Chapter 2: Perspectives on Abnormal Behaviour
What is considered abnormal behaviour is often dictated by the culture/society a person lives in, as well as the historical context of the time.
Prehistoric cultures often held supernatural views of abnormal behaviour, seeing abnormal behaviour as demonic possession that occurred when a person engaged in behaviour contrary to the religious teachings of the time. Treatment included trephination and exorcism.
Greco-Roman thought on abnormal behaviour rejected the idea of demonic possession. Hippocrates proposed that mental disorders are similar to physical disorders and had natural causes. He also proposed that mental disorders resulted when our humors were imbalanced. Plato further proposed that the mentally ill were not responsible for their actions and so should not be punished.
Progress made by the Greeks and Romans was reversed during the Middle Ages, when mental illness was yet again seen as the result of demonic possession. Exorcism, flogging, prayer, visiting holy sites, and holy water were all used as treatments. At the time, group hysteria was also seen in large numbers.
The Renaissance saw the rise in humanism, which emphasized human welfare and the uniqueness of the individual. The number of asylums began to rise as the government took more responsibility for people’s care.
The moral treatment movement began in the late 18th century in Europe and then rose in the United States in the early 19th century. This movement emphasized respect for the mentally ill, moral guidance, and humane treatment.
Theoretical orientations present a framework through which to understand, organize, and predict human behaviour. When used to treat people with mental illness they are referred to as therapeutic orientations.
The earliest orientation was psychoanalysis, developed by Freud. This model suggests that psychiatric problems are the result of tension between the id, superego, and ego. Although psychoanalysis is still practiced today it has largely been replaced by psychodynamic theory, which uses the same underlying principles of psychoanalysis but is briefer, more present-focused, and sometimes manualized.
Person-centered therapy is referred to as a humanistic therapy, and it is based on the belief that mental health problems arise when our innate human tendency for self-actualization gets blocked somehow. Person-centered therapy believes that providing clients with unconditional positive regard and a place of support will allow them to grow and change. In this sense, it is an unstructured therapy.
The behavioural model of psychopathology believes that how we act is learned, including dysfunctional, abnormal behaviour. It relies upon principles of operant conditioning. Behaviour therapises are popular choices for a wide range of mental illness, especially anxiety disorders. Overall, they focus on learning new behaviour.
The cognitive model arose in direct response to the behavioural model; cognitive theorists believe that by overlooking thoughts, behaviourism was missing an important component of mental illness. According to the cognitive model our thoughts, especially about how we interpret events, influence mental disorder.
Cognitive behavioural therapy (CBT) combines aspects of both behavioural therapy and cognitive therapy. It is one of the most popular therapies, internationally, and it works for a wide variety of diagnoses and presenting problems.
Newer forms of therapy include the acceptance- and mindfulness-based approaches. Mindfulness is a process that cultivates a non-judgmental state of attention. These types of therapies work by altering people’s relationships with their thoughts, behaviours, and emotions, whereas previously developed therapies try to change this content directly.
Emerging treatment strategies include the use of internet-delivered therapies, cognitive bias modification via gamification, and CBT-enhancing pharmaceutical agents
The biological model explains how mental illness develops from a medical perspective. The neuron is the fundamental unit of communication of the nervous system. Neurotransmitters like dopamine and serotonin play a key role in our mental health.
Genetic issues, hormonal imbalances, and viral infections can also influence mental illness.
There are five major categories of psychotropic medication: Antidepressants, anti-anxiety medications, stimulants, antipsychotics, and mood stabilizers. Electroconvulsive therapy and psychosurgery are also sometimes used to treat cases of mental illness that do not respond well to medication.
Pharmacokinetics refers to how the body handles drugs that we take, including different drug administrations and drug metabolism.
Controversial issues in psychopharmacology include the use of medications by juveniles and the elderly.
Evidence-based practice is the intentional and careful use of the best available research evidence combined with clinical experience and specific client preferences. Empirically-supported treatments are those that meet certain research criteria in order to be labeled as scientifically supported. Last, treatments that harm are those that cause damage to either clients or their families.