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Lecture 20

Lecture 20

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Waggoner Denton

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Lecture 20 (November 27 , 2012) th Morad Moazami Psychological  Disorders:     Psychopathology:  A  disorder  of  the  mind.     One  of  the  big  questions  is  how  do  we  distinguish  between  a  natural  emotional  experience  and   a  mental  disorder?  What  is  normal  and  what  is  abnormal?     We  watched  a  video  on  a  fucking  crazy  blow-­‐dryer  queen  who  needed  her  blow-­‐dryer.       • She  does  it  to  this  point  that  she  has  burns  on  her  hands  and  feet.     What  criteria  do  we  need  to  look  at  in  order  to  classify  something  as  a  psychological  disorder  or   not?   • Does  the  behavior  deviate  from  cultural  norms?   • Is  the  behavior  maladaptive?   • Is  the  behavior  causing  the  individual  personal  distress?     In  order  for  something  to  be  defined  as  a  psychological  disorder,  it  has  to  interfere  with  some   aspect  of  the  person’s  life.  It  has  to  interfere  with  their  social  life,  personal  life,  their  ability  to   take  care  of  themselves,  etc.     So  crazyblowdryerqueen's  addiction  may  deviate  from  cultural  norms,  because  some  people   sleep  with  fans  on,  etc.  But  the  behavior  is  maladaptive  because  she  could  burn  the  house   down  and  she’d  accidentally  burn  herself.  It  seemed  pretty  clear  also  that  it  was  causing  her   personal  distress,  because  she  didn't  want  to  be  so  dependent  on  her  blow-­‐dryer  either.     The  big  difference  between  sleeping  with  a  teddy  bear  or  none  of  these  things  would  be   different  than  sleeping  with  a  blow  dryer.     Diagnostic  and  Statistical  Manual  of  Mental  Disorders  (DSM-­‐ IV):     The  DSM  is  a  multi-­‐axial  system.  Someone  isn't  given  a  single  label,  but  a  diagnosis  based  on   five  different  axes.     Multiaxial  System:   • Axis  I:  Clinical  disorders  (the  big  kahuna):   o For  example:  schizophrenia,  depression,  phobias,  anorexia.   • Axis  II:  Personality  disorders  and  mental  retardation.   o Put  together  because  they  are  assumed  to  be  long-­‐lasting  with  little  chance   of  recovery  or  improvement.     o For  example,  borderline  personality  disorder.   • Axis  III:  General  medical  conditions,   o Anything  that  would  cause  problems  to  mental  health.   o For  example:  Alzheimer's,  obesity,  etc.   • Axis  IV:  Psychosocial  or  environmental  problems,   o For  example:  Unemployment,  divorce,  poverty,  etc.   • Axis  V:  Global  assessment  of  functioning.   o How  well  is  this  person  doing?   o They  are  given  a  scale  from  1  to  100,  with  1  being  a  high  risk  of  suicide  or   harming  others  while  100  is  being  irritatingly  great.     Assessment:       Assessment  involves  examining  a  person’s  mental  state  in  order  to  diagnose  (and  treat)   possible  psychological  disorders.     What  clinical  psychologists  want  to  do  is  to  get  information  from  many  sources  and  not  just   talking  to  the  one  person  or  having  a  personal  report.     Mental  status  exam  is  often  used  in  emergency  rooms.  They  are  a  relatively  quick  diagnosis   with  people  in  the  emergency  room  when  you  just  want  to  see  if  they  are  functioning  correctly:   looking  at  their  mood,  their  eyes,  asking  questions  about  what  day  it  is,  etc.     Clinical  interview  is  one  of  the  major  ways  of  assessing  a  patient,  which  involves  just  sitting   down  with  the  patient  and  interviewing  them.     Clinical  interviews  can  be  either  structured  or  unstructured.  Unstructured  is  when  the  patient   just  goes  with  the  flow,  but  when  they  do  have  a  set  of  questions  to  interview  multiple  different   patients,  that  is  a  structured  interview.  So  it  is  structured  versus  a  go-­‐with-­‐the-­‐flow  kind  of   interview.     Self-­‐report  and  observation  is  just  seeing  how  a  person  is  behaving.  What  are  they  wearing?   Are  they  taking  care  of  themselves  propery?     Psychological  and  neuropsychological  testing.   • Psychological  is  using  certain  questions  with  ten  different  scales  in  it  that  gives  you  a   range  of  how  a  person  is.  This  is  the  MMPI.   • Neuropsychological  are  questions  and  tests  when  you  give  the  patients  games  or   quizzes  to  see  how  they  behave.     We  want  everything  to  be  evidence-­‐bvased.  We  want  evidence  and  data  to  back  it  up.  When   we  make  a  diagnosis,  we  want  to  know  that  it  makes  sense.  That  there  is  evidence  that  this   type  of  person  has  this  type  of  disorder.     A  way  of  evidence-­‐based  realizations  are  comorbidity:  when  someone  has  a  mental  disorder,   they  have  others  too  which  are  associated  with  them.  For  example,  substance  abuse  is   comorbid  with  generalized  anxiety  disorder,  panic  disorder,  dysthymia,  etc.     Diathesis-­‐Stress  Model:     So  there  is  a  number  of  different  model  of  psychological  disorder,  and  every  disorder  we  go   through,  we  see  this  idea  that  there  isn't  just  a  single  factor  that  causes  psychological  disorders,   but  that  nature  and  nurture  are  entwined.     All  of  these  different  models  of  psychological  disorders  focus  on:  “It’s  not  just  genes  or  biology   or  parents.”     It  used  to  be  believed  that  people  became  schizophrenic  because  of  some  of  their  mother’s   behavior,  but  that  is  not  the  case.  There  are  multiple  factors  to  somebody’s  mental  disorder.     The  diathesis-­‐stress  model  summarizes  this:  When  somebody  has  an  underlying  vulnerability  or   an  underlying  predisposition  to  get  a  certain  mental  disorder.  This  might  be  biological  (you  may   have  a  schizo  parent),  their  chances  are  going  to  be  higher  than  others  in  the  population.   Childhood  trauma  could  also  make  them  vulnerable  to  a  mental  disorder  in  life.  This  creates  a   vulnerability  to  create  a  mental  disorder.  This  does  not  mean  that  this  person  will  develop  one   though.  Something  stressful  happens  and  you  have  this  underlying  vulnerability  and  you  can’t   cope  with  this  circumstance  and  you  lose  your  job  and  you  end  up  bankrupt  and  that’s  going  to   increase  your  chances  of  developing  schizophrenia.  Though  somebody  who  has  minimal   stressful  circumstances  has  a  lower  probability  of  mental  disorder.     There  is  thus  an  interaction  between  nature  and  nurture  that  can  contribute  to  the   development  of  a  mental  disorder.     Anxiety  Disorders:     There  are  a  number  of  disorders  that  flal  under  anxiety  diso
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