Ch. 15 - Psychological Disorders Flashcards
What are the 3 + 1 features of disordered psychological functioning?
• The psychological abnormality usually generates distress (anxiety, internal conflict, depression, confusion, etc.) (exceptions exist: antisocial personality disorder, lacking empathy)
○ Disproportionate
○ Prolonged
○ Impairs functioning
• The psychological abnormality involves patterns of behaviour/thought that are unusual/atypical and violate social norms
○ Occurs infrequently in the population (can
be positive or negative)
○ Behaviours must be understood within an
individuals culture (cultural relativism)
• It involves behaviours that are maladaptive or dysfunctional
○ Cognitive, emotional, or behavioural
○ Can be harmful or dangerous (self or others)
+ Diagnosis by a professional (clinical psychologist, psychiatrist) based on recognized criteria (ex. DSM)
Define mental disorder
a persistent disturbance of dysfunction in behaviour, thoughts, or emotions that causes significant distress or impairment
What is the medical model?
an approach that conceptualizes abnormal psychological experiences as illnesses that, like physical illnesses, have biological and environmental causes, defined symptoms, and possible cures
Suggests that the first step is to determine the nature of the problem through diagnosis
Define diagnosis
clinicians seek to determine the nature of a person’s mental disorder by assessing signs and symptoms that suggest an underlying illness
- Signs: objectively observed indicators of a disorder
- Symptoms: subjectively reported behaviours, thoughts, and emotions
What are the 3 general medical classification terms?
- Disorder: a common set of signs and symptoms
- Disease: a known pathological process affecting the body
- Diagnosis: a determination as to whether a disorder or disease is present
What are the two criticisms of the medical model?
- It is inappropriate to use clients’ subjective self-reports, rather than physical tests of pathology, to determine underlying illness
- The model often medicalizes or pathologizes normal human behaviour
Describe the evolution from the DSM to the DSM-5
The DSM (1952) and DSM-II (1968) provided new, common language for talking about disorders, but the diagnostic criteria were quite vague and based on theoretical assumptions
The DSM-III (1980) and DSM-IV (1994) included very detailed lists of symptoms that had to be present for a disorder to be diagnosed
• This led to a dramatic increase in reliability and consistency in diagnosis
The DSM-5 (2013) describes 22 major categories containing more than 200 different disorders
• It also includes conditions that could potentially be included as formal disorders, but that require more research
• There is also a section dedicated to cultural considerations in diagnosis
• Switched to Arabic over Roman numerals (5 vs V) in the hopes that more frequent revisions can be made as we make more rapid advances in our understanding of mental disorders (5.1, 5.2, etc.)
What is epidemiology?
the study of the distribution and causes of health and disease
Describe the World Health Organization World Mental Health Survey Initiative
a large-scale study in which people from nearly 2 dozen countries around the world were assessed for the presence of mental disorders; found that the major mental disorders seen in North America appear similarly in countries and cultures around the world (*except eating disorders)
What are cultural syndromes?
groups of symptoms that tend to cluster together in specific cultures (ex. Taijin kyofusho, a combination of social anxiety and body dysmorphic disorders)
What are cultural idioms of distress?
ways of talking about or expressing distress that can differ across cultures (ex. Kufungisisa, “thinking too much”, is an idiom of distress in Zimbabwe associated with many depressive and anxiety disorders)
What are cultural explanations, when it comes to psychological disorders?
culturally recognized descriptions of what causes the symptoms, distress, or disorder (ex. Many South Asian cultures believe mental disorder is caused by the loss of dhat or dhatu)
What is the International Classification of Diseases (ICD)?
similar to the DSM; hospitals and insurance companies generally use ICD codes because it allowed all countries to work together to track the incidence and treatment of various conditions around the world
What is the biopsychosocial perspective of psychological disorders? What does it suggest about mental illness?
Explains that mental disorders are the result of interactions among biological (genetics/epigenetics, brain/biochemical abnormalities), psychological (coping, interpersonal problems, cognitive bias), and social factors (stressful experiences, cultural inequities, poor socialization)
This perspective suggests that different people can experience a similar psychological disorder for different reasons, and that having multiple causes means there may not be a single cure
What is the diathesis-stress model of psychological disorders?
suggests that a person may be predisposed to a psychological disorder that remains unexpressed until triggered by stress
• Diathesis: one’s internal predisposition (brain structure, hormones, early learning, memory bias, genes, etc.)
• Stress: the external trigger (abuse, onset of physical illness, traumatic event, loss, life change, etc.)
A person who inherits a diathesis may never encounter the precipitating stress, whereas someone with little genetic propensity for a disorder may still come to experience it given the right pattern of stress
What is the Research Domain Criteria Project (RDoC)?
a new initiative that aims to guide the classification and understanding of mental disorders by revealing the basic processes that give rise to them
• Focuses more on basic biological, cognitive, and behavioural constructs that are believed to be the building blocks of mental disorders
• Not intended to immediately replace the DSM/ICD, but to inform future revisions to them
The hope is to shift from studying currently defined DSM/ICD categories and towards studying dimensional biopsychosocial processes
• These processes (fear, anxiety, attention, perception) are referred to as constructs
• Constructs are themselves grouped into broader categories referred to as domains, and there are 6 of them:
1. Negative valence systems
2. Positive valence systems
3. Cognitive systems
4. Systems for social processes
5. Arousal/regulatory systems
6. Sensorimotor systems
Overall goal is to shift the study of mental disorders in line with other medical disorders by avoiding focusing on surface symptoms in favour of focusing on understanding the processes that give rise to disordered behaviour
• A person with chest pain, headaches, fatigue, and shortness of breath doesn’t have chest pain disorder, headache disorder, etc.; they have hypertension
Similarly, a person with an addiction can be seen as having an abnormality in “responsiveness to reward”
Which disorders are included in the category of anxiety disorders in the DSM?
- Phobic disorders
- Panic disorder
- Generalized anxiety disorder
Which 5 categories do specific phobias fall into?
- Animals
- Natural environments (heights, darkness, water, storms, etc.)
- Situations (bridges, elevators, tunnels, enclosed places)
- Blood, injections, and injury
- Other (choking, vomiting, loud noises, costumed characters, etc.)
