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SOSC 103 Fall 2011 _BC 1 PSYCHOLOGICAL DISORDERS: Basic Concepts SOSC. 103 Fall 2011 Psychological Disorders I felt the need to clean my room … would spend four to five hours at it… At the time I loved doing it. Then I didn't want to do it any more, but I couldn’t stop… The clothes hung… two fingers apart… I touched my bedroom wall before leaving the house… I had constant anxiety… I thought I might be nuts. Defining Psychological Disorders Mental health workers view psychological disorders as ongoing patterns of thoughts, feelings, and actions that are deviant, distressful, and dysfunctional (Comer, 2004). Standards for deviance vary from culture to culture and over time. Definition used in Diagnostic and Statistical Manual of Mental Disorders (DSM) DSM-IV-TR Behavioral, psychological, or biological dysfunctions that are unexpected in their cultural context and associated with present distress or impairment in functioning or with increased risk of suffering, death, pain, disability, or an important loss of freedom. Deviant, Distressful & Dysfunctional Deviant behavior (going naked) in one culture may be considered normal, while in others it may lead to arrest. Deviant behavior must accompany distress. If a behavior is dysfunctional it is clearly a disorder. ADHD—Normal High Energy or Genuine Disorder? Attention-Deficit Hyperactivity Disorder (ADHD) is marked by the appearance by age 7 of one or more of three key symptoms: extreme inattention, hyperactivity, and impulsivity. Increasing rates of diagnoses of ADHD has lead to skepticism over whether normal childhood energy is being misdiagnosed as a psychological disorder. 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. Historical Conceptions: Supernatural Tradition Magical/supernatural forces (like demons or spirits) SOSC 103 Fall 2011 _BC Some still argued and believed that ‘insanity’ is an illness (naturalistic views) Religion took over responsibility for dealing with cases of ‘abnormality’ in the middle ages Explanations of the movements of moons and stars as the cause for psychological malfunctioning– hence the word ‘lunatic’ Treatment: different forms of exorcism such as trephining for treatment, confinements, beatings, prayers, hanging over poisonous snakes 2 Biological Tradition: Hippocrates and Galen Humoral theory of disorders: The balance of four bodily fluids affect behavior and personality o Sanguine (red like blood; cheerful), black bile (melancholic person), yellow bile (choleric person; hot tempered),phlegm (apathy and sluggish) Medical Model: Philippe Pinel (1745-1826) from France, insisted that madness was not due to demonic possession, but an ailment of the mind. Medical Model: Emil Kraepelin (1856-1926) First formal diagnosis and classification of psychological disorders, each with a different age of onset, course, and cause Formation of first state mental hygiene committee Medical Model: When physicians discovered that syphilis led to mental disorders, they started using medical models to review the physical causes of these disorders. A mental illness must be diagnosed on the basis of symptoms and cured through therapy which may include treatment in a hospital. The Biopsychosocial Approach Assumes that biological, socio-cultural, and psychological factors combine and interact to produce psychological disorders. Classifying Psychological Disorders Diagnostic classification aims to describe a disorder as well as predict its course, suggest treatment, and stimulate research. 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. SOSC 103 Fall 2011 _BC Disorders outlined by DSM-IV-TR are reasonably reliable. Therefore, diagnoses by different professionals are similar. Others criticize DSM-IV-TR for casting too wide a net and putting too many people in the category of having a mental disorder. 3 Labeling Psychological Disorders There are benefits to labelling disorders. Labels are helpful for healthcare professionals in communicating about their cases, trying to understand underlying causes, and discerning effective treatment. Critics of the DSM argue that labels may stigmatize individuals and may become self-fulfilling prophecies. With continued knowledge, some of the stigma seems to be lifting, but stereotypes linger and those with disorders are often portrayed negatively. Rates of Psychological Disorders: