2. I felt the need to clean my room … spent four to five hours at it … At the time I loved it but then didn't want to do it any more, but could not stop … The clothes hung two fingers apart …I touched my bedroom wall before leaving the house … I had constant anxiety … I thought I might be nuts. 2 Marc Sumemrs, diagnosed with obsessive-compulsive disorder

4.  How should we define psychological disorders?  How should we understand disorders?  How should we classify disorders?

5.  Psychopathology, psychological disorder, mental illness, mental disorder = same thing  Definitions: ◦ Any pattern of emotions, behaviors, or thoughts inappropriate to the situation and leading to distress or the inability to achieve important goals ◦ Persistently harmful thoughts, feelings, or actions ◦ When behavior is deviant (different from the norm), distressful, and dysfunctional (impairs one’s life) ◦ Maladaptive, atypical, unjustifiable, disturbing  Experts do not always agree!  However, in order for something to be considered a disorder, it must impair your life

6.  What qualifies as abnormal is a judgment call ◦ Three models from book: society, individual, mental health professional  Some think of disorders as part of a continuum ranging from the absence of a disorder to a severe disorder ◦ Disorders are an exaggeration of normal responses  Can also be influenced by culture ◦ Standards for deviant behavior differ from place to place  I.E. Hissing is a polite way to show respect for superiors in Japan  Time ◦ From 1952-1973, homosexuality was classified as a disorder

7.  Ancient world: Thought demons and spirits had taken control of a person’s mind and body ◦ Treatment: rituals to outwit or placate the supernatural beings  Greeks: Hippocrates thought mental disorders were a result of an imbalance between the body’s four humors (blood, phlegm (mucus), black bile, and yellow bile) ◦ Incorporated the idea that it is a medical disorder!  Middle Ages: Back to demons and witches ◦ Satan incited unusual behavior ◦ Cure: attempts to drive out demons…torture, execution  18 th Century: Mental disorders were diseases that had causes and required specific treatments; People were sick ◦ Placed in protective “asylums” (often became overcrowded and neglected)

9.  French reformer  Said that “madness” was a sickness of the mind  Patients released from chains  Believed in talking to patients, giving patients activity, and giving them clean air  In U.S.: Dorthea Dix

10.  Through the perspectives! ◦ There is no single factor that causes a disorder, so psychologists, psychiatrists, and other mental health professionals view disorders through the lenses of the perspectives we have discussed (and a few other models)  Medical Model: Mental disorders are diseases of the mind ◦ Encourages dependency on a doctor; What about the role of the patient in recovery? ◦ Puts psychologists out of business! Not supported by most clinical psychologists ◦ Similar to the biological model: Mental disorders are a result of physiological malfunctions (often genetic)  Most psychologists do recognize the importance of biology

11.  Psychoanalytic model: Unconscious conflicts often traced to childhood can cause disorders  Behavioral: Influence of environment ◦ How have rewards and punishments contributed to a disorder?  Cognitive: Thoughts, feelings, perceptions, and memories can contribute to disorders  Social: Social support system (or lack thereof) can contribute to disorders  Diathesis-Stress Model: A biological predisposition (diathesis) combines with a stressful circumstance to produce a disorder  Biopsychosoical Model: combination of biological, social, and psychological factors

13.  Why do we classify? ◦ Creates order and unity ◦ Helps us predict a disorder’s future course ◦ Helps us give the appropriate treatment ◦ Allows us to do research into causes  Diagnostic and Statistical Manual of Mental Disorders IV- TR (text revised, 2000) ◦ Published by the American Psychiatric Association ◦ DSM V came out last May http://www.dsm5.org/Pages/Defa ult.aspx http://www.dsm5.org/Pages/Defa ult.aspx

14.  Although it presents disorders in medical terminology (symptoms, diagnosing, illness) it is used by all mental health professionals  DSM diagnosis is needed by insurance companies before they pay for therapy!  Does NOT provide causes - just describes disorders  A diagnosis is made based off a series of questions centered around 5 axes (categories) ◦ An overall number value is then assigned  There are no blood tests, scans, or other medical procedures that can be used to determine if someone has a psychological disorder

17.  What is insanity?

18.  Prevalence: frequency with which a disorder occurs at one time  Incidence: number of new cases that arise in a given period  26% of adults in any given year meet the criteria for at least one disorder ◦ 6% have a serious mental illness  46 – 65% will at some time in their life

19.  You may see yourself in this unit ◦ Remember: Disorders are often thought of as exaggerated responses that fall along a continuum of normal to abnormal  I am not a clinical psychologist, nor are you  We will look at scenarios to identify disorders for the sake of learning the material  Don’t diagnose ourselves, our family, or our friends  Don’t fall into the first year medical student trap