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Chapter 1

Chapter 1 - Abnormal behaviour in historical context.

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PSYC 3140
Stephen Fleming

Chapter 1 A psychological disorder is a psychological dysfunction within an individual associated with DISTRESS or IMPAIRMENT IN FUNCTIONING and A RESPONSE THAT IS NOT TYPICAL OR CULTURALLY EXPECTED (atypical response). o Just having one criterion does not define abnormal behaviour. Psychological dysfunction refers to a breakdown in cognitive, emotional or behavioural functioning. o These problems are considered on a continuum. o Just having a dysfunction is not enough to meet the criteria for a psychological disorder. Phobia – a psychological disorder characterized by marked and persistent fear of an object or situation. Psychopathology is the scientific study of psychological disorders. Within this field there are specifically trained professionals: o Clinical psychologists (typically receive Ph.D.) o Counselling psychologists (sometimes receive Psy.D) o Psychiatrists (M.D.) o Psychiatric social workers o Psychiatric nurses o Marriage and family therapists o Mental health counsellors A scientist-practitioner is a mental health professional that takes a scientific approach to their clinical work. They can function as a scientist-practitioner in at least one of three ways: 1. Consumer of Science – they keep up-to-date with the latest scientific developments in their field and therefore use the most current diagnostic and treatment procedures. 2. Evaluator of Science – evaluate their own assessments or treatment procedures to see whether they work. 3. Creator of Science – conducts research that leads to new procedures useful in practice. Three major categories compose the study and discussion of psychological disorders: 1. Clinical description 2. Causation (etiology) 3. Treatment and outcome CLINICAL DESCRIPTION  behaviours, feelings and thoughts Presents (presenting problem) – traditional shorthand way of indicating why a person has come to the clinic. Describing a patient’s presenting problem is the first step in determining their clinical description – the unique combination of behaviours, thoughts and feelings that make up a specific disorder. Clinical – types of problems or disorders you would find in a clinic or hospital and the activities connected with assessment and treatment. An important function of the clinical description is to specify what makes the disorder different from normal behaviour or different disorders. Prevalence – How many people in a population as a whole have the disorder? Incidence – How many new cases occur during a given period, such as a year? Sex-ratio - What percentage of males and females have the disorder? The typical age of onset differs from one disorder to another. Most disorders follow a somewhat individual pattern or course. E.g. Schizophrenia follows a chronic course, meaning that it tends to last a long time, sometimes a whole lifetime. Mood disorders follow an episodic course in which the individual is likely to recover within a few months, only to have a recurrence of the disorder later. Some disorders have a time-limited course, meaning the disorder will improve without treatment in a relatively short period. Acute onset – disorders begin suddenly Insidious onset – disorders develop gradually over an extended time Prognosis – the anticipated course of a disorder ETIOLOGY Why a disorder begins? What causes it? The effect does not imply the cause. Somatoform – physical symptoms appear but no organic cause Delusion of persecution – everyone plotting against you Delusion of Grandeur – you are God Benzodiazepines – Valium and Librium  reduces anxiety Neuroleptics  hallucinations and delusional though processes Bromides  sedating drug Psychosocial  focuses on psychological, social and cultural factors Moral Therapy  Treating institutionalized patients as normally as possible  Setting encouraged and reinforced normal social interaction  Relationships were carefully nurtured  Restraint and seclusion were eliminated  Philippe Pinel Mental Hygiene Movement  Dorothea Dix Psychoanalysis  structure of the mind and the role of the unconscious processes Unconscious  Part of the psychic makeup that is outside the person's awareness. Catharsis  release of tension following the disclosure of emotional trauma Insight  fuller understanding of the relationship between current emotions and earlier events. Psychoanalytic Model (Freud)  seeks to account for the development and structure of personality, as well as the origin of abnormal behaviour, based primarily on inferred inner entities and forces. Id – source of our strong sexual and aggressive energies or our instinctual drives. Pleasure Principle. Primary process. • Illogical • Emotional • Irrational Ego – ensures we act realistically. Reality principle, secondary process. • Logical • Rational Superego – the conscience. Moral principles instilled in us by our parents and culture Intrapsychic conflicts  the struggles among the id, ego, and superego Defence Mechanisms  unconscious protective processes that keeps primitive emotions associated with conflicts in check so the ego can continue its coordinating function. Denial  n
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