Unit 11: Mental Illness and Therapies WHS AP Psychology Unit 11: Mental Illness and Therapies Essential Task 11-1:Describe contemporary and historical conceptions of what constitutes psychological disorders, recognize the use of the Diagnostic and Statistical Manual of Mental Disorders (DSM) as the primary reference for making diagnostic judgments with specific attention to five axis, and identify the positive and negative consequences of diagnostic labels (e.g., the Rosenhan study). Logo Green is R=8 G=138 B=76 Blue is R= 0 G=110 B=184 Border Grey is R=74 G=69 B=64

Abnormal Psych: Disorders Unit 11 Abnormal Psych: Disorders Mood Anxiety Personality Schizophrenia Childhood Dissociative Somatoform History, DSM

Treatment of Psychological Disorders Classical Operant Unit 11: Treatment of Psychological Disorders Biological Treatments Insight Therapies Cognitive Therapies Behavior Therapies Psychosurgery Antipsychotic Drugs Electroconvulsive Therapy Psychoanalysis Stress Inoculation Beck’s Cognitive Therapy Aversion Therapy Behavior Contracting Flooding Systematic Desensitization Client-Centered Gestalt Rational Emotive Therapy Classical Operant Token Economy We are here

Abnormal psychology the scientific study of abnormal behavior in order to describe, predict, explain, and change abnormal patterns of functioning

What makes a Behavior a Mental Illness? “The Five Ds” Deviance – Different, extreme, unusual Distress – Unpleasant & upsetting Dysfunction – Causes interference with life Disability – impairment of function Danger – Poses risk of harm OBJECTIVE 1| Identify criteria for judging whether behavior is psychologically disordered.

Mental Disorders (APA 2012) A behavioral or psychological syndrome or pattern that occurs in an individual That reflects an underlying psychobiological dysfunction The consequences of which are clinically significant distress (e.g., a painful symptom) or disability (i.e., impairment in one or more important areas of functioning) Must not be merely an expectable response to common stressors and losses (for example, the loss of a loved one) or a culturally sanctioned response to a particular event (for example, trance states in religious rituals) That is not primarily a result of social deviance or conflicts with society

National Institute of Mental Health Statistics An estimated 26.2 percent of Americans ages 18 and older — about one in four adults — suffer from a diagnosable mental disorder in a given year. Or 57.7 million people. About 6 percent, or 1 in 17 —suffer from a serious mental illness. In addition, mental disorders are the leading cause of disability in the U.S. and Canada for ages 15-44. Nearly half (45 percent) of those with any mental disorder meet criteria for 2 or more disorders, with severity strongly related to comorbidity. Most common disorders were anxiety, phobias, and mood disorders

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. OBJECTIVE 2| Contrast the medical model of psychological disorders with the biopsychosocial perspective on disordered behavior. John W. Verano Trephination (boring holes in the skull to remove evil forces)

Medical Perspective Philippe Pinel (1745-1826) from France, insisted that madness was not due to demonic possession, but an ailment of the mind. George Wesley Bellows, Dancer in a Madhouse, 1907. © 1997 The Art Institute of Chicago Dance in the madhouse.

Models of the Causes of Psychological Disorders Biological model Physiological or biochemical basis Psychoanalytic model Disorders are the result of unconscious conflicts Cognitive-Behavioral model Disorders are the result of learning maladaptive ways of behaving and thinking Diathesis-Stress model Biological predisposition to disorder which is triggered by stress

Systems theory Biopsychosocial Model Assumes that biological, socio-cultural, and psychological factors combine and interact to produce psychological disorders.

Medical Approach When physicians discovered that syphilis led to mental disorders, they started using medical models to review the physical causes of these disorders. Etiology: Cause and development of the disorder. Diagnosis: Identifying (symptoms) and distinguishing one disease from another. Treatment: Treating a disorder in a psychiatric hospital. Prognosis: Forecast about the disorder.

Classifying Psychological Disorders The American Psychiatric Association rendered a Diagnostic and Statistical Manual of Mental Disorders (DSM) to describe psychological disorders. The most recent edition, DSM-V (2013) Goals: Describe disorders. Determine how prevalent the disorder is. OBJECTIVE 3| Describe the goals and content of the DSM-IV.

DSM-V: Sections DSM III & IV’s multiaxial classification has been removed! Introduction – explains the chapter organization and changes from the previous edition Diagnostic categories(criteria) and their codes 22 Major categories of mental disorders Includes conditions that need additional research, a glossary of terms, and other important information. What used to be AXIS I, II, III are now included in the Section II

DSM-5: Categories of mental disorders: Neurodevelopmetal disorders Schizophrenia spectrum and other psychotic disorders Bipolar and related disorders Depressive disorders Anxiety disorders Obsessive-compulsive and related disorders Dissociative disorders Somatic symptom and related disorders Personality disorders Feeding and eating disorders Sleepwalking disorders We are not going to learn all 22. We are going to learn just a few. But it is still A LOT within the two week period.

DSM-5: Categories of mental disorders: Gender dysphoria Elimination disorders Sexual dysfunctions Disruptive, impulsive control, and conduct disorders Substance related and addictive disorders Neurocognitive disorders Paraphilic disorders Other mental disorder Medication-induced movement disorders Other conditions that may be the focus of clinical attention Substance related and addictive disorders (is addiction a mental disorder – yes one of the most common) 304.30 Cannabis dependence 304.40 Amphetamine dependence (or amphetamine-like) 304.50 Hallucinogen dependence's

Diagnostic Labeling Critics of the DSM argue that labels may stigmatize individuals. Labels may be helpful for healthcare professionals when communicating with one another and establishing therapy. Labeling a person can be disabling, we might not see Helen as a person who is suffering from schizophrenia, but instead she is a schizophrenic. The label can engulf and identity. And it can be damaging. Elizabeth Eckert, Middletown, NY. From L. Gamwell and N. Tomes, Madness in America, 1995. Cornell University Press. Asylum baseball team (labeling)

Diagnostic Labeling 3. Rosenhan study - "On being sane in insane places“ healthy associates or "pseudopatients" (including Rosenhan) pretended to have hallucinations (symptom of Schizophrenia) to see if they would be admitted to psychiatric hospitals Once admitted, the pseudopatients stopped pretending and asked if they could leave. All were forced to admit they had a mental disorder and they were told to take anti-psychotic mediations upon release. Round 2! Hospitals challenged Rosenhan to try again, and they would detect the pseudopatient. The hospitals identified 41/193 potential suspects. However, Rosenhan had not sent any! Admitted to all 12 locations in five different states!

Diagnostic Labeling 4. “Insanity” labels raise moral and ethical questions about how society should treat people who have disorders and have committed crimes. Elaine Thompson/ AP Photo Theodore Kaczynski (Unabomber)

Disorders outlined by DSM are reliable Disorders outlined by DSM are reliable. Therefore, diagnoses by different professionals are similar. Others criticize DSM for “putting any kind of behavior within the compass of psychiatry.”