Psychological Disorders: Historical and Modern Perspectives

Psychological Disorders: Historical and Modern Perspectives

Chapter Outline

• Characteristics and Prevalence of Psychological Disorders

• The History and Treatment of Psychological Disorders

• Current Perspectives and Treatment of Psychological Disorders

Describing Psychological Disorders

Identifying Psychological Disorders

Psychological disorders can sometimes be easily identified, but in many cases, symptoms are ambiguous and require careful assessment. Several core characteristics are used to define psychological disorders:

• Distress: The individual experiences significant emotional or physical suffering.

• Dysfunction: The disorder interferes with daily functioning in social, occupational, or other important areas.

• Deviance: The behavior deviates from societal or cultural norms.

• Danger: The individual poses a risk of harm to themselves or others.

Important Factors in Understanding Psychological Disorders

Contextual Influences

• Culture: Shared behavior patterns and lifestyles that differentiate groups. Culture-bound syndromes are abnormal behaviors specific to certain groups or locations.

• Socioeconomic Status (SES): Family income and educational achievement. Psychological disorders are more prevalent in low-income and less-educated groups, sometimes due to downward drift (decline in SES resulting from the disorder).

• Genetic Predisposition: Genetic factors may contribute to the onset of psychological disorders and impact academic or occupational achievement.

Prevalence of Psychological Disorders

Diagnostic Criteria and Epidemiology

• DSM-5-TR: The primary diagnostic guide, focusing on symptoms, clinical presentation, etiology, developmental stage, and functional impairment.

• Prevalence: The proportion of people diagnosed with a psychological disorder, varying across countries, cultures, ages, and genders.

Table: Prevalence of Selected Mental and Substance Use Disorders (U.S., 2017)

Disorder	Prevalence (%)
Anxiety disorder	6.64
Depression	4.54
Drug use disorder	3.45
Alcohol use disorder	2.04
Bipolar disorder	0.65
Eating disorder	0.51
Schizophrenia	0.33

Developmental Factors

• As children mature, behaviors that were once developmentally appropriate may become problematic.

• Developmental trajectory: Symptoms of a disorder can vary by age.

• Failure to consider developmental differences can lead to misdiagnosis.

The History of Abnormal Behavior and Its Treatment

Ancient Theories

• Ancient cultures (e.g., Egypt) attributed abnormal behavior to spirits controlling the environment and individuals.

• Trephination: Creating a hole in the skull to release evil spirits.

Classical Greek and Roman Periods

• Melampus of Pilus: Introduced the organic model of illness.

• Hippocrates (460–377 BC): Father of medicine; identified hallucinations, delusions, melancholia, mania; introduced 'hysteria'; believed in the imbalance of four bodily humors.

• Galen and Avicenna: Furthered medical understanding of mental illness.

The Middle Ages Through the Renaissance

• Dominance of the Roman Catholic Church; negative behaviors seen as the work of the devil.

• Witchcraft accusations (mostly women); mass hysteria and emotional contagion.

• John Weyer and Paracelsus promoted enlightenment; asylums were established.

The 19th Century and the Beginning of Modern Thought

• Philippe Pinel: Advocated for humane treatment; removal from asylums to specialized care facilities.

• William Tuke: Promoted moral treatment (respect, kindness, religion, vocation).

• Rush and Dix: Reformed U.S. mental health care.

• Franz Anton Mesmer: Proposed animal magnetism; debunked as placebo effect.

• Shift toward biological perspectives (syphilis, Kraepelin's dementia praecox, Charcot, Breuer's 'talking cure').

The 20th Century

• Psychoanalysis (Freud): Emphasized the unconscious, id/ego/superego, defense mechanisms, and insight through free association and transference.

• Behaviorism:

  • Ivan Pavlov: Classical conditioning (Pavlov's dogs).

  • John B. Watson & Rayner: Little Albert study (learning of fear).

  • Wolpe: Systematic desensitization.

  • B.F. Skinner: Operant conditioning, reinforcement, shaping.

  • Albert Bandura: Observational learning (modeling).

Current Perspectives and Treatment of Psychological Disorders

• Scientific advances have led to more sophisticated approaches.

• Insights from other sciences inform psychological understanding.

• Scientist-practitioner model: Psychologists integrate research findings into treatment.

Biological Perspectives

• Psychological disorders are linked to biological processes, especially in the brain.

• Key elements: neurons, synapses, neurotransmitters, brain structure and function.

• Potential causes: genetic/hereditary factors, behavioral genetics, viral infection theory.

Psychological Perspectives

• Psychodynamic: Unconscious forces, personality, and past experiences shape behavior (ego psychology).

• Humanistic: Focus on subjective perception, self-actualization, and client-centered therapy (Carl Rogers).

• Behavioral: Behavior is learned; dysfunction arises from maladaptive learning; therapy includes exposure and modeling (ABA).

• Cognitive: Disorders stem from distorted thinking (Aaron Beck's cognitive triad); therapy targets thought modification.

• Cognitive-Behavioral: Interactions among thoughts, feelings, and behaviors; therapy plans to reduce symptoms.

Sociocultural Perspectives

• Disorders must be understood in social and cultural context (race, ethnicity, gender roles, SES).

• Cultural factors influence symptom expression and diagnosis.

The Biopsychosocial Model

• No single model explains all psychological disorders; each case is unique.

• Diathesis-stress model: Disorders arise from genetic vulnerability (diathesis) activated by environmental stress.

Equation (Diathesis-Stress Model):

$\text{Psychological Disorder} = f(\text{Diathesis}, \text{Stress})$

Case Examples

• Simone Biles: Experienced panic attacks and mental blocks, withdrew from competition for mental health, highlighting the importance of recognizing and supporting psychological disorders in high-achieving individuals.

• Olivia: Experiences depression from homesickness; her case can be understood through multiple historical and modern perspectives (Hippocrates, Pinel, Freud, Skinner, cognitive, biological, biopsychosocial).

Additional info: This summary integrates textbook slides and expands on key concepts for comprehensive exam preparation.