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Psychological Disorders
Abnormal BehaviorAbnormal Behavior
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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
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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.
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The Early Twentieth Century
• The lobotomy introduced
• Quick and very popular
• “The” treatment until the 1950’s
• “Euthanasia of the mind”
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Dr. Freeman’s “Ice Pick” Lobotomy
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The 1960’s
• Movement to protect the human right of mental patients
• Community based
• Reduction of hospitalization
• Prevent psychological disorders instead of treatment only
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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
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Deinstituationalization – A Psychiatric Titanic
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US PUBLIC INPATIENT 1830-1955
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1830 1875 1920 1955
residents
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PUBLIC INPATIENT 1955-2006
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1955 1970 1990 2006
residents
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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?
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Criteria of Abnormal Behavior
• Deviance
• Maladaptive Behavior
• Personal Distress
• ALL SUBJECTIVE!!!
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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
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Etiology & Prognosis
• Etiology--Causation and developmental history of an illness
• Prognosis--Probable course of the illness and outcomes expected
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Methods to Diagnose Mental Disorders
• Clinical Interviews
• Neurological test
• Personality tests
• Projective tests (TAT and Rorschach)
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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
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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
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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”
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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
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Percentage of Mental Disorders
• Substance abuse 27%
• Anxiety 19%
• Mood 7-18%
• Schizophrenia 0.7%
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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)
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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