Download Brief History of Psychopathology

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Abnormality
Behavior, thinking processes and feelings deemed
Brief History of
Psychopathology
undesireable and therefore subject to control or
change.
Mag. Dr. Barbara Griesser
History of Psychopathology
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Criteria of Psychopathology
History of Psychopathology
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Theories of psychopathology
Criterias based on personal standards
Theories of psychopathology and the ways to treat it
were made in earlier periods of history by
Physicians
Philosophers
Theologians
Lawyers
Discomfort - Psychological pain (sadness, anxiety, ,..)
Disability or Impairment
Criterias based on social standards
Deviance
Unpredictable, bizarre or dangerous behaviour
Sources: extant writings, medical treatises, church and
legal documents, historical narratives, diaries, literature
History of Psychopathology
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Historical Concepts of
„Madness“
Connecting Treatment to
Etiology
Attitudes about a disorder influence treatment
Supernatural tradition
Abnormal behaviour caused by demons, spirits, influence
Different treatment of mental disorder due to:
History of Psychopathology
of moon, planets and stars
Weakness of character
Sinfulness
Heredity
Physical environment
Social environment
Psychological paradigma
Focuses on humanistic, cognitive and behavioural
causes and effects of psychopathology
Biological paradigma
Includes physical factors (genetics, neurochemistry)
History of Psychopathology
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History of Psychopathology
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Supernatural concept
Supernatural Concept
Possession of a person by evil spirits responsibel for
Paracelsus (1493-1541)
strange behaviour
Behavior influenced by movements of the moon and star
Book of Leviticus 20:27 (third book of the Hebrew Bible)
700 B.C:
„A man or a woman that hath a familiar spirit ... Shall surely
be put to death: they shall stone him with stones.“
History of Psychopathology
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History of Psychopathology
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Hippocrates’ Early Medical
Concepts
Biological Tradition
Psychological disorders are attributed to biological
Hippocrates (460-367 B.C.) “father of medicine”
causes
Brain is the primary center of
thought
emotion and
intelligence
Mental disorders are located
in the brain
History of Psychopathology
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History of Psychopathology
Hippocrates’ Early Medical
Concepts
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Hippocrates’ Early Medical
Concepts
Classification: Three categories
Four basic temperaments
Phrenitis – fever and delirium
Mania – extreme excitement
Melancholia – excess of black bile (melancholer)
Established tradition of case history
Choleric – yellow bile
Melancholic – black bile
Sanguine - blood
Phlegmatic - phlegm
Importance of relationship: diagnosis and treatment
Treatment: “do no harm”
Diet, massage, music, remedies promoting sleep and
rest, bloodletting, even marriage
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History of Psychopathology
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Early Philosophical
Conceptions
Plato (429-347 B.C.)
Claudius Galenus (Galen) (A.D. 131-201) – Greek
physican at the court of the Roman Emperor Marcus
Aurelius
Aristoteles (384-322 B.C.)
Theophrastrus (371-286 B.C)
Elaborated the „theory of humors“
Aretaeus (30-90 A.D.)
Greatest eclecticist physician
Treatment in the Hippocratic-Galenic tradition till 12th
century
History of Psychopathology
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Middle Ages: Middle East
Treatment and Classification
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History of Psychopathology
Middle Ages: Middle East
Treatment and Classification
First mental hospital established in Baghdad in A.D. 792
Avicenna (Arabia: A.D. 980-1037) “Galen of Islam”
Najab ud-din Unhammad (870-925, Arabian
Canon of Medicine
psychologist)
Nosology of nine categories of mental disorders which
Medical textbook in European universities from 10th
through 15th century
included 30 different mental illnesses (obsessivecompulsive disorders, delusional disorders, degenerative
diseases, involutional melancholia, states of abnormal
excitementA)
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History of Psychopathology
Middle Ages: Europe
(A.D. 500-1300)
Renaissance
Etiology of Mental Illnesses:
Paracelsus (1493-1541)
Folk myth, theology, occult beliefs
Theophrastus Bombastus von Hohenheim
Astrologer and alchemist
Behavior influenced by movements of the moon and stars
Pope Gregory IX established the Inquisition in 1233
Heinrich Kramer and Johann Sprenger:
„On the diseases which deprive men from health and
Malleus Maleficarium - „The Hammer Against Witches“
reason“
(1487-1489)
Taxonomy of perceived deviant behavior and proposed
Lunatici (moon)
guidelines for prosecuting
Insani (familiy heritage)
Vesani (food or drink)
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Melancholici (temperament)
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Reformation: Europe (16th Century)
Treatment - Establishment of Asylums
Places to warehouse troublesome people, used harsh
Thomas Sydenham (1624-1663)
tactics to control unruly or excited patients
the „English Hippocrates“
Developed organized and comprehensive hierarchical
classification systems
“Bedlam”: Monastery of St. Mary of Bethlehem in
London commissioned by King Henry VIII (1547)
One of the first mental institutions
Wealthy people paid to peer at the insane for entertainment
Origin of the term “Bedlam”
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History of Psychopathology
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History of Psychopathology
18th century
18th century
Francois Boissier de Sauvages (1706-1767)
William Cullen (1710-1790)
Leading taxonomist
Influenced by Thomas Sydenham and the biological
Most influental nosologist
Pioneer of neuropathology
taxonomy of Carl Linnaeus
Classification of mental disorders
10 classes
295 genera
24000 species
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History of Psychopathology
18th century
History of Psychopathology
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Humanitarian Reform – Key People
Philippe Pinel (1745-1826): influenced by Cullen
Philippe Pinel (Paris: 1745-1826)
Founder of modern psychiatry
Wrote 1. Textbook on psychiatry:
Physician-in-chief of the Bicêtre Hospital (asylum) in Paris
in 1792
Restored the „Moral treatment“
„Traité Médico-Philosophique sur la Manie“ (1806)
removed chains from the patients
Film: Stairways to light (1945)
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Humanitarian Reform – Key People
William Tuke (England: 1732-1822)
Jean Esquirol (1772-1840) (Pinel´s successor)
Establishment of “York Retreat” – Calming environment
Patients engaged in purposeful but calming activity
Talked with attendants
5 broad classification syndromes of mental disorder
Lypemanie
Monomanie
Manie
Dementia
Imbecility/idiocy
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History of Psychopathology
Humanitarian Reform – Key People
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History of Psychopathology
Humanitarian Reform – Key People
Benjamin Rush (1745-1813)
Dorothea Dix (America: 1802-1887)
Co-founder of the American Psychiatric Association
“Moral Treatment” in Philadelphia hospital
Influenced by “moral model” and medical sciences
Fought for establishment of state mental hospitals for the
mentally ill
32 states established at least one mental hospital
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History of Psychopathology
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History of Psychopathology
19th century
19th Century
Johann Christian Reil (1808)
Jules Baillarger (1809-1892) „Folie à double form“
coined term „Psychiatry“
Jean-Pierre Falret (1794-1870) „la folie circulaire“
alternating mania and depression
Karl Ludwig Kahlbaum (1828-1899) & Ewald Hecker
Dysthymia, cyclothymia, catatonia, paranoia,
hebephrenia
Wilhelm Griesinger (1817-1868)
advanced unitary scheme based on concept of brain
pathology
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History of Psychopathology
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20th Century
Emil Kraepelin
Proposed 15 categories
Emil Kraepelin (1856-1926): Pioneered classification of
mental illness based on biological causes
Psychogenic neurosis, psychopathic personality,
syndromes of defective mental developement,
homosexuality..
Published 1st psychiatry text
„Compendium der Psychiatrie“ (1883)
Proposed two major syndromes
Dementia praecox (later renamed schizophrenia)
Mental illness as syndrome
Catatonia, hebephrenia, dementia paranoides
Cluster of symptoms that co-occur
Manic-depressive psychosis
paranoia
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History of Psychopathology
Eugen Bleuler
History of Psychopathology
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Biological Approaches
Eugen Bleuler (1857-1939);
Generalparesis
Introduction of the term schizophrenia
Degenerative disorder with psychological symptoms
Caused by the tertiary stage of syphilis
(Krafft-Ebbing)
History of Psychopathology
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Biological Approaches
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Biological Approaches
Since general paresis had biological cause, other
Phenothiazine
mental illness might also.
Originally used as tranquilizer for surgery patients
Early Biological treatments:
Chlorpromazine
Insulin shock therapy (Sakel, 1935)
Electroconvulsive (electric shock) Therapy (ECT) (Cerletti
and Bini, 1938)
Prefrontal lobotomy (Moniz, 1937)
approval as antipsychotic drug in US in 1955
1955: 559,000 patients in state mental hospitals
1972: 276,000 patients in state mental hospitals
Imprecise slashing of the frontal lobe of the brain
History of Psychopathology
History of Psychopathology
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History of Psychopathology
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Genetics
Psychological Approaches
Rise of the idea that mental illness can be inherited
Franz Anton Mesmer (1734-1815)
(early 20th century)
Treated hysterical patients with “animal magnetism”
Behavioralgenetics
Early practitioner of hypnosis
Extent to which behavioral differences are due to
Josef Breuer (1842-1925)
genetics
Used hypnosis to facilitate catharsis
Catharsis - Release of emotional tension triggered by
Eugenics
Promotion of enforced sterilization to eliminate
reliving and talking about event
undesirable characteristics from the population
Many state laws required mentally ill to be sterilized
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History of Psychopathology
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The Rise of Anti-Psychiatry
Psychoanalytic Theory
Sigmund Freud (1856-1939)
1946 – 1963: Changing views of mental health services
Most influental psychologist and physican of the 20th
Mary Jane Ward published The Snake Pit (1946)
DSM-I published (1952)
Erving Goffman published Asylums (1961)
century
Hospitals similar to “total institution”
Breuer and Freud (1895/1896) “Studies on Hysteria”
including the case of Anna O.
History of Psychopathology
Thomas Szasz (1961)The Myth of mental Illness
Patients suffer from problems of living in a stressful world
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CLASSIFICATION SYSTEMS
Deinstitutionalization
Forces that initiated/shaped the movement
History of Psychopathology
International List of Causes of Death (ICD)
Developed by World Health Organization (WHO)
Now in its 11th edition (ICD-11)
Miracle drugs
Reconceptualization of Mental Illness
Recognition of Institutional Hazards
Economic Incentives
Diagnostic & Statistical Manual (DSM)
Developed by American Psychiatric Association (APA)
Now in edition DSM-V
Chinese Classification of Mental Disorders
Psychodynamic Diagnostic Manual
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ICD
DSM
www.who.en
The DSM-IV organizes each psychiatric diagnosis into
five dimensions (axes) relating to different aspects of
disorder or disability:
Chapter V: Mental and behavioural disorders
(F00-F99)
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History of Psychopathology
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The Dimensions of
Classification in DSM
AXIS I Clinical Disorders (e.g. anxiety disorders, mood
disorders, schizophrenia)
Magill, Frank (Ed.) (1996). International Encyclopedia of Psychology Volume I and II. Fitzroy
Dearborn Publishers: London, Chicago.
Mahrer, Winifred B. & Mahrer, Brendan A. (2003) Abnormal Psychology. In: Weiner, Irving B. &
Freedheim, Donald K. (ed.): Handbook of Psychology. History of Psychology, 1, 15, 303-336.
Hoboken, New Jersey: John Wiley & Sons.
Millon, Theodore & Simonsen, Erik (2010) A Précis of Psychopathological History. In: Millon,
Theodore, Krueger, Robert F., Simonsen Erik (ed.): Contemporary Directions in
Psychopathology. Scientific Foundations of the DSM-V and ICD-11, 1, 3-52, New York, London:
The Guilford Press.
AXIS II Personality Disorders, Mental Retardation
AXIS III General Medical Conditions (e.g. infectious
diseases, etc.)
AXIS IV Psychosocial & Environmental Problems (e.g.
educational problems, economic problems)
AXIS V Global Assessment of Functioning
History of Psychopathology
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History of Psychopathology
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