Psyc 238 Lecture 1.1: Examples and Definitions

Why is mental illness hard to define?

• We don’t know the processes or causes that are responsible for creating mental illness

• There are no specific laboratory tests that can confirm or diagnose mental illness

• There are debates in literature about what actually constitutes mental illness

Thomas Szasz (1960)

“The Myth of Mental Illness” : Says that mental illness is just a convenient label for behaviors that a person or their society finds to be unwanted/unpleasant. Abnormal behavior is a social phenomenon and might be a perfectly normal response to an abnormal environment

Jerome Wakefield (1992, 2010)

“Harmful Dysfunction” : Something is abnormal if it results from a failure of some internal mechanism to perform its natural function AND it causes harm to the person as judged by standards of that persons culture… Only behaviors that are socially devalued are considered disorders

Symptoms

Thoughts, feelings, and behaviors that indicate a mental disorder

Syndrome

A group of signs and symptoms that occur together and have the same etiology or cause

Duration

How long do symptoms last?

Impairment

To what degree is the person effected in terms of dysfunction?

Situation/Context

What is the environment under which the disorder or symptoms emerge?

What does the DSM-5 look at to determine psychopathology?

Categorizes based on symptoms, and looks at

• Current Distress: Is a person experiencing suffering due to their symptoms?

• Disability: Is there impairment in daily functioning?

• Risks: Are there increased risks of suffering, death, pain, or loss of freedom?

What are the 4 D’s of Abnormality?

1. Dysfunction: Does it interfere with daily life functioning?

2. Distress: Does it cause emotional or physical pain?

3. Deviance: Is it considered abnormal according to common attitudes and behaviors within society/culture?

4. Dangerousness: Are there behaviors or feelings that are of potential harm to the person or others?

What is culture?

Shared values, beliefs, and practices of a group of people.

Why does culture matter to psychopathology?

All definitions of psychopathology are embedded in a cultural context!

Culture changes over time and effects the prevalence of abnormality/disorders

Definitions of disorders can change to to a societies Zeitgeist (what is in or out during the time) (example: homosexuality was once considered a disorder)

HOWEVER: No mental disorder is considered to be entirely a result of cultural or social factors.

Zeitgeist

A german word for “spirit of the times”

Definitions of disorders can change to to a societies _______ (example: homosexuality was once considered a disorder)

What types of disorders are less impacted by culture?

Psychotic disorder (ex. schizophrenia)

What types of disorders are more heavily impacted by culture?

Non-psychotic disorders (ex. Anorexia, eating disorders)

Which are more likely to differ between cultures: Existence of disorders, or symptoms/manifestations of disorders?

Symptoms/Manifestations

Epidemiology

The study of the frequency and distribution of disorders within a population. Can be helpful in identifying patterns and risk factors for disorders.

Comorbidity

Manifestation of more than one disorder (at same time)

Incidence

the number of new cases of a disorder that occur in a population within a specific time period (Ex. The number of new cases of depression that occur in one year)

Prevalence

the total number of active cases (old and new) present in the population at a given time (ex. The number of new and old cases of depression that occur in one year)

Lifetime Prevalence

the total number of people in a given population who have been affected by the disorder at some point in their lives (ex. The number of new and old cases of depression that occur throughout an entire lifetime)

According to Jerome Wakefield, a condition is a mental disorder if and only if:

It results from failure of some internal mechanism to perform its natural function, and it causes harm to the person as judged by standards of that person’s culture.