Introduction, Diagnosis and Categorisation Flashcards
Psychopathology
Field concerned with the nature, development and treatment of mental disorders
How is a mental disorder characterised by the DSM-5?
- Occurs within the individual
- Personal distress or disability
- Difficulties in thinking, feeling, behaving.
- Not a culturally specific reaction to an event e.g. naturally occuring grief
Difficult to define bc it cannot be defined by a single characteristic.
Abnormal Psychology
Deviations from normality in which behaviour is negative for the individual or society.
Has 3 D’s.
- Deviance
- Distress
- Disability and dysfunction
Deviance
Characteristic of a mental disorder.
Behaviour not typical, extreme thought patterns/behaviours.
Problems
- Normal distribution of traits entails negative and positive extremes
- Extreme behavs not always a sign of a disorder
- Culturally and temporally dependent
- Importance of context
Distress
Characteristic of a mental disorder
- Not all cause distress or are seen as negative e.g. antisocial personality disorder.
- Not all behaviour that causes distress is disordered
Disability
Characteristic of a mental disorder.
- Impairment in an area of life which stops an individual from reaching their goals.
- Phobias can create this e.g. fear of flying
- Not all disorders lead to a disability
Dsyfunction
Characteristic of a mental disorder.
Wakefield (1992) argued that mental disorders can be defined as ‘harmful dysfunction’. Cannot perform natural function. However, the internal mechanisms involved in mental disorders are unknown so cannot say what is functioning properly.
DSM view is that the brain impacts behaviour and behaviour impacts the brain.
Explain the early biological explanation of psychopathology
- Hippocrates argued that there was a natural cause. A problem with brain pathology.
- Brain function depends on balance of fluids within body.
3 categories of mental disorders
- Mania
- Melancholia
- Phrenitis
Explain what happened during the dark ages which had an influence on psychopathology
- Monks care for those with mental disorders. Place relics.
- Kraepelin established foundations of classification system stating that mental disorders have distinct syndromes rather than a general mental illness.
Explain the development of asylums and its influence on psychopathology
Used as a form of entertainment.
Pinel reforms led to many treated in better conditions away from asylums. For upper class. Poor conditions for lower class.
Treatments meant to help, but ineffective.
Nosology
Branch of medical science which deals with the classification of diseases.
Etiology
The causes of a disorder
Epidemiology
Study of a disorders frequency and prevalence
Signs and Symptoms
Abnormalities that indicate a potential disorder
Signs - Objective indicators
Symptoms - Subjective indicators
Describe the biological approach to mental disorders
- Focused on the structural and functional abnormalities of the NS.
- Syphilis led to idea that if one type of psychopathology had a cause then others did too.
- Genetics - Idea that mental illness could run in family. Led to eugenics.
- Treatments - ECT. Prefrontal lobotomy to those with mental illness but led to cognitive deficits.
Problems
- Technological advancements in neuroscience show no biomarkers and no treatment advances
- No understanding of mechanism connecting structural/functional differences
Describe the psychological approach to mental disorders
Freud
- Divided mind into id, ego, superego.
- Psychoanalytic theory - Understand childhood exps to find key emotional themes.
- Influence on talking therapies
- Useful bc childhood exps help shape adult personality, there are unconscious influences on behaviour and causes and purposes of behav not always obvious.
Behaviourism
- Observable behaviour rather than internal
- Brain has been taught/ has learned that something should be avoided.
- Exposure therapy - Phobias, anxiety. Gradual exposure.
Cognitive Therapy
- Changing cognition in order to change thoughts, feelings and behaviours
Problems
- Difficult to test
- Ignores role of context
- No single theory can explain cause
- Emphasis on disorder within the indv
- Many do not respond to talk therapies e.g. schizophrenia
Define reliability and its different forms
Consistency of measurement. Often multiple tests are used.
Inter-rater reliability
Test-retest reliability - Observed twice, similar scores
Alternate-form reliability - Extent to which scores on 2 tests consistent
Internal consistency reliability - Whether itms related to one another within questionnaire
Reliability can vary between diff disorders in DSM.
Define validity and its different forms
Whether a measure, measures what it is supposed to.
Content Validity - Whether a measure adequately samples the concept of interest
Construct Validity - How valid can instruments differentiate between those high and low
Discriminative Validity - Identifying characteristics unique to a given disorder
Explain how the DSM works
- Goal - Standardise
- Multiaxial classification system - Two axes, rate severity along continuum with scales for each disorder. How serious it is.
- Symptoms used to diagnose. Doesn’t follow an approach.
- Severity ratings only used if they have a categorical diagnosis.
- Helmuth (2003) - Half of ppl seeking treatment have mild symptoms below threshold.
- Culture-bound syndromes - Diagnosis likely within a region. Argued that these correlate with other diagnoses.
- ICD is the alternative.
Advantages of DSM
- Facilitates communication across diff cultures. Good for research and treatment.
- Informed by research evidence rather than anecdotal experience.
- Receiving a diagnosis can be a relief. Join support groups, treatment
- Aims to be theory free
Criticisms of DSM
Too many diagnoses
- 300
- Poor discriminative validity - Most ppl can be diagnosed with another (45%).
Reliability in everyday practice
- Some clinicians don’t rely on criteria precisely
- Disagreements
- Diff definitions
- Role of culture
How valid are diagnostic categories?
- Categorical system forces to define one threshold as diagnosable
- Is there anything useful from diagnosis?
Misdiagnoses and over-diagnoses
- Hinder treatment
Stigmas
- People treated differently
- Loss uniqueness of person with diagnostic category applied to them.
Clinical Interviews
- Learn through conversation
- Vary in structure. Depends on responsiveness of interviewee and shaped by interviewer.
Structured Interviews
- Questions set out
- E.g. SCID
- Response determines next question asked
- Provides info on when to ask more and when to move on
Self-report Personality Inventories
- Provide statements and rate
- Answers similar to diagnostic group
- Contains validity scales to detect fake responses
Projective Personality Test
- Ambiguous drawings or inkblots
- Response due to unconscious processes which reveal true attitudes and motivations
- Freud
Intelligence Tests
- Asses current mental ability
- Predict school perf
- Diagnose learning disorders
- Identify intellectually gifted
- Part of neuropsychological evaluations
- Standardised
Genetic Paradigm
View that the environment shapes how genes are expressed and genes shape environment.
Psychopathology is polygenic. Genes turn self on and off as interact with environment. Mental illness develops through interation of our genes with envr.
Psychopathology caused/influenced by heritable factors
Neuroscience Paradigm
Emphasises the role of brain, neurotransmitters, HPA axis
Mental disorders linked to processes in the brain.
Role of brain areas. E.g. those with schizophrenia have enlarged ventricles.
Cognitive Behavioural Paradigm
Emphasises the roles of schemas, attention, and cognitive distortions about life experiences and their influences on behaviour.
Idea that behaviour will continue if reinforced.
CBT - Changing pattern of thought.