Introduction to disorders Flashcards
What does DSM stand for?
The Diagnostic & Statistical Manual of Mental Disorders
___ largely influences what people consider to be abnormal, which is possible problem
Culture
What 3 factors are important to consider when diagnosing a mental disorder?
1) a set of symptoms, 2) duration & 3) inability to function socially & professionally
According to the new DSM-V somebody who is depressed for __ days after a bereavement should be diagnosed with depression because…
- The same biological mechanisms characterise more and less reactive (to life events) depression
Anorexia nervosa & bulimia nervosa are characterised by…
body image distortion & compulsions to control perceived body weight
Bipolar depression is characterised by…
alternating expansive (manic) and low moods with secondary, physical & cognitive symptoms
Social phobia is characterised by…
fear and avoidance of social evaluation & humiliation
Name 4 ways in which we can define abnormality
1) Violation of statistical norms (infrequent behaviours), 2) Violation of social norms, 3) Behaviours which cause personal distress & 4) Behaviours which impair an individual’s own life or society
How might a mental disorder impair a) an individual’s own life & b) the functioning of society?
a) If you’re afraid of crowds you may not use public transport. If you abuse alcohol you may not be able to work. b) Pp with aggressive tendencies may be violent towards others
Name 2 problems with defining abnormality according to statistical norms
1) The threshold (cut-off point) is arbitrary & 2) It implies that people at the other end of the scale (e.g. very happy people) are abnormal too
What is the key problem with defining abnormality according to social norms?
What is socially acceptable varies across cultural & historical contexts e.g. seeing visions & hearing voices may be psychotic or a normal experience in religion. Homosexuality was once deemed a disorder but now a genetically influenced life choice
What are the 3 problems with defining abnormal behaviours as those which cause personal distress?
1) Not all mental disorders are characterised by personal distress e.g. antisocial personality disorder & conduct disorder, 2) not all Pp with a disorder experience distress e.g. Asperger’s vs. autism & 3) Pp without disorders experience distress as a normal response e.g. to war
What is the problem with defining abnormality according to personal or societal impairments?
What counts as an impairment is subjective
Which definition of abnormality is most commonly used? What is the alternative? Why are these not yet used?
The one which refers to societal or personal impairment. However, in a way none of the definitions are sufficient on their own. To use biomarkers. They’re also not 100% reliable
According to the DSM-IV there are 3 defining characteristics of a mental disorder - what are they?
A group of associated psychological features associated with 1) present distress, 2) disability & 3) a sig increased risk of death, pain or loss of freedom
What are the 3 excluding criteria? Which is likely to be dropped in the DSM-V published in May 2013?
If it is a) an expectable or culturally approved response to an event (to be dropped), b) deviant behaviour (e.g. the actions of political, religious or sexual minorities) or c) the product of conflict between the individual & society
What is the difference between the medical (DSM & ICD-10) & non-medical approaches to mental disorders?
The medical approach is qualitative: it assumes that you either have the disorder or you don’t in an all-or-nothing fashion & therefore that symptoms are either present or absent. The non-medical approach is quantitative: we all exhibit risk factors for mental disorders to differing, continuous degrees
Describe the 3 of the 5 criticisms of the medical approach which can be grouped under the 2 sub-headings “Symptom presence/absence” & “Qualitative differences”
1) It’s too reliant on subjective, clinical judgement (inter-rater reliability) & arbitrary cut-off points than empirical tests, 2) disorders are often preceded by sub-clinical symptoms, 3) The no. of symptoms exhibited varies continuously & in proportion with the psychosocial impairment
Describe the other 2 criticisms of the medical approach to classifying mental disorders
4) Relatives of patients often exhibit sub-clinical symptoms & 5) Symptoms in the normal range (e.g. low mood) are often associated with the same risk factors as the disorders (e.g. amygdala activation in normal and pathological anxiety)
Name the 2 disorders which seem more qualitative than any other mental disorders i.e. which don’t have obvious “normal variants” & so don’t seem to lie on a continuum of symptoms. Why is this so?
Schizophrenia & obsessive compulsive disorder (OCD) because they are characterised by a unique combination of symptoms
There are 3 main needs to categorise abnormality. What are they?
Medical categorisation is necessary because treatments, thoughts & labels are categorical. Medical diagnosis a) facilitates treatment, b) provides relief & c) raises awareness & reduces stigma = the products of perceiving a mental disorder in line with a physical disorder
What are the 2 problems with classifying or quantifying (continuously or categorically) abnormality at the behavioural rather than neural or cognitive mechanistic levels?
1) Disorders which appear different behaviourally may be driven by similar causes & underlying pathways & 2) Disorders which appear similar behaviourally may be driven by different causes & underlying pathways = a problem for treatment suitability
Give e.g.s of behavioural dissimilarity but mechanistic similarity & vv
1) Unipolar depression vs. eating disorders = distorted perceptions, 2) OCD vs. eating disorders = persistent, recurrent thoughts & repetitive acts to reduce distress. 1) Avoidance of social situations = autism vs. social phobia = the problem of misdiagnosis
Mareno (2007) argues that classification of bipolar depression at the behavioural level and resultant misdiagnoses may be to blame for…
The rise in the % of doctors’ appointments which concerned bipolar depression from 1994 to 2003, especially in youths (for which the rise is more prevalent than in adults)
