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Psychological Disorders.docx

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Lawrence Murphy

Psychological Disorders (Chapter 15) Defining Mental Disorder Mental Disorder  Any behaviour or emotional state that: o Causes an individual great suffering o Is self-destructive o Seriously impairs the person’s ability to work or get along with others, or endangers others or the community  But back then, slaves that ran away fulfilled all these criteria  were considered as mentally ill  Homosexuality was also considered a mental illness  NOT the same as insanity o Legal term only involving mental illness and whether person is aware of consequences and can control their behaviour Dilemmas of Definition Varying definitions of mental disorders  Mental disorder as a violation of cultural standards  Mental disorder as emotional distress  Mental disorder as behaviour that is self-destructive or harmful to others (ie. Tattoos)  In Canada, mental disorders the leading cause of disability in those aged 15-44 Dilemmas of Diagnosis  Typically classified using the Diagnostic and Statistical Manual of Mental Disorders (DSM)  Primary goal of DSM is to be descriptive and to provide clear diagnostic categories  ADD? DSM Categories Five dimensions (axes) clients are evaluated on:  Axis 1: Primary clinical problem  the actual disorder  Axis 2: Personality factors/ disorders  Axis 3: General medical conditions  Axis 4: Social and environmental stressors  Axis 5: Global assessment of functioning  the gap (a number between 0-100, where 100 = no mental issues)  Increasing number of DSM disorders as time goes on  Supporters of new categories answer that it is important to distinguish disorders precisely  Critics point to economic reasons: diagnoses are needed for insurance reasons so therapists will be compensated Problems with the DSM  It is important to be aware of limitations & problems present in attempts to classify mental disorders 1. The danger of over-diagnosis (eg. ADHD) 2. The power of a diagnostic label  can and has been used against people (ie. Labelling a person as schizophrenic) 3. The confusion of serious mental disorders with normal problems (ie. Shyness) 4. The illusion of objectivity and universality (eg. reflect cultural & social prejudices) 5. ADD? Advantages of the DSM  Defenders agree that boundaries between “normal problems” and “mental disorders” are fuzzy and difficult to determine o Many psychological symptoms fall along a continuum ranging from mild to severe  When DSM is used correctly, in conjunction with valid objective tests, it improves reliability of diagnosis Culture and Mental Illness  Recent inclusion of culture-bound syndromes: disorders that are specific to a particular culture context o Eg. ghost sickness: preoccupation with death and the dead, bad dreams, fainting  Comparing mental and emotional symptoms allows researchers to distinguish between universal disorders and culture-bound syndromes Iclicker: DSM-IV uses five “axes” to describe a person’s problem. Which axis contains the actual diagnosis of a disorder? Axis 1 Iclicker: in addition to providing info about symptoms and incidence, the DSM requires the diagnosis to be understood in terms of: the client’s personality, possible stressors and the client’s medical condition Dilemmas of Measurement  Diagnosis usually made by combination of clinical interview and psychological tests o Projective tests: tests used to infer a person’s motives, conflicts, and unconscious dynamics on the basis of the person’s interpretations of ambiguous stimuli o Objective tests: standardized objective questionnaires requiring written responses; typically include scales that people rate themselves on Projective Tests  Can help establish rapport with client  Tests lack reliability and validity (although some have tried to develop comprehensive scoring systems for responses)  Sometimes used inappropriately Objective Tests  Popular personality assessment is the Minnesota Multiphasic Personality Inventory (MMPI) o Contains 10 clinical scales for problems such as depression, paranoia, schizophrenia, introversion o Contains 4 validity scales to indicate whether responder is lying, defensive or evasive o Has been revised but still some cultural differences in scores on certain subscales Anxiety Disorders Anxiety  A general state of apprehension or psychological tension  Can be adaptive as they energize us to cope with danger Anxiety disorders  When fear and anxiety becomes detached from actual danger o Eg. chronic anxiety, panic attacks, phobias, OCD  Generalized Anxiety Disorder o A continuous state of anxiety marked by feelings of worry and dread, apprehension, difficulties in concentration, and signs of motor tension o Symptoms experienced in challenging or uncontrollable situations o No specific anxiety-producing event o Develop habits that foster their worry  Posttraumatic Stress Disorder (PTSD) o Person who has experienced a traumatic or life-threatening event has symptoms such as psychic numbing, reliving of the trauma, and increased physiological arousal o Not all who experience trauma develop PTSD  May involve a genetic predisposition, history of prior psychological problems, poor emotional adjustment & catastrophizing, smaller hippocampus than average  Panic disorder o An anxiety disorder in which a person experiences recurring panic attacks, feelings of impending doom or death, accompanied by physiological symptoms such as rapid breathing and dizziness o Interpretation of bodily reactions ADD  Fears & Phobias o Phobia: an exaggerated, unrealistic fear of a specific situation, activity or object o Social phobia: irrational fear where sufferers become extremely anxious in situations in which they will be observed by others, worrying they will do or say something that will be excruciatingly humiliating or embarrassing o Agoraphobia: set of phobias, often set off ADD  Obsessive-compulsive disorder (OCD) o
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