Test one: Chapters 1,3,191/22/14I. Preparatory RemarksBiogenic-psychogenic dichotomy (two different theories that say what caused the disorders)Biological disorders (Alzheimer’s)Psychogenic: anxietyProblems of DiagnosisFred McKinney-Sara J.Fred-Health-Clinic University of Missouri (12 in 12 years)Sara- 4 in one morningOpinionsADHD/BipolarOver diagnosedTwo options (Annie M.)Runner (hip replacement)Too often eye of the beholderHuman errorDo we need diagnostic system at all?RESPONSIBLEIRRESPONSIBLEICD 4 (international classification of disorders)II. Statistics of Diagnosis Disorders (DSM I-V)1952:601968: 150 (by these last two, being gay was a disorder)1980: 250wanted to revoke the fact gay was a disorder (1975)1987: 300+1994: 400+2013: 400+III. DSM V:Obsessive compulsive & related disorders:OCDHoardingBody Dysmorphic DisorderPeople don’t feel like their body is in synch with rest of their beingTrichotillomaniaPeople who pull their hair outSkin Picking DisorderPedophilia is now “Pedohebephilic disorder”“Major Neurocognitive disorder” replaces: DementiaIV. State Tax- Supported treatment programs1965 Texas department of health2004 Texas Department of mental health and mental retardation (TDMHMR)Now, DSH/DADS serves 254 Texas countiesDSH- mental illnessDADs- ageing and disability services, mental retardation10 mental health hospitals13 State supported living centers88yh41 community mental health/mental retardation centerskeeping people out of mental hospitalstaking care of them when they’re releasedmexia (meh-hay-uh)V. Mental Health ProfessionalsPsychiatristsMD degree, began 1840, 35,000, median age: 52, 75% male 75%whitePsychologistsPHD/PSYD/EDD, began late 1940’s. around 70,000 currently, median age:48, 23% male, 77% female, clinical/counseling/schoolEDD is old an outdated programAPA Approval255 programs in US190 clinical65 counselingAcceptance rates, PHD programsClinical 6%Counseling 8%PSYD programs 17%Clinical psychology training modelsBoulderScientists-practitioner modelScientists first, practitioner nextVailScholar-professional modelVI. Licensure as PsychologistsMid-1960’s study led to licensure50 states USA10 Provinces CanadaTexas state board examiners psychologistsPreston Smith VignetteMy experienceSun setting in FloridaComplaints to boardTexas State Board of Examiners of PsychologistsTSBEP.. administer exams, ethics, complaintsNo specialty licensure in TexasVII. LPC Licensed Professional CounselorTitle varies by stateLPC in TXLMHC used in other statesNCC Certification good credentialRequirements48 hours masters program100 hours face to face client contact3000 post-masters hours of supervisionfull time employment18 months minimumPass state licensure examLPA Licensed psychological associateTSBEP RegulatedMinimum 42-hour masters in psychologyPass state licensure examination (55%)450 Hours of direct supervisionReciprocityClinical psychologists: deals with more serious problemsCounseling psychologist: everyday problems that we’re all susceptible toLMT: (licensed marriage and family therapist)MS/MA/Doctorate required3,000 hours supervisionPass national examinationForensic psychologistRelatively new specialtyPopularized by FBI profiling2000 Members of psychology-law society13 PHD programs, 3 MS/MA programsSam Houston PHD programCh. 19: predicting dangerousnessPrescribing PsychologistsDOD pilot program instituted 198910 clinical psychologists1997 Follow-up, 7 still prescribingLegal two statesNew MexicoLouisiana300-hour training program (APA)NeurosciencesPharmacology & PsychopharmacologyPhysiology & PathophysiologyPhysical & laboratory assessmentClinical pharmacotherapeuticsChapter 3 in readings: Models of AbnormalityPsychodynamicOldest model, emphasizes underlying dynamic forces, Sigmund Freud was the founderBasic PostulatesPeople are basically bad, and if left to ourselves- self destructive…society keeps us from thatBehavior is determined- our adult behavior is locked in by our childhood experiences… Childhood is a blackmailer on our adult lives according to FreudIntrapsychic as opposed to interpersonalFreud continued:Trained as neurologists, MD degree… “Psychology is my tyrant”Hippocrates’ wondering uterusIf you get her pregnant she will no longer be troubleViews of religionCatholic, persecution of Jews: saw these as the two greatest enslaver of the human mindId, Ego, SuperegoPsyche… internal war to take over your personality and this where your problems come from. (Not external).Id: biological things: sex, aggression. [James Bond…what he doesn’t seduce, he shoots.]Ego: handles disputes between superego and ID, develops from experienceSuperego: sense of wrong, conscious…situationalEros & ThanatosEros: wish to live… we lift cars off ourselves if neededThanatos: wish to die, illegal drugs, alcoholBehavioralNeitherDeterminedFail to learn something that helps us adjust, or we overlearn something that is harmful to usHumanistic-existentialGood/freeCognitiveBiologicalSocioculturalLittle Albert (John Watson)John Watson was the “Father of American Behaviorism”PHD University of ChicagoLittle Albert 19209 months old, classically conditioned fearwhite rat & loud soundWith discovery of syphilis , tried to move away from demonology and get a reason behind mental illness…how do people become emotionally disturbed?Malaria-Induced Fever (1917)Treating mental illness with malariaFever and so on would get demons to go awayInsulin-induced coma (1927)Go into seizure state and purge the demonsInject glucose to get them into normalityMetrazol-Induced Come (1934)“biological antagonism”developed notion that using these treatments, we can make demons go away by making this system… what demon would want to be in an organism with these diseases in them?42% spinal fracturesElectro-convulsive shock (therapy) ECT (1937)Nominated for Nobel prizeWide spread useConsent, anesthetic, muscle relaxant, 800 milliamps, several hundred watts, 1-6 seconds, 3 times a week, 6-12 treatmentsTX ages 16-97, 1500 annually donePsychosurgery by Moniz“Ice pick therapy”LobotomyInfamous Dr. Walter FreemanKitchen ice pick3500 lobotomies in 23 statesOne in each hand, hotel rooms, the lobtomobileRosemary KennedyPsychotropic (Neuroleptic medications)Major tranquilizers (anti psychotics)First GenerationThorazine (Thor, God of thunder)StelazineMaellarilHaldolProlixinInjection… cant trade or sell pills now30 days or soHelping live in a house, keeping them out of a mental hospital