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MENTAL DISORDERS

MENTAL DISORDERS. Dr Ros Weston Psychology . MENTAL DISORDERS. Stress Diathesis Causation Evolutionary Psychological factors -Culture Biochemistry social factors Neurochemistry

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MENTAL DISORDERS

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  1. MENTAL DISORDERS Dr Ros Weston Psychology

  2. MENTAL DISORDERS • StressDiathesis • Causation Evolutionary • Psychological • factors • -CultureBiochemistry • social factors Neurochemistry • experiences Interactivity between all Culture of these • Social • factors Genes • Biology • Experience DSM IV • Clinical characteristics Advantages • Symptoms Disadvantages • Syndromes Use research • Definitions language to describe/ critically analyse/ evaluate Ethnics Limitations • Is it a form of Schizophrenia or not? MPD? • It a culture bound syndrome? • (Humphreys 1999) • (Berry et. al 1992) • Is it an exotic mental illness • Kora – Chowdley (1998) • Benstein & Gaw (1990) • Tobin (1996) • Running Amok • Knecht (1999) • Westmeyer (1973) • Examples : Hungerford : (1987) • : Hamilton: Dunblane • Columbine School USA (1998) • Anorexia : Holland et al (1988) • Sleep paralysis (Lim, Keh Ming 1996 • Schizophrenia & TV • Differences from Schizophrenia • presence of 2 or more distinct personalities. • It is a personality disorder not a episodic disorder • It is deeply engrained & enduring • It is also known as dissociative identity disorder (Allison& Schwaty) • “it is not various identities but simply multiple identities. • Evidence • Incidence : 1950’s Case study Eve Case Study • 130 cases : an epidemic evidence • M.P.D defence placed on trial 1. Three • Under & Over diagnosis faces of Eve • are patients genuine? 2. Sybil • Iatrogenesis : physical or therapist induced • (Meskey 1992) : leads to social desirability and • demand characteristics 3. Hillside • Hypnosis increase iatrogenic effect. (Sparos, 1995) strangler • Once a personality been given a name it becomes • reality • (Sparos 1985)

  3. Is MPD or Any Mental Illness Culturally Relative? Berry 1992: • Cultural Relativity or Culturally Universal? “Are there local expression of universal disorders?” • Cultural symptoms could be primary rather than cultural overlay • MPD also known as Disassociate Identity Disorder • Berry : Disorders worldwide : MPD; Schizophrenia; Depression; Manic Depression; Dementia; Senility • (Kendall & Hammen, 1995),

  4. Explaining Cultural Differences (Synoptic Issue) • Argument 1 • Suppression – facilitation model • (Weisz, 1987) • Suppressed behaviour will rarely be • seen if a culture expects it not to • happen. • (Social norms & values) • Expected behaviour is rewarded so • will be seen often : expected • behaviour is rewarded therefore it is • facilitated. • (if. US Children & Thai study schoolchildren in text book) • Reducing Cultural Bias • Need to understand language differences • between patients & clinician / therapist • Therapists & clinicians understanding cultural • differences & expression of these • Need to know how far client / patient identifies • with cultural group • Variations of symptoms not accounted for ie. DSM IV or ICD 10. (Ebigro, 1986) • Interpretation of DSM by individual psychiatrists problematic • Gender Bias / Difference (Robin et al) • This has been identified as Alpha & Beta bias in • Amnesia • Alcoholism • Anti – social bias / behaviour • Are these ‘real’ gender, differences or clinician / therapist bias? • Misdiagnosis : Stevens (1987) • There is a lot of misdiagnosis in • developing countries : India (Asia) & • Africa • Afro-Caribbean’s in the UK are 7* more • likely have a diagnosis of schizophrenia • than a white person • Blake, (1973) found evidence of cultural • relatively

  5. Stereotyping : Social Class Bias List Alpha & Beta Bias Here….. MALEFEMALE Umbenhavuer & De Wilts (1978) found • Bias towards poorer people (Social class bias) • Higher social classes have coping mechanism and can afford to pay for therapy, life coach etc. • See schizophrenia “Social Causation Hypothesis” • Social Drift Hypothesis • Bowerman (1981) • Kendall & Hammen, (1995) • Alpha bias exists in relation to “normality” (what is normal?) • This mitigates against women • Suppression – facilitation hypothesis : Men less • likely to seek help than women (Ford & Widiger, 1989)

  6. Causation of MPD

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