Clinical: Clinical and Abnormal Flashcards
You will be able to identify key aspects of psychological disorders, including causes, diagnosis, treatment, and cultural considerations in mental health. (206 cards)
What did Emil Kraeplin contribute to psychology?
Kraeplin created one of the first textbooks of co-occurring mental disorders, which he grouped together and classified with common symptoms. He also created the term “dementia praecox” for schizophrenic symptom clusters.
This became the ancestor to our modern Diagnostic and Statistical Manual of Mental Disorders (DSM).
Who was Philippe Pinel?
Pinel was one of the first mental health professionals to treat his patients with compassion and kindness. The model set by the Parisian hospital he ran was adopted by many other asylums.
Which American activist fought for asylum reform in the mid-1800s?
Dorothea Dix
Who wrote The Myth of Mental Illness?
Thomas Szasz
What is The Myth of Mental Illness about?
This book espouses the belief that labeling people as mentally ill makes them conform to the norms of society, rather than examining the societal roots of their mental problems. Szasz also espoused the belief that “mental illness” is a social construction.
To hear an excerpt of a speech by Szasz, please go here.
To what do the terms incidence, prevalence, and lifetime prevalence refer?
- Incidence is the number of new cases that appear in a population in a given period of time.
- Prevalence is the total number of active cases (old and new) present in a population in a given period of time.
- Lifetime prevalence is the total proportion of people who will meet criteria for diagnosis at some point in their lives.
What is comorbidity?
It’s another term for co-occurrence.
For instance, if an individual meets diagnostic criteria for both obsessive-compulsive disorder (OCD) and alcohol dependence, then that person could be said to have comorbid OCD and alcohol dependence.
Comorbidity is very common in clinical settings, and high rates of comorbidity suggest that many mental disorders are not clear-cut categories.
Diagnosis and Causes:
What is a necessary cause?
Something that must be present for a particular illness to occur:
If illness X occurs, then A must have been present.
Diagnosis and Causes:
What is a sufficient cause?
Something that by itself may cause a particular illness to occur:
B, in the absence of other factors, can result in illness X.
Diagnosis and Causes:
What is a contributing cause?
Something that makes it more likely that a particular illness either will occur or will continue:
If C is present, then illness X is more likely to happen or continue.
What does ICD stand for?
What is the ICD-10?
The ICD-10 is the International Classification of Diseases. The ICD currently is in its tenth edition.
The ICD-11 is expected to be released in 2018. Some of the revisions in the DSM-5 were made to make it more consistent with the ICD.
The ICD is a system of classifying diseases; it is published by the World Health Organization.
The U.S. and Canada use the DSM system for diagnosing mental illnesses; most of the rest of the world uses the ICD system.
What are 3 important factors to consider when determining whether or not an individual’s behavior is abnormal?
- Whether the behavior causes subjective distress or suffering to the individual
- Whether the behavior causes impairment or dysfunction
- Whether the behavior is atypical or deviant with respect to the individual’s current cultural context
Most definitions include only these 3 Ds (Distress, Dysfunction, and Deviance). But another factor to consider is Danger, whether the behavior can be harmful to one’s self or others.
Clinicians use signs and symptoms when diagnosing mental illness. What is a symptom and a sign?
- Signs: perceived by the clinician
- Symptoms: perceived by the patient
Signs e.g., patient appears disheveled, patient speaks unusually slowly, patient does not make eye contact.
Symptoms e.g., patient feels hopeless, patient experiences intrusive thoughts, patient has suicidal thoughts.
Describe the diathesis-stress model of mental illness.
This is a model in which a person has a diathesis to mental illness which can be activated by a stressor/stressors, thus precipitating mental disorder.
Diathesis: i.e., a vulnerability, which may be a distal necessary cause or a contributory cause.
Stressor/stressors: i.e., an experience or experiences that overtax an individual’s resources.
Using MDD, provide an example of a diathesis.
Having a short short (ss) allele for the serotonin transporter gene is a diathesis for depression.
Using MDD, provide an example of a stress.
Getting divorced is a stressor.
What is primary prevention?
Refers to attempts to prevent disease or disorder onset, i.e., reducing the incidence of preventable illnesses.
Primary prevention is not (yet) achievable for mental illness.
Challenges include identifying what factors encourage the precipitation of mental illnesses (only some have been identified) and attempting to prevent these situations before they happen, via good public mental health practices (some may not be preventable).
However, some are preventable. For instance, because prenatal malnutrition doubles the risk for an individual developing schizophrenia in adulthood, providing universal prenatal care may help reduce the incidence of schizophrenia.
Define:
dysphoria
An unusually high level of negative mood.
Define:
anhedonia
An unusually low level of positive mood; inability to feel pleasure.
Describe what David Rosenhan reported in his classic 1973 Nature article, “On Being Sane in Insane Places.”
Rosenhan and several other confederates were admitted into mental health facilties presenting with illnesses. The confederates all received diagnoses and had a difficult time being released, because the staff began to classify their regular behaviors as indicative of illness. Rosenhan interpreted the results to mean that diagnoses exist in the minds of the observers.
What were the implications of David Rosenhan’s experiment?
Rosenhan reported that the pseudopatients, rather than being released as never having been ill, were released with a diagnosis of schizophrenia in remission. Rosenhan noted that being labeled “insane” can persist throughout the life-span, which is dangerous. Rosenhan concluded that psychiatric diagnoses exist in the minds of observers: By naming something, we behave as if it is real (so yes, symptoms are real, but how we understand illnesses may be wrong).
Perhaps the most disturbing finding was that pseudopatients averaged less than seven minutes of direct therapeutic care per day, suggesting that patients in general received inadequate clinical care.
What are some limitations or critiques of Rosenhan?
Among other issues:
- The diagnosis of schizophrenia in remission was (and is) quite rare, suggesting that the psychiatrists were aware that these patients’ cases were not standard cases.
- Because symptoms, which are not externally visible, are used to determine diagnosis, in most situations, treaters must depend on patients to be honest to the best of their ability. The ability to fake an illness does not mean that the illness does not exist.
To read Spitzer’s critique of Rosenhan, go here.
From what school of thought are Beck’s cognitive therapy (for depression) and Ellis’s rational-emotive therapy?
They are forms of Cognitive Behavioral Therapy (CBT).
One of the important strengths of CBT is that it has empirical support. Empirical support means that is has been scientifically tested in clinical trials and found to be beneficial for patients.
What are the components of Beck’s Negative Cognitive Triad?
- Negative views of the self: e.g., “I suck.”
- Negative views of the world: e.g., “Everybody hates me.”
- Negative views of the future: e.g.,” My life will always suck.”