Lecture 1 Flashcards
What are the 4 main objectives for scientific study of behaviour?
- Describing: what behaviours are evident - do they fulfill criteria for a disorder
- Explaining: why a behaviour is evident
- Predicting: outcome
- Managing: behaviours that are considered problematic
What is the Relativist view
Symptoms & causes vary across cultures
What is the Absolutist view
A disorder is caused by the same biological factors
How do you define abnormal behaviour?
NO CLEAR-CUT DEFINITION. Largely subjective
is the individual behaving differently, deviantly, dangerously or dysfunctionally abnormal?
Does the behaviour cause distress or dysfunction for the individual or others
Duration
How many elements of abnormality are there and list them all?
- Personal suffering
- Maladaptiveness
- Irrationality and incomprehensibility
- Unpredictability and loss of control
- Level of emotional distress
- Interference in daily functioning
- Vividness and unconventionality
- Deviations from the norm (developmental, societal & cultural) - Observer discomfort
- Violation of moral and ideal standards
What does the DSM-5 focus on?
Symptoms and scientific basis.
- clinical presentation: what specific symptoms cluster together
- etiology: what causes the disorders
- developmental stage: does the disorder look different for children than it does for adults
What are involved in mental disorders?
Present distress
Disability (impairment in one or more areas of functioning)
Significant risk of suffering death, disability, or an important loss of freedom
What did Thomas Szasz say?
Clinical labelling leads to stigma and discrimination
What is epidemiology
They study of the frequency and distribution of disorders within a population
What does incidence refer to?
Incidence refers to the number of NEW CASES of a disorder that appear in a population within a specific time period.
What does prevalence refer to?
Prevalence refers to the TOTAL number of ACTIVE cases in a given population during a specific time period.
What is comorbidity?
Comorbidity means that more than one condition is present
What is life-time prevalence
Lifetime prevalence is the proportion of the population that is affected AT SOME POINT during their lives
Rank from greatest to least the lifetime prevalence rates of mental disorders
- Major depression
- Alcohol abuse
- Drug abuse
- PTSD
- Panic disorder
- Bipolar mood disorder
- OCD
- Schizophrenia
- Bulimia nervosa
- Anorexia nervosa
What were the three categories Hippocrates classified mental disorders into?
- Mania
- Melancholia
- Phrenitis (brain-fever)
What was the common conception for the cause of diseases during ancient times?
That ALL forms of diseases had natural causes.
Imbalance in essential fluids such as blood, phlegm, yellow and black bile. Thus, treatment procedures focused on restoring balance.
During Middle Ages how was abnormal behaviour viewed?
Interpreted as the work of the devil or witchcraft (exorcism). Many with mental disorders treated like witches.
Mentally challenged individuals were viewed demonically.
Who criticized demonology and what were their reasons?
Paracelsus - stars and planets affected the brain
Weyer - First physician to specialise in the treatment of mental illness
What was the first major asylum and How was the treatment of mentally ill individuals in asylums?
London’s Bethlehem Hospital
Treatment consisted of CONFINEMENT (isolation), TORTUROUS PRACTICES (ice-cold baths) and MEDICAL TREATMENTS (bloodletting)
When did reform into mental illness treatment begin, and who was a key figure during this time?
19th century; Philippe Pinel
List Pinel’s Classification System
- Melancholia
- Mania
- Mania with delirium
- Dementia
- Idiotism
List Kraepelin’s classifiers
Dementia praecox
Mania depressive psychosis
List somatic treatments (Slide 31)
Fever therapy - blood from people with malaria injected into patients to develop fever. Reason: symptoms sometimes disappeared in patients who became ill with typhoid fever
Insulin coma therapy - inject insulin to lower blood glucose levels and induce a hypoglycemic state and deep coma. Reason: observed mental changes among some diabetic drug addicts who were treated with insulin
Lobotomy - sharp knife inserted into skull to sever nerve fibers connecting the frontal lobes to the rest of the brain. Reason: saw decrease in negative emotion during stress among chimpanzees after performing same procedure
Who were involved in the psychoanalytic revolution
Franz Mesmer: neurologist who identified hysterical disorders and treated them with HYPNOSIS
Freud: trained by Jean Charcot, developed free association theory
Joseph Breuer: Hypnosis + catharsis
Who were key to the psychoanalytic revolution? And what did they discuss?
Freud and Breuer (through studies in Hysteria).
- Psychological factors affect behaviour
- Talking treatment is more effective than harsh physical & moral treatments
- Behaviour is influenced by thoughts, impulses & wishes we may be unaware of
- Non-psychotic disorders are worthy of treatment
What comprises the biopsychosocial framework?
What is it?
Biological factors
Social factors
Psychological factors
Environmental factors
Argues that the interaction between these factors determine the cause, manifestation, and outcome of wellness and disease.
List advances in treatment
Behavioural therapies
- Behaviour therapy
- CBT
- CBT + mindfulness and acceptance therapy
New Psychotic drugs
Out-patient psychiatric clinics focus on MANAGING the illness
Community mental health centres focus on REHABILITATION
What is the current view of abnormality?
Behaviour must always be considered in the context in which it occurs
To best understand abnormal behaviour requires adopting the scientist-practitioner approach (guided by observation, evidence, and theory)
Best to incorporate HOLISTIC or MULTIDISCIPLINARY approach to both development of and treatment of abnormal behaviour.
What is a symptom?
Subjective and objective signs of pathological conditions
What is a syndrome?
A group of symptoms that occur together that constitute a recognisable condition
Purpose of classification
Enables clinicians to diagnose a person’s problem as a disorder
Information retrieval
Facilitates research
Facilitates communication
Facilitates treatment selection (sometimes)
Problems with classification
Categorical approach - we are categorising people and where do we draw the line
Dimensional approach
Criticism of classification
Classification per se is irrelevant to the field of abnormal behaviour (Thomas Szasz view)
Loss of information (reducing people to single words)
Ignores differences
Labels controversy
- shape perceptions (struggling with jobs)
- prejudicial treatment
- self-fulfilling prophecy
Criticism of Diagnostic practice
Distinct entity vs Continuum approach
- behaviour problems in a child (when do we diagnose a child)
Reliability and validity
- some of the disorders are not that reliable for making diagnoses (comorbidity)
Diagnostic bias
- expectations of what we think their problems are
- Rosenhan Experiment: It’s clear that we cannot distinguish the sane from the insane in psychiatric hospitals
What is Clinical Assessment?
The process of gathering info important to diagnose, plan treatment and predict the future course of a disorder
Types of Clinical assessments?
Projective tests
- Rorschach Test
- Thematic Apperception Test
Personality Inventories
Self-report inventories
Intelligence tests
Neurological tests
Behavioural Assessment
Physiological Assessment
