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PSY210H1 Lecture Notes - Specific Phobia, Panic Attack, Palpitations

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Lecture #28
Mental Disorder (Part II)
ŸMany 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
ŸPatterns 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
ŸTheories and origins of abnormal behaviour=etiology is the study of the origins of behaviour
ŸNot 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)
ŸIf 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
ŸWe 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in our culture will be stigmatized, resources withdrawn, occupation limited, but in other cultures, when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
ŸDifficulties with classifying of behavioural disorders, if a person talks about all their symptoms, you
must categorize them to inform how you treat them
ŸThere are many issues with classifying, how do clinicians go about making decisions
ŸIn 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
ŸThe 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)
ŸThe clinician is more often right than wrong too, but computer will outperform
ŸIf 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
ŸOnce you know what diagnosis to give patient, you know how to treat them, this derails over and over
again (this example for medical community)
ŸFirst 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
ŸAs our field evolves, clinical psychologists are becoming better and more reliable
ŸThe concept of comobidity, refers to the co occurrence of diagnosis (dual or multiple)
ŸIn 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)
ŸDisgnosis should be the process fo figuring out what you have by eliminating other possibilities
Ÿa 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
ŸThe 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
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