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Roshan Singh 042108 Mr.Fournier PSYA02H3 Chapter 17 Notes Some mental disorders (especially less severe ones) appear to be caused by environmental factors or by a persons perception of these factors such as stress or unhealthy family interactions. Many of the more severe mental disorders appear to be caused by hereditary and other biological factors that disrupt normal thought processes or produce inappropriate emotional reactions. Emil Kraepelin (1856-1926) provided his version of a comprehensive classification system of psychological disorders. Psychologists stress that the most important feature of a mental disorder is not whether a persons behaviour is abnormal but whether it is maladaptive. In general, mental disorders are caused by the interaction of hereditary, cognitive and environmental factors. Once genetic factors are identified, the scientist faces the task of determining the physiological effects of the relevant genes and the consequences of these effects on a persons susceptibility to a mental disorder. Understanding cognitive factors requires identification of the origins of distorted perceptions and maladaptive thought patterns. Environmental factors include a wide range of factors, from a persons family history and present social interactions, to their diet, exposure to drugs or alcohol, and childhood diseases. The psychodynamic perspective suggests that the conflicts between the id, ego and superego may centre on attempts to control potentially harmful expressions of sexual or aggressive impulses or they may also arise from attempts to cope with external dangers and traumatic experiences. The result is that the defence mechanisms themselves distort reality or the individual begins to function in some areas of life in a manner characteristic of an earlier developmental stage. The consequent may involve symptoms such as extreme anxiety, obsessive thoughts and compulsive behaviour, depression, distorted perceptions and patterns of thinking and paralysis or blindness for which there is no physical cause. The medical perspective originated from the work of the ancient Greek physician Hippocrates. In the past almost everyone was institutionalized whereas today only people with very severe and intractable mental problems are institutionalized for long periods of time. The medical model is based on the ideas that mental disorders are caused by specific abnormalities of the brain and nervous system and that they should be approached for treatment in the same way as physical illnesses. The cognitive-behavioural perspective holds that mental disorders are learned maladaptive behaviour patterns that can best be understood by focusing on environmental factors and a persons perception of those factors. The humanistic perspective suggests that mental disorders arise when people perceive that they must earn the positive regard of others. Thus, they become overly sensitive to the demands and criticisms of others and come to define their personal value primarily in terms of others reactions to them. The sociocultural perspective suggests that the cultures in which people live in play a significant role in the development of mental disorders. www.notesolution.comRoshan Singh 042108 Mr.Fournier PSYA02H3 Chapter 17 Notes Diathesis-stress model A causal account of mental disorders based on the idea that mental disorders develop when a person possesses a predisposition for a disorder and faces stressors that exceed his or her abilities to cope with them. Diagnostic and Statistical Manual IV (DSM-IV) A widely used manual for classifying psychological disorders. The DSM-IV tends to be more consistent with the medical perspective on mental disorders than with other perspectives i.e. it only focuses on biological factors and that potential cognitive and environmental determinants may be overlooked. Thomas Szasz suggests that we should abandon all attempts to classify and diagnose mental disorders. He argues that the concept of mental illness has done more harm than good because of the negative effects it has on those people who are said to be mentally ill. Advantage of proper classification for a patient is that the recognition of a specific diagnostic category precedes the development of successful treatment for that disorder. If future research is to reveal more about causes and treatments of these disorders, we must be able to classify specific mental disorders reliably and accurately. In a survey conducted by Newman and Bland (1998), Edmonton was checked for incidence of mental disorders. In this survey, substance use disorders, mood disorders and anxiety disorders were found to be the most common types of mental disorders. Their findings are consistent with other prevalence surveys from different locations and suggest that mental disorders occur at a fairly high frequency. 2 activities contribute to diagnoses and predictions: collection of data and interpretation of data. Both are essential as unreliable or irrelevant data cannot be interpreted and good data can be spoiled through misinterpretation. In a clinical judgement, it is not the source of information that is important, rather it is the processing of that information. Clinical judgements Diagnoses of mental disorders or predictions of future behaviour based largely on experts experience and knowledge. Actuarial judgements Diagnoses of mental disorders or predictions of future behaviour based on numerical formulas derived from analyses of prior outcomes. It was first devised for setting the rates of insurance policies. Goldberg (1986) compared the 2 methods and found that on average, judges were correct 62% of the time about their patients, the best judge being correct 67%. The actuarial rule was superior as it was correct 70% of the time which was better than the best judge. Actuarial method is better because of its reliability as experts may become tired, their judgement may be influenced by some recent cases in which they were involved, or the order in which the information is
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