Steve Jensen Mahind (1114338)

Attention Deficit Hyperactivity Disorder

Attention deficit hyperactivity disorder (ADHD) is one of the most common childhood disorders. Causes of the disorder, ranging from genetic to environmental, ADHD is a non-curable disorder. A patient suffering from ADHD usually has normal brain structure and development but is slower in development. So far treatment can only remove the symptoms of the disorder, but cannot cure it.

In this essay I will talk of the symptoms and causes of ADHD. More importantly I will also speak of steps and methods for a person suffering from ADHD to cope with regular school and other activities.

Inattention is usually displayed in the following ways:

·         Easily distracted, having difficulty in focusing on one task, becomes easily bored with one task, having difficulty in finishing any task

·         Bad memory

·         Daydreaming more often than usual

·         Having difficulty in processing information quickly and accurately as others, struggle to follow instructions

Hyperactivity is exhibited through:

·         Fidgeting in their seats, difficulty in sitting in one spot

·         Running around, playing with everything in sight

·         Talking a lot

Symptoms of impulsivity include:

·         Impatience

·         Interrupting others

·         Having difficulty waiting in things, or even waiting their turn in games

ADHD is caused by several factors. Among all, the most common cause is heredity. Results from several international studies of twins show that ADHD often runs in families. 82% of identical twins whose parents had history of ADHD also showed symptoms of the disorder. Also Adoption studies show that, hyperactive children are more in character with their biological parents (proving that other factors such as parenting, environment etc are not the cause of ADHD) Researchers are looking at several genes that may make people more likely to develop the disorder. Knowing the genes involved may one day help researchers prevent the disorder before symptoms develop. One study showed that a particular gene caused the brain tissue that connected the both hemispheres of the brain is very thin during the person’s childhood. However this is not permanent, as the tissue grows to normal thickness after childhood.

Other causes for ADHD include cigarette smoking and alcohol consumption during pregnancy. A child below the age exposed to the same also show slower development in brain tissues, leading to inattention and hyperactivity. Injury to the brain as a result of trauma, brain tumour, stroke or diseases are other causes for ADHD, though it is atypical.

Treatment for ADHD:

ADHD can be treated through medication or psychotherapy. Stimulants such as methylphenidate and amphetamines are the most common type of medication used for treating ADHD. Although it may seem counterintuitive to treat hyperactivity with a stimulant, these medications actually activate brain circuits that support attention and focused behaviour, thus reducing hyperactivity. In addition, a few non-stimulant medications, such as atomoxetine, guanfacine, and clonidine, are also available. For many children, ADHD medications reduce hyperactivity and impulsivity and improve their ability to focus, work, and learn. (National Institue of Mental Health, 2012) Each child’s response to medication is different. To some it might be effective, to others it might have no effect, to some others they may need different dosage and yet others might need a combination of several medications. Side effects, if any also vary for different children. Therefore it is important to closely monitor the child’s reaction to medication. Stimulus medication comes in different forms; pills, liquid and skin patches. Some medications also come in short-acting, long-acting, or extended release varieties.

Side effects of medication may include decreased appetite and sleep problems. Some lesser known side effects development of ticks (repetitive movement or sounds) which usually stops with a change in dosage.

Currently medication does not cure ADHD, but only controls the symptoms so as to help the child pay attention in school and other academic activities. It is however advised to couple medication with some behavioural therapy, counselling and practical support to help the child cope with ADHD.

Psychotherapy can help the child manage ADHD. Behavioral therapy seeks to change behavior. It involves helping with practical assistance such as organizing school work, remembering tasks etc. It can also help child learn social skills, like waiting their turn, sharing toys and learning to control their anger by helping them think before they speak or do something.

Chances are children with ADHD have other disorders too, like learning disorder, anxiety and depression, bipolar disorder, conduct disorder etc. Recognizing ADHD symptoms and seeking help early will lead to better outcomes for both affected children and their families.

Parents also play an important role in helping their child cope with ADHD. Children with ADHD need guidance and understanding from their parents and teachers to reach their full potential and to succeed in school.

Before the child being diagnosed with ADHD, chances are that there has been a lot of anger and frustration built up towards the child. Parents need to be educated on how ADHD has to be dealt with. Parenting skills training helps parents learn how to use a system of rewards and consequences to change a child's behaviour. Parents are taught to give immediate and positive feedback for behaviours they want to encourage, and ignore or redirect behaviours they want to discourage.

Parents are also encouraged to share pleasant and relaxing activities with their child, to observe and point out to the child where he does well and encourage such activities. Also this gives them an opportunity to control the child’s environment is terms of number of friends he or she plays with (so as to not let the child get over-stimulated).

It is also important for parents to work with the child’s school. Most children with ADHD do not require any form of individualized education program. But if needed then, it is best to enrol the child in such a program.

Most children with ADHD continue to have symptoms well into their adolescence. It becomes more difficult to keep it in check as parents do not have as much control over them as before. At this stage, it is important to keep the teen focused on maintaining a schedule to keep the symptoms of ADHD in check. To help them stay healthy and provide needed structure, teens with ADHD should be given rules that are clear and easy to understand. Helping them stay focused and organized—such as posting a chart listing household chores and responsibilities with spaces to check off completed items—also may help.

In conclusion, it is important for ADHD to be detected early in life so as to effectively reduce its symptoms. Medication and psychotherapy is to be administered and conducted simultaneously with strict adherence to rules or structure.

References

http://www.nimh.nih.gov/health/publications/attention-deficit-hyperactivity-disorder/index.shtml

http://www.myadhd.com/causesofadhd.html

http://www.bie.edu/Programs/SpecialEd/index.htm

Narasimha 1114354

Throughout history, people have always tried to classify, explain and understand what we now term as abnormal behaviour  In olden times, supernatural explanations were given for the various abnormal disorders such as OCD, Alzheimer’s, and Dementia etc. and mostly passed of as the wrath of gods. Traditionally abnormal behavior has been explained in mystical terms, scientific terms, and more recently in humanistic terms.

In medieval times, the supernatural explanation was the most common way to deal with abnormal behavior. Exorcisms were performed routinely, in order to release ‘malevolent’ spirits from the afflicted or cursed individual. Some people would be branded as ‘witches’ and propagators of witchcraft, and then exiled from society. People labeled witches were often hunted mercilessly and out to death. ‘Mad houses’ were also common throughout medieval societies, filled with people with such abnormal behaviors.

These mental asylums started as early as the 16th century, according to the records of history. It dates back to 1547, when King Henry VIII of England established the St. Mary of Bethelem asylum for the mentally insane. These mad homes became ridiculously popular during this period, and even the Renaissance era. However, these asylums were not the asylums of today. In the asylums, patients were treated as outcasts, vagabonds, and foul beasts that were barely human, and were kept locked away from the rest of the world. These patients were also usually handed over for live experiments, to satisfy the scientific curiosity of some people.

Code of Hammurabi

In ancient Mesopotamia, the king of Babylon, Hammurabi, made the first known written laws of the world, in 1700 BC, some 3700 years back. His laws included laws that dealt with illnesses of that time, laws that physicians had to follow for while treating patients. Punishments were given out to those who failed to treat the wounded properly, as well as rewards for successful work. It is the world’s first known laws to deal with the treatment for people. In ancient Mesopotamia, supernatural elements were given as the reason for many abnormal behaviors, meaning that quite a staggering amount of unlucky physicians lost their limbs during his rule. The earliest form of surgery was also prevalent during these times, a process known as trephining, in which a physician would drill a hole in the skull of the cursed or afflicted person, in order to release the malevolent spirits from the person’s body. Evidence of this can be found in the skulls of these ancient people, with visible drill marks.

Greek and Roman empires

During the next 1000 years or so, as science slowly developed, scientific causes for abnormal behaviors started to find their voices. In the Greek and Roman empires, scientific approaches started to find their way, but the mystical and supernatural elements were still considered dominant, and the people propagating the scientific methods were often put to death or exiled from the society.  These people were people accursed by the Church and denounced in the names of god and men. Some of the prominent early scientific method connoisseurs were Plato, who argued in the favour of the environmental factors causing various illnesses, Hippocrates, who studied the brain and tried to explain that various mental disorders had their roots in the brain.

1500 AD onwards

Galen, a Greek physician who attended the Roman emperor Marcus Aurelius, adopted Hippocrates' teachings and is credited with discovering that arteries carried blood, not air,, as was formerly believed.  Johann Weyer, a Belgian physician during the period of the Renaissance, took up the cause of Hippocrates and Galen by arguing that abnormal behavior and thought patterns were caused by physical problems.

Only from the 18^th-19^th century onwards, have concrete efforts been made to scientifically understand abnormal behavior, using humanistic perspectives as well. Laws were made to convert the mad houses or asylums into actual proper centers where the afflicted would be given attention, following general public outrage at this. These people had been kept chained and in shackles to prevent them from escaping to the outside world, but were now kept in the emerging hospitals.

In 1789 Vincenzo Chiarugi, started to improve the asylum he owned in Florence. He introduced sanitary and hygienic measures, which made the place cleaner and improved the general living conditions. During this century, these insane asylums rapidly became health care centers, all across Europe.

Humanistic era

The humanitarian treatment of patients received great impetus from the work of Philippe Pinel (1745–1826) in France. In 1792, shortly after the first phase of the French Revolution, Pinel was in charge in Paris. In this capacity, he received the grudging permission of the Revolutionary Commune to remove the chains from some of the inmates as an experiment to test his views that mental patients should be treated with kindness and consideration as sick people, not as vicious. The monastery of St. Mary of Bethlehem in London became an asylum for the mentally ill in the reign of King Henry the VIII during the sixteenth century. The hospital, known as “Bedlam,” became infamous for its deplorable conditions and practices “(Robert, Butcher, Hooley, & Mineka, 2007).

William Tuke's work : “At about the same time that Pinel was reforming, an English Quaker named William Tuke (1732–1822) established the York Retreat, a pleasant country house where mental patients lived, worked, and rested in a kindly, religious atmosphere (Narby, 1982). This retreat represented the culmination of a noble battle against the brutality, ignorance, and indifference of Tuke’s time. The Quaker retreat at York has continued to provide humane mental health treatment for over 200 years (Borthwick, Holman, et al., 2001), even though the mental hospital movement spawned by its example evolved into large mental hospitals that became crowded and often offered less-than-humane treatment in the late nineteenth and early twentieth century’s” (Robert, Butcher, Hooley, & Mineka, 2007).

Great technological discoveries occurred both home and abroad in the latter years of the nineteenth century. There are four dimensions in abnormal psychology that spanned the nineteenth and twentieth century’s and generated powerful influences on our contemporary perspectives in abnormal behaviour:

1) Biological discoveries.

2) Development of a classification system for mental disorders.

3) The emergence of psychological causation views and

4) Experimental psychological research developments.

BIOLOGICAL DISCOVERIES:  Establishing the Link between the Brain and Mental Disorder.

References

 Robert, Butcher, Hooley, & Mineka. (2007). Abnormal Psychology (13th edition ed.). Pearson Education and Dorling Kindersley Publishing.

http://www3.niu.edu/acad/psych/Millis/History/mainsheet.htm

http://www.psych.ucsb.edu/~kopeikin/103lec2.htm

http://en.wikipedia.org/wiki/Abnormal_psychology

http://facstaff.gpc.edu/~nreynold/abnormal%20history.htm

Veena B. 1114333

CONTEMPORARY VIEWS OF ABNORMAL BEHAVIOR

                                   

The advances in the use of science had drastically developed and the need of scientific behavior in the application of abnormal psychology was found to be at a greater importance. There were four major themes that are to be taken into the account for the advances in nineteenth and the twentieth century, they are:

1.     Biological discoveries.

2.     The development of the classification system for mental disorders.

3.     The emergence of psychological causation views.

4.     Experimental psychological research developments. (Robert C Carson, 2007)

BIOLOGICAL DISCOVERIES: ESTABLISHING THE LINK BETWEEN THE BRAIN AND MENTAL DISORDER

Understanding the biological factors improved as a relying source in understanding physical and mental disorders. They have resulted in studying about a serious mental illness general paresis and syphilis.

            General Paresis and Syphilis- In 1927, Julius Wagner Jauregg has won a noble award for discovering the malaria treatment of general paresis. General paresis of the insane was first identified as a distinct disease by Antoine Laurent Jessé Bayle in the 1820s. He characterized it as having both physical and mental symptoms, a regular natural history and consistent post mortem findings. In the final stage of the illness, when the patient was weak, bedridden and demented, there was general agreement that treatment should be humanely restricted to palliative measures. Opinions about prevention were more varied, but generally the advice given was, as in other forms of insanity, directed at avoiding emotional turmoil and excesses of alcohol and sex. (Abnormal Behavior and Psychopathology) (Robert C Carson, 2007) (malaria.html)

            Brain Pathology As a Casual Factor- the question why most disorders do not explain the causations of a mental disorder was an important point to note down.

The scientists focused on physical ailments of the disorder and assumed that mental illness is caused by the pathology of organs- ‘Brain’. The results scores that brain pathology led to general paresis. Alzheimer’s disease was also established in the form of brain pathology following the general paresis. In 20^{th century} the pathologies laid the toxicities of mental disorders, mental retardation and mental illness.  (Robert C Carson, 2007) (Evidence of parallels between mercury intoxication and the brain pathology in autism.)

 

THE DEVELOPMENT OF CLASSIFCATION SYSYTEM

Emil Kraepelin played a crucial role in the role of biological development. He stressed on the fact on brain pathology leading to mental disorders and the other causes. His contribution to the pathology was DSM-IV-TR, a symptom occurred regularly enough to be retarded as a specific type of mental disease. He saw each type of mental disorder as a distinct way from the others and each disorder could be predetermined or predicted. Thus, this led to the wide description and classification of the mental disorders. (Robert C Carson, 2007)

CAUSATION VIEWS: ESTABLISHING THE PSYCHOLOGICAL BASIS OF MENTAL DISORDER

Understanding psychological factors in studying mental disorder was a great progression. Sigmund Freud took the major steps in getting hold with his theory of psychoanalytical perspective. The emphasis was on inner motives or internal behavior. The method he used to study is called as psychoanalysis. Hypnosis is considered to be a root for psychoanalysis.

Mesmerism- Franz Anton Mesmer, an Austrian physician developed the idea of Paracelsus; influence of the planets in human body. He believed that the planet in the form of magnetic fluids runs in our body, which determines the mental disorder or any disease. Thus he says that people who are attracted by these magnetic fluids influence other people effecting cures. Mesmer constructed his concept as an experiment in connection with hypnosis. And this technique was known as Mesmerism that explains the cures of the people.

The Nanny School- Ambrose August Liebeault who was practicing in the town of Nanny practiced hypnosis along with the relation of hysteria with the help of a doctor Hippoolyte Bernheim. They conducted an experiment which concluded that people treated with hypnosis were healed faster than through the other methods. Thereby this was called as self-hypnosis that treats hysteria. On the other hand Jean Charcot disagreed the findings with his experiments on mesmerism. The debates between them led to a conclusion of a similar view that psychological factors are involved in mental disorders.

How do mental disorders that are psychologically hidden develop?

The Beginnings of Psychoanalysis- Sigmund Freud was the founder theorists to analyze the beginning of it. He was convinced with the fact that powerful mental processes are hidden in ones consciousness from the use of hypnosis by the Nanny School and how they treated hysteria patients with the help of self-hypnosis. Freud practiced the use of hypnosis while he allowed his patients to talk freely about their problems during the session. While this session was taking place, Freud saw the release of his patient’s emotional behavior, which he called it as catharsis. This indeed revealed the state at which the patient’s symptoms along with the reason of why they are in that particular state of mind. It was this approach, which led to the discovery of unconsciousness- a state of feeling buried deep in our mind that we are unaware of and that is not released until an external support is provided. They are usually called as the internal image. Freud to study this found two methods:

    Free Association- involving patients to talk about their emotions, problems, motives and etc.

     Dream Analysis- involving patients to record their dreams.

These two techniques helped the patients to solve their problems and let free their peace of mind dominating. (Robert C Carson, 2007) (Psychoanalytic Approaches)

THE EVOLUTION OF THE PSYCHOLOGICAL RESEARCH TRADITION: EXPERIMENTAL PSYCHOLOGY

The earlier work of experimental psychology was not directly practiced in clinical side or in studying the abnormal side, but now psychologists has brought this trend into practice.

The Psychology Laboratories- Wilhelm Wundt established the first experimental psychology laboratory in 1879. Along with his collegians he set up basic experimental methods and strategies and influenced the early contributors to study the abnormal behavior in an empirical manner. In 1896, Lightner Witmer had set up the first American Psychological clinic with a combined research based on application and methods. The clinic focused on mentally deficient children’s problems in revelation of therapy along with the research. It become an encouraging profession and soon was established all over. Institute of Juvenile Research in Chicago was another major set up established by William Haely in 1909. They focused more on the symptoms of urbanization and not as a result of inner psychological problems. Soon by the first decade of twentieth century psychological labs and clinics were of great deal and matter in terms of both conducting research and treatment.

The Behavioral Perspective- the emergence of the behavioral school evolved opposing the views of free association and dream analysis as the technique could not be verified by the investigators and that its not a scientific technique. They view was the behavior can be studied only through direct observation.

The behavior perspective was initially developed in the laboratory and the main motive is to study the human behavior thorough learning. (Robert C Carson, 2007)

            Classical Conditioning- “the behavioral view of abnormal behavior was studied with an experimental work type learning called as classical conditioning; a form of learning in which a neutral stimulus is paired repeatedly with an unconditioned stimulus that naturally elicits an unconditioned behavior”. After repeated pairing the neutral stimulus becomes a conditioned stimulus that elicits a conditional response. This work was developed by Ivan Pavlov experimenting with a dog. Another psychologist J.B.Watson who was inspired by the idea of Pavlov studied the overt behavior called as ‘behaviorism’ rather than studying the mentally constructed set.

He challenged the psychologists that he could train a newborn child into either an entrepreneur or a thief through conditioning and studying about the environment.

By 1930, Watson’s approach played a crucial role in the social environment in development of ones personality, both normal and abnormal. (Chapter 4: Learning Theory and Behavioral Psychology )

            Operant Conditioning- E.L.Thorndike and B.F.Skinner studied the likelihood of a repeated behavior on similar occasions. For example, if a baby crying is a stimulus, the immediate response will be as giving food to the child. This repeated action is called as operant conditioning. They believed that this type of behavior ‘shapes’ ones personality in a way that is practiced. (Robert C Carson, 2007) (Chapter 4: Learning Theory and Behavioral Psychology )

Bibliography

Robert C Carson, J. N. (2007). Abnormal Psycholgy. Bangalore: Pearson.

Abnormal Behavior and Psychopathology. (n.d.). Retrieved July 15, 2013, from http://psych.fullerton.edu/rlippa/Psych101/outline4.htm

Evidence of parallels between mercury intoxication and the brain pathology in autism. (n.d.). Retrieved July 15, 2013, from http://www.ncbi.nlm.nih.gov/pubmed/22810216

Psychoanalytic Approaches. (n.d.). Retrieved July 15, 2013, from http://www2.cnr.edu/home/bmcmanus/psychcrit.html

(n.d.). Retrieved July 15, 2013, from malaria.html: http://med.brown.edu/HistoryofPsychiatry/malaria.html

(n.d.). Retrieved July 15, 2013, from Chapter 4: Learning Theory and Behavioral Psychology : http://allpsych.com/psychology101/conditioning.html