The Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) was released at the American Psychiatric Association’s Annual Meeting in May 2013
American Psychiatric Association DMS-5 Development:
5.1 Abnormal psychology: concepts of normality p. 136-147
Chris Crocker – What is “normal”?
- Cultural considerations in diagnosis
The video below looks at the changing attitudes in China toward homosexuality. The Chinese government declassified homosexuality as a mental illness in 2001. Compare this to the DSM IV (Diagnostic & Statistics Manual), which declassified homosexuality in 1980. Watch the video and feel free to post any responses.
Here is an interesting video (partially in Dutch) which introduces you to Hikokomori in Japan:
- Use the link below and know two culture-bound syndromeso that you could describe in basic detail in order to use it in a future essay. Until next class Tuesday week 38 present to the class:
5.2 Abnormal psychology: psychological disorders p. 148-165
1. Welcome to the Psychiatric Hotline.
If you are obsessive-compulsive, please press 1 repeatedly.
If you are co-dependent, please ask someone to press 2.
If you have multiple personalities, please press 3, 4, 5, and 6.
If you are paranoid-delusional, we know who you are and what you want. Just stay on the line so we can trace the call.
If you are schizophrenic, listen carefully and a little voice will tell you which number to press.
If you are depressed, it doesn’t matter which number you press. No one will answer.
2. In a psychiatrist’s waiting room two patients are having a conversation. One says to the other, “Why are you here?”
The second answers, “I’m Napoleon, so the doctor told me to come here.”
The first is curious and asks, “How do you know that you’re Napoleon?”
The second responds, “God told me I was.”
At this point, a patient on the other side of the room shouts, “NO I DIDN’T!”
Watch in class: Clip from One flew over the cuckoo’s nest
Affective disorders: major depressive disorder
Powerpoint: Major Depression
Great video and fantastic lecturer: Stanford’s Sapolsky On Depression in U.S. (Full Lecture)
Horizon Special: How Mad Are You?
The Question of Diagnosis. Rosenhan replicated? Sort of. This is a very cool series from BBC on mental illness. Take a look and feel free to comment.
Read the article Why Are So Many Women Depressed? (will discuss it in class)
(relates to the learning outcome: Discuss cultural and gender variations in prevalence of disorders)
Info about depression world wide:
Beck’s six types of faulty thinking
Article: Ethnic and Sex Differences in Suicide Rates Relative to Major Depression in the United States
More on the etiology of major depressive disorder regarding the biological factors:
Depression’s Evolutionary Roots
Two scientists suggest that depression is not a malfunction, but a mental adaptation that brings certain cognitive advantages:
PTSD – Post Traumatic Stress Disorder
PTSD: an anxiety disorder
EATING DISORDER (not taught this year)
WHAT IS BULIMIA?
Etiologies of bulimia nervosa:
5.3 Abnormal psychology: implementing treatment p. 166-181
History of treating psychological disorders (or strange behaviour)
one example is trephining (or trepanning) which invloves cutting a hole in the patient’s skull, believing that it would release the “evil spirit” or what ever they thought was causing the patient’s change in bevaiour.
The picture above comes from http://www.medhist-hbg.se/page/Bildgalleri-fran-museet.aspx Medicinhistoriska Museet in Helsingborg. Badkaret med täcke användes på S:ta Maria sjukhus på 1930-talet vid behandling av mycket oroliga patienter. Dessa fick ligga i 36-gradigt vatten upp till 12 tim.
DPs: We will visit the museum on Monday the 12th of November and get a guided tour.
Below is a very interesting article by Irving Kirsch, about the antidepressant myth:
Antidepressants: The Emperor’s New Drugs?
Posted: 1/29/10 01:35 PM ET
Antidepressants are supposed to be the magic bullet for curing depression. But are they? I used to think so. As a clinical psychologist, I used to refer depressed clients to psychiatric colleagues to have them prescribed. But over the past decade, researchers have uncovered mounting evidence that they are not. It seems that we have been misled. Depression is not a brain disease, and chemicals don’t cure it.
My awareness that the chemical cure of depression is a myth began in 1998, when Guy Sapirstein and I set out to assess the placebo effect in the treatment of depression. Instead of doing a brand new study, we decided to pool the results of previous studies in which placebos had been used to treat depression and analyze them together. What we did is called a meta-analysis, and it is a common technique for making sense of the data when a large number of studies have been done to answer a particular question.
It is rare for a study to focus on the placebo effect–or on the effect of the simple passage of time, for that matter. So where were we to find our placebo data and no-treatment data? We found our placebo data in clinical studies of antidepressants. All told, we analyzed 38 published clinical trials involving more than 3,000 depressed patients. What we found came as a big surprise. It turned out that 75 percent of the antidepressant effect was also produced by placebos – sugar pills with no active ingredients that are used to control the effects of hope and expectation in clinical trials. In other words, most of the improvement seen in patients given antidepressants was a placebo effect.
Worse yet, it seemed that even the small seeming drug effect might have really been a placebo effect. These studies were supposed to be double-blind. That means that neither the patients nor their doctors were supposed to know whether they had been given the real drug or a placebo. As it turned out, most of them were able to figure out which they were given, especially those who had been given the real drug. Antidepressants have side effects, and when a patient experiences these side effects, they know that they are in the drug group rather than the placebo group. That knowledge could be responsible for the small apparent advantage of drug over placebo.
As you might imagine, our study was very controversial. How could these drugs, which account for about 15 percent or all prescriptions in the US, be placebos? The antidepressants we studied had been approved by the FDA. If they were just placebos, why did the FDA approve them?
To answer these questions, my colleagues and I used the Freedom of Information Act to get the data that the drug companies had sent to the FDA in the process of getting their medications approved. What we found was even more shocking that what our 1998 study had shown. The difference between drug and placebo was even smaller in the data sent to the FDA than it was in the published literature. More than half of the clinical trials sponsored by the pharmaceutical companies showed no significant difference at all between drug and placebo. What they did find was differences in side effects, like nausea and sexual dysfunction, produced by antidepressants; and the FDA later determined that SSRIs, the most common type of antidepressants, actually increases the risk of suicide for children, adolescents and young adults.
So why did the FDA approve these drugs? All they require is that there are two trials showing a statistical difference between drug and placebo. The drug company might have conducted 10 trials, and most have them might have failed to show positive results. Still, if there are two trials that have been successful, the antidepressant can be approved. And even in these two successful trials, it doesn’t matter how large the drug effect is. It can be small enough to make no real difference in people’s lives. It doesn’t have to be clinically significant; It just has to be statistically significant.
Fortunately there are alternatives to treatment with dangerous but largely ineffective drugs. Psychotherapy works, and some types of therapy have been shown to be much more effective than antidepressants over the long run. Physical exercise also works, and at least for mildly depressed people, there are self-help books like David Burns’s Feeling Good, that have been tested in clinical trials and found to be effective. So if you’re feeling blue, you may not have to take pills to get better. Instead, talk to your doctor about safer and more effective alternative treatments.
Irving Kirsch is Associate Director of the Program in Placebo Studies and a lecturer in medicine at the Harvard Medical School and Beth Israel Deaconess Medical Center. He is also a professor emeritus of psychology at the University of Hull, United Kingdom and the University of Connecticut in the United States. Irving is also the author of “The Emperor’s New Drugs: Exploding the Antidepressant Myth” (Basic Books, 2010).
11 Writing papers in psychology: SAQs and essays p. 381-387
Test: Paper 2 Option 1