psychological health and when it goes awry Flashcards
what are psychological health problems
human experiences
emotions, perceptions, judgements, thoughts, physiological sensations, urges, motivations, behaviours - that cause distress to self and others, difficulties in daily living and lie outside of a normal range of function
positives of receiving a diagnosis
can help things make sense
reduce self blame
help find access to services
help find support
negatives of receiving a diagnosis
stigma
sense of difference
defeat
may feel trapped by label
how is diagnosis usually classified
based on recurring and reliable patterns of human experiences
categorises and classifies into discrete entities called diagnosis or disorder
nothing inherently wrong with this - in fact it is highly useful in scientific perspectives
what are the aims of classification
reliability - to ensure confidence that the talking about and study of these experiences are about the same phenomena
underlying assumption- furthers understanding of mechanisms and causes, which leads to effective treatment
2 types of classification systems
DSM 5 - diagnostic and statistical manual of mental disorders
ICD 11 - international classification of diseases
symptoms of major depressive disorder
experience 5+ symptoms during the same 2-week period, at least 1 symptoms should be
1 - depressed mood or 2 - loss of interest/pleasure
depressed mood most of day, nearly every day
diminished interest in almost all activities most of day nearly every day
significant weight loss when not dieting, weight gain or appetite change nearly every day
thought has slowed, physical movement decreased (observable by others)
fatigue or low energy nearly every day
feelings of worthlessness, excessive or inappropriate guilt
recurrent thoughts of death, suicidal ideation without specific plan, recurrent attempts, or plan for attempts
diminished ability to think, concentrate or indecisiveness nearly every day
symptoms must cause clinically significant distress, social/occupational and functional impairment
must not be result of substance abuse, medical condition or recent bereavement
DSM 5 critiques
understanding of biological causes in psychiatric disorders isn’t happening so we don’t know if diagnoses are actually discrete things
there are no confirmation tests
ultra common comorbidity (simultaneous presence of another disorder)
ultra common diagnostic differences among clinicians
it is a dictionary and lacks validity - based on consensus about clusters of symptoms not objective measure (Insel 2013)
minor changes to criteria make big difference in diagnostic rates (especially for ADHD and ASD)
diagnoses have proliferated over time but arbitrary deletions too
financial linked between DSM5 task force and pharmaceutical companies
DSM is income for APA
what is a psychological formulation and what is it used for
a person specific theories in an attempt to use existing psychological knowledge to understand origins, mechanisms, maintenance of an individual persons problems
can be alternative to diagnostic criteria, and/or complement them
- emphasise collaboration, meaning and understanding
the 5 p’s
- predisposing factors, precipitating factors, protective factor, perpetuating factor, presentation of problem
how to use the psychological formulation for interventions
build collaboratively with person over time
not imposed, it is explained, practised and encouraged
puts meaning and understanding into the problems and cycles
highlights places needing intervention in therapy but also with surrounding others and other support agencies
factors with influence psychological health and wellbeing
macro
interpersonal
intrapersonal
- these overlap and intertwine
macro level influences
justice failures
- poverty
- social exclusion (stereotypes and stigma can be harmful and internalised, childhood poverty is particularly damaging, intergenerational transmission of poverty)
- discrimination (associated with many diagnosed disorders (depression, anxiety, PTSD, eating disorders)
- intersectionality (resilience VS cumulative risk, depression and anxiety are most common, strong evidence for cumulative risk and weak evidence for resilience)
intrapersonal influences
psychological processes
- personal history factors (associations between early life adversity and all psychological disorders developing, persisting severely, general processes such as unprocessed memory intrusions and formation of negative experiences and self-belief (cognitive processes), disruption of social bonds and developmental pathways)
- cognitive factors (selective attention to threat stimuli, selective memory of negative self related information, overly general memory, absence of selective memory, selective interpretations/judgements, intrusive repetitive thinking, difficulty with inhibitory control, psychopathology)
- behavioural factors (classical - avoidance, escape create habituations, prevents extinction, safety behaviours)
interpersonal influences
family, friends, society
- attachment (secure and insecure - avoidant, ambivalent, disorganised -> a general risk factor for poor psych health)
- family dynamics/parenting (lack of maternal warmth controversially suggests this as a cause for autism, established links to depression and anxiety)
- peer groups (overt bullying linked to later psych health problems, more likely to happen to children of lower SES)
- authority/leadership figures
- social support /connectedness (buffering hypothesis - social support prevents individual from negative consequences of stressful events, acting as buffer (Cohen and Wills, 1985))
- sources of alienation (discrimination, bullying)
prior to WW2 - overarching goals of psychology
curing psychological illness
making everyone’s life more productive and fulfilling
identifying and nurturing giftedness is all forms
after WW2 - overarching goals of psychology
founding of the NHS and US national institute for mental health
