Psychopathology Flashcards
1
Q
What is abnormal?
A
- Suffering
- Maladaptiveness
- Statistical Deviancy
- Violation of Societal Standards
- Social Discomfort
- Irrationality/Unpredictability
- Dangerousness
2
Q
Mental Disorder
A
- A syndrome characterized by clinically significant disturbance in an individual’s cognition, emotion regulation or behavior
- That reflects a dysfunction in the psychological, biological, or developmental processess underlying mental functioning
- Excludes:
- Expectable or culturally sanctioned response to an event
- Socially deviant behavior
- Conflicts between individual and society
3
Q
Percentage of US population that meets criteria for DSM-IV diagnosis in lifetime
A
46%
4
Q
Amok
A
- Malaysian rage disorder
- Usually found in males who are withdrawn, quiet, brooding, and inoffensive
- Precipitated by a perceived slight or insult
- Sudden, wild outbursts of violence or homicidal behavior
- In Amok stage, person jumps up, yells, grabs a knife, and stabs people or objects within reach
- Followed by exhaustion, depression, amnesia
- “Running amok”
5
Q
Koro
A
- Southeast Asia and China
- Fear reaction or anxiety state
- Man fears his penis will withdraw into his abdomen and he may die
- Intense anxiety with sudden onset
- May appear after sexual over-indulgence or excessive masturbation
- “Treated” by having penis held firmly by patient, family members, or friends
- Often the penis is clamped to wooden box
6
Q
Zar
A
- North Africa and Middle East
- Person believes he or she is possessed by a spirit
- Dissociative episodes with shouting, laughing, singing, and weeping
- May also show apathy and withdrawal, not eating or working
7
Q
Windigo
A
- Algonquin Indian hunters
- Fear reaction
- Hunter becomes anxious and agitated, convinced that he is bewitched
- e.g., fear of being turned into a cannibal by the power of a monster with an insatiable craving for human flesh
8
Q
IQ Scores
A
- More than 68 percent of population scores between 84 and 116 points (Average is 100)
- Those who are MR fall below 68 - about 2% of population
9
Q
Most common individual disorders
A
- MDD
- Alcohol abuse
- Specific/social phobias
10
Q
Prevalence
A
- 12-month prevalence: 26.2% of US population
- Severe: 22.3% of these cases (e.g. 5.8% of US population)
11
Q
Demographics for lifetime prevalence
A
Sex - women are no more or less likely
Race - Non-Hispanic blacks are 30% less likely than non-Hispanic whites
Age - most common in teenagers/young adults
12
Q
Average Age of Onset of Disorders
A
14
13
Q
Inmates with 12-month mental health problem
A
- 2% Local Jail
- 2% State Prison
- 8% Federal Prison
14
Q
Deinstitutionalization
A
- Prison rate increases as mental hospitals decrease
15
Q
Arriving at DSM 5 - 1844
A
APA published predecessor of DSM as a statistical classification of institutionalize mental patients
16
Q
Arriving at DSM 5 - 1880
A
- mania
- melancholia
- Monomania was a form of partial insanity conceived as single pathological preoccupation in an otherwise sound mind
- Paresis (weakness of voluntary movement or partial loss of voluntary movement or by impaired movement)
- Dementia
- Dipsomania (Uncontrollable craving for alcohol)
- Epilepsy
17
Q
Arriving at DSM 5 - 1908
A
American Bureau of the Census asked the American Medico-Psychological Association to develop standard classification system for purpose of national statistics
18
Q
Arriving at DSM 5 - 1918
A
Statistical Manual for the Use of Institutions for the Insane
19
Q
Arriving at DSM 5 - 1952
A
DSM-I
20
Q
Arriving at DSM 5 - 1967
A
DSM-II
21
Q
Arriving at DSM 5 - 1980
A
DSM-III
22
Q
Arriving at DSM 5 - 1987
A
DSM-III-R
23
Q
Arriving at DSM 5 - 1994
A
- DSM-IV
- Purpose: better overlap with ICD, improved documentation of empirical support
- Purpose was not to add, delete diagnoses (left with 297)
- Result: 3 volumes of a DSM-IV sourcebook
- Expanded text to include: cultural and ethnic group variation, variation across age, lab and physical exam findings
24
Q
Arriving at DSM 5 - 2000
A
DSM-IV-TR
25
Organization of DSM-5
- Organized developmentally and with consideration to lifespan
- Internalizing disorders, externalizing disorders, neurocognitive disorders, other disorders
26
Some Changes from DSM-IV to DSM 5
- Elimination of multiaxial system
- Removal of the Global Assessment of Functioning (GAF) scale
- Term "mental retardation" replaced with "intellectual disability"
- Autism spectrum disorders
- Removal of subtypes of Schizophrenia
- Addition of Premenstrual Dysphoric Disorder
- Anxiety Disorders no longer include OCD or PTSD
- Obsessive Compulsive and Related Disorders added
- Trauma- and Stressor-Related Disorders
- Feeding and eating disorders
- Disruptive, impulse control, and conduct disorders
- Substance-Related and Addictive Disorders
- No changes to personality disorders
27
Outstanding Issues with DSM 5
- Boundary between abnormal and normal?
- What is sufficient impairment?
- Categorical and dimensional models of classification
- Should we focus on symptoms or syndromes?
- High rates of comorbidity
28
Subtypes
- Mutually exclusive subgroupings within a diagnosis
| - E.g., Bipolar Disorder II, most recent episode Hypomanic/most recent episode Depressed
29
Specifiers
- E.g., severity and number of episode specifiers for depression
- Includes course (e.g., in partial remission)
30
Principal Diagnosis
Reason for the visit/main focus of treatment
31
Provisional Diagnosis
Strong presumption that the full criteria will ultimately be met for disorder, but insufficient information is currently available
32
Rule-out
Additional evaluation should rule out as a condition
33
Diagnostic Approaches
- Descriptive (the "what")
- Psychological (the "why")
- Changes to DSM indicate shift to descriptive approach
- E.g., DSM-II "Depressive Neurosis to DSM-IV-TR "Major Depressive Disorder"
34
Differential Diagnosis
choosing correct diagnosis from conditions with similar features
35
Diagnosis
1) Was the condition caused by a known medical condition or a drug?
2) Was it psychosis, nonpsychosis, or personality disorder?
36
Most common male diagnoses
- Substance abuse
- ASPD
- Paranoia
37
Most common female diagnoses
- Depression
- Eating Disorders
- Anxiety Disorders
38
Explaining Abnormal Behavior: Middle Ages and Renaissance
- The medical model was coexisted with supernatural explanations (spirits, God, devil)
- Exorcism (submerge in water, whipped, or starved to make the body less comfortable for the devil
39
Explaining Abnormal Behavior: The Medical Model (19th Century)
- Biogenic causes of abnormal behavior - the problem results from a malfunction in the body
- (i.e. symptom, syndrome, pathology, disease, mental illness, patient, diagnosis therapy, treatment)
40
Explaining Abnormal Behavior: Greek Civilizations
Insanity was a sign of minor and major transgressions
41
Hippocrates
- Naturalistic view - mental and physical out to be explored in patients
- Emphasized - brain is the primary center for thought and emotion
- Empirical approach as compared to "philosophical thought"
- Humors
- Valued sleep and rest as remedies
- Talked about unconscious forces
42
Hippocrates Recommended:
- Exercise, tranquility, massage, music, diet, marriage, and bloodletting
- The above would balance the humors (earth, fire, water, and air)
- Disorders were a result of imbalance among the humors (vital fluids in the body: phlegm, blood, black bile, and yellow bile)
43
Wilhelm Wundt (1832-1920)
- Father of modern psychology
- University of Leipzig
- First person to call himself a psychologist
- Established first experimental laboratory
- Studied the nature of religious beliefs, identified mental disorders, and explored damaged parts of the brain
44
Emil Kraeplin
- Wundt's student
- First studied psychopathology or abnormal psychology
- Concept of syndrome - he first classified mental illness into different categories and developed a classification system
- Dementia praecox
45
Franz Anton Mesmer
- Began the idea of psychogenic theory (psychological disturbances are primarily due to emotional stress)
46
Eugen Bleuler
```
Coined Schizophrenia (formerly dementia praecox)
- "split brain"
```
47
Richard von Kraftt-Ebing
- Wrote Psychopathia Sexualis
| - Coined the term masochism
48
The Asylum
- The early asylums - first psychiatric hospital was in Spain in the early 15th century
- London's Bethlem Hospital gave rise to the word "bedlam" because it was so bad
- Patients Kept in Chains and isolated
- Hospitalization and the increase of moral therapy (an approach to mental disorder based on humane care
- The exodus from hospitals (deinstitutionalization & community mental health centers)
49
Pinel
First big reformer of asylums - "mentally ill were simply deprived of their reason by severe personal problems"
- He also began record keeping or charting
50
Dorothea Dix
School teacher who reformed prisons and hospitals for the mentally ill by lecturing state legislators
51
Prefrontal lobotomy
1940s and 1950s
52
Exodus from Hospitals
- 1950s - introduction of psychotropic medications
- De-institutionalization
- Cross-institutionalization
- Community mental health
- 1980s managed care
- Problems: Homeless - 1/4 are severely mentally ill, 1/2 suffer from substance abuse
53
Cultural Signs: 13, 4, & Small feet
13 -unlucky
4 - Japanese, close to death
Small feet - mark of beauty in China
