Week 1: Psychopathology in Historical Context Flashcards
What are the three main characteristics of a Psychological Disorder?
(1) Psychological dysfunction within an individual
- A breakdown in cognitive, emotional, or behavioural fx (e.g., maladaptive fear, anger)
- Important to consider dimensions, not just categories
(2) associated with distress or impairment in functioning
- Some disorders also lack distress (e.g., mania) and distress is a part of life
(3) and a response that is not typical or culturally expected.
- Abnormal: deviation from average
- Cultural differences in what is considered “normal”
- Behaviour may be considered abnormal if is uncommon and violates cultural norms
Each component alone is NOT ENOUGH to meet criteria for a
psychological disorder!
ALL must be present to some degree!
What is the DSM-5-TR definition of a psychological disorder?
Behavioural, psychological, or biological dysfunctions
that are unexpected in their cultural context and
associated with present distress and impairment in
functioning, or increased risk of suffering, death,
pain, or impairment.
What is Psychopathology? Give examples of who used it.
The scientific study of
psychological disorders.
Who studies this?
Mental health professionals
(clinical psychologists,
psychiatrists, social workers)
who take a scientific approach to clinical work
What are three types of Scientist Practitioners. What makes their research scientific?
- Consumers of science
- Use new scientifically researched strategies to enhance the practice.
- Empirically supported methods - Evaluator of practice
- Evaluate the effectiveness of the practice.
- Practise based evidence - Creator of scientific knowledge
- Conduct research-generate new knowledge.
- Goal to describe determine and treat disorders
Approaches are evidence-based, practice-based evidence, and
research-oriented
Scientist-Practitioners focus on what three things?
Clinical description:
- Presenting problem
- Why the person is seeking help
- Type of course followed (e.g. chronic, episodic)
- What type of disorder
- It’s onset (acute-sudden, insidious)
- Prognosis: anticipated course
- Patient’s traits
Causation treatment and outcome:
- Etiology (the study of origin)
- biological physiological and social dimensions
- Causes, often social or situational.
- figure out cause can figure out treatment and same vise versa
Supernatural
Tradition
What is it?
Who is it?
How was it treated?
What is it?
Deviant behaviour
considered a
reflection of good
and evil.
Who?
Think demons and
witches
Treatment?
- Exorcisms
If that fails, they try and make the body inhabitable for demon
Cause:
Disorders punishment for evil deeds
or
They are witch or possessed
What is the Biological
Tradition?
Example?
Supporters?
- Deviant behaviour
attributed to brain
and bodily functions.
(Physical causes for mental disorders) - Physical disease
ex. syphilis; psychological symptoms treated by treating bacterial infection
- thought of time: could this be how we treat all disorders?
- Hippocrates
Humours (by Galen)
- humours was a liquid in the body that could affect a person’s temperament
- too much or too little resulted in disease
- black bile (melancholic) yellow bile, phleme, blood (sanguine)
- Hippocrates and Galen
- Phycological disorders can be treated like any other disease.
- Relate to head trauma and genetics
Psychological Tradition:
What is it?
Examples?
- Focuses on psychological and social/cultural factors
- Deviant behaviour
attributed to social,
cultural, psychological
factors.
Example
*Moral therapy: psychological or emotional therapy
*Mental hygiene movement: challenged the idea that people with mental illness were unhelpable. Criticized the cruel practices toward the mentally ill.
Psychopathology in the Ancient World:
- Ancient Egypt
- Hippocrates and Galen
- Plato
- Ancient Egypt (latter)
Ancient Egypt:
- Brain was the site of mental activity, but it could be disrupted by demonic possession
- Later on focused on relaxation diet and education
Hippocrates (Greek) and Galen (roman):
- Abnormal behaviour result of physical disease (rejected
supernatural)
o Normal brain functioning related to bodily humors
o Blood, black bile, yellow bile, phlegm
o Imbalance of humors led to disease (~ current ideas of
brain chemical imbalances)
Plato:
Beliefs
o Sociocultural influences on behaviour
o Criminal responsibility (Nope)
Causes
- Causes of maladaptive behaviour were the social and cultural influences in a person’s life and the learning that took place in that environment.
-Something wrong in environment? Then emotion and impulses overcome reason
o Importance of dreams
Treatment
- Treat institutionalized patients as normally as possible
The Middle Ages and mental health
(500–1500 CE)
Describe: Arab World, Persia and Europe.
What tradition did they follow?
Arab:
Early asylums and mental health units (800 CE) – places of refuge
o First hospital unit for people with psychological disorders opened in
Baghdad
- healing and calm environment
Persia:
- Natural causes and environment
o Methods similar to 20th Century therapies
- Disorders were a natural response to environmental experiences
Both important for biological and psychological traditions
Europe:
Supernatural tradition
o Psychopathology caused by witches and demons
o Mental illness was thought to be punishment for evil deeds (BLAMING)
o Treatment terrible! Snakes, cold water, exorcisms (trying to shock demon out of them or make body uninhabitable)
o Influence until 1400s
Psychological tradition
o Stress and melancholy
o Insanity caused by mental and emotional stress
o Treatment better: rest, sleep, potions, baths
European asylums (1500-1700)
Bethlem Royal Hospital in England 1547
o Underfunded
o Terrible conditions: shackled to walls, inadequately fed, not allowed to wash
Barlow et al., 2024
Moral Therapy & the Mental Hygiene Movement (1700 & 1800s)
Who are the three prominent figures/ what did they do?
Remember the names:
Philippe rushed to Dorothea then everything turned to crap (Emil Kraepelin)
Philippe Pinel (1745–1826)
– Encouraged humane, socially facilitative
atmosphere for patients
- Worked at French version of Bethlehem royal hospital
o Benjamin Rush (1745–1813)
- Father of North American psychiatry
o Dorothea Dix (1802-1887)
– Mental hygiene movement
- Pushed for better treatment for people with mental illness
- Treatment to all who needed it
– But improved conditions ended up resulting in overcrowding
Return of the Biological Tradition (1800s)
(Syphilis)
Discoveries suggested biological causes for disorders
– Syphilis (general paresis of the insane)
Symptoms:
mania, euphoria, grandiose delusions, paralysis of death.
Conclusion:
If there is a biological cause to a disorder, there must be a biological cure.
– Lead to Birth of psychopharmacology
Progress of the Biological Tradition in the 1900s
- 1930s: Standard practice to use biological tx
– Insulin shock therapy (inject insulin until shock is induced), ECT (electric shock therapy still used today), brain surgery (lobotomy) - 1950s: Introduction of key psychiatric medications
– E.g., first generation antipsychotics/neuroleptics
(e.g., reserpine)
Sigmund Freud’s Psychoanalytic model:
- Unconscious mind:
Id (Pleasure principals - intrinsic desires) ego (reality
principal logical and rational) superego –(consciousness/moral principles)
*Catharsis: if you talk about stuff you feel better
- Structure of mind: id ego superego
- Defence mechanisms:
- Protects you too much can be harmful
ex. Denial, displacement, rationalization repression sublimination
Psychoanalytic Psychotherapy
vs.
Psychodynamic Psychotherapy
Psychoanalytic Psychotherapy:
– Hidden intrapsychic conflicts
– Free association, dream analysis
– Transference and counter-transference
- Criticisms: unscientific unfalsifiable
Psychodynamic Psychotherapy:
– Briefer, more focused on relieving suffering
– Stronger empirical support
Humanistic Theory:
Prominent figures and their insights.
Jung and Adler: All of us can reach our heighest potential if we have freedom to grow.
- People are basically good and strive toward
self-actualization - Abraham Maslow (1908-1970)
– Hierarchy of needs - Carl Rogers (1902–1987)
– Person-centred therapy: therapist takes passive role (lets patient do self discovery)
– Unconditional positive regard (complete acceptance of person’s feelings) - Fritz Perls (1893-1970)
– Gestalt therapy with
humanistic elements - Focuses on + and creative potential empaths on the present
The Behavioural Model:
What is behavioural therapy?
What is exstinction?
Who are some prominent figures what are their contributions?
Blassical conditioning:
* Pavlov (dogs and bell: unconditioned stimulus food, unconditioned response salivate, conditioned stimulus bell conditioned response salivate), Watson (little Albert-fear can be learned),
– Extinction: conditioned stimulus no longer effective.
– Mary Cover Jones (1896-1987): If fears can
be learned, they can be unlearned
– CC relevant to panic and post-trauma
- B. F. Skinner and operant conditioning (consequence learning)
- Behaviour is strengthened or weakened depending on consequence/reinforcement
– OC relevant to treatment - Behaviour therapy
– Tends to be time-limited and direct (vs. psychoanalytic
approaches)
What is psychopathology currently like?
- Psychopathology is multiply determined
- Reciprocal relations between biological, psychological, social, and
experiential factors - 2000s: an explosion of knowledge about psychopathology
Who was known for their influence in contemporary practices of psychodynamic psychotherapy?
Freud
—– Is a person centred psychological theory that regards humans as primarily good and capable of self actualization?
Humanistic therapy
Who is this:
A schoolteacher who had worked in various institutions, she had firsthand knowledge of the deplorable conditions imposed on people with mental disorders, and she made it her life’s work to inform the public and their leaders of these abuses. Her work became known as the mental hygiene movement.
Dorthy Dix
——— ——–brought the systematic development of a more scientific approach to psychological aspects of psychopathology.
Behavioural model
These agents, which might be divinities, demons, spirits, or other phenomena such as magnetic fields or the moon or the stars, are the driving forces behind the ——-
Supernatural
—— is a founder of modern psychiatry and coined the term syndrome?
Emil Kraplin
What psychological theory of behaviour….
moral therapy
If someone was excessively cheerful or singuine what would be the solution proposed by….
Hippocratic-Galenic
bloodletting
—–, or the study of origins, has to do with why a disorder begins (what causes it) and includes biological, psychological, and social dimensions.
Etiology
What are the 3 components essential for defining psychological disorders?
- Psychological dysfunction
- Personal distress or importance
- Response is atypical or not culturally expected
What role did Emil Kraepelin play? What were some of his diagnosis?
Emil on test
Emil Kraepelin (1856–1926): one of the founders of
modern psychiatry
* Coined the term syndrome (a collection of symptoms that tended to go together in patients)
* Some of his diagnoses:
* Dementia praecox (schizophrenia)
* Manic depression (bipolar)
