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Chapter 1

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University of Toronto Scarborough
Mark Schmuckler

Abnormal Psychology 4 Canadian Edition Chapter 1 - Introduction - Challenges in study: understanding behaviour outside the normal range, the need to remain objective - Psychopathology: field concerned with the nature and development of abnormal behaviour, thoughts and feelings What is Abnormal Behaviour? - Of the several characteristics listed, no single one is adequate, but each is able to capture some part of what might be the full definition - Abnormality is usually seen with the presence of several characteristics at one time - Statistical Infrequency o Abnormal behaviour is infrequent in the general population o Used in diagnosing mental retardation with an IQ under 70, intellectual functioning is considered sufficiently subnormal - Violation of Norms o Whether the behaviour violates social norms or threatens/makes anxious those observing it o Forms of unusual behaviour can be tolerated depending on cultural norms o Criminals violate social norms but are not usually studied within abnormal psychology - Personal Distress o Behaviour is abnormal if it creates distress and torment in the person experiencing it o Not all forms of distress are studied i.e. hunger - Disability or Dysfunction o Impairment in some area of life because of an abnormality o A phobia can produce distress and disability - Unexpectedness o Distress and disability are considered abnormal when they are unexpected responses to environmental stressors History of Psychopathology - Early Demonology o The doctrine that an evil being may dwell in a person and control his/her mind and body o Hebrews: deviancy was attributed to possession of the person by bad spirits o Exorcism was often involved in treating the possessed by ritualistic chants or torture to render the body uninhabitable to devils o Trepanning of skulls creating a surgical opening in the skull with some instrument. The opening would allow the evil spirits within to escape - Somatogenesis o Notion that something wrong with the soma (physical body) disturbs thought and action o Psychogenesis a disturbance has psychological origins o Hippocrates father of modern medicine classified 3 types of mental disorders: mania, melancholia, phrenitis (brain fever) o Hippocrates believed in natural (not supernatural) causes and left records of conditions now recognized as epilepsy, alcoholic delusion, stroke, and paranoia o Hippocrates conceived normal brain functioning to be dependent on a balance of 4 humours: blood, black bile, yellow bile, phlegm; disorders were caused by an imbalance - The Dark Ages and Demonology o When churches gained in influence, monks replaced physicians as healers o The Persecution of Witches Demonology was used to account for recurring famines and plagues Witchcraft was seen as a denial of God, inexplicable occurrences were blamed on them o Witchcraft and Mental Illness Later Middlethges: Mentally ill were considered witches From the 13 century onwards, hospitals came under secular jurisdiction - Development of Asylums o When leprosy disappeared from Europe, leprosariums were converted to asylums during the 15 and 16 centuries, hospitals specifically for the mentally ill emerged as well o Bethlehem and Other Early Asylums Bedlam: place or scene of wild uproar and confusion The Priory of St. Mary of Bethlehem became a tourist attraction where viewing the patients and their antics was considered entertaining Benjamin Rush (1769) believed mental disorder was caused by excess blood in the brain and chose to treat them by drawing large quantities of blood o Moral Treatment Philippe Pinel patients are essentially normal people who should be approached with compassion and understanding and treated with dignity, but reserved humanitarian treatment for upper class Moral treatment sympathetic and attentive treatment Pinel central aspect of moral treatment was restoring a patients sense of self- esteem by lettthg them demonstrate self-restraint In the early 19 century, drugs (including alcohol, cannabis, opium, chloral hydrate) were also a frequent treatment used in mental hospitals, although < 1/3 of patients improved or recovered (according to records from the York Retreat) Dorothea Dix helped to see that 32 state hospitals were built for patients that private hospitals could not accommodate Dixs emphasis on early detection and treatment >150 years is consistent with current views Hospitals came to be administered by physicians who were interested in the biological and physical aspects of the illness, rather than the psychological 1840s-80s most formal asylums were first established - Asylums in Canada o The process of establishing a network of asylums in Canada began with humane intentions as part of a progressive and reformist movement, which attempted to overcome neglect and suffering in the community, jails, penitentiaries, almshouses, poorhouses, and hospitals (Sussman, 1998, p. 260) th o Many strategies employed in Canada in the 20 century were harsh, while some were severe and had tragic consequences th o Htel-Dieu, Quebec City, est. 1714 earliest precursor to 19 century asylums; facility cared for indigents, crippled people, and idiots o Asylum superintendents were typically British-trained physicians who modelled the asylums after British forms of structure, treatment, and administration o Asylums experienced overcrowding that was so severe to the point where death was thought to be the sole creator of vacancies o The developmental history of mental institutions in Canada can be characterized by two trends: provisions for the mentally ill were separate from provisions for the physically ill, indigents, and criminals; the institutions were separated from the wider community - 1.1 Dorothea Dix and the Development of the Asylums in Canadao Jan. 21, 1850 In a presentation to the Nova Scotia legislature, Dix requested construction of a public mental hospital, spoke about moral treatment and results of failure to obtain help at an early point o Dix took an active role in choosing the site for the Nova Scotia hospital - 1.2 The Mental Hospital in Canada: The 20 Century and into the New Millennium o Provincial mental hospitals became extremely overcrowded, individual treatment was very often unavailable o Drugs became the central means of treatment o With a large deinstitutionalization of mental hospital patients, Canadas goal was to shift care from psychiatric hospitals into the community o The intended focus on community support systems has not been as successful because community mental health programs were allocated 3% of provincial mental health budgets (1990), with most of the money still going to hospitals and physicians o Mental hospitals run as a part of Canadian health insurance program medicare, but treatment is still considered custodial in nature, patients get little contact with psychiatrists o Psychiatric hospitals in the new millennium have a tertiary role to provide specialized treatment and rehab services to those whose needs for care are too complex to be managed in the community - The Beginning of Contemporary Thought o Vesalius discovered that Galens presentation of human physiology which he thought mirrored that of apes, was incorrect o An Early System of Classification Emil Kraepelin a syndrome, a certain group of symptoms, which tends to appear is regarded as having an underlying physical cause
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