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Abnormal Psychology 3.docx

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Konstantine Zakzanis

Abnormal Psychology Chapter 3: Classification and Diagnosis - Disorder must be categorized correctly before its causes and treatments can be found o If one research group has found a successful treatment for depression but has defined the treatment in an unconventional manner, the finding is not likely to be replicated by another group of investigators - The Diagnostic and Statistical Manual of Mental Disorder (DSM) now in the fourth addition known as DSM-IV-TR A Brief History of Classification - Gradually people recognized that different illnesses required different treatments - Also sought to develop classification schemes Early Efforts at Classification - Great inconsistency in the classification of abnormal behavior - Several attempts made to provide a system that would be widely adopted - Four different attempts: o In UK, Statistical Committee of the Royal Medico-Psychological Association o In Paris, the Congress of Mental Science single classification system o In the US, the Association of Medical Superintendents of American Institution adopted revered version of the British system o New York State insisted on their own system - LOTS of inconsistency Development of the WHO and DSM system - The World Health organization added mental disorders to the international list of causes of death - It was adopted at the WHO conference, but mental disorder section was not widely accepted - The American Psychiatric Association published their own DSM - British had Glossary of Mental Disorders - 1968 produced DSM-II contained crucial information but did not specify the symptoms for the disorders - 1980 DSM III revised version - DSM- IV o An important change in the process for this edition was the adoption of a conservative approach to making changes in the diagnostic criteria the reasons for changes in diagnoses would be explicitly stated and clearly supported by data o Its used throughout the US and Canada and is becoming widely accepted around the world - DSM-IV-TR revised version contain changes to the diff diagnostic categories and criteria - The DSM is controversial o it is not the book of truth nor is it universally embraced by psychiatrists o Some question whether the majority of the DSM correspond to real, underlying entities; they argue that they refer to hypothetical constructs that may or may not exist in reality - Psych diagnoses not identical to medical diagnoses where the basic cause is known and the presence of the disease can be objectively determined The Current Diagnostic System of the APA Definition of Mental Disorder - Provides the following definition o A clinically significant behavioral or psychological syndrome or pattern that occurs in an individual and that is associated with present distress or disability impairment In one or more areas of functioning) or with significantly increased risk of suffering death, pain, disability or an important loss in freedom o In addition, this syndrome or pattern must not be merely an expectable and culturally sanctioned response to a particular event, for example the death of a loved one Five Dimensions of Classification - Multitaxial classification each individual is rated on five separate dimensions, or axes o Axis I all diagnostic categories except personality disorders and mental retardation o Axis 2 Personality disorders and mental retardation o Axis 3 General Medical Conditions o Axis 4 Psychosocial and Environmental Problems o Axis 5 Current level of functioning - Most people consult a mental health professional for an Axis 1 condition, such as depression or an anxiety disorder but prior to that they may have has an Axis 2 disorder - Axis 1 + 2 means that it will be more difficult to treat - Axis 3 the clinician indicates any general medical conditions believed to be relevant to the mental disorder in question ex. Having a heart condition with depression would have implications for treatment the antidepressants would worsen the heart condition - Axis 4 include occupational problems, economic problems, interpersonal difficulties with family members - Axis 5 current level of adaptive functioning social relationships, occupation, leisure time Diagnostic Categories - For many the DSM indicates the disorder may be due to a medical condition or substance abuse Disorders usually first diagnosed in Infancy, Childhood or Adolescence - The child with separate anxiety disorder has excessive anxiety about being away from home or parents - Conduct disorder repeatedly violate social norms and rules - Attention deficit hyperactivity difficulty sustaining attention and are unable to control their activity when the situation calls for it - Mental Retardation show low intellectual functioning and deficits in adaptive functioning - Pervasive developmental disorders autistic disorder, a severe condition in which the individual has problems in acquiring communication skills and deficits - Learning disorder delays in acquisition of speech, reading, arithmetic, and writing skills Substance Related Disorders - Ingestion of some substance has changed behavior enough to impair social or occupational functioning - Unable to control or discontinue ingestion of the substance and may develop withdrawal symptoms if he or she stops itSchizophrenia - Contact with reality is faulty - Language and communication are disordered, shift from one subject to another - Experience delusions believing that thoughts that are not their own have been placed in their heads - Hallucinations hearing voices that come from outside themselves - Emotions blunted, flattened or inappropriate Mood Disorders - Moods are extremely high or low - Major depressive disorder deeply sad or and discouraged o Suicidal thoughts and feelings - Mania euphoric, irritable, more active than usual, possessed of HIGH self esteem - Bipolar disorder episodes of mania an depression Anxiety Disorders - Irrational or overblown fear - Phobia fear an object or situation so intensely that they must avoid it - Panic Disorder the person is subject to sudden but brief attacks of intense apprehension, so upsetting that he or she is likely to tremble and shake, feel dizzy, and have trouble breathe o Agoraphobia fearful of leaving familiar surroundings - Generalized Anxiety Disorder fear and apprehension are pervasive and persistent and uncontrollable o Worry constantly, feel on edge and easily
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