2030-Lecture 1.docx

1/7/2013 3:52:00 PM Chapter 1-Abnormal Behavior in Historical Context  What is abnormal behavior? Is there a normal?  Mental illness is something contrary to cultural norm- societal expectations- different cultures have different norms-interferes with daily life  What is psychologically normal?  What the majority of people do?  Function autonomously?  Do we perceive reality? Psychosis-break from reality  Regulated moods  Relate to each other in a non-violent manner  Not severely stressed  Misconceptions about abnormal behavior  Assume they are bizarre  Different in kind  Former patients are unstable and dangerous-people would prefer to have their child babysat by a murder that a psychiatric patient  Ashamed  Ones susceptibility  Weak in character  Mental illness is a hopeless situation-new treatments coming out all the time to improve behavior  Toward a definition of abnormal behavior  Psychological dysfunction- A breakdown in cognitive, emotional, or behavioral function  Distress or impairment- difficulty performing appropriate and expected tasks and causing distress o Impairment is set in the context of a persons background  Atypical or unexpected cultural response-reaction is outside societal norms  Abnormal behavior defined  Psychological disorder and psychological abnormality are used interchangeable  Mental illness is a less preferred term  Psychopathology is the scientific study of psychological disorders  The Diagnostic and Statistical Manual (DSM-IV)  Widely accepted system for classifying psychological problems and disorders-you want it to be reliable and consistent  DSM contains diagnostic criteria for behaviors that o Fit a pattern-noticeable pattern o Cause dysfunction or subjective distress-reason for distress o Are present for a specific duration o And for behavior that are not otherwise explainable- ie taking street drugs  Approaches to the scientific study of psychological disorders  Mental health professionals o The Ph. D.s: Clinical and counseling psychologists o The Psy. D.s: Clinical and counseling “doctors of Psychology” (No Psy. D. Programs currently in Canada) o In Canada, regulation of the profession is under the jurisdiction of the provinces and territories o M.D.’s: Psychiatrists o M.S.W.’s: Psychiatric and non-psychiatric social workers-involved with talking to families and discharges o MN/MSN’s: Psychiatric nurses-were in charge or administering drugs  The Scientist-Practitioner  Producers of research-you are a scientist understanding how to create, test, and accept a hypothesis  Consumers of research-we must keep up to date with procedures  Evaluators of their work using empirical methods-evaluate effectiveness of a program through the scientific method  Categories o Focus of clinical description, causation (etiology) and treatment and outcome  Clinical Description o Begins with the presenting problem o Description (general) aims to  Distinguish clinical significant dysfunction from common human experience o Describe prevalence and incidence of disorder  Incidence is number of new cases, prevalence is number in a population o Describe onset of disorders  Acute vs. insidious onset  Insidious-over time o Describe course of the disorder  Will this patient get better, how long and is it possible  Episodic, time-limited or Chronic course o Prognosis- good vs. guarded (not too sure if it will get better)  Causation, treatment and outcomes o What factors contribute to the development of psychopathology? = Study of etiology o How can we best improve the lives of people suffering from psychopathology? =Study of treatment development  Includes pharmacologic, psychosocial, and/or combined treatment o Have we alleviated psychological suffering?  Study of treatment outcome  The past: Historical conceptions of abnormal behavior o Major psychological disorders have existed  In all cultures  Across all time periods-has always been o The causes and treatment of abnormal behavior varied widely  Across culture  Across time periods o Three dominant traditions include:  Supernatural, biological (from Greece- separate mind/body), and psychological  Hole in the skull or frontal lobotomy-scramble frontal lobe o Deviant behavior: believed to be caused by:  Demonic possession, witchcraft, sorcery  Mass hysteria (St. Vitus’dance or Tartanism)-could have been food  Movement of moon and stars  Paracelsus and Lunacy  Both “outer force” views were popular during the middle ages  Few believes that abnormality was an illness on par with physical disease  Treatments included exorcism, torture, beatings and crude surgeries o Hippocrates’: Abnormal behavior as a psychical disease  Hysteria “the wandering uterus” –cure was marriage or pregnancy o Galen extends Hippocrates work  Humoral theory of mental illness  Treatments remained crude  Heat, moisture, cold, bloodletting, induced vomiting o Galenic-Hippocraic tradition-first 2 to look at a physical possibility  Foreshadowed modern views linking abnormality with brain chemical imbalances  The Nineteenth Century o General Paresis (syphilis)- first time it was proven that psychological disorder was caused by a bacteria- step towards modern views  Associated with several unusual psychological and behavioral symptoms by a pathogen  Pasteur discovered the cause- a bacterial microorganism  Led to Penicillin as a successful treatment  Now have an abnormal behavior linked to a pathogen treated by a chemical  Bolstered the view that mental illness = physical illness and should be treated as such o John Grey- due to brain pathology = incurable (mid 1800’s was a psychiatrist) would find through autopsy  Mental illness = Physical illness  The Development of Biological Treatments o Kraeplin- Disorders due to brain disorder o By the 1930’s: Biological treatments were standard practice  Insulin shock therapy, ECT (people with epilepsy rarely get schizophrenia)  ECT can work well- in modern treatment anesthesia is used, is it humane?  Brain surgery (i.e., lobotomy) o By the 1950’s several medication were established  Examples: narcoleptics (i.e., reserpine and major tranquilizers  Side effects, addictions, effectiveness???  The Psychological Tradition o The rise of moral (emotional and psychological) therapy