Understanding Abnormal Behavior and Mental Illness

2. Chapter 1 OVERVIEW TO UNDERSTANDING ABNORMAL BEHAVIOR

3. DEFINING MENTAL ILLNESS

4. Any mental illness (AMI) • Mental Illness: A mental, behavioral, or emotional disorder. • AMI can vary in impact, ranging from no impairment to mild, moderate, and even severe impairment • In 2017, there were an estimated 46.6 million adults aged 18 or older in the United States with AMI. • This number represented 18.9% of all U.S. adults. • The prevalence of AMI was higher among women (22.3%) than men (15.1%). • Young adults aged 18-25 years had the highest prevalence of AMI (25.8%) • Adults aged 26-49 years (22.2%) and aged 50 and older (13.8%).

5. SERIOUS MENTAL ILLNESS (SMI) • Serious mental illness (SMI) is defined as: • A mental, behavioral, or emotional disorder resulting in serious functional impairment, which substantially interferes with or limits one or more major life activities. • In 2017, there were an estimated 11.2 million adultsaged 18 or older in the United States with SMI. This number represented 4.5% of all U.S. adults. • The prevalence of SMI was higher among women (5.7%) than men (3.3%). • Young adults aged 18-25 years had the highest prevalence of SMI (7.5%) compared to adults aged 26-49 years (5.6%) and aged 50 and older (2.7%).

6. How do we define a psychological disorder? • Abnormal behavior that involves disturbance of psychological function or behavior. • Psychological dysfunction associated with distress or impairment that is not typical or culturally appropriate

7. Is there such a thing as a “normal” person? Criteria for ABNORMAL BEHAVIOR. (Examples) Any one alone, is not (necessarily) an indication of Mental Illness • Behavior that is unusual • Behavior that is socially unacceptable or violates social norms • Perception or interpretation of reality is faulty • Clinical significance • Distress • Behavior cannot be a socially expectable response • Psychological or biological disturbance • Behavior that is self-defeating • BEHAVIOR THAT IS DANGEROUS TO SELF/OTHERS!!! (MOST TELLING CRITERIA; NEEDS INTERVETION ASAP)

8. Causes of Abnormality Social scientists use the term BIOPSYCHOSOCIAL to characterize the interactions among these three dimensions.

9. WHAT ARE POTENTIAL Risk Factors for BEING DX WITH Mental Illness? • Social Conditions: Poverty, homelessness, overcrowding, stressful living conditions • Family Factors: Parents who are immature, mentally ill, abusive, or criminal; poor child discipline; severe marital or relationship problems • Psychological Factors: Stress, emotional problems, low self-esteem, interpersonal problems • Biological Factors: Genetic defects or inherited vulnerabilities; poor prenatal care, head injuries, exposure to toxins, chronic physical illness, or disability

10. Abnormal Behavior is created by a variety of factors Biological Factors (genetics, biochemistry, and brain structures) Psychological Factors (Personality traits, coping ability, and perception) Sociocultural Factors (Experiences throughout life, family dynamics, and your environment)

11. When these factors come together in the perfect combination, psychological disorders ARE LIKELY TO emerge Biological Factors Sociocultural Factors Psychological Factors

12. PSYCHOPATHOLOGYMYTHS AND MISCONCEPTIONS ON MENTAL ILLNESS

13. Psychopathology • Definition • Psyche: mind. • Pathos: disease/illness • Logos: study of • Branch of Psychology which deals with the scientific study of mental illness

14. Myths and Misconceptions of Mental Illness What are some common myths about mentally ill individuals? • Mentally ill people always act bizarre (weird) • There is a clear difference between normal and abnormal behavior • Mentally ill people are unpredictable and dangerous • Once “crazy” always “crazy” • People who are severely disturbed live in their own world, and not aware of surroundings. • Only mentally ill people need psychological help. • Only poor and less intelligent people are likely to become disordered. • Mental illness is a single symptom • Mental Illness is caused by a personal weakness. • Psychiatric disorders are not true medical illnesses like heart disease and diabetes

15. History of Mental Illness Treatment Trephination • As one of the earliest forms of mental health treatment, trephination removed a small part of the skull using an auger, bore or saw. • Dated from around 7,000 years ago, this practice was likely used to relieve headaches, mental illness or even the belief of demonic possession. Not much is known about the practice due to lack of evidence. Bloodletting and Purging • Though this treatment gained prominence in the Western world beginning in the 1600s, it has its roots in ancient Greek medicine. • Claudius Galen believed that disease and illness stemmed from imbalanced humors in the body. • He argued that “an internal biochemical relationship was behind mental disorders. Bleeding, purging, and even vomiting were thought to help correct those imbalances and help heal physical and mental illness,” • These tactics were used to treat more than mental illness, however: Countless diseases like diabetes, asthma, cancer, cholera, smallpox and stroke were likely to be treated with bloodletting using leeches or venesection during the same time period.

16. Isolation and Asylums • Isolation was the preferred treatment for mental illness beginning in medieval times, so it’s no surprise that insane asylums became widespread by the 17th century. • These institutions were “places where people with mental disorders could be placed, allegedly for treatment, but also often to remove them from the view of their families and communities.” • Overcrowding and poor sanitation were serious issues in asylums, which led to movements to improve care quality and awareness. • At the time, the medical community often treated mental illness with physical methods. This is why brutal tactics like ice water baths and restraint were often used. • Insulin Coma Therapy • This treatment was introduced in 1927 and was used for several decades until the 1960s. • They believed large fluctuations in insulin levels could alter the function of the brain. • Insulin comas could last anywhere between one and four hours. Patients were given an insulin injection that caused their blood sugar to fall and the brain to lose consciousness. Risks included prolonged coma (in which the patient failed to respond to glucose), and the mortality rate varied between 1 and 10 percent. • Electroconvulsive therapy was later introduced as a safer alternative to insulin coma therapy.

17. Metrazol Therapy • In metrazol therapy, physicians induced seizures using a stimulant medication. • Seizures began roughly a minute after the patient received the injection and could result in fractured bones, torn muscles and other adverse effects. The therapy was usually administered several times a week. • Seizure therapy was the precursor to electroconvulsive therapy (ECT) Lobotomy • This now-obsolete treatment won the Nobel Prize in Physiology and Medicine in 1949. It was designed to disrupt the circuits of the brain but came with serious risks. • Popular during the 1940s and 1950s. It consisted of surgically cutting or removing the connections between the prefrontal cortex and frontal lobes of the brain. The procedure could be completed in five minutes. • Some patients experienced improvement of symptoms; however, this was often at the cost of introducing other impairments. • The procedure was largely discontinued after the mid-1950s with the introduction of the first psychiatric medications.

18. 1970’s – Deinstitutionalization and Community Mental Health Care • In the United States, it constituted a radical shift in social policy and the way mental health care was provided • Replaced inpatient hospitals with community-based care, day treatment, and outreach programs • Considered more humane and cost-effective

19. Twentieth Century Deinstitutionalization – Did it work? • Fewer patients spend time in inpatient hospitals • Patients spend less time in inpatient hospitals • More patients are re-hospitalized • Where are they instead? • Homeless • Nursing homes • Group homes • Jail

20. NAMI: National Alliance on Mental Illness • From its inception in 1979, NAMI has been dedicated to improving the lives of individuals and families affected by mental illness. • http://www.nami.org/