Exam 1 Flashcards
1
Q
How many people will experience a diagnosable mental health condition in any given year
A
1/5
2
Q
What percentage of adults are currently taking medication for a mental health condition
A
25%
3
Q
What percent will meet criteria for a mental health condition at some point in their lives
A
50%+
4
Q
What is the single largest cause of disability worldwide
A
Mental health conditions
5
Q
What was the total global economic burden of mental disorders
A
8.5 trillion dollars
6
Q
What is not categorically less effective compared to medicine as a whole
A
Psychiatric intervention
7
Q
Psychotherapy
A
- various modalities (cognitive behavioral)
- various systems (individuals)
- various settings (in-patient)
8
Q
What percent of adults with a diagnosable mental health condition received treatment in 2018
A
43.3%
9
Q
What percent of counties don’t have a single practicing psychiatrist
A
60%
10
Q
What percent of people say they’re reluctant to seek mental health services
A
60%+
11
Q
What is the average delay between symptom onset and treatment
A
11 years
12
Q
What is the inverse care law
A
Profound inequalities in availability and access to care
13
Q
Misconceptions
A
- bipolar disorder means you’re sad one moment and then completely enraged or ecstatic the next moment
- schizophrenia means having multiple personalities
- depression is the direct result of a “simple chemical imbalance”
- eating disorder only affect young, white women
- the insanity defense is a “get-out-jail-free card” that too often succeds
14
Q
Stigma
A
- “mark of disgrace or shame”
- “Penumbra” of stigma often extends to families
-devastating consequences such as social rejection and employment
15
Q
ABCs of Stigma
A
Affective (prejudice)
Behavioral (discrimination)
Cognitive (stereotyping)
16
Q
Link & Phelan’s (2001) Process Model
A
- begins with identifying and labeling (actual or alleged) human differences
-dominant cultural beliefs link labeled persons to undesirable characteristics (negative stereotypes)
17
Q
Sanism
A
- systemic oppression on the basis of an actual or perceived mental attribute or condition
18
Q
Factors to Consider: 4-D
A
- Distress
- Dysfunction
- Deviations
-Duration
19
Q
Constellations of Symptoms
A
- descriptive syndromes defined by collections of co-occurring behaviors or symptoms
- ex: persistent low mood, trouble sleeping
- no valid biological diagnostic tests
20
Q
What isn’t unique to psychopathology
A
Caveat
21
Q
Categorical Model
A
- depressed vs non-depressed
- organize and describe constellations of symptoms
- conduct research
- suggest appropriate treatments or interventions
- make group-level predictions about course of illness
22
Q
Dimensional Models
A
- continua or spectra
-ex: energy, sustained attention
23
Q
Harmful Dysfunction Model (Jerome Wakefield)
A
- it results from the inability of some internal mechanism (mental or physical) to perform its natural function (ex: mechanisms that regulate emotions or energy levels)
- it causes some harm to the person as judged by the standards of the person’s culture (often measured in terms of distress or difficulty performing expected social or occupational roles)
24
Q
Social Model (People are disabled by the barriers)
A
- isolation
- no lifts
- badly designed buildings
- no Ramps
-poor job prospects - special schools
25
Medical Model (People are disabled by the medical conditions)
- can’t hear or see
- need help and carers
- looking for a cure
- can’t walk
- can’t work
- dependent
26
Pathology is not a disorder, but another kind of order (Olthof)
- humans are complex systems that interact with, adapt, and change over time in response to both internal and external demands
- you can’t fully separate the person from the environment
- syndromes, themselves, may function like systems: ex: insomnia-> fatigue->concentration problems-> frustration-> insomnia
- how problematic vs helpful a given response or system is depends on context: ex: adaptions to threat might help a soldier survive in a combat zone and then cause problems when they return to civilian life if the system doesn’t re-adapt
27
Biopsychosocial Model (Engel)
Biological
- physical health
-disability
-genetic vulnerabilities
Psychological
- self-esteem
-coping skills
- social skills
Social
- peers
- school
-family circumstances
28
Three Historical Classes of “Models”
Supernatural: The Soul
Biological: The Body
Psychological: The Mind
29
Early Biological Model: Hippocrates 4 Humors
- normal function of brain, body depended on balance of four humors: blood (sanguis), black bile (melancholic), yellow bile (choler), phlegm
- imbalance of the humors produced illness
- treatments include changes in diet, physical activity, physical environment
- innovative, but not evidence-based (“ wandering uterus”
30
Return to the Supernatural
1621: demonic possession listed as potential cause of mental disorder
792 CE: First mental hospital founded in Baghdad
Avicenna writes The Canon of Medicine
31
Supernatural Theories
1490-1541: Paracelsus rejects demonology “lunacy”
1576-1660: ST. Vincent de Paul: Mental disease is no different than bodily disease
32
Early Asylum
General hospital of Paris founded in 1656
Treatment was generally harmful
Conditions were comparable to dungeons
Confinement of beggars
33
Reforms and Moral Treatment (Philippe Pinel’s)
- Pioneer of humanitarian treatment
- Argued patients should be treated with kindness
- 1842: The Lunancy Inquiry Act requires periodic inspections of asylums in Britain
34
Benjamin Rush (Founder of American Psychiatry)
- observations and inquiries upon the disease of the mind
- mental illness as a disease of the brain
- blood-letting
- alienism
35
Psychological Treatments
Jean Martin Charcot and Josef Breuer: interested in hysteria and hypnosis
Breuer’s cathartic method: recall suppressed traumatic memories while under hypnosis
Sigmund Freud: studied with both Charcot and Breuer
All were trained as physicians who were running the asylums
36
Freudian Psychoanalysis
- human behavior determined by unconscious forces, innate drives
- early development, trauma
- tap into the unconscious mind (free association)
37
What was the clear biological cause that was conducted between 1897-1906 from experiments
Syphilis
38
What are scientific paradigms (Kuhn)
Conceptual frameworks that acts as filters and shape production, interpretation, and use of science
39
Behavioral Genetics
Attempt to estimate the proportions of genetic vs environmental influence on a trait
40
Heritability
- trait can be passed on along familial lines through genetics
- the proportion of the variability in a trait that can be explained by genetic differences among people within a given population
41
Misconception of heritability
For every trait, there is a single, immutable number that represents the heritability of that trait
42
Heritability coefficient depend on
- population being studied
- environment in which that population is being studied/ changes in the environment
- trait being studied/ the method of measurement and estimation
43
Clarifications of Heritability
- property of populations, not individuals
Ex: If Trait X has a heritability of .70 and my parents have Trait X, that doesn’t mean that I am 70% likely to have that trait
- doesn’t tell us how hard a trait is to change
Ex: height is highly heritable,but
-doesn’t always tell us how genetic a trait is
Ex: two-armed-ness
- isn’t always informative about the causes of between-group differences
Ex: height is heritable, but white US-born men used to be taller, on average, than Dutch men
44
Molecular genetics
Identify contributions of specific genes, genetic variants
45
Genotype to Phenotype Problem
- essential to understand how genetic variation -> phenotypic variation
Ex: if we know that a set of genes is involved in regulating the sleep-wake cycle and that it’s associated with bipolar disorder
46
Example of X is a gene for Y (Kendler)
mHtt is the gene for Huntington’s disease
47
What are interdependent
Genes and environment
- genes are correlated with the environment that you are born into
48
Behaviorism (Role of Learning)
Behaviors are learned- lassi al and operant conditioning
- behaviors are shaped by our environments -and how those environments respond to us
49
Cognitive Science (Role of Mental Processes)
Spotlight in the importance of cognition: biases, perceptions, memory, beliefs, decision-making
50
Affective Science (Role of Emotions)
Emotions have (evolved) functions
51
Intrapersonal functions
Ex: fear might coordinate our response to seeing a venomous snake
52
Interpersonal and social functions
Ex: the look on your face when you see the snake might give your friend a key piece of information
53
Emotion dysregulation
These functional emotional systems can become dysregulated
- they persist long after their initial trigger (or not long enough)
- their intensity is disproportionate to the trigger (too strong, too weak)
- efforts to regulate, cope with, or satisfy emotions lead us to engage in unhelpful or harmful behavior ( problematic substance use)
- inappropriate or I’ll-suited to the situation to our goals
54
Environmental factors
Can trigger, exacerbate, or maintain the symptoms that make up the different disorders
- can be broad scale ( availability of firearm is associated with higher suicide rates across countries)
- person-specific ( major life events, quality of social relationships)
55
What can culture influence
- symptom expression
- availability of treatment
- willingness to seek treatment
56
Paradigms Matter
- assumptions we make
- questions we ask
- methods we use to answer those questions
- funding, public policy
- interpretation of, responses to reserach findings
- development and uptake of new treatments
57
Reliability
Consistency of measurement
58
Validity
Meaningfulness of measurement
59
Standardization
Uniform application of a measure
60
Types of reliability
- across time (test-retest)
- across rafters (inter-rater)
61
Construct validity
Is the test measuring what it claims to?
62
Nosology
The branch of medical science dealing with the classification of diseases
63
The Diagnostic and Statistical Manual of Mental Disorders (DSM)
- contains information about, diagnostic criteria for recognized mental illnesses
64
Criticisms of Diagnosis
- concerns about “overmedicalization” or “overpathologization”
- stigma
- categories do not capture the uniqueness of the person
65
Rationales for Diagnosis
- can potentially guide research, treatment, advocacy
- can potentially facilitate communication between and among professionals and service users
- can potentially be a relief for some service users
66
Polythetic criteria
Ex: BPD dx requires endorsement of 5 of 9 symptoms
67
Alternatives
- HiTOP
- RDoC
68
Psychological Assessment
- describe current of past functioning, strengths, problems, level of risk
- identify potential causes or contributing factors
- arrive at a diagnosis
- inform treatment strategy
- monitor treatment progress
69
Behavioral Observation
- can occur in more controlled (lab) or more naturalistic (classroom) settings
70
Self- Report Questionnaires
- can be normed to facilitate comparison
- often used for screening, monitoring progress in treatment
- self-monitoring can potentially have therapeutic value
- easy, time-efficient to administer
71
Projective Tests
- scoring can be highly subjective-> poor reliability
- even when more rigorous scoring systems are used, validity if often lacking
- can sometimes be a jumping off point for clinically interesting conversations
72
Culture
Influences the meaning of behavior
73
Diagnostic Overshadowing
- Tendency to attribute all behavioral, emotional and health issues to a certain diagnosis while other issues are not considered
-when people with psychiatric diagnoses seek medical care
74
Why it’s challenging to sample in clinical psychology
- low base rates
- hard to reach
-ability to participate
-may not meet the criteria
75
Ecological fallacy
What’s true at the group level is not always true at the individual level
76
Nomoethic research
Attempts to ask questions about what’s true at the group level
77
Idiographic research
Asks what’s true at the person-specific level
78
LOTS of Data
Life data: academic records, medical records
Observational data: auditor or video recording someone at home or lab
Test data: performance on a well-validated cognitive test
Self-report: questionnaires and interviews
79
Correlation
Doesn’t equal causation
80
Classical experimental research
A well controlled experiment has high internal validity= inference of causality
Concerns about external validity= does this generalize to the “real world”
81
Validity Crisis
Validity of constructs, measures, methods increasingly being called into question
