Chapter 1: Introduction and Historical Overview
Psychopathology = the field concerned with the nature, development, and treatment of
psychological disorders
Psychological disorder = clinically significant behavioral or psychological syndrome or pattern, which
includes a number of key features
Due to infinite variations in behavior, not single marker of pathology, and normal people also
showing problematic behavior, it is difficult to define psychological disorder
Personal distress (suffering): if a person's behavior causes that person great distress
o Someone with antisocial personality disorder may not feel distress about its behavior
o Not all behavior that causes distress is disordered: grieving after losing someone
Disability: impairment in some important area of life
o Being rejected by peers, serious arguments, poor work performance, phobias
o Bulimia nervosa doe snot necessarily involve disability as that person leads its life
without impairment, while bingeing and purging in private
Dysfunction: something that has gone wrong and is not working as it should
Violation of social norms (deviance)
History of psychological disorders
Good and bad manifestations of power beyond human control were seen as supernatural
o Exorcism = the ritualistic casting out of evil spirits
Hippocrates rejected the belief of supernatural causes and thus insisted on natural causes
which should be treated like other diseases
o He believed there should be a balance among blood, black bile, yellow bile, and
phlegm, to have a healthy brain
o Mania: due to too much yellow bile
o Melancholia: due to too much black bile, which could be treated with tranquility,
sobriety, care in choosing food an drink, and abstinence from sexual activity
o Phrenitis / brain fever: due to too much blood
After the death of Galen the Dark Ages started in West Europe, where belief in supernatural
forces and causes for human behavior regained popularity
o Though in the Islamic world the Golden Era started through works of Ibn Sina, Al-
Bhrazi, and Al-Balkhi
Lunacy trials (13th century) to determine one's mental health
o Lunacy comes from the physician Paracelsus, who attributed odd behavior to a
misalignment of the moon and stars
During the 15th century people built asylums = refuges established in Western Europe to
confine and provide for people with mental illness: forerunners of the mental hospital
o Bethlehem in London was considered entertainment as people with psychological
disorders were confined in spaces between rooms where they could be viewed by
passersby
o Pinel changed the way asylums worked as he believed that people in his care should
be approached with compassion and understanding and should be treated with
dignity, though this treatment was reserved for upper class only
Moral treatment = a therapeutic regimen whereby mentally ill patients were released from
their restraints and were treated with compassion and dignity rather than with contempt
and denigration
Electroconvulsive therapy, ECT = a treatment that produces a convulsion by passing electric
currents through the brain
o Despite public concerns about this treatment, it can be useful in alleviating severe
depression for some people
Prefrontal lobotomy = a surgical procedure that destroys the tracts connecting the frontal
lobes to other areas in the brain
, Hysteria = physical incapacities for which no physical cause could be find (e.g. blindness /
paralysis)
o Mesmer is considered the earliest practitioners of hypnosis (mesmerism) to treat
hysteria
o Catharsis / cathartic method = reliving an earlier emotional trauma and releasing
emotional tension by expressing previously forgotten thoughts about the event
Freud believed that psychopathology results from conflicts in the
unconscious = the part of the personality, the id impulses or energy, of
which the ego is unaware, according to Freud's theory
id = the part of the personality present at birth, comprising all the
energy of the psyche and expressed as biological urges that strive
continually for gratification
Ego = the predominantly conscious part of the personality,
responsible for decision making and for dealing with reality, which
develops during the second 6 months of life
Defense mechanisms = reality-distorting strategies
unconsciously adopted to protect the ego from anxiety
Repression = keeping unacceptable impulses or
wishes from conscious awareness
Denial = not accepting a painful reality into
conscious awareness
Projection = attributing to someone else one's own
unacceptable thoughts or feelings
Displacement = redirecting emotional responses
from their real target to someone else
Rationalization = offering acceptable reasons for an
unacceptable action or attitude
Superego = the part of the personality that acts as the conscience
and reflects society's moral standards as learned from parents and
teachers, which develops throughout childhood
Psychotherapy = a primarily verbal means of helping troubled
individuals change their thoughts, feelings, and behavior to reduce
distress and to achieve greater life satisfaction
Psychoanalysis = therapy entailing free association, dream
analysis, and working through transference
Transference = a person's responses to his or her
analyst that seem to reflect attitudes and ways of
behaving toward important people in the person's
past
Freud's ideas have lack of research to support them though some of
his work has influenced commonly held assumptions
Childhood experiences help shape adult personality
There are unconscious influences on behavior
The causes and purposes of human behavior are not always
obvious
Behaviorism = an approached which focused on observable behavior rather than on
consciousness or mental functioning
o Classical conditioning = a basic form of learning in which a neutral stimulus is
repeatedly paired with another stimulus that naturally elicits a certain desired
response, and after repeated trials, the neutral stimulus becomes a conditioned
stimulus and evokes the same or a similar response, now called the conditioned
response
, Extinction = the elimination of a classically conditioned response by the
omission of the unconditioned stimulus
o Operant conditioning = the acquisition or elimination of a response as a function of
the environmental contingencies or reinforcement and punishment
Extinction = the elimination of a behavior by the omission of reinforcement
Law of effect = a principle of learning that holds that behavior is acquired by
virtue of its consequences
Intermittent reinforcement = rewarding a response only a portion of the
times ti appears, which makes new behavior more enduring (e.g. gambling)
Positive reinforcement = the strengthening of a tendency to exhibit desired
behavior by rewarding responses in that situation with a desired reward
Negative reinforcement = the strengthening of a tendency to exhibit desired
behavior by rewarding responses in that situation with the removal of an
aversive stimulus (e.g. beeping of the car stops when you tie your seatbelt)
Negative punishment = removing something pleasant from the situation
after certain behavior, which decreases the probability of this behavior being
repeated
Positive punishment = adding something unpleasant to the situation after
certain behavior, which decreases the probability of this behavior being
repeated
o Modeling = learning by observing and imitating the behavior of others or teaching by
demonstrating and providing opportunities for imitation
Ways in which people appraise situations can influence behavior dramatically
o CBT helps people change their cognition in hopes of changing their feelings,
behaviors, and symptoms
Stigma = the destructive beliefs and attitudes held by a society about groups considered different in
some manner
Knowing more about the causes or available treatments of psychological disorders does not
decrease stigma
o Knowing more is linked to a greater desire for more social distance from people with
psychological disorders
1. Distinguishing label is applied
2. Label refers to undesirable attributed
3. People with the label are seen as different
4. People with the label are discriminated against
Stigma can be fought through different ways
o Community strategies
Housing options (high homelessness rate for people with psychological
disorders)
Personal contact
Coming into contact with someone with a psychological disorder
reduces stigma which persist in the long-term
Familiarity is associated with less stigma though sometimes it is
linked to more stigma
Due to family burden or job burnout which can foster stigma
o Mental health and health profession strategies
Mental health evaluations
Education, training, and support
o Individual and family strategies
Education for individuals and families
Support and advocacy groups
Mental health professions
, Clinical psychologist = an individual who has earned a PhD (more focus on research) degree
or a PsyD (more focus on clinical training) degree and whose training ahs included an
internship in a hospital or clinic
o Learning techniques of assessment and diagnosis of psychopathology
o Learning how to practice psychotherapy
Counseling psychologist = mental health professional who has earned a PhD and works with
people on relationships, life goals, improving coping and resilience, and other issues
impacting well-being
o Less focused on psychological disorders
Psychiatrist = a physician (M.D.) who completes medical training and also specialized
postdoctoral training, called a residency, in the diagnosis, treatment, and prevention of
psychological disorders
Psychiatric nurse = a nurse who receives specialized training in mental illness, and where an
advanced psychiatric nurse can prescribe psychiatric medications
Social worker = a mental health professional who holds a master of social work (M.S.W.)
degree
DSM-5-TR limitations
Reification = treating a diagnostic label as if it s a real, concrete entity
o DSM labels describe, they do not explain behavior
Circular reasoning = using the diagnosis to explain the symptoms that define it
o Hyperactivity <-> ADHD
Psychopathology = the field concerned with the nature, development, and treatment of
psychological disorders
Psychological disorder = clinically significant behavioral or psychological syndrome or pattern, which
includes a number of key features
Due to infinite variations in behavior, not single marker of pathology, and normal people also
showing problematic behavior, it is difficult to define psychological disorder
Personal distress (suffering): if a person's behavior causes that person great distress
o Someone with antisocial personality disorder may not feel distress about its behavior
o Not all behavior that causes distress is disordered: grieving after losing someone
Disability: impairment in some important area of life
o Being rejected by peers, serious arguments, poor work performance, phobias
o Bulimia nervosa doe snot necessarily involve disability as that person leads its life
without impairment, while bingeing and purging in private
Dysfunction: something that has gone wrong and is not working as it should
Violation of social norms (deviance)
History of psychological disorders
Good and bad manifestations of power beyond human control were seen as supernatural
o Exorcism = the ritualistic casting out of evil spirits
Hippocrates rejected the belief of supernatural causes and thus insisted on natural causes
which should be treated like other diseases
o He believed there should be a balance among blood, black bile, yellow bile, and
phlegm, to have a healthy brain
o Mania: due to too much yellow bile
o Melancholia: due to too much black bile, which could be treated with tranquility,
sobriety, care in choosing food an drink, and abstinence from sexual activity
o Phrenitis / brain fever: due to too much blood
After the death of Galen the Dark Ages started in West Europe, where belief in supernatural
forces and causes for human behavior regained popularity
o Though in the Islamic world the Golden Era started through works of Ibn Sina, Al-
Bhrazi, and Al-Balkhi
Lunacy trials (13th century) to determine one's mental health
o Lunacy comes from the physician Paracelsus, who attributed odd behavior to a
misalignment of the moon and stars
During the 15th century people built asylums = refuges established in Western Europe to
confine and provide for people with mental illness: forerunners of the mental hospital
o Bethlehem in London was considered entertainment as people with psychological
disorders were confined in spaces between rooms where they could be viewed by
passersby
o Pinel changed the way asylums worked as he believed that people in his care should
be approached with compassion and understanding and should be treated with
dignity, though this treatment was reserved for upper class only
Moral treatment = a therapeutic regimen whereby mentally ill patients were released from
their restraints and were treated with compassion and dignity rather than with contempt
and denigration
Electroconvulsive therapy, ECT = a treatment that produces a convulsion by passing electric
currents through the brain
o Despite public concerns about this treatment, it can be useful in alleviating severe
depression for some people
Prefrontal lobotomy = a surgical procedure that destroys the tracts connecting the frontal
lobes to other areas in the brain
, Hysteria = physical incapacities for which no physical cause could be find (e.g. blindness /
paralysis)
o Mesmer is considered the earliest practitioners of hypnosis (mesmerism) to treat
hysteria
o Catharsis / cathartic method = reliving an earlier emotional trauma and releasing
emotional tension by expressing previously forgotten thoughts about the event
Freud believed that psychopathology results from conflicts in the
unconscious = the part of the personality, the id impulses or energy, of
which the ego is unaware, according to Freud's theory
id = the part of the personality present at birth, comprising all the
energy of the psyche and expressed as biological urges that strive
continually for gratification
Ego = the predominantly conscious part of the personality,
responsible for decision making and for dealing with reality, which
develops during the second 6 months of life
Defense mechanisms = reality-distorting strategies
unconsciously adopted to protect the ego from anxiety
Repression = keeping unacceptable impulses or
wishes from conscious awareness
Denial = not accepting a painful reality into
conscious awareness
Projection = attributing to someone else one's own
unacceptable thoughts or feelings
Displacement = redirecting emotional responses
from their real target to someone else
Rationalization = offering acceptable reasons for an
unacceptable action or attitude
Superego = the part of the personality that acts as the conscience
and reflects society's moral standards as learned from parents and
teachers, which develops throughout childhood
Psychotherapy = a primarily verbal means of helping troubled
individuals change their thoughts, feelings, and behavior to reduce
distress and to achieve greater life satisfaction
Psychoanalysis = therapy entailing free association, dream
analysis, and working through transference
Transference = a person's responses to his or her
analyst that seem to reflect attitudes and ways of
behaving toward important people in the person's
past
Freud's ideas have lack of research to support them though some of
his work has influenced commonly held assumptions
Childhood experiences help shape adult personality
There are unconscious influences on behavior
The causes and purposes of human behavior are not always
obvious
Behaviorism = an approached which focused on observable behavior rather than on
consciousness or mental functioning
o Classical conditioning = a basic form of learning in which a neutral stimulus is
repeatedly paired with another stimulus that naturally elicits a certain desired
response, and after repeated trials, the neutral stimulus becomes a conditioned
stimulus and evokes the same or a similar response, now called the conditioned
response
, Extinction = the elimination of a classically conditioned response by the
omission of the unconditioned stimulus
o Operant conditioning = the acquisition or elimination of a response as a function of
the environmental contingencies or reinforcement and punishment
Extinction = the elimination of a behavior by the omission of reinforcement
Law of effect = a principle of learning that holds that behavior is acquired by
virtue of its consequences
Intermittent reinforcement = rewarding a response only a portion of the
times ti appears, which makes new behavior more enduring (e.g. gambling)
Positive reinforcement = the strengthening of a tendency to exhibit desired
behavior by rewarding responses in that situation with a desired reward
Negative reinforcement = the strengthening of a tendency to exhibit desired
behavior by rewarding responses in that situation with the removal of an
aversive stimulus (e.g. beeping of the car stops when you tie your seatbelt)
Negative punishment = removing something pleasant from the situation
after certain behavior, which decreases the probability of this behavior being
repeated
Positive punishment = adding something unpleasant to the situation after
certain behavior, which decreases the probability of this behavior being
repeated
o Modeling = learning by observing and imitating the behavior of others or teaching by
demonstrating and providing opportunities for imitation
Ways in which people appraise situations can influence behavior dramatically
o CBT helps people change their cognition in hopes of changing their feelings,
behaviors, and symptoms
Stigma = the destructive beliefs and attitudes held by a society about groups considered different in
some manner
Knowing more about the causes or available treatments of psychological disorders does not
decrease stigma
o Knowing more is linked to a greater desire for more social distance from people with
psychological disorders
1. Distinguishing label is applied
2. Label refers to undesirable attributed
3. People with the label are seen as different
4. People with the label are discriminated against
Stigma can be fought through different ways
o Community strategies
Housing options (high homelessness rate for people with psychological
disorders)
Personal contact
Coming into contact with someone with a psychological disorder
reduces stigma which persist in the long-term
Familiarity is associated with less stigma though sometimes it is
linked to more stigma
Due to family burden or job burnout which can foster stigma
o Mental health and health profession strategies
Mental health evaluations
Education, training, and support
o Individual and family strategies
Education for individuals and families
Support and advocacy groups
Mental health professions
, Clinical psychologist = an individual who has earned a PhD (more focus on research) degree
or a PsyD (more focus on clinical training) degree and whose training ahs included an
internship in a hospital or clinic
o Learning techniques of assessment and diagnosis of psychopathology
o Learning how to practice psychotherapy
Counseling psychologist = mental health professional who has earned a PhD and works with
people on relationships, life goals, improving coping and resilience, and other issues
impacting well-being
o Less focused on psychological disorders
Psychiatrist = a physician (M.D.) who completes medical training and also specialized
postdoctoral training, called a residency, in the diagnosis, treatment, and prevention of
psychological disorders
Psychiatric nurse = a nurse who receives specialized training in mental illness, and where an
advanced psychiatric nurse can prescribe psychiatric medications
Social worker = a mental health professional who holds a master of social work (M.S.W.)
degree
DSM-5-TR limitations
Reification = treating a diagnostic label as if it s a real, concrete entity
o DSM labels describe, they do not explain behavior
Circular reasoning = using the diagnosis to explain the symptoms that define it
o Hyperactivity <-> ADHD
