WHS AP Psychology

Unit 11: Mental Illness and Therapies

Essential Task 11-1:Describe contemporary and historical conceptions of what constitutes psychological disorders, recognize the use of the Diagnostic and Statistical Manual of Mental Disorders (DSM) as the primary reference for making diagnostic judgments with specific attention to five axis, and identify the positive and negative consequences of diagnostic labels (e.g., the Rosenhan study).

Unit 11

Abnormal Psych:

Disorders

MoodDisorders

MoodDisorders

AnxietyDisordersAnxiety

Disorders

PersonalityDisorders

PersonalityDisorders

SchizophreniaSchizophrenia

ChildhoodDisorders

ChildhoodDisorders

DissociativeDisorders

DissociativeDisorders

SomatoformDisorders

SomatoformDisorders

History,DSM

We are here

Unit 11:

Treatment of Psychological

Disorders

Unit 11:

Treatment of Psychological

Disorders

Biological Treatment

s

Biological Treatment

s

Insight TherapiesInsight

Therapies

Cognitive TherapiesCognitive Therapies

Behavior TherapiesBehavior Therapies

Psychosurgery

Antipsychotic Drugs

Electroconvulsive Therapy Psychoanalysis

Stress Inoculation

Beck’s Cognitive Therapy

Aversion Therapy

Behavior ContractingFlooding

Systematic Desensitization

Client-Centered

Gestalt

Rational Emotive Therapy

Classical Operant

Token Economy

Abnormal psychology

• the scientific study of abnormal behavior in order to describe, predict, explain, and change abnormal patterns of functioning

Mental Disorders

• "a clinically significant behavioral or psychological syndrome or pattern that occurs in an individual and that is associated with present distress (e.g., a painful symptom) or disability (i.e., impairment in one or more important areas of functioning) or with a significantly increased risk of suffering death, pain, disability, or an important loss of freedom."--Diagnostic & Statistical Manual of Mental Disorders 4th Ed.

National Institute of Mental Health Statistics• An estimated 26.2 percent of Americans ages 18 and older

— about one in four adults — suffer from a diagnosable mental disorder in a given year. Or 57.7 million people.

• About 6 percent, or 1 in 17 —suffer from a serious mental illness.

• In addition, mental disorders are the leading cause of disability in the U.S. and Canada for ages 15-44.

• Nearly half (45 percent) of those with any mental disorder meet criteria for 2 or more disorders, with severity strongly related to comorbidity.

• Most common disorders were anxiety, phobias, and mood disorders

What makes a Behavior a Mental Illness?

• Many definitions have been proposed, yet none are universally accepted

• ¨ Most definitions, however, share some common features…

• “The Four Ds”– Deviance – Different, extreme, unusual– Distress – Unpleasant & upsetting– Dysfunction – Causes interference with life– Danger – Poses risk of harm

Understanding Psychological Disorders

Ancient Treatments of psychological disorders include trephination, exorcism, being caged

like animals, being beaten, burned, castrated, mutilated, or transfused with animal’s blood.

Trephination (boring holes in the skull to remove evil forces)

John W. V

erano

Medical Perspective

Philippe Pinel (1745-1826) from France, insisted that madness was not due to demonic

possession, but an ailment of the mind.

Dance in the madhouse.

George W

esley Bellow

s, Dancer in a M

adhouse, 1907. © 1997 T

he Art Institute of C

hicago

Models of the Causes of Psychological Disorders

• Biological model– Physiological or biochemical basis

• Psychoanalytic model– Disorders are the result of unconscious conflicts

• Cognitive-Behavioral model– Disorders are the result of learning maladaptive

ways of behaving and thinking• Diathesis-Stress model

– Biological predisposition to disorder which is triggered by stress

Systems theory Biopsychosocial Model

Assumes that biological, socio-cultural, and psychological factors combine and interact

to produce psychological disorders.

Medical Approach

When physicians discovered that syphilis led to mental disorders, they started using medical models to review the physical causes of these

disorders.

1. Etiology: Cause and development of the disorder.

2. Diagnosis: Identifying (symptoms) and distinguishing one disease from another.

3. Treatment: Treating a disorder in a psychiatric hospital.

4. Prognosis: Forecast about the disorder.

Classifying Psychological Disorders

The American Psychiatric Association rendered a Diagnostic and Statistical Manual of Mental Disorders (DSM) to

describe psychological disorders.

The most recent edition, DSM-IV-TR (Text Revision, 2000), describes 400 psychological

disorders compared to 60 in the 1950s.

The DSM spells out the specific diagnostic criteria • An example of this can be seen in the diagnosis of

a major depressive episode. • A person must exhibit at least five or more of the

listed nine characteristics and the symptoms must be evident for at least the last two weeks for that person to be diagnosed with this disorder.

• When diagnosing a client the American Psychological Association recommends that the clinician use a multiaxial Assessment System.

Multiaxial Classification

Are Psychosocial or Environmental Problems (school or housing issues) also present?Axis IV

What is the Global Assessment of the person’s functioning? (GAF Scale is out of 100 with the lower the school the more limited their functionioning.

Axis V

Is a General Medical Condition (diabetes, hypertension or arthritis etc) also present?Axis III

Is a Personality Disorder or Mental Retardation present?

Axis II

Is a Clinical Syndrome (cognitive, anxiety, mood disorders [16 syndromes]) present?Axis I

Sample

• Axis I 296.21 Major Depressive Disorder 303.90 Alcohol Dependence

• Axis II 301.6 Dependent Personality Disorder

• Axis III None • Axis IV Recent Divorce, unemployment • Axis V 58

Multiaxial ClassificationNote 16 syndromes in Axis I

Multiaxial ClassificationNote Global Assessment for Axis V

Goals of DSM

1. Describe (400) disorders.2. Determine how prevalent the

disorder is.

Disorders outlined by DSM-IV are reliable. Therefore, diagnoses by different professionals are similar.

Others criticize DSM-IV for “putting any kind of behavior within the compass of psychiatry.”

Diagnostic Labeling

1. Critics of the DSM-IV argue that labels may stigmatize individuals.

Asylum baseball team (labeling)

Elizabeth E

ckert, Middletow

n, NY

. From

L. G

amw

ell and N

. Tom

es, Madness in A

merica, 1995. C

ornell University P

ress.

Diagnostic Labeling

2. Labels may be helpful for healthcare professionals when communicating with one another and establishing therapy.

3. Rosenhan study -

Diagnostic Labeling

3. “Insanity” labels raise moral and ethical questions about how society should treat people who have disorders and have committed crimes.

Theodore Kaczynski(Unabomber)

Elaine T

hompson/ A

P Photo