Mental Health

Ab/Normal

Context

Cultural

Appendix now has Cultural variations

Global appearance but also looks different

Guilt NOT a large part of Dep. in japan, Iran

Latinos Dep.= headaches

Somatic complaints (sick in heart) not in emotive words

Stima in other countries is great

Duration/persistence

Intensity of pain

Subjective distress

Social deviance

Psych Handicap

Level of functioning

Diagnostic & statistical Manual of Mental Disorders DSM IVRT

Created by Kraeplin in 19th C

Spitzer changed to a checklist of symptoms

Goal:increase Validity

Doctors all use same checklist

Beginning of evidence based practice

Reliability of DSM 4

r

Bi polar .84Depression 64Schizophrenia 65Alcohol abuse 75panic disorder 58Social phobia 47Anorexia 75Over 70 is good reliability

Reliability

Consistent over many tests

Validity

Measures what is suppose to be measured

Social work and the DSM

Pro

Organizes information

Common language

Assessment more efficient

Collective knowledge on problem

Use in non-clinical (awareness/screening)

Con

Just descriptions

assumes universal categories

Ignores social aspect (axis IV helps)

No adress to concerns of social workers

Dependence on category (if no fit no problem)

pathologize behaviour (more power to proffessional)

Disease model of emotional distress

Ignores strengths

Pathologize social norms (Subservient women)

obscures individual differences

Labeling

not useful in treatment plan

dimentional/contextual assessment better

Perspective

Empower or disempower

Subjective or objective reality

intersubjectivity of human expression

Diagnosis not truth that resides within ppl

Categories are social constructions

reflects don't Negate DSM either

Multiaxial Assessment

Axis 1: Clinical disorders

Severe

Psychoic

Mood

Anxiety

Generalized

Specific

Axis 2 Personality Disorders

Personality

Axis 3 General medical Conditions

Axis 4: Psychosocial & environmental problems

Axis 5: Global assessment of Functioning

What is it?

Duration and intesity

Altered thinking mood behaviour

M.I. and physical healh occur together

Economic impact is great

Subtopic

Who?

not all uniform

Community focused

women

youth

Affects families

Subtopic

Subtopic

Bio-Psycho-Social Framework

r

Offers a NO blame theoryMental Illness runs in families

Birth

Predisposing

Onset

Precipitating

Present

Perpetuating

Protecting

Psychological

r

Personality characteristicsCoping mechanismsEmotional/Cognitive development

Biological

r

Systems of bodyInnate characteristicsTempermentHealthPhysical development

Family

r

Events and reltionships within family/extended family.

Social

r

peer groups, community, school, and ethnic factors.