CM: Foundations of Psych Flashcards
What is psychiatry and what manifestations of illnesses does it treat?
branch of medicine that deals with mental, emotional, or behavioral disorders
manifest as either subjective disturbance or behavioral dysfunction
What are the Feighner criteria that influenced the DSM III?
clinical description of syndrome (most observable) lab studies delimitation from other disorders follow up studies family studies
What are mental disorders associated with according to the DSM IV?
present distress (painful symptom) or disability or risk of suffering pain, death, disability or imp loss of freedom
What can a syndrome NOT be to be classified as a mental disorder according to the DSM IV?
expectable and culturally sanctioned response to particular event (death of loved one)
deviant behavior or conflict b/w individual and society
MUST be manifestation of behavioral, psychological, or biological dysfunction in individual
What are the benefits of the DSM?
reliable
advantages to research = comparing apples w apples
advantages to clinical practice - drs have common language and pts can ask questions
What are the problems with the DSM?
validity not as good as reliability
high rates of comorbid disorders
heterogeneity w/i same disorders
relies on expert consensus
What are neuroscience discoveries that raised concerns about the DSM?
given disorder might be associated with genetic polymorphisms at many sites
particular mechanism might be implicated in number of different DSM disorders
What are the proposed domains of the RDoC?
negative affect: fear, distress, aggression
positive affect: reward seeking and gratification, learning and habit formation
cognition - attention, perception, memory, executive fxn
social processes - attachment, pair bonding, parenting, facial recognition, etc.
regulatory systems - arousal, sleep, circadian rhythyms
What are the biological correlates of negative affect according to the RDoC?
Amygdala and hippocampus in fear onset, circuits connecting these to the prefrontal cortex in fear response control, and in fear extinction
What are the biological correlates of positive affect according to the RDoC?
mesolimbic dopamine system, orbital frontal cortex, and the ventral and dorsal striatum
What are the biological correlates of cognition according to the RDoC?
parietal areas (attention), thalamic and occipital (perception), dorsolateral prefrontal cortex (working memory/executive function), hippocampus (long term memory), and anterior cingulate (conflict resolution)
What are the biological correlates of social processes according to the RDoC?
oxytocin and vasopressin circuits
What are the biological correlates of regulatory systems according to the RDoC?
reticular activating systems, ventral tegmental area, locus ceruleus
Why is neuroscience not enough to explain psychiatric disorders?
need to consider brain, mind (personal subjective experience), and culture
What is the four perspectives model of psychiatric illnesses?
disease
dimensions
behavior
life story
What is the disease perspective?
begins with abnormal symptoms that form syndrome, then describe pathology, then look for etiology, then target it for Rx
some part of the system is broken
When is the disease perspective most useful?
symptoms quite stereotypical and abnormal (ex: voices in schizo)
symptoms already clearly linked to underlying pathology (alzheimers and plaques)
What is the dimensions perspective and what is the clearest example?
some traits on bell shaped curve - difficulties if off the curve, manifest when social challenges can’t be met
ex = intelligence and mental retardation, (personality)
How does personality apply to the dimensions perspective?
temperament is a matter of degrees
2 axes: introversion-extroversion, neuroticism-stability
What is the introversion-extroversion axis?
relates to type of emotional response people have
extrovert - quick emotional rxns that focus on here and now
introvert - slower rxns that focus on implications for future or past
What is the neuroticism-stability axis?
relates to variation in intensity of emotional response
neuroticism - very strong emotional response
What are the four personality types resulting from the 2 axes?
extrovert-stable: sociable, leaders, easygoing, lively
extrovert-neurotic: restless, impulsive, touchy, excitable
introvert-stable: careful, thoughtful, even-tempered
introvert-neurotic: anxious reserved moody
tend to see clinical problems along neurotic dimension - extroverts have acting out problems, introverts have anxious and obsessional problems
How does the dimensions perspective change the approach to treatment?
think of guidance and improved coping, rather than cure - use insight into vulnerabilities, skills training, and maturing of defenses
What is the goal driven behavior perspective?
problem arises when either a basic physiologic goal oriented behavior becomes distorted in some way or a normal social need becomes directed toward maladaptive goal
