PSYC104 Lecture Notes - Lecture 9: Attention Seeking, Social Isolation, Somatization Disorder
1 Jun 2018
School
Department
Course
Professor
Psychopathology
Mental Health, Problems & Disorders
• Mental health = state of emotional and social wellbeing
• Mental health problems = emotional and behavioural abnormalities
which impair functioning
• Mental disorders = cause significant distress to self or others and
impairs functioning (social, occupational, personal, health)
• Emotional problems affect us all → interviewed by Wesley mission
surveying 3000 people (2010)
o 53% surveyed had a psychological disorder
o In the last 12 months = 26%
o Family member or close friend = 64%, add on colleague – 77%
▪ Male = 72%
▪ Female = 83%
▪ Rural = 86%
o Not sought help – 55% (emotional) vs. 7% (physical)
• This statistics shows the stigma revolving around mental health –
considering majority of people do not seek help
• Prevalence varies with –
o Gender → females increase
o Age → 16-24 years vs. 75 years – 4 times higher
o Education → tertiary education puts people less at risk
o Homelessness → many people suffer mental disorders
o Incarceration → increase in mental disorders for people in jail
• Days out of role per year –
o Affective (mood) disorder = 6.2 days
o Anxiety disorder = 4.5 days
o Substance use disorder = 3.5 days
o Any disorder = 4 days
Definitions of Abnormality:
• Statistical infrequency
o Unusual or abnormal? – Thomas Szasz says that people that do not
conform/non-conformity are punished
• Personal distress
o Subjective e.g. mania (enthusiastic, exaggerated sense of own capacity,
impulsivity), sociopaths
• Social or occupational disability
o Hypomania (less intense form of mania), transvestism
• Violating social norms or a threat to others
o Homosexual, criminals and prostitutes? – traditional views
• How deviant?
o Normality-abnormality on a continuum
• CONCLUSION – definitions are socially determined and varies with time and
place → criteria for classification needs to be explicit, valid (testable) and
reliable
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Explanations for Mental Disorders –
• Nature and range of mental illness, psychological disturbance or disorders
o Infant/childhood/adolescent disorders → ADHD, mental retardation,
intellectual impairment
o Cognitive/organic disorders → dementia, amnesia, neurological
problems
o Substance related disorders → alcohol, cannabis etc.
o Schizophrenia and psychotic disorders → paranoia, catatonic (freeze
disorders)
o Mood disorders → major depression, bipolar
o Anxiety disorders → panic disorder, agoraphobia
o Dissociative disorders → amnesia, identity disorder
o Somatoform disorders → hypochondriasis
o Eating disorders → anorexia, bulimia, EDNOS
o Sleep disorders → insomnia, narcolepsy
o Personality disorders → OCD
• Historical accounts of mad/eccentric behaviour: Demonic possession
o Possession/taken over by demons
o Witches in league with the devil (history has killed people thinking
they are witches associated with devil)
o Victims of God’s punishment
o Cruel, barbaric and superstitious treatments (chants, rituals, exorcisms,
torture, confinement, death)
o Dominant view in some communities today
• Medical model (illness as a disease)
o The view of demonic possession was replaced by the medical model
o Advantages → sickness not possession
o People are sick – sympathy replaced hatred and fear = more humane
treatment
o Pinel’s reforms – French psychiatrist → eventually led to more
humane approaches
o Physical explanations for general paresis and dementias (clearly brain
changes and abnormality in the brain – proving that people have
something wrong neurologically)
o Scientific investigation of causes and treatment
o Psychiatric hospitals built and were isolated from towns as there was a
belief that those people are dangerous to the public
o Still led to lifetime incarceration
• Disadvantages of the medical model
o Social isolation of sufferers
o The absence of effective treatments led to inhumane detention
o E.g. psychiatric hospitals on rivers and behind high walls
o Labeling: potentially derogatory, social stigma, self-fulfilling prophesy
o Calling it an illness is a Pseudo-explanation = description not
explanation
▪ Encourages passivity → may hinder recovery
• Refinements to the Medical/Biological Model
o Neural circuits → e.g. amygdala, frontal lobes (dysfunction in these
can give rise to disorders)
o Neurotransmitter dysfunction → e.g. norepinephrine
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o Genetic predisposition and heritability (partial explanation)
• Conclusion re medical/biological model
o No identified physical pathology in many disorders
o Disease is only an analogy – still may be a helpful metaphor
o Unable to account for many disorders – need other explanations
• Rise of psychological explanations
o Failure to find organic or neurological explanations
o Studies of hysteria (Conversion disorder) by Freud
o Most behaviour and disorders are multi-determined: biological,
psychological and social
• Alternative Explanations: Nature vs Nurture
o Psychodynamic → neurosis, P.D., Psychosis
o Cognitive-behavioural → learning and cognitive processes
o Systems → family systems, roles, boundaries, alliances
o Evolutionary → selection of adaptive traits that aid survival and
increase adaptive fitness
• Diathesis-Stress model
o Assumes underlying vulnerability (diathesis) and stress triggers onset
of disorder
o Diathesis (vulnerability) may be biological or the way we have learned
(personality)
o Environmental stress may trigger vulnerability
o Vulnerability heightens our reaction to events
o Both may vary over time
o The same reaction may be the result of different combinations of
vulnerability and stress e.g. people being depressed for different
reasons
DSM5 Definitions –
• Purpose of classifying disorders
o Encourage standardization
o Guide to treatment
o Facilitate research
o Assist communication between professionals
• DSM-5 definition – mental disorder =
o Based on distress, disability, risk of suffering (death, pain or disability)
or an important loss of freedom
• DSM-5 diagnoses now based upon =
o Specific observable symptoms, not assumed causes of theories (i.e.
Descriptive)
• Examples of DSM definitions of disorders or syndromes
o E.g. paranoid personality disorder
• DSM-5 Criteria Example - paranoid personality disorder
o A global mistrust and suspicion of others motives which commences in
early adulthood, as indicated by four (or more) of the following:
▪ Believes others are using, lying to, or harming them without
apparent evidence
▪ Doubts about the loyalty and trustworthiness of others
▪ Will not confide in others due to the belief that their confidence
will be betrayed
find more resources at oneclass.com
find more resources at oneclass.com
