Chapter 1: History of Mental Health Flashcards
1
Q
What are the standards for what is normal and abnormal?
A
- Cultural relativism
- Unusualness of behaviour
- Discomfort of the person exhibiting the behaviour
- Mental illness
- Maladaptiveness
2
Q
How does cultural relativism define the standards of what is abnormal?
A
- behaviours can only be abnormal relative to cultural norms
- gender is a particularly powerful instance of culture
3
Q
How does unusualness define the standards of what is abnormal?
A
- abnormality defined as statistical concept
- abnormal = relatively infrequent occurrence in the population
- one must consider the rarity of the behaviour, the person demonstrating it, and the context in which it occurs
4
Q
How does discomfort define the standards of what is abnormal?
A
- behaviour is only abnormal if the individual suffers as a result and wishes to be rid of the behaviour
5
Q
What are objections to discomfort as standard for defining what is normal?
A
- people are not always aware of the problems that their behaviour may create for themselves or others
- also may not care about what causes great discomfort in others
6
Q
How does mental illness define the standards of what is abnormal?
A
- behaviour may be caused by an identifiable disease
- implying physical process creates specific pattern of behaviours & symptons
7
Q
What are the 3Ds of maladaptiveness?
A
Dysfuntion - Does the behaviour prevent normal, daily functioning?
Distress - Does the person suffer distress?
Deviance - Is the behaviour highly unusual?
8
Q
When does abnormality become a harmful dysfunction?
A
- dysfunction of the internal mechanisms to perform naturally selected functions (such as not eating or sleeping or trying to kill themselves)
- however dysfunction must cause harm (subjective distress or impairment)
9
Q
What is categorical classification of mental illness?
A
- zero sum game, either you have mental illness or you don’t
i.e. “Are you depressed?”
“Y/N”
10
Q
What is dimensional classification of mental illness?
A
- people are on a continuum of mental illness
i.e. “How depressed are you?”
“I am depressed X amount.”
11
Q
Does the DSM-V employ categorical or dimensional classification?
A
- more dimensional classification
12
Q
What is the diathesis-stress model?
A
- diathesis: a vulnerability or predisposition to developing a disorder
- stress: a life event that acts as a trigger for the emergence of a disorder
- the amount of stress that triggers a disorder depends upon the diathesis (predisposition), thus those with little predisposition can function normally even with severe stressors while others have impaired function and may even suffer a breakdown.
- basically: vulnerability + stress = disorder
13
Q
What are the biological theories of mental illness?
A
- mental illness is similar to a physical disease
- results from breakdown of some systems of the body
14
Q
What were the theories of mental illness in the stone age?
A
- spirit possession
- treated with exorcism and trephination
15
Q
What were the theories of mental illness in Ancient China?
A
- spirit must be balanced with a positive force (yang) ad a negative force (yin)
- internal organs controlled emotions, this it was important to maintain proper air movements (deep breathing, tai chi, etc.)
16
Q
What were the theories of mental illness in Ancient Egypt, Greece, and Rome?
A
- primarily “natural” theories
> wandering uterus, hystersa, Hippocrates’ four basic humours - some spirituality imbued in their medical practice
17
Q
What were the theories of mental illness during Medieval times?
A
- back to supernatural, such as witchcraft and psychic epidemics
18
Q
Who was Avicenna and what was his major contribution to the medical field?
A
- Persian doctor (well he did like a ton of shit but here he’s mostly known for the doctoring)
- wrote “The Canon of Medicine”, which covered several topics in the medical field
- emphasised on natural causes such as psychological and environmental factors
19
Q
Describe in brief the beginning of the use of mental asylums.
A
- established as early in the 12th century
> Arab countries created them as a home for the mentally ill and for treatment and support - once adopted in Europe, though the spirit of compassion was at first maintained it quickly became inhospitable and inhumane
> most prominent example being St. Mary of Bethlehem Hospital, where we get the word “bedlam”
20
Q
How were the mentally ill treated in Europe during the beginning of the 18th century?
A
- more humane
- treatment focused on rest and relaxation
- incorporated a psychological view
i. e. people went mad because they were separated from nature and succumbed to the stresses of modern life
21
Q
Name two major mental health reformers during the 18th century and their contributions.
A
PHILIPPE PINEL
- advocated for “moral therapy”, the treatment of the mentally insane without the use of physical or chemical restraints but by means of respect
- proposed that they were better treated with quiet, peaceful surroundings and plenty of moderate exercise
DOROTHEA DIX
- started the “mental hygiene movement”, characterized by desire to protect and provide for the mentally ill
22
Q
What was the problem with mental asylums?
A
- became overcrowded and underfunded
- care for mentally ill shifted from the family to local community
23
Q
What was Emil Kraplein’s major contribution to psychology?
A
- wrote “Clinical Psychiatry” textbook, attempting to clarify mental illnesses
- focused on diagnosis and classification since treatments didn’t seem possible at the the time
- grouped symptoms occurring together as discrete “syndromes”
24
Q
What was Richard von Kratt-Ebing’s major contribution to psychology?
A
- found the connection between syphilis and general paresis
> disorder evinced by mania, grandiosity, and euphoria followed by dementia and paralysis - also found it could be cured by infecting patient with malaria
> high fever killed infectious agents - linked for the first time mental attributes to physical diseases
25
What is somatogenesis?
- idea that psychopathology is caused by biological factors
| - gained prominence as a result of succcess at identifying cause of general paresis of the insane
26
How was insulin used to treat patients and how did that lead to the use of electroconvulsive therapy?
- insulin induced seizures as well as a coma, but people waking up from it seemed totally fine
(possibly because they didn't want to be given any more seizures)
- seizures then induced by Metrozol
- once that proved difficult to administer, shock therapy was introduced
27
What is electroconvulsive therapy?
- use of electricity to induce seizures in mental patients by placing electrodes on the skull and administering a convulsive shock
- used today to treat major depression
28
What is the psychoanalytic theory of mental disorders?
- focuses on the role of the unconscious
- belief that engaging with thoughts can change behaviour
- roots lie with Mesmer but field has been associated with Sigmund Freud
29
What is the behaviorist view of mental disorders?
- emphasizes role of environment
- examines role of reinforcement and punishment in determining behaviour (learning principles)
- insane behaviour is result of unfortunate learning that could be then unlearned
- i.e. exposure therapy
30
What was the cognitive revolution?
- started in the 1960s
- focus on thought as determinate of behaviours and emotion
- i.e. Bandura & self-efficacy, Beck & depression
31
What was Albert Bandura's theory of self-efficacy?
- people have central psychological constructs about themselves and the world
- change the constructs, change the person
32
What was Albert Ellis's Rational Emotive Therapy?
- people don't apply enough reason to their thought processes
- teach them to reason correctly and their mental illness will cease
33
What was Aaron Beck's theory of depression?
- people have abnormal self-beliefs
| - help them change their beliefs and they'll get better
34
What fueled deinstitutionalization of mental asylums?
- success of antipsychotic medications
(especially tricyclic antidepressants)
- patient's rights movement
(advocating that mentally ill have better recovery if they're integrated in the community; promotes autonomy and enhance quality of life)
35
What was the problem with deinstitutionalization?
- masses of patients discharged into the streets but community-based facilities weren't set up properly
- increased homelessness and incarceration
36
What are the professions within abnormal psychology?
- Psychiatrists
- Clinical psychologists
- Clinical social workers
- Psychiatric nurses
- Occupational therapists
- Marriage and family therapists
37
What was Mesmer's treatment for "hysteria"?
- believed "hysteria" was caused by distributed distribution of magnetic fluids in the body
- corrected by using rods that allegedly channelled "animal magnetism" to arrange these fluids
- ACTUALLY using suggestion
38
How did Breuer use hypnotism to treat patients?
- put them under to have them relive unpleasant past events
| - "cathartic experience"
39
What is the Mental Health Commission of Canada (MHCC)?
- nonprofit organization created to focus national attention on mental health issues and to work to improve the health and social outcomes of people living with mental illness
- catalyst for reform of mental health policies and improvements in service delivery
- shift away from emphasizing biological basis to reduce stigmatization
40
What are two problems with defining what is "abnormal"?
- eccentric/unusual behaviour or beliefs are not necessarily abnormal according to diagnostic criteria
- behaviours that are repugnant/threatening to others are not always signs of underlying psychological disorder
41
What is a general definition of psychological abnormality?
- behaviour, speech, or thought that impairs the ability of a person to function in a way that is generally expected of them
42
What is a general definition for a psychological disorder?
- specific manifestation of impairment of functioning as described by some set of criteria
43
What are the two definitions of psychopathology?
1 - scientific study of psychological abnormality
2 - problems people who suffer from such disorders
44
What is the problem with "rarity" defining abnormal behaviour?
- not clear how unusual a given behaviour has to be to be considered "abnormal"
45
What is the problem with "norm violation" defining abnormal behaviour?
- gives false impression that psychologically abnormal people are unpredictable and somehow dangerous
- social norms vary over time and space
- different cultural groups manifest psychopathology differently and exhibit their own strategies for dealing with psychological distress
46
What is trephination?
- prehistoric form of surgery possibly intended to let out evil spirits; involved chipping a hole into a person's skull
- also may have dug out splinters/blood clots caused by warfare or to release intracranial pressure
47
What did Hippocrates believe about mental illness and how to treat it?
- all disorders had natural causes
- dreams were important in understanding disorder (predating Freud)
- treatment should involve quiet life, vegetarian diet, exercise, and abstinence from alcohol
→ also bloodletting and induced vomiting
48
What did Plato believe about mental illness?
- emphasis on sociocultural influences on thoughts/behaviours
49
How were disorders treated during the Middle Ages?
- patients went to clergy for care who offered refuge in monasteries and occasional pilgrimages
- treatment started mildly, emphasizing prayer, until exorcism came into fashion
50
How was exorcism performed?
- cursing the devil inside to drive them out
| - eventually escalated to "bodily insults" aka torture the crap out of them
51
What is degeneration theory?
- introduced by Benedict Augustin Morel
- proposed that deviations from normal functioning are transmitted by hereditary processes and these deviations degenerate over generations
- apparently supported by Darwin for people who don't understand how genetics works
