Chapter 2 Flashcards
Edwin Smith papyrus
- Egyptian papyrus from 16th century B.C.
- detailed descriptions of treatments of wounds and other surgical operations
- brain is described for possibly first time in history and is described as site of mental functions
Ebers papyrus
- Egyptian papyrus from 16th century B.C.
- covers internal medicine and circulatory system
- relies on incantations/magic for explaining/curing diseases w unknown causes
In early writings, the Chinese, Egyptians, Hebrews, and Greeks attributed abnormal behavior to…
a demon or god who had taken possession of a person. (primary treatment for demonic possession was exorcism)
Shift in understanding mental disorders from supernatural forces to problems in the human body
- ancient Greeks, around 400 B.C.E.
- Hippocrates (father of modern medicine) widely considered responsible for shift
Hippocrates’ 3 categories of mental disorders
- mania
- melancholia
- phrenitis (brain fever)
Hippocrates/Galen doctrine of 4 humors
- four elements combined to form 4 essential fluids of the body: blood (sanguis), phlegm, bile (choler), and black bile (melancholic)
- these fluids combine in different proportions in different individuals and temperament is determined by dominant humor!
- Hippocrates also thought dreams were important in understanding personality
Plato (429-347 B.C)
- Greek philosopher
- viewed psychological phenomena as responses of the whole organism (reflecting its natural state and natural appetites)
- took into account sociocultural influences in shaping thinking and behavior
- ideas about treatment similar to psychotherapy
- believed that mental disorders were in part divinely caused
Hippocrates (460-377 B.C.)
- classified mental disorders into 3 categories (mania, melancholia, phrenitis)
- relied heavily on clinical observations
- mental disorders have natural causes (are due to brain pathology) and have appropriate treatments
- emphasized importance of heredity in development of mental disorders
- little knowledge of physiology (ex thought hysteria was bc of uterus wandering)
Aristotle (384-322 B.C)
- pupil of Plato
- “thinking” as directed will eliminate pain and help attain pleasure
- generally subscribed to Hippocratic theory of disturbances in the bile
Galen (A.D. 130-200)
- one of most influential Greek physicians (practiced in Rome)
- dissected animals to learn about anatomy of nervous system
- divided causes of psychological disorders into physical and mental categories
Early Chinese conceptualizations of abnormal behavior
- one of earliest developed civilizations that brought attention to medicine and mental disorders
- yin and yang are positive and negative forces in the body that must be balanced
- Chung Ching (Hippocrates of China) also based views on clinical observations; believed stressful psychological conditions could cause organ pathologies; treatments (like Hippocrates) used drugs and regaining of emotional balance through appropriate activities
- from 2nd to 9th century, views regressed to implicating supernatural forces
Views of abnormality during the Middle Ages (A.D. 500 - A.D. 1500)
- more scientific aspects of Greek medicine survived in Islamic countries of Middle East
- first mental hospital established in Baghdad in A.D. 792
- Avicenna from Persia (‘prince of physicians’) author of The Canon of Medicine
- middle ages in Europe relatively devoid of scientific thinking and humane treatment
- witchcraft was not really associated with mental illness!
Humanism
- Latter part of Middle Ages and early Renaissance (1500s and 1600s)
- movement emphasizing importance of specifically human interests and concerns
- challenged superstitious beliefs
Paracelsus (1490-1541)
- Swiss physician
- early critic of superstitious beliefs about possession
- formulated idea of psychic causes for mental illness
- advocated for treatment by ‘bodily magnetism’ (hypnosis)
- he thought the moon exerted supernatural influence on the brain
Johann Weyer (1515-1588)
- German physicial and writer’
- disturbed by torture/burning of people whose strange behavior led them to be accused of witchcraft
- argued those accused of witchcraft were mentally ill
- one of first physicians to specialize in study/treatment of mental disorders (founder of modern psychopathology!)
- scorned by peers, works banned by church
Early Asylums
- beginning in 16th century
- places of refuge for care of those with mental illness
- created to remove troublesome individuals from community
- residents often lived in conditions of incredible filth and cruelty
- 1768: first US hospital dedicated to mental illness
Philippe Pinel (1745-1826)
- French physician placed in charge of mental hospital La Bicetre
- removed chains from patients and allowed better living conditions (good results!)
William Tuke (1732-1822)
- English Quaker established York retreat for patients with mental illness
- thought kindness and acceptance would help people with mental illness
Lunacy Inquiry Act (1842)
- lobbied for by Thomas Wakley
- ensured inspections of asylums and houses every 4 months
County Asylums Act (1845)
- required every county in England to provide asylum to those with mental illness
- policy of humane treatment extended to colonies
Benjamin Rush (1745-1813)
- founder of American psychiatry
- encouraged more humane treatment of those with mental illness
- BUT medical theory included components from astrology and he would use bloodletting and restraints as treatment
Moral management
- wide-ranging method of treatment that focused on patient’s social, individual, and occupational needs
- became widespread in early part of humanitarian reform
Dorothea Dix (1802-1887)
- important driving force in humane treatment for psychiatric patients
- grew the mental hygiene movement (advocated for method of treatment focused almost exclusively on physical well-being of hospitalized patients)
Alienists
- name for psychiatrists in nineteenth century
- gradually gained control of mental asylums and used traditional moral management therapy
- considered conditions like melancholia to be the result of nervous exhaustion
Clifford Beers (1876-1943)
- followed pioneering work of Dix
- described own struggles with mistreatment in mental institutions
- won support of many influential people including William James and Adolf Meyer
National Institutes of Mental Health (est. 1946)
- provided active support for research and training (psychiatric residencies and clinical psyc training programs)
Hill-Burton Act (1946 ish) and Community Mental Health Act of 1963
- far-reaching programs to develop outpatient psychiatric clinics, inpatient facilities in general hospitals, and community consultation and rehab programs
Need for reform in psychiatric hospitals
- prominent concern of many professionals and laypeople in 1950s and 1960s
- movement enhanced by scientific advances like antipsychotics and mood stabilizers
Deinstitutionalization Movement
- from 1950s to 1980s
- vigorous efforts made to shut down mental hospitals and return psychiatric patients to community to provide more integrated humane treatment
- hope that new meds would allow patients to live productive lives outside of the hospital
- accompanied by rise in imprisonment which was problematic
General Paresis
- syphilis of the brain
- brain deterioration that caused paralysis, mood changes, seizures, and death within 2-5 years
- A.L.J Bayle (identified disorder)
- Richard Von Krafft-Ebing (est. relationship between paresis and syphilis)
- August von Wasserman (blood test)
- Julius von Wagner-Jauregg (malarial treatment)
- 1925 hospitals used malarial treatment
- now use penicillin
Chlorpromazine
- beginning of newer phase in dev. of psychotropic medicine starting 1950s
- drug found to be effective at rapidly reducing psychotic and manic symptoms but has side effects
- blocks neurotransmitter dopamine
- newer antipsychotic meds (clozapine) block dopamine and serotonin
Emil Kraepelin (1856-1926)
- German psychiatrist with big role in development of methods for classifying abnormal behavior
- created scheme of classification that is the basis of system used today
- mental disorders are distinct and have distinct and predictable causes
Sigmung Freud (1856-1939)
- developed comprehensive theory of psychopathology (psychodynamics)
- method of treatment and study of patients called psychoanalysis
Franz Anton Mesmer (1734-1815)
- Austrian physician further dev. ideas of Paracelsus ab influence of planets over the human body
- planets affect a universal magnetic fluid in the body, the distribution of which determine health or disease
- we can use magnetic forces to cure disease (he used a wand lol)
- magnetized objects didnt actually help, but it worked if the people believed that they would (power of suggestion)
- techniques known as MESMERISM
Catharsis
- discharge of emotional tension associated with something, such as by talking about past traumas
- Freud and Breuer had patients talk ab problems while hypnotized so they could wake up and feel catharsis afterwards
- led to discovery of the unconscious
Free associaton
- method used by Freud in which patients talk freely ab feelings and motives
Dream analysis
- method used by Freud involved having patients record and describe their dreams
Wilhelm Wundt (1832-1920)
- established first experimental psyc lab at University of Leipzig (1879)
- devised many basic experimental methods and strategies
- influenced early contributors to study of abnormal behavior like William James and G. Stanley Hall
Lightner Witmer (1867-1956)
- Student of Wilhelm Wundt
- founder of clinical psychology
- established first American psychological clinic at Uni of Pennsylvania