exam 3 Flashcards
What determines mental disorders?
Subjectivity– no one absolute way to determine what is a mental disorder
Social construction– reality is constantly shaped by society and social interactions
Cultural values– certain disorders exist exist exclusively in certain cultures
Two fundamental questions– what determines a mental disorder
What year is it?
Historical contexts
Where am I?
Cultural context– why some cultures think some disorders to be abnormal vs. normal
Deviance (4 d’s)
strays from what we consider the “norm”
Distress (4 d’s)
causes the individual discomfort
Personality disorder are marked by a lack of internal distress
They like the way they are, the distress is coming from those around them
Shows there’s no absolute truths, just a good rule of thumb of what constitutes a mental illness
Disfunction (4 d’s)
interferes with many aspects of their life
Key word is many– has to impact work, school, social, and interpersonal domain of life
Every single mental illness has to meet with this criteria
where subjectivity comes into play
Danger (4 d’s)
harm to oneself, not necessarily others
Data shows people with mental illnesses are more likely to be victimized by violent crime than to be perpetrators
Cultural relativism
there is no one universal standard to measure culture by, and that all cultural values and beliefs must be understood relative to their cultural context
Supernatural– Historical explanations of mental illness
supernatural
Demon possession
Trephination– if they think demons are possessing the brain, drilling holes in people brain would have a way of leaving the brain
People were awake and alert when this was happening
Many people were able to survive this procedure
Biological– Historical explanations of mental illness
“Somatogenesis”– origin of body
Something originating in your body may be perpetuating mental illness
Johann weyer
irst used the phrase “mental illness”
Revolutionary because some of the main perspectives were demonic and witchy, especially for women
Syphilis
propelled current thought about the biological view of mental illness
If infected and left untreated lead to symptoms of psychosis
The mind
“psychogenesis”
Something originating in our mind might be contributing to illness of the mind
Freud– founder of psychoanalysis
Something in unconscious or early childhood experiences could eventually contribute to psychopathology
Buddha– promoted the idea that suffering is the result of our mental activity
“Lunatic asylum”
movement started in europe in the 15th-16th centuries
Torturing patients
First attempt of having a place for people with mental illness but in all actuality it was only a place to torture patients
State and public hospitals
were later established in US for “persons of insane and disordered minds”
Insane asylums
Phillipe pinel– advocated against insane asylums
Tried to create a diagnostic system to help understand what they are experiencing and to treat them
Dorothea Dix
activist for moral treatment
Start treating people with mental illness morally rather than torturing them
Established hospitals that were doing a better job of taking care of people with mental illness
DSM 1
1952
Around 30 pages
Reliability was poor– no consistency
Included comments on etiology– psychoanalytic perspectives (defensive mechanism)
No consideration of biological or cultural reasons
No mention of childhood disorders– ADHD, intellectual disability
Homosexuatlity was included as a sexual deviation disorder
Sociopathic personality disturbance
DSM 2– 1968
Homesexuality declassified as a disorder in a 1973 printing
Replaced it with a new diagnostic code– individuals who are distressed by their homosexuality
Childhood B disorders now included
DSM 3– 1980
Improved specificity and reliability
“Atheoretical”– did not have empirical evidence on these disorders
Mostly based on therapist and psychologist opinions
Acknowledgment of culture
ICD-10– 1993
International classification of diseases
Includes not just mental illness diagnosis but physical diagnosis as well
DSM IV– 1994
First attempt at synching mental health codes
Goal– a worldwide system of nosology for mental disorders
DSM V– 2013
Most recent, many updates
Examples–
Name changed– intellectual disability instead of mental retardation
Autism spectrum disorder– more comcompassing)
ADHD– used to have to exhibit symptoms before the age of 7, but changed it to 13
Gambling disorder added
DSM– pros
Standardization of language and citieria
Reliability– is person going to consistently get the same diagnosis from a different psychologist
Has improved across editions
Direction for treatment
Validation
DSM– cons
Stigmatization
Pathologizing
Reliance on medical model
Presumes that there are diseases or disorder that should be cured
People who have disorders that can be managed but not cured, are “incurable” or “unwell”
No universal idea of mental health
Cultural concepts of mental health
Our idea of what constitutes “normal” vs “abnormal” behavior is shaped by our culture
Therefor, we must be aware of cultural values to better understand mental illness
Biological vs. supernatural– etiology
Western cultures often emphasize biological factors (genetics, neurotransmitters) → medical model
Non western cultures may attribute disorders to supernatural influences (possession, curses, communication with ancestors)
Psychological vs. social– etiology
Western cultures tend to focus on internal and individual factors (feelings, lack of mastery)
Non western cultures emphasize collective factors (family dynamics, community stressors, discrimination)
Differences in expression of symptoms
Presentation of mental illnesses varies across cultures
Some cultures (east asian cultures) report more of the somatic symptoms (headaches, stomach issues, fatigue)
Other cultures (US and europe) tend to report more of the psychological experiences (sadness, worry)
Stigma and help-seeking
Some cultures report more negative attitudes and beliefs about mental health
Ex– east asian, middle eastern, and some african cultures
Others report more accepting or tolerant attitudes
Ex– western, scandinavian, and pacific islander cultures
Those that harbor more negative attitudes to mental health care may prioritize seeking support from family, friends, or religious leaders, not professional mental health care
Culture-bound syndromes
“Symptoms that are considered to be a recognizable disease only within a specific society or culture”
In the DSM 5, there are 9 “cultural concepts of distress” or culture-bound syndromes included
Important note– these are listed in the appendix of the DSM-5, and providers in the US can’t actually diagnose these
Just a suggestion that culture influences mental health
Personality
“ones characteristic patterns of behaving, thinking, and feeling”
Type approach
sed to express and communicate a set of expected behaviors based on shared characteristic
ENTJ– life’s natural leaders
Trait approach
people have certain basic traits and it is the strength and intensity of those traits that account for personality differences
Psychologist tend to like this one better
Big 5 personality traits
Is personality heritable
Heritability estimate (HE)
How much variation in population due to genetics
Between.42 - .57 for the Big 5
Is personality stable
Not so much in childhood, but increasingly so over lifetime
Meta analysis of 152 longitudinal studies
Trait score correlation over seven years
150 countries included with over 50,000 participants
Personality gets more stable as you get older
