reading questions for
Nancy Andreasen's The Broken
- How has our understanding of mental illness
changed since the last century? How should we now view the
- Why is "The Broken Brain" a good name for this
- What is the difference in Freud's and
Kraepelin's approaches to mental illness?
- How did Kraepelin's classification of
disorders help the diagnosis of mental illness?
- How would behavioral therapy differ from the
Freudian approach? From the biological approach?
- Which of the three methods would you say is
based on the "medical model"?
- How close did your answer to the third
question in chapter 2 come to Andreasen's description of the
- Why is "reciprocal inhibition" (also known as
"systematic desensitization") a behavioral therapy?
- How does the example of breakthroughs in the
treatment of Parkinson's disease show the relatedness of the
various neurological disciplines?
- Why are the "somatic" therapies (i.e. drugs
and surgery) called "medical"?
- What is "affect" and how does it help define
the nature of "affective disorders"?
- "Dysphoria" is a major symptom of depression.
What are others?
- "Euphoria" is a major symptom of mania. What
- What is the relationship between depression
and mania in bipolar affective disorder?
- When Andreasen says that schizophrenia is a
chronic illness while affective disorders are episodic, how does
that effect our judgment of the severity of the
- "Schizophrenia" means "splitting of the mind",
but is it the same as "split, or multiple,
- What is the difference between a delusion
(such as paranoia) and hallucinations? What are other symptoms of
schizophrenia? Why are some symptoms called "florid", or
"positive", while others are called "defect", or
- What are the physical symptoms of anxiety
disorders, and how do they tie in with the "autonomic nervous
system"? Psychological symptoms?
- What was Freud's role in the definition of
- How do phobic disorders, anxiety states, and
post-traumatic stress disorders differ from one another? What are
the differences between panic, generalized anxiety, and
- How do symptoms of dementia compare and
contrast with symptoms of other disorders?
- How did "natural experiments" lead to the
- Distinguish between "cerebral specialization"
and "cerebral dominance". How do "Broca's area" and "Wernicke's
area" exemplify these two concepts?
- Both Andreasen and Isaacson (in The Undaunted
Psychologist) say that there are no accurate metaphors to describe
the functions of the brain. How do some of the models in this book
and in Isaacson's chapter fall short?
- Where is the cerebral cortex?
- Look at Fig.2 on page 93, then read pages
94-95. What different senses do the occipital and temporal lobes
moderate? What else does the temporal lobe control (remember
- Why would the parietal lobe, which is home to
the "somatosensory area", be thought to control "spatial
- How would the "motor control area" in the
frontal lobe differ from the "somatosensory area"? What else does
the frontal lobe control?
- Again going back to Isaacson, which parts of
the brain described by Andreasen may be part of the neocortex? The
limbic system? The R-complex?
- The thalamus ("marriage bed") comes up often
in later chapters. What is its function? What do the basal ganglia
- How do the cerebral hemispheres (left and
right) effect motor control and language functions?
- What does H.M., who had his hippocampus
removed and then suffered anterograde amnesia, show us about how
memory works in the brain? How does anterograde amnesia highlight
the difference between short-term and long-term
- How does the neuroendrocine system
("hormones") connect the brain with the rest of the
- What is an "action potential" and what is its
course through a neuron? Which comes first in an action potential,
the axon or dendrites?
- What is the role of neurotransmitters, and
what is their connection to the action potential?
- How, according to Andreasen, can knowledge of
the brain change our views of mental illness?
Chapter 6 & 7
- What is diagnosis, and why is it so important
to treating mental illness?
- What is DSM-III? How does it reflect the
medical model (over psychodynamic or behavioral models) of mental
- How does DSM-III help diagnosis and treatment
(think especially in terms of "reliability" and
- In terms of "history", "differential
diagnosis", and laboratory confirmation, how has psychiatric
diagnosis changed with the return of the medical
- How do brain imaging (like CT, NMR, and PET
scans), neurochemical tests (such as MHPG measures), and mapping
electrical activity (or "EEG") each differ from one another? What
role does each type of laboratory test play in
Chapter 8 & 9
- Why are psychoactive drugs considered
"treatments" for mental illness, as opposed to both restraints and
- What is the difference between side and target
effects? For example, list both types of effects for
- How did the effect of chlorpromazine (a
neuroleptic) change when it was chemically altered into imipramine
- How do antianxiety agents differ from
antipsychotics, even though both are called
- Which different disorders do MAOIs and lithium
treat? How is lithium different from antianxiety
- What is the "placebo effect", and why does it
force researchers to use double-blind trials when testing new
- Why is speaking of the "cause" of a particular
illness likely to lead to confusion?
- Now that you have read about brain functions
(e.g. the roles of brain structures and neurotransmitters) and the
diagnosis of mental illness (e.g. the classification of
schizophrenia and affective disorders), you can understand the
sections on the causes of different disorders. What are the types
of ways the brain can "break down" (e.g. through abnormalities in
- How can we trace these different types of
causes? For example, what do twins studies tell us about genetic
factors for schizophrenia or affective disorders?