這是用戶在 2024-10-29 1:18 為 https://app.immersivetranslate.com/pdf-pro/ead01698-2e7f-4fb1-9f87-8904ba36adee 保存的雙語快照頁面,由 沉浸式翻譯 提供雙語支持。了解如何保存?

Chapter 1  第一章

Abnormal Behavior in Historical Context
歷史背景下的異常行為

Outline 大綱

  • Understanding Psychopathology
    理解心理病理學
  • Historical Conceptions of Abnormal Behavior
    歷史上對異常行為的概念
  • The Supernatural Tradition
    超自然傳統
  • The Biological Tradition 生物傳統
  • The Psychological Tradition
    心理傳統
  • The Present 現在
  • The Scientific Method 科學方法
  • An Integrative Approach 整合性方法

Focus Questions 焦點問題

  • How do psychologists define a psychological disorder?
    心理學家如何定義心理障礙?

    *\cdot What is a scientist-practitioner?
    *\cdot 什麼是科學家-實踐者?
  • What supernatural influences were formerly believed to explain abnormal behavior?
    過去人們相信哪些超自然影響可以解釋異常行為?
  • How do psychological approaches including psychoanalysis, humanism, and behaviorism explain abnormal behavior?
    心理學方法,包括精神分析、人本主義和行為主義,如何解釋異常行為?

What is a Psychological Disorder? (slide 1 of 2)
什麼是心理障礙?(第 1 張幻燈片,共 2 張)

  • Psychological dysfunction associated with distress and/or impairment in functioning
    與痛苦和/或功能障礙相關的心理功能障礙
  • Involves a response that is not typical or culturally expected
    涉及一種不典型或不符合文化預期的反應
  • May include cognitive, behavioral and/or emotional elements
    可能包括認知、行為和/或情感元素

What is a Psychological Disorder? (slide 2 of 2)
什麼是心理障礙?(第 2 張幻燈片,共 2 張)

Copyright © 2018 Cengage Learning. All Rights Reserved.
版權所有 © 2018 Cengage Learning。保留所有權利。

Distress, Impairment and Cultural Context
困擾、損傷與文化背景

  • Distress is normal in some situations
    在某些情況下,痛苦是正常的
  • Dysfunctional distress occurs when person is much more distressed than others would be
    功能失調的痛苦發生在一個人所感受到的痛苦遠超過其他人時
  • Impairment: Must be pervasive and/or significant
    損傷:必須是普遍的和/或顯著的
  • Mental disorders are often exaggerations of normal processes (e.g., extreme shyness or sadness)
    心理障礙通常是正常過程的誇張表現(例如,極度的害羞或悲傷)。
  • Culture: Consider “normalcy” relative to behavior of others in same cultural context
    文化:將“正常”視為相對於同一文化背景中他人行為的標準
Rule of thumb: Mental disorder = harmful dysfunction
經驗法則:心理障礙 = 有害的功能失調

An Accepted Definition 被接受的定義

  • Behavioral, psychological, or biological dysfunctions that are unexpected in their cultural context and associated with present distress and/or impairment in functioning, or increased risk of suffering, death, pain, or impairment
    行為、心理或生物功能障礙在其文化背景中是意外的,並與當前的痛苦和/或功能障礙相關,或增加了遭受痛苦、死亡、疼痛或功能障礙的風險

The Science of Psychopathology
心理病理學的科學

  • Psychopathology: Scientific study of psychological dysfunction
    心理病理學:心理功能障礙的科學研究
  • Mental health professionals
    心理健康專業人士
  • The Ph.D.: Clinical and counseling psychologist (trained in research and delivering treatment)
    博士:臨床與諮詢心理學家(受過研究和提供治療的訓練)
  • The Psy.D.: Clinical and counseling “Doctor of Psychology” (trained in delivering treatment)
    心理學博士(Psy.D.):臨床與諮詢的“心理學博士”(接受過治療提供的訓練)
  • M.D.: Psychiatrist 醫學博士:精神科醫生
  • Psychiatric nurses 精神科護理人員
  • LICSW: Licensed clinical social worker (trained in delivering treatment)
    LICSW:持牌臨床社會工作者(接受過治療提供的訓練)

The Scientist-Practitioner
科學家-實踐者

  • Practice (treatment delivery) and research mutually influence each other
    實踐(治療提供)和研究相互影響
  • A scientist-practitioner:
    科學家-實踐者:
  • Stays current with research in field
    保持與該領域的研究同步
  • Evaluates own assessment and treatment
    評估自己的評估和治療
  • Conducts research 進行研究

The Scientist-Practitioner
科學家-實踐者

Chapter 章節

Copyright © 2018 Cengage Learning. All Rights Reserved.
版權所有 © 2018 Cengage Learning。保留所有權利。

Clinical Description (slide 1 of 3)
臨床描述(第 1 張,共 3 張)

  • Begins with the presenting problem
    開始於呈現的問題
  • Symptoms (e.g., chronic worry, panic attacks)
    症狀(例如,慢性擔憂、恐慌發作)
  • Description aims to: 描述的目的是:
  • Distinguish clinically significant dysfunction from common human experience
    區分臨床上顯著的功能障礙與常見的人類經驗
  • Describe prevalence and incidence of disorders
    描述疾病的流行率和發生率

Clinical Description (slide 2 of 3)
臨床描述(第 2 張幻燈片,共 3 張)

Clinical Description (slide 3 of 3)
臨床描述(第 3 張幻燈片,共 3 張)

  • Describe onset of disorders
    描述疾病的發作
  • Acute vs. insidious onset
    急性發作與隱匿發作
  • Describe course of disorders
    描述疾病的過程
  • Episodic, time-limited, or chronic course
    情節性、時間有限或慢性病程
  • Prognosis 預後
  • Good vs. guarded 好與防備
  • Consider age of onset, which may shape presentation
    考慮發病年齡,這可能影響表現

Causation, Treatment and Outcome
因果關係、治療與結果

  • Etiology 病因學
  • What contributes to the development of psychopathology?
    什麼因素促進了心理病理學的發展?
  • Treatment development 治療開發
  • How can we help alleviate psychological suffering?
    我們如何能幫助減輕心理痛苦?
  • Includes pharmacological, psychosocial, and/or combined treatments
    包括藥物治療、心理社會治療和/或綜合治療

Historical Conceptions of Abnormal Behavior (slide 1 of 2)
歷史上對異常行為的概念 (幻燈片 1/2)

  • Major psychological disorders have existed across time and cultures
    主要的心理障礙在不同的時代和文化中一直存在
  • Perceived causes and treatment of abnormal behavior varied widely, depending on context
    感知到的異常行為的原因和治療因情境而異,差異很大

Historical Conceptions of Abnormal Behavior (slide 2 of 2)
歷史上對異常行為的概念 (幻燈片 2/2)

  • Three dominant traditions have existed in the past to explain abnormal behavior
    過去有三種主要的傳統用來解釋異常行為
  • Supernatural 超自然
  • Biological 生物的
  • Psychological 心理的

The Supernatural Tradition (slide 1 of 3)
超自然傳統(幻燈片 1/3)

  • Deviant behavior as a battle of
    偏差行為作為一場戰鬥

    “Good” vs. “Evil” 「善」與「惡」
  • Believed to be caused by demonic possession, witchcraft, sorcery
    被認為是由於惡魔附身、巫術、魔法所引起的
  • Treatments included exorcism, torture, religious services
    治療包括驅魔、酷刑、宗教儀式

The Supernatural Tradition (slide 2 of 3)
超自然傳統(幻燈片 2 之 3)

  • “Stress and melancholy” = anxiety and depression
    “壓力和憂鬱” = 焦慮和抑鬱
  • Competing view that coexisted with supernatural tradition: “insanity” is caused by emotional stress, not supernatural forces
    與超自然傳統共存的競爭觀點: “精神失常”是由情緒壓力引起的,而非超自然力量
  • Treatments: Rest, sleep, healthy environment, baths, potions
    療法:休息、睡眠、健康環境、沐浴、藥水
  • Possession 擁有權
  • Mental illness sometimes believed to reflect possession by evil spirits
    精神疾病有時被認為是受到邪靈附身的反映
  • Treated by shocking/scaring out spirits (e.g., hang patient over snake pit)
    用驚嚇/驅趕靈魂的方式治療(例如,將病人懸掛在蛇坑上)

The Supernatural Tradition (slide 3 of 3)
超自然傳統(幻燈片 3/3)

  • Mass hysteria 集體歇斯底里
  • Saint Vitus’s Dance/Tarantism
    聖維圖斯之舞/塔蘭蒂斯主義
  • Modern mass hysteria 現代大眾歇斯底里
  • Emotion contagion 情感傳染
  • Mob psychology 群眾心理
  • The moon and the stars
    月亮和星星
  • Paracelsus: Swiss physician suggested that mental health problems are affected by pull of moon and stars
    帕拉塞爾蘇斯:瑞士醫生建議心理健康問題受到月亮和星星的影響
  • Led to term “lunatic” 導致“瘋子”這個詞

The Biological Tradition 生物傳統

  • Hippocrates (460-377 BC) 希波克拉底(公元前 460-377 年)
  • Father of modern Western medicine
    現代西方醫學之父
  • Etiology of mental disorders = physical disease
    精神障礙的病因 = 身體疾病
  • Hysteria “the wandering uterus” - psychological symptoms were a result of the uterus moving around in the body
    歇斯底里「遊走的子宮」- 心理症狀是由於子宮在體內移動所引起的
  • Linked abnormality with brain chemical imbalances
    與大腦化學失衡相關的異常
  • Foreshadowed modern views
    預示了現代觀點
  • Galen (129-198 AD) extended Hippocrates’ work
    蓋倫(公元 129-198 年)擴展了希波克拉底的工作

Galenic-Hippocratic Tradition
伽倫-希波克拉底傳統

  • Humoral theory of disorders: Functioning is related to having two much or too little of four key bodily fluids (humors)
    體液失調理論:功能與四種主要體液(體液)過多或過少有關
  • Blood, phlegm, black bile, yellow bile
    血、痰、黑膽汁、黃膽汁
  • Example: Depression caused by too much black bile
    抑鬱症是由過多的黑膽汁引起的
  • Treated by changing environmental conditions (e.g., reducing heat) or bloodletting/vomiting
    通過改變環境條件(例如,降低熱量)或放血/嘔吐進行治療

The 19th Century (slide 1 of 2)
十九世紀(幻燈片 1/2)

  • General paresis (syphilis) and the biological link with madness
    一般麻痺(梅毒)與瘋狂之間的生物聯繫
  • Several unusual psychological and behavioral symptoms
    幾種不尋常的心理和行為症狀
  • Pasteur discovered the cause - a bacterial microorganism
    巴斯德發現了原因 - 一種細菌微生物
  • Led to penicillin as a successful treatment
    導致青黴素成為成功的治療方法
  • Bolstered the view that mental illness = physical illness
    強化了心理疾病 = 身體疾病的觀點

The 19th Century (slide 2 of 2)
19 世紀(第 2 張幻燈片,共 2 張)

  • John P. Grey and the reformers
    約翰·P·格雷與改革者們
  • Psychiatrist who believed mental illness had physical roots
    相信精神疾病有生理根源的精神科醫生
  • Championed biological tradition in the U.S.
    在美國倡導生物傳統。
  • Led to reforms of hospitals to give psychiatric patients better care
    導致醫院進行改革,以提供精神病患者更好的護理

The Development of Biological Treatments
生物治療的發展

  • Psychotropic medications became increasingly available in 1950s
    精神藥物在 1950 年代變得越來越普及
  • Electric shock 電擊
  • Crude surgery 粗糙的手術
  • Insulin (discovered by accident to calm psychotic patients)
    胰島素(意外發現可安撫精神病患者)
  • Major tranquilizers (discovered mid-20 th C th  C ^("th ")C{ }^{\text {th }} \mathrm{C} )
    主要鎮靜劑(於 20 世紀中期發現)
  • Minor tranquilizers (e.g., benzodiazepines) - commonly prescribed for anxiety today
    輕度鎮靜劑(例如,苯二氮平類藥物)- 當今常用於治療焦慮的處方藥

Consequences of the Biological Tradition
生物傳統的後果

  • Overall, mental illness understood to have physical roots
    整體而言,精神疾病被理解為有生理根源
  • Increased hospitalization
    住院人數增加
  • Mental illness often seen as “untreatable” condition
    精神疾病常被視為“無法治療”的狀況
  • Improved diagnosis and classification
    改善診斷和分類
  • Emil Kraepelin was father of classification
    艾米爾·克雷佩林是分類學的奠基人
  • Increased role of science in psychopathology
    科學在精神病理學中的角色增強

The Psychological Tradition (slide 1 of 2)
心理傳統(幻燈片 1/2)

  • The rise of moral therapy
    道德療法的興起
  • Became popular in first half of 19 th 19 th  19^("th ")19^{\text {th }} century
    19 th 19 th  19^("th ")19^{\text {th }} 世紀的上半葉變得流行
  • “Moral” = referring to psychological/emotional factors
    “道德” = 指心理/情感因素
  • Main idea: Treat patients as normally as possible in normal environment
    主要思想:在正常環境中儘可能正常地對待病人
  • More humane treatment of institutionalized patients
    對機構化病患更人道的對待
  • Encouraged and reinforced social interaction
    鼓勵和加強社交互動

The Psychological Tradition (slide 2 of 2)
心理傳統(第 2 張幻燈片,共 2 張)

  • Proponents of moral therapy
    道德療法的支持者
  • Philippe Pinel and Jean-Baptiste Pussin - patients shouldn’t be restrained
    菲利普·皮內爾和讓-巴蒂斯特·普辛 - 患者不應被束縛
  • Benjamin Rush - led reforms in U.S.
    本傑明·拉什 - 在美國推動改革。
  • Dorothea Dix - mental hygiene movement
    多蘿西亞·迪克斯 - 精神衛生運動
  • Asylum reform > more patients getting care
    庇護改革 > 更多病人獲得照護
  • Moral therapy declined because more difficult with large groups of patients
    道德療法因為面對大量病人變得更加困難而衰退
  • Soon followed by emergence of competing alternative psychological models
    隨之而來的是競爭性替代心理模型的出現

Psychoanalytic Theory (slide 1 of 2)
精神分析理論(幻燈片 1/2)

  • Freudian theory of the structure and function of the mind
    弗洛伊德的心智結構與功能理論
  • Unconscious 無意識
  • Catharsis 宣洩
  • Psychoanalytic model sought to explain development and personality)
    精神分析模型旨在解釋發展和個性
  • Structure of the mind 心智結構
  • Id (pleasure principle; illogical, emotional, irrational)
    本我(快樂原則;不合邏輯、情感、非理性)
  • Superego (moral principles)
    超我(道德原則)
  • Ego (rational; mediates between supergo/id)
    自我(理性;在超我與本我之間調解)

Freud's Structure of the Mind
弗洛伊德的心智結構

Psychoanalytic Theory (slide 2 of 2)
精神分析理論(第 2 張幻燈片,共 2 張)

  • Defense mechanisms: Ego’s attempt to manage anxiety resulting from id/superego conflict
    防衛機制:自我的嘗試以管理由本我/超我衝突所產生的焦慮
  • Displacement & denial 位移與否認
  • Rationalization & reaction formation
    合理化與反應形成
  • Projection, repression, and sublimation
    投射、壓抑與昇華
  • Psychosexual stages of development
    心理性發展階段
  • Oral, anal, phallic, latency, and genital stages
    口腔期、肛門期、陰莖期、潛伏期和生殖期
  • Theory: conflicts arise at each stage and must be resolved
    理論:在每個階段都會產生衝突,必須加以解決

Later Developments in Psychoanalytic Thought (slide 1 of 2)
後續的精神分析思想發展(幻燈片 1/2)

  • Anna Freud and self-psychology
    安娜·弗洛伊德與自我心理學
  • Emphasized influence of the ego in defining behavior
    強調自我在定義行為中的影響
  • Melanie Klein, Otto Kernberg, and object relations theory
    梅蘭妮·克萊因、奧托·肯伯格與對象關係理論
  • Emphasized how children incorporate (introject) objects
    強調了孩子們如何內化物體
  • Objects - significant others and their images, memories, and values
    物件 - 重要他人及其形象、記憶和價值觀

Later Developments in Psychoanalytic Thought (slide 2 of 2)
後續的精神分析思想發展(第 2 張幻燈片,共 2 張)

*\cdot The “Neo-Freudians”: Departures from Freudian thought
《新弗洛伊德派》:對弗洛伊德思想的偏離
  • De-emphasized the sexual core of Freud’s theory
    淡化了弗洛伊德理論中的性核心
  • Examples: 範例:
  • Carl Jung emphasized the “collective unconscious”
    卡爾·榮格強調了「集體無意識」
  • Alfred Adler focused on feelings of inferiority, invented “inferiority complex”
    阿爾弗雷德·阿德勒專注於自卑感,創造了“自卑情結”

Psychoanalytic Psychotherapy: The "Talking" Cure
精神分析心理治療:談話療法

  • Unearth the hidden intrapsychic conflicts
    挖掘隱藏的內心衝突
  • “The real problems” 真正的問題
  • Therapy is often long-term
    治療通常是長期的
  • Techniques 技術
  • Free association 自由聯想
  • Dream analysis 夢的分析
  • Examine transference and counter-transference issues
    檢視移情與反移情問題
  • Little evidence for efficacy
    有效性證據甚少

Psychodynamic Psychotherapy (slide 1 of 2)
心理動力學心理治療(第 1 張幻燈片,共 2 張)

  • Therapy with themes of psychoanalysis, but often shorter and more goal-directed
    以精神分析為主題的治療,但通常較短且更具目標導向
  • Emphasizes conflicts and unconscious, may help uncover trauma and active defense mechanisms
    強調衝突和無意識,可能有助於揭示創傷和主動防衛機制
  • Focus on: 專注於:
  • Emotional expression 情感表達
  • Avoidance and other cognitive or behavioral patterns
    避免及其他認知或行為模式
  • Past experience 過去的經驗
  • Interpersonal experience 人際經驗
  • Therapeutic relationship 治療關係
  • Wishes, dreams, fantasies
    願望、夢想、幻想

Psychoanalytic Psychotherapy (slide 2 of 2)
精神分析心理治療(第 2 張幻燈片,共 2 張)

  • Major criticism: Largely unscientific and untested
    主要批評:在很大程度上不具科學性且未經測試
  • Contributions 貢獻
  • Unconscious processes have been empirically demonstrated
    無意識過程已經經過實證證明
  • Cues outside of conscious awareness can trigger emotions
    潛意識中的線索可以觸發情感
  • “Therapeutic alliance” is important
    “治療聯盟”是重要的
  • Defense mechanisms 防衛機制

Humanistic Theory (slide 1 of 2)
人文主義理論(第 1 張,共 2 張)

  • Theoretical constructs 理論構念
  • Intrinsic human goodness 內在的人性善良
  • Striving for self-actualization
    追求自我實現
  • Person-centered therapy 以人為本的療法
  • Carl Rogers (1902-1987) 卡爾·羅傑斯(1902-1987)
  • Hierarchy of Needs 需求層次理論
  • Abraham Maslow (1908-1970)
    亞伯拉罕·馬斯洛(1908-1970)
  • Humans fulfill basic needs first (e.g., food, safety) before moving onto higher needs like self esteem
    人類首先滿足基本需求(例如,食物、安全),然後再轉向更高層次的需求,如自尊。

Humanistic Theory (slide 2 of 2)
人文主義理論(第 2 張幻燈片,共 2 張)

  • Person-centered therapy 以人為本的療法
  • Therapist conveys empathy and unconditional positive regard
    治療師表達同理心和無條件的正向關懷
  • Minimal therapist interpretation
    最小化的治療師解釋
  • No strong evidence that purely humanistic therapies work to treat mental disorders
    沒有強有力的證據表明純人文主義療法能有效治療心理障礙
  • More effective for people dealing with normal life stress, not suffering from psychopathology
    對於處理正常生活壓力的人來說更有效,而不是遭受心理病理的人

The Behavioral Model (slide 1 of 3)
行為模型(第 1 張,共 3 張)

  • Derived from a scientific approach to the study of psychopathology
    源自於對心理病理學研究的科學方法
  • Classical conditioning (Pavlov; Watson)
    古典條件反射(巴甫洛夫;華生)
  • Ubiquitous form of learning
    無處不在的學習形式
  • People learn associations between neutral stimuli and stimuli that already have meaning (unconditioned stimuli)
    人們學習中性刺激與已經具有意義的刺激(無條件刺激)之間的聯繫
  • Conditioning explains the acquisition of some fears
    條件反射解釋了某些恐懼的獲得

The Behavioral Model (slide 2 of 3)
行為模型(第 2 張幻燈片,共 3 張)

  • Classical conditioning - concepts
    古典條件反射 - 概念
  • Stimulus generalization 刺激泛化
  • Start to respond in the same way to similar stimuli. E.g., a child taught to fear the color red (because it is paired with a loud, scary noise) may also fear the color orange
    開始以相同的方式對類似的刺激作出反應。例如,一個被教導害怕紅色的孩子(因為它與響亮、可怕的噪音相伴)也可能害怕橙色。
  • Extinction 滅絕
  • When the conditioned stimulus is repeatedly presented without the unconditioned stimulus, the association is weakened.
    當條件刺激反覆出現而沒有無條件刺激時,聯結會減弱。

The Behavioral Model (slide 3 of 3)
行為模型(第 3 幻燈片,共 3 幻燈片)

*\cdot John B. Watson (1878-1958)
約翰·B·華生(1878-1958)
  • Believed that psychology should be as scientific and objective as possible
    相信心理學應該盡可能科學和客觀
  • “Little Albert” experiment: Baby Albert was taught to fear a white rat when it was repeatedly paired with a loud noise (classsical conditioning)
    “小阿爾伯特”實驗:嬰兒阿爾伯特在白鼠與大聲噪音反覆配對時被教導去害怕白鼠(古典條件反射)
  • Mary Cover Jones (1897-1987)
    瑪麗·卡佛·瓊斯(1897-1987)
  • One of the first to treat phobias with exposure and extinction of learned association
    最早使用暴露療法和消除學習聯結來治療恐懼症的專家之一

The Behavioral Model - Operant Conditioning
行為模型 - 操作性條件反射

  • E.L. Thorndike (1874-1949)
    E.L. 索恩代克 (1874-1949)
  • Law of effect: Behavior will repeated more often if it is followed by good consequences and less often if it is followed by bad consequences
    效果法則:如果行為後有良好的結果,則該行為會更頻繁地重複;如果行為後有不良的結果,則該行為會較少重複
  • B.F. Skinner (1904-1990) B.F. 斯金納 (1904-1990)
  • Behavior “operates” on environment and is managed by consequences (rewards and punishments)
    行為「運作」於環境中,並由後果(獎勵和懲罰)來管理
  • Behavior “shaping”: New behavior can be learned by reinforcing successive approximations
    行為「塑造」:透過強化逐步接近的方式,可以學習新的行為

The Beginnings of Behavior Therapy
行為療法的起源

  • Behavior therapy: Creating new associations by practicing new behavioral habits, and/or reinforcing useful behaviors with positive consequences
    行為療法:通過練習新的行為習慣來創造新的聯結,和/或用正面後果來強化有用的行為
  • Behavior therapy tends to be time-limited and direct
    行為療法通常是時間有限且直接的
  • Strong evidence supporting the efficacy of behavior therapies
    強有力的證據支持行為療法的有效性

    *\cdot Example: Joseph Wolpe (1915-1997)
    *\cdot 例子:約瑟夫·沃爾佩(1915-1997)
  • Systematic desensitization: Individuals gradually exposed to fears (usually through imagination) while practicing relaxation exercises
    系統性脫敏:個體逐漸接觸恐懼(通常透過想像)同時練習放鬆練習

The Present: The Scientific Method and an Integrative Approach
當前:科學方法與整合性方法

  • Defining and studying psychopathology
    定義和研究心理病理學
  • Requires a broad approach
    需要廣泛的方法
  • Multiple, interactive influences
    多重互動影響
  • Biological, psychological, social factors
    生物、心理、社會因素
  • Scientific emphasis continues to be very important
    科學重視仍然非常重要
  • The supernatural tradition no longer has a place in a science of abnormal behavior
    超自然的傳統在異常行為的科學中已不再有立足之地
  • Advances in neuroscience and cognitive and behavioral science will add to our knowledge
    神經科學以及認知和行為科學的進展將增進我們的知識