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Women and Mental Health

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Women and Mental Health DSM- IV Diagnostics and statistics manual of mental disorders. The definition of normality changes depending on the social context. – PowerPoint PPT presentation

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Title: Women and Mental Health


1
Women and Mental Health
2
DSM- IV
  • Diagnostics and statistics manual of mental
    disorders.
  • The definition of normality changes depending on
    the social context.
  • Based on the medical model.
  • The distinction between what is deemed normal
    and abnormal has profound implications for
    cultural understanding of what is acceptable
    behaviour (Kingwell,1998).

3
How is the DSM Constructed?
  • With minimal agreement among raters and extreme
    methodological weaknesses (ie.small samples,
    self-selection).
  • Made by consensus votes and committees.
  • DSM is based on sexist, narrowly defined
    definitions of mental illnesses which are tied up
    to political agendas and power issues (Caplan,
    1995).

4
Mark Kingwell (1998),
  • Fewer than two hundred people are involved in
    the process, culled from a membership that is
    disproportionably male. In general, these
    professionals are resistant to change and
    jealous of their reputations They insist, as
    always that aberrant behavior is susceptible to
    treatment with medication, the patients
    considered in isolation from social and cultural
    forces. The standards of scientific proof
    acceptable for the identification of mental
    illnesses also seem to vary according to the
    desires of the small, inordinately powerful group
    of authors (Kingwell, 1988, p.132).

5
Depression
  • Formal Diagnostic Criteria
  • Sad, depressed mood most of the day nearly every
    day.
  • Loss of interest and pleasure in usual
    activities.
  • Difficulties in sleeping such as not falling
    asleep, sleeping to much, waking to early or
    frequently.
  • Either feeling restless, agitated or figidity
    or the opposite, lethargic and slow.
  • Poor appetite and weight loss, or the opposite
    increased appetite and weight gain.
  • Loss of energy and feeling very tired.
  • Negative self concepts such as feelings of guilt
    or worthlessness.
  • Inability to make every day decisions or an
    inability to focus and concentrate.
  • Recurrent thoughts of death and suicide.
  • Five out of these nine symptoms must be met
    in order to meet criteria for clinical
    depression.

6
Prevalence Rates
  • Two to three times as common in women as in men.
  • General North American prevalence rate is said to
    be close to 5 percent.
  • Tends to reoccur so that 80 percent of people who
    experience depression once will experience
    another episode at some time in their lives.

7
Why Women?
  • 1- Diagnostic Bias
  • Therapists tend to over diagnose depression in
    women and under diagnose depression in men. Why
    do you think this is ?
  • 2- Gender Discrimination Against Women.

8
  • 3- Poverty
  • 4- Housework
  • 5- Physical Appearance
  • 6- Violence

9
  • 7- Womens Relationships
  • 8- Pharmaceutical Influence

10
Anorexia Nervosa
  • I always lie about my weight. I dont want
    anyone to know how much I weigh. Thats because
    Im ashamed of it. I hate my fat hips and thighs.
    They are grotesque. I feel like everyones
    thinner than I am. They always look good, and Im
    a fat disgusting thing (Meadow and Weiss, 1992,
    p. 8).

11
  • 90 of people with anorexia are females.
  • onset is between age 14-18
  • Highest mortality rate - 10 percent of women with
    anorexia die from it.
  • Also associated with a host of physical
    problems including organ failure, osteoporosis
    and deathly nutritional deficiencies.

12
Anorexia Nervosa
  • Formal Diagnostic Criteria DSM-IV
  • Refusal to maintain body weight at or above a
    minimally normal weight for age and height.
  • Intense fear of gaining weight or becoming fat,
    even though underweight.
  • Disturbance in the way in which one's body weight
    or shape is experienced, undue influence of body
    weight or shape on self-evaluation, or denial of
    the seriousness of the current low body weight.
  • In postmenarcheal females, amenorrhea, i.e., the
    absence of at least three consecutive menstrual
    cycles.

13
Bulimia Nervosa
  • Binge eating means consuming huge amounts of food
    2000- 3000 calories at one sitting and then
    trying to get rid of it through vomiting or
    laxatives.
  • Obsessed with food, eating and physical
    appearance.
  • 90 of people with bulimia are women.
  • 1- 5 of these women are adolescents.
  • Medical consequences of bulimia include
  • gastrointestinal, heart, liver and metabolism
    problems.

14
Formal Diagnostic Criteria DSM-IV
  • Recurrent episodes of binge eating characterized
    by both of the following
  • eating, in a discrete period of time (as within
    any 2 hours), an amount of food that is
    definitely larger than most people would eat
    during a similar period of time and under similar
    circumstances
  • a sense of lack of control over eating during
    the episode (a feeling that one cannot stop
    eating or control what or how much one is
    eating) 
  • B. Recurrent inappropriate compensatory behavior
    in order to prevent weight gain, such as
    self-induced vomiting misuse of laxatives,
    diuretics, enemas, or other medications fasting
    or excessive exercise 
  • C. The binge eating and inappropriate
    compensatory behaviors both occur, on average,
    at least twice a week for 3 months
  • D. Self-evaluation is unduly influenced by body
    shape and weight

15
Why Women?
  • Culture of Slimness
  • 1- Media
  • 2- Discrimination Against Overweight Women
  • 3- Female Dissatisfaction with Bodies

16
Psychoanalytic
  • Affective disorders a result of incomplete
    satisfaction at a particular stage in childhood,
    setting up a vulnerability in adulthood for
    affective instability.
  • A fixation, particularly at the oral stage
    creates an environment ripe for the development
    of depression at a later stage in response to
    loss of a loved one.
  • The major theoretical underpinning of the
    psychodynamic view is that depression is anger
    turned towards oneself.

17
Cognitive- Behavioural
  • Depressed people feel as they do because their
    thinking is biased towards negative
    interpretations (Beck, 1967).
  • Creation of negative schemata ( a tendency to see
    the world negatively) is at the root of false or
    irrational beliefs about the self which lead to
    depression or dejection about the self.
  • Negative view of the self, world and future ?
    Negative schemata or beliefs triggered by
    negative life events ? Cognitive Biases ?
    Depression.
  • What are some problems with the Cognitive
    Approach to treating disorders in women?

18
Biological
  • The biological explanation assumes that there is
    a bio-chemical imbalance that causes affective
    disorders.
  • Focus on genetics and neurochemistry.
  • Research has consistently shown that
  • chemical changes can cause changes
  • in behavior. However, it has also shown
  • that behavior and emotion can change
  • chemical make up in the body

19
  • Consciousness creates the body. Our bodies are
    made up of dynamic energy systems that are
    affected by our diets, relationships, heredity,
    and culture and the interplay of all these
    factors and activities. (Northrup, p. 3)
  • Our emotions and thoughts have such profound
    effects on us on us because they are physically
    linked to our bodies via the immune, endocrine,
    and central nervous systems. All emotions, even
    those that are suppressed and unexpressed, have
    physical effects. Unexpressed emotions tend to
    stay in the body like small ticking time bombs
    they are illnesses in incubation. (Northrup, p.
    19)

20
  • The mind is located throughout the body.
    (Pert,1997). The mind can no longer be thought
    of as being confined to the brain or the
    intellect it exists in every cell of our bodies.
    Every thought we think has a biochemical
    equivalent. Every emotion we feel has a
    biochemical equivalent. ( Northrup, pg. 30)
  • What came first, the depression or the chemical
    change? And what does this mean in our treatment
    of women with depression?

21
Principles of Feminist Therapy ( Matlin, p.411).
  • 1- Womens major problems are not internal,
    personal deficiencies instead, the problems are
    primarily societal ones, such as sexism and
    racism.
  • 2- Women and men should have equal power in
    their social relationships.
  • 3- Society should be changed to be less
    sexist women should not be encouraged to adjust
    to a sexist society by being quieter and more
    obedient.

22
  • 4- We must focus on womens strengths, not on
    characteristics that are presumed as
    deficiencies. Women can use these strengths to
    help define and solve problems.
  • 5 - We must work to change those
    institutions that devalue women, including
    governmental organizations, the justice system,
    educational systems and the structure of the
    family.
  • 6- Inequalities with respect to ethnicity, age,
    sexual orientation, social class, and
    disabilities should also be addressed gender is
    not the only inequality.

23
Eating Disorders and Feminist Therapy
  • Occurs 90 percent in females
  • Possible Causes
  • Genetic
  • Faulty family relationships
  • Child abuse
  • Personality factors such as perfectionism and/or
    need for high control
  • Low self esteem

24
Principles of Feminist Therapy ( Matlin, p.411).
  • 1- Womens major problems are not internal,
    personal deficiencies instead, the problems are
    primarily societal ones, such as sexism and
    racism.
  • 2- Women and men should have equal power in
    their social relationships.
  • 3- Society should be changed to be less
    sexist women should not be encouraged to adjust
    to a sexist society by being quieter and more
    obedient.

25
  • 4- We must focus on womens strengths, not on
    characteristics that are presumed as
    deficiencies. Women can use these strength to
    help define and solve problems.
  • 5 - We must work to change those institutions
    that devalue women, including governmental
    organizations, the justice system, educational
    systems and the structure of the family.
  • 6- Inequalities with respect to ethnicity, age,
    sexual orientation, social class, and
    disabilities should also be addressed gender is
    not the only inequality.

26
  • What Would Feminist Mental Health Look Like to
    You?
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