Kohne's article Flashcards
Problems DSM
Categories; Differentiation often false
Comorbidity Boundaries between normality and pathology seem arbitrary. impossible to find 1 good diagnosis
Heterogenity: Patients w same diagnosis have no symptoms in common
Diagnositc threshold is arbitrary
Essentialism
Frame of thought we have that the cause of a disorder originates from an essence of some sort. It explains the ocurrence of all symptoms or a cluster, which are independent bc of different causes. Problem is; we don’t have the essence
Problems
We miss possiblity that symptoms cause each other, we work with nonspecific diagnoses and treatments that hardly tells us anything about the patient etc
Having 1 model is problematic
Dimensional trait models
Latent trait theory, 5 factor model, HiTOP
Not in a category but on a dimension with uncerlying p-factor (eg neuroticism). Step forward but still essentialist. intstead of describing psychopathology like the DSM, it explains it
The Network model (5 principles
Hold a central mechanism doenst exist, but that disorders are complex systems. Not the effect of a common cause but. aresult of connections between symptoms.
Latent factors like neurobio cause still exist, but not explained as the cause of a syndrome.
Covariance follows network structue. Causally connected symptoms for new homeostasis
idea of hysteresis; if trigger of network is gone, network gets stuck on active state.
Symptoms component correspondence. No descrete categories, but common network structures of symptoms w common categories in DSM
Problems w network theory
Uses DSM components. If you’d change to problems of living, what decides what to include in the network.
Transdiagnostic approach
Maintaining mechanisms of disorders that explain the high comorbidity rate. Some processes in specific categories and others in all. Things like emotional awareness/regulation, mentalization and self-esteem.
Bottom up approach, originated from observation of patients in clinical practice. The approach broadens our cymptom conceptualization
The personalized approach
Interventions are effective at the level of the group but can fail to be effective at individual level
Precision psychiatry; treatments are not developed for individual patients, but a high level of exactness will be achieved such that eventually it will be personalized.
