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psychology 4039 week 4

by: Lindsey Notetaker

psychology 4039 week 4 PSYC 4039

Lindsey Notetaker
GPA 3.5

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these notes finish up the asylum era and continue through the invisible plague power point. all of this information will be on exam 1 which is next week
A. Baumeister
Class Notes
25 ?





Popular in Psychology (PSYC)

This 4 page Class Notes was uploaded by Lindsey Notetaker on Thursday September 15, 2016. The Class Notes belongs to PSYC 4039 at Louisiana State University taught by A. Baumeister in Fall 2016. Since its upload, it has received 3 views. For similar materials see MADNESS AND MEDICINE in Psychology (PSYC) at Louisiana State University.


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Date Created: 09/15/16
 The Snake Pit o Mary Jane Ward wrote it o 20 Century- Fox, 1949 o Things to look for in the movie  Depiction of institutions and the ward system  Depiction of mental illness  Medical treatments  Electro conclusive therapy  Narcoanalysis  Hydrotherapy  Cause of Virginia’s illness  How Virginia is ultimately cured  Asylums 2009 o Now there is about 500,000 people in mental hospital. It isn’t that the mentally ill got better, it is the deinstitutionalization that let them out. o Around 20-25% of people in US prisons are mentally ill o A lot of mentally ill people are homeless  Frontline o Focus on mentally ill people in prison who are released  Some end up dead very soon  Most of them end up back in prison 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  A perplexing bias o There is a tendency to believe that mental illness has always been with us. o A well-known psychiatrist who has written extensively on this topic, E Fuller Torrey, “ almost everyone who has written about insanity in the past half century has assumed that insanity’s increase was not real.” o The reason this is perplexing is that almost all diseases vary in prevalence and incidence across time, geography, and populations. Mental illness is not any different o According to Torrey, the prevalence of mental illness increased dramatically in the modern era. This is called the invisible plague because the putative rise in mental illness was insidious. o In 1880 the US census bureau gave the census takers a separate form to fill out about mental illness. They sent forms to 100,00 physicians across the country to ask them to identify cases of mental illness (80% response rate.) Arguably, the 1880 census is the best effort that has ever been made to count the mentally ill people  In 1900, congress took this section out of the census.  In 1904 the US census takers were given the task to count how many patients were in mental hospitals o The conclusion to be drawn from these data is that either the-extra hospital population of mentally ill in 1904 was zero- which is highly implausible- or the prevalence of mental illness increased.  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 the 20 th 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  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 during the 19 century  At the end of 19 th 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


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