Abnormal Psychology - Midterm Flashcards
Define statistical infrequency
statistical infrequency: a behavior that occurs rarely or infrequently
hallucinations and delusion, intellectual disability (under 70%
Within 1 SD from the mean, usually on the lower end
How many Canadians will personally experience a mental illness in their lifetime
20%
Suicide accounts for ___ of all deaths among 15-24 year olds
24%
When do most (70%) mental health problems start
during childhood or adolescence
Canadians in the ___ income group are _ to__ times more likely than those in the __ income group to report poor mental health
lowest/ 4/5/ highest
What does violating the norm implies
a behavior that defies or goes against social norms; it either threatens or makes anxious those observing
What should be consider when refering to violating norms
culture, context & situation, historical context, age, gender, etc.
e.g. stanger culture is different in eastern europe than UK (more touching, closer)
Give examples of norm violation that don’t apply to psychopathologies and vice versa
a prostitute; some cultures it violates norms but isn’t considered a psychopathology
anxiety, depression; doesn’t violate norms and very common
Define personal distress
a behavior that creates personal suffering, distress or torment in the person
this criterion fits many forms of psychopathology/mental health problems, such as depression and anxiety
however
psychopathy, mania : they don’t feel distress, yet still considered a pathology
Name 7 criterion to psychopathologies and name the 4Ds
- statistical infrequency
- violation of norms
- personal distress
- disability/impairment
- risk of harm
- unpredictability
- irrationality/incomprehension
4ds
- deviance
- distress
- dysfunction
- danger
Define Disability or Impairment
a behavior that causes impairment in some important area of life e.g. work, personal relationships, recreational activities
however
sometimes abnormal behavior can be adaptive (e.g. compulsive behavior in OCD)
same for psychopathy
Define risk of harm
to self or others
suicide, auditory hallucinations suggesting violence
however
‘regular’ criminals & ‘professional assassins’
in many psychological disorders there is no risk of harm
Define Unexpectedness & unpredictability
a surprising or out-of-proportion response to environmental stressors can be considered abnormal
we would expect a person to be sad if they lost a loved one; we would not expect a person to laugh after being assaulted, etc
e.g. an anxiety disorder is diagnosed when the anxiety is unexpected and out of proportion to the situation
however
very arbitrary e.g. DSM-IV two months bereavement exclusion (removed from DSM-5, which caused even more controversy)
closely related to the ‘violation of norms’
we could add to this list ‘irrationality & incomprehensibility’ and other characteristics
Why is it important to take into consideration cultual and social aspect when looking at psychopathologies
Some sets of symptoms recognized as disorders in certain parts of the world are not familiar to most Westerners, e.g.
Koro : south eastern asia, huge anxiety developed around the fear that the genitals are going inside you and you are going to die. It shows up in clusters, like mini epidemics
Other behaviors could be considered disorders, e.g.
Possession trance: people who lose someone close to them may experience that the spirit of the deceased possess them and they start acting into specific rituals
Give 3 examples of things that use to be labelled as mental illnesses but aren’t anymore
homosexuality (removed from DSM in 1973)
5,854 psychiatrists voted to remove homosexuality from the DSM, and 3,810 to retain it
sluggish schizophrenia– dissidents in Soviet Union (”invented” in 1960s)
anyone against the regime, or wanting to leave the country
would be given ‘treatment’ such as medication and ECT
drapetomania - slaves’ running away (coined by Samuel A. Cartwright in 1851)
Though a serious mental illness, drapetomania, wrote Dr. Cartwright, was happily quite treatable: ‘‘The cause, in the most of cases, that induces the negro to run away from service, is as much a disease of the mind as any other species of mental alienation, and much more curable. With the advantages of proper medical advice, strictly followed, this troublesome practice that many negroes have of running away can be almost entirely prevented.’’
Who is more at risk of being diagnosed on the Schizophrenia Spectrum
African Americans are 3-5 times more likely than White Americans to receive a diagnosis on the Schizophrenia Spectrum
Latino Americans are 3 times more likely than White Americans to receive a diagnosis on the Schizophrenia Spectrum
Immigrant racial minorities are more likely to receive a diagnosis on the Schizophrenia Spectrum than natives with majority racial background
Why are non-white more at risk of being diagnosed on the schizophrenia spectrum
This could be explained because the diagnosis tools are developed by white american/european. Therefore, the ‘normal’ standard will highlight more atypical elements in racial minorities
International research is comparable: Canada has a Cultural Consultation Service (CCS). After reviewing 323 cases, 49% of Schizophrenia diagnoses were changed; however the largest population whose diagnoses were not changed were Black Canadians (44%)
What diagnosis is under dignosed in african american
mood disorder, and overddiagnosis of schizophrenia
Explain Thomas Szasz point of view
actually proposed that mental illness was a myth
Emphasis on stigma and the fact that diagnosing someone with a mental illness assigns a label that may influence how the diagnosed person feels about himself or herself and how that person is seen and treated by others
What are some stigmas that Canadians hold against mental illness
almost 50% of Canadian believe that ‘we call something mental illness because it gives some people an excuse for poor behaviour and personal failings’
they would avoid socializing with (42%) or marrying (55%) someone who is mentally ill
27% are afraid to be around someone with serious mental illness
50% would decline to tell friends or workers about a family member suffering from a mental illness (but 75% would share a cancer diagnosis)
most would not hire someone with mental illness
the stereotype of a violence ‘madman’ remains despite people diagnosed with psychosis actually being more likely to be assaulted than to assault others
in the US, Canada and western European countries,
the perception of dangerousness and unwillingness to have a ‘schizophrenic’ as neighbor, has increased over the past couple of decades
biologically oriented de-stigmatization programs
‘mental illness is an illness like any other, caused by ‘biological factors such as chemical imbalance, brain dysfunction and genetic heritability’
how do exterior people react (negatively) to diagnostic labeling
perceived dangerousness perceived unpredictability perceived lack of responsibility for own actions perceive lack of ‘humanity’ perceived dependency pessimism about recovery rejection and desire for distance
Name 3 negative attitudes that is produced by the medical model of mental illnesses
despite less blame, the very idea that actions of mentally ill may be beyond their conscious control can create fear of their unpredictability and thus the perception of dangerousness, leading to avoidance
‘us vs them’ attitude - defining individual with mental illness as fundamentally different
mental illnesses seen as less responsive to treatment and more persistent
How to reduce stigma (7)
portraying mental health difficulties as understandable reactions to adverse life events
de-emphasize causality
inclusion/increasing contact with people with mental health problems
promoting their positive participation and contribution
acknowledging and valuing differences
tackling stereotypes about violence
including the people in the receiving end of the discrimination in the design and management of programs
What are 3 major factors associated with mental health problems
current stress
childhood trauma
social support
What are the rates of mental illnesses in Canada + severe mental illness + region differences
About 20% of people in Canada have one or more mental disorders and about 2% are severely mentally ill.
There are some regional differences
good mental health in Newfoundland and Labrador and Prince Edward Island (people there report most happiness and least distress)
Quebec is noteworthy because it reported very high levels of self-esteem and mastery but the least happiness and most distress
What is the goal of Deinstitutionalization
attempt to reintegrate the mentally ill with the rest of Canadian society and
prevent involuntary hospitalization and treatment
What are 3 negative consequences to deinstitutionalization
homelessness
jailing of the mentally ill
multiple re-admissions
What would be an ideal model for deinstitutionalization
research show that a more desirable model would include sufficient number of smaller local community-based services and half-way houses
Explain the pre-scientific view of psychopathologies
Mental disorders were regarded as supernatural; believed to be caused by events beyond the control of humankind, such as:
eclipses, earthquakes, storms, fires…
demonic possession
divine punishment
Where was demonic possession diagnosed and what was the treatment
found in the records of the early Chinese, Egyptians, Babylonians, and Greeks
treatment often involved:
Exorcism
Trepanning
What is trepanning (when, where, to treat what)
used already by the Neolithic cave dwellers (late Stone Age, starting around 10,000 BCE)
used to treat epilepsy, headaches, and psychological disorders attributed to demons
believed to be introduced into the Americas from Siberia
most common in Peru and Bolivia
several British-Columbia Aboriginal specimens found
What is the devine punishment (where, why)
Mesopotamia around 2000 BCE
Ishtar: coordination witchcraft and mischief
Idta: demon in charge of other demons
Persians
Ahriman vs. Ormuzd
if you were believed to be hurt by one god, you would go to the other one for treatment
Hindus
Shiva vs. Vishnu
Old Testament
“A man or woman who is a medium or a wizard shall be put to death; they shall be stoned with stones” (Leviticus 20: 27), however…
“And it came to pass, when the evil spirit from God was upon Saul, that David took an harp, and played with his hand: so Saul was refreshed, and was well, and the evil spirit departed from him” (Samuel 1: 16.23 )
What did hippocrates contribute to the field of abnormal psychology
Separated medicine from religion, magic, and superstition
Rejected belief that gods send physical diseases and mental disturbances as punishments
Insisted that mental disorders had natural causes and thus should be treated like other illnesses (first ‘medical model’ of madness
Explain the difference between Somatogenesis vs. Psychogenesis
Hippocrates is one of the earliest proponents of somatogenesis
Somatogenesis (genesis = origin) (body)
Mental disorders are caused by aberrant functioning in the soma (i.e., physical body) and this disturbs thought and action
hysteria, plato, hippocrates
Psychogenesis (mind)
Mental disorders have their origin in psychological malfunctions
Explain Hippocrates’ Humoral Physiology
Hippocrates’ treatments were different from often violent exorcisms
e.g., tranquility, proper nutrition, abstinence from sexual activity were prescribed for melancholia
Mental health dependent on a delicate balance among four humors, or fluids, of the body
Imbalances and results
increase in blood = changeable temperament, in extreme form today would be mania and bipolar
increase in black bile = melancholia, today would be depression
increase in yellow bile = irritability and anxiousness, today could be anxiety disorder
increase in phlegm = sluggishness and dullness, today could be linked to lack of motivation & pleasure in schizophrenia
What did Plato invent
contributed with the ‘invention’ of hysteria
wandering uterus
pages and pages on symptom, around 25% of women ‘diagnosed’ with hysteria
What did Asclepiades (129-40 BCE) and Cicero (106-43 BCE) proposed instead of Hippocrates’ humoral theories,
e.g., they proposed that melancholy resulted not from an excess of black bile but from emotions such as rage, fear, and grief.
stems from emotional problems
Psychogenesis (mind)
What contribution did Cicero’s bring to diagnosis
Cicero’s questionnaire (like today) for the assessment of mental disorders – similar to today’s mental state examination; it included sections on:
habitus (appearance)
orationes (speech)
casus (significant life events)
What were the Early Chinese conceptualizations of mental illness
YIN & YANG
daoism
treatment based on finding the balance between yin and yang
Chung Ching (2nd century CE) called the Hippocrates of China (organ pathology as primary causes but ALSO stressful conditions could cause organ pathologies…)
2nd-9th century – “ghost-evil insanity” etc. - but those “dark ages” much less severe than in Europe…
What were the Middle East views on mental illness
The first mental hospital established in Baghdad in 792 CE followed soon by those in Damascus and Aleppo
Humane treatment
Avicenna from Persia (c.980-1037) – very innovative almost contemporary talk therapy
physician, mathematician, poet, theologian
What happened during the dark ages
Churches gained in influence, papacy was declared independent of the state
The idea of madness as divine punishment or demonic possession was reinstated
Christian monasteries replaced physicians as healers and as authorities on mental disorder
The monks cared for and nursed the sick by:
praying and touching them with relics
concocting special potions
What led to the persecution of witches
during the 13th and the following few centuries, major social unrest and recurrent famines and plagues
people turned to demonology to explain disasters
obsession with the devil;‘witches’ blamed and persecuted
1484 Pope Innocent VIII exhorted European clergy to leave no stone unturned in the search for witches
sent 2 Dominican monks to northern Germany as inquisitors who later issued the manual entitled the Malleus Maleficarum
used to guide witch hunters
came to be seen by the Catholics and Protestants as a textbook on witchcraft
Over the next several centuries, hundreds of thousands of people accused, tortured, and murdered (mostly women, many children)
What is the Malleus Maleficarum
Malleus Maleficarum specified that a person’s loss of reason was a symptom of demonic possession and that burning was the usual method of driving out the supposed demon.
Those accused of witchcraft were to be tortured if they did not confess; those convicted and penitent were to be imprisoned for life; and those convicted and unrepentant were to be handed over to the law for execution
How was perceived witchcraft from the 15th to the 18th century
15th and 16th centuries - possessed individuals were persecuted; they were seen as being under the Devil’s influence by their own choice
17th century - possessed individuals viewed as the victims of the spell thus not held responsible for their behaviors; at this time the person most commonly persecuted was the presumed perpetuator of the possession
first decades of 18th century most of the behaviors formerly identified with devil’s influences suddenly were seen as the result of God’s intervention; witches and sorcerers became prophets…
What were the beginning of asylum development
Until the end of the 15th century there were very few mental hospitals in Europe but numerous leprosy hospitals. However, leprosy gradually disappeared from Europe and thus…
Leprosariums were converted to asylums
asylums took disturbed people and beggars (social control)
many tailored purely for the confinement, with no specific regimen for their inmates but work (forced labor)
confinement began in earnest in the 15th-16th centuries
Describe the Development of Asylums: St. Mary of Bethlehem
In England some hospitals took over churches’ responsibility to tend to the ill starting in13th century
The priory of St. Mary of Bethlehem - founded in 1243; in 1547 Henry VIII handed it over to the city of London to become a hospital devoted solely to the confinement of the mentally ill
Conditions were deplorable (bedlam)
Eventually became one of London’s great (paid) tourist attractions
Describe the contributions of Benjamin Rush
considered the father of American psychiatry
he slightly improved the living conditions
developed methods such as
drawing large quantities of blood
frightening patients by drowning
Describe the contributions of Philippe Pinel
Philippe Pinel (1745–1826) - primary figure in movement for humanitarian treatment of the mentally ill in asylums
put in charge of a large asylum in Paris (La Bicêtre)
removed the chains
patients treated as human beings with dignity & compassion, not as beasts
light and airy rooms replaced dungeons
walks around the grounds were allowed
Results
got better, and they would eventually leave
Describe the contribution of Emil Kraepelin
Beginning of contemporary thought: somatogenesis
Emil Kraepelin created a classification system to establish the biological nature of mental illnesses; noticed clustering of symptoms (syndrome) which were presumed to have an underlying physical cause
Kraepelin’s early classification scheme became the basis for the present diagnostic categories (DSM & ICD)
Describe the contributions of Franz Anton Mesmer
Beginning of contemporary thought: psychogenesis
Austrian physician practicing in Vienna and Paris in the late 18th century; believed that hysterical disorders were caused by a disturbance of distribution of the universal magnetic fluid in the body.
would put small containers on the ground with different fluids in them
he would then touch people with them according to their symptoms
he would go an magnetize trees so people could touch the tree instead of coming to him to get healed
he gets dismissed when people prove there is no difference between the magnetized tree and regular tree
Discribe the contributons of Jean Martin Charcot
psychogeneis
studies hysterical states, including anesthesia (loss of sensation), paralysis, blindness, deafness, convulsive attacks, and gaps in memory
at first a proponent of a biological causes of hysteria, but later became interested in non-physiological interpretations
interested in hypnosis
Describe the contributions of Joseph Breuer
Psychogenesis: Breuer and the cathartic method
Joseph Breuer (1842-1925) - treated a woman (Anna O.) who have become bedridden with a number of hysterical symptoms; he used hypnosis to release emotional tension… it became very easy for her to talk about her trauma in hypnotic treatment, as it goes the better she becomes physically
What did the rise of genetics understanding cause
1933 Germany - the law has passed allowing compulsory sterilization in case of ‘congenital mental defect, schizophrenia, manic-depressive psychosis, hereditary epilepsy, hereditary chorea, hereditary blindness, hereditary deafness, severe physical deformity and severe alcoholism’
by 1939 about 350,000 had been sterilized (Strous, 2006)
similar laws were passed in Norway, Denmark, Finland, Sweden in 1930s
In U.S. by 1928 20 states had compulsory sterilization for “feeble-minded and insane classes”; in Canada, Alberta (1928) and BC (1933) passed similar laws
by 1938 in Germany sterilization begun to be replaced with murder
by 1942 about 250,000 of mental patients had been killed, primarily with carbon monoxide and later with lethal injection
half of these will be diagnosed with schizophrenia
What happened in McGill in the 1950s with Ewen Cameron
Dr. Ewen Cameron, a world-renowned Montreal psychiatrist, was head of the Allan Memorial Institute at McGill University in the 1950s and early 1960s
in 1955 he initiated a nine-year series of experiments (funded by CIA) on unsuspecting psychiatric patients, apparently in a misguided attempt to discover breakthrough treatments or a “cure” for mental illness - “beneficial brainwashing”
administered massive doses of hallucinogenic drugs, repeated ECT (often three times each day), patients were kept in a drug-induced coma for as long as three months
Name 5 paradigms of abnormal psychology
Biological Paradigm Cognitive-Behavioral Paradigm Psychoanalytic Paradigm Humanistic-Existential Paradigms Integrative Paradigms
What are the main features of the biological paradigm
Continuation of the somatogenic hypothesis
mental disorders caused by aberrant or defective biological processes
also referred to as the medical model or disease model
the dominant paradigm in Canada and elsewhere from the late 1800s until middle of the twentieth century (1950), psychoanalysis will be the other dominant model
Explain the difference between genotype and phenotype
Genotype – unobservable genetic constitution
Fixed at birth, but it should not be viewed as a static entity
Phenotype – totality of observable, behavioral characteristics
Changes over time; product of an interaction between genotype and environment
Explain 3 methods to conduct studies through the biological paradigm
Family method
is it more prevalent in first (50% genetic material), second (25%) family degree vs the population
Twin method
sharing 100% genetic material
Adoptees method
observe if the children mental illnesses are more linked to biological vs adopting parents
Describe the Genetic Overlap Between Major Mental Disorders
Common inherited genetic variation accounted for up to about 28 percent of the risk for some disorders, such as ADHD (dark green). Among pairs of disorders (light green), schizophrenia and bipolar disorder (SCZ-BPD) shared about 16 percent of the same common genetic variation (coheritabilities)
