Category: Abnormal Psychology

Posts specifically targeted toward my Abnormal Psychology courses.

Inside Venezuela’s Crumbling Mental Hospitals

The state-run El Pampero Hospital in Venezuela has almost no drugs left for its tormented patients, let alone food and clothing, amid the nation’s economic crisis.

The New York Times has an excellent photo spread illustrating the horrific conditions in Venezuela’s mental “health” system.

In the beginning of the semester, we talked about the horrible conditions in asylums from the middle ages until the advent of the moral therapy movement. Things were still pretty bad until the development of psychotropic drugs that could treat the symptoms of mental illness.

Because Venezuela’s national economy is in the dumps, medication is not purchased for the hospital and the patients are floridly symptomatic. It is truly a nightmare, and a good reminder of how far we have come in treating mental illness.

The worst part is:

The Venezuelan government denies that its public hospitals are suffering from shortages, and has refused multiple offers of international medical aid.

Source: Inside Venezuela’s Crumbling Mental Hospitals

Depression Is Poorly Diagnosed and Often Goes Untreated – The New York Times

One of the topics discussed in our Abnormal Psychology class is the merits of general physicians (as opposed to psychiatrists) prescribing psychoactive drugs for psychological disorders.

The NY Times has a good summary of results from a national survey that confirms the prevalence of depression in the general population, but also the low rates of treatment. Conversely, general physicians are treating individuals for depression with antidepressant drugs without administering the simplest of screening measures.

This calls for greater education of physicians about the inpirtance of using the screening before going straight to medication. On the other hand, physicians have incentives to use medication immediately: potential malpractice if the patient does have the disorder and the physician did not treat it, and simply the negative social (and business) implications of refusing to treat a person who insists. It is a complicated issue.

About 8.4 percent of the people interviewed had depression. But of those, only 28.7 percent had received any treatment. At the same time, of those who were treated for depression, only 29.9 percent had screened positive for the disorder. Many people with less serious psychological problems were being treated with antidepressants and other psychiatric medicines.

Source: Depression Is Poorly Diagnosed and Often Goes Untreated – The New York Times

Mentally ill inmate who spent 1,001 days in solitary confinement now feels alone outside

The Miami Herald has an interesting article about one recently released inmate who spent nearly his entire three year term in solitary. Worse yet, he had mental illnesses that were exacerbated by solitary.

In Abnormal Psychology we were discussing the effects of deinstitutionalization and the shift to community care, but the lack of community care shifting mental illness to the streets. Another big location that people with mental illness wind up is prison. The article makes the point that community mental health services are underfunded and lacking. We see the cost here.

Devon Davis was one of more than 2,000 North Carolina inmates released each year after being imprisoned with a mental illness. He is one of hundreds released directly from solitary confinement within a state prison. They emerge from a cell roughly the size of a parking space into a world they sometimes know little about.

Source: Mentally ill inmate who spent 1,001 days in solitary confinement now feels alone outside | Miami Herald

Psychology Of A Pedophile

Later in Abnormal Psychology we will be studying Sexual Disorders. One such disorder is generally known as paraphilias, disorders that are characterized by the preference for atypical sexual practices, but most importantly practices or desires that the person is distressed by or that cause harm to another or involve unwilling partners or those who cannot give consent. One such paraphilia is pedophilic disorder. There’s an interesting article in IFL Science on pedophiles that covers the behaviors, causes, and implications.

One of the points made in the article is that 90% of sexual abuse of minors is by someone known to the victim. This statistic made me think of the current moral panic over transgender individuals using the bathroom of their gender identity. A main argument made by the Texas attorney general is that some pedophile might switch gender identity for a day to gain access to children in bathrooms. Specifically, he claimed non-discrimination would set up a situation that would allow “men to have open access to girls in bathrooms.”

Unfortunately his argument is specious, since it involves public schools, which already have policies in place to prevent people from entering the grounds that do not have legitimate business there. So, a pedophile would not be able to walk off the street and into a girls bathroom without breaking the law.

While I can appreciate the horror that any parent will feel thinking that their child could possibly be abused by a stranger in a bathroom, I believe the resources of the state of Texas and the other states joining the lawsuit would be better spent on identifying children at risk for actual abuse in their own homes or by someone they know, and preventing that abuse, or funding treatment, rather than to propose a lawsuit framed by worry about a hypothetical abuse that is statistically much much less likely.

Furthermore, the health and productivity cost to transgender people caused by discrimination is real, not hypothetical. Rates of anxiety, depression, suicide, and substance use are much higher (also see this abstract) in transgender people, compared to non-transgender individuals, and it is exacerbated discrimination, and the identity conflict that discrimination sets up.

Why would we want to create policies and laws that limit the potential of anyone to live a full, happy life, and that might contribute to their depression, substance use, and suicide? Oh right, it’s an election year.

Having worked with police forces in Australia and the United Kingdom identifying those who sexually prey on children, people are always asking me how you can tell a paedophile from everyone else. Well, I can tell you one thing – they don’t have horns and tails. They look and act like you and me. Except for one key difference: they’re sexually attracted to children. What Is A Paedophile?

Source: Psychology Of A Paedophile: Why Are Some People Attracted To Children? | IFLScience

Promise derailed

picThe Washington Post has a profile of a star athlete who was bound for the WNBA, until schizophrenia took her off course. It is a striking profile, and well illustrates the potential for stress to sometimes trigger the emergence of this disorder.

Link to the article: How one of the nation’s most promising basketball players became homeless – The Washington Post.

Weight stigma negatively impacts mental and physical health

We talked about weight stigma in General Psychology a week or so ago. A good article in the NY Times illustrates the depth of the problem. A new study by a social psychology graduate student, Jeffrey Hunger, at UC Santa Barbara finds:

those who were overweight or obese were more likely to report problems like depression, anxiety, substance abuse and low self-esteem if they had experienced weight-based discrimination in the past.

It also includes a quote from a professor of popular culture, Courtney Bailey:

fat stigma intensified after 9/11, when Americans’ sense of vulnerability translated into increased animosity toward the fat body

This echoes some research we did in Mark Shcaller’s lab at UBC where it was found that perceived vulnerability to disease was correlated with anti-fat prejudice.

Link to the article: Is Fat Stigma Making Us Miserable? – The New York Times.

Making sure we consider the biopsychosocial model

The NY Times has a good Op-Ed piece by George Makari on the problem of mental health being reduced to biological processes. It argues that we need to be careful to not dismiss the power of psychological and social factors in mental health and illness. This is the “biopsychosocial” model I refer to frequently in class. He uses the 2015 study by Kane, et al. that I presented in class as an example of the strength of a multi-modal understanding of mental illness and treatment. He also lambasts the NIH for making new rules that require grants to include biomarkers and neurological circuit investigations in future researcn.

clinical pragmatism has seriously declined in the United States, as psychiatry has veered toward pharmacology

Link to the article: Psychiatry’s Mind-Brain Problem – The New York Times.

Justice and Bias, Mental Health and Poverty, Oh My!

Two recent opinion pieces provide some interesting perspective on topics we have discussed recently in Social Psychology class: implicit bias and social drift. Implicit bias is the ways we are influenced to judge other people based on baises we are completely unaware of. It has influence in many areas of law and decision making from police shootings to suspect lineups to jury and judge decisions. Adam Benforado is a law professor at Drexel University:

With the aid of psychology, we see there’s a whole host of seemingly extraneous forces influencing behavior and producing systematic distortions. But they remain hidden because they don’t fit into our familiar legal narratives.

via Flawed Humans, Flawed Justice – NYTimes.com.

We also talked about social drift in Abnormal Psychology. Nicholas Christof has an excellent opinion piece summarizing a lot of research on the relationships between poverty and mental health (among other health problems):

If you’re battling mental health problems, or grow up with traumas like domestic violence (or seeing your brother shot dead), you’re more likely to have trouble in school, to self-medicate with drugs or alcohol, to have trouble in relationships.“There’s a strong association between poverty and low mental health,” notes Johannes Haushofer, a psychologist at Princeton University.

A second line of research has shown that economic stress robs us of cognitive bandwidth. Worrying about bills, food or other problems, leaves less capacity to think ahead or to exert self-discipline. So, poverty imposes a mental tax.

via It’s Not Just About Bad Choices – NYTimes.com.

Psychoanalysis and therapy

In Abnormal Psychology this week, we will be discussing psychotherapy. The NY Times has an opinion piece on the process of psychotherapy from the point of view of a patient. He suddenly and without warning has suicidal ideations and obsessive thoughts about hurting his children. His story is about the power of psychoanalysis. Also note that he is a very active participant in his therapy, which is important for successfully navigating the morass of emotions and memories that come to play in abnormal behavior.

I talked with increasing freedom and trust about anything and everything — dreams, memories, doubts, fears — and about matters that had been hiding in closed rooms of my mind.

Link to the article: Psychotherapy as a Kind of Art – NYTimes.com.

The importance of the biopsychosocial approach to understanding mental illness

In Abnormal Psychology yesterday, we discussed the film Back From Madness, which we watched as a class. One topic raised by a student was how important social support was for the recovery of people in the film.

There is a general misconception (perhaps promoted by pharmaceutical companies) that treating mental illness involves merely “fixing” the neurochemistry or brain circuitry that is responsible for the mental illness. As we will see in class, the diagnosis and treatment of mental illness is much more complex.

An Op-Ed in the Sunday Times Magazine questions the categorization of people with mental illness as simply having an underlying neurochemical imbalance. It calls for a more nuanced notion of mental illness:

The implications are that social experience plays a significant role in who becomes mentally ill, when they fall ill and how their illness unfolds. We should view illness as caused not only by brain deficits but also by abuse, deprivation and inequality, which alter the way brains behave. Illness thus requires social interventions, not just pharmacological ones.

I agree, and always point out that diagnosis and treatment should always proceed from the biopsychosocial (emphasis intentional) perspective—that although the individual’s biology plays a part in predisposing a person to illness, individual construal processes and social systems are very (perhaps more) important in diagnosing and treating psychological disorders.

Link to the article: Redefining Mental Illness – NYTimes.com.