Psychology 309a
Fall, 1998
Doug Davis
Final Exam

This final examination is a writing exercise in three parts. The first part is a five-page response to the first topic below, due the last day of classes (12/8/98). The final two parts (five pages each) are due the last day of examinations (12/18/98). Of course, I expect to be in communication with you over the coming weeks as you work on all three parts. Each question is designed to focus your attention on important questions in the definition, etiology, and treatment of psychopathology; and each is intended to give you considerable leeway in selecting particular topics for discussion and in deciding which aspects of a very complicated process to emphasize. If you feel you can productively relate the topics or structure your responses so that one argument helps to clarify another, please discuss this with me. If you would like to have me respond to a draft of any part of your exam, just email it to me as far ahead of the due date as possible. I welcome reactions to these topics, suggestions for clarification, and requests for additional resources.

Many of the major classes of mental disturbance we have been discussing this semester can be characterized as combinations of relatively common and minor developmental "risk" factors that are shared by millions of members of the culture -- and that typically lead to recognizable "stylistic" features of the personalities of those who experience them -- but that result in serious pathology in a few individuals. For example, a common neurotic style may be much more common in the background of one than another sufferer from a major psychosis that has developed in response both to pre-existing personality factors and to recent life stresses. Our understanding of how this process works is still incomplete and involves the discourses of behavioral genetics, psychoanalysis, family systems, and psychopharmacology. Pick an example other than schizophrenia from among the major disorders discussed and explain its specific etiology in a way analogous to what Meehl does with schizophrenia. Are there analogues to "schizotaxia," "schizotypy," and "schizophrenia"? What "orders of dispositon" can be usefully distinguished in the etiology of this disorder? Should the disorder's responsiveness to drug or psychotherapeutic treatment change our thinking about its etiology?

Elaine Showalter's book Hystories describes a class of individual reactions to psychological stress and socio-cultural expectations that she argues can be understood as a kind of psychopathological epidemic. She offers an array of examples of this process, some of which may be more and some less convincing to you. Summarize Showalter's argument briefly and identify the specific phenomena that you feel are most and least successfully understood or treated as "hystories." Explain why, and offer your own perspective on each of these phenomena. Why does it matter whether we take individual sufferers' accounts of what has happened to them to cause the problems they now have literally? Why do such epidemics occur at the historical moment and in the cultures that they do?

Each of the detailed case histories we will be reading at the end of the semester ("Carol," "A Child Is Being Eaten," "The Evil Contest," and "Barabbas") presents us with many of the puzzling issues suggested by the previous two topics. That is, in each case we wonder how this individual illustrates more general issues of developmental psychopathology and how we may understand the very specific ways in which they have reacted to inheritance, early child-rearing, and recent life stresses to produce the clinical picture described by the author of the case history. Pick the case example that seems to you to offer the most interesting and productive material for an analysis of the interplay of etiology, psychodynamics, and therapeutic possibility and do the following:

Run a brief diagnostic work-up of the patient in terms of DSM procedures or the Web tool and explain why you feel the patient fits best in the particular category -- or identify the most important decision to be made about which category fits the patient.

What are the most important and characteristic aspects of this individual's background from the point of view of explaining their relations to others in the period before they became the subject of case history? How do these background factors allow you to understand this person as a member of a class of persons with certain personality issues and ways of relating to the world shared by many others but consistent with the whole picture they present to the author of the case history? Why did this person fall ill at this time and in this way? This is your chance to be specific, to get into the details of the lives described and explore the kinds of understanding the clinician seeks.