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DSM IV Definition of a mental disorder (3 Defining Characteristics + 3 exclusiond)
- Beahviour or Psychological Syndrome with:
- 1) Present distress (or painful symptoms)
- 2) Disabiliy (impaired function in 1+ areas of life)
- 3) Significant increased risk of death, pain, disability or loss f freedom.
- 1) Exceptable or culturally sanctioned response
- 2) Deviant Behviour
- 3)Conflicts that are b/w individual & Society
What is Harmful Dysfuncton? (2 criteria)
Way of defining a mental disorder
- 1) Condition results from inability of some internal mechanism to perform its natural function
- 2) Condition causes some harm to the person (by standads of culture +subjective distress or diffculty in performing expected social & work roles)
Define: Epidemiology, Incidence, Prevalence & Lifetime Prevalence.
Epidemiology: Scientify study of frequency & distribution of disorder within a ppopulation.
Incidence: Number of new cases of a disorder that appear in a popultions during a specifc period of time.
Prevalence: Total number of active cased old & new that are present in a population during a specifc period of time
Lifetime Prevalence: Total proportion of people in a given population who have been affected by the diorder at some point in their lives.
Overall Gender Difference in Mental Disorders
- Females: MD, anxiety, ED,
- Males: Alcoholism, antisocial personality
3 ways to define abnormal behaviour (advantages/disadvatages of each)
- 1) Subjective Distress;
- A-self report/help seek bhv. D- lack of insight, can be fakes, can be situationally appropriate
- 2)Statistical rarity
- A-anchored to normal bhv. D- might be unusal but no harmful, how rare does it have to be? dep isn't?
- 3)Disability or dysfunction
- A-context is importanct, if can improve support may no be so severe as to be a 'disorder' D-its a judgment call on psychs behalf.
A system with varifiable boundaries that delineates the major categories of psychopathology. ie Mood disorders, Anxiety Disorders, Psychotic.....
Pros and Cons of DSM Classification System
- 1.Communication (Individual/orgaisations/specialists/education)
- 2.Prognosis- predictable course of the disorder
3.Guides evidence based treatment
- 2.Danger of self-fulfillment
- 3.Fosters power inbalance and dependency
- 4.Limits view of client
- 5.Implies understanding
- 6. Insensitive to contexual influences
- 7. Getting it wrong
Who was called the 'Father of Medicine", what contribution did he make to psychology, in what era?
Hippocrates (460-377 B.C)
- -Fist to suggest abnormal bhv was from natural cause, not supernatural.
- -Unitary: mental and physical illness both seen an imbalance of four body fluids
- -Treatments:bloodletting, purging, heat and cold).
- -First idea that differnt characteristic cluster together in simular ways (beginings of classigication system)
What was the dominate beleif on Mental illness in the 500's-1500s?
- Middle Ages
- -Suprnature explanations
- -Possession, witchcraft, punishment for sins
What happened in the 16-1700's relevant to mental illness? What was the shift in thinking? what caused this change?
- Creation of Asylums (place of refuge) to house the mentally ill.
- -Communites as a whole should be responsible for their care.
Late 1700's and 1800's What was the movement?
Who were most influenton?
What factors contributed to the change?
- -Moral Treatment Movement.
- -Pinel (France), Tuke (England), Rsh & Dix (US)
- -Economy change, urbanisation, population growth
- -Moral treatment offered support, care, and degree of freedom, not just housing.
- -Asylms seen as more humane and economical can leaving them in the community.
-1844 Worcester Lunatic Hospital was the first modern, public hospital. Led to AMSAII and publications of cases amount professionals
Who was responsible for the early clssification systems of MI?
Pinel (early 1800's) based on observations of patiencts he started to identify groups of bhv
Kraepelin (late 1800's) Dementia Praecox (schizophrenia)
Influential factors:Mid 1930s; Mid 1940s; 1952; 1987, 2000?
- 30s- First classification system designed fr usein hospitals
- Somatic treatments introducted (Fevers, Insulin coma, Lobotomy)
- 40s- Hospitals, war departments, and veteran affairs all led to contempory diagnostic systems.
- 1952- DSM published by APA (86 DSM-II)
- 1987-DSM III: multiaxial system, neutral to aetiology, contained clinical descriptions and detaled criteria
- 2000-DSM IV made to tie in with medical model of ICD-10
DSM IV-TR Axis
- 1-Clinical Disorders: Can have things on Axis 1 that ares of clinical interest but not a disorder
- 2-Personality Disorders & Mental Retardation (12 main). Can include maladaptive personality features, characterists defence mechanisms or coping stles that would be relevant to treating a Axis 1 disorder.
- 3-General Medical Conditions (includes medical conditions that can cause symptoms of Axis 1&2 or act as psychological stressors.
- 4-Psychosocial & Environmental problems, (life events from past years that may impact diagnosis or treatment ie divorce, unemployment).
- 5- Global Assessment of Functioning: level of psychological, social, occupational functioning on scale from 1-100.
- -Very specific criteria but decisions are arbitrary (ie must have 4 symptoms)
- -Doesn't always include current knowledge of normal development
- -Cormorbidity (high overlap in some disorders ie GAD)
- -Cutoffs-implying categorical when its continuous.
Explain systems apprach to abnoral behavior & 6 concepts.
- Intergrates a variety of contributions to abnormal bhv.
- Biopsychosocial approach.
- Key Concepts
- 1-Holism & reductionism
- 2-Levels of analysis
- 3-Equifinality/multiple pahways
- 3-Reciprocal causality
- 4-Diathesis-stress model
- 5-Developmental psychopathology
Biological factors in AB
- 1-Neurons & neurotransmitters (ie meds)
- 2-Brain structures
- 3-bhv genetics (polygenic inheritence)
- 1-Evolutionary psych (species-typical characteristic/natural selection/sexual selection)
- 2-Attachment theory
- 3-Temprament (characteristic style of relating to the world/ play role in personality disorders/goodness of fit bio and enviro)
- 4-Emotions and emotional regulation (regulated through cognitions but still brain controlled)
- 5-Learning and cognitions (Modelling/mofidying emo, mot, and temp through learning tho limited)
- 6-Stages of development (Frued & Erikson)
- 1-Social roles and expectations (scripts/labeling theory/SFP causes AB)
- 2-Familial and social relationship functioning( social support/worse to be actively rejected than neglected)
- 3-Genderr and gender roles (influence how psychopathology is expressed)
- 4-Prejudice & Povery (povery to linked to many stessors, linked to minories-prejudice)
- 5-Ethnic and cultural values(shape definition of AB)
What does the term psychopathology mean
Used to refer to the symptoms and signs of metal diorders
What is disorderd behaviour?
A lack of intergration of bhvs impairing coping with different situations.
4 Paradigms for understanding AB
- 1- Biological
- 2-Psychological (unconscience mental conflicts have roots in childhood)
- 3-Cognitive Behavioural (Bhv & thought process is learned)
- 4-Humanistic (bhv is product of free will)