wk 4 MH Flashcards
What is a transdiagnostic approach?
‘Transdiagnostic’ means ‘across diagnoses’
Nowadays a ‘full’ transdiagnostic approach applies to all mental health diagnoses not just various categories
address all problems together
Kessler et al. (2005) more than ____ of people diagnosed with a disorder in a given year, meet the criteria for ____ disorders
50%
multiple
Barca-Garcia et al. (2007) followed up 10,000 patients at ten time points:
Only ___%of specific personality disorders were stable over time
__% of cases of schizophrenia were stable
29%
70%
Findings (Caspi et al., 2013)
Assessed diagnostic symptoms for a wide range of disorders
Used factor analysis to explore inter-correlations between symptoms
They found evidence pointing to one general underlying dimension that summarized individuals’ propensity to develop any and all forms of common psychopathologies.
The p factor correlated with:
-great life impairment -great childhood maltreatment -poorer brain function in early life (the higher p score- more impairment)
They concluded that ‘the p factor explains why it is challenging to find causes, consequences, biomarkers, and treatments with specificity to individual mental disorders.
Transdiagnostic approaches may improve research.
biological genetic factors influencing comorbidity/transdiagnostic factors
Genetics - many disorders have shared genetic vulnerabilities
e.g: schiz, bipolar, ADHD, major depression
social factors influencing comorbidity/transdiagnostic factors
shared interpersonal factors/ expressed emotion. (such as hostility and over criticism in family members)
biological brain circuitry factors influencing comorbidity/transdiagnostic factors
Structurally: found gray matter loss converged across diagnoses in 3 regions
Functional patterns: found overlapping activity in brain areas in people with mental health disorders
When exploring cognitive behavioural processes (brain function in different parts of the brain) they found patterns of thinking and behaviour that maintain distress, such as:
- Worry (Wells & Matthews, 1994)
- Avoidance (Mowrer, 1939)
- Selectively attending to threat in the environment (Macleod & Mathews, 1985)
these are all elevated across psychological disorders
Therefore, representing transdiagnostic factors
Themes of loss of ______ – at the ‘rock bottom’ & regaining ______ as the process of recovery
control
control
Perceptual Control Theory
proposes that
psychological distress is the loss of control due to unresolved goal conflict
Conflict can be intra personal or inter personal
Conflict is resolved through shifting and sustaining attention to the source of the conflict (Method of Levels; Carey 2006)
Likely to require flexible use of multiple brain networks
Method of Levels therapy
Method of Levels is a talking therapy, based on the principles of Perceptual Control Theory (PCT) (Powers, 1973).
PCT proposes that individuals experience distress as a result of reduced control over important goals in their lives.
MOL therapy directs an individual’s attention towards identifying important goals
It also helps individuals identify conflicting goals
Lastly it supports individuals to find solutions to their own problems (Carey et al., 2015).
2 main goals in therapy: keep the person talking about the problem and notice disruptions
Distinctive features of Method of Levels
The client books their own appointment and talks about the problem of their choice
The counsellor/therapist is naturally curious, asking about the problem & the client’s experiences right now
In short, the counsellor/therapist keeps ‘out of the way’
Counsellor/therapist has goals but no specific techniques
Assumes that change happens spontaneously within the client
Assumes that the client knows when they no longer need MOL
