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Chapter 14

PSYA02 - Chapter 14.docx

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Steve Joordens

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Chapter 14 Psychological Disorders
- to qualify as a mental disorder, thoughts, feelings, and emotions must be
persistent, harmful to the person experiencing them and uncontrollable
- the complicated human mind can produce behaviors, thoughts, and emotions that
change radically from moment to moment
Identifying Psychological Disorders: What is Abnormal?
- in ancient times people who acted strangely or reported bizarre thoughts or
emotions were often understood in the context of religions or the supernatural
- in some cultures and religious traditions, madness is still interpreted as possession
by animal spirits or demons or as God’s punishment
- these ways of looking at psychological abnormalities have been replaced in
industrialized areas of the world by a MEDICAL MODEL => the conceptualization of
psychological disorders as diseases that, like physical diseases, have biological
causes, defined symptoms, and possible cures
- treating abnormal behavior in the way we treat illness suggests that the first step
is to determine the nature of the problem through diagnosis
- in diagnosis, clinicians seek to determine the nature of the patient’s mental disease
by assessing symptoms -> behaviors, thoughts and emotions suggestive of an
underlying abnormal syndrome, a coherent cluster of symptoms due to a single
- every action or thought suggestive of abnormality cannot be traced to an
underlying disease
Classification of Disorders
- psychologists have adopted an approach developed by psychiatrists who use a
system for classifying mental disorders
- that is why a consensual diagnostic system was published
- the current version of this manual is the Diagnostic and Statistical Manual of
Mental Disorders (Fourth Edition, Text Revision) or DSM-IV-TR
- DSM-IV-TR => a classification system that describes the features used to diagnose
each recognized mental disorder and indicates how the disorder can be
distinguished from other, similar problems
- each disorder is named as classified as though it were a distinct illness
- major misconception -> that a mental disorder can be defined entirely in terms of
deviation from the average, the typical, or “healthy”
- people who have mental disorders may behave, think, or experience emotions in
unusual ways, but simple departure from the norm is not the whole picture

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- the DSM-IV-TR definition takes these concerns into account by focusing on 3 key
elements that must be present for a cluster of symptoms to qualify as a mental
=> a disorder is manifested in symptoms that involve disturbances in
behavior, thoughts, or emotions
=> the symptoms are associated w/ significant personal distress or
=> the symptoms stem from an internal dysfunction (biological,
psychological, or both)
- psychological disorder exists along a continuum from normal to abnormal w/o a
bright line of separation
- the DSM-IV-TR recognizes this explicitly by recommending that diagnoses include
a global assessment of functioning, a 1 to 100 rating of the person, w/ more
severe disorders indicated by lower numbers and more effective functioning by
higher numbers
- in general the DSM-IV-TR produces better diagnostic reliability than earlier DSM
- many diagnostic categories continue to depend on interpretation based criteria
rather than on observable behavior and diagnosis continues to focus on patient self-
- level of agreement among different diagnosticians can vary depending on the
diagnostic category
- diagnostic difficulty is further increased when a person suffers from more than one
- people w/ depression (a mood disorder) often have secondary diagnoses of
anxiety disorders
- the co-occurrence of two or more disorders in a single individuality is referred to
as COMORBIDITY and is very common
- Comorbidity raises a host of confusing possibilities
Causation of Disorders
- the medical model suggests that knowing a person’s diagnosis is useful because
any given category of mental illness is likely to have a distinctive cause
- a specifiable pattern of causes (or etiology) may exist for different psychological
- it also suggests that each category of psychological disorder is likely to have a
common prognosis, a typical course over time and susceptibility to treatment and
- but it is rarely useful to focus on a single cause that is internal to the person and
suggests a single cure
- an integrated perspective that incorporates biological, psychological, an
environmental factors offers the most comprehensive and useful framework for
understanding most psychological disorders
- on the biological side => the focus is on genetic influences, biochemical
imbalances, and structural abnormalities of the brain
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