Module 1: Historical Perspectives on Psychopathology and Classification of Mental Disorder Flashcards
Refers to behaviour, speech, or thought that impairs the ability of a person to function in a way that is generally expected of them in the context where the unusual functioning occurs
Psychological Abnormality
Psychopathology
Refers to the scientific study of psychological abnormality and the problems faced by people who suffer from such disorders
A specific manifestation of this impairment of functioning, as described by some set of criteria that have been established by a panel of experts
Psychological disorder (or mental disorder)
Mental Illness
A term used to convey the same meaning as psychopathology, but implies a medical rather than psychological cause.
What did Wakefield conclude?
That harmful dysfunction is the key notion - where dysfunctions refers to “failures of internal mechanisms to perform naturally selected functions”.
To conclude that a given behaviour is disordered “requires both a scientific judgement that there exists a failure of designed function and a value judgement that the design failure harms the individual”.
Therefore, unless there are dysfunctional consequences to the invidivdual, in that they are unable to perform a natural function, it makes little sense to call behaviour abnormal.
Persons who are initially trained in general psych, and then receive graduate training in the application of this knowledge to the understanding, diagnosis, and amelioration of disorders of thinking and behaviour
Clinical psychologists
What are four general attempts at defining abnormality?
1) statistical concept
2) Personal distress
3) Personal dysfunction
4) Violation of norms
Bodily fluids, disturbances of which, according to Hippocrates, resulted in psychological dysfunctioning
Humours
Rowdy, chaotic behaviour
Bedlam
Moral Therapy
Form of treatment advocated by Pinel that held that the insane could be controlled without the use of physical or chemical restraints, by means of respect and quiet and peaceful surroundings, plenty of rest, a good diet, moderate exercises and activities.
Biological Approaches
-heredity
-Syndromes
-Infection
—–Shock therapy and Psychopharmacology
Psychological Approaches
Hypnotism + birth of psychoanalysis
Behaviourism
A system of rules for recognizing and grouping various types of problems
Diagnostic system (or classification system)
What important functions does a diagnostic system for mental disorders serve (4)?
1) Providing a description of different mental disorders
2) Describing and organizing different mental disorders
3) Serves a critical function to identify individuals who meet criteria + exclude those who don’t in order to study the specific disorder of interest.
4) Needed for surveying population health and for understanding the prevalance and etiology of particular mental health problems.
What would the perfect diagnostic system do?
- Classify disorders on the basis of presenting symptoms, etiology, prognosis and response to treatment.
Patterns of experiences and behaviors
Symptoms
Etiology
history of the development of symptoms and underlying causes
Prognosis
future development or maintenance of symptoms
What would comprise in the development of the perfect diagnostic system?
1) A Large number of people would be thoroughly assessed psychologically and physically in terms of feeling, thoughts and behaviours
2) Thorough history taken to understand how various features develop
3) Various treatments tried
Characteristics of a strong diagnostic system:
1) Reliability
2) Validity
3) Predictive Validity
Functions of a good classification system:
1)Organization of clinical info
2) Shorthand communication
3) Predication of natural development
4) Treatment recommendations
5) Heuristic value
6) Guidelines for financial support
Refers to the extent to which 2 clinicians agree on the diagnosis of a particular patient
Inter-rater reliability
Concurrent Validity
Refers to the ability of a diagnostic category to estimate an individuals present standing on factors related to the disorder but not themselves as part of the diagnostic criteria
The ability of a test to predict the future course of an individuals development.
The key to a clear understanding of a disorder and its progression
Predictive validty
Atheoretical
Not based on or concerned with a particular theory
An individual may be diagnosed with only a certain subset of symptoms without having to meet all criteria
Polythetic
DSM-5-TR Organizational Structure
Section I: Intro to use of manual (history, guidelines, development)
Section II: Diagnostic criteria and codes (also collects info on patient’s life circumstances)
Section III: Emerging measures and models (aids clinicians decision making and increase sensitivity to patients’ cultural context).
Innovations and Limitations of DSM-5
- Revised as researchers gather new empirical evidence
-Development into greater consideration
-Organization. Reorganized into new categories based on spuerficial similarities and empirical evidence
-Major critisim is its categorical approach (no in between)
-Some researchers advocate a dimensional approach to diagnosis based on continuum from non-existent or mild to moderate and to severe
-Another goal of DSM development was to enhance clinical utility
The extent to which a diagnostic system assists clinicians in describing patients’ problems, communicating clinical info to patients and other health care providers, selecting effective interventions and predicting the course of a disorder.
Clinical Utility
Criticisms of DSM
-Gender biased in 4 categories:
1) fostering traditional gender roles
2) bias in expectations and devaluation of women
3) sexist use of psychoanalysis
4) treating women as sex objects
- Cultural Bias
- Politics
Research Domain Criteria (RDoc) Matrix
Domains:
Negative Valence
Positive Valence
Cognitive Systems
Systems for social processes
Arousal/Regulatory systems
Sensorimotor systems
Behavioural Dimensions:
Genes
Molecules
Cells
Circuits
Physiology
Behaviour
Self Reports
Mental Health Community uses critereia like:
1) statistical rarity
2) Personal Distress
3) Personal dysfunction
4) Violation of norms
*but none of these is full proof criteria. So we need to constantly be evaluating our diagnoses
What is the highest principle clinical psychologists adhere to in their code of ethics?
Maintaining the dignity of the individual
What are the two main streams of thought concerning mental health disorders?
1) Biological
2) Environmental (roughly following nature/nurture)
Biological approaches tend to…
dismiss/downplay the influence of experience
Psychological/environmental approaches tend to…
Emphasis external factors (poverty, parenting style)
Alternate-form reliability is…
when two different but equivalent forms of a test are created. It is particularly useful when multiple administrations of the same test are required, and the researchers are concerned about biases such as practice or recovery effects
What are the criteria for judging behaviour “abnormal”?
Statistic rarity, personal distress, violation of norms
How has our thinking about behaviour changed historically?
Hint: How have we treated mental health over time, what are some key turning points (books, figures), diagnostic system.
For much of history, abnormal behaviour was thought to be a result of supernatural causes and bodily disturbances.
Defining abnormal behaviour strayed away from such ideas and moved towards more caring, scientific, and naturalistic causes
How do we judge the pros and cons of various classification systems?
Hint - think about reliability and validity
