Transcript MENTAL DISORDERS

MENTAL
DISORDERS
Dr Ros Weston
Psychology
MENTAL DISORDERS
DSM IV
o
Clinical characteristics
o
Symptoms
o
Syndromes
o
Definitions
Stress
Advantages
Disadvantages
Use research
language to describe/
critically analyse/
evaluate
Ethnics
Limitations
o
Diathesis
Causation
Psychological
factors
-Culture
-social factors
-experiences
Biochemistry
Neurochemistry
Interactivity
between all
of these
Culture
Is it a form of Schizophrenia or not?
Evolutionary
Social
factors
Genes
Biology
MPD?
o
o
It a culture bound syndrome?
(Humphreys 1999)
(Berry et. al 1992)
Is it an exotic mental illness
Kora – Chowdley (1998)
Benstein & Gaw (1990)
Tobin (1996)
o
Running Amok
Knecht (1999)
Westmeyer (1973)
oExamples
: Hungerford : (1987)
: Hamilton: Dunblane
Columbine School USA (1998)
o
Anorexia : Holland et al (1988)
o
Sleep paralysis (Lim, Keh Ming 1996
o
Schizophrenia & TV
Evidence
o
Incidence : 1950’s Case study Eve
130 cases : an epidemic
o
M.P.D defence placed on trial
o
Under & Over diagnosis
are patients genuine?
o
o
Iatrogenesis : physical or therapist induced
(Meskey 1992) : leads to social desirability and
demand characteristics
Hypnosis increase iatrogenic effect. (Sparos, 1995)
Once a personality been given a name it becomes
reality
(Sparos 1985)
Experience
Differences from
Schizophrenia
Case Study
evidence
1. Three
faces of Eve
2. Sybil
3. Hillside
strangler
o presence of 2 or
more distinct
personalities.
o It is a personality
disorder not a
episodic disorder
o It is deeply
engrained &
enduring
o It is also known
as dissociative
identity disorder
(Allison& Schwaty)
“it is not various
identities but simply
multiple identities.
Is MPD or Any Mental Illness
Culturally Relative?
Berry 1992:
 Cultural Relativity or Culturally Universal? “Are there
local expression of universal disorders?”
 Cultural symptoms could be primary rather than
cultural overlay
 MPD also known as Disassociate Identity Disorder
 Berry : Disorders worldwide : MPD; Schizophrenia;
Depression; Manic Depression; Dementia; Senility
 (Kendall & Hammen, 1995),
Explaining Cultural Differences (Synoptic Issue)


Variations of symptoms not accounted for ie. DSM IV or ICD 10. (Ebigro, 1986)
Interpretation of DSM by individual psychiatrists problematic
Argument 1
Suppression – facilitation model
(Weisz, 1987)
Reducing Cultural Bias
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•
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Suppressed behaviour will rarely be
seen if a culture expects it not to
happen.
(Social norms & values)
Expected behaviour is rewarded so
will be seen often : expected
behaviour is rewarded therefore it is
facilitated.
(if. US Children & Thai study schoolchildren in
text book)
Misdiagnosis : Stevens (1987)
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There is a lot of misdiagnosis in
developing countries : India (Asia) &
Africa
Afro-Caribbean’s in the UK are 7* more
likely have a diagnosis of schizophrenia
than a white person
Blake, (1973) found evidence of cultural
relatively
•
•
Need to understand language differences
between patients & clinician / therapist
Therapists & clinicians understanding cultural
differences & expression of these
Need to know how far client / patient identifies
with cultural group
Gender Bias / Difference (Robin et al)
This has been identified as Alpha & Beta bias in
•
Amnesia
•
Alcoholism
•
Anti – social bias / behaviour
Are these ‘real’ gender, differences or clinician /
therapist bias?
Stereotyping : Social Class Bias
Umbenhavuer & De Wilts (1978) found
 Bias towards poorer people (Social
class bias)
 Higher social classes have coping
mechanism and can afford to pay
for therapy, life coach etc.
 See schizophrenia “Social
Causation Hypothesis”
 Social Drift Hypothesis
 Bowerman (1981)
 Kendall & Hammen, (1995)
 Alpha bias exists in relation to
“normality” (what is normal?)
 This mitigates against women
 Suppression – facilitation
hypothesis : Men less
 likely to seek help than women
(Ford & Widiger, 1989)
List Alpha & Beta Bias Here…..
MALE
FEMALE
Causation of MPD
Iatrogenic
Psychodynamic
Behaviour
Situational Theory of
state-dependent
learning
Self hypnosis
Social
Construction
Biological
Evolutionary
Cognitive
Your
Explanation