Exam 1 Flashcards
30% of adults will..
suffer from a mental disorder in their lifetime
20% of adolescents will…
Suffer from a mental disorder
In nonwestern culture, the concept of depression is
soul loss
In hispanic culture anxiety is
an attack of the nerves
Among native americans
hearing voices of recently deceased is normal
Aborigional australians believe
halluciantions are normal
Abraham Lincoln
had depression
Ernest Hemingway
Had alcoholism that led to depression
what 2 mental disorders show up throughout history
depression and schizophrenia
Asian Americans tend to
Be the least likely to seek out and finish therapy
Control (in therapy)
to modify or change
Psychosis
madness
reactions to black and white cards
depression
reactions to red cards
anxiety or anger
african americans typically labeled as
schizophrenia or substance abuse disorder
Hispanics typically labeled as schizophrenic but it should be
cognitive impairment
asian americans complain about
Physical symptoms of disorder
DSM 5 Integrated definition of abnormality
Normality and abnormality defined from 3 vantage points: that of society, that of the individual, and that of the mental health professional
DSM 5 bio/psyco/social definition of abnormality
- involves a significant disturbance in thinking, emotional regulation, or behavior caused by a disfunction in the basic psychological, biological, or developmental processes involved in normal development
- causes significant distress of difficulty with day to day functioning
- is not merely a culturally expected response to common stressors or losses or a reflection of political or religious beliefs that conflict with societal norms
Deviance
extremely unusual or bazzare behavior
Distress
physical and psychological discomfort
individuals tend to be defined as abnormal when behavior, thoughts, and feelings cause distress
Disfunction
breakdown in cognitive emotional or behavioral function
person unable to function personally, socially, or occupationally
Faulty perception of reality
having hallucinations of delusions
distorted view of reality
Delusion
persistent false beliefs that are steadfastly held by an individual despite evidence the beliefs are incorrect or exaggerated reality
Why don’t we use “mental illness”
lacks clear definition
use “mental disorder” instead
Mental Status exam
based on observation of clients behavior and self preservation and response to questions that probe various aspects of cognitive functioning
may vary from clinician to clinician
Appearance
appearance of client in mental status exam
behavioral observation
verbal and nonverbal behaviors
body movement posture, facial expressions
Orientation
does client show lapse in orientation (where we are, who they are, etc.)
Memory
can client recall recent events
Sensorium
individuals entire sensory apparatus
clients focusing of attention, capacity for concentration, awareness of the world
Perceptual processes
process by which people interpret the information provided by the sense
mood
prevailing emotions displayed (sadness, anxiety, anger, etc)
affect
emotions or feelings the client attaches to objects or ideas
intelligence
intellectual functioning based on speech, expression of ideas, level of sophistication, socioeconomic status
Thought Processes
form and content of thought
logical and coherent?
Insight
do they recognize a problems
Judgement
approached thoughtfully and rationally or impulsively?
Subjective Discomfort Criteria (6 D’s of diagnosis)
- psychological distress
- psychological disfunctional behavior (disability)
- deviance
- danger to oneself or others
- disordered
- social discomfort
Van Goh
- orignally diagnosed as schizophrenic
- gerschwinds syndrome (interictal personality disorder)
- Menieres syndrome (fluid in ear)
Medical Student Disease model
-learning about disorders can make you believe you have one
- influenced by: universality of human experience, tendency to compare our own functioning to other people’s functioning
etiology
causation
comorbidity
- the co-occurence of two or more disorders within one person at the same time
- 2/3 develop anxiety then depression
- suffer from two by chance
- one disorder leads to another
- two disorders stem from common cause
- existence of one disorder may make treatment more or less difficult
Problems with DSM 3
needed to improve reliability and accuracy of personality disorders
Advantages of DSM 5
- based upon empirical findings
- specific diagnostic criteria
- clinicians should come up with same diagnosis
- does not subscribe to single theory of abnormailty
- increased awareness of importance of accurate diagnosis
Disadvantages of DSM 5
- shows little consideration for etiology
- not completely atheoretical (personal/cultural assumptions)
- relies on medical model (biological causation)
Why don’t we use multi-axis system
- clinicians wanted specific diagnosis-based system
- distinctions between axis I and II never clearly justified
- subject of opinion for global assessment of functioning
Cultural Relativism
- no universal standards for labeling behavior as abnormal
- different cultures have different definitions of abnormality
Why do women suffer more than men?
- women more likely to be diagnosed with anxiety or depression
- women internalize problems more
- more stressful life events before onset of disorder
Reliability
consistency
diagnostic agreement among clinicians
Validity
accuracy of the diagnosis
concurent validity
whats going on now
predicted validity
course of the disorder
incidence
how many new cases occur during a given period of time
prevalence
number of people in population as a whole with the disorder
presenting problems
the reason someone seeks out treatment
Clinical Psychology
discipline concerned with the study, assessment, treatment, and prevention of abnormal behavior
Goals of clinical psychology
describe, predict, explain, control abnormal behavior
Thomas Szaz
myth of mental illness
- deviations that society call abnormal are simply problems in living not signs of abnormality
- the concept of mental illness is dangerous and was invented by psychiatrists to justify their power and control
- throughout history society labels groups and individuals as abnormal to justify their removal from society
- to label an individual as “sick” deprives people of responsibility for their behavior
- labeling a patient with a diagnosis of a mental disorder leads to the self fulfilling prophecy
Drapetomania
psychological disorder that caused enslaved people to try to escape
Structured Interview
primary means of obtaining clinical and useful information
standardized
Unstructured Interview
clinician decides what question to ask, typical intake interview, clinician gets to know person, open ended questions
Bender Gestalt
Used to assess organic impairment/ brain damage
- Client must copy geometric figures to assess for brain damage and then copy from memory to see if memory has been impaired
Neurotransmitters- dopamine
schizophrenia
neurotransmitters- seratonin
depression
John Exner Jr
Rorschach comprehensive scoring
most commonly taught administrative and scoring procedure
pros: reveals information that other measures do not obtain, important to decision making
Cons: reliability, adequacy of normative data, validity of score
Cultural Universality
a fixed set of mental disorders exist that cause symptoms that are the same in all cultures and societies
- depression
-schizophrenia
inpatient care dropped from..
77% to 6%
outpatient care rose to
23% to 94%
number of people in hospitals in 1950-2010
500,000 in 1950 to 100,000 in 2010
why is it important for clinicians to consider cultural factors when diagnosing
must:
- increase cultural sensitivity
- show respect
- prevent cultural factors that may play a role in the disorder
- understand that different nationalities experience mental disorders in different ways
Psychological assessment
a collection, organization, and interpretation of information about a person and their current symptoms and possible causes
goals of psych assesment
- provide description, accurate portrait of person (personality, cognitive functions, mood, behavior)
- description needed to determine the diagnosis for the persons problem, understand the causes and treatment, and predict the future course of the disorder
Subjective discomfort criteria
what is disturbing to one person about another person may not be disturbing to that person
elements of psychological disorder
- impairment or distress
- psychological disfunction
- statistically unusual cultural considerations
