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Chapter 17

Chapter 17


Department
Psychology
Course Code
PSYA02H3
Professor
Oren Amitay
Chapter
17

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Chapter 17 Notes – The Nature And Causes Of Psychological Disorders
x
Etiology
the causes or origins of a disorder
x
Psychological disorders are characterized by abnormal behaviour, thoughts, and feelings
x
The term abnormal literally refers to any departure from the norm
o
Thus, a short or tall person is “abnormal”, and so is someone who is especially
intelligent
o
But the term abnormal has taken on a pejorative connotation: we use it to refer to
characteristics we dislike or fear
o
The distinction between normal and abnormal can be very subjective; it’s stressed that
the most important feature of a psychological disorder is not whether a person’s
behaviour is “abnormal”, but whether it is maladaptive
Psychological disorders cause distress or discomfort and interfere with people’s
ability to lead satisfying, productive lives
o
But is a person is disliked, should we say they have a psychological disorder? No
o
Abnormal is distressing and dysfunctional; anything that may cause harm to you or
anyone else, or prevents growth
But virtually everything we do can cause someone else harm
x
This is intentional, as everyone is abnormal in some way or another; it is
over-inclusive
But this over-inclusiveness is a strength because it reduces stigma
Also, if you know you’re abnormal, then why don’t you try to fix it?
And how do you define hurt/harm? This term is too vague
o
For most disorders, you need to meet 1 of 2 criteria: either causes you significant
distress, or impairs your functioning
x
Although the diagnosis of psychological disorders should be as objective as possible, it may
never be completely free from social and political judgements
x
There is not a single cause of psychological disorder; generally they are caused by the
interaction of hereditary, cognitive, and environmental factors
o
In some cases, the genetic component is strong and the person is likely to develop a
psychological disorder even in a very supportive environment
But in other cases, the cognitive and environmental components are strong
x
The
psychodynamic perspective
is based on Freud’s early work, where psychological disorders
originate in intrapsychic conflict produced by the three components of the mind; id, ego, and
superego
o
These conflicts may centre on attempts to control potentially harmful expressions of
sexual or aggressive impulses, or may also arise from attempts to cope with external
dangers and traumatic experiences
o
For some, the conflict becomes so severe that the mind’s defence mechanisms cannot
produce a resolution that is adequate for mental health; the result is that the defence
mechanisms distort reality or the individual begins to function in some areas of life in a
manner characteristic of an earlier developmental stage
The consequent psychological disorders may involve, among other symptoms,
extreme anxiety, obsessive thoughts, compulsive behaviour, depression,
distorted perceptions, and paralysis or blindness for where there is no physical
cause
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x
The
medical perspectives
origins lie in the work of Hippocrates; he formulated the idea that
excesses from the four humours (black bile, yellow bile, blood and phlegm) led to emotional
problems
o
They extended the ideas and developed the concept of mental illness, and as such,
asylums were established, and the conditions were often mistreated
o
Later however conditions improved, and those who were specifically trained in medical
treatment were hired
o
Today however, they are treated with drugs to help decrease and in some cases,
eliminate the symptoms; usually only those with severe problems are institutionalized
x
The
cognitive-behavioural perspective
holds that psychological disorders are learned
maladaptive behaviour patterns that can best be understood by focusingon environmental
factors and a person’s perception of those factors
o
In this view, psychological disorders are not things that arise spontaneously within a
person, but instead caused by a person’s interaction with the environment
E.g. people who’re on drugs may be reinforced by the relief from tension
o
It is not merely the environment that matters – what also counts is a person’s ongoing
subjective interpretation of the events taking place in his or her environment, and
therefore encourage their clients to replace maladaptive thoughts and behaviours with
positive ones
x
The
humanistic perspective
argues that proper and natural personality development occurs
when people experience unconditional positive regard, and as such, psychological disorders
arise when people perceive that they must earn the positive regard of others
o
Thus they become overly sensitive to the demands and criticisms of others and com to
define their personal value primarily in terms of others’ reactions to them, lacking
confidence in their abilities and feeling as though they have no stable, internal value as
people
This result may cause them to feel that they have no control over the outcomes
of important events in their lives, often accompanied by depression
o
The goal is to persuade people that they do have intrinsic value and to help them
achieve their own, unique positive potential as human beings
x
The
sociocultural perspective
finds that the cultures in which people live play a significant role
in their development of psychological disorders
o
Proper treatment requires an understanding of cultural issues
Cultural variables influence the nature and extent to which people interpret
their own behaviours as normal or abnormal; what is considered as normal in
one culture may be abnormal in another
o
Moreover, psychological disorders exist that appear to occur only in certain cultures,
called culture-bound syndromes
x
The
biopsychosocial perspective
asks certain questions: are disorders caused by conflict within
the individual? Are they caused by genetic factors or by abnormalities of the brain and nervous
system, or both? Are they caused by learning, by faulty subjective interpretations of
environmental events, or by the way our particular culture says we should think ad behave?
o
No single perspective is completely adequate; different approaches can be combined to
form larger, more comprehensive perspectives
o
Diathesis-stress model
a causal account of psychological disorders based on the idea
that psychological disorders develop when a person possesses a predisposition for a
disorder and faces stressors that exceed his or her abilities to cope with them
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Genes that are involved are not necessarily specific to particular disorders but
may constitute a more general predisposition; however the symptoms of a
specific disorder will only emerge if that person is confronted with stressors that
exceed their coping abilities
i.e. a person may be predisposed towards a psychological disorder yet not
develop it, either because he or she has not encountered sufficient stressors to
trigger it or because he or she possesses cognitive-behavioural coping skills
adequate to counter the stressors that are present
o
Biopsychosocial perspective
a view that the causes of psychological disorders can best
be understood in terms of interactions of biological, psychological, and social factors
x
Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR)
a widely used manual for
classifying psychological disorders
o
The DSM-IV-TR provides descriptions of individuals psychological condition using 5
different criteria, called axes
Axis I
contains information on major psychological disorders that require clinical
attention, including disorders that may develop during childhood
Axis II
includes personality disorders
x
Diagnoses can be made that include both axis I and axis II disorders, and
multiple diagnoses can occur on either axis alone
o
E.g. major depression and alcohol dependence are both on axis I
disorders, and both disorders may characterize an individual at
any one period of time
x
A person’s psychological condition may be due to several different
psychological disorders described in the DSM-IV-TR
Axes III through V provide information about the life of the individual in addition
to the basic classification provided by axes I and II
Axis III
is used to describe any physical disorders, such as skin rashes or
heightened blood pressure accompanying the psychological disorder
Axis IV
specifies the severity of stress that the person has experienced
x
This axis details the source of stress and indicates it's severity and
approximate duration
Axis V
describes the person’s overall level of psychological, social, or
occupational functioning
x
The purpose of axis V is to estimate the extent to which a person’s
quality of life has been diminished by the disorder, made on a 100-point
“global assessment of functioning” (GAF) scale, with 100 representing
the absence or near absence of impaired functioning, 50 representing
serious problems in functioning, and 10 representing impairment that
may result in injury to the individual or others
o
It is also possible for the same person to suffer different disorders at different points in
time
Comorbid
the appearance of two or more disorders in a single person
o
E.g. alcohol dependence (axis I) can be Comorbid with major depressive disorder (axis I).
Alcohol dependence often leads to marital problems, which may also be partly
associated with an anti-social personality disorder (axis II). Marital problems may lead to
divorce, and these problems and the divorce are themselves stressors (axis IV) that
subsequently may contribute to an episode of major depression (axis I). Alcohol
dependence also may lead to physical problems, such as cirrhosis (Axis III). These
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