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psych 337 > CHAPTER 1: DIAGNOSIS, CONCEPTUAL ISSUES AND CONTROVERSIES > Flashcards

CHAPTER 1: DIAGNOSIS, CONCEPTUAL ISSUES AND CONTROVERSIES Flashcards

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1
Q

What is the difference between a system of classification and diagnosis in mental illness?

A

A system of classification is an overarching taxonomy of mental illness, whereas diagnosis is the act of placing an individual into a category within that taxonomy based on signs and symptoms.

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2
Q

What are syndromes in the context of mental illness?

A

Syndromes are constellations of signs and symptoms that co-occur across individuals and are at the lowest rung of the hierarchy of understanding.

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3
Q

What does the term ‘syndrome’ mean in Greek?

A

Syndrome means ‘running together’ in Greek.

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4
Q

Provide an example of a syndrome and its characteristics.

A

Antisocial personality disorder is an example characterized by signs like the use of an alias and symptoms like lack of remorse.

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5
Q

What is the current understanding of the pathology and etiology of antisocial personality disorder?

A

The pathology and etiology of antisocial personality disorder are largely unknown.

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6
Q

What is the argument regarding psychopathic personality (psychopathy) by some authors?

A

Some authors argue that psychopathy may not be a classical syndrome but a configuration of several largely independent constructs.

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7
Q

List the constructs that may define psychopathy.

A
  • Boldness
  • Coldness
  • Disinhibition
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8
Q

What is Gerstmann’s syndrome characterized by?

A

Gerstmann’s syndrome is marked by:
* Agraphia
* Acalculia
* Finger agnosia
* Left-right disorientation

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9
Q

What distinguishes disorders from syndromes?

A

Disorders are syndromes that cannot be readily explained by other conditions.

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10
Q

What are the criteria for diagnosing obsessive-compulsive disorder (OCD)?

A

OCD can be diagnosed if symptoms and signs cannot be accounted for by a specific phobia.

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11
Q

What is the highest rung of the hierarchy of understanding in mental illness classification?

A

Diseases are the highest rung, where pathology and etiology are reasonably well understood.

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12
Q

Provide an example of a prototypical disease and its characteristics.

A

Sickle-cell anemia is a prototypical disease characterized by crescent-shaped erythrocytes containing hemoglobin S and two autosomal recessive alleles.

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13
Q

What is the primary pathology identified in Alzheimer’s disease?

A

The primary pathology includes senile plaques, neurofibrillary tangles, and granulovacuolar degeneration.

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14
Q

What is a significant limitation of the current psychiatric classification system?

A

Most diagnoses in the current system are almost exclusively syndromes or, in rare cases, disorders, indicating that pathology in most cases is largely unknown.

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15
Q

True or False: Few mental illnesses are classified as disorders in the strict sense of the term.

A

True

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16
Q

Fill in the blank: The act of placing an individual into a category based on signs and symptoms is known as __________.

A

[diagnosis]

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17
Q

What are the three principal functions of diagnosis?

A
  1. Diagnosis as Communication 2. Establishing Linkages With Other Diagnoses 3. Provision of Surplus Information
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18
Q

What does diagnosis as communication allow professionals to do?

A

It allows professionals to be reasonably confident that they are referring to the same condition.

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19
Q

What is nosology?

A

The branch of science that deals with the systematic classification of diseases.

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20
Q

What is the purpose of establishing linkages with other diagnoses?

A

To understand the relationships between different conditions and their etiological links.

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21
Q

What does a valid diagnosis provide according to Robins and Guze?

A
  1. Clinical description 2. Laboratory research 3. Natural history 4. Family studies
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22
Q

Fill in the blank: A diagnosis helps us to learn new things; it affords us _______.

A

[surplus information]

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23
Q

What is meant by differential diagnosis?

A

The task of distinguishing a diagnosis from similar diagnoses.

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24
Q

What is the significance of validity in a diagnosis?

A

It measures whether a diagnosis accurately reflects what it purports to measure.

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25
What is the relationship between bipolar I disorder and major depression?
Bipolar I disorder is marked by manic or mixed episodes, while major depression involves severe mood disturbances.
26
What are endophenotypes?
Measurable components along the pathway between disease and distal genotype.
27
True or False: All psychiatric diagnoses are considered fixed categories.
False
28
What does the term nomological network refer to?
The system of lawful relationships between theoretical entities and observable indicators.
29
What is the limitation of Robins and Guze's approach to construct validation?
It emphasizes external validation without considering internal validation.
30
What is factorial validity?
The extent to which the factor structure of a diagnosis aligns with theoretical predictions.
31
What did Andreasen (1995) extend in the Robins and Guze framework?
Indicators from molecular genetics, neurochemistry, and brain imaging.
32
What are the implications of a diagnosis being an open concept?
1. Fuzzy boundaries 2. Indefinitely extendable indicators 3. Unclear inner nature
33
What are the potential consequences of reifying psychiatric categories?
It can lead to viewing them as fixed essences rather than approximations of true states.
34
According to Goodwin and Guze, what is the relationship between diagnosis and prognosis?
Diagnosis is closely linked to predicting the trajectory of a case.
35
Fill in the blank: Valid diagnoses can help predict an individual's response to _______.
[treatment]
36
What is the common error regarding measures of psychiatric conditions?
Referring to them as 'gold standards'.
37
What is the role of internal validation in construct validation?
To ascertain the construct's inner structure and homogeneity.
38
What is the primary focus of external validation?
To determine the construct's associations with correlates outside the construct.
39
What is a chronic course in the context of schizophrenia?
A pattern with few or no periods of entirely normal functioning.
40
What does the diagnostic label of bipolar I disorder describe?
A distinctive constellation of indicators, including manic or mixed episodes.
41
What is Misconception #1 regarding mental illness?
Mental illness is a myth; it is merely a metaphor for problems in living ## Footnote Associated with psychiatrist Thomas Szasz, who argued that mental illness labels are used to control nonconformists.
42
According to Szasz, what serves as a justification for societal compliance?
The mental illness label ## Footnote Szasz believed it was used to force maladjusted members of society to conform.
43
What does Szasz argue about medical disorders and mental illness?
Only the body can become diseased; mental disorders do not have identifiable lesions ## Footnote He contended that medical disorders are traceable to anatomical lesions, unlike mental disorders.
44
What logical principle is mentioned in relation to the validity of the mental illness concept?
Abusus non tollit usum (abuse does not take away use) ## Footnote Historical misuse of a concept does not negate its validity.
45
What is Misconception #2 about psychiatric diagnosis?
Psychiatric diagnosis is merely pigeonholing individuals ## Footnote Critics argue it strips away individuality by implying all within a category are alike.
46
What does a psychiatric diagnosis imply about individuals within the same diagnostic category?
They display the signs and symptoms of that condition ## Footnote This does not mean they are alike in all respects.
47
What is Misconception #3 regarding psychiatric diagnoses?
Psychiatric diagnoses are unreliable ## Footnote Critics claim they lack consistency.
48
What does reliability refer to in the context of psychiatric diagnosis?
The consistency of a diagnosis ## Footnote High reliability does not guarantee validity.
49
What are the three major subtypes of reliability?
* Test-retest reliability * Internal consistency * Interrater reliability ## Footnote Each subtype measures different aspects of reliability.
50
What does test-retest reliability measure?
The stability of a diagnosis over a brief time interval ## Footnote Typically assessed over about a month.
51
What is internal consistency in psychiatric diagnosis?
The extent to which signs and symptoms correlate with one another ## Footnote Assessed using metrics like coefficient alpha.
52
What does interrater reliability indicate?
The degree to which different observers agree on a diagnosis ## Footnote High interrater reliability is essential for valid research.
53
What misconception exists regarding the reliability of psychiatric diagnoses?
Many believe they possess low levels of reliability ## Footnote This perception is fueled by media portrayals of expert disagreements.
54
What is Misconception #4 about psychiatric diagnoses?
Psychiatric diagnoses are invalid ## Footnote Critics argue they do not provide new information.
55
What distinction did Millon propose regarding psychiatric labels and diagnoses?
A label describes behaviors, while a diagnosis helps to explain them ## Footnote This differentiation highlights the potential utility of diagnoses.
56
What is Misconception #5 concerning psychiatric diagnoses?
They stigmatize people and result in self-fulfilling prophecies ## Footnote Advocates of labeling theory argue that these diagnoses have adverse effects.
57
What study is often cited in support of labeling theory?
The 1973 study by Rosenhan ## Footnote It involved normal individuals posing as patients in psychiatric hospitals.
58
What is the relationship between reliability and validity in psychiatric diagnoses?
Reliability is a prerequisite for validity, but not vice versa ## Footnote High reliability can exist without validity.
59
What can affect the assessment of interrater reliability?
The base rate of the disorder in question ## Footnote High base rates can lead to misleading percentages of agreement.
60
How do most investigators today operationalize interrater reliability?
Using the kappa coefficient ## Footnote This corrects for chance agreement among raters.
61
What is a common issue with interrater reliability for personality disorders?
It tends to be considerably lower than for other conditions ## Footnote This is likely due to the inferential nature of personality disorder constructs.
62
What is a significant criticism of diagnostic labels in mental health?
They stigmatize patients and can become self-fulfilling prophecies ## Footnote This leads observers to misinterpret mild behaviors as serious mental illness.
63
What did Rosenhan's 1973 study demonstrate regarding psychiatric labels?
Psychiatric labels color observers' perceptions of behavior, making it difficult to distinguish mental illness from normality ## Footnote The study involved pseudopatients who were admitted to psychiatric hospitals with minimal symptoms.
64
How long did pseudopatients in Rosenhan's study remain in the psychiatric hospitals on average?
3 weeks
65
What diagnosis did most of Rosenhan's pseudopatients receive upon discharge?
Schizophrenia in remission
66
What was one of the striking results from Rosenhan's study?
Hospital staff misinterpreted innocuous behaviors as indicative of abnormality ## Footnote For example, note-taking was seen as a sign of illness.
67
What conclusion did Rosenhan draw from his findings?
Psychiatric labels can distort perceptions of behavior
68
What criticism did Spitzer make regarding Rosenhan's findings?
Psychiatrists were able to distinguish mental illness from normality ## Footnote All pseudopatients were released with diagnoses in remission.
69
What does the research suggest about the source of stigma in mental health?
Stigma arises from disturbed behavior, not from diagnostic labels ## Footnote Studies indicate that behavior precedes labeling.
70
How quickly do children react negatively to peers with ADHD?
Within 30 minutes or less
71
What is one finding regarding accurate psychiatric diagnoses and stigma?
Accurate diagnoses can sometimes reduce stigma ## Footnote They provide explanations for otherwise inexplicable behaviors.
72
How do adults evaluate intellectually disabled children when labeled as mentally retarded?
More positively than when they are not labeled
73
Fill in the blank: Rosenhan's study involved _______ posing as pseudopatients.
normal individuals
74
True or False: The majority of research supports the idea that diagnostic labels cause stigma.
False
75
What was a key finding regarding peers' evaluations of essays written by children with ADHD?
Essays were rated more positively when children were labeled with ADHD ## Footnote This suggests that labeling can influence perceptions positively.

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