Lecture 1 Intro to psychopathology and diagnostic systems - I

Question 1

Which 4 fields are integrated into psychopathology?

Answer 1

• Clinical Psychology: How symptoms present (pathological, maladaptive, not working) and how it is impacting a person
• Psychiatry (medical approaches to mental health)
• Neuroscience: biological basis
• Social Sciences: How culture and environment shape mental health

Question 2

What were ‘ancient’ views on mental illness?

Answer 2

Mental illness was often attributed to supernatural forces.

Treatments included exorcisms and rituals.

Question 3

What did Hippocrates propose about mental illness?

Answer 3

Hippocrates proposed that mental illness was due to bodily imbalances (e.g., the four humors).

Question 4

How were disorders viewed during the Middle Ages?

Answer 4

Seen as moral failings or demonic possession, leading to harsh treatments.

Question 5

What characterized the Asylum Era?

Answer 5

Institutionalization became widespread, but care was often poor.

Question 6

What developments occurred in modern psychiatry?

Answer 6

The rise of psychoanalysis, behaviorism, neuroscience, and evidence-based treatments.

Question 7

How is DSM-5-TR structured and what are its strengths and weaknesses?

Answer 7

The DSM-5 is structured around SYMPTOM CLUSTERS (mental health conditions only).

Strengths
* Standardized diagnostic criteria
* Useful for research and treatment

Weaknesses:
* Lack of cultural and social context
* Can be rigid
* Does not account for symptom severity variations

Question 8

What emphasis does ICD-11 place more on compared to DSM-5-TR?

Answer 8

Greater emphasis on psychosocial factors

Question 9

What is the basis for diagnoses in the Categorical Model?

Answer 9

Symptom clusters

This model uses specific groupings of symptoms to categorize mental health disorders.

Question 10

What is the focus of the Dimensional Model?

Answer 10

Traits existing on a continuum

This model emphasizes a spectrum of traits rather than strict categories.

Question 11

What advantage does the Dimensional Model offer over the Categorical Model?

Answer 11

Assessment of severity rather than binary diagnosis

e.g., autism where each symptom can be on a continuum and presentations vary widely

This allows for a more nuanced understanding of an individual’s condition.

Question 12

What are the 3 ways to ASSESS clients

Answer 12

1. SCREENING: To inform broad, generalisations about individuals and their functioning (e.g., DASS)

Screeners are not for diagnosis.

2. TESTING
   Use of tests and inventories to assess characteristics of individuals.

Sometimes diagnostic. More detailed and specific than screener

3. ASSESSMENT
   Use of data from testing and other sources in a convergent integrative manner.

Come up with recommendations for client.

Screening provides a preliminary understanding and is typically brief.

Question 13

Why are diagnostic categories important?

Answer 13

• They provide a structured way to assess and classify mental health disorders based on
  A) symptom presentation,
  B) duration, and
  C) severity

Question 14

What are neurodevelopmental disorders?

Answer 14

Disorders that
- typically emerge in early childhood
- affect cognition, behaviour, or social interaction.

Be mindful that anxiety presentations may have underlying, primary NDD

These disorders can have a significant impact on an individual’s development and quality of life.

Question 15

Name a key disorder in the neurodevelopmental category characterized by difficulties in social interaction.

Answer 15

Autism Spectrum Disorder (ASD)

ASD encompasses a wide range of symptoms and severity levels.

Question 16

What are the core characteristics of Autism Spectrum Disorder (ASD)?

Answer 16

Difficulties in social interaction, communication, and repetitive behaviours.

Severity varies: Some individuals require significant support, while others function independently.

Acronym VRIFI
- Verbal/non-verbal cues and gestures are persistently difficult to understand
- Repetitive Behaviour
- Insistence on sameness and routine
- Fixation on narrow interests
- Increased sensitivity (or lack thereof) to environmental sensory stimuli

Severity can vary greatly among individuals with ASD.

Question 17

What are the core symptoms of Attention-Deficit/Hyperactivity Disorder (ADHD)?

Answer 17

Inattention, impulsivity, and hyperactivity.

Symptoms must be persistent, impair daily life, and present before age 12.

Acronym: GIDD

-Garrulous and impatient
-Inability to sit still/ remain quiet
- Difficulty maintaining interest in a task, or having mental focus required for a task.
- Difficulty remembering routine activities

These symptoms can manifest in various ways and impact daily functioning.

Question 18

What defines Intellectual Disability (ID)?

Answer 18

I.A.
Intellectual deficits (e.g., reasoning, problem-solving, abstract thinking).

Adaptive Deficits (failing to meet expected levels of independence and social responsibility across home, work, study, self-care

Impacts adaptive functioning (e.g., daily living skills, social participation).

Diagnosed by clinical assessment and standardised test (WISC)

ID affects how individuals learn and adapt to daily life.

Question 19

What is the primary impact of mood disorders?

Answer 19

A person’s emotional state and ability to function

Mood disorders can significantly affect daily activities and relationships.

Question 20

Name and define a key disorder in the category of mood disorders.

Answer 20

Major Depressive Disorder (MDD)

• Persistent low mood
• Loss of interest
• Changes in sleep/appetite
• Fatigue
• Feelings of worthlessness
• Suicidal thoughts

MDD is characterized by severe symptoms affecting daily life.

Question 21

What is the duration for symptoms to qualify as Major Depressive Disorder (MDD)?

Answer 21

At least two weeks

Symptoms must also cause significant distress.

Question 22

What is Bipolar Disorder (BP)?

Answer 22

Involves episodes of mania and depression

Mania is characterized by elevated mood and impulsivity.

Question 23

What are the two main types of Bipolar Disorder?

Answer 23

• Bipolar I: At least one manic episode (may include depression)
• Bipolar II: At least one hypomanic episode and one major depressive episode

Hypomania is a milder form of mania.

Question 24

What are anxiety disorders characterized by?

Answer 24

Excessive fear, worry, or avoidance

Anxiety disorders can significantly impact daily functioning.

Question 25

What is Generalized Anxiety Disorder (GAD) and some of its key symptoms?

Answer 25

Persistent, excessive worry about multiple aspects of life * Restlessness * Muscle tension * Fatigue * Difficulty concentrating ## Footnote Common concerns include work, health, and relationships.

Question 26

What characterizes Panic Disorder and what are common symptoms?

Answer 26

Unexpected panic attacks * Intense fear * Heart palpitations * Dizziness ## Footnote Panic attacks involve intense fear and physical symptoms.

Question 27

What is a common consequence of experiencing panic attacks?

Answer 27

Fear of future attacks ## Footnote This often leads to avoidance behaviors.

Question 28

What defines Social Anxiety Disorder?

Answer 28

Fear of social situations due to fear of embarrassment, judgment, or rejection ## Footnote This disorder can significantly hinder social interactions.

Question 29

What are 2 Trauma and Stress-related disorders and what are they characterised by?

Answer 29

These disorders develop after exposure to traumatic or stressful events. 1. (PTSD) & complex PTSD in ICD * Symptoms include intrusive memories, avoidance, negative mood, and hyperarousal. * Must persist for over one month after trauma. 2. Acute Stress Disorder (ASD) * Similar to PTSD but symptoms last less than a month.

Question 30

What are the key features of psychotic disorders, and what are 2 main types?

Answer 30

Psychotic disorders involve **D D H** (delusions, disorganized thinking/speech/behaviour, and hallucinations) Key disorders in this category include: 1. Schizophrenia * DDH and negative symptoms (e.g., flat affect, social withdrawal). * Must persist for *at least six months*. 2. Schizoaffective Disorder * Features of both schizophrenia and mood disorder (depression or mania).

Question 31

What are personality disorders and 2 main types of them?

Answer 31

Involve long-term, maladaptive behaviour patterns affecting **relationships** and **self-identity**. 1. Borderline Personality Disorder (BPD) * Intense emotions, unstable relationships, fear of abandonment, impulsivity, self-harm. 2. Antisocial Personality Disorder (ASPD) * Disregard for rules, lack of empathy, manipulative.

Question 32

What are the 5 steps Clinicians use to determine an accurate diagnosis?

Answer 32

1. Gather Comprehensive Information 2. Compare Symptoms to DSM-5-TR or ICD-11 Criteria 3. Rule Out Alternative Explanations 4. Assess Severity and Functional Impact 5. Develop a Treatment Plan (this is the purpose of diagnosing!)

Question 33

What does gathering comprehensive information entail?

Answer 33

* Clinical interview * Self-report questionnaires, information from third parties (families, schools, etc). * Medical history and collateral reports

Question 34

What is the purpose of comparing symptoms to the criteria (DSM or ICD)

Answer 34

* Symptoms must match official diagnostic criteria.

Question 35

What are 3 possible alternative explanations to a mental health (DSM) diagnosis?

Answer 35

* Medical conditions: Hypothyroidism can mimic depression. * Substance use: Some symptoms may be drug-induced. * Cultural and contextual considerations: Hearing voices may be seen as pathological in Western psychiatry but spiritually significant in some Indigenous cultures.

Question 36

What are the 3 levels of severity and functional impact?

Answer 36

* Mild: Symptoms cause distress but do not impair daily life. * Moderate: Symptoms interfere with work and relationships. * Severe: Significant impairment in all life areas.

Question 37

What is the purpose of diagnosing?

Answer 37

* A diagnosis should lead to a treatment strategy, not just a label. * Example: A cognitive-behavioural approach for anxiety vs. medication plus therapy for severe depression.

Question 38

What is a Clinical Assessment, and its 4 goals?

Answer 38

A systematic process of gathering and interpreting information to understand a person's psychological functioning. To determine: 1. The presence and severity of symptoms 2. The impact of symptoms on daily life 3. Whether the symptoms meet criteria for a mental disorder 4. Appropriate treatment recommendations.

Question 39

What are the 4 principles of a strong clinical assessment?

Answer 39

R. V. S. C. 1. Reliability 2. Validity 3. Standardisation: The use of uniform procedures to ensure fairness in assessment. 4. Cultural Sensitivity: Consideration of cultural, linguistic, and contextual factors in interpretation.

Question 40

What is the clinical interview?

Answer 40

The most widely used assessment method in psychopathology. Explores mental health concerns, symptom patterns, and relevant life history.

Question 41

What does a comprehensive interview typically include?

Answer 41

A comprehensive interview typically includes: (P S F M R) 1. Presenting Problem: Why is the client seeking help? 2. Symptom History: Onset, duration, and severity of symptoms. 3. Family and Social History: Genetic predispositions and life circumstances. 4. Medical History: Any medical conditions or substance use that could impact symptoms. 5. Risk Assessment: Evaluation of suicidal ideation, self-harm, or harm to others.

Question 42

Types of clinical interviews: What is an unstructured Interview?

Answer 42

1. Unstructured Interviews are open-ended conversations where the clinician explores symptoms flexibly. ➢ Advantages: * Allows for natural conversation. * Encourages clients to share information freely. ➢ Disadvantages: i) Lack of structure can make it less reliable between clinicians. ii) Risk of overlooking key diagnostic criteria. ➢ E.g.,: A clinician asks, "Can you tell me about your experiences with anxiety?" and follows up based on the client’s responses.

Question 43

What is a Structured Interview?

Answer 43

It uses predefined questions to ensure consistency across assessments). ➢ Advantages: i) Increases diagnostic reliability. ii) Ensures all relevant symptoms are covered. ➢ Disadvantages: i) Can feel rigid or impersonal. ii) May miss unique client experiences.

Question 44

What is a semi-structured interview?

Answer 44

Semi-Structured Interview (structured questions w flexibility to explore relevant details). ➢ Advantages: * Balances standardization and clinical judgment. * Allows for follow-up questions based on client responses. ➢ Disadvantages: * Requires more training and clinical skill to conduct effectively.

Question 45

What are 4 ethical considerations in clinical assessment?

Answer 45

1. Informed Consent 2. Avoiding Overdiagnosis and Labelling 3. Confidentiality and Data Protection 4. Cultural Competency in Assessment