pysc 4039 week 6
pysc 4039 week 6 PSYC 4039
Popular in MADNESS AND MEDICINE
Popular in Psychology (PSYC)
This 7 page Class Notes was uploaded by Lindsey Notetaker on Sunday October 2, 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 5 views. For similar materials see MADNESS AND MEDICINE in Psychology (PSYC) at Louisiana State University.
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Date Created: 10/02/16
THE FIRST BIOLOGICAL PSYCHIATRY th Main Narratives of 19 century psychiatry Asylum psychiatry and the putative increase in severe mental illness The beginning of university psychiatry and biological research on mental illness o University psychiatry was born of the need to educate medical students about mental illness; growing specialization and knowledge necessitate adding psychiatry medical curriculum Ascendance of the Clinical/Descriptive Method of Kraepelin The rise of minor mental illness (i.e., “The Psychoanalytic Hiatus”) The beginning of university psychiatry Wilhelm Griesinger established modern psychiatric department in 1865 at Charite Hospital in Berlin o Clinic in a teaching department Created modern model of psychiatric department. Department within a medical school that had a psychiatric clinic within the school’s teaching hospital. This integrated psychiatry with general medicine. Not isolated like asylum. Clinic for teaching and research not custodial care. Patients kept for short time then released into community or to an asylum. Considered founder of 1 biological psychiatry. Trained with Schonlein – turned German medicine toward natural science. Shorter doesn’t say what he trained in, but apparently went to work in an asylum right out of medical school. Published a psychiatry text at age 28. After about 7 or 8 years (book unclear) he begins practice in internal medicine, then returns to psychiatry in a few years. o Integrated psychiatry with other services o Research as well as teaching mission Doctoral dissertation Postdoctoral habilitation o Founded archive for psychiatry and nervous diseases in 1867 First scientific journal- was peer reviewed; big contribution The “First Biological Psychiatry” Thomas Kuhn in “The structure of scientific revolutions” sciences cycle between 2 phases: normal science and scientific revolution Normal science refers to phases of “continuity” Revolutionary science refers to “discontinuity” The term “the first biological psychiatry” implies discontinuity However, research in biological psychiatry is a continuous progression from the mid-1800s to present. Biological psychiatry never ended, even during other periods throughout psychiatry, biological psychiatry was always more popular The “first biological psychiatry” more accurately refers to research ca 1850- 1900 that had 2 principal subjects: heredity, neuroanatomy INHERITANCE OF MADESS: degeneration, evolution, eugenics Degeneration: mental illness is inherited and it worsens as it passes from one generation to the next. Believed in inheritance of acquired characteristics o Evolutionary decline, or the idea that genetic disorders get worse as they pass through successive generations o Widely accepted idea in 19 century: insanity is the end stage of the degenerative process o Morel and others proposed a degenerative sequence: Criminality Sexual perversion Mental illness o Stigmatized the mentally ill and created fear and loathing of psychiatrists (early roots of antipsychiatry) Theory of evolution in a nutshell o Considerable variation in physical and psychological traits exist among individuals of a species o These variations can be passed from parent to offspring o Scarcities of resources and mates create a struggle to survive (and reproduce) o Those individuals with variations that give even a slight advantage in the struggle for existence will tend to be preserved, have more offspring, and pass on to those offspring that trait that advantage the parent o Those individuals with variations that give less advantage or disadvantage tend (for any variety of reasons) to have low fecundity o The natural selection changes the gene pool which is the basis for evolutionary change o Some implications of evolution Life was not created suddenly in its present form We are mere biologic machines created by our genes for purpose of propagating those genes The chicken is the egg’s way of making another egg You are DNA’s way of making more DNA Human species not immutable Course of human evolution is alterable through human intervention Social Darwinism Emerged shortly after Darwin published “On the Origin of Species” in 1859 The early history of social Darwinism is most closely associated with Herbert Spencer who coined the term “survival of the fittest” Social Darwinism is based on the idea that societies compete for survival and evolve or degenerate through natural selection Central focus of early social Darwinism was on the evolutionary benefit of laissez-faire capitalism o In unbridled capitalism the strong would survive and the weak would perish Social Darwinists were against any government program that would promote reproduction or survival of the unfit. They were against any social support for the weak Eugenics o The “Science” of controlling human evolution through “artificial selection” accomplished by control of human breeding o Sir Francis Galton (1822-1911) father of eugenics- Charles Darwin’s cousin o Galton’s zeitgeist Galton was born in British “high society” He believed- like many of his peers- that wealthy, successful, powerful people in England were these things by virtue of their inherited superiority. In his book “Hereditary Genius” he attempted to prove this “superiority complex” by showing that relatives of eminent, wealthy, successful, powerful people were far more likely to be eminent, wealthy, successful, and powerful than those in the general population Galton recognized the tendency of “eminence” to run along family lines could be explained by environment or heredity Coined the phrase “nature and nurture” o Nature vs nurture Refers to relative contribution of genes vs environment in determining a particular characteristic Galton acknowledged that nurture (environment) can have an effect on “genius”, but he made various arguments that heredity was by far stronger “Americans have more opportunity and their lower classes are better educated; but for all that, America certainly does not beat us in world-class works…” The numbers of eminent relatives dropped off when going from the first degree to the second degree relatives, and from the second degree to the third Proposes and uses twin studies as a method for measuring the separate contributions of genes and environment o Galton’s eugenics In the second sentence of “Hereditary Genius” Galton argued that just as “better” animals can be produced through “artificial selection” it is possible to produce a particularly gifted “race of men” through “judicious marriage” Advocated that government should reward “fit: men and women for marrying and having children In Galton’s view, social institutions such as welfare and insane asylums were allowing inferior humans to survive and reproduce at levels faster than the more “superior” humans in respectable society, and if corrections were not soon taken, society would be awash with “inferiors” o Galton’s anthropomorphic lab Galton recognized that for eugenics to work it was necessary to develop methods to measure “fitness” Thought intelligence was most important adaptation of humans Develops first test of mental ability Thought intelligence was reflected in sensory ability His “intelligence” test was based primarily on sensory measures (e.g., thresholds) and reaction time o Eugenics methods Positive vs negative eugenics Positive- promote reproduction among the fit o Identification of eugenic stock o Incentivize marriage (reproduction) among couples who have “good” genes, e.g., monetary incentivize from government for marriage between people who have eugenic stock Negative- preventing reproduction among the unfit o Identification of cacogenic stock o Bar marriage of the unfit o Limit social support of the needy and infirm o Segregate genders of unfit to prevent them from reproducing o Forced sterilization of the unfit o Euthanasia (murder) of the unfit o Eugenics in America 1900 America fertile ground for eugenics Reasons: Large immigration of putative cacogenic stock High fertility among persons of putative cacogenic stock Low fertility among persons of putative eugenic stock Eugenics consistent with capitalism, particularly Laissez- faire capitalism o Philanthropists and eugenics Andrew Carnegie Establishes center for study of human evolution at Cold Springs Harbor, hires Davenport to run it Mary Harriman and John D Rockefeller Establish Eugenics Record Office John D Rockefeller and George Eastman Established American Eugenics Society o Selling Eugenics People would set up booths at fairs in order to get people to believe the eugenics movement Protests Fitter family contest to see if you are genetically fit for reproduction o “hateful” eugenics rhetoric Mentally ill were called “useless eaters”, “viruses”, “social wastage” “they have no right in the first instance to be born, but having been born, they have no right to propagate their kind” (Urologist William Robinson) 1937 Harvard professor Earnest Hooton compared insane to “malignant biological growths” whose germplasm constitutes “poisonous slime” o Sterilization laws 1907 Indiana first state to pass compulsory sterilization law During next 2 decades’ states pass sterilization laws Those in need of sterilization included “criminals, rapists, idiots, feeble-minded, imbeciles, lunatics, drunkards, drug fiends, epileptics, etc.” Statistics: by 1945 over 45,000 Americans had been sterilized half of whom were in mental hospitals Nearly half of sterilization performed in California 1937 Fortune Magazine poll found 66% of Americans favored sterilization of defectives 1927 Compulsory sterilization upheld by the US supreme court in 8 to 1 decision o Buck vs Bell “It is better for all the world, if instead of waiting to execute degenerate offspring for crime, or to let them starve for their imbecility, society can prevent those who are manifestly unfit from continuing their kind. The principle that sustains compulsory vaccination is broad enough to cover the cutting of the fallopian tubes. Three generation of imbeciles are enough” (Oliver Wendell Holmes) o Euthanasia Though capital punishment is a crude method of grappling with the difficulty it is infinitely superior to that of training the feeble minded and criminalistic and the letting them loose upon society and permitting them to perpetuate in their offspring these animal traits” (Davenport, 1911) o Dr. Harry J. Haiselden A doctor who advocated for defective babies to die right after they are born- don’t give it nourishment, don’t feed it, etc. Has a picture of him letting a baby die with Jesus in the background—as if Jesus wanted him to do it o Eugenics in Germany 1925 Hitler, in Mein Kampf, lauds American eugenics 1920s Rockefeller Foundation gives millions to German institutes for research on eugenics and to survey “degenerative traits” Ernst Rudin leading architect of Nazi eugenics and racial theory was a psychiatrist 1930s Germany passes sterilization laws and established Heredity Health Courts and sterilized over 375,000 persons Germany was the most progressive nation in restricting fecundity among the unfit o Homo spiens 1900 German vs soviet eugenics Though capital punishment is a crude method of grappling with the difficulty it is infinitely superior to that of training the feeble minded and criminalistic and the letting them loose upon society and permitting them to perpetuate in their offspring these animal traits” (Davenport, 1911) Germany focused creating a race of “beautiful” people Soviets more interested in developing intellectual and artist capabilities Politics and genetic theory Communists favored Lamarckism Fascists favored mendalism Neuroanatomy: the search for structural abnormalities in the brains of the mentally ill o Hitzig did the first electrical brain simulation o Carl Wernicke- Wernicke’s area (superior temporal gyrus); Wernicke’s aphasia (unable to understand speech) o Paul Broca- Broca’s area (inferior frontal gyrus); Broca’s aphasia (unable to produce speech) o Bartholow does first human electric brain simulation o Paul Flechsig- pioneering studies on cerebral localization; correlated brain development and function o Phineas Gage- tamping iron blown into his left check and through his right frontal love; Gage’s personality changed o Confirmation of localization of brain function, in general principle, was obtained though both clinical and experimental techniques Theodore Meynert st o Epitomized the anatomical aspect of 1 biological psychiatry o Physician who specialized in neuropathology o Director of psychiatric clinic university of Vienna o Thought the cause of mental illness could be found in microscopic study of the brain o Employed clinical-pathologic approach o Had little interest in therapeutics; famous for “therapeutic nihilism” and callous treatment of patients o Microscopic study of the brain became known as “the graveyard of neuropathologists” o No interest in therapeutics. Thought mental illness was incurable. Clinical cases material was only of interest for correlating with histology. o This approach is widely considered to have been a failure. Later ridiculed by the Freudians. Meynert discovered little of note in psychiatry other than lesions of neurosyphilis. This failure of this approach led to the demise of the first biological psychiatry. Achievements of the clinical pathological method o Alzheimer’s disease o Neurosyphilis o Aphasia o ALS What about neurochemistry and mental illness? o Johann Ludwig Wilhelm Thuduchum o Founder of neurochemistry o “Many forms of insanity are unquestionably the external manifestations of the effects upon the brain-substance of poisons fermented within the body, just as the mental aberrations accompanying chronic alcoholic intoxication are the accumulated effects of a relatively simple poison fermented out of the body. These poisons we shall, I have no doubt, be able to isolate after we know the normal chemistry to its uttermost detail. And then will come in their turn the crowning discoveries to which all our efforts must ultimately be directed, namely, the discoveries of the antidotes to the poisons, and to the fermenting causes and process which produce them.” (Thudichum, 1884, p. xiii)
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