Chapter 16 Flashcards
what is abnormal??
it is relative but generally
The personal values of a given diagnostician
The expectations of the culture in which a person currently lives
The expectations of the person’s culture of origin
General assumptions about human nature
Statistical deviation from the norm
Harmfulness, suffering, and impairment
Social Construct 3 D’s
Distressing-to self or others
can be internal or external
Dysfunctional- for person or society
things like not being able to hold normal relationships
Deviant-violates social norms
pissing on the train
Demonological View
Abnormal behaviour = result of supernatural forces
Possessed by a spirit
Treatment
Trephination - ‘hole in the skull’
Early biological views of mental illness
Mental illnesses are diseases like physical illness that effect the brain (Hippocrates, 5th Century B.C.)
Breakthrough-early 1900s moved away from the devil stuff and treated ppl like humans, demystifying it.
General paresis - caused by syphilis
Disorders linked to physical causes
Current - physiological & psychological
The Diathesis-Stress Model
Each of us has some degree (range) of vulnerability for developing a psychological disorder, given sufficient stress
a combo of being vulnerable(internal) and getting triggered (external)`
reliability
Means that clinicians using the system should show high levels of agreement in their diagnostic decisions.
consistency of measured items, can be assessed by diff ppl and get the same results
validity
Means that the diagnostic categories should accurately capture the essential features of the various disorders
measures the proper items, my math grade is not reflective of my psych grade
The DSM-5: Integrating Categorical and Dimensional Approaches
Integrating Categorical and Dimensional Approaches
Detailed behaviour must be present for diagnosis
moved away from categorization to a spectrum model
you have autism->you have 6/10 traits for autism, not real by yk
Five axes / dimensions
Assess both person & life situation
the stuff that is measured
Axis I: Clinical Symptoms
Diagnosis (e.g., depression, schizophrenia, social phobia)
has some of the dsm4 categorization like negative affect, withdrawal, psychoticism
Axis II: Developmental & Personality Disorders
E.g., autism, mental retardation (typically first evident in childhood )
Personality disorders
Long lasting & encompass way of interacting with the world
E.g., Paranoid, Antisocial, Borderline Personality Disorders
Axis III: Physical Conditions
E.g., brain injury or HIV/AIDS that can result in symptoms of mental illness
even things like long covid is associated with depression and suicide
Axis IV: Severity of Psychosocial Stressors
E.g., death of a loved one, starting a new job, college, unemployment, marriage
Axis V: Highest Level of Functioning
Level of functioning both at present time & highest level within previous year
Social & Personal issues in Diagnostic Labelling
the dsm 5 is only really used in NA
Becomes too easy to accept label as description of the individual
May accept the new identity implied by the label
May develop the expected role and outlook
legal consequences of diagnostic labelling
Involuntary commitment
Loss of civil rights
Indefinite detainment
these can be anything from getting meds and accommodation to getting institutionalized
for crimes:
Competency
State of mind at time of a judicial hearing
Insanity
State of mind at time crime was committed-truly believing that the person you killed was satan
Anxiety Disorders
the most common disorder
normal when the anxiety experienced is proportional to the stressor, disorder when the response outweighs it and interferes with daily life
Phobias, generalized anxiety disorder, obsessive-compulsive
components of anxiety disorders
emotional symptoms-feelings of tension and apprehension
cognitive-worry, thoughts abt inability to cope
physiological-increased heartrate, muscle tension, etc
behavioral-avoidance of feared situations, decreased task performance, increased startle response
phobic disorder
Strong, irrational fears of objects or situations
Most develop during childhood, adolescence, young adulthood
Seldom go away on their own
Can intensify over time
Degree of impairment
Depends on how often condition is encountered
most common phobias in western society
Agoraphobia
Fear of open spaces, public places
Social phobias
Fear of certain situations, can be generalized or specific
Specific phobias
Fear of specific objects such as animals or situations
Generalized Anxiety Disorder
State of diffuse, ‘free-floating’ anxiety
Not tied to specific situation; condition
Feeling of something is going to happen; don’t know what
5% of population between 15-45 years
panic disorder
Occur suddenly, unpredictably, intense
May occur with or without agoraphobia
Fear of future attacks
3.5% of population
symptoms- cant breathe, hyperventilation, general fear, can’t think straight, dissociation
it becomes a disorder when you have to worry about them randomly happening
Obsessive-Compulsive Disorder (OCD)
Obsessions = cognitive component
Repetitive & unwelcome thoughts
Compulsions = behavioural component
Repetitive behavioural responses
2.5% of population
neuroscience of OCD
Executive dysfunction model
Problem with impulse control and behavioural inhibition
Involvement of prefrontal cortex, caudate nucleus
Modulatory control model
Dysfunction in orbitofrontal cortex and associated areas
Causal Factors in
Anxiety Disorders and OCD
biological-low levels of GABA can cause a highly reactive nervous system
gender diff-emerges that females exhibit more as early as 7 years old
psychodynamic-neurotic anxiety impulses threaten to overwhelm ego’s defenses
cognitive-maladaptive thoughts and beliefs appraise things catastrophically-leads to spiralling