Research areas: ADHD & externalizing disorders Validity issues in diagnosis, assessment, and treatment
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) 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 For women: More _________________ and _________________ disorders
For men: More _________________ _________________
_________________ _________________ 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 Study of the nature, development, and treatment of psychological disorders
Challenges to the study of psychopathology:
Maintain objectivity
Avoid preconceived notions
Reduce stigma 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 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? Early Demonology Possession by evil beings or spirits
_________________
Early Biological Explanations Hippocrates (5 th 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 Dark Ages (2 nd century AD)
Monks cared and prayed for mentally ill
Witches (13 th 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. Lunacy Trials Trials held to determine sanity Began in 13 th century England
_________________ authorities assumed responsibility for care of mentally ill
Lunacy attributes insanity to misalignment of moon (luna) and stars Asylums (15 th 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 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 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 General paresis and _________________ Degenerative disorder with psychological symptoms (delusions of grandeur) and physical symptoms (progressive paralysis) By mid-1800s, 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 Galtons (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 Insulin-coma therapy Sakel (1930s)
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
Mesmer (1734-1815) Treated patients with hysteria using animal magnetism Early practitioner of hypnosis (started with iron rods in bathtubs, found he didnt 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 Breuer and Freud (1856-1939) jointly publish, Studies in Hysteria in 1895, which serves as the basis for Freuds theory.
Freudian or Psychoanalytic theory
Human behavior determined by _________________ forces.
Psychopathology results from _________________ among these unconscious forces. Id Unconscious
_________________ principle Immediate gratification Libido Energy of ID
Ego Primarily conscious
_________________ principle Attempt to satisfy IDs demands within realitys constraints
Superego The ____________________ Develops as we incorporate parental and society values Id, Ego, & Superego continually in conflict
Conflict generates _________________
Ego generates _________________ to protect itself from anxiety
Defense mechanisms (see next slide) Psychological maneuvers used to manage stress & anxiety Goals of Psychoanalytic Therapy or Psychoanalysis Understand early-childhood experiences, particularly key (parental) relationships Understand patterns in current relationships
Psychoanalytic Techniques Free Association Analysis of Transference Interpretation
Jung (1875-1961) Analytical psychology
Collective unconscious Archetypes
Catalogued personality characteristics _________________ vs. _________________
Adler (1870-1937) Individual psychology Fulfillment derived from working for the _________________ good Childhood experiences help shape adult personality
There are _________________ influences on behavior
The causes and purposes of human behavior are
not always _________________ John Watson (1878-1958)
Behaviorism Focus on _________________ behavior Emphasis on _________________ rather than thinking or innate tendencies
Three types of learning: Classical Conditioning Operant Conditioning Modeling
Discovered by Pavlov (1849-1936) Unconditioned Stimulus (UCS) Meat powder (automatically elicits salivation) Unconditioned Response (UR) Salivation (automatic response to meat powder) Neutral Stimulus (NS) Initial ringing of bell (does not automatically elicit salivation) Conditioned Stimulus (CS) After pairing the NS and the UCS, the NS becomes a CS (bell now automatically elicits salivation) Conditioned Response (CR) Salivation (automatic response to bell) Extinction CS (bell) not followed by UCS (meat powder) causes gradual disappearance of CR (salivation)
2012 John Wiley & Sons, Inc. All rights reserved. E. Thorndike (1874-1949) Learning through consequences
Law of _________________ Behavior that is followed by satisfying consequences will be repeated; behavior that is followed by unpleasant consequences will be discouraged
B.F. Skinner (1904-1990)
Principle of _________________
Positive reinforcement Behaviors followed by pleasant stimuli are strengthened
Negative reinforcement Behaviors that terminate a negative stimulus are strengthened Learning by watching and imitating others behaviors
Can occur _________________ reinforcement
Bandura & Menlove (1968) Modeling reduced childrens fear of dogs
Behavior Therapy or Behavior Modification
Systematic _________________ Used to treat phobias and anxiety Combines deep muscle relaxation and gradual exposure to the feared condition or object Starts with minimal anxiety producing condition and gradually progresses to most feared
_________________ Reinforcement Rewarding a behavior only occasionally more effective than continuous schedules of reinforcement
Limitations of Behavior Therapy How we think or appraise a situation influences our feelings and behaviors
Cognitive Therapy Emphasize how people think about themselves and their
experiences can be a major _________________ of psychopathology
Focus on understanding maladaptive thoughts
Change _________________ to change feelings and behaviors