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Chapter 15

Chapter 15

4 Pages
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Department
Psychology
Course Code
Psychology 2035A/B
Professor
Doug Hazlewood

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Chapter 15: Psychological Disorders (P478-491) Abnormal Behaviour: Concepts and Controversies The Medical Model Applied to Abnormal Behaviour - The medical model proposes that is it useful to think of abnormal behaviour as a disease th - Became prominent in the 19/20 century, before which abnormal behaviour was based on superstition (thought to be possessed, victims of god’s punishment). Their disorder were thus “treated” with rituals such as chants, and exorcisms and were locked up in dungeons or killed if seen as dangerous - Thomas Szasz is a critic of the medical model and says that strictly speaking disease can only affect the body, and abnormal behaviour usually involved a deviation from social norms rather than an illness - He contends that such problems are “problems with living” rather than medical problems - However, medical concepts such as diagnosis, prognosis, and etiology (causation and developmental history) have proven useful in the study of abnormality Criteria of Abnormal Behaviour 1. Deviance- as Szasz said, people are said to have a disorder when their behaviour deviated from what society views as acceptable. E.g. transvestic fetishism is a sexual disorder when a man is aroused by dressing in women’s clothing; shows the arbitrary nature of cultural norms b/c cross dressing is acceptable for women yet deviant for men 2. Maladaptive behaviour-for the diagnosis of substance use disorders b/c alcohol in and of itself is not deviant or unusual and only becomes maladaptive when it interferes with a personals social and occupational functioning 3. Personal Distress- usually for people with depression or anxiety who report a great deal of personal distress - People are viewed as disorders when they have 1 or any combination of the 3 criteria - Diagnoses of disorders involve value judgements about what represents normal/ abnormal behaviour (compare to a physical illness where people agree that a malfunctioning kidney is pathological regardless of their personal values) they reflect cultural values, social trends, and political forces aside from the science - E.g. Homosexuality was viewed as a disorder until 1973 when it was deleted b/c: attitudes towards gays in our society became more tolerant, gay rights activists campaigned vigorously for the change, and research showed that gays and heterosexuals were indistinguishable on measures of psychological health - Normal/abnormal is a continuum everyone experiences some personal distress or does something deviant, so it’s only viewed as a disorder when the behaviour becomes extreme Psychodiagnosis: The Classification of Disorders - The American Psychiatric Association unveiled the Diagnosis and Statistical Manual of Mental Disorders in 1952 to provide guidelines for diagnosis which then included ~100 disorders. - Revisions led to the DSM-II in 1968, and the DSM-III in 1980 which showed a big improvement in the explicitness and clarity of criteria - The current edition DSM-IV was released in 1994, and slightly revised in 2000 built upon the DSM-III and expanded the # of disorders to ~3x more then the original - The DSM-III introduced a new multiaxial system of classification where individuals were judged on 5 separate dimensions/axes, which most theorists agree to be a step up b/c it recognizes the importance of information besides a traditional diagnostic label o Axis I: (1) disorders that arise before adolescence (ADD, autism, mental retardation), (2) organic mental disorders (dysfunction of brain tissue- dementia, amnesia), (3) substance related, (4) schizophrenia & other psychiatric dis., (5) mood disorders (key is emotional disturbance- depression bipolar, dysthymic, cyclothymic), (6) anxiety (panic, generalized anxiety dis.), (7) somatoform (w/ symtoms that resemble physical illness- somatisation, conversion disorders, hypochondriasis), (8) dissociative dis. (sudden, temporary alteration of memory, consciousness, identity, & behaviour- dissociative amnesia, multiple personality), (9) sexual and gender identity dis. (3 types: gender identity (discomfort with identity of M/F), paraphilias (preference for unusual acts to achieve arousal), and sexual dysfunctions (impairment in functioning)) o Axis II: Personality Disorders- patterns of personality traits that are longstanding, maladaptive, inflexible; borderline, schizoid, and antisocial personality disorders o Axis III: General Medical Conditions- physical disorders/conditions recorded here; diabetes, arthritis, and hemophilia o Axis IV: Psychosocial and Environmental Problems- things that can affect the diagnosis and treatment or disorders (Axis I&II)- can be a negative life event, interpersonal distress, inadequacy or personal support or personal resources, or another problem that describes where a person’s difficulties have developed from (in the past yr) o Axis V: Global Assessment of Functioning Scale- 100 is superior functioning10 which is a persistent danger or hurting oneself or others (in the past yr) The Prevalence of Psychological Disorders - epidemiology: study of the distribution of mental/physical disorders in a population; mental disorders study lifetime prevalence-% of ppl having a disorder at any time in life - Studies in the 80s and early 90s found dis. in 1/3 of the population, and subsequent research that focused on a younger sample (18-54 instead of 18+) suggests that 44% will struggle with some sort of psych. dis. at some point in life, and latest research suggests a lifetime risk of 51% - According to the study yielding a 44% prevalence the most common disorders are (1) substance use, (2) anxiety, and (3) mood disorders Anxiety Disorders - Marked by feelings of excessive apprehension and anxiety - There are 4 principle types, which are not mutually exclusive: 1. Generalized Anxiety Disorder- chronic high level of anxiety not tied to any specific threat. People worry about how much they worry. Anxiety is accompanied by physical symptoms (muscle tension, diarrhea, dizziness, faintness, sweating, & heart palpitations). Has a gradual onset w/ a lifetime prevalence of ~5% & seen more frequently in females 2. Phobic Disorde
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