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psychopathology 1.docx

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Joe Kim

Module 1 – Introduction Introduction Event that consumes you so much it affects all aspects of your life and you can’t just ‘move on’, what if the all-consuming state of mind was a voice or a crippling fear of strangers, or feelings of intense sadness = psychological disturbance. Abnormal behaviour, classification system for diagnosing various psychological disorders, the different models that are used to explain and treat abnormal behaviour, and a few of the most common disorders. Module 2 – What is Abnormality? The Four D’s Abnormal behaviour can vary between people, cultures, time periods, making it difficult to define what makes behaviour truly abnormal. Four D’s: deviance, distress, dysfunction, and danger, criterias that are used as guidelines, and exhibiting one or more of these characteristics does not necessarily label someone as having a psychological disorder. Deviance Having thoughts, emotions and behaviours that fall far outside of the standards of what others are doing (does not mean that all people who differ from the norms of the group have a psychological disorder, ex.: cultural practises of minority population as psychological disorders). Includes both those who fall well below and well above the standard of the group. Ex.: if we are to label all individuals with very low IQ disordered, should we do the same to those with very high IQ? Distress If a person experiences intense negative feelings due to their behaviour, such as anxiety, sadness, or despair, this may be indicative of a psychological disorder. Some exceptions and a person who is free of distress is not necessarily psychologically healthy. Ex.: bipolar patients in the manic phase often feel extremely elated and larger than life – certainly not distressed. Ex.: patients with antisocial personality disorder are also known to feel no remorse or distress when causing harm to other people. Dysfunction Behaviour tends to interfere with the person’s ability to function properly in their daily lives. Behaviours that are dysfunctional are often described as being “maladaptive” because they prevent an individual adapting well to their environment. Dysfunction doesn’t necessarily mean that the person has a psychological disorder. A person may choose to stop functioning in society as a means of protest, like someone on a hunger strike. Danger Danger to oneself or another. Ex.: person who engages in risky behaviours that lead to drug addiction or a person who engages in violence towards others. Dangerous behaviour alone does not prove that a psychological disorder exists. Ex.: athletes who participate in extreme sports or office workers who do not get weekly exercise and unhealthy food. Module 3 – Classifying Disorders The DSM Line dividing normal and abnormal is not clear-cut. We need to be able to properly classify and diagnose the disorder. Allows us to learn about potential causes, the best treatment, and the likely prognosis of the disorder. DSM (Diagnostic and Statistical Manual) used as a guideline for proper diagnosis Two main functions: it categorizes and describes mental disorders so that clinicians will have a common set of criteria for applying a diagnostic label to the symptoms of their patients. DSM also allows researchers to talk to each other about mental disorders using a common language. Diagnostic Criteria DSM outlines two general criteria that must be met before a clinician can make any diagnosis regarding mental health, regardless of the specific disorder question. 1) Disorder must originate within the person, rather than being a reaction to something in the environment. Ex.: a person who is crying uncontrollably with thoughts of despair wouldn’t necessarily be diagnosed with clinical depression if you were aware that they had just lost their entire family in a car accident (response considered a normal response to an external factor). 2) Disorder is involuntary, and the person suffering from the disorder is unable to control the symptoms that they experience. This rules out someone who is on a hunger strike as a means of protest. Categories in the DSM Attempts to group together disorders that have similar sets of symptoms, with the assumption that similarities suggest a common cause and that they can be similarly treated. Can change as researchers discover new information about specific disorders, this leads to changes in the criteria for diagnosis and grouping of disorders, new version of DSM is released. Module 4 – Models of Psychopathology Functions of Models DSM only describes a pattern of symptoms. Does not offer explanation or treatment methods. Models of psychopathology attempt to explain the causes of the disorder and to help decide how to treat it. Four main models: t biological, psychodynamic, behavioural and cognitive models. Biological Models Also known as the medical or disease model, assumes that a psychological disorder results from malfunction in the brain, because it is physically damaged, or because there is abnormal activity of chemicals in the brain known as neurotransmitters. Usually points to genetics, nutrition, disease, and stress, to explain brain malfunction. Advocates the use of drugs to treat the disorder. In extreme cases, treatment may also include electroconvulsive shock or brain surgery. Psychodynamic Model Believes that mental disorders are rooted in an internal malfunction; however, instead of physical malfunction, it is thought to be a psychological malfunction. It is the mind and its processes, not the physical brain, which is working improperly. Mental disorder is usually attributed to maladaptive attempts to deal with strong, unconscious conflicts, stemmed from unresolved childhood issues. No physical therapy, such as drug treatment, can actually cure a mental disorder – all it can do is temporarily alleviate the symptoms. Psychological therapy such as psychoanalysis can get to the root of the problem and end the disorder. Popular psychological therapies focus on personal insight in which therapists try to help patients understand themselves so they can cope better with life stressors. Behaviourist Model Both the medical and psychodynamic models agree that mental disorder is an internal problem. Disordered and maladaptive behaviours that we see on the outside are merely symptoms of the internal problem, just as a fever may be a symptom of an infection. Behavioural model: disordered behaviours and emotions are not symptoms of anything inside the person. These behaviours and emotions are the problem. The abnormal behaviours are often the most striking thing that first draws our attention. Disordered behaviours are established through classical and instrumental conditioning. Contingencies, rewards and punishments received for our actions influence our behaviours. Ex.: your behaviours lead to sympathy and attention of others or keep you out of anxiety- producing situations. Some behaviours may be inappropriately generalized from situations where they have an appropriate function, to situations where they do not. Attempt to treat maladaptive behaviours using principles from conditioning. Ex.: classical conditioning to treat phobias. Downsides: can you really say that someone who hears and responds to voices in their head has learned to behave that way? Although behavioural treatment is often effective while inside the comfort of the therapists’ office, it does no always transfer well to other environments. The behavioural model has been criticized for treating people as simple reflexive beings that just react to their environment, rather than having the ability to plan, remember, and predict things in their world. Cognitive model Mental disorder result from maladaptive or inappropriate ways of selecting and interpreting information from the environment. We are anxious or depressed not because of what is happening around us, but rather because of the way we interpret those events. Ex.: some people enjoy public speaking, while others are so anxious about it that they are almost paralyzed in front of an audience. It isn’t the audience that causes the anxiety, but rather, the way the speaker interprets the situation. Experience and learning play an important role in shaping maladaptive thinking. Cognitive therapies are designed to identify maladaptive thinking, and to change it through more positive experiences. Because cognitive and behavioural approaches to therapy complement each other, and many therapies combine these procedures designed to change both thinking and behaviour, cognitive- behavioural therapies. Module 5 – Mood Disorders Introduction Axis I: Clinical Syndromes Axis II: Developmental Disorders & Personality Disorders Axis III: Physical Conditions Axis IV: Severity of Psychosocial Stressors Axis V: Highest Level of Functioning Characterizing Mood Disorders Characterized by disturbances in emotion, which includes both the depressed mood of depression and the elevated mood of mania. Two main types of depressed mood disorders, Unipolar Depression, and Bipolar Depression. Case Study John lost his job as head engineer, instead of searching for a new job, he now spends his time at home sleeping. Little interest in doing anything, and finds it hard to get out of bed in the morning. Normally very physically active, lately he has very little appetite and he feels chronic headaches and muscle sores. When he does try to do something, he moves very slowly and has trouble concentrating on the task at hand. His mind is filled with negative thoughts that he has failed his family, and sometimes he feels very guilty about it. Can’t get thoughts of suicide out of his head, thinking it is the only way to end his misery. John displays all the symptoms of Unipolar Depression, also called Major Depression. Depression can present itself in a less severe form and not every symptom needs to be present for a clinician to make a diagnosis. Episodes of Major Depression are recurrent, but left untreated, can last for several months. In between episodes, a person usually returns to normal functioning. However, because of the suicide risk, and the harmful effects of depression to a person’s social well-being and physical health, it is not usually advisable to leave depression untreated. Dysthymia Chronic variant of depression. Dysthymia has symptoms of depression that are less severe, but they rarely return to normal levels of functioning in between bouts of depression. Being mildly depressed all the time. Bipolar Disorder
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