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Abnormal Psychology > 2 - Historical & Contemporary Views of Abnormal Behaviour > Flashcards

2 - Historical & Contemporary Views of Abnormal Behaviour Flashcards

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0
Q

What was in the Edwin Smith papyrus?

A
  • detailed description of treatment of wounds & other surgical operations
  • 1st record of description of brain; clearly identified as centre of mental functioning
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1
Q

What provides clues to the earliest treatments of diseases and behaviour disorders?

A

Two Egyptian papyri - the Edwin Smith papyrus and the Ebers papyrus

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2
Q

What was in the Ebers papyrus?

A
  • internal medicine
  • circulatory system
  • reliance on incantations & magic to explain/cure diseases w/ unknown causes
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3
Q

Name four peoples who believed abnormal behaviour was caused by possession.

A

Chinese, Greeks, Hebrews, & Egyptians

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4
Q

How were “possessed” people treated?

A

Depended on whether they were thought to be possessed by a good or bad/angry spirit/god
• good: reverence & awe; believed they had supernatural powers
• bad/angry: attempted exorcism (or other means of expelling the dark force)

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5
Q

What did exorcism usually entail?

A

Magic, prayer, incantation, noise-making, & use of horrible-tasting concoctions

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6
Q

Who is often referred to as the father of modern medicine?

A

Hippocrates - Greek physician (460-377bce)

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7
Q

What are five ways Hippocrates’ approach was progressive or revolutionary?

A
  • believed mental disorders had natural causes & appropriate treatments
  • emphasized importance of heredity & predisposition
  • acknowledged importance of environment
  • gave thorough descriptions of disorders based on clinical observation
  • considered dreams to be important
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8
Q

What were the four humours and who was associated with them?

A
  • blood (sanguis), phlegm, bile (choler), black bile (melancholer)
  • described four temperaments: sanguine, phlegmatic, choleric, & melancholic - depending which fluid was thought to be dominant in the person
  • initially associated w/ Hippocrates; later w/ Galen (Roman physician)
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9
Q

What was one way that Hippocrates’ approach was strange and flawed?

A

He believed hysteria (disease w/o physical cause?) was only sufferable by women and caused by a uterus wandering about the body pining for a child (Greeks saw the body as sacred and would not cut it open - had poor knowledge of physiology)

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10
Q

Name three people who contributed to our understanding of depression.

A

Philippe Pinel - improved classification schema & examined causes
Wilhelm Griesinger - sought biological determinants
Emil Kraepelin - created classification schema upon which modern system is founded & identified manic depression as a main category

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11
Q

What were some of Plato’s contributions to understanding mental illness?

A
  • said mentally disturbed individuals were not responsible for their acts & should be treated differently - ie, not be punished the same way
  • made provisions for mental cases to be cared for in community
  • viewed psychological phenomena as responses of whole organism reflecting internal state & appetites
  • emphasized importance of individual differences in abilities
  • looked at sociocultural influences in shaping thinking & behaviour
  • proposed treatment in which they would be engaged in conversations comparable to psychotherapy to promote health of their souls
  • still felt there was some divine causation
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12
Q

What were Aristotle’s contributions to psychology?

A
  • felt that “thinking” as directed would eliminate pain & help attain pleasure
  • rejected idea that mental disorders could be caused by psychological factors such as frustration & conflict; generally followed Hippocrates’ theory of disturbances in the bile
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13
Q

How did physicians in Alexandria, Egypt treat mental patients?

A

Being a Greek city, physicians there continued from Hippocrates’ work; temples to Saturn were first-rate sanatoria
• pleasant surroundings considered to be of great therapeutic value
• constant activities like parties, dances, walks in the gardens, rowing the Nile, & concerts
• used dieting, massage, hydrotherapy, gymnastics, & education
• also practiced bleeding, purging, & used mechanical restraints

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14
Q

What did Asclepiades contribute?

A
  • theory that disease was caused by flow of atoms through pores
  • developed treatments like massage, special diets, bathing, exercise, listening to music, & rest/quiet
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15
Q

What did Galen contribute?

A

A Roman physician (130-200 AD)
• elaborated on Hippocratic tradition
• studied anatomy of nervous system (by dissecting animals)
• divided causes into physical & mental categories

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16
Q

What is contrariis contrarius?

A

“Opposite by opposite” - eg having patients drink chilled wine while in a warm bath

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17
Q

Discuss the early views of mental disorders in China.

A
  • yin/yang - sought to treat by balancing these energies/forces
  • Chung Ching (sometimes called the Hippocrates of China) implicated organ pathologies as primary causes & based his theory on clinical observations; also believed that stressful psychological conditions could cause organ pathology & used both drugs & appropriate activities to restore emotional balance
  • regressed to supernatural causes (like in the West), eg possession
  • “Dark Ages” in China were shorter & less severe (in terms of treatment)
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18
Q

What survived in Islamic countries in the Middle Ages?

A

Scientific aspects of Greek medicine; first mental hospital was established in Baghdad in 792 AD, followed by two others (in Damascus & Aleppo), where patients received humane treatment

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19
Q

Who was Avicenna?

A
  • called the “prince of physicians”
  • from Persia; lived 980-1037 AD
  • wrote The Canon of Medicine (possibly most widely studied medical work ever written)
  • humanely & creatively treated a delusional patient who thought he was a cow and wanted to be killed
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20
Q

What were the Middle Ages like in Europe?

A
  • limited inquiry into abnormal behaviour
  • treatment of mentally ill characterized by ritual/superstition
  • largely devoid of scientific thinking or humane treatment for mentally ill
  • mental illness prevalent especially near end when institutions, social structures, & beliefs were changing
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21
Q

When did mass madness reach its peak?

A

During the 13-1400s
• Black Death was ravaging Europe, disrupting social organization
• likely that the depression, fear, & wild mysticism engendered by the events of this period was correlated

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22
Q

Describe two modern cases of mass hysteria.

A

April 1983 - affected hundreds of West Bank Palestinian girls

1990 - men in Nigeria feared their genitals had vanished; accompanying fear of death; thought it occurred supernaturally for the magical benefit of others; occurred at a time when women were more successful during economic strain

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23
Q

Who mainly dealt with mental illness in Europe during the Middle Ages?

A

The clergy - used prayer, holy water, sanctified ointments, breath/spit of priests, touching of relics, visiting holy places, & mild forms of exorcism; were generally quite kind

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24
Q

What was thought to be the connection between mental illness and those accused of witchcraft in the Middle Ages? What is now thought to be the connection?

A
  • used to think mentally ill were accused of witchcraft & killed
  • now think that both mentally ill and “witches” were thought to be possessed; different types of possession
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25
Q

Give some examples of mass madness.

A
  • tarantism

* lycanthropy

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26
Q

Who was Paracelsus?

A
  • Swiss physician (1490-1541)
  • critic of superstitious beliefs about possession
  • rejected demonology
  • believed in astral influences (especially the moon - hence lunatic)
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27
Q

Who was Johann Weyer?

A
  • German physician (1515-1588)
  • carefully studied imprisonment, torture, & burning of “witches” b/c it deeply disturbed him
  • published “On the Deceits of the Demons”, a point-for-point rebuttal of the Malleus Maleficarum (witch-hunting handbook, published nearly 100 years prior)
  • felt that all “witches” were really sick (in mind or body)
  • one of first physicians to specialize in mental disorders
  • viewed as the founder of modern psychopathology
  • writings banned by church; scorned by peers
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28
Q

What did St Vincent de Paul say?

A

“Mental disease is no different than bodily disease and Christianity demands of the humane and powerful to protect, and the skillful to relieve the one as well as the other.”

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29
Q

What were asylums like initially?

A
  • storehouses for insane; aim was to remove them from society (those who were troublesome & incapable of caring for themselves)
  • deplorable conditions (eg Bedlam); patients/inmates treated more like beasts than human beings
  • often charged a fee to let people view the patients
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30
Q

What was the first hospital in the US devoted exclusively to mental patients, and what were their methods?

A

The Public Hospital in Williamsburg, Virginia (1773)
• believed that patients had to choose rationality over insanity
• “treatments” involved intimidation and were aggressive; based on scientific views of the day, aiming to restore balance to the physical body and brain
- powerful drugs
- water treatments
- blistering
- bleeding
- electric shocks
- physical restraints

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31
Q

What was Philippe Pinel’s experiment?

A

To remove chains from patients and treat them with kindness
• proposed this when he took over La Bicêtre in France in 1792
• would likely have been beheaded if it failed
• proved a great success
• created impetus for reform in the rest of Europe & America
* Pussin (Pinel’s predecessor) said he had taken humanitarian steps in his time - replacing chains w/ straitjackets for some patients & forbidding staff from beating them

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32
Q

Who was William Tuke?

A
  • English Quaker

* established York Retreat

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33
Q

Describe the York Retreat.

A
  • established around same time as when Pinel took over La Bicêtre (1792)
  • pleasant country house
  • mental patients lived, worked, & rested in a kindly, religious atmosphere
  • Quakers believed in treating all people w/ kindness & acceptance
  • their belief that kind acceptance would help mentally ill people sparked growth of more humane psychiatric treatment in a time when mental patients were ignored/mistreated
  • continues today
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34
Q

Discuss the reform of mental care in England following the work of Tuke and Pinel.

A
  • word of Pinel’s success spread to England
  • Tuke gained support of medical practitioners
  • Samuel Hitch put trained nurses and trained supervisors in staff at Gloucester Asylum
  • Thomas Wakley lobbied for reforms
  • Lunacy Inquiry Act passed (1842) - required regular & effective inspection of asylums
  • County Asylums Act passed (1845) - every county required to provide asylum to “paupers and lunatics”
  • expanded policy to colonies after scandal in Jamaica
35
Q

Who was Benjamin Rush?

A
  • founder of American psychiatry
  • signed Declaration of Independence
  • wrote first systematic treatise on psychiatry in America
  • first American to organize a course in psychiatry
  • believed in astrological influences
  • relied mainly on bloodletting & purgatives
  • invented & used “tranquilizing chair”
36
Q

Describe moral management and discuss its effectiveness.

A
  • emphasized moral & spiritual development & rehabilitation of “character” rather than physical/mental disorders
  • treatment usually involved manual labour, spiritual discussion, & humane treatment
  • highly effective - 59-71% discharge rate (compared to 45.7% “cure” rate at Bedlam)
  • surprising considering lack of antipsychotic drugs & prevalence of syphilis (CNS disease; then incurable)
37
Q

Why was moral management abandoned?

A

• ethnic prejudice (created tensions between staff & patients)
• leaders failed to train successors
• overextension of hospital facilities (thought only difference between large hospital & small hospital was size)
• rise of mental hygiene movement
• advances in biomedical science
* by 1950s, discharge rates were down to about 30%

38
Q

Who discovered that electric shock could be therapeutic? Who began implementing it and to treat what?

A
  • Benjamin Franklin discovered it

* Cerletti & Bini implemented it in 1938 to treat depression

39
Q

Who was Dorothea Dix?

A
  • New England teacher forced to retire b/c of tuberculosis
  • taught in women’s prison - saw deplorable conditions of asylums
  • campaigned for change for 40 years -contributed to development of mental hygiene movement
  • established 32 mental hospitals
  • helped reform several countries (including US, Canada, Scotland)
40
Q

What criticisms have been aimed at Dix?

A
  • claimed building hospitals & increasing # of people in them -> overcrowded facilities
  • argued that separation from society impeded moral therapy & deferred search for more effective treatments
41
Q

How did military medicine contribute to the advancement of mental health treatment?

A
  • first mental health facility for war casualties opened by Confederate Army
  • psychiatrists in Germany in late 1800s worked w/ military administration to detect mental health issues that could interfere with performance of duty
42
Q

Who were “alienists”, and what was their role during the 19th century?

A
  • medical doctors treating the “alienated”, or insane; effectively psychiatrists
  • gained control of asylums in latter part of century (instead of laypersons)
  • maintained that emotional problems were caused by depletion of bodily energies from excesses in living; believed this to be treatable
43
Q

Why did psychiatrists do little to educate the public or reduce their fear about insanity in the early 20th century?

A
  • had little information to impart

* sometimes employed procedures that were damaging to patients

44
Q

Who was Clifford Beers?

A
  • Yale graduate
  • described his own mental collapse & the bad treatment he got in 3 typical institutions of the day (including being put in a straitjacket)
  • recovered in home of a kind attendant
  • campaigned to make people realize that this was no way to handle the sick
  • gained attention of William James & Adolf Meyer (“dean of American psychiatry”)
45
Q

What year marked the beginning of an important period of change?

A

1946
• Mary Jane Ward published “The Snake Pit” - also made into a movie, raised awareness & concern about treatment of mental patients
• NIMH established

46
Q

Name two pieces of legislation that helped change the state of mental health care in the US.

A
  • Hill-Burton Act - funded community mental health hospitals
  • Community Health Services Act (1963) - helped create far-reaching set of programs to develop outpatient psychiatric clinics, inpatient facilities in general hospitals, and community consultation & rehabilitation programs
47
Q

When did deinstitutionalization begin, where is it happening, what was the original intention, and what are some of the actual outcomes?

A

• began after 1950
• happening internationally (US, Hong Kong, Netherlands, Finland, England, Wales, Australia, Italy)
• originally considered more humane (and cost effective)
- prevent negative adaptations to hospital confinement
- prevent “escape” from demands of life & submission to sick role
- hope that meds would help adjustment & functioning in society
• many homeless people are mentally ill; outreach & community services have failed to bridge the gaps
[looks a lot like executives didn’t want to spend money on housing “crazy” people, giving them an excuse to not be part of society; they preferred them being homeless because that was better for their bottom line.]

48
Q

Name four major themes that developed in the last two centuries that have influenced our views of abnormal behaviour.

A
  • biological discoveries
  • development of classification system
  • emergence of psychological causation views
  • experimental psychological research developments
49
Q

What biological discovery led to the exploration of brain pathology as a causal factor in mental illness?

A

General paresis (ie brain syphilis) was gradually better understood & eventually treated
• discovered they didn’t react to injections from syphilitic patients
• developed blood test for syphilis
• malarial treatment

50
Q

Who were Albrecht von Haller & Wilhelm Griesinger?

A

Advocates of researching brain pathology’s relation to mental illness

51
Q

Name at least two other disorders that were found to have organic pathologies.

A
  • cerebral arteriosclerosis
  • senile mental disorders
  • toxic mental disorders
  • certain types of mental retardation
52
Q

What were some of the medical missteps in the 20th century?

A
  • surgeries removing body parts (eg teeth, tonsils, gonads - Henry Cotton)
  • lobotomy (Egas Moniz -> Walter Freeman)
53
Q

Who was Emil Kraepelin?

A

(1856-1926; German psychiatrist)
• created system of classification that led to DSM
• argued that brain pathology was an important factor in mental disorders
• believed that course of disorder could be accurately predicted

54
Q

What are the “ancestral” roots of psychoanalysis?

A

Hypnosis - induced state of relaxation in which one is highly open to suggestion - especially in its relation to hysteria

55
Q

Name two drugs that were employed to treat psychosis as of 1956 in a widespread fashion in the US.

A
  • reserpine - derived from Rauwolfia (used as herbal folk remedy in India for centuries)
  • chlorpromazine - first used as malaria treatment, then anaesthetic
56
Q

Who was Franz Anton Mesmer?

A

(1734-1815; Austrian physician)
• developed ideas of Paracelsus (influence of planets on human body)
• believed there was a universal magnetic fluid in all people responsible for health/illness, & that it was influenced by planets & magnetic forces in other people
• developed technique (mesmerism) which utilized many techniques later associated w/ hypnosis
• discredited by colleagues who found that results were due to patients’ belief that they were receiving effective treatment [placebo effect]

57
Q

Who started the Nancy School and on what bases?

A

Liébault & Bernheim
• phenomena observed in hysteria (eg paralysis of a limb, inability to hear, anaesthetic areas) could be reproduced in normal subjects through hypnosis
• same symptoms could also be removed through hypnosis

58
Q

Who opposed the Nancy School? What was his view?

A

Jean Charcot; believed degenerative brain changes caused hysteria (eventually proven wrong - then promoted study of psychological factors in mental disorders)

59
Q

What major step was taken because of the Nancy School-Charcot debate, and what question remained unanswered?

A
  • became clear that mental disorders could have psychological bases, physiological bases, or both
  • how do psychologically based mental disorders actually develop?
60
Q

What was Freud’s role in answering the question of how psychologically based mental disorders develop?

A

• studied with Charcot; later became acquainted w/ work of Liébault & Bernheim
• worked w/ Breuer, who had incorporated innovative methods of hypnosis into his work w/ patients
- directed patients to speak freely of their problems while hypnotized
- usually resulted in considerable emotional display & catharsis
- generally unaware of any connection between problems & hysterical symptoms - led to notion of unconscious mind
• eventually dispensed w/ hypnosis entirely, replacing it w/ free association & dream analysis

61
Q

Discuss the early psychology laboratories.

A
  • began with Wilhelm Wundt in 1879 (established first experimental psychology laboratory in Germany)
  • Cattell brought Wundt’s methods to the U.S.
  • Witmer (father of clinical psychology) combined research w/ application & established first psychological clinic in U.S.
  • William Healy established Institute of Juvenile Research & was one of first to acknowledge environmental/sociocultural factors in mental illness
62
Q

What did Watson contribute to the understanding of human behaviour?

A

That there are sociocultural influences which shape both normal and abnormal behaviour

63
Q

What are the problems with examining historical times?

A 
• tenacity of misinformation 
• open to reinterpretation 
• can't rely on direct observation (must rely on documents)
  - out of context
  - lack of understanding of motives or purposes of documents
  - bias of writers
• varied meanings of terms 
• bias of interpreters
64
Q

What were asylums historically?

A

Institutions meant solely for care of mentally ill

65
Q

What is the behavioural perspective?

A

Theoretical viewpoint organized around theme that learning is central in determining human behaviour

66
Q

What is behaviourism?

A

School of psychology that restricted itself primarily to study of overt behaviour

67
Q

What is catharsis?

A

Discharge of emotional tension associated w/ something (eg talking about past traumas)

68
Q

What is classical conditioning?

A

NS paired w/ US repeatedly, eliciting UR, until NS becomes CS (eliciting CR, which resembles UR)

69
Q

What is deinstitutionalization?

A

Movement to close mental hospitals & treat people with severe mental disorder in the community

70
Q

What is dream analysis?

A

Method involving recording, describing, & interpreting patient’s dreams

71
Q

What is exorcism?

A

Religiously inspired treatment procedure designed to drive out evil spirits or forces from a possessed person

72
Q

What is free association?

A

Method for probing the unconscious by having patients talk freely about themselves, their feelings, & their motives

73
Q

What is insanity?

A

Legal term for mental disorder, implying lack of responsibility for one’s actions & inability to manage one’s affairs

74
Q

What is lycanthropy?

A

Delusion of being a wolf

75
Q

What is mass madness?

A

Widespread occurrence of group behaviour disorders that were apparently cases of hysteria

76
Q

What was the mental hygiene movement?

A

Advocated method of treatment focused almost exclusively on the physical well-being of hospitalized mental patients

77
Q

What is mesmerism?

A

Theory of “animal magnetism”

(hypnosis) formulated by Anton Mesmer

78
Q

What was moral management?

A

Wide-ranging method of treatment focusing on patient’s social, individual, & occupational needs

79
Q

What was the Nancy School?

A

Group of physicians in 19th-century Europe who saw hysteria as a form of self-hypnosis

80
Q

What is operant (instrumental) conditioning?

A

Form of learning in which reinforced responses are more likely to occur again in similar situations

81
Q

What is psychoanalysis?

A

Methods Freud used to study and treat patients

82
Q

What is the psychoanalytic perspective?

A

Theory of psychopathology that emphasizes inner dynamics of unconscious motives

83
Q

What was Saint Vitus’s dance?

A

Dancing mania & mass madness that spread from Italy to Germany (& rest of Europe) during Middle Ages

84
Q

What was tarantism?

A

Dancing mania that occurred in Italy in 13th century

85
Q

What is the unconscious?

A

Major portion of the mind consisting of hidden mass of instincts, impulses, & memories; not easily available to conscious awareness but plays important role in behaviour

Abnormal Psychology (3 decks)

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