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mental disorders
| Question | Answer |
|---|---|
| Mental Health - What is 'normal'? Mental health: is a state of emotional and social well-being in which individuals realise their own abilities, can cope with the normal stresses of life, can work productively and can contribute to their community. | Mental illness: is a mental disorder that affects one or more functions of the mind. A mental illness can interfere with a person's thoughts, emotions, perceptions and behaviours. |
| Mental disorder: implies the existence of a clinically recognisable set of symptoms and behaviours that usually need treatment to be alleviated. Mental illness is more severe and ongoing than a mental health problem. | What is normal? A behaviour is generally considered to be normal when it helps a person to assimilate appropriately into their society and culture and to function independently as expected for their age. |
| Functional approach to normality. Psychological dysfunction: occurs when there is a breakdown in the way a person thinks, feels and behaves. | Medical approach to normality. The medical approach to normality states that a person's state of mental health is determined by a set of symptoms. If a mental illness is diagnosed, then treatment is required - psychological, pharmaceutical or both. |
| >> Chapter 18 Diagnosing Mental Disorders. | Disorder: a set of symptoms that interfere with daily functioning. Symptoms are reasonably consistent between patients but origins/causes may differ. |
| Communication and Control. Diagnostic and Statistical Manual of Mental Disorders (DSM): one of the main systems for classifying and diagnosing mental health disorders. | DSM-IV-TR is the fourth text revision and the most widely used in Australia, the DSM-V is due for publication in 2013. |
| International Classification of Diseases (ICD): one of the two main systems for classifying and diagnosing mental health issues. | It is descriptive and largely based on symptoms reported by the patient and the criteria ranked as important by professionals. |
| It is used to diagnose most health problems, including both physical and mental health issues. | > One of the roles of a psychologist is to diagnose mental illness. |
| > Naming a mental disorder improves communication between psychologists and other professionals. It also helps clarify and define variables for research in the area. | > A correct diagnosis is extremely important as it can assist with the course of treatment and the control of the disorder and symptoms. |
| > The two main systems of classifying and diagnosing mental health disorders are the International Classification of Diseases (ICD) and the Diagnostic and Statistical Manual of Mental Disorders (DSM. | - the most widely used classification system in Australia. |
| > The ICD covers a wide range of illnesses than the DSM, which is more commonly used to diagnose mental health conditions. | There have been several revisions of the DSM since it was first published in 1952, and the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) is the current version. |
| > The number of disorders has increased as the different revisions have been published and now stands at 365. | > When a person presents to a psychologist with a mental health problem, the steps in intervention are as follows: - clinical interview - assessment of personality, cognitive or behavioural traits |
| - neuropsychological assessment - identification of clinical symptoms - use DSM or ICD to diagnose the disorder - design the interventions | - implement treatment - review intervention. |
| > The way the DSM works is to identify a person's presenting issues on five different axis: - axis 1: clinical disorders - axis 2: mental retardation and personality disorders - axis 3: general medical conditions | - axis 4: psychosocial and environmental problems - axis 5: global assessment of functioning (GAF). |
| > Criticisms of the DSM system include issues to do with: - cultural variation - validity of the categories - writing by committee - subjectivity - health insurance. | > Psychological illnesses do not fit into neat categories as most medical conditions do, and very often people with one diagnosed disorder have symptoms of one or more other disorders. |
| > It is expected by many that the fifth edition of the DSM (DSM-V) will move towards a less categorical structure by introducing dimensional classifications, particularly of personality disorders. | Dimensional Diagnosis in Action. Dimensional diagnosis: a system of diagnosis in which conditions are assessed by the extent to which patients show particular symptoms. |
| > Autistic disorder, high-functioning autism and Asperger's disorder are referred to as 'spectrum disorders', where autism grades into high-functioning autism which shares many characteristics with Asperger's disorder. | The Biopsychosocial Model. > Was first developed by George L. Engel. |
| > He believed that to truly understand and treat a person's mental and/or phyical illness, it was important to consider their condition in terms of biological, psychological and social influences. | > His model was a 'holistic' option to the traditional biomedical model that had separated the body and the mind for centuries. |
| > The biomedical approach tended to treat the individual from a purely physiological and molecular or ellular level in a distant and impersonal manner that ignored human distress. | > Engel also believed that the clinician/doctor/psychologist had an important role in influencing the course of both treatment and the person's recovery. |
| If the clinician was perceived to be uncaring and disinterested in the patient, the recovery could be hampered and delayed. | > His aim was to bring greater 'empathy and compassion' into the patient-practitioner relationship, with the objective of attaining a better recovery outcome. |
| > According to Engel, biological factors include physiological/anatomical, neurotransmitters, genetic factors, gender, age and ethnicity. | > Psychological factorsare the individual's subjective perceptions, personality predisposition and their unique thoughts, feelings and behaviours. |
| > Social influences include family, friends, societal expectations and available services, cultural background and environment. | > The biopsychosocial model became a 'collaborative pathway to health'. |
| > The biopsychosocial model has developed since its first inception and has been applied successfully in both medical and organisational settings. It considers questions such as: | > Is there a family history of physical or mental illness? > Are there any difficulties at home, work or school? > Is this person experiencing psychological distress (sadness, anxiety) because of an underlying psychological condition? |
| > What social support structures do they have in place? | Biological factors. Considers a person's functioning in terms of bodily structures such as the brain and nervous system, biochemical processes (for example the role of particular neurotransmitters) and genetic predisposition (what has been inherited). |
| Types of assessment/treatment include: > neuroimaging - devices such as CAT scan, PET scan, EEG, MRI or fMRI. | > medication - antidepressants, psychotropic drugs, mood stabilising drugs.. > neuropsychological testing - questionnaires, intelligence quotient tests. > medical procedures. |
| Psychological factors. Psychological fators such as the folowing are taken into account: > personality > behaviour > perception > cognition > attention > motivation. | Social factors. A range of social and cultural influences can either increase a person's resilience or contribute to their ill health. These influences can include: |
| > school environment and pressures > work environment and pressures > level of education > availability and access to appropriate medical and support facilities > socioeconomic factors such as poverty and homelessness. | > These factors can be crucial to a person's recovery if they have been ill. Research has found that social support networks are just as important to an individual's recovery as the actual medical attention or diagnosis they receive. |
| > There is great emphasis on developing a professional but also caring relationship between clinician/doctor/psychologist and patient/client. |
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