University of Toronto - PSY 240

CHAPTER 1

Concepts of Abnormality throughout History

1)Your housemate has been overly concerned with keeping the kitchen clean. In fact, he scrubs the sinks and counters for half an hour each time someone puts something on them. In order to determine his diagnosis, a practitioner in North America would be most likely to consult the

1. American Medical Association's Treatment Manual (AMA-TM).
2. Diagnostic and Statistical Manual, fourth edition (DSM-IV-TR).
3. International Classification of Mental and Behavioural Disorders (ICD-10).
4. Diagnostic and Statistical Manual, sixth edition (DSM-VI).
5. The North American Guide to Psychiatric Disorders (NAPD-IV).

1. Psychopathology refers to

1. the same disorder as psychopathy.
2. disorders of the brain.
3. a physical cause to psychological problems.
4. only severe psychological disorders.
5. the study of the nature of psychological problems.

2. What is one difficulty in defining abnormal behaviour?

1. eccentric behaviour usually indicates abnormal behaviour
2. everyone is to some degree abnormal in their behaviour
3. unusual behaviour may not be abnormal according to diagnostic criteria
4. all people experience anxiety now and then
5. people's behaviour depends on the situation

3. Abnormal behaviour has been defined as that which occurs infrequently. Which of the following examples illustrates a problem with this definition?

1. People with IQs below 70 are considered abnormal.
2. Most people get depressed from time to time.
3. Mathematical geniuses are considered rare in the population.
4. Children often believe in the existence of monsters.

5. Anxiety disorders are relatively rare in a given population.

4. Dr. Jayvonna is working with a patient who has to arrange and rearrange her food on her plate after each bite. Although her patient does not find this behaviour strange, other people find it odd. The definition of abnormality applicable to this patient is

1. statistically unusual behaviour.
2. violating the norms of society.
3. distress to self and others.
4. personal dysfunction.
5. expert diagnosis

5. Perhaps the biggest problem with using inappropriate behaviour as a criterion for abnormal behaviour is

1. what is considered appropriate differs over time and location.
2. mentally ill people are usually not dangerous.
3. social norms tend to be constant over time.
4. inappropriate behaviour is often the norm in North American culture.
5. killers and murderers are generally sane.

6. Which one of the following groups of principles have been used to define abnormality?

1. diagnosis by an expert, personal distress, poor emotional control
2. personal distress, delinquent activity, poor emotional control
3. violation of norms, abnormal intellectual functioning, personal distress
4. infrequency, personal distress, impaired functioning
5. psychiatric diagnosis, harmful dysfunction, abnormal intellectual functioning

7. Changes in the way that abnormality has been viewed over time has resulted in

1. a clear understanding of the etiology of disorders.
2. effective treatments for all disorders.
3. fewer diagnostic categories.

4. high reliability of all diagnoses.
5. a shift from supernatural to natural causes in explaining disorders.

8. If you lived in a society that explained changes in the weather as being influenced by the gods, you would likely view madness as being caused by

1. schizophrenia.
2. demon possession.
3. brain dysfunction.
4. weakness of character.
5. irrational thoughts.

9. What type of treatment was thought to be used by Stone Age people to treat madness?
   1. religious chanting
   2. death
   3. herbal brews to poison evil spirits
   4. trephination
   5. exorcism

10. Several methods were used during prehistoric times to treat abnormal behaviour. Which approach, however, was NOT common?
    1. trephination
    2. bedrest
    3. induced trances
    4. special care in asylums
    5. magic

11. To whom can we credit with the original idea that dreams play an important role in understanding mental illness?
    1. Freud
    2. Aristotle

1. 3. Plato
   4. Hippocrates
   5. Galen

12. Hippocrates played a major role in both how the causes and treatment of mental illness were viewed. However, his greatest contribution to psychology was
    1. being the father of psychoanalysis.
    2. proving the value of leading a healthy life in preventing madness.
    3. emphasizing the natural causes of mental illness.
    4. separating the causes of madness into medical and magical causes.
    5. his idea that psychological functioning resulted from disturbances of bodily fluids.

13. According to Hippocrates, mental disorders should be treated by which one of the following?
    1. exorcism
    2. magical spells
    3. trephination
    4. healthy diet and exercise
    5. food and water deprivation

14. Hippocrates believed that psychological functioning was influenced by imbalances in bodily fluids. Each of the following was considered an essential fluid EXCEPT
    1. blood.
    2. black bile.
    3. brown bile.
    4. green bile.
    5. phlegm.

15. An ancient Greek was behaving quite aggressively and was quite short-tempered. He would likely have been diagnosed as having

1. 1. too little yellow bile.
   2. an excess of blood.
   3. excess phlegm.
   4. too much yellow bile.
   5. an overabundance of black bile.

16. Plato and Aristotle accepted many of Hippocrate's ideas, but rejected others. Which of the following best describes their belief about the cause of mental illness?
    1. that an imbalance in essential bodily fluids affected functioning
    2. that brain dysfunction affected behaviour
    3. that environmental factors played the critical role
    4. lack of education could cause mental illness
    5. that mental illness had natural causes

17. The idea that both mental and physical disorders were caused by problems in the body was held by
    1. Soranus.
    2. Aristotle.
    3. Plato.
    4. the Greek physician Aretaeus.
    5. Hippocrates.

18. Jennifer is a psychotherapist, and she considers talking about problems to be therapeutic. Which of the following groups would most likely agree with her?
    1. early Egyptians
    2. Arabians
    3. classical Greek and Romans
    4. Europeans during the Middle Ages
    5. prehistoric people

19. Early Arabian asylums were established to
    1. protect society from the mentally ill.
    2. provide the mentally ill with a safe haven.
    3. begin the tradition of group therapy.
    4. reintroduce trephination as a major form of treatment.
    5. fulfill the requirements of the Koran.

20. Avicenna's The Canon of Medicine may have included early forms of which of the following modern methods of treatment?
    1. homeopathic treatment
    2. dream analysis
    3. behaviour therapy
    4. psychotherapy
    5. bloodletting

21. The notion of “possession” during the Middle Ages was often applied to
    1. people who disagreed with Church doctrine.
    2. people who sinned frequently.
    3. men who beat their wives.
    4. people who had suffered a nervous breakdown.
    5. people suffering from a mental illness.

22. During the 13th and 14th centuries, a women caught talking to her garden plants would
    1. be treated by either prayer or exorcism of demons.
    2. be treated with hypnotism.
    3. be treated using special herbs and potions.
    4. be accused of witchcraft and tortured to prevent her evil powers from spreading.
    5. be considered psychotic.

23. The spiritus vitae was
    1. a disorder where people begin to dance in the streets and drink red wines.
    2. a spirit believed to possess individuals and cause madness.
    3. a bodily fluid believed by Paracelsus to result in mental illness.
    4. a naturalistic cause of madness.
    5. the venom of the tarantula.

24. Your sister suddenly begins to leap about, jumping and dancing in the streets. During the Middle Ages, she would most likely be diagnosed with
    1. melancholia.
    2. trephination.
    3. the Tarantella.
    4. an excess of phlegm.
    5. spiritus vitae.

25. According to Paracelsus, St. Vitus' Dance was caused by
    1. tarantula bites.
    2. psychic conflicts.
    3. imbalances in bodily fluids.
    4. mania.
    5. possession by evil spirits.

26. Which of the following persons and treatments DO NOT match?
    1. Paracelsus and hypnotism
    2. Hippocrates and rest
    3. Galen and sympathetic listening
    4. Weyer and chanting
    5. Avicenna and behavior therapy

27. What do the views of Paracelsus, Teresa of Avila, and St. Vincent de Paul have in common?
    1. They all attempted to develop a new system of classification.
    2. They believed that religious approaches could lead to a cure.
    3. They established asylums to humanely care for the mad.
    4. They argue for a more naturalistic approach to viewing mental illness.
    5. Each of them contributed to Freud's system of psychoanalysis.

28. The term “bedlam” originated from
    1. a method of treatment used in early asylums.
    2. the lack of beds that was common in early asylums.
    3. the bizarre behaviour known as St. Vitus' dance.
    4. moments of frenzy among mad people.
    5. behaviour of the patients in deplorable early European asylums.

29. Early treatment of the mentally ill in the United States
    1. was more successful than many of the earlier treatments had been.
    2. was more humane than most of the approaches outside North America.
    3. was at times similar in cruelty to early supernatural treatments.
    4. differed from European treatment due to different societal values.
    5. was less successful than treatments introduced during the Middle Ages.

30. Treatment in the town of Gheel is similar to
    1. modern day treatment programs.
    2. a humanistic approach.
    3. a community treatment approach.
    4. that of the early Greeks.
    5. treatment advocated by many of the early Europeans.

31. English “workhouses” were
    1. established during the Enlightenment period to deal with the insane.
    2. run by the patients.
    3. run by physicians.
    4. were special places where the mentally ill could work.
    5. used to hide the poor from society.

32. Which of the following individuals is known for promoting a more humanitarian approach in mental hospitals?
    1. Benedict Morel
    2. Philippe Pinel
    3. St. Vincent de Paul
    4. Johannes Weyer
    5. Benjamin Rush

33. This individual's campaign to improve the conditions for the mentally ill resulted in the opening of 32 state hospitals, including two in Canada.
    1. Dorothea Dix
    2. Cabanis
    3. Benjamin Rush
    4. William Tuke
    5. Philippe Pinel

34. The mental hygiene movement
    1. resulted in a reduction in the number of people in institutions.
    2. resulted in an increase of patients in mental institutions.
    3. led to an increase in moral therapy.
    4. was criticized by Philippe Pinel.
    5. led to the advent of antipsychotic drugs.

35. All of the following are valid criticisms of the mental hygiene movement EXCEPT
    1. psychosocial treatments were less effective due to the large number of patients.
    2. physical treatments were often unpleasant.
    3. living conditions in the asylum were unpleasant.
    4. the original goals of the movement were less than nobel.
    5. overcrowding in asylums prevented proper care.

36. Moral therapy implies that
    1. psychological therapy should be administered by the Church.
    2. psychological therapy should be used more often.
    3. mentally ill patients can benefit from spiritual enlightenment.
    4. mentally ill patients need to be taught a moralistic approach to life.
    5. mentally ill patients can be treated without chemical or physical restraints.

37. Which of the following accomplishments are NOT attributed to Pinel?
    1. looking to natural explanations as the cause of mental illness
    2. clearly describing the symptoms of disorders
    3. emphasizing the role of psychological and social factors in the development of mental illness
    4. developing a systematic approach to classifying disorders
    5. bringing moral therapy to North America

38. Cabanis (1757-1808) introduced the idea that personal factors as well as somatic factors accounted for mental disorders. His theories encouraged the                                approach to treatment.
    1. physical
    2. social
    3. institutional
    4. psychological
    5. biological

39.                     introduced “degeneration” theory, which proposed that abnormal functioning was transmitted by hereditary processes.
    1. Pinel
    2. Cabanis
    3. Charles Darwin
    4. Cesare Lombroso
    5. Benedict Morel

40. Clinical Psychiatry, published by Kraepelin in 1883, was an important textbook because it
    1. introduced pioneering treatments for severe mental disorders.
    2. explained the causes of many common mental disorders.
    3. attempted to classify mental illnesses.
    4. joined together the professions of clinical psychology and psychiatry.
    5. described methods of treatment for psychiatric disorders.

41. Which of the following are classification systems of mental illness?
    1. CP-10
    2. GPI
    3. ECT
    4. WRS-R
    5. DSM-IV-TR

42. “All mental disorders are the result of biological problems.” Who would be most likely to agree with this statement?
    1. Breuer
    2. Kraepelin
    3. Pinel
    4. Freud
    5. Watson

43. Kraepelin's system of classification of mental illness
    1. did not influence later classification systems.
    2. suggested that psychological factors caused disorders.
    3. failed to recognize that certain groups of symptoms tended to occur together.
    4. recognized that different disorders were distinct.
    5. offered suggestions for treatment.

44. Groups of symptoms that tend to occur together are called
    1. biological.
    2. disabilities.
    3. categories.
    4. diatheses.
    5. syndromes.

45. Symptoms during the later stages of general paresis of the insane may show similarity to
    1. bipolar disorder.
    2. disorders such as Alzheimer's.
    3. antisocial personality disorder.
    4. autism.
    5. schizophrenia.

46. The germ theory of disease led to the idea that
    1. it was important to wash your hands after being with psychiatric patients.
    2. only biological treatments are beneficial for mental illness.
    3. heredity plays an important role in the transmission of mental disease.
    4. General Paresis of the Insane may be a consequence of syphilis.
    5. germs may cause anxiety.

47. Somatogenesis refers to
    1. a disorder where people feel their body is not theirs.
    2. the idea that mental disorders are caused by biological factors.
    3. somatization disorder.
    4. a method of treating general paresis.
    5. the idea that mental disorders are caused by psychological factors.

48. Insulin-induced comas were used by Sakel during the mid-20th century to treat
    1. schizophrenics.
    2. anxiety disorders.
    3. depression.
    4. diabetics.
    5. alcoholics.

49. ECT (electric shock therapy) proved to be most successful in treating
    1. epilepsy.
    2. anxiety.
    3. drug addiction.
    4. depression.
    5. schizophrenics.

50. Dr. Ramos treats patients suffering from mood disorders, and she believes that their illnesses are a result of imbalances of chemicals in the brain. She would most likely adhere to which field of psychology?
    1. psychopharmacology
    2. cognitive psychology
    3. psychoanalysis
    4. clinical psychology
    5. health psychology

51. Jason has been given Ritalin to control his hyperactive moods. He is receiving
    1. pharmacotherapy.
    2. palliative therapy.
    3. psychotherapy.
    4. psychosurgery.
    5. psychoanalysis.

52. Mesmer believed that hysteria was the result of
    1. a wandering uterus.
    2. disturbances in the distribution of magnetic fluids.
    3. imbalances in brain chemicals.
    4. too little of the neurotransmitter acetylcholine.
    5. animal magnetism.

53. You are one of Mesmer's assistants during the 1700s. Your treatment of choice for dealing with hysteria would be considered a predecessor of
    1. psychopharmacotherapy.
    2. hypnotism.
    3. spiritual healing.
    4. the cathartic method.
    5. psychotherapy.

54.                     believed that hypnotism was not valuable in treating hysterics.
    1. Braid
    2. Breuer
    3. Charcot
    4. Janet
    5. Watson

55. In the mid to late 1800s, several therapists became quite well known. Which of the following represents a correctly matched therapist and his treatment?
    1. Breuer & talk therapy
    2. Charcot & anesthesia therapy
    3. Mesmer & animal hypnosis
    4. Freud & sex therapy
    5. Watson & hypnotherapy

56. In writing an essay on behaviourism, you would be likely to include all of the following statements EXCEPT
    1. abnormal behaviour is learned.
    2. psychology must be restricted to observable behaviour.
    3. behavioural approaches produced a revolution in psychological thought.
    4. Watson acknowledged that abnormal behaviour was likely present at birth.
    5. behavioural approaches have become established in treatment of disorders.

57. Jonah is afraid of heights. Dr. Morlin employs an approach to deal with Jonah's phobia that involves having Jonah practice exposing himself to high places. This approach would best be viewed as
    1. psychopharmacological.
    2. behavioural.
    3. biological.
    4. cathartic.
    5. psychoanalytical.

58. The first asylum for the mentally ill established in Canada was
    1. Vancouver Psychiatric Hospital.
    2. Montreal's Allen Memorial Hospital.
    3. the Rockwood asylum in Kingston.

1. 4. the Hotel Dieu in Quebec.
   5. the Hotel Dieu in Calgary.

59. In which province of Canada was the development of proper places of care for the mentally ill during the early 17th century most accepted?
    1. Alberta
    2. Manitoba
    3. Quebec
    4. British Columbia
    5. Ontario

60. The first textbook printed in Canada dealing with the care and housing of the mentally ill
    1. encouraged patience and tolerance.
    2. suggested that the mentally ill be treated at home.
    3. reflected the moral therapy approach.
    4. recommended treating them with floggings.
    5. recommended drug therapy.

61. Lobotomies were widely used treatments in Canada during the mid-1940s. This treatment involved
    1. lesioning of the brain by electrodes.
    2. pharmacotherapy.
    3. disconnection of the frontal lobes of the brain.
    4. removal of the cerebellum.
    5. removal of the ovaries in women.

62. Montreal's Allen Memorial Hospital was
    1. the first place in Canada to use psychoanalysis.
    2. founded by Ewen Cameron.

1. 3. a place where the criminally insane were housed.
   4. the site of a research project funded by the CIA.
   5. a leading Canadian hospital in the treatment and care of psychiatric patients.

63. Cameron's experiments were problematic because
    1. he attempted to brainwash patients through various “treatments”.
    2. patients agreed to participate.
    3. he did not realize the CIA were involved.
    4. they received public approval.
    5. his patients were not troubled by the research.

64. Dr. Ruth Kajander can be noted for
    1. unique blend of drug and talk therapy with severely disordered patients.
    2. her role in the CIA-funded research in Montreal.
    3. recognizing the value of tranquillizers in treating depression.
    4. treating and reducing anxiety in patients prior to surgery.
    5. using chlorpromazine to treat schizophrenics.

65. Each of the following persons based in Canada contributed to both theory and treatment EXCEPT
    1. J. F. Lehman.
    2. Donald Meichenbaum.
    3. Albert Bandura.
    4. Ruth Kajander.
    5. Richard Walters.

66. Which of the following persons and accomplishments are INCORRECTLY matched?
    1. Breuer and hypnosis
    2. Meichenbaum and cognitive-behaviour therapy
    3. Bandura and social learning theory

1. 4. Kajander and depression
   5. Bandura and aggressive behaviour

67. Canadian psychologist Donald Meichenbaum's early work contributed significantly to the growth of     therapy.
    1. moral
    2. social-behaviour
    3. psychopharmalogical
    4. cognitive-behaviour
    5. social learning

68. According to the statistical concept, abnormal behaviour is that which occurs relatively infrequently.
    1. True
    2. False

69. Distress must be present in order for an individual to be diagnosed as suffering from a mental disorder.
    1. True
    2. False

70. Many mentally ill people are unpredictable and dangerous to themselves and others.
    1. True
    2. False

71. Thomas Szasz claimed that the labels used to describe mental disorders reflected ways of controlling individuals suffering problems in living.
    1. True
    2. False

72. Sigmund Freud has been called the father of modern medicine.
    1. True
    2. False

73. The bodily fluids believed to influence mental functioning were called humours.
    1. True
    2. False

74. The ancient physician Galen believed that mental disorders were entirely the result of physical causes.
    1. True
    2. False

75. The Arab world's approach to dealing with the mentally ill was that of compassion and humanity.
    1. True
    2. False

76. Galen wrote The Canon of Medicine, one of the most widely read medical books ever written.

77. Supernatural explanations of mental illness became popular in Europe during the Middle Ages.
    1. True
    2. False

78. In the Middle Ages it was generally believed that those who were insane were possessed.
    1. True
    2. False

79. Johannes Weyer rejected the four humours theory of mental illness and claimed that mental illness resulted from disturbances of the spiritus vitae.
    1. True
    2. False

80. Paracelsus believed that psychic conflicts may result in mental illness and treated patients using and early form of hypnotism.
    1. True
    2. False

81. The first mental institution in North America was built by the Moors at San Hippolyto in Mexico.
    1. True
    2. False

82. Teresa of Avila and St. Vincent de Paul influenced the development of a more scientific approach to treating mental illness.
    1. True
    2. False

83. During the 17th century in Europe, the trend was toward an increasingly more humane and rational approach to dealing with the mentally ill.
    1. True
    2. False

84. Philippe Pinel was responsible for bringing moral therapy to North America.
    1. True
    2. False

85. Mesmer's work with hysteria sparked an interest in psychological explanations of disorders.
    1. True
    2. False

86. The early efforts of Canadian provincial governments to care for the insane were characterized by an unsystematic approach.

1. 1. True
   2. False

87. Albert Bandura and Richard Walters were responsible for developing cognitive behavioural therapy.
    1. True
    2. False

88. Explanations for abnormal behaviour depend on various factors. Use several examples and describe some reasons why certain behaviours are or are not considered “abnormal.”

89. Briefly describe and critique the principles used to establish the criteria for abnormality. Which definition best defines the concept of abnormality?

90. Approaches to conceptualizing and treating abnormality have changed over time. Why is it valuable to be aware of the historical approaches to treating the mentally ill?

91. Compare and contrast the causes and treatment methods for madness used in Stone Age cultures and by the ancient Greeks and Romans and the Arabs.

92. Describe the contributions of two historical persons in Europe who influenced the theory and treatment of mental illness.

93. Despite its aims, the mental hygiene movement of the 19th century did not meet its goals. Describe the reasons for this movement, the instrumental figures responsible for this movement, and the reasons behind its lack of success.

94. Moral therapy was an important approach in the treatment of the mentally ill. Define the basis of this approach, describe the individuals responsible for promoting this approach, and why it lost popularity.

95. The growth of mental health services in Canada has been characterized by both positive and negative accomplishments. Describe two of the negative practices used and speculate on the importance of these events for modern practices.

96. Describe why the discovery that syphilis was the cause of general paresis was important to the modern view of mental illness.