AB PSYCH (UNIT 1 & 2)INTRO AND HISTROTICAL TRADITIONS.docx

**Psychological Disorder** - **Psychological Dysfunction** - **Distress/Impairment** - **Atypical or Not Culturally Expected** **FOUR D's** - **DYSFUNCTION** - **DISTRESS** - **DEVIANCE** - **DANGEROUSNESS** **Important terms in DSM 5** Diagnostic Criteria Prevalence Incide...

**Psychological Disorder** - **Psychological Dysfunction** - **Distress/Impairment** - **Atypical or Not Culturally Expected** **FOUR D's** - **DYSFUNCTION** - **DISTRESS** - **DEVIANCE** - **DANGEROUSNESS** **Important terms in DSM 5** Diagnostic Criteria Prevalence Incidence Course Onset Prognosis Etiology Ego-Syntonic/Dystonic Comorbidity Differential Diagnosis - **Diagnostic Criteria** - a set of signs, symptoms, and tests used to determine the diagnosis of a person - Positive and Negative - **Incidence** - How many new cases occurred in a given period - **Prevalence** - How many in a population have/had the disorders - **Course** - pattern of symptoms - Chronic - Episodic - Time-Limited - **Onset** - Acute - **Insidious** -- gradually over an extend period of time - **Prognosis** - Anticipated course of the disorder - **Etiology** - Study of the origins - **Ego-Syntonic/Dystonic** - Consistency and inconsistency of behaviors with your personal values - **Comorbidity** - Existence of another disorder - **Differential Diagnosis** - a differential diagnosis is a method of analysis that distinguishes a particular disease or condition from others that present with similar clinical features +-----------------------------------------------------------------------+ | THE SUPERNATURAL TRADITION | | -------------------------- | +-----------------------------------------------------------------------+ - Deviant behavior has been considered a reflection of the battle between **good and evil** - In the **Great Persian Empire (900-600 B.C.,)** - **Possession → Psychological Disorders → Misfortune** - The bizarre behavior of people afflicted with psychological disorders was seen as the work of the devil and witches. - Treatments included **exorcism.** - shaving the pattern of a cross in the hair of the victim's head - securing sufferers to a wall near the front of a church so that they might benefit from hearing Mass. - The conviction that sorcery and witches are causes of madness and other evils continued into **15th century.** **STRESS AND MELANCHOLY** - 15th century - Insanity was a natural phenomenon, caused by mental or emotional stress - Symptoms such as despair and lethargy were often identified by the church with the sin of ***acedia, or sloth*** - Common treatments were: **rest, sleep, and a healthy environment.** Other treatments includes **baths, ointments and various potions.** **NICHOLAS ORESME** - King advisers, 14th century bishop, and Philosopher - Suggested that **Melancholy (depression)** was the source of some bizarre behavior, rather than demons. - Pointed out that much of the evidence for the existence of sorcery and witchcraft, particularly among those considered insane, was obtained from people who were tortured and who, quite understandably, confessed to anything. **MASS HYSTERIA** - Large scale outbreaks of bizarre behavior. - **Saint Vitus's Dance and tarantism.** - Demonstrate the phenomenon of **emotion contagion.** - **Emotion Contagion** - **Mob Psychology** **THE MOON AND THE STARS** - **Paracelcus (1493-1541)** - Swiss Physician - Rejected the notions of possession by the devil. Suggesting instead that the movements of the moon and the stars had profound effects on people's psychological functioning. - Speculated that the gravitational effects of the moon on the bodily fluids might be a possible cause of mental disorders. - This theory inspired the word ***lunatic.** (Derived from latin word **luna)*** - +-----------------------------------------------------------------------+ | THE BIOLOGICAL TRADITION | | ------------------------ | +-----------------------------------------------------------------------+ **HIPPOCRATES AND GALEN** - **Hippocrates (460-377 B.C.)** - The father of modern Western medicine. - Him and his associate left a body of work called the - Psychological disorders could be treated like any other disease. - They believed that psychological disorders might also be caused by **brain pathology or head trauma and could be influenced by heredity (genetics)**. - considered the brain to be the seat of wisdom, consciousness, intelligence, and emotion. - recognized the importance of psychological and interpersonal contributions to psychopathology, such as the sometimes negative effects of family stress. **BIOLOGICAL TRADITION - HIPPOCRATES** - Hippocrates also coined the word **hysteria** to describe a concept he learned about from the Egyptians, who had identified what we now call the **somatoform disorders.** - the physical symptoms appear to be the result of a medical problem for which no physical cause can be found, such as paralysis and some kinds of blindness. - Because these disorders occurred primarily in women, the Egyptians (and Hippocrates) mistakenly assumed that they were restricted to women. - They also presumed a cause: - The prescribed cure might be marriage or, occasionally, fumigation of the vagina to lure the uterus back to its natural location. - **Galen (129-198 A.D.)** - Adopted the ideas of Hippocrates creating the humoral theory of disorders. - **Humoral theory of disoiders** - **Blood** came from the heart, **black bile** from the spleen, **phlegm** from the brain, and **yellow vile** from the liver. **TREATMENT OF HUMORS** - Excesses of one or more humors were treated by regulating the environment to increase or decrease heat, dryness, moisture, or cold, depending on which humor was out of balance. - Resr, good nutrition, and exercise. - **Bleeding or bloodletting** - **Anatomy of Melancholy** **BIOLOGICAL TRADITION - CHINA** - The Chinese focused on the movement - Unexplained mental disorders were caused by blockages of wind or the presence of cold, dark wind (yin) as opposed to warm, life-sustaining wind (yang). - Treatment involved restoring proper flow of wind through various methods, including **acupuncture**. **THE 19TH CENTURY** **SYPHILIS** - A sexually transmitted disease caused by a bacterial microorganism entering the brain - Behavioral and cognitive symptoms includes believing that everyone is plotting you **(delusion of persecution)** or that you are God **(delusion of grandeur)** - In **1825,** the condition was designated a disease, **general paresis,** because it had consistent symptoms (presentation) and a constant course that resulted in death - **Louis Pasteur's germ theory of disease (1870),** facilitated the identification of the specific bacterial microorganism that caused syphilis. **JOHN P. GREY** - His position was that the cause of insanity were always physical. Therefore, the mentally ill patient should be treated as physically ill. - The emphasis was again one rest, diet, and proper room temperature and ventilations. - He even invented the rotary fab to ventilate his large hospital. - Under his leadership, the conditions in hospitals greatly improved and the became more humane, livable institutions. **MANFRED SAKEL** - A Viennese physician that developed the **insulin shock therapy** - Injecting increasingly higher dosages of insulin until, finally, patients convulsed and became temporarily comatose - actually recovered their mental health, much to the surprise of everybody, and their recovery was attributed to the convulsions. Some **BENJAMIN FRANKLIN** - Discovered that a mild and modest electric shock to the head produced a brief convulsion and memory loss (amnesia). - A dutch physician who was a friend and colleague of Franklin tried it on himself and discovered that the shock also made him "strangely elated" and wondered if it might be a useful treatment for depression. **ELECTROCONVULSIVE THERAPY** - **Joseph von Meduna** - Two italian physicians, **Ugo Cerletti** and **Lucio Bini,** in 1938- a surgeon in London treated a depressed patient by sending six small shocks directly through his brain, producing convulsions. - The patient recovered. Although greatlt modified, shock treatment is still with us today. **DRUGS** - During the 1950s, the first effective drugs for severe psychotic disorders were developed - Before that time, a number of medicinal substances, including **opium** (derived from poppies) had been used as sedatives, along with countless herbs and folk remedies. - With the discovery of **Rauwolfia serpentine** (later renamed reserpine) and another class of drugs called **neuroleptics** (major tranquilizers), be diminished in some patients, these drugs also controlled agitation and aggressiveness - Other discoveries included benzodiazepines (minor tranquilizers), which seemed reduce anxiety **EMIL KRAEPLIN** - One of the founding fathers of modern psychiatry - Extremely influential in advocating the major ideas of the biological tradition, but he was little involved in treatment. - His lasting contribution was in the area of diagnosis and classification +-----------------------------------------------------------------------+ | THE PSYCHOLOGICAL TRADITION | | --------------------------- | +-----------------------------------------------------------------------+ **PSYCHOLOGICAL ORIGINS - MORAL TREATMENT** - **Moral** - Its basic tenets included: - Treating institutionalized patients as normally as possible in a setting that encouraged and reinforced normal social interaction, thus providing them with many opportunities for appropriate social and interpersonal contact. **MORAL THERAPY** - Form of psychotherapy from the **19th century** - Advocates humane and ethical treatment and was a radical deperture from the prevailing practice at that time of viewing the "insane" with suspicion and hostility, confining them in unsanitary conditions, and routinely abusing them. **WILLIAM TUKE (1732-1822)** - Raised funds to open the **York Retreat.** - **York Retreat** **PHILIPPE PINEL (1745-1826)** - Created new institutions in which patients were not kept in chains or beated but, rather, were given healthy food and benevolent treatment. - Advocated for the staff to include in their treatment of each patients a **case history, ongoing treatment notes,** and an illness classification of some kind. **ELI TODD (1762-1832)** - Was able to raise funds to ope the first humane treatment center in the US, **Connecticut Retreat for the Insane** in Hartford, Connecticut, in **1824.** - In the **20th century,** the hospital was renamed the **Institute of Living** and is known by that name today. **DOROTHEA DIX (1802-1887)** - In **1841,** she saw firsthand that many of the inmates were there as a result of mental illness or retardation rather than crime - Dix visited every public and private facility she could access, documenting the conditions she found. She then presented her findings to the legislature of Massachusetts, demanding that officials take action toward reform. - The asylums funded through Dix's campaigns began accepting patients in the **1830's,** freeing scores of people from restraints. With an approach that incorporated elements of **moral treatment,** superintendents strove for more than humane custody; they sought to cure their patients. There is evidence that many patients improved and some even recovered. **FRANZ ANTON MESMER** - Suggested to his patients that their problem was caused by an undetectable fluid found in all living organisms called "**animal magnetism"** which could be blocked. - He has his patients sit in a dark room around a large vat of chemicals with rods extending from it and touching them. Dressed in flowing robes, he might then dentify and tap various areas of their bodies where their animal magnetism was blocked while suggesting strongly that they were being cured. - He is widely discovered as **the father of hypnosis** - **Hypnosis** **JEAN MARTIN CHARCOT** - A distinguished neurologist, He demonstrated that some techniques of mesmerism were effective with a number of psychological disorders, and he did much to legitimize the fledgling practice of hypnosis. - Significantly, in **1885** a young man named **Sigmund Freud** came from Vienna to study with Charcot. **JOSEF BREUER** - While his patients were in the highly suggestible state of hypnosis, Breur asked them to describe their problems, conflicts and fears in as much detail as they could. - His discovery is that it is therapeutic to recall and relive emotional trauma that has been made unconscious and to release the accompanying tension. This release od emotional material became known as **catharsis.** **SIGMUND FREUD** - Three provinces of the mind, Psychosexual Stages, Oedipus Complex, Fixation, Defense Mechanisms.  **HEINZ KOHUT** - According to Kohut, infants require adult caregivers not only to gratify physical needs but also to satisfy basic psychological needs. - He believed that infants are naturally narcissistic. They are self-centered, looking out exclusively for their own welfare and wishing to be admired for who they are and what they do. **According to Kohut - The early self becomes** **crystallized around two basic narcissistic needs:** - **(1) the need to exhibit the grandiose self** is established when the infant relates to a "mirroring" self object who reflects approval of its behavior. The infant thus forms a rudimentary self image from messages such as "If others see me as perfect, then I am perfect." - (**2) the need to acquire an idealized image** of one or both parents. It implies that someone else is perfect. Nevertheless, it too satisfies a narcissistic need because the infant adopts the attitude "You are perfect, but I am part of you." **MELANIE KLEIN** - According to Klein, the child's relation to the breast is fundamental and serves as a prototype for later relations to whole objects, such as mother and father. **PSYCHOLOGICAL ORIGINS** - **Heinz Kohut** - **Melanie Klein** - **Carl Jung** - **Alfred Adler** - Free Association -; Dream Analysis (Freud) - Transference & Counter Transference **HUMANISTIC ORIGINS** - **Abraham Maslow** - **Carl Rogers** - **Thomas Szasz** **HANS SELYE - GENERAL ADAPTATION SYNDROME - 3 STAGE OF PHYSIOLOGICAL PROCESS** 1. **Alarm** 2. **Resistance** 3. **Exhaustion** **BEHAVIORAL ORIGINS** - **JOHN WATSON** - **EDWARD TITCHENER** - **IVAN PAVLOV** - **EDWARD THORNDIKE** - **B.F SKINNER** - **jOSEPH WOLPE** **GENETICS** - **Genes** - Dominant v. Recessive - **Erik Kandel** - **DIATHESIS STRESS MODEL** - **GENE - ENVIRONMENT CORRELATION MODEL** +-----------------------------------------------------------------------+ | ADDITIONAL INFO | | --------------- | +-----------------------------------------------------------------------+ | ### | +-----------------------------------------------------------------------+ +-----------------------------------------------------------------------+ | #### | +-----------------------------------------------------------------------+ **Flooding -** Too many patients.