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Chapter #17 – The Nature and Causes of Mental Disorders
Classification and Diagnosis of Mental Disorders
- the need for a comprehensive classification system of psychological disorders was first recognized by
Emil Kraepelin
What is Abnormal?
- mental disorders are characterized by abnormal behaviour, thoughts, and feelings
- “abnormal” – refers to any departure from the norm
- the distinction between normal and abnormal behaviour can be very subjective
- mental disorders cause distress or discomfort and interefere with ppl’s ability to lead satisfying,
productive lives
Perspectives on the Causes of Mental Disorders
- no single cause
- they are caused by the interaction of hereditary, cognitive, and environmental factors
oonce genetic factors are identified, the scientist determine the physiological effects of the
relevant genes and the consequences of these effects on the person’s susceptibility to a mental
ounderstanding cognitive factors involved in mental disorders requires identification of the
origins of distorted perceptions and maladaptive thought patterns
oenvironmental factors include a wide range of factors (from person’s family history to their diet,
exposure to drugs and alcohol, etc)
-The Psychodynamic Perspective:
oBased on Freud’s early work
oMental disorders originate in intrapsychic conflict produced by 3 components of the mind:
The id, ego, and superego
oattempt to control potentially harmful expressions of sexual or aggressive impulses, or they may
also arise from attempts to cope with external dangers and traumatic experience
osometimes so severe, mind’s defense mechanisms cannot produce a resolution that is adequate
for the mental health
odefense mechanism themselves distort reality
osymptoms include:
extreme anxiety
obsessive thoughts and compulsive behaviour
distorted perceptions and patterns of thinking
paralysis or blindness
- psychodynamic therapists attempt to make their clients aware of their intrapsychic conflicts and defense
mechanism failures as part oaf the process of regaining mental health
-The Medical Perspective:
oWork of Hippocrates

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oFormulated the idea that excesses of the 4 humours (black bile, yellow bile, blood, and phlegm)
let to emotional problems
oToday, many persons with severe mental disorders are no longer confined to mental institutions
oThey are treated on an outpatient basis with drugs that help decrease/eliminate symptoms of
mental disorders
oMedical model is based on the ideas that mental disorders are caused by specific abnormalities
of the brain and nervous system and that, in principle, should be approached b for treatment in
the same way as physical illnesses
-The Cognitive-Behavioural Perspective:
oHolds that mental disorders are learned maladaptive behaviour patterns that can be understood
by focusing on environmental factors and a person’s perception of those factors
oCaused by a person’s interaction with the env’t (ex/ excessive use of alcohol)
oAlso, a person’s ongoing subjective interpretation of the events taking place in their env’t also
contributes to the causes
oTherapists operating from the this perspective will tell their clients to replace maladaptive
thoughts and behaviours with more adaptive ones
-The Humanistic Approach:
oMental disorders arise when ppl perceive that they must earn the positive regard of others
oThey become overly sensitive to the demands and criticisms of others and come to define their
personal value primarily in terms of other’s reactions to them
oLack confidence in abilities and feel as thought they have no stable, internal value as persons
oFeel no control over life and such feelings often accompany depression
oGoal of this approach is to persuade ppl that they do have intrinsic value and to help them
achieve their own, unique, positive potential as human being
-The Sociocultural Perspective:
oCultures in which ppl live play significant role in the development of mental disorders
oProper treatment requires an understanding of cultural issues
oCultural variables influence the nature and extent to which ppl interpret their own behaviours as
normal or abnormal (what is normal in 1 culture may be not in another)
oCulture-bound syndromes mental orders exist that appear to occur in certain cultures
-The Diathesis-Stress Model of Mental Disorders
oNo single perspective is completely accurate in accounting for the origins of mental disorders
(all perspective is important), elements are combined to form a different perspective
Diathesis-stress model – a causal account of mental disorders based on the idea that mental disorder develop
when a person possesses a predisposition for a disorder and faces stressors that exceed their abilities to cope
with them
- in other words, person may be predisposed to a mental disorder but haven’t encountered sufficient
stressors to trigger its development

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The DSM-IV Classification Scheme
Diagnostic Statistical Manual IV (DSM-IV) - a widely used manual for classifying psychological factors
(system most commonly used in North America today & presented in the American Psychiatric Association)
- uses 5 different criteria, called axes to describe conditions:
oAxis I: require special clinical attention such as disorders usually first appearing in infancy,
delirium, dementia, schizophrenia, etc (*** see page 566 in text for the chart ***)
oAxis II: personality disorders found
- Axes III – V provide info about the life of the individual in addition to the basic classification provided
by Axes I and II
oAxis III: describes any physical disorders, such as skin rashes, heightened blood pressure
oAxis IV: specifies severity of stress experienced (past year)
oAxis V: describes the person’s overall level of psychological, social, or occupational
- a person’s psychological condition may be due to several different psychological disorders described in
DSM-IV, just as one person may suffer simultaneously from several different physical disorders
- an example of a person going through all stages is as follows:
oAxis I: Alcohol Dependence
Major Depressive Disorder
oAxis II: Antisocial Personality Disorder
oAxis III: Alcoholic cirrhosis
oAxis IV: Severe – divorce, loss of job
-Axis V: Global Assessment of Functioning (GAF) evaluation = 30, which represents a very serious
impairment of functioning, 100 = near absence of impaired functioning
Problems with DSM-IV Classification
- tends to be more consistent with the medical perspective on mental disorders than with other
- this means it emphasizes biological factors, which means that potential cognitive and environmental
determinants may be overlooked
- its reliability – evaluating psychological disorders is not so easy (not always 100% accurate)
- diagnosing a psychological disorder only describes the symptoms of the disorder, it does not explain the
underlying causes and psychological processes
- we need to be on guard against associating the names of disorders with people rather than with their
The Need for Classification
- b/c labeling can have negative effects, some ppl, such as Thomas Szasz have suggested that we shold
abandon all attempts to classify and diagnose mental disorders (believe it does more harm than good)
- however, proper classification has advantages for a patient
othe recognition of a specific diagnostic category precedes the development of successful
treatment for that disorder
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