History of Mental Illness

Lecture 2: Historical Context

• Early views of mental illness attributed it to supernatural causes like demonic possession or witchcraft.
• Trepanning involved drilling holes in the skull to release spirits as a treatment.
• Hippocrates was the first to separate mental illness from supernatural causes.
• The Humoral Theory suggests mental disorders result from an imbalance in bodily fluids, specifically blood, phlegm, black bile, and yellow bile.
• Humoral Theory treatments included diet and lifestyle changes.
• During the Dark Ages, there was a shift back to supernatural explanations for mental illness due to church influence.
• The Malleus Maleficarum was a guidebook for identifying and punishing witches, contributing to the persecution of the mentally ill.
• St. Mary of Bethlehem (Bedlam) in London was one of the first major mental asylums.
• Early asylums often had harsh, overcrowded, and inhumane conditions.
• Philippe Pinel in France advocated for moral treatment, emphasizing kindness towards patients.
• Benjamin Rush in the U.S. emphasized treatments like bloodletting and tranquilizing chairs.
• The York Retreat in England provided humane care for the mentally ill.
• Deinstitutionalization involved shifting care from asylums to community-based treatments.
• Transinstitutionalization unintentionally led to many patients ending up in prisons or homeless.
• Community Treatment Orders (CTOs) are legal tools used for mandatory treatment.

Lecture 3: Theoretical Paradigms

• The biological paradigm attributes mental disorders to biological causes, such as genetics, neurotransmitters, or brain structure abnormalities.
• The psychoanalytic paradigm, developed by Freud, posits that unconscious conflicts cause disorders.
• Psychoanalytic methods include free association, dream analysis, and understanding defense mechanisms.
• The humanistic paradigm, championed by Carl Rogers, emphasizes self-actualization and free will.
• Client-Centered Therapy is a key component of the humanistic paradigm.
• The Cognitive-Behavioral Paradigm, influenced by Aaron Beck, focuses on the negative cognitive triad, which includes negative views of self, world, and future.
• Cognitive restructuring is used in cognitive therapy to change maladaptive thoughts.
• The Diathesis-Stress Model suggests that disorders arise from a combination of genetic vulnerability and environmental stress.
• The Biopsychosocial Model states that mental disorders result from biological, psychological, and social influences.

Lecture 4: Cognitive and Behavioral Perspectives

• Cognitive Therapy (CT) focuses on identifying and changing negative thoughts.
• Schemas are mental frameworks that shape perception and behavior.
• Cognitive-Behavioral Therapy (CBT) combines cognitive and behavioral techniques.
• CBT is used for depression, anxiety, PTSD, and eating disorders, among others.
• Aaron Beck researched depression and maladaptive thought patterns, significantly contributing to cognitive therapy.
• Beck's therapy emphasizes changing dysfunctional beliefs.
• Childhood trauma, stress, and socioeconomic factors significantly impact mental health.
• Risk factors increase the likelihood of mental health issues, while protective factors decrease it.
• There are cultural differences in how mental health is experienced and how treatment outcomes vary.

Lecture 5: Research Strategies

• A theory is a framework explaining behavior and mental processes.
• A hypothesis is a testable prediction derived from a theory.
• Qualitative research includes case studies and interviews, providing rich data but with low generalizability.
• Quantitative research includes experimental and correlational studies, offering objective, statistical analysis.
• A correlation measures the relationship between variables but does not establish causation.
• Experimental designs involve manipulation of an independent variable (IV), random assignment, and measurement of a dependent variable (DV).
• The placebo effect is improvement due to expectations rather than the actual treatment.
• A double-blind study ensures that neither participants nor researchers know group assignments to reduce bias.
• Meta-analysis combines multiple studies to determine treatment effectiveness.
• Effect size measures the overall impact of a treatment in meta-analysis.

Lecture 6: Classification and Diagnosis

• Classification of mental disorders aids in research and treatment.
• Classification is necessary for insurance and access to care.
• DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) was first published in 1952, with the latest version being DSM-5-TR (2022).
• The DSM has shifted from a multi-axial system to a categorical approach.
• Categorical classification provides a yes/no diagnosis.
• A clear advantage of the categorical approach is clear treatment decisions.
• A disadvantage of the categorical approach is the loss of information about the severity of the condition.
• Dimensional classification considers severity on a continuum.
• An advantage of dimensional classification is a more detailed assessment.
• A disadvantage of dimensional classification is that it is harder to apply in practice.
• Disruptive Mood Dysregulation Disorder was a new disorder introduced in the DSM-5.
• The introduction of DMDD has been criticized as pathologizing childhood tantrums.
• The DSM-5 removed the bereavement exclusion for depression.
• There are concerns about over-diagnosis and pharmaceutical influence.
• Allen Frances critiqued the DSM, warning against “medicalizing normal life.”
• HiTOP (Hierarchical Taxonomy of Psychopathology) focuses on symptom dimensions rather than categories.
• RDoC (Research Domain Criteria) emphasizes neuroscience and biological markers.

Explore the historical perspectives on mental illness, from supernatural explanations to early asylums. Discover the key figures like Hippocrates and Pinel, and concepts such as the Humoral Theory. Trace the evolution of understanding and treatment approaches.