Psych Health Reading 1 Flashcards
diagnostic literalism
mistaking mental health problems for the diagnoses by which they are classified
diagnoses
clinically useful categorical idealizations to facilitate treatment selection and prognosis
reductionism
isolated study of individual elements of mental disorders
psychiatric nosology
the classification and scientific study of mental disorders
what forces have shaped the DSM?
sociopolitical forces i.e. minimizing stigma, patient advocacy, adherence to precedent
historical forces
path dependence
mental health problems are
complex biopsychosocial processes that unfold in individuals over time
for most diagnoses DSM ignores
causes and etiology
classification systems differ
considerably in their conceptualization of some diagnoses
there are dozens of diff measurement tools to diagnose same disorder
interrater reliability
for some common diagnoses is low
comorbidity and transdiagnostic
there is comorbidity between diagnoses
many risk factors are transdiagnostic
diagnoses are categorical but
most mental health problems = dimension of severity
from absent to very severe
equifinality
different starting points may lead to same diagnosis
multifinality
similar starting points may lead to different diagnoses
clinical psychology / psychiatry have devoted most resources to X instead of X
diagnostic labels that summarize complex mental health states
rather than
how biopsychosocial processes give rise to mental health problems
psychiatric literature is dominated by
case-control studies
healthy control group compared with group diagnosed with specific disorder
what is the issue with case-control studies in psychiatry
unlikely that such designs are optimally positioned to inform research
approach is flawed as mental health problems = not the diagnostic idealizations they are summarized as
complex systems contain
interdependent elements
properties depend on each other
need the study of system parts + relationship among those parts across levels
explanatory reductionism
lower levels i.e. biology offer explanatory power inherently superior to higher levels i.e. psychology, environment
explanatory reductionism has constrained
research funds
health-care policy
delivery of clinical services
NIMH have stated that mental disorders are X that can be identified with X and understood through X
brain disorders / dysfunctions in neural circuits
identified with tools of clinical neuroscience
understood through neuroscience-based psychiatric classification
issues with explanatory reductionism
- lower levels not superior in explaining higher-level processes
- biomarkers for mental health problems do not drive their higher-level outcomes i.e. feelings/behaviours
- complex phenotypes likely differ in brain activation across/within individuals
what has biological psychiatry led to
insights into human biology but little about biology of specific diagnoses
genome-wide association studies have resulted in transdiagnostic hits that explain negligible variance
why is there a lack of progress in biological psychiatric research
due to focus on study of particular DSM labels that are likely the wrong targets
due to studying biology in isolation
the cycle of reification is caused by
after identifying weak correlates we reify diagnoses by essentializing mental disorders
+ flawed inferences from measurement
+ external validation
probablistic feature relations allow for
interindividual differences within a DSM diagnosis
equifinality
multifinality
what other features are useful markers for identifying specific diagnoses beside symptoms
etiology
personality
a systems view casts diagnoses and reductionism as
useful epistemological tools for describing the world
not ontological convictions about how the world dis
