PSY 001 Lecture Notes - Lecture 24: American Psychiatric Association, Major Depressive Disorder, Mental Disorder
12 Jun 2018
School
Department
Course
Professor
Psych – Abnormal Psychology
Jadzia Wray
What Is….?
- Abnormal psychology
o The scientific study of mental disorders and their treatment
- The diagnosis and classification of mental disorders
o Treat a person and their symptoms rather than the disorder. Psychiatry you treat the
disorder based on clinical trials.
- Six major categories of mental disorders
- The treatment of mental disorders
The Diagnosis and Classification of Mental Disorders
- Is the behavior/thought process atypical (statistically infrequent)?
o What is considered typical and what is atypical?
▪ Cry once a week vs. cry everyday
▪ Depressed → need to be sad most of the day, every day, for two weeks. If not,
you are just sad.
- Is the behavior/thought process maladaptive (i.e., does it prevent the person from successfully
functioning and adapting to life's demands)?
o Emotions signal different things
o With mental disorder, people with disorders have it flipped. With depression, person
cannot have job, etc. they are prevented form doing things. It is maladaptive.
o Sad from grief makes you feel like you care, then it is adaptive.
- Is the behavior/thought process personally distressing?
o Person is comfortable being the way they are at times. They are not in distress.
- Is the behavior/thought process irrational?
- MOST IMPORTANT: It has to be functionally impairing
o Physically cannot get out of the bed to go to do activities
Diagnostic and Statistical Manual
- The DSM-5, published in 2013 by the American Psychiatric Association, is the most widely used
diagnostic system for disorders.
- It first appeared in 1952 and, at that time, described only about 60 disorders.
o Today, there are more than 400 known disorders.
- There are 20 major categories in DSM-5
- It is the most widely used diagnostic classification system in the United States.
- It is descriptive, not explanatory.
o Does’t eplai ho to teat, hat to do, et. just desies hat ould e see
- The DSM-5
o Manual moved to nonaxial assessment system, which requires clinician disorder
identification by patient symptoms and symptom severity and impairment
- Strengths
o More reliable classifications
o Current state of knowledge about mental disorders
o Provision of common language for clinicians and researchers
o Meets insurance criteria for payment for therapy
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- Weaknesses
o Possible that many aspects of normal behavior may fit criteria for diagnosis of mental
disorder
International Classification of Diseases – 10
- The ICD-10 is created by the World Health Organization
- It is the international standard for defining and reporting diseases and health conditions.
- It is more comprehensive than the DSM-5
- It has 21 chapters
- It is the most widely used diagnostic classification system in the world.
- DSM-5 has DSM codes and ICD-10 codes
Classification of Mental Disorders
- What is a mental disorder?
o A sdoe haateized liiall sigifiat distuae i a idiidual’s ogitio,
emotion regulation or behavior that reflects a dysfunction in the psychological, biological
or developmental process underlying mental functioning.
- What a mental disorder is not?
o An expectable or culturally approved response to a common stressor or loss, such as the
death of a loved one
▪ In some cultures, hallucinations are okay and like a sig fo God. Ca’t sa the
are psychotic because it is acceptable in their culture
o Socially deviant behavior and conflicts that are primarily between an individual and
society (unless the deviance results from a dysfunction in the individual
Labeling People with Mental Disorders
- Perceptual bias of labeling
o Diagnostic disorder labels tend to lead to negative perceptions and interpretations of a
person's behavior in terms of the label.
▪ For the person, getting a diagnosis makes them feel better because then they
ko hat is og ad that it is’t just the ad it’s thei iolog
▪ For other people, they are labeled a way and it causes them to be judged and
stereotyped against and they are mistreated. Learn what a label means.
▪ With labels, we assume symptoms with that label rather than actually asking
about what is happening at the time of the symptoms.
o Disordered people are often misrepresented on television and the media.
o Historically used to institutionalize minorities e.g. DSM-3 diagnosis of schizophrenia used
terms more stereotypically associated with African American men.
▪ Most of the psychiatrists were white male. Disproportional ratio of schizophrenic
males in the U.S. to the ones in other countries. Be careful of labels and be aware
of them.
o Biases in diagnosis-women more likely to be diagnosed with borderline personality
disorder, men are more likely to be diagnosed with antisocial personality disorder.
▪ A oa out of lie ho did’t follo the os as see as haig a pole
▪ Boys are more likely to have ADHH than girls.
▪ Many biases in the way we diagnose.
find more resources at oneclass.com
find more resources at oneclass.com
Perceptual Bias of Learning
- Rosenhan (1973)
o Researchers (pseudopatients) were admitted with a diagnosis of schizophrenia to mental
hospitals when complaining of a single symptom of auditory hallucinations.
o After being admitted, they acted normal, said that they no longer heard the voices, and
that they were feeling normal again.
o Subsequent normal behavior was misinterpreted in terms of their diagnosis.
o Even when released, they caied the lael shizopheia i eissio.
Assessment of Disorders
- Structured clinically interviews
o Structured Clinical Interview for DSM-5 (SCID)
o Mini International Neuropsychiatric Interview (MINI)
- Self-Report forms:
o Beck Depression Inventory
o Beck Anxiety Inventory
o Positive and Negative Symptom Scale
o PTSD Checklist
- Clinician forms: should have more than one rater → based on reliability → consistency between
two raters
o Hamilton Depression Scale (HAM-D) → for inpatient units
o Young Mania Questionnaire
o Montgomery-Asberg Depression Rating Scale (MADRS) → new
Mental Disorders Approaches
- Most causal explanations for mental disorders are tied to the four major research approaches:
biological, behavioral, cognitive, and sociocultural.
- No one approach is better at explaining all the various disorders.
- The biopsychosocial approach explains abnormality because of interaction among biological,
psychological, and sociocultural factors.
Biopsychosocial Model
- Examine the contributions of multiple factors-including biological, psychological and
sociocultural, in the development of psychological disorders
- Diathesis-Stress Model:
o Diathesis (Predisposition or Vulnerability) and Stress (Environmental Stress) cause a
disorder.
o E.g. a genetic vulnerability to depression (diathesis) and the negative stressful life events
(stress) cause Major Depressive Disorder.
find more resources at oneclass.com
find more resources at oneclass.com
Document Summary
Jadzia wray: the scientific study of mental disorders and their treatment. The diagnosis and classification of mental disorders: treat a person and their symptoms rather than the disorder. Psychiatry you treat the disorder based on clinical trials. Is the behavior/thought process atypical (statistically infrequent): what is considered typical and what is atypical, cry once a week vs. cry everyday, depressed need to be sad most of the day, every day, for two weeks. Is the behavior/thought process maladaptive (i. e. , does it prevent the person from successfully functioning and adapting to life"s demands): emotions signal different things, with mental disorder, people with disorders have it flipped. With depression, person cannot have job, etc. they are prevented form doing things. It is maladaptive: sad from grief makes you feel like you care, then it is adaptive. Is the behavior/thought process personally distressing: person is comfortable being the way they are at times.
