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PHSI 208 (10)
Chapter 5

Chapter 5.doc

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PHSI 208
Neil Hibbert

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Chapter 5 Factitious disorder  A diagnosis of factitious disorder is applied to ppl who intentionally produce or complain of physical or psychological symptoms, apparently cuz of a psychological need to assume the role of a sick person. Adjustment disorders  Involves the development of emotional or beh symptoms following the occurrence of a major life stressors. However the symptoms that ensue do not meet diagnostic criteria for any other axis I diagnosis Impulse control disorder  Include a # of conditions in which the persons beh is inappropriate and seemingly out of control  In intermittent explosive disorder the person has episodes of violent beh that result in destruction of property or injury to another person  In kleptomania the person steals repeatedly but not for the monetary value of the use of the object  In pyromania the person purposefully sets fires and derives pleasure from doing so  In pathological gambling the person is preoccupied with gambling, is unable to stop and gambles as a way to escape from problems.  Trichotillomania is when the person cannot resist the urge to pluck out his or her hair often resulting in hair loss Personality disorders  Defined as enduring, inflexible and maladaptive patterns of beh and inner experience  In schizoid personality disorder the person is aloof, had few friends, and is indifferent to praise and criticism  The indiv with a narcissistic personality disorder has an overblown sense of slef importance, fantasizes about great successes, requires constant attention and is likely to exploit others  Anti social personality disorders surfaces as conduct disorder before the person reaches age 15 and is manifested in truancy, running away from home, delinquency, and general belligerence. In adulthood the person is indifferent about holding a job, being a responsible partner or parent, planning for the future or ever for tm, and staying on the right side of the law. Ppl with anti social personality disorder –also called psychopathy---do not feel guilty or shame for transgressing social norms Other conditions that may be a focus of clinical attention  If an indivs medical illness appears to be caused in part or exacerbated by a psychological condition the diagnosis is psychological factors affecting physical conditions. Among the other diagnoses in the category are the following  Academic problem – underachievement  Anti social beh- in professional thieves  Malingering- faking physical or psychological symptoms to achieve a goal such as avoiding work  Relational problems – poor relationship with siblings and spouse  Occupational problems- dissatisfaction with work  Physical or sexual abuse  Bereavement  Non-compliance with treatment –refusing meds  Religious or spiritual problems – questioning ones faith  Phase of life problem- difficulties created by a life transition such as starting school Delirium, dementia, amnestic and other cognitive disorders  Cognition is seriously disturbed  Delirium is a clouding of consciousness, wandering attention, and an incoherent stream of thought. It may be causes by several medical conditions such as malnutrition as well as by substance abuse  Dementia, a deterioration of mental capacities esp memory, is associated with Alzheimer’s disease, stroke and several other medical conditions as well as with substance abuse  Amnestic syndrome is an impairment in memory when there is no delirium or dementia  Delirium and dementia are associated with aging. Amnesties syndrome is often linked with alcohol abuse ISSUES IN THE CLASSIFICATION OF ABNORMAL BEHAVIOURA  Those who are critical of the DSM, one group asserts that classification per se is irrelevant to the filed of ab beh and a 2 group finds specific deficiencies in the manner in which diagnoses are made in the DSM General criticisms of classification  Some critics of classification argue that to classify someone as depressed or anxious results in a loss of info about that person  The existing research shows that the general public holds a relatively negative view of mental patients esp those diagnosed with one of the psychotic disorders The value of classification and diagnoses  For ex: mental retardation is sometimes caused by phenylketonuria. A deficiency in the metabolism of the protein phenylalanine results in the release of incomplete metabolites that injure the brain. A diet drastically reduced in phenylaanine prevents some of this injury  Only after a diagnostic category has been formed can we study ppl who fit its definition Specific criticisms of classification  The principal ones concern whether discrete diagnostic categories are justifiable whether the diagnostics categories are reliable and valid Discrete entity vs continuum  The DSM represents a categorical classification, a yes-no approach to classification  Discrete (separate) diagnostic entities, does not allow continuity between normal and ab
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