History of Abnormal Psychology

Paleolithic Era

• In the Paleolithic era, it was believed that evil spirits, considered invisible beings or enemies, possessed individuals.
• Treatments during this era included magic and trephination.

Demonology

• Demonology describes evil beings dwelling within a person, controlling their mind and body.
• This belief was held by the Chinese, Egyptians, Babylonians, Hebrews, and Greeks.
• It was thought that evil entities that took possession of individuals acted on the displeasure of the gods.

Somatogenesis

• Thales contributed to Somatogenesis.
• Pythagoras developed the concept that biological chemicals/humors are the source of problematic behavior.
  • He rejected the view of disease as punishment from God.
  • He focused on natural causes for intellectual and physical problems.
• Hippocrates, a Greek physician, believed that deviant behavior could arise from brain pathology.

The Dark Ages

• During the Dark Ages, there was recurrent famine and plagues.
• The influence of the church increased at this time.
  • There was a return to demonology as an explanation for problematic events.
  • People became obsessed with Satan.
  • Treatments involved prayer, touching relics, or concocting potions.
• The mentally ill were viewed as witches, a view instigated by Satan.
  • Pope Innocent VIII urged clergy to hunt down witches in 1484.
  • A manual called Malleus Maleficarum (the witches hammer) was created.
  • Treatment involved torture and burning.

St. Mary of Bethlehem Hospital

• St. Mary of Bethlehem Hospital provides treatment of chained, beaten, fed only enough to keep them alive, bloodletting, and public display.
• The hospital was devoted to the confinement of the mentally ill and established in 1547.

Medicine Takes Charge

• Benjamin Rush (1745-1813) was a signer of the Declaration of Independence, a sergeant for the general of the continental army, created the first psychiatry textbook, and is considered the father of American psychiatry.
  • The emergence of the field of medicine suggested that excess blood in the brain might be the cause of mental illness.
  • Classification and theorizing causes and possible cures were investigated.
  • Mental disorder was thought to be caused by excess blood in the brain.
  • Treatments included frightening people by convincing patients of their impending death and spinning them.
  • Rush was a pioneer in the study of addiction.

Room for Humanity

• Joseph D'Aquin (1733-1815) and Phillipe Pinel (1745-1826).
  • This treatment included occupational therapy, bathing, and mild purgatives.
  • Advocated for the moral treatment of human beings.
  • Cruel treatment was not good.
  • Humanism: Joseph D’Aquin; methods of natural science.
  • Embraced the idea of understanding.
  • Advocated for mild forms of treatment (occupational therapy).
  • They maintained precise case histories, recording everything about the person's experiences, including the timing of their symptoms.
  • Phillipe Pinel ordered people in the Paris asylum to be released from their chains.
  • He had a friend who experienced mental illness and advocated for stopping blood-letting.
• Dorothea Dix (1802-1887) became shocked at the horrible conditions in hospitals.

Order to the Chaos

• Emil Kraepelin (1856-1926)
  • Studied experimental psychology with Vunte and brought a scientific approach to psychopathology.
  • Theorized hereditary biological malfunction.
  • Committed to conducting natural history of mental disorders using Vunte practices.
  • Developed a systematic classification for mental disorders, which was a forerunner for the DSM system that developed later.
  • In 1899, manic depressive psychosis was thought to be an irregular metabolic function transmitted by heredity.
  • Looked for patterns of onset and different courses of mental disorders.
  • Returned to somatogenesis with the idea that the “irregular metabolic function transmitted by heredity."
  • Search for somatic cause dominated into early 20th century.
• Dynamic theories in the mental health field are considered non-science.

Jean-Martin Charcot

• Jean-Martin Charcot (1825-1893)
  • Neuroses: nervous disorders with no signs of brain or spinal lesions.
  • Disorders included disintegration of the myelin sheath in multiple sclerosis.
  • In 1870, Charcot entered into the study of neuroses by moving patients with epilepsy into another ward where people who had hysteria were housed.
    • Hysteric patients began having seizures.
• Vacation oriented health resorts: 18th century spa doctors.
  • Doctors at vacation oriented health resorts treated some patients with repetitive gastrointestinal discomfort.
• Hysteria is clinical signs of pathology that are not correlated with underlying anatomical knowledge.
  • Wide ranging, congenital neurological deficiency, biological and genetic.
  • Sudden onset paralysis of half of the body.
  • Paralysis shifting.
  • Glove anesthesia: inability to feel anything in your hands.

Hippolyte-Marie Bernheim

• Hippolyte-Marie Bernheim (1840-1919) was a professor at the nancy school in France.
  • He tried treating a patient with sciatica for 6 years without success, and referred the patient to a professional who used hypnosis treatment to relieve symptoms.
  • He considered the hypnotic state to be "psychological," not neurological.
  • He suggested that unconscious self-suggestion might underlie symptoms of hysteria and other mental disorders.
  • He labeled hysteria a psychogenic disorder, coining the term "psychoneurosis."
    • Bernheim founded psychogenesis, describing psychological malfunction.
• Freud was a neurologist by training who was interested in Charcot's work.

Joseph Breuer

• Joseph Breuer (1842-1925) was an internist who authored case studies on hysteria, such as Bertha Pathenine.
  • Breuer treated a patient named Bertha Pathenine, discovering that she had been through a traumatic experience caring for her father through his terminal illness.
    • He was responsible for what emerged in the field as much as other clinicians.
    • Perpetual squinting was shared with Breuer and the squinting went away.
  • Hypnotic memories were accompanied by intense emotional outbursts, creating emotional catharsis.
  • Emotional trauma leads to repressed memories.
• 1895 studies on hysteria
• 1900 interpretation of dreams

Psychosurgery

• Carlyle Jacobsen conducted behavioral experiments with chimpanzees. The chimpanzees exhibited violent reactions during experimental tasks and became less violent when the tasks were removed.
• Antonio Egas Moniz was a Portuguese neuroscientist. He believed that psychotic patients suffer from abnormally fixed arrangements, where in fixed neural pathways was a function of neural communication that was in a pathological loop.
  • He convinced a neural surgeon to conduct frontal lobotomies on patients which relieved violent states and emotional distress in patients, and he won a Nobel Prize for this work.
• Walter Freeman developed the transorbital lobotomy by drilling a hole in the bone above the orbital eye and severing the bundle fibers using a specified tool.

Psychopharmacology

• In 1950, modern psychopharmacology was born with the discovery of the first antipsychotic (later known as chlorpromazine), which possessed antipsychotic properties.
• The late 1950s saw the emergence of behavior modification.
• The late 1960s marked the cognitive revolution in psychology.
• In the 1990s, the biopsychosocial model gained prominence.
• The 2000s were characterized by evidenced-based practice.
• By the 2010s, psychopharmacology surpassed $50 Billion (US alone), becoming the dominant approach in the field.

Clinical Research Design Issues

• Experimental-RCT (random assignment to condition and control of other variables; causal determinations of what happens; trying to understand causal relationships).
  • Control groups (randomized control trials).
    • No treatment control group: if the treatment group gets better, it is not because time passed (passage of time does cure mental illness sometimes).
      • Assessment process : people may get better with somebody who knows how to assess them; no treatment control group doesn't get treatment being assessed.
    • Waiting-list control group delaying treatment for those in this group, but not withholding it.
    • Another possibility is a Placebo control group that could be happening that is not controlled for (person is assessed and given a non-specific treatment that does not have the active ingredients of the real ingredients, thus a placebo treatment): control for non-specific elements of treatment .
• Case studies are a great source for ideas and hypotheses - Descriptive.
  • There are values and limitations.
  • Case studies allow us to study rare phenomena.
• Case Study - Experimental
  • Features include baseline assessment and continuous assessment. -There are advantages.
  • Limitations include that statistics cannot be used (no statistical significance from the results).