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Chapter 1

PS280-Chapter 1 Lecture Notes.doc

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John Stephens

1 PS280-Abnormal Psychology Chapter 1: Definitional and Historical Considerations Psychopathology · Field concerned with the nature and development of abnormal... o Behaviour o Thoughts (cognitions) o Feelings (emotions) · Always looked at the affective domain (feelings and emotions); the #1 affective domain is depression o Behavioural aspects- “all I want to do is sleep” “I can’t sleep at all” o Cognitive aspects- “my life sucks” “my relationships suck” “the world sucks” o Physical aspects- shoulders shrunken, drawn face, tears What Is Abnormal Behaviour? · Abnormality is usually determined by the presence of several characteristics at one time such as : o 1. Statistical Infrequency o 2. Violation of Norms o 3. Personal Distress o 4. Disability or Dysfunction o 5. Unexpectedness Statistical Infrequency · A behaviour that occurs rarely or infrequently o A 14 year old boy wetting his bed; mental retardation (IQ < 70) occur infrequently, as do most mental disorders o Why don’t we feel the same way about people on the other end of the spectrum; IQ > 100; they are well known and admired instead · Discussion point: is statistical infrequency a good enough marker to determine if behaviour is abnormal? o Consider elite athletic ability o Consider the flip side of mental retardation – intellectual giftedness (IQ > 130) Violation of Norms · A behaviour that defines or goes against social norms; it either threatens or makes anxious those observing it o Anti-social behaviour of the psychopath violates social norms and is threatening to others o But “violation of norms” needs to be considered in reference to prevailing cultural norms  What is the norm in one culture may be abnormal in another · Discussion point: a prostitute violates social norms but does this mean that she/he would necessarily meet diagnostic criteria for a mental disorder? 2 Personal Distress · A behaviour that creates personal suffering, distress or torment in the person · This criterion fits many of the various forms of abnormality (such as depression) but some disorders do not necessarily involve distress o Psychopaths are often not distressed by their own behaviour, but their behaviour clearly impacts others in a negative way o Hunger and childbirth cause distress, but is this abnormal? · Fits most of the abnormalities seen in humans, but not all · Ex. Narcissistic personality disorder; they themselves are not distressed but the people around them are the one with the major distress · OCD- if you do it well, no distress; people with moderate OCD manage their stress realistically and help prevent their anxiety from arising; others take it overboard and cause more distress Disability or Dysfunction · A behaviour that causes impairment in important areas of life (e.g. work, personal relationships, recreational activities) · Examples of exceptions: o Being short if you want to be a professional basketball player o Transvestism is not necessarily a disability although it is currently diagnosed as a mental disorder if it distresses the person o “Would you judge me if I wore women's underwear under my clothes, if it helped me teach better” · Discussion point: why would transvestism without distress not be considered a disability? o Most transvestites are married, lead conventional lives, and usually cross- dress in private Unexpectedness · A surprising or out-of-proportion response to environmental stressors can be considered abnormal o Ex. We would expect a person to be sad if they lost a loved one to cancer o Ex. We would not expect a person to laugh after being sexually assaulted o Ex. Anxiety disorder diagnosed when anxiety is unexpected + out of proportion to the situation The Study and Treatment of Mental Disorders · There are approximately: o 3600 practicing psychiatrists o 13000 psychologists and psychological associates o 11000 nurses specialize in the mental health area o But, they are not the only people in others lives that help with mental health problems  Ex. Parents, friends, family 3 · Non-medical practitioners usually work within hospital or agency settings on a salary or in private practice · Public health plan reimbursement of fees-for-service is limited to medical doctors · Most of the primary mental health care is delivered by general practitioners · Most mental health help is from your family physician, or dentists (especially for people with eating disorders) · We have shifted and changed to family health networks; after hour care, where the physician is with a group, the group has many various physicians to help families o Ex. The movie Dangerous Method – psychological movie Psychiatrist and Psychologists – What is the difference · Clinical psychologists typically have a Ph. D or Psy. D. degree o Entails four to seven years of graduate studies · Psychiatrists hold a MD degree and have had postgraduate training, in which they receive supervision in the practice of diagnosing and psychotherapy o In New Mexico, and Arizona however psychologists can prescribe medicine · Because psychiatrists have an MD degree, they can prescribe psychoactive drugs, whereas psychologists can not o Focus on discover 1.1 The Mental Health Professions History of Psychopathology · “Those who cannot remember the past are condemned to repeat it” Pre-scientific Inquiry · Mental disorders were believed to be caused by: o Events beyond the control of humankind, regarded as supernatural  Such as eclipses, earthquakes, storms, fire, diseases o Behaviour that seemed outside individual control was subject to similar interpretation · Thus, many early philosophers, theologians, and physicians believed that deviant behaviour reflected the displeasure of the gods or possession by demons · Ex. TRET’s, there is no control of your thoughts, you just say what comes to mind o Back in the day if someone had TRET’s, they would think they were possessed by demons o Classic TRETs is rare, more commonly see coughing, barking, random noises, not thoughts Early Demonology · Demonology: the doctrine that an evil being (such as the devil) may dwell within a person and control his or her mind and body o Found in the records of the early Chinese, Egyptians, Babylonians, and Greeks · Given that abnormal behaviour was caused by possession, treatment often involved exorcism o Ranged from elaborate rites or prayer to flogging and starvation as a way of rendering the body uninhabitable to devils/demons 4 Trepanning · Involved the making of a surgical opening in a living skull by some instrument o Treatment used by Stone Age or Neolithic cave dwellers · Used to treat epilepsy, headaches, and psychological disorders attributed to demons · Thought to be introduced into the Americas from Siberia o Practice was most common in Peru and Bolivia o 3 British-Columbia Aboriginal specimens found Hippocrates (460-377B.C) · Separated medicine from religion, magic, and superstition · Rejected belief that the gods sent physically diseased and mentally disturbed as punishment · Insisted that illnesses had natural causes thus should be treated like other common illnesses Somatogenesis vs. Psychogenesis · Hippocrates is one of the earliest proponents of somatogenesis o Somatogenesis: mental disorders are caused by aberrant functioning in the soma (physical body) and this disturbs thought and action o Psychogenesis: mental disorders have their origin in psychological malfunctions Hippocrates Humoral Physiology · Hippocrates’ treatments were different from exorcist tortures o Tranquility, proper nutrition, abstinence from sexual activity were prescribed for melancholia · Mental health depended on a delicate balance among four humours (or fluids) of the body · Imbalances and results: o ↑ blood = changeable temperament o ↑ black bile = melancholia o ↑ yellow bile = irritability and anxiousness o ↑ phlegm = sluggish and dullness The Dark Ages and Demonology · Churches gained in influence, papacy was declared independent of the state · Christian monasteries replaced physicians as healers and as authorities on mental disorder · The monks cared for and nursed the sick: o By praying and touching them with relics o Concocting fantastic potions for them Persecution of Witches 5 · During the 13 and the following few centuries, major social unrest and recurrent famines and plagues · People turned to demonology to explain disasters · Led to an obsession with the devil – ‘witches’ blamed and persecuted · 1484 Pope Innocent VIII exhorted European clergy to leave no stone unturned in the search for witches o Sent 2 Dominican monks to northern Germany as inquisitors who later issued the manual entitled the Malleus Maleficarum  Used to guide witch hunters
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