What is a psychological disease?

Question 1

What are the two main methods of assessing whether something is a psychological disease?

Answer 1

Statistical - differences and norms

Theoretical - disease mechanisms

Question 2

What is the statistical method of diagnosis?

Answer 2

Comparison of participant with norms based on normal distribution

Question 3

What is a z-score?

Answer 3

How many standard deviations an individual score is away from the mean, allowing us to compare two or more scores to a normal distribution

Question 4

What are the advantages and disadvantages of standardised tests of evaluation?

Answer 4

Advantages
- Diagnostic
Disadvantages
- Require large control group to establish normal distribution in the population
- Said control group may not apply for different individuals (e.g children, elderly)
- Not everything is normally distributed

Question 5

What are rating scales?

Answer 5

Compare performance over time and so can be used to measure responses to treatment (non-diagnostic!)
e.g Hamilton Depression Rating Scale and Beck depression scale (self-evaluation)

Question 6

What are the advantages and disadvantages of rating scales?

Answer 6

Adv 
- Allows participant to monitor their own progress
- Allows non-normal distributions 
- Lower cost
Disadv
- Non-diagnostic 
- Risk of operator error 
- Self-reporting errors (better-than-average effect)

Question 7

What are statistical manuals?

Answer 7

e. g DCM5 and ICD111
- Provide clinicians with a definitive list of mental health conditions based on symptoms
- Common language and standard diagnostic criteria

Question 8

What are the disadvantages of diagnostic manuals?

Answer 8

• Provide no evidence of biological causation
• No evidence of reliability and validity of prognostic value
• Problem of co-morbidity (such as anxiety + depression)
• Risk of medicalising normality

Question 9

How does the British Psychological Society suggest is the correct approach for clinical psychology? What are the possible drawbacks of this?

Answer 9

Describing the problem for the individual rather than the diagnostic label

• This could hinder research
• Is difficult to incorporate into insurance or law

Question 10

What are the 3 main theoretical models of health and disease?

Answer 10

• Biological
• Cognitive
• Social

Question 11

What evidence has been provided for a genetic link to mental health?

Answer 11

Higher incidence of depression in monozygotic twins, however this is only 46% so therefore does not entirely predict the disease

Question 12

What are the advantages and disadvantages of genetic studies?

Answer 12

adv
- Presence of an obvious biomarker can remove guilt
- Can then use causal treatment
disadv
- lack of control over one’s own mental illness
- only explains a few diseases in an adequate way (e.g Huntington’s)

Question 13

What is the neuropharmacological model for mental illness?

Answer 13

Cased by an imbalance of neurotransmitters

- 50-70% of patients with major depression recover after SSRI (however 40% recover after placebo)

Question 14

What are the advantages and disadvantages of a neuropharmacological model?

Answer 14

adv
- Biomarker removes sense of guilt
- Causal tratment
disadv
- Can result in passivity
- What is the cause of the neurotransmitter imbalance?
- Not 100% efficient and can therefore not be the full story

Question 15

What are cognitive neuroscientific models of mental illness?

Answer 15

Mental illness is caused by the malfunction of neural circuits which support psychological functions

Question 16

What are the advantages and disadvantages of cognitive neuroscientific models?

Answer 16

adv
- Can be diagnostic with the use of functional imaging (fMRI, EEG and EMG)
- Treatment using brain stimulation
disadv
- Field is still in its infancy
- No evidence for long term effect of treatment

Question 17

What is the cognitive psychology model?

Answer 17

Mental disease is caused by faulty thinking e.g people suffering from depression are more likely to recall negative effects

Question 18

Give two examples of cognitive psychology models

Answer 18

Beck’s cognitive triad, Seligman’s attribution theory

Question 19

What are the advantages and disadvantages of cognitive psychology models?

Answer 19

Adv
- Retaining control of menta illness can be empowering
- Allows for individualised assessment and treatment
disadv
- What is the cause of the faulty thinking?
- Can create guilt
- Sometimes negative thinking is rational

Question 20

What is an environmental model of depression?

Answer 20

That depression-like symptoms can be induced by physical and emotional stress
(shown in mice exposed to isolation and aggression)

Question 21

What are the advantages and disadvantages of environmental models?

Answer 21

adv
- Removes need to treat patient, instead must change the environment
disadv
- Cross-cultural similarities of clinical manifestations are unexplained
- create feelings of guilt in social environment

Question 22

Give an examples of environmental models of depression

Answer 22

• Mice exposed to social defeat by a larger and more aggressive CD-1 type mouse
• Induced long term depression like behaviours, increased levels of corticosterone and gene changes in ventral tegmental area (associated with depression)

Question 23

What are the characteristics of the Hamilton depression scale?

Answer 23

• Practicioner rated form
• Rates different symptoms of depression (e.g guilt, sadness) from 1-4 (where 4 is most severe) over the past week
• Total score then gives severity of depression where >23 is severe

Question 24

What are the characteristics of Becks depression scale?

Answer 24

• Self rated form

- 21 questions with four possible answer choices which range in severity

Question 25

What does a clinical assesment consist of?

Answer 25

an interview which tests to assess a presumed diagnosis and tests to exclude alternative diagnoses (differential
diagnosis)