Lecture 1- Understanding Psychopathology Flashcards
-what is abnormail -Models of psychopathology -How do we study psychopathology -DSM framework -Alternate frameworks: dimensional, continuum, RDoC, clinical staging
According to the DSM-5 general definition of a mental disorder, there are two things
that must be present in order to make a diagnosis. Name one of these two things.
Disturbance in cognition, emotion regulation, or behavior OR significant distress and/or functional impairment
Other possibilities (0.5points):
- Not better explained by medical illness, substance use, or another disorder
- Fulfillment of specific criteria for a given disorder (e.g., 5 of 9 symptoms for depression)
- Not due to a culturally normative response to a common stressor or experience
Based on what was presented in lecture, what is the single best argument for using
categorical diagnoses of mental disorders (rather than non-categorical – e.g., dimensional or
transdiagnostic - alternatives)? (Note, it is unacceptable to say that there is not one).
Provision of clinical services. Treatment decisions are always categorical and clinical services are limited, therefore, it is reasonable to make diagnostic decisions on a similar basis.
Other possibilities include (0.5 points):
- Facilitation of communication among clinicians, scientists, etc.
- Facilitation of care (identification of treatment, description of illness, possible aetiology and prognosis)
- Facilitation of research (test treatment efficacy and understand etiology)
- Education (teach models of mental disorders)
- Information management (measure and pay for care)
In lecture, I presented four different ideas (also in textbook) that are often used to determine abnormality. Name one of those four ideas.
- Statistical Infrequency (e.g. bell curve)
- Norm violation (Violation of society rules)
- Personal distress (to the individual themselves)
- Disability/dysfunction (E.g. “pathological” desire to escape slavery)
A 14-year woman has unstable relationships, feels she lacks an identity, has outbursts of anger, and has unstable mood. Is this abnormal? Why or why not?
No, these are normal/common symptoms among adolescents. context is still important
Aaron Beck, Albert Ellis, and Donald Meichenbaum were champions of cognitive models of psychopathology. What do these models emphasize as the core problem and/or target underpinning psychopathology?
- Cognition
- Thinking
- Thought patterns
- Schema
- Relationship between affect/emotion (A), behavior (B), and thoughts/cognition (C)
True or False. Diathesis-Stress models of psychopathology argue that psychopathology emerges as the result of some vulnerability (e.g., genetic liability, maladaptive personality features) OR an influential life experience (e.g., stressor, adverse event, trauma).
FALSE. It is the interaction between these two things (vulnerability & life experience)
Name one of the six broad domains from the Research Domain Criteria framework proposed by Tom Insel and Bruce Cutherbert (National Institues of Health in the US).
- Negative Valence System
- Positive Valence System
- Cognitive Systems
- Systems for Social Processes
- Arousal/Regulatory Systems
- Sensorimotor System
How is the clinical staging model (McGorry, Hickey, Jackson and colleagues) different from a stepped care approach to treatment?
Stepped care argues for an escalation in treatment (start from the lowest level of possible treatment and progress accodringly).
Clinical staging argues for treatment consistent with the level of illness/disease severity (according to stage of illness development).
The Hierarchical Taxonomy of Psychopathology (Kotov and colleagues) is an example of what kind of diagnostic system?
Answer (1 point): - Dimensional - Transdiagnostic Answer (0.5 points): - Contemporary - Categorical Alternative - Hierarchical or nested system
In lecture, I presented 8 different ways that psychopathology is commonly assessed. Name two of these 8 different methods. PCBAPMPN
9th point is context- e.g. grievance may look like depression but it is understandable in the situation
- Pen and paper tests
- Clinical interview
- Behavioral assessment
- Activity diary
- Psychological test
- Medical test
- Psychophysiological test
- Neuropsychological test
What is a mental disorder and what is not a mental disorder according to DSM-5?
A MD is a clinically significant disturbance in an individual’s cognition, emotional regulation and behavior……usually associated with significant distress/disability in social, occupational or other impt activities.
A MD cannot be an expected/ culturally approved response to a common stressor loss, such as death of a loved one (e.g. grief)
*although grief can be considered disorder if prolonged over extended period of time.
Explain the 4 controversies/setbacks of mental health diagnoses.
• Lead to bias or restricted thinking
– Diagnostic boundaries are rarely distinct and diagnoses change over time.
Eg. if one assumed to have PTSD, then only ask questions regarding PTSD.
• Are associated with jargon
– Are clinicians in fact talking about the same construct? Jargon may mask what is actually being discussed.
e.g. clinicians use complex terms for diagnoses that can confuse ppl, assume its of the same construct
• Inhibit research
– See the case for RDoC. If we only study conditions meeting specific criteria, we may be missing a big part of the picture.
• Can be stigmatizing and have personal implications
– How does this effect existing experience? If a brain disorder, is brain ”broken”? If not a brain disorder, is something wrong with ”you”?
But why is it important to diagnose and classify psychopathology? CCREI
- Facilitate Communication: among clinicians, between science and practice
- Facilitate Care: identification of treatment, and prevention of mental disorders, description of experience, possible etiology and prognosis.
- Research: test treatment efficacy and understand etiology
- Education: teach psychopathology
- Information Management: measure and pay for care
In case study, what are the 7 factors to analyze? PCPAACP
• Presenting problem
• Clinical picture or clinical description (Family history etc)
• Prevalence (proportion of population with a disorder),
incidence (new cases over a time period)
• Age of onset
• Acute/ delayed onset
• Course – episodic, recurrent, chronic, time-limited
• Prognosis
Give an example each of sign, symptoms, and syndrome during MD diagnosis
Signs: objective findings observed by a clinician
§ Tachycardia
§ Pressured speech
§ Poor eye contact
Symptoms: subjective complaints reported by a patient
§ Low mood
§ Anxiety
§ Paranoia
Syndrome: signs, symptoms and events that occur in a
particular pattern and indicate the existence of a disorder
§ Bipolar disorder
§ Depression
