Psychopathology1 - History, Classification, Assessment

Question 1

What are the four main objectives of abnormal psychology?

Answer 1

Describing - what behaviours are evident;
Explaining - why they’re evident;
Predicting - outcome;
Managing - problematic behaviour

Question 2

Describe the Relativist view of abnormality and provide evidence

Answer 2

Symptoms and causes vary across cultures; eating disorders are more prevalent in Western countries

Question 3

Describe the Absolutist view of abnormality, and why both views have merit

Answer 3

A disorder is caused by the same biological factors; schizophrenia exists cross-culturally, but developing countries deal with it better; varies according to context

Question 4

List the main elements of Abnormality

Answer 4

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

Question 5

What four main areas does the DSM-5 focus on?

Answer 5

Clinical presentation (specific symptoms clustering together); Etiology (causes); Developmental stage (children vs. adults); Functional impairment (immediate and long-term consequences)

Question 6

What did Thomas Szasz argue about the label “mental illness”

Answer 6

That it really just means “problems in living”, and the label’s used as a means of social control and oppression

Question 7

What was Drapetomonia, and what can labelling lead to?

Answer 7

A mentally ill term for black slaves who escaped for freedom; stigma and discrimination

Question 8

What are the requirements to practice psychology professionally?

Answer 8

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)

Question 9

Define Epidemiology

Answer 9

The study of the frequency and distribution of disorders within a population

Question 10

What do Incidence and Prevalence refer to?

Answer 10

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

Question 11

What does Lifetime Prevalence refer to?

Answer 11

Proportion of population affected by mental illness at some point during their lives

Question 12

What’s the term for the presence of more than one condition?

Answer 12

Comorbidity

Question 13

According to Queensland statistics, what’s the rate of mental illness occurring during the lifespan?

Answer 13

One in every four people; over half a million where it interferes with their daily lives

Question 14

100 Australians attempt suicide every day, of these, around what percentage are males?

Answer 14

77%

Question 15

What age groups show the highest rate of suicide?

Answer 15

35-44 years

Question 16

According to NCS-R, which mental illness shows the highest rate of lifetime prevalence?

Answer 16

Major depression (17%)

Question 17

Hippocrates classified mental disorders into what three categories?

Answer 17

Mania (excessive behaviour); Melancholia (depression); Phrenitis (brain fever)

Question 18

According to Hippocrates, all forms of disease could be attributed to natural causes, and were seen as an imbalance in which essential fluids?

Answer 18

Blood; Phlegm, Yellow and Black bile

Question 19

What was the dominant view of mental disorders during the Middle Ages?

Answer 19

A supernatural view - abnormal behaviour was interpreted as the work of the devil or witchcraft (exorcisms; burning at the stake)

Question 20

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?

Answer 20

Paracelsus believed the stars and planets affected the brain; Weyer was the first physician to specialise in the treatment of mental illness

Question 21

Describe the conditions of the first established asylums in the mid 16th century

Answer 21

Confinement; torturous practices; medical treatments (bloodletting, purgatives); more about isolation from society than treatment

Question 22

How did the rise of modern thought in the 19th century impact on the treatment of mentally ill people?

Answer 22

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

Question 23

Late 19th century saw the rise of the Scientific Model. List the five categories in Pinel’s Classification system

Answer 23

Melancholia; Mania; Mania with delirium; Dementia; Idiotism

Question 24

Kraepelin followed up Pinel’s categories in the 1920s, and made an important distinction between which two disorders?

Answer 24

Dementia praecox (schizophrenia) and Manic depressive psychosis

Question 25

Which mental disorder was identified to be caused by syphilis in the late 1880s, and what did this discovery lead to?

Answer 25

General paresis (paralytic dementia); it led to a search for biological causes of mental disorders

Question 26

Give three examples of somatic treatments employed in the 1920s-30s, and the scientific evidence behind it

Answer 26

Fever therapy; Insulin coma therapy; Lobotomy;

There was no scientific evidence; they were dangerous and ineffective

Question 27

Which neurologist identified hysterical disorders and treated them with hypnosis?

Answer 27

Franz Mesmer (late 18th century)

Question 28

What main methods did Breuer and Freud use, which marked the beginning of the Psychoanalytic Revolution?

Answer 28

Breuer - hypnosis and catharsis; Freud - free association

Question 29

What were Breuer and Freud’s four theories based on their studies in hysteria?

Answer 29

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

Question 30

According to the Biopsychosocial Framework, abnormal behaviour reflects a combination of what main factors?

Answer 30

Biological; Psychological; Social; Environmental

Question 31

What does the diathesis-stress model propose?

Answer 31

An interaction between predisposition and exposure to stressors

Question 32

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?

Answer 32

They were mostly discovered by accident when treating other conditions; many were essentially tranquillisers and subdued people

Question 33

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?

Answer 33

Community mental health centres with a focus on rehabilitation

Question 34

Where do we stand in our current view of mental health?

Answer 34

Behaviour must be considered within its context; it’s best to adopt a scientist-practitioner, holistic, multi-disciplinary approach

Question 35

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?

Answer 35

Samuel Woodward

Question 36

List five purposes for the classification system

Answer 36

Enables clinicians to diagnose; Information retrieval; Facilitates research, Communication and (sometimes) Treatment selection

Question 37

What are some problems with classification?

Answer 37

Mental illness works on a continuum (dimensional) and the cut-off is arbitrary; we’re all somewhere on the spectrum

Question 38

The psychiatric classification system was developed by hospital superintendents in what time period?

Answer 38

Mid 1930s

Question 39

The DSM-5 lists 200 mental disorders. What information is included about each disorder?

Answer 39

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

Question 40

In what ways has the DSM improved over time?

Answer 40

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

Question 41

Classification has been criticised as being irrelevant to the field of abnormal behaviour. Why?

Answer 41

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)

Question 42

How did the Rosenhan’s (1973) experiment show how context and expectation can affect our judgement?

Answer 42

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

Question 43

What’s involved in a clinical assessment?

Answer 43

It’s the process of gathering information important to diagnose, plan treatment and predict the future course of a disorder

Question 44

Why is a clinical interview (supplemented by other assessments) an essential component of a clinical assessment?

Answer 44

It allows testing of hypotheses; allows clinician to form a diagnostic formulation, and judgments about why the disorder is present and treatment

Question 45

List some different types of clinical assessments

Answer 45

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

Question 46

List some of the different aspects of personality that the MMPI assesses

Answer 46

Hypochondriasis; Depression; Hysteria; Psychopathic deviance; Paranoia; Psychasthenia (fears/compulsions); Schizophrenia; Hypermania

Question 47

Describe three disadvantages of using intelligence tests for clinical assessment

Answer 47

Factors unrelated to intelligence can influence performance; Cultural bias; Tests measure what psychologists consider intelligence to be (ignores the different types)