Comps - Psychopathology (Subdomain 7) Flashcards
What is the history of women being misdiagnosed? (Ussher, 2013)
-18th-19th century: women were often classified as hysterical
-Hysteria was viewed as intrinsic to women (became a catch-all for what ails women)
-This is echoed today in the overdiagnosis of HPD, BPD, and PMDD in women
What considerations should you make when diagnosing disorders related to emotional regulation for men versus women? (Nolan-Hoeksema, 2012)
-Men may be more likely to cope with alcohol, engage in automatic nonconscious emotional regulation, and may bond using active-oriented behaviors
-Women may be more likely to ruminate (which may result in more anxiety and depression), engage in conscious linguistically-driven emotion regulation, and bond with self-disclosure and co-rumination
What are some considerations for diagnosis among different racial/ethnic groups? (Gana, 2012)
-Differences in diagnosis are observed but not necessarily explained
-SES
-Acculturation
-Worldview
-Adversity
-There is likely much more complexity here
-Black people are more likely to be overdiagnosed with schizophrenia
Internalizing Factors (Eaton, 2012)
Depression and anxiety
Externalizing Factors (Eaton, 2012)
Substance use, conduct disorder, and antisocial
Internalizing and externalizing factors considering cultural competence
-Cultural differences in internalizing or externalizing symptoms may relate to diagnosing differences
-Demographic differences in disorders may be explained by latent internalizing-externalizing factors in a large epidemiological study
What is the minority stress model? (Meyer, 2003)
-A social research and public health framework that helps explain the experiences of people in oppressed communities
-It suggests that minority groups experience stress from discrimination and stigma, which can lead to negative physical and mental health outcomes
How does the minority stress model relate to diagnosis? (Meyer, 2003)
-Attacks on self-identity have a greater impact than other stressors
-These factors harm mental health outcomes, academic and vocational ability, and cause emotional labor
Specific stressors to consider with marginalized clients (Meyer, 2003)
-Marginalized people develop hypervigilance which costs emotional labor
-Victimization from discrimination can change perceptions of the world, cause a loss of security, and lead to isolation
-They may have the cognitive load that comes from hiding parts of themselves (i.e., gay clients who are not “out”)
-Experience internalization
Cultural factors affecting diagnosis
-Prominence/salience of identity
-Valence of identity
-Synthesis
Prominence/Salience of Identity
-The more strongly the person identifies with their identity group, the more emotional toll the person will receive from identity-related stressors
-Prominence of identity is fluid and changes across contexts
Valence of Identity
-How one evaluates their identity
-Ex. internalized homophobia and self-acceptance are both opposite aspects of valence
Synthesis
The ability to integrate aspects of one’s identity
What mistakes do clinicians make when trying to be culturally competent in diagnosis? (Sue et al., 2022)
-Diagnostic overshadowing
-Confirmatory strategy
-Attribution error
-Judgmental heuristic
Diagnostic Overshadowing
-When a therapist’s focus on race or other identity factors leads them to miss important aspects of the client
-Do not assume problems relate to the person’s identity
-Focus on the whole person, not just on one aspect
