exam 1 study guide
exam 1 study guide PSYC 4039
Popular in MADNESS AND MEDICINE
Popular in Psychology (PSYC)
This 14 page Study Guide was uploaded by Lindsey Notetaker on Tuesday September 20, 2016. The Study Guide belongs to PSYC 4039 at Louisiana State University taught by A. Baumeister in Fall 2016. Since its upload, it has received 12 views. For similar materials see MADNESS AND MEDICINE in Psychology (PSYC) at Louisiana State University.
Reviews for exam 1 study guide
Report this Material
What is Karma?
Karma is the currency of StudySoup.
You can buy or earn more Karma at anytime and redeem it for class notes, study guides, flashcards, and more!
Date Created: 09/20/16
Psychology test 1 review 50 multiple choice BRING A SCANTRON WHAT YOU NEED TO KNOW THAT WASN’T DISCUSSED IN LECTURE: 1. Prisons have about 500,000 mentally ill people in prisons while mental hospitals have 50,000 2. Ohio prison was chosen for the documentary because it was supposed to be one of the best prisons where the mentally ill were supposed to be treated better 3. In the preface, the author talks about old histories of psychiatry. Psychologist were viewed as evil, then the Freudians came along. 4. What does shorter argue against the Foucauldian doctor. He argues that schizophrenia is genetically influenced disease of brain development 5. Read what the book has to say about romantic psychiatry FROM LECTURE: The history o Definition: description of events (what happened), including a chronology (dimension of time), and explication of cause and effect based on evidence o 2 theories of history The great man theory- the man makes the times (“Zeitgeist”) The naturalistic theory- the times (“Zeitgeist”) makes the man Things develop, knowledge develops, that makes a situation ripe for happening. Example: evolution Darwin wasn’t the only person who had a theory of evolution. Several others were coming up with theories at the same time. The idea didn’t originate with him. o Practitioner vs academic historians o Practitioner is trained in another field (like psychiatry) and write history of medicine o Academic historians have little interest in the history of science o Internalism vs externalism Internalism Focus on events most tangibly and immediately related to a particular historical events (ex: the discovery of something) o Context less important Internalist histories more likely to be written by practitioner historians Externalism Focus on the broad intellectual, cultural, social, economic “currents” indirectly tied to a particular event o Context is the essence of externalism Extreme externalism is a hallmark of “post-modern” writings (ex: hermeneutics) o Hermeneutics is the theory and methodology of interpretation of written and oral communications Attempts to reveal author’s true, but obscure, meaning and motive o Synchronical vs diachronical approaches Synchronic approach focuses on particular in time without concern for how things develop to that stage Great emphasis on externalism (context) Emphasizes the naturalistic perspective (Zeitgeist) This approach is often called “historicism” and failure to place events in historical context is often described as “ahistorical” (lacking historical context) Many “historicists” writings are considered “ahistorical” Diachronical approach focuses on the change over time Tends toward emphasis on internalism, but externalism is appropriate/ useful Tends toward emphasis on the personalistic perspective, but this is not a necessary aspect o Presentism: usually used in a pejorative sense The word has multiple meanings Present day ideas and perspectives are anachronically introduced into depictions or interpretations of the past (ex: cavemen riding dinosaurs) Moral judgements based on today’s standard; only bad in context of moral relativism o Morality changes over time. Something that was right at an earlier time is wrong now. Using past to understand the present and vice versa Science, philosophy, and history o Putative differences between history and science Historical events are unique, not replicable Science prides itself on being able to reproduce events In science the causal variables can be identified by isolation and manipulation Science yields law o Similarities between history and science Historical and scientific conclusions are evidence- based (both are empirical) Both strive for proof Knowledge grows as history and science progress Historical conclusions are subject to refutation Some sciences deal with non-reputable events (ex: evolutionary biology, geology, cosmology) History is arguably, lawful. Big debate going on about this. If history is science, then the problems of science are the problems of history o Two foundations for “scientific skepticism” The problem of induction Science relies on inductive reasoning Inductive reasoning is invalid; that is, the conclusion is not necessarily true even if the premises are true o Ex: I looked at 100 dogs, they all have fleas. I conclude all dogs have fleas. The premises is true, the conclusion is not true. This is why no scientific statement can even be said to be true with absolute certainty However, while no scientific statement can ever be strictly “proven”, they can be disproven Popperain model of science o Conjecture o Refutation The interpretation of experience All scientific conclusions should be based on empirical evidence verifiable though sensory experience. o All sensory experience is an interpretation of the real world o The nature of reality as we perceive it, is nothing more than a pattern of neural impulses in our brains CONSTRUCTION OF REALITY Foucault’s Social Construction of reality Truth I relative to culture and time There is no absolute truth—something that is true to one culture, may not be for another o All knowledge is uncertain o Both truth and morality are culturally defined and relative o We have no objective knowledge of the external world The new historicism/ postmodernism o Implications No distinction between fact and fiction Foucault believed mentally illness was not real. He believed all of the mentally ill were put on a ship and sailed around, got off at ports and then got back on the boat. No distinction between history and literature HISTORY OF PSCYHIATRIC NOSOLOGY (CLASSIFICATION) First solid evidence of mental illness The ancients: o Melancholia o Depression o Phrenitis Brain fever- probably refers to delirium which is associated with a very high fever o Hysteria Plays a big role in the development of Freudian psychology A person has physical symptoms and a lot of emotionality, but the psychical symptoms have no biological bases Example: going blind after experiencing something horrible o Mania (madness, etc.) Different than how we define it today—a person has racing thoughts, they’re agitated, psychotic, today it has a specific clinical meaning It used to be a general term for severe mental illness o Melancholia and mania have been the 2 main bases of mental illness for years We call severe mental illness, EXCLUDING mania, psychosis o Von Feuchtersleben coined the term psychosis in 1845 PHILOSOPHY OF MADNESS 2 bed-rock theories of mind o Dualism Mind and body are fundamentally different substances; they are both real, but irreducibly distinct Popularized by Rene Descartes Proposed two-way interactionism Mind influences body Body influences mind Strict dualism excludes the mental from science o Monism Mind and matter are not fundamentally different; they can be unified; one can be reduced to the other Idealism, it’s all mind, no matter George Berkely- “to be is to be perceived” o If everyone leaves the classroom except for you, you do not exist because no one perceives you. o Everyone and everything is held into existence by the existence of God Materialism, it’s all matter, no mind; all mental activity is strictly dependent on physical activity of the brain Materialistic monism Most widely accepted theory of mind by scientists Identity theory o Mental events= physical events in the brain o Relation between mind and brain is like water = H2O; water is nothing but H2O, water and H2O are synonyms Logical behavioral o Mental states are behavioral dispositions o All that need to be said about a mental state is a description of behavior that allows observers to infer mental state in another Example: thirst is nothing more than the tendency to drink when given water Materialism implies reductionism and determinism o Reductionism A philosophical position that hold that a complex phenomenon is nothing more than the sum of its part Higher phenomena (like consciousness) are wholly explained by (can be reduced to) the properties of lower order phenomena (brain cell activity) o Determinism Every event (even mental) has a physical cause The present is the effect of the past and he cause of the future If you had “God-like” knowledge (of everything), according to determinism, you could predict the future with absolute certainty Don’t have free will, everything is an illusion Antithesis of reductionism and determinism 1. Emergence When simple things combine to create a more complex phenomenon new laws and concepts “emerge” that are necessary for understanding the more complex phenomenon The whole is more than the sum of its parts The whole cannot be explained by reductions o Freedom or free-will The future is indeterminate and probalistic Humans can choose what they think and doo Humans have “free-will” MADNESS FROM PREHISTORY TO THE ENLIGHTENMENT Mental illness in prehistory o We don’t know much since nothing was written down. o Fairly safe assumption to believe that mental illness existed in this time period o The only hard evidence we have of mental illness is many instances when skulls have neatly cut-out parts of the skull- believed to be an early attempt to cure mental illness. The most common explanation for this: people would open up the skull of a mentally ill person to release the demon Early antiquity o Babylonians o Idta, demon of insanity?? Might be made up o Code of Hammurabi contained record of beginning of “systematized” medicine. Described many diseases (epilepsy), introduced study of life history, emphasized hygiene and medical ethics. o Medicine was magical, religious, animistic, and astrological o Egyptians o Imhotep, god of medicine o Brain seat of mental function o Hysteria- though to be due to a misplaced uterus, fumigation of vagina. o Primarily religious and magical but had drawn modern aspects (ex: dance, concerts, drawing). Describes the brain as seat of mental function o Hebrews o One God is the source of health and disease o Mental illness is a punishment by God o Influenced by Babylonians and Egyptians. No medical text, relied on the Talmud (Jewish Law). Psychologically sophisticated. o Thought the heart was the seat of intellect and emotion o Insanity caused by demon possession o Greeks o Adopted supernatural perspective o Homer- Odysseus plows field and sows with salt to feign insanity o God of medicine: Asclepius o If you had a mental illness, you would go to a temple. Priests were appealing to a god to cure your mental illness o Central theme: supernaturalism The advent of “modern” medicine in the Hellenistic period, roughly (323 BC- 30 BC) o Hippocrates- the father of medicine o Emphasized naturalism and observation (empiricism) Naturalism- focuses on the natural world being the cause as opposed to the supernatural world o Move away from supernaturalism to explain disease o Hippocratic Corpus 26 treatises More than 50 subjects- everything from infectious diseases to the treatment of hemorrhoids Written by various physicians None of these early writing dealt with mental illness but in the course of describing these other diseases there are descriptions that sound like mental disorders o Hippocratic theory- often referred to as the humoral theory Thought mental disorders were due to disturbance in body fluid Blood, phlegm, black bile, and yellow bile Examples of causes of illness: Eat wrong portion of hot or dry food Wrong exposure to elements (ex: too much hot or dry wind) Loss of fluid (ex: the menstruation or masturbation) Treatment- reestablish balance through bleeding, enemas, etc. “proto-psychology” theory of personality (or temperament) Phlegmatic: relaxed, peaceful, lethargic Choleric: short-tempered, irritable Sanguine: optimistic, social cheerful Melancholic: analytical, quiet, sad “on the sacred disease” The sacred disease is believed to be epilepsy. People with severe epilepsy found themselves in mental hospital people used to think it was a mental disorder o “it appears to me to be nowise more divine nor more sacred than other diseases” o “from nothing else but the brain come joys, delights, laughter and sports, and sorrows, griefs, despondency, and lamentation…And by this same organ we become mad” o This is the first explicit biologic explanation for why we become mad o Soranus (A.D. 93-138) o Methodist Solidism The believe that mental illness comes from the solid parts of your body, not the liquids. This is the difference between soranus and Hippocrates Atomism The body is made up of atoms, there must be pores between the atoms. conditions of these pores, whether they were constricted or relaxed, determined health and disease o Wrote “On Acute and Chronic Diseases” Contained chapters devoted to Mania and Melancholia Characteristics of mania (generic term of psychosis back then, not the mania we know today) o Impairment of reason o Sudden emotional change o Delusions Characteristics of melancholia o “downcast”, rarely cheerful o Mental anguish st o Longing for death o Aretaeus (1 century AD) o Eclectic (didn’t belong to a particular school) o Wrote “Causes and symptoms of chronic disease” Separate chapters on mania and melancholia Thought melancholia was the “commencement and part of mania” o Often credited as first person to recognize bipolar disorder o Galen (A.D. 129-216) o Founder of experimental physiology Distinguished between venous and arterial blood Traced 7 cranial nerves Distinguished between sensory and motor nerves Said that nerves relay impulses to and from brain and spinal cord o Promoted Hippocratic doctrine o In over 200 publications, Galen codified and disseminated medical theory to Medieval world and beyond o Dominated western medicine for about 1500 years The Enlightenment th o 18 intellectual movement away from authority (particular religious) toward science and reason. o Extended into social realm and medicine o One consequence of enlightenment: the birth of “therapeutic optimism” toward mental illness o Began therapeutic “nihilism” o growing belief that mental illness is curable o key: hospitalization was seen as essential to recovery mental illness o the idea of therapeutic mental hospital gave birth to the specialty of psychiatry and leads to the “modern” period of psychiatry. THE BIRTH OF MODERN PSYCHIATRY The alienists o For most of the 19 thcentury these doctors were called “alienists”- one who treats mental alienation o Term “psychiatry” coined in 1808 by Reil o From Greek psyche- “mind” + iatreia “healing, care” o Most of the first alienists (psychiatrists) were superintendents of mental hospitals o Original name of the American Psychiatric Association was “Association of Medical Superintendents of American Institutions for the Insane” o Some early Alienists Battie- England Idea of therapeutic hospital originates in England with William Battie Psychiatry begins with him Considered the leading “mad doctor” of his day First person to advocate asylum as a treatment center First alienist Chiarugi- Italy First to experiment with “moral therapy” (moral=mental). Example: encourage hope among melancholic Advocate humane treatment of mentally ill Wrote a book on the specifics of how to “do” moral therapy Pinel- France Name most often associated with origin of moral therapy Became influential in Europe and America due to his book “Treatise on Insanity” published in 1806 Ordered the unchaining of the patients Bnejamin Rush- America Father of American psychiatry Has mixed reputation as a reformer o Often criticize for inhumane treatment, but emphasized humane treatment. Accounts of patients in cells conflict with his humanitarian writing Studied moral therapy in Europe Advocated moral therapy in his writings Actuality his hospital more like old custodial model Believed mental illness had a biological basis Practiced harsh treatments o Copious bleeding o Spinning chair Worked on a theory that mental illness was caused by too much blood in the brain. His procedure was to put mentally ill patients into chairs. The idea was that the forces of motion would drive the blood away from the core of the body o Tranquilizing chair William Tuke Birtish tea merchant and quaker Built the “York Retreat” to care for mentally ill Quakers Well founded on moral therapeutic principles: benevolence, comfortable living, encouraging self- reflection, occupational therapy, gardening, entertainment, hydrotherapy, diet, concept of “therapeutic community” Use of restraints limited, punishment banned Advocated humane care and moral therapy His grandson developed a world-wide reputation because he wrote a book about how moral therapy was practiced at the retreat All of the early Alienists believe mental illness is biologically based Hospital construction boom o Therapeutic hospital and moral therapy increased demand for hospital beds o Belief that metal illness was increasing Dix advocated the building of public hospitals (most hospitals were private) The early 20 thcentury was still considered to be part of the asylumthra, but less hospitals were being built than in the end of the 19 century o Growing humanitarian concern for treatment of the mentally ill Visited a women’s prison to teach how to read and write disgusted by what she sees when she goes in there. She believes many of the prisoners are mentally ill. This kindles her goals to change the mentally ill treatments Spent a lot of her time talking to law makers, making arguments for humanitarian care o The situation ca. 1900 Construction never kept pace with demand The result was severe overcrowding in most public hospitals by the end of the 19 century Overcrowding precluded the type of “moral” therapy envisioned by the originators of the therapeutic hospital Some people say that these moral therapy practices failed- if they did it was because of the overcrowding and it was impossible to keep up with all of them Both the public and professionals generally believed that hospitalization was NOT therapeutic Many hospitals dropped pretense of therapy and reverted to a custodial mission o Early 20thcentury effort to deal with the hospital problem: prevention and reform Mental hygiene movement Clifford Beers wrote “A Mind that Found Itself” 1908 Yale graduate Became insane in early adulthood- put in private and state hospitals Wrote book of experience Became famous among mental health professionals Died in asylum in 1943 HISTORICAL ANALYSIS OF PREVALENCE AND INCIDENCE OF SEVERE MENTAL ILLNESS IN THE US During the period between 1800 and 1950 many psychiatrists, scientists, and bureaucrats made the claim that mental illness appeared to be increasing at an alarming rate. The distinction between prevalence ad incidence o Prevalence is the percent or proportion of a population that has a disorder at some point in time or during some interval of time Affected by duration of disease If duration increases (e.g., due to decrease effectiveness of treatments) prevalence increases If duration decreased (e.g., increasing death rates) prevalence decreases o Incidence is the number of new cases that occur in a period of time o The relationship between prevalence and incidence can be complicated e.g., the common cold has high incidence but low prevalence The Nay Sayers (The “nosocomial” argument) o Nosocomial means “pertaining to the hospital” o People were increasingly drawn to US mental hospitals in the 1 half of th the 20 century because attitudes toward these hospitals by the general public became increasingly positive Redistribution is responsible for SOME of the growth, but not all The redistribution hypothesis has merit, but only for the initial phase of mental hospital population growth. If mental illness was not increasing, then the size of the extra hospital pool, adjusted for population growth. If mental illness was not increasing, then the size of the extra hospital pool was finite. This means that, to the extent that redistribution was responsible for the growth of mental hospital populations, growth due to this source should have stopped when the extra hospital pool was hospitalized. Doesn’t make any sense because the voluntary admission dropped o Boundaries of mental illness expanded by inclusion of less severe, more ambiguous cases The problem with this argument is that the hospitals were already bursting at the seams, it wouldn’t make sense for us to loosen the boundaries for mental illness leading to more people in the hospitals Retrospective diagnosis agrees with original diagnosis meaning the standards for being mentally ill doesn’t change The social construction argument o Mainly associated with Michel Foucault o Mental illness is not real o Mental illness was created by a conspiracy between capitalists and government to control an unruly and unproductive segment of society He proposes that: There was a large group of people that didn’t want to work, were not very smart and were decreasing productivity in society so we locked them away in mental hospitals o Against the social construction argument The mentally ill were not treated well before the industrial revolution and capitalism The first hospitals were private not public Asylums were built in non-capitalist countries Another possibility o The rise in mental hospital populations may be due to an increase in incidence of mental illness o Incidence is the number of new cases occurring in a period of time (ex: 1 year) o First admissions are used as a proxy (index) for incidence by historians on the assumption that someone being admitted to a hospital for the st 1 time recently became ill (ex: is a “new” case) First admissions both in absolute numbers as a proportion of the US population rose steadily and significantly during the first half of the 20 century o Overcrowding should have been a pressure against first admissions, but the first admissions are actually going up. Hospitals were growingly increasingly reluctant to take new patients for the first time, favoring instead readmitting patients who had been previously hospitalized. Candidate diseases that may have increased incidence o Syphilis (general paresis of the insane, GPI) o Alcoholism o Mental illness related to senility (Alzheimer’s) Population was aging, this is one of the reasons why prevalence and incidence increased during this period of time o Schizophrenia The number of people being admitted for the first time was going up during this period of time. This suggest and increase in incidence. The recency hypothesis of schizophrenia o First admission data suggests that the apparent rise in mental illness is a least partly explained by an increase in schizophrenia o The idea that schizophrenia is a relatively new disease is called the “recency hypothesis” o Additional supporting data: Before 1800 unambiguous descriptions of “classic” schizophrenia (early onset, progressive deterioration, end state dementia) are non-existent th In 19 century a British psychologist describe for the first time a form of adolescent insanity with progressive course ending in dementia Studies of hospital files show an increase in psychotic symptoms th during the 19 centuryth At the end of 19 century adolescent insanity ending in secondary dementia may be regarded as the typical from of mental disease o Why the increase? Stress With the industrial revolution, survival required more education and highly developed mental skills Those not “equipped” to deal with increasingly complex society were prone to more stress and possibly mental illness The british actually thought their high rate of mental illness was a “Badge of Civilization” Infectious disease There is a correlation between schizophrenia and flu pandemics Season of birth effect, schizophrenics are more likely to be born in winter when viral diseases are more common Would also explain correlation with urbanization DEINSTITUTIONALIZATION Shift in federal policy beginning in 1961 is responsible for deinstitutionalization o Joint commission of mental illness 1961 o Increase federal funding for care of elderly in nursing homes o Medicaid and Medicare o Resident count, first admission, and readmissions decrease coincides with the completion the final report on mental health needs issued by the joint commission of mental illness and health in 1961. A central theme of the final report was that treatment be shifted from long-term care in state mental hospital to intense acute care in the community. As can be seen, it is only after the issuance of this report that first admissions and readmissions begin to decline. So social policy, not drugs was responsible for the rapid decline in the population of mental health hospitals
Are you sure you want to buy this material for
You're already Subscribed!
Looks like you've already subscribed to StudySoup, you won't need to purchase another subscription to get this material. To access this material simply click 'View Full Document'