Abnormality (11.10 Lecture)

Question 1

what is the criteria for abrnormality?

Answer 1

no one is necessary, no one is sufficient
1. statistical deviance
2. cultural deviance
3. observer discomfort (mental disorder if making people uncomfortable with their behavior)
4. emotional distress (people are distressed by their symptoms)
5. maladaptiveness of behavior (impairs ability to take care of ourselves and function)

Question 2

drawbacks of (1) statistical deviance

Answer 2

• what is the threshold for abnormal?
• super high is not always as bad as super low (ex. chronically happy?)
• is it that uncommon? a study found that 83% of people met the criteria for a mental disorder some time in their life

Question 3

drawbacks of (2) cultural deviance

Answer 3

• how they feel is authentic, sometimes people choose not to conform
• cultures change (homosexuality used to be defined as a clinical disorder)

Question 4

drawbacks of (3) observer discomfort

Answer 4

• ex. psychopathy (antisocial personality disorder) superficial charm but sociopath, they don’t make people uncomfortable but have a mental disorder
• people purposely make people uncomfortable (ex. comedians, leaders–Gandhi, Rosa Parks–bc fighting injust norms)

Question 5

drawbacks of (4) emotional distress

Answer 5

• ex. grief, normal distress (proportionate response)
• ex. mania (emotional high from bipolar disorder) have mental disorder but don’t feel distressed

Question 6

drawbacks of (5) maladaptiveness of behavior

Answer 6

• developmental stage, can’t always take care of themselves (old people and babies) but don’t all have mental disorders
• culture, ex. all-nighter to study, not super adaptive in all contexxts

Question 7

DSM

Answer 7

diagnostic and statistical manual of mental disorders
currently, 5 editions because of updates in research

Question 8

how is mental disorder defined in the DSM?

Answer 8

• clinically significant disturbances in someone’s cognition, emotional regulation, or behavior
• associated with signs of distress and disability in social, occupational, or other important activities

Question 9

what is not considered a mental disorder according to the DSM?

Answer 9

• an expected culturally approved response to a common stressor (ex. the death of a loved one)
• socially deviant behavior (political, religious, sexual_ and conflicts between society and individuals unless deviance is because a dysfunction in the individual

Question 10

looking into major depressive disorder, working backwards

Answer 10

mental disorders: neurodevelopmental disorders, bipolar, depressive disorders, etc.
depressive disorders: disruptive mood, dysregulation disorders, major depressive disorder, etc.

Question 11

what qualifies as major depressive disorder?

Answer 11

at least 5 of the below symptoms must be present during a two week period and be a change from the norm
(consider all of them to be most everyday or a significant change)

Question 12

major depressive disorder symptoms

Answer 12

(at least one of these must be present)
1. depressed mood
2. loss of interest in things that gave you pleasure

3. weight/ appetite change
4. insomnia/ hypersomnia
5. greater agitation/ retardation
6. fatigue/ loss of energy
7. feelings of worthlessness or guilt
8. loss of ability to concentrate
9. recurrent thoughts of death or suicide

Question 13

psychotic delusions

Answer 13

unshakable false beliefs sometimes associated with depression

Question 14

why DSM diagnoses are complicated

Answer 14

• a single disorder can look different across people
• single symptoms can characterize multiple disorders
• diagnoses often co-occur within people (ex. anxiety and depression)

Question 15

a different approach to diagnosis

Answer 15

research domain criteria (RDoC)

Question 16

what is RDoC

Answer 16

• beyond surface-level symptoms (domains of psychological functioning that can break down – systems of mind)
• investigates each domain at various levels of analysis (ex. genes, molecules, behaviors, etc.)

Question 17

factor-base analysis (RDoC)

Answer 17

symptom-based categories (DSM) –> integrated data –> new “constructs” of psychological dysfunction based on data –>
1. negative valence systems “stop sign”
2. positive valence systems “green light”
3. cognitive system
4. social processing system (interact with people)
5. arousal/ regulatory systems (managing energy levels)

Question 18

are mental disorders caused by internal or external causes?

Answer 18

rare that its just internal (one exception): Huntington disease

Question 19

what are mental disorders caused by?

Answer 19

interaction of predisposing risk factors (diathesis) and precipitating event or events (stress)

Question 20

diathesis-stress view of mental disorders

Answer 20

mental disorders are caused by the interaction of predisposing risk factors (diathesis) and a precipitating event or events (stress)

Question 21

diathesis

Answer 21

can be genetic or anything early in life:
- maternal stress
- prenatal exposure to environmental toxins
- prenatal inflection or immune system function
- learned helplessness (hopeless and passive acceptance of events as beyond their control bc of outcomes in the past)
- high level of neuroticism
- all of their interactions

Question 22

stress

Answer 22

high diathesis associated with low external stress –> low likelihood of diagnosis
low diathesis associated with high external stress –> low likelihood of diagnosis
high and high –> high likelihood of diagnosis

Question 23

the diathesis-stress model applied to depression

Answer 23

transporter protein of seratonin, 2 variants (long and short allele) long allele is better at transporting seratonin
(study): assessed genotype, stressful event, and how they interacted. assessed whether they’ve experienced depression in the last year
RESULTS - found that they interactand the effect of one depends on the other

Question 24

benefits of diagnostic labels

Answer 24

• validates what people are experiencing as “real”
• allocates and coordinates resources (ex. NIMH, money for insurance)
• predicting behavior and knowing how to respond (ex. teaching a child with autism)

Question 25

harms of diagnostic labels

Answer 25

overdiagnosis (wanting to overapply label)

Question 26

overdiagnosis

Answer 26

• medical students disease (“i have OCD”)
• tendency to overdiagnose in clinical communities, diagnostic inflation (similar to over-prescribing antibiotics)

Question 27

study on overdiagnosis

Answer 27

patients in experimental group ask doctor’s is anti-depressants is right for them vs. them not asking
RESULTS: for exact same types of patients, more likely to give anti-depressants if ask for them despite little differences in clinical presentation

ADHD is overdiagnosed for young kids (just active, they’re kids)