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lOMoARcPSD|11700591Hlthage 1CC3 Final Exam Notes
Introduction to mental health and illness (McMaster University)
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Hlthage 1CC3 Exam Notes
Intro To Mental Illness
Why “Mental” Illness?
• Use “mental disorder” but there’s much “physical” in mental disorder, just as there’s much “mentaL’ in
physical disorder
• Medical model, division isn’t cause (etiology), but rather symptom (expression)
But Mental Disorders are Different
• Agency, blame, stigma; if you want to change behaviour — DO something about it, meaning there’s an
assumption there’s control over how you behave (ex— Depression; “Just get up”)
• Think about cancer, why is it considered (when affected) “brave” but when mentally ill, it is own’s
fault?
• It affects the whole self, not just one part of the body. It defines the whole person
• Not always seen negative; some ppl are fond of the disorder
• Ex — Bipolar Disorder; when “manic” you feel amazing, love how you feel, don’t want it to go
away
• Power of Psychiatry; they decide what’s abnormal and what’s normal, feels like they can label a person
and “remove” them from society (Ex— an insane person must be in asylum)
• Psychiatrists have a lot of power, kinda like a judge. To determine if they’re mentally unstable when
committing a crime
• Non-absolute; value judgement involved in diagnosis of mental disorder. Ex— Wheezing versus
anxiety
• In theory, psychiatrists rarely directly examine the organ they treat.
Classification of Mental Disorders
• DSM (Guidebook): it’s kind of like a dictionary of what defines a mental illness, the symptoms that are
shown and what to diagnose.
• No one really knows the actual cause of mental illness, we just evolved and learn new theories as years
go by
• DSM definition of Mental Disorder: characterized by disturbance in cognitions, emotion regulation, or
behaviour that reflects dysfunction in psychological, biological, or developmental processes underlying
mental functioning. Usually associated with great distress/disability in social & occupational activities
• Criticism of DSM
• Lack of science, mostly relies on symptoms
• Ignores context of person being diagnosed; context shapes how we behave, DSM only looks at
what’s presented there and now; focus on symptoms rather than experience
• Refer to Freud and the “cause” behind behaviour, whereas DSM is more objective
• Doesn’t provide treatments/therapy
• How “real” are these illnesses? Can pressure also change what counts as disease? Can people
put pressure on Psychiatrists that something can count as a mental disorder?
• DISORDERS CHANGE CONTINUALLY
• Reliability (consistency) isn’t the same as validity; some diagnoses aren’t acc valid
The Difficulty w/Diagnosis
• Disorder formation done by committee, a clash or personalities contribute to DSM
• Biases based on race/gender/class/obesity — sometimes change the diagnosis
• Culture; British Vs. Americans diagnosis on diff disorders
• Are diagnoses way of circumventing other judgments? Ex — that behaviour is immoral or evil?
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Hlthage 1CC3 Exam Notes
• Ex: Psychopathy — Is it bc you’re a criminal or actually mentally ill
• How can we verify them? There’s no test (blood, urine, etc) to confirm diagnosis
Alternative Definitions of Mental Disorder
• Significant and involuntary deviations from what’s considered “normal” behaviour in a certain group/
culture/society
• Deviance; any act/behaviour that violates social norms w/given social system & interferes w/a person’s
ability to function in society
Disorder or Distress?
• Where’s the line drawn between distress & a disorder? — Often impossible to draw the line
• Subjective; depends on if it’s clinically significant, itself something that’s not objectively measurable
• Greenberg (A psychologist); “there’s no conflict of interest, if I don’t determine clinical significance, I
don’t get paid” — He’s pushed to diagnosis a person
How Common are Mental Disorders?
• 1/3 - 1/2 of ppl report symptoms of mental disorder at one point in life
• An epidemic of psychopathology?
• Recent increases in various disorders, including depression, ADHD, DID, anorexia, OCD,
PTSD, and anxiety
• More astute diagnosis and greater public awareness?
• Less stigma? Real rise? Medicalization?
Psychotic Disorders
Psychosis vs Schizophrenia
• Psychosis: “losing touch with reality” (talks in “psychotic episodes”)
• 2 Diff definitions:
• Schizo is a disease of the brain, involves loss of contact w/reality
• Schizo is a severe mental disorder affecting language, perception, and sense of self
• Symptoms of Schizo:
• Positive (added, it is “acute"):
• Hallucinations (auditory, visual, etc..)
• Delusions (thinking on a mission from God, someone is spying on them, etc…)
• Negative (what’s absent, it’s “chronic”)
• Emotions
• Appetite
• Blunted Affect
• Anhedonia (loss of interest)
• Asociality (isolation)
• Avolition (loss of motivation)
• Alogia (not wanting to talk very much)
• There’s a lot of misdiagnosis w/bipolar disorder in adults & autism in children
• But how separate are they?
• The problem with the word “misdiagnosis” is that we don’t truly know what’s right and wrong
• The “correct” diagnosis is whatever the last diagnosis u got
• Sometimes there might be brain differences, looking at neurotransmitters (more serotonin)
• Globally, more than 5% of pop. hears voices, the Hearing Voices Network is saying to not look at it as a
negative thing, can be projections of unconscious mind or variation of “normal” internal monologue
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Hlthage 1CC3 Exam Notes
• Stress the many positive aspects of hearing voices — creativity, encouragement, etc. And taking
antipsychotics can sometimes take away these “benefits”
• Diff types of delusions
• Paranoia (someone out to get you)
• Being “controlled” by an external force
• Reference (think the news is coded and only meant for them)
• Grandiosity (have powers, on a mission from God)
• Delusions are “fixed false beliefs”, not a very good definition bc…
• Ppl can have false beliefs and not be psychotic (Ex — the earth is flat)
• Fixed beliefs aren’t provable (Ex — religious beliefs)
• Not all problematic beliefs are false (Ex — sometimes the CIA really is watching, or your
partner is cheating on u)
• Cognitive/Disorganize Symptoms
• Shifting topics
• resigning with irrelevant responses
• repeating themselves
• “word salad”
• neologisms
• Bizarre behaviour
• Sometimes motor behaviour
• Inappropriate affect (Ex — Catatonia)
• Classification of Schizo
• How long it existed?
• Reason we don’t have long prehistoric records of schizo is because it’s a new disease
Emil Kraepelin & Eugen Blueler
• Kraepelin: various symptoms been distinct disorder should be grouped together (dementia praecox,
schizo a brain disorder)
• When schizo is diagnosed, usually in ppl in adolescence
• Blueler: didn’t always start in adolescence nor result in dementia, schizo (split mental associations)
• Considered negative symptoms for more important than positive
• Europeans stayed closer to K’s view, Americans drifted more to B’s view
Schizo Epidemiology
• Basically, how often does an illness and its symptoms appear in a certain pop.
• Schizo reportedly found in all cultures across the world, both genders likely to be diagnosed, mostly
between the ages 15-35
• 1% of pop? — Debatable though…
• Hearing voices doesn’t always mean it’s a sign of mental illness, can SOMETIMES be seen as a good/
beneficial thing
• The outcome of schizo in developing countries much better than developed, why?
• Less stigma?
• More fam support?
• More employment?
• Diff approach to care?
Etiology of Schizo
• Lots of stakeholders in this debate:
• Whose fault is it?
• Who can fix it?
• What caused schizo? — the big question
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