Preview

1. Preview • Basic Issues of Mental Disorders • Diagnostic issues • Perspectives to study mental disorders • The idea of multiple causation • Sex differences in diagnosis

2. Mental Disorders, Basic Concepts • “Mental Disorder” controversy • Symptom vs. Syndrome • symptom: individual characteristic of thought, feelings, behaviors • syndrome: constellation of symptoms an individual shows • Syndrome • clinically significant detriment • internal source of distress • involuntary manifestation

3. Issues with Diagnosis • reliability: individual diagnosticians reach the same conclusions using the same system • DSM-IV: observable characteristics to maximize reliability • validity: the extent to which the system’s categories are clinically meaningful • Labeling people

4. Perspectives on Mental Disorders • Biological Perspective • mental disorders as physical diseases • brain abnormalities • chemical imbalances • birth difficulties • heritability

5. Perspectives on Mental Disorders • Psychodynamic Perspective • Sigmund Freud • Unconscious conflicts and drives • Early childhood trauma • therapy helps person become aware of underlying conflicts

6. Perspectives on Mental Disorders • Cognitive Perspective • conscious thoughts • learned maladaptive thought patterns cause mental disorder • Behavioral Perspective • learned maladaptive patterns of behavior cause mental disorder

7. Perspectives on Mental Disorders • Sociocultural Perspective • larger culture important to development of mental disorders • supporting evidence from culture-bound syndromes • Koro in Southeast Asia • Anorexia and Bulimia in North America and Western Europe

8. High Disorder manifested Amount of stress Disorder not manifested Low High Low Predisposition for the disorder Multiple Causation • Predisposing causes • in place before onset • make person susceptible • inherited characteristics • learned beliefs • sociocultural beliefs

9. High Disorder manifested Amount of stress Disorder not manifested Low High Low Predisposition for the disorder Multiple Causation • Precipitating causes • immediate events that bring on the disorder (stress) • loss (e.g., loved one, job) • perceived threat • when predisposition high, precipitating event may be small

10. Multiple Causation • Maintaining causes • consequences of the disorder • keep disorder going once it begins • sometimes positive consequences (e.g., extra attention) • often negative consequences (e.g., lack of friends)

11. Sex Differences in Prevalence • Large sex differences in prevalence • Differences in Reporting • men report less psychological distress than women • don’t admit distress? • Physiological vs. psychological distress • tradeoff? • Men use more alcohol and drugs • men seem to express anger more than distress

12. Diagnosed as histrionic personality Diagnosed as antisocial personality Bias in Diagnosis • diagnose men with “male” disorders and women with “female” disorders • Ford & Widiger (1989) • antisocial = “male” disorder • histrionic = “female” disorder

13. Differences in Experiences • Men & women have different social experiences • Women • abuse from spouses • abuse in childhood • traditional roles • As employment for genders becomes more similar, gender gap in some disorders decreases

14. Summary • Symptom vs. Syndrome in disorders • Diagnostic issues of reliability validity • Biological, Sociocultural, Behavioral, Psychodynamic, Cognitive perspectives • Predisposing, Precipitating, Maintaining factors • Why sex differences in diagnosis?