1 Flashcards
(40 cards)
Classification of mental disorders
DSM-5: North American (2013) and ICD-10: Europe (1992)
Issues/ Concerns with classifications
Important to diagnose to proceed to evidence-based therapies as the treatment must fit the symptoms the individual is suffering from, Only a subset of patients are used in research because most people have comorbid conditions -> what is experienced isn’t easy to translate into the classification methods, Labels are important for vocabulary, research, treatment, Often there are many comorbities which complicate realities
Defining abnormality
Professionals cannot agree on diagnostics because there are many grey areas. There are many people who may define social norms but that we wouldn’t necessarily consider abnormal
Variability in abnormality
Same disorders have different intensities and variations (ex: ADHD, autism spectrum, different symptoms of depression), There are some core symptoms/difficulties that are common to all
Abnormal Criteria, Statistically rare
However some things that are rare are advantageous rather than problematic (ex:
intelligence) and some illnesses are extremely common (depressive episodes)
Abnormal criteria, personal distress
Common feature of most disorders however not always true for example no distress during a manic episode
or with suffering dementia
also distress is a normal part of life. Not necessarily dysfunctional. Different
thresholds.
Abnormal Criteria, Dysfunction
Behaviour interferes with functioning for example thoughts, energy levels, there’s an Inability to adapt
description by Wakefield: “harmful dysfunction”
that There is a dysfunction (failure of internal mechanisms to perform naturally selected functions) that harms the individual
However can be hard to meet because many disorders represent socially undesirable behaviour, not personally undesirable
Abnormal Criteria, Violation of social norms
Psychological disorders produce violations of social norms (thoughts,
behaviours, etc.) However Criminals are violating social norms, but don’t necessarily meet diagnostic criteria
and most individuals with mental disorders are not dangerous/harmful to others (vs themselves)
there also needs to be consideration of culture: different behaviours are considered atypical in different cultures/times
for example sexuality. Diagnoses based on stereotypes. and further Diagnoses evolve over time
Abnormal Criteria, Diagnosis by an expert
Includes psychiatrists, clinical psychologists, psychiatric nurses, psychiatric social workers where Abnormality is essentially just defined when diagnosticians apply the DSM-5 criteria Differential diagnosis: there can often be multiple potential diagnoses
For example Amber Heard trial. and children with language disorders being misdiagnosed as autistic
Diagnosis
There is no single definition that can satisfy all the facets of psychological disfunction and No sole criterion is necessary or sufficient. A combination of criteria is normally used
influence of history on abnormal psychology
The theories of mental illnesses reflected the societal views at the time
Pre history and abnormal psychology
Supernatural explanations for disorders (evil spirits, demons) o Harsh treatments (directed at the supernatural)
o Evidence: skulls are perforated to “let the demons out
Greek and roman views of abnormal psychology
Preferred naturalistic explanations
o Hippocrates: emphasized the roles of brain dysfunction and stress
▪ Importance of dreams
▪ Disturbances in bodily fluids (“humours”) caused disorders
▪ “Wandering uterus”: the uterus moved around the body, causing symptoms
o Treatments: bleeding, vomiting (to remove the “poison”), “quiet life”, no alcohol, vegetarianism, etc. Mostly physical treatments
o Plato (and Aristotle) placed more emphasis on sociocultural influences on thought and behaviour
▪ Not just the physical individual
▪ Elaborated more on the importance of dreams. Less inhibition of the
unconscious desires
▪ People with psychological disorders should not be held responsible for crimes.
Should be cared for.
Egyptian view on abnormal psychology
adopted the idea of the Greek after Alexander the Great they as a treatment Established sanitoriums for the mentally ill (peaceful, safe, humane)
▪ Compassionate, but not necessarily effective, because did not address the
underlying issue
Arab world view on abnormal psychology
Asylums where people were treated generally well.
o Avicenna: specialist in mood disorders. “Melancholia”. Emphasized
environmental/psychological factors and compassion
Dark ages view abnormal psychology
Supernatural beliefs: exorcism, witchcraft, St. Vitus’ Dance
▪ Possession was a vague term. It referred to any sort of “nervous breakdown”
(also vague)
▪ Witchcraft: women, often those that were just not compliant socially
▪ Exorcisms were often cruel as they were attempting to drive out a demon
▪ St. Vitus’ Dance
* Mass hysteria. People were “hit with” the urge to dance and shout
* Cult/mob mentality
Push for compassion in the dark ages
Paracelsus (1493-1541): Swiss psychologist. The issue was a disease, not a possession. Spoke out against dominant treatments.
* Tried to (basically unsuccessfully) classify disorders
* Natural and physical treatment
* Still thought that the devil was the cause of some illnesses (with
schizophrenia, delusions are linked to culture. People would talk about
the devil)
▪ Weyer and the Moors (Spain) followed Paracelsus’ ideas
Pushback of the supernatural accounts
Teresa of Avila and St Vincent de Paul wanted to counter the dominant narrative of the supernatural
▪ Accounts suggested the physical and psychological disorders had common causes
Beginning of Asylims and workhouses
funded. Like a zoo. Entertainment. People were chained to walls.
* A way to punish those who weren’t working. People were singled out
and sent away
▪ Mental Hygiene Movement: push for reforms. Age of reason.
* P. Pinel: developed a systematic approach to treating disorders. Named a lot of descriptions. Pushed for reform.
* B. Rush: helped bring moral therapy to North America. Pushed to give people things to do, physicians for support.
* Individuals were treated with compassion in a comfortable environment
18th contrary view on abnormal psychology
There was a biological influence
Hereditary theory in 18th century
Benedict Augustin Morel: degeneration theory. Deviations from normal function are
transmitted hereditarily
o Lombroso: criminality was inherited and could be identified by phrenology
Classification in 18th century
Emil Kraepelin: book. Clinical psychiatry (1883), attempted to classify mental illnesses
▪ Groups of symptoms were coined “syndromes” (still used today)
▪ Different disorders had distinct features and different ages of onset ▪ Proposed that biological causes underpin mental disorders
▪ DSM in some ways evolved from this
Infection as a role in the 18th centrally view
Richard Von Krafft-Ebing: suggested that general paresis of the insane (GPI) (a bit like
what we now call dementia) might be the result of infection
▪ We now know that untreated infection from syphilis can cause mental illness
▪ Maybe all mental disorders would be found to be caused by biological factors?
▪ To treat GPI, people would induce fever. This did stop progression of the
disease, but became a bit of an obsession.
shock therapy as a treatment
Applied to a large range of disorders
▪ Initially used by Sakel (German) to treat withdrawal from morphine addiction
▪ Electroconvulsive therapy (ECT) was introduced by Ugo Carletti. Embraced for
schizophrenia (not very good)
▪ Late 1950s: discovered that the convulsions induced could be beneficial for
depressed patients
