CH 1/2 - Concepts and Theories of Abnormality

Question 1

psychopathology

Answer 1

field concerned with nature and development of abnormal behaviour, thoughts/cognitions, feelings, emotions

Question 2

criteria for defining abnormal behaviour

Answer 2

1. unusual behaviour (statistical infrequency)
2. violating social norms
3. faulty interpretation of reality
4. personal distress
5. maladaptive behaviour (disabilty/dysfunction)
6. dangerous behaviour
7. unexpectedness

Question 3

statistical infrequency

Answer 3

• one measure of abnormalcy
• behaviour that occurs rarely or infrequently
  ex. 14 y/o boy wetting the bed, Intellectual Developmental Disorder (low IQ), most mental disorders
  problem: there’s a value component to which side of the curve you’re on, and we hardly consider the intellectually gifted or elite athletes as abnormal or concerning

Question 4

violation of norms

Answer 4

• a measure of abnormalcy
• behaviour that defies or goes against social norms; either threatens or makes nervous those observing it
  ex. anti-social behaviour of the psychopath
  problems: this definition is relative to one’s culture/group, and what is the norm for one may be abnormal for another; doesn’t necessarily imply abnormality (ex fashion trends, prostitution) nor qualify someone for a diagnosis

Question 5

personal distress

Answer 5

• a measure of abnormal behaviour
• behaviour that creates personal suffering, distress, or torment in the person
  problem: fits many forms of abnormality such a depression (suicidal thoughts) but not all disorders involve distress (pedophillia) but that shouldn’t proclude it from being a mental issue; some things cause distress that aren’t disorders (hunger)

Question 6

disability/dysfunction

Answer 6

• measure of abnormal behaviour
• behaviour that causes impairment in some important are of life (work, personal relationships, recreational activities)
  exceptions: being short if you want to be a professional basketball player
• gender dysphoria isn’t a disability (but can be diagnosed as a mental disorder if it distresses the person)

Question 7

unexpectedness

Answer 7

• surprising or out-of-proportion response to env stressors, which can be considered abnormal
  ex. expect sadness from smn who lost a loved one to cancer, don’t expect laughter from a sexual assault survivor; anxiety disorders are diagnosed when the anxiety is unexpected and out of proportion to the situation
  problem: unexpected according to whom? everything is a spectrum, so at what pt do we draw the clinical line?

Question 8

in canada, most primary mental health care is delivered by:

Answer 8

general practitioners, who are the least trained to do so

Question 9

psychiatrist vs psychologist

Answer 9

clinical/counselling psychologists:

• have a PhD or psy. D (Dr of psych), which entails 4-7 years grad studies
• cannot prescribe psychoactive drugs

psychiatrist:

• hold an MD (medical Dr)
• have postgrad training in practice of diagnosing and psychotherapy
• can prescribe psychoactive drugs

Question 10

understanding of mental disorders pre-scientific inquiry

Answer 10

• beleived to be caused by events beyond the control of humankind (eclipses, earthquakes, storms, fire, diseases)
• largely thought to be supernatural and any behav that seemed outside of physical control also thought to be supernatural
• many believed that deviant behaviour reflected displeasure of the gods or possession by demons

Question 11

early demonology

Answer 11

• doctrine that evil beings, esp the devil, may dwell w/in a person and control their mind/body; not unique to any one theology
• given that abnormal behaviour was caused by possession, treatment often involved exorcism (elaborate rites of prayer, noise-making, force feeding of concoctions, flogging, starvation, all in an effort to make the body uninhabitable)

Question 12

trepanning

Answer 12

• making a surgical opening in a living skull by some instrument
• treatment used by stone age/neolithic cave dwellers for epilepsy, headache, psychological disorders attributed to demons

Question 13

hippocrates

Answer 13

• separated medicine from religion, magic and superstition
• rejected believe that gods sent physical diseases and mental disturbances and punishment
• insisted mental illness had natural causes that should be treated like other illnesses
• one of the earliest proponents of somatogenesis

Question 14

somatogenesis

Answer 14

“bodily origin”; the mental illness is caused by some type of abberant function in the soma, or bodily deficit

Question 15

psychogenesis

Answer 15

“mental origin”; mental illness has its origins in psychological malfunction of some kind, or perhaps cognitive distortion, etc

Question 16

hippocrates’ mental classifications

Answer 16

mania, melancholia, phrenitis (brain fever)

Question 17

hippocrates’ humoral physiology

Answer 17

-treatments differed from exorcist tortures, focusing instead on things like tranquility, proper nutrition and sexual abstinence (for melancholia)
-MH dependent on delicate balance among 4 humours (fluids) of the body:
too much blood = changeable temperament
too much black bile = melancholia
too much yellow bile = irritability and anxiousness
too much phlegm = sluggishness and dullness

Question 18

persecution of witches

Answer 18

• in the dark ages, christian monasteries replaced physicians as healers and authorities on mental disorder; nursing the sick fell to monks and nuns
• the 13th cent brought maj social unrest, recurrent famine and plagues which let to a renewed obsession with the devil and demonology
• “witches” were blamed for hardship and zealously persecuted

Question 19

development of asylums

Answer 19

• confinement began in 15th/16th centuries; leprosariums converted to asylums which took disturbed ppl and beggars
• had no specific regimen for inmates but work
• despite desire to help the mad, hospitals tailored for confinement of the mentally ill also emerged

Question 20

st mary of bethlehem

Answer 20

• london hospital devoted solely to confinement of the mentally ill
• conditions were deplorable; a place of wild uproar and confusion that gave rise to the term bedlam
• eventually became one of london’s greatest tourist attractions; ppl paid to watch ppl behave in bizzar fashions

Question 21

dorothea dix

Answer 21

• school teacher who taught sunday school at a local prison and was shocked by the conditions
• she inspired interest in the condition of patients and campaigned to improve the lives of ppl with mental illness
• resurrected moral treatment

Question 22

emil kraepelin

Answer 22

• created classification system to establish biological nature of mental illness
• noticed clustering of symptoms (syndrome) presumed to have an underlying physical cause
• illness as distinct, with its own genesis, symptoms, outcomes, etc
• proposed 2 maj groups of severe mental diseases: dementia praecox (an early term for schizophren which he thought was caused by chemical imbalance) and manic-depressive psychosis (now called bipolar disorder, which he thought was caused by metabolic irregularity)

Question 23

general paresis and syphilis

Answer 23

general paresis is characterized by stead physical and mental deterioration, delusions of grandeur, progressive paralysis from which there was no recovery

• leads to late stage syphilis
• an example of the increasing use of empirical approaches to understand mental illness
• the finding caused renewed interest in somatogenic causes (bc if one condition has biological causes, why not many others?)

Question 24

louis pasteur

Answer 24

-established the germ theory of disease, which laid the groundwork for demonstrating the relationship btw syphilis and general paresis; helped establish a causal link btw infection, destruction of brain areas, and a for of psychopathology

Question 25

deinstitutionalization

Answer 25

• aim(s/ed) to shift care from psychiatric hospitals into the community
• enthusiasm was tempered though by evidence that many discharged ppl lead lives of poverty in the community, with a significant number included among the homeless and prison populations

Question 26

transintitutionalization

Answer 26

• what actually happened when we tried to deinstitutionalize

- instead of getting into community programs, people with severe MH concerns were instead incarcerated

Question 27

current role of psychiatric hospitals

Answer 27

tertiary: provide specialized treatment and rehab services for individuals whose needs are too complex to be managed by the community

Question 28

community treatment orders (CTOs)

Answer 28

• legal tool issued by medical practitioners that establish conditions under which a mentally ill person may live in the community, including requirements for compliance with treatment (ex. to stay in the community, you have to visit me 2x a month and take your injections)
• consequence for failing to follow is being returned to psychiatric facility for assessment

Question 29

community psychology

Answer 29

-often focuses on prevention in contrast to the more usual situation of trying to reduce the severity or duration of an existing problem (they seek out potential problems instead of waiting around for them to occur)

Question 30

self-stigma

Answer 30

the tendency to internalize MH stigma and to see oneself in more negative terms as a result of experiencing psychological difficulties

Question 31

mental illness and violence

Answer 31

• there is a very small but significant relationship btw schizophrenia and violent acts (but it’s also true that the overwhelming majority of schizophrenics are not at all)
• one study found the incidence of violence to be higher for ppl with severe mental illness, but was only significant for those with co-occurring substance abuse/dependence

Question 32

mental health literacy

Answer 32

• the accurate knowledge that a person develops abt mental illness, its causes, and treatment
• more positive and informed attitudes are found among individuals who are younger, more educated, trained, or have personal experience

Question 33

mental illness in canada: gender issues

Answer 33

• women more likely to meet criteria for mood or anxiety disorders, eating attitude problems, and agoraphobia
• men more likely to meet criteria for substance dependence

Question 34

mental illness in canada: geopgraphy

Answer 34

• ppl in newfoundland and labrador and PEI reported most happiness and least distress
• QC reported high lvls of self-esteem and mastery, but least happiness and most distress