Chapter 5: Diagnosis and Classification of Psychological Problems Flashcards

1
Q

What does psychopathology examine?

A

examines the nature and development of abnormal behaviour, thoughts, and feelings

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2
Q

Definition of psychopathologist:

A

scientists that studies the cause of mental disorders and the factors that influence its development

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3
Q

What do we need to know about the definition of abnormal behaviour?

A

definitions of abnormality vary widely and may not capture all aspects of psychopathology

it is hard to define abnormal behaviour – no one definition is sufficient

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4
Q

Does abnormal behaviour indicate mental illness?

A

Abnormal behaviour does not necessarily indicate mental illness.

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5
Q

What are the 5 characteristics of abnormal behaviour?

A

Disability
Personal Distress
Violation of Social Norms
Dysfunction
Statistical Infrequency

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6
Q

What is the disability characteristic of abnormal behaviour?

A

impairment in a key area

ex. chronic alcohol consumption results in job loss

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7
Q

What is the personal distress characteristic of abnormal behaviour?

A

emotional pain and suffering

ex. helplessness and hopelessness of depression

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8
Q

What is the violation of social norms characteristic of abnormal behaviour?

A

makes others uncomfortable or causes problems

ex. antisocial behaviour of the psychopath

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9
Q

What is the dysfunction characteristic of abnormal behaviour?

A

Biological, social and occupational

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10
Q

What is the statistical infrequency characteristic of abnormal behaviour?

A

suggest that rare behaviours are abnormal

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11
Q

What does the curve in statistical infrequency as a characteristic of abnormal behaviour indicate?

A

Normal curve indicates that some behaviours are common while others are rare

Common behaviours are at the middle of the normal curve

Rare behaviours fall at the tails of the curve

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12
Q

What are the 3 definitions of abnormal psychology?

A

Statistical Infrequency or Violation of social norms

Subjective distress

Disability, Dysfunction or Impairment

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13
Q

What is the Definition Abnormal Psychology: Statistical Infrequency or Violation of Social Norms?

A

Person whose behaviour is deviant or non-conforming is likely to be noted as “abnormal”

Normal curve indicates that some behaviours are common while others are rare

Common behaviours are at the middle of the normal curve

Rare behaviours fall at the tails of the curve

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14
Q

What are the advantages of the definition statistical infrequency or violation of social norms?

A

Cutoff Points: Has cutoff marks that are quantitative (a low score can be compared to the cutoff point). Ex: Used to compare psychological test scores (above the cutoff is clinically significant).
- Can be established and used

Intuitive Appeal: Behaviours that we consider abnormal would be judged as abnormal by others.
- We tend to think we know abnormal behaviour when we see it

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15
Q

What are the problems of the definition statistical infrequency or violation of social norms?

A

Choice of Cutoff Points: onformity criteria are limited as it is difficult to establish cutoff points. Very few guidelines on how to form cutoff points. Shouldn’t categorize every abnormality as deviant.
- How to decide?

The Number of Deviations: How many deviant behaviours are needed to earn the label “deviant”?
- Number of deviations required

Cultural Relativity: What is classified as deviant for one group, is not deviant for another. Also some behaviors that are appropriate at one developmental stage may be inappropriate at another (focus on comparison to same-age peers and not all-peers).
- Deviance differs for different groups

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16
Q

What is the Definition Abnormal Psychology: Subjective Distress?

A

Subjective feelings and sense of well-being of the individual (ex. Feeling happy, sad, troubled…)

Behaviours that are accompanied by distress are abnormal

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17
Q

What are the advantages of the definition subjective distress?

A

Individuals are aware of their emotional experiences and can express them: harder for children.

Seems reasonlable to expect that person can assess whether or not s/he is experiencing distress

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18
Q

What are the problems of the definition subjective distress?

A

Labelling someone as maladjusted only works if their behaviour is specified and their behavioural manifestations are stated.

Can think of a number of exceptions: antisocial Personality Disorders, Manies, Psychosis

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19
Q

What is the Definition Abnormal Psychology: Disability, Dysfunction or impairment?

A

Disability/dysfunction definition argues that impairment of life can be a component of abnormal behaviour

Social: Interpersonal relationships are affected
Occupaitional: Job is disrupted, perhaps even lost
Perosnal: Day-to-day functioning is impaired

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20
Q

What are the advantages of the definition disability, dysfunction, or impairment?

A

Relatively little interference is needed; people seek treatment for social and work problems.

Often prompts people to seek treatment because their normal life is interrupted

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21
Q

What are the problems of the definition disability, dysfunction, or impairment?

A

Judgements regarding social and occupational dysfunction is relative not absolute (no standard)
- There are self-report inventories and interviews to assess work and social functioning.

In how many domains of functioning must you see problems? (1,2,3, more?)

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22
Q

Definition of mental illness?

A

The syndrome (cluster of abnormal behvaiours) must be associated with distress, disability, or increased risk of problems

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23
Q

A mental disorder is considered to represent?

A

a dysfunction within an individual

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24
Q

Are all deviant behaviour or conflicts in society are indicative of a mental disorder?

A

Not all deviant behavior or conflicts in society are indicative of a mental disorder (ex: cultural, religious…)

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24
Are all deviant behaviour or conflicts in society are indicative of a mental disorder?
Not all deviant behavior or conflicts in society are indicative of a mental disorder (ex: cultural, religious…)
25
Definition of diagnosis?
The classification of disorders by symptoms and signs
26
Advantages of diagnosis?
Communication Enables and promotes empirical research Research on etiology possible Diagnosis suggests treatment
27
What do diagnostic systems assume?
Diagnostic systems assume that abnormality can be detected and classified by clusters of symptoms and signs
28
What does each cluster in the diagnostic system reflect?
Each cluster is thought to reflect a different disorder Each cluster may requir a different treatment
29
When was the DSM-I published?
1952
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What does the DSM-I consist of?
Glossary Used term "reaction"
31
When was the DSM-II published?
1968
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What does the DSM-II consist of?
Attempted to be more theory-neutral Encouraged multiple diagnoses
33
When was the DSM-III published?
1980
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What does the DSM-III consist of?
Defined mental disorder Descriptive approach/criteria sets Etiology unknown Narrowed definition of schizophrenia Broadened defined of affective disorder Multiple diagnoses allowed on Axis I and II
35
When was the DSM-III-R published?
1987
36
When was the DSM-IV published?
1994
37
How many axis are there is DSM-IV?
5
38
What is Axis I of the DSM-IV?
All clinical disorders and other conditions (except personality disorder and mental retardation)
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What is Axis II of the DSM-IV?
Personality disorders and mental retardation
40
What is Axis III of DSM-IV?
General medicine condition that are relevant to the treatment of Axis I and II
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What is Axis IV of DSM-IV?
Psychosocial and environmental problems
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What is Axis V of the DSM-IV?
Global assessment of Functioning (GAF) score on scale of 1-100
43
What edition is the DSM-IV-TR?
4th edition, text revision
44
Who was the DSM-IV-TR published by?
American Psychiatric Association (APA)
45
What is meant by the DSM_IV-TR is a multi axial system?
Diagnosis based on 5 axes or dimensions Complete diagnostic evaluation; clients are evaluated on 5 domains
46
What were the changes in the DSM-IV-TR based on?
Changes made in DSM-IV-TR was based far more on empirical data than was previous versions
47
What are the selected Axis I Diagnostic Criteria's?
Disorders usually first diagnosed in infancy, childhood, or adolescence (Learning Disorders & Pervasive Developmental Disorders) Substance-related problems (Alcohol-related and Amphetamine-Related disorders) Schizophrenia and other Psychotic Disorders Anxiety Disorders (panic, generalised, OCD) Mood Disorders (major depressive and bipolar disorders) Eating disorders (anorexia and bulimia nervosa)
48
4 main improvements of the DSM-IV-TR?
Specific diagnostic criteria More extensive descriptions Increasing number of diagnostic categories Issues and possible diagnostic categories in need of further study
49
DSM-IV-TR; What was improved regarding specific diagnostic criteria?
less vague, more explicit and concrete than DSM-II
50
DSM-IV-TR: What was improved regarding more extensive descriptions?
Essential features Associated features (e.g. lab findings) Differential diagnosis
51
DSM-IV-TR: What was improved regarding increasing number of diagnosis categories?
Comorbidity - the presence of one or more disorders
51
DSM-IV-TR: What was improved regarding increasing number of diagnosis categories?
Comorbidity - the presence of one or more disorders
52
DSM-IV-TR: what was improved regarding issues and possible diagnostic categories in need of further study?
Caffeine withdrawal or premenstrual dysphoric disorder
53
Culture can influence?
Risk factors Types of symptoms experienced Willingness to seek help Availablity of treatments
54
What are the 5 factors regarding DSM-IV-TR Cultural Formulation?
Cultural identity of the client Cultural explanations of the client’s problems Cultural factors related to the psychosocial environment Cultural influences on the relationship between the client and the mental health professional Overall cultural assessment for diagnosis and care:
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What to consider in regards to Cultural identity of the client
Note the client’s ethnic or cultural reference groups as well as language abilities and preferences
56
What to consider in regards to Cultural explanations of the client’s problems
Note how the idneitide cultural group might explain the present symptoms and how these symptoms compare to those expericned by those in the cultural reference group.
57
What to consider in regards to Cultural factors related to the psychosocial environment
Note how the cultural references group might interpret the social stresses, as well as availability of social supports and other resources that may aid treatment
58
What to consider in regards to Cultural influences on the relationship between the client and the mental health professional
Indiciate differences in cultural and social status between the client and mental health professioanl that might infleunce diagnosis and treatment
59
What to consider in regards to Overall cultural assessment for diagnosis and care:
Summarize how culutral facors and considerations are likely to influence the assessment and treatment of the client
60
Difference between categorical and dimensional systems?
Categorial: presence/absence of a disorder - advantages for research understanding Dimensional: rank on a continuous quantitate dimension - may better capture an individual's functioning
61
What is inter-rater reliability?
The extent to which clinicians agree on the diagnosis
62
Is reliability in everyday settings lower or higher than in formal research settings?
Reliability in everyday settings may be lower than in formal research settings
63
What is construct validity?
A construct is an abstract concept or inferred attribute Involves correlating multiple indirect measures of the attribute Important method for evaluating diagnostic categories
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What are the 5 general issues in classification?
Categories vs. dimensions Bases of Classification Description and Coverage Validity Bias
65
What are the 6 major models of psychopathology?
Biological Developmental Psychodynamic Learning Cognitive Humanistic
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What is the Diathesis-Stress Model?
Diathesis = predisposition or vulnerability Stress = external/environmental factors The combination of a genetic predisposition and an external stressor may produce psychological problems
66
What is the biological model of psychopathology?
Process in central nervous system (CNS) have gone awry
67
Example of the biological model of psychopathology?
Schizophrenia is caused by an excess of dopaminergic activity
68
What is the developmental psychopathology model of psychopathology?
Maladjustment arises from a distortion in the path or trajectory in healthy adaption; maladjustment is due to interactions between the individual and their environment
69
Example of the developmental psychopathology model of psychopathology?
Depression is caused by interpersonal stressors that make it hard to learn appropriate coping skills, and depression cyclically leads to later additional interpersonal stressors
70
What is the psychodynamic model of psychopathology?
intrapsychic conflict
71
Example of the psychodynamic model of psychopathology?
Specific phobia is due to the displacement of an intrapsychic conflict onto a external object that can be avoided
72
What is the learning model of psychopathology?
Learned that same way normal behaviour is learned
72
Example of the learning model of psychopathology?
Specific phobic phobia is learned via classical conditioning
73
What is the cognitive model of psychopathology?
Due to maladaptive cognitions
74
Example of the cognitive model of psychopathology?
Depression results from negative views about oneself, the world, and the future
75
What is the humanistic model of psychopathology?
Relative neglect of one's own self-view and over reliance on the appraisals of others when the two are incongruous
76
Example of the humanistic model of psychopathology?
Generalised anxiety disorder reflects this over-reliance and incongruity
77
What are criticism of classification?
Stigma against those classified with a mental illness (treated differently by others, difficulty finding a job) Categories do not capture the uniqueness of a person (the disorder does not define the person) Classification may emphasise trivial similarities (relevant information may be overlooked)
77
What are criticism of classification?
Stigma against those classified with a mental illness (treated differently by others, difficulty finding a job) Categories do not capture the uniqueness of a person (the disorder does not define the person) Classification may emphasise trivial similarities (relevant information may be overlooked)