Module 1: Historical Perspectives on Psychopathology and Classification of Mental Disorder

Question 1

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

Answer 1

Psychological Abnormality

Question 2

Psychopathology

Answer 2

Refers to the scientific study of psychological abnormality and the problems faced by people who suffer from such disorders

Question 3

A specific manifestation of this impairment of functioning, as described by some set of criteria that have been established by a panel of experts

Answer 3

Psychological disorder (or mental disorder)

Question 4

Mental Illness

Answer 4

A term used to convey the same meaning as psychopathology, but implies a medical rather than psychological cause.

Question 5

What did Wakefield conclude?

Answer 5

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.

Question 6

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

Answer 6

Clinical psychologists

Question 7

What are four general attempts at defining abnormality?

Answer 7

1) statistical concept
2) Personal distress
3) Personal dysfunction
4) Violation of norms

Question 8

Bodily fluids, disturbances of which, according to Hippocrates, resulted in psychological dysfunctioning

Answer 8

Humours

Question 9

Rowdy, chaotic behaviour

Answer 9

Bedlam

Question 10

Moral Therapy

Answer 10

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.

Question 11

Biological Approaches

Answer 11

-heredity
-Syndromes
-Infection
—–Shock therapy and Psychopharmacology

Question 12

Psychological Approaches

Answer 12

Hypnotism + birth of psychoanalysis
Behaviourism

Question 13

A system of rules for recognizing and grouping various types of problems

Answer 13

Diagnostic system (or classification system)

Question 14

What important functions does a diagnostic system for mental disorders serve (4)?

Answer 14

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.

Question 15

What would the perfect diagnostic system do?

Answer 15

• Classify disorders on the basis of presenting symptoms, etiology, prognosis and response to treatment.

Question 16

Patterns of experiences and behaviors

Answer 16

Symptoms

Question 17

Etiology

Answer 17

history of the development of symptoms and underlying causes

Question 18

Prognosis

Answer 18

future development or maintenance of symptoms

Question 19

What would comprise in the development of the perfect diagnostic system?

Answer 19

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

Question 20

Characteristics of a strong diagnostic system:

Answer 20

1) Reliability
2) Validity
3) Predictive Validity

Question 21

Functions of a good classification system:

Answer 21

1)Organization of clinical info
2) Shorthand communication
3) Predication of natural development
4) Treatment recommendations
5) Heuristic value
6) Guidelines for financial support

Question 22

Refers to the extent to which 2 clinicians agree on the diagnosis of a particular patient

Answer 22

Inter-rater reliability

Question 23

Concurrent Validity

Answer 23

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

Question 24

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

Answer 24

Predictive validty

Question 25

Atheoretical

Answer 25

Not based on or concerned with a particular theory

Question 26

An individual may be diagnosed with only a certain subset of symptoms without having to meet all criteria

Answer 26

Polythetic

Question 27

DSM-5-TR Organizational Structure

Answer 27

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).

Question 28

Innovations and Limitations of DSM-5

Answer 28

• 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

Question 29

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.

Answer 29

Clinical Utility

Question 30

Criticisms of DSM

Answer 30

-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

Question 31

Research Domain Criteria (RDoc) Matrix

Answer 31

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

Question 32

Mental Health Community uses critereia like:

Answer 32

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

Question 33

What is the highest principle clinical psychologists adhere to in their code of ethics?

Answer 33

Maintaining the dignity of the individual

Question 34

What are the two main streams of thought concerning mental health disorders?

Answer 34

1) Biological
2) Environmental (roughly following nature/nurture)

Question 35

Biological approaches tend to…

Answer 35

dismiss/downplay the influence of experience

Question 36

Psychological/environmental approaches tend to…

Answer 36

Emphasis external factors (poverty, parenting style)

Question 37

Alternate-form reliability is…

Answer 37

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

Question 38

What are the criteria for judging behaviour “abnormal”?

Answer 38

Statistic rarity, personal distress, violation of norms

Question 39

How has our thinking about behaviour changed historically?

Answer 39

Hint: How have we treated mental health over time, what are some key turning points (books, figures), diagnostic system.

Question 40

How do we judge the pros and cons of various classification systems?

Answer 40

Hint - think about reliability and validity