TYPES OF MENTAL ILLNESS

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WHAT IS MENTAL ILLNESS?
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SOPRANOS

• BEHAVIORS VIEWED AS DISEASES
• CHANGE OVER TIME FROM ROWDY TO SICK
• CONFLICT WITH MUCH LAY CULTURE
• RISE OF M.H. PROFESSIONALS
• TREATMENT NOT PUNISHMENT

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WHY WANT DEFINITION OF MENTAL ILLNESS?

• DISTINGUISH FROM NORMAL
• INDICATE NEED FOR MENTAL HEALTH TREATMENT
• WHAT CONDITIONS SHOULD BE REIMBURSED?
• DETERMINE CRIMINAL LIABILITY - PUNISH OR TREAT?

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DSM-IV DEFINITION (1)

• MENTAL DISORDER IS A CLINICALLY SIGNIFICANT
  BEHAVIORAL OR PSYCHOLOGICAL PATTERN THAT IS
  ASSOCIATED WITH PRESENT DISTRESS OR DISABILITY.
  

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DISTRESS OR DISABILITY

• MUST HAVE EITHER DISTRESS (MENTAL PAIN) OR
  DISABILITY (LOSS OF FUNCTIONING)
• EITHER MUST REALLY BOTHER PEOPLE - E.G. THINK
  LEFT STOVE ON
• OR HAVE NEGATIVE IMPACT ON THEIR LIVES - E.G. ASPD

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DSM (2)

• IN ADDITION, THIS PATTERN MUST NOT BE MERELY AN
  EXPECTABLE AND CULTURALLY SANCTIONED RESPONSE TO
  A PARTICULAR EVENT, FOR EXAMPLE, THE DEATH OF A
  LOVED ONE.

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NOT EXPECTABLE RESPONSE

• BEREAVEMENT EXCLUSION
• SYMPTOMS ARE NORMAL
• ROMANTIC BREAKUPS
• SOLDIER ENTERING COMBAT
• SYMPTOMS THEMSELVES ARE NOT SUFFICIENT
• MUST KNOW CONTEXT

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DSM (3)

• WHATEVER ITS ORIGINAL CAUSE, IT MUST CURRENTLY
  BE A BEHAVIORAL, PSYCHOLOGICAL, OR BIOLOGICAL
  DYSFUNCTION IN THE INDIVIDUAL.

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INTERNAL DYSFUNCTION

• SOME PSYCHOLOGICAL SYSTEM (MOOD, FEAR, THOUGHT,
  EMOTION, ETC.) IS NOT FUNCTIONING APPROPRIATELY
  - SOMETHING HAS GONE WRONG
• MANY CAUSES BIOLOGICAL, PSYCH., SOCIAL OF
  M.I.

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DSM (4)

• NEITHER DEVIANT BEHAVIOR (E.G. POLITICAL,
  RELIGIOUS, OR SEXUAL) NOR CONFLICTS BETWEEN THE
  INDIVIDUAL AND SOCIETY ARE MENTAL DISORDERS
  UNLESS THE DEVIANCE OR CONFLICT IS A SYMPTOM OF A
  DYSFUNCTION IN THE INDIVIDUAL.

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MENTAL DISORDER IS NOT DEVIANCE

• DEVIANCE IS VIOLATION OF MORAL STANDARDS OR
  SOCIAL NORMS - BAD BEHAVIOR
• PEOPLE WHO DRINK TOO MUCH, TAKE WRONG KIND OF
  DRUGS, OR STEAL, CHEAT, AND LIE NEED NOT BE
  MENTALLY ILL
• DEVIANCE IS A CHOICE

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DEVIANCE OR M.I.?

• ONLY MENTAL DISORDER WHEN SOME MECHANISM IS
  UNABLE TO FUNCTION AS IT IS SUPPOSED TO
• ALCOHOLIC OR ADDICT WHO CANT STOP DRINKING OR
  TAKING DRUGS
• NOT JUST DEFIANCE OF RULES
• VERY DIFFICULT TO DISTINGUISH

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SUMMARY

• MENTAL DISORDER IS HARMFUL INTERNAL DYSFUNCTION
• CAUSES CAN BE PSYCHOLOGICAL, BIOLOGICAL, OR
  SOCIAL
• DISTINGUISH FROM EXPECTABLE RESPONSES TO
  STRESSORS AND FROM SOCIAL DEVIANCE

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MAJOR PROBLEM

• DSM DEFINITION OF MENTAL DISORDER IS GOOD
• DSM AND SURVEYS BASED ON IT DO NOT APPLY THE
  DEFINITION IN PRACTICE
• VIEW ALL SYMPTOMS AS INDICATING DISORDER

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TYPES OF MENTAL ILLNESS
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PSYCHOSES

• MOST SEVERE KIND OF M.I.
• SCHIZOPHRENIA
• BI-POLAR (MANIC DEPRESSION)

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SCHIZOPHRENIA

• PERHAPS MOST IMPORTANT MENTAL ILLNESS
• CREATES STEREOTYPE OF MENTAL ILLNESS - CRAZY,
  NUTS, BIZARRE

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IMPORTANCE

• MOST ADMISSIONS AND RESIDENTS OF PUBLIC MENTAL
  HOSPITALS
• CHRONICITY AND SEVERITY MEAN COSTLY AND DIFFICULT
  TO TREAT
• PUBLIC POLICY - HOMELESSNESS, NOTORIOUS CRIMES
• TREMENDOUS FAMILY BURDEN

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SYMPTOMS

• THOUGHT DISORDER
• POSITIVE SYMPTOMS
• THOUGHT INSERTION AND BROADCAST
• LOOSE ASSOCIATION
• HALLUCINATIONS - AUDITORY
• DELUSIONS - PARANOIA, GRANDIOSITY