evolution of mental illness
cyclical, normal vs abnormal behaviour = depend on context surrounding behaviour → times & culture
3 General theories of etiology of mental illness
Supernatural
Somatogenic
Psychogenic
Supernatural
possions by evil/demonic spirits, displeasure of gods, planets, curses, sin
Trephination
yin & yang positive & negative bodily forces
temple attendance in classical antiquity
repenting sins - Hebrews
persecution of witches
trephination
drill hole in skull, release evil spirits
Somatogenic
illness, genetic inheritance, brain damage, imbalance → disturbances in physical functioning
hysteria → wandering uterus
hippocrates - humorism
purges, bleedings, emetics
blood-lettings, gyrators, tranquilizer chains
psychotropic medications: restraints, electroconvulsive shock therapy, lobotomies
chemical imbalances in brain
Hippocrates 4 categories of mental illness
epilepsy, mania, melancholia, brain fever
Psychogenic
focus on traumatic/stressful experiences, maladaptive learned associations & cognitions, distorted perceptions
Galen: source = psychological stress
compassionate care & physical labour
mesmerism → hypnosis as treatment
Josef Breuer & Sigmund Freud: Cathartic method → recall & relive traumatic events
Psychoanalysis
Establishment of hospitals & asylums
house & confine mentally ill, poor, homeless, unemployed, criminals
protect public from mentally ill
government responsible house & feed
treated somatogenically
institutionalized against will, chained, exhibitions
Move to humanitarian treatment mental illness (18th Cent)
St Boniface hospital - remove chain, encourage hygiene, recreational & occupational training
Jean-Baptise Pussin - traitment morale
New American Asylums
compassionate care & physical labour
Dorothea Dix
discover overcrowding and ill treatment in american asylums → advocate establish state hospitals → establish new mental institutions →
Clifford Beers
founded mental hygiene movement, germ theory, revert somatogenic theory of mental illness
Biopsychosocial model
used today
psychogenic & somatogenic model co-exist
genetic predisposition + psychological stressors → develop disorder
Emil Krapelin
publish comprehensive system of psychological disorders → centered around pattern of symptoms, suggest underlying physiological cause
Diagnostic and Statistical Manual (DSM)
current version = 5
clinical diagnoses
list relevant medical conditions, psychosocial, environmental stressors
streamline diagnosis & work better with other diagnostic systems
International Classification of Diseases
made by WHO
diagnostic classification standard for all health conditions
gender incongruence is not mental disorder = condition related to sexual health
Anxiety
negative mood state w/ bodily symptoms: increased heart rate, muscle tension, sense of unease, apprehension about future
benefits of anxiety
motivate to plan for future
too much anxiety (intense)
no longer helpful/useful, if interfere life in significant way = disorder
triple vulnerabilities that increase risk develop anxiety disorder
Biological vulnerabilities
psychological vulnerabilities
Specific vulnerabilities
Biological vulnerability
specific genetic & neurobiological factors → predispose to develop anxiety disorder
Psychological vulnerability
early experiences influence how view world, unpredictable stressor/traumatic experience → see world as unpredictable & uncontrollable/dadngerous
Generalized Anxiety Disorder
difficult/impossible to turn off worries
sensitive & vigilant toward possible threats
Worrying & Generalized Anxiety Disorder
way to gain control over uncontrollable/unpredictable experiences/outcomes
way to avoid feeling distressed
doesn’t get closer to solution/answer → take attention away from important things
Symptoms of Generalized Anxiety Disorder
muscle tension, fatigue, agitation/restlessness, irritability, difficulties with sleep, difficulty concentrating
DSM-5 criteria for Generalized Anxiety Disorder
= 6 months of excessive anxiety and worrying more days than not for good proportion of day
Panic Disorder
unexpected panic attack/false alarm
out of blue/situations not expected to be anxious
no apparent reason/cue
interpret normal physical sensations badly → trigger more panic
actively avoid sensations experienced during panic attack
interoceptive avoidance
Diagnosis for Panic disorder
experience continued intense anxiety & avoidance related to attack for more than 1 month AND cause sig distress/interference in life
Interoceptive avoidance
avoid internal bodily/somatic cues by avoid situations /activities that give same physiological arousal as panic attack
Agoraphobia
avoid places/situations OR endures situations with mucho apprehensions & anxiety
Specific Phobia Criteria
irrational fear of a specific object or situation → interfere with ability to function
Major subtypes of specific phobia (5)
Blood-Injury-Injection (BII)
Situational
Natural Environment
Animal
Other
Blood-injury-injection (BII) phobia
differ in physiological reaction vs ppl w/ other types of phobias → decrease heart rate & blood pressuring, fainting, runs in family
Phobic reactions
cause surge of activity in sympathetic nervous system, increase heart rate & blood pressure, panic attack
social anxiety disorder (Social phobia)
STRONG fear & anxiety associated with social situation → avoid entirely/endure with great deal of distress, can lead to panic attack
feared social situation
any type of situation that potentially draw attention to person
Social anxiety disorder performance only
diagnosis when fear is limited to performance-based situations
causes of social anxiety disorder
learning that social evaluation = dangerous as a child
social trauma (bullying, being humiliated)
Post-traumatic Stress Disorder (5)
lasting reaction to trauma
intrusive reminders of event
intense fear another traumatic event happen
isolation & emotional numbing
engage protective behaviors
Criteria for PTSD (8)
exposed to event involved actual/threatened death, serious injury, sexual violence
re-experience event → intrusive memories & nightmares
flashback
avoid stuff remind of trauma
emotionally number/restricted ability to feel
not remembers aspects of what happened during event
feel sense foreshortened future
jumpy, easily startled, hyper-vigilant, quick to anger
ways you can exposed to event PTSD (4)
directly experience
witness
learn happen to close relative/friend
repeated/extreme exposure to details
most common precipitating trauma for PTSD
combat & sexual assault
ways ppl avoid internal & external cues that remind traumatic experience
avoid watch intense/emotional movies → emotional arousal
avoid convos, reminders, emotion
external stimuli → colour, smell