jeff Bridges, tells the story of a man who once was a
university professor but becomes unglued by a tragic event.
Literature Guide and Suggested Readings
Andreasen, N. C. (1987) Creativity and mental illness: Prevalence rates in writers and their first-degree
relatives. American Journal of Psychiatry, 144,1288-92.
Basic Behavioral Science Task Force of the National Advisory Mental Health Council (1996). Basic
behavioral science research for mental health: Vulnerability and resilience. American Psychologist, 51,
22-28.
Cool, L. C. (1997, March). Is mental illness catching? American Health for Women, 72-75.
Jones, A. H. (1998). Mental illness made public: Ending the stigma? Lancet, 352, 1060.
Laing, R. D. (1983). The politics of experience. New York: Vintage. This classic “anti-psychiatry” book
presents the argument that mental illness is a social and political construct and that society, not
individuals, is “sick.”
Neugebauer, R. (1979). Medieval and early modern theories of mental illness. Archives of General
Psychiatry, 36, 477-484.
Porter, R. (2003). Madness: A brief history. Oxford University Press, USA.
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Rosen, G. (1975). Madness in society: Chapters in the historical sociology of mental illness. New York:
Anchor Books.
Rosenhan, D. L. (1973). On being sane in insane places. Science, 179, 250-258.
Secker, J. (1998). Current conceptualizations of mental health and mental health promotion.
Health Education Research, 13, 57-66.
.
Sheehan, S. (1983). Is there no place on earth for me? Vintage Publishing. This book is about the life
story of a woman who becomes schizophrenic as a teenager and depicts the revolving-door lifestyle of
chronic schizophrenics.
Spanos, N. P. (1978). Witchcraft in the histories of psychiatry: A critical appraisal and an alternative
conceptualization. Psychological Bulletin, 35, 417-439.
Star, S. A. (1952). What the public thinks about mental health and mental illness. Paper presented at the
annual meeting of the National Association for Mental Health.
Szasz, T. (1961). The myth of mental illness. New York: Harper & Row. Like Laing (above), Szasz
believes that mental illness is a social construct.
Teplin, L. A., Abram, K. M., McCleland, G. M. (1994). Does psychiatric disorder predict violent crime
among released jail detainees? A six-year longitudinal study. American Psychologist, 49, 335-342.
Millon, T. (2004). Masters of the mind: Exploring the story of mental illness from ancient times to the
new millennium. John Wiley & Sons, Inc.
Monahan, J., Steadman, H. J. (1994). Violence and mental disorder. Chicago: University of Chicago
Press. Excellent selection of articles about the relationship between various mental disorders and
symptoms and mental illness.
Winerip, M. (1995). 9 Highland Rd. New York: Vintage. Revealing and evocative account of the
members of a group home for the mentally ill that focuses on six residents and their lives over a three
year period.
Paper Topics
1. Parity refers to the effort to treat mental health financing on the same basis as financing for general
health services. In recent years advocates have repeatedly tried to expand mental health coverage with
some success. The fundamental motivation behind the Parity Act of 2007 is the desire to cover mental
illness on the same basis as somatic illness. Have students assess whether we have met this goal.
2. Students may find it fascinating to read Thomas Szasz’s book The Myth of Mental Illness (listed
above) and provide a detailed written report of the author’s views
2. Have students read the book Is There No Place On Earth For Me?; have them write a timeline of
Sylvia Frumkin (the pseudonym of the character) and prepare a time line of her life, focusing on the
situations, dates, events, hospitalizations, and family dynamics that contribute to her experience with
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schizophrenia. Be sure to have students find and read the final installment of Sylvia’s life, which
appeared in The New Yorker on February 20 and 27 (double issue), 1995, 200-211.
3. Students could construct a survey that could be administered in several of their other classes to assess
student attitudes regarding mental illness.
4. Using Nancy Andreasen’s research on creativity and mental illness as a foundation, students might
want to examine the biographies of individuals like Ernest Hemmingway, Sylvia Plath, Vincent van
Gogh, or a more recent example, such as Kurt Cobain, for a more case-based perspective on creativity
and mental disorders.
5. Rent and watch the video Nuts with Barbara Streisand and Richard Dreyfuss. Streisand’s character
insisted that she was not “crazy” but that her parents and the “system” were. Write a report about how
the movie portrays the criminal justice system’s efforts to deal with what it perceives to be abnormal
behavior or how life experiences (with parents, in the home, as well as when living independently)
lead to psychological suffering.
6. Have students create a mock experiment. Have them research the ethical review process at your
campus.
7. Using the Surgeon General’s Executive Summary Report on Mental Health (1999), have students
attempt to solve the overwhelming task of dealing with stigma within the field of mental health.
8. According to a study conducted by Roberti & Storch (2005), students with tattoos or piercings have a
greater likelihood to experience anxiety or mood disorders. Have students read and critique this
article.
Roberti, Jonathan W., Storch, Eric A. (2005). Psychosocial adjustment of college students with tattoos and piercings.
Journal of College Counseling, 8 (1), 14-19.
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CHAPTER 1

Prominent Themes in Abnormal

The Social Impact of Research Methods in Abnormal

What Causes Abnormal

1.0 What Is Abnormal Behavior?

2.0 The Social Impact of Psychological Disorders

3.0 Defining Abnormality

4.0 What Causes Abnormal Behavior?

5.0 Prominent Themes in Abnormal Psychology throughout History

6.0 Research Methods in Abnormal Psychology

7.1 Experimental Design

8.1 Correlational Design

9.1 Types of Research Studies

10.0 Chapter Boxes

Lecture Discussion Topics and Controversies

The seance is opened by singing and drumming. After a time the

Demonstrations and Classroom Exercises

Faces Interactive Classroom Exercises (www.mhhe.com/faces)

Videos and Films

Literature Guide and Suggested Readings

Porter, R. (2003). Madness: A brief history. Oxford University Press, USA.

Rosenhan, D. L. (1973). On being sane in insane places. Science, 179, 250-258.

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