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1. APPLICATIONS TO PSYCHOLOGY ABNORMAL PSYCHOLOGY 2. ABNORMALITY TOPIC <ul><li>Diagnosis bias </li></ul><ul><li>Aetiology of…
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  • 2. ABNORMALITY TOPIC <ul><li>Diagnosis bias </li></ul><ul><li>Aetiology of schizophrenia </li></ul><ul><li>Two treatments for schizophrenia </li></ul><ul><li>Aetiology of unipolar depression </li></ul><ul><li>Treatments for unipolar depression </li></ul>
  • 3. Discuss diagnostic bias in classification systems for mental disorders. (25 marks) <ul><li>Main sources of bias found p.597 - 620; </li></ul><ul><li>DIAGNOSTIC TOOLS USED </li></ul><ul><li>CULTURAL BELIEFS </li></ul><ul><li>HISTORICAL BELIEFS </li></ul><ul><li>GENDER STEREOTYPING </li></ul>
  • 4. Qu. What is the difference between being ‘ abnormal ’ and ‘ mentally ill ’?
  • 5. Issues with diagnostic tools : <ul><li>All systems stem from Emil Kraepelin (1913), who claimed that certain symptoms occurred together with sufficient frequency to merit the term 'disease'. </li></ul><ul><li>His classification was embodied in the UK Mental Health Act (1959) </li></ul>German diagnostician, born the same year as Freud
  • 6. DSM & ICD SYSTEMS OF CLASSIFICATION: <ul><li>The UK currently uses the ICD-10 </li></ul><ul><li>Published by the World Health Organisation, 1987) </li></ul>
  • 7. DSM-IV-R <ul><li>The USA uses the DSM-IV-R (2000) </li></ul><ul><li>Diagnostic & Statistical Manual of Mental disorders . </li></ul><ul><li>Reviewed in 2012 </li></ul><ul><li>(DSM-I, 1952, DSM-II, 1968, DSM-III, 1980). </li></ul>
  • 8. Chinese Classification of Mental Disorders ( CCMD-3) <ul><li>First devised in 1979 </li></ul><ul><li>third edition in 2001 </li></ul>
  • 9. ICD & DSM SIMILARITIES? <ul><li>The two systems do overlap : </li></ul><ul><li>1) Both avoid use of the term ‘ mental illness ’ instead preferring the term ‘ mental disorder ’ </li></ul><ul><li>Qu. Why change the wording? </li></ul>
  • 10. SIMILARITIES <ul><li>2) Both have dropped the traditional distinction between neurosis and psychosis </li></ul><ul><li>However: </li></ul><ul><li>The ICD-10 retains the term ' neurotic ' </li></ul><ul><li>The DSM-III-R the term ' psychotic ' </li></ul><ul><li>Qu. What do these terms mean? </li></ul>
  • 11. Similarities? <ul><li>3) Both DSM & ICD have introduced an ‘ operational criteria for diagnosis ’ . </li></ul><ul><li>i.e., for each category there is a specific list of symptoms </li></ul><ul><li>all or some of which must be present </li></ul><ul><li>for a specified period of time . </li></ul>
  • 12. Differences: <ul><li>1) DSM has a larger number of specific categories of mental disorders than the ICD. </li></ul><ul><li>Qu. Why? </li></ul><ul><li>2) ICD distinguishes Mental retardation from mental disorders - whist DSM groups them under ‘ disorders first evident in childhood or adolescence ’. </li></ul>
  • 13. Differences: <ul><li>3. DSM-IV has a category for drug misuse – addiction, dependency & withdrawal. </li></ul><ul><li>BUT, the ICD-10 does not class drug misuse as a mental illness. </li></ul><ul><li>Qu. How would this affect the prevalence rates of mental disorders in each culture? </li></ul>
  • 14. MENTAL ILLNESS PREVELANCE? WHO – ICD-10 (2001 report) <ul><li>1 in 4 of us will suffer a mental illness in lifetime </li></ul><ul><li>Account for 35% of all GP appointments </li></ul><ul><li>20% of women will report mental illness </li></ul><ul><li>14% men report mental illness </li></ul><ul><li>Qu. What is the most commonly reported mental disorder according to the ICD-10? </li></ul><ul><li>Depression is the most commonly reported mental illness. (1 in 6 of us will suffer from it). </li></ul>
  • 15. Qu. How will drug issues affect diagnosis? <ul><li>Key facts; </li></ul><ul><li>85% of patients in drug services (in the UK) have mental health problems ( Weaver 2002) </li></ul><ul><li>Drug dependency is three times more likely in men. </li></ul>
  • 17. <ul><li>Qu. How will these facts effect American prevalence rates of mental disorders? </li></ul>
  • 18. MENTAL ILLNESS PREVELANCE? DSM-IV-R (2006 report by NIMH) <ul><li>1 in 4 of us will suffer a mental illness in lifetime </li></ul><ul><li>Only I in 7 of us go for treatment </li></ul><ul><li>20 million Americans suffer from Depression </li></ul><ul><li>40 million people have anxiety issues </li></ul><ul><li>(16 million alone have social phobia’s) </li></ul><ul><li>But, the most common disorder is? </li></ul><ul><li>Drug issues – 16% of American pop have drug problems = #1 mental health issue </li></ul>
  • 19. Is there any behaviour that we should not class as a mental illness? <ul><li>The DSM-IV does not classify the following as mental disorders; </li></ul><ul><li>POLITICALLY DEVIANT BEHAVIOUR </li></ul><ul><li>RELIGIOUS DEVIANT BEHAVIOUR </li></ul><ul><li>SEXUALLY DEVIANT BEHAVIOUR </li></ul>
  • 20. Falun Gong practitioners detained in mental hospital in Beijing 2002
  • 21. Task: Using the DSM-IV axis of assessment, (on the handout) what categories would you put the following true-life behaviours into?
  • 22. Case study no.1 <ul><li>Last Friday I had interrupted my laboratory work and was seized with a feeling of great restlessness and mild dizziness. At home, I lay down and sank into a not unpleasant delirium, which was characterised by extremely exciting fantasies. In a semi-conscious state with my eyes closed fantastic visions of extraordinary realness and with a kaleidoscope of colours assaulted me. </li></ul>
  • 23. Case Study no.2 <ul><li>A 27 year old male had been brought into a hospital emergency department after being picked up by the police for lying down in the middle of a busy intersection. He said that he had wanted to die and was very depressed. He said he had no memory of the event prior to being picked up by the police. He knew nothing of his name or his life history. After several tests, he was found to have no brain abnormalities, no physical malfunction and no diagnosed illness. Under hypnosis details began to emerge of his past life but not his name or events prior to the hospitalisation. </li></ul>
  • 24. Case Study no.3 <ul><li>Jonathan is a 37 year old building worker who was brought to the psychiatric clinic by his wife. At the time of his admission, Jonathan was agitated and suicidal, even going so far as buying a gun to kill himself. He had lost his appetite and had developed insomnia during the preceding two weeks. He had become hypersensitive in his dealings with his neighbours, co-workers and family, insisting that others were being over-critical of him. This was the second such episode in his life, the first occurring five years earlier following the loss of his job due to forced redundancies. </li></ul>
  • 25. Case Study no.4 <ul><li>Half the time I am thinking about one thing and thinking about half a dozen other things at the same time. It must look weird to people when I laugh about something that has got nothing to do with what I am talking about, but they don’t know what’s going on inside my head. You see, I might be talking about something quite serious to you and other things come into my head at the same time that are funny and this makes me laugh. If I could concentrate on one thing at a time I wouldn’t look half as daft. </li></ul>
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