Psychopathology in Historical Context

Who works in psychopathology?

  • Clinical psychologists

    • Assess, diagnose, therapy

    • Cannot prescribe medication

  • Counselling psychologists

    • Study/treat adjustment, vocational issues

  • Psychiatrist

    • Biological view

    • Can prescribe medication

  • Psychiatric social worker

    • Collecting info on social/family

  • Psychiatric nurses

    • Part of treatment team

What is a scientist practitioner?

  • Consumer of science, evidence based practice

  • Evaluator of practice, practice based evidence

  • Research producers, conduct research in hospitals, clinics, universities, etc.

Terminology

  • Presenting problem → why are they coming to the clinic

  • Clinical description → what makes the disorder different from day to day behaviours/feelings

  • Course → chronic vs episodic

  • Onset → what age did this start happening, acute vs insidious

  • Prognosis → what is the probable outcome

  • Prevalence → how many people have this disorder

  • Incidence → new cases during a given period

  • Sex ratio → proportion of males and females with disorder

    • Trans and gender diverse people understudied

    • Gender bias

  • Etiology → the study of origins

    • Genetics

    • Environmental

    • History of trauma

    • Bio, psycho, social

Supernatural tradition

  • 1400s

  • Unusual behaviour work of devil, witches

  • Inhumane treatment

    • Exorcism

      • Beating

      • Heat

      • Confinement

      • Making the body inhabitable

  • Psychological disorders caused by stress

  • Very community oriented, people supporting each other

  • Divine punishment

  • The moon and the stars causing symptoms

    • “Lunatic”

Biological tradition

  • Hippocrates → can be treated like other diseases

  • Importance of psychological and interpersonal contributions

  • Galen → four bodily fluids

    • Black bile → depression

    • Blood → insomnia and delirium

    • Phlegm → apathy and sluggish

    • Yellow bile → hot temper

  • Treatment

    • Regulate environment

    • Blood letting

    • Induced vomiting

  • Hysteria

  • Syphilis → late stage manifests as psychosis symptoms

  • Dr. John Grey

    • Psychological disorders always have physical causes

    • Recommended rest, diet, environmental changes

    • Led to more “humane” hospitals

Moral therapy

  • Philippe Pinel

  • Encouraged more humane treatment of peopel

  • Development of asylums

  • Mid 19th cent. humane treatment declined

  • Too many patients per institution, exceeded staffing

  • Bio essential views

  • Dorothea Dix → mental hygiene movement

  • Anton Mesmer → “animal magnetism”

    • Magnetic forces in body that can be blocked

    • Benjamin Franklyn did studies against this

Psychoanalytic theory

  • Structure of the mind

  • Id → illogical, emotional, irrational, driven by pleasure principle

  • Ego → logical, rational, driven by reality principle

  • Superego → conscience, driven by moral principle

  • Defence mechanisms

    • Unconscious mechanisms

    • Denial, projection, rationalization, reaction formation, repression, sublimation

Humanistic theory

  • Carl Jung and Alfred Adler

  • Removing barriers to both internal and external growth helps individual naturally improve and flourish

  • Carl Rogers → client-centred therapy, therapist has passive role

Behavioural model

  • Pavlov and classical conditioning

  • Watson, Little Albert

  • Mary Cover Jones → if fears are learned, they can also be unlearned

  • Systematic desensitization

    • Gradual exposure to the fear

  • B. F. Skinner and operant conditioning

    • Reinforcement

    • Shaping behaviour

21st century

  • Cognitive science

  • Neuroscience

  • Behavioural and molecular genetics