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Midterm

PSY240 Notes before Midterm.pdf

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Department
Psychology
Course
PSY240H5
Professor
Hywel Morgan
Semester
Fall

Description
Intro to abnormal  it's easy to identify than it is to define abnormal behavior  depression as an example o hmm what's the definition?  sad affect  lost of enjoyment of usual enjoyable things o but we experience that sometimes too o when does it become abnormal?  when extends over a long period of time  sad affect doesn't go away, NOT NORMAL  duration, intensity...  STATISTICAL CRITERIA o psych is a science, which means we use the methodology of collecting data  bell curve from behavior of people  the middle will be the norm! the average people response o hmm, example what color is the jacket? black, the norm, tree? hmm schizo! psychoses o disregards deviant behaviors that are favorable, accepts most common behaviors  glaring example, intelligence! is above average intelligence abnormal? pathological ?  this is the problem with this definition o also includes common behaviors that are unfavorable  eg drug use, it's the norm to participate, but society says abnormal o factors other than mere occurrence may override statistical considerations  CULTURAL NORMS o alcohol usage not common in Muslim communities Jewish communities, but it's normal in western societies o DSM isn't the common diagnostic, ICD 10 is more common around the world, published by the WHO, it does differ from DSM o in general most cultures recognize behaviors that reduce interfere or destruct the individuals personal and social adjustment, abnormal o cultural norms are often situationally defined, depends on what the situation is!  hmm public nudity or showering in the gym?  behaviors regarding age, child hitting parent, or adult violence  DEVELOPMENTAL NORMS o milestones, development stages o child wetting the bed, age three or age ten  FREQUENCY, INTENSITY, DURATION o current methods o we try to measure these things  how anxious are you  how many times a day  etiological models of abnormal behavior, CAUSES o psychology is a paradigmatic science, different ways of conceptualizing things  both the strength and weakness of this field o MEDICAL DISEASE MODEL (nature)  genetic  genes are the underlying  for some psychiatric disorders, there are gene markers  studied by observing identical twins, hmm no they don't have the same diseases!  but um concordance rate is around fifty percent, but not the same genes? one percent ish so CLEARLY there is a genetic component  biochemical  schizo? too much dopamine, biochemical markers  depression, abnormal serotonin levels dopamine levels norepinephrine levels  anxiety? GABA abnormal levels  neurophysiological  I.e. brain not functioning properly  inherited, ..., or ....  ADHD children, we know the frontal lobe is to functioning properly  anxiety, amygdala not functioning properly  psychoanalytic  Freud was first to propose psychopathology came from the inside, he was a medical doctor though o ENVIRONMENTAL MODEL (nurture)  external variables, economic, cultural, etc  sociocultural models  family, socioeconomic status, urban vs rural, cultural religious affiliations ...  learning models  classical and operant conditioning  we can recondition the person!  straightforward treatment  hmm anxiety, phobia? irrational! lets teach you other wise, recondition, replace with other thoughts  humanistic models  some people put a third category for this  touchy feeling psychology  stresses the experience and the individual reaction to themselves and the world  hmm you have the skills, we just have to find the right environment  whole person, present functioning and future possibilities  respects the worth of people and the choices that people make  hmm unconditional positive regard ASSESSMENT  consider a case of long term sad affect o initial diagnosis is depression o but may be incorrect! might not be the whole story, might be other psych disorders influencing this, or physiological factors o note the potential for misdiagnosis becuase of symptom overlap o so we try to quuantify sympptoms that reliably go together, syndromes o was the problem of DSM, validity issues  referral o first part of the whole procedure o "what brought you here today?" o this is the quick and dirty initial assessment  clinnical methods, tools of assessment o the interview  most important (in adults)  structured and unstructured interviews  structured means a set list of questions on paper that covers all aspects of the patients life, it is long and exhausting  advantage is thoroughness, nothing will be missed  raport, this results in poor rapport, patient not happy  unstructured means free to ask any questions thought appropriate to the working hypothesis  high in rapport but low in validity and reliability o clinical observations  deportment: appropriate or inappropriate  physical appearance and deformities, cuts and bruises? abuse selff mutilation epilepsy  relationships when possible, appropriatee or inappropriate  affect: nervousness or anxiety  hmm countertransferrence in morgan example off passive aggressive patient o psychological tests  exclusive field of psychologists, no other mental health profession does psychological testing  every two years anew manual is developed  two types: cognitive or intellectual tests and personality or affect tests  the WAIS test: weschler adult intelligence scale  at least 2 to 3 hours to administer  verbal functioning and visio-spacial functioning  personality tests  there are a large number of personality tests  the most common is MMPI minneasota muliphasic personality inventory, asks questions about different aspects of your personality  these tests give us quantitative results, compares to the rest of people o behavioural assessment  like clinical observations bbut much more structured  behaviours are expected DIAGNOSIS  imformation will be supplemented by more information outside of the textbook  what is the most obvious benefit of diagnosis, selection and implementation of treatment  significant harm in our society is stigma, eg people with schizo being called schizophrenics, wrong!  clinically derived systems: o DSM IV or the newest V o ICD is the other system other countrries use, international classification of diseases o for the most part, over 99% compatible, goals of DSM V was to achieve 100% o DSM is published by the american psychiatric association o ICD is published by the WHO under the UN o note, here in canada physicians are required to record diseases for stats purposes and they use the ICD coding system o this is actually the seventh edition of DSM, dsm, 2, 3, 3R, 4, 4TR, 5  what makes for a good classification system (clusters of symptoms) o categories need to be clearly defined  mood disorders of mania and sadness, used to be together in IV now seperated in V  four had category childhood and adolescence, eliminated and put together with similar symptoms o the categories must exist  misdiagnosis probability is very high due to high symptom overlap o reliability  ie consistency  same conclusion from different people diagnosing set symptoms: interrater reliability  five has tried to make diagnosis more inclusive, not so strict standards, critics say comprimise reliability, over diagnosis o validity  four wasnt so good, symptom overlap, significant potential for misdiagnosis  defines categories clearly discriminable o clinical utillity  is it clinically useful? DSM yes  it is useful in selecting a treatment  factor analysis o concept in statistics o large amounts of data collected and trends in the data are analyzed o basically looking at everything in the environment that changes o useful in discovering common symptom clusters o the other major goal of five was to use factor analysis to determine diagnosis, they failed however, attempt to become an imperically devised system o remains a clinically derived system, where people decide on experience and consensus among experts  mulitaxial diagnosis system from four, different ways to diagnosis o axis 1 complaint  issue of comorbiditiy, say anxiety and depression  common in psychopathology o axis 2 relatively permanent  personality  mental retardation, intellectual development disorder o axis 3 relevant physical conditions  somatoform disorders o axis 4 severity of psychosocial stress  prognosis is lots of stress is not good for you, not likely to get better  hmm reduce stress  remains in section three of DSM V o axis 5 global assessment of functioning in the past year  0 low functioning to 100  prognostic value for below 50 not function well  completely eliminated  DSM V three sections o 1 indicating utility of this system o 2 categories themselves o 3 future considerations and expllanation of elimination of axis system as well as severity of psychosocial stresses LEGAL AND ETHICAL ISSUES 1. what is legal o laws are a set of rules that tell you how you must behave (or must not) 2. what is ethical o laws are based on ethics, ethics are based on morals, morals change from time to time o ethics are what you should do  some things are unethical but not illegal, eg sex with clients? lose license but no jail 3. legal issues 1. people in social conflict  most often reason people seek treatment  laws are about social interaction, sometimes social interaction plus mental issues can become illegal, violence etc
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