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Chapter 1

Abnormal Psychology Chapter 1.docx

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Department
Psychology
Course
PSYB32H3
Professor
Konstantine Zakzanis
Semester
Summer

Description
Chapter 1: Introduction: Definitional and Historical Considerations and Canada’s Mental Health System Psychopathy – the field concerned with the nature and development of abnormal behaviour, thoughts, and feelings. What is Abnormal Behaviour? Abnormal Behaviour –Patterns of emotion, thought and action deemed pathological for one or more of the following reasons: infrequent occurrence, violation of norms, personal distress, disability or dysfunction and unexpectedness. 1. Statistical Infrequency Abnormal behaviour is INFREQUENT in the general population Normal Curve – the bell-shaped distribution of a measurable trait depicting most people in the middle and few at extremes.  Normal = does not deviate much from the average of a trait/behaviour Eg. Diagnoses mental retardation  diagnoses through low IQ below 70 BUT only certain infrequent behaviours are studied (NOT great athletic ability)  infrequency doesn’t help determine which behaviours to study 2. Violation of Norms Violates Social Norms – threatens or makes anxious those observing it  Eg. anti-social behaviour of psychopath, complex rituals of OCD, conversations with imaginary voices of psychotic person. Violation of norms  abnormality is RELATIVE; various forms of unusual behaviour can be tolerated depending on the cultural norm/diversity Violation of norms is too broad and too narrow  Doesn’t include criminals and prostitutes but focuses on the anxious person who doesn’t violate social norms 3. Personal Distress Personal Suffering – behaviour is abnormal if it creates great distress and torment in the person experiencing it  Eg. anxiety disorders and depression BUT some don’t involve distress; psychopath is cold-hearted and violate laws without guilt, remorse, or anxiety. Not all distress (childbirth) is studied 4. Disability or Dysfunction Disability – impairment in some important area of life (Eg. work or personal relationships) because of an abnormality  Eg. substance-abuse disorders = social or occupational disability, phobia = distress and disability. Disability applies to SOME disorders.  Eg. Transvestism is diagnosed as a mental disorder if it distresses the person (NOT a disability)  most are married, lead normal lives, cross- dress privately Disabilities determined by circumstances  NO rule to determine which disabilities belong  Eg. being short ≠ professional basketball player  NOT disability 5. Unexpectedness Distress and disability are abnormal when they are UNEXPECTED responses to environmental stressors  Eg. anxiety disorder = anxiety is unexpected and out of proportion to the situation BUT hunger is an expected reaction to not eating All Factors = Abnormality BUT it’s definition is constantly changing and not certain Focus on Discovery 1.1: The Mental Health Professions Clinicians – A health professional authorized to provide services to people suffering from one or more pathologies. Clinical Psychologist – An individual who has earned a Ph.D. degree in psychology or a Psy.D. and whose training has included an internship in a mental hospital or clinic.  1995 Agreement on Internal Trade  Mutual Recognition Agreement 2001 to recognize the credentials of psychologists from one part of Canada in others  Gauthier: 5 core competencies to become a registered psychologist 1. Interpersonal relationships 2. Assessment and evaluation (including diagnosis) 3. Intervention and consultation 4. Research 5. Ethics and standards Clinical psychology Ph.D. is the scientist-practitioner model with lab work, research design, statistics, and empirically based study of human and animal behaviour + Assessment – finding out what is wrong with a person, what may have caused a problem or problems and what step may be taken to improve the person’s condition - and Diagnosis – the determination that a patient’s set of symptoms or problems indicates a particular disorder - of mental disorders + how to practice Psychotherapy – a primarily verbal means of helping troubled individuals change their thoughts, feelings, and behaviour to reduce distress and to achieve greater life satisfaction. Clinical graduate programs Psy.D. is the scholar-practitioner model with clinical practice. Psychiatrist – A physician (M.D.) who has specialized post-doctoral training (residency), in the diagnosis, treatment and prevention of mental disorders.  Psychoactive Drugs – Chemical compounds having a psychological effect that alters mood or thought process. Eg. Valium Psychoanalyst – A therapist who has taken specialized postdoctoral training in psychoanalysis after earning an MD or a Ph.D. degree. Social Worker – A mental health professional who holds a master of social work (M.S.W.) degree. Counseling Psychologist – A doctoral-level mental health professional whose training is similar to that of a clinical psychologist, with usually less emphasis on research and severe psychopathology. Psychiatric Nurse – has training in the mental health field. 2.15% of Canadians used psychologists in the last year  it’s service is underused and focused on urban areas. The debate as to administering drugs, is still debated due to psychiatrist’s training and whether efficiency is worth the cost. History of Psychopathology Earlier, when the earth seemed supernatural, the mind and it’s behaviour’s seemed so too. Early Demonology Demonology – the doctrine that a person’s abnormal behaviour is caused by an autonomous evil spirits  Hebrews  deviancy = possession of bad spirits after God in his wrath had withdrawn protection o Exorcism – the casting out of evil spirits by ritualistic chanting or torture. Treplanning – the making of a surgical opening in a living skull by some instrument  Stone age, Aboriginals in Canada brought from Siberia, common in Peru and Bolivia to treat conditions such as epilepsy, headaches, and “demonic possession”. Somatogenesis Hippocrates:  Somatogenesis – the notion that something wrong with the soma or physical body disturbs thought and action o (opposite)Psychogenesis – belief that disturbance has psychological origins o more medical treatment rather than religious help  3 categories of mental disorders: mania, melancholia and phrenitis (brain fever)  Melancholia prescribed: tranquility, sobriety, care in choosing food and drinks and abstinence from sexual activity  had cures for epilepsy, alcoholic delusion, stroke and paranoia  He believed that mental health depended on a balance of 4 humors/fluids of the body: blood, black bile, yellow bile, phlegm.  Too much black bile = melancholia, too much yellow bile = irritability and anxiousness, too much blood = changeable temperance. The Dark Ages and Demonology Began with Galen, Greek physician who died in the 3nd century  Christian monasteries, through their missionary and educational work, replaced physicians as healers and as authorities on mental disorder. The Persecution of Witches 13 century Europe there were a lost of famines and plagues  demonology explanation  witch hunt instigated by Pope Innocent VIII 1484  Malleus Maleficarum “guide to witch hunting”: tortured if they didn’t confess, those convicted and penitent were imprisoned for life, those convicted and unrepentant were executed by fire as an exorcism. Witchcraft and Mental Illness Witchcraft bizarre confessions were primarily due to mental illness and torture. In England (torture banned) there weren’t demonic confessions and hospitals kept the mad safe till they have reason. Early 13 century “Lunacy trials” occurred for strange behaviour linked to physical illness or injury or emotional shock  Crown to gain citizen’s estate. Development of Asylums Many Leprosariums - institution were people with leprosy were isolated, which was believed during the time to be caused due to committing a sin, or being sexually promiscuous - were converted to Asylums - refuges established in western Europe th in the 15 century to confine and provide for the mentally ill; the forerunners of the mental hospital – after the Crusades. Asylums contained many beggars and mentally ill  used to work, but were later just confined. Bethlehem and Other Early Asylums Bethlehem was a hospital built for the confinement of the mentally ill. The conditions were deplorable. Over the years the word Bedlam - a contraction and popular name for the London hospital became a descriptive term for a place or scene of wild uproar and confusion where unrestrained groups of mentally ill people interacted with each other. It became a destination place for viewing the violent patients and their antics as many found it entertaining. Benjamin Rush - (the father of American psychiatry) believed that an excess of blood in the brain caused mental disorders. Consequently, his favored treatment was to draw great quantities of blood or scaring them. Moral Treatment Philippe Pinel - A primary figure in the movement for humanitarian treatment of the mentally ill in asylums BUT his humanitarian treatment was reserved for the upper class.  Moral treatment – therapeutic regimen during the French Revolution, where mental patients were released from their restraints and were treated with compassion and dignity rather than contempt and denigration. o = sense of self-esteem by allowing self-restraints th Drugs were being used in early 19 century  First drugs: alcohol, cannabis, opium, chloral hydrate  outcome unfavourable Dorothea Dix – advocated for development of state hospitals for patients who couldn’t stay in private hospitals BUT less moral treatment  more focus on biological than mentality Dr. Henry Hunt Stabb – efforts to institute moral treatment and non-restraint at the Lunatic Asylum in St. John’s NFL BUT failed due to financial troubles and overcrowding. Asylums in Canada J.F. Lehman – wrote first textbook in Canada that focused on the care and control of mentally ill people using stringent discipline and harsh treatments (flogging). Sussman – services of mentally ill in Canada varied in each province.  1840s-1880s formal asylums established from a country wide need to develop separate facilities with better conditions for the mentally ill. The French in Quebec city began the asylums in Canada and cared for indigents, crippled and idiots  contracting system where the King of France paid religious orders of the French Roman Catholic Church to care for the mentally ill. BUT after Britain invaded, their influence of care practices, asylum management and funding.  overcrowding and noisy, unruly, violent patients  discharge rate of 52% & 20% deaths  wealthy privilege  Private Lunatic Asylums Act to accommodate wealthy people  Homewood Retreat Asylum where Dr. Lett used moral therapy (good treatment for the poor too, not just rich) The history of the development of institutions for the mentally disordered in Canada can be characterized in terms of two distinctive trends: 1. With the advent of the 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- “The institution and the community were two separate and distinct solitudes. Community treatment order (CTOs): a legal tool issued by a medical practitioner that establishes the conditions under which a mentally ill person may live in the community. th Canadian Perspectives 1.2: The Mental Hospital in Canada: the 20 Century and into the New Millennium Provincial Psychiatric Hospitals – A facility where chronic patients are treated. Such hospitals provide protection, but treatment is often custodial and may involve little psychosocial treatment. Community Treatment Orders – Written orders that serve as a form of community commitment designed to ensure treatment compliance. The Beginnings of Contemporary Thought Vesalius – proved that Galen’s presentation of human anatomy was incorrect. Thomas Sydenham – successful in advocating an empirical approach to classification & diagnosis An Early System of Classification Wilhelm Griesinger - insisted that any diagnosis of mental disorder specify a biological cause. Emil Kraepelin - discerned among mental disorders a Syndrome – a group or pattern of symptoms that tend to occur together in a particular disease. He regarded each mental illness as distinct from all others, having its own genesis, symptoms, courses, and outcomes. Even though cures had not been worked out, at least the course of the disease could be predicted.  2 major groups of severe mental diseases: 1. dementia praecox, an early term of schizophrenia caused by chemical imbalance 2. manic-depressive psychosis (bipolar disorder) caused by irregularity in metabolism General Paresis and Syphilis Discovery of the full nature and origins of syphilis, a venereal disease that had been recognized for several centuries.  Symptoms: General Paresis – mental illness characterized by deterioration of physical and mental abilities and several impairments (delusions of grandeus, progressive paralysis) that lead to death in 5 years. o Common in men and sailors Louis Pasteur - Germ Theory of disease - the view that disease, is caused by infection of the body by minute microscopic organisms and viruses  connected syphilis to GP Richard von Krafft-Ebing – inoculated paretic patients with matter from syphilitic sores 1905: The specific microorganism for syphilis was discovered link between infection, destruction of brain, and a form of psychopathology. Psychogenesis Search for Somatogenesis throughout 20 century BUT 19 & 18 century mental illnesses had different origins. Mesmer and Charcot Many people were subject to hysterical states; they suffered from physical incapacities, such as blindness or paralysis, for which no physical cause could be found. Mesmer – hysteria wascaused by disturbances of a universal magnetic fluid in the body; one person could influence the fluid of another to bring about a change in the other’s behaviour. He used rods to touch afflicted parts of the patient’s bodies to transmit animal magnetism and adjust the distribution of the universal magnetic fluid. He was considered one of the earlier practitioners of modern-day hypnosis  “mesmerize” = “hypnotize”. Charcot - studied hysterical states, including anesthesia (loss of sensation) paralysis, blindness; deafness, convulsive attacks, and gaps on memory. One of his students showed him that he hypnotized a woman to display certain actual hysterical patient, thus Charcot became interested in non-physiological interpretations of these very puzzling phenomena. Breuer and The Cathartic Method Breuer - Catharsis - The experience of reliving an earlier emotional catastrophe and releasing the emotional tension caused by suppressed thoughts about the event, using hypnosis. Cathartic Method – a therapeutithprocedure introduced by Breuer and developed further by Freud in the late 19 century whereby a patient recalls and relives an earlier emotional catastrophe and re-experiences the tension and unhappiness, the goal being to relieve emotional suffering. Current Attitudes Toward People With Psychological Disorders Suspicions that are reinforced with threats, violence, frightening behaviour, those who refuse to take medicat
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