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Psychological Disorders and Diagnosis


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Title: Psychological Disorders and Diagnosis

Psychological Disorders and Diagnosis
  • An Introduction

What are the Boundaries between Normal and
Abnormal Behavior??
  • Unconventional and Unusual
  • behavior that is so different that it violates a
    norm or cultural standard AND experienced by only
    a few
  • Disturbing
  • behavior that is troublesome to other people
  • Maladaptive
  • behavior that is destructive or harmful to
    oneself or others
  • Unpredictable and Irrational
  • Does not make sense to the average person

May only need to meet one to be diagnosed with a
What fits the description for abnormal behavior
depends on a few things
  • Culture Bases of Abnormal Behavior
  • Psychologists take into account the cultural
    context when making judgments about abnormal
  • The same behavior may be considered normal in one
    culture but abnormal in another
  • Examples of Cultural Bound Disorders
  • Susto Latin America anxiety and fear of black
  • Koro Southeast Asian Men
  • Time Period and Social Conditions
  • ADHD
  • Is it a real problem or just kids being active
  • Energetic child boring school ADHD
  • Homosexuality

How do we classify and learn about Psychological
  • We use the DSM
  • the big book of disorders
  • Classifies disorders on the basis of their
    distinctive features or symptoms

Classifies and describes the disorders but does
NOT NOT NOT discus their causes or
Two Major Classifications in the DSM
  • Neurotic Disorders
  • Psychotic Disorders
  • Distressing but one can still function in society
    and act rationally.
  • Person loses contact with reality, experiences
    distorted perceptions.

John Wayne Gacy
So How does the DSM work??
  • Uses a system of Axes or Dimensions (5 in total)
    that help the examiner conduct a comprehensive
    evaluation of a persons mental health
  • Axis I and Axis II
  • Contains lists of disorders
  • Axis III
  • Contains general medial conditions and diseases
  • Axis IV
  • Any psychosocial and environmental problems that
    may impair function
  • Axis V
  • Global assessment of functioning (GAF)
  • A numerical value that indicates overall level of
    mental health

A Sample DSM Evaluation
The Clinical Picture of Angela Savanti
  • Angela was rarely reinforced for any of her
    accomplishments at school, but she gained her
    mothers negative attention for what Mrs. Savanti
    judged to be poor performance at school or at
    home. Mrs. Savanti repeatedly told her daughter
    that she was incompetent, and any mishaps that
    happened to her were her own fault.......When Mr.
    Savanti deserted the family, Angelas first
    response was that somehow she was responsible.
    From her mothers past behavior, Angela had
    learned to expect that in some way she would be
    blamed. At the time that Angela broke up with
    her boyfriend, she did not blame Jerry for his
    behavior, but interpreted this event as a failing
    solely on her part. As a result, her level of
    self-esteem was lowered still more.
  • Angelas uncertainties intensified when she was
    deprived of the major source of gratification she
    had, her relationship with Jerry. Despite the
    fact that she was overwhelmed with doubts about
    whether to marry him or not, she had gained a
    great deal of pleasure through being with Jerry.
    Whatever feelings she had been able to express,
    she had shared with him and no one else. Angela
    labeled Jerrys termination of their relationship
    as proof that she was not worthy of another
    persons interest. She viewed her present
    unhappiness as likely to continue, and she
    attributed it to some failing on her part. As a
    result, she became quite depressed.

The Clinical Picture ofAngela Savanti
  • The Diagnosis
  • Axis I
  • Major Depressive Disorder
  • Axis II
  • Dependent personality Disorder
  • Axis III
  • Diabetes
  • Axis IV
  • Problems related to social environment
    (termination of relationship Jerry and Father)
  • Axis V
  • GAF 55

A Cautionary Note
  • The DSM-IV provides an invaluable tool to
    psychologists, but it doesnt come without its
  • Some believe it can turn normal problems of
    living into diseases i.e. ADHD or the
    argument over PMS
  • Also, some believe the DSM-IV makes diagnosis of
    disorders scientific when they are actually
    highly subjective
  • The problem of Labeling

The Influence of Labels
  • Should people who were once diagnosed with a
    psychological problem carry that diagnosis for
    the rest of their lives?
  • Can lead to stigmatization
  • The Rosenhan Study
  • rooms for rent story
  • Can change reality
  • a student is gifted or hostile

What are the Causes of Psychological Disorders??
It depends on your views of psychology
  • Medical Perspective
  • disorders are sicknesses and can be diagnosed,
    treated and often cured.
  • Learning or Behavioral Perspective
  • disorders result from the reinforcement of
    abnormal behavior
  • Psychodynamic Perspective
  • disorders result from defenses against internal,
    unconscious conflicts
  • Humanistic Perspective
  • disorders result from a failure to strive towards
    ones potential or being out of touch with ones
  • Sociocultural Perspective
  • disorders result from a dysfunctional environment

Current Perspectivescont.
  • Bio-Psycho-Social Perspective
  • assumes biological, psychological and
    sociocultural factors combine to interact causing

One Example The Diathesis-Stress Model
Diathesis predisposition or vulnerability
Inherited predisposition To develop the disorder
Environmental Stressors
Are you Insane??
  • Mental Illness vs. Insanity
  • Mental Illness
  • A medical decision
  • Insanity
  • A legal decision
  • To be insane a person must be unable to control
    behavior and be unaware that behavior is wrong
  • Insanity defense is based on the principle that
    punishment is justified only if the person is
    capable of understanding and controlling his or
    her behavior

Sex and Mental Disorders
  • Does the gender of a person influence (1) the
    type of disorder or (2) the frequency of various

Of Course it Does but Why??
  • Differences in reporting or suppressing
    psychological distress
  • Clinicians expectations
  • Differences in social roles and experiences
  • Differences in ways of responding to stressful

Early Theories on Mental Illness and Disorders
  • Afflicted people were possessed by evil spirits.

Early Theories on Treatment
  • Music or singing was often used to chase away
  • In some cases trephining was used

Cutting a hole in the head of the afflicted to
let out the evil spirit.
(No Transcript)
Early Theories on Treatment
  • Another theory on treatment was to make the body
    extremely uncomfortable.

Hopefully, this would drive out the evil spirits
History of Mental Disorders
  • In the 1800s, disturbed people were no longer
    thought of as madmen, but as mentally ill.

They were first put in hospitals.
Did this mean better treatment?
Early Mental Hospitals
  • They were nothing more than barbaric prisons.
  • The patients were chained and locked away.
  • Some hospitals even charged admission for the
    public to see the crazies, just like a zoo.

Philippe Pinel and Dorethea Dix
Moral-treatment Movement
  • Doctors who were the first to take the chains off
    and declare that people are sick and a cure must
    be found!!!

Out of this movement, large state-supported
asylums were built
Good intentions, but poor concept.why??
New Drugs and a feeling of optimism all could
make it if given a chance lead to an emptying
of mental hospitals
Most ended up either homeless or in prisons
Types of Disorders
Anxiety Disorders
  • A group of disorders in which either fear or
    anxiety is a major symptom
  • fear, phobia and nervous condition, that come on
    suddenly and prevent pursuing normal daily
  • Includes panic disorder, obsessive-compulsive
    disorder (ocd), post-traumatic stress disorder,
    general anxiety disorder, and phobias

Mood Disorders
  • A condition where the emotional mood is distorted
    or inappropriate to the circumstances
  • Includes major depression, dysthymic disorder
    (mild depression) and bipolar disorders

Dissociative Disorders
  • A psychological state or condition in which
    certain thoughts, emotions, sensations, or
    memories are separated from the rest of the
    conscious identity
  • Includes Dissociative Identity Disorder (DID),
    formerly known as Multiple Personality Disorder
    (MPD), and different types of amnesia

  • Mental disorder characterized by impairments in
    the perception or expression of reality and by
    significant social or occupational dysfunction

Personality Disorders
  • A class of mental disorders that are
    characterized by long-lasting rigid patterns of
    thought and behavior that disrupt social
  • Includes paranoid personality disorder, avoidant
    personality disorder, narcissistic personality
    disorder and borderline personality disorder

Eating Disorders
  • A person eats in a way which disturbs their
    physical health
  • Includes anorexia, bulimia, and binge-eating