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Chapter 10 Pysch and the Law notes.docx

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David Nussbaum

Chapter 10 Mentally Disordered Offenders y The concept of mental disorder presupposes that it is possible to discriminate between normal and abnormal behaviour y In North America the primary tool used to diagnose mental disorders is the Diagnostic and Statistical Manual of Mental Disorders DSM y The DSM organizes the diagnoses into five levels relating to different aspects of disorders o Axis 1 clinical disorders including mood disorder anxiety disorders phobias etc o Axis 2mental retardation and personal disordersincluding avoidance dependent and obsessive compulsive schizoid and schizotypal o Axis 3 general medical conditions that may be related to the mental disorder or that might influence the choice of medications for treating the disorder o Axis 4 psychosocial or environmental factors that contribute to disorders including family problems educational problemseconomic problems or problems with the legal system o Axis 5 assessment of the patients general level of functioningy There have been a number of criticisms of the DSM including construct validity and reliability of the diagnostic categories and symptoms y Critics have argued DSM lacks a strong empirical basisand they also argue that it places undue emphasis on the existence of symptoms which in turn leads to the proliferation rise of disorders y DSM has also been criticized for having a reductionist bias its system of making categorical distinctions between disorders and between normal and abnormal is unjustifiedy Despite these criticisms it remains as a default tool for diagnosing mental disorders in North America some people feel DSM should use a dimensional approach and should include a level of impairment since the impact of symptoms varies across individuals Mentally Disordered Offendersy With the advent of new psychotropic medications a movement to deinstitutionalize started and many patients were moved into the community starting in the 60s y there is an overrepresentation of serious mental disorders in patients with many prisoners suffering from anxiety and depression
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