Chapter 1

• Psychological Disorder is a psychological dysfunction within an individual associated with distress or impairment in functioning and a response that is not typical or culturally expected.
• Phobia, a psychological disorder characterized by marked and persistent fear of an object or situation.
• Psychological dysfunction refers to a breakdown in cognitive, emotional, or behavioral functioning.
• Problems are often considered to be on a continuum or a dimension rather than to be categories that are either present or absent.
• Clinically significant distress or impairment in social, occupational, or other important areas of functioning documented by an established relationship with a licensed behavioral health provider.
• The 4 D's (or 5 D's) of psychological disorder or abnormal behavior are dysfunction, distress, deviance, danger, (and duration).
• Abnormal is described in DSM-5 as behavioral, psychological, or biological dysfunctions that are unexpected in their cultural context and associated with present distress and impairment in functioning,

  or increased risk of suffering, death, pain, or impairment.
• A prototype is a “typical” profile of a disorder that we consider to match how apparent a disease or disorder is. The diagnostic criteria from DSM-IV-TR as well as the emerging criteria for DSM-5 found throughout this book are examples.
• Psychopathology is the scientific study of psychological disorders.
• Scientist-practitioners are mental health professionals who take a scientific approach to their clinical work. The adoption of scientific methods to learn more about the nature of psychological disorders, their causes, and their treatment.
• Presents or presenting problem is a traditional shorthand way of indicating why the person came to the clinic. The first step in determining her clinical description.
• Clinical description, which represents the unique combination of behaviors, thoughts, and feelings that make up a specific disorder.
• This figure is called the prevalence of the disorder. Statistics on how many new cases occur during a given period, such as a year, represent the incidence of the disorder.
• a chronic course, meaning that they tend to last a long time, sometimes a lifetime.

  an episodic course, in that the individual is likely to recover within a few months only to suffer a recurrence of the disorder at a later time. This pattern may repeat throughout a person’s life. 


  a time-limited course, meaning the disorder will improve without treatment in a relatively short period.
• an acute onset, meaning that they begin suddenly;
• others develop gradually over an extended period, which is sometimes called an insidious onset
• The anticipated course of a disorder is called the prognosis
• the study of changes in behavior over time developmental psychology, and we refer to the study of changes in abnormal behavior as developmental psychopathology.
• Etiology, or the study of origins, has to do with why a disorder begins (what causes it) and includes biological, psychological, and social dimensions.
• Mass hysteria may simply demonstrate the phenomenon of emotion contagion, in which the experience of an emotion seems to spread

  to those around us.
• The Greek physician Hippocrates (460–377 B.C.) is considered to be the father of modern Western medicine. They wrote Hippocratic Corpus in which they suggested that psychological disorders could be treated like any other disease.
• the Hippocratic-Galenic approach is the humoral theory of disorders which assumes that normal brain functioning is related to four bodily fluids or humors: blood, black bile, yellow bile, and phlegm. Blood came from the heart, black bile from the spleen, phlegm from the brain, and choler or yellow bile from the liver.
• Hippocrates also coined the word hysteria to describe a concept he learned about from the Egyptians, now called somatic symptom disorders which refer to the physical symptoms that appear to be the result of a medical problem for which no physical cause can be found
• Advanced syphilis, a sexually transmitted disease caused by a bacterial microorganism entering the brain, include believing that everyone is plotting against you (delusion of persecution) or that you are God (delusion of grandeur), as well as other bizarre behaviors.
• Psychosis refers to psychological disorders characterized in part by beliefs that are not based in reality (delusions), perceptions that are not based in reality (hallucinations), or both.
• John P. Grey (Bockoven, 1963) proposed that the causes of insanity were always physical. Therefore, the mentally ill patient should be treated as physically ill. The emphasis was again on rest, diet, and proper room temperature and ventilation, approaches used for centuries by previous therapists in the biological tradition.
• insulin shock therapy is called when an insulin was occasionally given to

  stimulate appetite in psychotic patients who were not eating, but

  it also seemed to calm them down. In 1927, a Viennese physician,

  Manfred Sakel, began using increasingly higher dosages until,

  finally, patients convulsed and became temporarily comatose

  (Sakel, 1958)
• Benjamin Franklin discovered accidentally, and then confirmed experimentally in the 1750s, that a mild and modest electric shock to the head produced a brief convulsion and memory loss (amnesia) but otherwise did little harm.
• Ugo Cerletti and Lucio Bini, Italian physicians, in 1938—a

  surgeon in London treated a depressed patient by sending six small

  shocks directly through his brain, producing convulsions (Hunt,

  1980). The patient recovered. This is called electroconvulsive therapy.
• with the discovery of Rauwolfia serpentine (later renamed reserpine) and another class of drugs called neuroleptics (major tranquilizers), for the first time hallucinatory and delusional thought processes could be diminished in some patients; these drugs also controlled agitation and aggressiveness. Other discoveries included benzodiazepines (minor tranquilizers), which seemed to reduce anxiety.
• Emil Kraepelin (1913) was one of the first to distinguish among various psychological disorders, seeing that each may have a different age of onset and time course, with somewhat different clusters of presenting symptoms, and probably a different cause. Many of his descriptions of schizophrenic disorders are still useful today.
• Modern psychosocial treatment focuses not only on psychological factors but also on social and cultural ones as well.
• Patients with psychological disorders were freed from chains and

  shackles as a result of the influence of Philippe Pinel (1745–1826), a

  pioneer in making mental institutions more humane.
• Philippe Pinel (1745–1826), a French psychiatrist, and his close associate

  Jean-Baptiste Pussin (1746–1811), who was the superintendent

  of the Parisian hospital La Bicêtre originated the system of moral therapy.
• After William Tuke (1732–1822) followed Pinel’s lead in

  England, Benjamin Rush (1745–1813), often considered the

  founder of U.S. psychiatry, introduced moral therapy in his early work at Pennsylvania Hospital. It then became the treatment of choice in the leading hospitals. Asylums had appeared in the 16th century, but they were more like prisons than hospitals.
• Dorothea Dix (1802–1887) began the mental hygiene movement and spent much of her life campaigning for reform in the treatment of the mentally ill.

  
• The first major approach was psychoanalysis, based on Sigmund

  Freud’s (1856–1939) elaborate theory of the structure of the mind

  and the role of unconscious processes in determining behavior.
• The second major approach was behaviorism, associated with John B. Watson, Ivan Pavlov, and B. F. Skinner, which focuses on how learning and adaptation affect the development of psychopathology.
• Franz Anton Mesmer (1734–1815) suggested to his patients that their problem was caused by an undetectable fluid found in all living organisms called “animal magnetism,” which could become blocked. He is widely regarded as the father of hypnosis, a state in which extremely suggestible subjects sometimes appear to be in a trance.
• Jean-Martin Charcot (1825–1893) demonstrated that some techniques of mes merism were effective with a number of psychological disorders,

  and he did much to legitimize the fledgling practice of hypnosis.