Psychopathology Flashcards
What is psychopathology?
Patterns of thought, felling or behaviour that disrupt a person’s functioning or wellbeing
Although some abnormal behaviour is universal, what is abnormal can depend on a person’s culture
Indicators of abnormality:
No single behaviour is sufficient in determining abnormality, but indicators include:
- subjective distress
- maladaptiveness
- statistical deviancy
- violation of standards of society
- social discomfort
- irrationality and unpredictability
- dangerousness
Decisions about abnormal behaviour involve judgements and are based on cultural values and expectations and change over time
Mental health and mental disorders: definitions
Mental health: state of emotional and social wellbeing
Mental health problems: emotional and behavioural abnormalities which impair functioning
Mental disorder: clinically recognisable symptoms that cause distress and impair functioning, generally requiring treatment
People who are most at risk for mental disorders:
- children and adolescents
- older people
- aboriginal and torres strait islanders
- those living in rural and remote areas
- homeless individuals
- incarcerated individuals
- culturally and linguistically diverse individuals
Historical accounts of mental disorders include:
- demonology, gods, magic (possession by evil spirits, perhaps punishment from god) –> treatment = exorcism
- hippocrates (mental disorders due to brain pathology and imbalance of blood, phlegm, bile, black bile) –> treatment = balance the four humours
- early chinese medicine (yin and yang) –> treatment = restore balance
- middle ages in europe (supernatural causes of mental illness) –> treatment = prayer, holy water, sanctified ointments, touching relics, mild forms of exorcisms
- renaissance period (scientific questioning re-emerged, very slowly replaced superstition) –> treatment = asylums, 16th century and onward
- philippe pinel (removed chains from inmates to test hypothesis that mentally ill patients should be treated with kindness)
- william tuke (established the york retreat)
Biological perspective of mental health
Genetic vulnerability:
- usually not one gene, almost always polygenic
- genotype-environment interactions (diathesis stress model)
Brain Dysfunction and neural plasticity:
- genetics –> neutral activity (–> +
Psychodynamic perspective on mental disorders:
- capacities in love, work and relation to reality is based on the level of disturbance (normal to neurotic, personality disordered, psychotic)
- the conscious (ego, super ego), preconscious (ego, super ego), unconscious (super-ego, ID)
New psychodynamic perspectives on mental disorders (object relations, interpersonal perspective, attachment theory)
Object relations: emphasises that interactions with real and imagined other people could give rise to inner conflicts
Interpersonal perspective: emphasises cultural and social forces rather than inner instincts as determinants of behaviour
Attachment theory: emphasises the importance of early with attachment relationships as laying the foundation for later functioning throughout life. Quality parental care is needed to develop secure attachment
Behavioural perspective –> why did it arise, what is central to this approach of learning?
- Arose as a reaction against the unscientific methods of psychoanalysis
- only observable behaviour and the stimuli reinforcing properties of it can serve as the basis for understanding behaviour
- Central to this approach is learning:
a) modification of behaviour as a consequence of experience
b) classical (Pavlovian) conditioning
c) instrumental (Operant) conditioning
Pavlovian Conditioning
Before conditioning: neutral stimulus –> no response
During conditioning: neutral stimulus –> unconditioned stimulus –> unconditioned response
After conditioning: neutral stimulus –> conditioned response
Operant conditioning
An individual makes an association between a particular behaviour and consequence –> i.e. there is a stimulus, and then a key relationship between the response and the reinforcer (e.g. a light goes off to let the rat know that if it pulls the lever, food will appear)
Cognitive behavioural perspective: how did it arise, why is it important, what are the key areas?
- arose as a reaction against radical behaviourism
- important to understand how thoughts and information processing can become distorted and lead to maladaptive emotions and behaviours
- self efficacy: the belief that one can achieve desired goals
- cognitive distortions: an exaggerated or irrational thought pattern involved in the onset and perpetuation of pscyhopathological states
- attentional bias: the tendency for people’s perception to be affected by their recurring thoughts at the time
Social perspective - what is likely to leave a person vulnerable to psychopathology?
Exposure to multiple uncontrollable and unpredictable frightening life events is likely to leave a person vulnerable to psychopathology.
- early life deprivation or trauma
- problems with caregivers
- marital discord and divorce
- low SES and unemployment
- maladaptive peer relationships
- prejudice and discrimination
This approach has highlighted the importance of environment and has contributed to the development of programs designed to improve the social conditions that lead to maladaptive behaviour.
What are the causes of psychopathology?
- biological influences
- behavioural influences
- emotional and cognitive influences
- social and interpersonal influences
- developmental influences
What does the diathesis stress model do?
The diathesis stress model posits that mental disorders develop from a genetic or biological predisposition for that illness combined with stressful conditions that play a precipitating or facilitating role.
Dopamine and serotonin
Dopamine plays a role in addiction + reward, whereas serotonin plays a role in anxiety and depression
Which theorists distinguish three broad classes of psychopathology that form a continuum of functioning, from the least to the most disturbed, and what are these classes?
Psychodynamic theorists distinguish psychopathology by neuroticism, personality, psychosis
What type of conditioning has been applied as an etiological model for anxiety?
Pavlovian fear conditioning
What has the behavioural perspective taught us?
That maladaptive behaviour is the result of learning
Difference between classification and diagnosis?
Classification is an overall overarching taxonomy of illness
The act of placing someone in a category of that system is a diagnosis.
Do disorders have known entities?
No, they can only be diagnosed by their symptoms, they have no known entities.
How does the DSM5 define mental disorders?
a syndrome characterised by clinically significant disturbance in an individual’s cognition, emotion regulation or behaviour that reflects a dysfunction in psychological, biological or developmental processes
What is the most important standard for the DSM5 criteria?
clinical utility for prognosis and treatment response
DSM5 guiding principles
- must be practical for use in clinical practice
- only create changes that are supported by empirical evidence
- try to maintain continuity with DSM4
- harmonise with ICD11
- aim to include cultural variations where possible
- reduce excessive use of not otherwise specified