UNDERSTANDING PSYCHOPATHOLOGY

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UNDERSTANDING PSYCHOPATHOLOGY

• History of Psychopathology

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LECTURE OVERVIEW

• Definitions
• Psychopathology
• Positive Mental Health
• History
• Four dominant models of psychopathology

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WHAT DEFINES ABNORMALITY? THE BEHAVIOR/EXPERIENCE
IN QUESTION..

• Causes distress
• Is associated with impairment
• Causes risk to self or others
• Is socially or culturally unacceptable

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PSYCHOPATHOLOGY

• The study of the causes of deviant/ abnormal
  behavior (Davison Neale)
• The science dealing with behavior disorders
  (Shahakian)
• The scientific study of abnormal behavior
  (Klerman)

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WHY DO WE WANT TO UNDERSTAND PSYCHOPATHOLOGY?

• Intellectual curiosity
• Tolerance, acceptance
• Treatment
• Prevention
• Public Policy

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IF THERE IS ABNORMAL--THERE MUST BE NORMAL
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MARIE JAHODA CRITERIA FOR POSITIVE MENTAL HEALTH

• Current Concepts of Positive Mental
  Health New York Basic Books, 1958.

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CRITERIA FOR POSITIVE MENTAL HEALTH

• Attitudes toward self
• Growth, development, self-actualization
• Integration
• Autonomy
• Perception of reality
• Environmental mastery

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WHY STUDY THE HISTORY OF PSYCHOPATHOLOGY?

• Science is cumulative
• Continuity/discontinuity of psycho-pathology
  informs theories about etiology
• Continuity across vastly different historical
  contexts points to biological causes
• Continuity across similar historical contexts
  points to cultural explanations
• BUT historical similarity/difference is a matter
  of emphasis.

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EXAMPLE OF CONTINUITY
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The person suffering from excited insanity
initially feels sad, eating and sleeping less he
then becomes grandiose, feeling that he is very
smart and noble, talking and scolding all day and
night, singing, behaving strangely, seeing
strange things, hearing strange voices, believing
that he can see the devil or gods. (Tseng,
1973, based on Huang Ti, 2674 B.C.)
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DOMINANT VIEWS OF PSYCHOPATHOLOGY

• Natural theories (Somatogenesis (Medical
  Model)
• Supernatural theories (including demonology)
• Psychogenesis
• Sociocultural theories

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PARADIGM OF PSYCHOPATHOLOGY DELINEATES...

• Causes (etiology)
• Treatment approach
• Therapist
• Scientific method

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IF NATURAL--WHAT IS THE SOURCE OF THE DISEASE?

• Life forces (Yin-Yang)
• Air flow through vital organs
• Wandering uterus
• Imbalance of humors or bodily fluids
• Germs
• Structural or functional changes in the brain

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A NEW PSYCHIATRIC REVOLUTION?

• Decade of the brain (1990-2000)
• Consumer groups embrace the medical model
• Mental health enters the political mainstream
  (Surgeon General report White House conference
  on mental health Democratic convention speeches
  feature mental illness as important)

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THE SURGEON GENERALS REPORT ON MENTAL HEALTH AND
MENTAL ILLNESS (David Satcher, M.D., 1999)

• First ever Surgeon Generals report on mental
  health and mental illness
• Science based report
• Contributors reviewed more than 3,000 research
  articles and utilized first-person accounts from
  individuals with a mental disorder