PSY240H5 Chapter Notes - Chapter 1: Blind Experiment, Abnormal Psychology, Bipolar Disorder

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29 Nov 2011
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Case studies
- female drinks a lot, but not in the morning; doesn’t think she has a drinking prob
b/c she doesn’t drink in the morn.; she also smokes marijuana and can’t stop
-Family aggregation: whether a disorder runs in families
- male hears voices with malicious intent; was normal before – experiencing
- Box 1.1 Developments in Research Do magnets help with repetitive-stress injury?
- magnets marketed to ppl who have chronic hand/wrist pain – know as repetitive-stress
- double blind experiment – 3 groups – 1) wore the bracelet with magnet 2) wore an
identical bracelet w/o the magnet (placebo) 3) no treatment
- results showed that ppl typed more words with the magnet due to placebo effect
- Box 1.2 – The World Around Us – The Elements of Abnormality
-Elements of Abnormality the more of these one has, the more likely he/she has
some form of mental disorder
-1. Suffering
- psychological suffering
- neither a sufficient condition (all that is needed) nor even a necessary condition (that all
cases of abnormality must show) for us to consider something as abnormal
-2. Maladaptiveness
- maladaptive behaviour
- not all disorders involve it
- ex. con artists don’t consider their behaviour maladaptive b/c it is how they make their
living, but it is maladaptive for society so we consider them abnormal
-3. Deviancy
- statistically rare and undesirable considered abnormal
-4. Violation of the Standards of Society
- whether it is abnormal depends on magnitude of the violation and how commonly it is
violated by others
-5. Social Discomfort
- when someone violates a social rule
-6. Irrationality and Unpredictability
- imp whether person can control his or her behaviour
in general, what society considers abnormal changes over time – ex. homosexuality
was thought to be a mental disorder before
- provides us with nomenclature: naming system
- also allows us to structure info in a more helpful manner
oallows one to study diff. disorders, learn more and determine how best to treat someone
- Social and political implications
oestablishes range of probs that mental health profession can address
odelineates which types of probs should get reimbursement
- Box 1.3 Extreme Generosity or Pathological Behaviour
- a man gave away his fortunes, proceeded to donate his kidney and wanted to give his
whole body away to help others
- loss of info
-Stigma: disgrace attached to receiving a psychiatric diagnosis
- Case study
- a man lived with bipolar disorder for many years, he was hospitalized for a suicide
attempt; contacted mental health authorities about dealing with mental illness and was
told that ppl like him don’t go back to work
- this case study shows Stereotyping: automatic beliefs that ppl have about others based
on knowing one thing about them
-Labelling: a person’s self-concept may be directly affected by being given a diagnosis
omay still remain the same after a full recovery
- Table 1.1
-Symptom: single indicator of a prob; can involve affect, behaviour or cognition
-Syndrome: group or cluster of symptoms that all occur together
oex. depression can be a symptom when about affect, but a syndrome when
it has all the symptoms
- America Psychiatric Association’s Diagnostic and Statistical Manual of Mental
- DSM-IV-TR (text revision)
- def’n by DSM does not refer to causes of mental disorder; attempts to be “atheoretical”
-Limitations of the def’n
- What is meant by “clinically significant” and how should this be measured?
- how much distress or disability should be experienced by someone before she or she
can be said to be suffering from a mental disorder
- who determines what is “ulturally sanctioned”?
- what constitutes a “behavioural, psychological or biological dysfunction”?
- problematic behaviour cannot itself be the dysfunction because that would be like
saying mental disorders are due to mental disorders (circular reasoning)
-Wakefield’s def’n of mental disorder:
- proposed that mental disorder is “harmful dysfunction”
- harm is based on social values (ex. suffering, being unable to work, etc.)
- dysfunction refers to underlying mechanism that fails to perform according to its
(presumably evolutionary) design
- limitation evolutionary theory does not provide us with list of what is functional and
what is not
- cultural factors affect presentation of disorders found all over the globe
osome cultures don’t have a word for mental disorder, but have words for the
symptoms and syndromes related to them
- culture can also shape clinical representation of disorders
oex. depression is china refers to the physical aspects and not the emotional
-Kyofusho: prevalent in Japan; anxiety disorder; fear that one’s body, body parts of body
functions may offend/embarrass others or make them feel uncomfortable often afraid
of blushing, fear upsetting others with facial expression, gaze or body odour
-Ataque de nervios: found in some Latino-Caribbean and Latin Mediterraneans;
symptoms (include crying, trembling, uncontrollable screaming, general feeling of
being out of control; sometimes aggressive physically or verbally; may faint or
experience something like seizure) triggered often by stressful event (ex. loss of loved
one); once ataque is over, no memory of what happened
-Abnormal behaviour: deviates from the norms of the society in which it is enacted
ouniversally considered abnormal - ex. defecating, urinating in public
- imp to know because allows one to determine how funds should be allocated
- ex. depression in women is 2:1 of men generally; not the case in Jews both affected
almost equally; Jewish males more likely to have depression than non Jewish males
-Prevalence and Incidence
-Point prevalence: estimated proportion of actual, active cases of the disorder in a
given pop. at any instant in time
-One-year prevalence: count everyone who suffered at any time during the whole year
(higher than point prevalence)
-Lifetime prevalence: estimate of how many ppl had suffered from a particular disorder
at any time in their lives (even if they have recovered now)
-Prevalence Estimates of Mental Disorders
-Comorbidity: presence of two or more disorders in the same person
- NCS-R study found widespread occurrence of comorbidity
oespecially high in those with severe forms of mental disorders
- not all people receive treatment
osome delay it due to difficulty accessing mental health services, others b/c of their
attitudes towards seeking help
oimmigrants less likely to get treatment
- over the years, number of admissions to mental hospitals have decreased due to:
omedication that control symptoms
odevelopment of effective psychological treatments
oincreasing costs
orecognition that probs can be effectively treated on an outpatient basis
- trend away from use of traditional hospitalization = “deinstitutionalization”
-The Mental Health “Team” - See Box 1.4 (p.14)
- Box 1.1 Access to Mental Health Services for New Canadian Immigrants
- Caribbean immigrants go there less often than Canadian born residents but more often
than other immigrant groups
- steps to improve: Transcultural Child Psychiatry Service at Montreal they do this
through things like:
ohire interpreters
ocollaborate with other professionals
ogive access to culturally appropriate resources