PSY 4791 Lecture Notes - Agoraphobia, Thought Disorder, Anxiety Disorder

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31 Jan 2013
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Many ways in defining abnormal, but none of the definitions are complete, many ways of constituting it,
but it is hard to cover all that we mean by this term
Patterns of behaviour from what is normative or expected, typically but not always involves personal
distress at a developmental stage, particular way in who other people think feel or act is distressing to
you, and it worries other people, and at some level this set of symptoms, impairs your ability to
function and thrive in an important domain, you want to succeed but as a result of your situation you
are unable to
Theories and origins of abnormal behaviour=etiology is the study of the origins of behaviour
Not trying to say by resisting medical model, resist medicine, and use symptom and disease theology,
clinical psychology is different, where a disease that is postulated has the same symptoms as the
disease (sadness and depression)
If symptoms cluster, anxiety, depression, the cluster of symptoms does not mean there is a biological
cause, there is something going on in the brain, but whether or not those things in the brain is the cause
of the symptoms is another matter
We should not assume then that a biological basis for disorder means that culture has no role, many
disorders have biological predisposition, but culture is also relevant, for e.g. schizophrenia (delusions,
thought disorder, hallucinations), but cultural meanings vary, different cultural meanings, a young adult
in our culture will be stigmatized, resources withdrawn, occupation limited, but in other cultures, when
you demonstrate the same symptoms, you can be made a venerated member of society, everything will
be brought to you, hallucination in that society it’s a sign of a vision
Difficulties with classifying of behavioural disorders, if a person talks about all their symptoms, you must
categorize them to inform how you treat them
There are many issues with classifying, how do clinicians go about making decisions
In the role of a clinician, someone is in your office and presenting series of symptoms, how can you figure
out what disorder best suits this person, most often clinicians use their head, use their expertise of the
knowledge they have, administer some tests, interview of some kind, all of this data which you must
make sense of=use your head to arrive to a decision
The problem is, if there is any formula being used, its not explicit, when researchers make decisions they
want to be more explicit it so they developed a general formula instead of using their best judgement
(formula is NOT always right, and clinicians aren’t always wrong, if you study these two entities over
time, on average the formula will outperform the clinician)
The clinician is more often right than wrong too, but computer will outperform
If someone comes in with a set of symptoms, if you bring different doctors, they should arrive at the same
decision and conclusion, and when deciding what disorder they have, your eliminating the ones that
they don’t have as you collect more and more information about the patient
Once you know what diagnosis to give patient, you know how to treat them, this derails over and over
again (this example for medical community)
First is problem of reliability, level of agreement for clinicians are not idea, factors that increase reliability,
if we use standardized tests and structured interviews rather than un-systemized processes
As our field evolves, clinical psychologists are becoming better and more reliable
The concept of comobidity, refers to the co occurrence of diagnosis (dual or multiple)
In clinical psychology, as your probability of one diagnosis goes up, you are more likely to get another
diagnosis, which completely defeats the purpose of figuring out the main diagnosis (like in medical
decision making)
Disgnosis should be the process fo figuring out what you have by eliminating other possibilities
a lot of the time the whole process of differential diagnosing makes no difference when it comes to
treatment, for e.g. if you have major depresive disorder, you will receive anti-depressents and therapy,
if you have an anxiety disorder, you receive anti-depressants and therapy, doesn’t matter what you get,
you get the same treatment
The treatment will change depending on the diagnosis, (point overstated), small differences, but virtually
everyone is recommended to egt psychotherapy, and if you talked ot practising psychotherapists, their
diagnosis is not important, what is going to inform what you do in the session is your theory of how
they became sick and what caused it (your theory of how person is the way they are=case formulation
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