Week 1,2,3 Flashcards
Psychopathology
Development of abnormal behaviors and feelings that are shaped by context, deviant from societal norms
Case formulation includes
Clinical theory, 4ps (predisposing, precipitating, perpetuating & protective factors), working hypothesis
How is the use of counter transference used in diagnosis?
As a way to emphasize! By feeling the patients emotions
Categorical monothetic criterion sets
Requires all symptoms to be present to meet the diagnosis, higher interrater reliability & overly restrictive inclusion criteria for diagnostic classification
Categorical Polythetic criterion sets
Disorders that are defined by multiple symptoms and not all listed symptoms are necessary to consider a mental disorder present in a specific individual
Criticism of categorical criteria
Poor discriminant validity and lack of reliability and excessive co-morbidity (medical condition present with another)
Pro of polythetic sets
Greater inclusion of diagnostic classifications by utilizing polythetic criterion sets
Cons of polythetic sets
Excessive within group heterogeneity (patients who present different sets of symptoms may be classified with the same diagnosis)
Dimensional models
Used to calculate intercorrelations among large amounts of variable data, factor analysis examines patterns within groupings such as behaviors traits and symptoms
What does the dimensional approach allow a clinician to do?
Allows clinician more latitude to assess the severity of a condition and does not imply a concrete threshold between normality and disorder
How do dimensional approaches place behaviors and symptoms
On a continuum of frequency and severity
Z-codes (DSM)
Things you are treating but they are not mentally diagnosed, such as child abuse
Differential diagnosis
A list of possible conditions that could be causing patients symptoms, and narrowing it down
Malingering
Faking a disease for secondary gain
Factitious
Doing it for attention to be diagnosed
3 culture ways of understanding or describing distress or illness that are brought up in clinical encounters
Cultural explanation, cultural idiom of distress & cultural syndrome
Cultural idiom of distress
Phrase or a way of talking about symptoms problems or suffering
Cultural syndrome
A cluster of group of co-occurring distinctive symptoms found in specific cultural groups, communities
What does case formulation do?
It guides treatment
Nomothetic
Approach involves trying to make generalizations about the world to understand large-scale social patterns
Idiographic
relating to something that is unique, individual, or concrete. Similar symptoms can present differently in different individuals (dimensional)
Psychological case formulation of the 4Ps
Predisposing, precipitating, perpetuating and protective factors
Predisposing factors
Certain factors may make an individual more vulnerable toward developing a certain type of mental illness (genetic, family history, substance, trauma)
Precipitating factors
Include all types of triggers for the mental illness or mental health problems that are being presented (what triggered it, losses, divorce, relapse)
Perpetuating/maintaining factors
Contextual factors or situations that maintain or worsen the problem (these keep you from moving on, drug you, aggressive behaviors, habitual)
Protective factors
Conditions or attributes in individuals, families, communities or the larger society that mitigate or eliminate mental health problems or illness (ex: community support, motivation for change)
Bergners (1998) Characteristics of clinical case formulation
Organized around a linchpin, targets factors amenable to intervention and enables beneficial use by the client
Linchpin
the idea of identifying a central organizing factor in a clinical case
Bergners procedures steps
- Determine the facts of the case, 2. Develop the facts into an explanatory account, 3. Check implement, and revise if indicated
When does a categorical classification approach work best?
When members of a diagnostic class are homogenous, mental disorders are not homogeneous
Transference
The persistence of childhood patterns of mental organization in adult life implies that the past is repeating itself in the present (ex: mom: I don’t have time for this. Daughter: I wonder if my therapist will think I’m needy)
Good case formulation
Being concise, include all facts, patients history, symptoms, predisposed, why problem persists, anticipate how the patient will respond to treatment
Dimensions in DSM
Psychiatric symptoms can occur both within and across disorders
Measure symptoms in 3 ways
- Acknowledges symptoms not primary
Ex: depression and anxiety occurring at one time
Specifiers like anxiety travel across disorders
- Measure Symptom Magnitude
Ex: clinician rated dimensions of psychosis symptom severity
8 item measure compelted by clinicians
Clinician rates symptom in past 7 days
- Screen for a mental disorder. This refers to the dimensional model’s approach to using screening tools to detect for the presence of a disorder.
Disadvantages with Dimensional
Limited clinical utility (clinicians prefer categorical diagnosis), lack of clear boundaries, overlapping symptoms, stigma and acceptance (categorical models provide better labels for diagnosis)
