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Chapter 16

Chapter 16 - Psychological Disorders

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Western University
Psychology 1000
Terry Biggs

Chapter 16: Psychological Disorders The Scope and Nature of Psychological Disorders What is Abnormal? Defining what normal and abnormal is takes into account many measures such as: - Personal values of a given diagnostician - Expectations of the culture in which a person lives - Expectations of the persons culture of origin - General assumptions about human nature - Statistical deviation from the norm - Harmfulness, suffering and impairment Abnormal behaviour can be defined as behaviour that is personally dysfunctional, and/or so culturally deviant that other people judge it to be inappropriate or maladaptive Historical Perspectives on Deviant Behaviour According to the vulnerability-stress model, each of us has some degree of vulnerability for developing a psychological disorder, given sufficient stress In most instances, a predisposition creates a disorder only when a stressor some recent or current event that requires a person to cope combines with vulnerability to trigger the disorder Diagnosing Psychological Disorders Reliability in psychological testing, the consistency with which a measure assess a given characteristic, or different observers agree on a given score; the degree to which clinicians show high levels of agreement in their diagnostic decisions Validity the extent to which a test measures what it is supposed to; the degree to which a diagnostic systems categories contain the core features of the behaviour disorders and permit differentiation among the disorders DSM-IV-ITR most widely used diagnostic classification system in North America - Contains detailed lists of observable behaviours that must be present in order for a diagnosis to be made - Allows diagnostic information to be represented along five dimensions, or axes, that take both the person and his or her life situation into account o Axis I the primary diagnosis/primary clinical symptoms o Axis II reflects long-standing personality or developmental disorders o Axis III notes relevant physical disorders o Axis IV rates intensity of environmental stressors o Avis V global assessment of level of functioning DSM-V: Integrating Categorical and Dimensional Approaches Current classification system is a categorical system, in which people are placed within specific diagnostic categories - However, criteria is so detailed and specific that many people dont fit neatly into the categories - Also does not provide a way of capturing the severity of the persons disorder, nor can it capture symptoms that are adaptively important but not severe enough to meet the behavioural criteria for the disorder An alternative to the categorical system is a dimensional system, in which relevant behaviours are rated along a severity measure Critical Issues in Diagnostic Labelling Social and personal implication once a diagnostic label is attached to a person, it becomes easy to accept the label as an accurate description of the individual rather than of the behaviour Legal consequences psychiatric diagnoses also have important legal consequences - Competency refers to a defendants state of mind at the time of a judicial hearing (not at the time the crime was committed) - Insanity relates to the presumed state of mind of the defendant at the time the crime was committed Anxiety Disorders Anxiety state of tension and apprehension that is a natural response to perceived threat In anxiety disorders, the frequency and intensity of anxiety responses are out of proportion to the situations that trigger them, and the anxiety differs with daily life Anxiety responses have four components: - a subjective-emotional component includes feelings of tension and apprehension - a cognitive component includes subjective feelings of apprehension, a sense of impeding danger, and a feeling of inability to cope - physiological responses includes increased heart rate and blood pressure, muscle tension, rapid breathing, nausea, dry mouth, diarrhea, and frequent urination - behavioural responses includes avoidance of certain situations and impaired task performance Anxiety disorders take a number of different forms, including phobic disorders, generalized anxiety disorders, panic disorders, post-traumatic stress disorders, and obsessive-compulsive disorders Two statistics are commonly used in epidemiological research: - Incidence refers to the number of new cases that occur during a given period - Prevalence refers to the number of people who have a disorder during a specified period of time Phobic Disorder Phobias are strong and irrational fears of certain objects or situations Can develop at any point in life, but many of them develop during childhood, adolescence and early adulthood Once developed, they rarely go away on their own, and may broaden or intensify over timeGeneralized Anxiety Disorder Generalized anxiety disorder is a chronic state of diffuse or free-floating anxiety that is not attached to specific situations or objects Can interfere with daily functioning hard to concentrate, make decisions, and remember commitments Panic Disorder Panic disorders occur suddenly and unpredictably, and are much more intense In most cases, they occur out of the blue and in the absence of any identifiable stimulus Formal diagnosis requires recurrent attacks that do not seem tied to environmental stimuli, followed by psychological or behavioural problems Obsessive-Compulsive Disorder (OCD) Obsessive-compulsive disorders usually consist of two components one cognitive and one behavioural although either one can occur alone Obsessions are repetitive and unwelcome thoughts, images, or impulses that invade consciousness, are often abhorrent to the person, and are very difficult to dismiss or control Compulsions are repetitive behavioural responses that can be resisted only with great difficulty often responses to obsessive thoughts and function to reduce the anxiety associated with the thoughts Causal Factors in Anxiety Disorders Biological factors: - Genetic factors may create a vulnerability to anxiety disorders - Hereditary factors may cause overreactivity of neurotransmitter systems involved in emotional responses - Low levels of the inhibitory neurotransmitter,
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