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Chapter 1

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Konstantine Zakzanis

Psychopathology: field of psychology concerned with the nature and development of abnormal behavior, thoughts, and feelings. This subject offers few hard and fast answers. o A challenge we face in studying abnormal psychology is that is the need to remain objective. o One disadvantage in studying abnormal psychology is that it people tend to bring to their study their preconceived notions of what the matter is. What is abnormal behavior? o No single definition is adequate. o Abnormality is usually determined by several characteristics at one time o Best definition includes such characteristics as statistical infrequency, violation of norms, personal distress, disability or dysfunction, and unexpectedness Statistical Infrequency o Abnormal behavior is infrequent in the general population. Normal curve: aka. Bell shaped curve places the majority of people in the middle; few people fall at the extremes o An assertion that a person is normal implies that he or she does not deviate much from the average in a particular trait or behavior pattern. o Statistical infrequency is used explicitly in diagnosing mental retardation. o Only certain infrequent behaviors such as deep depression fall into the domain of abnormal psychology. Violation of Norms o Consider whether the behavior violates the norms or threatens or makes anxious those observing it o Various forms of unusual behavior can be tolerated depending on the prevailing cultural norms o Take note that prostitutes and criminals have violated social norms but are not usually considered within the domain of abnormal psychology. o Cultural diversity can affect how people view social norms. What is normal in one culture can be abnormal to another. Personal Distress o Behavior is abnormal if it creates great distress and torment (personal suffering) in the person experiencing it. o Some disorders do not necessarily involve distress o Psychopaths for example, do not experience guilt, remorse or anxiety. o Not all forms of distress (e.g. childbirth) belong to the field. Disability or Dysfunction Disability: impairment in some important area of life because of an abnormality o Substance abuse are partly defined in part by the social or occupational disability o A phobia can produce distress and disability o Disability applies to some but not all disorders o We do not have a rule that tells us which disabilities belong and which does not. Unexpectedness o Distress and disability are considered abnormal when they are unexpected responses to environmental stressor. The Mental Health Professions Clinicians: the various professionals authorized to provide psychological services Clinical psychologists: requires a Ph.D. Or a Psy.D. Degree (4-7 years of studying) -In Canada, professional regulation of the psychology profession is within the jurisdiction of the provinces and territories. Psychologists may have a Master’s or a Ph.D. depending upon regulatory statutes.  Psychological services are underused.  Psychological services are more available in urban areas than in rural areas.  There is been a lively debate concerning the merits of allowing clinical psychologists with suitable training to prescribe psychoactive drugs. History of Psychopathology Early Demonology Demonology: the doctrine that an evil being, such as the devil, exist within a person and is in control of his or her mind and body  Following from the belief that abnormal behavior was caused by possession, its treatment often involves exorcism. Exorcism: is the casting out of evil spirits by ritualistic chanting or torture Trepanning of skulls: the making of the surgical opening in the living skull by some instrument  One popular theory is that it was a way of treating conditions such as epilepsy, headaches, and psychological disorders attributed to demons within the cranium. Somatogenesis  Hippocrates is often regarded as the father of modern medicine. He separated medicine from religion, magic, and superstition. He thought that mental illnesses had natural causes and should be treated like any other medical condition. He regarded the brain as the organ of consciousness. He is often considered one of the very earliest proponents of somatogenesis. Somatogenesis: the notion that something is wrong with the soma, or physical body that disturbs thought and action Psychogenesis: is the belief that a disturbance has a psychological origin  Hippocrates classified mental disorders into three categories: mania, melancholia, and phrenitis [or brain fever].  For melancholia, he prescribed tranquility, sobriety, care in choosing food and drink, and abstinence from sexual activity.  He depended among four humors, or fluids, of the body, namely, blood, black bile, yellow bile, and phlegm. An imbalance produced disorders. The body was sluggish and dull, for example, the bodies supposedly contain a preponderance of phlegm. A preponderance of black bile was the explanation for melancholia; too much yellow bile explained irritability and anxiousness; and too much blood, changeable temperament. The dark ages and demonology  The death of Galen marked the beginning of the dark ages for Western European medicine and for the treatment and investigation of abnormal behavior.  Christian monasteries, replaced physicians as healers on mental disorder. The persecution of witches  During the 13th century, people in Europe became obsessed with the devil. Faced with inexplicable and frightening occurrences, there was enormous blame on those regarded as witches. Burning was the usual method of driving out the supposed demon. Hundreds and thousands of women, men, and children were accused of being witches and were then tortured, and put to death. Witchcraft and mental illnesses  The mentally ill were generally considered witches.  More detailed examinations of this historical period, however, indicate that many of the accused were not mentally ill. The delusional-like confessions were obtained during brutal torture; words were put into the mouth of the tortured.  From the 13th century and on, hospitals popped up, the insane were kept safe in hospitals until they were restored of reason. In England, there were lunacy trials to determine a person's sanity. Development of asylums  Confinement of the mentally ill began in the 15th and 16th centuries. Leprosariums were converted to asylums. These asylums took in a mixed of disturbed people and beggars. Bethlehem and other early asylums  St. Mary of Bethlehem was a hospital devoted solely to the confinement of the mentally ill. The conditions were extremely unacceptable. Bedlam: a contraction in popular name for St. Mary of Bethlehem Hospital. It became a descriptive term for a scene of wild uproar and confusion.  Bethlehem was a great tourist attraction. Viewing of violent patients was considered entertaining. Medical treatments were often cruel and painful.  Benjamin Rush is considered the father of American psychiatry. He believed that mental disorders were cause by an excess of blood in the brain. His treatment consisted of drawing great quantities of blood. He believed that being frightened could cure many lunatics. Moral treatment  Philippe Pinel is a primary figure for humanitarian treatment of the mentally ill in asylums.  He removed the chains of the people imprisoned in La Bicetre. Light and airy rooms replace dungeons he believed that patients were normal people and should be treated with compassion and understanding, treated with dignity as individual human beings. His theory is that if reason left his patient because of severe social or personal problems, it could be restored through comforting and counsel.  However, he was not a total egalitarian. He reserved the more humanitarian treatment for the upper classes.  Jean Baptiste Pussin first removed the chains of the mentally ill in asylums. Moral treatment: treatment influenced by sympathetic and attentive treatment  Pinel believed that an aspect of moral treatment was to restore a patient's sense of self-esteem by letting him demonstrate self-restraint.  Drugs were also frequently used in mental hospitals. The first drugs consisted of alcohol, cannabis, opium, and chloral hydrate. The outcomes were not favorable. Less than one third were cured.  Moral treatment was abandoned in the latter part of the 19th century.  Dorothea Dix was a crusader for improved conditions for people with mental illness. She helped build 32 state hospitals to accommodate patients whom the private hospitals could not accommodate. State hospital staff members were unable to provide the individual attention, which was a hallmark of moral treatment. Hospitals at this time came to be administered by physician were interested in the biological aspects of illness and in the physical rather than the psychological well being of mental patients. Asylums in Canada  Many strategies employed in Canada during the 20th century were just as harsh and had tragic consequences.  The first asylums in Canada and British North America were built during the institution-building period prior to the First World War. The asylums were usually modeled after the British forms of structure, treatment, and administration.  Almost 20% of the inmates in the chief asylum in the University branch died while in the institution, a large number due to general paresis of the insane and a condition called phthisis.  Canada is possibly developing a two-tier medical system in which the wealthy will have more opportunity for, and quick access to, superior quality care.  In 1883 the private lunatic Asylum's act was passed to accommodate the wealthy and alternatives to the public asylums.  The history of the development of institutions for the mentally disordered in Canada can be characterized in terms of two distinctive trends: o 1) with the coming of the asylums, provisions for the mentally ill were separate from the provisions for the physically ill, indigents(extremely poor), and criminals; and o 2) the process was segregated from the wider community –“the institution and the community were two separate and distinct solitudes" The beginning of contemporary thought An early system of classification Wilhelm Greisinger: a German physician who insisted that any diagnosis of mental disorders specify a biological cause – a return to the som
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