Unit 1 Flashcards
psychology
studies interplay of behavior, mind and brain
abnormality
deviance, distress, danger, and dysfunction- presence of these 4 doesn’t predict mental illness
deviance
different, unusual, or bizarre- statistical connotations
dysfunction
interfering with ability to carry out daily activities
danger
to oneself/ others
distress
upsetting or unpleasant mental states
DSM V assumptions
1- a behavioral syndrome/ psych pattern occurs in the individual AND
2- the symptoms have psych and or bio cause AND
3- the consequence of the symptoms is either: clinically significant distress or dysfunction
4-the symptoms are above and beyond what would be normal response to stressors (CONTEXT)
5-BUT the perceived mental illness is not primarily a result of social deviance or conflict with society
therapy
any process/ procedure that alleviates symptoms- includes bio, psych, and combinations
3 major views on mental illness
1- spiritual/ supernatural- demon possession, etc
2- humanitarian- result of cruelty, stress, and poor living conditions
3- scientific- search for quantifiable causes
trephination
earliest supernatural type treatment
-6500 BCE; focused on demon possession and sorcery
Ancient Greek and roman
500 BCE-500 CE; philosophers and physicians rejected supernatural explanations
hippocrates
did not believe mental illness was shameful or that mentally ill individuals should be held accountable for their behavior
-illness as imbalance of 4 humors
middle ages
500-1350 CE; demonology returns
- Roman Catholic rejected scientific research; religious beliefs dominate; exorcisms (st. Martin)
- care of mentally ill became family based bc of shame; idea of contagious nature of mental illness and physical punishment to teach better behaviors
renaissance
1400-1700 CE; demonological views decreased; medical views returned; Johann Weyer (German physician) believed that the mind was as susceptible to sickness as the body
Asylums
first in the 1400s- for “lunatics”- primary purpose was care of mentally ill, conditions deteriorated over time
mid 16th century
conditions decline in asylums, no treatment or supply for demand; individuals with mental illness were institutionalized alongside undesirables and no one improved or left
- most against will
- demonstrated to public for a fee
- treatments= purges, bleeding, emitting
colonial america
1st asylum (1773)= Williamsburg VA- chained to wall of small room, one bed etc… soon overcrowded and deteriorated to filth and mistreatment
late 1700s europe
moral treatment
-William tuke (England), Philippe pinel (france), and dorthea dix and Benjamin rush (US)
=patients in asylums are sick and should be treated with sympathy and kindness
tukes retreat at Yorke
was run as a strict, well-run household
- sanity was to be restored via self control in family environment- rules and expectations and contributions (paternalistic)
- given support and advice
- critics claimed it encouraged dependency- replacing visible chains with less clear ones
moral treatment vs asylums
freedom to move about, well-lit rooms, seen as potentially productive beings, engagement in activities
19th century
moral treatment spread to US- some patients were able to leave, but not most
Dorothea dix
American advocate for moral treatment (1840-1880) researched conditions in asylums throughout US- successfully lobbied US congress to pass bill that established a system of state hospitals to care for mentally ill
-32 hospitals (state) throughout country are credited to her
state hospitals
meant to be self-supporting (somewhat) institutions
- patients engaged in “therapeutic work”- staff lived on premises to reduce cost
- patients worked on farm and did chores
- overcrowding eventually occurred due to lack of treatments
- public prejudice against patients in institutions led to reduced funding (many patients were poor immigrants)
the somatogenic perspective (early 20th century)
abnormal functioning has physical causes. two factors were responsible for this rebirth
1) Emil Kraepelin= physical factors (fatigue) are responsible for mental dysfunction
2) bio discoveries on link between untreated syphilis and “general paresis”
- common somato treatments=hydrotherapy, radiation, sedatives, ECT, psychosurgery (lobotomies), insulin-induced comas
- improvements in treatment came in 1950s
the psychogenic perspective
abnormal functioning has psychological causes
- rise in popularity of this was based in Friedrich Mesmer’s work on hypnosis and later Sigmund freud’s theory of psychoanalysis (early childhood and unconscious)
- by early 20th century, psychoanalytic theory was well accepted
- provided either out-patient or in-private psychiatric hospitals
- less likely to be part of therapy at state hospitals
psychotropic medication
1949- introduction of lithium to treat extreme mood fluctuation
- in 1950s= antipsychotic drugs for schizophrenia, antidepressant drugs and anti anxiety drugs
- finally allowed discharge from hospitals
deinstitutionalization
trend in which people with mental disorders were released from hospitals into communities
-caused by 1) medications, 2) public outcry on conditions, 3) JFK signed (1963) funding for community mental health centers (agency to meet with psychiatrists) and out patient treatment for formerly hospitalized patients
current LESS severe MI treatment (US)
outpatient care is preferred mode of treatment
- private psychotherapy and psychiatry (med mngmt)
- non residential programs for subs abuse
- community based MH clinics
current SEVERE MI treatment (US)
outpatient care is primary mode
- usually short hospitalization with discharge into community based care
- *lack community programs for current pop
- significant number do not receive treatment of any kind
- needs of this pop= community programs are insufficient
- funding cuts continue
- 250,000 with severe MI are incarcerated or homeless
SAMHSA survey
- 5% of all US adults had mental illness
- of that, 4% had severe MI
- 1/3 of severe receive no help
Insurance with MI
- no coverage pre-WWII
- historically policies didn’t cover MI to the same extent as physical illness
Parity laws
laws that say insurance companies must cover physical and psych illness at the same rate of reimbursement
- 2011= law went into effect
- some insurance companies solved by discontinuing all funding for MH
biopsychosocial approach
integrates 3 areas of influence when considering causes of MI and their treatment
- bio= brain structure, chemistry, etc
- psych= trauma, cognition, stress
- social= culture, peers, family
MH clinician
anyone who provides services to people with psych problems
theoretical models
describe how MI forms and how it differs from the unaffected population
-models can conflict
-isolating a cause is very difficult (complex behavior)
== X is a RISK for Y (not a cause)
necessary causes
factors that must be present for disorder to occur
- have not been identified for most MI
- exceptions= general paresis (due to syphilis) and HD
contributory causes
factors that increase the risk of developing a MI, but don’t guarantee
distal risk factors
event occurs early in life, disorder appears later