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Chapter 1

Chapter 1 - PSYC 235.docx

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Queen's University
PSYC 235
Kelly Suschinsky

Chapter 1 - Historical Background What is a Psychological Disorder? No one criteria fully defines abnormality Psychological dysfunction: breakdown in cognitive, emotional or behavioural functioning Criteria for defining a psychological disorder: 1. Psychological dysfunction 2. Distress or impairment 3. Atypical response or not culturally expected Phobia: psychological disorder characterized by marked and persistent fear of an object or situation Personal Distress Cant define psychological disorder by distress alone o E.g. Jody was distressed in his phobia of blood Impairment o E.g. many people consider themselves shy or lazy, not abnormal If its to an extreme social functioning is impaired Atypical or Not Culturally Expected o The more productive you are in society, the more eccentricities are tolerated o Sometimes defining abnormal means deviating from the average, but not all the time o If you are violating social norms it is abnormal o E.g. entering a trance or state isnt normal in Western culture but is in many other societies o E.g. Masai woman crazy for killing a goat and hearing voices (only Masai men kill goats, hears voices at the wrong times) o The best we can do define disease or disorder is to consider how it matches a typical profile of a disorder o Prototype: when most of or all symptoms that experts agree are part of the disorder at the present o the patient may have only some features or symptoms that experts agree are part of the disorder and still meet the criteria for the disorder o Szasz and Albee highly critical of medical diagnoses being used in the case of psychological disorders o Szasz mental illness is a myth o Albee biggest mistake made by clinical psychologists is uncritically accepting the concept of mental disease and using the medical model and associated diagnosis in conceptualizing abnormal behaviour Psychopathology Psychopathology: scientific study of psychological disorders Psychological disorder: psychological dysfunction associated with distress or impairment in functioning that is not a typical or culturally expected response Professional psychologists are regulated by the College of Psychologists of Ontario o Only can be called psychologists Counselling psychologists: study and treat adjustment and vocational issues encountered by relatively healthy individuals Clinical psychologists: concentrate more on psychological disorders Psychiatrist: investigates the nature and causes of psychological disorders, often from a biological view, make diagnoses, and offer treatments o M.D. from medical school o Specialize in psychiatry in a 3-4 year residency Psychiatric social worker: o masters in social work o treat disorders Psychiatric nurses: advanced degrees and specialize in the care and treatment of patients with psychological disorders Marriage and family therapists and mental health counselors: o 1-2 years of a masters o under supervision of a doctoral level clinician usually in hospitals or clinics Scientists practitioners: o consumer of science o enhancing practice o evaluator of science o determining the effectiveness of the practice o creator of science o conducting research that leads to new procedures useful in practice e.g. new miracle cures reported to media would not be used by a scientist-practitioner who did not have sound scientific data showing they work Studying psychological disorders: 1. Clinical description 2. Causation 3. Treatment and outcome Presenting problem: original complain reported by the client to the therapist. The actual treated problem may sometimes be a modification derived from the presenting problem Clinical description: details of the combination of behaviours, thoughts, and feelings of an individual that make up a particular disorder o What makes the disorder different from normal behaviour or from other disorders? Prevalence: how many people in the population as a whole have this disorder? Incidence: how many new cases occur during a period? Sex ratios: % of males to females with disorder Age of onset: differs from one disorder to another Most disorders follow a certain individual pattern or course Course: pattern of development and change of disorder over time o Chronic: last a long time (e.g. schizo) o Episodic: likely to recover within months only to have a recurrence later. Pattern may be repeated (e.g. mood disorders). o Time- limited: will improve without treatment in a relatively short period Acute onset: sudden disorder development Insidious onset: develops gradually over time Prognosis: anticipated course of a disorder Age is important in the clinical description e.g. children present their symptoms often different from adults, like an anxiety disorder. Children will assume they are physically ill and are often misdiagnosed
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