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Chapter 15

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PSY 202
Lili Ma

1 PSY 202 - Chapter 15: Psychological Disorders: When Adaptation Breaks Down March 30 2012 Lecture Preview Discuss conceptions of mental illness and identify criteria for defining mental disorders Describe and explain how people experience anxiety Identify the characteristics of different mood disorders Explore dissociative disorders and schizophrenia Examine the link between personality disorders and substance abuse What Defines a Mental Disorder? You cant classify mental disorders on only these things! It is very difficult to classify mental disorders. Statistical rarity? What about an exceptionally high IQ? Some mental disorders are uncommon in the population. We cant rely on statistical rarity to define mental disorder. Subjective/personal distress? Not all psych disorders generate distress (eg manic phase of bipolar disorder a person can shift between manic extreme excitement this switches to depression; they go through highs and lows). Impairment? keep in mind that completely normal people go through a phase that they undergo impairment but they do not have a disorder Exam time for students? Most interfere with everyday life but this doesnt mean a mental illness is present. Societal disapproval? You cant rely on society Homosexuality? Example racism is justifiably deplored by society but isnt considered a mental disorder. Biological dysfunction? What about: Learned behaviour? Little children may learn to be afraid of dogs if they see their parents act anxious around dogs. Not all mental disorders are due to breakdown of physiological systems. Family resemblance view mental disorders dont all have one thing in common, rather they share a loose set of features. Within a category, between categories the features are shared. Mental disorders dont all have one thing in common just as brothers and sisters look similar but dont all have exactly the same features. Historical Conceptions of Mental Illness (Describe conceptions of diagnoses across history and cultures) Demonic model for a long period of time the view of mental illness was that evil spirits possessed these people and we have to come up with a way to remove these evil spirits. Egyptians used to drill holes in the skull to release them. View of mental illness in which odd behaviour, hearing voices, or talking to oneself. Medical model western model; it wasnt any better than the demonic model. The reason why this was good because it started to look at mental related issues from a physical view. Perception that regarded mental illness as due to a physical disorder requiring medical treatment. o Governments began to house troubled individuals in asylums 1 2 they moved the people outside of society. These buildings housed troubled people and they were treated inhumanely. o Bloodletting and snake pits were often used as treatments they drained their blood; or lets shock the disorder out of the individual by throwing them into snake pits. Snake pit is a synonym for an insane asylum. More Modern Approaches Moral treatment - the approach to mental illness calling for dignity, kindness and respect for the mentally ill. Deinstitutionalization taking the individuals out of hospitals or asylums. 1960s- 1970s government policy that focused on releasing hospitalized psychiatric patients into the community and closing mental hospitals. Releasing hospitalized psychiatric patients into the community and closing mental hospitals. What do you think are some of the benefits and costs of the policy of deinstitutionalization? Puts more of a responsibility on the society and their family. Benefits some patients returned to normal lives and continued outpatient programs. It has saved the government a large amount of money Costs many patients ended up homeless. This can still be seen today as a recent study indicated that 15% of all patients treated for mental disorders are homeless. Psychiatric Diagnoses Over Time Diagnostic labels devoid of scientific support: Codependency when you are excessively dependent on another individual. A condition in which spouses and significant others become excessively dependent on and overly caring of loved ones with alcoholism and other substance abuse disorders. Sexual addiction a condition that characterizes people who cant control their sexual impulses. Road rage disorder a condition marked by explosive anger outbursts while driving Compulsive shopping disorder an inability to restrain oneself from purchasing unnecessary items. ** we want diagnoses to explain these labels. Labels only describe behaviours; a diagnosis helps to explain them. Psychiatric Diagnosis Across Cultures Many mental illnesses are specific to certain cultures (culture-bound) Amok episodes of intense sadness followed by uncontrollable attacks on people Koro in a number of Asian countries, men with this condition falsely believe their penis and testicles are disappearing and receding into their abdomen. This is funny for us, but examples like this do exist. 23 Bulimia nervosa - unique to Western cultures. This is very specific. They still can diet and work out, but they purge (throw up) after eating food. Likely genetic, but triggered by sociocultural expectations it exists in families where there is no incidence. Anorexia nervosa - more culturally universal. When a person completely stops eating, or diets or works out excessively. Complete control of what goes into the body. Many mental disorders are culturally universal (schizophrenia, alcoholism, psychopathic personality) Graph: The Media and Unrealistic Ideals: Weights of Playboy Centerfolds Over Time Late 70s were lower. The weight has gone up, it isnt realistic. Popular Misconceptions about Psychiatric Diagnosis Psychiatric diagnosis is nothing more than pigeonholing, like sorting people into different boxes psychiatrists actually realize that people differ. When we diagnose people with a mental disorder, we deprive them of their uniqueness: Psychiatric diagnoses are unreliable for major mental disorders, interrater reliability is high the extent to which different raters agree on patients diagnoses. Psychiatric diagnoses are invalid dia
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