Day 1, Week 1
Day 1, Week 1 PSYC 4240
Popular in Psychopathology
Popular in Psychology (PSYC)
This 5 page Class Notes was uploaded by Selin Odman on Wednesday April 20, 2016. The Class Notes belongs to PSYC 4240 at University of Georgia taught by Miller in Summer 2016. Since its upload, it has received 49 views. For similar materials see Psychopathology in Psychology (PSYC) at University of Georgia.
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Date Created: 04/20/16
PSYC 4240 – Maymester 2016 5/16/16 Historical Concept Disorder – no single definition Important consequences -Insurance: diagnosis for treatment -Legal responsibility -Disability Diagnoses are always changing according to culture -Childhood masturbation -homosexuality Most behavior is on a continuum Myths w/ mental illness: can be controlled, crazy, lazy, dumb, dangerous Approaches to Defining Ab. Behavior (Wakefield) Disorder as a pure value concept -judgment according to social norms and disorders Disorder as whatever professionals treat -internalizing (depression/anxiety) vs. externalizing (ADHD, addiction, narcissism) disorders -but people can come in just to talk Disorder as statistical deviance -can be statistically deviant in other direction or many traits…being deviant does not = disorder (i.e. being super rude) but does this lead to impairment? Disorder as biological disadvantage -if it lowers reproductive fitness -if mental mechanism is not performing specific function it was designed to perform (normal anxiety vs. pathological anxiety) -if designed mech doesn’t work and leads to impairment, then it is a disorder Disorder as distress or suffering *Wakefield – “harmful dysfunction”: Hybrid of “value judgment” and biological advantage -society defines what is socially harmful Psychological Dysfunction -breakdown in cognitive, emotional and behavioral function Personal Distress or Disability (functional impairment) -difficulty performing applied and expected roles -may be unable to judge when something is bad A typical or unexpected cultural response -reaction varies Widiger Argues 2 constructs are fundamental to define mental disorder -dyscontrol -maladaptivity We’ll never really have a perfect definition DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) Widely accepted system -used to classify psych problems and disorders -American Psychiatric Association puts it out…but psychologists use it the most DSM contains diagnostic criteria for behavioral patterns -fits pattern -causes dysfunction/distress -present for specified duration (i.e. depression – 2 weeks; anxiety – 6 months; schizophrenia – 6 months) -threshold of matching prototype (i.e. 4 of 9 symptoms) Clinical Descriptions of Abnormality Begins w/ the Presenting Problem -what is bringing client/patient into treatment -what client says is the problem (not diagnosis) Clinical Description -distinguish clinical significant dysfunctions vs. common human experience -describe demographics, symptoms, age of onset, precipitating factors Keep in mind: -prevalence (# of ppl w/ it) vs incidence (# new cases over time) -course of disorders – episodic, time-limited, chronic -onset of disorder – acute (suddenly) vs insidious (creeping) -acute means you can recover better Prognosis – good v. guarded -Anorexia is guarded prognosis…no good treatment Causation, Treatment and Outcome in Psychopathology Etiology – what contributes to development (genetics, social?) Treatment Development – How can we help alleviate psych suffering -Includes pharm, psychosocial, or combined Treatment Outcome Research – How do we know we’ve helped -limited in figuring actual causes of disorders Historical Concepts – The Past Major Psych Disorders have existed -in all cultures, across all times Causes and treatments vary widely -across cultures and time 3 dominant traditions -Supernatural, Bio and Psych Supernatural -battle between Good vs. Evil -demonic possession or witchcraft, movement of stars -Treatments: exorcism, torture, beatings, crude surgeries -Some worked… -Still around, but less common in West Biological -Hippocrates believed psych disorders could be treated like any disease -Believed disease, head trauma, heredity could cause disorders -Galen extends Hippocrates’ Work -Humoral Theory of Mental Illness -Imbalance of blood, black bile, yellow bile, and phlegm -Linked abnormality w/ brain chemical imbalances -Foreshadowed modern views -Biological interest comes back in 1800s -Treatment of syphilis brought back Biological ideas -Advanced syphilis led to psychosis -mental illness = physical illness -provided a biological bases for madness = biological treatment -1930s: standard practices include insulin shock therapy, ECT, brain surgery -1950s: medications become available Neuroleptics: (antipsychotics) reduce hallucinations, delusions, aggressions (i.e Haldol) These are like tranquilizers -1970s: Valium, antidepressants Psychological Plato vs. Aristotle thought social and cultural environment had affects Moral Therapy: normalizing treatment of mentally ill – reinforce and model appropriate behavior. Emphasized nurturing environment This treatment was short-lived b/c there weren’t enough people to help with treatment Dix – led mental hygiene movement: “custodial care”, gave care to a lot of ppl -rise of bio tradition and notion and notion that mental illness was due to pathology and is incurable -psych tradition re-emerges in 1900s; psychoanalysis, Humanism, Cognitive- Behaviorism Freud and Breuer Breuer’s patients describe problems under hypnosis 2 “discoveries” Unconscious mind – hypnosis led to material outside of explicit awareness Catharsis – indiv. Felt better after discussing/reliving emotionally painful events/feelings, or “release” Freudian Theory: Structure and Function of Mind -Id (pleasure) – demands immediate gratification -processes info in primary process – emotional, irrational, primal -dream analysis primary process -libido: sexual and aggressive motives; “energy” -Eros: drive for sex and fulfillment -Thanatos: “death instinct” drive for aggressions/death -Ego: reality principle or “negotiator” -balances Id w/ society; logic and reason -Ppl after Freud focused on this concept -Superego: “conscience” represents morality learned from parents, etc. -develops from punishment/rewards for behaviors -counteracts Id Ego must balance Id and Superego -if this balance is broken, intrapsychic conflict will occur Freud felt Id and Superego were almost entirely unconscious. Defense mechanism when balance is ruined -> leads to anxiety which is a warning that ego may be overwhelmed -defense mechanism (unconscious) process which keeps primitive feelings in check -i.e. humor, denial, projection -can be adaptive or maladaptive -seen as primitive ***Review defense mechanisms Psychosexual Stages of Development 5 basic stages which represent different ways to gratify needs -Inappropriate/Inadequate gratification leads to being stuck in a phase, but ppl can digress, too. Oral (birth – 2): central focus on food; sucking, lips, tongue -adults -> smoking, eating, gum, chewing Anal (2-3): Expulsion v. retention; completed w/ successful toilet training -adults -> uptight, controlling vs. disorganized, impulsive Phallic (3-5/6): Notice genitals (own and others) -adults -> Oedipal complex (identifies w/ dad) Electra complex -child identifies w/ same gender parents (girls want a penis???) Latency (6-puberty): sexual interest is dormant and interests include school and play Genital (Puberty – onward): central focus returns to genitals in a sexual phase -fixation at earlier phases = not fully developed -development was done when ppl developed heterosexual relationships Psychoanalysis Therapy Many times (3-5x) a week for years (2-5yrs) Used catharsis and insight to make fundamental changes about someone -very expensive -focus is not on symptom reduction, but on lifetime changes Techniques -patient lies on couch; analyst sits behind couch -Free association – no censorship -Dream analysis -Examine Transference and Counter-Transference End goal – trying to project client’s issues on psychoanalyst Efficacy Data is limited – too expensive to test a lot of ppl and see if this method works
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