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Abnormal Psychology > Classification System (Week 2) > Flashcards

Classification System (Week 2) Flashcards

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1
Q

Supernatural Tradition: Part 1

A
  • Causes included demonic possession, witchcraft, sorcery (e.g. 14th + 15th century Europe, Salem witch trials US).
  • BUT also some belief in ‘stress’
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2
Q

Supernatural Tradition: Part 2

A
  • Mass hysteria (St. Vitus’ dance or Tarantism – 14C-17C) i.e. many people simultaneously acting strangely! (“dancing”) Insect bites? Emotion contagion?
  • Treatments included exorcism, torture, beatings & crude surgeries.
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3
Q

Supernatural Tradition: Part 3

A

Other worldly causes:
•Movement of the moon and stars affect psychological functioning
•Paracelsus (Swiss German physician, botanist, astrologer) and lunacy = lunatic; “It must have been a full moon”

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4
Q

Biological Tradition: Part 1

A

•Hippocrates (460-377BC): Abnormal Behaviour
as a Physical Disease (disease, brain pathology, genetics!)
•Galen (129-198AD) extends Hippocrates Work
•Humoral theory of mental illness: imbalance of 4 bodily fluids – blood (heart), black bile (spleen), yellow bile (liver), phlegm (brain)
•Treatments remained crude e.g. environmental regulation, bloodletting

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5
Q

Biological Tradition: Part 2

A
  • Ancient Greece
  • Hysteria (medical problem with no apparent physical cause e.g. paralysis)
  • “The Wandering Uterus”*
  • Galenic-Hippocratic Tradition
  • Linked abnormality with brain chemical imbalances
  • Foreshadowed modern view
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6
Q

Biological Tradition: Part 3

A
  • General Paresis and Syphilis – 19th C
  • STD with psychosis-like symptoms e.g. delusions (especially persecutory and grandeur), hallucinations
  • Pasteur: a bacterial micro-organism entering the brain; STD
  • Led to penicillin as a successful treatment
  • Bolstered the view that mental illness = physical illness
  • Provided a biological basis for madness
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7
Q

Consequences of Biological Tradition

A

The 1930’s:
• Biological treatments were standard practice
• Insulin shock therapy, ECT (shock therapy – causes
convulsions), brain surgery
The 1950’s:
• Medications increasingly available
• Neuroleptics (i.e.reserpine) & major tranquilisers e.g.
Valium
• Medication still often the first point of call in NZ

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8
Q

Psychological Tradition: Part 1

A
  • Already identified by Plato, Aristotle – Ancient Greece
  • The Rise of Moral Therapy 18C
  • Not “moral” in the usual sense of the word, but psychological or emotional
  • Key tenet: Treating patients ‘normally’, encouraging social interaction, focus on relationships, individual attention, education
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9
Q

Psychological Tradition: Part 2

A

•Philippe Pinel (1745- 1822) & Jean-Baptiste Pussin
(1746-1826) in Paris, France
•William Tuke (1732-1822) – Followed Pinel’s lead in
England
•Benjamin Rush (1745-1813) – Led reforms in the USA
•Dorothea Dix (1802-1887) in US – Led mental hygiene
movement; but unfortunate consequences – increase
in number of patients, inadequate staffing…so more
into custodial care
•And then shift in19C – cause is brain pathology and
incurable?

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10
Q

Psychological Theories: Freud (1856-1939)

A

Psychoanalysis: unconscious mind, id/ego/superego, defence mechanisms, psychosexual stages of development
•Key tenet: Adult personality and problems reflect childhood experiences/ trauma
•Treatment: Talk therapy, free association,
dream analysis, transference and countertransference

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11
Q

Psychological Theories: Erikson (1902-1994)

A

Psychosocial stages of development
•Key tenet: Each stage has particular issues that need to be resolved
•E.g. 0– 18mths: trust vs mistrust; 3-5yrs: initiative vs guilt
•Particular life tasks or challenges not successfully resolved

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12
Q

Psychological Theories: Rogers (1902-1987)

A

Humanistic psychology:
•Key tenet: People are basically good and strive towards self-actualisation; problems arise when blocked growth occurs

  • Treatment: Talk therapy –warmth, empathy, unconditional positive regard
  • Minimal therapist directives
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13
Q

Psychological Theories: Part 1

A

•Behavioural psychology (early 20C)
•Key tenet: All behaviour may be learned
—Conditioning & Cognitive Processes
•Respondent & operant learning (Pavlov, Thorndike, Skinner)
•Learned helplessness
•Modelling, observational and social learning (Bandura)

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14
Q

Psychological Theories: Part 2

A

—Cognitive theories
—Tenet: Focus on how we make senseof what happens to us
—Treatment
•Wolpe – Systematic desensitisation
•Lazarus – Multi-modal behaviour therapy
•Beck – Cognitive therapy, Ellis – REBT
•CBT
•ACT
•Behaviour Therapy
•Tends to be time-limited, direct, here-and-now focused
•Behaviour therapies have widespread empirical support

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15
Q

Concept of Multiple Causations: Part 1

A

One-dimensional models:
• Explain behavior in terms of a single cause: reductionist
• Could mean a paradigm, school, or conceptual approach
• Problem - other information is often ignored! Reductionist

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16
Q

Concept of Multiple Causations: Part 2

A

Multi-dimensional models:
• Interdisciplinary, eclectic & integrative
• “System” of influences that cause & maintain suffering
• Predisposing (underlying; set the stage) and
Precipitating (immediate trigger or precipitant) causes (+
Perpetuating factors)*
• Uses information from several sources
• Abnormal behaviour as multiply determined; various theoretical perspectives may explain different components
• Principle of equifinality (a disorder may have a number of
causes)

17
Q

The Diathesis-Stress Model

A

•Genetic contribution – psychological disorders?
•But many genes may act together, and may be
influenced by the environment
•Eric Kandel and Gene-Environment Interactions
•The Diathesis-Stress Model (stress vulnerability
model)
•Individuals inherit certain vulnerabilities/tendencies
(diathesis) that make them more susceptible to a
disorder when the right type of stressor comes along

18
Q

Interaction of Genes and Environment: Part 1

A

Reciprocal Gene-Environment Model
•Individual’s genetic vulnerability towards a disorder may make it more likely that they will experience the stressor(e.g. because inherit particular personality traits) that in turn, triggersthe genetic vulnerability and thus the disorder
•Possible examples: depression; divorce (particular traits + environment)
e.g. rumination; impulsivity, short-tempered

19
Q

Interaction of Genes and Environment: Part 2

A

Environmental influences may override genetic influences
e.g. immediate effects of environment, such as early stressful experiences (or opposite), impact cells that can turn certain genes on or off (e.g. kids with parents with schizophrenia adopted into functional families with high quality parenting)
NB: concept of critical time periods.

20
Q

Neuroscience Contributions: Part 1

A

The role of the nervous system in disease and
behaviour
• Role of neurotransmitters (biochemicals
released from one neuron and transmitting
impulse to another neuron) e.g. serotonin,
dopamine (look at relative excess or deficiency)
and neuroendocrine activity (e.g. thyroid).

21
Q

Neuroscience Contributions: Part 2

A

• Can change brain structure and function (e.g.
studies have shown that therapy/trauma/stress
can lead to changes in brain functioning)
• Core concept: mind body connection e.g. PTSD;
psychosocial dwarfism

22
Q

Socio-Cultural Theorists

A
  • E.g. anorexia among young, white women in industrialised nations
  • E.g. insect phobia (W); alcoholism (M); depression (W); anxiety
  • Thus ask: To what extent do cultural expectations or gender roles affect the expression of MH issues? i.e. may not be the cause, but influences the form and content of a disorder
23
Q

Assessment: Interviews : Part 1

A
  • Process of gathering info by talking to them!
  • Clinical interview – either structured or unstructured
  • Structured e.g. DSM interview or MSE
  • Unstructured
  • Usually begins open-ended
24
Q

Assessment: Interviews : Part 2

A 
History of the problem
• Safety concerns
• Medical/psychiatric history
• Current medication
• Previous support
• Treatment history - effective?
• Interpersonal & social functioning; cultural factors
• Educational & occupational history
• Stressors
• Resilience
25
Q

Mini-Mental Status Examination

A
  • Appearance and behavior e.g. hygiene, averts gaze, lethargic
  • Thought processes e.g. rate of speech, coherence, content
  • Mood (feeling state) and affect (observed) e.g. depressed mood but laughing; blunted or flat
  • Intellectual functioning
  • Sensorium (awareness of surroundings)
26
Q

Psychological Testing

A

Psychological Testing- Must be reliable and valid
÷Beck Depression Inventory (BDI-II; Beck, 1996) which measures the severity of depression
÷Beck Anxiety Inventory (BAI; Beck, 1990) which measures the
severity of anxiety symptoms

27
Q

Assessments: Tests

A

Cognitive tests e.g. assist in diagnosis –cognitive deficit/giftedness, different disorders reflect in different ways
•Projective tests: based on assumption that people’s response to and interpretations of ambiguous stimuli
reveals important aspects of themselves
•E.g. Rorschach test, TAT*, drawing tests, sentence completion tests

28
Q

Medical Check up: Part 1

A

Physical Exam VERY IMPORTANT, EG, TO RULE OUT:
•Problems presenting as psychological (behavioural, cognitive or mood) may be related to the effects of:
• Medication/drugs e.g., “drug cocktail” of prescription medication in the elderly; cocaine withdrawal - panic attacks
• Medical condition e.g. brain tumour - psychotic symptoms - delusions or hallucinations; thyroid difficulties (GAD, depression)

29
Q

Medical Check - Up: Part 2

A

•Diagnose or rule out physical etiologies
• Toxicities
• Medication side effects
• Allergic reactions
• Metabolic conditions
Neuroimaging - Pictures of the brain that examine its structure & function (expensive, still advancing)

30
Q

Diagnoses / Assessment

A

To distinguish different syndromes. What client has in common with others –useful for treatment planning, prognosis, understanding.

Process of gathering information about a client in order to make a diagnosis. Individual –critical for full understanding.

31
Q

Diagnosing Psychological Disorders

A

Clinical Assessment vs Psychiatric Diagnosis:
• Assessment - Idiographic approach (Interested in what is unique about an individual)
• Diagnosis - Nomothetic approach (Interested in naming or classifying in terms of a general
class of problems)
• Both are important in treatment planning & intervention

32
Q

DSM-5-TR (2022)

A

Widely accepted system psychiatrists and other
mental health professionals (however…..)
—Used to classify psychological problems and
disorders e.g. depression, anxiety, psychosis
—DSM contains diagnostic criteria for behaviours
that
¡Fit a pattern (set of symptoms and signs)
¡Cause dysfunction or subjective distress
¡Are present for a specified duration
¡And for behaviours that are not otherwise
explainable

33
Q

Updated DSM - 5 - TR (2022)

A 
•Prolonged grief disorder as a condition
•Reinstate unspecified mood disorder 
•Added non-suicidal self-injury.
•Acknowledgement of the historical 
role of racial discrimination in clinical 
diagnoses
•Updated language to promote 
inclusivity for People of Colour and marginalized groups.
•Emphasis om gender-inclusive language
34
Q

Criticism of the DSM: Part 1

A
  1. Comorbidity; ‘fuzzy’ boundaries between disorders
  2. Lack of biological markers, but DSM5 more medical model/disease entity – initially, DSM1 used the word ‘reaction’ e.g. depressive reaction, to reflect that diagnoses aren’t diseases entities in themselves but reactions to psychological, social, and biological factors
  3. Medical model orientation –pathologizing and possibly disempowering
  4. Emphasize reliability, sometimes at the expense of validity
35
Q

Criticism of the DSM: Part 2

A
  1. Debate regarding issues with the DSM-5
    ØMore “lenient” criteria (e.g. no. of criteria; refer MDD example)
    ØRefer “Creating a diagnosis” pp. 99-100 e.g.mixed anxiety-depression*
    —Section 3: disorders needing further study e.g.caffeine use, internet gaming, suicidal behaviour DO -
  2. Possible invention rather than discovery of problems/reification
36
Q

Criticism of the DSM: Part 3

A
  1. Definition of mental illness is so wide it embraces
    virtually any problem of thinking, feeling or behaving
    An updated edition of a mental health bible for doctors may include diagnoses for “disorders” such as toddler tantrums and binge eating, experts say, and could mean that soon no-one will be classed as normal.
37
Q

DSM - 5 - TR Disadvantages

A

> . Complexity of categorizing psychopathology –
always a work in progress.
. Labelling, discrimination and stigma – dehumanizing (Read: Girl Interrupted); Identity is lost?
. Can minimize the unique qualities of
individuals’ problems.
. Problem seen as “belonging to” individual – problem
with cultural insensitivity
. Diagnosis seen by some as static – labels stick!

38
Q

DSM - 5 - TR Use

A

Perhaps it’s about:
• People’s attitudes towards mental illness
• Ignorance, lack of education, fear
• Should be seen as a tool (constantly changing), reference
(see preface of DSM)
– cautious and considered use

Abnormal Psychology (5 decks)

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