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PSY 113 – LT 1 Reviewer Chapter 1: Introduction and Historical Overview  Psychopathology – the field concerned w the nature, development and treatment of mental disorders o Continually developing and adding new findings  Challenge we field face: to remain objective o Human behavior is personal and...

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PSY 113 – LT 1 Reviewer

Chapter 1: Introduction and Historical Overview  Psychopathology – the field concerned w the nature, development and treatment of mental disorders o Continually developing and adding new findings  Challenge we field face: to remain objective o Human behavior is personal and powerfully affecting, making it difficult  Another side of the coin: our closeness to the subject matter adds to its intrinsic fascination o We bring to the study our preconceived notions of what the subject matter is o Each of us has developed our own certain ways of thinking and talking about mental disorders  Stigma – destructive beliefs and attitudes held by a society that are ascribed to groups considered different (i.e. people w mental illnesses, LGBT, women); 4 characteristics: o Distinguishing label is applied o Label refers to undesirable attributes o People with the label are seen as different o People with the label are discriminated against  Mental illness remains one of the most stigmatized of conditions in the 21st century o In 1999, David Satcher said “stigma is the most formidable obstacle to future progress in the area of mental illness and mental health” o 10 years later, this still holds true  in 2006, people believed that mental illneses, such as schizophrenia, depression and addiction are biological but stigma did not decrease 1.1 Defining Mental Disorders  A difficult task faced by those in the field of psychopathology  Characteristics essential to the concept of mental illness (by DSM-5): o Occurs w/i the individual o Involves clinically significant difficulties in thinking, feeling or behaving o Involves dysfunction in processes that support mental functioning o Is not a culturally specific reaction to an event o Is not a primarily a result of social deviance or conflict w/ society  4 key characteristics that any comprehensive mental disorders definition ought to have (4 d’s): o Distress o Disability o Violation of Social Norm (Deviation) o Dysfunction  No single characteristic can fully define the concept  Mental disorder is usually determined based on the presence of several characteristics at one time Personal Distress  A person’s behavior may be classified as disordered if it causes him or her great distress  Characterizes many forms of mental disorders; but not all mental disorder cause distress; and not all distress is disordered Disability  Impairment in some important area of life  Like distress, disability alone does not define mental disorder; because some mental disorders do not necessarily involve disability Violation of Social Norm  In the realm of behavior, social norms are highly held as standards o Behavior that violates social norms may be classified as disordered  Social norms vary a great deal form culture to culture, so behavior that violates social norm in one group may not do so at all in another o Culture and ethnic diversity applies to descriptions, causes and treatments of mental disorder Dysfunction  Proposed by Wakefield: mental disorders could be defined as harmful dysfunctions; 2 parts: o A value judgment that behavior is harmful requires some standard and this standard are the social norms o Scientific component—the dysfunctions are said to occur when an internal mechanism is unable to perform its natural function—that is, the function that it evolved to perform

PSY 113 – LT 1 Reviewer

 But, we cannot say exactly what internal mechanism are involved in mental disorders, thus we cannot say exactly what may not be functioning properly  The DSM definition provides a broad concept of dysfunction, specifically refers to the fact that behavioral, psychological and biological dysfunction are all interrelated o Brain impacts behavior and behavior impacts the brain this dysfunction is interrelated 1.2 History of Psychopathology  It is important to consider how concepts and approaches have changed (or not) over time, because we learn not to make the same mistakes and because current concepts and approaches are likes to change Early Demonology  All good and bad manifestations of power beyond human control were regarded as supernatural  Behavior seemingly outside individual control was also ascribed to supernatural causes o Displeasure of the gods or possession by demons  Demonology – doctrine than an evil being or sprit can live within a person and control his or her mind and body  This belief led to the treatment of exorcism o Ritualistic casting out of evils spirit Early Biological Explanation  Hippocrates – father of modern medicine; separated medicine from religion, magic and superstition o He rejected the prevailing Greek belief that the gods sent mental disturbance as punishment  Brain – as the organ of consciousness, intellectual life and emotion o Thus, disordered thinking was indication of pathology  3 categories of mental disorder: mania, melancholia and phrentitis  Mental health depended on humors: blood, black bile, yellow bile and phlegm o Imbalance of this humors = disorders  Preponderance of phlegm = sluggish  Preponderance of black bile = melancholia  Preponderance of yellow bile = irritability and anxiousness  Preponderance of blood = changeable temperament  Treatment for imbalances was usually avoidance and abstinence w/ food and sex The Dark Ages and Demonology  Death of Galen (last great physician of the classical era) as the beginning of dark ages o Greek and Roman civilization ceased to be o Christian gained in influence o Papacy was declared independent of the state o Christian monasteries replaced physicians as healers and as authorities on mental disorders  Monks cared for people with mental disorders by praying over them and touching them w relics  The return of the belief in supernatural causes of mental disorders The Persecution of Witches  People turned to demonology to explain disasters  Witchcraf – instigated by Satan, was seen as heresy and denial of God  A person’s sudden loss of reason was a symptom of mental disorder  Modern Investigators believed all that were accused of being witches were mentally ill o Later on, debunked Lunacy Trials  Mental illness was not primarily ascribed to witchcraf  Hospital began to come under secular jurisdiction  People who were hospitalized were not ascribed as being possessed  Lunacy Trials – conducted under the Crown’s right to protect the people with mental illness Development of Asylums  Leprosariums were converted to asylums o Refuges for the confinement and care of people with mental illness Bethlehem and Other Early Asylum

PSY 113 – LT 1 Reviewer

The Priory of St. Mary of Bethlehem – handed by Henry VII to the city of London, thereafer to be a hospital devoted solely to the confinement of people with mental illness  Bedlam – place or scene of wild uproar and confusion  Benjamin Rush – considered as the father of American psychiatry o Believed that mental disorder was caused by an excess of blood in the brain o People with mental illness could be cured be being frightened  One of his cure: To convince the patient that death was near! Pinel’s Reforms  Philippe Pinel – considered as the primary figure in the movement for humanitarian treatment of people with mental illness in asylums o He was put in charge at La Bictere – in the hospitals are chained prisoners  Jean-Baptiste Pussin – set freed the victims Moral Treatment  Patients had close contact with attendants, who talked and read to them and encouraged them to engage in purposeful activity  Dorethea Dix – helped effect changed to start hospitals that cared for patients with mental illness 

1.3 The Evolution of Contemporary Thought  William Black, recorded the hypothesized causes of maladies observed among patents in Bethlehem o Half of the presumed causes were biological o Half were psychological o 10 % percent of the causes were spiritual Biological Approaches Discovering Biological Origins in General Paresis and Syphilis  Understanding of anatomy and nervous systems, but not enough was known to conclude that mental disorders were based on these  In Late 1700s, elucidation of the nature and origin of syphilis, a venereal disease o Used empirical approach – basis of contemporary science  General Paresis – delusions of grandeur and progressive paralysis o Later established that people w this also have syphilis o But no relationship  In 1860s and 1870s, Louis Pasteur – established the germ theory of disease, which posited that disease is caused by infection of the body by minute organisms  In 1905, specific microorganism that causes syphilis was discovered  Conclusion, if one type of psychopathology had a biological cause, so could others; Biological approaches gained credibility and searches for more biological causes were off and running Genetics  Francis Galton – originator of genetic research with twins, because of his study of twin in the late 1800s, attributed many behavioral characteristics to heredity o Coined nature and nurture  Unfortunately, Galton is also credited with creating eugenics movement o Advocates of this movement sought to eliminate undesirable characteristics from the population by restricting certain people to have children o Stalled research process on mental illness  In the late 1800s and early 1900s, U.S. state law prohibited people with mental illness form marrying and forced them to be sterilized in order to prevent them from “passing on” their illness o Middle of 20th century, halted o More than 45,000 people were forcibly sterilized Biological Treatments  Sakel – introduced inducing coma with large dosages of insulin, ¾ of people with schizophrenia showed significant improvement o Stopped, as it turned out to be dangerous  Electroconclusive Theraphy (ECT) – originated by Ugo Cerletti and Lucino Bini o Effective treatment for people with schizophrenia and depression  Egas Moniz – introduced the prefrontal lobotomy

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A surgical procedure that destroys the tracts connecting the frontal lobes to other areas of the brain o Used for people w violent behavior o Fell into a disrepute in the 1950s afer realizing it caused brain damage instead of healing Psychological Approaches Mesmer and Charcot  People in the 18th century were observed to be subject to hysteria o Physical incapacities w with no physical cause could be found  Franz Anton Mesmer – believed hysteria was caused by a particular distribution of a universal magnetic fluid in the body, moreover, he felt that one person could influence the fluid of another o First to practice modern-day hypnosis  Jean Martin Charcot – also studied hysterical states Breuer and the Cathartic Model  Jose Breuer – Cathartic Method (talking freely under hypnosis) o Case of Anna O. o Later on partnered with Sigmund Freud Freud and Psychoanalysis  Freud postulate that much of human behavior is determined by forces that are inaccessible  Psychoanalytic Theory – psychopathology results from unconscious conflicts in the individual o Structure of the Mind (Psyche):  Id – present at birth; pleasure principle; libido; unconscious  Ego – present at 6 months of life; reality principle; director; conscious;  Superego – person’s conscience; develops throughout childhood o Defense Mechanisms – a strategy used by the ego to protect itself from anxiety o

Psychoanalytic Therapy (Psychoanalysis) – understand the person’s early-childhood experiences, the nature of key relationships and the pattern in current relationships  Free Association – patient tries to say whatever comes to mind without censoring anything  Transference – patient responds out to the analysts in ways that the patient has previously responded to other important figures in his or her life  Interpretation – analysts points out to the patient the meaning of certain of the patient’s behaviors Neo-Freudian Psychodynamic Perspectives  Disagreements arose about many issues about psychoanalytic theory  Carl Jung and Analytical Psychology o There is a collective unconscious or the part of the unconscious that is common to all human beings; archetypes o Most important catalogue of personality: Extroversion vs. Introversion  Alfred Adler and Individual Psychology o Fulfillment was found in doings things for social good o

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o Compensations Continuing Influences of Freud and His Followers  Impact of Freud on the field of psychopathology: o Childhood experiences help shape adult personality o There are unconscious influences on behavior o The causes and purposes of human behavior are not always obvious The Rise of Behaviorism  Behaviorism - John B. Watson; focuses on observable behavior rather than on unconsciousness or mental functioning  Classical Conditioning – Ivan Pavlov o USC, UCR, CS, CR o Extinction – disappearing or CR  Operant Conditioning o Edward Thorndike - Law of Effect: behaviors that is followed by a pleasant stimulus will be repeated; while behavior that is followed by unpleasant stimulus will be inhibited o B.F. Skinner – introduced the Operant Conditioning  Positive Reinforcement  Negative Reinforcement o Voluntary avoid; voluntart exposure  Modeling – watching and imitating others o By Bandura and Menlove  Behavior Therapy – applied procedures based on classical and operant conditioning to alter clinical problems o Behavior Modification – another term o System Desensitization – use to treat phobias and anxiety  Deep muscle relaxation  Gradual exposure o Intermittent Reinforcement – rewarding a response only a portion of the times it appears; makes behavior more endruing Importance of Recognition  Human beings don’t just behave, they think and feel  Cognitive Therapy o Emphasize that how people construe themselves and the world is a major determinant of psychological disorders o Therapist make the client more aware of their maladaptive thoughts o Changing cognitions = changing feelings, behaviors and symptoms o Rational-Emotive Behavior Therapy (REBT) – emotional reactions are caused by internal sentences  By Ellis and Beck 1.4 The Mental Health Professions  Clinical Psychologist - psychotherapy  Psychiatrist – prescribes psychoactive medications  Psychiatric Nurse – practitioner that will allow them to prescribe psychoactive medications  Counseling Psychology – vocational issues; less on mental disorders more of emphasis on prevention, education and general life problems  Social Workers – do not receive training in psychological assessment; psychotherapy  Marriage and Family Therapists – focusing on the ways in which these relationships impact a variety of mental health issues

PSY 113 – LT 1 Reviewer

Chapter 2: Current Paradigms in Psychopathology  Thomas Kuhn said subjective factors as well as our human limitation enter into the conduct of scientific inquiry  Central to scientific activity in Kuhn’s view is the notion of paradigm o A conceptual framework or approach within which a scientist works—basic assumptions, a general perspective  Three paradigms that guide the study and treatment of psychopathology: genetic, neuroscience and cognitive behavioral; additionally, the role of emotion and sociocultural factors are also included 2.1 The Genetic Paradigm  Basic assumptions: o Almost all behavior is heritable to some degree o Despite this, genes do not operate in isolation from the environment; instead throughout the environment shapes how our genes are expressed  Nature vs. Nurture  Genes – the carriers of the genetic information (DNA) passed from parents to offspring  Gene Expression – proteins switch, or turn, on and off other genes  There is not one gene that contributes to vulnerability, instead psychopathology is polygenic o Several genes, perhaps operating at different times during the course of development, turning themselves on and off as they interact with a person’s environment is the essence of genetic vulnerability o Thus, we do not inherit mental illness from our genes, we develop mental illness through the interaction of our genes with our environment  Heritability – refers to the extent to which variability in a particular behavior in a population can be accounted for by genetic factors o Range from 0.0 to 1.0: the higher the number the greater the vulnerability o Relevant only for a large population of people, not a particular individual  Shared vs Nonshared Environment o Shared – factors that include those things that members of a family have in common o Nonshared (unique environment) – factors that are distinct among members of a family and these are believed to be important in understanding an individual who is different from his or her family members Behavior Genetics  The study of the degree to which genes and environmental factors influence behavior  Genotype – total genetic makeup of an individual, consisting of inherited genes  Phenotype – the totality of observable behavioral characteristics, such as level of anxiety o Changes over time and is the product of an interaction between genotype and environment o E.g. Intelligence Molecular Genetics  Seek to identify particular genes and their functions  2n = 23  Alleles – different forms of the same genes  Polymorphism – difference in DNA sequence on a gene that has occurred in a population  Interest of studies: o Single nucleotide polymorphism SNPs – study of gene sequence involves identifying this; refers to difference between people in a single nucleotide o Copy number variations (CNVs) – study of differences between people in gene structure, including identification of these; abnormal copy of one or more sections of DNA within genes  Can be additions or deletions  Specific genes can be taken out of of mice DNA – knockout studies because a particular gene is knocked out of the animal’s system Gene-Environment Interactions  Means a given person’s sensitivity to an environment event is influence by genes  Measures a particular gene called, serotonin transporter gene (5-HTT) o Polymorphic o Related to depression  Epigenetics – study of how environment can alter gene expression or function

PSY 113 – LT 1 Reviewer

The term means “above or outside of the gene” and refers to chemical “ marks” that are attached to and protect the DNA in each gene  Control gene expression Reciprocal Gene-Environment Interactions  How genes may promote certain types of environments  The basic idea that genes may predispose us to seek out certain environments that then increase our risk for developing a particular disorder Evaluating the Genetic Paradigm  Genetics is an important part of the study of psychopathology  In many way, genes might be involved in psychopathology  Genes do work via the environment  Biggest challenge: specify how genes and environments reciprocally influence one another 2.2 The Neuroscience Paradigm  Basic Assumption: Mental disorders are linked to aberrant process in the brain  Data that we interesting: Neurons and Neurotransmitter  Neurons – cells in the nervous system; 4 major parts: o Soma – cell body o Dendrites – receive information from one neuron o Axon – sends information from one neuron o Terminal button – end branches of axon  Nerve Impulse – message that travels from the dendrites to the terminal button of the axons  Synapse – small gap between the terminal endings of the sending axon and the cell membrane of the receiving neurons  Neurotransmitter – chemicals that allow neurons to send a signal across the synapse to another neuron o Dopamine and Serotonin involved in depression, mania and schizophrenia o Norepinephrine involved in producing states of arousal and thus may be involved in anxiety disorders and other stress-related conditions o Gamma-Aminobutyric Acid (GABA) inhibits nerve impulses throughout most areas of the brain and may be involved in anxiety disorders  Reuptake – taking back of neurotransmitters  Second Messenger – released when a cell has been firing more frequently, play a role in adjusting the sensitivity of postsynaptic receptors  Agonist vs. Antagonist o Agonist – stimulates the activity of a particular neurotransmitter receptor o Antagonist – dampens the activity of a particular neurotransmitter receptor Structure and Fun...