Chapter 7

Question 1

What is Nosology and one method of classification?

Answer 1

The study of how medicine classifies illnesses
- one method = cause (typically for physical/medical illnesses but difficult with mental)

Question 2

How are mental disorders classified?

Answer 2

According to Symptoms… descriptive/symptom based approach

Question 3

What are two key issues of symptom based classification?

Answer 3

Symptom overlap and Heterogeneity

Question 4

What is symptom overlap?

Answer 4

Some symptoms are common to many mental illnesses, challenge discerning diving lines between different mental disorders

Question 5

What is Heterogeneity?

Answer 5

Individuals with the same diagnosis may have very different symptoms and present differently… wide variety of symptoms for each disorder… DSM criteria only require some of the noted criteria ->makes it difficult to explain behaviours and determine best treatments

Question 6

What is OCD?

Answer 6

A manifestation of anxiety revolving around obsessive and intrusive thoughts
- obsessions = disruptive, anxiety producing thoughts and/or mental images - uncontrollable thoughts
- compulsions = repetitive actions of thoughts performed in order to relieve anxieties
- presence of obsessions, compulsions, or both
- often thought as chronic or persistent, but can be treated
- avoidance

Question 7

What is PTSD?

Answer 7

• typically after single traumatic event (wide range) or repeated trauma over time
• symptoms brought on by trauma

Question 8

What are the symptoms of PTSD?

Answer 8

• dissociative episodes (flashbacks) associated with triggers
• nightmares
  -negative moods
  -sleep disruption
  -tension

Question 9

What are some similarities of OCD and PTSD?

Answer 9

• anxiety
• attempts to avoid triggers
• OCD may manifest after experience of trauma
• similar treatments (CBS and exposure based therapies)

Question 10

What are some differences of OCD and PTSD?

Answer 10

• obsessions and compulsions are very different from flashbacks
• OCD not always triggered by a traumatic incident

Question 11

What is somatic symptom disorder?

Answer 11

Describes individuals who have anxiety and/or a fixation on somatic symptoms… may or may not have a diagnosis for a physical illness that is causing symptoms… ‘excessive and abnormal’ psychological reaction to physical symptoms

Question 12

What is illness anxiety disorder?

Answer 12

Excessive worry about the possibility of becoming ill…

Question 13

How do these disorders around health demonstrate a complex link between physical and mental health?

Answer 13

Who determines when health concerns are excessive = traditionally a clinician but what about patient perspective
- might these diagnoses pathologies people who have medically unexplained illnesses? perhaps there is a real yet unknown medical condition at root of the symptoms?

Question 14

What are the two clinical perspectives about knowledge?

Answer 14

• Positivist Framework
• Constructivist perspective

Question 15

What is the Positivist Framework?

Answer 15

• Scientific knowledge always improving
• mental health/illness as objective and concretely knowable (one reality)
• assumes we will discover the nature of mental health and best way to diagnose and treat

Question 16

What is the Constructivist perspective?

Answer 16

• knowledge is fluid, contingent, contextual
• unanswered questions will not be easily solved or solved at all
• understanding based on social reality
• what is agreed upon is subject to change and consensus reached not by best evidence but culture, scientific trends…

Question 17

If we were to divide a disorder into subtypes what would be the difference?

Answer 17

causes, levels of functioning, treatment options different for each

Question 18

What is symptom dimension approach?

Answer 18

Possible to have several types of symptoms (representing potential subtypes) at varying levels of severity

Question 19

What is a conceptual issue about creating subtype categories?

Answer 19

Not based on empirical evidence but researchers’ assumptions (rationally rather than empirically derived)

Question 20

What is the Yale Brown Obsessive Compulsive scale?

Answer 20

• comprehensive symptom checklist
  -7 types of obsessions
• 6 types of compulsions

Question 21

What is the autogenous vs reactive symptom model?

Answer 21

Autogenous symptoms = self generated triggers (sexual or aggressive thoughts) vs Reactive symptoms- responses to external stimuli (triggers regarding contamination or symmetry)

Question 22

What is the core dimensions model?

Answer 22

• defines dimensions based on symptom theme
• Harm avoidance - thoughts and actions to avoid harm
• Fear of incompleteness - one’s actions or intentions have not been correctly achieved

Question 23

What are two defining symptoms of PTSD?

Answer 23

• hyper-arousal - being highly vigilant and alert
• re-experiencing of events related to the trauma

Question 24

What is PTSD-DS

Answer 24

• Dissociative subtype
• Dissociation - psychobiological defence mechanism where normal integration of consciousness, memory, identity, perception, emotion, body representation, motor control, behaviour is disturbed
• can provide temporary psychological escape in times of extreme trauma or stress
• severity in part due to cognitive impairment with dissociation

Question 25

What are two defining symptoms of PTSD DS?

Answer 25

• Depersonalization - feeling outside one’s body or not belonging to body
• Derealization - feeling things around you are strange and unfamiliar

Question 26

What are the difficulties associated with dissociation and cognitive impairment of PTSD DS

Answer 26

• lower attention, memory, executive function (organizing thoughts, time management, problem solving, decision making)
• poorer social cognition
• poorer treatment response

Question 27

What does social trajectory of a disorder mean?

Answer 27

• how it ‘emerges’ or comes to attention in society
• how it comes to be officially recognized
• is it considered ‘treatable’?