Transcript Psychological Disorders

Psychological Disorders
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Mental disorders account for 15.4% of the years of life lost
due to death or disability, scoring slightly below
cardiovascular conditions and slightly about cancer. (Murray
& Lopez, 1996).
Rates and symptoms of psychological disorders vary by
culture, but no known society is free of the two terrible
maladies of depression and schizophrenia.
Mental health workers view psychological disorders as
patterns of thoughts, feelings, or actions that are deviant,
distressful, and dysfunctional. (Stein et al., 2010).
Remember that this definition is created in a social context;
this disorder must apply both to the individual and to the
primary group (eg: biological family) that they interact with.
In a word disorder = distress.
Standards for Deviance
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Anatomy of a disorder: Attention Deficit Hyperactivity Disorder
(ADHD)(m627 c607)
Being distractible, fidgety, and impulsive sounds like Y
chromosome; ADHD is diagnosed 3x as much in boys than
girls.
After 1987, the proportion of American schoolchildren
diagnosed quadrupled.
Although African-American youth display more ADHD
symptoms than do Caucasian youth, they less often recieve an
ADHD diagnosis. (Miller et al., 2009)
Is it the child? Or today's abnormal (by evolutionary standards)
environment?
But...in neuroimaging studies, ADHD is associated with
abnormal brain-activity patterns. (Barkley et al., 2002).
Causes of ADHD
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Extensive TV watching and video gaming are associated
with reduced cognitive self-regulation and ADHD. (Bailey et
al., 2011)
ADHD often coexists with a learning disorder of with defiant
and temper-prone behaviour.
ADHD is heritable, meaning there are culprit genes and
abnormal neural pathways. (Poelmans et al., 2011).
ADHD is treatable with Ritalin and Adderall, stimulants that
(counter-intuitively) calm hyperactivity and increase focus.
(Barbaresi et al., 2007)
Behavioural therapies such as shaping can help the distress
of ADHD.
But...it there a cost to the child of long-term use of stimulant
drugs in treating ADHD?
The Medical Model
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The concept that disease, in this psychological disorders,
have physical causes that can be diagnosed, treated, and in
most cases, cured, often through treatment in a hospital.
Fig. 47.1 (m629 c609 15.1)The bio-psycho-social approach
to psychological disorders studies how biological,
psychological, and socio-cultural factors interact to produce
specific psychological disorders.
This is a good approach to the Western-only disorders of
bulimia and anorexia nervosa.
But..schizophrenia symptoms are world-wide, including
irrationality and incoherent speech.
The diagnosis of 'schizophrenia' provides a handy shorthand
for describing a complex cluster of disorders.
DSM-IV TR
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Table 47.1(m631 c611 15.1) will be on the next exam.
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Axis One: Is a Clinical syndrome present?
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Axis Two: Is a Personality disorder or mental retardation
present?
Axis Three: Is a General medical condition present?
Axis Four: Are Psychosocial or Environmental problems
present?
Axis Five: What is the Global Assessment of this person's
functioning?
Many arguments pro and con...but...depression and
hyperactivity are genuine disorders even if triggered by a
major life stress such as a death when grief does not go
away. (Kendler, 2011).
Labeling Psychological Disorders
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Once we label a person, we see that person
differently.(Farina, 1982).
Labels matter. The Langer et al., (1980) experiment had
therapists view videotaped interviews, being told that the
interviewees were psychiatric or cancer patients, and gave
them pathological labels.
Stereotypes do linger. Apart from the few who experience
threatening delusions or hallucinated voices that command a
violent act, mental disorders seldom lead to violence. (Fazel
et al., 2010).
In real life, the mentally ill are more likely to be victims than
perpetrators. (Marley & Bulia, 2001).
The representativeness and the availability heuristics lead to
self-fulfilling prophecies. (Snyder, 1984).
Jail or Hospital?
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Jared Lee Loughner was charged with the 2011 Tucson,
Arizona shooting that killed six people and injured
Congresswoman Gabrielle Giffords.
He had a history of mental illness, and was diagnosed with
schizophrenia. Usually, schizophrenia is associated with
violence only when accompanied by substance abuse.
(Fazel et al., 2009)
In 2002, Andrea Yates was taken off her medication for
clinical depression, and drowned her five children (the real
Shutter Island story)
As Yates' fate illustrates, 99% of those whose insanity
defense is accepted are nonetheless institutionalized, often
for those as long as those convicted of crimes. (Litienfeld &
Arkowitz, 2011).
Who is Most Vulnerable?
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One predictor of mental disorder, poverty, crosses ethnic &
gender lines.
Schizophrenia understandably leads to poverty, yet the
stresses and demoralization of poverty can also precipitate
disorders, especially depression in women and substance
abuse in men. (Dohrenwend et al., 1992).
Table 47.3, Risk & Protective Factors for Mental Disorders,
will be on the next exam. (m635 c646 15.6)
Over 75% of disorders strike by median age 24. (Robins &
Regier, 1991); anti-social personality disorder as early as
age 8, alcohol dependency, obsessive-compulsive disorder,
bipolar disorder, and schizophrenia by median age of 20;
major depressive disorder later at age 25. Consider the
neurology of the disorders as brain events.