1 1 Psychological Disorders Chapter 14 Psy12000.003 Online Course Evaluations … Announcements • Exam 4 will NOT be taken in classroom. • Exam 4 to be taken in PsychPortal as you did for first three exams. – 10am-1pm for most – 6pm - 9pm for Friday Night Exam Group • No class on Friday 2 3 Psychological Disorders I felt the need to clean my room … spent four to five hour at it … At the time I loved it but then didn't want to do it any more, but could not stop … The clothes hung … two fingers apart …I touched my bedroom wall before leaving the house … I had constant anxiety … I thought I might be nuts. Marc, diagnosed with obsessive-compulsive disorder (from Summers, 1996) http://www.youtube.com/watch?v=Rn1OYlYzgm8&feature=related 4 Psychological Disorders People are fascinated by the exceptional, the unusual, and the abnormal. This fascination may be caused by three reasons: During various moments we feel, think, and act like an abnormal individual. Psychological disorders may bring unexplained physical symptoms, irrational fears, and suicidal thoughts. A reminder of our species’ fragility. 5 Psychological Disorders To study the abnormal is the best way of understanding the normal. There are 450 million people suffering from psychological disorders (WHO, 2004). [current population of US is 307 million] Depression and schizophrenia exist in all cultures of the world. William James (1842-1910) 6 Defining Psychological Disorders Mental health workers view psychological disorders as persistently harmful thoughts, feelings, and actions. When behavior is deviant, distressful, and dysfunctional psychiatrists and psychologists label it as disordered (Comer, 2004).2 7 Deviant, Distressful & Dysfunctional Deviant behavior (going naked) in one culture may be considered normal, while in others it may lead to arrest. Deviant behavior must accompany distress to be a disorder. If a behavior is dysfunctional it is clearly a disorder. In the Wodaabe tribe men wear costumes to attract women. In Western society this would be considered abnormal. Carol Beckwith 8 Understanding Psychological Disorders Ancient Treatments of psychological disorders include trephination, exorcism, being caged like animals, being beaten, burned, castrated, mutilated, or transfused with animal’s blood. Trephination (boring holes in the skull to remove evil forces) John W. Verano 9 Medical Perspective Philippe Pinel (1745-1826) from France, insisted that madness was not due to demonic possession, but an ailment of the mind. Dance in the madhouse. George Wesley Bellows, Dancer in a Madhouse, 1907. © 1997 The Art Institute of Chicago 10 Medical Model When physicians discovered that syphilis led to mental disorders, they started using medical models to review the physical causes of these disorders. 1. Etiology: Cause and development of the disorder. 2. Diagnosis: Identifying (symptoms) and distinguishing one disease from another. 3. Treatment: Treating a disorder in a psychiatric hospital. 4. Prognosis: Forecast about the disorder. 11 Biopsychosocial Perspective Assumes that biological, socio-cultural, and psychological factors combine and interact to produce psychological disorders. 12 Classifying Psychological Disorders The American Psychiatric Association rendered a Diagnostic and Statistical Manual of Mental Disorders (DSM) to describe psychological disorders. The most recent edition, DSM-IV-TR (Text Revision, 2000), describes 400 psychological disorders compared to 60 in the 1950s.3 13 Multiaxial Classification Are Psychosocial or Environmental Problems (school or housing issues) also present? Axis IV What is the Global Assessment of the person’s functioning? Axis V Is a General Medical Condition (diabetes, hypertension or arthritis etc) also present? Axis III Is a Personality Disorder or Mental Retardation present? Axis II Is a Clinical Syndrome (cognitive, anxiety, mood disorders [16 syndromes]) present? Axis I 14 Multiaxial Classification Note 16 syndromes in Axis I 15 Multiaxial Classification Note Global Assessment for Axis V 16 Goals of DSM 1. Describe (400) disorders. 2. Determine how prevalent the disorder is. Disorders outlined by DSM-IV are reliable. Therefore, diagnoses by different professionals are similar. Others criticize DSM-IV for “putting any kind of behavior within the compass of psychiatry.” 17 Labeling Psychological Disorders 1. Critics of the DSM-IV argue that labels may stigmatize individuals. Asylum baseball team (although comprised of hospital staff, observers saw psychological symptoms in these players) Elizabeth Eckert, Middletown, NY. From L. Gamwell and N. Tomes, Madness in America, 1995. Cornell University Press. 18 Labeling Psychological Disorders 2. Labels may be helpful for healthcare professionals when communicating with one another and establishing therapy. BUT, Rosenhan’s “study” - self-perpetuating aspects of labels Graduate students, during psychiatric assessment, claimed to be hearing voices that were often unclear, but which seemed to pronounce the words "hollow", "empty", and "thud."4 19 Labeling Psychological Disorders 3. “Insanity” labels raise moral and ethical questions about how society should treat people who have disorders and have committed crimes. NGRI, GBI?? Theodore Kaczynski (Unabomber) Elaine Thompson/ AP Photo 20 Anxiety Disorders Feelings of excessive apprehension and anxiety. 1. Generalized anxiety disorders 2. Phobias 3. Panic disorders 4. Obsessive-compulsive disorders 21 Generalized Anxiety Disorder 1. Persistent and uncontrollable tenseness and apprehension. 2. Autonomic arousal. 3. Inability to identify or avoid the cause of certain feelings. Symptoms 22 Panic Disorder Minute-long episodes of intense dread which may include feelings of terror, chest pains, choking, or other frightening sensations. Anxiety is a component of both disorders. It occurs more in the panic disorder, making people avoid situations that cause it. Symptoms 23 Phobia Marked by a persistent and irrational fear of an object or situation that disrupts behavior. 24 Kinds of Phobias Phobia of blood. Hemophobia Phobia of closed spaces. Claustrophobia Phobia of heights. Acrophobia Phobia of open places. Agoraphobia http://phobialist.com/5 25 Obsessive-Compulsive Disorder Persistence of unwanted thoughts (obsessions) and urges to
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