316 Abnormal Psychology
Descriptive psychiatry with classification of data did not
develop until, with the growth of institutions and the increas-
ing professionalization of psychiatry, a sufficient number of
mental patients were gathered for observation over a period
of time. In the second half of the nineteenth century, more
than 15 national and international psychiatric societies were
organized and almost fifty journals of psychiatry appeared in
the United States and Europe. Classifying types of mental
illness began by establishing standard ways of describing
symptoms and symptom clusters.
Emil Kraepelin (1856–1926) developed the first widely
accepted classification of mental disorders and is considered
the founder of modern psychiatric nosology. Kraepelin sys-
tematically collected and described facts, on the basis of
which he classified types of severe mental disorder. His
Compendium der Psychiatriewent through eight editions
between 1883 and 1914, growing to a multivolume textbook
of psychiatry. Kraepelin divided the major psychoses into
manic-depressive psychoses and dementia praecox, and sub-
classified dementia praecox into three types: catatonia
(characterized by mutism and maintenance of a bodily pos-
ture for long periods of time), hebephrenia (characterized by
inappropriate, often silly, speech and behavior), and paranoia
(characterized by delusions of persecution and/or grandeur).
He concluded that persons suffering from manic-depressive
disorder can recover, whereas those with dementia praecox
deteriorate, and hence hypothesized that dementia praecox
may be of metabolic origin. Kraepelin emphasized the phys-
iological causes of mental disorders and considered the per-
sonal side of a patient’s illness as incidental to understanding
psychopathology. He presented ordered groups of obser-
vations, with clear detail and fully documented statistical
tables, in order to establish that serious mental illness, like
other diseases, has a predetermined course and outcome
(Kraepelin 1915). No consistent, central system of diagnosis
was established within the United States until the appearance
of the Diagnostic and Statistical Manual: Mental Disorders
(DSM),first published in 1952 by the American Psychiatric
Association. Although this was a step forward, criticisms
attacked its inherent inconsistency because the categories
included disorders defined on the basis of etiology, on the
basis of behavioral symptomology, and on the basis of pre-
sumed psychodynamics. However, the process of defining
classification had begun, and revisions have followed
throughout the latter half of the twentieth century. Eugen
Bleuler (1857–1939), a Swiss psychiatrist, professor, and
director of Burghölzli Asylum, Zurich, from 1898 to 1927,
originated the term schizophrenia(“split-mind”) in 1908 as
a generic label for the category of mental illnesses that
Kraepelin had called dementia praecox. Bleuler believed that
schizophrenia represents a split between a person’s emotional
life and faculty of reasoning that results from morbid thought
processes that disturb the emotional integrity of the self, and
that schizophrenia is amenable to psychotherapy.
By the 1870s, the field of medicine had entered the era of
modern scientific experimentation. Claude Bernard, French
physician and physiologist considered the founder of experi-
mental medicine, published his classic Introduction to Exper-
imental Medicinein 1865, which established the value of
experimental methods for determining mechanisms regulat-
ing the activity of bodily systems and their relation to physi-
cal pathology. Medical advances, such as Pasteur’s germ
theory were based on the use of the pathogen model of dis-
ease, sometimes loosely known as the “medical model.”
Knowledge of the role of pathogens and the accompanying
social benefits of immunological procedures established this
model as the most effective strategy and has profoundly influ-
enced approaches to psychopathology. In so doing it has cre-
ated vigorous controversy. Applied to the understanding of
psychopathology the model assumes that disordered behaviors
are symptoms of a particular pathology, the hidden cause of
which must be discovered. The first step is to sort mentally ill
people into groups based on clusters of symptoms (syndromes)
common to each group. The second step is to determine the
particular pathogen that has caused the disease in order to
solve the problem of etiology. The third step, once a psy-
chopathology has been diagnosed and its etiology established,
is to determine the appropriate treatment for the condition. The
hidden pathogen may be biological (genes, for example) or
may be past stressful experience. In the psychoanalytic model,
the pathogen is an unconscious conflict, hidden from the
patient and allegedly requiring the skill of the analyst to dis-
cover. The critical difference between this metaphorical use of
the termpathogenand its original meaning is that the analyst’s
discovery cannot be visibly demonstrated to all who look, but
its presence is inferred on theoretical grounds.Brain Pathology Model of Psychopathology
and Nervous DiseasesBy the end of the eighteenth century and during the early
nineteenth century, the development of new technologies to
study the brain and nervous system produced findings that
were to provide the foundations of modern neurology. The
medical community accepted the role of electrical impulses
transmitted within central nervous system tissue in the medi-
ation of behavior, and old beliefs about the role of the blood
and generalized vis nervosafaded from the scene. It had be-
come clear that the central nervous system integrates the sen-
sory and motor systems of the higher organisms. The brain’s
importance as the organ of human thought and behavior was
firmly established and led to the emphasis on disorders of the