The myths of mental illness
Download
1 / 33

The Myths of Mental Illness - PowerPoint PPT Presentation


  • 70 Views
  • Uploaded on

The Myths of Mental Illness. Chapter 4. What is Abnormal?. Judgments between normal and abnormal differ depending on time and culture…….a social construction “Medicalization of deviance” Judgments of abnormality based on 3 Ds Distressing to self or others

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about ' The Myths of Mental Illness' - rogan-franco


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript

What is abnormal
What is Abnormal?

Judgments between normal and abnormal differ depending on time and culture…….a social construction

“Medicalization of deviance”

Judgments of abnormality based on 3 Ds

Distressing to self or others

Dysfunctional for person or society

Deviant: violate social norms

Mental illness as a form of deviance and mental health as a form of conformity are difficult to define



Four categories of mental disorders
Four Categories of Mental Disorders

  • Most likely associated with violent, serious criminal or antisocial behaviour

    • Schizophrenic disorders

    • Personality disorders (PDs)

    • Mood disorders

    • Paranoid disorders


What is a psychopath
WHAT Is A Psychopath?

  • Defined as a personality disorder with a cluster of interpersonal, affective, & behavioural characteristics

    • Dominant, selfish, manipulative individuals who engage in impulsive and antisocial acts

    • Feel no remorse or shame for behaviour that often has a negative impact on others


Behavioural descriptions of a psychopath
BEHAVIOURAL DESCRIPTIONS of a PSYCHOPATH

Research by Cleckley & Hare

Outgoing, Charming, & Verbally fluent

Psychological testing – score higher on IQ tests

Not mentally disordered by traditional standards

Flat emotional reactions, inability to give affection, superficial emotions, impulsive, disregard for truth

Cardinal trait: lack of remorse or guilt; semantic aphasia

Not always criminals


The criminal psychopath
The Criminal Psychopath

  • Demonstrate wide range of serious repetitive crimes with violence

  • Motives:

    • Primarily instrumental (planned, motivated by external goal, revenge or retribution)


Psychological measures of psychopathy
Psychological Measures of Psychopathy

See generally www.hare.org (good articles )

Psychopathy Checklist (PCL)

http://www.minddisorders.com/Flu-Inv/Hare-Psychopathy-Checklist.html

Assesses: two behavioural dimensions; interpersonal and emotional components & socially deviant lifestyle

Score of 30 or above qualifies a person as a primary psychopath

See Focus 4.1 in text


Mental disorders among offenders
Mental Disorders Among Offenders

High rates among prisoners

More visible; more likely caught & plead guilty; revolving door

Prevalence Rates of Psychiatric Disorders in a Sample of Defendants (Bland et al., 1990)


Mental disorders among offenders1
Mental Disorders Among Offenders

  • Most no more dangerous (exceptions may be subset of population – male, history of violence & current illness; schizophrenia (paranoid); substance abuse plus schizophrenia problematic)

  • Frontline: The New Asylums

  • www.pbs.org/wgbh/pages/frontline/shows/asylums


Re offending and risk assessment
Re-Offending and Risk Assessment

Two components of primary concern:

Future criminal activity or violent acts (prediction component); danger to self or others

Development of strategies to manage or reduce risk level (management component)

Need for information that enable legal judgments, parole

Errors and biases in making predictions

Implications of errors varies – stakes may be high for individual or for society


Dangerousness and the assessment of risk
Dangerousness and the Assessment of Risk

  • Canada at forefront

  • Actuarial instruments v. structured professional judgment

  • Violence Risk Assessment Guide (VRAG)

  • Historical/Clinical/Risk Management scaled (HCR-20)

  • MacArthur Network research

  • Specific types of violence: spousal, sexual, workplace

  • Measured primarily actuarial in nature


Dangerousness and the assessment of risk1
Dangerousness and the Assessment of Risk

  • Charles Joseph Whitman

  • http://www.youtube.com/watch?v=n22pRAK9N2Q&feature=related

  • James Huberty

  • http://www.youtube.com/watch?v=PjpL8HfWiiY

  • Risk factors unique for each individual



Risk factors associated with violence committed by people with mental disorders
Risk Factors Associated with Violence Committed by People with Mental Disorders

History of violence

Personality factors

Active symptoms & clinical diagnosis

Failure to keep appts/take meds

Drugs and alcohol

Homelessness

Situational factors

Specific situations? Previous victimization?

High levels of anger & poor impulse control?

Hallucinations & delusions?

Deterioration

Social network, sense of belonging, easy access?

Substance use, lack of supports –increases risk

Specific to individual (past violence; crowding)


Mental disorder and criminal behaviour
Mental Disorder and Criminal Behaviour with Mental Disorders

  • Schizophrenia

    • Complex and poorly understood

    • Behavioural manifestations varied: severe breakdown in thought patterns

      • Delusions (false beliefs about the world)

      • Hallucinations (auditory most common)

    • Aggression & violence serious problems

    • Characteristic positive & negative symptoms

      • Crime as a response to positive symptoms?


Inducing the symptoms
Inducing the Symptoms with Mental Disorders

  • Symptoms can be provoked in “normal” people

    • Sleep deprivation

    • Sensory deprivation

    • Bereavement

    • Trauma

    • Solitary confinement


Think of a person with drug related psychosis would you consider them to be either

Dangerous to others with Mental Disorders

Unpredictable

Hard to talk to

Have only themselves to blame

Would improve if given treatment

Feel the way we all do at times

Will eventually recover fully

Could pull themselves together if they wanted to

Not dangerous to others

Predictable

Easy to talk to

Are not to blame for their condition

Would not improve if given treatment

Feel different from the way we all do at times

Will never recover fully

Can’t do anything to improve how they feel

Think of a person with drug-related psychosis. Would you consider them to be either:


The real story about schizophrenia
The real story about schizophrenia with Mental Disorders

  • www.youtube.com/watch?v=f4R6jln_eZg


The history of mental illness within the law
The History of Mental Illness within the Law with Mental Disorders

1800’s – idea of insanity – Criminal Lunatics Act - insane person not blamed because the person was not acting as themselves but overcome by uncontrollable urges or delusions

successful use of defence (not guilty by reason of insanity) resulted in acquittal and custody into an asylum


The history of mental illness within the law1
The History of Mental Illness within the Law with Mental Disorders

  • Flash-forward: Criminal Code in Canada

  • Basic idea behind defence did not change, changes made to terminology used, restrictions on time and some of the legal processes

    • Change ‘insanity’ to ‘mental disorder’ and provide more fair treatment (fitness hearing)

    • Change ‘NGRI’ to ‘Not Criminally Responsible’

    • Review boards created; dispositions with time line


Mental disorder and the law
Mental Disorder and the Law with Mental Disorders

Elements that must be present for criminal guilt:

Actus Reus = physical act of committing a crime

Mens Rea = mental intent to commit a crime

Controversy with mentally ill is they are incapable of having mens rea in some instances


Fitness to stand trial and criminal responsibility
Fitness to Stand Trial with Mental Disordersand Criminal Responsibility

Both fitness and CR are concerned with mental status

CR is concerned with mental status at the time of the crime

Fitness is concerned with the mental status at the time of the trial

Fitness assessment must precede judgment of criminal responsibility


Fitness to stand trial
Fitness to Stand Trial with Mental Disorders

  • “Is unable on account of mental disorder to conduct a defence at any stage of the proceeding before a verdict is rendered or to instruct counsel to do so, and in particular, unable on account of mental disorder to a) understand the nature or object of the proceedings b) understand the possible consequences of the proceedings, or c) communicate with counsel.”

    • (Canadian Criminal Code)


The insanity defense
The Insanity Defense with Mental Disorders

Insanity is not being of sound mind, and being mentally deranged and irrational at the time the offence was committed

Legally, insanity removes the responsibility of performing an act because of uncontrollable impulses or delusions

e.g., hearing voices


The insanity defense1
The Insanity Defense with Mental Disorders

  • M’Naghten Rule:

    • Excuses a defendant who, by virtue of a defect of reason or disease of the mind, does not know the nature and quality of the act, or, if he does, does not know that the act is wrong.

    • Emphasis on cognitive elements


Influential cases of the insanity standard
Influential Cases of the Insanity Standard with Mental Disorders

  • The Durham Rule

    • Assumed person cannot be held responsible for criminal act if suffering a mental illness

    • Excuses a defendant whose conduct is the product of mental disease or defect.

    • Brawner & Ali Rule (incorporates cognitive & volition elements)

      • Excuses a defendant who, because of a mental disease or defect, lacks substantial capacity to appreciate the criminality (wrongfulness) of his conduct or to conform his conduct to the requirements of law. Excludes repeated criminal or antisocial behaviour (psychopaths & APDs )


So where does that leave us
So Where Does That Leave Us? with Mental Disorders

As a group, no more likely than general population to commit crimes

More visible presence within community

Appear frequently in criminal justice system

Co-occurring problems make them vulnerable


Mental disorders as defences
Mental Disorders as Defences with Mental Disorders

  • Dissociative Identity Disorder

    • Formerly multiple personality disorder

    • Presence of at least 2 distinct identities or personality states

    • Hillside Strangler (Kenneth Bianchi)


Amnesia
Amnesia with Mental Disorders

Refers to complete or partial loss of an event or series of events

Temporary

Faking memory loss?


PTSD with Mental Disorders

  • Post-traumatic stress disorder

    • Characteristic symptoms following exposure to extreme traumatic stressor (identifiable cause for psychic damage)

    • Variants such as battered-woman syndrome


Personality disorders pds
Personality Disorders (PDs) with Mental Disorders

Occur when:

personality traits become inflexible and maladaptive and cause significant functional impairment or subjective distress.

Very important to note:

virtually all individuals exhibit some behaviors associated with the various personality disorders from time to time.


Diagnosing disorders
Diagnosing Disorders with Mental Disorders

DSM-IV-TR (APA, 2000)

Contains detailed lists of observable behaviours that must be present in order for a diagnosis to be made

Checklist of symptoms

Some 400 mental disorders; revised periodically

http://allpsych.com/disorders/dsm.html


ad