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MODULE 43 PREVIEW Mental health workers label behavior psychologically disordered when it is atypical, disturbing, maladaptive, and unjustifiable. The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) provides an authoritative classification scheme. Although diagnostic labels may facilitate communication and research, they can also bias our perception of people’s past and present behavior and unfairly stigmatize them. Survey results indicate that 32 percent of U.S. adults have experienced a psychological disorder. Most show the first symptoms by early adulthood. GENERAL INSTRUCTIONAL OBJECTIVES 1. To define psychological disorders, and to discuss the controversy surrounding the use of diagnostic labels. 2. To describe the prevalence of the different psychological disorders. MODULE GUIDE Introductory Exercise: Fact or Falsehood? Project: Exploring Psychological Disorders on the Web Videos: Discovering Psychology: Psychopathology; The World of Abnormal Psychology Defining Psychological Disorders 1. Identify the criteria for judging whether behavior is psychologically disordered. There is a fine and somewhat arbitrary line between normality and abnormality. A psychological disorder is a harmful dysfunction in which behavior is judged atypical, disturbing, maladaptive, and unjustifiable. Lecture: Defining Psychological Well-Being Exercise: Defining Psychological Disorder Projects: Encounters with a “Mentally Ill” Person; Normality and the Sexes Understanding Psychological Disorders 2. Describe the medical model of psychological disorders, and discuss the bio-psycho-social perspective offered by critics of this model. The medical model assumes that psychological disorders are mental illnesses that need to be diagnosed on the basis of their symptoms and cured through therapy. Critics argue that psychological disorders may not reflect a deep internal problem but instead a growth-blocking difficulty in the person’s environment, in the person’s current interpretation of events, or in the person’s bad habits and poor social skills. Psychologists who reject the “sickness” idea typically contend that all behavior arises from the interaction of nature (genetic and physiological factors) and nurture (past and present experiences). The bio-psycho-social perspective assumes that disorders are influenced by genetic factors, physiological states, inner psychological dynamics, and social circumstances. Lectures: Tourette Syndrome; Culture-Bound Disorders Exercise: Multiple Causation Video: Segment 33 of the Scientific American Frontiers Series, 2nd ed. Transparency: 151 The Bio-Psycho-Social Perspective Classifying Psychological Disorders and Labeling Psychological Disorders 3. Describe the aims of DSM-IV and discuss the potential dangers associated with the use of diagnostic labels. The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition), nicknamed DSM-IV, is the current authoritative scheme for classifying psychological disorders. It assumes the medical model and groups some 400 psychological disorders and conditions into 17 major categories of “mental disorder.” DSM-IV describes disorders and their prevalence without presuming to explain their causes. Thus, the once popular term neurosis is no longer a diagnostic category—because neurosis was Freud’s idea of the process by which unconscious conflicts create anxiety. DSM-IV does, however, mention neurotic disorders as a contrast to the more debilitating psychotic disorders. Many psychiatrists and psychologists believe that a system for naming and describing psychological disorders facilitates treatment and research. PsychSim: Mystery Client Video: Psychopathology—Diagnostic Vignettes Series Diagnostic labels facilitate mental health professionals’ communications and research. However, critics point out that labels also create preconceptions that bias our perceptions of people’s past and present behavior and unfairly stigmatize them. Labels can also serve as self-fulfilling prophecies. Exercise: The Effects of Labeling Video: Myths About Madness:Challenging Stigma and Changing Attitudes Rates of Psychological Disorders 4. Describe the prevalence of various disorders and the timing of their onset. A National Institute of Mental Health survey conducted during the 1980s revealed that 32 percent of American adults had experienced a psychological disorder and that 20 percent had an active disorder. The three most common were alcohol abuse or dependence, phobias, and mood disorders. Those who experience a psychological disorder usually do so by early adulthood, with over 75 percent showing its first symptoms by age 24. Lecture: The Commonality of Psychological Disorders Transparency: 157 Percentage of Americans Who Have Ever Experienced Psychological Disorders