psychological disorders abnormal behavior. history of mental disorders & institutions originally...

Psychological Disorders

Abnormal BehaviorAbnormal Behavior

History of Mental Disorders & Institutions

• Originally called “lunatics”, it was believed to be related to a full moon.

• Possession• Removal and

Institutionalization• Ice baths• Vomiting and bleeding• Chains

Moral Management• 1800’s- belief that

environment is important part of treatment

• 1840’s- Dorothea Dix• Shock therapy via

insulin injections• Effect of the Civil War• Opium• Reverting back to the

older methods due to overcrowding.

The Early Twentieth Century

• The lobotomy introduced

• Quick and very popular

• “The” treatment until the 1950’s

• “Euthanasia of the mind”

Dr. Freeman’s “Ice Pick” Lobotomy

The 1960’s

• Movement to protect the human right of mental patients

• Community based

• Reduction of hospitalization

• Prevent psychological disorders instead of treatment only

Present Day• Deinstitutionalization- move

patients from in-patient institutions to community-based facilities with emphasis on out patient care

• Drug therapies• Increase in homelessness

(20-25% of homeless pop.)• Denial of services

Deinstituationalization – A Psychiatric Titanic

US PUBLIC INPATIENT 1830-1955

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1830 1875 1920 1955

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PUBLIC INPATIENT 1955-2006

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1955 1970 1990 2006

residents

QOD #2

• What is something/situation of which you or someone you know is afraid?

• How do you or does the person you know manage this fear?

Criteria of Abnormal Behavior

• Deviance

• Maladaptive Behavior

• Personal Distress

• ALL SUBJECTIVE!!!

Mental Disorder v. Insanity

• Mental Disorder-- Interfere with a person’s well-being and ability to function for more than 6 months

• Insanity--Not knowing right and wrong

Etiology & Prognosis

• Etiology--Causation and developmental history of an illness

• Prognosis--Probable course of the illness and outcomes expected

Methods to Diagnose Mental Disorders

• Clinical Interviews

• Neurological test

• Personality tests

• Projective tests (TAT and Rorschach)

Look for the following

1. Number of responses

2. Length of time to reply or refusal to answer.

3. Was shape of color included?

4. Seen as a whole or separate parts

5. What was seen

Results

• Subject gave between 15-30 total responses to the 10 figures

• Depressed people give FEWER answers

• Reaction time took 20-30 minutes but schizophrenics took much less time and often refused to answer, gave most “original” ideas

• Common responses were animals or insects

DSM History• Introduced by APA in 1952

• DSM I had only 106 disorders

• DSM-II 1968 182 disorders

• DSM III 1980 265 disorders

• DSM IV 1995 297 disorders

• DSM V (~2013) ? disorders

• Pro and Cons of Diagnostic Labeling- Rosenhan’s 1973 Study “On Being Sane in Insane Places”

Levels of DSM

• Axis 1: Nine Major Clinical Syndromes

• Axis II: Personality Disorders

• Axis III: General Medical Conditions

• Axis IV: Psychological & Environmental problems

• Axis V: Global Assessment of Functioning Scale

Percentage of Mental Disorders

• Substance abuse 27%

• Anxiety 19%

• Mood 7-18%

• Schizophrenia 0.7%

Types of Therapy• Insight

– Psychoanalysis• Interpretation

• Resistance

• Transference

• Client-Centered– Therapist gives little guidance and keeps advice to a

minimum– Therapist provides feedback to help client sort out

their feelings (clarification)

Types of Therapy• Cognitive

– Goal is to change the way the person thinks– Rational-Emotive Therapy (Aaron Beck)- change

self-defeating statements

• Behavioral– Goal is to unlearn maladaptive behavior

• Group Therapy

• Biomedical- psychopharmacotherapy