Lecture 1 - Diagnosis Flashcards
What is the shortened definition of a mental health condition?
Psychological dysfunction
Emotional distress or impaired functioning
Not typical or culturally expected response
Mental health condition definition - what is there clinically significant disturbance to?
Clinically significant disturbance to cognition, emotion regulation or behaviour
Mental health condition definition - what is there dysfunction in?
Dysfunction in psych, bio or developmental processes
Mental health condition definition - what does significant distress or disability affect?
Affects social or occupational or valued activities
Can a MH condition be defined by an expectable or culturally approved response to a common stressor or loss e.g. death of a loved one?
No
Can a MH condition be defined by socially deviant behaviour (e.g. political, religious or sexual) and conflicts that are primarily between the individual and society?
No
What are six ways of operationalising non-typical behaviour?
S, E, F, S, M, D
Statistically rare
Extreme departure from social norms
Faulty perceptions and interpretations of reality
Significant personal distress
Maladaptive or self-defeating behaviour
Dangerousness
What was Rosenhan’s critique of diagnosis? Was his study highly valid?
Study - people faked psychotic symptoms and were admitted despite being mentally healthy
All ‘normal’ behaviours pathologised once inside the hospital e.g. notetaking was named as ‘obsessive’
All had to take psychiatric drugs
However:
Unreliable research - Rosenhan’s write up was not accurate, lacked integrity
What are four critiques of classification of mental health conditions?
F, P, D, U
Fallible (history shows)
Product of social and cultural phenomena
Does it do what it is meant to do?
Useful at all? If so, what should replace it?
What did Spitzer (led development of DSM III) shift focus of mental health conditions to?
Shifted away from Kraeplin’s emphasis on neuropathological causes
He thought that cause did not matter, symptoms and treatment matter
What five significant developments occurred within the DSM III?
C, P, E, R, H
Cause not discussed
Psychoanalytic thought is moved away from
Empirical findings are important
Reliable signs and symptoms of conditions
Helped remove homosexuality as condition
Why as the DSM III almost not published?
Almost not approved for publication because of objections to the removal of Freudian term ‘neurosis’
Who was a key figure in writing of the DSM IV and what changes were made in this manual?
Allen Frances
Field trials to test diagnostic reliability
Included some dimensional phenomena, but fundamentally categorical
What changes were made in the DSM V?
Terminology changes e.g. person with schizophrenia, not ‘schizophrenic’
More diagnoses, including those on the threshold of normality
What are five key issues with the DSM?
O, D, N, R, V&R
- Over-reliance on a medical model
- Distinctions between disorders or between having or not having disorder are not clear
- No specific biological pathology and specific therapy for each disorder (goes against Kraepelin)
- Risk of pathologising normal human experiences
- Validity and reliability?
Are psychological symptoms dimensional and normally distributed?
Generally dimensional, not always normally distributed
What is the most recent edition of the DSM and what changes did it make?
Current = DSM V TR (got rid of unacceptable language around gender and ethnicity)
What is incidence?
New cases in a period of time
What is remission?
The rate at which a condition ceases to be present in previously affected people
What is prevalence? (Point, period and lifetime)
Percentage of a population with a condition
Point = people with condition at specific point in time
Period = people with condition during period of interest (e.g. 12 months)
Lifetime = people who have ever had condition
What is aetiology?
The process of development of a disorder
What is course?
The progression of a disorder over time
What is comorbidity/co-occurence?
Concurrent condition alongside primary condition
What is an odds ratio?
Probability of an event happening compared to another event (e.g. remission vs non-remission)
