Psychopathology1 - History, Classification, Assessment Flashcards
What are the four main objectives of abnormal psychology?
Describing - what behaviours are evident;
Explaining - why they’re evident;
Predicting - outcome;
Managing - problematic behaviour
Describe the Relativist view of abnormality and provide evidence
Symptoms and causes vary across cultures; eating disorders are more prevalent in Western countries
Describe the Absolutist view of abnormality, and why both views have merit
A disorder is caused by the same biological factors; schizophrenia exists cross-culturally, but developing countries deal with it better; varies according to context
List the main elements of Abnormality
Personal suffering; Maladaptiveness; Irrationality and incomprehensibility; Unpredictability and loss of control; Emotional distress; Interference in daily functioning; Vividness and unconventionality (deviations from norm); Observer discomfort; Violation of moral standards
What four main areas does the DSM-5 focus on?
Clinical presentation (specific symptoms clustering together); Etiology (causes); Developmental stage (children vs. adults); Functional impairment (immediate and long-term consequences)
What did Thomas Szasz argue about the label “mental illness”
That it really just means “problems in living”, and the label’s used as a means of social control and oppression
What was Drapetomonia, and what can labelling lead to?
A mentally ill term for black slaves who escaped for freedom; stigma and discrimination
What are the requirements to practice psychology professionally?
APS membership (6 year degree + 2 years supervised experience); APS College of Clinical Psychologists membership (post-grad degree in clinical psych + 2 years supervised experience)
Define Epidemiology
The study of the frequency and distribution of disorders within a population
What do Incidence and Prevalence refer to?
Number of new cases of a disorder appearing in a population within a specific time period;
Number of active cases in the population within a time period
What does Lifetime Prevalence refer to?
Proportion of population affected by mental illness at some point during their lives
What’s the term for the presence of more than one condition?
Comorbidity
According to Queensland statistics, what’s the rate of mental illness occurring during the lifespan?
One in every four people; over half a million where it interferes with their daily lives
100 Australians attempt suicide every day, of these, around what percentage are males?
77%
What age groups show the highest rate of suicide?
35-44 years
According to NCS-R, which mental illness shows the highest rate of lifetime prevalence?
Major depression (17%)
Hippocrates classified mental disorders into what three categories?
Mania (excessive behaviour); Melancholia (depression); Phrenitis (brain fever)
According to Hippocrates, all forms of disease could be attributed to natural causes, and were seen as an imbalance in which essential fluids?
Blood; Phlegm, Yellow and Black bile
What was the dominant view of mental disorders during the Middle Ages?
A supernatural view - abnormal behaviour was interpreted as the work of the devil or witchcraft (exorcisms; burning at the stake)
During the Renaissance period demonology was criticised and there was a more humane view of mental illness. What role did Paracelsus and Weyer play in this?
Paracelsus believed the stars and planets affected the brain; Weyer was the first physician to specialise in the treatment of mental illness
Describe the conditions of the first established asylums in the mid 16th century
Confinement; torturous practices; medical treatments (bloodletting, purgatives); more about isolation from society than treatment
How did the rise of modern thought in the 19th century impact on the treatment of mentally ill people?
They were treated morally; The revolution led to a focus on individual rights, humanitarian ideas and establishing reforms to care for them (e.g.Phillipe Pinel); people improved
Late 19th century saw the rise of the Scientific Model. List the five categories in Pinel’s Classification system
Melancholia; Mania; Mania with delirium; Dementia; Idiotism
Kraepelin followed up Pinel’s categories in the 1920s, and made an important distinction between which two disorders?
Dementia praecox (schizophrenia) and Manic depressive psychosis
Which mental disorder was identified to be caused by syphilis in the late 1880s, and what did this discovery lead to?
General paresis (paralytic dementia); it led to a search for biological causes of mental disorders
Give three examples of somatic treatments employed in the 1920s-30s, and the scientific evidence behind it
Fever therapy; Insulin coma therapy; Lobotomy;
There was no scientific evidence; they were dangerous and ineffective
Which neurologist identified hysterical disorders and treated them with hypnosis?
Franz Mesmer (late 18th century)
What main methods did Breuer and Freud use, which marked the beginning of the Psychoanalytic Revolution?
Breuer - hypnosis and catharsis; Freud - free association
What were Breuer and Freud’s four theories based on their studies in hysteria?
Psychological factors affect behaviour; Talking is more effective than harsh physical/moral treatments; Behaviour is influenced by thoughts, impulses and (unconscious) wishes; Non-psychotic disorders are worthy of treatment
According to the Biopsychosocial Framework, abnormal behaviour reflects a combination of what main factors?
Biological; Psychological; Social; Environmental
What does the diathesis-stress model propose?
An interaction between predisposition and exposure to stressors
Though treatments advanced with the rise of behavioural therapy and new psychotropic drugs created in the 30s-40s, what were some disadvantages with the drugs?
They were mostly discovered by accident when treating other conditions; many were essentially tranquillisers and subdued people
Advances in treatment led to deinstitutionalisation in the 70s and out-patient psychiatric clinics focusing on managing the disorders, until what proactive approach was finally taken?
Community mental health centres with a focus on rehabilitation
Where do we stand in our current view of mental health?
Behaviour must be considered within its context; it’s best to adopt a scientist-practitioner, holistic, multi-disciplinary approach
Who believed that at least half of his cases at Worcester Lunatic hospital (in 19th century), could be traced to immoral behaviour, improper living conditions and exposure to natural stresses?
Samuel Woodward
List five purposes for the classification system
Enables clinicians to diagnose; Information retrieval; Facilitates research, Communication and (sometimes) Treatment selection
What are some problems with classification?
Mental illness works on a continuum (dimensional) and the cut-off is arbitrary; we’re all somewhere on the spectrum
The psychiatric classification system was developed by hospital superintendents in what time period?
Mid 1930s
The DSM-5 lists 200 mental disorders. What information is included about each disorder?
Criteria for diagnosis; essential clinical features; associated features; prevalence; development and course; risk and prognostic factors; culture and gender related diagnostic issues; suicide risk; functional consequences; differential diagnosis; comorbidity
In what ways has the DSM improved over time?
More detailed and objective criteria; focus on entirely verifiable symptoms; psychopathology not regarded as subset of medicine; discarded the multi-axial assessment; diagnostic specificity; more closely aligned with ICD-11
Classification has been criticised as being irrelevant to the field of abnormal behaviour. Why?
Making inferences can lead to missing critical information; Ignores individual differences; Labeling can shape perceptions, cause prejudicial treatment and foster self-fulfilling prophecy; Forces clinicians to make distinctions that can have major treatment implications; We all fluctuate at different stages (continuum); Reliability and validity are variable (contradictory information); Diagnostic bias (expectations based on sex, race, SES, etc)
How did the Rosenhan’s (1973) experiment show how context and expectation can affect our judgement?
He had 8 pseudopatients feign symptoms to gain admission – all but one was diagnosed with schizophrenia; when Rosenhan sent 193 new patients to a psychiatric facility, 41 were identified as pseudopatients but none of them were; they couldn’t distinguish between sane and insane
What’s involved in a clinical assessment?
It’s the process of gathering information important to diagnose, plan treatment and predict the future course of a disorder
Why is a clinical interview (supplemented by other assessments) an essential component of a clinical assessment?
It allows testing of hypotheses; allows clinician to form a diagnostic formulation, and judgments about why the disorder is present and treatment
List some different types of clinical assessments
Clinical intake interview; Clinical tests; Projective tests (Rorschach and Thematic apperception tests); Personality inventories (MMPI); Other self report inventories (affective, social skills, cognitive, reinforcement inventories); Intelligence tests; Neuropsychological tests; Behavioural assessment; Physiological assessment
List some of the different aspects of personality that the MMPI assesses
Hypochondriasis; Depression; Hysteria; Psychopathic deviance; Paranoia; Psychasthenia (fears/compulsions); Schizophrenia; Hypermania
Describe three disadvantages of using intelligence tests for clinical assessment
Factors unrelated to intelligence can influence performance; Cultural bias; Tests measure what psychologists consider intelligence to be (ignores the different types)
