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Abnormal Psych History.docx

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Psychology 2030A/B
David Vollick

NORMAL BEHAV What’s psych norm?- majority, fcn autonomously, perceive reality, regulated moods, relate non-violently, not severely stressed -continuum w/ norm at one end and abnormal at other, ppl somewhere in btw, diff pts, can pull back in line if not abnormal MISCONCEPTIONS ABOUT ABNORMAL BEHAV -bizarre- diff in kind -former patients are unstable and dangerous -ashamed -one’s susceptibility -weak in char (should know better) -hopeless PSYCH DYSFUNCTION -breakdown in cognitive, emotional, or behavioral functioning -distress or impairment: difficulty performing appropriate and expected -impairment is set in context of person’s background -atypical or unexpected cultural re: -psych disorder and psych abnorm are used interchangeably -mental illness less used -psychopathology is the scientific study of psych disorders DIAGNOSTIc AND STAT MANUAL (DSM-IV) -widely accepted system for classifying psych probs and disorders -contains diag criteria for behaviours that: -fit a pattern -cause dysfcn or subjective distress -are present for a spec duration -behav not otherwise explainable APPROACHED TO SCI STUDY OF PSYCH DIS -Mental Health Pros: -Ph.D.s: clinical and counseling psychologists (more clin) -Psy.D.s: clinical and counseling “Dr’s of psych, none currently in Ca) -In Ca, reg’n of pro is under jurisdic’n of individual province -M.D.’s: psychiatrists -M.S.W’s: psychiatric and non-psychiatric social workers -MN/MSN’s: psychiatric nurses, w/ spec training -Scientist-Practitioner Model: producers of research, consumers of research, evaluate work using Empirical methods, CLINICAL DESCRIPTION -begins w/ presenting prob -description aims to: distinguish clinically sign dysfcn from common human experience -describe prevalence and incidence of disorders -describe onset of disorders-acute vs insidious onset -describe course of disorder- episodic, time-limited, chronic course -prognosis- good vs guarded CAUSATION, TREATMENT AND OUTCOMES - factors contribute to development of psychopathology- study of etiology -how best improve lives of ppl suffering from psychopath’y- study of treatment development -includes pharmacologic, psychosocial, and/or combined -alleviated psychological suffering- study of treatment outcome HISTORICAL CONCEPTIONS ABOUT ABNORM BEHAV -maj psych disorders have existed: in all cultures, all time periods -causes and treatment varied widely: across cultures, across time periods -3 dominant traditions: -i) supernatural (demons), ii) biological (from Greece, separate mind/body) iii) psychological DEVIANT BEHAV BELIEVED TO BE CAUSED BY: -demonic possession, witchcraft, sorcery -mass hysteria (St Vitus’ dance or Tartanism) -movement of moon and stars (Paracelsus ancient physcician called it lunacy) -both “outer force” views popular during Middle Ages (in Europe) -few believed abnormality was illness on par w/ physical disease -treatments included exorcism, torture, beatings, crude surgeries, blood letting -Hippocrates’: abnorm behavior as phys disease- abnorm physiology, coined hysteria due to “wandering uterus” cure marriage and pregnancy -Galen extends Hipp’s work- humoral thoeyr of mental illness- humors like chem imbalance in body fluids (not in brain) treatments still crude ie extreme heat/cold, bloodletting, induced vomiting, -Galenic-Hippocratic tradition (phys possibility of mental ill) -foreshadow modern views linking abnorm w/ brain chem imbalances 19 THCENTURY: -General Paresis- was psych disorder of unusual psych and behav, found caused by syphilis, first proof that phys cause -Pasteur discover cause was bacterial microorganism - led to penicillin as successful treatment -bolsteres view that mental illness=phys illness, treated as such (and hope could treat anything w/ right chem) -John Grey- due to brain pathology= incurable (mid 1800’s), just hospitalize -Kraeplin- also thought mental ill due to brain disorder -by 30’s bio treatments were standard practice (not just chem but -insulin shock therapy, Electric Convulsive Therapy (ECT works, humane?) - brain surgery i.e. lobotomy -by ‘50’s meds established -ex neuroleptics (i.e., reserpine), major tranqs (halidol, chloroprozine) -side effects, (tardive diskensia for older ones, weight gain, blood probs, etc but less now), addictions, effectiveness? THE PSYCHOLOGICAL TRAD -rise of moral (emo + psych) therapy -practice of allowing institut’zed patients treated as norm as poss and encourage + reinforce social interaxn -Phillipe Pinel + Jean-Baptiste Pussin- instigators in France -William Tuke- in England -Ben Rush- US -Clarence Hinks – Canada -reasons for falling out of moral therapy: -Dorothea Dix + Reformers (wanted treated just like phys disorders, deinst’z) -unknown brain disease= untreatable (Grey) -emergence of competing alternatives PSYCHOANALYTICAL TRAD -Freud’s structure of mind- figure 1.4 in txt, drive theory, have to satisfy Id- works on pleasure principle (may satisfy by day dreaming or go after)- primary processes (dreams, wish fufillment not touch reality though you can act b/c of it) Ego- develop to control Id, works on reality principle-secondary process, mediates btw id and superego, tries to avoid conflict btw Superego- develops around 5, conscience, works on moral principle- keeps id in balance -interpsychic conflict is reason for disorders, tension btw 3, don’t want unacceptable to rise from unconscious and create tension, no accidents, norm and abnormal through unconscious -Defense mechanisms: -displacement & denial -rationalization, repression, sublimation -projection, r
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