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1

Historical developments

1. Nature (mental illness and eugenics)
2. Nurture (backlash after WWII)
3. Nature (first anti-psychotic drugs 1950s, antipsychiatry movement and critical medical anthropology 1960s, mental illness with genetic components 1960s, and mental illness as biological phenomenon 1970s
++++recognizing the false dichotomy

2

DSM-V

-Manual used by psychiatrists to diagnose mental illness
-published 2013, first edition 1952

3

defining mental illness

-showing signs of abnormal behaviour
-expressed and defined culturally, standard set by DSM-V

4

psychiatrist

-psychiatrist is a physician who specializes in psychiatry, the branch of medicine devoted to the diagnosis, prevention, study, and treatment of mental disorders

5

clinical psychologist

Clinical psychologists are licensed professionals who are qualified to provide direct services to patients. Their work may include administering and interpreting cognitive and personality tests, diagnosing mental illness, creating treatment plans, and conducting psychotherapy..

6

epidemiologist (in the context of mental health)

-focused on the population aspect of mental illness
-patterns and demography of mental illness as a disease

7

evolutionary biologist (in the context of mental health)

-evolutionary understanding of mental disorders

8

I am illness concept

-chronic conditions that people do not simply have but also become
-EX) hemophilia--> hemophiliac
-EX) diabetes--> diabetic

9

examples of culture-bound syndromes (what, where, epidemiology)

-combination of psychiatric and somatic symptoms that are considered to be a recognizable disease only within a specific society or culture

Western Examples:
-anorexia nervosa, PMS, Petism, OCD, Hoarding, Spasmophilie, fatigue

Piblotoq
-'arctic hysteria' in Inuit populations

Susto
-'soul loss' in latin America

Amok
-malay region and island areas of Southeast Asia

Latah
-southeast asia, murhphy and simons

10

Eating disorders (definitions and characteristics, patterns within Western context and manifestation outside, etiology)

DSM-V: anorexia nervosa, bulimia nervosa, binge-eating
-Riadh Abed (1998): and an evolutionary model
-Erving Goffman (1963) and stigma

11

Riadh Abed

-relationship between eating disorders and female intrasexual competition (ISC)
was studied.

12

Erving Goffman

-defined stigma
The phenomenon whereby an individual with an attribute which is deeply discredited by his/her society is rejected as a result of the attribute. Stigma is a process by which the reaction of others spoils normal identity.

More specifically, he explained that what constituted this attribute would change over time. "It should be seen that a language of relationships, not attributes, is really needed. An attribute that stigmatizes one type of possessor can confirm the usualness of another, and is therefore neither creditable nor discreditable as a thing in itself.

13

ADHD (symptoms, medicalization)

-worldwide prevalence 5%
symptoms pervasive:
----inattention, hyperactivity, impulsivity
-Timimi and Taylor (2004) debate on whether ADHD is best understood as a cultural context
-now treated with a variety of amphetamines in the West

14

Timimi and Taylor debate

-2004 debate on whether ADHD is best understood as a cultural construct

15

Mood disorders (definitions and characteristics, evolutionary explanations)

-mental illnesses caused by a disruption in mood
-Two primary forms:
----depression & bipolar disorder/manic depressive disorder
Depression:
-most common form of mood disorder
-must satisfy a minimum of 5 out of 9 DSM established criteria for diagnosis
-cultural complications to expression and diagnosis (Spero Manson 1996)
-explaining sex-based prevalence with evolutionary models
Bipolar/ Manic Depressive:
---widely known but relatively rare (0.5-1.5 prevalence)
---characterized by both depressive and manic episodes
---diagnosis must include at least 3 of 7 symptoms
SYMPTOMS OF A MANIC EPISODE:
-inflated self esteem/grandiosity
-decreased need for sleep
-more talkative than usual/ pressure to keep talking
-flight of ideas or subjective experience that the thought are racing
-distractability
-increase in goal-directed activity or psychomotor agitation
-excessive involvement in pleasurable activities that have a high potential for painful consequences
BIPOLAR AND CREATIVITY
-seems to be heavily correlated
-similar characteristics which contribute to creativity may also contribute to bipolar disorder
-potential evolutionary selective advantage?

16

Substance use and abuse- explanations.

NESSE and BERRIDGE (1997)
-identify two types of psychoactive substance (stimulants and blockers)
-mismatch from environment of evolutionary adaptedness

SULLIVAN AND HAGEN (2002)
-emphasize antiquity and co-evolution of people w/ psychoactive substances
-parallel uses as foods and medicines
-ability to gain access to beneficial effects of some plant allochemicals

17

Schizophrenia (definition and characteristics, evolutionary explanations)

KEY FEATURES:
-approx 1% population, variable rates across different populations
-NOT same thing as DID
-appears to be universal condition
-Age of onset usually late teens/ early 20s

DSM-IV diagnostic criteria
-delusions
-hallucinations
-disorganized speech (frequent derailment or incoherencea)
-grossly disorganized or catatonic behavior
-negative symptoms; affective (emotional) flattening, alogia (poverty of speech), and avolation (lack of motivation or persistence to complete a task).

EVOLUTIONARY MODELS:
-challenging b/c condition seem reduce fertility
-all models maintain condition represents extreme phenotype assoc. w/ genes also expressed to some extent in non-affected individuals
3 MODEL TYPES:
---heterozygous advantage
---increased fitness to related carriers
---genetic load arguments

18

Sleep (processes, historical patterns, EEA in contet of sleep, sleep disorders)

2 PROCESSES
-circadian cycle (regulates daily sleep and wakefulness, influenced by the SUPRACHIASMIC NUCLEUS in the hypothalamus)
-homeostatic cycle (pathways involving a number of brain regions and responds to 'tiredness')
2 TYPES OF SLEEP
-cycle every 90-100 mins
-non-rapid eye movement (NREM)-deepest sleep
-REM-more vivid dreams
-changing sleep patterns with modern times?
ex.) decline of polyphasic sleep

SLEEP DISORDERS
-insomnia
-narcolepsy
-sleep apnea
-sudden unexplained nocturnal death syndrome
-----HMONG-linked to brugada syndrome
-sleep paralysis and nightmares