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Chapter 17

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University of Toronto Scarborough
Oren Amitay

Pg 547-585 Chapter 17 March 26/10 Etiology the causes or origins of a disorder Some psychological disorders, especially the less severe ones, appear to be more heavily influenced by environmental factors, such as stressors or unhealthy family interactions, or by a persons perception of these factors. Ex: a child who is constantly criticized by an overbearing, demanding parent may learn to be passive and non-responding. In contrast, many of the more severe psychological disorders appear to be more heavily influenced by hereditary and other biological factors that disrupt normal cognitive processes or product inappropriate emotional reactions Psychologists stress that the most important feature of a psychological disorder is not whether a persons behaviour is abnormal different from that of most other people but whether it is maladaptive. Psychological disorders cause distress or discomfort and interfere with peoples ability to lead satisfying productive lives. Understanding the cognitive factors involved in psychological disorders requires identification of the origins of distorted perceptions and maladaptive thought patterns. Psychodynamic Perspective based on Freuds work; psychological disorders originate in intrapsychic conflict produced by the three components of the mind: the id, ego and superego. These conflicts may center on attempts to control potentially harmful expressions of sexual or aggressive impulses, or they may also arise from attempts to cope with external dangers and traumatic experiences. The result is that the defence mechanisms themselves distort reality or the individual begins to function in some areas of life in a manner characteristic of an earlier developmental stage. Medical Perspective based on ideas that psychological disorders are caused by specific abnormalities of the brain and nervous system and that, in principle, they should be approached for treatment in the same way as physical illnesses. Most early asylums were poorly run and the patients problems were poorly understood and often mistreated. The conditions of asylums were so poor they may have further contributed to patients disorders. Today, people with psychological disorders are no longer confined in mental institutions (unless they have extreme/severe problems) but rather are treated on an outpatient basis with drugs that help decrease, and in some cases eliminate, the symptoms of psychological disorders. Cognitive Behavioural Perspective psychological disorders are learned maladaptive behaviour patterns that can best be understood by focusing on environmental factors and a persons perception of those factors. It is not something that spontaneously arises but rather caused the persons interaction with environment. Ex: alcohol abuse. Therapists with this perspective encourage their clients to replace maladaptive thoughts and behaviours with more adaptive ones. Humanistic Perspective psychological disorders arise when people perceive that they must earn the positive regard of others. They come to feel that they have no control over the outcomes of the important events in their lives. The goal is to persuade people that they do have intrinsic values and to help them achieve their own unique positive potential as human beings. Pg 547-585 Chapter 17 March 26/10 Sociocultural Perspective cultural variables influence the nature and extent to which people interpret their own behaviours as normal and abnormal. What is considered normal in one culture may be considered abnormal in another. Moreover, psychological disorders exist that appear to occur in certain cultures is a phenomenon called cultural bound syndromes. Biopsychosocial Perspective a view that the causes of psychological disorders can best be understood in terms of the interaction of biological, psychological and social factors. Ex: diathesis stress model a causal account of psychological disorders based on the idea that psychological disorders develop when a person possess a predisposition for a disorder and faces stressors that exceed his/her abilities to cope with them. Diagnostic and Statistical Manuel of Mental Disorders (DSM-IV-TR) a widely used manual for classifying psychological disorders. It provides descriptions of an individuals psychological conditions using 5 different criteria, called axes: 1. Axes I major psychological disorders that require clinical attention, including ones that may develop during childhood 2. Axes II personality disorders 3. Axes III physical disorders accompanying the psychological disorder 4. Axes IV details the source of stress and indicates its severity and duration 5. Axes V their overall level of psychological, social or occupational functioning. It allows to estimate the extern to which a persons quality of life has been diminished by the disorder. Rating are made on a 100 point Global Assessment of Functiong (GAF) scale with 100 representing the absence or near absence of impaired function, 50 representing serious problems in functioning and 10 representing impairment that may result in injury to the individual or to others. Comorbid the appearance of two or more disorders in a single person. Problems with the DSM-IV-TR: - Emphasizes biological factors and may overlook cognitive and environmental factors - 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. No two people with the same disorder will behave in the same way. - Validity an experiment showed that using the DSM as a checklist is not a valid way to classify a disorder. An experiment involved normal people who saw therapists and lied about symptoms. They were sent to insane asylums for up to 3 weeks until the therapist actually noticed they were normal and did not have any mental disorder. Labelling someone can affect clinical judgments as shown in figure 17.1. Two groups of psychoanalysts were told to watch a person. One group was told he was a job applicant and the others were told he was a patient. The group that was told he was a patient rated him disturbed. Labelling people to have mental disorders can have negative effects on that person, however, it is required in order to provide treatment. Also, if future research is to reveal more about causes and treatments of these disorders, we must be able to classify specific psychological disorders reliably and accurately.Pg 547-585 Chapter 17 March 26/10 Substance disorders, mood disorders and anxiety disorders are found to be the most common Once data are gather, clinicians can interpret them in two ways: 1. Clinical judgements diagnoses of psychological disorders or predictions of future behaviour based largely on experts experience and knowledge 2. Actuarial judgements diagnoses of psychological disorders or predictions of future behaviour based on numerical formulas derived from analysis of prior outcomes; more accurate and have higher reliability however less common due to therapists wanted to make their own decision rather than relying on numbers. They feel that it may dehumanize people because everyone is unique Attention deficit disorder a psychological disorder found in childhood characterized by impulsivity, a lack of attention, and hyperactivity. The inattention characteristic of the disorder is marked by the failure to attend closely to details and the tendency to make careless errors. Despite finding of high heritability in studies involving identical twins, there is no clear indication of how genes and environment might produce the symptoms. The cerebral cortex reaches maximum thickness by 7, but children with this disorder dont reach maximal thickness until age 10. Autistic disorder abnormal development of social interaction and communication, accompanied by pronounced limitations of activity and interestssymptoms that must appear prior to age 3. They prefer activities where they can be alone and are often oblivious to the presence of oth
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