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Chapter 1

POLB32 Chapter 1.doc

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University of Toronto Scarborough
Konstantine Zakzanis

Chapter 1: Introduction: Definitional and Historical Considerations, and Canada’s Mental Health System PAGES 1-36 Psychopathology: the field concerned with the nature and development of abnormal behavior, thoughts, and feelings PART I: WHAT IS ABNORMAL BEHAVIOR Abnormal behavior: includes such characteristics as statistical infrequency, violation of norms, personal distress, disability or dysfunction and unexpectedness. Statistical Infrequency - One aspect of abnormal behavior is that it is infrequent in the general population. - Normal curve: or bell-shaped curve, places the majority of people in the middle as far as any particular characteristic is concerned; very few people fall in either extreme. 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. - Statistical infrequency is used explicitly in diagnosing mental retardation. Violation of Norms - Another characteristic to consider is whether the behavior violates social norms or threatens or makes anxious those observing it. Personal Distress - Another characteristic is personal suffering, that is, behavior is abnormal if it creates great distress and torment in the person experiencing it. Disability or Dysfunction - Disability-that is, impairment in some important area of life (ex work or personal rela- tionships) because of an abnormality. Unexpectedness - Distress and disability are considered abnormal when they are unexpected responses to environmental stressors. Focus on Discovery 1.1- The Mental Health Professions (go back to read) - Clinicians: the various professionals authorized to provide psychological ser- vices, takes different forms. - Clinical psychologist: - Assessment - Diagnosis - Psychotherapy PART II: HISTORY OF PSYCHOPATHOLOGY Early Demonology - Demonology: the doctrine that an evil being, such as a devil, may dwell within a per- son and control his or her mind and body. - Following from the belief that abnormal behavior was caused by possession, its treat- ment often involved exorcism: the casting out of evil spirits by ritualistic chanting to tor- ture. - Trepanning of skulls: the making of a surgical opening in a living skull by some instru- ment by stoneage or neolithic cave dweller was quite widespread. Somatogenesis th - In the 5 century BC Hippocrates (ca 460-377BC) (often regarded as the father of modern medicine) separated medicine from religion, magic, and superstition. - He rejected the prevailing Greek belief that the gods sent physical diseases and men- tal disturbances as punishment. - Insisted they were natural causes. - Somatogenesis: the notion that something wrong with the soma, or physical body, disturbs thought and action. - Psychogenesis: the belief that a disturbance has psychological origins. - Hippocrates classified mental disorders into 3 categories: mania, melancholia, and phrenetic (or brain fever) - For melancholia he prescribed tranquillity, sobriety, care in choosing food and drink, and abstinence from sexual activity. - He conceived of normal brain functioning, and therefore of mental health, as depen- dent on a delicate balance among 4 humours, or fluids of the body, namely blood, black bile, yellow bile and phlegm-imbalanced produced disorders. The Dark Ages and Demonology - Historians often suggest that the death of Galen (130-200AD), the second century Greek who is regarded as the last major physician of the classical era, marked the be- ginning of the dark ages for western European medicine and for the treatment of and in- vestigation of abnormal behavior. The Persecution of Witches Witchcraft and Mental Illness - The prevailing interpretation for some time in the later middle ages was that the men- tally ill were generally considered witches. The Development of Asylums - Leprosariums were converted to asylums: refuges established for the confinement and care of the mentally ill. Bethlehem and Other Early Asylums - The priory of St. Mary of Bethlehem was founded in 1243. Over the years the word bedlam-a contradiction and popular name for this hospital, became a descriptive term for a place or scene of wild uproar and confusion. - Benjamin Rush (1745-1813) began practicing medicine in Philadephia in 1769, is con- sidered the father of American psychiatry. - He believed that mental disorder was caused by the excess of blood in the brain. - His favored treatment was to draw great quantities of blood. - He also believed that many lunatics could be cured by being frightened. Moral Treatment - Phillipe Pinel (1745-1826) is considered a primary figure in the movement for humani- tarian treatment for the mentally ill in asylums. - In1793, while the French revolution raged, he was put in change of a large asylum in Paris known as La Bicetre. - In the wake of Pinel’s revolutionary work in La Bicetre, the hospitals established in Eu- rope and the United States were for a time relatively small and privately supported. - A prominent merchant and Quaker, William Tuke (1732-1822) shocked by the condi- tions at York Asylum in England, proposed to the society of friends that it found its own institution. - In1796 the York retreat was founded on a country estate, providing mentally ill people with a quiet and r
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