Exam 1 Flashcards
(129 cards)
Define Biological Psychiatry
Understand metnal disorder in terms of biological function. Everything psych is bio, BUT lifestyle/environment alters biology
What does DSM tell us? What does it not?
What tries to fix this problem?
Tells symptoms of disorders.
Doesn’t tell you APPROACHES. Also HETEROGENEITY: disorder can look different in different people.
RDoC
To diagnose depression, you need / sumptoms including at least 1 of depressed mood and loss of interest/pleasure
5/9
3 causes of mental illness throughout time
- Supernatural
- Somatogenic (bio)
- Psychogenic
Who declared mental disorders disorders of the brain?
Wilhelm Griesinger (1817-1868)
German neurologist/psychiatrist
In first half 20th century, was emphasis more on bio?
No, psych with Freud
What brought back bio interest in 2nd half 20th century?
genetics development. Schizoprenia had genetic component.
Thorazine (Chlorpromazine) marketed in 1954
NEUROCHEMICAL INBALANCE became big explanatory model thanks to drug development
When did 1st edition of DSM come out?
1952
What did the gov declare 90’s to enhance public awareness of brain research?
What journal founded in 1997?
Decade of the brain
Molecular psychiatry
New findings: effects of psychiatric drugs not primarily exerted via NT in synaptic cleft, BUT
Up and down regulation of receptors, effects on intracellular cascades
DSM 5 on may 18th 2013, but what was Thomas Insel’s problem 3 weeks earlier?
Lacks validity
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If DSM doesn’t have validity, then what is it good for?
Clinical utility
DSM 5 (2013) to DSM-5-TR (2022)
Updated sections. New diagnosis of prolonged grief disorder, 70 modified crieria set, intro and use of manual guides, considers racism/discrimination, New ICD-10_CM codes to monitor suicidal behavior and suicidal self-injury, updated old codes 50 coding updates for substance intoxication and withdrawal and other disorders
People only diagnosed with disorder IF
Harm to other or self and significant impariment
When was homosexuality taken out of the DSM
DSM 3
The DSM-5, more than other versions, tries to what?
Incorporate research findings in classifications
Why is DSM 4 anxiety split into 4 categories?
Data from neuroscience, imaging, and genetic studies suggests differences in heritability, risk, course, and treatment.
Fear based (phobias)
OCD
trauma (PTSD)
dissociative disorders
What is RDoC?
Research framework for investigating mental health disorders.
Integration of many levels of information.
Dimensional apporach involving multiple analysis levels
Framework to study mechanisms that cut across traditional diagnostic categories
What is required for RDoC to pass for group in internal NIHM workshop?
- Persuasive evidence for validity
- Evidence for neural circuit or system that implements the psychological function described
Implicit: linkable to psychiatric clinical phenomenon
Similarities and differences of RDoC and HiTOP
Similarities: both move away from diagnostic categories. Both work-in-progress approaches.
Differences: how they define dimensions, content and units of analysis, current gaps and limitations.
RDoC reserach framework
HiTop is a dimensional classification system (general p factor)
Who made the RDoC? Why?
NIMH
Neuroscience has not made major breakthroughs towards prevention and treatment. NO satisfacotry theory of pathophysiology, biology doesn’t map onto DSM
Why use the RDoC? How has neuroscience failed?
- Heterogeneity (more than 1 way for a symptom)
- measuring biology on different levels is very expensive
- Comorbidity
- Only enroll subjects based on diagnosis
- to understand mental health and illness adopt dimensional conceptualization
- DSM diagnosis aren’t great constructs to begin with
Why is PTSD not an anxiety disorder in DSM5?
fear/anxiety not central to PTSD
Fear- alarm to present/imminent danger real or perceived
Flashbacks specific to PTSD, low base-rate symptom
What symptoms does PTSD share with depression?
Anhedonia, difficulty sleeping, irritaiblity, difficulty concentrating