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ABNORMAL PSYCH: CHAPTER 1
Psychopathology- the field concerned with the nature and development of abnormal behaviour, thoughts,
Challenges we face in studying abnormal psych: the subject offers hard and fast answers. Also the need
to remain objective. ALL of use bring to our study preconceived notions about what the subject matter is!
Abnormality is usually determined by the presence of several characteristics at one time. Our best def’n
of abnormal behaviour includes statistical infrequency, violation of norms, personal distress,
disability or dysfunction and unexpectedness.
One aspect of abnormal behaviour is that it is infrequent. The normal curve, or bell shaped curve places
the majority of people in the middle as far as any particular characteristic is concerned. An assertion that a
person is normal implies that he or she does not deviate much from the avg in a particular trait or
1) Statistical infrequency is used explicitly in diagnosing mental retardation
2) Another characteristic to consider is whether the behaviour violates social norms, or threatens or makes
anxious those observing it. But VOSN is still too broad and too narrow, just because you violate social
norms does not indicate that you’re a psychopath, example prostitutes. Also, differ norms in diff cultures.
3) Personal distress; behaviour is abnormal if it creates distress or torment to the person experiencing it.
Problem; not all forms of distress show abnormality; childbirth, and not all abnormal ind face distress
4)Disability; impairment in some area of life because of abnormality. Ex: phobias can cause distress &
disability. Not always applicable tho, transvestites are considered abnormal yet many don’t feel distress.
5) Unexpectedness; distress or disability are considered abnormal when they are unexpected responses to
According to GOERING “ The major proportion of mental health care in Canada is delivered by general
Psychiatrists in Canada have a great deal of clinical autonomy. Hunsley et al concluded from studies that
psychological services are vastly underused. Also psych services are more available in urban areas than
rural, since psychiatrists are mostly in major urban centres.
EARLY DEMONOLOGY: The doctrine that an evil being, like the devil, may dwell w/in a person and
control his or her mind and body is called demonology. Records of this type of thinking are found in early
Chinese, Egyptians, Babylonians and Greeks and Hebrews. Since ppl thought abnormal behaviour was
caused by possession, exorcism was used; which usually took the form of elaborate rites of prayer,
noisemaking, forcing the afflicted to drink terrible brews, and flogging n starvation.
Trepanning was also used by Stone Age or Neolithic cave dwellers. Trepanning was presumably
introduced into the America’s from Siberia. (In 3 aboriginal men found in B.C w trepanning done the
openings were located in the same area; the upper central occipital lobe.
HIPPOCRATES: In 5th century B.C (often seen as father of modern medicine) separated medicine from
religion, magic, and superstition. Said illnesses had NATURAL causes n should be treated as other
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maladies like constipation n colds. Regarded brain as organ of consciousness of intellectual life n
emotion, n so thought that deviant thinking/behaviour were indicators of some kind of brain pathology.
He classified mental disorders into 3 categories; mania, melancholia, and phrenitis(brain fever).
-Hippocrates also left behind very detailed records of symptoms now known as epilepsy, alcoholic
delusions, stroke and paranoia. He also conceived of normal brain functioning/mental health to be
dependent on a balance t/w the 4 fluids; black bile, blood, yellow bile, and phlegm. An imbalance
-In 1853 the legislature passed the PRIVATE LUNATIC ASYLUMS ACT to accommodate the wealthy
in alternatives to the public asylums. The Homewood Retreat was established in 1883 in Guelph. It was a
profit-oriented, independent, private asylums, the first medical superintended DR LETT believed in the
humane care of patients. Resisted “cult of curability”’.
There are two trends in the history of dev’t of mental institutions in Canada: 1)w the advent of asylums,
provisions for the mentally ill were separate from provisions for the physically ill, indigents, and
criminals. 2) the process was segregated from the wider community. Institution and community were 2
separate and distinct solitudes.
Thomas Sydenham- was particularly successful in advocating an empirical approach to classification and
diagnosis. Greislinger was impressed by Sydenham, and insisted that any diagnosis of mental disorder
specify a biological cause.
Emil Kraeplin- follower of Greislinger created a classification system in order to establish the biological
nature of mental illnesses. He discerned that mental disorders had a tendency for a certain group of
symptoms, SYNDROME, to appear together. He regarded each mental illness as distinct from all the
others, each had their own genesis, symptoms, course and outcome. He proposed dementia praecox (early
term for schizophrenia) and manic-depressive disorder ( bi-polar disorder). Said chemical imbalance was
cause of schiz. and irregulatory of metabolism was cause of manic-depressive disorder.
Somatogenesis gained credibility w the discovery of syphilis. A causal link was established b/w
infection, destruction of certain areas of brain, and a form of psychopathology.
PSYCHOGENESIS- various psychogenetic points of view, which attributed to mental disorders to
psychological malfunctions, were fashiona le in France and Austria.
Mesmer- used iron rods, magnetism to cure ppl of hysteria. Though hysterical disorders were strictly
physical, n caused by distribution of universal magnetic fluid in the body. Early practioner of modern day
hypnosis. Charcot- studies hysterical states, amnesia, paralysis, blindness, etc. revived interest in
BREUER- found that relief and cure of symptoms seemed to last longer if under hypnosis patients used
catharsis (able to recall the precipitating event or symptom n their original emotion was expressed). His
method became called cathartic method. PUBLISHED studies in hysteria.
According to CAMH the social stigma surrounding depression is why only 1/3 of est 3 mill ppl in
Canada who suffer from depression seek help.
The majority of mentally ill ppl never perpetrate violent acts, they are more likely to be victims. An
insidious myth is that ppl w psychological disorder can never be cured and can never contribute
meaningfully to society again. This is def not true for ex: Clarence Hinks suffered from serious and
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chronic psychological problems but was able to devote his life to helping the mentally ill and trying to
change the public’s attitudes towards them. He was founder and longterm medical director of Canadian
mental health Assosiation.
In Canada; mental health services are tied closely to the health care system. –Stephens et al concluded
that mental health is relatively poor among young ppl but tends to improve w age. A large community
study found that about 20% of ppl in Ontario have one or more mental disorders. Research suggests that
there are a few major diffs b/w the province but ppl in NEWFOUNDND AND PEI reported rly good
mental health most happiness and leave distress.
However, as noted by Goering the preferred mental health service model is one that emphasizes intensive
local community support and services along w general hospital psychiatric units and regional tertiary care
-Just as there is an emphasis on evidence-based treatment, there is currently a focus on best practice
models of service delivery. We must 1) ensure that newer antipsychotic and other medications are
available to those who can benefit from them. 2) ensure that new and effective rehab approaches, like
community treatment teams are widely available.
Latimer-argued that if evidence-based practices are to be implemented w any real success, they require
both integration of ppl from diff agencies w/in the same clinical team and specialized support. “ an
evolutionary approach of gradually introducing integrated, evidence-based programs, supported by
centralized technical assistance n support services may provide the most feasible strategy for improving
According to Goering et al. over 5yr period the use of mental health services in B.C and Ont increased
faster than use for other health problems.
Altho the strongest predictor of help seeking was psychiatric diagnosis, it was also associated w marital
disruption and poverty. Another study confirms that proff services are underused.
Sareen et al concluded that if actual diagnoses are combined w perceived need, an estimated 1 in 5 cdns
require mental health services. A national study in the U.S found that a majority of of ppl w “lifetime”
disorders eventually make treatment contact but this is more likely for mood disorders relative to anxiety,
impulse control, substance disorders.
Community psychology- operates in the “seeking mode”. Rather than waiting for ppl to initiate contact,
community psych’s seek out problems/potential problems. They focus on prevention. We must focus on
the preventive method if we are going to solve the problem of mental illness in Canada. There are
ongoing programs that promise to fulfill prevention goals in the future ex: the Aboriginal Head Start to
help dev’t n school readiness.
Roy Romanow- commissioner of the Commission on the Future of Health Care in Canada release a
comprehensive template for the dev’t of health care in Canada, that reaffirmed and expanded on the five
principles of the Canada Health Act. Promoted expand of medicare coverage beyond just physicians and
hospitals. , direct support to informal caregivers, and improve services in rural and remote areas. The
principle of Accountability also must be added to the Canada health act.
-Canada is the only G8 country that does not have a national mental health strategy.
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