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10963 results in Psychology: general interest

Page 254 of 549

Abnormal Psychology in Context
  • The Australian and New Zealand Handbook
  • Nadine Pelling, Lorelle Burton
  • Published online:
    06 August 2018
    Print publication:
    01 February 2017
  • Abnormal Psychology in Context is a practical and contemporary handbook for both students of abnormal psychology and allied mental health practitioners. This text is one of the first of its kind, providing a specific focus on abnormal psychology from Australian and New Zealand - rather than US - perspectives. Nadine Pelling and Lorelle Burton have crafted a highly relevant resource, showcasing the most recent Australasian research in a clear format designed for ease of use. Written by leading researchers from Australia and New Zealand, each chapter examines a particular psychological disorder, details symptoms and responses, and includes relevant statistics, case studies, further reading and links to community resources. The chapters give equal weight to Australian and New Zealand experiences in abnormal psychology matters. Succinctly written yet richly detailed, Abnormal Psychology in Context is an essential resource that students can carry from the classroom into the workplace.

  • 2 - Handbook structure

  • from Section I - Rationale, structure, and overview
  • Nadine Pelling, University of South Australia, Lorelle Burton, University of Southern Queensland
  • Book:
    Abnormal Psychology in Context
    Published online:
    06 August 2018
    Print publication:
    01 February 2017, pp 4-5

  • Summary

    This handbook has been purposefully created to focus on Australian and New Zealand (NZ) abnormal psychology research, statistics, and applied practice. This handbook has thus been designed with a specific structure for ease of use. Specifically, after general handbook rationale and structure information is offered, some basic information regarding abnormal psychology and applied practice is provided. This presentation is followed by a brief examination of the cultural and demographic compositions of Australia and NZ and related resources. The bulk of this handbook then examines various psychological disorders. Finally, the handbook concludes with an examination of two psychological practice-related items relevant to abnormal psychology: suicide and non-suicidal self-harm and then mandated or involuntary treatment.

    As noted previously, the bulk of this handbook focuses on various psychological disorders. The disorders examined are those presented in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5; American Psychiatric Association, 2013), and are in the same order as in the DSM-5. The exceptions to this presentation are those disorders for which there was limited Australian- and NZ-based information to justify inclusion in this handbook. Therefore, this handbook examines 17 specific disorders (or areas of treatment foci) whereas the DSM-5 presents a greater number of diagnostic categories.

    For each disorder (or area of treatment focus) examined, a standard organisation has been maintained for presentation. Explicitly, contributing authors have been asked to begin with an introduction to each disorder (or area of treatment focus) including an examination of signs and symptoms, followed by an examination of the presentation of same in Australia and then NZ including incidence and prevalence, and then to present a case example. Cases have been chosen to focus on either an Australian or NZ example, and to comply with ethical standards relating to the presentation of client information for educational purposes (specifically, either a created or composite example is presented). Specific de-identified client material has only been used with the written permission of said client (Australian Psychological Society, 2007). Authors have identified research and practice support information specific to both Australia and NZ. References are provided for readers who wish to explore the topics examined in context in greater detail.

  • 12 - Anxiety disorders

  • from Section III - Disorders and psychological practice related items
  • Nadine Pelling, University of South Australia, Lorelle Burton, University of Southern Queensland
  • Book:
    Abnormal Psychology in Context
    Published online:
    06 August 2018
    Print publication:
    01 February 2017, pp 116-128

  • Summary

    Introduction

    Anxiety disorders are characterised by excessive fear, anxiety, or worry, and are associated with significant distress or impaired functioning. The anxiety disorders are presented here in an order consistent with the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5; American Psychiatric Association, 2013). A brief description of each follows, along with the shared DSM-5/ICD-10 code. However, refer to the DSM-5 for a full description of the diagnostic criteria.

  • • Separation anxiety disorder (F93.0) is characterised by excessive fear or anxiety about separation from particular individuals or from home. Symptoms include excessive distress, worry, or physical symptoms when anticipating or experiencing separation, reluctance to sleep away from home or away from attachment figures, nightmares about separation, reluctance or refusal to go out, or worry about untoward events that would cause separation from attachment figures.

  • • Selective mutism (F94.0) describes a failure to speak in specific situations where it is expected, despite being able to speak in other social situations. This failure is not due to lack of familiarity or knowledge of the language or a communication disorder.

  • • Specific phobia (F40.2) is associated with intense fear or anxiety in the presence of a specific object or situation (code varies according to the specific phobia). Examples include fear of animals (e.g., spiders), blood, or injections, and flying on an aeroplane. Individuals with specific phobia avoid feared stimuli or situations or endure intense anxiety when exposed to them.

  • • Social anxiety disorder (F40.10) involves excessive fear or anxiety of social situations in which an individual may be evaluated. This includes social interactions, performance anxiety, and other situations where others observe an individual and there is the potential for embarrassment or negative assessment. The fear is out of proportion to the threats these situations pose, causes distress, and often leads to avoidance of social situations.

  • • Panic disorder (F41.0) describes recurrent panic attacks, which are intense periods of fear or discomfort that include a range of physical and cognitive symptoms. These symptoms include palpitations, sweating, sensations of shortness of breath or choking, chest pain, nausea, dizziness, and a fear of losing control. They are exacerbated by misinterpretations of these symptoms (e.g., “I'm having a heart attack,” “I'm going to die,” or “I'm going crazy”).

  • 7 - Clinical practice with Indigenous Australians

  • from Section II - Cultural diversity and resources
  • Nadine Pelling, University of South Australia, Lorelle Burton, University of Southern Queensland
  • Book:
    Abnormal Psychology in Context
    Published online:
    06 August 2018
    Print publication:
    01 February 2017, pp 57-62

  • Summary

    Joseph Randolph Bowers

    As an area of enquiry, abnormal psychology tends to focus on mental and emotional disorders and their consequent diagnosis and treatment. Relating to Indigenous Australians, it is important to challenge the conceptual focus on a diagnostic model and the consequent focus on mental disorder treatment. Instead, Aboriginal and Torres Strait Islander peoples tend to focus on the cultural and spiritual aspects of human experience.

    Cultural and spiritual phenomena, including great focus on family and tribal relationships, are essential in the culture of Aboriginal and Torres Strait Islander peoples. If we remember mainstream family norms at the turn of the 19th century, extended families were much more common. Children were raised by their uncles, aunts, and grandparents. The nuclear family of couple and children alone is a recent development. Indigenous culture, by comparison, maintains the centrality of familial bonds that integrates with a “national” identity. In Australia, I have found this is expressed by the sacredness of “country” as both a geophysical place and also as a spiritual space that is connected to Dreamtime within family and blood relations.

    When psychologists – or for that matter, any other helping professional – approach issues of mental health and other phenomena, we need to first take note of our biased and prejudicial positions. You may say, I am not prejudiced! I don't have bias! This is a natural reaction. But when we decode the meaning of bias and prejudice, we begin to realise that our family upbringing, parental influences, sibling relationships, school experiences, learning opportunities or challenges, familial genealogy, cultural, and linguistic background all have a great part to play.

    Many then ask, how are these factors important to my work today? From an Aboriginal and Torres Strait Islander perspective, we say that my identity is not my own. I am my family, tribe, and nation. In other words, I am the sum total of all my experiences – but more than this, my Indigenous social being is of higher value than my identity as a person. In another way of speaking, my identity is my people and my country. Like the Australian song, “We are one, though we are many.”

  • 21 - Neurocognitive disorders

  • from Section III - Disorders and psychological practice related items
  • Nadine Pelling, University of South Australia, Lorelle Burton, University of Southern Queensland
  • Book:
    Abnormal Psychology in Context
    Published online:
    06 August 2018
    Print publication:
    01 February 2017, pp 243-257

  • Summary

    Introduction

    The primary feature of the neurocognitive disorders (NCDs) is a decline in cognitive function. Other conditions such as schizophrenia and depression can have associated cognitive impairment, but for the NCDs it is the defining characteristic (e.g., Laughren, 2011). The name – neurocognitive disorders – arguably hides the fascinating diversity within this disorder class. It includes conditions such as Alzheimer's disease with its long, slow, progressive cognitive decline and uncertain aetiology, and Huntington's disease with its relatively rapid course and clear genetic basis. NCDs primarily affect adults, especially older adults. As the population of Australia and New Zealand (NZ) ages, NCDs are likely to become more prevalent. The NCDs are also not without controversy. Some people question whether they should be classified as a mental disorder (Robles et al., 2015). They are unique in that, unlike other diagnoses in the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5; American Psychiatric Association, 2013), the pathology, and in some cases the aetiology of the conditions, is largely known (Ganguli et al., 2011).

    The hallmark of a person with a neurocognitive disorder is a decline in one or more formally defined areas of cognition. In the DSM-5, these are complex attention, executive function, learning and memory, language, perceptual-motor, or social cognition. The extent of decline separates the two main divisions within this disorder class, of major or mild neurocognitive disorder, as per the following example.

  • • Major NCD refers to disorders previously referred to as dementia or delirium where there is significant decline from previous functioning in one or more of the six areas of cognitive functioning. This decline is: 1. noticeable, it is evident to the affected person (they describe it) or a close other (e.g., a knowledgeable informant); 2. demonstrable, when formally assessed; and 3. impactful, it interferes with the person's capacity to do everyday tasks.

  • • Mild NCD differs in extent only. Mild NCD refers to cognitive difficulties at a level where the person needs to use strategies to function in everyday life.

    • We all experience cognitive decline as we age, so drawing the line between normal and abnormal decline can be difficult. Some consider the threshold suggested by the DSM-5 too low.

  • 25 - Suicide and self-harm

  • from Section IV - Special foci relevant to abnormal psychology
  • Nadine Pelling, University of South Australia, Lorelle Burton, University of Southern Queensland
  • Book:
    Abnormal Psychology in Context
    Published online:
    06 August 2018
    Print publication:
    01 February 2017, pp 290-300

  • Summary

    Introduction

    Suicide, intentional self-harm, and suicidal thinking form a wide spectrum of treatable thought patterns and behaviours. Together suicide and intentional self-harm are often known as “suicidal behaviours” and can be emotionally confronting. Intentional self-harm commonly presents as an event, such as taking an overdose of prescribed tablets or deliberate cutting of the skin. However, it is usually part of an ongoing story with themes that may include past abuse, relationship conflicts, employment difficulties, personal illness and especially mental illness, bereavement, and substance misuse. Intentional self-harm behaviours are usually associated with suicidal thinking or intent of varying frequency, intensity, and chronicity.

    Self-harming behaviours are widely stigmatised. The national identities of both Australia and New Zealand (NZ) include notions that they are healthy and peaceful societies with fewer apparent reasons for despondency than in many other parts of the world. Yet suicidal behaviours are significant problems in both jurisdictions. The topic is a highly emotional subject for many people, reacted to on the basis of simple moral precepts regarding self-conduct and personal responsibility.

    In Australia, about 2500 people die by suicide each year, around 1.7% of all deaths, with an age-standardised rate of 11/100 000 in 2012 (Australian Bureau of Statistics [ABS], 2010). It is the leading single cause of death from age 15–34 years, in 2013 accounting for over one-quarter of all deaths in that age band, and similarly for those aged 35–44 years, accounting for almost 16% of all deaths (ABS, 2015).

    In NZ, each year more than 500 people die by suicide, with an age-standardised rate of 12.2/100 000 in 2012, the most recent year for which official figures are available (Statistics New Zealand, 2016). Suicide deaths in NZ peaked in 1998, with 577 deaths (age-standardised rate of 15.1/100 000; Statistics New Zealand, 2016). In 2012, young adults aged 15–24 years had the highest suicide rates, with males significantly more likely to die by suicide than females (Ministry of Health NZ, 2015a, 2015b).

    Suicide is a topic of great societal concern. Often the deaths themselves are difficult to understand. Every suicide death has significant emotional impacts on friends, family, health professionals, and witnesses, often for many years. While the effects of suicide can be great, it is actually a statistically rare event.

  • 26 - Compulsory treatment

  • from Section IV - Special foci relevant to abnormal psychology
  • Nadine Pelling, University of South Australia, Lorelle Burton, University of Southern Queensland
  • Book:
    Abnormal Psychology in Context
    Published online:
    06 August 2018
    Print publication:
    01 February 2017, pp 301-309

  • Summary

    Introduction

    Self-determination is greatly valued in Australasian society. The primacy given to an individual's autonomy is reflected both in various ethical codes (Australian Psychological Society, 2007; New Zealand Psychological Society, 2012) and in law as it applies to psychological treatment.

    Generally, individuals should not be provided treatment unless they are adequately informed of its risks, its benefits, and the alternatives available to them. Individuals then freely agree to the treatment offered. If a psychologist failed to gain valid consent in this way, and some injury to the client were to result, the psychologist could be open to a claim of negligence (Kerridge, Lowe, & Stewart, 2013). Additionally, it is generally unlawful to restrict the movement of, or even touch, another person without his or her consent.

    In most cases, as long as adults are able to understand the information relevant to a treatment choice, and are able to adequately consider that information, they cannot be forced to have treatment they refuse (Ryan, Callaghan, & Peisah, 2015). This is true even if their refusal will result in their own serious injury or death. This is why, for example, people of the Jehovah's Witness faith can successfully refuse certain medical procedures.

    There are circumstances, however, where the law permits treatment without consent. Some of these circumstances relate to psychological conditions. The laws and ethical considerations that apply in these circumstances are the subject of this chapter.

    Compulsory treatment of severe psychiatric illness

    Each jurisdiction in Australia and New Zealand (NZ) has a mental health Act that sets down conditions under which a person with a serious mental illness may be detained and treated without consent. In the Acts, the definitions of mental illness are described in terms of various symptoms (e.g., delusions, serious disturbance of mood, irrationality). The exact definitions vary between jurisdictions but all are designed to capture not only severe depression, mania, and schizophrenia, but also people temporarily overcome with emotional turmoil, such as might occur in extreme grief.

    As outlined so far, general medical treatment cannot be given to an adult unless the adult has lost the ability to understand and weigh the information relevant to the decision.

Page 254 of 549