Psychology 1000 Lecture Notes - Soltyrei, Xerostomia, Borderline Personality Disorder

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16 Jan 2013
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Chapter 13
Psychological Disorders
-22% of the population suffers from a diagnosable mental disorder
-Nearly half of all North Americans between the ages of 15 and 54 will experience a
psychological disorder at some time in their lives
-Psychological disorders are the second leading cause of disability, after heart disease
-One adolescent commits suicide every 90 seconds
The Demonological View:
Abnormal behavior is caused by supernatural forces:
*Treatment called trephination is when a sharp tool is used to chisel a hole in the skull
in order to “remove the demon/evil spirit” from the person’s body.
Medieval Europe: Disturbed people are either a) possessed or b) voluntarily made a pact
with the evil forces.
*Killed witches (if they threw a woman in the water and she floated then she is possessed
because evil spirits rise up, so she must be killed).
Early Biological Views:
Hippocrates: people with disordered behavior are sick just like with a physical disease
(it is their BRAIN that is ill!) and so they are not possessed.
Biological view started being widely accepted when:
General Paresis (a disorder with mental deterioration and bizarre behavior) was found to
have resulted from massive brain deterioration caused by syphilis.
Psychological Perspectives:
Freud’s Psychoanalysis:
Psychological disorders are caused by unresolved conflicts from childhood that make the
person vulnerable to certain kinds of life events. These situations cause anxiety and the
person tries to cope by using defense mechanisms:
Inappropriate or extreme use of the defense mechanisms results in maladaptive patterns
of behavior.
Neuroses: Disorders that do not involve a loss of contact with reality (obsessions).
Psychoses: Freud says that sometimes the anxiety from the unresolved conflicts is so
great that people can no longer deal with reality and they withdraw from it
(schizophrenia).
Behavioral Perspective:
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Disordered behaviors, just like normal behaviors, are learned through classical and
operant conditioning, and modeling.
Cognitive Perspective:
There are maladaptive and self-defeating thought patterns that are linked to disorders.
Humanistic Perspective:
Abnormality is the result of environmental forces that frustrate or pervert people’s
inherent self-actualization tendencies and search for meaning in life.
E.g. Conditions of worth = the development of a negative self-concept and the need to
deny or distort certain aspects of experience.
E.g. Intense self-Incongruence = breakdown
Vulnerability-Stress Model:
One way to think about the causal factors (psychological, biological, environmental) is in
terms of the relation between vulnerabilities and stress.
A vulnerability (a predisposition to a disorder all of us have them for every disorder
whether it is genetic, psychological or environmental) ONLY CREATES A DISORDER
WHEN a stressor (some recent or current event that requires the person to cope)
combines with vulnerability to trigger the disorder.
DEFINING AND CLASSIFYING PSYCHOLOGICAL DISORDERS
What is “Abnormal”?!
-Judgments differ based on time and culture (e.g. in the 1940s, a women who chose
career over family would be considered insane).
-1840’s, Senator Calhoun of South Carolina identified slaves from different cultures as
“insane”. Medical experts soon defined “Drapetomania” a new mental disorder that
involved an obsessive desire for freedom that drove some slaves to flee from captivity.
*This diagnosis applied to any slave who tried to escape more than twice
-Recently: political battle whether the following should be a real disorder:
Self-defeating/masochistic personality disorder = people who repeatedly involve
themselves in hurtful circumstances and relationships.
Define “Abnormal” by the “3 D’s”:
(one or more of them seem to apply to any behavior regarded as abnormal):
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Distressing: Behaviors are abnormal is they are intensely distressing to the individual
(e.g. depressed) or others, particularly if the individual has little control over the reaction.
Dysfunctional: Either for the individual or for society (e.g. behaviors that seem to
interfere with the person’s ability to work or experience satisfying relationships),
particularly if the individual cannot control such behaviors.
Deviance: Society’s judgment of how deviant the behavior is from society’s norms.
SO:
Abnormal behavior is behavior that is personally distressful, personally dysfunctional,
and/or so culturally deviant that other people judge it to be inappropriate or maladaptive.
DIAGNOSING PSYCHOLOGICAL DISORDERS
Need to have:
Reliability: Especially since people of unique professions are qualified to diagnose the
same people with wide ranges of disorders, there needs to be a system couched in terms
of observable behaviors that can be reliably detecting and minimize subjective
judgments.
Validity: The diagnostic categories should 1) accurately capture the essential features of
the various disorders, and 2) differentiate between the disorders.
The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-
IV):
1) The most widely used diagnostic classification system in North America.
2) Contains a detailed list of observable behaviors that must be present in order for a
diagnosis to be made (over 350 diagnostic categories in it).
3) Allows diagnostic information to be represented along 5 dimensions that take both the
person and the person’s life situation into account:
Axis I: The primary diagnosis = person’s primary clinical symptoms
Axis II: Reflects long-standing personality or developmental disorders
Axis III: Notes any relevant physical conditions (e.g. high blood pressure)
Axis IV: Rates intensity of recent environmental stressors
Axis V: Person’s coping resources as reflected in recent adaptive functioning.
*NOTE: Criticisms: 1) the criteria are so strict that many people don’t fit into the
categories, 2) Axis II may overlap with Axis I and this reduces reliability and validity.
CRITICAL ISSUES IN DIAGNOSTIC LABELLING
Social and Personal Implications:
-People accept the diagnosis as a description of the individual rather than the behavior
and act differently towards the person.
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