chapter 24 A

• Psychopathology is the study of mind illnesses or psychological disorders
• Criteria for distinguishing disorders from normal behaviour

  • Statistical deviance
  • Maladaptiveness
  • Personal distress
• Statistical deviance


  How much the behaviour differs from normal behaviour, but what is considered normal is culturally defined. Some statistically normal behaviour may not be considered healthy or appropriate. Eccentricity and genius are also abnormal.
• Maladaptiveness


  How harmful the behaviour is to the person and to others, but some behaviours may be viewed as maladaptive in certain cultures but not in others
• Personal distress


  Some people with abnormal behaviour feel no such distress, for example when harming others. Also, not all personal distress is abnormal.
• There is no clear-cut answer to the problem of what is normal and what is not. This is an ongoing problem in the field of psychology, and is reflected in how the boundaries of what constitutes normality have shifted throughout history. Broader political and sociocultural forces have been shown to have an important impact on how we view mental or psychological disorders.
• Homosexuality used to be a diagnosable mental disorder in many parts of the world, but since 1973 it has no longer been regarded as a mental disorder because there were no clear links to be found between mental disorders, abnormality and homosexuality.
• Problems with madness and insanity have always been a part of the human condition. The dominant understanding of mental illness during the early era was informed by a belief that individuals who became psychologically disturbed were possessed by evil, supernatural forces.
• Hippocrates (460-377 BC) believed that psychological disorders were the result of imbalances in four essential fluids or humours in the body, and prescribed naturalistic remedies to heal these kinds of problems. This marked the rudimentary beginnings of the biomedical approach to understanding psychopathology.
• During the Middle Ages, the naturalistic approach to understanding mental disorder fell out of favour, and religion dominated all explanations of psychopathology. Mental illness was seen as a punishment for sins committed, or as a form of demonic possession. The church became the main vehicle through which such so-called possessions could be exorcised.
• Formal segregation of mentally disturbed individuals began in the late Middle Ages when the Church, supposedly out of charity, began locking up the so-called insane.
• During the Renaissance (1400-1600), patients who were psychologically ill began to be treated more humanely, and ideas related to witchcraft were more openly challenged.
• Formal segregation of mentally disturbed individuals began in the late Middle Ages when the Church, supposedly out of charity, began locking up the so-called insane
• The best-known institution for the insane was established in the religious house of St Mary of Bethlehem (often called Bedlam, a term that has come to connote confusion, disorder and chaos) in London late in the 14th century
• Renaissance era


  1400-1600, patients who were psychologically ill began to be treated more humanely, and ideas related to witchcraft were more openly challenged
• Johann Weyer


  A German physician who argued that such individuals were not possessed by the devil but were mentally unstable and could not be held responsible for their actions
• Reginald Scot


  Published Discovery of witchcraft in 1584, in which he argued that so-called demonic possessions were medical illnesses and not visitations from evil spirits
• Asylum era


  The institutionalisation of the mentally ill was on the increase in the 16th century, patients were housed in asylums that became well known for their inhumane treatment
• Common treatments in asylums


  • Restraining patients for long periods of time
  • Placing them in dark cells
  • Subjecting them to torture-like treatments
  • Electric shocks
  • Bleeding to rid the body of supposedly dangerous fluids
  • Powerful drugs
  • Starvation
• Philippe Pinel


  Put forward the idea that mental patients needed to be treated with kindness and consideration if they were to recover, argued that their chains should be removed, they should be moved out of the dungeons where they had been incarcerated and placed in sunny rooms, they should also be permitted to do exercise and to partake in other constructive activities
• William and Henry Tuke


  Established a country retreat in England where patients could rest peacefully and work in a caring and supportive atmosphere
• Many patients were reported to have completely recovered from their mental illnesses once they were treated in a humanitarian fashion
• Despite these developments, mental patients in some places around the world are still subjected to extreme forms of restraint such as being chained
• Scientific era


  Towards the end of the 19th century, scientific discoveries related to mental disturbance began to increase
• General paresis (syphilis of the brain)


  A disease that caused paralysis and insanity, had a biological cause and could be successfully treated
• This fuelled the search for other biological causes that might be associated with mental illness and formed the foundation of modern-day psychiatry
• Emil Kraepelin


  Observed that certain symptoms occurred with specific types of mental disease, developed a classification system for a number of disorders, most notably dementia praecox (known today as schizophrenia) and manic-depressive psychosis (known today as bipolar disorder)
• Kraepelin's views about classification were revolutionary and served as a precursor to the Diagnostic and statistical manual of mental disorders that is currently used to make a diagnosis
• Sigmund Freud


  Devised a means of treating patients who suffered from hysterical and neurotic conditions, his treatment known as psychoanalysis was based on his theory that psychopathology is largely caused by the repression of forbidden wishes or instinctual drives
• Behaviourism


  Emerged in the 1950s, based on the work of influential theorists like Skinner and Pavlov, believed that we could better understand psychopathology by observing how abnormal behaviour is learned and reinforced by the external environment
• Psychological treatments that have emerged in the past 50 years


  • Existential psychotherapy
  • Primal therapy
  • Cognitive-behaviour therapy
  • Gestalt psychotherapy
  • Logo-therapy
  • Neurolinguistic programming
• The choice of different treatment modalities remains an ongoing debate in psychology, and a great deal of research is being compiled to find out if some treatments are indeed more effective than others