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Department
Psychology
Course
PS101
Professor
Jim Mc Cutcheon
Semester
Fall

Description
10/27/2013 8:46:00 AM Defining mental disorder Any behavior or emotional state that causes an individual great suffering Is self destructive Seriously impairs the persons ability to work or get along with others, or endangers others or the community Drapetomia – causes negroes to run away…meets the criteria! Homosexuality – meets the criteria because the way it fits into society Mental disorder is not the same as Insanity! Legal term only involving mental illness and whether person is aware of consequences and can control their behavior Dilemmas of Definition Varying definitions of mental disorders Mental disorder as a violation of cultural standards Mental disorders as emotional distress Mental disorder as behavior that is self-destructive or harmful to others In Canada, mental disorders the leading cause of disability in those aged 15- 44 Dilemmas of Diagnosis Disorders typically classified using the Diagnostic and Statistical Manual of Mental Disorders Primary goal of DSM is to be descriptive and to provide clear diagnostic categories (see 582 in text) Lists symptoms, onset, predisposing factors, course of disorder, prevalence, sex ratio, and cultural issues in diagnosis. DSM Five dimensions (axes) clients are evaluated on: Axis I: primary clinical problem Axis II: personality factors/disorders Axis III: general medical conditions Axis IV: social and environmental stressors Axis V: global assessment of functioning (0-100) Increasing DSM disorders? - Supporters of new categories answer that it is important to distinguish disorders precisely - Critics point to economic reasons: diagnosis are needed for insurance reasons so therapists will be compensated Problems with the DSM It is important to be aware of limitations and problems present in attempts to classify mental disorders 1. The danger of over-diagnosis (e.g. ADHD) 2. The power of diagnostic labels 3. The confusion of serious mental disorders with normal problems 4. The illusion of objectivity and universality (e.g. drapetomania, reflect cultural and social prejudices) Advantages of the DSM Defenders agree that boundaries between “normal problems” and “mental disorders” are fuzzy and difficult to determine Many psychological symptoms fall along a continuum ranging from mild to severe When DSM used correctly, in conjunction with valid objectives tests, improves reliability of diagnosis Culture and Mental Illness Recent inclusion of culture-bound syndromes: Disorders that are specific to a particular culture context (see table 15.2) E.g. ghost sickness: preoccupation with death and the dead, bad dreams, fainting comparing mental and emotional symptoms allows researchers to distinguish between universal disorders and culture bound symptoms culture bound syndromes: Amok – violent outburst caused by slight insult in men Ataque de nervios – uncontrollable shouting, crying, trembling Brain fag – brain tiredness Ghost sickness – preoccupation with death Pibloktoq – episode of extreme excitement Taijin kyofusho – fear of embarrassment of body, displease others Zar – possession by a spirit Dilemmas of Measurement Diagnosis usually made by combination of clinical interview and psychological tests Projective tests: tests used to infer a person‟s motives, conflicts, and unconscious dynamics on the basis of the person‟s interpretations of ambiguous stimuli Objective tests: standardized objective questionnaires requiring written responses; typically include scales that people rate themselves on Projective Tests Most popular is Rorschach Inkblot Test Can help establish rapport with client Tests lack reliability and validity (although some have tried to develop comprehensive scoring systems for responses) Sometimes used inappropriately Anxiety Disorders Anxiety: A general state of apprehension or psychological tension Can be adaptive as they energize us to cope with danger (positive) Anxiety Disorders: When fear and anxiety become detached from actual danger E.g. chronic anxiety, panic attacks, phobias, obsessive-compulsive disorder Anxiety Disorders Generalized Anxiety Disorder A continuous state of anxiety marked by feelings of worry and dread, apprehension, difficulties in concentration, and signs of motor tension Symptoms experienced in challenging or uncontrollable situations No specific anxiety-producing event Develop habits that foster their worry Posttraumatic Stress Disorder (PTSD) Person who has experienced a traumatic or life-threatening event has symptoms such as psychic numbing, reliving of the trauma, and increased physiological arousal Not all who experience trauma develop PTSD May involve a genetic predisposition, history of prior psychological problems, poor emotional adjustment and catastrophizing smaller hippocampus than average Panic Disorders An anxiety disorder in which a person experiences recurring panic attacks, feelings of impending doom or death, accompanied by physiological symptoms such as rapid breathing and dizziness Delayed panic attacks can occur after life-threatening scares are common. Interpretation of bodily reactions is key in developing panic attacks (diagram from book) Fears and Phobias Phobia An exaggerated, unrealistic fear of a specific situation, activity, or object Social Phobia Irrational fear where sufferers become extremely anxious in situations in which they will be observed by others, worrying that they will do or say something that will be extremely humiliating or embarrassing Agoraphobia set of phobias, often set off by a panic attack, involving the basic fear of being away from a safe place or person. “A fear of fear” Anxiety Disorders Obsessive-compulsive disorder (OCD) An anxiety disorder in which a person feels trapped in repetitive, persistent thoughts (obsessions) and repetitive, ritualized behaviours (compulsions) designed to reduce anxiety Uncontrollable with ones life May involve depletion of serotonin from prefrontal cortex (may create cognitive rigidity) R.D. Laing Bo
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