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CIDS tentamen > Lecture 3: categorical taxonomies and DSM > Flashcards

Lecture 3: categorical taxonomies and DSM Flashcards

1
Q

waaruit bestaat een symptoom

A

discourses: social, medical, scientific, institutional, political, economic

expectations - norms

observations - deviations - problems - theories

symptom

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2
Q

wie had de basis gelegd voor psychiatric disorders

A

Emil Kraepelin

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3
Q

wat dacht emil kraepelin

A

psychiatric syndrome (course, prognosis, etiology) -> leads to symptoms

(what mental disorder causes the symptoms the patient is having?)

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4
Q

wat dacht Freud

A

unconscious conflicts, fantasy, defense mechanisms -> symptoms

(welke unconscious fantasies, drives and conflicts are these symtpoms an expression and compromise?)

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5
Q

wat dacht Burrhus F. Skinner

A

behaviours learned through conditioning of stimuli -> symptoms

(how have these symptoms been shaped through conditioning?)

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6
Q

dus welke woorden horen bij elke van die 3 mannen

A

emil kraepelin - distinguishing psychiatric disorders
sigmund freud - formations of the unconscious
burrhus f. skinner - behaviourism

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7
Q

wat zeiden ze in DSM-I en DSM-II over anxiety

A

Psychoneurotic disorders:
The chief characteristic of these disorders is “anxiety” which may be directly felt and expressed or which may be unconsciously and automatically controlled by the utilization of various psychological defense mechanisms (depression, conversion, displacement, etc.)

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8
Q

wat kwam er vanaf de 50s

A

humanistic and existentialist approaches
- carl rogers
- gestalt
etc

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9
Q

wat was er in de 60s and 70s

A

antipsychiatry

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10
Q

Neo-Kraepelian revolution: door wat werd deze aangewakkerd en wat was het

A

dus een soort van weer terug naar distinguishing psychiatric diagnoses, zoals Kraeplin dat ook wilde doen.

  • 60s and 70s: critique on reliability of diagnosis, quality of research and the authority of psychiatrists
  • 1972: the Feighner criteria for syndromes
  • 1972-1974: Research Diagnostic Criteria (RDC)
  • 1980: DSM III
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11
Q

the Feighner criteria for syndromes =

A

indelen in verschillende condities, zoals primary affective disorders, schizophrenia, anxiety neurosis, antisocial personality disorders, etc. dus een soort boek voor het indelen van symptomen naar diagnosesn, soort voorloper van de DSM

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12
Q

wat was tijdens de Neo-Kraepelian revolution het idee over syndromes

A

syndromes = covariance of problems

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13
Q

wat gebeurde er toen in de 80s and 90s

A
  • DSM II
  • rise of psychofarmacology and biopsychiatry
  • RCTs
  • DSM-CBT procolized treatment
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14
Q

dus na welke DSM kwam de Neo-Kraepelian revolution

A

tussen DSM II en DSM III
1968 - 1980

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15
Q

wat was er met de ICD6

A

in de ICD 6 werden eindelijk de psychiatrische disorders geincludeerd

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16
Q

hoe zijn de DSM en ICD uiteindelijk samengekomen

A

tussen ICD 6 en DSM 1 -> steeds meer allignment. tot op een gegeven moment de convergence of the DSM IV and ICD 10.

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17
Q

en waar is vanaf ongeveer 2000 steeds meer de nadruk op

A

dimensional taxonomy & recovery movement

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18
Q

wat is Ian Hackings punt in ‘making up people’

A

“Sometimes, our sciences create kinds of people that in a certain sense did not exist before.“

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19
Q

core ideas van Making Up People

A
  • Making up people
  • Moving targets
  • Looping effects
  • Transient mental illness
  • Engines of discovery are also engines of making up people
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20
Q

five part framework =

A

institutions
people
classification
knowledge
experts

21
Q

historical dynamic

A
  • The (hi)story is different for each classification
  • The (hi)story is told in different ways by different people
  • Implications and consequences for individuals in mental healthcare greatly vary
22
Q

multiple personality disorder wanneer

A

1970

23
Q

hoe presenteerde multiple personality disorder zich in die tijd

A
  • first, a person had two or three personalities
  • within a decade the mean number was 17
  • this became a way to be a person (identificatie)
24
Q

hoe is multiple personality disorder toen in de DSM gegaan

A

1980: DSM 3 criteria voor MPD
1994: multiple personality was renamed dissociative identity disorder, symptoms evolve, patients are no longer expected to come with a roster of altogether distinct personalities

25
Q

welke twee manieren heb je om disorders te omschrijven

A
  • A sentences: realism
  • B sentences: dynamic nominalism
26
Q

hoe beschrijf je disorders in ‘realism’

A
  • A sentences
  • “does it really exist?”
27
Q

hoe beschrijf je disorders in ‘dynamic nominalism’

A
  • what happens after a classification (name/nomen) has first been proposed?
  • how does this affect the people classified? how do these people in turn affect the classification?
28
Q

hoe werd autisme door de jaren heen omschreven

A
  • 1943: Leo Kanner – ‘infantile autism’
  • Later: ‘high-functioning autists’
  • 1980: DSM-III: autism criteria
  • 1981: Lorna Wing: Asperger’s syndrome
  • 1994: Aspergers’ syndrome in DSM-IV
  • 2013: DSM-V: autism spectrum syndrome
  • Emerging since the 90s: Neurodiversity movement
29
Q

hoe omschrijf je autisme in A sentence

A

A. There were no high-functioning autists in 1950; there were many in 2000.

B. In 1950 this was not a way to be a person,p people did not experience themselves in this way, they did not interact with their friends, their families, their employers, their counsellors, in this way; but in 2000 this was a way to be a person, to experience oneself, to live in society.

30
Q

hoe omschrijf je MPS in A en B sentences

A

A. There were no multiple personalities in 1955; there were many in 1985; there are none in 2023.
B. In 1955 this was not a way to be a person, people did not experience themselves in this way, they did not interact with their friends, their families, their employers, their counsellors, in this way; but in 1985 this was a way to be a person, to experience oneself, to live in society. In 2023 it is quite rare for people to identify themselves as MPS.

31
Q

waar over nadenken als we het hebben over classical taxonomy en de dsm

A
  • Is it a good idea to create and give diagnoses?
  • What values are implicit in DSM-5? Or in personal recovery?
  • What would you want and need as a client?
  • How do you think you should be working as a clinician?
32
Q

reflexivity slide

A
  • We cannot be neutral on values and ethics
  • Our values reflect our position in the world
  • Our values derive from our personal history
  • Our personal history is embedded in
  • Family history
  • Social, economic, political situations
  • Cultural histories

-> We cannot step out of ourselves, but we can expand our horizon

33
Q

wanneer explosive increase in the importance and dominance of the dsm

A

1980-2020

34
Q

sinds wanneer kritiek op de dsm en ontwikkeling van alternatieven

A

since 1990’s

35
Q

critical issues raised against classification and the dsm

A
  • Stigma
  • Reïfication
  • Commodification
  • Dominant attributions
  • Lack of context, meaning, personalized narrative and hope
36
Q

reïfication=

A
  • when you think of or treat something abstract as a physical thing.
  • A created concept is so often named and discussed that we take it simply as a thing that exists ‘in nature’.
  • The danger is that we tend to forget the human choices that were involved in the construction of our concepts.
  • And this may easily block our options and imaginations of alternative perspectives
37
Q

commodification =

A
  • Something is reconstructed in such a way that it can be traded on markets. (Dus kapitaliseren van de mentale gezondheid)
  • This means that one should be able to clearly generalize and compare.
  • Individuality has to be ‘translated’ in comparable measures.
  • So a transition from qualities to quantities is necessary in order to determine prices:
    How many pills can be sold for depression for which price? How much should an insurance pay for how severe problems? How many sessions of therapy can be sold for a given quantity of symptoms?
38
Q

dominant attributions=

A
  • bijvoorbeeld: hij is zo omdat hij ADHD heeft
  • alternative attributions: what may cause this inattention? for whom is this a problem? being playful and energetic? interesting differences in abilities and preferences? what environment suits this kid? are the expectations correct, should we expect the same from all children?
39
Q

stigma =

A

an attribute that is deeply discrediting

40
Q

drapetomania

A

in 1851: a psychic disturbance that causes black slaves to escape

41
Q

backgrounds of the recovery moment

A
  • patient voicing their experiences and critical views
  • client-centered and humanist ideas
  • anti-authoritarian impulses (bv van anti-psychiatry movement)
  • dissatisfaction with the dominant discourse since the 80s (DSM, RCT, protocolized treatment, psychofarmaca)
42
Q

patient voicing their experiences and critical views =

A
  • lack of context and meaning
  • lack of personalized narrative
  • lack of hope
43
Q

dsm-5 as a tool in clinical practice=voordelen

A

I. Provide a common international language for mental health problems
II. Make treatment possible within current social practices
III. Generate hypotheses on etiology, course, prognosis and vulnerabilities
IV. Generate hypotheses on treatment options

44
Q

I. a common international language =

A
  • If someone meets criteria for a DSM-5 or ICD-11 syndrome anywhere in the world, we have at least some common understanding of what that means.
  • If DSM-5 is used in a research project people have some common understanding of the kind of problems people in that study were experiencing.
  • In communication between mental health professions and the rest of society we have some common ground for telling what kinds of problems we are treating in our practices.
45
Q

II. make treatment possible

A
  • Socio-political status as a medical profession.
  • Diagnosis-Treatment combination for insurance (may change)
  • Clear and easy message to a patient: “you have X, we know that people with X often profit from Y, so we will start with Y.”
  • Clear and easy message to society: ‘We have evidence that providing X to people with Y has positive consequences’.
46
Q

III. Hypotheses on etiology, course, prognosis, vulnerability =

A

research on large groups -> dsm 5 -> specific individual

47
Q

IV. Hypotheses for treatment =

A

randomized clinical trial -> dsm 5 -> specific individual

48
Q

DSM-5 can be a useful tool to generate ideas: op welke manier?

A

Hypotheses + Other diagnostic approaches <-> Individual case formulations <-> Individualized Treatment.

zie schrift

CIDS tentamen (13 decks)

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