Textbook Notes (368,013)
Canada (161,562)
Psychology (9,695)
PSYA02H3 (961)
Chapter 17

Chapter 17

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Steve Joordens

Chapter 17 – The Nature and Cause of Psychological Disorders Classification and Diagnosis of Psychological Disorders - Emil Kraepelin – comprehensive system of psychological disorders - Etiology: the causes or origins of a disorder What is Abnormal? - Abnormal – any departure from the norm o Commonly used to refer to characteristics we dislike or fear - Psychological disorders cause distress or discomfort and interfere with people’s ability to lead satisfying, productive lives - Perspectives on the Causes of Psychological Disorders - Caused by the interaction of hereditary, cognitive, and environmental factors - Genetic component can be strong in some cases - The Psychodynamic Perspective o Freud’s early work o Psychological disorders originate in intrapsychic conflict produced by the 3 components of the mind: id, ego, and superego o Conflicts may centre on attempts to control potentially harmful expressions of sexual or aggressive impulses o Conflicts can become severe and mind’s defense mechanisms can’t produce a resolution o Defense mechanisms distort reality or the individual begins to function in some areas of life in a manner characteristic of an earlier developmental stage o Symptoms can include extreme anxiety, obsessive thoughts and compulsive behavior, depression, distorted perceptions and patters on thinking, and paralysis or blindness for which there is no physical cause - The Medical Perspective o Origins from ancient Greek physician Hippocrates o Excess of 4 humors (black bile, yellow bile, blood and phlegm) led to emotional problems o Developed concept of mental illness – illness of the mind o Early asylums were poorly run and the patient’s problems were poorly understood and often mistreated  Conditions were so poor that they may have contributed to the illnesses o Many people with psychological disorders are treated on an outpatient basis with drugs that help decrease, and in some cases eliminate, the symptoms of psychological disorders o Only those with very severe and intractable psychological problems are institutionalized for long periods of time o Medical model is based on the ideas that psychological disorders are caused by specific abnormalities of the brain and nervous system, and that they should be approached for treatment in the same way as physical illnesses o Examples of psychological disorders with biological factors: schizophrenia and bipolar disorder - The Cognitive-Behavioral Perspective o Holds that psychological disorders are learned maladaptive behavior patterns that can best be understood by focusing on environmental factors and a person’s perception of those factors o Disorder is caused by the person’s interaction with their environment o It is not merely the environment that matters; a person’s ongoing subjective interpretation of the events taking place in his or her environment o Therapists encourage their clients to replace or substitute maladaptive thoughts and behaviors with more adaptive ones - The Humanistic Perspective o Proper and natural personality development occurs when people experience unconditional positive regard o Psychological disorders arise when people perceive that they must earn the positive regard of others  Become overly sensitive to the demands and criticisms of others and come to define their personal value primarily in terms of others reactions to them o Goal of humanistic therapy is to persuade people that they do have intrinsic value and to help them achieve their own unique, positive potential as human beings - The Sociocultural Perspective o Proper treatment requires an understanding of cultural issues o Cultural variables influence the nature and extent to which people interpret their own behaviors as normal or abnormal o Culture-bound syndromes – psychological disorders exist that appear only in certain cultures - The Biopsychosocial Perspective 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  Combination of a person’s genes and early learning experiences may produce dispositions (diathesis) for a variety of psychological disorders o The genes that are involved are not necessarily specific to particular disorders but may constitute a more general predisposition o Symptoms of a specific disorder will emerge only if that person is confronted with stressors that exceed is or her coping abilities o Diathesis-stress model represents the biopsychosocial perspective o Biopsychosocial perspective: a view that the causes of psychological disorders can be best understood in terms of the interaction of biological, psychological, and social factors The DSM-IV-TR Classification Scheme - Diagnostic and statistical manual of mental disorders: a widely used manual for classifying psychological disorders - Devised to provide a reliable, universal set of diagnostic categories having criteria specified as explicitly as possible - Provides descriptions of an individual’s psychological condition using 5 different criteria (axes) - Axis I contains information on major psychological disorders that require clinical attention, including disorders that may develop during childhood - Axis II contains personality disorders - Axes III through V provide information about the life of the individual in addition to the basic clarification provided by Axes I and II - Axis II is used to describe any physical disorders such as skin rashes or heightened blood pressure, accompanying the psychological disorder - Axis VI specifies the severity o stress that the person has experienced. Details the source of stress and indicates its severity and approximate duration - Axis V describes the person’s overall level of psychological, social, or occupational functioning o Main goal is to estimate the extent to which a person’s quality of life has been diminished by the disorder o Ratings are made on a 100-point GAF scale; 100 represents the absence or near absence of impaired functioning, 50 represents serious problems in functioning and 1- represents impairment that may result in injury to individual or others - Comorbid: the appearance of 2 or more disorders in a single person Some Problems with DSM-IV-TR Classification - Potential cognitive and environmental determinants may be overlooked - Problem with reliability – psychological disorders do not have distinct borders that allow a mental health professional to diagnose a disorder in a person with 100% accuracy all the time - Validity – with truth The Need for Classification - The recognition of a specific diagnostic category precedes the development of successful treatment for that disorder Prevalence of Psychological Disorders - 11% of Canadians suffer from a psychological disorder or substance abuse problem - Substance use disorders, mood disorders, and anxiety disorders were the most common types Clinical Versus Actuarial Diagnosis - 2 activities contribute to diagnosis and predictions: collection of data and interpretation of data - Once data are gathered, clinicians can interpret them in two ways: clinical method or using the actuarial (statistical) method - Clinical judgment: diagnoses of psychological disorders or predictions of future behavior based largely on experts’ experience and knowledge - Actuarial judgment: diagnoses of psychological disorders or predictions of future behavior based on numerical formulas derived from analyses of prior outcomes Disorders Usually Diagnosed in Childhood - Attention-Deficit/Hyperactivity Disorder o A psychological disorder found in childhood characterized by impulsivity, a lack of attention, and hyperactivity o Symptoms associated must be presented before age 7 o Impairment must be displayed in 2 different settings and must demonstrably interfere with age-appropriate functioning socially, academically, or otherwise o Inattention characteristic of the disorder is marked by the failure to attend closely to details and the tendency to make careless errors o Hyperactivity is displayed by excessive running or jumping and excessive talking in situations where it is inappropriate o Symptoms of impulsivity include impatience, difficulty in delaying response, interrupting or intruding on others inappropriately, blurting out answers before the question is asked, filing to listen to instructions, grabbing items that others have, and touching or knocking over objects that are not supposed to be touched - Autistic Disorder o Abnormal development of social interaction and communication, accompanied by pronounced limitations of activity and interests o Before age 3 Anxiety, Somatoform, and Dissociative Psychological Disorders - Neuroses – anxiety, somatoform, and dissociative disorders are strategies of perception and behavior that have gotten out of hand - Pathological anxiety may result from an inadequate number of defense mechanisms, from immature defenses that cannot cope with the anxiety, or from defense mechanisms applied so rigidly that they have become maladaptive - Those with neuroses experience anxiety, fear, and depression, and generally are unhappy Anxiety Disorders - Anxiety: a sense of apprehension or doom that is accompanied by many physiological reactions, such as accelerated heart rate, sweaty palms, and tightness in stomach - Panic Disorder: Description o Panic: a feeling of extreme fear mixed with hopelessness or helplessness o Panic disorder: unpredictable attacks of acute anxiety that are accompanied by high levels of physiological arousal and that last form a few seconds to a few hours o Symptoms of panic attacks – shortness of breath, clammy sweat, irregularities in heartbeat, dizziness, faintness, and feelings of unreality o Anticipatory anxiety: a fear of having a panic attack; may lead to the development of phobias - Panic Disorder: Possible Causes o Genetic and Physiological Causes  People with panic disorder periodically breathe irregularly both when awake and when asleep o Cognitive Causes  Focuses on expectancies  People who suffer from panic attacks appear to be extremely sensitive to any element of risk or danger in their environments  People with panic disorders focus on negative aspects of their environments - Phobic Disorders: Description o Phobias are persistent, irrational fears of specific objects or situations o Phobic disorder: an unrealistic, excessive fear of a specific class of stimuli that interferes with normal activities. The object of the anxiety is readily identifiable: it may be a snake, an insect, the outdoors, or closed spaces o Agoraphobia: a psychological disorder characterized by fear or and avoidance of being alone in public places; this disorder is often accompanied by panic attacks o Social phobia: a psychological disorder characterized by an excessive and irrational fear of situations in which the person is observed by others o Specific phobia: an excessive and irrational fear of specific things such as snakes, darkness, or heights - Phobic Disorder: Possible Causes o Direct classical conditioning – occurs when a particular animal or object is present in an especially unpleasant situation o Vicarious classical conditioning – occurs when a person observes another person show fright in the presence of a particular animal or object o Environmental Causes – Learning  Many people with phobias do not remember having had specific, early life experiences with the objects they fear - Obsessive-Compulsive Disorder: Description o Recurrent, unwanted thoughts or ideas and compelling urges to engage in repetitive ritual-like behavior o Obsession: an involuntary recurring thought, idea, or image o Compulsion: an irresistible impulse to repeat some action over and over even though it serves no useful purpose o Most commonly begins in young adulthood o 2 principle kinds of obsession  Obsessive doubt or uncertainty  Obsessive fear of doing something prohibited o 4 kinds of compulsion  Counting  Checking  Cleaning  Avoidance - Obsessive-Compulsive Disorder: Possible Causes o Cognitive Causes  People with this disorder believe that they should be competent at all times, avoid any kinds of criticism at all costs, and worry about being punished by others for behavior that is less than perfect o Genetic Causes  Found 5 times more frequently in first-degree relatives of those with the disorder  Tourette’s syndrome: a neurological disorder characterized by tics and involuntary utterances, some of which may involve obscenities and the repetition of others’ utterances Somatoform Disorders - A psychological disorder involving a bodily or physical problem for which there is no physiological basis - Somatization Disorder: Description o Occurring mostly in women; involves complaints of wide-ranging physical ailments for which there is no apparent biological cause o Characterized by persistent complaints of serious symptoms for which no physiological cause can be foun
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