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Chapter 1

Chapter 1

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Konstantine Zakzanis

PSYB32 Sept 18, 2012 Chapter 1 – What is Abnormal Behaviour? - Psychopathology: the field concerned with the nature and development of abnormal behaviour, thoughts, and feelings. WHAT IS ABNORMAL BEHAVIOUR - Abnormal behaviour: includes such characteristics as statistical infrequency, violation of norms, personal distress, disability or dysfunction, and unexpectedness Statistical infrequency - Behaviour is infrequent in the normal population - The normal curve places the majority of people in the middle as far as any particular characteristic is concerned (bell curve) - Normal = does not deviate from the average Violation of norms - Behaviour violates social norms or threatens or makes anxious those observing it Personal distress - Creates great distress and torment in the person experiencing it Disability or dysfunction - Impairment in some important area of life (ex. work or personal relationships) Unexpectedness - Distress and disability are considered abnormal when they are unexpected responses to environmental stressors ^ none by itself yields a fully satisfactory definition of abnormal behaviour, but together offer a useful framework The mental health professions - Clinical psychologist: PhD or PsyD (4-7 years grad study); learn assessment and diagnosis of mental disorders; learn how to practice psychotherapy - Psychiatrist: can administer psychoactive drugs (which control how people think and feel); has their MD HISTORY OF PSYCHOPATHOLOGY - In the past ppl thought that deviancy reflected the displeasure of the gods or possession by demons Early demonology - The idea of a demon living inside a person and controlling them - The solution was exorcism: casting out a demon by ritualistic chanting or torture - Trepanning: making an opening in the live skull to relieve demons from the skull – cavemen and Neolithic cave dwellers Somatogenesis - Hippocrates thought that the illnesses weren’t attributed to demons but were of natural causes and should be treated like colds/constipation - He thought abnormal behaviour/thinking was because of the brain - First to come up with somatogenesis: something wrong with the soma, or the physical body, disturbs thought and action - Psychogenesis: ^ the disturbance has psychological origins - Hippocrates thought that normal brain functioning was dependent on: blood, black bile, yellow bile, and phlegm  imbalance produced disorders - He classified mental disorders into 3 categories: mania, melancholia and phrentis - Known for his naturalistic approach and premise that human behaviour was affected by body structure or substances The dark ages and demonology - Death of Galen in 200AD was around the start of the dark ages - Religious ppl replaced physicians and healers The persecution of witches th - 13 + centuries, ppl turned to demonology as an explanation for disasters - Ppl who were possessed by demons were considered witches Witchcraft and mental illness - More sane than insane ppl were prosecuted, thought to be witches th - After 13 century hospitals became common and mentally ill ppl were stored there, many of them not being deemed possessed - Some trials deemed the person a lunatic and linked the behaviour to physical illness or injury or emotional shock Development of asylums - At first there were more asylums for leprosy than there were for mental ppl - After the crusades and the decline in leprosy, attention turned to mental ppl - Began 15 /16 centuries - Asylum: refuge for the confinement and care of the mentally ill Bethlehem and other early asylums - Bedlam – hospital for the mentally ill in London - Tickets to admission into bedlam were sold to ppl who wanted to see the crazy ppl - Benjamin rush believed that patients could be cured by draining some blood from their head; lunatics could be cured by being frightened - Other doctor thought drowning them was a cool idea… Moral treatment - Philipe Pinel (1745-1826) began humanitarian treatment of the mentally ill in hospitals – started treating them like humans whose sanity could be restored through comfort and compassion - William Tuke made the York Asylum in England (-1822) in which patients were treated in a quiet religious atmosphere - Moral treatment came about – patients had close contact with attendants who talked and read to them and encouraged trhem to engage in purposeful activity - Drugs were common treatment - Less than 1/3 patients were recovered or improved - This moral treatment trend declined for a while, dorothea dix tried to bring it back again but at the hospitals they built by her suggestion, attendants weren’t as attentive - The physicians in the hospitals were more concerned with biological causes than psychological - Dr. henry hunt stabb also tried to reinstate moral treatment but didn’t have adequate funding Asylums in Canada - JF Lehman wrote the first textbook published in Canada with the focus on the care and control of mentally ill ppl - Hospitals were disbursed and treatment was different according to where you were - What was beginning here was influenced by great Britain and how they structured their hospitals, but they were governed by diff. norms and functioned diff. - Wealthy ppl had access to better care - Profit oriented private asylum (Homewood retreat) built in Canada; dr. lett promoted moral therapy - With the advent of asylums, provisions for the mtentaly ill were separate from provisions for the physically ill, indigents and criminals - the institution and the community were 2 separate and distinct solitudes th -most of the 20 century patients weren’t treated that well still –indv. Treatments rare, dependence of psychoactive drugs, little resources -started to change when between 1960-1976 there were 35000 less patients … then budget cuts in the 80s and 90s -many psychiatric hospitals are not close to large metropolitan centres -those who have committed criminal acts but are let off due to mental disorder are still tightly monitored and guarded -patients in hospital don’t get a lot of time with psychologist; sometimes they only even have grouptherapy and not one on one sessions -hospitals have been drug oriented for quite some time -it might be hard to leave once you’re accustomed to living there -focus on reducing# of beds, only taking in those who cant be managed in the community -shorter lengths of stay -on march 31 2009, Ontario officially closed its institutions for the mentally disabled (retarded) after the last residents left the Huronia Regional centre in Orillia -community treatment order: a legal tool issued by a medical practitioner that establishes the conditions, under which a mentally ill person may live in the community including compliance with treatment -torontos centre for addiction and mental health (CAMH) is the new archetype The beginning of contemporary thought - knowledge via direct observation came about in the late middle ages - after galens death, Vesalius said that galen was wrong about human anatomy resembling apes anatomy - Thomas Sydenham advocated empirical approach to classification and diagnosis An early system of classification - Griesinger wante diagnosis of mental disorder to specify a biological cause - Kraepelin made a book that specified the causes ^ - Found that people with common symptoms (then, syndromes) could be grouped together as having a same underlying physical cause - Each mental illness was different from each other; could see patterns in the behaviour of ppl under each classification - Kraepelin proposed 2 major groups: dementia praecox (schizophrenia) and manic-depressive psychosis (bipolar) General paresis and syphilis - General paresis (1825) – had a steady deterioration of physical and mental abilities, also suffering impairments - Some who suffered this had syphilis before - Germ theory of disease – Louis Pasteur – disease caused by infection of the body by minute organisms - Found the infection that caused syphilis and so ppl now knew that one form of psychopathology could been due to a biological cause Psychogenesis - Ppl started to think that mental disorders might not have a biological basis Mesmer and charcot - Franz anton Mesmer (-1815) thought that hysterical disorders were caused by a particular distribution of a universal magnetic fluid in the body – ones person could influence anothers’ - Dude would come into a room filled with people, and touch them with a rod dipped in some chemicals and by doing so he thought he could transmit animal magnetism to them … ppl with hysterical disorders claimed it helped - Early practitioner of modern-day hypnosis - Jean martin charcot (-1893) also studied hysterical states; soon became interested in non- physiological interpretations of these phenomenon Breuer and the cathartic method - Hypnotized a hysterical Anna O who became more open about her emotions and felt much better upon awakening - Catharsis: reliving an earlier emo
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