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PSYC 241
Dagmar Bernstein

Abnormal psychology: application of psychological science to the study of mental disorders Psychopathology: field concerned with the nature and development of abnormal behaviour, thoughts and feelings. Abnormal behaviour is determined by: 1. Statistical infrequency – when the behaviour or characterization is infrequent in the general population. This is not a sufficient marker because having an IQ>130 is also infrequent 2. Violates norms – the behaviour threatens or makes anxious those watching. Anxious individuals do not violate social norms. 3. Personal Distress – behaviour that creates distress and torment in the person. A Psychopath feels no remorse or anxiety, or a woman in labour feels pain of childbirth. 4. Disability or dysfunction – and impairment in some important area of life. Being short and wanting to play basketball is not a disability. 5. Unexpectedness: unexpected or out of proportion responses to environmental stressors. Being happy at a funeral or phobia of spiders. According to the DSM mental disorders are defined: 1. Present stress 2. Disability or impairment in functioning 3. Increased risk of suffering death, pain, disability, loss of freedom Conditions excluded: 1. Expectable/culturally sanctioned response to an event 2. Deviant behaviour (political, religious, or sexual minorities) 3. Conflicts between individual and society Psychological disorder: distress or impairment of functioning that is not typical or culturally expected. In Canada, who provides the major proportion of mental health services? General practitioners because public health plan reimbursement of fees-for-service is limited to medical doctors Who regulates and has jurisdiction over the practice of psychology in Canada? Professional regulation of the psychology profession is within the jurisdiction of the provinces and Territories History of psychopathology Early Demonology: doctrine that an evil being (devil) may dwell within a person and control their mind and body. Many believed that deviancy reflected the displeasure of the gods or possession by demons. Abnormal behaviour often involved exorcism by ritualistic chanting or torture. Trepanning: making a surgical opening in a skull to release or make an opening for demons or evil spirits to escape. It was most common in Peru and Bolivia. Hippocrates: - separated medicine from religion (father of modern medicine), rejected beliefs that gods sent physical and mental diseases as punishment. Said that mental illnesses had a natural cause like any other illness, and regarded the brain as the organ of consciousness. - Somatogenesis: something wrong with the soma (body) disturbs thoughts and actions. - Psychogenesis: disturbances are from psychological origins - Classified mental disorders into 3 categories: Mania, melancholia, and phrenitis (brain fever) - Mental health has to be balanced in four humours (fluids of body): o Too much blood = changeable temperament o  black bile = melancholia o  yellow bile = irritability/anxiousness o phlegm = sluggish and dullness Death of Galen, the last major physician of the classical era = beginning of dark ages. There were many plagues, famines, disasters to follow. - 13 century - Persecution of women assumed to be witches – obsession with the devil – in 1484 pope innocent VIII sent out monk to look for witches and later they came out with a manual “Malleus Maleficarum” to guide witch hunts. Those who rependent were imprisoned for life and those who didn’t were executed/burned. Mentally ill were generally considered witches, but most were not mentally ill rather just admitted after the toture. - 15-16 Hospitals started emerging taking in both dangerously insane and incompetent. Lunacy trials then held in England to determine insanity (allowed crown to take over the person’s estate), possession in the middle ages wasn’t a common explanation for mental illness. th Asylums: in 12 century there were hundreds of leprosy hospitals, but after the crusades it disappeared and the focus turned to the mentally ill. Leprosy hospitals turned to asylums to confine the mentally ill. Asylums took in beggars and mentally ill and had no regime except make them work, but more hospitals came up to specifically confine mentally ill. St Mary of Bethlehem (1547) – because hospital to confine mentally ill. BEDLAM – place of wild uproar and confusion, comes from the name of this hospital. It became a tourist attraction – viewing the violent patients was considered entertaining. Benjamin rush: father of American psychiatry. Believed that mental disorder is caused by excess blood in the brain and that lunatics were cured by being frightened. Philippe Pinal: humanitarian treatment of the mentally ill, !793 during French revolution, removed chains of people in asylum, treat patients as sick not beasts, replaced the dungeons with light airy rooms. More humanitiarian treatment for people of upper class, lower class people still subjected to coercion. Restore patients self-esteem and let them demonstrate self restraint. Drugs such as cannabis and alcohol were used. Moral treatment was abandoned but Dorothea Dix resurrected it: 32 state hospitals. Asylums in Canada: varied from province to province. Dorothea visited the canadas and presented and appeal to nova scotia to request construction of a public mental health hospital Describe the deinstitutionalization process of Canada. In the 1970s, the restrictive nature of a mental hospital led to concern, and the deinstitutionalization of a large number of mental hospital patients. Goal: To shift care from psychiatric hospitals into the community. This changed philosophy caused a decrease in bed capacity of Canadian mental hospitals o From 50,000 beds to ~15,000 beds from 1960 to 1976 BUT beds in general hospitals increased from 1000 to ~6000. Budget cuts in 1980-1990s caused further deinstitutionalization Deinstitutionalization attitudes were weakened because those that were previously in hospitals led a life of poverty (esp. homeless and prison populations). Emil Kraeplin - classification system involving the biological nature of mental illnesses - symptom: group of symptoms which appear together regularly enough to be regarded as having an underlying physical cause. - Dementia praecoz: schizophrenia – chemical imbalance - Manic-depressive psychosis: bipolar disorder – irregularity in metabolism - General Paresis and Syphilis: in mid 1800’s senile an presenile psychoses and mental retardation are identified as biological. - Discovery of nature + origin of syphilis: -general paresis: physical and mental deterioration, delusions of grandeur and paralysis from which there was no recovery (found that some patients previously had syphilis) - germ theory of disease – Louis Pasteur – demonstrated the relationship between syphilis and general paresis and linked infection and destruction of brain areas to a form of psychopathology (has a biological cause which demonstrated others could). Disease is cause by infection of the body by minute organisms. So, somatogenesis gained credibility - Psychogenesis: mental disorders are attributed to psychological malfunctioning Mesmer and charcot: hysterical disorders are cause by distribution of a universal magnetic fluid in the body and one person could influence the fluid in another person. Used hypnosis to treat hysteria, blindness and paralysis (strivle physical). Breuer: Cathartic Method: reliving an earlier method through hypnosis and releasing emotional tension caused by supressed thoughts. (collaborated with freud). Dr. Cameron and the CIA in Canada World-renowned Montreal psychiatrist conducted a nine-year experiment on unknowing psychiatric patients Misguided attempt to discover breakthrough “cures” for mental illness No consent Theory of “beneficial brainwashing” with tragic consequences for hundreds of Canadians His “mind-control” experiments were secretly funded by the CIA and federal government of Canada CIA hoped these strategies could be used on Cold War “enemies” Stereotyping and stigmatization Over 50% of Canadians were embarrassed to suffer from mood, anxiety, or substance- dependence disorders, faced discrimination People with both a psychiatric and physical disability faced more perceived stigma and discrimination than those with a psychiatric disability alone. Stereotyping – a fixed belief that involves negative generalization about a group or class of people; general public generally endorse negative beliefs about mentally ill Stigmatization – reduction in the status of a group of people due to perceived deficiencies Myths: violence and the mentally ill Common belief that people with psychological disorders are unstable/dangerous Research doesn’t confirm relation between schizophrenia and violent acts Incidence of violence was higher only with co-occuring substance abuse/dependence Mentally ill are more likely to be victims Myths: mental illness is incurable Plenty of celebrities have a mental illness but are great contributors of society Ipsos Reid survey 2008 survey, extent of negative attitudes and discrimination towards mental illness 46% believe mental illness is a label for poor behavior and personal failings 42% would avoid socializing or marrying (55%) someone with mental illness 27% are afraid of being near the mentally ill 50% decline to tell friends about a mentally ill relative (72% would share cancer diagnosis) Most wouldn’t hire someone with a mental illness Mental health literacy – refers to the accurate knowledge that a person develops about mental illness and its causes and treatment Why is the health of Canadians better than the health of Americans? Canada taxes are employed for universal health care, including care for psychological disorders, Medicare, Canada Health Act, rationed by medical judgments and level of funding in the system United States health care is rationed by individual income (40% of families have no health insurance) What factors are associated with mental health in Canada? Current stress (strongest correlate) Social support (second correlate) Life events Education (strongly correlated with positive mental health) Childhood trauma (strongly associated to poor mental health) What did the Ontario Ministry of Health (1994) study find? 20% of people in Ontario have one or more mental disorders Many have difficulty performing their main activity (i.e., job); difficulty conducting the typical activities of daily living; and have troubled relationships, marital problems, and difficulties relating to children. Dissatisfied with life, income, main activity, leisure activity, and housing 2% of Ontarians can be considered severely mentally ill 72% are 25-44 years old; separated, divorced, or widowed Similar to a national survey in Canada Evidence-based practice – treatments and interventions that have been shown to be effective according to controlled experimental research Gender differences Problem of underuse is underestimated because women are more willing to seek help than men Gender differences in the use of outpatient mental health services for mood disorders, anxiety disorders, substance-use disorders, and anti-social behaviours Men are less likely to consult with an MD and other resources Promotional campaigns in s
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