Download model

Psychological Disorders Chapter
15
Abnormal Psychology:
Psychopathology
So what constitutes a disorder?
• Statistically infrequent behaviour?
• “Bizarre” behaviour?
• Behaviour that violates cultural standards or
expectations?
• Maladaptive, harmful behaviour?
• Emotional distress?
Health Canada
Population & Public Health Branch
• Mental illnesses indirectly affect all Canadians
• 20% of Canadians will personally experience a mental
illness during their lifetime
• The economic cost=at least $7.331B in 1993
• In 1999, 3.8% of all admissions in general hospitals
(1.5 million hospital days) were due to anxiety d/o,
mood d/o, schizophrenia, personality d/o, eating d/o &
suicidal behaviour
• Mental illnesses affect people of all ages, educational
and income levels, and cultures
• The onset of most mental illnesses occurs during
adolescence and young adulthood
Perspectives on Abnormality
• Practitioners turn to models to explain the
causes of abnormal behavior
• A model is an analogy that helps discover
relationships among data
Major Depressive Disorder: Onset
and Duration
• Most people who experience major
depressive disorder undergo the first
episode prior to age 40
• Symptoms are readily apparent and may last
for days, weeks, or months
• Episodes of major depression may occur
once or many times
Major Depressive Disorder: Prevalence
• Major depressive disorder affects about 1.3
million Canadians each year
• Women are twice as likely to be diagnosed
and express their feelings openly
• Studies show not due to differences in
reporting, then why this?
• Let’s look at some explanations…
Major Depressive Disorder: Clinical
Evaluation
• Diagnosis of depression (or any other
mental disorder) should involve a complete
clinical evaluation:
• A physical examination- WHY?
• A psychiatric/ psychological history
• A mental status examination
The Medical-Biological Model
• The medical-biological model focuses on
the physiological conditions that initiate and
underlie abnormal behaviour
Causes of Major Depressive Disorder
• Biological theories imply both genetics and
neurotransmitters may underlie depression
• Monoamine theory suggests that depression
results from deficiencies of monoamines or
inefficient receptors
• SSRIs- lower levels of serotonin
The Behavioural Model
• The behavioural model states that abnormal
behaviour is learned through selective
reinforcement and punishment
The Cognitive Model
• The cognitive model asserts that human
beings engage in both prosocial and
maladjusted behaviors because of their
thoughts
Learning and Cognitive Theories
• Lewinsohn feels that people who fail to
receive reinforcement are deprived of
pleasure
Learned HelplessnessBehavioral
• Learned helplessness is the behaviour of
giving up or not responding exhibited by
people and animals exposed to negative
consequences over which the feel they have
no control
• Seligman suggests that people’s beliefs
about the causes of failure determines
whether they will become depressed
Beck Cognitive
• Beck says depressed people have negative
views (thoughts, cognitions) of themselves,
the environment and the future
Depression – Cognitive
Cognitive Habits (content & process of thinking)
• Beliefs about self, others, world (situation is
permanent, uncontrollable; others don’t want to be
around me; I am a failure)
• Rumination – thinking continually about the negative
aspects of one’s life
Few rewarding
experiences
Hopeless,
pessimistic
Withdrawal (social
life, activities)
Depressed
mood
The Sociocultural Model
• According to the sociocultural model,
maladjustment occurs within and because
of a context
Child Abuse
• Child abuse is the physical, emotional, or sexual
mistreatment of a child
• Victims of abuse and neglect are at greater risk of
mood disorders and antisocial personality
disorders, PTSD, depression, suicide, and sexual
disorders
• Child abusers usually do not have any diagnosable
mental disorder
Intimate Partner Violence
• Intimate partner violence is also known as
spouse abuse and domestic violence
• Women are more likely to be the victim
• Partner violence is more likely in couples
and societies in which gender roles are rigid
and women have little power
Which Model Is Best?
• Some psychologists use only one model to
analyze all behavior problems
• Others may take an eclectic approach
The Biopsychosocial Model
• Vulnerability is a person’s diminished
ability to deal with life events
• The more vulnerable the person, the less
stress or anxiety is needed to initiate
depression
• The link between vulnerability and stress is
called diathesis-stress model
Depression – Etiology
The Vulnerability-Stress Model
(aka the Stress-Diathesis Model)
(aka the Interactionist Model):
Vulnerabilities
(genetic
predispositions,
neurochemical
abnormalities,
personality
traits, or habits
of thinking)
+ Stressful Events = Depression
(environmental
stressors,
significant
losses)
Diagnosing Psychopathology: The
DSM
• The American Psychiatric
Association has devised a
system for diagnosing
maladjusted behaviour, the
Diagnostic and Statistical
Manual of Mental
Disorders (DSM)
The Insanity Plea
• Insanity refers to a condition that excuses
people from responsibility
• Legally, a person cannot be held responsible
for a crime if, at the time of the crime, the
person lacked the capacity to distinguish right
from wrong, or to obey the law
• Criminal Code of Canada (2000)
– Defense of mental disorder: Not criminally responsible for
an act made while suffering from a mental disorder that
rendered the person incapable of appreciating the nature
and quality of the act, or of knowing that it was wrong
Insanity Defense
• March 2002 – case of Andrea Yates
– Severe clinical depression with psychotic episodes, high
levels of stress and demands
– Long history of depression, suicidality, psychotic
episodes; strong family history of mental disorders
– Drowned her five young children, claiming she believed
she was saving them from perishing in the fires of hell…
• She was convicted and sentenced to life in prison.
Was this an appropriate sentence?
The Insanity Plea
• Most people overestimate how often
the insanity plea is made
• Only about 1% of felony defendants
use an insanity defense
• Even when successful, the defendant
seldom leaves the courtroom a free
person