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Lecture 3

Week 3 (part 2).docx

4 Pages

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PSYC 3390
Mary Manson

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Unit 3 Summary (Part 2) p. 102-110, 114-138, 139-146 p. 102-110 Sociocultural Viewpoint th  20 century – sociology and anthropology are recognized as separate disciplines and working towards understanding sociocultural factors regarding human development and behaviour  There is a relationship between sociocultural factors and psychological disorders – these discoveries have aided in modern perspectives of abnormal behaviour  Sociocultural viewpoint -> concerned with impact of culture and other features of the social environment on psychological disorders o These relationships are complex o Studied mainly through cross-cultural studies  Cross cultural research enhances knowledge about a range of variation in human behavioural and emotional development; it also generates ideas about what causes normal and abnormal behaviours that can later be tested in laboratories  Research supports that many psychological disturbances in children and adults are universal  The Minnesota Multiphasic Personality Inventory (MMIP-2) is the best validated and most widely used test that has been adapted for use in many cultures, and has been used to identify many forms of psychopathology that occur across all cultures (i.e. schizophrenia)  Nonetheless, although some universal symptoms appear, they are influenced by sociocultural factors such as which disorders develop, the forms they take, how prevalent they are, and their course o i.e. although anxiety disorders occur everywhere, the World Health Organization did a study which showed the prevalence among many different countries – they varied greatly o As well, key symptoms in one country/region for a particular disorder might not be the same in another country/region  There are also marked difference in over- and under-controlled behaviour across countries o Chinese are intolerant of undercontrolled behaviours in their children (aggression, disobedience, disrespect, etc.) whereas North Americans have a higher tolerance  Raises the question: would overcontrolled behaviours (shyness, anxiety, depression, etc.) be higher in China as compared to North America?  Cultural differences in psychopathology may also relate to parent-child attachment relationships Sociocultural Causal Factors  Sociocultural groups are formed from thousands of years of social evolution – as each generation is taught the same things, the members all seem to be somewhat alike; the more uniform the teachings, the more similar the members  Subgroups of general sociocultural environments (such as family, gender, age, etc.) foster beliefs and norms of their own largely by social roles they learn to adopt  When social roles are unclear, conflicting, or difficult to achieve, healthy personality development may be impaired  There are many sources of pathogenic social influences: o Low socioeconomic status and unemployment  In our society, the lower the SES class, the higher the incidence of mental disorders  Strength of this inverse correlation varies depending on the mental disorder – antisocial personality disorder has a high negative correlation with SES as compared to depressive disorders which are only mildly related  Why? Some people with mental disorders “slide down the economic ladder and stay there” because they do not have the personal resources to climb back up, or due to stigma and prejudice  People who live in poverty also encounter more (and more severe) stressors in their lives  More affluent people are better able to get help or hide their problems  Children from low SES families tend to have more problems (correlation between SES and IQ, mental distress, higher risk taking and affiliating with deviant peers, and aggressiveness)  Unemployment is associated with higher rates of psychopathology and vulnerability, as well as higher rates of depression, marital problems, and somatic complaints (spouses are also adversely affected) o Prejudice and discrimination in race, ethnicity, and gender  Perceived discrimination can lower levels of well-being, autonomy and self-acceptance as well as increase prevalence of psychological disorders (stressor)  Two main types of discrimination against women:  Access discrimination: women are not hired because of gender  Treatment discrimination: women have jobs and are paid less, treated more poorly, and receive fewer opportunities for promotion  Women also experience sexual harassment in the workplace o Violence  There are vast numbers of violence worldwide, especially against women and children  There is an increased toll on medical care, lost productivity, and increased rates of anxiety, depression, posttraumatic stress disorder, and suicidality o Homelessness  Approximately 10,000 Canadians are homeless on any given night  Mental and behavioural disorders (substance abuse disorders and psychotic disorders such as schizophrenia) account for 52% of Canadian acute care hospitalizations, and about 1/3 of homeless Canadians suffer from mental illness  Being homeless also increases the risk of mental distress, such as anxiety, depression, suicidality, and physical illness  Increased understanding of sociocultural influences has led to programs designed to improve social conditions that foster maladaptive behaviours and mental disorders, as well as community programs for early detection, treatment, and long-range prevention p. 114-138 Basic Elements of Clinical Assessment  Presenting problem: major symptoms and behaviour (first step in identification) o Situational? Stressors? o Long term disorder? o Recent deterioration in cognitive function? Etc.  Relationship between assessing and diagnosing – important to have adequate classification of the presenting problem o Formal diagnosis needed for health insurance coverage o Knowledge of disorder influences treatment planning and management o Aids in determining which treatment facilities are available  Clinical purposes – formal diagnostic classification is much less important than having a clear understanding of individuals behavioural history, intellectual functioning, personality characteristics, and environmental pressures and resources o Personality factors: assessment includes description of any relevant long-term personality characteristics (deviance, maladaptive, self-absorbed?) o Social context: assesses the social context in which the individual usually operates (environmental demands, supports, stressors?)  All of these bits of information need to be integrated into a consistent and meaningful picture, often referred to as “dynamic formulation”  These factors should allow the clinician to have a plausible explanation for the behaviors exhibited, and allow them to make hypotheses about the clients future behaviours  Where feasible, decisions about treatment are made collaboratively with the consent and approval of the individual o In severe cases however this may not be possible – or even without the consent of reasonable family members  How clinicians go about the assessment process depends on basic treatment orientations o i.e. psychiatrist is likely to focus on biological assessment methods, psychoanalysts are likely to focus on personality assessment methods, etc.  it is important clients feel they can trust their clinicians in order for psychological assessments to proceed effectively  They need to be assured that their feelings beliefs and personal history will be used appropriately and held in confidence  Confidentiality – test results and information are released to a third party only if the client signs an appropriate release form; in the case that the client is being tested for a third party (court, etc.) the client in effect is the referring source, not the individual being tested Assessment of the Physical Organism  In some situations, medical evaluation may be necessary to rule out the possibility that physical abnormalities are causing/contributing to the problem  This may include a general physical exam and special examinations aimed at assessing the structural and functional integrity of the brain o General physical exam: used in cases where physical symptoms are part of the presenting clinical problem; medical history is obtained, major systems of the body are checked o Neurological exam: brain pathology is sometimes involved in mental disorders, specialized neurological exams can be administered  EEG (electroencephalogram): assesses brain wave patterns by recording electrical activity  If it reveals a dysrhythmia (irregular pattern; i.e. adult males with ADHD) other specialized techniques may be used
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