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Chapter 16

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Psychology 1000

Chapter 16: Psychological Disorders Scope & Nature of Psychological Disorders 26% of population suffers from diagnosable mental disorders Psychological disorders are 2 leading cause of disability, exceeding physical illnesses and accidents Medications used to treat anxiety & depression are among most frequently prescribed drugs What Is Abnormal Defining normal & abnormal not easy & depends on o The personal values of a given diagnostician Too arbitrary o The expectations of the culture in which a person currently lives Differs based on culture & time (ex. homosexuality was considered mental disease) o The expectations of the person's culture of origin Differs based on culture & time (ex. homosexuality was considered mental disease) o General assumptions about human nature Differs based on culture & time (ex. homosexuality was considered mental disease) o Statistical deviation from the norm Highly intelligent people would be seen as abnormal o Harmfulness, suffering, and impairment (distress, dysfunction & deviance) Seem to govern decisions about abnormality Labeling Behaviours as Abnormal o If intensely distressing Excessively anxious, depressed, dissatisfied or seriously upset at life long-lasting o If dysfunctional Interfere with persons ability to work or to experience satisfying relationships Interfere with society Ex. suicide bomber o If deviant Conduct within every society is regulated by norms Violation of norms defines criminal behaviour abnormal Abnormal Behaviour o Personally distressing, personally or societally dysfunction and/or culturally deviant that other people judge it to be inappropriate or maladaptive Major Diagnostic Categories o Anxiety disorders Intense, frequent, or inappropriate anxiety No loss of reality contact Includes phobias, generalized anxiety reactions, panic disorders, obsessive-compulsive disorders, and post-traumatic stress disorders o Mood (affective) disorders Disturbances of mood, including depression and mania (extreme elation and excitement) o Somatoform disorders Physical symptoms, such as blindness, paralysis, or pain, that have no physical basis and are assumed to be caused by psychological factors Excessive preoccupations and worry about health (hypochondriasis) o Dissociative disorders Problems of consciousness and self-identification, including amnesia and multiple personalities (dissociative identity disorder) o Schizophrenic and other psychotic disorders Severe disorders of thinking, perception, and emotion that involve loss of contact with reality and disordered behaviour o Substance-abuse disorders Personal & social problems associated with use of psychoactive substances, such as alcohol, heroin, or other drugs o Sexual and gender identity disorders Inability to function sexually or enjoy sexuality (sexual dysfunctions) Deviant sexual behaviours, such as child molestation and arousal by inappropriate objects (fetishes) Strong discomfort with one's gender accompanied by desire to be a member of other sex o Eating disorders Include anorexia nervosa (self-starvation) & bulimia nervosa (bingeing and purging) o Personality disorders Rigid, stable, and maladaptive personality patterns, such as antisocial, dependent, paranoid, and narcissistic disorders Historical Perspectives on Deviant Behaviour Stories in the Bible, Mozart (paranoia), Abraham Lincoln & Winston Churchill (depression), Cameron Diaz (obsessed with germs) Human societies explained and respond to abnormal behaviour in different ways based on values and assumptions about life at that time Abnormal as Supernatural o Reflected evil spirits attempt to escape from individual bodies o Trephination To release spirit Sharp tool was used to chisel a hole about 2 cm in diameter in the skill o Medieval Europe Demonological model Disturbed people either were possessed involuntarily by devil or made pact with the devil Ex. Killing of witches Bind a womans hand and feet and throw her into a lake or pond Diagnostic test: woman that sank & drowned could be declared pure Hippocrates o Suggested that metal illnesses were diseases like physical disorders o Site of mental illness was the brain biological basis o General Paresis Disorder characterized by mental deterioration and bizarre behaviour, resulted from massive brain deterioration caused by the sexually transmitted disease syphilis Sigmund Freud o Theory of psychoanalysis disordered behaviour o Joined by other models based on behavioural, cognitive, and humanistic concepts o Focus on different classes of causal factors o Help to capture complex determinants of abnormal behaviour (especially culture) Vulnerability-Stress Model (Diathesis-Stress Model) o Every individual has some degree of vulnerability (range: very low to very high) for developing psychological disorders, given sufficient stress o Vulnerability (Predisposition) Can have biological basis Genes, neurotransmitter, hair-trigger autonomic nervous system or hormones Could be due to personality factors Self-esteem, pessimism Could be influenced by environmental factors Poverty Severe trauma or loss Cultural factors play a role o Stressor Recent or current even that requires individuals to cope Diagnosing Psychological Disorders Reliability o Means that clinicians using the system should show high levels of agreement in their diagnostic decisions o Professionals with different types of training o Psychologists, psychiatrists, social workers, and general physiciansmake diagnostic decisions Validity o Means that diagnostic categories should accurately capture the essential features of the various disorders o Research show that a given disorder has four behavioural characteristics diagnostic category for that disorder should also have those four features DSM-IV-TR o Most widely used diagnostic classification system in North America o Has 350 diagnostic categories contains detailed lists of observable behaviours that must be present in order for a diagnosis to be made o Allows diagnostic information to be represented along five dimensions take both person and life situation into account o Axis I Primary diagnosis Represents the person's primary clinical symptoms o Axis II Reflects long-standing personality or developmental disorders Ex. Ingrained, inflexible aspects of personality, that could influence the person's behaviour and response to treatment o Axis III Notes any physical conditions that might be relevant, such as high blood pressure o Axis IV Rates the intensity of environmental stressors in the person's recent life o Axis V Person's coping resources as reflected in recent adaptive functioning DSM-V: Integrating Categorical & Dimensional Approaches Current classification system is a categorical system o People are placed within specific diagnostic categories o Criteria are so detailed and specific that many people don't fit neatly into categories o People who receive same diagnosis may share only few symptoms & look very different o Does not provide a way of capturing severity of the person's disorder o Cannot capture symptoms that are adaptively important but not severe enough to meet behavioural criteria for the disorder Alternative System: Dimensional System o Relevant behaviours are rated along a severity measure o Based on assumption that disorders are different in degree, rather than kind Critical Issues in Diagnostic Labelling Social & Personal Implications Diagnostic label is attached to a person very easy to accept label as accurate description of individual rather than of the behaviour Difficult to look at person's behaviour objectively Likely to affect how we will interact with that
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