1. 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).

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

3. We are here Unit 11: Treatment of Psychological Disorders Unit 11: Treatment of Psychological Disorders Biological Treatments 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

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

5. Mental Disorders "a clinically significant behavioral or psychological syndrome or pattern that occurs in an individual and that is associated with present distress (e.g., a painful symptom) or disability (i.e., impairment in one or more important areas of functioning) or with a significantly increased risk of suffering death, pain, disability, or an important loss of freedom."--Diagnostic & Statistical Manual of Mental Disorders 4th Ed.

6. 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

7. What makes a Behavior a Mental Illness? Many definitions have been proposed, yet none are universally accepted ¨ Most definitions, however, share some common features… “The Four Ds” –Deviance – Different, extreme, unusual –Distress – Unpleasant & upsetting –Dysfunction – Causes interference with life –Danger – Poses risk of harm

8. 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. Trephination (boring holes in the skull to remove evil forces) John W. Verano

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

10. 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

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

12. Medical Approach When physicians discovered that syphilis led to mental disorders, they started using medical models to review the physical causes of these disorders. 1.Etiology: Cause and development of the disorder. 2.Diagnosis: Identifying (symptoms) and distinguishing one disease from another. 3.Treatment: Treating a disorder in a psychiatric hospital. 4.Prognosis: Forecast about the disorder.

13. 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-IV-TR (Text Revision, 2000), describes 400 psychological disorders compared to 60 in the 1950s.

14. 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 Psychological Association recommends that the clinician use a multiaxial Assessment System.

15. Multiaxial Classification Are Psychosocial or Environmental Problems (school or housing issues) also present? Axis IV What is the Global Assessment of the person’s functioning? (GAF Scale is out of 100 with the lower the school the more limited their functionioning. Axis V Is a General Medical Condition (diabetes, hypertension or arthritis etc) also present? Axis III Is a Personality Disorder or Mental Retardation present? Axis II Is a Clinical Syndrome (cognitive, anxiety, mood disorders [16 syndromes]) present? Axis I

16. Sample Axis I 296.21 Major Depressive Disorder 303.90 Alcohol Dependence Axis II 301.6 Dependent Personality Disorder Axis III None Axis IV Recent Divorce, unemployment Axis V 58

17. Multiaxial Classification Note 16 syndromes in Axis I

18. Multiaxial Classification Note Global Assessment for Axis V

19. Goals of DSM 1.Describe (400) disorders. 2.Determine how prevalent the disorder is. Disorders outlined by DSM-IV are reliable. Therefore, diagnoses by different professionals are similar. Others criticize DSM-IV for “putting any kind of behavior within the compass of psychiatry.”

20. Diagnostic Labeling 1.Critics of the DSM-IV argue that labels may stigmatize individuals. Asylum baseball team (labeling) Elizabeth Eckert, Middletown, NY. From L. Gamwell and N. Tomes, Madness in America, 1995. Cornell University Press.

21. Diagnostic Labeling 2.Labels may be helpful for healthcare professionals when communicating with one another and establishing therapy. 3.Rosenhan study -

22. Diagnostic Labeling 3.“Insanity” labels raise moral and ethical questions about how society should treat people who have disorders and have committed crimes. Theodore Kaczynski (Unabomber) Elaine Thompson/ AP Photo