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Exam (elaborations)

Psych Final Exam Review

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Introduction/ History and Legal Aspects of Mental Illness (approx. 10 Questions) ● DSM definition of mental disorder/ illness ○ A mental disorder is a syndrome characterized by clinically significant disturbance in an individual’s cognition, emotion regulation, or behavior that reflects a dysfunction in the psychological, biological, or developmental processes underlying mental functioning. ○ Mental disorders are usually associated with significant distress or disability in social, occupational, or other important activities ● Major historical landmarks/ key players/advances in treatment and medicine (Pinel, Bedlam, etc) ○ Mental illness has always been present ○ Accepted etiologies change—ex. Homosexuality used to be dsm defined ○ Prehistoric evidence—primitive, magical, religious explanations/interventions ■ Trepanation: hole in the skull to release demons and fix problems ○ Greek and Roman Civilizations ■ Hippocrates—used era of organic explanation along side magico-religious, tx with diet and lifestyle ● Credited with describing melancholia, mania, phobia ○ Middle Ages ■ Care of mentaly ill by family and community ■ Re-emergence of magico-religious ■ Tx=beating, exorcism, shocks, purging, fasting, bloodletting ■ Assylums established by muslim, Persian and Arabian cultures ○ 15-17th Century ■ mentally ill=undesirable ■ social abandonment, highly unregulated asylums, restrain, harsh tx, chains, beating, barbaric means ■ Patients grouped with prisoners, Bedlam : paid tourists to look at patients ○ Era of enlightenment ■ Shift towards a moral treatment ■ Philippe Pinel - individualized treatment plans ■ Benjamin Rush—father of American psych, thought blood flow rushed to brain ■ Dorothea Dix—worked in the civil war, advocated for better treatment ○ 20th century ■ terms change: asylums→hospitals, inmate→patient, lunacy→mental illness ■ rethinking due to etiology: Sigmund freud w/ psych explanations ■ Eugenics 1 ■ Mental hygiene movement ■ WWII—tx for soldiers trying to adjust from war=lobotomies, insulin shock therapy, electroconvulsive therapy: ● Walter freeman—ice pick lobotomy 1945 ■ 1949—National Institute of Mental health established→ de-institutionalization→psychopharmacology ● chlorpromazine/thorazine—typical antipsychotic ■ 1960’s—Deinstitutionalization and community mental health movement—community mental health centers act ■ 1990s—decade of brain, new meds developed (SSRIs) ● Voluntary admission/ Involuntary admission/72 hour notice ○ Voluntary Admission ■ Patient requests hospitalization ■ May sign self out ● 72 hours to evaluate ● May be converted to involuntary if assessed by provider to be a danger ■ Voluntary Admission—person applies in writing to enter the hospital, discharge is collaboratively determined with the psychiatrist ■ Involuntary Admission ● Emergency detention ~24 hrs

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