Mental Illness 1

Front 1

What were the three questions Spitzer & Wilson asked when trying to define mental disorder?

Back 1

1) Whether certain mental conditions should be regarded as undesirable
2) How undesirable these mental conditions should be to be classified as mental disorders
3) Even if undesirable, whether the conditions in question should be treated within psychiatry or some other discipline

Front 2

What is sympathetic magic?

Back 2

Sympathetic magic/similarity: Idea that 2 things can produce effect on each other through a secret relationship. (2 things that look alike affect each other through their similarity bc the shared likeness places them in “sympathy” with each other) Thus, “like” is believed to produce “like.”
(Ex: voodoo)

An example of sympathetic magic comes from the Shona tribe in southern Zimbabwe in Africa. Here, a common practice of witch doctors is to administer the shell of a tortoise to a patient to promote a general feeling of strength and security; or a portion of bone removed from a python’s back may be used to try to restore strength in a patient’s back by having the patient eat the bone fragments.

Front 3

What is contagious magic?

Back 3

Contagious magic/solidarity:
Idea that things that have once been in contact continue to be related to each other.
Ex: a shaman might use a fingernail, tooth, or hair as the object of a magical act to affect the source of that part in some way.
Might obtain some article of clothing that an enemy has worn close to his body, take it to a shaman who can produce a spell on it, and supposedly cause the enemy to become ill.

Front 4

How are symptoms of schizophrenia experienced and treated in Zimbabwe?

Back 4

-hear voices of their ancestor spirits and are paranoid about witches and sorcerers.
-stigmatized because they are believed to be victims of witchcraft, and diseases caused by spirits are contagious.
-mental disorders are caused by witchcraft or ancestor bewitchment

-practice of psychiatry avoided because it was considered too close to witchcraft and regarded as an area of medicine better managed by traditional healers and the clergy

Front 5

What 4 ways are psychiatrists and witch doctors the same, according to Torrey?

Back 5

1) Provide a shared worldview to the patient that makes possible the naming of pathological factors in terms understood within his or her respective culture.
2) Have a personal relationship with the patient that makes the therapist’s personality characteristics significant to the healing process
3) Engender hope in the patient and raise the expectation of being cured through the therapist’s reputation and the atmosphere of the therapeutic setting
4) Share techniques of psychotherapy, such as the use of drug therapy, shock therapy, confession, suggestion, hypnosis, ream interpretation, conditioning, and group and milieu therapies

Front 6

When did the witch trials begin (in earnest) in France?

Back 6

Began in earnest in 1245 in France and reached their zenith between 1450 and 1670.

Front 7

What are the four humors and how are they related to mental illness? Whose theory was this?

Back 7

(1) blood, (2) phlegm, (3) black bile, and (4) yellow bile


-related to mental illness because Hippocrates suggested that the cause of abnormal behavior could be attributed to an imbalance in the interaction of the four so-called humors within the body (with black vile being the one responsible for mental illness)

Front 8

What are the four reasons illness occurred, according to those living in preliterate cultures?

Back 8

1) Had lost a vital substance (such as their soul) from their body
2) Had a foreign substance (such as an evil spirit) introduced into their body
3) Had violated a taboo and were being punished
4) Were victims of witchcraft

Front 9

What are the four goals of community mental health programs?

Back 9

1) View the mental patient’s entire social environment as a “therapeutic community” with treatment resources for mental health professionals.
2) find some means in order to use the patient’s relationships with family and friends to improve therapy and to prevent recurrence of the mental disorder
3) develop and organize local community control over these centers so that center policies are community based and oriented
4) reduce patient populations at state and local mental hospitals by providing prompt response and 24 hour service

Front 10

Where are grandiose ideas acceptable?

Back 10

among the Kwakiutl

Front 11

Where are hallucinations acceptable?

Back 11

among Siberian Eskimos

Front 12

Where are fears of persecution acceptable?

Back 12

among the Dobu

Front 13

Who is the “Father of Medicine”? What did he believe?

Back 13

Hippocrates
Hippocrates believed in the humoral theory, which postulated the existence of four humors: blood, phlegm, black bile, and yellow bile—bodily fluids whose proportion and balance were significant to health. One’s state of mind determined by the balance of these humors. Madness was an imbalance of humors, usually an excess.

Front 14

What were the four legal restrictions on the insane during the Graeco-Roman era?

Back 14

o 1) Forbidden to marry
o 2) Could not acquire property
o 3) Could not make a will
o 4) Could not witness a will

Front 15

When was Malleus Maleficarum published? Who wrote it? What four groups were depicted as witches?

Back 15

Published in 1487
Written by Johan Sprenger and Heinrich Kramer.


1) dissidents
2) mad people
3) deviants (psychological, behavioral, or physical)
4) especially women as “witches” who had made a compact with the Devil and were then in his employ
Anyone who showed psychological, behavioral, or physical deviation was labeled as a witch or a sorcerer.

Front 16

Who was Johann Weyer? What book did he publish and when?

Back 16

German physician, who is considered a central figure in the history of psychiatry because of his methodical attempts to prove that witches were mentally ill and should be treated by physicians


In 1563, Weyer published “De Praestigus Daemontum” (The Deception of Demons), a rebuttal to the Malleus Maleficarum. This proved that women persecuted as witches were actually mentally sick [natural causes]

Front 17

Four factors that facilitated the ascendance of the medical model.

Back 17

The great confinement of lunatics and other deviants
The separation of the able-bodied from the lunatics
The entrance of physicians
The emergence of a unitary concept of mental illness

Front 18

Who was Pinel?

Back 18

1st revolution in mental health
Great humanitarian director of the French asylums at Bicetre and Salpetrietre, who removed the chains of the mad and liberated them from physical bondage
Emphasized the role of heredity as the first cause of the development of madness
Presented a classification of mental disease: melancholia, mania, dementia, and idiocy, which were located in the region of the stomach

Front 19

Who was Tuke?

Back 19

Founded York Retreat and developed his own brand of moral treatment.
Therapy at York Retreat was more an educational process, a pragmatic attempt to teach moral values and self-control, to remove obstacles that impeded the natural recovery process

Front 20

Who was Chiarugi?

Back 20

Humanitarian
Outlawed chains as a means of restraint and led the development of new rules establishing a more humane regime.

Front 21

What were the four causes of insanity as understood by physicians during the asylum-building period?

Back 21

 1) Lack of discipline
 2) Social mobility
 3) Disappointed ambition
 4) Economic depression

Front 22

What did the report issued by Hartford Retreat in 1827 announce?

Back 22

21 of 23 new cases of insanity, an amazing 91%, had been cured by the “asylum cure”. This marked the beginning of a curability craze

Front 23

What four types of disorders were most Freudians (Freud and his early followers) concerned with?

Back 23

o 1) hysteria
o 2) obsessions
o 3) compulsions
o 4) phobias

Front 24

Who is SKF? When did they enter the scene? And, what did they do?

Back 24

Pharmaceutical corporation Smith, Kline, and French (SKF)
May 1954
Introduced chlorpromazine under the trade name Thorazine in the United States (known as miracle drug)

Front 25

What two factors dictate an integration of the medical model of disease with a sociological perspective?

Back 25

1) The sociologist’s task of determining how and to what extent social factors contribute to, modify, or mediate the risk, course, and outcomes of psychiatric disorders is arguably easier when biological factors are better defined and measured.
2) The medical model’s classification of persons with mental illness as having a disease or disorder places an obligation on society to care for those persons, and an obligation on persons with the illness to accept the privileges and constraints of such care.

Front 26

What are two problems with the DSM’s phenomenological approach?

Back 26

1) Lack of correspondence between objective and subjective measures
2) The distinction between “mental” and “physical” conditions

Front 27

What are the nine types of anxiety disorder?

Back 27

• (1) Panic disorder without agoraphobia
• (2) Panic disorder with agoraphobia
• (3) Agoraphobia without history of panic
• (4) Specific phobia
• (5) Social phobia
• (6) Obsessive-compulsive disorder
• (7) Posttraumatic stress disorder
• (8) Acute stress disorder
• (9) Generalized anxiety disorder

Front 28

What is the prevalence of attention deficit hyperactivity disorder (ADHD)?

Back 28

3-5%

Front 29

How many states had public institutions for the insane by 1860?

Back 29

28 of the 44 states

Front 30

Who was Dorothea Dix?

Back 30

most energetic and famous figure in the moral treatment movement of the belief in the curative powers of the asylum.
She reported in painful detail on the wretched condition of the insane in poorhouses and jails.

Front 31

What are three components of the program on moral treatment?

Back 31

o 1) The institution would arrange and administer a disciplined routine that would curb uncontrolled impulses without cruelty or unnecessary punishment
o 2) The institution would recreate fixity and stability to compensate for the irregularities of the society.
o 3) Thus, the institution would rehabilitate the casualties of the system

Front 32

Who was Thomas Kirkbride? What book did he publish?

Back 32

head of the prestigious Pennsylvania Hospital for the Insane from 1840 until his death in 1883

one of the leading textbooks on insanity, “On the Construction, Organization, and General Arrangements of Hospitals for the Insane, with some Remarks on Insanity and Its Treatment”

Front 33

What were the three postulates of the asylum program?

Back 33

1) prompt removal of the insane from the community. As soon as the first symptom of the disease appeared, the patient had to enter a mental hospital.
2) the institution itself, like the patients, was to be separate from the community. It was to be built at a distance from centers of population.
3) most important element in the new program, the core of moral treatment, which lay in the daily government of the mentally ill. The institution’s most difficult and critical task was that the institution had to control the patient without irritating him, to impose order but in a humane fashion. It had to bring discipline to bear but not harshly, to introduce regularity into chaotic lives without exciting frenetic reactions.

Front 34

What hospital led the way in regards to the procedures used for the patient’s daily schedule?

Back 34

• The Pennsylvania Hospital for the Insane

Front 35

What was the ratio of attendants to patients in the early asylum?

Back 35

• Pennsylvania Hospital—1 attendant for every 6 inmates
• New York’s Bloomingdale Asylum—1 attendant for every 7 inmates
• Boston’s McLean Hospital—1 attendant for every 4 or 5 inmates or patients
• Utica Asylum—1 attendant for every 15 patients

Front 36

When was The AVMH and Illness study conducted? Who conducted this study?

Back 36

Original AVMH (Americans View Their Mental Health) and Illness study was conducted in 1957 (and again in 1976) by Gerald Gurin, Joseph Veroff, and Sheila Feld to assess the subjective mental health of "normal" American adults and to determine in detail how they coped with problems of adjustment.

Front 37

What three factors are believed to play an important role in lack of treatment-seeking?

Back 37

o 1) Lack of knowledge about mental illness
o 2) Stigma of mental illness
o 3) Ignorance about effective treatments

Front 38

What percentage of Americans say mental illness is defined as psychosis, in 1950 and 1996?

Back 38

• In 1950, 40.7% of Americans say mental illness is defined as psychosis.
• In 1996, 34.9% of Americans say mental illness is defined as psychosis.

Front 39

What percentage of Americans say mental illness is defined as depression, in 1950 and 1996?

Back 39

• In 1950, 48.7% of Americans say mental illness is defined as depression.
• In 1996, 34.3% of Americans say mental illness is defined as depression.

Front 40

What percentage of Americans know someone who has been hospitalized due to a mental health problem? What percentage knows relatives, friends, etc…?

Back 40

• Half (50.2%) of all Americans know someone who has been hospitalized due to a mental health problem.
• Roughly a quarter of respondents indicated that the hospitalized person was a member of their immediate family, another relative, or a close friend.
o Immediate family—25.3%, Other relative—27.2%, Close Friend—26.9%

Front 41

What percentage of Americans’ definitions of mental illness included those who were violent, dangerous, or frightening in 1950? In 1996?

Back 41

• In 1950, 7.2% of Americans’ definitions of mental illness included those who were violent, dangerous, or frightening.
• In 1996, 12.1% of Americans’ definitions of mental illness included those who were violent, dangerous, or frightening.

Front 42

Rosenhan: describe the sample; what were their instructions; what was duration of stay (shortest to longest)?; what was the final diagnosis; what was the conclusion of the study?

Back 42

8 pseudopatients
Instructed to gain admission to 12 psychiatric hospitals by claiming to “hear voices” saying “empty” “hollow” “thud”
Duration of their stay was 7-52 days (average stay = 19 days)
oAll were eventually released after their stay in hospital (but diagnosed as “schizophrenia in remission”; Type 2 error: false positive)
35/118 patients said they knew they were faking!
Final diagnosis of the sample - “schizophrenia in remission”
Conclusion: Too easy to gain admission into hospitals. The physicians had admitted false positives (people who were given diagnosis of schizophrenic but really were not). The study was conducted again later on, but this time Rosenhan told physicians he would be sending in a pseudo patient. Physicians had identified ~40 potential pseudo patients, but in fact Rosenhan had not sent a pseudo patient like he said he would.

Front 43

Two pros of DSM?

Back 43

o Provides a common language for psychiatrists
o Uses standard classification criteria

Front 44

Two cons of DSM?

Back 44

o No clear definition of mental illness (no consensus)
o Labels lead to stigma (work, housing) myths

Front 45

What are two differences between the early versions of the DSM (DSM-I-DSM-II) and later versions (DSM-III and beyond)?

Back 45

• Early versions of the DSM—Dimensional assessment
• Later versions of the DSM—Categories of Illness

Front 46

Regarding the AVMH: what were three characteristics of the MacArthur Module?

Back 46

o 1) Used a case or vignette describing a person who met clinical diagnosis of either schizophrenia, major depression, alcohol dependence, or drug dependence
o 2) Core of items used to mark changes in the public’s understanding, experiences of, and responses to mental health problems and issues over a 40 year period [N=1,444]
o 3) These ideas, background work and coding were developed by members of the Indiana Consortium for Mental Health Services Research (IUB)

Front 47

Perceived cause of mental illness in India?

Back 47

Possessed by devil/demons/supernatural entity; believe the devil has taken over and is possessed by an evil spirit; believe people in the shrines can heal; Supported by the family; treatment in hospital, one person in the family stays with the patient

Front 48

Perceived cause of mental illness in Italy?

Back 48

battle between the forces of good and evil; relationship between religion and health; worst patients were taken away to protect people; open door policy, more accepting/open about the disease; drugs are given but in better conditions

Front 49

Perceived cause of mental illness in New York?

Back 49

mental illness is thought of as a medical problem (biological, neurological, genetic…); believe something is wrong with one’s internal body or mind; use of group talks

Front 50

What are at least three symptoms of schizophrenia exhibited by those featured in this film?

Back 50

Paranoia, delusions, hallucinations, mood fluctuations, hearing voices, flat affect, withdrawn

Front 51

What percentage of adults is diagnosed with schizophrenia?

Back 51

1% worldwide

Front 52

What is the Revolving Door Syndrome?

Back 52

refers to repeatedly releasing and readmitting patients into institution