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Lecture 3

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Psychology 3301F/G
Peter Hoaken

Psych 3300A: lecture 02/10/2012 Issues in defining psychological problems  Common reasons that people seek treatment include: o Relationship problems o Self-esteem problems o Identity-related problems o Achievement problems o Physical problems  These should probably best be considered problems in living, rather than formal disorders  Problems in living can probably be helped with the aid of Counsellor or Social Worker. Clinical psychologists are trained to deal with psychopathology  When we discuss psychopathology, we often differentiate between a 'sign', a 'symptom', and a 'syndrome'  Sign o A sign is a problem or abnormality that is observed by a clinician, but not (always) perceived by the patient  Symptom o An abnormality or complaint perceived by a patient o Only a sing if the psychologist also observes the abnormality or complaint as a problem  Syndrome o A syndrome is a group of signs or symptoms that are indicative of a health-related condition o In the context of clinical psychology, what we're typically talking about is a mental health-related condition  Myths and misconceptions about abnormal behaviour o There is no single definition of psychological abnormality (for that matter, there is no single definition of psychological normality) o What there is an abundance of is misinformation re: mental illness:  Lazy, crazy, dumb  Somehow "weak of character"  Dangerous to self or others  Approaches to defining abnormal behaviour 1. It is not rare, if someone on one end of the scale (mentally retarded) is defined as abnormal, then someone of the other end of the scale (genius) should also be considered abnormal 2. Personal distress?  Generalized anxiety disorder = feeling anxious or frightened most of the time 3. Personal dysfunction?  Does not always equate to psychopathology  Abnormality: a psychological dysfunction associated with distress or impairment in functioning that is not a typical or culturally expected response 4. Violation of norms?  Depends on the context/culture (can be normal under the situation/current culture)  DSM-IV-TR o Widely accepted system for classifying psychological problems and disorders o DSN-IV-TR contains diagnostic criteria for behaviours that:  Fit a pattern  Cause dysfunction or subjective distress  Are present for a specified duration  Are not otherwise explainable  History of classification of psychopathology: o Emil Kraepelin is considered the father of the modern classification systme  A major break from Freud, this text viewed mental illness as "symptomatic" - not in terms of etiology o In this text, Kraepelin coined two important terms  Manic depression (now seen as comprising a range of mood disorders such as major depression and bipolar disorder  Dementia praecox (when we now know as schizophrenia) o Eventually description of mental illness began to appear in the international Classification of Diseases (ICD)  First DSM (from the APA) was introduced in 1952. DSM II released in 1968  DSM III (1980). It was radically different from all predecessors (details coming)  DSM III - R (1987). "House cleaning" of DSM -III. Improved relability of diagnoses  DSM IV (1994). Supposed to match ICD - 10 which came out in 1993. ICD - 10 was the first ICD to have specific diagnostic criteria  DSM -IV -TR (2000). An update with very little changes  There was a great deal of resistance to the changes between DSM - II and DSM - III (around 1980)  Why? Several reasons: 1. Atheoretical i. In the creation of DSM - III, all disorers became defined by explicit lists of criteria created by select task force groups. But the approach was atheoretical; dropped compltely was any discussion of etiology 2. Polythetic i. In a classical typological approach, all symptoms are necessary for the diagnosis ii. Definition: "(of a class of things) having many, but not all properties in common iii. What was new was the acknowledgement that the same category of psychopathology could manifest differently in different patients, and even differently at different times in the same patients iv. A set of criteria are sufficient for the diagnosis; items can have different efficiency and be weighted v. Example: major depressive disorder  Criterion A:  Must have either depression of anhedonia (an inability to derive pleasure from normally pleasurable activities)  Must manifest at least five of a total list of nine symptoms  Multiaxial assessment refers to the new appreciation of understanding the person's life circumstances as a whole, not simply focussing on their reported primary complaint o Begins to acknowledge the roles of occupation stressors, medical problems, physical illnesses, etc. o Case study: John  Axis I: Clinical disorders  Other conditions that may be a focus of clinica
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