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concerned with understanding the nature, causes, and treatment of mental disorders

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Abnormal Psych

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when a disorder runs in the family (e.g. Monique's family also have drinking issues)

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family aggregation

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we do not, and probably will never, know. However some elements and indicators help. Suffering, Maladaptiveness, Statistical Deviancy, Violation of the Standards of Society, Social Discomfort, Irrationality and unpredictability, dangerousness. Usually abnormal behavior involves social judgments and are based on values and expectations of society at large. CULTURE is a huge part of it (e.g. murder a woman for premarital or extramarital relationships?). AND CULTURE CHANGES! e.g. homosexuality or pierced bodies.

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What is the definition of a disorder?

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if psychological pain. But, if manic episodes? is patient suffering? And what about normal suffering? Suffering is not sufficient or a necessary condition of mental disorder

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Suffering as an indicator of mental disorder

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interferes with wellbeing or with ability to enjoy work or relationships. Does the possible disorder interfere with their life? But what about antisocial personality disorder? is their behavior maladaptive to them? probably not, but might be for society (e.g. con artist)

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Maladaptiveness as indicator of mental disorder

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statistically rare behavior is abnormal. But... a genius or someone with perfect pitch is not "abnormal." And what about illnesses (e.g. common cold) that affect MANY people?

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Statistical Deviancy as indicator of mental disorder

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if break cultural rules/laws/moral standards? But many are arbitrary. Still consider not following norms to be abnormal. But... driving a car is seen as not normal for amish. Depends on magnitude of violation and how often it's violated by others. If not following rules = statisticaly common (like parking illegally), then not abnormal. But mother drowning child is definitely abnormal.

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Violation of the Standards of Society as indicator of mental disorder

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violates social rule and others feel uncomfortable. You just kind of know if something is abnormal

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Social Discomfort as indicator of mental disorder

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if unpredictable behavior, abnormal. Like someone screaming and yelling for no apparent reason. Can the person CONTROL their behavior? Is it out of CHARACTER?

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Irrationality and Unpredictability as indicator of mental disorder

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if danger to himself or other. But... need more than just this (e.g. is soldier in combat mentally ill? bad driver mentally ill?). Also, do you have to have a mental disorder to be dangerous? No. Serious crimes are committed by normal people too. And you can have a mental disorder and not be dangerous as well. Dangerousness is more of an exception than a rule.

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Dangerousness as indicator of mental disorder

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most sciences rely on classification. but mostly, provides us with NOMENCLATURE and enable us to STRUCTURE INFO in a more helpful manner. Also allows us to study different disorders. And can help us treat people more effectively. Also, social and political implications. Furthermore delineates which types of psychological difficulties warrant insurance reimbursement.

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Why classify mental disorders?

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classification is shorthand, so LOSE INFO. The person and their personal history is more than a diagnosis. We lose the personal details. Also, STIGMA associated with mental disorder. there is real or imagined fear that speaking candidly about having a psychological disorder will result in unwanted social or occupational consequences or discrimination. Also, STEREOTYPING. we have ideas about what mental disorders are and how people will behave if they have one. Less competent? irresponsible? dangerous? unpredictable? Also, LABELING. a person's self-concept may be affected by being given a classification of a mental disorder. The diagnosis can be hard to shake. Classification should not classify people, but rather the disorders that people have. People are not defined by their illness. somebody is not a schizophrenic, he or she is a person with schizophrenia. Person is not the diagnosis

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Disadvantages of Classification

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Contact with people from that stigmatized group.

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How to reduce stigma

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Christian cultures afraid of number 13, Japanese afraid of number 4. No word for depressed in certain Native American, Alaska Native, or Southeast Asian cultures. How disorders present themselves may differ based on culture. Some people in other cultures focus on physical rather than emotional pain. Most of the literature is Euro-American and research published in non English tends to be disregarded.

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How does culture affect what is considered abnormal?

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taijin kyofusho is an anxiety disorder that is prevalent in Japan. fear that one's body may offend, embarrass, or otherwise make others feel uncomfortable. ataque de vervios is common in Latin cultures. often triggered by stressful events include crying, trembling, uncontrollable screaming, and feeling of loss of control. Possible aggression. May faint or have seizure like fit. Once fit is over, little or no memory of incident.

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Cultural-Specific Disorders

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generally hearing voices, laughing at nothing, defecating in public, drinking urine, and believing things no one else believes are universally considered abnormal.

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Universal Abnormality

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study of the distribution of diseases, disorders , or health related behaviors in a given population. Mental health epidemiology is the study of distribution of mental disorders.

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Epidemiology

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refers to the number of active caes in a population during any given period of time

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Prevalence

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refers to the estimated proportiona of actual, active cases of the disorder in any given population at any given point in time.

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Point Prevalence

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count everyone who experienced depression at any point throught the entire year.

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1 year prevalence figure

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estimate of number of people who have had a particular disoder at anytime in their lives.

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lifetime prevfalence

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number of new cases that occur over a given period of time (usually a year).

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incidence

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major depressive disorder, alcohol abuse, specific phobias. Social phobias are also very common.

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Most common disorders

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term used to describe presence of 2 or more disorders in the same person. Especially high in people with severe forms of mental disorders. e.g. drinking excessively and depressed and anxious. If condition is mild, usually exception.

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Comorbidity

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those short in duration

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acute disorders

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those long in duration

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chronic disorders

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causes of disorders.

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etiology

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takes placei n clinics, hospitals, schools, prisons, naturalistic observaitons of homelessness, etc. They can be case studies - prone to bias because writer selects info to include and what to omit. They have low generalizability (they cannot be used to draw conclusions babout other caes even when those cases involve people wit ha seemingly similar abnormality). Self Reported Data - questionnaires, interviews. Can sometimes be misleading becuaes peeps may not be good reporters on their own experiences. people lie or misinterpret question or desire to be liked. Direct Observation - watch behavior and/or look at physical symptoms like heart rate. Look at hormones. Could be fMRI, TMS, etc.

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Abnormal Psych Research

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the extent to which we can generalize our findigns beyond the study itself. Would need to involve both males an females, all ages, incomes, education, etc.

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External Validity

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reflects how confident we can be in the results of a particular given study. Is it methodologically sound? Free of confounds, sources of error?

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Internal Validity

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Also called COMPARISON GROUP. group of people who do not exhibit disorder but comparable to all other major respects to the CRITERION GROUP (people with disorder)

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Control Group

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reflects the size of the association between two variables independent of the sample size. if = 0, then no association between the variables. Independent of sample size.

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effect size

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try to colelct info about how patients behaved before disorder to try to indentify factors.

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Retrospective research

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looking ahead in time. Look at people with higher than likilood of becoming psychologically disorderede and to focus research attention on them before any disorder manifests.

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Prospective Researfch

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different phasses of intervention. A is baseline condition. collect data on or from participant. B phase introduce treatment. Then withdraw treatment to see if change in behavior was really from treatment. To see if change in behavior is attainable again, reinstate treatment in second B phase.

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ABAB design

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animal studies usually. Study not the true item of interest, but an approximation of it. May also involve humans (study depression by studying healthy, but sad, research participants).

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analogue studies

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he was like. Guys. It's not possession. It's science. mental disorders, like other diseases have natural causes and should have appropriate treatments!

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Hippocrates

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he was like I've studied these individuals and they were in some "obvious" sense, not responsible for their acts and should not receive the same punishment as normal people.

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Plato

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Chinese dude. believed stressful psychological conditions could cause organ pathologies. He utilized both drugss and the regaining of emotional balance through appropriate activities for treatment.

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Chung Ching

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during last half of the middle ages, cases of group hysteria. Dancing manias, whole groups of people affected simultaneously. e.g. TARANTISM - a disorder that included an uncontrollable impulse to dance. later spread to Germany and rest of europe where it was known as SAINT VITUS'S DANCE. Lycanthropy - a condition where people believed the ywere possessed by wolves. This was a time of social disorganization with black death, oppression, famine, etc. Probably relateed to depression, fear, and wild mysticism during this period. Today, mass hysteria occurs occasionally.

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mass madness

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treatment for witchcraft/possession. Usually mentally disturbed treated with kindness. Treatment = prayer, holy water, sanctified ointments, touching relics, and mild forms of exorcisms.

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Exorcisms

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physician and was like dude. dancing mania is not possession. It's like totally a disease. And let's treat it thus. Postulated conflict between instinctual and spiritual natures of human beans, formulated the idea of psychic causes for mental illness, and advocated treatment by bodily magnetism (i.e. hypnotism). but.... he thought astrology had a lot to do with it. so, "lunatic" is a thing now.

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Paracelsus

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from 16th century onward. Sanctuaries/places of refuge for mentally ill. Started as way to remove society of troublesome individuals. They were usually really crappy and filled with filth and cruelty.

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Asylum

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London asylum created by Henry VIII. Became widely known for deplorable conditiosn and practices. Violent patients exhibited to public for a penny a look. Harmless inmates forced to seek charity on streets.

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Bedlam

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asylum in Vienna. doctors and keepers lived in square rooms and patients were confined in spaces between walls of rooms and outside towere where they were put on exhibit for fee. Inmates treated like beasts.

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Lunatics Tower

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not better than Europe. philosophy of treatment involved belief that patients needed to choose rationality over insanity. Treatment techniques were agressive and aimed at restoring physical balancei n body and brain. Intimidate patients.

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US Asylums

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french reformer. in charge of asylum in Paris. Got permission to remove chains from some inmates as experiment in treating mental patients with kindness and consideration (as sick people, not beasts). Might have lost head if experiment failed. But it was a great success! chains removed, sunny rooms, permited to excercise, kindness. order and peace.

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Philippe Pinel

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English quaker established the York Retreat. Country house where mental patients lived, worked, and rested in kindly religious atmosphere. Quakers believed in treating all people with kindness and acceptance. His retreat has continued to provide health treatment for over 200 years.

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William Tuke

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Passed in England and required every county to provide asylum to paupers and lunatics. Policy of more humane treatment was substantially expanded to colonies.

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Country Asylums Act of 1845

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founder of American psychiatry. Associated with Pennsylvania Hospital and encouraged more humane treatment of mentally ill. First american to organize cours in psychiatry. Still, medical belief tainted by astrology and bloodletting and purgatives. invented Tranquilizing Chair which was pretty torturous.

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Benjamin Rush

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wide ranging method of treatment that focused on patients social, individual, and occupational needs became widespread. began in Europe and then moved to America. emphasized patients moral and spriitual development and their character rather than disorders. higher degree of affectiveness. A lot of success but abandoned by latter part of 19th cent. this was partially due to immigrant prejudice and failure of training new people.

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Moral Management

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part of reason for demise of moral management. Advocated almost exclusively on physical wellbeing of mental patients. Comfort levels improved, but no help for mental patients. Advances in biomedical science also contributed to demise of moral management and rise of mental hygiene movement. Looking for biological cures.

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Mental Hygiene Movement

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experimented with electricity. among earliest efforts to explore electric shock to treat mental illness.grew out of his observations that a severe shock he had experienced altered his memories. thought might work with meloncholia. Another physician experienced the same thing and called for clinical trials. But it wasn';t until 1938 that electric shock was first used as treatment.

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Benjamin Franklin

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important driving force inin humane treatment for psychiatric patients. Taught in jails and asylums as teacher. Based on what she saw, she started campaign that aroused people and legislatures to do something about inhuman treatment accorded the mentally ill. Reformed asylum system both in the US and many other countries! Credited with establishing 32 mental hospitals. Critics say that housing so many patients in instututions away from society interfered with the treatment of the day (moral therapy) and deferred search for more appropriate and effective treatments for mental disorders. However, her advocacy of humane treatment of mentally ill stood in stark contrast to treatment common at time.

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Dorothea Dix

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Mary Jane Ward published influential book in 1946. Called attention to plight of mental patients and helped create concern over need to provide more humane mental health carei nt he community in place of the overcrowded mental hospitals.

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The Snake Pit

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organized in 1946 and provided active support for research and training through psychiatric residencies and later clinical psych training programs.

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National Institutes of Mental Health

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movement in latter part of 20th century to move away from mental hospitals to more humane and community based treatment for mental illness. This was also accompanied by advances in drugs. Many hospitals were closed and the number of patients in them dramatically decreased. However, it has also created great difficulties for many psychologically disturbed people and for many communities as well. It is an international movement. Many professionals were worried that the mental hospital allowed for people to become permanent refuges and settle into a chronic sick role with a permanent excuse for letting others take care of them. Hope that new medications would promote healthy readjustment. But many former patients have not fared well in community living. there has seemed to be an "abandonment" of chronic patients to a cruel and harsh existence. Failure of society to develop ways to fill gaps in mental health services in the community.

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deinstitutionalization

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