Chapter 1: Abnormal psychology, overview and research approaches Flashcards
What is abnormal psychology concerned with?
Understanding the
-nature
-causes
-treatment
of mental disorders.
What are the indicators of abnormality/ that someone has a mental disorders?
-subjective distress: primary indicator
-maladaptiveness
-statistical deviancy
-violation of social standards
-social discomfort
-unpredictability
-dangerousness (to self and others)
What is maladaptiveness?
actions that prevent someone from adapting, adjusting, or participating to different aspects of life.
What is the DSM-5 adapted and modified by?
The American Psychiatric Association
What does DSM stand for?
Diagnostic and Statistical Manual of Mental Disorders
When was the DSM-5 published?
2013
Besides the DSM-5; What other major psychiatric classification system exists?
-World Health Organization’s International Classification of Diseases
-Chapter 5 covers mental and behavioral disorders
What is the DSM-5 definition of a mental disorder?
A syndrome that is present in an individual and that involves clinically significant disturbance in behavior, emotion regulation, and cognitive functioning.
What do we mean by clinically significant “disturbance”?
Disturbances represent dysfunction in biological, psychological, or developmental processes needed for mental functioning
What consequences in life can a mental disorder come with?
Mental disorders are associated with significant distress or disability in social or work life.
What are the advantages of a classification system? 6
-Provide nomenclature
-Provide a common language for clinicians and researchers
-Allow structuring of information in a helpful manner
-Facilitate research
-Health policy planning
-Required for insurance reimbursement (need diagnosis to be reimbursed)
What are the disadvantages of classification?
-Loss of specific info and personal details due to simplification: a specific diagnosis doesn’t always capture everything that’s happening in a patient’s life
-stigma, stereotyping
-negative self-image
What may be the reasons for a general negative attitude and stigma around mental disorders?
-fear, make us feel uncomfortable
-dehumanization of mentally ill people
-helplessness about their situation
-all in their head, so we tend to think they could do something about it if they tried
How can classification lead to a negative self-image?
-we have empathy batteries around distressed people
-but being around them can be distressing for us and pull our mood down
What was determined as not useful to reduce the stigma around mental illness?
A better understanding of the neurobiological causes of mental disorders
How can we reduce prejudicial attitude toward people who are mentally ill?
-contact with mentally ill individuals
-However: studies show interaction may also lead to distress and unpleasant physical reactions
How can culture have an influence on abnormality?
- Culture affects the way abnormality is defined
-Different cultures vary in the way they describe psychological distress
-Culture can shape the clinical presentation of disorders
-culture can influence the forms of psychopathology experienced by people in that culture
What is an example of how different cultures can vary the way in which they define psychological distress?
The indigenous don’t have a word for depression
What is taijin kyofusho?
-Japanese culture-specific syndrome
-translation: fear of interpersonal relations
-symptoms: extremely embarrassed about themselves, fearful of displeasing others with bodily functions or appearances, fear of embarrassing other people with their presence.
Why is it important to understand the number and types of people with diagnosable disorders?
-planning, establishing, and funding mental health services for specific disorders
-understanding the causes of mental disorders in different groups of people
What is mental health epidemiology?
The study of the distribution of mental disorders in a given population
What is prevalence?
number of active cases in a population during any given period of time
What is point prevalence?
the estimated proportion of actual, active cases of a disorder in a given population at a given point in time.
What is 1-year prevalence?
estimate of the number of people who experience a disorder at any point during the entire year.
What is lifetime prevalence?
estimate of the number of people who have had a particular disorder at any time in their lives
What is incidence?
-number of new cases in the population over a given period of time; typically lower than prevalence figures
What is incidence?
-number of new cases in the population over a given period of time; typically lower than prevalence figures
Who was the National Comorbidity Survey Replication done by?
Kesler
What information does the NCS-R give?
Most comprehensive source of prevalence estimates for adults in the USA
What are the most prevalent disorders according to the NCS-R?
anxiety disorders
What are the three most common individual disorders according to the NCS-R?
-major depressive disorder
-alcohol abuse
-specific phobias
-social phobias are also very common
What disorder are people most likely to seek help for?
Major Depressive Disorder
Why aren’t people suffering from alcohol abuse likely to seek help?
they don’t think they have a problem
What is the percentage of people with phobias who seek help?
only 1%
What information does the National Survey on Drug Use and Health provide? (NSUDH)
the most recent information
In what case is comorbidity most likely to occur?
-in serious cases; not mild cases
-the more a condition becomes severe; the more likely it is other conditions are gonna come along
What is the 1-year prevalence of serious mental illness in adults in the USA?
4%
How much do mental and substance use disorders account for in the global burden of disease?
7%
How do people generally react in the face of disease and deciding for treatment?
-Not all people receive treatment
-Most people delay treatment
How are people generally treated?
-many people treated by family physicians
-Vast majority of treatment is done on outpatient basis
For what matters does inpatient hospitalisation usually happen?
Typically in psychiatric units
Why won’t some people seek treatment?
-denial
-stigma
-gaslighting
-so distressed that going through the process is overwhelming
How are inpatients treated?
-different mental health professionals work as a team
-intense treatment (more rapid recovery)
In what cases will you be an inpatient?
-if there is significant impairment
-facilitates treatment because better controlled
How are outpatients treated?
-smaller team
-psychiatrist, psychologist, specialised counsellor.
What are the benefits of research?
Learn about disorders
-symptoms
-prevalence
-duration (acute, chronic)
-accompanying problems
Understand etiology (causes) and nature of disorder
Discover how to provide the best patient care
In what case is a disorder acute or chronic?
-acute: short in duration
-chronic: long in duration
What is the etiology of a disorder ?
the causes of a disorder
What is the main source of information of scientist ?
Case studies
What are case studies?
Detailed accounts of individual patient behavior, based on observation.
What are disadvantages of case studies?
-subject to bias, writer decides what to include and omit
-conclusions have low generalisability (can’t be used to draw conclusions about other cases)
What does it mean that conclusions of case studies have low generalisability ?
can’t be used to draw conclusions about other cases
What are advantages of case studies?
-Can provide insights into unusual/rare clinical conditions
-Can serve as a stimulus for research
Why may self-report data be inaccurate?
-people can lie
-misunderstand the question
-want to present themselves in a certain way
How can we make sure that a self-report is as accurate as possible?
-Have to be in ability to access the information the interviewer is tryna get from them
-Need to make sure the patient is a free and comfortable enough to really have a proper insight
What is direct observation?
outward behavior is recorded by trained observers
How can biological variables be observed in observational approaches?
-Brain imaging (fMRI)
-Transcranial magnetic stimulation
What is clinical research often a mix of ?
Observational and self-report methods
What is a hypothesis often sparked by?
anecdotal accounts and unusual research findings
What is the most effective way of sampling?
Large, randomly selected groups are ideal
What are samples of convenience?
For a example a researcher in a university will sample from university students, which is not representative of the population as a whole
What is external validity?
Extend to which a research study’s findings can be generalised. Conditions in which you do your lab study has to match real-world situations as much as possible.
What is internal validity?
Extend to which a study is methodologically sound
What is a criterion group?
People with the condition being studied
What is the comparison (control) group?
People who do not have the condition being studied but who are otherwise comparable to the criterion group.
What is a correlational research ?
-Studying the world as it is
-Does not involve any manipulation of variables
-Examining naturalistic relations among two or more variables (eg, depression and self-esteem)
What is a positive correlation ?
Two measures vary together in a direct, corresponding manner
What is a negative correlation?
Two measures vary inversely
What is statistical significance?
Probability that the correlation would occur purely by chance
What influences statistical significance?
-strength of correlation
-size of sample
What is effect size?
reflects the size of the association between two variables independent of the sample size
What does effect size 0 mean?
There is no association between variables
What does effect sizes of .20, .50 and .80 mean?
.20= small
.50= medium
.80=large
What is a meta-analysis?
a statistical approach that calculates and then combines the effect sizes from all the studies (each study= one individual participant)
What is the relationship between correlational and causality?
Correlation does not mean causation (third variable problem)
What can’t correlational studies do and what can they do?
-CAN’T prove causal relationships
-CAN pinpoint questions for further research
What is retrospective research?
involve looking back in time: how the patients were earlier and what wet wrong
What is prospective research ?
looking ahead in time: identify high-risk individuals and focus on them before any disorder manifests
What is a longitudinal study?
a study that follows a group of people over time
What is experimental research ?
Allows researchers to draw conclusions about causality and resolve questions of directionality.
In what case is a dependent variable regarded as the cause of the outcome?
If dependent variable changes as independent variable changes, it is regarded as a cause of the outcome.
What is a quasi-experimental research design?
Either expose to success experience or failure experiences.
How is treatment research executed?
Proposed treatment is given to a designated group of patients and withheld from a similar group of patients
In a treatment research how do we choose who gets the treatment and who doesn’t?
random assignment
What is a standard treatment comparison study?
alternative in which two (or more) treatments are compared in differing yet comparable groups.
What is a double blind study ?
Neither the subjects nor the experimenters know who is in the control group.
What is a placebo treatment?
Participants are given a treatment with no effect
What are single-case research designs ?
-case studies used to develop and test therapy techniques within a scientific framework
-same individual studied overtime
-behavior assessed before and after treatment
What is an example of single-case experimental design?
ABAB design:
-(a) collect data, establish baseline
-(b) introduce treatment
-(a) withdraw the treatment
-(b) reinstate treatment
