chapter01 变态心理学.ppt

Chapter1AbnormalBehaviorinHistoricalContext,MythsandMisconceptionsAboutAbnormalBehavior,NoSingleDefinitionofPsychologicalAbnormalityNoSingleDefinitionofPsychologicalNormalityPsychologyDisorderv.MentalillnessManyMythsAreAssociatedWithMentalIllnessLazy,crazy,dumbWeakincharacterDangeroustoselforothersMentalillnessisahopelesssituation,WhatisaPsychologicalDisorder?,PsychologicalDysfunctionBreakdownincognitive,emotional,orbehavioralfunctioningPersonalDistressDifficultyperformingappropriateandexpectedrolesImpairmentissetinthecontextofapersonsbackgroundAtypicalorNotCulturallyExpectedResponseReactionisoutsideculturalnorms,Figure1.1Thecriteriadefiningapsychologicaldisorder,DefinitionofAbnormalBehavior(cont.),AbnormalBehaviorDefined,APsychologicalDysfunctionAssociatedWithDistressorImpairmentinFunctioningThatisnotaTypicalorCulturallyExpectedResponseTheDiagnosticandStatisticalManual(DSM-IV-TR)DSMContainsDiagnosticCriteriaPsychopathologyistheScientificStudyofPsychologicalDisorders,TheScienceofPsychopathology,MentalHealthProfessionalsThePh.D.s:Clinical,counselingandschoolpsychologistsThePsy.D.s:Clinical,counselingandschool“DoctorsofPsychology”M.D.s:Psychiatrists(medications)ChildorAdultBoardCertifiedM.S.W.s:Psychiatricandnon-psychiatricsocialworkersMN/MSNs:PsychiatricnursesLPC-LicensedMentalHealth/ProfessionalCounselorUnitedbytheScientist-PractitionerFramework,PsychologyTrainingModels,BoulderModel1948Ph.D.ScientistPractitioner(4-5yearsoftraining)ProducersofResearchConsumersofResearchEvaluatorsofTheirWorkUsingEmpiricalMethodsVailModel-1973Psy.D.ProfessionalPractitioner(4-5yearsoftraining)PracticefocusConsumerofresearchEmpiricalvalidatedmethods,Figure1.2Functioningasascientist-practitioner,DimensionsoftheScientist-PractitionerModel(cont.),DimensionsoftheScientist-PractitionerModel(cont.),Figure1.3Threemajorcategoriesmakeupthestudyanddiscussionofpsychologicaldisorders.,ClinicalDescription,BeginswiththePresentingProblemDescriptionAimstoDistinguishclinicallysignificantdysfunctionfromcommonhumanexperienceDescribePrevalenceandIncidenceofDisordersDescribeOnsetofDisordersAcutevs.insidiousonsetDescribeCourseofDisordersEpisodic,time-limited,orchroniccourseOtherfeatures(e.g.age,developmentalstage,ethnicity,race),Causation,Treatment,andOutcome,WhatFactorsContributetotheDevelopmentofPsychopathology?StudyofetiologyHowCanWeBestImprovetheLivesofPeopleSufferingFromPsychopathology?StudyoftreatmentdevelopmentIncludespharmacologic,psychosocial,and/orcombinedtreatmentsHowDoWeKnowThatWeHaveAlleviatedPsychologicalSuffering?Studyoftreatmentoutcome-“EvidenceBasedTreatment”Limitedinspecifyingactualcausesofdisorders,HistoricalConceptionsofAbnormalBehavior,MajorPsychologicalDisordersHaveExistedInallculturesAcrossalltimeperiodsTheCausesandTreatmentofAbnormalBehaviorVariedWidelyAcrossculturesAcrosstimeperiodsAsparticularlyasafunctionofprevailingparadigmsorworldviewsThreeDominantTraditionsInclude:Supernatural,Biological,andPsychological,TheSupernaturalTradition,DeviantBehaviorasaBattleof“Good”vs.EvilDeviantbehaviorwasbelievedtobecausedbydemonicpossession,witchcraft,sorceryTreatmentsincludedexorcism,torture,beatings,andcrudesurgeriesTheMoonandtheStarsParacelsusandlunacy,TheBiologicalTradition,Hippocrates:AbnormalBehaviorasaPhysicalDiseaseHysteria“TheWanderUterus”GalenExtendsHippocratesWorkTreatmentsremainedcrudeGalenic-HippocraticTraditionForeshadowedmodernviewslinkingabnormalitywithbrainchemicalimbalances,The19thCentury,GeneralParesis(Syphilis)andtheBiologicalLinkWithMadnessAssociatedwithseveralunusualpsychologicalandbehavioralsymptomsPasteurdiscoveredthecauseAbacterialmicroorganismLedtopenicillinasasuccessfultreatmentBolsteredtheviewthatmentalillness=physicalillnessandshouldbetreatedassuchJohnGreyandtheReformers,ConsequencesoftheBiologicalTradition,MentalIllness=PhysicalIllness,ThePsychologicalTradition,TheRiseofMoralTherapyInvolvedmorehumanetreatmentofinstitutionalizedpatientsEncourageandreinforcedsocialinteractionProponentsofMoralTherapyDorotheaDixPhilippePinelandJean-BaptistePussinWilliamTukefollowedPinelsleadinEnglandReasonsfortheFallingOutofMoralTherapyEmergenceofCompetingAlternativePsychologicalModels,PsychoanalyticTheory,FreudianTheoryoftheStructureandFunctionoftheMindTheStructureoftheMindId(pleasureprinciple;illogical,emotional,irrational)Ego(realityprinciple;logicalandrational)Superego(moralprinciples;keepsIdandEgoinbalance)DefenseMechanisms:WhentheEgoLosestheBattlewiththeIdandSuperegoDisplacement&denialRationalization&reactionformationProjection,repression,andsublimationPsychosexualStagesofDevelopmentOral,anal,phallic,latency,andgenitalstages,ThePast:AbnormalBehaviorandthePsychoanalyticTradition(cont.),Figure1.4Freudsstructureofthemind,LaterDevelopmentsinPsychoanalyticThought,AnnaFreudandSelf-PsychologyEmphasizedtheinfluenceoftheegoindefiningbehaviorMelanieKlein,OttoKernberg,andObjectRelationsTheoryEmphasizedhowchildrenincorporate(introject)objectsExamplesincludeimages,memories,andvaluesofsignificantothers(objects)TheNeo-Freudians:DeparturesFromFreudianThoughtCarlJung,AlfredAdler,KarenHorney,ErichFromm,andErikEricksonDe-emphasizedthesexualcoreofFreudstheory,PsychoanalyticPsychotherapy:The“Talking”Cure,UnearththeHiddenIntrapsychicConflicts(“TheRealProblems”)TherapyIsOftenLongTermTechniquesIncludeFreeAssociationandDreamAnalysisExamineTransferenceandCounter-TransferenceIssuesLittleEvidenceforEfficacy,HumanisticTheory,AbrahamMaslowandCarlRogersMajorThemesThatpeoplearebasicallygoodHumansstrivetowardself-actualizationHumanisticTherapyTherapistconveysempathyandunconditionalpositiveregardMinimaltherapistinterpretation,TheBehavioralModel,DerivedfromaScientificApproachtotheStudyofPsychopathologyIvanPavlov,JohnB.Watson,andClassicalConditioningClassicalconditioningisaubiquitousformoflearningConditioninginvolvesacontingencybetweenneutralandunconditionedstimuliConditioningwasextendedtotheacquisitionoffear,TheBeginningsofBehaviorTherapy,ReactionaryMovementAgainstPsychoanalysisandNon-ScientificApproachesEarlyPioneersJosephWolpeSystematicdesensitizationEdwardThorndike,B.F.Skinner,andOperantConditioningAnotherubiquitousformoflearningMostvoluntarybehavioriscontrolledbytheconsequencesthatfollowbehaviorLearningTraditionsGreatlyInfluencedtheDevelopmentofBehaviorTherapyBehaviortherapytendstobetime-limitedanddirectStrongevidencesupportingtheefficacyofbehaviortherapies,Behavior-Cognitive,AlbertEllisRationalEmotiveBehaviorTherapyRET/REBT1950s-ItiswhatwethinkthatcausesustobedisturbedAlbertBanduraSocialLearningTheory1960(vicariouslearning)Aaron(Tim)BeckCognitiveTherapy(1960DavidBurnsCognitivedistortionsArnoldLazarusMultimodalTherapy1970s7domainstoaddressintreatmentBASIC-ID,ThePresent:AnIntegrativeApproach,PsychopathologyIsMultiplyDeterminedUnidimensionalAccountsofPsychopathologyAreIncompleteMustConsiderReciprocalRelationsBetweenBiological,psychological,social,andexperientialfactorsDefiningAbnormalBehaviorisAlsoComplex,Multifaceted,andHasEvolvedTheSupernaturalTraditionHasNoPlaceinaScienceofAbnormalBehavior,WarningSignsAdults,ConfusedthinkingProlongeddepression(sadnessorirritability)FeelingsofextremehighsandlowsExcessivefears,worries,andanxietiesSocialwithdrawalDramaticcha