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Basic Issues of Mental Disorders
Diagnostic issues
Perspectives to study mental disorders
The idea of multiple causation
Sex 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 disorder
Behavioral 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 culturebound syndromes
Koro in Southeast Asia
Anorexia and Bulimia in North America
and Western Europe
Multiple Causation
Predisposing causes
High
Amount of stress
in place before onset
make person
susceptible
inherited
characteristics
learned beliefs
sociocultural beliefs
Disorder
manifested
Disorder
not
manifested
Low
Low
High
Predisposition for the disorder
Multiple Causation
 Precipitating causes
High
Amount of stress
immediate events
that bring on the
disorder (stress)
loss (e.g., loved
one, job)
perceived threat
when
predisposition high,
precipitating event
may be small
Disorder
manifested
Disorder
not
manifested
Low
Low
High
Predisposition for the disorder
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 prevalence
Differences in Reporting
men report less psychological distress
than women
don’t admit distress?
Physiological vs. psychological distress
tradeoff?
Men use more alcohol and drugs
men seem to express anger more than distress
Bias in Diagnosis
Diagnosed as
histrionic
personality
Diagnosed as
antisocial
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 disorders
Diagnostic issues of reliability validity
Biological, Sociocultural, Behavioral,
Psychodynamic, Cognitive
perspectives
Predisposing, Precipitating,
Maintaining factors
Why sex differences in diagnosis?