Week 19 Readings Flashcards
Has the evolution of mental illness been linear, cyclical or progressive?
cyclical
What is a cultural relativist view of abnormal behavior?
What alternative perspective is used to define abnormal behavior outside of cultural relativism?
A cultural relativist view considers mental illness within the context of cultural and temporal norms, rather than applying a fixed definition across societies.
A less cultural relativist view defines abnormal behavior based on whether it poses a threat to oneself or others or causes significant distress that interferes with work or relationships.
How has the classification of mental illness been used as a form of social control?
In the past, behaviors that deviated from sociocultural norms were sometimes labeled as mental illness to silence or control certain individuals or groups.
What is etiology?
The causal description of all of the factors that contribute to the development of a disorder or illness.
What is trephination and what was its believed purpose in ancient treatments?
Trephination involved drilling holes in the skull, believed to release evil spirits or treat head injuries and conditions like epilepsy, dating back to as early as 6500 BC.
How did ancient Chinese medicine explain mental and physical illness?
Ancient Chinese medicine attributed illness to an imbalance of “yin and yang,” with mental illness arising from this imbalance, and emphasized the need for harmony and proper flow of vital air for health.
What is the “wandering uterus” theory, and how did it relate to mental illness in ancient Mesopotamia and Egypt?
How did the Egyptians and Greeks treat mental illness caused by the wandering uterus?
The “wandering uterus” theory, described in Mesopotamian and Egyptian papyri from 1900 BC, suggested that a dislodged uterus could cause mental illness by attaching to other body parts, leading to dysfunction and painful symptoms.
The Egyptians and Greeks used a somatogenic treatment involving strong-smelling substances, where pleasant odors were used to lure the uterus back into place and unpleasant ones to dispel it.
How was mental illness understood and treated in classical antiquity?
Mental illness was often attributed to supernatural causes like demonic possession or godly displeasure, with treatments including religious healing ceremonies. The Hebrews saw madness as punishment from God, and treatment involved confession and repentance.
What was Hippocrates’ approach to mental illness?
Hippocrates rejected supernatural explanations and proposed that mental illness resulted from imbalances in the body’s four humors (blood, yellow bile, black bile, and phlegm), with treatments like bloodletting for specific imbalances. He classified mental illnesses into epilepsy, mania, melancholia, and brain fever.
How did Hippocrates and Greek physicians view mentally ill individuals?
Hippocrates and Greek physicians believed mental illness was not shameful and that mentally ill individuals should not be held accountable for their behavior, with care being provided primarily by family members.
How did Galen’s views on mental illness differ from earlier beliefs?
Galen rejected the idea of a uterus having an animistic soul but agreed that an imbalance of the four bodily fluids could cause mental illness. He also introduced the idea that psychological stress could contribute to mental illness, paving the way for psychogenic explanations.
How were Galen’s psychogenic theories received by later physicians?
Galen’s psychogenic theories were largely ignored for centuries, as most physicians continued to attribute mental illness to physical causes throughout the following millennium.
What is the concept of an animistic soul, and how was it linked to mental illness?
The animistic soul is the belief that every person and thing has a “soul,” and mental illness was often attributed to animistic causes, such as evil spirits controlling an individual’s behavior.
How did supernatural theories of mental illness resurface during the late Middle Ages, and how were the mentally ill treated?
Supernatural theories, fueled by natural disasters and political turmoil, dominated Europe between the 11th and 15th centuries. Mentally ill individuals, especially women, were often persecuted as witches, accused of demonic possession, and subjected to treatments like prayer, confessions, and relic touching.
What was the role of the Church in the witch hunts, and how did some challenge the link between mental illness and demonic possession?
The Church’s Inquisition fueled witch hunts, peaking between the 15th and 17th centuries, with the publication of Malleus Maleficarum guiding the persecution. Johann Weyer and Reginald Scot argued that accused witches were mentally ill, not possessed, but their writings were banned by the Church.
How were mental illness and its treatment addressed with the establishment of hospitals and asylums starting in the 16th century?
Beginning in the 16th century, hospitals and asylums, such as St. Mary of Bethlehem (Bedlam) and the Hôpital Général of Paris, housed the mentally ill, the poor, and the criminal, often in poor conditions. These institutions focused on confinement and public protection, with inmates living in filth, chained to walls, and exhibited for a fee.
Mental illness was treated somatogenically, with methods like purges, bleedings, and emetics.
How were the mentally ill viewed in the 16th and 17th centuries, and how did this influence treatment?
The mentally ill were seen as akin to animals (animalism), lacking reason, control, and sensitivity to pain or temperature, and capable of violence without provocation. This view led to treatments aimed at instilling fear, believed to restore reason to the disordered mind.
How did the treatment of the mentally ill change in the 18th and 19th centuries?
In the 18th century, protests against inhumane conditions led to a more humanitarian approach. Physicians like Vincenzo Chiarughi removed chains and encouraged hygiene, recreation, and occupational training. Philippe Pinel and Jean-Baptiste Pussin introduced “traitement moral” at La Bicêtre and Salpêtrière, which involved unshackling patients, providing better living conditions, and promoting purposeful activity and freedom.
What is a traitement moral?
A therapeutic regimen of improved nutrition, living conditions, and rewards for productive behavior that has been attributed to Philippe Pinel during the French Revolution, when he released mentally ill patients from their restraints and treated them with compassion and dignity rather than with contempt and denigration.
How did William Tuke and Dorothea Dix contribute to humanitarian reforms for the mentally ill?
William Tuke, driven by religious concerns, established the York Retreat in 1796, where patients were treated with dignity and courtesy. Dorothea Dix worked to change negative perceptions of mental illness in America and helped create institutions focused on compassionate care.
How did the treatment of mentally ill individuals change in the United States compared to earlier practices?
Early American asylums, like Pennsylvania Hospital, followed somatogenic theories with treatments like blood-letting and tranquilizer chairs.
However, inspired by Tuke’s York Retreat, new private asylums like the Friends Asylum and Bloomingdale Asylum adopted psychogenic treatments, emphasizing compassionate care and physical labor.
Why did moral treatment for the mentally ill decline in the late 19th century, and what did Dorothea Dix do in response?
Moral treatment declined due to overcrowding in asylums, which became more custodial and unable to provide adequate care. Dorothea Dix advocated for state hospitals, helping establish over 30 institutions in the U.S. and Canada between 1840 and 1880.
How did the mental hygiene movement replace moral treatment in the late 19th century?
The mental hygiene movement, influenced by advancements in germ theory and medical treatments like vaccines, shifted focus back to somatogenic theories of mental illness. The movement was founded by Clifford Beers, following the publication of his memoir A Mind That Found Itself in 1908.
What was the debate over the causes of hysteria in 18th and 19th century European psychiatry, and who were the key figures involved?
European psychiatry struggled between somatogenic (physical) and psychogenic (psychological) explanations for hysteria, which caused symptoms like blindness or paralysis without physiological causes. Key figures included Franz Anton Mesmer, who linked hysteria to imbalances in a magnetic fluid, and James Braid, who shifted to a belief in hypnosis. Charcot, Liébault, and Bernheim debated whether hysteria’s suggestibility was neurological or a general trait.
How did Josef Breuer and Sigmund Freud contribute to resolving the hysteria debate?
Breuer and Freud supported a psychogenic explanation for hysteria, treating it with hypnosis, which led to the development of the cathartic method, a precursor to psychoanalysis in the early 20th century.
What is the cathartic method?
A therapeutic procedure introduced by Breuer and developed further by Freud in the late 19th century whereby a patient gains insight and emotional relief from recalling and reliving traumatic events.
How did psychoanalysis influence the development of psychotherapy in the 20th century?
What factors contribute to the efficacy of psychotherapy, regardless of the specific approach used?
Psychoanalysis, the dominant psychogenic treatment in the first half of the 20th century, served as the foundation for over 400 different schools of psychotherapy, including behavioral, cognitive, psychodynamic, and client-centered approaches.
The efficacy of psychotherapy is primarily due to factors shared across all approaches: the therapist-patient alliance, the therapist’s commitment to the therapy, therapist competence, and placebo effects.
How did somatogenic treatments for mental illness evolve in the mid-20th century?
In the mid-20th century, psychotropic medications became the leading somatogenic treatment for mental illness, replacing earlier practices like restraints, electro-convulsive therapy, and lobotomies, which continued in American state institutions until the 1970s. The pharmaceutical industry began viewing and treating mental illness as a chemical imbalance in the brain.
What is the biopsychosocial model of human behavior, and how do genetic, psychological, and sociocultural factors contribute to mental illness?
How does the biopsychosocial model reflect historical thinking on mental illness?
The biopsychosocial model explains that mental illness can result from a combination of genetic predisposition, psychological stressors, and sociocultural factors like political unrest, poor living conditions, or problematic relationships. It acknowledges that both somatogenic (biological) and psychogenic (psychological) factors play a role.
Despite modern advancements, the biopsychosocial model continues to reflect the same somatogenic and psychogenic theories of mental illness that have been present throughout history.
How did the diagnosis of mental illness evolve, and who contributed to the development of standardized classification systems?
Why is a standardized diagnostic system important for the treatment and research of mental illness?
The recognition of mental illness diagnoses dates back to the Greeks, but it was not until 1883 that German psychiatrist Emil Kräpelin published a comprehensive system based on patterns of symptoms suggesting physiological causes. This paved the way for the American Psychiatric Association’s 1952 publication of the first Diagnostic and Statistical Manual (DSM).
A standardized diagnostic system creates a shared language among mental health providers, improving communication and clinical research by offering agreed-upon definitions of psychological disorders.
How did the DSM evolve, and what changes were introduced in the 1980 DSM-III?
What changes were made in the DSM-5, and why were these revisions important?
The DSM has undergone several revisions (1968, 1980, 1987, 1994, 2000, 2013), with the 1980 DSM-III introducing a multiaxial classification system that considered the whole individual rather than just the specific problem behavior. It included five axes: clinical diagnoses (Axes I & II), relevant medical conditions (Axis III), psychosocial/environmental stressors (Axis IV), and a global assessment of functioning (Axis V).
The DSM-5 combined the first three axes and removed the last two to streamline diagnosis and improve compatibility with other diagnostic systems, such as the World Health Organization’s health diagnosis standards.
What are some criticisms of the DSM as a diagnostic tool?
The DSM has been criticized for being based on Western cultural norms, particularly those of the United States.
It uses a medicalized, categorical classification system, which assumes mental disorders are distinct types rather than existing on a continuum.
Additionally, the increasing number of diagnosable disorders (tripling since its 1952 publication) raises concerns about overdiagnosis, labeling, and stigmatizing individuals.
These concerns remain relevant even with the DSM-5 (2013).
How does the DSM-5 differ from the ICD-11 in diagnosing mental illness?
The DSM-5 is widely used in North America and reflects American psychiatric perspectives, while the ICD-11 is used globally and includes a broader range of health conditions. A key difference is that in the DSM-5, Gender Dysphoria is considered a mental disorder, whereas the ICD-11 classifies Gender Incongruence as a condition related to sexual health, not a mental disorder.
What is the name of the ancient Greco-Roman belief that mental illness was caused by an imbalance in the four bodily fluids?
humorism
The Greek physician Galen was one of the first people to believe that mental illness could have a ______ cause such as stress, in addition to other bodily causes.
social.
epidemiological.
supernatural.
psychogenic.
somatogenic
psychogenic
What book allows psychiatrists and psychologists to standardize their diagnoses of mental illness?
Psychogenic Causes of Mental Illness, vol. 3.
Diagnostic and Statistical Manual of Mental Disorders.
Malleus Maleficarum.
The Mind’s Yin and Yang.
Mental Illness A-Z
Diagnostic and Statistical Manual of Mental Disorders.
The idea that the cultural norms and values of a society can only be understood in their own context is known as what?
cultural relativism
Mesmerism
Derived from Franz Anton Mesmer in the late 18th century, an early version of hypnotism in which Mesmer claimed that hysterical symptoms could be treated through animal magnetism emanating from Mesmer’s body and permeating the universe (and later through magnets); later explained in terms of high suggestibility in individuals.
