Midterm 1 Flashcards

1
Q

Psychiatry before the 18th

A

Responsibility of the family
Help of religious order
Often exiled or jailed

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2
Q

Psychiatry during the 18th

A

Mental hospitals spread as a means of control
The great confinement
The insane as objects of bizarre curiosity

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3
Q

Psychiatry in the 19th century

A

Some reform of institutions
Religious people took in mentally i’ll people and gave them tasks
Humanity enters into the equation

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4
Q

Institutionalization

A

1800-1955
Total institutions
Often misused for deviants
Treatments like lobotomies, insulin comas and ECT

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5
Q

20th Century psychiatry

A

Freud - put everyone on a spectrum
Pharmaceutical intervention –> revolutionary
Deinstitutionalization and community psychiatry

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6
Q

Causes of deinsitutionalisation

A
  • Development of anti-psychotic drugs
  • Philosophical changes (60s liberation movement)
  • Legal changes
  • Economic changes (hospitals expensive - sold)
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7
Q

Mental disorder used

A

for diagnostics

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8
Q

Mental health used

A

like “well being” can have MI with good MH

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9
Q

“Mental disease” is

A

Archaic and rarely used

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10
Q

Madness, lunacy, and insanity

A

Used to label behaviour commonly considered extremely bizarre and disruptive

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11
Q

Influence of Freud

A
  • he said lots of people experienced “neuroticisms” (different from madness)
  • He believed in mental illness as a continuous variable not a categorical one
  • Blurred the line between normal and abnormal
  • Began idea of community psychiatry
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12
Q

DSM

A
  • list of all mental illnesses
  • has evolved
  • 400 discrete MD
  • some people say it’s a cultural document
  • used for diagnosis
  • new diseases invented not discovered
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13
Q

Definitions and types are

A

not timeless

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14
Q

Theories can relate to

A
  • Cause (distal)
  • Onset (proximal)
  • Course (natural history)
  • Outcome (symptoms or function based)
  • Recovery
  • Also: labelling, stigma, inequalities, categorization
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15
Q

3 main theoretical lenses to view mental disorder

A
  • Biological
  • Psychological
  • Social
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16
Q

Biological approach to MD

A
  • primary theory used
  • studies on separated twins (50% heritability of schizophrenia)
  • Mixed effects of pharmacological interventions
  • theories : not enough serotonin - depression, too much dopamine - schizophrenia (LACKS STRONG EVIDENCE)
  • research funded by pharmaceutical companies
    + other things like sleep, exercise, diet…
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17
Q

Psychoanalytical approach to MD

A
  • Childhood experience in later pathology
  • interplay of unconscious through life
  • struggle between personal drives and societal/familial/constraint
  • “talking therapies” with trained analysts
  • considered pseudoscience by mainstream psychiatry
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18
Q

Stress-vulnerability model

A
  • Mental illness can be activated in people with pre-existing vulnerability
  • supported by epigenetic theory
  • Durkheim
  • Farhis and Dunham (chicago - toxic fumes)
  • Brown and Harris
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19
Q

Epigenetic theory

A

Idea that people have a genome either turned on or off based on social experience
Genes turned on might be implicated in depression

20
Q

Brown and Harris

A

1978 - study of life events and depression

  • Ongoing difficulties as important as bad life events
  • Social re-adjustment rating scale
  • importance of factor of transition in vulnerability
  • Common theme also - certain traditional societal expectations
21
Q

Labelling theory

A
  • label used to control deviant people

- pathologizes social groups

22
Q

What model is psychiatry based on today

A

bio-bio-bio

23
Q

Individual level measurement of mental illness

A

diagnosis of one person

24
Q

Community level measurement of mental illness

A

looks at statistics and samples

25
Epidemiological studies
- Population or collective level - Branch of public health - Looking at stats Important to make mental health policies and population level programs - also important for planning treatment at the individual level - Understanding the change of MI over time and place
26
Epidemiologists' instruments are
forms
27
An item
a question
28
Aim of epidemiology is to assess
Prevalence incidence Risk factors
29
Prevalence
Proportion of people who have a MI
30
Incidence
Rate per year | Amount of people who have had an onset of MI in a year
31
Risk factors
Causal factors related to an illness
32
Epidemiology deals with problems of
bias - non representative sample | false positives and negatives
33
Definition of medicalization
It is a theory/hypothesis (NOT FACT) referring to a process whereby everyday problems and conditions are allegedly transformed into medical diagnosis and become the location for medical investigation and intervention
34
Critics of medicalization
Looping Bracket creep Medicine as social control Medicalization turning social problems into medical problems It enforces normative social roles and behaviours Insidious role of pharmaceutical companies
35
Critics of medicalization
Looping Bracket creep Medicine as social control Medicalization turning social problems into medical problems It enforces normative social roles and behaviours Insidious role of pharmaceutical companies
36
Looping cycle of illness:
creation → marketing of illness → drug creating → further marketing until illness/drug is taken for granted
37
Main themes of anti psychiatry
- medicalization - False epistemological basis of psychiatry - against institutionalization - against coerced and forced treatment - importance of small scale and therapeutic communities and alternative therapies
38
Key figures of anti psychiatry
Foucault Goffman Szasz RD Laing
39
Foucault on anti psychiatry
- Madness is a social construct - means of social control - Psychiatry as an extra-judicial disciplinary mechanism - surveillance - panopticon
40
Goffman on anti psychiatry
- asylums as total institutions - reinforce chronicity - labelling - "stigma"
41
Szasz on anti psychiatry
- MD are a myth - actually "problems in living" - hospitalisation as infringement of basic liberties - "psychiatry is a branch of law, no medicine" - pb of labelling
42
RD Laing on anti psychiatry
- "The divided self" - how modern living can lead to a "fragmented self" - disorders are "a perfectly rational response to an insane world --> we live in a "sick society" - MD also as result of intense nuclear family (ex. refrigerator mother) - Double bind theory - Kingsley hall - as therapeutic community
43
Double bind theory of schizophrenia
you develop it if you are given contradictory information by the same person (esp. mother when growing up)
44
Consumer Survivor Movement
- made up of ex-psychiatric patients and allies - survived system and/or illness - they want more choice in the system, more recovery-oriented systems, action regarding social injustices - movement is pro-psychiatry - want more funding - grassroots movement unlike anti psychiatry movement
45
Spectrum of social constructionism in psychiatry
- Strictly - MI is not real - Middle: MI constructed through language (signifiers) - Science in action approach : concerned with construction of scientific facts
46
Consequences of psychiatry (?) on women according to SC theorists
- Social control of women - reifies a particular society or culture's notion of an ideal self - construction of a normative femininity - individualises experiences - ignores social influence and factors
47
Historical example of medicalization in women's health
Hysteria Nymphomania Suburban neurosis