P SYCHOLOGICAL D ISORDERS Unit 4

W HAT ARE PSYCHOLOGICAL DISORDERS ? Section I

W HAT A RE P SYCHOLOGICAL D ISORDERS ? A man living in the Ozark Mountains has a vision in which God speaks to him. He begins preaching to his relatives and neighbors, and soon he has the whole town in a state of religious fervor. People say he has a “calling.” His reputation as a prophet and healer spreads, and in time he is drawing large audiences everywhere he goes. However, when he ventures into St. Louis and attempts to hold a prayer meeting, blocking traffic on a main street at rush hour, he is arrested. He tells the policemen about his conversations with God, and they hurry him off to the nearest mental hospital.

D EFINING & I DENTIFYING P SYCHOLOGICAL D ISORDERS What is normal? (Who defines that?) Poll Question Does different mean mental illness? Certainly a teenager who uses drugs to “fit in” with his friends has problems, right? How then do we define abnormality?

D EVIATION F ROM N ORMALITY One approach is to say whatever most people do is normal Abnormality then becomes deviation from the average or from the majority It’s normal to shower every day, express grief at the death of a loved one, and wear warm clothes when going outside in the cold It then would be abnormal to take 10 showers per day, laugh at the death of a loved one, and wear your bathing suit in the snow Cultural context of behavior must be considered

A DJUSTMENT Normal people are able to get along in the world Physically Emotionally Socially Abnormal people then are those who fail to adjust

P SYCHOLOGICAL H EALTH “Mental illness or “mental health” imply that psychological disturbance or abnormality is like a physical sickness – such as the flu or tuberculosis Idea is that there is some “ideal” way for people to function psychologically Self-Actualization (Maslow & Jung) These people are at least striving toward ideal functioning Full acceptance and expression of one’s own individuality and humanness How can you tell if a person is actualizing themselves? Abnormal people are mentally ill

P SYCHOLOGICAL H EALTH Since definitions of abnormality are somewhat arbitrary, some theorists have concluded that labeling a person as mentally ill simply because his or her behavior is odd is a mistake as well as cruel and irresponsible. What areas does someone have to adjust to be considered normal? Physical Emotional Social All of the above

P SYCHOLOGICAL H EALTH Thomas Szasz: Mentally ill are not ill at all They have “problems living” Szasz says that psychiatrists label patients as sick and sent them off to hospitals with societies norms remaining unchallenged Argues that patients are the ones that lose by being labeled abnormal and deprived of responsibility for their behavior and dignity as human beings Szasz is in the minority Just because it is difficult to define abnormal doesn’t mean it does not exist – what it means is that we have to be careful when judging a person as mentally ill because a person might behave in a way we might not understand

P ROBLEM OF C LASSIFICATION People assume that abnormal behavior can be described much like any physical illness This is difficult In 1952 the American Psychiatric Association agreed upon a system for classifying abnormal symptoms, which it published in the Diagnostic and Statistical Manual of Mental Disorders, or DSM. DSM (1952) DSM II (1968) DSM III (1987) DSM IV (1994) DSM V (2013)

P ROBLEM OF C LASSIFICATION New ways of categorizing mental illness: Essential Features: characteristics that define the disorder Associated Features: additional features that are usually present Differential Diagnosis: how to distinguish this disorder from other disorders which it might be confused Diagnostic Criteria: a list of symptoms taken from the list of essential and associated features, that must be present for the patient to be given a particular diagnostic label

P ROBLEM OF C LASSIFICATION 5 major dimensions, or axes, describe a persons mental functioning: Axis I —used to classify current symptoms into explicitly defined categories. Axis II —used to describe developmental disorders and long-standing personality disorders or maladaptive traits. Axis III —used to describe physical disorders or general medical conditions that are potentially relevant to understanding or caring for the person. Axis IV —used to measure the current stress level at which the person is functioning. Axis V —used to describe the highest level of adaptive functioning present within the past year.

A DAPTIVE F UNCTIONING Three major areas of adaptive functioning: – Social relations – Occupational functioning – Use of leisure time