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Concepts of Abnormality
Deviance: Statistical rarity
Deviance: Moral violation
Distress
Dysfunction
Danger
     Lanterman-Petris-Short Act
         Danger to self
         Danger to others
         Grave disability
2 PC (Two Physician Certificates)
Loose Public image
Antinomy
Mental health work by students

History of Mental Disorder
Prehistoric views: Demonology
     trephination
     exorcism
Greek & Roman times
     Hippocrates: 4 humors
Dark Ages: Demonology returns
Renaissance: Asylums, Geel
19th Century: Reforms, moral
     treatment
20th Century: Somatogenic &
     psychogenic theories

Models of Abnormality
Biological
Psychodynamic
Behavioral
Cognitive
Humanistic
Existential
Sociocultural

Euphemism
Euphemism
Dysphemism
Paleologic

Mental Health Vocations
Physician     MD    Diagnosis, Physical treatments
Psychiatrist   MD+residency  Diagnosis, Physical
and psychological treatments
Clinical Psychologist    Ph.D. in Clinical Psychology, 3000 hours supervised practice,
state certification
Psychoanalyst  MD or Ph.D.  Psychological
treatment
Psychotherapist MD or Ph.D.  Psychological treatment
Psychopathologist  Ph.D. (a few MDs)   Research
Counselor, Therapist, Life Coach  No specific credential;
Psychological treatment
Marriage & Family Counselor     MFCC, 3000 hours of
          supervised practice ;   Psychological treatment
Self-help Groups    Experience       Support

Nursing
Registered Nurse        R.N.
Psychiatric Nurse     R.N. + Special training
Psychiatric Technician/Aide/Attendant Inservice training
Vocational Nurse LVN

Clinical Assessment
Multi-method procedure
Standardized test, e.g. MMPI
Unstandardized methods, e.g. clinical interview (structured or unstructured)
Meta Analysis
Nomothetic vs. Ideographic Assessment
Clinical tests:
     projective; personality
     IQ tests
     physiological and neurological procedures
Diagnosis, Prognosis
DSM (Diagnostic & Statistical
     Manual)
QUESTION FOR CLASS DISCUSSION:
Do you think Video Game Addiction should be added to DSM 5?
Labeling, pros and cons

Stress Disorders
Stages in the disaster syndrome (Different
    authors list different numbers of stages)
Shock
Suggestibility
Defense (Denial, Projection)
Grieving
Recovery
Disaster Response Network: 4-Stage Approach
Post-Traumatic Stress Disorder (PTSD)
Examples of stress disorders:
Combat disorders
Pathological responses to civilian catastrophes, malignant illness, divorce, crime,
plus many other stressors.
Anxiety disorders
Generalized Anxiety Disorder
Phobia
  Specific phobia
  Agoraphobia
  Social phobia
Panic Disorder
Obsessive-Compulsive Disorder

Psychoanalytic Approach
Developmental Stages
oral, anal, phallic, latency, genital
Id, Super Ego, Ego
Birth trauma
Anxiety
Case of Little Hans
Psychoanalysis
     Transference

Behavior Therapies (Behavior Mod)
Classical conditioning
     Pavlov
         UCS, UCR, CS, CR
  Yerofeeva
  Shenger-Krestnovika
  Petrova
  Liddell
Treatments:
 Systematic desensitization (Wolpe); Flooding;
 Modeling; Aversive conditioning
Virtual reality techniques
Operant conditioning
     Skinner
     Token economy
     Behavioral contract

Somatoform disorders
Conversion disorder
Somatization disorder
Pain disorder
Hypochondriasis
Body dysmorphic disorder
Dissociative disorders
Dissociative amnesia
   localized, selective, generalized, continuous
Dissociative fugue
Dissociative identity disorder (multiple personality)          

Personality disorders (pd)
"odd"
Paranoid pd
Schizoid pd
Schizotypal pd
"dramatic"
Antisocial pd
Borderline pd
Histrionic pd
Narcissistic pd
"anxious"
Avoidant pd
Dependent pd
Obsessive-compulsive pd

Institutional symptoms
Loss Of Independence
Disculturation
Damage And Stigma
Estrangement
Isolation
Stimulus Deprivation
Deinstitutionalization
Transinstitutionalization
Dumping

Criminal Insanity
M’Naghton test
Irresistible impulse test
Durham rule
ALI (American Law Institute) test
Guilty but mentally ill verdict
Diminished capacity defense
CASES: Right to treatment (Donaldson)
Suitable conditions (Wyatt v. Stickney)
Duty to warn (Tarasoff)
Napa State Hospital patient population: 2005
75% Criminal commitments
     Not guilty by reason of insanity
     Incompetent to stand trial
     Mentally disordered sex offender
25% Civil commitments
     LPS (Lanterman Petris Short)

Sexual disorders
Four Sex Researchers & Their Methods
Alfred Kinsey: Survey research
William Masters & Virginia Johnson: Experiments plus sex therapy
Evelyn Hooker: Phenomenological approach
Laud Humphries: Observational research

Eating disorders
Anorexia nervosa
Bulimia nervosa
(Binge-purge syndrome)

Alcohol Abuse
     Drinking
     Drunkenness
     Alcoholism (Alcohol Addiction)
Delirium Tremens (DTs)
Korsakoff’s Syndrome
Alcoholics Anonymous (AA), Al Anon, Al Ateen
Antabuse, Naltrexone
Aversive conditioning
Relapse prevention
Examples of Scandinavia, Russia, Prohibition in US

Substance abuse
Vocabulary used in Comer. Previous textbooks used different terminology. I will use
Comer's definitions for the exam.
Substance dependence (Addiction)
Tolerance
Withdrawal
We can't discuss all drugs; here are the one's we'll cover in class:
Depressants: Alcohol, barbiturates
Stimulants: Caffeine, Amphetamine (+ "Smart Pills" such as Adderall), Cocaine
Narcotics: Opium, morphine, codeine, heroin, methadone, OxyContin and abuse of
prescription drugs, "Pharm parties'
 [Naltrexone- treatment drug]
Hallucinogens: Marijuana, PCP, DXM, LSD, "shrooms"
"Designer drugs": Ecstasy
Strategies for dealing with drug abuse:
Note: Education and treatment can be part of all of them
Enforcement -  prison
Harm reduction – needle exchange; methadone maintenance; overdose      drugs
Decriminalization – possession OK; production or sale illegal
Legalization – government regulation

Schizophrenia
Dementia praecox
Schizophrenia:
     Undifferentiated (Simple) Schizophrenia
     Disorganized (Hebephrenia) Schizophrenia
     Catatonic Schizophrenia
     Paranoid schizophrenia
     Residual Schizophrenia
Hallucinations, Delusions, illusions
Bleuler
Freud
Jung
Sullivan
Arieti: Schizoid, Stormy personality
     Antipsychiatrists
Laing
Szasz
Hypothesized Biochemical & Brain Abnormalities
Early tranquilizing drugs
     Rauwolfia serpentina: Serpasil, Reserpine, Thorazine)
Early theories--  LSD-like substance in brain
Current theory: Dopamine hypothesis
     Phenothiazines
     Parkinson’s
Enlarged ventricles (brain cavities)
     Note: After 50+ years of research, findings are stilll
very tentative.

Genetic aspects
Risk (Family pedigree) studies
Twin studies
Adoption studies

Mood Disorders
Mood Disorders  = Affective Disorders =
Manic-Depressive Disorders
     Bipolar or Unipolar
Dysthemic Disorder (Mild)
Major Depressive Disorder (Severe)
     Reactive or Endogenous depression
Seasonal Affective Disorder (SAD)  Light therapy
Hypomanic Disorder (mild)
Acute Mania (Severe)
Cyclothymic Disorder (Mild mood swings)
Electroconvulsive Therapy (ECT or EST)
Tricyclic Antidepressants
Schneidman identifies four types of people who intentionally
end their lives:
Death seekers
Death initiators
Death ignorers
Death darers
Responding to callers to a Suicide Hotline:
Establish a positive relationship
Clarify problem
Assess suicide potential
Assess & mobilize caller’s resources
Formulating a plan

Cognitive disorders
Brain injury
    Case of Mr. P; use of psychological testing
WAIS (WechslerAdult Intelligence Scale, 14  subtests)
Bender Gestalt
Goldstein-Scheerer
     Color-Form Test
     Sorting Test
Rorschach Test
Delirium
Dementia:
   Alzheimer’s ( formerly Senile Dementia)
   Vascular Dementia
Intelligence
     Crystallized
     Fluid
Hold/ Don’t Hold Subtests

Mental Retardation (Developmental Disability)