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Lecture 11

PSY 202 Lecture 11 Psychological Disorders

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Ryerson University
PSY 202
Brad Meisner

Psychological Disorders – Lecture 11 - Mental Disorders o When adaptation breaks down o Maladaptive responses o Within a person’s context o Statistically rare o Not explained by cultural norms o Societal disapproval o Causes multiple outcomes:  Subjective distress  Impairment in functioning - They do not all have commonalities! - They merely share a loose set of features Common Misconceptions 1. Abnormal behaviours are always bizarre 2. A clear distinction can be drawn between “normal” and abnormal” behaviours - Abnormality is a matter of degree - Not all people fit neatly into one of two categories - “Abnormality” consists of a poor fit between behaviour and the situations in which it is enacted o Who talks to themselves when alone? o How about in public? 3. As a group, former mental patients are unpredictable and dangerous - The typical former mental patient is no more volatile or dangerous than people in general - Exceptions to this rule generate the most media attention 4. Mental disorders indicate a fundamental deficiency in personality, and are thus shameful - Everyone shares the potential for becoming disordered and behaving abnormally 5. Because mental illness is so common, there is reason to be fearful of one’s own vulnerability. 6. Geniuses are particularly prone to emotional disorders - Terman’s study of high IQ children showed that high-IQ people actually may be more well-adjusted than the population in general 7. Most mental disorders are incurable - Between 70%-80% of those hospitalized as mental patients eventually recover Historical Context • Demonic Model – Mental illness and related odd behaviours were attributed to evil spirits infesting the body. • Hearing voices, talking to oneself, etc. • Medical Model – Mental illness was due to a physical disorder requiring medical treatment. • Governments housed troubled individuals in asylums • Attempts to scare a person out of their disorder • I.e., bloodletting and snake pits (early medical model treatments) • Chlorpromazine, circle 1950s – Anti-psychotic drug – Chlorpromazine helped bring upon the deinstitutionalization movement in the 60s-70s • Benefits: Some patients returned to normal lives and continued outpatient programs. It has saved the government a large amount of money. • Costs: Many patients ended up homeless. This can still be seen today as a recent study indicated that 15% of all patients treated for mental disorders are homeless. – Reduced the “need” of unethical and inhumane medical treatments Cultural Contexts • Many mental disorders are culturally universal such as schizophrenia, alcoholism, psychopathic personality, etc. • Eating disorders are most commonly associated with Western cultures. – Anorexia nervosa • More culturally universal – Bulimia nervosa • Unique to Western(izing) cultures • We must be careful to avoid the use of popular psychology labels for psychological disorders • Not all disorders show the same trends Classifications and Diagnoses • Pinpoints symptoms, helps select treatments, and assists professional communication. • Some common misconceptions associated with diagnosis are: – Diagnosis stigmatizes people. • Labeling theorists believe that diagnosis can exert a negative influence on behaviours and perceptions • Leads health practitioners to self-fulfilling prophecies. – Diagnosis is simply pigeonholing individuals into boxes. • Psychiatrists realize that people differ – Diagnosis is invalid. • Diagnoses tell us something new about the person – Diagnosis is unreliable. • For major mental disorders, interrater reliability is high DSM (1952) • Outlines diagnostic criteria and “decision rules” for each current mental disorder. • Also provides research, medical, therapeutic, and insurance information for each disorder • Adopts and biopsychosocial approach o Organized in 5 Axis  Major Axis I – Clinical disorders • Substance-related disorders, schizophrenia  Major Axis II – Developmental and personality disorders • Antisocial personality disorder, borderline personality disorder, psychopathic personality disorder  Major Axis III – General medical conditions • Secondary (physical or mental) conditions • Infectious and parasitic diseases  Major Axis IV – Psychosocial and environmental problems • Problems with primary support group, economic problems, occupational problems • Problems associated with external stress • Problems related to the social environment  Major Axis V – Global assessment of functioning • General Assessment of Functioning (GAF) o Continuum of mental health – mental illness o Considers the:  Severity and duration of symptoms  Impact on psycho, social, and occupational functioning o Scale of 0-100 Criticisms of the DSM • Exclusive reliance on a categorical model – Some mental disorders may better fit a dimensional model as they may differ from normal functioning by degree rather than type • E.g., depression and anxiety. • Classifications may not reflect precise boundaries of a mental disorder. – Lacking an operational definition between normality vs. pathology – Not everything is based on scientific data – Some disorders are based on subjective committee decisions. • High level of comorbidity among diagnoses. • Exclusive reliance on a categorical model. • Often overlooks individual differences. – Differences in ethinic/cultural background, gender/sex, age, etc. Anxiety Disorders • The most prevalent of all psychiatric disorders – Lifetime prevalence of 29% – Average age of onset is about 11 years • Younger than most disorders • Somatoform Disorders – Class of conditions marked by physical symptoms that suggest an underlying medical illness, but that are actually psychological in origin. • Hypochondriasis – think you have a condition, but not actually having one (“Let’s see which illness I have today!”) • Panic Disorder – Repeated and unexpected panic attacks, along with a change in behaviour to avoid panic attacks. – Nervous feeling escalate to fear/terror – About 20%-25% of college students report at least one panic attack within a year • Generalized Anxiety Disorder – Extensive periods of continual feelings of worry, anxiety, physical tension, and irritability. – Spend on average 60% of each day worrying. • Compared to 18% of general population – Often experience other anxiety disorders such as panic disorder or phobias • Phobia – An irrational fear to a non-threatening object where the reaction is disproportionate to ac
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