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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