Mental Illness: Critical Perspectives
Psychology 420-010
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Instructor: Brian Ackerman
Fall 2014
Office: 228 Wolf Hall
E-mail: BPA@psych.udel.edu
Telephone: 831-2385
Office Hours: T 11-12, TH 2-3
Course Plan and Goals:
Concepts of mental illness reflect psychological and psychiatric models that are rooted in history, in
culture, in science, and in belief systems. The core question of this course concerns how we think about these
models. My plan in this course is to describe and critique psychiatric models that underlie historical and current
views of mental disorders. My goal is to teach you to understand and engage in systematic assessment of
psychiatric/psychological claims about mental distress and disturbed behavior, and thus teach you to be a critical
consumer of psychiatric claims and information.
Course Requirements:
The course requirements will consist of (a) a midterm essay exam on Tuesday, October 14, (worth 120
points) and (b) a final essay exam (150 or 160 points) given during the finals period. These essay exams will be,
well, strenuous. So, be prepared. (c) You must compose nine short (3 pages) analyses of specific readings.
These assignments consist of organized answers to the remarkably insightful questions I have provided about
selected readings. Most of the readings are actually, probably, well maybe, interesting and worth reading, or at
least brousing. But you’ll need to persevere a bit for some. Even more incredibly, I actually have purposes for
the analyses, which are (a) to get you to read and “discover” on your own, (b) to prepare you for examination of
the content area in class, (c) have you rehearse the model-analytic approach of the course (very important), and
(d) provide a buffer for weak performances on the (difficult) tests. Each analysis is worth 20 points and you will
lose an excruciating amount of points for a late submission. If you have a problem with the due date, please
notify me in advance and we can negotiate. I may take your second born child instead of your first born.
Grading is based on the extent of your reading (yes, read them all if you want a shot at full credit), the
organization and clarity of your answer, and the editing.
I need to emphasize that you must attend class all the time if you plan to pass this class, much less do
well. Class attendance is MANDATORY. If you have to miss class, maybe because aliens have landed and
scooped up your dog, your hamster, and your honey, make sure you get the notes—and from a student who is
doing well. The reasons, that will become obvious, are that the class is not based on a textbook (we have none),
and if you don’t get the concepts in class you won’t get them. In each of the times I’ve taught this course, I’ve
ended up flunking (that would be an “F”) students who found it in their hearts to miss about ¼ of the classes.
Soooooo, while I’m sympathetic to the notion that hot dates have priority in your lives, in this case you will
need to cool down and attend class. Save your ardor for our discussions.
The following percentage system will help to determine your final grade:
If you earn:
90% of the points (430/440 total)
80%
65%
60%
< 60%
Your grade will be at least:
ABCDF
“At least” means that I credit improvement. Later grades can compensate somewhat for poor early
grades, but only somewhat. Do the extra credit if you need to compensate for poor early grades. I reserve the
right to improve (but not reduce) final grades based on distributions of total points and on scintillating class
performance. Put simply, I reward a student who helps me teach the class above and beyond all others. I also
reserve the right to cancel an analysis if we fall too far behind, or if Mars falls into Lake Erie.
Syllabus
Please follow the syllabus and come to class with the readings prepared. I’ll try to do the same.
Adjustments in the dates may be necessary, as the University seems inclined to cancel classes when confronted
with hurricanes or heavy snows, and I have only a vague idea about (a) how dense I can make certain topics
without losing you, (b) your tolerance and interest levels, and most important, (c) my attention span. It is
critical for your success in this course that you read the material that may not figure directly (only indirectly) in
the written analyses, including the chapters in the book.
Week of
Aug 26
I.
Topic
Assignment
Introduction
MAD Ch 1
Arts 1, 2, 3
A.
B.
C.
D.
Aug 28
II.
Cultural Framing
Illness Concepts
Explanatory Frameworks
Generic Illness Model
Age of Reform 1800-1850
MAD Ch 2
A. Birth of the Asylum
B. Moral Model
C. Rise of Somaticism
III. Victorian Somaticism, 1850-1900
Sept 2
A. Cultural Context
B. Physical Medicine
C. Mental Medicine
1. Somatic Model
2. The Woman Question
3. Crisis of the Somatic Model
Sept4
IV.
Progressive Medicine, 1900-1950
A. Cultural Context
B. Psychogenic Models
1. Freud
2. Psychiatric Deluge
C. Somatic Model
1. Degeneracy and Eugenics
2. Institutional Psychiatry
Sept11
Sept 18
V.
Sept 25
Modern Approaches: Diagnosis
A. Cultural Context
B. Diagnostic Revolution
C. Application: ADHD
Sept 30
VI.
Arts 3, 4-8,
MAD Chs, 3, 4
Arts 9-12, 13
Art 13,
MAD Chs 5, 6
MAD Ch 7 (pp. 161-175)
Arts 14-19
Modern Etiology: Psychogenic/Adjustment Models
Oct 2
Oct 7
Oct 14, 21
Oct 28
A. Cultural Context
B. Psychogenic Perspspectives
1. Developmental Risk: FOO
2. Attachment
3. RMS and Child Sexual Abuse
C. Traumatic Events: PTSD
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VII.
Nov 6
Nov 11
Nov 18
Nov 25
Modern Etiology: BioPsych/Brain
A. Brain Model
B. Conduct Disorder
C. Depression
D. Psychopharmacology
Arts 20-24
Arts 25-30
Arts 31-35
MAD, Chs, 7, 8, 9
Arts 36, 37
Arts 38-44
Arts 45-50, CMI Ch 7
MAD Ch 11, Epilogue
Arts 51-57, 3, 18, 47
Readings
Text: Mad in America (Revised, 2010) by R. Whitaker (MAD on the syllabus)
This book is available in the bookstore and widely available from web-site sources, like Amazon.com.
Articles: Obtain these readings from (a) the electronic journals function on the library website (EJ), or (b) from
me via e-mail (mail). The complete references are in a separate handout. If an article is unavailable on
electronic journals, please let me know right away. Sometimes the library cancels a subscription in mid-stream.
I reserve the right to cancel readings if we get behind or the workload for a particular topic seems too heavy.
Note that many of these articles are short and many are from the popular press and quite readable (surprise!).
1. Contested Boundaries by C. E. Rosenberg
EJ
2. The Americanization of Mental Illness by E. Watters
Mail
3. Listening to Lyrica: contested illnesses…. by K.K. Barker
EJ
4. The Cult of True Womanhood by B. Welter
EJ
5. The Hysterical Woman by C.S. Rosenberg
Mail
6. The Uses of a Diagnosis by B. Sicherman
Mail
7. Chlorotic Girls, 1870-1920 by J.J. Brumberg
EJ
8. Hysterical Circus by A. Scull
Mail
9. Madness on the Couch, Chs 1,2 by E. Dolnick
Mail
10. Mother, The Invention of Necessity by N.P. Weiss
EJ
11. “Mother’s little helper: The crisis of psychoanalysis… by J. M Metzl
EJ
12. Freudian Hysterics by A. Scull
Mail
13. The mental health sector …in post-WWII America…… by A. Scull
EJ
14. DSM-III and the Revolution in the Classification… by R. Mayes & A. Horwitz
EJ
15. The Dictionary of Disorder by A. Spiegel
Mail
16. From Hyperactive Children to ADHD Adults by P. Conrad & D. Potter
EJ
17. How an Age of Anxiety Became an Age of Depression by A. V. Horwitz
EJ
18. ‘Get with the Program!’: Pharmaceutical marketing… by M. Ebeling
EJ
19. Transforming Normality into Pathology by A. V. Horwitz
EJ
20. Overview of the field of attachment. by M. Main
EJ
21. Parental Beliefs, Infant Temperament,….. by M.S.Wong et al.
EJ
22. Early attachment organization with both parents…. by Kochanska & Kim
EJ
23. Interplay of genes and early mother-child relationship… by Kochanska et al.
EJ
24. Infant-mother attachment classification: Risk…. By NICHD Network
EJ
25. Childhood and Adolescent Sexual Abuse of Community Women by A.C. Fuqua et al.EJ
26. Suicide attempts, gender, and sexual abuse by Bebbington et al.
EJ
27. Methodological Issues in the Study of Sexual Abuse Effects by J. Briere
EJ
28. The Impact of Childhood Abuse and Neglect by A.V. Horwitz et al.
EJ
29. Childhood Sexual Abuse, Stigmatization… by C.Feiring et al.
EJ
30. Alcohol and sexual risk behaviors as mediators… by M. Testa et al.
EJ
31. Post-Traumatic Stress Disorder by G.N. Grob & A.V. Horvitz
Mail
32. Who develops PTSD? by Ozer & Weiss
EJ
33. Resilience in the Face of Potential Trauma by G.A. Bonanno
EJ
34. Problems with the PTSD diagnosis and its future in DSM-V by Rosen et al.
Mail
35. The developmental mental-disorder histories of adults… by K.C. Koenen et al.
EJ
36. Blaming the Brain by E.S. Valenstein
Mail
37. Genetic Essentializm, Neuroessentialism, and Stigma by N. Haslam
EJ
38. From genes to brains to antisocial behavior by A. Raine
EJ
39. Neurocognitive Impairments in Boys… by A. Raine et al.
EJ
40. “A gene for…”: The Nature of Gene Action by K.S. Kendler
EJ
41. Impulsive and callous traits… by Meier et al.
EJ
42. Integrating Biological and Social Processes… by P.A. Brennan et al.
EJ
43. Heritability for Adolescent Antisocial Behavior… by C. Tuvblad et al.
EJ
44. From antisocial behavior to violence… by Van Ryzin & Dishion
EJ
45. Depression by G.N. Grob & A.V. Horwitz
Mail
46. An epidemic of depression or the medicalization of distress? by R. Mulder
EJ
47. Assessing the Impact of SSRI Antidepressants… by J.M. Metzl & J. Angel
EJ
48. The proximity of common unhappiness and misery by J. Schnittker
EJ
49. Can’t a mother sing the blues? by L. Held & A. Rutherford
EJ
50. Antidepressant drug effects and depression severity by Fournier et al.
EJ
51. Antidepressants and the placebo response by I. Kirsch
Mail
52. The Disease-Centered Model of Drug Action in Psychiatry by J. Moncrieff
Mail
53. ‘Rapid tranquillisation’….. by L. Allison & J. Moncrieff
EJ
54. The Epidemic of Mental Illness and The Illusions of Psychiatry by M. Angell
EJ
55 . How pharmaceutical industry funding… by A. Sismondo
EJ
56. Influence of Patients’ Requests … by R. L. Kravitz et al.
EJ
57. ‘A pill for every ill’:… by J. Busfield
EJ
Guidelines for Course Success
1. Class attendance is MANDATORY. You must come to class. The topics will be new to most of you and
they definitely are not common sense.
2. I have ZERO TOLERANCE for CELLPHONES. If I see you using a cellphone in class, I will not grade
the next thing you hand in—including the final exam. If twice, then twice, etc. Just accept that I am irrational
on the topic.
3. Similarly, I have ZERO TOLERANCE for CLASS-UNRELATED COMPUTER USE. If you use a
computer to take notes, and I see that you are using it for some other purpose, I will impose the same penalty as
#2 above. How will I know? It is really easy to tell from your expression and from the poor synchrony of your
computer use and class activities. If I am wrong, you will have to make the case after I hand back your next
product with a zero.
4. Ask questions, and slow me down. The more passive you are, the more material we will cover, and the more
material will be tested. Be critical!! ENGAGE!!!!
5. Hand in the written analyses on time. Each one will help you digest current material and contribute to class
discussion.
6. Make the material your own—relate it loosely to your life and the lives of your acquaintances. Remember,
however, that no topic is about you—the topics concern groups and abstract ideas.
7. Don’t try to guess my positions on topics. I often take extreme positions to provoke you and to set up a later
discussion. My personal viewpoints are mostly gray and complex—though I am consistently questioning.
Tentative Event Schedule
Event-Topic
Readings
Due Date
Analysis #1- Woman Q
Arts 3, 4-8
Thursday, Sept 4
Analysis #2- Freud
Arts 9-13
Thursday, Sept 11
Analysis #3- DSM
MAD 7 (161-175), Arts 14-19
Tuesday, Sept 25
Analysis #4- Attachment
Arts 20-24
Tuesday, Oct 7
Mid-Term Exam
Tuesday, Oct 14
Analysis #5- CSA
Arts 25-30
Tuesday, Oct 21*
Analysis #6- PTSD
Arts 31-35
Tuesday, Oct 28*
Analysis #7-Conduct Disorder Arts 38-44
Tuesday, Nov 11*
Analysis #8- MDD
MAD, 7-9, Arts 45-51
Tuesday, Nov 18*
Analysis #9- PHARMA
MAD 11, Epilogue
Arts 51-57, 3, 18, 47
Tuesday, Nov 25* **
* These dates are tentative.
** Analysis 9 is for extra-credit.