Lecture 1 Intro to psychopathology and diagnostic systems - I Flashcards
Which 4 fields are integrated into psychopathology?
- Clinical Psychology: How symptoms present (pathological, maladaptive, not working) and how it is impacting a person
- Psychiatry (medical approaches to mental health)
- Neuroscience: biological basis
- Social Sciences: How culture and environment shape mental health
What were ‘ancient’ views on mental illness?
Mental illness was often attributed to supernatural forces.
Treatments included exorcisms and rituals.
What did Hippocrates propose about mental illness?
Hippocrates proposed that mental illness was due to bodily imbalances (e.g., the four humors).
How were disorders viewed during the Middle Ages?
Seen as moral failings or demonic possession, leading to harsh treatments.
What characterized the Asylum Era?
Institutionalization became widespread, but care was often poor.
What developments occurred in modern psychiatry?
The rise of psychoanalysis, behaviorism, neuroscience, and evidence-based treatments.
How is DSM-5-TR structured and what are its strengths and weaknesses?
The DSM-5 is structured around SYMPTOM CLUSTERS (mental health conditions only).
Strengths
* Standardized diagnostic criteria
* Useful for research and treatment
Weaknesses:
* Lack of cultural and social context
* Can be rigid
* Does not account for symptom severity variations
What emphasis does ICD-11 place more on compared to DSM-5-TR?
Greater emphasis on psychosocial factors
What is the basis for diagnoses in the Categorical Model?
Symptom clusters
This model uses specific groupings of symptoms to categorize mental health disorders.
What is the focus of the Dimensional Model?
Traits existing on a continuum
This model emphasizes a spectrum of traits rather than strict categories.
What advantage does the Dimensional Model offer over the Categorical Model?
Assessment of severity rather than binary diagnosis
e.g., autism where each symptom can be on a continuum and presentations vary widely
This allows for a more nuanced understanding of an individual’s condition.
What are the 3 ways to ASSESS clients
- SCREENING: To inform broad, generalisations about individuals and their functioning (e.g., DASS)
Screeners are not for diagnosis.
- TESTING
Use of tests and inventories to assess characteristics of individuals.
Sometimes diagnostic. More detailed and specific than screener
- ASSESSMENT
Use of data from testing and other sources in a convergent integrative manner.
Come up with recommendations for client.
Screening provides a preliminary understanding and is typically brief.
Why are diagnostic categories important?
- They provide a structured way to assess and classify mental health disorders based on
A) symptom presentation,
B) duration, and
C) severity
What are neurodevelopmental disorders?
Disorders that
- typically emerge in early childhood
- affect cognition, behaviour, or social interaction.
Be mindful that anxiety presentations may have underlying, primary NDD
These disorders can have a significant impact on an individual’s development and quality of life.
Name a key disorder in the neurodevelopmental category characterized by difficulties in social interaction.
Autism Spectrum Disorder (ASD)
ASD encompasses a wide range of symptoms and severity levels.
What are the core characteristics of Autism Spectrum Disorder (ASD)?
Difficulties in social interaction, communication, and repetitive behaviours.
Severity varies: Some individuals require significant support, while others function independently.
Acronym VRIFI
- Verbal/non-verbal cues and gestures are persistently difficult to understand
- Repetitive Behaviour
- Insistence on sameness and routine
- Fixation on narrow interests
- Increased sensitivity (or lack thereof) to environmental sensory stimuli
Severity can vary greatly among individuals with ASD.
What are the core symptoms of Attention-Deficit/Hyperactivity Disorder (ADHD)?
Inattention, impulsivity, and hyperactivity.
Symptoms must be persistent, impair daily life, and present before age 12.
Acronym: GIDD
-Garrulous and impatient
-Inability to sit still/ remain quiet
- Difficulty maintaining interest in a task, or having mental focus required for a task.
- Difficulty remembering routine activities
These symptoms can manifest in various ways and impact daily functioning.
What defines Intellectual Disability (ID)?
I.A.
Intellectual deficits (e.g., reasoning, problem-solving, abstract thinking).
Adaptive Deficits (failing to meet expected levels of independence and social responsibility across home, work, study, self-care
Impacts adaptive functioning (e.g., daily living skills, social participation).
Diagnosed by clinical assessment and standardised test (WISC)
ID affects how individuals learn and adapt to daily life.
What is the primary impact of mood disorders?
A person’s emotional state and ability to function
Mood disorders can significantly affect daily activities and relationships.
Name and define a key disorder in the category of mood disorders.
Major Depressive Disorder (MDD)
- Persistent low mood
- Loss of interest
- Changes in sleep/appetite
- Fatigue
- Feelings of worthlessness
- Suicidal thoughts
MDD is characterized by severe symptoms affecting daily life.
What is the duration for symptoms to qualify as Major Depressive Disorder (MDD)?
At least two weeks
Symptoms must also cause significant distress.
What is Bipolar Disorder (BP)?
Involves episodes of mania and depression
Mania is characterized by elevated mood and impulsivity.
What are the two main types of Bipolar Disorder?
- Bipolar I: At least one manic episode (may include depression)
- Bipolar II: At least one hypomanic episode and one major depressive episode
Hypomania is a milder form of mania.
What are anxiety disorders characterized by?
Excessive fear, worry, or avoidance
Anxiety disorders can significantly impact daily functioning.
What is Generalized Anxiety Disorder (GAD) and some of its key symptoms?
Persistent, excessive worry about multiple aspects of life
- Restlessness
- Muscle tension
- Fatigue
- Difficulty concentrating
Common concerns include work, health, and relationships.
What characterizes Panic Disorder and what are common symptoms?
Unexpected panic attacks
- Intense fear
- Heart palpitations
- Dizziness
Panic attacks involve intense fear and physical symptoms.
What is a common consequence of experiencing panic attacks?
Fear of future attacks
This often leads to avoidance behaviors.
What defines Social Anxiety Disorder?
Fear of social situations due to fear of embarrassment, judgment, or rejection
This disorder can significantly hinder social interactions.
What are 2 Trauma and Stress-related disorders and what are they characterised by?
These disorders develop after exposure to traumatic or stressful events.
- (PTSD) & complex PTSD in ICD
* Symptoms include intrusive memories, avoidance, negative mood, and hyperarousal.
* Must persist for over one month after trauma. - Acute Stress Disorder (ASD)
* Similar to PTSD but symptoms last less than a month.
What are the key features of psychotic disorders, and what are 2 main types?
Psychotic disorders involve D D H (delusions, disorganized thinking/speech/behaviour, and hallucinations)
Key disorders in this category include:
- Schizophrenia
* DDH and negative symptoms (e.g., flat affect, social withdrawal).
* Must persist for at least six months. - Schizoaffective Disorder
* Features of both schizophrenia and mood disorder (depression or mania).
What are personality disorders and 2 main types of them?
Involve long-term, maladaptive behaviour patterns affecting relationships and self-identity.
- Borderline Personality Disorder (BPD)
* Intense emotions, unstable relationships, fear of abandonment, impulsivity, self-harm. - Antisocial Personality Disorder (ASPD)
* Disregard for rules, lack of empathy, manipulative.
What are the 5 steps Clinicians use to determine an accurate diagnosis?
- Gather Comprehensive Information
- Compare Symptoms to DSM-5-TR or ICD-11 Criteria
- Rule Out Alternative Explanations
- Assess Severity and Functional Impact
- Develop a Treatment Plan (this is the purpose of diagnosing!)
What does gathering comprehensive information entail?
- Clinical interview
- Self-report questionnaires, information from third parties (families, schools, etc).
- Medical history and collateral reports
What is the purpose of comparing symptoms to the criteria (DSM or ICD)
- Symptoms must match official diagnostic criteria.
What are 3 possible alternative explanations to a mental health (DSM) diagnosis?
- Medical conditions: Hypothyroidism can mimic depression.
- Substance use: Some symptoms may be drug-induced.
- Cultural and contextual considerations: Hearing voices may be seen as pathological in
Western psychiatry but spiritually significant in some Indigenous cultures.
What are the 3 levels of severity and functional impact?
- Mild: Symptoms cause distress but do not impair daily life.
- Moderate: Symptoms interfere with work and relationships.
- Severe: Significant impairment in all life areas.
What is the purpose of diagnosing?
- A diagnosis should lead to a treatment strategy, not just a label.
- Example: A cognitive-behavioural approach for anxiety vs. medication plus therapy for
severe depression.
What is a Clinical Assessment, and its 4 goals?
A systematic process of gathering and interpreting information to understand a person’s psychological functioning.
To determine:
1. The presence and severity of symptoms
- The impact of symptoms on daily life
- Whether the symptoms meet criteria for a mental disorder
- Appropriate treatment recommendations.
What are the 4 principles of a strong clinical assessment?
R. V. S. C.
- Reliability
- Validity
- Standardisation: The use of uniform procedures to ensure fairness in assessment.
- Cultural Sensitivity: Consideration of cultural, linguistic, and contextual factors in interpretation.
What is the clinical interview?
The most widely used assessment method in psychopathology.
Explores mental health concerns, symptom patterns, and relevant life history.
What does a comprehensive interview typically include?
A comprehensive interview typically includes:
(P S F M R)
- Presenting Problem: Why is the client seeking help?
- Symptom History: Onset, duration, and severity of symptoms.
- Family and Social History: Genetic predispositions and life circumstances.
- Medical History: Any medical conditions or substance use that could impact symptoms.
- Risk Assessment: Evaluation of suicidal ideation, self-harm, or harm to others.
Types of clinical interviews: What is an unstructured Interview?
- Unstructured Interviews are open-ended conversations where the clinician explores symptoms flexibly.
➢ Advantages:
* Allows for natural conversation.
* Encourages clients to share information freely.
➢ Disadvantages:
i) Lack of structure can make it less reliable between clinicians.
ii) Risk of overlooking key diagnostic criteria.
➢ E.g.,: A clinician asks, “Can you tell me about your experiences with anxiety?” and follows up based on the client’s responses.
What is a Structured Interview?
It uses predefined questions to ensure consistency across assessments).
➢ Advantages:
i) Increases diagnostic reliability.
ii) Ensures all relevant symptoms are covered.
➢ Disadvantages:
i) Can feel rigid or impersonal.
ii) May miss unique client experiences.
What is a semi-structured interview?
Semi-Structured Interview (structured questions w flexibility to explore relevant details).
➢ Advantages:
* Balances standardization and clinical judgment.
* Allows for follow-up questions based on client responses.
➢ Disadvantages:
* Requires more training and clinical skill to conduct effectively.
What are 4 ethical considerations in clinical assessment?
- Informed Consent
- Avoiding Overdiagnosis and Labelling
- Confidentiality and Data Protection
- Cultural Competency in Assessment
