Unit 1: Concepts of Abnormality

Question 1

What is the most broadly accepted system for identifying particular types of disorders?

Answer 1

The Diagnostic and Statistical Manual of Mental Disorders (currently DSM-5-TR).

International Classification of Mental and Behavioural Disorders (ICD-11) is also used, primarily outside of North America.

Question 2

What are 2 problems associated with defining abnormality?

Answer 2

1) Eccentric and unusual behaviour or beliefs are not necessarily abnormal according to diagnostic criteria, though the boundary is not always clear

2) Behaviours that are repugnant and threatening to others are not always signs of a psychological disorder

Question 3

What is PSYCHOLOGICAL ABNORMALITY?

Answer 3

Behaviour, speech, or thought that impairs the ability of a person to function in a way that is generally expected of them in the context where usual functioning occurs

Question 4

What is MENTAL ILLNESS?

Answer 4

a term used to convey the same meaning as psychopathology, but implies a medical rather than psychological cause; criteria varies across time and place

Question 5

What is PSYCHOPATHOLOGY?

Answer 5

the scientific study of psychological abnormality and the problems faced by people who suffer from such disorders

Question 6

What is a PSYCHOLOGICAL DISORDER?

Answer 6

a specific manifestation of this impairment of functioning, as described by some set of criteria that have been established by a panel of experts (DSM-5); occurs in all societies and have been apparent at all times in history

Question 7

According to Wakefield, a behaviour can be considered disordered when:

Answer 7

there is evidence of failure in a designed function, and a judgement that the design failure is harming the person

Question 8

What are the principles used to establish criteria for psychological abnormality?

Answer 8

Statistical concept
Personal distress
Personal dysfunction
Violation of norms
Diagnosis by an expert

Question 9

Describe statistical concept as a criteria for psychological abnormality.

Answer 9

Behaviour is judged as abnormal if it occurs infrequently in the population&raquo_space; PROBLEM: “exceptional” skill or innovative ideas don’t fall under this label

It is not clear how unusual a given behaviour must be in order to be considered abnormal&raquo_space; PROBLEM: depression and anxiety occur in university students at a rate of 15-18%, which is not statistically infrequent

Question 10

Describe personal distress as a criteria for psychological abnormality.

Answer 10

Most people with psychological disorders report being distressed&raquo_space; but not all do, and some people who appear outwardly happy and successful might report distress to friends

Personal distress is a frequent, but not essential, feature of abnormality

Question 11

Describe personal dysfunction as a criteria for psychological abnormality.

Answer 11

When a behaviour clearly interferes with appropriate functioning, it is said to be abnormal&raquo_space; BUT how do we define “appropriate functioning”? Some features of some disorders may be warranted given the circumstances (ex: anxiety).

“Harmful dysfunction” is key - failures of internal mechanisms to perform naturally selected functions&raquo_space; behaviour can be judged as disordered when both scientific and value judgements find dysfunction or harm

Question 12

Describe violation of norms as a criteria for psychological abnormality.

Answer 12

The behaviours and thoughts of individuals with mental disorders are considered inappropriate&raquo_space; HOWEVER, people sometimes have reactions to things they find personally repulsive or offensive

It is incorrect to think that people who suffer from psychological disorders are unpredictable and violent.

Social normals vary over time and place; few disorders are truly universal across cultures
EX: homosexuality was previously classified as a disorder

Question 13

Describe diagnosis by an expert as a criteria for psychological abnormality.

Answer 13

CLINICAL PSYCHOLOGIST: trained in general psychology and graduate training in understanding, assessment, diagnosis and amelioration of disorders of thinking and behaviour; treatment methods are typically psychological interventions

PSYCHIATRIST: trained in medicine prior to specialized training in dealing with mental illness; focused on diagnosis and medical treatment, emphasizing the use of pharmacological agents

Question 14

How did scientists at the time view mental illness in the context of Darwin’s Theory of Evolution?

Answer 14

those whose intellectual, social, or economic functioning was inferior were defective, maladaptive, and should be sterilized to eliminate defective genes

Question 15

What is TREPHINATION and what was its purpose?

Answer 15

removing circular sections of the skull while the individual is still alive, to let out evil spirits

mental disorders caused by supernatural elements, demon possession

Question 16

What did the Greeks and Romans generally think of mental disorders?

Answer 16

Temples of healing were established that emphasized natural causes for mental disorders.

Question 17

Who was Hippocrates and what were his views?

Answer 17

The father of modern medicine.
Denied the popular belief that psychological problems were caused by interventions from the gods or demons.
Did not distinguish mental from physical diseases.
Stress could influence mental functioning; dreams could be important in understanding why someone was suffering.
Advocated for a quiet life, vegetarian diet, healthful exercise, abstinence from alcohol, and bleeding/purging (disorders were linked to disturbances in bodily humors).

Question 18

What are the bodily humors and how were they linked to psychological disturbances?

Answer 18

Cheerfulness = excess of blood
Ill-temper = excess of yellow bile
Gloom = excess of black bile
Listlessness = excess of phlegm

Question 19

What was HYSTERIA and what was Hippocrates’ proposed cause?

Answer 19

psychologically induced blindness, deafness, or other apparent defects in perceptual or bodily processes (now known as “conversion disorder”), due to a “wandering” uterus, only occurring in women

Question 20

Despite their absurdity, why were Hippocrates’ ideas important?

Answer 20

They pointed to natural causes rather than demonic possession and other supernatural events; encouraged the beginning of a scientific understanding of disordered behaviour and thought.

Question 21

What were Plato’s ideas about treatment of mental patients?

Answer 21

People who are mentally disturbed and commit crimes should not be held criminally responsible.
The mentally ill should be cared for at the homes of relatives.
For those who were hospitalized, their thinking must be rationally challenged in a conversational style of therapy.

Question 22

What were TEMPLES TO SATURN?

Answer 22

In Alexandria, Egypt, Temples to Saturn were sanatoriums for people who were psychologically unwell; peaceful surroundings, interesting and calming activities, healthful diets, massage and education.

Question 23

What school of thought rejected Hippocrates’ theories?

Answer 23

Methodism > Soranus of Ephesus.

Regarded mental illness as a disorder resulting from constriction of body tissue or a relaxation of those tissues due to exhaustion; the head was a primary site of affliction.

Question 24

Who provided the first clinical observations of disorders and made the first attempts at classifcation?

Answer 24

Greeks.
Theories were rarely accurate and treatments weren’t always successful, but they were devoted to naturalistic explanations.

Question 25

How did the Romans approach treatment of mental disorders?

Answer 25

Thought it was necessary for effective treatment to provide comfortable surroundings for patients; no stressful procedures.
Talk through problems with a sympathetic listener.

Question 26

How were and are the mentally ill treated in the Arab world?

Answer 26

Generally supportive and kid methods.
The Quran reflects compassionate attitudes, and these are still practiced.
Units were created in hospitals and asylums 500 years before any in Europe.

Question 27

During the Middle Ages, physicians held what belief about “mad” people? What did these people need?

Answer 27

They were possessed and in need of exorcism.

Question 28

During the Middle Ages, who primarily treated and cared for people suffering from mental disorders? What approach did they take?

Answer 28

The clergy, the only ones with sufficient concern and resources to provide assistance.

Treatment was typically mild, emphasizing prayer and a generally caring approach.

Question 29

Who was Paracelsus? What theory did he reject? What were his beliefs?

Answer 29

A famous Swiss alchemist and physician.

One of the first to attack the beliefs about supernatural possession; rejected the four-humors theory.

Claimed that all mental illness resulted from disturbances of the spiritus vitae (breath of life), which was sometimes upset by the stars or by vapors arising in various parts of the body.

Question 30

What was the intention of asylums and what did they end up becoming?

Answer 30

Compassionate intentions, places for humane treatment.
Most patients were treated cruelly and lived in appalling conditions, including being shackled to the walls, inadequate food and hygiene, treated like animals.

Question 31

How were the funds raised to run the asylum run by Henry VIII?

Answer 31

One procedure was to invite the public to visit and charge a small sum. The fee allowed visitors to tease and poke at the residents, who screamed and moaned (bedlam).

Question 32

What were the basic ideas of the Enlightenment?

Answer 32

the superiority of reason in the analysis of problems
progress was an inevitable and desirable feature of human society
it was both appropriate and necessary to challenge traditional ideas, including religious doctrine.

Question 33

Who was PHILIPPE PINEL and what is he most known for?

Answer 33

A leader of the Enlightenment, made director of La Bicetre Asylum.
Significantly improved the conditions at the asylum, treating patients with kindness.
Remembered as one of the leaders of humanitarian reforms in Europe during the 18th and 19th centuries.

Question 34

What else is Pinel remembered for?

Answer 34

Developing a systematic and statistically based approach to the classification, management, and treatment of disorders; emphasizing the role of psychological and social factors in the development of mental illness; asylums should be therapeutic.

Question 35

What was the MENTAL HYGIENE MOVEMENT?

Answer 35

a desire to protect and to provide humane treatment for individuals with mental illness.

Question 36

Who was CABANIS and what was the impact of his theories?

Answer 36

A theorist in the 16th century who combined psychological and somatic factors in his account of mental disorder.
His theories were influential and encouraged the development of psychological approaches to treatment.
First clear theoretical basis for moral therapy

Question 37

What was Morel’s theory?

Answer 37

Degeneration Theory: deviations from normal functioning are transmitted by hereditary processes and these deviations progressively degenerate over generations

Question 38

Who was EMIL KRAEPELIN and what where his influences on the diagnosis and classification of mental disorders?

Answer 38

Published a landmark text which aimed to diagnose and classify, Clinical Psychiatry.
Noted that certain groups of symptoms tended to occur together.
The first to recognize that different disorders not only had distinct features but also differed in their age of onset and typical course over time.
Proposed that different disorders probably had different causes.

Question 39

What are SYNDROMES, according to Kraepelin?

Answer 39

certain groups of symptoms that occur together; these could serve as a way to group patients who shared certain features

Question 40

Electroconvulsive Therapy (ECT) was first used to treat which disorder? For which disorder is it still used today?

Answer 40

Schizophrenia.
Major depressive disorder.

Question 41

During the period of the 1950s (beginnings of psychopharmacology), what was thought to be the cause of mental illness?

Answer 41

Disordered brain chemistry

Question 42

Describe the process of DEINSTITUTIONALIZATION

Answer 42

Beginning in the 1950s, hundreds of thousands of institutionalized patients were discharged and psychiatric facilities were closed.
Because these closures were not balanced by a strengthening of community resources, many individuals with mental disorders were left homeless and lacking support.

Question 43

What did Josef Breuer’s ‘cathartic method’ entail?

Answer 43

Breuer’s approach employed hypnosis in order to have the patient talk freely about, and relive, unpleasant past events that Breuer believed caused hysteria. He thought that vividly reliving these past experiences would somehow exhaust the emotional problems that resulted from them.

Question 44

According to the behaviourist perspective, for psychology to be considered a true science, it must only study what?

Answer 44

the study of observable features, the behaviour of organisms

Question 45

Describe John Watson’s perspective of abnormal functioning

Answer 45

Abnormal functioning was learned, and could be unlearned.
Derived from Pavlov’s classical conditioning.
Problematic functioning is the result of unfortunate conditioning experiences.

Question 46

Watson’s behaviourism was based on:

Answer 46

classical conditioning

Question 47

What did ALBERT ELLIS propose?

Answer 47

developed a behaviourist view of abnormal behaviour that focused primarily on the role of reinforcement of dysfunctional behaviours

Question 48

What was the name of the first asylum in Canada? What kind of people stayed there?

Answer 48

Hotel Dieu in Quebec.
“So-called idiots” = patients suffering from all types of mental disabilities and dysfunctions
“Indigents” and “Cripples”

Question 49

Who was the author of the first textbook printed in Canada dealing with the care and housing of the mentally ill? What did he advocate?

Answer 49

JF Lehman in 1840.
Advocated for a regimen of severe discipline to rid the afflicted of their disorder; flogging.

Question 50

What is a LOBOTOMY and why was it performed?

Answer 50

Psychosurgery; removal/disconnection of the frontal lobes of the brain.
Performed to alleviate hospital management problems or to advance research rather than for the benefit of the patient.

Question 51

Who was DR. RUTH KAJANDER and what did she recognize?

Answer 51

A pioneer in the treatment of schizophrenia; recognized the value of a tranquilizer in treatment, noting its use to relax a patient without rendering them unconscious.

Question 52

Who is ALBERT BANDURA?

Answer 52

developed social learning theory to explain how aggressive behaviour is acquired on the part of the learning process which occurs in childhood.
This theory was so successful that it was extended to human behaviour in general and generated a number of effective treatment techniques for various disorders

Question 53

What is CBT?

Answer 53

Cognitive Behavioural Therapy - the extension of behavioural approaches to include modification of cognition

Question 54

What was DAVID MEICHENBAUM’S significant contributions to the growth of CBT and other treatments?

Answer 54

early work provided a significant impetus to the growth of CBT; subsequent efforts have led to the development of effective treatments for impulsivity, pain, anxiety, and anger, stress and PTSD.

Question 55

What is the goal of the Mental Health Commission of Canada?

Answer 55

To address the gaps in Canadian mental health policy.
Leads the development of innovative and collaborative mental health programs and policies

Question 56

What is EVIDENCE BASED PRACTICE and what is its goal?

Answer 56

Health care based on established scientific findings rather than practitioners’ assumptions.
To bolster the efficacious treatment of mental disorders, to increase accountability, and reduce liability.