-genetics

-neuroanatomy

-neurochemistry

-clinical/descriptive methods

-degeneration

-evolution

-eugenics

-idea that genetic disorders get worse as they pass through generations

-criminality

-sexual perversion

-mental illness

 (proposed by Morel)

-stigmatized the mentally ill and created fear and loath of psychiatrists (early roots of antipsychiatry)

-people would be reluctant to get themselves or a fmaily member diagnosed (didn't want the label)

-society 

-species

-individual

-gene (elemental unit of selection) 

-social Darwinism (spencer) 

societal level of selection

-altruism

-effect that you have on promoting copies of your genes in other individuals including those who are not your offspring

1. we are machines created by genes for purpose of propagating genes

2. human species are not immutable

3. course of human evolution is alterable through human intervention

Eugenics

-who

-book

-what it was (4)

-Sir Francis Galton

-hereditary genius

-eminent men have eminent offspring

-eugenics="well born"

-advocated government control of human breeding

-mental measurement

positive eugenics

-AES hold "fitter families" contest w/ $500 for best eugenics sermon

negative eugenics

-limit social support of needy, segregation of mentally ill by confinement, marriage prohibition & sterilization

-twin studies

-give heritability estimates- variance in a phenotype that is explained by genetic variation (population characterstic not trait)

-does NOT imply the phenotype is fixed

-fit in well with 1900 America

-immigrants that were bad were reproducing a lot but rich weren't ("race suicide"

-worked with John D Rockefeller

-established eugenics record office

-hired people to go around the US and identify "bad stock"

worked with George Eastman

-established American Eugenics Society

-Indiana 1907

-30 states in next 2 decates

-1927 upheld by supreme court 8 to 1

-Buck vs. Bell 

Carrie buck deemed mentally ill (controversial) was a housekeeper raped by a boy

-state conspiracized to make her look mad

-judge (Holmes) decided to allow sterilization

-1925 Hitler (mein kampf) lauds eugenics

-1920s Rockefeller foundation gave $ to Germany for research on degenerative traits

-Psychiatrist Ernst Rudin was the leading architect of Nazy eugenics and racial theory

-1930s Germany passes sterilization laws and establishes Hereditary Health Courts 

Germany - mentalism (characteristics developed during the life could not be passed down) concurrent with fascism

Soviet- Lamarckism (characteristics developed during live could be passed down ) concurrent with socialism/communism (more importance on artistic ability)

-asylum psychiatry (hospitalization, isolation)

-university psychiatry

- teaching- psychiatry becomes a medical specialty

-research- medicine becomes applied experimental biology, uses bio to explain illness of all kinds

-Germans take the lead- culture, political structures

-after a person dies link their symptoms back to the pathology of the brain tissues

-principle method used by university psychiatrists

-dissertation was for MD and habilitation was for PhD, had to find something novel

-considered more important than the MD dissertation

-Credited with starting modern University psychiatry (1st biological psychiatry)

-Trained with Schonlein 

-Established psychiatric department at Charite Hospital in Berlin (clinic in a teaching department, integrated with other disciplines, teaching and research mission)

-advocated mental illnesswere due to nerves/brain

-Founded Archive for Psychiatry and Nervous Diseases

-pioneering studies on cerebral localization

-differences in myelination using clinical-pathology method

-electrical brain stimulation (motor cortex stimulation moves limbs)

-1st biological psychiatry

-Histology-looking for abnormalities in sliced up brains of mentally ill to find cause of illness in microscopic study

-physician who specialized in neropathology

-little interest in therapy (Nilism- no good treatment of mental illness) 

-"the graveyard of neuropathologists"

-discovered important things but did not find the cause of psychosis

-Alzheimer's Disease (Alzheimer)

-Neurosyphilis (Bayle)- meninges are inflamed

-Wernicke's aphasia (Wernicke)

-ALS (Charlot)

-clinical/descriptive method (not about finding underlying cause but instead clasifying them)

-most important person in psychiatry

-still incorporated some bio (Shorter was wrong)

-MD then studied neuropathology in Leipzig under Flechsig but it didn't work out

-studied under Wundt

-rest of the career in clinical psychiatry

-retired as head of research institute of psychiatry in munich

Kraepelin

-using drugs to understand brain function

NOT psychopharmacology which uses drugs to alter psych

Kraepelin 

-got life info and followed patients after treatment (huge database w/ notecards)

-used course and outcome as basis for classification

psychic processes of degeneration overarching category

Functional psychosis into two groups (manic-depressive and dementia praecox)

Subtypes of dementa preaecox-catatnoic, paranoid, hebephrenic

-diagnosed based on onset and course (prognosis)

-described 2 onset patterns of schizophrenia

-later in life and got better was reactive schizophrnia

-and dementai preacox

-coined term schizophrenia

-psych processes (be sad but appear happy) 

talked about importance of course of disorder

-anticipated kraepelin

-found demence precoce

-anticipated kraepelin

advocated clinical descriptive method

-introduced symptom complexes (syndrome) to defined disorders

-described hebephrenia

-anticipated kraepelin

-elaboration of hebephrenia

-developmental onset, progressive course

-anticipated kraepelin

-worked with baillarger

-circular insanity (cycled between mania and depression) 

-anticipated Kraepelin

-put all of info into a comprehensive tb

-functional psychoses consists of 2 types (dementa praecox and manic-depressive) 

-types are differentiated by course

-mental illness is best understood w/ longitudinal study of lots of cases

-put schizophrenia and bipolar at center of psychiatry 

George Cheyne

-all about spleen vapours ans spirits

-anxiety

-neurotic depression

-OCD

-Hysteria (women, unteris) & hypochondria (male)

-general practitioners and spa doctors

-then switched to neurologists

-linked neuropathology to clinical symptoms in multiple sclerosis

-described ALS

-pioneered study of hysteria and use of hypnosis (best known for this)

Rest cure (used for neurasthenia)

-seclusion and bed rest

-milk diet

-electrical stimulation

-massage

-suggested psychological etiology of disorders

-hypnotism and rest cure were effective psych tx

-lead to development of systematic psych theories and therapy (patient/client relationship, improvement)

-received MD
-residenty in neurology w/ Meynert

-studied hysteria w/ Charcot

-opened neurology practice in Vienna (talk about Charcot that was taken badly)

-worked with Breuer 

-Breuer and freud published "Studies on Hysteria" including Anna O. 

-introduced cathartic method, talking cure, and free associations

-insight therapy 

• Freud's lecture at clark 
• Brille found 1st psychoanalytic society in America
• societies started training institutes
• American psychoanalytic association (APsaA became federation of societies and requires psychiatric residency
• immigration of psyychoanalysts from europe
• take over department chairs
• takes over American psychiatric association
• power disproportionate to numbers

-improvement of doctor/patient relationship

-expansion of psychiatry's domain (out of asylums to offices with a new population

-appeal to the dysphoric middle and upper class (jews) 

-holocaust

-popular movement (media) 

-disbelief (poor face validity)

-pseudoscience

-ineffective in psychosis and asylum medicine

-questionable efficacy in neuroses (resistant to research) 

-rise of psychopharmacology