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Midterm 1.docx

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University of Toronto Scarborough
Konstantine Zakzanis

Lecture 1: What is abnormal behaviour? o Tests conducted & when statistically infrequent, then its a good indication that there may be some abnormality (only part of the definition because if someone can rmb 20 #s then he is stat infreq, but may not be abnormal) nd o 2 criteria to define abnormality: personal distress (nicks obsession w/ feces ex) but not always (not all abnormalities cause personal distress) Ex: psychopath doesnt always feel personal distress but stress or anxiety will cause personal distress o Violation of norms nicks behaviour Not complete explanation (its relative to time/ culture) Ex: homosexuality (used to be a disorder but not anymore) o Behaviour must threaten or make person watching anxious o Disability/ dysfunction impt difference b/w impairment and ability (Can be impaired but still be able) Ex: depressed but still functional (going to school) o Unexpectedness (Nicks behaviourunexpected) distress & disability the behaviour is unexpected (??) Ex: person with a lot of $ worries about not having enough $ to the point that he cant go to work to make $ Nefinition for abnormality (no 2 patients are the same, but they have similarities) Mental Health Professions: Clinical psychologists/ neuropsychologists o Does a lot of assessment work (mostly dont prescribe medication) Psychiatrist o Mostly about prescribing medication (but engage in counselling too sometimes) Social worker Occupational therapist Counselling psychologist Psychiatric nurse Speech language therapist -Early demonology- when things were abnormal there was no science to explain it blamed it on demonic Gods (body/ mind possessed) - get rid of it through exorcism (but if it didnt work, they drilled a hole in their skull or froze person close to death etc) -tried to drown them, if they died then they were possessed, if they survived, they were taken to their st death via beheading. (1 psychological test) - eventually came up w/ asylums (w/ horrific names/ treatments) -hydrotherapy- sprayed by h20 to stimulate them (video: dates back 50-60 years) - tried to sedate patients (lamps used to relax them) -insulin therapy (used for schizophrenia) - gave insulin to make them go into a coma led to drooling & sweating , (+) convulsions (risky & dangerous) -seizure therapy: brain shocks -glucose given through tubes to bring them out of coma -ECT (electric convulsive therapy) -Phrenology- feeling the head/ skull shape to see if he could draw connections b/w shape and brain activity st (for the 1 time) tried to establish relationship b/w brain and mind -1861 Paul Broca tan patient that could understand but couldnt generate words - conducted autopsy & discovered brocas area - Paul Broca & Aphasia (ppl w/ Brocas aphasia cant formulate words) - Karl Wenicke ppl who could speak fluently but couldnt understand - pt of brain called: Wernickes area -> lesion to it results in Wernickes aphasia - More ppl b/came fascinate that the brain could be responsible for abnormal behaviour. -1848 John Harlow executive disorder - patients frontal lobes affects and polite/ hardworking patient b/came a liar, ill-mannered person - Psychoanalysis was born - idea that psycho-genesis was responsible for abnormal behaviour - relation b/w ego- superego- id (etc) - shift from biological explanation to external (ego) explanation - after this time, people went to war -Norman Geshwind saw soldiers who could understand but not talk & husbands who werent who they were before they left. - brought back the idea that brain damage could be the reason & not Freuds idea. st - 1 to create tests (psychological & neuropsychological) - early 70s CT scale invented scanned peoples brain (see if there was any physical damage conclusive data) Video: - Study of identical twins allow for comparisons to be made b/w affected twin and healthy twin - Can compare scans of activity of the brain - Biological momentum (@ its current peak) - Eventually medications introd -Biology doesnt explain all the behaviour, but bio-psycho social method (multi-method) does. - 2 twins share 100% of their genes but one has schizo and o/ doesnt ( not biological) - pendulum of understanding always swinging -sometimes things change a s a result of social politics (ex: homosexuality removed from DSM) Lecture 2: - The role of Paradigms: A set of basic assumptions a clinician will make. A general perspective that defines how to conceptualize, study a subject, patient, how to gather and interpret data and how to think about the subject. - Ex: psychiatrist believes in medication alters neurochemistry to alter behaviour (their paradigm= a biological approach) - Ex: Psychotherapist psychogenic original beliefs to problems - 4 main paradigms: 1. Biological Paradigm: Medical model Mental disorders arise due to some neurobiological antecedent Behavioural genetics: study of individual difference in behaviour that are attributable to differences in genetic makeup. o Some sort of clue if a disease/ illness has a genetic component to it. o Genotype vs. Phenotype Genotype: inherited and unobservable. Get it from biological parents Phenotype: Observable behavioural characteristics product of genotype and environmental factors (ex: anxiety level in person) A disorder is not inherited genetically. Can have the genetics that leave you pre-disposed to presenting w/ the phenotypes of this disorder (schizophrenia, anxiety, depression) but not inherited. One disorder that is inherited= Huntingtons disease o Know this b/c we use diff study methods. There are 4 methods: 1) Family Method 2) Twin Method a. Monozygotic twins (MZ Twins) 100% identical twins b. Dizygotic twins (DZ) 00> 50% identical 3) Adoptees method 4) Linkage Analysis Family Method: -If pre-disposition for a mental disorder can be inherited, study of family relationship should show relationship b/w # of shared genes in index case (person w/ disorder) & prevalence of disorder in probands (relatives) st - Ex: individual w. schizophrenia, learned from family method that if you are 1 degree relative, then 10% likelihood more of getting schizophrenia (norm pop 1% chance of getting it) - 1 degree relatives examples siblings/ parents (10%) Twin Method: - Twin set, both have schizophrenia, known as concordance (similar diagnostically speaking) - Monozygotic twins (if they show a higher concordance level than dizygotic twins, then genetic obviously genetic component plays a role) strong argument that characteristic is heritable Adoptee Method: - Twins grow up in an environment away from biological family (may rule out environmental factors) ex: if twins have schizophrenic mom and grow up w. adoptive parents and b/come schizo then envio of mom being schizo didnt play a role. Linkage Analysis: - Look for a large collection of individuals w/in a family unit who might have a disorder (looking for biological or genetic markers) blood samples, urine samples etc. Try to see if anything is common - Neurotransmission & reuptake = key terms o Neurotransmission: molecules that move from 1 neuron to the next= neurotransmitters (transmitters detected that carry messages about pain, pleasure, anxiety etc)
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