Transcript Mental disorder

Psychology:
From Inquiry to Understanding 2/e
Scott O. Lilienfeld
Steven Jay Lynn
Laura Namy
Nancy J. Woolf
Prepared by Assoc. Prof. Dr. Gülbahar Baştuğ
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Chapter Fifteen
Psychological Disorders:
When Adaptation Breaks Down
Lecture Preview
• Conceptions of mental illness
• Anxiety disorders
• Mood disorders and suicide
• Personality and dissociative disorders
• Enigma of schizophrenia
• Childhood disorders
• http://www.youtube.com/watch?feature=play
er_detailpage&v=dRlzCSqPijw
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Ida ???
Bill ???
Ann???
Terrell ???
Johnny???
• What have these people in common?
What is Mental Illness?
• Psychopathology (mental illness) is often seen
as a failure of adaptation to the environment.
• What distinguishes psychological abnormality
from normality?
• Mental disorder does not have a clear cut
definition. The definition isn’t simple.
What is Mental Illness?
• Any one criterion doesn’t distinguish mental disorders
from normality. Mental disorders don’t all have one thing
in common. They share a number of features.
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1.Statistical rarity
2.Subjective distress
3.Impairment
4.Societal disapproval
5.Biological dysfunction
In the mid-1800s, drapetomania was the “disorder” of slaves who attempted repeatedly
to escape from their masters. A physician prescribed whipping and toe amputation as
“treatments”. Psychiatric diagnoses are shaped by the views of the historical period.
– a need for treatment,
– irrationality,
– and loss of control over one’s behavior.
Historical Conceptions of MI
• From nonscience to science.
• During Middle Ages, mental illnesses were often
viewed through a demonic model.
• Odd behaviors (hearing voices, talking to oneself,
etc) were the result of evil spirits inhabiting
(infesting) the body.
• Exorcisms and witch hunts were common during
this time.
Malleus maleficarum (1486)
• written by two Dominican priests was witchhunt manuals.
The infamous “dunking test” for witches. According to the dunking test, if a
woman drowned, it meant she wasn’t a witch. In contrast, if she floated to the
top of the water, it meant she was a witch and needed to be executed.
The photograph has been taken in Girne Museum by Bahar Baştuğ.
Historical Conceptions of MI
• During Renaissance, the medical model saw MI as a
physical disorder needing treatment.
• In the 15 th century, began housing people in
asylums – but they were often overcrowded and
understaffed.
• Treatments were no better than before
(bloodletting and snake pits).
Michel Foucault
DELİLİĞİN TARİHİ
Bedlam
St. Mary of Bethlehem Hospital in London— Bedlam
(1547) was opened. Cures included ice water
(hydrotherapy) and bloodletting.
Above photograph has been taken in British
Museum by Bahar Baştuğ.
Historical Conceptions of MI
• Reformers like Phillippe
Pinel and Dorothea Dix
pushed for moral
treatment .
Historical Conceptions of MI
• Treated patients with dignity, respect, and
kindness.
• Prior to moral treatment, patients in asylums
were bound in chains; following moral
treatment, they were free to roam the halls of
hospitals, get fresh air, and interact freely with
staff and other patients.
• Still no effective treatments, though, so many
continued to suffer with no relief.
Modern Era
• In early 1950s, chlorpromazine (Largactil) was
developed.
• Moderately decreased symptoms of schizophrenia and
similar problems. Many patients with these conditions
became able to function independently, and some
returned to their families.
• With advent of other medications, policy of
deinstitutionalization was enacted.
Modern Era
• Deinstitutionalization had mixed results.
• Some patients returned to almost normal lives
but tens of thousands had no follow-up care and
went off medications.
• Community mental health centers attempt to
help this problem.
Diagnosis across Cultures
• Psychiatric diagnoses are shaped not only by
history, but also by culture.
• Certain conditions are culture-bound.
• Koro involves believing your genitals are
disappearing and withdrawing into your abdomen.
• Amok is marked by episodes of intense sadness and
brooding followed by uncontrolled behavior and
causeless violence.
Diagnosis across Cultures
• Taijin kyofushu is a fear of offending others by
saying something offensive or body odor.
• Culture may influence how people express
interpersonal anxiety.
CULTURAL UNIVERSALITY
• Many severe mental disorders (schizophrenia,
alcoholism, psychopathy) appear to be universal
across cultures.
The “evil eye” is a culture-bound syndrome common in Mediterranean
and Latin countries. Believed by its victims to be brought on by the
glance of a malicious person, it is marked by insomnia, nervousness,
crying for no reason, and vomiting.
• What is psychopathology?
• History of Psychopathology
– Demonic model, medical model,
– moral treatment, deinstitutionalization
• Diagnosis of culture –bound.
Psychiatric Classification and Diagnosis
Psychiatric diagnoses serve two functions:
1) They help us identify the psychological problem a
person is experiencing. Once we’ve identified the
problem, it’s often easier to select a treatment.
2) Psychiatric diagnoses make it easier for mental
health professionals to communicate.
Misconceptions
• Psychiatric diagnosis is nothing more than
classifying.
• Psychiatric diagnoses are unreliable.
• Psychiatric diagnoses are invalid.
• Psychiatric diagnoses stigmatize people.
Trials involving “dueling expert witnesses” may contribute to the
erroneous public perception that psychologists can’t agree on the
diagnoses of individuals with suspected mental disorders.