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Psychology (9,695)
PSYB32H3 (1,174)


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Konstantine Zakzanis

Chapter 1: Intro -need to remain objective, dificult Abnormal Behaviour -difficulty in how to define abnormal behavior Statistical Infrequency -normal curve places the majority of people in the middle as far as any particular characteristic is concerned; very few ppl fall at either extreme. -statistical infrequency is used explicitly in diagnosing mental retardation. Violations of Norms -norms in one culture can vary. diffrent norms for different cultures. Personal Distress Disability or Dysfunction -tranvestism: cross-dressing for sexual pleasure Unexpectedness -ex. an anxiety disorder is diagnosed when the anxiety is unexpected and out of proportion to the situation, as when a person who is well off worries constantly about his/her financial situation. History of Psychopathology -Hebrews-deviancy was attributed to possession of the person by bad spirits, after God in his wrath had withdrawn protection -exorcism can from the belief that abnormal behavior was caused by possession. -trepanning-one popular theory was that it was a way of treating disorders attributed to demons within the cranium -individual would return to normal by creating an opening through which evil spirits could escape -Kidd suggested that trepanning were done to relieve pressure resulting from depressed fractures caused by war clubs Somatogenesis -Hippocrates= the father of modern medicine, separated medicine from religion, magic, and superstition -regarded the brain as the organ of consciousness, of intellectual life and emotion; thus thought that deviant thinking and behavior were indications of some kind of brain pathology. -the SOMA= physical body -the 3 categories hippocrates classified mental disorders into: MANIA, MELANCHOLIA, PHRENITIS(BRAIN FEVER) -hippocrates humoral physiology did not withstand later scientific scutiny but his basic premise- that human behavior is markedly affected by bodily structures or substances and that abnormal behavior is produced by some kind of physical imbalance or even dmg. The Dark Ages and Demonology -Galen was the last major physician of the classical era Persecution of Witches -population turned to demonology to explain disasters, ppl in Europe became obsessed with the devil. -witchcraft viewed as instigated by satan- seen as denial of God -burning of wtiches were seen seen as method of dirving out the supposed demon. Witchcraft and Mental Illness -mentally ill were generally considered witches -many of the accused were NOT mentally ill -confessions were a result of brutal torture- words were put in mouths -lunacy trails determined a person's sanity Development of Asylums -very few mental hospitals in europe until the end of the crusades in the 15th century. -when leprosy was no longer a great social concern, focus turned to the mad. Bethlehem and other early Asylums -the Priory of St.Mary of Bethlehem was FOUNDED in 1243. -handed to the city of London in 1547 to be a hospital devoted solely to the confinement of the mentally ill. -BENJAMIN RUSH- considered the father of American Psychiatry- believed that mental disorder was caused by an excess of blood in the brain -further he beleived that any lunatics can be cured by being frightened Mortal Treatment -PHILIPPE PINEL- considered a primary figure in the movement for humanitarian treatment of the mental ill in asylums -began to treat the patients as sick humans beings rather than as beasts-"remove chains" -Pinel reserved more humanitarian treatment for the upper class, the lowers classes were still subjected to terror and coercion as a means of control -Williams Tuke inspired by Pinel's work -sympathetic and attentive treatment- MORAL TREATMENT -RESTORATION OF PATIENT'S SELF ESTEEM by letting them demonstrate SELF- RESTRAINT -drugs were the most common treatment -moral treatment abandoned in the latter part of the 19th century -Dorothea Dix, a crusader for improved conditions for people w/ mental illness, helped effect this change Asylums in Canada -a network of asylums was eventually established in Canada -J.F Lehman wrote the first textbook published in Canada with a focus on the care and control of mentally ill ppl. In contrast to the compassionate, humane views of reformers such as DIx and Stabb, Lehman recommended discipline and harsh treatments. -Many strategies in Canada during the 20th century were just as harsh and a few were much more severe and had tragic consequences. -52% discharge rate, 20% death rate while in the instituion. A large # of the deaths due to "general paresis of the insane" and to a condition called "phthisis". The Mental Hospital in Canada- 20th Century -provincial mental hospitals became extremely overcrowded. Drugs became the central means of treatment -in the 1970s, concerns about the restrictive nature of confinement in a mental hospital led to the deinstitutionalization of a large number of metal hospital patients -the goal in Canada was to shift care from psychiatric hospitals into the community -a somewhat specialized mental hospital, sometimes called a PRISON or FORENSIC HOSPITAL, is reserved for ppl who have been arrested and judged unable to stand trial and for those who have been acquitted of a crime because they are "not criminally responsible on account of mental disorder" -in canada there are 3 MAXIMUM-SECIRUITY FORENSIC HOSPITALS -even in the best hospitals, patients usually precious LITTLE CONTACT with psychiatrists/ clinical psychologists -institutionalized mindset is difficult to reverse once ppl have resided in mental hospitals for more than a YEAR -an ongoing cocern is the need to balance the rights of mentally ill individuals with the rights of the community to be protected from them if they are a danger. CTOs- COMMUNITY TRREATMENT ORDERS -noncompliance with CTOs results in being returned to psychiatric facility for assessment. -the asylums will no doubt all but disappear in the 21st century The Beginning of Contemporary Thought -emerging empirical approach to medical science that gathered knowledge by direct observation -Thomas Sydenham was particularly successful in advocating an empirical approach to classification and diagnosis, one that subsequently influenced those interested in mental disorders An Early System of Classification -Wilhelm Griesinger- insisted that any diagnosis of mental disorder specify a BIOLOGICAL CAUSE- a return to the somatogenic views first espoused by Hippocrates. -Emil Kraepelin furnished a classification system in order to establish the biological nature of mental illnesses -Kraepelin proposed 2 major groups of severe mental diseases: DEMNTIA PRAECOX (early term for schiz) and MANIC-DEPRESSIVE PSYCHOSIS (bipolar disorder) -postulated a chemical imbalance as the cause of shiz and an irregularity in metabolism as the explanation of manic-depressive psychosis. General Paresis and Syphilis Psychogenesis Mesmer and Charcot -hysterical disorders were caused by a particular distribution of a universal magnetic fluid in the body. Moreover, thought that one person could influence the fluid of another to bring about a change in the other's behaviour. -removal of hysterical disorder by touching rods that transmitted animal magnetism and adjusted the distribution of the universal magnetic fluid, thereby removing the hysterical disorder. -considered of a form of hypnosis Breuer and the cathartic method -young woman with a number of hysterical symptoms Current Attitudes Toward People With Psychological Disorders -consistent with other minority groups in Canada, people with psychological disorders often face NEGATIVE STEREOTYPING and STIGMATIZATION -jim carrey's character in "you, me and irene" suffers from schiz rather than DISSOCIATIVE IDENTITY DISORDER The Public Perception -myths of violence and the mentally ill -myths about never being able to be cured -Clarence Hincks founded the CANADIAN MENTAL HEALTH ASSOCIATION -objectives of the CNCMH: psychiatric examination and care of war recruits and returning soldiers suffering from shell shock, post-war psychiatric screening of immigrants, adequate facilities for diagnosis and treatment of mental disease, adequate care of the mentally deficient, prevention -women were more willing to admit to receiving treatment than men Anti-Stigma Campaigns -the reduction of the stigma of schiz is the focus of the worldwide campaign by the World Psychiatric Association Mental Health Literacy= the accurate knowledge that a person develops about mental illness and its causes and treatment. Canada's Mental Health Care System -Canada>USA in terms of health care Medicare -in Canada, taxes are employed for universal health care, including care for ppl with psychological disorders- the Canadian MEDICARE system has been in effect since 1970. Mental Health of Canadians: First View What Factors are associated w/ Mental health in canada? -mental health status -mental health is relatively poor among young ppl but tends to improve w/ age What is the Extent of Mental Health Problems in the People of Canada? -20% of ppl in Ontario have one or more MENTAL DISORDERS -2% of all Ontarians can be considered severely mentally il. Regional Differences -did not find any major independent association between mental health and a respondent's province of residence. HOWEVER, good mental health in both Newfoundland and Labrador and P.E.I- most happiest and least distress Treatment and Prevention Deinstitutionalization and other challenges to service delivery -mood disorders were the most common psychiatric disorders leading to hospital treatment followed by schiz, substance abuse, dementia, anxiety, and personality disorders Delivery of Psychotherapy -evidence based treatment -common phenomenon of "therapist drift" away from using eivdenced-based therapies that can occur in the real world-typially a shift from "doing therapies" to "talking therapies". Help-seeking and Perceived Need for Help -some ppl from minority groups have difficulty asking for help for psychological problems -COMORBID: the presences of 3 or more disorders simultaneously- increased liklihood for asking for help Community Psychology and Prevention -preventative programs Cost of Mental Health Problems -personal misery, disruption of family life, lower quality of life, loss of productivity -total mental health care spending in Canada is only 5% of the total health care spending. The Future The Romanow Report -recommended that mental health be made a priority within the system. Broadening medicare to include a limited number of home care services and some drug treatments. The Senante Committee Final Report -AKA the KIRBY REPORT Chapter 2: Current Paradigms and the Role of Cultural Factors -paradigm The Role of Paradigms -4 types of major paradigms: biological, cognitive-behavioural, psychoanalytic, humanistic-existential. The Biological Paradigm -was the dominant paradigm in Canada and elsewhere from the late 1800s until at least the middle of the 20th century. Contemporary Approaches to the Biological Paradigm -3 areas of research within the biological paradigm: BEHAVIOUR GENETICS, MOLECULAR GENETICS, BIOCHEMISTRY Behavior Genetics -genes turn on/off throughout one's life so should not be seen as a fixed entity (genotype) -various clinical syndromes are disorders of the phenotype, NOT OF THE GENOTYPE. -about 10% of first degree relatives can have schiz if it is genetically in inherited, compared to 1% of total pop. -CONCORDANCE higher is genetically identical MZ pairs than in DZ pairs -when the MZ pair concordance is higher than the DZ pair concordance= characteristic is HERITABLE -adoptee methods eliminates the effects of being raised by disordered parents. Molecular Genetics Neuroscience and Biochemistry in the Nervous System -NEUROSCIENCE is the study of the brain and the nervous system -neuron stimulated at its cell body or through its dendrites----> leads to nerve impulse -nerve impulses cause the synaptic vesicles to release molecules of their transmitter substances, and these molecules flood the synpase and diffuse toward the receiving, or postsynaptic cell. -NOREPINEPHRINE= a NT of the sympathetic nervous system. -SERATONIN-Depression -DOPAMINE-schiz -GABA-inhibits some nerve impulses and may be involved in anxiety disorders -the onset of puberty in adolescents DECREASE SEROTONIN AND DOPAMINE ACTIVITY in certain cortical areas. -the deulsions and hallucinations of schiz may result from an overabundance of dopamine receptors (ie problems with reuptake, oversensitivity) Structure and Function of the Human Brain -frontal lobe lies in front of CENTRAL SULCUS, parietal lies BEHIND it and ABOVE the LATERAL SULCUS, temporal is BELOW the LATERAL SULCUS, occipital lies BEHIND the PARIETAL and TEMPORAL lobes. -white matter makes up most of the INTERIOR of the brain -BASAL GANGLIA-four masses of neuron cell bodies within each hemisphere, named collectively -the MEDULLA also contains nuclei that maintain the regular LIFE RHYTHMS of the heartbeat, of the rising and falling DIAPHRAGM, and of the constricting and dilating BLOOD VESSELS. BIOLOGICAL APPROACHES TO TREATMENT -prevention or treatment of mental disorders should be possible by altering bodily functioning. -DISORDER: BIOLOGICAL DEFECT, TREATMENT: BIOLOGICAL INTERVENTION -neuroimaging studies have become an increasingly important area of psychiatric research over the past 30 years and have advanced our understanding of the pathophysiology and treatment of disorders such as ocd, schiz, bipolar, depression and dementia Evaluating the Biological Paradigm -reductionism -the cognitive-behavioural(learning) paradigm is regarded as a generally effective, evidence-based approach -very influential today -psychodynamic and humanistic-existential are less influential today than in the past. -all of these roles emphasize the role of social factors, including socio-cultural considerations and internal psychological processes. THE CONGNITIVE-BEHAVIOURAL PARADIGM -cognitive-behavioural therapy -CBT THE BEHAVIOURAL PERSPECTIVE The Rise of Behaviorism -JOHN B. WATSON= key figure in the rise of behaviourism -responded with a focus on behaviorism when there was a focus on INTROSPECTION Classical Conditioning -john watson and rosalie rayner discovered that classical conditioning could instill pathological fear. -striking steel bar when child reached for mouse (who previously did not fear the mouse) -the abnormal tendency of people with shiz to make context-inappropriate associations may be an example of classical conditioning gone awry as strong associations are made to seemingly neutral stimuli Operant Conditioning -can produce abnormal behavior- ie aggression is often rewarded, as when one child hits another to get a toy(getting the toy is a reinforcer) Modelling -witnessing someone perform certain activties can increase/decrease diverse kinds of behavior -children of parents with phobias or substance-abuse problems may aquire similar behaviour patterns, in part through modelling. -Bandura concluded that there are FOUR key processes in observational learning: ATTENTION, RETENTION, REPRODUCTION, MOTIVATION -Self Efficacy: an individual's perceived sense of being capable Behavioural Therapy -is an attempt to change abnormal behaviour, thoughts, and feelings by applying in clinical context the methods used and discoveries made by experimental psychologists in their study of both normal and abnormal bahviour. -cognitive therapy is often considered a FOURTH aspect of behavior therapy Counter conditioning and Exposure -behavioural approaches assume that behavior is the result of learning -Wolpe hypothesized that counterconditioning underlies the efficacy of desensitization; a state or response antagonistic to anxiety is substituted for anxiety as the person is exposed gradually to stronger and stronger does of what he/she fears. -exposure therapy is a form of cognitive intervention that specifically changes the expectancy of harm Operant Conditioning as an Intervention -socially withdrawn child could be reinforced for playing with others -time out is an operant procedure wherin the consequence for misbheaviour is removal to an environment with no positive reinforcers THE COGNITIVE PERSPECTIVE -COGNITION: the term that groups together the mental processes of of percieving, recognizing, conceiving, judging, and reasoning COGNITIVE PARADIGM The basics of cognitive theory -we are bombarded by far more stimuli than we can possibly respond to -schema -new information may fit the scehma. but if it does not, the learner reorganizes the scehma to fit the information or construes the information in such a way as to fit the schema. Beck's Cognitive Therapy -aaron beck -based on the idea that a depressed mood is caused by distortions in the way people perceive life experiences -therapists points out overlooked favourable happenings, alter their negative schemas and dysfunctional beliefs and attitudes -replaces negative thoughts with more adaptive thoughts Rational-Emotive Behaviour Therapy -Albert Ellis -emotional reactions are caused by internal sentences that people repeat to themselves, and these self- statements reflect somes unspoken assumptions- IRRATIONAL BELIEFS -REBT -if the person makes an error, it becomes a catastrophe bc it violates the deeply held conviction that he or she must be perfect. -once a client verbalizes a different belief or self-statement during a therapy session, it must be made part of everyday thinking COGNITIVE BEHAVIOUR THERAPY -classical behavioural therapies emphasize the direct manipulation of overt behavior and occasionally of covert behavior, with thoughts and feelings being construed as internal behaviors (mediational learning) -cognitive behaviour therapists pay attention to private events- thoughts, perception, judgements, self- statements and even unconscious assumptioons -manipulated these processes in their attempts to understand and modify over and covert disturbed behavior COGNITIVE RESTRUCTURING: general terms for changing a pattern of thought that is presumed to be causing a disturbed emotion or behavior. Meichenbaum's cognitive-behavior modification -Self instructional training: helps the client prepare to make specific coping statements when confronted with difficult situations. -Stress-inoculation training: multi-component coping-skills approach that incorporates systematic aquisition of coping skills through learning to cope with small but manageable amounts of stress. THE COGNITIVE-BEHAVIOUR INTEGRATED APPROACH -the concepts on which the cognitive component of the cognitive-behavioural paradigms is based on abstract and not always well defined THE PSYCHOANALYTIC PARADIGM Classical Psychoanalytic Theory Structure of the Mind -Freud divided the mind into THREE principle parts: ID, EGO, SUPEREGO -ID -accounts for all the energy needed to run the psyche. Only later as the infant develops, is this energy (LIBIDO) COVERTED INTO PSYCHIC ENERGY, all of it UNCONSCIOUS, below the level of awareness. Acts towards the PLEASURE PRINCIPLE. When the id is not satisfied, tension is produced and the id wants to elimante this tension. Primary process thinking generates IMAGES of what is DESIRED- short-term satisfaction. -EGO -develops from the ID during the second six months of life. Ego realizes that acting on the pleasure principle is not the most effective way of maintaining life. Thus operates on REALITY PRINCIPLE -SUPEREGO -Freud believes that the superego developed from the ego as much as the ego developed from the ID. -the ID's instincts as well as many of the superego's activities are not known to the sonscious mind. While the ego is primarily conscious and is involved in thinking and planning, it , too has imporantant unconscious aspects (defense mechanisms). Neurotic Anxiety -moral anxiety punishes bc individual not meeting expectations and thereby satisfying the principle that drives the superego- PERFECTION PRINCIPLE. DEFENCE MECHANISMS: COPING WITH ANXIETY -OBJECTIVE ANXIETY,rooted in reality, can often handled by removing or avoiding the danger in the external world or by dealing with it n a rational way. -NEUROTIC ANXIETY, dealt with by DEFENCE MECHANISM -repression is the MOST IMPORTANT defence mech -defense mechanisms allow the ego to discharge some id energy while not facing frankly the true nature of the motivation. More readily observed, provides reason for consulting a therapist -FOR THE MOST PART, DEFENCE MECHANISMS ARE MALADAPTIVE WHAT IS PSYCHOTHERAPY? -particular kinds of verbal/nonverbal exchanges in a trusting relationship can achieve goals, such as reducing anxiety and eliminating self-defeating or dangerous behaviour -insight thereapies/action(behavioural) therapies -assume that behaviour, emotions, and thoughts become disordered bc ppl do not understand what motivates them, especiailly when their needs and rives conflct PSYCHOANALYTIC THERAPY -attempts to remove the earlier repression and help the client face the childhood conflict, gain insight into it, and resolve it in the li
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