Instructor: Kevin J. Armstrong, Ph.D. ◦ Director, Clinical Psychology Training Program Associate Professor & Licensed Psychologist ◦ Research areas: ADHD & externalizing disorders Validity issues in diagnosis, assessment, and treatment PSY 3213: Abnormal Psychology
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Instructor: Kevin J. Armstrong, Ph.D.
◦Director, Clinical Psychology Training Program Associate Professor & Licensed Psychologist
◦Research areas: ADHD & externalizing disorders Validity issues in diagnosis, assessment, and
treatment
PSY 3213: Abnormal Psychology
◦ 1 in ___ adults suffer from diagnosable mental disorders in a given year 2003 2012 1. Anxiety Disorders 13.3% (18%) 2. Depressive disorders 9.5% (9.5%) 3. Addictive Disorders 6% * 4. Eating Disorders 2-5% ? 5. Schizophrenia 1.1% (1.1%)
(Numbers from NIMH web page, 2003 & 2012)
Adults: __% in 2003, __% in 2012
A recent study by the World Health Organization, the World Bank, and Harvard University
Mental disorders account for ___ of the 10 leading causes of disability in established market economies worldwide. major depression manic-depressive illness schizophrenia, and obsessive-compulsive disorder.
Other research has estimated that the cost of mental illnesses in the
United States, including indirect costs such as days lost from work,
was _______billion in 1990, the last time the total bill was measured. NIMH (1999). http://www.nimh.nih.gov/publicat/numbers.cfm
Are mental illnesses costly to society?
For women: ◦More _________________ and _________________ disorders
For men: ◦More _________________ _________________
_________________ _________________
Diagnoses differ
Chapter 1: Introduction and Historical Review
I. Introduction to the Study of Mental Disorders
II. History of Psychopathology
III. The Evolution of Contemporary Thought
IV. The Mental Health Professions
Chapter Outline
Study of the nature, development, and treatment of psychological disorders
Challenges to the study of psychopathology:
◦ Maintain objectivity
◦ Avoid preconceived notions
◦ Reduce stigma
Psychopathology
Personal _________________◦ Emotional pain and suffering
Helplessness and hopelessness of depression
_________________◦ Impairment in a key area (e.g., work, relationships)
Chronic substance abuse results in job loss
Violation of Social _________________◦ Makes others uncomfortable or causes problems
Antisocial behavior of the psychopath
_________________◦ Wakefield's Harmful Dysfunction: failure of internal
mechanisms in the mind to function properly
Defining Mental Disorder
◦Can the person, given the behavior pattern in question, meet their life demands?
keep job/stay in school maintain reasonable relationships with family/friends pay bills on time, stay out of jail basically, can they handle their responsibilities
related to food, shelter, clothing, and transportation?
How I think about maladaptivenesss:
Early Demonology◦ Possession by evil beings or spirits
_________________
Early Biological Explanations◦ Hippocrates (5th century BC)
Mental disturbances have natural (not supernatural) causes (problems with the brain) Three categories of mental disorders: mania, melancholia, &
phrenitis (brain fever) Normal brain functioning depended on balance of four humors:
blood, black bile, yellow bile, & phlegm
History of Psychopathology
Dark Ages (2nd century AD)
◦ Monks cared and prayed for mentally ill
Witches (13th century AD)◦ _________________ sometimes led to bizarre delusional
sounding confessions, e.g., concourse with demons. Initially, historians concluded many of the accused were
mentally ill.
Further research found little support for this conclusion.
History of Psychopathology: Dark Ages
Lunacy Trials◦Trials held to determine sanity Began in 13th century England
◦_________________ authorities assumed responsibility for care of mentally ill
◦Lunacy attributes insanity to misalignment of moon (“luna”) and stars
History of Psychopathology: Lunacy Trials
Asylums (15th century AD)◦ Establishments for the confinement and care of mentally ill
◦ Priory of St. Mary of Bethlehem (founded in 1243) One of the first mental institutions
The wealthy _________________ to gape at the insane
Origin of the term _________________(wild uproar or confusion)
◦ Treatment non-existent or harmful at asylums Benjamin Rush recommended drawing copious amounts of
blood, to relieve brain pressure
History of Psychopathology: Asylums
Philippe _________________(1745-1826)
◦ Pioneered _________________ treatment at LaBicetre
Moral Treatment◦ Small, privately funded, humanitarian mental hospitals
Friends Asylum (1817) Patients engaged in purposeful, calming activities
(e.g., gardening) Talked with attendants
History of Psychopathology:Pinel’s Reforms and Moral Treatment
Dorothea Dix Crusader for prisoners and mentally ill
◦ Urged improvement of _________________
◦ Worked to establish 32 new, public hospitals
◦ Unfortunately, small staffs at these new public hospitals could not provide necessary individual attention
◦ Hospitals administered by physicians, who were more
interested in _________________ rather than psychological aspects of mental illness
History of Psychopathology: Dorothea Dix(1802-1887)
General paresis and _________________◦ Degenerative disorder with psychological symptoms
(delusions of grandeur) and physical symptoms (progressive paralysis)
◦ By mid-1800’s, it was known that general paresis and syphilis occurred together in some patients
◦ In 1905, biological cause of syphilis found◦ Since general paresis had biological cause, other mental illness
might also
_________________ causes of psychopathology gained credibility
The Evolution of Contemporary Thought: Biological Approaches
Galton’s (1822-1911) work lead to notion that mental illness can be inherited
◦ Nature (genetics) and _________________(environment)
◦ _________________ Promotion of enforced sterilization to eliminate
undesirable characteristics from the population
Many state laws required mentally ill to be sterilized
The Evolution of Contemporary Thought : Genetics
Insulin-coma therapy ◦Sakel (1930’s)
Electroconvulsive Therapy (___________)◦Cerletti and Bini (1938)◦Induce epileptic seizures with electric shock
Prefrontal lobotomy◦Moniz (1935)◦Often used to control violent behaviors; led to
listlessness, apathy, and loss of cognitive abilities
Early Biological Treatments
Mesmer (1734-1815)◦ Treated patients with hysteria using “animal magnetism”◦ Early practitioner of hypnosis (started with iron rods in
bathtubs, found he didn’t need them…)
Charcot (1825-1893)◦ His support _________________ hypnosis as treatment for hysteria
Breuer (1842-1925)◦ Used hypnosis to facilitate catharsis in Anna O. ◦ Cathartic Method
Release of emotional tension triggered by reliving and talking about event
The Evolution of Contemporary Thought:Psychological Approaches
Breuer and Freud (1856-1939) jointly publish, “Studies in Hysteria” in 1895, which serves as the basis for Freud’s theory.
Freudian or Psychoanalytic theory
◦ Human behavior determined by _________________ forces.
◦ Psychopathology results from _________________ among these unconscious forces.