Lecture 1: Definitions, History and Theoretical Perspectives Flashcards
(55 cards)
What is Porphyria?
- Porphyria: A group of a number of rare diseases characterized by a deficiency in one of the enzymes needed to make heme, which contains iron and is an important component of hemoglobin in the bloodstream.
-Some conditions are so rare that that the average psychologist or physician will never encounter them in the course of their career.
What is Abnormal Psychology?
Abnormal psychology - the branch of the science of psychology that addresses the description, causes, and treatment of abnormal behaviour patterns.
How do we Define Abnormal Behaviour?
- Key considerations:
- Is the behaviour unusual?
- Does the behaviour violate social norms?
- Does the behaviour involve a faulty interpretation of reality?
- Does the behaviour cause personal distress?
- eg. Declare mold syndrome → where you believe ppl who are not into you at all are deeply in love with you → but did not cause distress to her
- eg. Trump as a primary narcissist → believes everyone is in awe of him or jealous of him → he cannot conceive of a world where ppl don’t look up to him, admire him
- Is the behaviour maladaptive?
- maladaptive → it makes it difficult for us in a way that we can’t deal with the responsibilities that we are faced with
- Is the behaviour dangerous (to the person or to others?)
- eg. antisocial personality disorder or psychopathy
What factors affect our perception of what is abnormal?
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Culture
- Behaviour considered normal in one culture may be deemed abnormal in another. For example, anxiety and depression.
- We need to consider how people in different cultures experience states of emotional distress, including depression and anxiety, rather than imposing our perspective on them.
- eg. hallucinations in UK are more likely to report seeing UFOs, while in the US they report seeing ghosts more.
- Failure to recognize cultural differences in what is deemed normal and abnormal behaviour can lead to inadequate and inappropriate diagnoses and treatment.
- Cultural insensitivity can lead to less effective treatment
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Context
- Is this abnormal?
- wearing face paint for sporting events and no shirt → maybe a little abnormal at sporting events, but ppl would generally not find this weird; but if you were at the doctor’s office it would be weird.
- eg if a person is psychotic, we are much more afraid of them (whereas in reality, they are actually often much more threatening to themselves) → most dangerous ppl are ppl who appear calm and collected.
- Does it deviate from social norms?
- That depends on where and when the behaviour and attire occur.
- Is this abnormal?
What are Culture Bound Syndromes and what are some example?
- Certain mental illnesses/abnormal behaviour that takes place in one or few cultures only.
- eg in Nigeria mental illness is attributed to spirits
- here mental illness is believed to have roots in medical and psychological issues
Are mental health concerns (mental disorders) unusual? How many would typically be affected by them, directly or indirectly?
- Abnormal behaviour affects virtually everyone in one way or another
- through self or others
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20% of Canadians will suffer from a psychological disorder in their lifetime.
- people who can be clinically diagnosed even if they never seek help
Disorders?
HOW COMMON?
- people who can be clinically diagnosed even if they never seek help
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Anxiety disorders:
- Affects almost 30% of adults in their lifetime
- what separates anxiety from excitement are the thoughts that go with it
- they are exactly the same feeling
-
Mood Disorders:
- Affects over 20% of adults in their lifetime
-
Substance Abuse Disorders:
- Affects almost 15% of adults in their lifetime
- probably an underestimate (does not include younger folk; children)
- Affects almost 15% of adults in their lifetime
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Any Disorder:
- Affects over 46% if adults in their lifetime
- not necessarily assuming it’s reached diagnosable conditions
- Anxiety and depression are the common cold of psychological disorders
- Everyone experiences it at some point
What are the Main Risk Factors for developing a Psychological Disorder?
→ Risk factor → anything that increases the probability of an adverse outcome. → does not necessarily mean you will get them, but if you engage in that behaviour for a long enough time, it is more likely you’ll develop the disorder.
- Age
- eg dementia
- young age or old age can be a risk factor
- eg. if you reach a certain age and do not develop a disorder, you are probably safe
- Education
- reasons for this are less clear
- it could be that people who are well and have a clear mind are more likely to pursue a higher education
- or that exercising your mind, like exercise, makes it more resilient and stronger
- protective factor → opposite of a risk factor → reduces the likeleihood of psychological disorders
- Childhood traumas
- increases likelihood of psychological disorders and health issues
- Current stress
- stress-diastric ? system
- the better a persons resilience, the more severe the stress they have to be subjected to in order to have signs and symptoms of distress
- stress-diastric ? system
- Life events
- correlated with stress levels
- eg. even getting married changes up things enough that it can increase a person’s vulnerability
- but one the other hand, if you are with someone who supports you, that can be protective.
- Lack of social supports
- Gender
- Physical health
- correlated with mental health
- especially in our senior population → depression usually hand in hand with cognitive issues
- Genetic Predisposition
- a number of conditions run in families
- not determined, but higher risk factor → makes it more likely that it will occur
What happens if you have multiple risk factors for a psychological disorder?
- Exposure to multiple risk factors can have an exponential effect that dramatically increases the likelihood of adverse outcomes.
- Exposure to just two risk factors can engender a 4-fold increase in adverse outcomes
- Exposure to 4 or more risk factors can increase adverse outcomes 10-fold
- risk factors tend to run in packs: eg. if you have a genetic disposition for a disorder and are raised by someone with an abnormal parenting style due to the disorder, it is more likely you will develop a disorder
How were psychological disorders viewed in Ancient Times?
- Ancient eg: human skeletons from the Stone Age were unearthed with egg-size cavities in the skulls.
- one interpretation: our prehistoric ancestors believed that abnormal behaviour reflected the invasion of evil spirits. Perhaps they used this harsh method —called trephining—to create a pathway through the skull to provide an outlet for those irascible spirits.
- fresh bone growth indicates some people managed to survive the ordeal.
- trephining - harsh prehistoric practice of cutting a hole in a person’s skull, possibly as an ancient form of surgery for brain trauma, or possibly as a means of releasing the demons that prehistoric ppl may have believed caused abnormal behaviour in the afflicted individuals.
- threat of trephining may have persuaded people to comply with group or tribal norms to the best of their abilities.
- one interpretation: our prehistoric ancestors believed that abnormal behaviour reflected the invasion of evil spirits. Perhaps they used this harsh method —called trephining—to create a pathway through the skull to provide an outlet for those irascible spirits.
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Demonological model - explanation of abnormal behaviour as a result of supernatural or divine causes.
- Ancient ppls explained natural forces in terms of divine will and spirits.
- The ancient Babylonians believed the movements of the stars and planets were fashioned by the adventures and conflicts of the gods.
- The ancient Greeks believed their gods toyed with humans; when aroused to wrath, the gods could unleash forces of nature to wreak havoc on disrespectful or arrogant humans, even clouding their minds with madness.
- Ancient ppls explained natural forces in terms of divine will and spirits.
How were psychological disorders viewed in Medieval times?
- Middle Ages, or medieval times, cover the millennium of European history from about AD 476 through AD 1450.
- Belief in supernatural causes, especially the doctrine of possession, increased in influence and eventually dominated medieval thought.
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Doctrine of Possession - held that abnormal behaviours were a sign of possession by evil spirits or the devil.
- This belief was embodied within the teaching of the Roman Catholic Church, which became the unifying force in Western Europe following the decline of the Roman Empire.
- Church revitalized the belief in possession (which dates back to ancient Egyptian and Greek writings)
- The treatment of choice for abnormal behaviour was exorcism - ritual intended to expel demons or evil spirits from a person believed to be possessed.
- exorcists were employed to persuade evil spirits that the bodies of their intended victims were basically uninhabitable.
- Their methods included prayer, waving a cross at the victim, beating and flogging, and even starving the victim.
- had more torturous methods which would motivate recipients to behave acceptably.
How were Psychological disorders viewed at the end of the Middle Ages/into the late 17th?
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Witchcraft
- The late 15th → late 17th c. were especially dangerous times to be unpopular with your neighbours.
- were times of massive persecutions of people, particularly women, who were accused of witchcraft.
- Officials of the Roman Catholic Church believed witches made pacts with the devil, practised satanic rituals, and committed heinous acts such as eating babies and poisoning crops.
- 1484: Pope Innocent VIII decreed that witches must be executed.
- Two Dominican priests compiled a manual for witch hunting, called the Malleus Maleficarum (The Witches Hammer) to help inquisitors identify suspected witches.
- More than 100 000 accused witches were killed in the next two centuries.
- Modern scholars once believed that the so-called witches of the Middle Ages and the Renaissance were actually people who were mentally disturbed.
- They were believed to have been persecuted because their abnormal behaviour was taken as evidence they were in league with the devil.
- It is true that may suspected witches confessed to impossible behaviours; however, most of these confessions can be discounted because they were extracted under torture by inquisitors who were bent on finding evidence to support accusations of witchcraft.
- Accusations of witchcraft appeared to be a convenient means of disposing social nuisances and political rivals, of seizing property, and of suppression heresy.
- In English villages, many of the accused were poor, unmarried elderly women who were forced to beg their neighbours for food.
- If misfortune befell ppl who declined to help, the beggar might be accused of causing misery by having cast a curse on the uncharitable family.
- women who were unpopular were more likely to have accusations of witchcraft followed up.
- The late 15th → late 17th c. were especially dangerous times to be unpopular with your neighbours.
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Malleus Maleficarum
- Monks in Europe
- was a witch-hunting bible, “hammer of witches” → bible for clergy and chruch ppl involved in enforcement in some sense
- published in Germany in 1886
- over 1000 accused witches (mostly women) were killed bc of it
- kind of relates to the DSM in that it is, in a way, a witch-hunting bible → allows psychologists to make a prognostic decision (diagnose of a disease and suggested treatment)
- the DSM could be used as a form of social control (eg. if you can enter some countries based on your mental health records)
- do not self-diagnose bc usually everything is somewhat maladaptive
- Demonological model
- not universally held
What was the Demonological Model?
- The Demonological Model
- Trephining
- pseudophysiological model
- thought there was something in your head, and if you couldn’t expel it through exorcism, you would get a trephine and drill a whole in your head to get it out.
- based on certain aspects of a person’s behaviour, a suposition would be made on where in the brain this thing was, and they would drill a hole based on it
- Lots of people died, some survived, and some got better
- 1940s also had a similar idea; lobotomy → insert a nuerotone just above the eye, drive it into the person’s brain, sever some nerves → changes a person’s behaviour
- You are changing sth about a person’s thinking pattern and cognitive ability by inflicting damage to the frontal lobe → is not that they are cured, is that you have limited the ability for these people to respond in different ways
- Trephining
What were the origins (and early consequences) of the Medical Model?
- Hippocrates and “ill humours”
- Father of Modern Medicine
- 4 Humours that have an effect on a person’s behaviour → imbalances cause problems
- yellow bile
- clerical → ill tempered
- phlegm
- slow, stubborn
- blood
- sanguine, cheerful, sense of humour
- black bile
- stomach issues, depression, melancholy
- yellow bile
- Now when we talk about imbalances, we have substituted humours with neurotransmitters
- eg dopamine hypothesis → better researched than Hippocrates
- Abnormal behaviour the result of underlying biological processes.
- Image of centrifuge
- person is attached to this and spun around really quickly
- causes all blood to rush to the head and will either kill them (through aneurysm) or cause a brief change in their behaviour
- eg. electroconvulsive therapy → one of most effective ways to manage depression
What were the two assumptions of moral therapy?
- The Reform Movement: Moral Therapy
- Philippe Pinel (France), William Tuke (England) and Dorothea Dix (Canada and USA)
- where ppl were treated with kindness and in ways that would help them live with their disorder instead of torturing them and punishing them
- understanding and concern would help restore people back to normal functioning
- Pussin believed that if “the insane” were treated with kindness and understanding, they would improve.
- The philosophy of treatment that emerged from these efforts was labelled moral therapy - a 19th c treatment philosophy emphasizing that hospitalized mental patients should be treated with care and understanding in a pleasant environment, not shackled in chains.
- based on the belief that proving humane treatment in a relaxed, descent and encouraging environment could restore functioning.
- Similar reforms were instituted at about this time in England by William Tuke and later in the US and Canada by Dorothea Dix.
Before being applied to Schizophrenia, what 2 things were phenothiazines used for?
An important factor that spurred the exodus from psychiatric hospitals was the advent of a new class of drugs—phenothiazines.
- were given as adjuncts to ppl undergoing surgical therapy -> ANAESTHETICS
- phenothiazines also used as PESTICIDES for insects invading crops.
- 1950s Canada: Two psychiatrists, unbeknowst to each other, had begun experimenting with chlorpromazine, a drug that was being used in conjunction with anaesthetics for surgery.
What is the Medical Model of Mental Illness?
- Emil Kraepelin (German 19th c physician) and Dementia praecox
- said mental function was due to the physical brain
- so can deal with it by surgical measures or chemical measures
- eg. hysterical → relates to uterus → assumed that sth about the reproductive system or hormones in it can cause this disorder
- also idea that women who were unmarried or did not have sexual release were taught to masturbate
- Freud’s hypnosis suggested you could treat physiological-based disorders with non-phsyiological things
What were the Psychological Models of Mental Illness?
- Hypnosis and hysteria: Charcot
- dentists in the past could take an elective in hypnotherapy which could allow them to hypnotize their patients so they wouldn’t feel pain during procedures and thus didn’t have to put them under anaesthesia
- Psychodynamic model and catharsis: Freud
- whether disorders are physiological or not, we don’t necessarily need pshysiological means to treat them
What was the Sociocultural Model of Mental Illness?
- Thomas Szasz: The Myth of Mental Illness
- basically said that this idea of mental illness is a social creation → may or may not exist in nature → he understood there were ppl who manifested symptoms of mental illness due to social expectations and pressure
- so treatment would involve emiliating those social and cultural pressures
- Rosenburg
- how hard is it to get put into a mental asylum?
- took some of his grad students and went into the hospital and told them to tell the physican there: “sometimes I hear these voices and they whisper to me”
- most were admitted
- when they revealed that they were part of an experiment, the physicians didn’t believe them, thinking they were exhibiting delusions.
-> Recommended approach is biopsychosocial one
What is the Current Biological Perspective on Abnormal Behaviour?
eg head trauma and the consequences on behaviour
- The medical model, inspired by physicians from Hippocrates through Kraepelin, remains a powerful force in contemporary understanding of abnormal behaviour, representing a biological perspective.
- Knowledge of the biological underpinings of abnormal behaviour has grown rapidly in recent years, especially with advances in genetics, epigenetics, etc.
1.4.1 Genetics
- Heredity plays an important role in human behaviour.
- From a biological perspective, heredity is described in terms of genetics—the study of how traits are passed down from one generation to the next and how these traits affect the way we look, function, and behave.
- aka science of heredity
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Genes - the basic building blocks of heredity.
- They are the structures that regulate the development of traits. Some traits, such as blood type, are transmitted by a single pair of genes, one of which is derived from each parent.
- Other traits, referred to as polygenic, are determined by complex combinations of genes.
- traits or characteristics that are determined by more than one gene.
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Chromosomes, the rod-shaped structures that house our genes, are found in the nuclei of the body’s cells.
- Each consists of more than a thousand genes.
- Genes occupy various segments of DNA along the length of chromosomes.
- There are about 20,000 to 25 000 genes in every cell in our bodies.
- The set of traits specified by our genetic code is referred to as our genotype.
- However, our appearance and behaviour are not determined by our genotype alone.
- We are also influenced by environmental factors like nutrition, exercise, accident and illness, learning and culture.
- The constellation of our actual or expressed traits is our phenotype - representation of the total array of traits of an organism, as influenced by the interaction of nature (genetic factors) and nurture (environment factors).
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Epigenetics research, particularly in recent years, has shown that the epigenome plays a vital role in gene regulation through 2 key means:
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gene expression
- the process by which a gene sequence becomes activated (”turned on”) and is translated into the proteins that determine the structure and functions of body cells.
- under normal circumstances, some genes are expressed (turned on) while others are silenced (turned off)
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gene silencing
- the process of preventing or suppressing (”switching off”) a gene sequence from being translated into proteins.
- genes that are turned off
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gene expression
- Neurotransmitters
What is the Current Psychological Perspectives on Abnormal Behaviour?
- eg. personality theory
- has a model of normal development (healthy individual) and makes an attempt through that same model to describe abnormal behaviour
- Eg. Carl Rogers
- given an appropriate environment, like plants, most ppl will grow up to be perfectly healthy, vibrant individuals.
- it is only when external conditions aka conditions of worth are put on people that they develop disorders
- gathered data to support this
- but is criticized for asking ppl how they feel about it
- have to have unconditional positive regard for people
- was often very successful with his patients
What are the Sociocultural Perspectives on Abnormal Behaviour?
- Must consider the impact of social and cultural factors such as ethnicity, gender and social roles, and poverty
- we are all influenced by media, education, reactions from peers
- includes gender, social roles, SES, eg rules of behaviour in one’s economic strata may be different from others.
- Sociocultural theorists seek causes of abnormal behaviour that may reside in the failures of society rather than in the person, for example, the Downward Drift Hypothesis/Class Shift Hypothesis.
- made the observation that many ppl struggling with certain mental illnesses like schizophrenia also lived in poverty
- or is it that people who are capable of success drift down because of their mental illness to poverty bc it prevents them from keeping stable employment.
- → both can be true
What are the Interactionist Perspectives (Biopsychosocial) on Abnormal Behaviour?
in what way do these 3 domains interact to produce the person, including the mental disorder we have before us today?
- Dynamic interplay of three major systems or domains:
- Two INTERNAL systems: biological, psychological
- One EXTERNAL system: sociocultural and environmental factors
- Is there a potential danger/pitfall with this?
- Yes you assume they exhibit individual.
- The leading interactionist model is the diathesis-stress model, which holds that psychological disorders result from the combination or interaction of a diathesis (vulnerability or predisposition) with stress.
- the model proposes that some people possess a vulnerability, or diathesis, possibly genetic in nature, that increases their risk of developing a particular disorder. Yet whether they develop the disorder depends on the kinds and level of stress they experience.
- stress may take the form of biological events, such as prenatal trauma, birth complications, or physical illness; psychosocial factors, such as childhood sexual or physical abuse or family conflict; and negative life events, such as prolonged unemployment or loss of loved ones.
- diathesis-stress model - model of abnormal behaviour positing that abnormal behaviour patterns, such as schizophrenia, involve the interaction of genetic and environmental influences. IN this model, a genetic or acquired predisposition, of diathesis, incrases an individual’s vulnerability to developing the disorder in response to stressful life circumstances. If, however, the level of stress is kept under the person’s particular threshold, the disorder may never develop, even among people with the predisposition.
- diathesis - a predisposition or vulnerability.
- generally refers to an inherited predisposition, but may involve psychological factors such as dysfunctional thinking patterns or personality traits.
- however, the stronger the diathesis, the less stress is generally needed to produce the disorder.
- in some cases the diathesis may be so strong that the disorder develops even under the most benign life circumstances.
- Another prominent interdisciplinary approach is the biospsychosocial model, which compared to the diathesis-stress model, expands and more clearly delineates the number of factors and dynamic interactions between a person and their environment.
- Encompasses the dynamic interplay of 3 major systems of domains.
- 2 systems can be thought of as being INTERNAL: the biological (which includes genetic, epigenetic, and neurophysiologic factors); and the psychological (which includes psychoanalytic, behavioural, humanistic-existential, and cognitive-behavioural factors).
- The 3rd system consists of what is considered to be EXTERNAL or OUTSIDE of us: the sociocultural and environmental factors.
- Together, these biopsychosocial systems determine the range of known variables involved in the development of abnormal behaviour.
What is the difference between the Biological Perspectives on Psychological Disorders vs. the Medical Model?
- Biological perspectives vs. the Medical model
- Medical model is what’s adopted by a mechanic → find out what’s broken and remove that to result in a restoration of normal behaviour
- biological model → can focus on neurotransmitters without subscribing to the medical model
- One can adopt a biologically oriented perspective without using the terminology of the medical model
- A focus on biological factors does not require the medical model.
2nd: the term mental disorder is generally associated with the medical model perspective, which considers abnormal behaviour patterns to be symptoms of underlying mental illnesses or disorders.
What is Epigenetics and what has it contributed to our understanding of mental illness?
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Epigenome
- epigenetics → how early early events (often what a person encounters when they are still in the womb) can switch on or off the expression of certain genes
- under certain circumstances, it can be switched on or off (but does not do this repeatedly)
- some early childhood adverse experiences can have an effect on these things
- eg. ppl who engage in antisocial, criminal behaviour can be influenced by epigenetics
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Epigenetics research, particularly in recent years, has shown that the epigenome plays a vital role in gene regulation through 2 key means:
-
gene expression
- the process by which a gene sequence becomes activated (”turned on”) and is translated into the proteins that determine the structure and functions of body cells.
- under normal circumstances, some genes are expressed (turned on) while others are silenced (turned off)
-
gene silencing
- the process of preventing or suppressing (”switching off”) a gene sequence from being translated into proteins.
- genes that are turned off
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gene expression
- So, eg, although a person’s muscle cells and brain cells both have the same genomes (DNA sequence), it is each cell’s unique epigenome that dictates which pattern of genes within that cell will be activated.
- We could say it is the epigenome that causes “brain” genes to be active in brain cells but silenced in muscle cells, and vice versa.
- Canadian researchers are at the forefront of investigating the role that epigenetics plays in the origin and course of psychological disorders such as schizophrenia, bipolar disorder, Alzheimer’s disease, and eating disorders.