Chapter 1 -- Introduction and Historical Overview

I. Stigma about Abnormal Behavior

A. Distinguishing label is applied
B. Label refers to undesirable attributes
C. People with the label are viewed as different
D. Others discriminate against the labeled people

II. Strategies to Fight Stigma

A. Policy and Legislation
1. Parity in Insurance Coverage with physical illness
2. Nondiscrimination Laws
3. Employment Efforts
4. Decriminalization

B. Community Strategies
1. Housing options
2. Personal contact with others
3. Education about psychological disorders

C. Health Profession Strategies
1. Mental health evaluations or check-ups
2. Education and training about stigma, reduce microaggressions

D. Individual and Family Strategies
1. Education for individuals and families
2. Support and Advocacy Groups, such as GMU Active Minds

III. Defining Abnormal Behavior

A. Distress (negative emotions)
B. Disability (severe cognitive, behavioral,or interpersonal difficulties)
C. Dysfunction (less severe cognitive, behavioral, or interpersonal difficulties)
D. Deviant (socially and culturally unacceptable, violate social norms)
E. Dangerous (risk to self or other people)
F. Distinct statistically (very low IQ, intellectual disability)
G. Diagnostic and Statistical Manual Of Mental Disorders (DSM-5 in May 2013)

IV. Biopsychosocial Evidence of Abnormal Behavior

A. Biological (genes, brain structure, neurotransmitters, hormones)
B. Psychological (behaviors, emotions, thoughts)
C. Sociocultural (relationships, cultural norms, laws)

V. Abnormal Psychology Throughout History

A. Supernatural vs. Natural Explanations
B. Prehistoric Times:  Evil Spirits in the Body
C. Ancient Greece:  Brain and Bodily Fluid Levels Lead to Behaviors, Thoughts, and Emotions
D. Middle Ages:  Religious Explanations such as demons and witches, punishment for sin
E. 1400-1800s:  Asylums,Moral Treatment
F. 1800s:  Biological (germs & genes) and Psychoanalysis
G. 1900s:  Cognitive-Behavioral, Humanistic & Family-Systems Models

VI. Psychodynamic Theories (Freud)

A. Pathology results from conflicts between the Id (instincts), Ego (self-awareness), and Superego (internal rules)
B. Defense mechanisms protect against anxiety (repression, projection, regression)
C. Fixations at oral (depression), anal (anger), and phallic (anxiety) stages
D. Importance of childhood, unconscious, and hidden motivations
E. Psychoanalysis includes free association, transference, and interpretations
F. Difficult to test the theory in research

VII. Behavioral Theories (Pavlov, Watson, Skinner & Bandura)

A. Abnormal behavior is learned
B. Classical Conditioning (Pavlov)
1. Unconditioned Stimulus (dog bite)
2. Unconditioned Response (fear)
3. Conditioned Stimulus (dog growling)
4. Conditioned Response (fear)

C. Operant Conditioning (Skinner)
1. Reinforcement (rewards)
2. Extinction (lack of rewards)
3. Punishment (aversive consequences)

D. Observational Learning and Social Cognition (Bandura)
1. Modeling (imitate others)
2. Self-Efficacy (believe one can do the behavior)
E. Relaxation, Contingency Management, Role Plays
F. Difficulty with generalization, reduces intrinsic motivation

VIII. Humanistic Theories (Rogers & Maslow)

A. Pathology from blocked growth, lack of acceptance, conditions of worth
B. Discrepancy between real and ideal self
C. Therapists provide unconditional positive regard and genuineness
D. Lacks research evidence

IX. Mental Health Professionals

A. Psychiatrist (M.D., 8 years, medication)
B. Clinical or Counseling Psychologist (Ph.D., Psy.D., 5 years, assessment & research)
C. Doctor of Nursing Practice (DNP, 4 years, medication)
D. Psychiatric Social Worker (M.S.W., 2 years, case management)
E. Marriage and Family Therapist, (M.S., 2 years)
F. Counselor (M.A., 2 years, groups, schools)

X. Recent Trends

A. Drug revolution in Psychiatry to make it the most common treatment
B. Prescription privileges for Psychologists, Nurses
C. Managed Health Care to reduce costs
D. Increases in Mental Health Professionals
E. Appreciation for research evidence
F. Multicultural models