Chapter 14 Notes.docx

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Chapter 14 Psychological Disorders
Abnormal Behaviour: Myths, Realities and Controversies
The Medical Model Applied to Abnormal Behaviour
- The medical model: it is useful to think of abnormal behaviour as a disease
o Brought improvements in the treatment of those who exhibited abnormal
The end of chanting, imprisoning, etc.
o Has been suggested that this model has outlived its usefulness Szasz says this
model converts moral and social questions about what is acceptable behaviour
into medical questions
Text says disease analogy is still useful (mental illness is not a disease in a
strict sense)
- The following have proven very useful in the treatment and study of abnormality:
o Diagnosis: distinguishing one illness from another
o Etiology: the apparent causation and developmental history of an illness
o Prognosis: a forecast about the probable course of an illness
Criteria of Abnormal Behaviour
- Deviance:
o Each culture has certain norms; when people violate these norms, they may be
labelled mentally ill
Ex: transvestic fetishism when a man achieves sexual arousal by
dressing in women’s clothing
- Maladaptive behaviour:
o When a person’s everyday adaptive behaviour is impaired
Ex: used in the diagnosis of substance abuse like when a cocaine
addict’s functioning is affected by his drug use
- Personal distress:
o Diagnosis of a psychological disorder is based on an individual’s report of great
personal distress
- People are often viewed as disordered when just one of the above criterion is met
o Diagnosis involves value judgements about what abnormal behaviour is can
reflect prevailing cultural values, social trends, political forces and scientific
o Normality and abnormality exist on a continuum
It is only when the above criteria are manifested in extremes that a person
can be considered mentally ill
Stereotypes of Psychological Disorders
- Psychological disorders are incurable…
o While some do not respond to treatment, many people do recover from their
mental illnesses either spontaneously or as a result of treatment
- People with psychological disorders are often violent and dangerous…
o Contrary to media coverage, there is only a modest association between mental
illness and violent tendencies (especially if people have had violent histories)
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- People with psychological disorders behave in bizarre ways and are very different from
normal people…
o This is only true in a minority of very severe cases
o Often people with disorders are indistinguishable from those without
Rosenhan’s experiments – pseudopatients were admitted into a mental
hospital after acting completely normal other than complaints about
hearing voices
Proves that we cannot distinguish the sane from the insane in
hospitals which impose a certain environment where behaviour can
be misunderstood by expectation and the situation
Psychodiagnosis: The Classification of Disorders
- System of classifying psychological disorders matching symptoms are current
functioning to pre-established categories of psychological disorders in the American
Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM)
o DSM has been republished 4 times (maybe 1 additional time since this textbook
was published) each time including more disorders with more explicit
diagnostic guidelines
o There is a multiaxial system of classification (5 axes)
Axis 1 Clinical Syndromes
Axis 2 Personality Disorders or Mental Retardation
Axis 3 General Medical Conditions
Axis 4 estimates the severity of stressful life events
Axis 5 Global Assessment of Functioning (GAF) Scale individuals
current level of adaptive functioning (social and occupational behaviour)
- Problems with diagnosis:
o Self-fulfilling prophecy
o Social stigma
o The “label” colours one’s perception
The Prevalence of Psychological Disorders
- Epidemiology: the study of the distribution of mental or physical disorders in a
- Prevalence: the percentage of a population that exhibits a disorder during a specified time
o Lifetime prevalence the percentage of people who endure a specific disorder at
any time of their lives
80s/90s - Studies have found psychological disorders in one third of the
More recent studies - 44% of the adult population will struggle with some
sort of psychological disorder at some point in their lives
Most recent studies estimated lifetime risk of psychiatric disorder = 51%
- Overall rates for males and females with psychological disorders are about the same
o But there is gender variation across categories of disorders
o 68% of people who reported symptoms of disorders did not seek assistance
- Having a psychological disorder is costly to patients and the health system
**There are 3 types of neurotic disorders: anxiety, somatoform, dissociative
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Anxiety Disorders
- Anxiety disorders: a class of disorders marked by feelings of excessive apprehension and
o There are five principle types of anxiety disorders (it is possible to have more than
one at the same time)
1) General Anxiety Disorder: marked by a chronic high level of anxiety that is not tied to any
specific threat
- Also known as free-floating anxiety
- Anxiety is often accompanied by physical symptoms like trembling, muscle tension,
diarrhea, dizziness, faintness, sweating and heart palpitations
- Has a gradual onset
- Is more common in females than in males
2) Phobic Disorder: marked by a persistent and irrational fear of an object or situation that
presents no realistic dangers
- Having a phobia is only considered a disorder when it interferes with everyday behaviour
- Phobic reactions tend to be accompanied by trembling and palpitations
- Phobias of almost anything can exist but some phobias are more common than others
o Ex: arachnophobia
- People with this disorder usually realize their fears are irrational but are unable to control
their fears, regardless
3a) Panic Disorder: characterized by recurrent attacks of overwhelming anxiety that usually
occurs suddenly and unexpectedly
- Panic attacks are accompanied by physical symptoms of anxiety
o Attacks exist on a continuum with the poles being nonclinical and clinical
- Onset of panic disorder occurs during late adolescence or early adulthood
- People begin to worry that their panic attacks will happen in public and may start to avoid
leaving home
o This leads to agoraphobia
3b) Agoraphobia: a fear of going out to public places
- Research has suggested that this is a complication of panic disorder instead of just a
regular phobia
- 2/3 people who suffer from this are female
4) Obsessive-Compulsive Disorder (OCD): marked by persistent, uncontrollable intrusions of
unwanted thoughts (obsessions) and urges to engage in senseless rituals (compulsions)
- Prevalent in about 2.5% of the population
- Most cases emerge before the age of 35
- 4 factors seem to underlie the symptoms of OCD obsessions and checking, symmetry
and order, cleanliness and washing, and hoarding
5) Post-Traumatic Stress Disorder (PTSD):
- May not surface until months/years after a person’s exposure to severe stress
- 7%-8% of people have suffered from PTSD at some point in their lives
o More in women than in men
- Common symptoms include nightmares and flashbacks, alienation, problems in social
relationships, an increased sense of vulnerability, and elevated levels of arousal/
anxiety/anger /guilt
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