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DSM > Week 1 > Flashcards

Week 1 Flashcards

1
Q

Etiology

A
  • The cause of something
  • presumed or theorized cause
  • Many disorders have many which can be different in each client even though they have the same disorder
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2
Q

Epidemiology

A
  • the prevalence of a disorder
  • how common
  • distribution (racial, worldwide, etc)
  • ex: 1 in 1000, common among men, etc
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3
Q

Key Treatment Conditons

A
  • What are “they” saying about how we should go about treating this?
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4
Q

Treatment Strategies

A
  • What are effective/ineffective?
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5
Q

Premorbid

A
  • Condition that existed first
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6
Q

Comorbid

A
  • coexisting condition
  • what else does client have?
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7
Q

1484 Pope Innocent

What was treatment for people declared “strange?” (Possessed by the devil)

A
  • admit possession and repent
  • Be tortured until one admits
  • Death to force the soul from devil
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8
Q

1520

What did Martin Luther declare?

A
  • “Mad people are possessed by the devil.”
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9
Q

The Age of Enlightenment (After Middle Ages)

What was the thought on what to do with “the criminal, the demented, and the debtor?”

A
  • Institutionize rather than kill them.
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10
Q

Moral Treatment of Mentally Ill

What is Millieu therapy?

A
  • Reinforce good and decent behavior by changing environment
  • recover, life moves on
  • revival/ religious experience to set you on the road to proper living
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11
Q

Social Darwinism

What is Social Darwinism?

A
  • “Survival of the fittest” MI are inferior and should be sterilized lest they contaminate the gene poool Misfits should be “locked up”
  • 25 states passed sterilization laws by 1936
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12
Q

Settlement Movement

What was the Settlement Movement?

A
  • Help unfortunate
  • Child labor laws passed Compulsory education enacted
  • WWI saw a conservative swing
  • anti- immigrant sentiment flared “Jewish Peril”
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13
Q

Word War II

What is shell shock called now?

A
  • PTSD
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14
Q

1950

What resulted in the breakthrough on Psychotropic medications?

A
  • less physical restraints
  • less labotomies
  • people no longer had to be hospitalized if given medication
  • managed difficult people
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15
Q

1948

What was the National Institute of Mental Health founded and funded for?

A
  • Drive research
  • policy
  • dollars
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16
Q

The Age of Enlightenment (After Middle Ages)

What was the big change in the perception of the cause of mental illness?

A
  • Considered NOT to be a result of witchcraft, etc
  • NOT demonic
  • Something wrong with the person
  • ”You are the problem/it’s your fault”
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17
Q

1484 Pope Innocent

What were the results of Pope Innocent’s actions towards mentally ill?

A
  • witch burning
  • inquisiton
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18
Q

Advantages of the 1963 Act

What was made practical because of advances in psychotropic medications?

A
  • halfway houses
  • group homes
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19
Q

1975

For what did Congress begin requiring services?

A
  • children
  • aged
  • alcohol and drug patients
  • follow-up treatment for hospitalized patients
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20
Q

Advantages of the 1963 Act?

What did the substantial decrease in institution admissions mean?

A
  • The fewer people in institutions means more people in the community
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21
Q

Problems with the 1963 Act

What were some of the problems with the CMHA?

A
  • Areas to be served by mental health centers were too large
  • Boundaries between rich/poor were confused
  • Clnics wanted “best” areas which were in nice areas with less issues.
  • Focus on Clinical services rather than prevention
  • too much for the centers to handle with managed money
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22
Q

1963 Community Mental Health Act

Which of the aspects of the act couldn’t meet the demands of the people?

A
  • Prevention
  • JFK thought of this and only could get 5% of allocated dollars for the act
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23
Q

1963 Community Mental Health Act

For what did the established funding for community mental health centers provide?

A

Inpatient service

Outpatient Service

Partial hospitalization

24-hour emergency care

Consultations, education, prevention

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24
Q

1963 Community Mental Health Act

What serves as a foundation for the system we have today as well as the current delivery of treatment?

A
  • The Community Mental Health Act
  • The compromise bill that was finally passed.
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25
Q

1960 JFK

What was The Kennedy Plan?

A
  • reintegrate mentally ill into community so therefore dollars and jobs were at stake
  • able to do this because of medications
  • prevention was a key idea
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26
Q

1960 JFK

What did the AMA think about JFK’s thoughts on prevention?

A
  • They opposed JFK
  • feared socialized medicine (health care) would follow which was kin to communism apparently
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27
Q

The Age of Enlightenment (After the Middle Ages)

Describe the conditions in the institutions?

A
  • Deplorable
  • People were chained and caged
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28
Q

The Reform Movement

What were the conditions like in institutions during the Reform Movment?

A
  • Conditions were bad
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29
Q

Ancient Greece

What was the general thought on the mentally ill in Ancient Greece?

A
  • Mentally ill are under influence of angry gods
  • must be shunned
  • deparate them by placing them on islands together
30
Q

North Africa/Eastern Mediterranean Countries

What is Trephination?

A
  • releases evil spirits
  • 2 cm hole in the head
  • we learned this from exacavations
  • recent incidents of trephinaton in Cali
31
Q

Emerging Medical Beliefs

What was the medical treatment proposed?

A
  • In April, bleed the patient
  • in may, purge the patient,
  • in October, bleed the patient or give them an ice cold water dip (precursor to shock treatment)
  • alternative to moral treatment
32
Q

Scientific Psychology (1900)

Describe the theory?

A
  • Psychological rather than organic factors dominant in mentally ill
  • theories followed from friend to your theory of mentally ill (all theories)
33
Q

North Africa/Eastern Mediterranean Countries

How were mentally ill people viewed?

A
  • MI ppl are possessed by evil spirits stuck inside them
34
Q

Colonial Times in the USA

What happened to the mentally ill during the colonial times?

A
  • hanged
  • imprisoned
  • tortured as agents of satan
35
Q

Moral Treatment of Mentally Ill

What was the assumption about the mentally ill that still exist in threads today?

A
  • person’s own devious behavior caused them to be possessed
  • Insane are normal and need moral environment to recover
  • 80% recovery reported, not ill expected to recover sanity
  • Moral treatment was essentially Millieu therapy
  • disorder is a reflection of “moral weakness” (not same as moral values)
36
Q

The Reform Movement

Dorthea Dix

A
  • “Insane asylums are scandal and disgrace”
  • worked worldwide for reform to clean up institutions
37
Q

The Reform Movement

Benjamin Rush 1745-1813

A
  • Father of American Psychiatry
  • Encouraged more humane TX Treat the MI with respect and dignity,
  • moral hospitals were deplorable
  • first to suggest that addiction was public health issue
  • on the Declaration of Independence (I think)
38
Q

Emerging Medical Beliefs

What were some of the emerging medical beliefs?

A
  • Insane suffer from brain lesions or oversupply of blood or yellow bile
39
Q

1950 Scientific Psychiatry

What did the focus become?

A
  • Classify disturbances
  • Deal with problems of Moral Treatment
40
Q

1850 Scientific Psychiatry

What was taking shape during this time?

A
  • Medical Model takes shape
  • DSM was starting to be developed
  • something wrong with brains but it was unknown
  • figuring out classifications of different issues
  • advances in brain physiology, chemistry, medicine, etc,
  • signaled hope
41
Q

Scientific Psychology

Wht does the research say about Scientific Psychology?

A
  • Research failed to reveal organic pathology in most Pts who were MI
  • Psychological rather than organic factors dominate in MI
  • Theories followed from Freud to your theory of MI
42
Q

Scientific Psychology (1900)

What was the focus for scientific psychology?

A
  • Observable data;
  • experimental Psychology
  • Testing significance
  • Deduce from the way ppl answer questions what might be goin on in their head
  • measuring IQ
43
Q

USA late 19th century

What societal changes do we see during the late 19th century?

A
  • Social shift from agrarian to urban Increase in immigration
44
Q

USA Late 19th Century

What was the assumption about the immigrants that were coming in from all over the world, especially Europe?

A
  • Generally inferior, lack moral fiber and desire to improve themselves
  • immigrants, especially Catholic were undesirable
45
Q

USA Late 19th Century

What were the mental health implications?

A
  • Admissions to mental health hospitals doubled in US but for “foreigners” it increased six times Because they weren’t easily understood they were made to be mentally ill
46
Q

Politics & Mental Healthcare

What do liberals believe about mental health?

A
  • Environmental conditions drive mental disturbances
    • poverty
    • anxiety
  • Would spend money on treatment
    • create jobs
    • more facilities
47
Q

Politics & Mental Healthcare

What do conservatives typically believe about mental health?

A
  • Environment is fine
  • problem is the bad individual
  • individual’s problem
  • individual’s responsibility
48
Q

Great Depression

Great Depression

A
  • Institutions neglected again.
  • Economic reform followed but not social reform
  • Reforms that were instituted in 1929 were reversed a few years back
  • Wall Street Crashed
49
Q

1960 JFK

What does the “rise of liberal thinking” mean?

A
  • Optimism
  • Time of possiblity
  • Our nation can solve everything
50
Q

1960 JFK

What did the Joint Commisison Report claim about what drives the mentally ill?

A
  • Lack of education
  • Poverty
  • Social/psychological connection
51
Q

1980-2010

What was the result of the reemergence of conservative policies in Lansing and Washington?

A
  • Deinstitutionalize even if there is no community placement possible
  • mental health money went to jails and prisons
  • mental illness has now become an issue for the judicial system
52
Q

1980-2010

What happened to LaFayette clinic in Detroit?

A
  • Closed in Detroit in the middle of the night and Pts removed
53
Q

Clinton Health Reform Proposals

What were the Clinton Health Reform Proposals?

A
  • Single payer system
  • MI and Substance abuse Tx not carve out
  • Portability of coverage
  • No penalty for pre-existing conditions
  • Defeated by conservative lobby
54
Q

The Affordable Care Act (2010) Obama Care

What did the Affordable care act do?

A
  • Eliminated meaningless and cheap healthcare insurance
  • Requires basic coverage
  • Be insured or fined Added 24 million or so covered individuals (helped marginal hospitals in Rural America survive
55
Q

The Affordable Care Act (2010) Obama Care

What basic coverage is required?

A
  • Children to 26,
  • pre-existing conditions not excluded,
  • mental health covered,
  • substance abuse Tx covered,
  • Women’s coverage without increased premium etc
56
Q

USA Late 19th Century

What happened to the mental health system during the late 19th Century?

A
  • System became overwhelmed
  • moral treatment could not cope
  • physicians concluded that “they are incurable, brain defects, nothing to be done.”
57
Q

JFK 1960

What was the “War on Poverty?”

A
  • Reduce poverty and you decrease mental illness
58
Q

1850 Scientific Psychiatry

What was the thought on the mentally ill?

A
  • Illness is based on organic brain pathology
  • something must be wrong with the brain
59
Q

What are the prevalent mental disorders for males?

A
  • Alcohols and drug dependencies
  • Anxiety disorders
  • Dysthymia
  • other mood disorders
  • Antisocial personality disorders
60
Q

What are the prevalent mental disorders in females?

A
  • Anxiety disorder
  • Major depressive disorder
  • other mood disorder
  • Alcohol dependancies
  • Obsessive compulsive disorder (anxiety disorder)
61
Q

Modern Healthcare

How do Diagnostic Systems impact counseling?

A
  • Client must be diagnosed
  • must meet criteria
62
Q

What does the Preauthorization Process look like?

A
  • biopyschosocial history first session
  • diagnose and get authorization for more sessions
  • diagnosis clinically significant
  • treatment plan with goals and objectives
  • gatekeeper decides how many sessions are needed
63
Q

Modern Healthcare

How does Philosophy impact counseling?

A
  • Should we treat everyone or reserve for treatable?
64
Q

Modern Healthcare

How does fashion impact counseling?

A
  • Cognitive behavior is 85% all therapy, it is a fad these days
  • whats the next big thing in treatment
65
Q

Historical Approach

What is the Development Model?

A
  • Mechanistic view: behavioral
  • organismic view: humanistic
  • contextual view: cognitive behavioral
66
Q

Historical Approach

What is the Remediation Model?

A
  • Something wrong/ problem
  • Medical view: seek to understand the biochemical drivers
67
Q

Historical Approach

What is the takeaway from developmental model and remediation model?

A
  • Both models co-exist today.
  • combination of these models work together
68
Q

Modern Healthcare (Delivery of Services to Mentally Ill)

How does Economics impact counseling?

A
  • Who is paying?
  • What does it cost?
  • MUST be considered as part of the treatment plan
    • some things are covered some are not
    • whats the next thing?
    • Dollars matter
69
Q

Managed Care Model (operates today)

What does the Managed Care Model look like today?

A
  • We’re not paying for it unless you show and tell what you’re doing,
  • Can’t do it you don’t get paid
  • Treatment planning, be able to translate into behavioral language different behavioral approaches
  • We’re not paying for “talking”
  • Controls coverage, sessions, everything “managed” by someone else
70
Q

Gatekeepers

What is the role of the Gatekeepers?

A
  • Take down insurance data
  • Make sure it’s valid
  • Set up an appointment
  • Intake covered
  • Biopsychosocial intake
  • Clinician justifies disorder by talking language of DSM
  • authorize who gets treatment and how much

DSM (7 decks)

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