1. Introduction Flashcards
What does psychopathology mean?
Pathology of the mind
What is psychopathology the study of?
Abnormal behaviour
What are the implications of psychopathology?
- Psychologists as scientist-practitioners
- Psychologists as evaluators of science
- Psychologists as contributors to science
What is the first approach to defining psychopathology?
If a behaviour/or way of being causes subjective distress leading to help-seeking behaviour
What is the second approach to defining psychopathology?
If it deviates from expected statistical norm - an experience most people do not have
- How rare should it be?
- Is a rare behaviour necessarily harmful?
- Are common behaviours necessarily unharmful?
What is the third approach to defining psychopathology?
Results from “harmful” dysfunction. A physical or mental mechanism cannot perform its natural/normal function, which causes harm to the person considering the culture which they live. implies: not every such dysfunction leads to disorders
What are functions that could be disrupted?
thoughts, feelings, perception, communication and motivation
what does the DSM-5 rely on?
Heavily reliant on the harmful consequences (either subjective distress or impairment)
what does the DSM-5 utilise?
utilises the notion of a syndrome .
What is the notion of syndrome?
A cluster of associated features that might be recognised by evaluating signs and/or symptoms
Signs
things we observe in others
symptoms?
are reported to us
what is a mental disorder according to the DSM-5?
A mental disorder is a syndrome characterised by clinically significant disturbances in an individual’s cognition, emotion regulation or behaviour that reflects a dysfunction in the psychological, biological or developmental processes underlying mental function
what are mental disorders usually associated with?
significant distress or disability in social, occupational, or other important activities
what are mental disorders NOT associated with?
An expectable or culturally sanctioned response; nor the product of “social deviance or conflicts with society”
According to the DSM-5, a behaviour is NOT a mental illness if the presentation is…?
- An expectable and culturally sanctioned response to a particular event (such as the death of a loved one)
- Socially deviant behaviour (such as the actions of political, religious or sexual minorities)
- Conflicts that are between the individual and society (such as voluntary efforts to express individuality).
What is the effect of culture on mental disorders?
All mental disorders are shaped, to some extent, by cultural factors. But no mental disorders should be entirely due to cultural or social factors. Disorders should occur across cultures. Social and cultural influence is recognised in the DSM-5
How is abnormal behaviour defined in practice?
it is defined in terms of an official classification system - i.e. mental illness is anything defined in the DSM.
What is the DSM-5
A tool for the identification of various “categories” of mental illness; with further specifications of (ideally discrete) illness subcategories
What is the purpose of the categories in the DSM-5?
They are intended to group together similar conditions (although their placement has been subject to change
How is the mental illness identified using the DSM05?
A formula (or prescription) for the identification of mental illness provides for a “common language” for understanding; facilitating efforts such as an understanding of the epidemiology of psychopathology.
When as the most recent DSM-5 released?
2013
What are the imperfections of the DSM?
- Process criticisms (field trials, composition of task force).
- The lowering of diagnostic thresholds
- The introduction of new disorders without a clear scientific basis
- Failure to test/demonstrate validity of diagnostic categories
- Reification of ‘disorders’
- Failure to deliver on the promise of neuroscience
- The reduced ‘reliability’ of many diagnoses
what are the implications of the imperfections of the DSM?
Awaits empirical evidence and is yet to play out but some anticipate that:
- medicalisation and stigmatisation of normative experiences
- diagnostic inflation and false epidemics
What is epidemiology?
The scientific study of the frequency and distribution of disorders within a population
what does epidemiological data tell us?
Tells us which disorders are most common [These data are hard to ascertain (why?): when estimates vary, they need to be reconciled]
What does national and international data suggest about mental illnesses?
it is a staggering health problem
Incidence
the number of new cases of a disorder that appear in a population during a specific time (e.g. per year)
Prevalence
the number of active cases of a disorder in a population during a specific period
lifetime prevalence
total proportion of people from a population who will have a disorder at some point during their lifetime
What are some key studies or surveys that provide benchmark data for mental illness?
– National Comorbidity Survey Replication (NCS-R)
– The World Health Organisation Global Burden of Disease
– Australian Institute of Health and Welfare Surveys (Australian-specific data)
According to the WHO Global Burden of Disease Study (1990; 2004), how many deaths do mental illnesses cause?
1% of deaths
According to the WHO Global Burden of Disease Study (1990; 2004), how does mental illness affect disability?
Accounts for 47% of disability in developed countries and & 28% of disability in un- (or under-) developed countries respectively.
What is the predicted effect of mental health by 2020?
By 2020, mental health problems & mental disorders will account for as much as 15% of the worldwide “disease burden” (mortality plus disability).
how many australians meet the criteria for mental disorders in the last 12 months?
1/5
3 million experience symptoms of a mental disorder each year
45% of all australians between 16-85 will experience a mental health related disorder during their lifetime
Most common conditions?
Depression, anxiety and substance use
Descriptive psychopathology
diagnosis does not imply an understanding of causes of aetiology. A descriptive apporach makes a classification on whether particualr signs and symptoms are present. Most have no defined cause
what infers an effective treatment?
Explanations of abnormal behaviour and mental illness may vary over time and across cultures; leading to different treatments.
What is fever therapy?
To induce ‘fever’, blood from people with malaria was injected into
psychiatric patients
what is the rationale of fever therapy?
Observation that symptoms sometimes disappeared in patients who became ill with typhoid fever
Insulin coma therapy
Insulin injections (producing hypoglycaemia and coma)
Rationale of Insulin coma therapy
Observed mental changes among some diabetic drug addicts when treated with insulin
Lobotomy
Surgical procedure involving cutting nerve fibres to disconnect frontal lobes from the rest of the brain
Rationale of lobotomy
Observed that same surgery in chimpanzees lead to reduced expression of negative emotion during stress
Biological assumptions about human nature
competitive but some altruism
Psychodynamic assumptions about human nature
aggressive, sexua
Cognitive-behavioural assumptions about human nature
neutral abula rasa - refers to the epistemological idea that individuals are born without built-in mental content and that therefore all knowledge comes from experience or perception
Humanitic assumptions about human nature
basic goodness
biological causes of abnormality
neurochemicals and genes
Psychodynamic causes of abnormality
early childhood experiences
Cognitive-behavioural causes of abnormality
social learning
Humanistic causes of abnormality
frustration of society
Biological treatment types
medication and other physical things
Psychodynamic treatment types
psychological therapy
Cognitive-behavioural treatment types
CBT
Humanistic treatment types
non-directive therapy
Biological paradigmatic focus
bodily functions and structures
Psychodynamic paradigmatic focus
unconscious mind
cognitive-behavioural paradigmatic focus
observable behaviour
Humanitic paradigmatic focus
free will
What does an integrative model suggest causes mental illness and the importance of psychosocial factors
interactions between many factors - biological, social, economic, psychological, spiritual and environmental.
These factors exert influence on many different levels - individual, family, community, state, national and global. Some of these factors can be called psychosocial factors which are important determinants of mental health
systems / biopsycholigical / integrative approach
integrates evidence across different fiels of psychology. such evidence may include: genetic, biological, behavioural, emotional, cognitive and social factors.
Diathesis-stress model
mental disorders develop when a stress is added on top of a predisposition (diathesis)
Equifinality
different experiences can lead to the same experience
multifinality
same experience may lead to different outcomes
genetic influences of Karen
inherited overactive sinoaortic baroreflex arc (tendency to overreact to sudden increases in blood pressure, but reducing blood pressure. The possible genetic predisposition to this behaviour as suggested by the diathesis-stress model
biological influences of Karen
light-headedness and queasiness
fainting
behavioural influences of Karen
conditioned response to sight of blood or related stimuli (e.g. words, imagery)
Escape and avoidance of situations involving blood - negative reinforcement
behaviour may be reinforced by responses of family/friends
Emotional-cognitive influences of Karen
increased fear and anxiety - heightened threat response
vigilance to situations
Social influence of Karen
fainting results in disruptions at university and home
friends and family rush to her help
Mental health professions
Psychiatry Psychology social work nursing occupational theroay
Each brings a different perspective. when working together, can enrich understanding of health and wellbeing
Role of GPs
GP as a gateway service
- mental health care plans
- specialist referrals
- treatment provider
86% of mental health related prescriptions (subsidies and under co-payment) were provided by GPs with 8% being prescribed by psychitrists and 6 % by non-psychitist specialists
syndrome
a collection of symptoms that occur together and are assumed to represent a specific type of disorder
diagnosis
the identification of a syndrome as a classifiable disorder
differntial diagnosis
diagnosis aimed at determining which of two or more disorders is present
comorbidity
the presence of two or more disorders in the same individual at the same time; for example, a mood disorder and substance use disorder
epidemiology
the scientific study of the frequency and distribution of disorders within a population
