Psychological Disorders “The measure of a civilization is how it treats its weakest members”

History of Mental Illness & 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 In 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

PUBLIC INPATIENT

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 total responses to the 10 figures Depressed people give FEWER answers Reaction time took 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 disorders- In the early 70’s, gay movement protested homosexuality should NOT be included in DSM III DSM III disorders DSM IV disorders DSM Pro and Cons of Diagnostic Labeling- Rosenhan’s 1973 Study “On Being Sane in Insane Places”

Percentage of Mental Disorders Substance abuse 27% Anxiety 19% Mood 7-18% Schizophrenia.7%

Perspectives and Disorders Psychological School/PerspectiveCause of the Disorder Psychoanalytic/PsychodynamicInternal, unconscious drives HumanisticFailure to strive to one’s potential or being out of touch with one’s feelings. BehavioralReinforcement history, the environment. CognitiveIrrational, dysfunctional thoughts or ways of thinking. SocioculturalDysfunctional Society Biomedical/NeuroscienceOrganic problems, biochemical imbalances, genetic predispositions.

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 (Albert Ellis)- change self-defeating statements Behavioral (Aaron Beck) –Goal is to unlearn maladaptive behavior Group Therapy Biomedical- psychopharmacotherapy