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Basic Issues of Mental DisordersDiagnostic issuesPerspectives to study mental disordersThe idea of multiple causationSex differences in diagnosis

Mental Disorders, Basic Concepts

“Mental Disorder” controversy Symptom vs. Syndrome

symptom: individual characteristic of thought, feelings, behaviors

syndrome: constellation of symptoms an individual shows

Syndrome clinically significant detriment internal source of distress involuntary manifestation

Issues with Diagnosis

reliability: individual diagnosticians reach the same conclusions using the same system DSM-IV: observable characteristics to

maximize reliability

validity: the extent to which the system’s categories are clinically meaningful

Labeling people

Perspectives on Mental Disorders

Biological Perspective mental disorders as physical diseases brain abnormalities chemical imbalances birth difficulties heritability

Perspectives on Mental Disorders

Psychodynamic Perspective Sigmund Freud Unconscious conflicts and drives Early childhood trauma therapy helps person become aware of

underlying conflicts

Perspectives on Mental Disorders

Cognitive Perspective conscious thoughts learned maladaptive thought patterns

cause mental disorderBehavioral Perspective

learned maladaptive patterns of behavior cause mental disorder

Perspectives on Mental Disorders

Sociocultural Perspective larger culture important to development

of mental disorders supporting evidence from culture-bound

syndromesKoro in Southeast AsiaAnorexia and Bulimia in North America and

Western Europe

Multiple Causation

Predisposing causes in place before onset make person

susceptible inherited

characteristics learned beliefs sociocultural beliefs

Disordermanifested

Disordernotmanifested

Low

Low

High

High

Predisposition for the disorder

Am

ou

nt

of

stre

ss

Multiple Causation

Precipitating causes immediate events

that bring on the disorder (stress)

loss (e.g., loved one, job)

perceived threat when predisposition

high, precipitating event may be small

Disordermanifested

Disordernotmanifested

Low

Low

High

High

Predisposition for the disorder

Am

ou

nt

of

stre

ss

Multiple Causation

Maintaining causes consequences of the disorder keep disorder going once it begins sometimes positive consequences (e.g.,

extra attention) often negative consequences (e.g., lack

of friends)

Sex Differences in Prevalence

Large sex differences in prevalenceDifferences in Reporting

men report less psychological distress than women

don’t admit distress?Physiological vs. psychological distress

tradeoff? Men use more alcohol and drugsmen seem to express anger more than distress

Bias in Diagnosis

Diagnosed asantisocial

personality

Diagnosed ashistrionic

personality

diagnose men with “male” disorders and women with “female” disorders

Ford & Widiger (1989) antisocial = “male” disorder histrionic = “female” disorder

Differences in Experiences

Men & women have different social experiences

Women abuse from spouses abuse in childhood traditional roles

As employment for genders becomes more similar, gender gap in some disorders decreases

Summary

Symptom vs. Syndrome in disordersDiagnostic issues of reliability validityBiological, Sociocultural, Behavioral,

Psychodynamic, Cognitive perspectivesPredisposing, Precipitating, Maintaining

factorsWhy sex differences in diagnosis?