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).
 Mood
Mood Personality
Personality
Disorders
Disorders Disorders
Disorders

Unit 11

Anxiety
Anxiety Abnormal
Schizophrenia
Schizophrenia
Disorders
Disorders Psych:
Disorders
History,
DSM

Somatoform
Somatoform Childhood
Childhood
Disorders
Disorders Disorders
Disorders
Dissociative
Dissociative
Disorders
Disorders
Electroconvulsive We are Client-
Psychosurgery Psychoanalysis
Therapy here Centered

Biological
Biological
Insight
Insight
Treatment
Treatment Gestalt
Therapies
Therapies
ss
Unit
Unit11:
11:
Antipsychotic Treatment
Treatment ofof
Drugs Psychological
Psychological
Disorders
Disorders
Token
Behavior
Behavior Economy
Therapies
Therapies

Stress Cognitive
Cognitive
Inoculation Therapies
Therapies Aversion
Therapy Classical Operant

Beck’s Rational
Systematic Behavior
Cognitive Emotive Flooding Contracting
Therapy Desensitization
Therapy
Abnormal psychology

• the scientific study of abnormal

behavior in order to describe, predict,
explain, and change abnormal patterns
of functioning
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.
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
 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
 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.

John W. Verano

Trephination (boring holes in the skull to remove evil forces)

Medical Perspective
Philippe Pinel (1745-1826) from France,
insisted that madness was not due to demonic
possession, but an ailment of the mind.

George Wesley Bellows, Dancer in a Madhouse, 1907. © 1997 The Art Institute of Chicago
Dance in the madhouse.
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
Systems theory
Biopsychosocial Model
Assumes that biological, socio-cultural, and
psychological factors combine and interact to
produce psychological disorders.
 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.
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.
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.
Multiaxial Classification
Is a Clinical Syndrome (cognitive, anxiety,
Axis I
mood disorders [16 syndromes]) present?
Is a Personality Disorder or Mental Retardation
Axis II
present?
Is a General Medical Condition (diabetes,
Axis III
hypertension or arthritis etc) also present?

Axis IV Are Psychosocial or Environmental Problems

(school or housing issues) also present?
What is the Global Assessment of the person’s
functioning? (GAF Scale is out of 100 with the
Axis V lower the school the more limited their
functionioning.
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
Multiaxial Classification
Note 16 syndromes in Axis I
Multiaxial Classification
Note Global Assessment for Axis V
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.”
 Diagnostic Labeling

1. Critics of the DSM-IV argue that labels may

stigmatize individuals.

N. Tomes, Madness in America, 1995. Cornell University Press.

Elizabeth Eckert, Middletown, NY. From L. Gamwell and
Asylum baseball team (labeling)
Diagnostic Labeling

2. Labels may be helpful for healthcare professionals

when communicating with one another and
establishing therapy.
3. Rosenhan study -
Diagnostic Labeling

3. “Insanity” labels
raise moral and
ethical questions
about how
society should
treat people who
have disorders
and have

Elaine Thompson/ AP Photo

committed
crimes.

Theodore Kaczynski
(Unabomber)