Psychopathology + Probs in Living Unit 1 - Part 1

words to describe insanity before

Crazy, Insane, Psycho, Nuts, Deviant, Mental, Weird, Loony, Abnormal psychology

psychology

study of behavior thoughts emotion

psychopathology

suffering of the mind

abnormal psychology

when behaviors, thoughts, emtions “go wrong” don’t function properly

supernatural and middle ages

battle between good and evil

• Treatment: trephining (religious figures -drilling hole in peoples head for evil spirits to come out)

• Movements of sun and earth - abnormality

Lunatic comes from latin

moon

• treatment approaches - church

• make body uninhabitable

-e.g. exercism, burning, drowning, when devil posses man they would make garlic portions

medical / biological view

• plato - insanity defense for mental ill

• hippocrates

• treat psychological disorders like other medical problems

• 3 classes of mental disorders

-mania

-Melancholia

-phrenitis

phrenitis

brain fever

galen

humoral theory of mental disorders

-body had four main liquids

body main 4 liquids by galen

blood (sanguine, black bile (spleen), melancholic, phlegm (brain), yellow bile liver

galen treatment

• put humors back in balance / regulate the environment

-barbers pole game from galen: symbolizing historical roots as they were barber surgeons, blood and white meant blood and bandages and blue was veins

historical perspective

• Asylum, 

• bedlam

• La Bicetre(st. Mary in Bethlehem and was made into an asylum, widely known for bad conditions and practices, exhibited to public, one penny a look

-treatment here was inhumane (patients were shackled to the walls, no furnishing, never swept or cleaned)

asylums - humanitarian

• pinel - 1792 in france (La Bicetre)

• moral managment in america

pinel -1792 in France (La Bicetre

treat mental patients with kidness and consideration

moral managment in America

-focused on patient’s social, individual, and economic needs

-emphasized patients moral and spirtual development and not just focused on illness

-benjamin rush was bag component in moral managment

mental hygiene movement

-dorthea dix

-biological basis

-social and psychological side was relevant

dorthea dix

advocated for human treatment in asylums, started 32 institutions in the U.S.

19th century “alienists”

emotional problems caused by expending too much energy, excess living

-exhausted nerves

-nervous breakdown: connecting the perceived cause of mental illness and treatment

modern approaches

biological, psychological

modern approaches: biological

• general paresis and psyphilis + psychotic symptoms

paresis

syphilis of brain (die 2-5 years after diagnosis)

differentiating paresis from psychosis

• live longer life with psychosis

• course of illness: how condition develops and changes over time

paresis cont’d

• 1897: von krafft-ebing inoculated paresis patients with syphilis sores

• 1917: treated syphilis with malaria

• causes and treatment of mental disorder by medical science

drug treatment of mental illness

• resperine

• chlorpromazine and neuropletics in 1950s

• beginning of search of biological cause of psychotic disease

resperine

originally for cardiac problems, in 1950 it accidently was found

dopamine hypothesis for schizophrenia

that high dopamine was the cause

• in todays modern world the National Institute of Mental Health (NIMH) want to find biological causes and reasearch

psychological approaches

mesmer, Jean Charcot, Breuer and Freud

Mesmer

• from vienna in late 1700s

• gets the name mesmorizedL wore a robe and touched patients with chemicals to remove hysterical fits and paralysis

• began hypnosis

• believed people have magnetic forces that are in your body

jean Charcot

• paris 1800s

• began psychological cause of mental disorders like hysteria

• psychological causes

• influences freud

Breuer

• breur used hypnosis to treat patients

• talking cure to treat patients like Anna O.

catharsis

emotional release of unconscious tenion

-insight was lacked of individual problems

-unconscious mind was discovered

freud and psychoanalysis

structure of mind was used to explain human behavior

-Id

-ego

-superego

-psychosexual state of development

ID

the primal part of your personality, instinct, drive, pleasure principal, immedite gratification

ego

rational to mediate between your desires and desires of external world

super ego

your own oral context, judges your actions and others from internalized standard

-defense mechanisms: unconscious resources used for protection of mind battle

defense mechanisms

unconscious resources used for protection of mind battle

Psychosexual state of development: Freud life was built through tension and pleasure with sexual energy

psychosexual state of development

Freud life was built through tension and pleasure with sexual energy

neurosis and disorders

result of unconscious battles or conflict, arose when defense mechanisms were not working well

free association and dream analysis

two types of treatment, free association; speaking freely of one self and anything on their mind, then dream analysis: patients record and say their dreams, share what u dreamt and connect it to your mental health

defense mechanisms

-denial

-displacement

-projection

-rationalization

-reaction formation

-repression

-sublimation

displacement

•  discharging pent up feelings, e.g. someone treated badly at work initiates an argument with partner at home

projection

express your motives to others

rationalization

• sing explanations to conceal or disguise motives for ones behavior; can be present in someone who steals money bc they needed it more than person

reaction formation

expression of unacceptable desires; teases or insults crush

repression

preventing painfull thoughts into your conscious

sublimation

• channeling frustrated energy into substitute activities that are more socially acceptable

experiemental psychological laboratories

-wihelm wundt, cattell, lightner, chiacgo juvenile psychopathic institute

wihelm wundt

first experiment lab, studied memory and sensations

cattell

mental functions

lighter witmer

combined research with application

chicago juvenile psychopatic institute

1909, saw delinquency came from the environment not personality

behaviorsim

understanding human behavior

pavlov

classical conditioning, e.g. dogs salivate to a non food stimulus like bell when bell was before presented with food

watson

founder of behaviorism, the role of environment is important in abnormal and normal.

we need to study things we see was believed by

rosalie rayner, mary cover jones, joseph wolpe, skinner

rosalie rayner

(little albert was a kid conditioned to fear white fluffy things)

mary cover jones

found ppl can unlearn conditions fear

joseph wolpe

elaborate on Jones' systematic desensatization: can treat mental disorders with behaviorism. Anxiety is a condition response, treating phobias: when someone is afraid of spiders you take them outside and feel less anxious

skinner

associated with operate conditioning, shaving: behavior is shaped when something reinforces an activity

cognitive perspective

aaron beck and albert ellis

aaron beck

important for this perspective; schemas came from his work that guides and process information

albert ellis

rational-immotive behavior therapy which is maladaptive thought process that hurt you in the long run

biopsychosocial model

if someone has depression or anxiety they can take a medication

why define abnormality?

·       As humans we like to categorize things and it improves communication to reduce confusion. Need a consensus / working definition to make scientific process, makes easier for research or clinical work

classification

cutoffs/thresholds for defining normal-abnormal, we want to be objective

implications and dilemmas of having a definition

• Abnormal Implies undesirable

-wrong behavior or needs to be fixed

• Most definitions of abnormality are arbitrary

• Or the definition change over time/history with the context we’re in

-the treatment to patients changes

-we can disagree because beliefs change with time and future

categorical psychopathology

  symptoms in a category are the same and don’t overlap, it’s either abnormal or normal

categorical psychopathology strengths

simple and clear, useful for treatment, communicates well, research, and consistency

categorical psychopathology weaknesses

oversimplifies psychopathology, comorbidity, heterogeneity, diagnostic thresholds are arbitrary, stigma, limited individualization

dimensional psychopathology strenghts

 

a.     it’s on a spectrum of normal to abnormal, you can have a mix of both, can use percentage above or below, e.g. above 95% for weight is overweight for age, 50% is in the middle, 25% is low

-e.g. Blood pressure is dimensional; it’s on a continuum, top number can be 80-120 or the bottom can be 60-90

-measuring a patients anxiety level

dimensional strengths

captures severity, more individualized, recognizes continuity, better for comorbidity, tracks change, avoids rigid cutoffs

dimensional weakness

less simple, cutoffs may be needed, more complex assessment, less familiar, unclear boundaries

prototype psychopathology

mixture of categorical and dimensional, there are essential characteristics that must be present, secondary features are sometimes not present

-e.g.
Define a dog; dogs can have fur and ears but so can a bear

-you know it when you see it, some things have to be there

-traits come together that are recognizeable

-e.g.
With depression you think you know it when you see it, feeling worthless,
insomnia, but it can look different in other people

-e.g.
Patient 1 has insomnia but patient 2 sleeps well but has gained a lot of
weight: they both have major depression, their symptoms overlap

prototype strengths

flexible, realistic, less rigid, clinically useful, can capture unusual cases

prototype weaknesses

subjective, less precise, potential for bias, less standardized, overlap

statistical deviation

  rare behavior that deviates from the average: more deviation, more abnormal

-if you’re 1-2 standard deviations above your normal

how to decide the cutoff for a problem?

·       E.g. the amount of times you check if your door is locked

Is it associated with the negative vs positive side of the problem?

When we think of sadness versus happiness, we focus on the negative side of things.

what about people who are not distressed?

     E.g. people deviate from normal behavior, but does that make it abnormal? People who are manic can have a skewed perception of themself

distress

   more distressed a person is the more abnormal they can be, personal suffering defines abnormality

normative deviation

does behavior violate cultural / societal norms

e.g. shaving your beard was weird, if you were left-handed it was seen as bad luck or evil and kids were retained

-these things can change overtime

-CONEXT important

classification, why

a.     As humans we like to categorize things, we need cutoffs/thresholds for defining normal-abnormal, we want to be objective. Define/ classify abnormality can improve communication; reducing confusion. We. Need a consensus / working definition to make scientific process, make it easier for research or clinical work.

*on test: ways of defining abnormality is height and weight, natural variation and ranges,

what does a classification system do?

• summarizes much information in fewer dimensions (e.g. periodic element chart),  improves communication

• Clinicians can communicate better when there’s a classification

• helps new predictions; advance science

-can compare and contrast things, put a label

• Importance: is it an apple or an orange?

-makes it so we put apples and oranges in separate nuggets

-system used drives what we know at a certain time and what we don’t know

what are the challenges and controversies about calssifying human behavior?

Human behavior is complex and exists on a continuum, so putting people into fixed categories can be difficult. Classification systems can have overlapping disorders, cultural biases, stigma, and problems with reliability and validity. There is also debate over whether mental disorders represent distinct diseases or different combinations/severities of problems in living.

DSM history from 1-5

DSM: 1 (1952): try to standardize diagnosis after WW2

DSM II (1968): both narrative, jargony, low reliability, psychodynamic theoretical basis

DSM III (1980): different approach – improve reliability, introduced simplistic diagnostic criteria

-later on made revisions to classifications, overtime descriptions should change

DSM IV (1994)

DSM -5 (2013)

emil krapelin

·      Important historical figure: based on biological tradition

-strong viewpoint biologically through mental disorders

* categorical classification: each disorders has a clear cause, each disorders is different than another disorder, each disorder is different from normality.

* categorized “psychotic” people into manic and dementia praecoz (schizophrenia)

4 D’s of psychopathology

dysfunction, distress, deviance, dangerousness

dysfunction

• can you function on the daily

distress

• does it cause physical or emotional distress to the individual or people around them.

deviance

does it lead to judgments of abnormality, social cultural or historical context

dangerousness

• behaviors or feelings that can harm the individual or those around them

-suicidal thoughts or self harm

-kids hitting their parents

*At what point does this become significant? Is it different from person to person

jerome wakefield

• “A mental disorder is a mental condition that a) causes significant distress or disability, b) is not merely an acceptable response to a particular event, and c) is a manifestation of a mental dysfunction

harmful dysfunction

• a breakdown of one's emotional or behavioral function. You hallucinate or lose touch of reality. Being afraid when leaving the house

-failure of our faculties to function the way they were supposed to

thomas szasz

myth of mental illness

-conventional label

-social construct

-social phenomenon

-value judgment

-NOT suffering from mental illnesses, but rather from problems in living

conventional label

• just wants to label the behavior that society finds unwanted or unpleasant

social construct

• mental illness is a social construct and not a mental illness

social phenomenon

•  metaphor or strategy  for managing deviant behavior

value judgment

how we all judge things differently

reliability

measure gives same result each time, DSM IV big improvement; good reliability

validity

a.     measures what designs to measure

-reliability necessary for validity