Psych notes : 238 UIUC

Psychopathology : the suffering of the mind

Understanding major historical views on causes and treatments

Middle ages

• Seen as a battle between good vs. evil medieval forces

• Treatment was often left to key religious figures as many thought it was “banishing evil spirits”

• Treatments

  • Trepining : drilling holes into the head

  • any type of holy thing

• A lot was also based on the movement on the sun and moon

Medical/Biological

• Hippocrates : treated psych disorders as medical problems. Developed 3 classifications

  • Mania

  • Melancholia/Depression

  • Phrenitis (brain fever)

• Plato : insanity defense and madness disease

• Galen : put the nervous system into humors

  • Humoral theory of mental disorders: if the humors were out of balance, you would have a mental disorder

    • blood

    • black bile

    • phlegm

    • yellow bile

• 19th century “Alientst” / psychiatrists

  • treated the alienests

  • early day psychiatrists

  • Believed that emotional problems came from expending too much energy/excess living

    • Exhausted nerves

    • “Nervous breaking”

    • Connected the cause of mental illness to treatment

• Historical treatment

  • Asylums housed those who needed treatment

    • had really bad conditions and treated patients badly

    • Bedlam was an asylum in London known for it’s particularly bad treatment and showcased ill patients to the public

    • patients couldn’t lie down, had poor food, bad sanitation, and poor bedding

  • Humanitarian movement

    • Pinel: treated patients with kindness, allowing for visitors, sunlight, and movement

    • lead to improvement

    • moral managment

      • focused on character

      • social, individual, and economic needs

    • mental hygeine : more focused on intervention

  • General paresis and syphilis

    • paresis is just syphilis of the brain, represented by psychotic symptoms

    • Paresis vs. Psychosis - they have different courses of illiness

      • Paresis : dies 2-5 years after diagnosis

      • Psychosis : can live a stable life

    • Van Krafft Ebing inoculated paresis patients with syphilis

      • they treated syphillis with malaria

      • showed that psych problems can be treated like medical problems

Psychological approaches

• 1700-1800

  • Franz Mesmer : hypnosis as treatments, also said planets effect magnetic forces in the body and that hypnosis helped solve that

  • Jean Charcot : began looking for the psychological cause of mental disorders

  • Breuer & Freud

    • Both had heavy focus on the unconscious mind.

    • Breuer - hypnosis helped people talk about their issues and treat the problem

      • patients were to talk freely under hypnosis

    • Freud - psychoanalysis, everything that was happening was in your unconcious mind

      • structure of the mind

      • defense mechanisms

        • Denial

        • Displacement

        • Projection

        • Rationalization

        • Reaction formation

        • Repression

        • Sublimation

      • memories and disorder

      • free associations and dream analysis

      • psychosexual stages of development

• 1900s

  • Wundt : first psychology lab

  • Skinner : operant conditioning

  • Pavlov : classical conditioning with the dog and bell

  • Beck & Ellies : cognition

    • Beck’s work led to the development of schemas

      • Schema : how our brain processes stuff through pre-built ideas

    • Ellis’s work led to rational emotive behavior therapy which became the foundation of CBT

      • rational emotive behavior therapy helps identify bad thoughts or behaviors and address them

How has classifying mental disorders changed? How are they changing? How do they inform the future?

• Kraeplein - father of psychiatry

  • bioloigcal concepts and medical concepts together

  • found mood disorders and psychosis

• The need for a definition

  • it helps with communication and reduces confusions

  • serves as a classification including cutoffs and thresholds for normal vs abnormal

• Ways of defining

  • Categorical - normal vs abnormal

  • Dimensional - spectrum based

  • Prototype - mixture of the two above

    • focuses on essential characteristics

  • Implications

    • it can spread stimaga

    • definitions are hard to draw the line on

    • can imply undesireability

• DSM

  • Looks at dysfunction, distress, deviance, and dangerousness

  • Syndrome : clinical assumptions that go together

  • describes the disorder or behavior, NOT the cause

  • DSM 1

    • standardized diagnosis for the first time

    • 1952

  • DSM 2

    • expanded but was still really jargony

    • 1968

  • DSM 3

    • imrpoved reliablility

    • 1980

• Issues

  • Comorbidity - multiple different disorders

    • makes diagnosis difficult

  • Accuracy

  • Reliability