Basic Concepts of Psychological Disorders Module 40 401 HOW SHOULD WE DRAW THE LINE BETWEEN NORMALITY AND DISORDER According to psychologists and psychiatrists psychological disorders ID: 681429
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Basic Concepts of PsychologicalDisorders
Module 40Slide2
40-1: HOW SHOULD WE DRAW THE LINE BETWEEN NORMALITY AND DISORDER?According to psychologists and psychiatrists,
psychological disorders are marked by a “clinically significant disturbance in an individual’s cognition, emotion regulation, or behavior” (American Psychiatric Association, 2013). Such thoughts, emotions, or behaviors are dysfunctional
or
maladaptive.They interfere with normal day-to-day life.The dysfunctional person is often distressed.
Basic Concepts of Psychological DisordersSlide3
40-2: HOW DO THE MEDICAL MODEL AND THE BIOPSYCHOSOCIAL APPROACH INFLUENCE OUR UNDERSTANDING OF PSYCHOLOGICAL DISORDERS?
In earlier times, abnormal behavior attributed to strange forces (movement of the stars, godlike powers, evil spirits).
During
the Middle Ages, it was commonly believed
that
abnormal people were possessed by devils.“Therapy” often involved physical and mental torture.Philippe Pinel (1745–1826) recognized abnormal behavior as sickness of the mind.Opposed barbaric treatments of patients.Introduced and encouraged reforms and humane treatments.
Basic
Concepts of Psychological Disorders
Understanding
Psychological DisordersSlide4
Through the ages, psychologically disordered people have received brutal treatments, including the trephination evident in this Stone Age skull.
Drilling skull holes like these may have been an attempt to release evil spirits and cure those with mental disorders.
It
looks doubtful that
this
patient would have survived the “cure.”
YESTERDAY’S “THERAPY”Slide5
The Medical ModelBy the 1800s the search began for physical causes of
mental disorders and for curative treatments.With the medical model of mental disorders, mental illness
is to be diagnosed on the basis
of
symptoms and treated through therapy, often in a psychiatric hospital.Reinvigoration of the medical model has come from recent research in genetically influenced brain abnormalities in brain structure and biochemistry.
Basic
Concepts of Psychological Disorders
Understanding
Psychological DisordersSlide6
The Biopsychosocial ApproachGeneral approach positing that biological, psychological, and social-cultural factors all play a significant role in human functioning in the context of disease or illness
.Some symptoms of disorders are culture-related, which points to environmental influences.For example, the eating
disorders
anorexia nervosa and bulimia nervosa occur mostly in food-abundant cultures.Depression and schizophrenia
occur worldwide
.Basic Concepts of Psychological Disorders Understanding Psychological DisordersSlide7
The Biopsychosocial ApproachDisorders reflect Genetic predispositions and physiological states
Psychological dynamicsSocial and cultural circumstancesThe biopsychosocial approach
emphasizes
that mind and body are inseparable.Epigenetics
: The
study of environmental influences on gene expression that occur without a DNA change.Epigenetics shows that our environment can affect the expression (or not) of a gene, thus affecting the development of psychological disorders.
Basic
Concepts of Psychological Disorders
Understanding
Psychological DisordersSlide8
BIOPSYCHOSOCIAL
APPROACH TO
PSYCHOLOGICAL
DISORDERSSlide9
40-3: HOW AND WHY DO CLINICIANS CLASSIFY PSYCHOLOGICAL DISORDERS, AND WHY DO SOME PSYCHOLOGISTS CRITICIZE THE USE OF DIAGNOSTIC LABELS?Classification orders and describes symptoms
Diagnostic classification in psychiatry and psychology attempts to:Predict the disorder’s future courseSuggest appropriate
treatment
Prompt research into its causes
Basic
Concepts of Psychological Disorders Classifying Disorders—and Labeling PeopleSlide10
The most common tool for system for classifying disorders is the Diagnostic and Statistical Manual
of Mental Disorders now in its fifth edition (DSM-5), 2013Published by the American Psychiatric Association
Describes
disorders and estimates their occurrenceIn the new DSM-5, some changes include:
Some label changes (e.g.,
autism spectrum disorder; intellectual disability)New categories: Hoarding disorder, binge-eating disorderNew or altered diagnoses—some controversial (e.g., concern that simple bereavement may be too quickly diagnosed as a depressive disorder) Basic Concepts of Psychological Disorders
Classifying Disorders—and
Labeling
PeopleSlide11
DSM criticisms include:Critics have long faulted the DSM for casting too wide a net
Antisocial personality disorder and generalized anxiety disorder did poorly on field trials for the new DSM-5 .DSM-5 continues the path of potentially pathologizing everyday life
Labels
are or may act as society’s subjective value
judgments
DSM benefits include:Helping mental health professionals communicateIt is useful in researchClients often relieved to identify suffering
Basic
Concepts of Psychological Disorders
Classifying Disorders—and
Labeling
PeopleSlide12
40-4: WHY IS THERE CONTROVERSY OVER ATTENTION-DEFICIT HYPERACTIVITY DISORDER?
Attention-deficit/hyperactivity disorder (ADHD): Marked by extreme inattention and/or hyperactivity and impulsivity
11 percent American 4- to 17-year-olds receive this diagnosis after displaying its key symptoms; 2.5 percent adults have ADHD symptoms.
Critics fear this disorder
is
overdiagnosed, leading to overuse of prescription drugs.Those who say ADHD is overdiagnosed argue: Symptoms displayed sound like the “ disorder” of having a Y chromosome; ADHD is three times more prevalent in boys
than girls
.
ADHD
may
in effect be marketed
by companies that offer drugs for its treatment (Thomas
, 2015).
Energetic
child + boring school = ADHD diagnoses?
ADHD—Normal
High
Energy or Disordered Behavior?Slide13
Alternate view of those arguing that ADHD is not overdiagnosed: More frequent diagnoses due to increased awareness of disorder
Scientific community agrees ADHD is a real neurobiological disorderCoexists with learning disordersIs heritable
It is treatable with medications
There is debate over the safety of long-term
use of
these stimulant medications in treating ADHD.ADHD—Normal High Energy or Disordered Behavior?Slide14
40-5: DO PSYCHOLOGICAL DISORDERS PREDICT VIOLENT BEHAVIOR?Mental disorders seldom lead to violence and clinical prediction of violence
is unreliable.Most people with disorders are nonviolent and are more likely to be victims than perpetrators of violence.When they are violent,
moral and ethical questions about whether society should hold people with disorders responsible for their violent actions
are raised.Triggers for violence acts by people with mental disorders
,
in addition to disordered thinking, include substance abuse.Basic Concepts of Psychological Disorders Are People With Psychological Disorders Dangerous?Slide15
40-6: HOW MANY PEOPLE HAVE, OR HAVE HAD, A PSYCHOLOGICAL DISORDER? IS POVERTY A RISK FACTOR?
The U.S. National institute of Mental Health estimates just over 1 in 4 adult Americans “suffer from a diagnosable mental disorder in a given year” (Kessler et al., 2008). Psychological disorder rates vary by time and place.
Immigrant paradox
: Those born to immigrants to the United States at greater risk of mental disorder than the immigrants (for example, Mexican-Americans born in the U.S.).
Poverty is a risk factor:
Incidence of serious psychological disorders is doubled .Conditions and experiences associated with poverty contribute to the development of psychological disorders.But some disorders, such as schizophrenia, can drive people into poverty; correlation goes both ways.
Basic
Concepts of Psychological Disorders
Rates
of Psychological DisordersSlide16
Psychological disorders usually strike by early adulthood (first symptoms by age 24 in most cases)Symptoms arrive at the following median ages:
Antisocial personality disorder (age 8)Phobias (age 10)Alcohol use disorder (near age 20)Obsessive-compulsive disorder (near age 20)Schizophrenia (near age 20)
Major depressive disorder (age 25)
Basic
Concepts of Psychological Disorders
Rates of Psychological DisordersSlide17
PERCENTAGE
OF AMERICANS
REPORTING SELECTED PSYCHOLOGICAL
DISORDERS IN THE PAST YEARSlide18
What Increases
Vulnerability to
Mental
Disorders?