Flashcards in 3 Classification and diagnosis 2 Deck (27):
According to Freud, when does the Id (Das Es) develop?
You're born with it.
According to Freud, when does the Ego (Das Ich) develop and why?
At age 2, to negotiate drives of the Id.
According to Freud, when does the Superego develop and what does it mark?
Around age 6. Marks internalisation of society's values and resolution of oedipal conflict.
What are defence mechanisms for?
To prevent anxiety that would arise from realising drives of the Id (e.g. want to kill father).
What is the defence mechanism of displacement?
Shifting emotion from one person to another. E.g. hate father, shift this onto all authority figures.
What is the defence mechanism of projection?
Attributing to others what you feel towards them.
What is the defence mechanism of sublimation?
Energy of the id is channeled into other outlet. e.g. art.
What is the defence mechanism of reaction formation?
Form opposite behaviour to what is happening in subconscious. E.g. homophobic army dad in American Beauty
How does the ego protect you from anxiety?
It stops you from knowing what's going on in the unconscious.
What defence is the cause of depression, according to psychoanalysis?
Displacing hatred onto self. e.g. hate father, displace onto self.
What defence is the cause of paranoia, according to psychoanalysis?
What defence is the cause of overprotection/dependence, according to psychoanalysis?
Reaction formation. I actually hate my child so I'm going to look after him really, really well.
What defence is the cause of obsessiveness, according to psychoanalysis?
Repressing everything is a lot of work – must control everything, become OCD.
How do the psychoanalytical and medical models conceptualise mental illness differently?
In psychoanalysis, mental illness is on a continuum, rather than a distinct entity. Pathological is severe end of normal. Everyone has unconscious conflict.
No distinction between sick/not sick.
How does psychoanalysis distinguish between psychosis and neurosis?
It doesn't. Psychosis is just when you get so neurotic you lose touch with reality.
How did the rise of psychoanalysis lead to a proliferation of mental health professions?
Because illness (neurosis) was seen as ubiquitous, everyone can be treated.
What is the mechanism of paranoid SZ, according to psychoanalysis?
Extreme form of defence mechanism of projection – ascribing to others characteristics you can't accept in yourself. Paranoid SZ is just mega-projection.
What was the distinction between organic and reactive conditions in DSM-I (1952) and II (1968)?
Organic conditions - known to be caused by biological factors (brain damage, poisoning).
Reactive – caused by psychological factors.
What is the proposed cause of depression in DSM-I & II?
"Anxiety... allayed and partially relieved by depression and self-deprecation"
What caused psychoanalysis to be scrapped as model for DSM?
No clear-cut lines between health and illness. So third-party payers dissatisfied.
What is the problem with the 1) reliability and 2) validity of DSM-I & II?
1) Low inter-rater reliability.
Different health-care professionals gave different diagnoses based on DSM criteria.
2) Low validity based on unproven theories of aetiology.
e.g. Is depression really reaction formation to loss of someone you feel ambivalent about? May not be valid theory.
What approach was taken in DSM-III (1980)?
A Neo-Kraepelian approach.
No assumptions about aetiology.
Clear description of symptoms, and identification of syndromes.
How are symptoms measured according to DSM-III?
From patient’s report or from direct observation/measurement – not from speculations about the unconscious.
Why were psychoanalytic categories of mental illness not changed in DSM-III?
Because can of worms. If the clients already exist with these disorders, they might suddenly all be cured!
DSM-III was much more reliable, but what are 4 problems with its validity?
1) Comorbidity is very high. Having more than one mental disorder is the norm.
2) Diagnostic instability is high – patients move from one disorder to another
3) Lack of treatment specificity. E.g. SSRIs work across
What is suggested by the high comorbidity, diagnostic instability and lack of treatment specificity of DSM categories?
Non-independence of disorders. They have common causes/shared aetiology.