15.1 The history of clinical psychology and mental disorder diagnosis Flashcards
clinical psychology
the area of psychology devoted to understanding and treating mental disorder
Trepanning
hole is drilled into a persons skull to release evil spirits
-in the middle ages, mental disorder was thought to arise from possession by evil spirits
excorcisms
-common treatment for mental disorder which amounted to ritualized torture
later , mental disorder became views as having ________ _____
biological cause, like physical diseases
- led to the establishment of large psychiatric hospitals, or asylums such as London’s bethlehem hospital
- despite this change, treatments of mental disorder remained cruel and ineffective
caging
for restricting movement
birching
for beating the disorder out of people
the tranquilizer
for minimizing sensory inputs
water therapy
to spray the disorder out
rotational therapy
to shock and vomit the disorder out
bloodletting
to remove bad blood
philippe pinel and dorothea dix
the moral treatment
the moral treatment
reformers like pinel and dix shamed society into ensuring that residents in mental institutions were treated humanely and compassionately
institutionalization
by the 1950s public opinion shifted against institutionalization
in 1950, about 66000 Canadians were permanent residents of psychiatric hospitals
Chlorpromazine
an antipsychotic medication
seemed effective at eliminating the worst symptoms
deinstitutionalization (1955-1985)
over 30 years, the population of mental institutions dropped by 80% contributing to a dramatic increase in urban homelessness
The medical model
approach focuses solely on reducing mental disorder symptoms but the root causes of mental disorder are far more complicated than that
the biopsychosocial model
the model of viewing psychological issues -psychological -social -biological all these play a factor
statsitical abnormality
cannot provide the sole basis for defining mental disorders
-defining mental disorder based on what has been statistically normal in the past would identify some clearly insane attitudes and activities as perfectly fine
maladaptive
a persons behaviours, feelings, or thoughts are maladaptive if they cause a person or those around them significant distress, impair a persons daily functioning, or increase the likelihood that the person or those around them will experience harm or injury
maladaptive definition has problems
since activities that would not be considered mental disorders might well cause distress to others in a persons life, might also increase a persons injury risk
1840 census
included questions about which citizens fell into the category of idiocy/insanity
- mental disorder diagnoses are sometimes political and corrupt
- -the insane category in this time was used to classify many free black americans as insane, as a way to justify the institution of slavery
Psychiatry rose to considerable prominence during world war II
based on mental disorders identified by military psychiatrists and the world health organization, in 1952, the american psychiatric association published the first ed of the diagnostic and statistical manual of mental disorders (DSM-1)
- after a few other revisions, the APA published the DSM-IV in 1994, which provided details about 350+ mental disorders
- DSM-5 was published in 2013
DSM-5
-describes the number and type of symptoms that define each mental disorder
-describes the typical etiology (or cause of each disorder
-provides details about the typical prognosis (or expected progression of symptoms) for each order
the DAM sys is beloved by some but also receives much criticism
DSM problem
- different therapists will often generate different diagnoses for the same person
- What is viewed as a mental disorder changes as our culture changes across time (earlier DSM listed homosexuality as a mental disorder)
* instead of scientific evidence, what is viewed as a mental disorder has also been determined by current social values, popular attitudes, and exploitation
* previously, any amount of masturbation was though of as a symptom of mental disorder
* Drapetomania was considered a mental disorder in US in mid 1800s-(slaves who wanted to run away from their owners) - labelling someone with a mental disorder might make their problems seem permanent and unchangeable and might take away the motivation to address the root causes of mental problems
* receiving a mental disorder label can also lead ppl to avoid social interactions bc they fear that the stigma against those with mental disorder will cause others to be uncomfortable around them
* eliminating the stigma against people who have a mental disorder would significantly reduce the severity of mental disorder symptoms, especially since ppl with mental disorders are actually far more likely to be victims of crime than to commit crimes - some diagnoses might be a way to justify controlling inconvenient behaviour with medications, rather than representing an actually mental disorder
- the number of symptoms that a person must have to receive a disorder is arbitrary and determining who does vs does not have a disorder symptom can be very subjective
David rosenham
tried to get admitted into a psychiatric hospital and researched ppls behaviour toward them (how long would it take for workers to diagnose them without a mental disorder when they act as normal as they can)
-being sane in insane places
mental disorder defence
explaining criminal actions as a consequence of an extreme and abnormal state of mind, preventing an individual from recognizing that the actions were illegal or immoral
- ex. in 2008 vince li killed tim mclean on a greyhound bus not fare from portage la prairie. a judge ruled that his actions were the result of schizophrenia and that he was not criminally responsible
- this is a very rare case, since defense lawyers only make this defense in
