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Chapter 1

PSYC 235 Chapter 1: PSYC235 Chapter 1

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PSYC 235
Christopher Bowie

WEEK 1 - Chapter 1: Abnormal Behaviour in Historical Context Psychological Disorder - Defined as a psychological dysfunction within an individual that is associated with distress or impairment of functioning - Response that is not typical or culturally accepted - Ex. The boy who fainted at the sight of blood has a phobia o This is a psychological disorder characterized by marked and persistent fear of an object or situation; can be very disabling at varying degrees What is a Psychological Disorder? Psychological Dysfunction - Refers to a breakdown in cognitive, emotional or behavioural functioning, known as a dysfunction - These are known to exist on a continuum or as a dimension, instead of being absent or present - You cannot just have a dysfunction to have a psychological disorder Personal Distress or Impairment - Disorder must be associated with distress and individual must be upset - This by itself does not define abnormal behaviour as it is quite common to be distressed at times, let’s say if a family member dies - Some disorder occur where suffering and distress are absent (ex. Being in a manic episode and being extremely elated) - Also think of impairment (ex. Avoiding interaction with people) o Disorders are extreme expressions of otherwise normal emotions, behaviours and cognitive processes (ex. Boy who fainted was impaired by phobia, but many people have similar, less severe reactions and they are not impaired) Atypical or Not Culturally Expected - Considered abnormal because occurs infrequently (ex. Abnormally tall/short) - Also if you are violating social norms o In Western culture: considered abnormal to believe you are possessed thus, a psychological disorder is possible, but in other societies not - Wakefield: psychological disorder is when one or more mechanisms fail to perform their evolved function, hence causing distress o Provides objective/scientific POV o Allows culturally bound definition of what is harmful/distressful o Ex. Jody’s phobia of blood: reminds him of danger and would trigger self- protective mechanisms, fainting means psychological disorder - If behaviour is out of person’s control - DSM-5 agrees it is difficult to provide a clear, encompassing definition o Most common definition describes biological, behavioural and psychological dysfunctions unexpected in their culture WEEK 1 - Chapter 1: Abnormal Behaviour in Historical Context - Best to consider how “typical” it is compared to profile of disorder o Ex. Depression has various symptoms and signs that most agree on o This is called a prototype o Can have all or only some and still meet the prototype; very individualized - Szasz and Albee highly critical of medical diagnosis o Szasz denied existence of mental illness ▪ Argued a big difference in physical disease determination and mental ▪ Ex. Blood tests versus subjective accounts o Albee did not agree with idea and using a medical model ▪ Ex. The DSM system The Science of Psychopathology - Scientific study of psychological disorders o Includes psychologists, psychiatrists, nurses, social workers etc - Only those registered with provincial board or college are permitted to call themselves “psychologists” and uni profs in psyc o “Psychotherapist” and “therapist” not regulated by board - Counselling Psychologists, Psychiatrists, Psychiatric Social Workers, Psychiatric Nurses, Mental Health Counsellors The Science Practitioner - Mental health professionals that take scientific approach to clinical work 1. Consumer: Keep up with scientific developments: evidence-based practice 2. Evaluator: Evaluate own assessments to see if they work 3. Creator: May conduct research of their own (ex. Would not use miracle cure unless knew that it worked, through research) Clinical Description - Presenting Problem: why the person came to the clinic - Clinical Description: unique combination of behaviours, thoughts and feelings; specifies what makes the disorder different from normal behaviour - Statistical data is also relevant in this case o Prevalence: how many people in the population as a whole have the disorder? o Incidence: how many new cases in a specific time - Most disorders also follow a course o Schizophrenia has a chronic course o Mood disorders follow episodic course o Sleep disorders follow time-limited course - Also differences in onset o Acute Onset: begin suddenly o Insidious Onset: develop gradually - Anticipated course of disorder is called prognosis (can be good or bad) - Age is important in determining disorder WEEK 1 - Chapter 1: Abnormal Behaviour in Historical Context Causation, Treatment and Outcomes - Etiology: study of origins of the disorder, what caused it (biological, psychological and social) o If a new drug is successful in treatment, gives us hints of where it came from ▪ Ex. If a drug that affects the nervous system alleviates a disorder, we know something in NS is causing it, or maintaining it - Effect does not imply cause o Your headache was not caused by lack of Tylenol; it just helped - Instead of using same treatment for all disorders, it is more effective to use different ones for their own respective disorder The Supernatural Tradition Demons and Witches - Society as a whole began to believe in power of witches and demons o People turned to this when they had problems - People affected by psychological disorders were thought to be possessed and would be responsible for all misfortune in town o Treatments: exorcism, shaving cross into head secured to church to hear mass Stress and Melancholy - Enlightened view that insanity is a natural phenomenon, caused by mental and emotional stress; curable - People with disorders (physical and mental) were moved from house to house; now we know better to keep in own space - Nicholas Oresme said that depression was not from witches/demons o Said that evidence of sorcery was based on people who would confess to anything - As we see in King Charles VI case, supernatural vs no supernatural had influences o Most believed madness was cause supernaturally Treatments for Possession - Because HIV is most common in gay men, some people believe it is punishment for their “abhorrent behaviour” - Possession is not always connected to sin, and may be seen as involuntary o Exorcisms are connected to relief of pain - Some hung people over a pit of poisonous snakes o Realized this may not be the best cure o Worked sometimes, strangely, and so they were built into institutions The Moon and the Stars - Paracelsus suggested the power of the moon and the stars; influenced the word lunatic - Belief that heavenly bodies affect human behaviour still exists - People around the world are still convinced in the power of the stars (ex. Astrology) WEEK 1 - Chapter 1: Abnormal Behaviour in Historical Context The Biological Tradition Hippocrates and Galen - Maher and Maher suggested that psychological disorders could be treated like any other disease o May also be caused by brain pathology or head trauma - Hippocrates thought the brain to be the seat of wisdom, consciousness, intelligence and emotion o Hence these disorders logically would be located in the brain o Important: psychological and interpersonal relationships, such as family stress - Humoral Theory of Disorders: brain functioning related to blood, black bile, yellow bile and phlegm o Disorder would result from too little/much of a certain humour o First time to connect chemical imbalance with brain dysfunction o Ex. Melancholy (depression) result from too much black bile o Treated by regulating environment o In bloodletting, blood is removed from the body, usually by leeches - Hippocrates coined word hysteria; describes somatic symptom disorders o Mistakenly assumed only restricted to women o “Wandering Uterus” in search of conception o Cure was marriage or “fumigation of vagina” The 19 Century - Syphilis: discovery of nature and cause of this helped with biological perspective o Symptoms include believing everyone is plotting against you, you are God, and other bizarre behaviours, but not the same as psychosis because the latter did not die o Would become paralyzed and die; was called a disease - Malaria Cure: o Man who had syphilis got malaria and hence, a high fever o This caused his illness to go away o First time they saw a mental illness go away with a physical “treatment” o Gene Therapy: injected people who has syphilis with malaria and enough people died that they didn’t do it again - John P. Grey: insanity always has physical causes so, mentall
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