Lecture 6 - Introduction to mental health Flashcards
(14 cards)
Brief history of clinical psychology
Imbalance of bile/liquids (Ancient Greece)
Demonological (evil spirits and exorcisms, medieval times)
Introduction of asylums in 15th century
Shift from biology to psychology in the 20th century
- Emil Kraeplin (“founder” of Modern psychiatry)
- oppositions of inhumane practises
- mental health can be diagnosed and treated
20th century
- psychodynamic perceptive (Freud)
- humanistic perspective (Rogers)
- behavioural perspective
- cognitive perspective
- Development of CBT -> most popular approach today
What is abnormal behaviour?
Some definitions include
- not cultural accepted
- statistically uncommon
- causes distress
- causes dysfunction
What is mental health
“Mental health is a state of well-being in which an individual realises his or her own absolutes, can cope with the normal stresses of life, can work productively and is able to make a contribution to his or her own community” -> WHO, 2021
- more than absence of psychological disorders or disabilities
- essential in collective and individual relationships and interaction, ability to think, earn a living and enjoy life
“Characterised by clinically significant disturbance in an individual’s cognition, emotion regulation, or behaviour that reflects a dysfunction in the psychological, biological, or developmental processes underlying mental functioning. Mental disorders are usually associated with significant distress or disability in social, occupational, or other important activities” -> APA 2013
- significant emotional distress (e.g. anxiety) and/or impaired functioning (e.g. not able to hold down a job)
- behaviours, thoughts emotions, responses that are not typical or expected within cultural context
Mental health is influenced by multiple factors
- social
- psychological
- biological
Research on mental health has focused on understanding and categorising mental illness and psychological distress
Behaviour on a continuum
<- normal - mild - moderate - psychological disorder, mild - psychological disorder, more severe ->
Assessing abnormal behaviour
Issues with assessment:
- the dividing line between normal and abnormal behaviour is often determined by social or cultural context
- strong stigma attached to psychological disorders
Stimga of mental illness
Stimga:
- negative attitudes and beliefs
- comes from inaccurate information
- mental disorders and violence
Overall, those with mental health issues do not have higher rates of violence
- those with symptoms of substance use disorder most likely to engage in violent behaviour
- those with severe mental disorder symptoms display slightly higher levels and violence
- stigma and negative stereotypes perpetuated via media
Essential terms
Psychopathology: study of symptoms and development of psychological disorders
Psychological disorder: pattern of behavioural or psychological symptoms
Lifetime prevalence: likelihood of someone experiencing disorder at some point in their life
Assessing mental health
DSM-5: published in 2013
- lists 20 categories of disorders
- covers more than 300 disorders
- takes an theoretical approach
- shows improved reliability over time
However
- having standards does not guarantee a correct diagnosis
The DSM
Defines mental disorder as a clinically significant disturbance in cognition, emotional regulation, and behaviour
- helps to identify dysfunction in mental functioning
- expectable reactions to common stress not mental disorders
- reflects a medical mode of psychopathology
- each disorder categorically listed and defined symptoms
Brief History of the DSM
- DSM -> earlier editions (I and II) -
- DSM-I published by APA in 1952
- revision published as DSM-II in 1968
- both similar to each other
- different from subsequent editions
Definitions not scientifically or empirically based - DSM-III (1980) -
- similar to previous two
- relied on empirical data
- used specific diagnostic criteria to define disorders
- Followed by DSM-II-R, DSM-IV, DSM-IV-TR -
- retained major changes introduced by DSM-III
- introduced significant other changes
- DSM-5: The current edition -
- published in 2013
- first substantial revision after 20 years
- researched over 12 years
- coordinated efforts with WHO
~ International Classification of Diseases (ICD)
~ Greater consistency with DSM-5
Diagnostic categories in the DSM-5:
1. neurodevelopmental disorders
2. schizophrenia spectrum and other psychotic disorders
3. bipolar and related disorders
4. depressive disorders
5. anxiety disorders
6. obsessive-compulsive and related disorders
7. trauma and stressor-related disorders
8. dissociative disorders
9. somatic symptom and related disorders
10. feeding and eating disorders
11. elimination disorders
12. sleep-wake disorders
13. sexual dysfunctions
14. gender dysphoria
15. disruptive, impulse control and conduct disorders
16. substance related and addictive disorders
17. neurocognitive disorders
18. personality disorders
19. paraphilic disorders
20. other disorders
Lifetime prevalence
- Disorder -> Median age of onset -> % prevalence -
Anxiety disorders, PTSD and OCD -> 11 years, 29%
Depressive and bipolar disorders -> 30 years -> 21%
Impulse-control disorders -> 11 years -> 25%
Substance use disorders -> 20 years -> 15%
Any disorders -> 14 years -> 46%
How do we assess?
- Unstructured interview -
- initially gather information concerning status of individual
- budding rapport with client
- identify areas of consideration for diagnosis
- Structured interview -
- similar questions across clients to provide consistency
- questions based on criteria taken from DSM-5
- Structured Clinical Interview for DSM Disorders (SCID):
~ an interview that probes for the existence of the criteria for disorders within the current classification manual the DSM-5 - Projective tests -
- Rorschach inkblot test
- thematic apperception test
- based on psychodynamic approaches
Strength: - informal format allows greater flexibility in administration and less likely to prompt social desirability
- potentially assess unconscious conflicts and desires
- good for rapport building, non-threatening
- helps to generate hypothesis and diagnosis
- add to “larger picture” over overall assessment
Limitaions: - reliability is questionable, even with coding guides
- not great at predicting behaviour long-term
- does not always help in understanding of behaviour
- may be adding unreliable piece to the puzzle
- clinicians may pause wrong avenue for diagnosis
- time could be better spent elsewhere
- Questionnaires -
- Minnesota Multiphase Personality Inventory (MMPI)
- Beck Depression Inventory (BDI)
- Hamilton Depression Rating Scale (HBRS)
- Generalised Anxiety Disorder Assessment (GAD-7)
- Neuropsychological testing -
- Wechsler Adult Intelligence Scale (WAIS)
- Wechsler Intelligente Scale for Children (WISC)
- Wechsler Preschool and Primary Scale of Intelligence (WPSSI)
Wechsler tests
Assesses general level of cognitive functioning
- IQ
- Verbal communication
- Perceptual reasoning
- working memory
- processing speed
DSM and categorisation
Mental disorders often categorial using DSM
- person either has or does not have disorder
- dimensional approach may describe severity
~ disorder on continuum
~ may guide treatment
