Exam 1 Flashcards
Medical Model
bleeding, spinning, blistering, water “therapy”, restraint chair, poison, terror
Alternative (Moral) Treatment
compassion, nutrition, low stress, work, exercise, community
Cultural Relativism
- Abnormal defined relative to one’s culture
- Premise: There is no absolute standard of mental health/illness
- Premise: “Normal” & “Abnormal” are social constructions
- Abnormal is simply whatever deviates from cultural norms
- Examples: homosexuality, workaholism, Nazi Germany, shamanistic visions
Cultural Relativism Pros
- culture has clear role in shaping perceptions of “normality”
- some disorders seem specific to specific cultures (bulimia)
culture-bound syndromes
Cultural Relativism Cons
- doesn’t explain why some disorders exist in all cultures
- ignores relevant scientific information about abnormality
- doesn’t permit cross-cultural comparisons (Pinker, Singer)
Harmful Dysfunction
- Scientific/medical approach
- Abnormal behavior represents failure of some designed function (it’s a dysfunction) – it involves disrupted biological and psychological mechanism(s) of adaptive behavior.
- Also regarded as harmful (as determined by cultural values)
- Abnormality is jointly determined by science (dysfunction) and cultural values (harmful)
Harmful Dysfunction Pros
- potential to compare & analyze behavior across cultures
- richly informed by biology, neuroscience, medicine, etc.
- still acknowledges a role for culture (via harm criterion)
Harmful Dysfunction Cons
- not always a mechanism we can yet identify (narcissism),
and most identified mechanisms only partially understood
Natural events
no conscious agent (intuitive physics)
Supernatural events
caused by agents (intuitive psychology)
Mind-body dualism
the mind and body are separate things - your mind is independent of your body - this is a common thought among people but it is not true
Paul Bloom’s thoughts
Mind-body dualism is intuitive but that doesn’t make it true
Trephination
Drilling holes into people’s skulls to let the demons/spirits escape - they thought that that was what was causing people to be mentally ill
Hippocrates
1) First to apply naturalism to human mind/body
2) four essential humors (blood, phlegm, yellow bile, black bile)
3) foreshadowed theory of neurochemical imbalance
4) classification of disorders based on scientific observation (paranoia, depression, etc)
5) emphasized role of stress & nutrition
6) promoted humane treatment of mentally ill
*Father of medicine
Philippe Pinel
1793: humanitarian reform in Paris
William Tuke
1796: “moral treatment” movement in England
Quaker - builds retreat center (no standard care)
Benjamin Rush
early 1800s: hybrid medical/moral treatment
*Founder of American Psychiatry
Dr. Thomas Kirkbride
Pennsylvania Hospital for the Insane (1840-1883)
- Largest moral treatment retreat center
- Got funding from the state
Dorothea Dix
A school teacher from New England who launched Mental Hygiene movement
Emil Kraepelin
Biological/medical model
1893 first systematic classification, first to classify schizophrenia & bipolar
general paresis
Cerebral syphillis - when the syphillis spreads to the brain and makes people start acting strange and eventually leads to death
Brain-damaging therapy
ECT (electric shock therapy), insulin coma, metrazol, lobotomy
Freud
Psychoanalytic model
- talk therapy
John Watson
Behavioral model
rumination
dwelling on something that hasn’t happened yet
fear vs anxiety
fear=threat right now
anxiety=threat maybe later
Prefrontal cortex
- perception of threat
- outter most part of frontal cortex - one of the newest regions of the brain which makes it buggy
- ability to do unbiased reasoning / critical thinking (but not very well)
- **People who suck at it think they’re good at it b/c of Dunning Krueger Effect
Diagnosis
medical model term . . . implies presence of disease
DSM5 Controversies and Concerns:
1) Poor inter-rater reliability (reliability as rate-limiting factor on validity)
2) Ineptitude and financial conflicts of interest (Francis, DSM-IV chair)
3) Expansion of diagnoses, prescribing (grief, ADHD, ‘psychotic risk’)
4) Protests – many moving to alternate systems (ICD-10, RDoC)
DSM5 Controversies and Concerns:
1) Poor inter-rater reliability (reliability as rate-limiting factor on validity)
2) Ineptitude and financial conflicts of interest (Francis, DSM-IV chair)
3) Expansion of diagnoses, prescribing (grief, ADHD, ‘psychotic risk’)
4) Protests – many moving to alternate systems (ICD-10, RDoC)
Amygdala
assigns emotional significance
- the hub of emotion regulation circuitry throughout the brain
- v fast in appraisal - quick and dirty: is this threatening or not?
- sends signal to prefrontal cortex to evaluate
Hypothalamus
triggers “fight or flight” response
- 4 F’s: Fight, Flight, Feeding, F—ing (reproducing)
Locus Coeruleus (brainstem)
directly controls SNS
Boaz
(Relates to cultural relativism)
assume all people aren’t always the same; it’s all relative
- applied Einstein’s discovery that space and time are relative to people
Peter Singer
circle of moral concern - ppl have more compassion w/ ppl in their in-group than marginal ppl/out-group ppl
Baumeister
remember the bad more than the good
habituation
repeated or prolonged exposure to any stimulus produces a decreased response to that stimulus
Defensive pessimisme
convince yourself that bad things are going to happen so that you’re motivated to work even harder and then you end up doing well
Pinker
declining violence and better treatment of out-groups over time
- the overall trend of violence is going down and this is not disproven just because hate crimes are on the rise currently - this is a short term event and the line can fluctuate (it is not a perfectly straight line but it is a downward sloping line)
Cystic fibrosis is an example of a
disease
Psychiatrist
- M.D.
- 4 years medical school, 4 years residency
- Low status among medical specialties
- Focus of career: Medication management = lower job satisfaction?
- Growing shortage of psychiatrists
Clinical Psychologist
Ph.D
- Average of 6 years to completion, including internship year
- Focus of career: Psychotherapy (and/or assessment)
- Highest status among psychotherapists
Counseling Psychologist
Ph.D
- Similar in most respects to clinical
- Focus of Career: Less training with severe mental illness
- Stronger focus on healthier individuals
- Slightly easier to get into counseling PhD program than clinical
- Slightly lower overall status, average salary
Clinical/Counseling Psy.D
- Professional degree (no research component)
- Average 5 years to completion
- Most are in “for-profit” institutes (diploma mills)
- Usually no financial aid
- Average acceptance rate 40% (per program)
- Lower salary than Ph.D
- Lower status than Ph.D (but same license)
Master’s Level Clinician
- Title of licensure depends on state – e.g., licensed mental health counselors (LMHC), licensed professional counselors (LPC)
- 2yr MA degree
- High acceptance rate
- Career focus: Psychotherapy (and/or assessment)
Clinical Social Worker
- 2 yr MSW program
- Psychotherapy, case management
- Fairly high acceptance rate
Psychiatric Nurse Practitioner
- Doctor of Nursing Practice (DNP) – 3 years
- Master of Science (MSN) – 2 years (phasing out)
- Very high acceptance rates for those with BSN and nursing experience
- Focus of career: Medication management (some also do therapy)
- Independent prescription privileges in 19 states (plus 17 more states with minimal MD oversight)
Rehabilitation Specialist, Clinical Case Manager
- Entry-level jobs for psychology majors (BA)
- Low salary: $25,000 – 30,000 range
- High burnout rate
Specific Phobia Diagnostic Criteria
- marked and persistent fear (excessive) cued by presence or anticipation of specific object or situation
- exposure consistently produces anxiety (possibly panic)
- person recognizes fear is excessive (otherwise - psychosis)
- feared situation is avoided
- anxiety and/or avoidance causes impairment in function
Thales
first encouraged naturalism - science
Middle Ages
- Neo-Platonic view (matter not real)
- Return to Supernaturalism
- Malleus Maleficarum: Witch’s Hammer - book on how to torture people
- Trephination: drilling into the skull to let the demons out
European Renaissance
- Thinking that mentally ill were “ill” not possessed
- Return to naturalism
- Avicenna: genius advanced mathematics and science
Sympathetic Nervous System responses
Pupils dilate; slow digestion; urinary tract stops; heart rate increase; blood glucose increase; sweating
PSN calms you down
Etiology (biological theory)
- Evolutionary preparedness theory: it is easier to form phobias of things that would have been harmful to our ancestors ex. snakes; the dark; etc.
- Genetic vulnerability: more likely to form phobia if a parent had the phobia b/c of genetics
- Vasovagal reflex: passing out b/c PSN overcompensates for the SNS by trying to drop the blood pressure
