Introduction to Psychopathological Conditions of Adulthood and their Treatment

Introduction to Psychopathological Conditions of Adulthood and their Treatment

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Styron: author's descent into depression and his near-fatal night of "despair beyond despair." Jamison: bipolar 1 disorder Rosenhan – Stanford study into mental hospitals Hanes and Fox: Kagan: temperament in humans – shy vs. outgoing Suomi: rhesus monkeys; temperament Ainsworth: attachment styles Harlow: cloth vs. wire mother Ellis: ABC model; rational emotive therapy Beck: cognitive triad – 3 distortions in rational processing Seligman: learned optimism Piaget: cognitive development Erickson: psychosocial development Baillergon (see Piaget video): infant cognition Introduction to Psychopathological Conditions of Adulthood and their Treatment The Value and Danger of Labels--Categorization and psychiatric diagnosis: % - facilitates professional communication % - leads to shorthand description, rich with implicative meaning % - entails predictive/postdictive probabilistic implications % - can assist planning maximally relevant treatments % - can trick us into thinking we understand when we don’t % - can stigmatize and lead to self-fulfilling prophesies Videoclip on David Rosenhan’s Classic Study: “On Being Sane in Insane Places” % (Science, 1973, Vol. 179, pp. 250-258) - “faking” hearing voices to get admitted to mental institution - abandoned symptom as soon as they got admitted - no one detected they were sane - discharged with paranoid schizophrenia in remission Critique, and Impact on Development of DSM’s: % Critique: % Was it unreasonable to label them “insane”? % After admitted, “we acted the way we usually behaved”? % - disregarded symptoms % % Impact of Study on the DSM and Diagnostic Practice: % - single symptoms are inadequate bases for diagnosis % DSM’s subsequently articulated detailed “diagnostic criteria” % see p. 86 Jamison for list of diagnostic questions, the answers to which form the
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basis for the clinical judgment about presence/absence of “criteria” DSM-IV’s multiaxial diagnostic system: % Axis I: everything else mental (schizophrenia, mood disorders, anxiety disorders, eating disorders, substance use disorders) % Axis II: personality disorders or level of mental retardation % Axis III: medical % Axis IV: stress – kinds of stress going on currently % Axis V: GAF – global assessment of functioning (to what degree has the person’s symptoms affected their daily lives in the past year) Axes I and II are Descriptive,A-theoretical, Non-Explanatory The “Diathesis-Stress” Model: A general framework for explaining the causes (etiology) of psychopathological conditions: % Diathesis = Predisposing Factors (e.g., genetics; personality trait dispositions developed via the combination of genetics and environmental influence; early and prolonged stressors and stress-responses resulting in emotionally and behaviorally maladaptive “circuits” in the brain) % Stress = Precipitating Factors or “Triggering” Factors (e.g., stressful major life events associated with the onset of psychopathological symptoms in adulthood)
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Introduction to Psychopathological Conditions of Adulthood and their Treatment

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