Woo Midterm Flashcards
Wakefields definition of psychopathology
psychopathology is a harmful dysfunction.
- harmful: a value judgment (what we consider to be harmful is socially constructed. this may change over time (e.g. male aggressiveness as necessary is now seen as harmful)
- dysfunction: failure of internal mechanisms to perform naturally selected functions (evolutionary theory)
What is a symptom?
experienced subjectively and reported by client (e.g. hallucinations)
whats the difference between a symptom, syndrome, and sign?
- symptoms: experienced subjectively and reported by client (e.g. hallucinations)
- signs: can be observed and documented objectively (e.g. agitation, crying, psychomotor retardation)
- syndrome: a cluster of signs and symptoms
ways in which culture can affect the manifestation of psychopathology
- psychiatric dx is an INTERPRETATION of a person’s experience
- they are concepts - not diseases (invented)
- interpretations of distress may be different depending on client’s background/tx provider
- language used to describe emotional difficulties (e.g. emotional or mental problem)
- what symptoms and signs of a syndrome are prominent or commonly reported (ex: PTSD)
- what approaches will be used to treat or deal w/ the problem (e.g. delays in help seeing among asian americans due to stigma might result in coming w/ more severe symptoms)
universalist approach to the question regarding manifestation of psychopathology across cultures (what are the basic tenets and assumptions?)
universal, see around the world, signs/clusters of syndromes with specific manifestations. basically, disorder are found everywhere, same symptoms occur no matter where you look. that said, teh manifestation of that disorder and the threshold varies between cultures.
relativistic approach to the manifestation of psychopathology across cultures? (basic tenets and and assumptions?)
culture shapes everything so on Dx system is not best, we may miss important disorders by trying to make them fit in the DSM and look homogeneous (Ex ataque de nervios and anxiety disorders). Depends on the disorder, some have evidence for a universal component (Schizophrenia) but different content in delusions.
-“there are certain groups of symptoms that we see only in certain environments. in some cases there are culture bound symptoms, that if missed, are confused for being same or mistake definition of symptoms mean same thing to different cultures
What is Emic versus etic perspective?
Emic and etic are terms used by anthropologists and by others in the social and behavioral sciences to refer to two kinds of data concerning human behavior. In particular, they are used in cultural anthropology to refer to kinds of fieldwork done and viewpoints obtained
- An ‘emic’ account is a description of behavior or a belief in terms meaningful (consciously or unconsciously) to the actor; that is, an emic account comes from a person within the culture. Almost anything from within a culture can provide an emic account.
- An ‘etic’ account is a description of a behavior or belief by an observer, in terms that can be applied to other cultures; that is, an etic account attempts to be ‘culturally neutral’.
What are the ways in which DSM tries to address cultural/ethnic diversity issues?
o for each clinical condition there is a “specific culture, age, and gender features section” that identifies variations in clinical presentation that can be affected by cultural or lifespan considerations
o provides information on differential prevalence rates related to culture/gender/age
o provides an outline for cultural formulation highlighting factors to consider in assessing clients from diverse cultural backgrounds
what is the dsmIV outline for cultural formulation?
cultural identity of individual
cultural explanations for illness
cultural factors related to teh psychosocial environment and level of functioning
cultural elements of the relationship between the individual and clinician
what is a syndrome?
a cluster of signs and symptoms
what is a sign?
can be observed and documented objectively (e.g. agitation, crying, psychomotor retardation)
what does culture influence?
the language used to describe the emotional difficulties, whether an experience is even conceptualized as an emotional or mental problem, what symptoms/signs of a syndrome are prominent of commonly reported, and what approaches will be used to treat ordeal with the problem? (ex is help seeking behaviors among asian clients due to stigma concerns)
Diversity/Special Considerations for assessing children and older adults:
for age: think of language abilities between kids and adults
ex: social phobia presents differently in kids versus adults, things like depression and dementia are frequently confused in older adults, and gender can come in to play (like how women are more often diagnosed with depression or autism in boys)
Monotheistic criteria sets? (include advantages and disadvantages)
this requires that each one of several diagnostic criteria have to be present in order to make a diagnosis; hence, the criteria are jointly necessary and sufficient. thus, before a diagnosis of depersonalization disorder can be assigned, all four diagnostic criteria must be met. this approach works best when disorders are homogeneous: in relation to their defining features, each category is mutually exclusive and the boundaries distinguishing different disorders are all clear. it tends to increase the reliability of diagnosis, but at teh expense of validity and clinical utility. it also runs the risk of reifying diagnostic categories and reduces the need for clinical judgment or inferences.
polytheistic criteria sets (include advantages and disadvantages)
need a list/subset of Dx criteria (Ex 5/9 of the following symptoms…)
this approach involves many possible signs or symptoms as diagnostic criteria. this format lists a range of symptoms and signs, not all of which are required for a diagnosis; an individual may be assigned diagnosis based on a subset of possible idagnostic features that were sufficient to meet the diagnostic threshold. this organization allows for more open diagnostic system that can accountfor the natural heterogeneity of psychiatric disorders. unfortunately, it increases the complexity and heterogeneity of the diagnostic categories.
what are the major models of psychopathology? (7 of them)
psychodynamic behavioral cognitive humanistic/existential systems/sociocultural neurobiological sociobiological/evolutionary
what does the behavioral approach emphasize?
role of learning principles in the maintenance of problem behavior or absence of adaptive behaviors (social learning theory, modeling). Every behavior serves a purpose or is being reinforced
• ex phobia as result of conditioning experience, depression as result of loss of reinforcement in one’s environment
• influence of modeling on behavior has implications for treatment (that we can model for our clients)
what does the psychodynamic approach emphasize?
unconscious drives/conflict are the basis for psychopathology, fixation or arrest at different developmental stages, defense mechanisms to deal with anxiety or other negative emotional states, quality of early relationships with caregivers
• Conflict within 3 parts of psyche (id/ego/superego)
• Ex. Dependent personality disorder: rely excessively on others due to problem in oral stage where over indulged and cannot resolve independence/dependence issue
• In the DSM: defensive functioning scale, a nod to psychodynamic theory
what does the cognitive approach emphasize?
psychopathology in terms of illogical, inaccurate cognitive schemas that dominate an individual’s thinking and ways of processing information
• distorted thought processes are associated with negative affective states that can effect one’s behaviors
• think of depression and Beck or anxiety disorders. Where thoughts, feelings, and behaviors all intervene in a triangle. We intervene with behaviors or thoughts, which lead to changes in feelings.
what does the humanistic/existential approach emphasize?
emphasis on free will and search for meaning,
• psychopathology from the inability to exercise free will, mastery in one’s life, experiences that call into question the fundamental assumptions about oneself and the nature of the world, inability to satisfy hierarchy of needs.
• Downplays emphasis on mental illness or diagnosis
• Unconditional positive regard, empathy, genuineness seen as necessary therapeutic elements.
what does the systems/sociocultural approach emphasize?
psychopathology must be understood in the wider social, interpersonal context in which it exists. Family and other social relationships affect individual behavior; each member of the system influences and is influenced by others in the system.
• DSM doesn’t reflect this very well, mostly V Codes
• Ex. Behavioral couples therapy for alcoholism, Minuchin and family dynamics in anorexia (families in anorexics are usually ridig, overprotective, etc)
• Counterproductive to focus solely on IP
what does the neurobiological approach emphasize?
emphasize the role of psychopathology from genetic factors, neurochemical abnormalities, impact of illness, injury, disease on brain function
• Even disorders that appear to have a strong psychosocial component involve the interplay of biological factors, like ptsd (where studies found high resting heartbeat is tied to increased likelihood of development)
• Some disorders in dsm like at border of neurology and psychiatry
• Ex. Dementia, Tic disorders
what does the sociobiological/evolutionary biological approach emphasize?
assumes that psychological phenomena occur as result of being evolutionary adaptive and maintained through natural selection
• ex. Anxiety as attention to physical dangers…now maladaptive in todays world
• however, in some cases, these phenomena may be maladaptive by today’s standards (ex biological preparedness and phobias)
describe maslow’s hierarchy of needs
-physiological (breathing, food, sex, sleep, water
-safety: security of body, employment, resources, morality, family, health, property
Love/Belongingness: friendship, family, sexual intimacy
Esteem: self-esteem confidence, achievement, respect of and by others
Biopsychosocial model
emphasizes the interplay of biologiocal, psychological, and social factors in understanding mental disorders. Like the diathesis-stress model of psychopathology. With diathesis being the biological or genetic predisposition, and the environmental events or stressors triggering the disorder.
define developmental path. term: equifinality
There are multiple paths to psychopathology east. disparate routes may lead to a common outcome. all roads lead to rome in that different factors can lead to same outcome
define development term: multifinality
a given risk factor or initial state can lead to disparate outcomes during the course of development across different individuals.
how is substance dependence different than abuse?
dependence involves physiological symptoms of tolerance and withdrawal or psychological perception that they need substance to feel ok or function optimally, and is characterized by addiction and impaired control.
abuse is a maladaptive pattern and dependence criteria have never been met and is characterized by denial and limited control.
what is tolerance?
celular and metabolic adaptations in response to continued presence of substance. more is needed to achieve same effect, use becomes more frequent, and cross tolerance.
what is withdrawal?
- experienced when administration of a substance to dependent individual is stopped/greatly reduced.
- characteristic withdrawal syndromes associated with different drugs
- withdrawal sx tend to be opposite to effects produced by drugs.
