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PSYC 2210

Lecture #28 Mental Disorder (Part II) Ÿ Many ways in defining abnormal, but none of the definitions are complete, many ways of constituting it, but it is hard to cover all that we mean by this term Ÿ Patterns of behaviour from what is normative or expected, typically but not always involves personal distress at a developmental stage, particular way in who other people think feel or act is distressing to you, and it worries other people, and at some level this set of symptoms, impairs your ability to function and thrive in an important domain, you want to succeed but as a result of your situation you are unable to Ÿ Theories and origins of abnormal behaviour=etiology is the study of the origins of behaviour Ÿ Not trying to say by resisting medical model, resist medicine, and use symptom and disease theology, clinical psychology is different, where a disease that is postulated has the same symptoms as the disease (sadness and depression) Ÿ If symptoms cluster, anxiety, depression, the cluster of symptoms does not mean there is a biological cause, there is something going on in the brain, but whether or not those things in the brain is the cause of the symptoms is another matter Ÿ We should not assume then that a biological basis for disorder means that culture has no role, many disorders have biological predisposition, but culture is also relevant, for e.g. schizophrenia (delusions, thought disorder, hallucinations), but cultural meanings vary, different cultural meanings, a young adult in our culture will be stigmatized, resources withdrawn, occupation limited, but in other cultures, when you demonstrate the same symptoms, you can be made a venerated member of society, everything will be brought to you, hallucination in that society it’s a sign of a vision Ÿ Difficulties with classifying of behavioural disorders, if a person talks about all their symptoms, you must categorize them to inform how you treat them Ÿ There are many issues with classifying, how do clinicians go about making decisions Ÿ In the role of a clinician, someone is in your office and presenting series of symptoms, how can you figure out what disorder best suits this person, most often clinicians use their head, use their expertise of the knowledge they have, administer some tests, interview of some kind, all of this data which you must make sense of=use your head to arrive to a decision Ÿ The problem is, if there is any formula being used, its not explicit, when researchers make decisions they want to be more explicit it so they developed a general formula instead of using their best judgement (formula is NOT always right, and clinicians aren’t always wrong, if you study these two entities over time, on average the formula will outperform the clinician) Ÿ The clinician is more often right than wrong too, but computer will outperform Ÿ If someone comes in with a set of symptoms, if you bring different doctors, they should arrive at the same decision and conclusion, and when deciding what disorder they have, your eliminating the ones that they don’t have as you collect more and more information about the patient Ÿ Once you know what diagnosis to give patient, you know how to treat them, this derails over and over again (this example for medical community) Ÿ First is problem of reliability, level of agreement for clinicians are not idea, factors that increase reliability, if we use standardized tests and structured interviews rather than un-systemized processes Ÿ As our field evolves, clinical psychologists are becoming better and more reliable Ÿ The concept of comobidity, refers to the co occurrence of diagnosis (dual or multiple) Ÿ In clinical psychology, as your probability of one diagnosis goes up, you are more likely to get another diagnosis, which completely defeats the purpose of figuring out the main diagnosis (like in medical decision making) Ÿ Disgnosis should be the process fo figuring out what you have by eliminating other possibilities Ÿ a lot of the time the whole process of differential diagnosing makes no difference when it comes to treatment, for e.g. if you have major depresive disorder, you will receive anti-depressents and therapy, if you have an anxiety disorder, you receive anti-depressants and therapy, doesn’t matter what you get, you get the same treatment Ÿ The treatment will change depending on the diagnosis, (point overstated), small differences, but virtually everyone is recommended to egt psychotherapy, and if you talked ot practising psychotherapists, their diagnosis is not important, what is going to inform what you do in the session is your theory of how they became sick and what caused it (your theory of how person is the way they are=case formulation theory) Ÿ Varieties of anxious experience, with respect to four disorders Ÿ Good reason w
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