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University of Toronto Scarborough
Konstantine Zakzanis

Chapter 1 - History Psychopathy: the field concerned with the nature and development of abnormal behaviour, thoughts, and feelings, we do well to keep in mind that the subject offers few hard and fast answers Abnormal behaviour: such characteristics as statistical infrequency, violation of norms, personal distress, disability or dysfunction, and unexpectedness Statistical infrequency: it is used to diagnosing mental retardation; low intelligence is a principal with detecting mental retardation - When IQ is below 70, individuals intellectual functioning is considered sufficiently subnormal Personal suffering: behaviour is abnormal if it creates great distress and torment in the person experiencing it Disability: impairment in some important area of life because of abnormality Substance use disorderes are also defined in part by the social or occupational disability Phobia can produce both distress and disability (fear of flying can prevent someone from taking on a job promotion) Transvestism: cross-dressing for sexual pleasure Mental Health Professions Clinicians: the various professionals authorized to provide psychological servies Clinical psychology: Ph.D or Psy.D degree – four to seven of graduate study (assessing, cognitive behavioural therapy) major difference between neuropsychologist is that they require more training and deals with more neuro/brain/cognitive functioning Psychiatrist: medication managing, treating more mood disorders Neurologist: Can prescribe medication but focuses more on brain & behaviour connection Psychotherapy: primarily verbal means of helping troubled individuals change their thoughts, feelings, and behaviour to reduce distress and to achieve greater life satisfaction History of Psychology: Early Demonology Before the age of scientific inquiry, all good and bad manifestations of power beyong the control of humankind were regarded as supernatural. Demonology: the doctrine that an evil being (devil) dwells inside a person and controls their minds and body Exorcism: abnormal behaviour were caused by possession and the treatment was to cast out the evil spirits by ritualistic chanting or torture Trepanning: making of a surgical opening in a living skull by some instrument to release the demons; usually solves their headaches & psychological disorders(stone age/Neolithic cave dwellers) Somatogenesis: the notion that something wrong with the soma/physical body that disturbs thought and action Psychogenesis: is the belief that a disturbance has psychological origins Hippocrates classified mental disorders into 3 categories: Mania Melancholia phrenitis (brain fever) Malleus Maleficarum (the witches hammer) During the middle ages, those who were mentally ill were considered witches Strange behaviour were liked to physical illness, injury or emotional shock Basic Tenets of Gal’s system: 1. The brain is the organ of the mind 2. The mind is composed of multiple distinct, innate faculities 3. Because they are distincy, each faculty must have a separate seat or “organ” in the brain 4. The size of an organ, other things being equal, is a measure of its power 5. The shape of the brain is determined by the development of the various organs 6. As the skull takes its shape from the brain, the surface of the skull can be read as an accurate index of psychology aptitudes and tendencies. Phrenology: measurements of the human skull, based on the concept that the brain is the organ of the mind and certain brain areas have localized Development of Asylums - lack of mental hospitals in England - 15th & 16th century: Leprosariums were converted to asylums were refuges estabilished for the confinement and care of the mentaly ill - took in mixture of disturbed people and beggars Bedlam: contraction and popular name for hospital (for mentally ill) – patients withtin the hospital were being viewed as tourist attractions (Lunatics) Moral Treatment Philippe Pinel: figure in the movement for humanitarian treatment for the mentally ill in the asylums. - began to treat sick humans as humans rather than beasts - light and airy rooms replaced the dungeons - Pinel approached with compassion and understanding and treated with dignity as individual human beings Moral treatment: patients had close contact with the attendants, and allowed then to interact and encourage them to live as normal live as possible. “prison”/forensic hospital: reserved for people who have been arrested and judged unable to stand trail and for those who have been acquitted of a crime Community treatment orders (CTOs): a legal tool issue by a medical practitioner that establishes the conditions under which a mentally ill person may live in the community in compliance with treatment Paul Broca & Aphasia - “tan” individuals would be able to understand but unable to talk (produce speech) due to a lesion (dead tissue) in the lower left frontal lobe that affects the speech location – known as Broca’s (area) aphasia - Wernicke – responsible for comprehension – couldn’t understand but able to speak general paresis: germ theory of disease: disease is caused by infection of the body by minute organisms psychogenesis: the search for somatogenic causes dominated the field of abnormal psychology cathartic method: the experience of reliving an earlier emotional catastrophe and releasing the emotional tension caused by suppressed thoughts (Breuer) The public perception: many common misconception or myths of mental illness Mental health literacy: created and referred to an accurate knowledge that a person develops about mental illness and its causes and treatment. Due to psychopharmacology (medication), many patients were deinstitutionalized, lack of housing support for those who were mentally ill Evidence-based treatment: treatments and interventions that have been shown to be effective according to controlled experimental research Community psychology: an approach to theraphy that emphasizes prevention and the seeking oout of potential difficulties rather than waiting for troubled individiuals to initiate consultation (prevention based on the environment/community, preventing a greater spread) Lessons of History: 1. Cycles of persecution, neglect and humanitarianism in the treatment of the mentally ill have occurred irrespective of the helping agency 2. Periods in which people who exhibited psychologically disordered behaviour were persecuted and treated cruelly have often alternated with periods of humanitarian reform and care for suffering people 3. Just as we now look back on what were once accepted treatments were revulsion, future generations may regard some of our more recent and current practices as cruel and inhumane 4. Recent reforms may easily be reversed during adverse economic, political, and social conditions 5. The pendulum of understanding is always swinging, we best understand abnormal psychology from all perspectives Chapter 2 Biological paradigm o Behaviour genetics: study of individual diffs and b that’s attributed to one’s genetic makeup o Genotype vs phenotype − Genotype: genetic makeup (DNA – unobservable) − Phenotype: the physical appearance ; observable characteristics that change over time • Product b/w genotype and environment . Family method − Searching for probands/index cases: someone w/ disorder . Twin method − Monozygotic twins : 100% identical genetic material (identical) - greater chance of sharing similar disorder compare to DZ twins − dizygotic : 50% identical genetic makeup (fraternal) Adoptees method − adopted & reared apart (finding biological family) Linkage method - method in molecular genetics that is used to study people (studying inheritance pattern) Gene-environment interactions: the notion that a disorder or related symptoms are the joint product of a genetic vulnerability and specific environmental experiences or conditions Biochemistry o Neurotransmitters − chemical substances that allow a nerve impulse to cross the synapse (small gap to receive membrane) o Reuptake − Process where, remaining in the synpse is broken down by enzymes and is pumped back into the preseynptic cell (terminal) Structure of the Brain meninges: cerebral hemisphere: corpus callosum: cerebral cortex: gyri: sulci: frontal lobe: parietal lobe: temporal lobe: occipital lobe; white matter: nuclei: ventricles: Structure and function of the brain Cortical vs subcortical o Cortical structurs responsible for higher order cognition: eg) learning, concentrate, consolidate, o Subcortical: structures w/in the brain; structures below the cortical structure − Disorder: parkinsons disease o Frontal lobes: − R: retrieval, ; L: o Parietal lobes: language, − R&l · Occipital lobes: sensation, calculation, vision, coordination Reductionism: the view that whatever is being studied can and should be reduced to its most basic elements or constituents Approaches to treatment Psychoactive drugs Anxiolytics: treats anxiety, sleep disorders o Benzodiazepine − Alprazolam (Xanax); Clonazepam (Klonopin); Diazepam (Valium); Lorazepam (Ativan) o Antidepressants − Selective Serotonin Reuptake Inhibitors (SSRIs) • Celexa; Prozac; Zoloft − Tricyclic Antidepressants • Elavil; Amitryptine − Monoamine Oxidase Inhibitor (MAOIs) • Nardil; Parnate o Psycho-Stimulants: used for ADD − Amphetamines − Ritalin; Aricept Sigmund freud o Results from unconscious conflicts: bring these conflicts to consciousness to cure it o Define the structure of the mind − ID: “want” • Unconscious, pleasure principle (seeks immediate gratification), primary process thinking • Anxiety arises when it doesn’t get what it wants • Deals with anxiety by engaging in the behaviour or primary process thinking (fantasy;illusion to temp gratify itself) − Ego: conscious & rational • Works Secondary process thinking: rationalizes • Aka reality principle − Superego: The Conscious/ Referee b/w ID and Ego o Defense mechanism − Strategy that protects ego from ID’s anxiety − Repression: putting unacceptable wants and thoughts into unconscious − Denial: − Projection: − Displacement: redirecting emotional’s response from dangerous object to substitute − Regression: − Rationalization: Psychoanalytic therapy Freud o About free association: think and talk about whatever comes to mid o When there’s resistance, the therapist tries to delve deeper to overcome this defense o Dream analysis − “royal road to unconscious” • Ego & defense mech are down, allowing for repressed material to enter sleeper’s consciousness. • Since the content is threatening, it doesn’t manifest itself in actual form • Thus, it appears as latent/symbolic content o Countertransference − Some sort of representation w/ someone in their likfe (not the therapist) o Interpretation o Contributions − Childhood experiences help shape adult personality − There are unconscious influences on behaviour − People use defence mechanisms Humanistic and Existential Paradigms Carl Rogers’s client-centred therapy: ppl can be understood from their own vantage point o Self-actualization o Unconditional positive regard of empathy: accepting one w/out judgement eg) dog o Empathy − Ppl are good and effective: w/out this, unconditional positive regard of empathy can’t exist o Healthy ppl have a premise and are goal directed o Pg. 63: under picture is a quote of self actualization: “When ppl aren’t concerned with eval, demands and prefs of others. When theyre no longer concerned, their lives are governed by the tendency of self actualization **on exam Existential therapy Gestalt therapy o Living and feeling in the now… − Ready to Live in the “Here & Now” Exercise o Treatment Techniques − I-Language − Empty chair technique − Projection of feelings − Attending to non-verbal cues − Use of metaphor Learning Paradigms Behaviourism o Focuses on the study of observable behaviour rather than on consciousness Classical Conditioning o Unconditioned stimulus (UCS) o Unconditioned response (UCR) o Conditioned stimulus (CS) o Conditioned response (CR) Operant Conditioning  example of prof’s germ phobia o Law of effect o Positive reinforcement − Germaphobic: # of times one got sick coincides with the # of times prof got sick o Negative reinforcement − The more times sanitizer was applied, the less times he got sick o Shaping o Successive approximations Modeling o Learning by watching and imitating others o Albert Bandura (1925- ) − Social learning and cognitive self-regulation − Can you think of any examples whereby Psychopathology is present because of Modeling principles??? Behaviour therapy o Counterconditioning − Systematic desensitization: progressive way in which one can become deconditioned to a stimuli • Therapist would create a hierarchy of one’s phobies • Therapist would create a calming environment and present the stimuli until it no longer scares the client • Upon success, client moves onto a higher item on the list of phobias until the client is completely okay/treated − Aversive conditioning o Operant conditioning − Time Out − Token economy o Modeling − Role-play The Cognition Paradigm o Recognizes that there are processes that can account for psychopathology o Cognition − Mental processes of perceiving, recognizing, conceiving, judging, and reasoning o Schema: we use schema’s as filters; − Cognitive set Cognitive behaviour therapy (CBT) o Beck’s cognitive therapy; o Ellis’s rational-emotive behaviour therapy (REBT): eliminate self-defeating beliefs through a rational examination of them o Beck’s CBT Consequences of Adopting a Paradigm “Abnormal behaviour is much too diverse to be explained or treated adequately by any one of the current paradigms. It is probably advantageous that psychologists do not agree on which paradigm is the best. We know far too little to make hard-and-fast decisions on the exclusive superiority of any one paradigm” Lecture 3 – Abnormal Psychology Classification and Diagnosis DSM (diagnostic and statistic manual of mental disorders) Definition of Mental Disorder (psycho pathology): a clinically significant behavioral or psychological syndrome or pattern that occurs in an individual - includes present distress or disabilities - a significantly increased risk of suffering death, pain, disability, or an important loss of freedom Symptom/impairment: it does not disable our daily living activities Excludes: an expectable and culturally sanctioned response to a particular event (expectable – grief from a death – criteria for depression culturally sanctioned – fasting for numerous days – criteria for anerixia) Deviant behaviour, conflicts that are primarily between the individual and society (homelessness, abortion) Diagnostic system of American Psychiatric Association Five dimensions of classification Axis I – all diagnostic categories (major mood disorders) Axis II – personality disorders and retardation Axis III – general medical conditions (cancer… medical conditions) Axis IV – psychosocial and environmental problems Avis V – current level of functioning If they have more than one issue, it may be harder to treat* Diagnostic categories: Disorders usually first diagnosed in infancy, childhood or adolescenece: - separation anxiety disorder - conduct disorder - attention-deflicit/hyperactivity disorder - mental retardation - pervasive developmental disorders - learning disorders Substance-related Substance abuse versus pendence (tolerance and withdraw) Schizophrenia: •language and communication are disordered •delusions (thoughts that aren’t theirs in their head) hallucinations (headings voices) • •emotions (blunt, flattened, inappropriate) • Mood disorders: • major depressive disorder • mania: boundless energy and the individual is disorganized(delusional) • the thoughts are possible but unlikely • bipolar disorder: mania/mood x depression anxiety disorder: common (central fear) • - phobia (specific trigger) - panic disorder; agoraphobia (everything causes stress) - generalized anxiety disorder - obsessive-compulsive disorder - post-traumatic stress disorder - acute stress disorder (mini post-traumatic stress disorder) • Somatoform Disorders: Somatization disorder: individual spends lots of time @ doctors - unsure what they really are ill of, causes distress and disability - conversion disorder - Pain disorder - Hypochondriasis: - Body dysmorphic disorder Dissociative disorders: sudden alteration in consciousness that affects memory and identity - dissociative amnesia (forgets past/losing a part of memory) - dissociative fugue (travels to new locales & new life) - dissociative identity disorder (multiple personality) - depersonalization disorder (feeling of unreality) Sexual and gender identity disorders - paraphilia: unconventional to complete a sexual response (arousal – organsm) - sexual dysfunctions (inability to complete the sexual response cycle) - gender identity disorder (confused and don’t feel their biological genders) Sleep disorders - dyssomnias: sleep in disturbed; unable to maintain sleep - parasomnias: abnormal events during sleep (sleep walkings/night terrors) Eating disorders anorexia nervosa: patients who will starve themselves to meet their criteria bulimia nervosa: they binge and purge; but they “abuse” to lose their weight Fa
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