abnormal psychology third canadian edition - wiley …：异常心理学第三加拿大版-威利…

abnormal PSYCHOLOGYThird Canadian Edition,Prepared by: Tracy Vaillancourt, Ph.D.,Chapter 1Introduction: Definitional and Historical Considerations,Psychopathology,Field concerned with the nature and development of abnormal: behaviourthoughtsfeelings,What is abnormal behaviour?,Abnormality usually determined by the presence of several characteristics at one time such as: statistical infrequencyviolation of normspersonal distressdisability or dysfunctionunexpectedness,Statistical Infrequency,Abnormal behaviour occurs infrequently.For example, mental retardation (IQ 130),Violation of Norms,Abnormal behaviour violates social norms or threatens or makes anxious those observing.anti-social behaviour of the psychopath violates social norms and makes those observing it anxiousbut, “violation of norms” needs to be considered in reference to prevailing cultural norms What is the norm in one culture may be abnormal in another.Discussion point: A prostitute violates social norms but does this mean that she/he would necessarily meet diagnostic criteria for a mental disorder?,Personal Distress,Abnormal behaviour creates great distress and torment in the person (personal suffering).This criterion fits many of the forms of abnormality such as depression but some disorders do not necessarily involve distress. psychopaths are often not affected by their behaviour although their behaviour clearly impacts others in a negative way hunger and childbirth cause distress, but is this abnormal?,Disability or Dysfunction,Abnormal behaviour is related to impairment in some important area of life such as work or personal relationshipsExceptions exist such as: being short if you want to be a professional basketball playertransvestism is not necessarily a disability although it is currently diagnosed as a mental disorder if it distresses the person.Discussion point: Why would transvestism without distress not be considered a disability? Most transvestites are married, lead conventional lives, and usually cross-dress in private.,Unexpectedness,Unexpected responses to environmental stressors can be considered abnormal behaviour.For example, we would expect a person to be sad if they lost a love one to cancer. We would not expect a person to laugh after being sexually assaulted.Other example: An anxiety disorder is diagnosed when the anxiety is unexpected and out of proportion to the situation.,The study and treatment of mental disorders in Canada,There are approximately:3,600 practising psychiatrists, 13,000 psychologists and psychological associates11,000 nurses specialize in the mental health area. Non-medical practitioners usually work within hospital or agency settings on a salary or in private practice. Public health plan reimbursement of fees-for-service is limited to medical doctors. Most of the primary mental health care is delivered by general practitioners.,Psychiatrist, psychologistwhats the difference?,Clinical psychologists typically have a Ph.D. or Psy.D. degree, which entails four to seven years of graduate.Psychiatrist hold an MD degree and have had postgraduate training (residency), in which they receive supervision in the practice of diagnosis and psychotherapy. Because psychiatrists have an MD degree they can prescribe psychoactive drugs whereas psychologists can not. See for more details “FOCUS ON DISCOVERY 1.1: THE MENTAL HEALTH PROFESSIONS”,History of Psychopathology,“Those who cannot remember the past are condemned to repeat it.”George Santayana, The Life of Reason,Pre-scientific Inquiry,Events beyond the control of humankind such as eclipses, earthquakes, storms, fire, diseases were regarded as supernatural. Behaviour that seemed outside individual control was subject to similar interpretation. Thus, many early philosophers, theologians, and physicians believed that deviancy reflected the displeasure of the gods or possession by demons.,Early Demonology,Demonology: The doctrine that an evil being, such as the devil, may dwell within a person and control his or her mind and body. Found in the records of the early Chinese, Egyptians, Babylonians, and Greeks. Given that abnormal behaviour was caused by possession, treatment often involved exorcismRanged from elaborate rites of prayer to flogging and starvation as a way of rendering the body uninhabitable to devils.,Trepanning,Involved the making of a surgical opening in a living skull by some instrument.widespread practice used by Stone Age or neolithic cave dwellersUsed to treat epilepsy, headaches, and psychological disorders attributed to demons. Thought to be introduced into the Americas from Siberia. practice was most common in Peru and Bolivia, 3 British Columbia Aboriginal specimens found,Hippocrates (ca. 460377 B.C),Separated medicine from religion, magic, and superstition. Rejected belief that the gods sent physical diseases and mental disturbances as punishment Insisted that illnesses had natural causes thus should be treated like other illnesses Regarded the brain as the organ of consciousnessThus abnormal thinking and behaviour were indications of brain pathology.,Somatogenesis vs. Psychogenesis,Hippocrates one of the earliest proponents of somatogenesis.Somatogenesissomething wrong with the soma (physical body) and this disturbs thought and action. Psychogenesis disturbance has psychological origins.,Hippocrates humoral physiology,Hippocrates treatments were different from exorcistic tortures. tranquility was prescribed for melancholia, Mental health dependent on a delicate balance among four humours, or fluids of the bodyImbalances and results blood = changeable temperament black bile = melancholia yellow bile = irritability and anxiousness phlegm = sluggish and dullness,The Dark Ages and Demonology,Churches gained in influence, papacy declared independent of the state. Christian monasteries replaced physicians as healers and as authorities on mental disorder. The monks cared for and nursed the sick by praying and touching them with relics or concocting fantastic potions for them,Persecution of Witches,During the 13th and the following few centuries, major social unrest and recurrent famines and plaguesPeople turned to demonology to explain disasters. Led to an obsession with the devil witches blamed and persecuted.1484 Pope Innocent VIII exhorted European clergy to leave no stone unturned in the search for witches. Sent 2 Dominican monks to northern Germany as inquisitors who later issued the manual entitled the Malleus Maleficarum Used to guide witch huntersCame to be seen by Catholics and Protestants as a textbook on witchcraft. Over the next several centuries, hundreds of thousands of people accused, tortured, and murdered.,Witchcraft and Mental Illness,Were so-called witches psychotic?Detailed examination of historical period indicates most not mentally ill.Delusion-like confessions obtained during torture,Other info. that witches not mentally ill,13th century on, hospitals took over churches responsibility to tend to the ill. laws allowed dangerously insane and incompetent to be confined to hospital. and people confined were not described as being possessedEarly 13th century “lunacy” trials held in England. Trials conducted to protect the mentally illJudgment of insanity allowed Crown to become guardian of estate Defendants orientation, memory, intellect, daily life, and habits were at issue in the trial.,Development of Asylums,Until to end of t 15th century very few mental hospitals in Europe but England and Scotland had 220 leprosy hospitals leprosy gradually disappeared from Europe and attention turned to the mentally illConfinement began in earnest in the 15th-16th centuriesLeprosariums were converted to asylumsasylums took disturbed people and beggars had no specific regimen for their inmates other workstill during the same period, hospitals tailored for the confinement of the mentally ill also emerged,St. Mary of Bethlehem,Founded in 1243 and devoted solely to the confinement of the mentally ill.Conditions were deplorable (bedlam) Eventually became one of Londons great (paid) tourist attractionsviewing the violent patients considered entertainmentDiscussion Point: What might be the effects of such inhuman treatment on the sequela of mental illness?,Moral Treatment,Philippe Pinel (17451826) considered primary figure in movement for humanitarian treatment of the mentally ill in asylums. Believed patients should be treated with dignityput in charge of a large asylum in Paris known as La Bicetre removed the chains of the people imprisoned began to treat patients as sick rather than as beastslight and airy rooms replaced dungeonswalks around the grounds were allowedResults?Some patients incarcerated for years discharged,Dorothea Dix,Moral treatment was abandoned in the latter part of the nineteenth century but Dorothea Dixs (180277) efforts resurrected it Boston schoolteacher who taught a Sunday-school class at the local prison shocked by deplorable conditions and interest spread to the conditions of patients in mental hospitals campaigned vigorously and successfully to improve the lives of people with mental illness,Asylums in Canada,network of asylums eventually established in Canada,Asylums in Canada,Asylums in Canada,Asylums in Canada,Beginning of Contemporary Thought,Return to the somatogenic views first espoused by HippocratesEarly system of classification established,Emil Kraepelin (18561926),created a classification system to establish the biological nature of mental illnesses.noticed clustering of symptoms (syndrome) which were presumed to have an underlying physical cause, In fact, mental illness seen as distinct with own genesis, symptoms, course, and posed two major groups of severe mental diseases:dementia praecox (early term for schizophrenia) thought chemical imbalance as the cause of schizophreniamanic-depressive psychosis (now called bipolar disorder). thought an irregularity in metabolism as the cause of manic-depressive psychosis,Importantly, Kraepelins early classification scheme became the basis for the present diagnostic categories,General Paresis and Syphilis,mid-1800s progress was being made in terms of understanding senile and presenile psychoses and mental retardation from a more biological perspectivefar more was however discovered about nature and origin of syphilisgeneral paresis characterized by steady physical and mental deterioration, delusions of grandeur and progressive paralysis from which there was no recoverydiscovery provides a a good example of the increasing use of empirical approaches used to understand mental illness,Louis Pasteur,Germ theory of disease is theorized by Pasteurlaid the groundwork for demonstrating the relation between syphilis and general paresisAlso helped establish a causal link between infection, destruction of brain areas, and a form of psychopathology. Light bulb moment: If one type of psychopathology had a biological cause, so could others. Result: Somatogenesis gained credibility and became a dominant theory,Psychogenesis Re-visited,somatogenic causes dominated field of abnorma