Psychological Disorders

8 Key excerpts on "Psychological Disorders"

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  eBook - ePub

  Introduction to Psychology

  • Ann L. Weber, Joseph Johnson(Authors)
  • 2011(Publication Date)
  • Collins Reference

    (Publisher)

  CHAPTER 14

  Psychological Disorders

  A ny layperson’s first associations with psychology are usually ideas about abnormal behavior and its treatment. Ideas of abnormality have varied over time and have affected attitudes toward disordered behavior and its treatment. In this chapter, we explore the definition of abnormality and the criteria for determining whether a pattern of behavior represents a psychological disorder. We also review theoretical models of psychological disorder and summarize identifiable behavioral patterns of many recognizable Psychological Disorders.

  DEFINING AND DIAGNOSING      DISORDERS

  Abnormality is a derivative concept, because it depends on an understanding of normality. Moreover, it does not prescribe what is necessarily healthy or adaptive. Recently, psychologists have turned to a term with fewer connotations, and refer to an abnormality as a psychological disorder, mental disorder, or psychopathology . These refer to a general pattern of disruptive thinking, feeling, and behaving that disturbs the person affected and/or those around him or her. The idea of abnormal behavior still guides thinking about these disorders, even if they go by a different name. It is helpful, therefore, to begin with an understanding of abnormality.

  Defining Abnormality

  Abnormal literally means “away from the norm.” The norm is the average or typical behavior or characteristic of the population. Thus, abnormality technically describes departures from norms of behavior relative only to a particular group (society or culture). Norms are different for different populations and can change with time and conditions. Abnormal behavior has been defined in different ways by psychologists and social scientists: statistically, culturally, and in terms of functioning.

  Statistical Abnormality

  Statistically abnormal behavior includes any behavior that is significantly different from the norm. In a normal distribution of characteristics or qualities, both very high scores and very low scores are considered statistically abnormal. For example, in terms of intelligence, only average intelligence is considered statistically normal—significant departures (above or below) from average intelligence are considered abnormal. In the statistical sense, unusually well-adjusted behavior might be considered abnormal, just as disordered behavior would be. Another way to think of abnormality in a statistical sense is as a rarity; that is, extremely rare or infrequent behavior—which is statistically unlikely—is abnormal.

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  eBook - ePub

  Toward a Theology of Psychological Disorder

  • Webb(Author)
  • 2017(Publication Date)
  • Cascade Books

    (Publisher)

  I was also aware of similar beliefs about mental illness in the faith community. Since my conversion to Christianity as an adolescent, I had attended churches of various denominations, and over the decades, I had heard statements from both religious leaders and congregants that associated psychological disorder with sin or spiritual failure. Yet, other than these occasional, negative messages, it seemed at times that Christians had very little to say about these afflictions. If I had not known otherwise from my training and clinical experience as a psychologist, I might have wondered if mental illness in the faith community was, for the most part, nonexistent.

  And yet, I did know otherwise. While data from epidemiological studies may vary, depending on the population studied and the research methods employed, psychological disorder is an increasing societal problem. In developed nations, mental disorders currently produce more disability than any other subset of medical conditions, surpassing even cardiovascular disease or cancer, with prevalence rates of approximately 25 percent of adults in the United States alone.1 The World Health Organization has reported that “lifetime prevalence rates for any kind of psychological disorder are higher than previously thought” and these rates “are increasing in recent cohorts.”2

  For individuals with these disorders, mental illness can assume a central role in life experience, as they struggle to navigate through daily events with any number of cognitive, affective, behavioral, and social impairments. Yet the epidemiological information I have cited above does not include the vast numbers of people who must also confront the challenges of psychological disorder because they are the spouses, parents, siblings, children, or close friends of individuals with these diagnoses. Mental illness profoundly impacts those with disorders and their loved ones as well.

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  eBook - ePub

  Essential Abnormal and Clinical Psychology

  • Matt Field, Sam Cartwright-Hatton(Authors)
  • 2015(Publication Date)
  • SAGE Publications Ltd

    (Publisher)

  For example, in some cultures a person who has ‘visions’ and speaks to themself is considered to have magical powers, whereas the same behaviour in many European countries would be considered ‘abnormal’ and cause for psychiatric investigation. Finally, these things have changed over time within cultures. For example, homosexuality was categorised as a psychological disorder until as recently as 1973, but today most people (extreme fringe groups aside) are quite shocked by that historical fact! To give another example, the distinction between someone who suffers from major depressive disorder and someone who is just a bit miserable and pessimistic (but basically ‘healthy’) is always going to be a difficult call to make. Successive revisions of psychiatric diagnostic manuals have generally reduced their thresholds for making this distinction, such that someone who would have been considered miserable but healthy in the 1950s might be diagnosed with a major depressive disorder from 2013 onwards (see Chapter 5). We revisit this issue throughout the book. Section summary It is impossible to agree on a universal definition of what makes a person ‘abnormal’. This is because definitions of abnormality are heavily influenced by broad social and cultural factors, and these are constantly shifting. However, it can be useful to think of the ‘four Ds’ (deviance, distress, dysfunctional and dangerous) as a starting point. Section 2: How are Psychological Disorders classified? In this section we describe the two main diagnostic systems for Psychological Disorders: the Diagnostic and Statistical Manual of Mental Disorders (or DSM for short) and the International Classification of Diseases (ICD) which includes Psychological Disorders and is published by the World Health Organisation (WHO) (see www.who.int/classifications/icd/en/). We will show how these diagnostic systems have changed over time and explain why they are structured in the way that they are

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  eBook - ePub

  Cross-Cultural Psychology

  Critical Thinking and Contemporary Applications, Sixth Edition

  • Eric B. Shiraev, David A. Levy(Authors)
  • 2016(Publication Date)
  • Routledge

    (Publisher)

  DSM is the main system of classification of Psychological Disorders in the United States and is utilized by the vast majority of mental health professionals, including psychiatrists, psychologists, social workers, and counselors working in both private and government agencies (Mirin, 2002).

  The International Statistical Classification of Diseases and Related Health Problems (ICD) is a detailed description of known diseases and injuries and is published by the World Health Organization, a branch of the United Nations (World Health Organization, 1992). It is revised periodically and is currently in its tenth edition, known as the ICD-10. In addition to diseases and injuries, it also contains descriptions of mental disorders. Because of the help and cooperation from U.S. clinicians, the mental disorders section of ICD-10 is very close to the DSM-5 in terms of terminology and structure.

   Two Views on Culture and Psychopathology

  What is madness? To have erroneous perceptions and to reason correctly from them. Voltaire (1694–1778)—French philosopher

  Culture can affect Psychological Disorders in at least five areas. The first area is the individual’s culture-based subjective experience, including knowledge about psychological problems. The second area is culture-based idioms of distress, that is, the ways individuals explain and express their symptoms according to culture-based display rules. The third area is culture-based diagnoses for various forms of Psychological Disorders, including professional and nonprofessional judgments. The fourth area is culture-based treatment, the way people, including professionals, attempt to overcome psychopathological symptoms. The fifth area is culture-based outcome

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  eBook - ePub

  Mental Health and Crime

  • Jill Peay(Author)
  • 2010(Publication Date)
  • Routledge-Cavendish

    (Publisher)

  Mental disorder

  Problems of definition and diagnosis

  It would be possible to write an entire book on what is meant by mental disorder. Indeed, an excellent one has already been written on just that topic (Bolton, 2008). Its treatment here will necessarily be partial.

  Mental disorder has been defined clinically, perhaps tautologically, perhaps simplistically, as ‘a disorder that presents with mental signs and symptoms’. As will emerge more fully in the latter sections of this book, the current legal definitions are hardly more helpful. And there is a further fundamental problem, namely whether mental disorders are indeed distinct from physical disorders. Reputable opinion would argue not (see Kendell, 2001, Matthews, 1999). Indeed Kendell, a former President of the Royal College of Psychiatrists, has argued that

  … if we do continue to refer to ‘mental’ and ‘physical’ illnesses we should preface both with ‘so-called’, to remind ourselves and our audience that these are archaic and deeply misleading terms. (Kendell, 2001:490)

  That said, this is not the place to review what is a fascinating literature on the infusion of ‘the mental’ into physical illness and/or vice versa. Rather, the book takes as its premise a widespread recognition of the concept of mental disorder, even if that concept is itself of dubious value.1

  The focus here is on a tension within the topic between an approach that emphasises a quasi-scientific basis, with all of the seeming certainty that that embraces, and one which places much greater stress on what is not yet known or understood (see Kendell, 2001 and Cheng, 2001, implicitly supporting the scientific view, and Turner, 2003, for a contrary view). The former approach might be typified by frequent resort to the accepted

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  Controversies and Dilemmas in Contemporary Psychiatry

  • Dusan Kecmanovic(Author)
  • 2017(Publication Date)
  • Routledge

    (Publisher)

  Only an objective organic-pathological finding, i.e., a reliable structural-functional correlate can be used to evaluate the validity of a specific definition of mental disorder. But unlike most physical diseases, there is no such objective indicator to validate the definition of mental disorders. As Allen J. Frances put it: “Although there have been many tantalizing putative biological findings for particular disorders, all reflect no more than group mean differences and none has achieved anything close to the needed sensitivity and specificity to qualify as a diagnostic test” (2009b).

  This critical discussion of the purposefulness of introducing the element clinically significant to the definition of mental disorder has brought us to the point of making any definition of mental disorder (even more) problematic. The reader might now wonder: does the fact that no valid definition of mental disorder exists mean that mental disorder does not exist? The answer is no.

  Mental disorders are associated with distress, dysfunction, disability, impairment in one or more areas, deviation from the individual and social standard, and other characteristics, but cannot be reduced to them as noted by Allen J. Frances, Thomas A. Widiger and Melvin Sabshin (1991 : 15). All these characteristics are simply imperfect indicators of mental disorder and not essential elements of its operational definition. They do not define what is meant by mental disorder but indicate that a specific individual is probably mentally disordered, but not for certain.

  The introducing the element of “clinically significant” into the operational definition of mental disorder has not helped establish its usefulness nor has it helped decrease the number of mentally non-disordered people who are diagnosed as mentally disordered (the false positives). Therefore, asserting that a specific behavioral or psychological syndrome or pattern must be clinically significant, along with the other characteristics, in order to be a mental disorder should be understood as one more failed attempt

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  eBook - ePub

  Psychology: A Complete Introduction: Teach Yourself

  • Sandi Mann(Author)
  • 2016(Publication Date)
  • Teach Yourself

    (Publisher)

  15 Psychological Disorders

  Chapter 14 began to examine some mental health conditions such as anxiety and depressive disorders that often occur in response to events (although sufferers may have an underlying predisposition towards the condition). This chapter concerns itself with Psychological Disorders that are caused by biological or physiological factors and that develop largely independently of external circumstances. These include mood disorders such as bipolar disorder, psychotic disorders such as schizophrenia, personality disorders such as multiple personality and developmental disorders such as autism and ADHD. Not every psychological disorder can be covered here but this chapter gives an overview of the more common ones.

  Bipolar disorder

  Bipolar disorder is sometimes referred to as ‘manic depression’ but, unlike clinical depression, discussed in Chapter 14 , bipolar disorder is a distinct condition. What makes bipolar disorder different from depression is that it includes not only periods of depression but also periods of elation. It combines episodes of mania with episodes of depression, alternating in cycles.

  The depressive symptoms of bipolar disorder are similar to those outlined in Chapter 14 and include:

  •   depressed mood

  •   no interest or pleasure in all, or almost all, activities previously enjoyed

  •   insomnia (inability to sleep) or hypersomnia (sleeping too much)

  •   fatigue or lack of energy

  •   feelings of worthlessness or excessive or inappropriate guilt

  •   diminished ability to think or concentrate

  •   recurrent thoughts of death (not just fear of dying)

  •   suicidal ideation.

  With bipolar disorder, the depression tends to lift and give way to manic symptoms. After a period of time, this mania also wanes and the sufferer sinks into depression once more. During the manic phase, which lasts for at least a week (for it to be classified as such) and often three to six months, the sufferer may experience three or more of the following symptoms:

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  eBook - ePub

  Handbook of Clinical Psychopharmacology for Psychologists

  • Mark Muse, Bret A. Moore(Authors)
  • 2012(Publication Date)
  • Wiley

    (Publisher)

  The patient’s unexpected response to any prescribed medication may suggest other clinical possibilities worthy of consideration. Perhaps the dose is too strong or too weak. Perhaps the patient is a poor metabolizer, ultrametabolizer, allergic or otherwise sensitive to the medication. Perhaps the diagnosis is incorrect. The possibilities are many, in large part due to the fact that the symptoms of various mental conditions, though often thought of as belonging to one disorder or another, frequently overlap. PSYCHOPHARMACOLOGICAL IMPLICATIONS FOR MENTAL DISORDERS WITH OVERLAPPING SYMPTOMATOLOGY Since the publication of the first edition of the DSM (Diagnostic and Statistical Manual of Mental Disorders) in 1952, psychiatrists, psychologists, and almost all health-care providers have proceeded to cluster psychiatric symptoms into discrete disorders. Since that time, the DSM has been revised five times to add, remove, or change the identified mental disorders (Nobleza & Carlat, 2011). The number of disorders has increased throughout the revisions of the text, as have the philosophical bases for the manual (from a psychodynamic to medical model). To this day, there is much disagreement among health-care providers regarding psychiatric diagnoses and their corresponding symptom criteria (e.g., the prevalence of early-onset bipolar disorder). It is important to remember that the DSM is a manual designed to be used as a guideline for diagnosing and treating mental disorders. The diagnoses have come about after many decades of observations by providers that mental-health symptoms often cluster into cohesive groups

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