1a: Mental Illnesses

Introduction to Psychopathology

  • Distinction between explaining (causes) and understanding (experience) of mental illness.

  • Scientific exploration of mental illness involves:

    • Aetiology: The study of causation or origination.

    • Progression: The development of symptoms over time.

    • Symptomology: The study of symptoms associated with mental disorders.

    • Classification: Categorizing different types of mental disorders.

    • Treatment: Approaches to manage and alleviate mental disorders.

  • Abnormal behaviors defining a mental disorder are considered a product of dysfunction or illness within an individual.

    • abonormal behaviour = product of dyfunction/illness

  • Reference: Dr Karl Jaspers, General Psychopathology (Allgemeine Psychopathologie), 1913.

Historical Context of Abnormal Behavior
Prehistoric Period

  • Belief in demonic possession, ancestral spirits, and sorcery as explanations for abnormal behavior.

Greco-Roman Era

  • Shift toward naturalistic explanations with emphasis on observation.

  • Attribution of abnormal behavior to organic causes (i.e., brain pathology).

Middle Ages

  • The Catholic Church influenced a return to supernatural explanations for mental illness became more popular again.

Renaissance

  • Emergence of humanism (opposes supernatural opinions) and a focus on human welfare, contrasting with witchcraft trials.

Reformation and Enlightenment

  • Moral treatment movement led to improved care for individuals with mental illness, emphasizing humane treatment.

  • advocating humane treatment for individuals with mental illness

Development of Asylums and Reform Movements

  • Lunacy Reform Movement: Aimed to improve conditions for the mentally ill.

  • Establishment of mental hospitals with a focus on treatment.

  • Key legislative acts:

    • Lunacy Act, 1845: Established guidelines for the care of the mentally ill (patients and not inmates).

    • County Asylums Act, 1845: Provided for the establishment of asylums in counties.

  • Historical asylums mentioned:

    • Bethlem/Bethlehem in Bishopgate (1247-1676): One of the first mental hospitals.

    • General Lunatic Asylum (1812-1902): Focused on treatment of the mentally ill.

    • Friends Hospital (1813-present): An ongoing institution for mental health treatment.

Difficulty in Defining Abnormality

  • Challenges posed to Western definitions of mental illness, exemplified by Jane Murphey's 1976 study that sought cultural understanding of the term.

  • Study question: "What words do you have to talk about mental illness?"

why do we want to define abnormal behaviour?

  • to describe the behaviour

    • identifying behaviours that causes distress or dysfunction (diagnosis)

  • to explain causes

    • clarify the cause of abnormal behaviour and associated experiences

    • causation leads to better and targeted treatment

  • to predict behaviour

    • inform likely patterns of behaviour to estimate impact and needs

  • to control and induce change

    • attempts to change the behaviour and reduce burden

Examination of Abnormal Behavior Criteria

  • There is no single criterion to define abnormal behavior, but several criteria have been proposed to aid its conceptualisation:

    • Statistical Rarity: Characteristics that are less common in the population and can have both positive and negative connotations.

    • Deviance: The cultural relativism perspective claims that abnormal behaviors can deviate from social norms.

    • Influencing factors may include:

      • History

      • Subculture

      • Age and gender differences

      • Situation and context

    • Distress: Involvement of subjective psychological distress associated with abnormal behaviors.

      • may not always be visible to others

      • absence of distress does not mean absence of disorder

    • Dysfunction: Abnormal behaviors interfere with an individual's daily functioning, influencing social roles such as work and family life, and can be adaptive or maladaptive.

    • Danger: Assessment of potential harm to oneself or others often intertwines with dysfunction and involves risk assessment.

Understanding Mental Disorder

  • Mental Disorder: Defined as a clinically significant disturbance that leads to distress and/or dysfunction in an individual.

  • Recent findings from the Australian National Study of Mental Health and Wellbeing (2020-2021):

    • 43.7% of individuals reported experiencing a mental disorder at some point in their lives.

    • 21.4% reported experiencing a mental disorder in the past 12 months.

Mental Illness Prevalence and Burden
Disability Adjusted Life Years (DALYs)

  • Definition: Daily Adjusted Life Years (DALYs) represent the total number of years lost due to illness, disability, or premature death.

  • The estimated count of DALYs attributable to mental disorders in 2019: 418 million, constituting 16% of global DALYs (Arias et al., 2022).

Burden of Disease Study (2018)

  • Key findings regarding mental and substance use disorders:

    • Ranked as the fourth largest contributor (13%) to the total burden of disease, falling behind cancer (18%), cardiovascular disease (14%), and musculoskeletal conditions (13%) (AIHW, 2021).

    • Contributed to 24% of the non-fatal total burden of disease in Australia, only exceeded by musculoskeletal conditions (25%) (AIHW, 2021).

  • Notable assertion: High prevalence does not correlate with high burden, and vice versa.

Mental Health Comorbidity

  • Approximately 94.1% of individuals with a mental and behavioral condition also report coexisting long-term health conditions, according to the ABS National Health Survey: Mental Health and Co-existing Physical Health Conditions, Australia (2014-15).

summary

  • 5 ways of exploring psychopathology

  • history