PSYCH 257 Test One Content
Chapter 1:
What is abnormal?
Statistical infrequency
Far from the bell curve; standard deviation
Behaviours that occur rarely or infrequently
Can be found in an absence or an excess
Violation of norms
A behaviour that defies or goes against social norms; it either threatens or makes anxious those observing.
Ex. antisocial behaviour of the psychopath violates social norms and is threatening to others.
Personal suffering
A behaviour that creates personal suffering, distress, or torment in the person
Ex. panic attack during an exam that one is prepared for.
Disability or dysfunction
Refers to a breakdown in cognition, emotion and/or behaviour.
An individual who is unable to experience pleasure would have a breakdown in emotion
Unexpectedness
A surprising or out-of-proportion response to environmental stressors can be considered abnormal.
Pre-Scientific Inquiry
Mental disorders were believed to be caused by events beyond the control of humankind, such as eclipses, earthquakes, storms and fires.
“You’re mentally ill because you angered god.”
Hippocrates
The first to separate medicine and religion, magic and superstition.
Somatogenesis
Mental disorders are caused by abnormal functioning in the soma (physical body).
Psychogenesis
Mental disorders have their origin in psychological malfunctions.
Early Classifications of Mental Disorders:
Hippocrates classified mental disorders into epilepsy, mania, melancholia, and phrenitis or brain fever.
Imbalances in the four humours resulted in mental health conditions
Blood = changeable temperament
Black bild = melancholia
Yellow bile = irritability and anxiousness
Phlegm = sluggishness and dullness
The Dark Ages, Demonology and Witch Hunts
11th to 15th century
Return to supernatural theories of and treatments for mental disorders
“Mental illness can be political; back then, things were run by churches.”
13th centuries
Saw the advent of the belief that women (whom they called witches) with mental illnesses were possessed.
16th century
Weyer and Scot advocated that mental illnesses were not due to demonic possession but were silenced by the church.
Confiement in Asylums
12th Century, England and Scotland had 220 leprosy hospitals. As leprosy gradually disappeared, attention was turned more toward people with mental illness.
“The mentally ill are dangerous, we need to keep them off of our streets.”
“They were pointed at and laughed at”
Leprosariums were turned into asylums to contain the mentally ill, the poor, the homeless, the unemployed, and the criminal.
Moral Treatment
Philippe Pinel was the primary figure in the movement toward humanitarian treatments of the mentally ill. Believed patients should be treated with dignity. Along with Jean-Baptiste Pussin
treated patients as sick rather than as beasts
unchained them from their beds
provided light and airy rooms
permitted walks around the grounds
provided counsel and purposeful activity
If they were rich.
“Only if you’re good enough.”
Dorothea Dix
She discovered the negligence and campaigned vigorously and successfully to improve the lives of people with mental illness
Emil Kraepelin
Created a classification system to establish the biological nature of mental illnesses
Proposed two major groups of severe mental diseases
Dementia praecox (schizophrenia)
Thought chemical imbalance was the cause of schizophrenia
Manic-depressive psychosis (bipolar disorder)
Thought an irregularity in metabolism as the cause of manic-depressive psychosis.
General Paresis and Syphilis
Mid-1800s, progress was being made in terms of understanding senile and presenile psychoses and cognitive disabilities from a more biological perspective
In particular new information emerged about general paresis
Characterized by steady physical and mental deterioration, delusions of grandeur and progressive paralysis from which there was no recovery
Mental Health Care in Canada
Canada has had a universal health care system since 1970.
Each province/territory is responsible for administering health care.
Health-care reorganization and funding cuts have led to the closing of long-term psychiatric mental hospitals and beds on psychiatric hospital wards.
Community services are expected to take over some of these services.
Canada doesn't, and has never had, a great reputation for the care of people with mental illnesses
Week 2: May 14th
The Duplessis Orphans
There were many children of unwed mothers were taken away and put into orphanages
Children were falsely diagnosed with mental illness
They weren't allowed to go to school and had no exposure to the outside world
The church prioritized work instead of education
Many were deemed to have low IQs
The children underwent physical, mental and sexual abuse, which led them to become psychiatric patients
Deinstitutionaliztion
Between 1960 and 1976, the capacity of Canadian mental hospitals went from about 50000 beds to 15000 due to a cut in funding
There were many that were not trained in how to deal with psychiatric patients.
Transinstitutionalization
There were many more mentally ill people in jails and in prisons than in hospitals.
In 2004-2005 there were 300% more patients with serious mental illnesses incarcerated in jails and in prisons than in hospitals.
They were given phones, however, they were not given other tools to make their court days (mode of transportation, a charger for their phone(??), etc.)
The Current Role of Psychiatric Hospitals
Psychiatric hospitals “provide specialized treatment and rehabilitation services for individuals whose needs for care are too complex to be managed in the community.”
These services are super expensive :/
Chapter 2: Current Paradigms and Integrative Approaches
Stereotypes
Cognitive
Fixed overgeneralized and oversimplified beliefs about a person or a group of people based on assumptions about the group
How we cateforize and label
Prejudice
Affective
Negative and unjust feeling about individuals based on their inclusion in a particular group
Discrimination
Behaviour
negative and unjust treatment of individuals based on our stereotypes and prejudices
The Impact of Stigma:
Increased isolation and loneliness
Fear and rejection
Loss of self-esteem
Difficulty making friends
Denial of adequate housing, loans, jobs
Creates an unwillingness to seek help
Some stats:
What does Mental Illness Cost Us?
The estimated economic burden of serious mental illness in Canada is substantial
50 billion dollars per year
Critical Reports
Romanor Report (2002)
47 recommendations
Include some homecare services for case management and intervention services.
Develop a national drug agency.
Provide a emergency drug program to help those with severe mental illnesses
Establish a program to support informal caregivers who assist the mentally ill in critical times.
Kirby Report (2006)
2 key recommendations
Creation of the Canadian mental health commission
Creation of the 10-year Mental Health Transition Fund
National Mental Health Strategy
TEST QUESTION
Mental Health Commission of Canada released Changing Directions, Changing Lives in 2012
26 priorities and 109 recommendations for action, grouped under the following 6 Strategic. Directions:
1. Promote mental health across the lifespan in homes, schools, and workplaces, and prevent mental illness and suicide wherever possible.
2. Foster recovery and well-being for people of all ages living with mental health problems and illnesses, and uphold their rights
3. Provide access to the right combination of services, treatments and supports, when and where people need them.
4. Reduce disparities in risk factors and access to mental health services, and strengthen the response to the needs of diverse communities and Northerners.
5. Work with First Nations, Inuit, and Métis to address their mental health needs, acknowledging their distinct circumstances, rights and cultures.
6. Mobilize leadership, improve knowledge, and foster collaboration at all levels
What are Paradigms
Different ways of seeing or understanding a study
A set of basic assumptions, a general perspective that defines how to study a subject
Paradigms we cover:
The Biological Paradigm
Behaviour Genetics
Molecular Genetics
Neuroscience and Biochemistry in the Nervous System
Methods for Studies on Behaviour Genetics
Family Method
Index cases (goes from first person with difference and work backwards on the family tree), or probands
Twin studies
Concordance rates
Monozygotic twins (identical) concordance rate is higher than the dizygotic twins (fraternal) rate, the characteristic being studied is said to be hertable.
Equal environment assumption
Adoptees Method
Used to study a genetic presiposition among members of a family when children with abnormal disorders are adopted and raised apart
High frequency of panic disorder in children raised apart from parents who also have panic disorder whild support a genetic link.
Issues with Interpretation
Nature vs. Nurture
Do we have enough evidence that there is a genetically transmitted predisposition
Equal Envirnment Assumption
Environmental factors that partial causes of illmess are equally influential for MZ and DZ twins
The envirnmant isn’t identical but they would experience equivalent amounts of stress
The Nervous System
Nerve impulse
A change in the electric potential of the cell that travels down the axon to the terminal endings.
Synapse
The space between two neurons
Neurotransmitters
Chemical substance that allow a nerve impulse to cross the synapse
Reuptake
Some of what remains in the synapse is broken down by enzymes and some is pumped back into the preynaptic cell.
Generational Trauma
Evidence that trauma can be passed down biologically
Both the Holocacust survivors and their children had higher methylation increased risk of developing PTSD
Biological Aproaches to Treatment
Drug Therapy
Electroconvulsive Therapy (ECT)
Deep Brain Stimulation
Transcranial magnetic Stimulation (TMS)
Cognitive-Behavioural Paradigm
The Behavioural Perspective
Views abnormal behaviour as responses learned in the same ways other human behaviour is learned
Classical Conditioning
Unconditioned Response
The dog did not need to be tought to salivate**
Acquisition
The learning curve
The more pairing between the CS and US, the more likely the association will be learned
The most rapid acquisition followed by the strongest response is a half-minute delay between the CS and US
Extincition
Reduction of a conditioned response after repeated presentations of the conditioned stimulus alone
Spontaneous recovery
Re-emergence of a conditioned response some time after extinction has occurred
Operant Conditioning
Behaviour that is followed by positive consequences will be repeated
Behaviour that is followed by negative consequences will be discouraged.
Reinforcement
Positive reinforcement
Presentation of a pleasant consequence following a behaviour to increase the probability that the behaviour will reoccur
Negative reinforcement
The removal of an unpleasant stimulus after a response to increase the probability that the behaviour will reoccur
May 21st
Punishment
Positive Punishment
“Adding something”
Ex. Hitting someone, yelling, praise
Negative Punishment
“Taking away something”
Ex. taking personal items away
Behaviour Therapy
Counterconditioning
Relearning is achieved by eliciting a new response in the presence of a particular stimulus
Systematic Desensitization
progressing through a list of feared situations
Aversive Conditioning
pairing an attractive stimulus with an unpleasant event
Operant Conditioning
Time-out
Modelling
Assertion training
The Cognitive Perspective
Regard the learner as an active interpreter of a situation, with the learner’s past knowledge imposing a perceptual funnel on their new experiences
Schemas
Cognitive sets
New information may fit the schema, but if it does not, the learner reorganises the schema
Beck’s Cognitive Therapy
Aaron Beck developed cognitive therapy for depression based on the idea that a depressed mood is caused by distortions in the way people perceive life experiences
Beck’s therapy tries to help clients change their opinions of themselves (alter their negative schemas) and the way in which they interpret life events.
Albert Ellis: Rational-Emotive Therapy
Sustained emotional reactions are caused by internal sentences that people repeat to themselves
Self-statements reflect sometimes unspoken assumptions (irrational beliefs) about what is necessary to lead a meaningful life
“I’m useless”
“I need to do everything right all of time”
“If I’m not perfect no one will love me”
Rational-Emotive Therapy
The goal is to eliminate self-defeating beliefs and assumptions that lead to disordered emotions, behaviours, and thinking
Point out irrational assumptions
Model the use of alternative assumptions
Uses cognitive restructuring
Effective for anxiety and assertiveness problems
Some therapists will argue with, cajole, or tease clients, others are much more subtle in their approaches
Cognitive-Behavioural Therapies
Cognitive-Behavioural Therapy (CBT)
Incorporates theory and research on cognitive and behavioural processes and represents a blend of cognitive and learning principles
Cognitive restructuring
A general term for changing a pattern of thought that is presumed to be causing a disturbed emotion or behaviour
Criticisms
Just because principles of learning can change a behaviour doesn't mean it was learned the same way
How does observation lead to learning?
More research is needed to better understand schemas
Unclear differences between behaviour and cognitive influences
Contributions
CBT has been found to be beneficial
Evidence that it helps improve symptoms of depression and anxiety and can help people with eating disorders, autism, and schizophrenia
can be more effective long-term than are antidepressants
Psychoanalytic Paradigm
Id (Devil)
Basic instinctual drives
Eating, sleeping, sex and comfort
Present at birth, largely unconscious
Pleasure principle
Ego (Referee)
Satisfies the id while complying with constraints on behaviour
Develops due to learning
Rational, problem-solving force
Works consciously and unconsciously
The mediator between the id and the superego
Superego (Angel)
Operates roughly as the conscience
Develops throughout childhood
Develops as we observe and internalize the behaviours of others in our culture
Anxiety and the Psychoanalytic Paradigm
Objective anxiety
When one’s life is in jeopardy one feels objective anxiety; the ego’s reaction to danger in the external world
Neurotic anxiety
A feeling of fear that is not connected to reality or to any real threat
Moral anxiety
Arise when the impulses of the superego punish an individual for not meeting expectations and thereby satisfying the principle that drives the superego–namely, the perfection principle
Defence Mechanisms
Unconscious strategies used to protect the ego from anxiety
Examples:
Repression
Which pushes unacceptable impulse and thoughts into the unconscious
Denial
Denying a traumatic experience and punching it into the unconscious
Projection
Attributing one’s own unacceptable through, feelings, or impulses
Displacement
Redirecting emotional responses from the original source to a substitute target that is less threatening
Reaction formation
Acting or feeling a way opposite to how we really feel
Regression
Retreating to the behavioural patterns of an earlier age
Rationalization
Inventing a reason for a unreasonable action or attitude
Sublimation channeling or redirecting socially unacceptable impulses or instincts into socially acceptable and constructive outlets
Psychoanalytic Therapy
An insight therapy that attempts to remove the earlier repression and help the client face the childhood conflict, gain insight into it, and resolve it in the light of adult reality.
Free Association
Resistances
blocks to free association where the client may suddenly become silent or change the topic
Dream analysis
Latent content (symbolic content)
Some key components of psychoanalytic therapy:
Transference
Countertransference
Interpretation
Used as individual, group, or brief therapy
Criticisms
Theories based on anecdotes during therapy sessions are not grounded in objectivity, thus, not scientific.
Freud’s observations, recollections could be unreliable
Contributions
Childhood experiences help shape adult personality
There are unconscious influences on behaviour.
People use defense mechanisms to control anxiety and stress.
Valid research shows the effectiveness of psychodynamic therapies
Humanistic Paradigm
Client-Centered Therapy
Based on following assumptions
People can be understood only from the vantage point of their own perceptions and feelings (phenomenological world).
Healthy people are aware of their behaviour, are innately good and effective, and are purposive and goal-directed.
Therapists should not attempt to manipulate events for the individual.
Create conditions that will facilitate independent decision-making by the client.
Key features
Unconditional positive regard
Empathy
Criticisms
Therapists inferences of the client’s phenomenology (world) may not be valid
Assumption not demonstrated: People are innately good and would behave in satisfactory and fulfilling ways if faulty experiences did not interfere.
Self-awareness does not necessarily lead to change
Adverse Childhood Experiences (ACEs)
Looks at negative, stressful, traumatizing events that occur before the age of 18 and confer health risk across the lifespan.
Exposure to toxic stress during childhood can lead to negative health outcomes in adulthood
As the number of ACEs increase so does the risk for negative health outcomes
Parenting Styles
AuthoritaTIVE (v for LOVE)
Warm, sensitive to child’s needs, nurturing; makes reasonable demands and encourages appropriate autonomy.
Discipline is used in conjunction with reason and warmth.
Authoritarian
Cold, rejecting; makes coercive demands; frequently critical of child
Children respond to the perceived harshness of their parents with externalizing problems or internalizing problems
Permissive
Warm, accepting, but overindulgent and inattentive
This is associated with internalizing and externalizing symptoms including disobedience, impulsivity, and overdependence on adults
Uninvolved
Emotionally detached and depressive; little time or energy for child rearing
Parental Mental Illness
Small but significant associations between maternal depression and higher levels of internalizing symptoms, externalizing symptoms, and general psychopathology among their children
Peers and the Broader Social Environment
Two key elements
Peer status
Peer victimisation
Popular children tend to be better adjusted than children who are less popular.
Negative peer status led to loneliness, which in turn predicted depression
Stockholm Birth Cohort study found sixth grade peer status predicted anxiety and depression 30 years later for women, not for men
Mental Illness in Minority Groups
Indigenous peoples make up 4% of the Canadian population but have proportionally higher levels of mental health problems
Hutterites in Manitoba live in isolated, religious communities have remarkably low levels of mental illness
A Statistics Canada report indicated that immigrants had comparatively lower rates of depression and alcohol dependence than Canadian-born members of the population
The healthy immigrant effect was stronger among recent arrivals than among those who had been living in Canada for some time
Integrative Paradigms
Diathesis-Stress Paradigm
Focuses on the interaction between predisposition toward disease (diathesis) and environmental, or life, disturbances (stress)
Possessing the diathesis for a disorder increases risk but does not guarantee it will develop.
Biopsychosocial Paradigm
Explanations for the causes of disorders typically involve complex interactions among many biological, psychological, and socio-environmental and sociocultural factors
Both paradigms emphasize the interplay among the biological, psychological, and social/environmental perspectives
Risks and Protective Factors
Risk Factors
Factors that interact to put people at greater risk of—or make them more vulnerable to—developing disorder
Protective Factors
Factors that if present, can help protect individuals from developing disorders
Resilience
The ability to bounce back in the face of adversity