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Lecture 5

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Lawrence Murphy

Chapter 15: Psychological Disorders  Clicker questions  DSM-IV uses five "axes" to describe a person's problem. Which axis contains the actual diagnosis of a disorder?  Axis I --> Primary Clinical Problems  In addition to providing information 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  Defining Mental Disorders  Mental disorder  Any behaviour or emotional state that:  Causes individual great suffering  Is self-destructive  Seriously impairs person's ability to work or get along with others, or endangers others or the community  Mental health is conceived in a context; that context is society;  Eg. If society is racist, black people trying to escape slavery is a mental health disorder (drapetomia)  Eg. If soceity is sexist, women trying to assert themselves is a mental health disorder  NOT the same as insanity  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:  Violation of cultural standards  Emotional distress  Behaviour that is self-destructive or harmful to others  In Canada, mental disorders the leading cause of disability in those aged 15-44  Dilemmas of Diagnosis  Disorders 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 (see Table 15.1 in text)  DSM Categories  Five dimensions (axes) clients are evaluated on:  Axis I: Primary clinical problem  Axis II: Personality factors/disorders  Axis III: General medical conditions  Axis IV: Social and environmental stressors  Axis V: Global assessment of functioning (GAF)  Increasing DSM Disorders  Supporters of new categories answer that it's 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 and problems present tin attempts to classify mental disorders  The danger of overdiagnosis (e.g., ADHD)  The power of diagnostic labels --> being labeled can stick with you; stigmas are associated with mental health disorders (it can be used against you)  The confusion of serious mental disorders with normal problems  The illusion of objectivity and universality (e.g., drapetomania, reflect cultural and social prejudices)  Advantages of the DSM  Defenders agree that boundaries b/w "normal problems" and "mental disorders" are fuzzy and difficult to determine  Many psychological symptoms fall along a continuum ranging from mild to severe  When DSM used correctly in conjunction with valid objective tests, improves reliability of di
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