M1: Lecture Material Flashcards
What characterizes chronic depression compared to temporary sadness?
Loss of enjoyment in life and inability to identify a single cause
Unlike those who can point to a specific event (a common experience of temporary sadness).
How can anxiety be beneficial?
It can motivate individuals and ensure safety
Anxiety is often linked to identifiable reasons.
What is Medical Student Syndrome?
The phenomenon where students believe they have the disorders they are studying
This occurs due to exhaustion and heightened awareness of symptoms.
What is the Statistical Approach to abnormality?
(an approach to viewing abnormal behaviour)
Defines abnormal behaviour based on societal NORMS
Think of people’s behaviour as being normally distributed
(some people are super resilient, some people are very maladaptive, and everyone else is in the middle).
Ex. naked man on robson street is extremely abnormal compared to norms
Behaviours outside the norm are considered disordered.
What is Subjective Discomfort in the context of abnormality?
(an approach to viewing abnormal behaviour)
Individuals determine if their behaviour is problematic
Example: deciding if a new mole on your skin is concerning.
What does Maladaptive Functioning refer to?
(an approach to view abnormal behaviour)
Inability to function in personal and professional areas of life
Judged by professionals based on societal functioning.
List the three characteristics that define abnormality.
- Distress (causes onself or others distress)
- Dysfunction (prevents person from functioning in daily life)
- Deviance (thoughts, behaviours, or feelings are highly unusual)
These characteristics help identify abnormal behaviours.
What is Harmful Dysfunction?
A theory that psychological disorders can be caused by a breakdown in a natural internal mechanism.
- An internal mechanism is not functioning normally
- Causes harm to self or others
This is important in understanding psychopathology.
Why is the diagnosis of abnormal behaviour complex?
It involves value judgements influenced by societal norms
Therefore, our understanding of what is abnormal changes over time.
Example: Homosexuality was once classified as a disorder.
Behaviour can be both —– and —— within the same person
Normal and Abnormal!
Ex. Ex. adaptive defense mechanisms that were vital at a young age but carry into the present unnecessary makes it appear pathological.
(blending into the background was life saving when she was a child, but as an adult it appears to be pathological)
What are the three most common kinds of psychopathology?
- Depression
- Anxiety
- Substance dependence
These disorders are most frequently reported in research and in surveys.
What percentage of Canadians aged 15+ reported symptoms of mood or anxiety disorders?
About 11%
Women more likely to experience depression than men.
This includes depression, anxiety, and substance dependence.
There is a significant increase in mood disorders over the last few decades. Is this bad news?
NOT bad news - people are simply freer to admit or REPORT that they have a depressive disorder now than 20 years ago.
Who is at the highest risk for suicide among individuals with psychological disorders?
Older, white men
Sheep herders have a high suicide rate due to means availability.
What is the leading cause of disability in developed countries?
Mental health problems!
What are the economic impacts of mental health problems in canada?
- Health Care Costs (ex. Treatment, hospitalization)
- Productivity Loss (ex. Sick leave and people not being able to work well).
Estimated annual cost = $15 billion in canada (1 billion in BC)
What procedure was used to allow evil spirits to escape the body?
Trephination or trepanning
Evidence of this happening over 7,000 years ago
Who proposed that abnormal behaviors had a physical basis around 400 BC?
Hippocrates
What are the four important fluids (humors) in the human body according to Hippocrates?
- Black bile = depression
- Yellow Bile = tension/anxiety
- Phlegm = dull, sluggishness
- Blood = mania, mood swings
What did Hippocrates believe could help heal individuals apart from physical means?
Putting people in a tranquil place
*we still see this idea today in calm places being used to improve mental health.
What historical model could connect to the modern idea of ‘chemical imbalance’ in the brain?
Hippocrates’ humor/fluid model
During the Middle Ages, what was believed to cause disturbed behavior?
The devil invading a person’s functioning
Treated with extrocism - prayer, beatings, potions, etc.
What infamous manual outlined how to treat witches?
Malleus Maleficarum
*is considered one of the most infamous publications to have existed.
*one of the most popular job during the 1400s was to be a witch hunter - and this mannual told people how to do it.
What were some characteristics that indicated a person might be a witch?
- Loss of reason
- Hallucinations
- Delusions
according to the Malleus Maleficarum
What was the ‘Water Test’ used for?
To determine if a person was a witch after being thrown in the water with rocks.
*think about the “witch sketch” video and how there was not really a designated way to tell if people are witches - which is what caused so many non mentally ill people from being deemed witches and killed.
Who was a scholar that linked abnormal behavior to the influence of the moon?
Paracelsus
He also made it clear that spirits did not cause mental illness.
He reccomended therapies of bleeding (for mania), essenences of metals, and charms (to treat those afflicted by witchcraft).
What term did Paracelsus coin to describe madness influenced by the moon?
Lunacy (meaning madness)
What were asylums originally built for?
Quiet retreats for people exhibiting psychopathology
(but eventually too many people needed to go to them, causing overcrowding and chaoticess)
What does the term ‘Bedlam’ refer to in the context of asylums?
Chaotic hospitals
Comes from the hospital Bedlaham in Europe that was specifically chaotic.
What are some of the forms of treatments used in asylums?
Ex. patient laid in bed and 4 clinicians spun a wheel to spin the patient around → to get behaviour under control
Ex. Sensory reduction chair
Ex. Crib → small jail where you cannot move
Ex. “Hollow Wheel” → a patient is placed in the door and runs in the wheel to change behaviour.
What significant reform was suggested in the 17/1800s regarding mental health patients?
Releasing patients into the community (a massive reform)
What is classification in clinical work and research?
An important activity that makes information more accessible, meaningful, and less cumbersome.
Mushroom Example
What did the empiricists focus on in Ancient Greek medicine?
Understanding the nature of the universe through observation.
Observe the complaint of the individual or see what was wrong → what you can SEE is what the problem is → get rid of what you can see - the bleeding, the growth, etc.
Focus on observable signs, symptoms, groups of co-occurring systems
DSM takes a empiricist approach today (focuses on observable signs)
What is the focus of the theorists (or pythagoreans)?
Understanding the underlying causes of observable symptoms.
Felt that it was important to observe what we can see, but that the WHY is more important to focus on
(why can we see them? why are they there?)
When people came in with an issue → theorists did not soley focus on the thing that was observable, they were focused on what might be producing the difficulties (the symptom exists for a reason)
Consistent with psychodynamic theories/treatments
What did Emil Kraepelin contribute to classification in psychopathology?
Contributed an empiricist approach identifying observable signs and symptoms.
Developed this while running his hospital where he noticed there was observable signs that coexisted in patients - took all those patients and gave them one name based on those observable signs.
Was Freud a theorist or a empiricist?
A theorist!!
Tried to understand what was happening under the surface to cause the observable symptoms.
What does the trend ‘symptom as focus’ imply?
Observable characteristics are seen as the cause of difficulties.
(a Kraepelin/Empiricist approach!)
Focus of assessment and treatment on eradicating the symptoms.
Trend is embraced by insurance companies because if disorders are only diagnosed with many symtoms, if you get rid of some of the, you don’t have the disorder and it saves the companies money.
Why is it problematic for observable characteristics to be seen as the CAUSE of difficulties?
“symptom as focus” idea
Problematic because once you start to use terms to classify physical things, the terms are no longer simply convenient words to represent this thing, that is a real entity
Ex. patients will come in and ask WHY they have these symptoms, told that what is causing the symptoms is depression → all of a sudden depression is a pathogen.
Depression is turned into a thing, when it was just a word we used to classify characteristics (Circular reasoning → “the reason you have these depressed symptoms is because of depression”)
What is the difference between “symptom focus” and “underlying cause is focus”?
Symptom focus looks at observable signs
Underlying cause (frued/theorist) focuses on examines deeper processes - psychodynamic and PDM.
What are the purposes of classification?
- Description and identification (classify symptoms reliably)
- Communication (teach clinicians how to identify the diagnoses that exist)
- Research (need to call disorders the same thing)
- Treatment
- Insurance
- Theory Development
- Epidemiological Information
Does diagnosis always lead to proper treatment?
NO, for example, Alzheimer’s Disease and depression treatments can vary.
What are the steps in classifying disorders?
- Divide disorders into mutually exclusive (distinct/cannot belong to two subclasses) and collectively exhaustive (all disorders must be classified) subclasses.
- Subclasses defined by necessary and sufficient conditions.
*must have reliability (should get the same result from the classification system each time)
*must have validity (classification system should say something about the “true world”)
What is the DSM-5?
A manual that categorizes over 400 disorders based on descriptive information.
Based on the empirist perspective and avoids psychoanalytical concepts, just focusing on observable features.
What is the difference between diagnosis and formulation?
Diagnosis = assigns a diagnostic category
(structured interview → diagnosis!)
Formulation = explains genesis and treatment processes
(assessment → formulation!)
What is the ICD?
The International Statistical Classification of Diseases and Health Related Problems.
Another DESCRIPTIVE manual.
What is OPD-2?
A diagnostic manual used in Germany based on a psychodynamic theoretical model.
What theoretical perspectives define the PDM?
- Psychoanalysis
- Object relations
- Attachment theory
These models are rooted in current psychodynamic theory.
What are the key elements of the PDM?
- Personality patterns
- Social and emotional capacities
- Unique mental profiles
- Personal experiences of individuals
These elements provide a comprehensive view of an individual’s psychological makeup.
What is the main idea of the PDM regarding mental disorders?
Disorders are seen as a result of underlying processes rather than discrete categories
This perspective shifts focus to personality and upbringing.
List some disorders included in the PDM’s P Axis.
- Depressive Personality Disorder
- Sadistic and Sadomasochistic PD
- Masochistic (Self-defeating) PD
- Somatizing PD
- Dissociative PD
These disorders reflect various personality patterns and disorders.
What is the goal of the Research Domain Criteria (RDoC)?
To understand the nature of mental health and illness in terms of dysfunctions in psychological/biological systems
Rather than findings symptoms that align with a named disorder, it looks at underlying systems in the brain
What are the five domains of RDoC?
Negative Valence Systems
(brain elements that lead to fear, anxiety, threat, loss)
Positive Valence Systems
(reflect functioning within reward responsiveness)
Cognitive Systems
(basic things like concentration, perception)
Systems for Social Processes
(attachment theory, early childhood, trauma, affiliation, communication)
Arousal Regulatory Systems
(arousal, sleep processes, circadian rhythms)
These domains help categorize various psychological functions.
True or False: The RDoC is intended to serve as a diagnostic guide.
False
RDoC focuses on understanding mental health rather than categorizing disorders.
How do classification systems like DSM and ICD differ from PDM and OPD?
DSM and ICD focus on assigning diagnoses (epericist), while PDM and OPD focus on developing formulations related to stated problems (psychodynamic - theorist)
According to Nancy McWilliams, what are the 10 things that represent what a mentally healthy person looks like?
1. Greater attachment security/sense of safety in relationships
2. More integrated and coherent experience of self and others
(being able to see good and bad in the self, and others, at the same time)
3. Increased sense of personal agency
(the sense that you have influence in your life).
4. More realistic and reliable self-esteem
(Realistic self-esteem = I am good enough & Reliable self-esteem = able to tolerate both criticism and both inflating)
5. Greater resilience/improved affect regulation
(capacity to keep yourself at bay during difficult times)
6. Greater capacity for both self-reflection and understanding of others’ experience
(see parts of myself that I want to change, but also have positive things about myself)
7. Increased comfort in functioning both independently and interdependently (communally)
8. More robust sense of vitality and aliveness
**9. Enhanced capacity for acceptance, forgiveness, and gratitude **
(accepting the stuff that cannot change and you grieve it to move on)
10. Movement toward more mature and flexible defenses
(being able to love, work, and play).
What myth areas revolved around Frued
Seuxal abuse (thought to be a pediphile, when he proposed the mental challenges associated with child abuse)
Hysteria (he observed hysteria in men - which was seen as impossible at the time - making everyone think he was insane)
Women theorist (thought to be a misogynist and anti-women, but there was truly an equal amount of women involved in psychoanalytic psychology)
What is a common misconception about evidence for psychoanalysis?
That the only evidence for psychoanalysis is for Cognitive Behavioral Therapy (CBT)
This myth undermines the existence of empirical support for psychoanalysis.
Is this a myth or a true statement: “projectives, like Rorschach or TAT, are NOT appropriate for use and not used in clinical psychology”
A MYTH - they projective tests are still common.
What is Division 39 within the American Psychological Association?
Psychoanalysis
EVIDENCE THAT PSYCHOANALYSIS IS NOT DEAD!
It represents professionals committed to the study, practice, and development of psychoanalysis and psychoanalytic psychotherapy.
What are the major features of psychoanalysis according to Shedler?
- Unconscious
- Conflict
- Past influences present
- Transference
- Defense
- Psychological causation
These features highlight the complexity of psychoanalytic theory.
How have psychoanalytic theories evolved over the past century?
They have been refined and expanded through research, clinical work, and theoretical work
Contemporary theories have little connection to Freud’s original ideas of the id, ego, and super ego, etc.
What Freudian ideas remain prevalent in our culture today?
- Trauma causes emotional and physical problems
- Early childhood experiences affect adult lives
- Sexual abuse of children has disastrous effects
- Emotional difficulties can be treated through talking
- We find faults in others that reflect our own issues
These ideas underscore the lasting impact of Freudian theory.
Why are textbooks and professors often inaccurate about psychoanalytic theory?
Psychoanalytic theory developed outside of academia, leading to arrogance and elitism.
Also, repetition of professors’ views and lectures, writings → people have created falsehoods about this discipline and it just continually gets repeated.
Resulted in hostility towards psychoanalytic ideas and the perpetuation of falsehoods.
What did work from Bornstein (2005) reveal?
That there are terms used in cognitive psychology that have the SAME meaning as words in psychoanalytic processes → but people refuse to use the word psychoanalytic words
Proof that pychoanalysis has been here but is HIDDEN.
