Psychology 1000 Study Guide - General Paresis Of The Insane, Mental Disorder, Learned Helplessness
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Chapter 16 - Psychological Disorders April 17, 2012
The Scope and Nature of Psychological Disorders
Defining what is normal and abnormal can be measured in different ways such as 1. The personal values
of a given diagnostician. 2. Expectations of the culture the person currently lives in. 3. Expectations of the
persons culture of origin. 4. General assumptions about human nature. 5. Statistical deviation from the
norm. 6. Harmfulness, suffering, and impairment.
The criteria inherent in number six (distress, dysfunction, and deviance) seem to govern decisions about
abnormality and one of them seems to apply to virtually any abnormal behaviour. We are likely to label
behaviours as abnormal if they are intensely distressing to the individual. Most behaviours judged
abnormal are dysfunctional either for the individual or society. Society’s judgements concerning
deviance of a given behaviour consist is someone violates unstated norms, especially if it makes other
uncomfortable and has no environmental cause. We define abnormal behaviour as behaviour that is
personally distressing, personally dysfunctional, and/or so culturally deviant people judge it to be
inappropriate or maladaptive. There are 374 disorders in the American psychiatric manual.
Historical Perspectives on Deviant Behaviour
The belief that abnormal behaviour is caused by supernatural foces goes back to Chinese, Egyptians,
and Hebrews who believed it was the work of the devil. Some believed it was an evil spirit trying to
escape the body and a procedure called trephination was carried out, where a hole what chiseled into
the skull which normally ended in death.
In Medieval Europe they believed they were possessed involuntarily by the devil or had made a pact with
the forces of darkness. The killing of witched was justified. In 5th centruy b.c. Hippocrates suggested that
mental illnesses were diseases in the brain. In the 1800s Western medicine believed that mental
disorders were biologically based. They discovered that general paresis, characterized by mental
deterioration and bizarre behaviour, resulted from massive brain deterioration caused by syphilis.8
The vulnerability-stress model says that each of us has some degree of vulnerability for developing a
psychological disorder, given sufficient stress. Vulnerability, or predisposition, can have a biological
basis, could be due to personality, environmental factors, or a cultural factor. In most instances, a
predisposition creates a disorder only when a stressor, a recent/current event that requires a person to
cope, combines with the vulnerability to trigger the disorder.
Diagnosing Psychological Disorders
A classification system has to meet standards of reliability and validity. Reliability means clinicians using
the system show high levels of agreement in their diagnostic decisions. Subjective judgement is
minimized. Validity means the diagnostic categories should accurately capture the essential features of
various disorders and allow differentiation between disorders.
The DSM-IV-TR is the most widely used diagnostic classification system in North America with more than
350 diagnostic categories containing detailed lists of observable behaviours that must be present. It
allows diagnostic information to be represented along five axes (dimensions). Axis I, persons primary
clinical symptoms. Axis II, long standing personality/developmental disorders. Axis III, physical condition
that might be relevant. Axis IV, the intensity of environmental stressors in the person’s recent life. Axis V,
the person’s coping resources.
The current system is a categorical system with critics say that it is too specific that many people don’t fit
into the categories and that people that fit the same category may share only certain symptoms. It also
doesn’t provide a way to capture severity or less sever symptoms. An alternative to this system, is a
dimensional system in which relevant behaviours are rated along a severity measure. This is being
overlooked by experts on the DSM-V revision panel. It may better represent the uniqueness of each
individual. DSM-V helps to link normal and abnormal personality functioning.
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Chapter 16 - Psychological Disorders April 17, 2012
A diagnostic label often makes it easy to accept the label as an accurate decision of the individual rather
than of the behaviour. It becomes difficult to look at behaviour objectively without preconceptions and this
likely affects interactions with the person.
Individuals judged to be dangerous to themselves or others can by involuntarily committed. There are
laws about mental states of accused criminals. Competency refers to the defendant’s state of mind at the
time of the hearing. If they are too disturbed to understand the proceedings they will be institutionalized
until the judged competent. Insanity relates to the presumed state of mind of the defendant at the time
the crime was committed. They may be declared “not guilty by reason of insanity” if they lacked the
capacity either to appreciate the wrongfulness of their acts or to control their conduct. The verdict in
Canada was changed to “not criminally responsible on account of mental disorder (NCRMD)”. Insanity is
a legal term. The verdict “guilty but mentally ill” imposes a normal sentence but send the defendant to a
mental hospital for treatment. If they get better they will serve the remainder of their sentence in prison.
Anxiety is a state of tension and apprehension that is a natural response to perceived threat. In anxiety
disorders the frequency and intensity of anxiety responses are out of proportion to the situations that
trigger them and the anxiety interferes with daily life.
Anxiety responses have four components. 1. A subjective-emotional component; feelings of tension and
apprehensions. 2. A cognitive component; sense of impending danger, feeling of inability to cope. 3.
Physiological responses; increased heart rate, diarrhea. 4. Behavioural responses; avoidance and
impaired task performance.
Different forms of anxiety disorders include phobic disorders, generalized anxiety, panic disorders, PTSD,
and OCD. Incidence refers to the number of new cases that occur in a given period. Prevalence refers to
the number of people who have a disorder during a specified period of time. Anxiety disorders tend to
occur more frequently in females than males.
Phobias are strong and irrational fears of certain objects or situations, the name being derived from
Phobos the Greek god of fear. People with phobias realize their fears are out of proportion to the danger
involved but feel helpless to deal with them. The most common phobias are agoraphobia, a fear of open
and public places, social phobias, fear of situations in which a person may be evaluated/embarrassed,
and specific phobias, like fear of spiders, dogs, etc. Animal fears are common among woman and a fear
of heights is common among men. Many phobias develop during childhood, adolescence, and early
adulthood. Social phobias usually evolve out of extreme shyness as a child. They seldom go away on
their own and can broaden and intensify.
Generalized anxiety disorder is a chronic state of diffuse anxiety that is not attached to specific
situations or objects. It may last for months on end with signs almost continuously present. People are
jittery, tense, and constantly on edge. They expect something awful to happen but don’t know what. They
also sweat, have upset stomach, and diarrhea. Onset usually occurs in childhood and adolescence.
Panic disorders occur suddenly and unpredictably and they are much more intense. Symptoms can be
terrifying and victims may feel like they are dying. They happen in the absence of any identifiable
stimulus. Many people with panic attacks develop agoraphobia. Formal diagnosis requires recurrent
attacks that do not seem tied to environmental stimuli, follow by psychological/behavioural problems.
Onset usually occurs in late adolescence or early adulthood.
Obsessive compulsive disorder (OCD) consists of two components. Obsessions are repetitive and
unwelcome thoughts, images, or impulses that invade consciousness, are disgusting to the person, and
are difficult to dismiss or control. Compulsions are repetitive behavioural responses that can be resisted
only with great difficulty. They are responses to obsessive though and reduce anxiety associate with
them. If the person does not perform the compulsive act, they may experience tremendous anxiety.
Compulsions reduce anxiety through negative reinforcement. Onset occurs in 20s.
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