Psychopathology Flashcards
Psychopathology is the study of…
Psychological disorders
What did Wells et al. find?
Maori and Pacific people were less likely to have accessed services
Te Whare Tapa Wha dimensions
Taha wairua
Taha whanau
Taha tinana
Taha hinengaro
5 criteria to define a disorder + nature of them for diagnosing one
Infrequency
Deviance
Distress
Disability
Danger
Can’t just have one to be diagnosed
Infrequency
How infrequent the behaviour we are seeing is
Deviance
Behaviours that are not considered typical in culture
Distress
The suffering the experience
To self or others
Disability
The degree of impairment experienced to their everyday things
Danger
The degree of risk present to;
Self
Others
From others
Property
What are the usualy 3 components to a disorder
A psychological factor (anxeity etc)
Distress or impairment
Atypical response
2 ways which we use to try and classify disorders
- DSM-5-TR
- ICD-11
In terms of meeting the 4 criteria, how does anxeity go?
Does not meet first criteria of infrequeny because it is experienced by most people and is common
BUT meets others because it is associated with
Distress
Danger
Disability
3 costs of anxeity
Distress
Impacts on physcial health (heart, immunity)
Social and occupational functioning
What is the contrast between Anxeity and Fear or panic?
Anxeity = future focused and an anticipated threat
Fear or Panic = present focused, an immediate threat, automatic
3 components of anxeity
Cognitive
- Thoughts and worries
Physiological
- Heart, stomach, sweating
Behavioural
- Avoidance
5 potential causes of anxeity disorders
Learning processes
Cognitive
Genetics
Neurobiology
Personality
Comorbid disorders?
Having one condition which leads to another condition
Managing anxeity is…..some ways to do so is…
Very important
Focus on skills (box breathing, muscle relaxation etc), address the thoughts, beleifs, and behaviours that reinforce the anxeity
Often, personality disorders are…
Poorly understood
Psychodynamic approach to treatment - aim + results
Aim: clients acheive insight on how the psychodynamic processes affect their functioning
Focus on dreams, past and free association
Eg; look at the card and see what they see
No evidence of this being too effective
Behaviour approach to treatment
Aim: clients identify that the behaviours are the cause of disorder
Focus on reinforcement of good behaviours rather than punishment
Exposure therapy - eg; virtual reality
Cognitive approach to treatment
Aim: clients identify and address maladaptive thoughts, beleifs and assumptions
Eg; Becks cognitive therapy, third wave cognitive therapy
Becks cognitive therapy
Fosters more positive beleifs
Identifying negative beleifs of the self, the world and others.
Third wave cognitive therapy
Adding other components to cognitive therapy
Eg; mindfullness and breathing
The most commonly effective treatment approach is…
Cognitive behavioural therapy
4 features of personality disorders
Persistent behaviours - constant, no episodes
Inflexible and pervasive across situations
Stable overtime
Usually linked to childhood or adolesence
Effects of personality disorders
Dificuilty in social interaction
Intense or reduced behavioural/ emotional reactions
Inflexible thinking
Impulsive behaviours
Personality disorder clusters a,b,c key words
a = odd or eccentric
b = dramatic
c = anxious
Cluster A personality disorder
Paranoid personality disorder
Schizoid personality disorder
Schizotypal personality disorder
Cluster B personality disorder
Anti social personality disorder
Boarderline personality disorder
Histrionic personality disorder
Narcissistic personality disorder
Cluster C personality disorder
Avoidant personality disorder
Dependant personality disorder
Obsessive compulsive personality disorder
4 dificulties with the criteria for personality disorders
Thresholds may not be useful
Comorbidities
Heterogenetiy within disorders
Steryeotypical presentations
3 potential causes of personality disorders
Genetics
Childhood experiences
Individual temperment
Some dificulties with treatment for personality disorders
Takes longer - intrenched beliefs
Therapy is dificuilt
Poor research base
High levels of stigma
Psychosis prevelance + causes
Relatively common - not everyone has but many have heard of
Can be caused by;
- Psychological disorders
- Major stress
- Drug use
5 Schizophrenia criteria (+ how many you need)
Delusions
Hallucinations
Disorginised speech
Catatonia
Negative symptoms
Need at least 2 of
3 potential causes of schizophrenia
Brain disorder
Birth month
Pregnancy or birth complications
2 methods of schizophrenia treatment
Anti-psychotic
CBT
3 clusters of symptoms
Positive symptoms - emotional experience above what we could expect from a typical population
Negative symptoms - below what you would expect from a typical population
Disorginised symptoms - word salad
What is the psychosis care like in NZ + barriers to it
Early intervention - before it gets bad
Wrap around
3 years of care
Care in community
Social work, employment, wellbeing focused
Barriers
Geography - location
Stigma
7 criteria for major depressive disorder
Low mood, loss of interest and loss of pleasire
Wight loss or gain
Sleep/ energy dificuilties
Changes in motor movements
Feelings of worthlessness
Dificuilties with concentration
Thoughts of self harm
In bipolar disorder there are periods of…
Major depressive episodes - hard to care for self
Depressive episodes - can care for self but not happy
Maniac episodes - talk fast, manic movements, impulse choices
Hypomaniac episodes - feel great, not enaging in super risky behaviours
Rapid cycling definition + effect
Times between mood states is very short
Associated with worse outcomes
2 potential causes of MDD
Genetic - how our brains uptake certain neurotransmitters
Environment - social and psychological
What is Becks theory of depression
People who experience depression are more likely to have negative beliefs about the 3 areas of…
Self
World
Future
Cognitive distortions are…
Assumptions we make in the thinking we do - eg; black and white thinking (all or nothing)
Values based vs traditional CBT
Values based = noticing thoughts and letting them stay but also not attactching to them and giving them any time/ thought
Traditional = finding thoughts, noticing them and challenging them
CBT focuses on
Behavioural principles
Thoughts
Inner emotions
Emotions
Bizarre delusions =
Impossible delusions, not connected to reality
Persecutory deliusions =
False beleif that one is being harmed by others
Nihilistic delusions =
Ending world
Referential beliefs =
Beleiving that a message is for self only - eg; news report is for them
Intrustive thoughts
Very common with very distressing content
Te Pa Harakeke
Child in the center of the plant - potential, needs good care to be grow up to be strong
Parents/ important caregivers are right beside child - they are part of important relationship
Further family on outside also need to nurture the family
If the child gets taken care of well, it will become the parents or grandparents in future
Neurodevelopmental disorders can be…
+ key features
Disagnosed in childhood and still cause challenges into adulthood
Key features:
During the developmental period
Genetic or biologcial cause Occur across the lifespan
4 neurodevelopmental disorders
Intellectual disability
Learning disorders
Autisim spectrum disorders
ADHD
2 Behavioural disruptive disorders
- Oppositional defiant disorder
- Conduct disorder
Opisitional defiant disorder
Children refusing to listen to instructions of anyone of authority
Conduct disorder
Children who violate social norms, engaging in severe behaviours
What is an eg of a child adaption to CBT - other than hot cross bun which could work for adults but not children
+ a cultural altenative
Skateboarding model
Waka model
What are the stats in NZ in terms of access to services for kids
It’s hard to access services
Half of parents report cost and waitlist barriers
What might be some reasons for adolecents taking substances
Anxeity and depression
Stress
Developmentally normal - social norms
Sustance use criteria
Tolerance
Withdrawal
Significant time invested in getting it/ using it
Distress
Physcial health + wellbeing harm
What did Ball et al. find?
The most common substance is alcohol
There is a decrease in substance use BUT
- Not due to smartphones
- Can be positive
- Young peoples substance use differs from adults
Treatment options for substance use
CBT
Motivational interviewing
Programmes like AA
Medications
For adolescent substance use, we need to take in to account…
Adolescent life is dificuilt and stressful which can contribute to psychopatholoy already
- Many life changes
… hold a big role in adolescent substance use
Whanau
Insomnia is…
Dissatisfaction with sleep for at least 3 months - quality or quantity
Across 1 or more of the following areas
- Falling asleep
- Maintaining sleep
- Early morning waking
Which causes distress
In NZ… there are… (sleep)
High rates of poor sleep
Sleep issues are common
There are varied causes of insomnia. 3 are…
Physical health causes (sleep obstruction, pain)
Psychological (anxeity, worry, stress)
Poor sleep hygiene
Treatment for insomnia
Medical intervention
Envrionmental intervention (stimulus control, sleep hygene, sleep restriction)
Psychologcial intervention (relaxation)
Stress =
Our bodies response to a demand or threat that exists in our envrionment
Short term stress can be…
Normal and even helpful sometimes
Symptoms of stress
Headaches, muscle tension
Feeling anxious
Changes in diet
Upset stomach
Poor sleep
Dificuilty concentrating
Sickness
Long term stress can be
Less helpful than short term stress and harmful.
Affects our physcial systems
- Increased stress hormones
- Increases ageing
Affects our mental health
- Depression, anxeity, worry
Some treatments for stress
Life style changes
Focus on values
Relaxation and mindfulness
Assertive skills training
Setting boundaries
Problem solving
What are some systemic factors which can affect access to stress treatment
Risk factors - age, poverty
Historical factors - colonization
Current processes - discrimination, racisim
ED’s are more common in…
Females
ED’s prevail in what ethnicity and age most
All ethnicities
17 yrs ish
Binge-eating criteria
Recurrent episodes of binge eating (large amount)
3 or more of:
- Eating more rapidly than normal
- Eating until feeling uncomfortably full
- Eating when not physically hungry
- Eating alone (hiding it)
- Feeling guilt afterwards
Functional impairment
Frequency must be: at least once a week for 3 months or more
No compensation
BMI catergories are used to define…
Normal weight
Calculated as the ratio of weight to height squared
BMI’s
Under 18.5 =
18.5 - 25.0 =
25.0 - 30 =
30+ =
= underweight
= normal weight
= overweight
= obese
4 criteria of Bulimia Nervosa Criteria
Recurrent episodes of binge eating (high emounts)
Recurrent inappropriate compensatory behaviour (vommiting, laxitives, fasting, excessive exersise etc)
Frequency A + B once a week for 3 months or more
Self concept unduly influenced by shape and body weight
Key difference between Binge eating and Bulimia =
Binge has no compensatory strategies after but bulimia does
3 Anorexia Nervosa Criteria
Restriction of energy intake
Intense fear of gaining weight even though underweight
Any of the following:
- Dential of severity
- Disturbance in the perception of body weight or shape
- Undue influence of body weight or shape on self concept
Key difference between anorexia and bulimia is…
Anorexia has low BMI and intense fear of not gaining weight
An eating disorder focuses on…
A body dismorphic disorder focuses on…
Food
Defects in body
