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Lecture 16

Psychology 1000 Lecture 16: Chapter-16-Psych


Department
Psychology
Course Code
PSYCH 1000
Professor
John Campbell
Lecture
16

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Chapter 16 – Psychological Disorder
Defining and Classifying Disorders
Abnormality
A social construction – function of cultural values
3 D’s
1- Distressing to individual – disproportionate; too long lasting
2- Dysfunctional – for individual or society
3- Deviant – especially if violate unstated norms
Historical Perspectives
Demonological View
Abnormal behaviour- result of supernatural forces – possessed by a spirit
Treatment – trephination – “hole in the skull”
Psychological Perspectives
Psychoanalytic
oInappropriate use of defense mechanisms = neuroses
oWithdrawal from reality = psychoses
Behavioural
oLearned responses
Cognitive
oThought processes
Humanistic
oFrustrations of achieving self-actualization
oNegative self-concept
Anxiety Disorder
A class of disorders marked by feelings of excessive apprehension and anxiety
Diagnosing Psychological Disorders
Issues
Reliable
Valid
DSM-IV-TR (diagnostic and statistical manual for mental disorders)
Detailed behaviour must be represent for diagnosis
Five axes/dimensions
Assess both person and life situation
Over 350 diagnostic categories
Dimensions
Axis 1 – Clinical Symptoms
Diagnosis
E.g. depression schizophrenia, social phobia)
Axis 2 - Development
Axis 3 – Physical Conditions
E.g. Brain injury or HIV/AIDS that can result in
symptoms of mental illness
Axis 4 – Severity of Psychosocial Stressors
E.g. Death of loved one, starting a new job, college,
unemployment, marriage
Axis 5 – Highest Level of Functioning
Level of functioning both at present time and
highest level within previous year

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DMS-5
Tool used by professionals to diagnose
Picture from slides
Issues in Diagnostic Labeling
Social and Personal
Becomes too easy to accept label as description of the individual
May accept the new identity implied by the label
May develop the expected role and outlook
Legal Consequences
Involuntary commitment
Loss of civil rights
Indefinite detainment
Legal Concepts
Competency – state of mind at time of a judicial hearing
Insanity – state of mind at time crime was committed
Rosenhan (1973)
What would happen if someone simply walked into a treatment facility complaining that they heard voices?
8 pseudo patients, including himself, did just that
Message from the voices unclear (hollow, empty, and thud)
If they were admitted to hospital, nothing was ever said again about the symptoms
If asked by the staff if they were hearing voices, they said they no longer heard them
To act as “normal” as possible
Diagnosis for all 8: schizophrenia
Results
All 8 were admitted to hospital with the diagnosis of schizophrenia
Upon discharge – diagnosis of schizo in remission
Not a single member of the staff at any hospital realized the pseudo patients were “faking it” – some people
did
Other patients did often say they were not “real patients”
Average stay was 19 days – range from 7-52 days
After hearing the results, many hospitals claimed that such an error would not happen with them
Rosenhan told a large teaching and research hospital that sometime over the next 3 months, one or more
pseudo patients would present themselves – he wanted to see if the hospital could find them and see if they
were fake
193 patients were admitted over those 3 months
41 were rated with high confidence to be “fake”
19 others were rated as a suspect
0 pseudo patients were actually sent
This is why the DSM is so important
What is Insanity?
Insanity is not actually a psychological term
It’s a legal term – often associated with a court case etc.
Related to the presumed state of mind of the defendant at the time a crime was committed
Anxiety Disorders
OCD
Obsessive-compulsive disorder
Persistent, uncontrollable intrusions of unwanted thoughts (obsessions) and urges to engage in senseless
rituals (compulsions)
E.g. Howe Mendel
Obsessions = cognitive component
Repetitive and unwelcome thoughts
Compulsions = behavioural component
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Repetitive behavioural responses
2.5 % of population
Phobic Disorder
Strong, irrational fears of objects or situation
Most develop during childhood, adolescence, young adulthood
Seldom go away on their own
Can intensify over time
Degree of impairments – depends on how often condition is encountered
Treatment: exposure therapy – gradual
Most common in western society – social phobias
Fear of certain situations that might involve evaluation/embarrassment
Specific phobias – fear of specific objects such as animals, or situation
E.g. Amathophobia, alektorophobia etc.
Generalized Anxiety Disorder
State of diffuse, ‘free-floating’ anxiety
Not tied to specific situation; condition
Feeling that something is going to happen; don’t know what
5% of population because 15-45 years
Panic Disorder
Occur suddenly, unpredictably, intense; person may feel they are dying
May occur with or without agoraphobia
Fear of future attacks
3.5% of population
Occasional panic attacks ~ 34% of Canadian students
Each time they back away from the situation, it gets harder and harder
Anxiety Disorders – Psychological Factors
Psychodynamic Explanations
Neurotic anxiety
Unacceptable impulses threaten to overwhelm ego’s
defenses
Cognitive Explanations
Maladaptive thought patterns and beliefs influences
development of anxiety
Things are appraised “catastrophically’
Learning explanations
Classical conditioning – learning by watching others
Negative reinforcement – anxiety-reducing behaviours (E.g. compulsions, avoidance)
Sociocultural Factors
Culture defines what is important
Some disorders are ‘culturally bound’
Fear of offending someone; fear of being possessed; fear of being overweight
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