Class 7 - Clinical Psychology - History of Clinical Practice Flashcards
What is Zeitgeist?
What were the following of particular historical period:
1. What were the dominant values, – beliefs, –and attitudes?
2. What were people concerned about
3. What were their hopes – and –fears?
4. What were the prevailing ideas about the mind, – the self, – and – human nature?
5. Think of it as the collective consciousness of a historical period, influenced by major events, social trends, technological advancements, and philosophical currents.
What are the key factors that influence a drug’s effect besides its action (Agonist, Antagonist)?
E P - A D
- Efficacy
- Potency
- Affinity
- Duration
What is Efficacy?
How STRONG – of an EFFECT – a drug produces.
What is Potency?
Which drug has high Potency?
- How MUCH – of an drug – is needed – to produce an EFFECT.
- Fentanyl.
What is Affinity?
How STRONGLY – a drug – BINDS – to a receptor.
What is Duration?
How LONG – a drug – STAYS binded – to the receptor.
Why is Naloxone effective against Fentanyl?
2 MCQ on Exam!
Naloxone has a stronger affinity – for opioid receptors – than Fentanyl, – so it can displace Fentanyl – and reverse its effects.
What allows Fentanyl to bind to opioid receptors?
2 MCQ on Exam!
Fentanyl has – a high affinity for opioid receptors, – meaning it binds strongly and activates them.
Why are multiple doses of Naloxone sometimes needed for Fentanyl overdose?
2 MCQ on Exam!
Fentanyl has a longer duration – than Naloxone, – meaning it stays in the body longer, – requiring multiple doses – of Naloxone to counteract its effects.
How does the potency of Fentanyl compare to Naloxone?
2 MCQ on Exam!
Fentanyl has a higher potency than Naloxone, – so even a small amount of Fentanyl – may require a large or very large amount – of Naloxone – to reverse its effects.
What is the efficacy of Fentanyl and Naloxone?
2 MCQ on Exam!
Both Fentanyl and Naloxone have high efficacy, — meaning they produce – strong effects – compared to other drugs.
How can increasing the potency of street drugs impact Naloxone?
2 MCQ on Exam!
If street drugs become too potent, – Naloxone might stop working, making overdoses – harder to treat.
ANCIENT PHARMACOLOGY
(before ~1500s)
– from here on –
(before ~1500s)
What two ingredients that make up Ayahuasca?
It’s Leaves contain:
- Psychedelic hallucination-inducing source (i.e., DMT source).
- And MAOI source.
How long does it takes for Ayahuasca to clear the body upon consumption if it is not combined with MAOI?
It clears the body within minutes
What are the key properties of DMT in terms of:
Efficacy
Potency
Affinity
Duration
DMT has:
- High Efficacy (produces strong effects)
- High Potency (works at low doses)
- High Affinity (binds strongly to receptors)
- Short Duration (unless combined with an MAOI).
Does Ayahuasca allows our imagination to run wild?
Yes
What does Ayahuasca does to our conciousness?
Give example.
It manipulates – our state of consciousness.
Example, people took it to escape anxiety and depression (even though these terms were not discovered then).
What was the Goal of Ayahuasca?
And what approach did it incorporate?
To transport an individual to the ‘OTHER WORLD,’ – incorporating a spirital belief – and – approaching hollistic approach connecting mind, body and soul.
Why is it difficult to determine the early use of Ayahuasca?
Because of – lack written descriptions – and – physical evidence.
What evidence exists of ancient Ayahuasca use?
Traces of Ayahuasca – have been found – in Inca mummies, – suggesting its use in ancient times.
Why Ayahuasca may have been used in ancient pharmacology?
It may have been used for:
- Rituals that strengthened community bonds
- Reinforced social hierarchies
- Possibly for medicinal purposes
Explain this image.
- Leaves contain:
- Psychedelic hallucination-inducing source (i.e., DMT source).
- And MAOI source.
DMT has:
- High Efficacy (produces strong effects)
- High Potency (works at low doses)
- High Affinity (binds strongly to receptors)
- Short Duration (unless combined with an MAOI).
It manipulates – our state of consciousness.
GOAL: To transport an individual to the ‘OTHER WORLD,’ – incorporating a spirital belief – and – approaching hollistic approach connecting mind, body and soul.
Records of early Ayahuasca – lack written descriptions – and – physical evidence.
Traces of Ayahuasca – have been found – in Inca mummies, – suggesting its use in ancient times.
It may have been used – for rituals that strengthened community bonds, – reinforced social hierarchies, and possibly for medicinal purposes.
Why might Indigenous South Americans have used psychedelics?
To:
- Escape reality
- Explore consciousness
- Address anxiety or depression
What is the connection between dreams and psychedelic use?
- Dreams = give access to the mind.
- Psychedelics = may enhance this exploration, similar to ancient theories from figures like Gilgamesh and Freud.
- It’s human innature nature to interpret dreams. – There is a reason why during different timelines humans focus on interpreting dreams. – Sikhsim explain it is the only time when our mind awakens and dreams act as a reminder that we humans have 1 purpose in life that is go back to our home, meaning merge with 1 consciousness instead of neing an individual consciousness atm.
Why do humans try to modify consciousness?
Human try to modify consiousness troughout different timelines using ayahuasca, mushrooms, weed, opoid, drugs – to escape reality, address anxiety or depression – because we are biologically wired to opt measures until we reach the state of happiness.
How do Marijuana and Ayahuasca differ in their effects, – and – what does our drug use reveal about human behavior?
- Marijuana helps calm anxiety and provides pain relief, – while Ayahuasca does not.
- Marijuana has been used medicinally for anti-anxiety, anti-depression, and pain management.
- Our use of drugs often focuses on immediate relief – rather than understanding the root cause of pain or psychological issues. For example, instead of investigating the cause of back pain, we take medication to make the pain go away.
Who recorded the earliest known use of cannabis, and for what purpose?
Emperor Shen Nung documented its medicinal use for ailments like :
- gout
- rheumatism
- malaria
What was the name of the book in which Emperor Shen Nung documented its medicinal use **for ailments like *gout, *rheumatism, and malaria
Pharmacopoeia
What was Marijuana widely used in history for?
- Pain relief
- Religious ceremonies and Rituals
- Introspection
- Meditation
What Zeitgeist does the following reflect: Marijuana has a wide history of use for many things like: pain relief, religious ceremonies and rituals, introspection and meditation.
- Our desire to alleviate suffering
- Search for meaning
- Seek connection
What is the earliest written record of cannabis use, and what does its history reveal about human nature?
- The earliest record comes from Emperor Shen Nung, who documented its medicinal properties for ailments like gout, rheumatism, and malaria.
- Throughout history, marijuana has been used for pain relief, religious ceremonies, introspection, and meditation—reflecting ZEITGEIST like humanity’s desire to alleviate suffering, seek meaning, and seek connection.
Where does opium come from, and what is derived from it?
- Opium is derived from the nectar of the poppy plant.
- Morphine, a powerful painkiller, is extracted from opium.
How was opium used in Ancient Egypt?
Ancient Egyptians used opium to calm noisy children —though this approach overlooked the root cause of distress.
How is opium consumed?
- Opium can be inhaled
- Diluted in alcohol
- Consumed orally.
- Stronger forms like heroin or fentanyl can be injected in vein using IV needle.
How do Opioids, like morphine, work in the brain?
Opioids, like morphine, mimic endorphins—natural painkillers in the brain. – They bind to opioid receptors, reducing pain signal transmission.
Why has opium been widely used across cultures?
Opium has been valued for its euphoric and pain-relieving properties,– often used as a quick solution rather than addressing the underlying issue.
What is opium, how is it consumed, and why has it been widely used?
Explain picture
Opium is derived from the nectar of the poppy plant and can be inhaled, taken as a tincture, or consumed orally. Stronger forms like heroin or fentanyl can be injected intravenously.
Across cultures, opium has been valued for its pain-relieving and euphoric properties, often used as a quick solution rather than addressing the root cause of pain or distress.
How far back does opium poppy cultivation date?
Archaeological finds in Switzerland suggest opium poppy cultivation dates back to 6000 BCE.
What did the Sumerians call opium, and what does it mean?
The Sumerians called opium “Hul Gil,” – meaning “joy plant,” – indicating its euphoric effects were recognized early.
How was opium used in Ancient Egypt?
Egyptians extensively cultivated opium for:
- Pain relief
- Sedation
- Treating various ailments
Which historical physicians studied and documented opium’s medical uses?
– Islamic Golden Age
Physicians like – Al-Razi – and – Ibn Sina – extensively studied and documented opium’s therapeutic applications.
How was opium used in early medicine?
Opium was used as a – treatment – for various ailments – and in early surgical procedures for pain relief and sedation.
What was the role of Bimaristans in opium use?
Bimaristans – (early hospitals during the Islamic Golden Age) – used opium to:
- Sedate patients
- Relieve pain
Why are some natural drugs, like opium, banned today?
Due to – overuse – and – addiction concerns, – many natural drugs have been banned, even though they were historically effective for pain relief.
How does modern pharmaceutical focus differ from historical drug use?
Today, pharmaceuticals focus on profit, – often replacing natural drugs with synthetic alternatives – rather than – using them in controlled, minimal doses.
What was opium used for in ancient medicine?
Explain picture.
Opium was used for pain relief, sedation, and treating ailments. It was also used in early surgeries to reduce pain and induce sedation, with historical records showing its use in Bimaristans (early hospitals).
MODERN
PHARMACOLOGY
(~1500s to ~1950s)
– from here on–
(~1500s to ~1950s)
– from here on–
Why did NOT synthesized drugs emerge before the modern period?
Because there was no perceived need for them before industrialization.
What SOCIETAL change led to the invention of modern drugs?
Industrialization, – which moved people from rural areas to cities, – exposing them to pollution, noise, and stress.
How did industrialization affect mental health?
It caused stress, insomnia, and anxiety, – leading to a demand for medications.
What role did trust in science play in drug development?
Society believed in medical advancements – and – sought quick fixes through – medication.
What was “neurasthenia”?
A condition – caused by industrialization, – characterized by:
- Headaches
- Sleeplessness
- Tension
Why were drugs like Bromide created?
Initially for seizures, – but later – used to manage neurasthenia.
What led to recognizing benzodiazepines as more dangerous than previously thought?
A pattern of drug development continued, with later reclassifications (e.g., bromide).
How did industrialization lead to the rise of modern drugs?
Industrialization moved people from rural areas to cities, exposing them to pollution, noise, and stress. This led to widespread issues like insomnia, anxiety, and “neurasthenia,” characterized by headaches and tension. Society, trusting science, sought quick medical fixes. Early drugs like Potassium Bromide were first used for seizures but later helped with neurasthenia. This pattern of drug development continued, with later reclassifications, such as recognizing benzodiazepines as more dangerous than previously thought.
How did trust in science contribute to the rise of modern drug use?
A: Science was seen as solving all problems, leading people to trust doctors as its representatives. Early drugs were given directly to people without first being tested on animals. Mental illness was “medicalized,” treated like a common cold—something to be fixed rather than understood. The success of Bromides increased demand for stronger drugs, leading to substances like Chloral Hydrate, which was used to manage anxiety and insomnia, reinforcing the idea of drugs as a primary treatment.
Why did people trust doctors as representatives of science?
Doctors were seen – as the face of science, — and since science was solving many problems, — people trusted doctors and the drugs they prescribed.
How were early drugs tested before being given to people?
Initially, drugs were given straight to people, – often those with mental health conditions, – without first being tested on animals.
How did Bromides influence the development of new drugs?
Bromides were effective and widely used, – sparking demand for stronger and more accessible drugs, – leading to the expansion of pharmaceutical treatments.
How did the medicalization of mental illness change society’s view of mental health?
Mental illness was treated like a cold—an inconvenience to be fixed with drugs – rather than something to be deeply understood.
What was Chloral Hydrate, and how did it differ from Bromides?
Unlike Bromides, which had medical uses, – Chloral Hydrate was created specifically to manage anxiety, insomnia, and other conditions, – showing the growing acceptance of drugs as primary treatments.
How did trust in science contribute to the rise of modern drug use?
Science was seen as solving all problems, leading people to trust doctors as its representatives. Early drugs were given directly to people without first being tested on animals. Mental illness was “medicalized,” treated like a common cold—something to be fixed rather than understood. The success of Bromides increased demand for stronger drugs, leading to substances like Chloral Hydrate, which was used to manage anxiety and insomnia, reinforcing the idea of drugs as a primary treatment.
How did industrialization, psychology, and pharmacology shape the rise of modern drug use?
– slides followed–
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How did drug advancements address side effects?
Instead of fixing side effects, – drugs were often rebranded based on its side effect.
Example:
- marketing a drug as a sleep aid – when drowsiness was a side effect.
Why did people turn to drugs instead of psychological solutions?
People wanted immediate results. – The frustration of slow progress – made drugs an attractive QUICK FIX, – leading to a preference for pharmacology over psychology.
How did industrialization contribute to increased drug use?
Industrialization caused stress and discomfort, – creating desperation for solutions. – People turned to drugs – as a way to feel better instantly.
What was the first pharmaceutical sedative-hypnotic drug?
Chloral Hydrate, introduced in 1869.
What was Wilhelm Wundt’s contribution to psychology?
He established – the first experimental psychology lab, – marking the beginning of psychology as a scientific discipline.
How did Sigmund Freud and Josef Breuer contribute to psychology?
In 1895, they published Studies on Hysteria, which helped shape psychoanalytic theory.
Why did people have faith in science despite its drawbacks?
A: Industrialization and scientific progress were seen as forces for societal advancement, leading people to trust medical and pharmaceutical innovations.
How did industrialization, psychology, and pharmacology shape the rise of modern drug use?
Explain picture.
- Industrialization caused stress, leading** people to seek quick relief** through drugs rather than slow psychological solutions.
- Science was revered, and pharmacology gained trust over psychology as people wanted immediate results.
- Early drugs like Chloral Hydrate (1869) and Phenobarbital (1903) were introduced to address distress, often repurposed based on side effects.
- While psychology advanced with figures like Wundt (1879) and Freud (1895), the growing demand for instant fixes led to widespread drug use and abuse, reinforcing faith in pharmacology despite its risks.
What major shift in drug use occurred after the 1940s?
The rise of Consumerism and Advertising – led to Increased Drug Sales – and – Overprescription, – causing skyrocketing deaths from overdose, suicide, and side effects.
How did WWII impact drug use and mental health?
PTSD cases increased after WWII, – leading to higher demand – for pharmaceutical treatments, – contributing to widespread drug use.
What types of drugs emerged in the 1930s and 1940s?
Amphetamines (1930s), Lithium (1940s) became widely used, often overprescribed and abused.
Why did barbiturate-related deaths lead to government intervention?
High-profile deaths, like Marilyn Monroe in the 1960s, – raised concerns, — leading to prescription limits in 1970.
How did consumerism, overprescription, and government intervention shape modern drug regulation?
After WWII, PTSD cases surged, and pharmaceutical drugs like Amphetamines, Lithium, and Antihistamines (1930s–1940s) became widespread. The rise of consumerism and advertising in the 1940s led to aggressive drug marketing, overprescription, and skyrocketing overdose deaths. Barbiturate abuse became a crisis, highlighted by high-profile deaths like Judy Garland and Marilyn Monroe in the 1960s. Public concern forced government action, leading to stricter prescription regulations in 1970, marking a shift toward recognizing drug-related risks.
How did doctors contribute to the destigmatization of mental health?
As psychiatric drugs became more common – in the 20th century, – doctors played a key role – in reducing mental health stigma by framing mental illness as treatable. — However, this also led to increased reliance on pharmaceuticals, – overshadowing psychological treatments.
How did pharmaceutical companies impact doctors and psychology?
Pharmaceutical companies capitalized on doctors’ authority, – shifting focus from psychology to prescription drugs for profit.
What are the pros and cons of psychological treatment for mental health?
Pros:
* Encourages holistic understanding
* Helps uncover root causes, individual-focused
* Contributes to brain research.
Cons:
* Cannot treat severe conditions like schizophrenia alone
* Difficult to find a therapist
* Requires long-term commitment
What are the pros and cons of pharmacological treatment for mental health?
Pros:
* Addresses both physical and mental symptoms
* Meds increases motivation
Cons:
* Provides a temporary fix
* Can lead to withdrawal symptoms
* Does not address underlying causes
How did the 20th century shape mental health treatment?
The professionalization of medicine gave doctors greater authority, increasing trust in science and pharmaceuticals. This led to a SHIFT from asylums to consumer-driven mental healthcare, increasing medication use while reducing public funding for psychological care.
How did the rise of psychiatric drugs impact mental health treatment in the 20th century?
Explain picture.
- Psychiatric drugs helped reduce the stigma around mental illness but led to over-reliance on medication.
- Pharmaceutical companies gained influence, psychology lost prominence.
- Treatment shifted from asylums to a consumer-driven, medication-focused approach.
Contemporary Pharmacology
– from ~1950s - now –
from ~1950s - now
How did society view people with schizophrenia before Chlorpromazine?
They were marginalized and often treated as less than human/ like animals.
What changed when science introduced Chlorpromazine?
The drug appeared to “FIX” schizophrenia, – changing perceptions – and – giving HOPE for treatment.
How did the introduction of Chlorpromazine affect the public’s view of doctors?
Doctors were seen as gods, – capable of – curing mental illness – with medicine.
What (negative) happened when Chlorpromazine was seen as a miracle drug?
It was overprescribed – to people – who didn’t have schizophrenia, — leading to severe side effects.
What new scientific question emerged from the success of Chlorpromazine?
Scientists started wondering – if diseases had a genetic cause – and – if genes could be altered – to eliminate disorders.
Why is it incorrect to assume mental illnesses are purely genetic?
No disorder is purely genetic—an environmental trigger – is needed – to activate the condition.
How did the Disease Model influence mental health treatment?
It led to the belief – that one drug could treat– all disorders, — which oversimplified mental health.
What HOPE did Chlorpromazine give to mental health care?
It gave HOPE that people with mental illnesses – could recover, — leading to advancements in psychiatric treatment.
How did Chlorpromazine impact the treatment of mental illness and shape perceptions of psychiatric care?
Initially, society marginalized individuals with schizophrenia, believing their condition was untreatable.
The introduction of Chlorpromazine in the 1950s changed this perspective, as it was seen as a “wonder drug” that could reduce symptoms, leading to hope for recovery.
This elevated doctors’ status, as they were perceived as “fixing” mental illness. However, overprescription of the drug extended beyond schizophrenia, causing severe side effects. The success of Chlorpromazine also fueled the disease model of mental illness, leading to a search for genetic causes of psychiatric disorders. Yet, contemporary understanding recognizes that genetics alone do not determine mental illness—environmental factors also play a crucial role.
This shift has influenced a more targeted and holistic approach to treating disorders like anxiety and depression rather than a one-drug-fits-all solution.
How did Chlorpromazine contribute to the deinstitutionalization of mental health care?
Chlorpromazine reduced symptoms of schizophrenia, – leading to mass deinstitutionalization – as patients were discharged. – This reinforced a medication-first approach, – shifting care from personalized support – to outpatient services.
How did the rise of Biological Psychiatry impact the perception of mental illness?
Biological Psychiatry promoted – the Disease model and “chemical imbalance” theory, – framing mental disorders as purely biological impairments – needing medication-based solutions. –This reduced the influence of psychoanalysis.
What were the unintended consequences of deinstitutionalization?
The release of mental health patients – increased societal visibility of mental illness, – leading to greater stigma and discrimination. – Many patients lacked proper community support.
How did Chlorpromazine influence mental health care and the rise of the disease model?
+
How did the success of Chlorpromazine contribute to the rise of the Disease Model in psychiatry?
Chlorpromazine led to deinstitutionalization, shifting mental health care from personalized support to a medication-first approach.
– This reinforced Biological Psychiatry, promoting the disease model and the “chemical imbalance” theory.
While it reduced psychoanalysis’ influence, it also increased stigma and left many patients without proper community support.
Chlorpromazine’s effectiveness in treating schizophrenia reinforced – the idea that mental illness could be treated like physiological diseases. – This led to a biological psychiatry boom, prioritizing drug therapies for all mental health conditions, despite limited understanding of neurotransmitter imbalances. – The push for medication – overshadowed – holistic care and alternative treatments.
What unexpected effect did Iproniazid have on TB patients?
Iproniazid, originally used to treat TB, was found – to elevate patients’ mood, – leading to its repurposing – as one of the first antidepressants.
What BELIEF did the sucess of drugs, e.g., Chlorpromazine lead to?
The BELIEF that mental disorders – were caused – by chemical imbalances – and required pharmaceutical solutions.
What were the pros and cons of expanding the Disease Model?
✅ Pro: Shifted mental illness from a character flaw to a medical condition, – reducing stigma.
❌ Con: Led to overreliance on medication – while neglecting – social, psychological, and environmental factors in treatment.
How did the GI Bill impact psychological research after WWII?
The GI Bill – injected significant funding into psychological research, – partly in recognition of psychologists’ roles during the wars, – leading to increased focus – on developing new drugs – for mental health issues, especially PTSD.
What role did the Thalidomide tragedy play in drug development?
The Thalidomide tragedy led to:
- A greater emphasis – on ethical research practices.
- Implementation of rigorous testing – to ensure the safety.
- Efficacy of new drugs.
rigorous = extremely thorough, exhaustive, or accurate.
How did the focus on animal research change in the mid-20th century?
Animal research – previously lacked – attention to ethical concerns – and robust methodologies. – However, from the 1950s to 1970s, animal rights groups – pushed for greater ethical scrutiny – and more explicit, comprehensive methodologies in animal research.
How did ethical concerns in animal research evolve post-WWII?
Ethical concerns surrounding animal research grew significantly, – as animal rights groups – raised awareness– about animal treatment, — prompting more ethical standards – and – transparency – in research practices.
How did WWII, the GI Bill, and the Thalidomide tragedy impact psychological and animal research?
Explain attached picture.
After WWII, the GI Bill funded psychological research, focusing on mental health treatments like PTSD.
The Thalidomide tragedy – led to more ethical drug development with rigorous safety testing.
Meanwhile, animal research gained attention, and animal rights groups promoted ethical standards – and – transparent methodologies in animal research.
What was benzodiazepines marketed for?
They were marketed – as a safe treatment – for – anxiety and insomnia – but later – became highly addictive and widely abused.
What neurotransmitter system do benzodiazepines affect?
Benzodiazepines are GABA agonists, – meaning they enhance GABA activity – by holding open the receptor channel longer, – leading to sedation and relaxation.
What are the risks associated with benzodiazepines?
- Cognitive impairment
- Rapid dependence
- Severe withdrawal symptoms (psychosis, death)
How did benzodiazepines impact public health?
Initially seen as safer alternatives to barbiturates, benzodiazepines – became one of the most dangerous – and widely abused prescription drugs.
What is the current/contemporary stance on benzodiazepines?
Due to their high potential for addiction – and – withdrawal dangers, legislation has decreased prescriptions, – limiting access despite patients’ dependence.
What was the impact of benzodiazepines on mental health treatment?
explain picture.
Marketed as a “safer” alternative to barbiturates, benzodiazepines (e.g., Valium, Librium) became widely prescribed for anxiety, insomnia, and seizures.
However, they caused rapid dependence, cognitive impairment, and severe withdrawal symptoms (delirium tremens, psychosis, death).
Today, they are one of the most dangerous and abused drugs, leading to stricter prescription regulations.
What was the next major psychiatric drug after benzodiazepines?
Prozac (an SSRI), – followed by SNRIs – and atypical antipsychotics.
How did the GI Bill, animal welfare movements, and the thalidomide tragedy influence drug development?
They led to:
- The rollout of medications that were more effective
- Had fewer side effects
- Were researched more ethically.
What was the public’s reaction to the pharmaceutical industry’s role in psychiatric medication development?
Over time, – negative perceptions of the pharmaceutical industry grew.
How has public perception influenced mental health treatment?
OR
What is the change happening in today’s world?
Interest in alternative medicine – and – holistic approaches has grown, – leading to a gradual shift – back toward – counseling-based treatments.
