Abnormal Psychology. response to a post

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whopper

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Oops should've titled this response to a PM.
I've gotten questions concerning Abnormal Psychology because I mentioned its a good idea to take it in undergrad for those who want to go into psychiatry.

Whopper,

Hey, just had a quick question for you. In a few different posts I've seen you mention that you think it'd be good to have taken an abnormal psych class as a psychiatrist. I was hoping you could clarify this statement as I have taken an abnormal psych class and am somewhat perplexed as to how it is not all within the domain of psychiatry and how a even one medical school rotation in psychiatry wouldn't cover everything an abnormal psych course would. Perhaps they were taught differently at our institutions. I'm genuinely interested, however.

Abnormal Psychology will of course differ somewhat depending on the institution where its taught, but all will have to follow the guidelines of what is required in a psychological curriculum.

Is Abnormal Psychology taught in medical school & residency? Yes and no.

Yes in the sense some of the facets of Abnormal Psychology would be taught in a curriculum in medical school or residency.

No-in the sense that it is not taught in the level of detail & sophistication it could be taught in an undergraduate course specifically for Abnormal Psychology.

Kinda like Reading a novel, or getting the Cliff Notes version of it (which actually isn't a fair analogy because several Cliff Notes I've checked out are quite extensive & detailed).
Let me give you some examples.

In residency, residents during lectures often times don't pay the amount of attention they would to material had it been an undergraduate course. Reason why is because residents aren't given frequent exams that require grading, and they are often recovering from lack of sleep. Often times during a lecture, a resident will get beeped to attend an emergency, and for that reason they'll miss the lecture completely. The thrust is also on treating the patient, which is much more specific & goal focused than learning about something on an academic level. An attending would be much more satisfied with a resident that does the clinical work, than one that is fighting to stay awake in lecture. Abnormal Psychology taught in undergraduate is about learning the subject as a whole without a specific slant. Most residents knowledge wise are more concerned about passing USMLE Step III where psychiatry is of little focus. While I always have encouraged residents know their non-psychiatric medical skills, the pressure to study for Step III often overrides the desire to spend free time studying psychiatry for the sake of psychiatry.

In medical school, knowledge is crammed into the brain, and for that reason, its taught in a manner where the person may not appreciate the true aspects of Abnormal Psychology. While I was in college, I had to read several books in my Abnormal Psychology course on the history of it, the scientific basis of defining abnormal behavior, & what is the definition of "normal" on a philosophical level. During medical school, perhaps only 30 minutes was discussed on this topic, and none of that stuff was tested so the medical students didn't seem to care much.

If you take Abnormal Psychology in undergrad, IMHO, it will probably be a richer educational experience than its equivalent in medical school or residency. Its been a reason why I sometimes ponder that a psychiatric residency education should incorporate some psychology courses such as Social, Abnormal, Endocrinological, & Physiological Psychology. I find this unlikely mostly due to political reasons.

I spent about 3 weeks in undergrad learning of the psychological effects of oxytocin in mammals while taking Psychological Neuroendocrinology, and I am convinced that this hormone, if properly utilized could have psychiatric benefits. I have never seen it focused or discussed much by fellow psychiatrists.

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I spent about 3 weeks in undergrad learning of the psychological effects of oxytocin in mammals while taking Psychological Neuroendocrinology, and I am convinced that this hormone, if properly utilized could have psychiatric benefits. I have never seen it focused or discussed much by fellow psychiatrists.

There are studies showing that oxytocin could be beneficial in autism. don't know the specifics and can't comment on if they are accurate -- but i've seen some news articles about it.

for abnormal psychology, a practical way to teach the subject might be -- have medical students read novels or passages from great novels/articles.
 
-- have medical students read novels or passages from great novels/articles.

All things being equal, I'd agree with you, however medschool is very test-USMLE oriented. If its not going to be majorly tested on the exam-dump it from the mind because there's too much to study. If you want medstudents to appreciate this aspect of mental health, IMHO you have to put it on the exam. Not just the DSM's explanation of normal vs abnormal, but test the data behind it as well. This in turn would bring up arguments that most medical doctors don't want to go into mental health, so why test to that degree?

That's just my opinion. I however remember the days where "if its not tested, don't study it" which was survival behavior. It wasn't because the students didn't want to learn, it was because there was too much information being given.

Which then brings up the argument, then perhaps it should be emphasized in the psychiatry rotation/residency. That IMHO would be a better approach, but that too falls into the traps I mentioned above. I've seen several residents miss lectures to get their clinical work done.
 
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Despite the new promising oxytocin studies out there, there is still no truly proven effective use for it. I.E. If I start giving it to my admitted autistic patints in the unit, will they recover faster and get kicked out faster.... will the guys in the clinic get out of their autistic withdrawn behavior faster?

Once this is proven in some solid trials, we'll see a more wide spread use. It's all good IMO, because Psychiatry is the practical side of Psychology. As a psychiatrist you need to be one making the decision of which is more compromised (mental status vs. body health) and why is it more important in this case.
 
, because Psychiatry is the practical side of Psychology.

I think I get your point. I guess kinda like Engineering is a more practical side of Physics.

Which was my point. In college undergraduate, the psychology courses are of a nature not emphasized in medical school or residency. For example, the Kitty Genovese incident is something rarely taught in psychiatry. It is a big factor in the understanding of group responsibility in psychology. It can have practical applications in psychiatry in understanding why a group may act a certain way in group therapy, or treating the individual who may have psychosocial stressors becuase of the group. Its something taught often in social psychology classes.

If for example Rorschach from Watchmen was your patient, of course knowing the Kitty Genovese incident would be germaine in understaning the root of his psyche. Its the reason why he believes he became what he did.
http://www.youtube.com/watch?v=JSVGaoih-uI

Or another more realistic example, in NYC on 6/11/2000, a number of women were sexually assaulted, one of the operating theories as why this event occurred was the same as the Genovese incident, described by a term taught in psychology curriculums but not psychiatry--Diffusion of Responsibility.
http://en.wikipedia.org/wiki/Diffusion_of_responsibility

And that's why I mentioned oxytocin. Didn't learn anything about how it can have a positive effect in psychiatry residency or medical school, but I did learn about it in psychology. That knowledge could be the stepping stone for a psychiatrist to want to consider using an oxytocin medication in a study.

Remember, psychology is the study of human mental processes & behavior. There are several classes that do not directly deal with issues that will be relevant to psychiatry. I am not reccomending all psychology classes be taken.

If you want to take something in undergraduate that'll help you as a psychiatrist, I can't think of better classes than the psychology classes that directly deal with the physiology of psychological processes and classes specifically geared toward being a clinician.

Mentioned this in another thread, but since I don't know if its still up, and I'm in a pseudo hypomanic mood--
Psychoanalysis
Physiological Psychology
Psychological Endocrinology
Psychopharmacology
Abnormal Psychology
Child Psychology
Adult Developmental Psychology
Geriatric Psychology
Social Psychology-
Drugs & Human Behavior
All of the above were classes had a wealth of material that is relevant in clinical psychiatry. Unfortunately they may not help you get a higher MCAT score, or be of much use in medical school, but will be very relevant once residency starts.
 
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im signed up for adult psychopathology next semester (300 level psych class). I assume this would be the same thing as what most places call abnormal psych right? (I dont think I saw abnormal psych in the course of study).
 
Abnormal Psychology, at least when & where I took it was more of a lower level intro course. Not as basic as General Psychology, but one of the classes someone would take right after General Psychology.

I'd bet the 300 course you mentioned is probably much more detailed.
 
Therapeutic issues & perspectives on life change with age. Even in a psychiatry curriculum, you will have to memorize the life development sequences as theorized from various psychologists such as Kohlberg, Piaget & Freud.

However in such a curriculum, they give the information to you in a condensed manner. e.g.
http://en.wikipedia.org/wiki/Jean_Piaget

Read up on the sensorimotor stage, that's the way its often times presented.

In a developmental psychology class teaching it, they'll cover & test this in much more depth & sophistication.
 
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