Study Notes for Module 22: Assessment & Psychological Disorders I

Case Study: Dennis Rader, the “BTK Killer.”
- Rader's public persona: loving husband, devoted father, law-abiding citizen.
- Hidden life: over a span of 17 years, he killed 10 individuals; method labeled "BTK" (Bind, Torture, Kill).
- Dichotomy in behavior:
  - Publicly, he appeared normal.
  - Privately, he exhibited severe criminal behaviors.
- Different profiles of serial killers: although unique, they often display specific patterns.
Legal Insanity vs. Mental Disorder:
- Legal definition of insanity: inability to discern right from wrong.
- Rader's defense did not claim insanity as he demonstrated awareness of his actions; was sentenced to life imprisonment.
- Mental disorders: prolonged or recurring problems impacting personal satisfaction and societal function.

Definition and Examples:
- Anxiety disorders defined as excessive fear that interferes with daily functioning.
- Example: Howie Mandel's germophobia and obsessive hand washing due to anxiety; illustrates the impact on behavior and daily life.
Historical Development of Understanding Mental Disorders:
- Evolution of thought from demon possession to modern assessments including biological and environmental factors.
- Biological Influences: genetics contribute to 30-60% of disorders like depression and anxiety. Specific examples:
  - Genetic predisposition linked to childhood fear (e.g., Joan’s social phobia linked to overactive amygdala).
  - Neurological factors involve specific structures in the brain, like the amygdala, reacting inappropriately to stimuli.
- Cognitive-emotional-behavioral factors: deficits in thought processing and behavioral problems contribute to anxiety disorders.

Abnormal definition approaches:
- Statistical frequency: behavior viewed as abnormal if infrequent; limitations identified (e.g., rare behaviors like PhDs or president).
- Deviation from social norms: behaviors seen as abnormal if they violate accepted standards; subject to change over time.
- Maladaptive behavior: behavior is deemed abnormal if it interferes with personal functioning and societal norms, regarded as the most commonly used definition.
  - Example: Dennis Rader's violent behaviors qualify as maladaptive whereas Richard Thompson's storm drain residence poses a complexity.

Definition of Assessment:
- Systematic evaluation of psychological, biological, and social factors contributing to issues.
Three Assessment Methods:
1. Neurological tests (MRI scans for brain functionality).
2. Clinical interviews (gather personal and behavioral information).
3. Psychological tests (objective and projective tests for personality assessment).

Overview of the DSM (Diagnostic and Statistical Manual of Mental Disorders):
- History of DSM revisions leading to more research-based diagnosis (latest updated to DSM-5).
DSM-IV-TR Structure:
- Five axes system for clinical diagnosis:
  1. Axis I: Clinical syndromes (e.g., depression, anxiety disorders).
  - Example Diagnoses:
    - Susan Smith indicated mood disorder due to evidence of depressive symptoms.
    - Howie Mandel indicated obsessive-compulsive disorder due to repetitive thoughts/actions relating to cleanliness.
  1. Axis II: Personality disorders (e.g., antisocial personality disorder in Dennis Rader).
  2. Axis III: General medical conditions impacting mental health.
  3. Axis IV: Psychosocial and environmental problems effecting individual’s diagnosis.
  4. Axis V: Global assessment of functioning scale (rating from 1 to 100).

Taijin Kyofusho (TKS):
- Unique to Japanese culture, TKS represents fear of offending others (social phobia) through unimpressive behavior.
Impact of Cultural Values:
- Differences in expectations between Western and Japanese cultures regarding interpersonal relations directly affect mental health diagnosis and treatment approaches.

Conduct disorder in relation to school shooters: evidence suggests many school shooters exhibit patterns of violence and distress.
Case studies: explore individual histories of shooters and shared characteristics triggering violent behavior, including bullying and lack of support.

Treatment Strategies:
- Cognitive-Behavioral Therapy (CBT) and Exposure Therapy as effective approaches for phobias.
Case Study: Christine's fear of flying exemplifying process through cognitive restructuring and gradual exposure to feared situations.

Examining behaviors and motivations of women attracted to imprisoned killers.
Discuss labeling in psychology and implications of such relationships within the DSM criteria.
Review of societal perceptions and biases regarding mental disorders and implications.