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**ABNORMAL PSYCHOLOGY** **Psychological Disorder** -- psychological dysfunction within an individual associated with distress or impairment in functioning and a response that is not typical or culturally expected **Psychological Dysfunction** -- breakdown in cognitive, emotional, or behavioral fun...

**ABNORMAL PSYCHOLOGY** **Psychological Disorder** -- psychological dysfunction within an individual associated with distress or impairment in functioning and a response that is not typical or culturally expected **Psychological Dysfunction** -- breakdown in cognitive, emotional, or behavioral functioning **Distress/Impairment** -- individual is extremely upset because he/she cannot function properly **Atypical Or Not Culturally Expected** -- deviates from the average or the norm of the culture **4 D's:** **DYSFUNCTION** --Ability to function in daily life is disrupted **DISTRESS** - Causes great stress to the person \- Brings restlessness and anxious energy to self and environment **DEVIANCE** --Highly unusual behaviour; Unusualness. Based on social/cultural norms \- hindi normal response sa situation **DANGEROUSNESS** -Potential harm to self and others **Important terms in DSM 5** **Diagnostic Criteria -** a set of signs, symptoms, and tests used to determine the diagnosis of a person \- Positive and Negative \- criteria to qualify sa isang disorder **Prevalence** - How many in a population have/had the disorders \- statistics **Course** -- pattern of symptoms, gaano katagal lumilitaw **Chronic** - matagalan **Episodic** -- nauulit, by episode **Time-Limited** -- once or may time lang **Incidence** - How many new cases occurred in a given period \- how frequently new cases are happening **Onset** -- Acute, lumalabas yung symptoms sa isang araw lang **- Insidious** -- gradually over an extend period of time **Prognosis** - Anticipated course of the disorder \- prediction **Ego-Syntonic/Dystonic** - Consistency and inconsistency of behaviors with your personal values **- ES** - your actions feel right to you. When your behavior matches your personal values or how you see yourself. \- **ED** - your actions feel wrong or uncomfortable. When your behavior doesn't match your values or feels out of character. **Etiology** - Study of the origins \- knowing the root cause of disorder **Comorbidity** - Existence of another disorder \- kapag hindi naagapan magtuturn in to another **Differential Diagnosis** - method of analysis that distinguishes a particular disease or condition from others that present with similar clinical features **HISTORICAL PERSPECTIVE OF MENTAL DISORDER** **Supernatural Tradition** \- deviant behavior has been considered a reflection of the battle between good and evil. \- Persian Empire from 900 to 600 b.c., all physical and mental disorders were considered the work of the devil (Millon, 2004) \- **Possession** -\> **Psychological Disorders** -\> **Misfortune** **Treatments:** \- 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 **Stress and Melancholy** **-** 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:** **-** rest, sleep, and a healthy and happy environment **Other treatments:** **-** baths, ointments, and various potions. **Nicholas Oresme** \- A 14th century bishop, one of the chief advisers to the king of France, \- 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 -** largescale outbreaks of bizarre behavior. \- Whole groups of people \- simultaneously compelled to run out in the streets, dance, shout, rave, and jump around in patterns \- as if they were at a particularly wild party late at night **- Saint Vitus's Dance and tarantism** **-** may simply demonstrate the phenomenon of **emotion contagion**, in which the experience of an emotion seems **to spread to those around us** **-** People are also suggestible when they are in states of high emotion. **-** if one person identifies a **"cause"** of the problem, others will probably assume that their own reactions have the same source. ** ** In popular language, this shared response is sometimes referred to as **mob psychology** **Paracelsus -** a Swiss physician who lived from 1493 to 1541, the movements of the moon and stars had profound effects on people's psychological functioning. the gravitational effects of the moon on bodily fluids might be a possible cause of mental disorders \- This influential theory inspired the word **lunatic**, which is derived from the **Latin** word **luna**, meaning **"moon."** **Biological Tradition** **Hippocrates -** Father of modern Western medicine \- Wrote the **Hippocratic Corpus**, in which they believed that psychological disorders might also be caused by brain pathology or head trauma and could be influenced by heredity \- considered the brain to be the **seat of wisdom, consciousness, intelligence, and emotion.** \- recognized the importance of psychological and interpersonal contributions to psychopathology **-** coined the word hysteria to describe a concept he learned about from the Egyptians, who had identified what we now call the **somatic symptom disorders.** **-** these disorders occurred primarily in women, the Egyptians (and Hippocrates) mistakenly assumed that they were restricted to women. \- The empty uterus wandered to various parts of the body in search of conception (the Greek word for "uterus" is hysteron). \- The prescribed cure might be marriage or, fumigation of the vagina to lure the uterus back to its natural location **Galen** - The Roman physician Galen adopted the ideas of Hippocrates creating the humoral theory of disorders. \- assumed that normal brain functioning was related to four bodily fluids or humors: blood, black bile, yellow bile, and phlegm. \- Blood came from the heart, black bile from the spleen, phlegm from the brain, and yellow bile 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. \- Rest, good nutrition, and exercise **- Bloodletting**, a carefully measured amount of blood was removed from the body, often with leeches \- Vomiting; \- **Anatomy of Melancholy**, Robert Burton recommended eating tobacco and a half-boiled cabbage to induce vomiting. **China** **-** focused on the movement of air or "wind" throughout the body. \- 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** **Syphilis** **-** A sexually transmitted disease caused by a bacterial microorganism entering the brain \- Behavioral and cognitive symptoms includes believing that everyone is plotting against you (delusion of persecution) or that you are God (delusion of grandeur), as well as other bizarre behaviors \- In 1825, the condition was designated a disease, **general paresis**, because it had consistent symptoms (presentation) and a consistent course that resulted in death. **- Louis Pasteur's** germ theory of disease, developed in about 1870, facilitated the identification of the specific bacterial microorganism that caused syphilis **John P. Grey** **-** The causes of insanity were always physical. Therefore, the mentally ill patient should be treated as physically ill. \- The emphasis was again on rest, diet, and proper room temperature and ventilation \- invented the rotary fan to ventilate his large hospital. \- Under Grey's leadership, the conditions in hospitals greatly improved and they became more humane, livable institutions. **Manfred Sakel** **-** a Viennese physician that developed the **insulin shock therapy** **-** nagiinject ng high dosage of insulin hanggang magconvulse at temporary coma yung patient \- some nakakarecover dahil dun sa convulsions pero yung iba hindi na nagigising dahil sa overdose **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 sinubukan sa sarili niya and nadiscover na yung shock also made him "strangely elated" and wondered kung useful treatment ba ito sa depression **Electroconvulsive Therapy** **- Joseph von Meduna** discovered schizophrenia was rarely found in individuals with epilepsy. \- 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 greatly 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), for the first time **hallucinatory and delusional thought processes could be diminished in some patients**; these drugs also **controlled agitation and aggressiveness**. \- Other discoveries included **benzodiazepines (minor tranquilizers),** which seemed **to reduce anxiety** **Emil Kraepelin** **-** one of the founding fathers of modern psychiatry \- extremely influential in advocating major ideas of biological tradition \- but little involved in treatment \- lasting contribution was in the **area of diagnosis** and **classification** **Psychological Origins** **Moral Treatment** **- Moral** actually **referred more to emotional or psychological factors** rather than to a code of conduct. \- Its basic tenets included treating institutionalized patients as normally as possible in a setting that encouraged and reinforced normal social interaction (Bockoven, 1963), thus providing them with many opportunities for appropriate social an interpersonal contact. \- It emphasized treating patients in a normal, socially interactive environment. This approach provided patients with chances for positive social and interpersonal connections. **Moral Therapy** **-** a **form of psychotherapy** from the 19th century **advocating humane and ethical treatment** was a radical departure from the prevailing practice at that time of viewing the "**insane**" with suspicion and hostility, confining them in unsanitary conditions, and routinely abusing them through the use of such practices as mechanical restraint, physical punishment, and bloodletting. \- approach to mental health that promoted humane and ethical treatment of patients. \- It was a big change from the harsh practices of the time, where people with mental illnesses were often mistreated and confined in poor conditions. \- Instead of using restraints and punishment, Moral Therapy focused on kindness and respect. **William Tuke (1732--1822)** \- He raised funds to open the **York Retreat**, a residential treatment center which focused on allowing patients to live in a community, **partake in daily activities** and not be subjected to the brutality of the commonplace asylum, all of which were very rare in the treatment of lunatics at that time. **Philippe Pinel (1745 1826)** \- He created new institutions in which patients were not kept in chains or beaten but, rather, were given healthy food and benevolent treatment. \- He advocated for the staff to include in their treatment of each patient a **case history, ongoing treatment notes**, and an illness classification of some kind **Eli Todd (1762 1832)** \- He was able to raise funds to open 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)** \- discovered that many inmates were mentally ill or retarded rather than criminals \- She documented the poor conditions in various facilities and presented her findings to the Massachusetts legislature, leading to reforms \- Her efforts resulted in the establishment of first asylums through Dix's Campaign in the 1830s, where patients were treated more humanely, with some showing improvement and even recovery **Psychological Origins** **Franz Anton Mesmer - animal magnetism** **-** suggested to his patients that their problem was caused by an undetectable fluid found in all living organisms called "**animal magnetism**," which could become blocked. \- 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 identify and tap various areas of their bodies where their animal magnetism was blocked while suggesting strongly that they were being cured. \- He is widely regarded as the father of **hypnosis**, a state in which extremely suggestible subjects sometimes appear to be in a trance **Jean Martin Charcot -- hypnosis** **-** A distinguished neurologist \- demonstrated that some techniques of mesmerism were effective with a number of psychological disorders \- he did much to legitimize the fledgling practice of hypnosis. \- in 1885 a young man named Sigmund Freud came from Vienna to study with Charcot **Josef Breuer -- catharsis -- talking cure** **-** While his patients were in the highly suggestible state of hypnosis, Breuer 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 of emotional material became known as **catharsis** **Sigmund Freud** \- Three provinces of the mind, Psychosexual Stages, Oedipus Complex, Fixation, Defense Mechanisms  **Heinz Kohut -** formation of self concept and the crucial attributes for progression \- infants require adult caregivers not only to gratify physical needs but also to satisfy basic psychological needs. \- 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. \- 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 -** Object relations; introjection \- 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. **Carl Jung** -- collective unconscious, word association **Alfred Adler**-- Inferiority Complex \- Free Association; Dream Analysis \- Transference and Counter Transference **Humanistic Origins** **Abraham Maslow** -- Hierarchy of needs **Carl Rogers** -- Person centered theory; EGU (empathy, genuineness, and unconditional positive regard) accepting the person without conditions or judgment. **Thomas Sasz** -- mental illness is a concept invented to uphold order **Hans Selye -- General Adaptation Syndrome -- 3 stage physiological process** 1\. **Alarm** -- initial symptoms under stress 2\. **Resistance** -- release of cortisol to counter shock 3. **Exhaustion** -- result of prolonged stress, no longer have energy **Behavioral Origins** **John Watson**-- Founder of Behaviorism \- theory that focuses on observable behaviors rather than inner thoughts or feelings. **Edward Titchener** -- Introspection; inner thoughts on stimuli (to study how people experience their own thoughts and feelings when exposed to different stimuli, like images or sounds) **Ivan Pavlov**-- Classical conditioning; stimulus generalization, extinction **Edward Thorndike** -- law of effect **B.F. Skinner** -- Operant Conditioning **Joseph Wolpe** -- systematic desensitization (helps reduce the fear or anxiety associated with the object or situation.) **GENETICS** Genes -- **46 chromosomes**; **23 pairs** (22 autosomes and 1 sexual) Dominant v. Recessive **Erik Kandel** - environment affects our genes; **Epigenetics** **Diathesis Stress Model** Vulnerability to tendencies of certain traits activated by stress \- This vulnerability doesn\'t cause problems on its own but can be triggered by stress. \- When someone with this vulnerability faces significant stress, it can lead to the development of mental health issues. **Gene -- environment correlation model** Genetically determined tendency to create the environment risk factors that trigger genetic vulnerability \- their genes can push them toward environments that trigger their genetic vulnerabilities.