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Steve Joordens

CHAPTER 17 THE NATURE AND CAUSES OF PSYCHOLOGICAL DISORDERS Recent studies identified complex interactions between an individuals genotype, brain chemistry and childhood environment in the etiology: the causes or origin of a disorder, of psychological disorders Less severe psychological disorders appear more heavily influenced by environmental factors More severe disorders appear to be heavily influenced by hereditary and biological factors that disrupt normal cognitive processes or produce inappropriate emotional reactions CLASSIFICATION AND DIAGNOSIS OF PSYCHOLOGICAL DISORDERS Need for a comprehensive classification system of psychological disorders first recognized by Emil Kraepelin, he made his version in a textbook of psychiatry published in 1988 The Association of Medical Superintendents of American Institutions for the Insane, a forerunner of the APA, later incorporated his ideas into a classification system of its own What is Abnormal? Psychological disorders defined by abnormal behaviour, but that is strictly anything away from normal, including tall people or smart people. But it has taken a pejorative connotation: we use it to refer to characteristics we dislike or fear Psychologists stress that the most important feature of a psychological disorder is not abnormal, but maladaptive Perspectives on the Causes of Psychological Disorders The Psychodynamic Approach Psychological disorders originate in intrapsychic conflict produced by the three components of the mind: id, ego, superego The consequent psychological disorders may involve, among other symptoms, extreme anxiety, obsessive thoughts and compulsive behaviour, depression, distorted perceptions and patterns of thinking and paralysis or blindness to which there is no physical cure The Medical Perspective Based on ideas that psychological disorders are caused by specific abnormalities of the brain and nervous system and that they should be approached for treatment in the same was as physical illness Biological factors are known at least to contribute to the development of psychological disorders including schizophrenia, and bipolar disorder The Cognitive-Behavioural Perspective Holds that psychological disorders are learned maladaptive behaviours learned that can be understood by focusing on the environment and a persons perception of those factors Therapists from this perspective suggest patients to replace or substitute maladaptive thoughts and behaviours with more adaptive ones The Humanistic Perspective Psychological disorders arise when people perceive that they must earn the positive regard of others They become oversensitive to the demands and criticisms of others and define their personal value primarily in terms of others reactions to them. Lack confidence in their abilities and feel as if they have no stable, internal value as a person The Sociocultural Perspective Cultures in which people life play a significant role in the development of psychological disorders Proper treatment requires understanding of cultural issues Cultural variables influence the nature and extent to which people interpret their own behaviours as (ab)normal The Biopsychosocial Perspective No one perspective is adequate in accounting for the origins of psychological disorders, this is not to say any of them are unimportant, different approaches can be combined to form larger perspective Diathesis-stress model: a causal account of psychological disorders based on the idea that psychological disorders develop when a person possesses a predisposition for a disorder and faces stressors that exceed his or her abilities to cope with them Biopsychosocial perspective: a view that the causes of psychological disorders can best be understood in terms of the interaction of biological, psychological, and social factors Biopsychosocial model may use info about thaw way genotypes of people diagnosed with specific psychological disorders differ from those of individuals who do not have Related interest may be info about the chemistry of neural pathways in individuals with the disorder and the correlations between those pathways and the individuals genotype The DSM-IV-TR Classification Scheme Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR): a widely used manual for classifying psychological disorders Provides descriptions of an individuals psychological condition using 5 criteria called axes Axis 1 information on major psychological disorders that require medical attention Disorders first appearing in infancy, childhood or adolescence; Delirium, dementia, amnestic, and other cognitive disorders; Psychoactive substance abuse disorders; Schizophrenia and other psychotic disorders; Mood disorders; Anxiety disorders; Somatoform disorders; Factitious disorders; Dissociative disorders; Sexual and gender identity disorders; Eating disorders; Sleep disorders; Impulse control disorders; Adjustment disorders Axis 2 Personality disorders Axis 3 through 5 provide info about the life of the individual in addition to the basic classification provided by axes 1 and 2 Axis 3 describes any physical disorders such as skin rashes or high blood pressure Axis 4 specifies the severity of stress the person has experienced Axis 5 describes the persons overall level of psychological, social, or occupational functioning (determines amount the persons life has been diminished by the disorder) Comorbid: the appearance of two or more disorders in a specific person Some Problems with DSM-IV-TR Classification Since it is strongly influence by psychiatrists, places emphasis on biological factors which may allow cognitive and environmental determinants to be overlooked Not completely reliable, it is like navigating an unfamiliar city with a crude map Other critics questioned the validity Rosenhan made up fake symptoms and his group of professional associates and himself were committed to asylums for average 3 weeks; only the real patients knew they were faking The Need for Classification
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