SOC2220 Midterm Exam

WHO statistics

1/8 people have a mental disorder, while a 2008 reports 46.4% of an Americans suffer from a mental disorder in their lifetime.

NIMH statistics

5.5% suffer from a serious MD.

Mental disorder

A significant deviation from standards of behavior generally regarded as normal by the majority of people in a society

1. Primarily psychological condition (separates (non)pyschiatric conditions).

2. A condition in a ‘full blown’ state regularly.

3. A distinct condition that responds to treatment.

Sympathetic magic

Two things that look alike affect each other through their similarity because the shared likeness places them in “sympathy” with each other.

Contagious magic

Based on the idea that things that have once been in contact continue to be related to each other.

Hippocrates

A Grecian figure who provided many of the principles underlying modern medical practice around 400 BC, suggesting that mental illness was due to natural causes.

Four humors

Blood, phlegm, black bile, and yellow bile.

• Developed by Hippocrates.

Galen

A Roman physician who reinforce the Hippocratic view by holding that the health of the soul was dependent upon the proper equilibrium among its rational, irrational, and lustful parts; emphasized importance of orgasms!!

Soranus

A Roman physician that argued that physicians needed to be supportive in helping mentally ill persons work out their insanity; humanitarian.

Roman insanity

A condition that could decrease an individual’s responsibility for having committed a criminal act.

Malleus Maleficarum

A book argued that it was women who were chiefly addicted to evil superstition, and all witchcraft derived from carnal lust lol lol lol. Illnesses are #demonic.

Ships of fools

Mentally ill were put ashore at a distant place in the Middle Ages.

The Great Confinement

An 18th century movement, in which hospitals spread across Europe, including care for the homeless and unemployed.

• The Protestant Ethic equates productive labor with goodness and morality

Chiarugi (1759-1820)

An Italian physician argued that medical personnel had a moral duty to treat the mentally ill as individuals and to treat them tactfully and humanely

Tuke (1732-1819)

An England merchant advocated that mental patients be treated as guests, with kindness and respect.

Pixel (1745-1826)

A French physician believed that mental health was dependent upon emotional stability. Stopped physical abuse and freed patients.

Benjamin Rush (1746-1813)

The father of American psychiatry, believing that abnormal behavior was caused by brain disease, but advocated for spirit healing; lead to formation of mental asylums.

19th century view of MD

1. No cohesive treatment program.

2. Critics believed moral treatment was method for enforcing patient conformity.

3. Most patients were from a low socioeconomic status, so citizens were bothered by increased taxes.

4. Madness was thought to be incurable.

5. Psychiatrists thought MDs were diseases caused organically and needed medical treatment over moral treatment.

Dorethea Dix (1802-1887)

A teacher who devoted her life to reforming conditions for the mentally ill, visiting jails and improving legislature.

Wilhelm Griesinger (1817–1868)

The author of  Pathology and Theory of Mental Diseases, proposing MD was caused by biochemical changes.

Freud (1836-1939)

Emphasized the role childhood experiences in MD, especially in psychosexual development.

Chlorpromazine

The first drug used in the US to treat schizophrenia, blocking dopamine.

• Part of the phenothiazine group.

DSM1-2

Not very impactful, opinion-based.

DSM-3

Attempted to classify mental disorders on the basis of scientifically verifiable evidence, relying less on Freud. Considered symptoms, PH, severity, etc., but over-emphasized the use of drugs.

DSM-4

Classification system using yes or no questions made MD diagnoses too narrow

DSM-5

Updated classification, ranking symptoms from 1-7

• Autism has been eliminated.

Schizophrenia

A disturbance in an individual’s mood, thinking, and behavior, characterized by a distorted sense of reality that includes delusions and hallucinations.

Gene C4-A (vs C4-B)

Schizophrenia gene

Bipolar disorder

Consists of manic and depressive episodes; equally common in men and women.

BPD1

Mania, associated with a euphoric or grandiose mood.

BPD2

More common, including depressive episodes with an emphasis on anhedonia.

Depressive disorder

Symptoms must be present for at least 12 months and occur in two different settings; more common in women.

Dissociative disorder

The temporary loss of motor behavior, consciousness, or identity; more common in women.

Somatic symptom disorders

Symptoms of physical illness for which there are no demonstrable physical causes, and are  due to psychological factors; NOT under the person’s control.

Elimination disorder

Involves the elimination of urine or feces from the body.

Personality disorder: cluster A

Paranoid personality disorder is a pervasive and long-standing suspicion and distrust of other people.

Personality disorder: cluster B

Antisocial personality disorder is found among individuals with a history of consistent antisocial behavior in which the rights of others are ignored.

Personality disorder: cluster C

Avoidant personality disorder is extremely sensitive to being rejected by others.

Paraphilic disorder

The persistent, intense sexually arousing fantasies.

Alienation from place

The disconnection from one’s role and status in a social network, affecting social interactions and the physical qualities of a location.

Elements of place (Norman Denzin)

1. self-reflexive individuals

2. individual settings

3. social objects

4. a set of rules that guide interactions

5. relationships legitimizing presence

6. definitions revealing personal views.

Recognizing Symptoms

Awareness of discrepancies between one's behavior and emotional states, often leading to self-diagnosis.

Madness as a Method of Coping

The concept that individuals with mental disorders may follow a different kind of order rather than being disordered.

The Definitive Outburst

A crucial moment leading to the designation of an individual as insane.

Rendering of Accounts

The explanations given by mentally disordered individuals about their behavior, which can be either remedial or negative.

Remedial Accounts

Excuses that attempt to maintain the person’s credibility and standing in their community, more common early in the experience of madness.

Negative Accounts

Attempts to shift blame to others, challenging the integrity of those around them.

The Paradox of Normalcy

Many symptoms of mental disorders mirror exaggerated forms of normal emotions and behaviors, making persistent madness seem 'normal'.

Removal from place

The point at which mental disorder becomes intolerable for the individual or their community, leading to disconnection.

The medical model

Based on the premise that all mental processes stem from the biological properties of the brain; holds the belief that abnormal behavior is symptomatic of an underlying organic disturbance, its approach is to discover and treat the cause.

Presumed criteria for physiological dysfunction

1. Having a specific cause

2. Being qualitatively different from normal functioning

3. Showing a demonstrable physical change

4. The process proceeds independently

Electroconvulsive Therapy

A  procedure that consists of placing electrodes around the brain and administering an electric current 70-170V.

• Targets the hypothalamus, releasing norepinephrine, acting as an antidepressant.

Electroconvulsive Therapy (results)

Enhanced neurotransmission of various substances, namely dopamine, serotonin, and adrenaline or noradrenaline that reverse the abnormal brain structures seen in severely depressed individuals.

• Most effective treatment for catatonic schizophrenia, lasting a few days.

Assessment of the Medical Model

• The model approaches MD as if they were illness, despite the origin not being from a disease.

• Focuses on controlling symptoms, rather than cures.

• Hasn’t found the cause of mental disorders.

The Pyschoanalytic Model

Focus on internal factors that affect mental health, but views abnormal behavior in psychological terms; views human beings as driven by powerful instinctual forces. Not only is the individual unable to control these forces, he or she is even unaware of their existence.

Id

Functions as the discharger of any energy or tension brought about by internal or external stimulation; uses its energy for instinctual gratification in fulfilling the pleasure principle.

Ego

The energizing of new processes of memory, judgment, perception; governed by the reality principle, whose function is to postpone the release of energy until the actual object has been located that will satisfy the need.

Superego

The moral or judicial branch of the personality; involves the internalization of parental values.

Stages of pyschosexual development

Oral, anal, phallic, latency, and genital.

Oral (birth-8 months)

• Erotic: tongue and lips.

• Sadistic: teeth and jaw.

Phallic (3-6 years)

The object of that energy becomes the opposite-sexed parent.

Latency (6-13 years)

Interest towards peers.

Genital

Provides the adolescent with the opportunity to resolve past conflicts as part of achieving a mature adult identity and sexuality.

Threats to ego

1. The id as it tries to overwhelm the ego with pressure for instinctual gratification.

2. The superego as it attempts to punish the ego through feelings of guilt.

3. The external danger that is perceived as being directed toward the ego.

Reveal of emotional problems

1. Development of PD

2. Development of pyschophysiological disorder

3. Neurotic or anxious

4. Pyschotic

Psychoanalysis

A one-to-one relationship between the therapist and the patient that utilizes free association as its primary technique.

Assessment of pyschoanalytic model

• It’s based upon speculation.

• It portrays human beings as being propelled by instincts.

• Overemphasizes the role of childhood.

• Under-emphasizng cognitive development.

• Still, it provides insights into the development of human personality, and it’s a model that is inseparable from physiological concepts.

Behavior therapy (note)

Behavior is learned, but it can also be unlearned and replaced with behavior that is more socially appropriate, using symptom desensitization, positive reinforcement, conditioning, etc.

The Stress Process Model

Mental disorders develops through a process in which exposure to stressors interacts with a person’s social resources and coping mechanisms, influencing mental health.

Stressors

Any condition having the potential to arouse the adaptive capacity of the individual.

Moderators

Coping abilities, sense of mastery, and sources of social support.

Outcomes

Refers to the health effects of the distress experienced by the person.

Life events

The accumulation of several events in a person’s life that eventually build up to a stressful impact.

Deviance

Behavior that’s different, breaks rules or violates norms, and is exceedingly offensive.

Emile Durkheim (deviance)

This sociologist emphasized structural effects on mental health i.e. economic recession; did lots of work with suicide.

Suicide (1951)

Not entirely an act of free choice by the individual, since suicide rates were unchanging.

• Egoistic

• Anomic

• Altruistic

• Fatalistic

Egoistic suicide

Suicide in which individuals become detached from society and are overwhelmed by the resulting stress i.e. retired cop without their squad.

Anomic suicide

Suicide in which an individual’s own norms and values are no longer relevant within the larger social system, so the controls of society no longer restrain them from taking their lives i.e. sudden poverty.

Altruistic suicide

Suicide in which individuals feel themselves so strongly integrated into a demanding society that their only escape seems to be suicide i.e samurai code.

Fatalistic suicide

People kill themselves because their situation is hopeless.

MD and economic change

Mental hospitalization will increase during economic downturns and decrease during upturns.

Symbolic interaction

Views society from the standpoint of the individual person; society is created through social interaction that people have with one another.

• All behavior is self-directed on the basis of symbolic meanings that are shared, communicated, and manipulated by interacting human beings in social situations.

Herbert Blumer (1969)

A sociologist that analyzes social action through

• The self

• The act

• (Non)symbolic social interaction

• Object

• Joint act

Non-symbolic interaction

A person makes a nonthinking response to a certain stimulus, such as stepping back from a growling dog.

Symbolic social interaction

To interpret and define actions and objects based upon symbolic meanings shared with other people. Subconscious.

Labeling Theory

Applying a deviant label to an individual by society or institutions significantly influences their self-identity and future behavior.

Edwin Lemert

Developed primary and secondary deviance.

Primary deviance

A normal person acts differently but the behavior is rationalized as atypical by others because it is perceived as not characteristic of the person’s own true self.

Secondary deviance

A person is relegated to a deviant role; that is, being deviant is thought to be a typical characteristic of that individual.

Social construction

• Rejects the view that MDs are diseases, since meanings aren’t inherent and come from social interaction; deviant behavior is a violation of social rules and has no reality apart from those rules.

• Criticizes psychiatry’s efforts to expand its classification of various behaviors as abnormal, but the classification system itself.

Epidemiologist

Focuses on health problems of social aggregates or large groups of people.

Epidemiological case

Refers to an instance of disorder, illness, or injury involving a person.

Risk

Exposure to a health problem.

Crude rate

The simplest ratio calculated by epidemiologists; the number of persons who have the characteristics being measured during a specific unit of time.

Incidence

The number of new cases of a specific health disorder occurring within a given population during a stated period of time.

Prevalence

The total number of cases of a health disorder that exists at any given time.

• Point vs lifetime

Epidemiologic Catchment Area (ECA)

An effort to measure mental health in a random sample of 20,000 persons aged 18 and over in particular cities.

National Comorbidity Survey

Used a widely dispersed sample consisting of 174 counties in 34 states.

CES-D

20-80 item scale of depression.

True prevalence

Must count treated and untreated cases.