Models of psychological disorders Flashcards
Spiritual model explanation for psychological disorders
Psychological disorders arise because the individual is out of harmony with some larger force - Spiritual and biological process are often intertwined in this model
Spiritual explanations in past societies
imbalance in vital energy, relationship to nature, spiritual forces, equilibrium between soul and body, soul loss, possessions , magical insertion, offenses, Satanic possessions, holy punishment
Tabu deaths
a person is convinced they are cursed. The person isolates from society and dies
Healing spiritual cerimonies work?
Beliefs are powerful - effective because the person believes they will be cured, so they are.
West-European medieval societies: Treatment
religious ceremonies, persecution and death. The insane were treated with cruelty, or thought to be witches (3 consequences: confession by torture, trial by water, examination for skin marks)
Spiritual treatments today
Fundamentalist western religions
Alternative therapies - yoga, meditation
Ceremonies: purification, religious rituals…
Goal: harmony
How Religion/spirituality can be good for mental health
Involvement in religious practices and communities = sense of meaning and resilience
36% lower depression; fewer suicide rates. Improved drinking outcomes
Medical patients and immune-system functioning
Mortality in the elderly lower
Religions can be bad for mental health
Negative religious coping - Feeling of being punished, alienation from community. Rejection of sexual/gender = Immune system declines
Historical oppression and discrimination
Why do cerimonies work for mental health?
Jerome Frank: Through Persuasion, Healing ceremonies can be:
Calming
Arousal of Positive expectations (optimism) = healthy
Focus on constructive thoughts and actions
Sense of control and meaning (vs. helplessness)
Religious healing ceremonies 3 steps
Socially sanctioned healer - gives explanation for problem and what should be corrected
Healer Provides a Ritual
These rituals can create positive effects
Psychologists and religion
lower level of these beliefs
“Religiosity gap”
Not included in diversity training
Why do psychologists need to study religion?
Asking about spirituality/values is associated with (even if patient is atheist) stronger therapeutic alliance
Patient self-disclosure
It is important to incorporate the patients beliefs to their treatment
Biological model explanation for psychological disorders
Psychological problems arise primarily out of underlying biological processes
Traditional societies: biological model
Folk medicine
Asia - 400 AD: major medical text-sections of insanity and Rauvolfia - herbal treatment for psychosis (Reserpine)
Thai and arab medicines
Hippocrates (400-377 B.C.) - Humoral theory
Postulates that every human had 4 humors - body fluids - ideally in balance - imbalance = psych disoder
Linked to elements, organs, temperament and diseases
Treatment in humoral theory
Diet
Change Physical environment
Bleedings, emetics, purges, leeches
19th century Biological Theories
German school - focus and names
Focused on the psychosis
Griesinger
Wernicker
Emil Kraepelin
Psychoses - Emil Kraepelin
Could be divided into endogenous and exogenous
Exogenous psychoses
caused by external conditions. Ex:
Korsakov- Wernicke - alcoholism
Krafft-Ebing - General paresis (paralitic dementia) caused by siphilis
Endogenous psychoses
Caused by internal conditions. Ex: Dementia praecox = premature dementia - today schizophrenia Involutional melancholia (today depression)
Types of Neuroses
Neurasthenia - passivity, weakness, exhausted nerves - later hysteria
Psychasthenia - phobias, irrational fears or OCD - a week psyche or weak nervous system
Treatment of neurosis 19th century
Mainly targeted women
Elixirs with alcohol, cruises, rest
Early 20th century biological treatments
Custodial care
Radical somatic treatments
Radical somatic treatments 20th century bio
Convulsive therapy - Von Meduna Insulin induced seizures for schizophrenia (was the opposite of epilepsy)
Cerletti and Bini - electro convulsive therapy
Egaz Moniz lobotomies
Freeman and Watts - psychosurgery
Egaz Moniz lobotomies
hoped to avoid chronic delusions by injecting alcohol into the frontal lobe and stabbing the prefrontal lobes - patient became apathetic
Freeman and Watts - psychosurgery
when emotion was higher than rationality. Solution: severing the link between frontal and emotional lobes
Learning from radical somatic treatments
Importance of empirical evidence
Informed consent - people should be told what the likely consequences are
Professional accountability - physicians are responsible
50’s - biological treatments
Neuroleptic medications –> Phenothiazines and
Lithium carbonate
Neuroleptic medications advantages
Allowed for Community management - patients could live in society - control of manic symptoms
Institutional management - didn’t require physical constraints
Neuroleptic medications Limitations
Immediate side effects Long-term health effects Kidney pathology Neuroleptic malignant syndrome Tardive dyskinesia
Contemporary Biological models causes
Genetic
Neurochemical
CNS structure and function
Contemporary Biological models treatment
+ Advance in medication (but not perfect) and somatic procedures (EST, TransMagnaticStimutaion, DBS - for parkinson’s) anesthesia before chocks and muscle relaxers to prevent seizure injury