modules 1-2 Flashcards
Define psychopathology
the study of mental disorders and abnormal behaviours indicative of mental disorder or psychological impairment
Name the four stated reasons to define abnormal behaviour
- To describe: identify behaviours that cause stress or dysfunction
- To explain: clarify the cause of abnormal behaviour
- To predict: inform likely patterns to estimate impact and needs
- To control: attempt to change behaviour and reduce burden
What are the five stated challenges of abnormal behaviour?
- Statistical rarity: less common in population
- Deviance: dependent on definition, influenced by culture, history etc.
- Distress: subjective, to individual
- Dysfunction: interferes with daily functioning
Danger: assessment of harm to self or others
Define DALYs
Disability Adjusted Life Years:
Total number of years lost to illness, disability or premature death
What is the approximate percentage of mental health comorbidity?
94.1% of individuals with a mental health or behavioural condition report a co-existing condition
Who developed the Biopsychosocial model?
Engel, 1977
What does the Biopsychosocial model aim to do?
Integrate the biological, psychological and sociocultural approaches to understand and acknowledge the complex interplay between the three factors
What field is associated with the study of the molecular structure of DNA and its cellular activity?
Molecular genetics
What field is associated with the study of the transmission of genes to influence behaviour?
Behavioural genetics
Define polygenetics
Observable traits (phenotypes) influenced by more than one gene
Define epigenetics
when behaviours and environments cause changes to the expression of genes
What is the difference between a localised and a diffuse brain injury?
Localised is confined to one area of the brain, such as a hematoma, contusion or haemorrhage
Diffuse occurs throughout the brain, such as a stroke
What is the difference between diffuse (axonal) injuries and ischemia?
In diffuse injuries the brain moves inside the skull, in ischemic injuries a lack of oxygen causes damage to brain cells, or cell death
What is the biological treatment where an electrode is placed within the brain and an electrical current is used to stimulate specific brain regions associated with targeted symptoms?
Deep brain stimulation
What is the biological treatment where an electrode is placed on the outside of the skull to target brain regions with an electrical current?
Transcranial direct-current stimulation
According to behaviourist models, what is abnormal behaviour caused by?
Observable and identifiable stimuli in the immediate environment which elicits reinforcement or punishment
What is the ABC model?
A cognitive model that is used the explain the interactions between thoughts, emotions and behaviour.
Activation, Beliefs, Consequences
How does cognitive-behavioural therapy treat mental illness?
By challenging/changing unhelpful cognitive distortions to improve emotional regulation and coping skills
What does the theory of reasoned action attempt to explain?
The relationship between, and influence of, people’s attitudes, beliefs and intentions and their behaviour
What does the theory of planned behaviour attempt to explain?
The influence of having the necessary resources and capabilities on performing a behaviour
Define fundamental attribution error
Overemphasis on dispositional (internal) explanations of behaviour while undervaluing external factors
Define confirmation bias
Seeking out or interpreting information that confirms pre-existing beliefs and attitudes
Define self-serving bias
Making dispositional attributions for own successes and situational attributions for failures
What does the diathesis-stress model describe?
How adding stress to other predisposing factors significantly increases the likelihood of mental illness manifesting
What are five considerations to ask the patient in a clinical interview?
- Areas of distress
- History of mental illness
- Social history, support/relationships
- Cultural factors/orientation
- Other factors such as medical conditions/family history
Describe an unstructured clinical interview style
Open questions, direction is influenced by the psychologist and their expertise
Describe a structured clinical interview style
Closed questions, standardised, pathways of direction for responses, training
Define cultural competency
Culturally relevant and appropriate treatments that are tailored to meet an individual’s social, cultural and linguistic needs
Define cultural awareness
The ability to be culturally competent and practice cultural safety
Define cultural safety
Refers to the experience of the person seeking help
What does the Scientist Practitioner Model aim to do
Integrate basic and applied science with professional practice in psychology. Using science to inform practice and practice to inform science
Describe the Mini Mental Status Exam and what it assesses
Quick and reliable assessment tool to assess cognitive functioning in initial stages of or throughout treatment.
Score of <24/30 indicates the presence of some form of cognitive impairment
Describe the Beck Depression Inventory and what it assesses
21 items that assess depression symptoms with high sensitivity and validity across different cultures, ages and population.
Limited use as a diagnostic tool
What are the four components in making a clinical diagnosis?
Signs: observable characteristics that accompany a disorder
Symptoms: subjective experiences that accompany a disorder
Syndrome: a cluster or signs and symptoms that commonly co-occur
Assumptions of medical model: classification of abnormal behaviour based on signs and symptoms
What is the purpose of a diagnosis?
To provide a description that can accommodate the patient’s different signs and symptoms
To effectively communicate with other professionals and to the client
To help research
Define stress
A physiological and psychological response to challenging or new situations (perceived threats)
What does the stress response curve describe?
Represents stress levels on a curve where lower levels of stress arousal can help to perform daily activities. Curve rises to a point where too much stress can cause physical and mental health problems
Define the fight-or-flight response
An activation of the SNS due to automatic perception of a physical, social or cognitive threat, causing physiological response.
What are the three stages in the General Adaption Syndrome Model?
- Alarm
- fight-or-flight due to stressor, adrenaline and other hormones released into bloodstream - Resistance
- body focuses resources against stressor returning respiration and heart rate to normal, glucose and stress-related hormones level remain high - Exhaustion
- body’s defences break down after prolonged stress, vulnerability to infection/disease due to stressor beyond body’s capacity
What does the theory of optimal stress describe?
Optimal performance occurs when arousal is moderate. If too low; boredom, deviation in attention. If too high; anxiety, overstimulation.
Optimal arousal level is task dependent; higher for simple tasks, lower for complex
Define the challenge and threat model
Stress can be viewed as either a challenge or a threat.
Threat: debilitating and impairs performance (low resources; high demand)
Challenge: energising and enhances performance (high resources; low demands)
Define the stress-buffering model
Resources, such as social support or perceived control, can act as a buffer to stress, dampening the negative effect on mental health
Define active coping
Actively trying to moderate or remove the stressor/its affects
Define planning as a coping style
Thinking ahead on how to cope with a stressor
Define suppression of competing activities as a coping style
Putting other projects aside, avoiding distractions in order to deal with stressor
Define restraint coping
Waiting until an appropriate moment presents itself to deal with the stressor
Define positive reinterpretation as a coping style
Reformulating a stressor in positive terms
Define seeking emotional social support as a coping style
Getting moral support, sympathy or understanding from others
Define acceptance as a coping style
Learning to accept the reality of a stressful situation
Define denial as a coping style
Refusal to acknowledge a stressor or treating the stressor as if it were not real
Define an acute stressor
A short-lived specific event or situation, typically threat or challenge, that causes a stress response
May resolve through coping and problem-solving strategies
Define a chronic stressor
Repeated activation to stress system for demand to a threat or action. Interferes with coping/problem-solving
Define a traumatic stressor
An event or experience that is typically life-threatening
Define fear
An adaptive reaction to an event or stimulus that triggers the fight or flight response. When fear becomes chronic, it can create maladaptive responses
Define complex trauma
Multiple and varied traumatic events, often beginning in childhood and involving interpersonal trauma
Define vicarious trauma
Emotional and psychological reaction after hearing or witnessing an event
Describe adjustment disorder
An event is experienced as distressing causing reactions that are out of proportion.
General distress within 3 months, terminating within 6 months
What are the DSM-5 criteria for adjustment disorder?
Symptoms within 3 and <6 months
Disproportionate reactions to events due to a previous distressing experience. Impairment in social, occupational, other functioning
Not an exacerbation of symptoms of another disorder or bereavement
Define acute stress disorder
Short-term clinically significant distress or impaired functioning due to direct exposure to an actual or threatened traumatic event
Symptoms last from 3 days to 1 month
What are the DSM-5 criteria for acute stress disorder?
Presence of at least 9 symptoms
Intrusive: recurrent symptoms, distressing dreams, dissociation, flashbacks, distress
Negative mood
Dissociative: altered reality, inability to recall event
Avoidance: avoiding memories, thoughts, reminders of event
Arousal: irritability/anger without provocation, hyper-vigilance, exaggerated startle response
Define post-traumatic stress disorder
Prolonged clinically significant distress or impaired functioning due to direct exposure to an actual or threatened traumatic event
Symptoms last >1 month
What are the DSM-5 criteria for PTSD?
Required to meet 1+ intrusive, 1+ avoidant symptoms
Intrusive: recurrent symptoms, distressing dreams, dissociation, flashbacks, distress
Avoidance: avoiding memories, thoughts, reminders of event
Negative cognition/mood: inability to recall, persistent negative affect (incl. shame, guilt), detachment/estrangement distorted cognitions,
Arousal: irritability/anger without provocation, hyper-vigilance, exaggerated startle response, reckless/self-destructive
What are the specifiers of PTSD?
Depersonalisation: persistent feelings of being detached from one’s own mental processes
Derealisation: persistent experience of unreality of surroundings
SNPs tell us about the_______ of genes, and CNVs tell us about the____ of genes.
sequence; structure
Describe the aetiology of PSTD
- Maladaptive appraisals
- Classical conditioning when event triggers lead to fear reactions
- Arousal responses release stress neurochemicals which strength fear conditioning
- Lack of social support can exacerbate symptoms
What are five ways the amygdala is relevant to the psychopathology of trauma?
- Fear conditioning
- Emotional memory
- Hypervigilance and threat perception
- Neuroplasticity and treatment targets
- Interaction with the hippocampus
What is it called when neutral stimuli are associated with fear or trauma, leading to exaggerated fear responses?
Fear conditioning
What is it called when emotional dysregulation in the amygdala contribute to vivid and intrusive recollections of traumatic events?
Emotional memory
How does the amygdala contribute to exaggerated perceptions of danger in individuals with PTSD?
Hyperactivity in amygdala leads to heightened sensitivity to threat cues. Can lead to hypervigilance to avoid triggers
How does the neuroplasticity of the amygdala benefit PTSD treatment?
By offering a treatment target for reduction of hyperarousal and emotional reactivity
How do processes in the amygdala affect the hippocampus in an individual with PTSD?
The amygdala can disrupt contextulation of traumatic memories through dysfunctional emotional regulation
What are five ways the hippocampus is relevant to the psychopathology of trauma?
- Memory consolidation
- Emotional regulation
- Contextual processing
- Neurogenesis and plasticity
- Interaction with the amygdala
How do alterations in memory consolidation contribute to PTSD?
Dysfunctional memory consolidation in the hippocampus can disrupt the encoding and future retrieval of memories related to traumatic experiences
How does dysfunction in emotional regulation contribute to PTSD?
Can lead to difficulties differentiating between past traumatic experiences and present reality
How does dysfunction in contextual processing in the hippocampus contribute to PTSD?
Alterations contribute to difficulties contextualising traumatic memories, which can lead to intrusive recollections and flashbacks detached from their original context
How do traumatic events impact neurogenesis and hippocampal plasticity?
Trauma can hinder normal nervous system regeneration and dendritic branching, which impacts the brain’s ability to adapt and recover
How do processes in the hippocampus affect the amygdala in an individual with PTSD?
Reduced hippocampal volume/function disrupts amygdala activity, adding to symptom severity and exacerbating hyperactivity
Why do adults who had adverse childhood experiences struggle to respond appropriately to non-threatening situations?
Repeated exposure to early childhood trauma causes the brain to be neurologically primed to deal with constant stress
______is the most common PTSD cause for men. ______ is the most common PTSD cause for women
Military trauma; Rape
Define Mowrer’s two-factor model of conditioning
Classical: event triggers lead to fear reactions > avoidance behaviours
Operant: avoidance is reinforced by reduction of fear associated with separation from conditioned stimulus
What brain region is associated with people’s ability to retrieve autobiographical memories?
The hippocampus
What is the psychological treatment for PTSD?
Exposure therapy to challenge negative beliefs about the trauma.
Working through an exposure hierarchy, person deliberately remembers or re-experiences the traumatic event.
Therapist helps to develop a more positive narrative about ability to cope
What is the PTSD treatment that combines exposure therapy with visual focus on the therapist’s external movements to reduce vividness and intensity of traumatic memories?
Eye movement desensitisation and reprocessing
What are the four domains of the Cultural Formulation Interview?
- Cultural identity of the individual
- Cultural explanations of illness
- Cultural factors related to psychosocial environment and levels of functioning
- Cultural elements of relationship between individual and clinician
Describe the difference between categorical classification and dimensional diagnostic systems
Categorical classification systems pose entities as present or absent whereas dimensional diagnostic systems describe the degree to which an entity is present (e.g. 1-10).
Describe three ways in which DSM-5-TR considers the role of culture in mental health
- Culture-related issues are described for most of the specific disorders
- CFI is provided
- Appendix describes cultural concepts of distress, culturally specific ways of expressing distress, and cultural explanations of symptoms
Describe a structured clinical interview diagnosis (SCID)
Questions are set out in a prescribed order for the interviewer to help determine whether a person meets diagnostic criteria for a disorder
What are the important subcortical areas of the brain?
Hypothalamus, anterior cingulate, hippocampus, amygdala
Which neurotransmitters are implicated in the psychopathology of multiple disorders?
Serotonin, norepinephrine, dopamine, GABA
What is the HPA axis and what is it responsible for?
Hypothalamus, pituitary glad and adrenal cortex
Responsible for the body’s response to stress, relevant for several stress-related disorders
What protein in the brain helps to initiate bodily responses to infection, and the activation of the HPA axis?
Cytokines
Walsh’s (2011) Therapeutic Lifestyle Changes self care model includes which self care practices (8)?
Exercise
Nutrition and diet
Recreation and enjoyable activities
Nature
Relationships
Relaxation
Religion
Contribution
What are the four components of Wise, Hersh and Gibson’s (2012) Foundational Principles of Self-Care?
- Flourishing: aim to flourish over simply surviving
- Intentionality: actively develop and engage in self-care
- Reciprocity: look after oneself so you can look after others
- Integration: self-care as part of regular routine
