1. Psychological Disorders and Therapies

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

3. Why should we care? According to the 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
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

4. 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)

5. What makes a Behavior a Mental Illness?
The following needs to happen over a relatively long period of time:
“The Four Ds”
Deviance – Different, extreme, unusual
Distress – Unpleasant & upsetting
Dysfunction – Causes interference with life
Danger – Poses risk of harm
OBJECTIVE 1| Identify criteria for judging whether behavior is psychologically disordered.

6. Theoretical Approaches to Psychological Disorders
Biological approach
Physiological or biochemical basis (medical model) for disorder
Psychological/Psychoanalytical Approach
Thoughts, emotions, the unconscious, personality contribute to disorder
Cognitive-Behavioral Approach
Disorders are the result of learning maladaptive ways of behaving and thinking
Diathesis-Stress Model (part of Biopsychosocial Approach)
Biological predisposition to disorder which is triggered by stress

7. Biological Approach: Medical Model.
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.

8. Classifying Psychological Disorders
The American Psychiatric Association rendered a Diagnostic and Statistical Manual of Mental Disorders (DSM) to describe psychological disorders.
OBJECTIVE 3| Describe the goals and content of the DSM-IV.

9. The DSM spells out the specific diagnostic criteria
An example of this can be seen in the diagnosis of a major depressive episode.
A person must exhibit at least five or more of the listed nine characteristics and the symptoms must be evident for at least the last two weeks for that person to be diagnosed with this disorder.
When diagnosing a client the American Psychiatric Association recommends that the clinician use a multiaxial Assessment System.

10. Multiaxial Classification
Axis I
Is a Clinical Syndrome (cognitive, anxiety, mood disorders, etc) present?
Axis II
Is a Personality Disorder or Intellectual Disability present?
Axis III
Is a General Medical Condition (diabetes, hypertension or arthritis, etc) also present?
Axis IV
Are Psychosocial or Environmental Problems (school or housing issues) also present?
Axis V
What is the Global Assessment of the person’s functioning? (GAF Scale is out of 100 with the lower the score the more limited their functioning).

11. Sample Axis I 296.21 Major Depressive Disorder
Alcohol Dependence
Axis II Dependent Personality Disorder
Axis III None
Axis IV Recent Divorce, unemployment
Axis V 58

12. Pros and Cons of DSM
Positive: Disorders outlined by DSM-5 are reliable. Therefore, diagnoses by different professionals are similar.
FYI: this is not the only diagnostic system. The WHO devised an International Classification of Diseases and Related Health Problems (ICD-10). It’s close to the DSM-5, but there are still differences.
Negative: Relies too much on social norms and subjective judgments
-Too many new categories lead to increase of people diagnosed with a disorder
-Prescribing medication seems to be encouraged, where other treatments can be just as effective.