Exam 1 Flashcards
What ‘not’ is Psychopathological?
Think 3
- Not a deviation from the norm
- Not personal suffering
- Not a violation of societal standards
What are some problems in defining psychopathology?
Variations
- Societal variations (i.e., suicide–in Japanese cultures and hallucinations–spiritual connectedness)
- Historical variations (i.e., adolescent males having sex with older males in Greece and Rome, ADHD not a disorder historically, Left-handed people)
What would be a suitable definition of psychopathology?
“A behavioural or psychological syndrome resulting in significant suffering or loss of freedom to self or others, increased risk of suffering or loss of freedom”
What are some arguments against classification?
- Classification of mental illness is society’s way of marginalizing people and behaviour it doesn’t like
- Mental illness implies something wrong with you rather than your environment
- Potentially allows you to avoid looking at the root cause
- Labeling
- Classification assumes discrete entities
- Psychiatric classifications not closely ties to causes or treatment, provides relatively useful information
- Most classification systems have a white, western view of psychopathology
- Severe disorders have poor reliability
- Most people with ‘mental illness’ are identified because they have sought out help themselves
- The brain is an organ like any other, things can and do go wrong
- Cross-cultural manifestations of all major mental disorders
- Classification systems a vehicle for further understanding
- Labels are often beneficial
- A categorical classification system is necessary in the real world
Who promoted that the classification of mental illness is society’s way of marginalizing people and behaviour it doesn’t like?
Thomas Szasz - Myth of mental illness
True or False: Homosexuality was a mental illness in the DSM until 1980.
True
What childhood diagnoses are products of a dysfunctional family are ignored when the diagnostic label is applied?
- Anorexia
- Conduct disorder
- Oppositional defiant
Explain the Rosenhan experiment.
The Rosenhan experiment was an experiment to determine the psychiatric validity. This is linked back to labels
Labels become a ____.
Self-fulfilling prophecy
Many physical diagnoses are _____ but most mental health problems _____
- Discrete
- Lie on a continuum
Physical diagnoses say a lot about cause and possible treatment however
Psychiatric terms do not
Several disorders have poor reliability and/ or valdidity
Personality disorders, subtypes of schizophrenia
People who have a ‘mental illness’ are identified because
They are willing allies in treatment and grateful for the help
What was derived from cross-cultural research?
the diagnostic criteria for depression, mania, and schizophrenia
Why are labels beneficial?
- People get relief from labels. It changed the connotation from being bad to ill
- Many labels efficiently provide valuable new information on cause, treatment, and prognosis
What are England’s classifications?
Idiocy and Lunacy (1400s-1500s)
When did the WHO develop 3 classifications
1948
What are the 3 Classifications WHO developped in 1948
- Psychoses
- Neuroses
- Personality Disorders
American Psychiatric Association published what?
DSM-I
What does ICD stand for?
International Statistical Classification of Diseases, Injuries, and Causes of Death
What was the Collaboration in 1968?
WHO collaborated with APA to produce ICD-8 and the DSM-II
Which one is False?
A) ICD-11 is very similar to the DSM
B) It is commonly used in Europe and outside of North America
C) World Health Organization was a co-writer
D) It was published it 2011
D) The ICD-11 was NOT published in 2011 (Published in 2018)
What are some characteristics of the DSM-5
- Published in 2013
- Published by the American psychiatric association
- Very explciit indicators and contrainders
- Similar ot the ICD
What are the current 3 legal definitions of importance in Canada?
- Unfit to stand trial (Canadian Criminal Code)
- Not criminally responsible because of a mental disorder (Canadian Criminal Code)
- Civil (involuntary) Commitment (Provincial Mental Health Act)
Which one of the following is NOT part of the Canadian Criminal Code?
A. Unfit to stand trial
B. Civil Commitment
C. Not criminally responsible because of a mental disorder
D. None of the above
C. Civil Commitment is part of the Provincial Mental Health Act
What would you need to be ‘fit to stand trial’?
- Understand the nature or object of the proceedings, possible consequences of the proceedings, or communicate effectively with counsel
Not Criminally Responsible means
The person is not criminally responsible for an act committed or omission made while suffering from a mental disorder that rendered the person incapable of appreciating the nature and quality of the act or omission or of knowing it was wrong.
Define ‘Mental Disorder’
A susbtantial disorder of thought, mood, perception, orientation, or memory that grossly imapairs: judgement, behaviour, capacity to recognize reality or ability to meet the ordinary demands of life.
What is a review board?
A review board is composed of lawyers, physicians, psychiatrists, and a member of the public that determines the conditions that should be imposed on the person considering the protection of the public and well-being of the person.
What Occurs during Involuntary Civil Commitment?
- Police officer can take the person to the hospital for an assessment if the individual appears to be a harm to self/ others and suffering from a mental disorder
- If physician at the hospital has the same assessment, the person is held for 72 hours
- Within those 72 hours, 2 physicians (including a psychiatrist) have to make the same assessment, if so, can require patient to be admitted for longer
Describe ‘incidence’
Incidence is a rate of new cases in a given time period
True or False: Prevalence is the percentage of population having a disorder at any given time.
True
Which of the following is false about prevalence and psychopathology between demographic groups?
A. Gender differences
B. More common in low socioeconomic groups
C. Highest in ages 15-24
D. All of the Above
A. There is no sex difference (females have higher rate of depression and anxiety v.s. males have higher rates of drug abuse and antisocial personality disorder)
Name 3 Rare Disorders
Dissociative disorders, paranoia, autism, conversion disorder, anorexia, schizophrenia
Which of the following disorders is seeking treatment?
A. Personality Disorders
B. OCD
C. Paranoia
D. Psychosexual disorders
B. Obsessive Compulsive Disorder
Provide an example of a culturally specific syndrome
Koro (Penis theft)
Amok
Latah
Piblokto
Taijin Kyofusho
Anorexia (Only in western cultures)
What are some Assessment Elements?
Clinical Interview, Behavioural Observations, 3rd Party Report, Psychometric Instruments, and Biological/ Neurological Testing
What are some disadvantages of a ‘Clinical Interview’?
- Often the only part of a clinical assessment
- Sometimes people do not know their own minds and may try to deceive you
What is a Behavioural Observation?
Observing the body language to ensure they remain consistent with what they are saying
How might a 3rd Party Report be useful?
To get an independent perspect. Specifically for addictions, this assessment element has more objective idea of the harm being caused
What is a Psychometric Instrument?
A standardized assessment instrumetn that is used by psychologists for mental health assessments
Which instruments are not restricted to psychologists?
- Beck Depression Inventory
- Hamilton Rating Scale for Anxiety
- Psychopathy Checklist
- Problem and Pathological Gambling Measures
20% of psychiatric patients have an unrecognized physical illness causing their psychiatric symptoms. What might some of those symptoms be?
- Side effects of prescription drugs
- Exposure to environmental toxins
- Endocrine dysfunction
- Metabolic problems
- Infection
- Brain tumour or localized seizures
What is the purpose of an assessment?
- Determine the nature of the problem
- Determine the severity of the problem
- Determine the impact of the problem
- Determine the causes of the problem
- Determine whether there is need for treatment
- Determine the type of treatment
- To establish a baseline
- To give the person objective feedback about their problem
- To engage the person into changing their behaviour
What are the causes of Psychopathology?
- Sin
- Personal choice
- Upbringing/ Parental Modelling
- Stress
- Neurochemical Imbalance
- Trauma
What is a Biopsychosocial Model
Captures the complex interaction and is accepted understanding of the causes of psychopathology
What is the order of the variables of the biopsychosocial model?
- Genetic inheritance
- Environmental experience
- Behavioural and psychological patterns
What is the result of an oversensitive brain?
Epilepsy
What is the result of an underdevelopped brain?
Intellectual disability
- I.e., FASD
What is the result of an oversensitive peripheral nervous system?
Anxiety, Inhibition
What is the result of an undersensitive Peripheral Nervous system
Delinquency, antisocial personality, risk taking
Cerebral Palsy is due to
Underdevelopped motor cortex
Undercontrolled sex, drug use, eating, anger is due to
Underdevelopped inhibitory systems
What is the result of emotional dysregulation
Anger control problems
ADHD, Depression, and Drug Abuse are all results of
A dysfunction in the reward systems
When is the greatest susceptibility to neurologicla damage/ alteration
During Gestations (1st Trimester)
What are 2 things that can contribute to neurological damage and alteration?
- Poor material nutrition
- Older age (21-29 optimum for having a child)
- Maternal disease
- Drug use
- Toxin exposure
- Radiation
- Emotional stress
- During birth
- During infancy
- Adverse Childhood Experiences
- Peer influence
- Societal influences
- Stress
What are epigenetics?
genes that you have inherited that have turned on or off by parents or grandparents
What is Anoxia?
Lack of oxygen - Due to damaged umbilical cord
What mineral has excess levels in Alzheimer’s?
Copper
Wernicker-Korsakoff Syndrome, Dementia, Depression, and Schizophrenia are linked to
A lack of vitamins
What is the role of an antioxidant?
To protect the body against damage from free racials, this should benefit the brain function
What is an Adverse Childhood Experience?
An adverse childhood experience is something that occurs during your childhood whether it’s due to the lack of rules, emotional or physical neglect, or physical, sexual, or emotional abuse, loss of a parent, poor parental modelling, overly involved and protective parents
Explain Materialism and Capitalism
Continually chasing money and material goods from the characteristics of Western culture. It only improves short-term happiness
True of False: 29% of Canadian households are a single person
True
True of False: In 1940, 0% of individuals live in single person households.
False
Which of the following is not an asocial entertainment?
A. Television
B. Going out in public alone
C. Phones
D. Social Media
B. You’re still around people when you go out in public whether you know them or not
Humans are social beings
Describe a Sedentary lifestyle
A lack of exercise
Lack of religion is
A. Sedentary lifestlye
B. Peer influence
C. Societal influence
D. Adverse childhood experience
C.
In what forms does stress occur?
- Health problems
- Relationship problems; isolation
- Work/ school problems
- Poverty and financial problems
- Legal and crime problems
What are malapdaptive psychological and behavioural patterns?
- Pessimistic outlook
- Poor coping and problm-solving skills
- Engaging in high-risk behaviour
Personality has an environment contribution of?
(Percentage)
50-70%
Which of the following is a non-genetic contribution?
A. Eating disorders
B. Bipolar
C. Autism
D. Learning disabilities
A. Eating disorders are strong in environmental origin
Which of these statements is false about family studies
A. 1st degree have 50% of the same genes
B. Cousins have 12.5% of the same genes
C. Grandparents share 25% of the same genes
D. Grandparents are of the 1st degree
D. Grandparents are 2nd degree
True or False: Both Identical and Fraternal Twins both share 100% of the same genes
False. Fraternal is 50%
True or False Identical Twins have 70% of the concordance rate for MDD
True
True or False: Fraternal twins have a 25% concordance for MDD
False
True or False: Dizygotic have higher concordance rates for developping mental disorders
False. It’s actually monozygotic
Why are the concordance rates higher in identical twins?
Due to genetic contributions
True or False: Indirect inheritance poses the same amount of risk for developping schizophrenia as direct inehritance
False. For this to be true, it would need to be an environmental contribution
Name the Biological Protective Factors
- No genetic history of mental health problems
- No neurological damage
- Resiliency to stress
- Good intellect (better ability to problem solve)
List the Protective Envrionmental Factors
- Nurturing, disciplined upbringing
- Good parental modelling
- Prosocial peer group
- Good schools/ teachers
- Absence of severe stressors
- Good social support
- Adequate income
- Positive societal orientation and practices
Mental health professions are ____
Very confusing to the general public
Clinical Psychologists must have ___
A Ph.D or Masters in Clinical psychology
Counselling Psychologists tend to ____
Be strong in counselling and tend to treat healthier people compared to clinical psychologists
There are about ____ registered psychologists in Alberta
4700
Registered Psychologists must pass ____
the Examination for Professional Practice in Psychology
How long is a psychiatrist residency?
5 years
What is the percentage of male psychiatrists?
53%
What is the percentage of female psychiatrists?
47%
Counsellors/ Psychotherapists/ Mental Health Therapists are ____
Varying in backgrounds and experience, it is not a hisotrically regulated profession or protected title
Psychosocial interventions are a restricted activity in:
A. B.C
B. Ontario
C. Alberta
D. Quebec
C.
Addictions Counsellors are ____
Sought after by AHS
A Freudian Orientation is utilized by ___
Psychoanlysts
~400 in Canada (Mostly in Quebec)
Psychoanalysts
What institutions offer a social work program?
- UofL
- UofC (Lethbridge Campus)
- Grant MacEwan
- MRU
To become a psychiatric nurse, you are required to have a B.N. or R.N. except in … and …
Quebec and Yukon
Family Physicians
Are medically oriented and have the least mental health training but see majority of people with mental health problem.
True or False: Self-help is the most common form of treamtent
True
True or False: Lots of people seek help for mental health treatment
False
True or False: 1/2 of people who attend treatment drop out before completion
True
Most adults see
A. Psychiatrist
B. Psychotherapists
C. Psychologists
D. Physicians
D. (Cost free in Canada and can prescribe psychiatric medications)
Name the Types of Treamtent for Mental Health
- Biological
- Behavioural
- Psychological
What is ‘biological treatment’?
A wide range of treatments designed to change the person’s neurochemistry and/ or neurobilogy
–Recognition that thoughts, emotions and behaviours are associated with neurological events
What are some methods of biological treatment?
- Medication
- Exercise
- Brain surgery (Lobotomy)
- Electroconvulsive Therapy (ECT)
- Transcranial Magnetic Stimulation
- Light Therapy
- Gene Editing
Medication is also known as?
A ‘quick fix’
What is a Lobotomy?
A surgery developped in 1935 by Moniz where they would insert an ice pick in a drilled hole in the forehead on top of the eye socket to destroy part of the frontal lobe
Exercise Mechanism is a combination of what?
- Decrease in cortisol
- Increase in endorphins and endocannabinoids
- Increased blood circulation to the brain
What are the side effects to the Lobotomy?
- Extreme listlessness
- Stupor
- Death
- Seizures
True or False: There is still a version of the lobotomy used today
True: Cingulatomy and Stereotaxic Tractomy
Only 25-50% get significantly better
What is ‘Transplantation of Embryonic Neurons’?
Taking tissue from aborted fetuses to change the patient’s neurological conditions
What is the voltage of seizure therapy?
70-130v
How many treatments are used in ECT
10 treatments in total; 3x/ week
True or False: Transcranial Magnetic Stimulation is less invasive than the ECT
True
Transcranial Magnetic Stimulation is useful in treating ___
Depression and OCD
What is a similarity between Transcranial Magnetic Stimulation and an ECT?
Both can induce seizures, and both are a biological treamtent
Seasonal Depression, Anxiety, and Bulimia can be treated with ___
30 minutes of bright outdoor light per day
Best given in the morning
Explain the process of gene editing
Gene editing involves replacing the defective genetic instructions that build the the body/ brain in the wrong way with the right instructions to correct the mistake
What are the problems of Gene Editing?
- Fixes the wrong gene
- We don’t know the genetic basis for many mental health problems
- Genetics are only partially responsible for mental health problems
- When genes are the cause for mental health problems there’s usually many genes involved
What is the role of classical conditioning?
To extinguish the associations by repeatedly presenting the conditioned stimulus in the absence of reward or punishment
Desensitization
List the forms of ‘Behavioural Treatment’
- Behaviour modification programs
- Desensitzation (Exposure Therapy)
- Aversion Therapy
What is the role of a behaviour modification program?
A formal program whereby you ensure that maladaptive behaviour is not followed by reward and adaptive behaviour is
Behaviour modification programs differ from ___
Informal use of reward and punishment by the consistency and explicitness of the rewards
What can effectively be use for all populations and all mental health problems as long as the person themselves rigorously adheres to the reward program?
A. Behaviour modification programs
B. ECT
C. Psychotherapy
D. Gene editing
A.
Exposure Therapy is also called ___
Desensitization
Which of the following is a form of desensitzation?
A. Eye movement Desensitization and Reprocessing
B. Lobotomy
C. Transcranial Magnetic Stimulation
D. Light Therapy
A.
What are some examples of aversion therapy being used?
- Pedophilia: when a person shows arousal to innapropriate imagery they get an electric shock, graphic image of a car accident, or an unpleasant smell
- Alcoholism: Taking medication everyday and when person drinks alcohol they get very sick
- Teenager smoking, and parent forces teenager to finish a whole pack of cigarettes in one go
What are the forms of Psychological Treatment?
- Insight Therapy
- Play Therapy
- Humanistic Treatment
- Cognitive Restructuring
- Counselling
- Hypnosis
Freud popularized ….. in the 1900s
Psychoanalysis
True or False: Psychotherapy has the same orientations
False
No each has a different orientation. There’s always new ones being made
Psychological/ talking therapies are almost always a …..
Component of treatment
Problems due to unresolved psychological conflicts is what kind of therapy?
Insight Therapy
Explain Humanistic Treatment
Humanistic Treatment empahsizes on people’s capacity to make rational choices and develop their maximum potential
Some examples of ‘Humanistic Treatment’ might be
- Client-Centred Therapy (Empathy and Unconditional Positive Regard)
- Gestalt Therapy (Here and Now)
Cognitive Behavioural Therapy would be an example of ____
Cognitive Restructuring
Cognitive restructuring is classically used for ___
Depression - Instrusive, negative thoughts
The most common type of counselling is:
A. Animal counselling
B. Indigenous counselling
C. Psychtherapy
D. Gestalt therapy
C.
How many people are hypnotizable?
~20%
True or False: Family Therapy is important for child/ adolescent problems such as anorexia in family dynamics
True
What are some of the benefits to group therapy?
- Sometimes treat a problem
- Cost efficient
- Provides social support for each participant
The placebo effect operates through what?
Most but not all types of therapies
Describe the Placebo Effect’s role in a non-specific therapeutic elements setting
- goal is to receive treatment and be receptive to it
- Expecting a positive outcome when receving treatment
- Natural recovery
- Personal interaction provides emotional support
True or False: Long-term treatment effectiveness is better than non-medication treatments
True
What is the percentage of people who receive the placebo treatment better off?
50%
What is the percentage of people who receive no treatmetn are better off?
33%
What can cause a weak relationship to treatment outcome?
- Setting
- Duration of Treatment
- Experience, training and profession of the therapist
- Type of evidence-based treatment
What creates a strong relationship to treatment outcome?
- Client qualities
- Therapist qualities
- Quality of relationship between the therapist and client
- Receving and staying in treatment
- Positive expectancies
- Providing comprehensive services
True or False: Inpatient and Outpatient Treamtent have different outcomes
False: both are equally the same
Outpatient more common; more cost effective
True or False: It is not counter-productive to specialize in one therapeutic treatment
False: You want to adapt to your client’s needs
What does it mean to be eclectic?
Conform and adapt to different/ new things