Chapter 13 – Disorders of the Mind and Body
-psychopathology – a disorder of the mind
-mental illness might be the result of conflicts between thought and emotion
How are Mental Disorders Conceptualized and Classified?
Mental Disorders are Classified into Categories
-Emil Kraepelin; first to propose a classification system for mental disorders.
-identified mental disorders based on groups of symptoms that occurred together
-Diagnostic and Statistical Manual of Mental disorders
-multiaxial system is based on the growing realization that mental health is affected by a
variety of factors.
-diagnosing a patient on all five axes provides a more complete picture of the person.
-See table for the five levels of AXIS
Mental Disorders Must Be Assessed before Diagnosis
-the process of examining a person’s mental functions and psychological health is known
-the goal of assessment is to make a diagnosis so that appropriate treatment can be
provided for the specific disorder.
-the course and probable outcome, or prognosis, can help the patient and family
understand what the future might bring.
-Mental Status Exam provides a snapshot of their psychological functioning.
-the exam involves evaluating the person for things such as personal groming, ability to
make eye contact, tremors or twitches, mood, speech, though content, and memory.
-offers insights into whether a person has a mental disorder.
-most symptoms of psychological problems develop over fairly long periods of time
-this clinical interview is the most common method of psychological assessment
Structured vs. Unstructured Interviews:
-Although this type of interview is flexible it is highly idiosyncratic – no two
unstructured interviews are likely to elicit identical information.
-structured interviews use standardized questions that are asked in the same order each
-the most commonly used structured interview is known as Structured clinical Interview
for DSM, which makes diagnoses according to DSM criteria.
-structured interviews facilitate assessment as well as research and treatment.
-in this method, the client is asked to perform certain actions, such as copying a picture,
drawing a design from memory, sorting cards that show various stimuli into categories
bsed on size, shape or color, placing blocks into slots on a board while blindfolded,
tapping fingers rapidly and so forth.
-examples of these types of tests are like the assessment of personality.
-the most widely used questionnaire for psychological assessment is the Minnesota
multiphasic Personality inventory.
-the latest version consists of 567 true/false items that assess emotions, thoughts, and
-ten clinical scales and the way a person scores on these scales produces a particular
profile that indicates whether he or she may have a particular mental disorder.
-a common problem with all self-report assessments, is that people do not necessarily
-to counter these response biases, the MMPI contains validity scales that measure the
probability that people are being less than truthful
-Other validity scales examine whether the text taker answers similar questions in the
same manner each time, endorses items that are extremely rare, and endorses and
especially large number of negative items.
-MMPI is has been criticized because it may not be appropriate for use in other countries
or with groups such as the poor, elderly, or racial minorities.
-tests such as the MMPI are widely used in psychological assessment, but they are
seldom the sole source of information.
Mental Disorders Have Many Causes
-Freud believed that mental disorders were due to mostly unconscious conflicts, often
sexual in nature that dated back to childhood.
-consistent with this perspective, many disorders in the first edtion of the DSM were
described as reactions to environmental conditions or as involving various defense
-Psychological factors play an important role in the manifestation and treatment of mental
-at the social level of analysis, thoughts, and emotions are shaped by the environment and
can profoundly influence behaviour, including abnormal behaviour.
-The Family Systems model is based on the idea that the behaviour of an individual must
be considered within a social context, in particular the family.
-the sociocultural model views psychopathology as the result of the interaction between
individuals and their cultures.
-schizophrenia, are more common among the lower socioeconomic classes, such as
anorexia nervosa are more common among the middle and upper classes.
-differences in lifestyles, expectations, and opportunities among the classes of society.
-that it is possible that there are cultural biases in the willingness to ascribe disorders to
different social classes.
Cognitive Behavioral Factors
-at the level of the individual, the central principle of the cognitive behavioural approach
is that abnormal behaviour is learned.
-the psychoanalytic approach focuses on unconscious internal factors, the behavioral
approach is based on observable variables.
-proponents of strict behaviorism argue that mental disorders are the result of classical
and operant conditioning
-the revised cognitive behavioral perspective includes the idea that thoughts and beliefs
should be considered as another type of behavior that can be tudied empirically.
-thoughts can become distorted and produce maladaptive behaviours and emotions.
-individuals are aware of, or can be easily made aware of, the thought processes that give
rise to maladaptive behaviour.
-the biological perspective on mental disorders focuses on how physiological factors,
such as genetics, contribute to mental illness.-other biological factors also influence the
development and course of mental illness.
-the fetus is particularly vulnerable, and there is evidence that some mental disorders may
arise from prenatal problems such as maternal illness, malnutrition, and exposure to
-structural imaging has revealed neuroanatomical differences, perhaps due to genetics,
between those with mental disorders and those without, but functional neuroimaging is
currently at the forefront of research into the neurological correlates of mental disorder.
Integrating the Factors involved in Mental disorders
-interaction among multiple factors.
-the diathesis-stress model provides one such way of thinking about the onset of mental
-individual an have an underlying vulnerability or predisposition.
-the vulnerability by itself may not be sufficient to trigger mental illness, but the addition
of stressful circumstances can tip the scales.
-if the stress level exceeds an individual’s ability to cope, the symptoms of mental illness
-a family history of mental illness suggests vulnerability rather than destiny.
The Legal System Has Its Own Definition of Psychopathology
-according to the current legal system, a person is not responsible if at the time of the
crime, a mental illness or defect led to an inability to appreciate the criminality of the act
or to an inability to conform to the requirements of the law.
-not guilty by reason of insanity.
-the notion of insanity is actually legal, not psychological.
Can Anxiety Be the Root of Seemingly Different Disorders
-anxiety itself is normal and even useful
-anxiety disorders are characterized by excessive anxiety in the absence of true danger.
-it is abnormal to feel strong chronic anxiety without cause
There Are Different Types of Anxiety Disorders
-people suffering from anxiety disorders feel tense, anxious, and apprehensive.
-chronic anxiety also causes a variety of somatic symptoms, due to the arousal of the
autonomic nervous system.
-sweating dry mouth, rapid pulse, shallow breathing, increased blood pressure, and
increased muscular tension are all consequences of autonomic arousal.
-chronic stress can produce atrophy in the hippocampus, a brain structure involved in
learning and memory
-the fact that chronic stress can damage the body and brain, however, indicates the
importance of identification and effective treatment of disorders that involve chronic
Chapter 13 disorders of the mind and body. Mental illness might be the result of conflicts between thought and emotion. Emil kraepelin; first to propose a classification system for mental disorders. Identified mental disorders based on groups of symptoms that occurred together. Multiaxial system is based on the growing realization that mental health is affected by a variety of factors. Diagnosing a patient on all five axes provides a more complete picture of the person. See table for the five levels of axis. The process of examining a person"s mental functions and psychological health is known as assessment. The goal of assessment is to make a diagnosis so that appropriate treatment can be provided for the specific disorder. The course and probable outcome, or prognosis, can help the patient and family understand what the future might bring. Mental status exam provides a snapshot of their psychological functioning.