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PSYC 337 > Lecture 1/2 > Flashcards

Lecture 1/2 Flashcards

1
Q

what is psychopathology

A

how do we define what is NOT normal

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2
Q

why define mental illness

A

some say yes some say no
have to have some sort of boundary as a starting point

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3
Q

what is a medical model/syndrome

A

physical diseases measurable entities and express themselves as clusters of symptoms - these models have evolved oevrtime

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4
Q

syndrome model was borrowed from what

A

medical models of illness

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5
Q

not every disease has

A

a single origin or single etiological source and its not categorized by a single sympltom

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6
Q

who defined metal illness as “harmful dysfunction”

A

wakefield J

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7
Q

what os dysfunction

A

an organ system performing contrary to its design; not at the peak of its design

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8
Q

what does wakefield argue

A

brain is designed to perform number of functions and any problem indicates a disorder

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9
Q

what does wakefield presume/ is problematic with what he says

A

we understand the fucntion and design of the brain, personality, emotions, etc

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10
Q

what is lillenfields critique

A

what is “natural function”
natural selection depends on variability

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11
Q

some disorders may represent ___ not ___

A

adaptations not maladaptations

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12
Q

what is widigers proposal

A

mental disorders are constructs

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13
Q

what else does widiger say in his proposal

A

not directly observable or definable, can only be measured indirectly thus needed a multimodal approach

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14
Q

what is a multimodal approach

A

the process of defining psychopathology is an ongoing iterative bootstrapping process

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15
Q

what do multimodal approaches assume

A

any form of psychopathology represents a complex latent construct which is multiply determined, meaning each construct represents the sum of all environmental influences in addition to the acivity of things

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16
Q

when measuring psychiatric disorders, what domains are they expressed across

A

self report, brain functionl, neural response, physiological responses, and behavioural responses

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17
Q

what is the purpose fo classification system

A

description, prediction, theory, communication

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18
Q

description

A

highlight critical features of a diagnosis

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19
Q

prediction

A

may tell you something about course, treatment, response, etiology

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20
Q

theory

A

provides a set of postulates abotu relationships of diff elements to one another

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21
Q

do symtoms co-occur fro a certain reason?

A

they should

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22
Q

communication between

A

clinicians

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23
Q

what are the five criteria proposed for valid classification of disorders

A

clinical description, course, treatment response, family history, and laboratory studies

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24
Q

clinical description

A

the disorder has to be characterized by a common set of symptoms that cluster together and are characteristic of the disorder

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25
Q

course

A

people with the disorder should follow a common trajectory and have similar onset

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26
Q

treatmnet response

A

if a disorder is valid, most people will response similarily to similar treatments

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27
Q

family hisotry

A

does the disorder run in the family? if so speaks to validity of diagnosis

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28
Q

laboratory studies

A

look fro biological and psychophysiological associations

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29
Q

what are the limitations of a classification system

A

loss of uniqueness and difficulty of boundary cases

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30
Q

loss of uniqueness

A

diagnosis implies that common features are more important than the ways in which individuals vary

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31
Q

difficulty of boundary cases

A

what do you do with people who are on the boundary? do we arbitrarily decide which group theyre more similar to?

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32
Q

procrustean beds

A

we alter or ignore or exclude information about individuals in order to make them fit into these discrete categories instead of altering the categories

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33
Q

what is a categorical system

A

presence/ absence of a disorder; eother you are anxious or you arent

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34
Q

what is a dimensional system

A

ran on a continuous quantitative dimension ;
degree to which a symptom is present

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35
Q

what do dimensional systems capture better

A

an individuals functioning

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36
Q

what does categorical approach have over dimsensional

A

for research and understanding

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37
Q

advantages of categorical systems

A

simplifies communication
natural preference among people to employ categories in speech

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38
Q

what happens to people in dimensional models

A

everybody falls somewhere

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39
Q

categorical systems are better-cuited for

A

clinical decision making

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40
Q

for clinical decision making what does dimensional lack in

A

arbitrary cut-offs

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41
Q

what are advantages of dimensional systems

A

preserves more information;
greater reliability (inter-rater and test-retest)

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42
Q

cutoffs in categorical system tend to what

A

magnify small differences

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43
Q

when did the DSM 1 come out

A

1952

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44
Q

DSM 2

A

1968; had few ccategries, no requirements for # of symptoms

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45
Q

what was the dominant paradigm in the DSM 2

A

psychoanalysis

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46
Q

DSM 3

A

1980
demand for more biological, empirical approach; psych needs to be more scientifically grounded

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47
Q

what did the DSM 3 introduce

A

inclusion criteria, duration criteria, exclusion criteria, multi-axial classification

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48
Q

inclusion criteria

A

what symptoms do you need to have and how many

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49
Q

duration criteria

A

how long do you need to exhibit these symtptoms

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50
Q

exclusion criteria

A

what symtpms rule out a diagnosis

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51
Q

what is not in the DSM 5

A

multi-axial classification

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52
Q

AXIS 1

A

major clinical disorders

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53
Q

AXIS 2

A

personality disorders

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54
Q

AXIS 3

A

medical conditions that might contribute to be relevant to treatment

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55
Q

AXIS 4

A

psychosocial stressors- something with which to record environmental contexts

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56
Q

AXIS 5

A

a simple rating of functions/ summary score for severity

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57
Q

how many number of categories were there in the DSM 1

A

106

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58
Q

how many number of categories were there in the DSM 2

A

182

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59
Q

how many number of categories were there in the DSM 3

A

265

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60
Q

how many number of categories were there in the DSM 3 R

A

292

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61
Q

how many number of categories were there in the DSM 4-TR

A

297

62
Q

how many number of categories were there in the DSM 5

A

157

63
Q

assumptions introduced in the DSM 3

A

symptoms are the most useful basis for assessment
nosology based on behaviour and symptoms
locus of pathology is in the individual

64
Q

nosology

A

how we describe the disorder

65
Q

locus of pathology

A

the dysfunction adheres to the individual

66
Q

what is the problem with locus of pathology

A

what about the family systems? social systems?

67
Q

DSM 4

A

1994; more research based

68
Q

what did the DSM 4 introduce

A

idea of clinically significant distress or impairment in social, occupational, or other important areas of functioning

69
Q

DSM 4-TR

A

2004; did not introduce new diagnosis or specific criteria but provided more information on each diagnosis and provided broad definition of mental illness

70
Q

dsm 5

A

2013; removed multi-axial system

71
Q

what did the DSM 5 introduce

A

dimensional assessment criteria for some diagnosis

72
Q

what did the DSM 5 do

A

re-classify some disorders and remove some diagnosed

73
Q

what are the challenges to categorical classification system

A

heterogeneity and comorbidity

74
Q

heterogeneity

A

people who get diagnosed with the same illness often look very different from one another

75
Q

comorbidity

A

many people who receive a diagnosis of anxiety also qualify for a diagnosis of depression ex

76
Q

of people who curently meet criteria fro one disorder

A

50% qualify for more than one and 70% over the course of their lifetime

77
Q

comorbidity affects

A

course, development, presentation, treatments response etc for each diagnisis

78
Q

comorbid patients tend to have poorer outcomes for

A

Shortened life course
Poor life
Poor academic outcomes
Social outcomes
Occupational functions

79
Q

what are the research implication of comorbidity

A

anything you find to be associated with one disorder may actually be a result of the comorbid disorder

80
Q

why does comorbidity exist

A

chance, sampling bias

81
Q

why does comorbidity present a major problem for both research and treatment

A

do you treat them the same? different times? which one first- there are not always good empirical support for those decisions

82
Q

of people who currently have any anxiety

A

64% have some sort of mood disorder

83
Q

of people with any mood disorder

A

29% with SOC
36% GAD
32% OCD

84
Q

what does this tell us about categorical boundaries

A

suggests that categories arent working very well; have to think about why it might exist

85
Q

comorbidity greater than chance alone would indicate

A

sampling bias, problems with diagnostic criteria, poorly draw diagnostic boundaries

86
Q

sampling bias

A

each disorder associated with a chance of being treated

individuals with more disorders are more likely to seek treatment

87
Q

what are problems with diagnostic criteria

A

many criterion sets overlap

 Suicidal ideation in MDD, Schiz, BPD, AUD, SUD
 Sleeplessness in MDD and GAD
 Worry in GAD and MDD, etc.

88
Q

multiformity

A

people with MDD frequently have panic attacks, this might give a wrong diagnosis of panic disorder
comorbid disorders may in fact reflect a 3rd, independent disorder

89
Q

what is the causal explanation fro comorbidity

A

one disorder is a risk factor for another

90
Q

what is RDoc intentend for

A
91
Q

tom awakenbot

A

factor analysis: hierarchical system

92
Q

what is the hierarchical system

A

put a bunch of variables in a data set
run factor analysis
which symtoms/ diagnosis circulate

93
Q

what are two underlined methods of psychopathology

A

internalizing and externalizing

94
Q

as long as you look at peoples current symptoms

A

they replicate very well onto the hierarchical model

95
Q

what are notable problems in

A

more disorders than just the ones listed
not always clear trying to load into this structure

96
Q

hierarchical taxonomy of psychopathology

A

most recent way of thinking about hierarchical about describing psychopathology

97
Q

in high top at least some

A

personality disorders are appearing

98
Q

what is high top not

A

a causal model; trying to describe the structure of psychopathology;
descriptive: just identifying factors that we could use to identify further

99
Q

Research Domain Criteria (RDoc)

A

intended to be used for research purposes not clinically
trying to move away from categorical diagnosis and express dysfunction in terms of the dysfunction of core systems that are critical to human functioning that can be measured in multiple ways

100
Q

prevalence

A

% of people in a population with a disorder at a particular point in time

101
Q

incidence

A

the % of people who develop a disorder for the 1st time during a specific time period

102
Q

prevalence =

A

incidence x chronicity

103
Q

risk factor for epidemiologists

A

a correlate associated with diff disorders

104
Q

psychologists use risk factor to mean

A

predictor or cause

105
Q

major depression

A

1-year prevalence
- 6.7%
Onset
- 14-15
- 30s

106
Q

persistent depressive disorder

A

1-year prevalence
- 1.5%
Onset
- 30s

107
Q

bipolar

A

1-year prevalence
- 2.6%
Onset
- 25

108
Q

panic

A

1-year prevalence
- 2.7%
Onset
- 24

109
Q

OCD

A

1-year prevalence
- 1.0%
Onset
- child/adolescent

110
Q

social anxiety disorder

A

1-year prevalence
- 6.8%
Onset
- 13

111
Q

GAD

A

1-year prevalence
- 3.1%
Onset
- 31

112
Q

PTSD

A

1-year prevalence
- 3.5%
Onset
- Any age

113
Q

mood disorder

A

lifetime prevalence 21%

114
Q

anxiety disorders

A

lifetimes prevalence 27%

115
Q

substance abuse disorders

A

lifetime prevalence 15%

116
Q

any disorder

A

lifetime prevalence 46%
onset: Symptoms almost always begun before diagnosis
This is when they meet full criteria = onset

117
Q

any disorder college vs non

A

45.8% and 47.7%

118
Q

anxiety disorder college vs non

A

11.9% and 12.7%

119
Q

mood disorder college vs non

A

10.6% and 11.9%

120
Q

alcohol use disorder college vs non

A

20.4% and 17%

121
Q

mental health usage college vs non

A

18.5% and 21.5%

122
Q

what is etiology

A

the scientific study of the causes of things

123
Q

environmental factors

A

Learning experiences

124
Q

what are freudian theories for environmental factors

A

“Schizophrenogenic mother”
“refrigerator mother”

125
Q

schizophrenic mother

A

idea that schizophrenia was caused by a certain mothering style: Alternating between overprotecting and rejecting

126
Q

refrigerator mother

A

mother who lacked genuine warmth can cause autism; popular int he middle of the last century

127
Q

genetics are not

A

deterministic

128
Q

most genes are

A

probabilistic

129
Q

probabilistic

A

the presence of a gene for disorder is alone, not going to determine the outcome; make small contributions to create the ultimate outcome

130
Q

strong evidence that psycopathology runs in

A

families

131
Q

researchers identifying dozens of genes that in certain combinations

A

lead to symptoms of different forms of psychopathology

132
Q

polygenic

A

influenced by many genes

133
Q

diathesis stress model

A

nature and nurture don’t acti independently

134
Q

diathesis

A

vulnerability or predisposition to develop a disorder

135
Q

stress

A

the environment - non-specific

136
Q

Rosenthol and Niel

A

give up on idea of nature vs nurture because its both

137
Q

diathesis present stress present

A

ILL

138
Q

stress absent diathesis present

A

well

139
Q

diathesis absent stress present

A

well

140
Q

stress absent diatheisis absent

A

well

141
Q

if you have a high diathesis

A

youre fine for stress

142
Q

medium diathesis

A

more susceptible to stress

143
Q

low diatheiss

A

high susceptibility to stress

144
Q

no diathesis

A

not perfectly protextive ; exposed to very high levels of stress could develop disorder

145
Q

etiological heterogeneity

A

assumes diathesis and stress are independent
gene environment correlation

146
Q

vulnerability stress-interactions

A

often non-independent in important ways

147
Q

scars as vulnerability

A

the experience of child abuse can become a diathesis for later problems

148
Q

vulnerability may shape

A

perception of the stress

149
Q

stress can influence the development of

A

the diathesis

150
Q

equifinality

A

people who get the disorder get it from different causes
many diff pathways

151
Q

final common pathway

A

mutliple pathways converge in this final step

152
Q

multifinality

A

can lead to many different results; child abuse can lead to different disorders

PSYC 337 (11 decks)

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