Midterm Flashcards
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1
Q
What is Carl Elliot’s primary question
A
Why is there a sudden recent surge in mental illness? Is it just because we’re getting better at diagnosis or there’s actually more autism, ADHD, etc?
2
Q
Elliot’s 4 distinct factors that influence mental illness prevalence rates
A
1) Ascendency of biomedicine
2) Treatment efficacy
3) Support & advocacy
4) Marketing
3
Q
Elliot’s 4 factors – ascendency of biomedicine
A
Biomedical definitions of mental illness are the primary way we diagnose; evolving defs –> changes in prevalence rate
4
Q
What is the DSM
A
Diagnostic & Statistical Manual
handbook of psychiatry; designed to created standardized diagnoses for mental health disorders
5
Q
How has the DSM changed over the years
A
Newer versions of the DSM have more disorders, more thorough descriptions, and evolving criteria
DSM-1 had 106 disorders and 103 pages, DSM-5 (most recent) has ~300 disorders and 900+ pages
6
Q
Elliot’s 4 factors – treatment efficacy
A
- Treatment SUCCESS produces uptick in diagnoses
- Many disorders not officially recognized until there was a success in treating it
7
Q
Elliot’s 4 factors – support and advocacy
A
Communities emerge and share vocab, spread info/awareness abt the condition, combat stigma
- Encourages ppl to be more outspoken abt their condition + be less afraid to get formal diagnosis
8
Q
Elliot’s 4 factors – marketing
A
Big pharma markets products to DOCTORS saying they “treat a proper illness”
- They may be promoting cures for bogus ailments in some cases
9
Q
Transient mental illness
A
Mental illnesses that only show up at some times and some places – can assume they’re connected with the culture of the place
10
Q
Interactive kinds vs indifferent kinds
A
Interactive kinds: classifications that influence the ppl they categorize
Indifferent kinds: classifications don’t affect the classified entities (e.g., chemical elements, quarks, a species)
11
Q
Human reflexivity
A
Describes how ppl often react to how they’re classified by changing an aspect of their behavior, identity, or self-perception (related to looping effects)
12
Q
Looping effects
A
Enough change from human reflexivity –> the original things we claimed to know are now false –> classification itself may change around the ppl in it
13
Q
Constructionist vs biological camp
A
Constructionist: disorders thought of as INTERACTIVE
Biological: disorders thought of as INDIFFERENT
14
Q
Does Hacking believe that something can be both interactive AND indifferent?
A
YES – argues that we should make room for both camps and that psychopathologies (i.e., mental illnesses) are both interactive AND indifferent
15
Q
Hacking’s Pathology P
A
Uses it as an example and ties it to autism to illustrate how smthn can be both interactive and indifferent
P is indifferent by definition, BUT it affects how the afflicted individual moves thru life, so its also interactive
16
Q
Classificatory looping vs biolooping
A
Classificatory looping: INTERACTIVE – literally just the looping effects and categorizations idk what else to say here
Biolooping: INDIFFERENT – changes in our ideas change our physical state (weird phenomena, but our genes don’t change their expression bc we tell them to)
17
Q
First example of an interactive kind
A
“Feeblemindnedness” in early 1990s
- Later became idiot, imbecile, mental retardation, intellectual disability
- Influenced eugenics
18
Q
According to Nomy Arpaly, how are BPD and diabetes similar
A
- Drug treatments
- Can’t be ‘“wished away”
- Ranges in severity
19
Q
What are the 2 dimensions of mental states
A
Warranty & Desirability
- Warranted vs unwarranted: whether or not the belief/emotion is justified
- Desirable vs undesirable: good or bad to feel a certain way in that context
20
Q
Physical causes vs content efficacy
A
Physical causes: you cry bc the opera is too loud
Content efficacy: you cry bc of the lyrics of the song
21
Q
Reason responsiveness
A
Specific kind of content efficacy adjacent to warranty
22
Q
According to Arpaly, what sets mental states apart from physical states
A
Warranty and content efficacy
23
Q
Resignation Syndrome + why it’s so strange
A
Condition where an individual who was originally fully functional but had experienced past traumatic events enters state of extreme withdrawal and apathy
- strange bc it seems to ONLY affect the children of asylum seekers in Sweden – no outside cases reported indicate a sociocultural factor
- Some pops like those from Russia seem to be most vulnerable
- Number of cases has reportedly decreased
24
Q
Hegemony of normalcy
A
The idea of using norms to enforce dominance over a group
- Does NOT work thru overt coercion; works thru consent, persuasion, and normalization of power structures
25
Impact of statistical norms + why its problematic
Emerged in 19th and 20th Cs -- used averages to define "normal" human traits
- Created hierarchy of desirability
- Led to belief that deviation from the statistical avg was inherently undesirable -- Equated "normal" with "ideal"
- Applications of statistical norms created false justifications that led to harmful policies, forced sterilizations, etc
26
Modern-day relevance of the impact of statistical norms
Gene editing, etc trying to "perfect" the human race
27
Statistical norms and capitalism
Capitalism defines the avg worker thru productivity metrics -- neglects personal circumstances
- pressure to conform to ideals can have negative impact on mental health
- according to Davis, to break out of the capitalistic mindset, we must recognize the intrinsic value of workers BEYOND traditional measures
28
Tyranny of the norm
The notion that the idea of a "normal" body or mind imposes rigid expectations that marginalizes anyone who doesn't fit the ideal
- reinforces ableism by framing disability as a deficit instead of a natural variation of human experience
29
According to Davis, what is the symbol for the tyranny of the norm
The bell curve
30
Do Hacking and Davis' views align
YES
- Hacking's normalizing perpetuates Davis' tyranny of the norm
31
Ableism vs disableism
Ableism: social systems that enforce the idea that someone with a disability is a deficiency
Disablism: manifestation of ableism; specific focus on the prejudice and discrimination ppl w disabilities face BC of their disabilities
- More interpersonal and situational
32
Compulsory able-bodiedness
Life is much easier for those who are able-bodied
33
Normalized able-bodiedness
We assume that everyone is able-bodied
34
Disability erasure
Framework that assumes everyone either is or should be able-bodied; ignores reality that many ppl experience temp or permanent disability in their lives
35
Expectation of passing
Ppl w disabilities often pressured to conform to able-bodied norms
36
Able-bodiedness and productivity
In capitalist society, ppl are valued based on their economic contributions; ppl needing aid or accommodations are looked down upon
37
Impact of ableism on identity
Internalizing ableist norms --> poorer outcomes
- diminished self-worth, poor mental health
38
What are the social consequences that can come from stigma surrounding disability
Social withdrawal, MASKING (hiding disability/extent of disability to fit in/not be looked down upon)
39
Do Hacking and Campbell's views align
YES
- Campbell describes how the privileging of able-bodiedness (e.g. ableist norms) marginalizes those who deviate
- Hacking's looping effects explain how those ableist norms are created and perpetuated
40
Elizabeth Packard
Rights activist; institutionalized in 1860 for having religious views different than her husband's
- advocated for release and eventually succeeded in appeals trial -- was declared sane by jury after only 7 mins
- fought for personal liberty laws to protect others from wrongful institutionalization
- advocated for the rights of married women and asylum patients
- REFLECTS DAVIS' TYRANNY OF THE NORM bc it highlights how deviations from societal normas are pathologized and punished
41
Leonard Roy Frank
Rights activist; institutionalized for spiritual beliefs and veganism
- became leading figure in anti-psychiatry movement after own experience -- critiqued practices like forced hospitalizations and shock therapy
REFLECTS HACKING'S LOOPING KINDS bc the label of "madness" shaped his experiences and resistance
42
Mad Pride Movement
Dedicated to resisting and critiquing clinician-centered systems and finding alt approaches
43
Did the Mad Pride Movement find inspiration from other rights movements
Yes
Black civil rights, women's movement, early lesbian & gay movement
44
3 key concepts of mad pride movement
1) reclaim the term "mad"
2) recognize social context of mental health
3) advocate for patients' autonomy and self-determination, not the psychiatric practice making all decisions
45
Mad pride movement's 3 core critiques of the biopsychiatric model
1) biological focus limitations: emphasizes biological facotrs and neglects role of env
2) unsubstantiated "chemical imbalance theory": posit that it oversimplifies mental health
- Chemical imbalance theory states that mental health disorders simply arise from chem imbalances in the brain
3) pathologizes what may just be non-conformity: tendency to label emotional distress as mental illness
46
Does Beresford's "Mad" align with the beliefs of the mad pride movement
YES
- both advocate for SOCIAL model of mental distress
- both emphasize importance of ppl labeled as "mad" having a say in the policies that affect THEIR lives (i.e., they get to speak for themselves)
47
Disability studies vs mad studies
Disability studies: disability seen as PERSONAL tragedy and MEDICAL problem -- creates cultural divisions and pressure to conform
Mad studies: frames mental distress as rooted in SOCIETAL systems + CRITIQUES medical model -- explores how binary reinforces stigma and pressure to conform to able-bodied norm
48
Do Beresford and Campbell's views align
YES
- Both emphasize importance of different perspectives + listening to those who are disabled
- Both advocate for emphasis of societal factors, NOT indiv pathology
49
3 challenges facing the mad pride movement according to Beresford
1) institutional resistance: mainstream psychiatric frameworks still prioritize biomedical model
2) Movement fragmentation: diverse perspectives can lead to disunity --> complicates efforts
3) Underrepresentation of voices: eurocentric focus often neglects the experiences of marginalized communities
50
Who was Thomas Insel
Director of NIMH for 13 yrs -- wrote "Healing"
Oversaw allocation of $20B over his tenure towards mental health — largely funded research and neuroscience, but wrote in “Healing” that he regrets that decision and wishes he allocated more towards addressing social aspects of mental health
51
What does Insel regret
Insel regrets directing all of the money towards researching the neurological causes behind mental illness; now feels like he neglected the social aspect
52
How does the story of Brandon Staglin support the social model
- Staglin is a man with schizophrenia referenced by Insel
- Experienced headaches and hallucinations beginning 1st yr of college -- sought psychiatric help, but looong process of trial and error to find right combo of drugs
- In grad school, he embarked on plan to "cover all his bases" -- medication and treatment, coaching for social skills, support for work, playing guitar, and meditation
- As of today, he hasn't had any bouts of psychosis in the last 20 yrs -- attributes it to the 3 Ms (medication, meditation, music)
53
What are Insel's three Ps?
People, place, purpose
54
Insel discussion of mental health clinic in Trieste, Italy
- Stark contrast to American mental health institutions
- Final goal of RECOVERY
- Holistic approach w emphasis on indiv's social connections, not their disorder
55
Dorthea Dix
1841 -- activist who visited psychiatric hospitals and was horrified, so she traveled across the US encouraging states to invest in the "moral treatment" of the "insane"
56
Penrose hypothesis
INVERSE relationship btw the number of ppl housed in asylums vs prisons (i.e., less ppl housed in asylums --> more ppl in prisons)
57
Liat Ben-Moshe's "new asylums" thesis
Assumes deinstitutionalization --> homelessness --> imprisonment
58
Does Alissa Roth agree with the Penrose hypothesis
NO
- argues that ppl released from hospitals didn't just go to jail or prison
- States that even in 1950 before spike institutionalization, majority of ppl w mental illnesses were either living in communities, with their fans, or independently
59
1963: Mental Retardation Facilities and Community Health Centers Construction Act
Passed by JFK -- did not live up to the hype
Vision: patients could avoid the dehumanization of hospital life and live in a safe environment where patients could lead relatively normal lives
Reality: for-profit nursing homes, room and board facilities, “welfare” hotels – all largely UNREGULATED by the states
60
1965: Medicare and medicaid
Passed by LBJ
Medicare for elderly, medicaid for poorer fams and patients
- PROBLEMS: benefits not given to residents in in-state hospitals + many states cut vast majority of patients to reduce elderly patient pops
- SAMSHA study referenced by Insel shows ppl on Medicare or Medicaid dying 15-30 yrs earlier
61
1971: "war on drugs" + "broken windows" policing
Nixon
- Crackdown on drug crimes
- Made ppl w mental illness esp vulnerable to incarceration -- many incarcerated ppl w mental illness known to have substance use disorder
- "broken-windows" policing: cracking down on less serious crimes to set precedent and deter ppl from more serious crimes
62
Carr guiding question
Is America REALLY in a mental health crisis, or is there something else happening? (i.e., are mental health rates really on the rise, or is it just that society sucks?)
63
Medicalization
Treatment of common human conditions as medical ailments
- Carr opposes medicalization bc it's too narrow
64
Reification
Problems caused by societal factors are made to seem like an individual’s issue
In mental health, focusing too narrowly on the condition as an individual incidence ignores the larger social problems that may be underlying it
65
Run over by a car syndrome
Addressing the wrong issue; not addressing the underlying cause — coined by Carr
66
Does Carr agree w Insel
Yes, but she's a bit more radical than him
67
Eugen Buehler
1912: introduces "autism" to describe social withdrawal in patients w schizophrenia
68
Leo Kanner
Identifies early infantile autism -- emphasizes social interaction and communication difficulties
69
Kanner's refrigerator mother theory
Autism CAUSED by mothers who were cold and didn’t provide their children w enough empathy an support
- problematic bc it implies the child’s condition is the mother’s fault
70
Hans Asperger
1944: publishes research on children w higher verbal skills + coins term "autistic psychopathology"
71
When and in what version of the DSM was autism officially recognized
1980 in the DSM-III
72
When was Asperger's Syndrome removed from the DSM
2013: DSM-5 consolidates autism subcategories into ASD and removes Asperger's Syndrome
73
DSM-5 diagnostic criteria of ASD
- Social communication impairment
- Rigid and repetitive behaviors
- Present in early development
- Causes clinically significant impairment in social, occupational, etc domains
- Disturbances not better explained by intellectual disability or global delay
74
Autism Self-Advocacy Network (ASAN) diagnostic critera of ASD
- Different sensory experiences and perceptions
- Unique ways of learning and problem solving
- Atypical, sometimes repetitive, movement
- Difficulty understanding and expressing verbal and non-verbal language that’s used in typical communication
- Difficulty understanding and expressing typical social interaction
75
Modeling autism
Old model was a classic spectrum, but newer models show specific areas of strength and weakness
76
How does the environment play a role in giving rise to ASD
Genetics provide predisposition, env exposures during critical periods of deve may "trigger" or amplify risks
77
Prenatal factors giving rise to ASD
Before birth
- Exposure to teratogens (e.g. substances, tobacco smoke, etc)
- Maternal infections (rubella, Zika)
- other complications during pregnancy
78
Perinatal factors giving rise to ASD
Around/during birth
- Low birth weight
- Premature birth
- Birth asphyxia
79
Postnatal factors giving rise to ASD
After birth
- Autoimmune disease
- Viral infection
- Hypoxia
- Environmental toxins (e..g mercury)
80
What are the 3 main relevant neural regions involved in giving rise to ASD? what do they have in common?
Amygdala, prefrontal cortex, nucleus accumbens
- All 3 are related to areas of difficulty for those w ASD -- social behavior, emotional reg, reward processing, motvation
81
Amygdala role in ASD
Emotional processing, social behavior fear and threat detection
- In ASD, often enlarged during childhood --> reduced growth/smaller volume in adolescence and adulthood
82
Prefrontal cortex role in ASD
- Executive func, social behavior and judgment, emotional reg
- In ASD, overgrowth in childhood --> normal or reduced growth in adulthood (like the amygdala)
- HYPOactivation during tasks requiring social judgment and flexible thinking
83
Nucleus accumbens role in ASD
- "reward system"; motivation and goal-directed behavior, reward processing, emotional reg
- Differences in structure may affect connection to PFC and amygdala
- May underlie repetitive behaviors or restricted interests
84
Steroid hormone lvl role in ASD
Steroid hormones (e.g. testosterone) influence brain dev in utero
- high lvls of test during fetal dev linked to autism-related traits in both boys and girls
85
True or false: autism in men and autism in women has been studied equally
FALSE
Women used to be believed not to be able to get autism – autism research done exclusively on mostly white males --> many females go undiagnosed bc there isn’t much knowledge on how autism affects them
86
Is the male or female ASD prevalence rate higher
Males diagnosed at SIGNIFICANTLY higher rate (4:1 m/f ratio) -- raises concerns for potential biases in diagnostic criteria
87
Female protective model
Multiple genetic factors contribute to ASD; women have higher genetic threshold (i.e., more things need to go wrong to get ASD)
87
Extreme Male Brain Theory
Regardless of gender, ppl w autism display "extreme male" brain type -- systemizing over empathizing
- Builds on Simon Baron-Cohen's empathizing-sympathizing theory that posits that on avg, women are better at empathizing than men are at systemizing
88
Gender-incoherence theory
Autism linked to androgynous features in both men and women
- Women w ASD may show more masculine traits
- Men w ASD may show more feminine traits
89
Is the gender-incoherence theory complete
NO
Neuroimaging studies show mixed results; gender-incoherence theory cannot account for observed differences in brain structure and function rn
90
Gil Eyal guiding question in "Autism Looping"
Instead of asking "why so many cases now?” we should be asking “why so few cases in the past?”
91
How was the mother always blamed for the condition of her child
Many mothers were encouraged to institutionalize their "retarded" child bc doctors worried that mothers of “retarded” children would spend all their time/energy on that kid and ignore the rest of the fam
BUT the mother was still blamed anyway for “rejecting” her child
92
Unintended consequences of institutionalizing young children
- Overpopulation and neglect in institutions PRODUCED social withdrawal, indifference, and self-stim behaviors (i.e., behaviors associated with autism)
- Lack of employees and proper training --> institution also couldn’t provide the kind of care that could nurture dev --> kept autism “under the radar” diagnostically
- Overall CANT discern who has an intellectual disability in institutional setting
93
Why did some parents accept some blame for the condition of their child
Found a little bit of hope in blaming themselves; if they change, their child might change --> removes stigma of “organic defect”
94
Parent-child dyad
New human "kind"; autistic person and "autism parent" bound thru similarity
95
Bernard Rimland
Main advocate behind modern autism parents’ movement to lobby for treatment (now called the Autism Society or National Society of Autistic Children)
96
Rimland "checklist survey"
Parents could fill out checklist survey and send it to Rimland for his analysis of the child
"open clinican's office door"
97
Lovaas' "Applied Behavior Analysis"
Home-centered, evidence-based treatment using operant conditioning to shape behavior
- Originally used aversives (e.g. spanking, shouting) to shape behavior, but that's a no no now
- Uses reward to shape behavior today
CONCERN: some worry it's shaping towards "neurotypicality"
98
Brain talk
"Language of neuroscience"
99
According to Ortega, are adolescents receptive to the idea of "brain talk"?
No
Adolescents resist the idea that their brain "made them do it" -- they want self-determination
100
Main idea of May's "Autism from the Inside"
May doesn't like books where autism from the outside is portrayed as voiced from the inside
(i.e., someone who doesn’t have autism/truly know what it’s like writes a character who has autism)
101
3 examples of books that portray autism from the outside
- Rain man
- The Rosie Project
- The curious incident of the dog in the nighttime
102
True or false: May is more critical of the publishers than the authors
True
103
Mindblindness
Coined by Simon Baron-Cohen -- states that autistic indivs lack ability to infer neurotypical ppl's mental states
104
Double-empathy problem
Counter to "mindblindness" by May and others
Posits that in the same way autistic ppl may not be able to properly “mindread” us, we are not able to “mindread” them; the problem is not one-sided
105
Oral history
Preserving the voiced memories of ppl/communities who experienced smthn firsthand
- Oldest type of historical inquiry
106
Benefits of oral history
- Prioritizes in-depth personal narrative often overlooked in traditional interviews – challenges dominant narratives
- Flexible questioning approach – INTERVIEWEES guide discussion, not interviewer
- Helps one engage w history on a more personal lvl
107
Person-first vs identity-first language
Person-first: "person with autism"
- Historically promoted by disability advocacy groups to reduce stigma
identity first: "autistic person"
108
According to Lydia XZ Brown, is person-first or identity-first language more favorable? why?
IDENTITY FIRST
- Identity-first recognizes and validates an individual’s identity as an autistic person
- Person-first implies that it is unfortunate and an accident that a person is autistic + that a person has value or worth and that autism is SEPARATE from that
