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PSYC 1030H (50)
Chapter 15

Chapter 15- Psychological Disorders.docx

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PSYC 1030H
Elizabeth Nisbet

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Chapter 15 Psychological DisordersDefining and Diagnosing DisorderDilemmas of Definition1Mental disorder as a violation of cultural standardsEmphasizes roles and rules of culture break rules deviant disturbed Issue many rules specific to a time or groupNormal for bereaved people to hear loved ones voice North America consider this abnormal crazy perfectly normal with Chinese and Hopi other cultures2Mental disorder as emotional distressIdentify disorders in terms of sufferingBehaviour that is unendurable or upsetting for one may be normal for anotherOverlooks behaviour of people that are disturbed but are not troubled about it3Mental disorder as behaviour that is selfdestructive or harmful to othersEmphasizes negative consequences of behaviourSomeone may feel fine and deny anything is wrong but behave disruptivelyMental disorder any behaviour or emotional state that causes an individual great suffering is selfdestructive seriously impairs the persons ability to work or get along with others or endangers others of the communityClassifying Disorders The DSMStandard reference manual used to diagnose mental disorders Diagnostic and Statistical Manual of Mental Disorders First edition published 1952 with 86 pages and 100 diagnoses DSMIV published 1994 with 900 pages and nearly 400 diagnosesPrimary aim is descriptive provide clear diagnostic categories so that clinicians and researchers can agree on which disorders they are talking about and then can study and treat these disordersClinicians evaluate clients based on five axes or dimensions1The primary clinical problem such as depression2Ingrained aspects of the clients personality that are likely to affect persons ability to be treated such as negative emotionality neuroticismdisposition to be pessimisticbitter3Medical conditions or medications that might contribute to the symptoms4Social and environmental stressors that can make the disorder worse such as job and housing troubles or having recently left a network of close friends5A global assessment of the clients overall level of functioning in work relationships and leisure time including whether the problem is of recent origin or of long duration and how incapacitating it isVirtually all textbooks in psychiatry psychology base discussions of mental disorders on DSMProblems with the DSM1The danger of overdiagnosisADHD fastestgrowing disorder in North America some diagnosed grow outBipolar fast growing in children only around 20 of diagnosed meet criteria2The power of diagnostic labelsOnce diagnosed seen in terms of diagnosis overlook other explanations and ignore changes in behaviour3The confusion of serious mental disorders with normal problemsEach edition of DSM adds more everyday problems to real mental illnesses4The illusion of objectivity and universalitySome say not based on empirical evidenceCultural Influences on Mental IllnessCertain mental disorders occur everywhereCulture influences how particular symptoms affect a sufferer how the disorder expresses itselfoLatin America and southern Europe anxiety attacks have feelings of choking being smothered dyingoAmerica fear of going crazy more common symptomoGreenland kayakangst sudden attack of dizzinessfear while in small kayakoDepression varies in symptoms willingness to talk about feelings and seek help likelihood of suicideIn US highest risk of suicide Native American men lowest black womenCulturebound syndromes disorders that are specific to particular cultural contextsoThese rarely overlap with DSM but can cause great suffering true mental disordersoJapan sensitive to social harmony not offending people disorder where they are afraid their body parts or functions are disgusting to othersSome culturebound syndromes understood as culturally permitted expressions of extreme psychological distressoLatinosepisode of uncontrollable screaming crying agitationoMalaysian men violent murderous outbursts
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