Theories Flashcards Preview

Adult Psychopathology Erin > Theories > Flashcards

Flashcards in Theories Deck (43):
1

Evolutionary Theory allows for psychological functions to be characterized in 1 of 3 ways:

1. The Mental Function has a current purpose (i.e., an adaptive value to the individual or group)
2. The Mental Function used to have purpose (adaptive value) in the past that is no longer relevant current adaptation needs (like body hair and probably the appendix)
3. The Mental Function is a Epiphenomena (byproduct) of other essential processes that have adaptive value (e.g., cellular respiration = metabolic process in cells in which biochemical energy in nutrients are converted to the coenzyme ATP -> results in the byproducts of Water, CO2, C3H6O3 [lactic acid])
**controversal psych functions = free will and consciousness (both=epiphenomena!!)

2

culture

Human beings live in complex social groups with intricate, long standing rules and practices that collectively are referred to as a culture
-Culture consists of proscriptions (things should not do) and prescriptions (things should do) for successful adaptation. They are transmitted across generations via the family unit, formal schooling, social and religious rituals, and the political economy

3

Culture Theory:

culture is the repository for The shared rules of conduct that a society prescribes to its members for maximizing the reinforcement/punishment (pleasure/unpleasure) ratio in their daily lives while preserving and enhancing social cohesion
-The most important rules of human cultural behavior are the rules that govern Cognitive Process (e.g., information pickup, storage, information manipulation and utilization) especially attentional behavior (i.e, culture shapes what attend to and what we ignore, recall, recognize and forgot, etc.)
-mind is the brain + culture
-personality = unique representation of your culture within your nervous system! (culture of one!)
-The sum of the cultural “programming” that allows us to effectively (or ineffectively) self regulate and synchronize our hedonic striving is what we typically refer to as our “personality”

-socially regulated - not self regulated!
-humans adapt to cultures
-culture lets you share in a rich reservoir of knowledge from thousands of years = advantage!

4

If learning is impaired….

considered mentally ill

5

2 important implications of culture theory:

a. Humans don’t strive to adapt to the environment per se, but rather to their culture

b. Mental health is largely determined by whether one is successful in adapting to, or chooses to adapt to, a particular culture. Consequently the severity of many mental health problems may be dependent upon the cultural context.

6

Theories of classification/description

(Identifying reliable and
valid groupings of symptoms, signs, context, and disorders

7

Theories of etiology

identifying reliable and valid causes of
symptoms, signs, and disorders)
*not great in psychology!

8

Emil Kraeplin

classification system that we use today (DSM) comes from him

9

Wilhelm Wundt

helped Kraeplin use experimental psychology to look at classification

10

1.disease
2.disorder
3.symptom
4. sign
5. syndrome

1. have a defining cause of the disorder!
2. generally presumes there is an underlying cause and a syndrome doesn’t make that claim because we don’t know!
3. reportable indicator of dysfunction
4. observable indicator of dysfunction
5. co-occuring symptoms and signs clustered together – co-vary

11

In order to have a classification system we must have 4 components...

1. rules for setting a threshold
2. rules and indices for est. level of severity
3. rules for identification of the contexts
4. Rules for parsing an collation

12

Rules for setting a threshold

(based largely on social and scientific consensus) for assigning labels of deviance (i.e., signs and symptoms) to observable and inferred behaviours (e.g., thoughts, feelings, etc.) almost all of which exist on a continuum (e.g., rate of speech, suspiciousness)

13

RULES AND INDICES FOR ESTABLISHING LEVEL OF SEVERITY

Commonly used indices include:
RANGE OF FUNCTIONS AFFECTED (pervasiveness)
PERSISTENCE OF DISRUPTION OVER TIME (course)
DEGREE OF DEVIANCE FROM NORMATIVE FUNCTIONING
(A) BETWEEN SUBJECT COMPARISONS
(CULTURE,SUBCULTURE, FAMILY)
(B) WITHIN SUBJECT COMPARISONS
1. OVER TIME (DETERIORATION)
2. IN RELTION TO OTHER FUNCTIONS
EXTENT OF ADVERSE IMPACT ON OCCUPATIONAL AND SOCIAL FUCNTIONING (INCLUDING SELF CARE)
*Range – how many things affected by this; Impact on your capacity to perform your expected social roles

14

rules for identification of the contexts

where the diagnostic criteria do and do not obtain or are less reliable (e.g., the extreme suspiciousness exhibited by someone who has been assaulted or raped in the past)

15

Rules for the parsing and collation

specific signs and symptoms into discrete syndromes and disorders.
-which signs and symptoms go together? requires many observations of many periods of time

16

Multiaxial system - DSM IV

I - Clinical disorders
II - personality disorder and mental retardation
III - general medical conditions
IV - Psychosocial and environment problems
V - global assessment of functioning (never used)

17

Major changes from DSM IV to V

1. no more Multiaxial system= 1,2,3 = combined; separate note for contextual and psychosocial (4) an disability (5)
2. reorganization of the manual = assemble existing disorders into larger clusters suggested by the scientific evidence – called the “meta-structure” of the manual and reflected in the new table of contents (3 sections)
20 Chapters (same number of disorders overall) are arranged to mirror the developmental lifespan
The disorders within each chapter are similarly rearranged
The ordering of chapters are also influenced by the degree of similarity between disorders – the more similar the disorders (all other things being equal) the closer they are to each other in the placement in the manual
Better alignment of the DSM diagnositc categories with that of the ICDII
-earlier likely to occur in development; earlier appears in the book!
3. Revision of criteria for some individual disorders!

18

differential diagnosis

refers to the disorders that are likely to be confused with particular disorder described

19

prevalence

number of cases in a unit time (knowing rarity can be helpful in diagnosis)

20

incidence

how many new cases in a unit time

21

Subtypes

mutually exclusive and jointly exhaustive phenomenological sub-groupings within a diagnosis. Indicated by the instruction “Specify whether..”
*can't be paranoid and disorganized schizophrenic

22

Specifiers

= not mutually exclusive or jointly exhaustive. Can have more than one specifier. Indicated by the instruction: “Specify” or “Specify if….”

23

Other Specified Disorder

= allows the clinician to specify the REASON why the presentation does not meet the full criteria for a specific disorder (e.g., “other specified depressive disorder, depressive episode with insufficient symptoms”)

24

unspecified disorder

used when no reason is given why the diagnostic criteria are not met (e.g., unspecified depressive disorder)

25

widiger and coker

believe that: dimensional models are being forced into a categorical box and a better way is to use the same dimensions that we up to describe personality
2 advantages: more similar to the real work - many sx's and signs, and many disorders
*prompted by: 1. high comorbitity 2. most common diagnosis is NOS
-created new diagnoses, subtypes, and modifiers

26

3 problems driving the revisions in the DSM 5

1. DSM 4 = high comorbidity diagnosis
2. widespread NOS dxs
3. too man its with sxs that straddle diagnoses"schizo affective" = best example
**Overall: The large number of narrowly defined diagnostic categories of the DSM-IV promote inter-rater reliability but inadvertently compromise validity by failing to capture the more complex reality faced by both clinicians and researchers

27

Goals od DSM 5...

structure it 
”… in a way that facilitates research across the current restrictive diagnostic silos without disrupting clinical practice and the administrative uses of the manual” 

And to
“assemble existing disorders into larger clusters suggested by the scientific evidence and then to encourage researchers, granting agencies, and journal editors to facilitate research within and across clusters.”

28

Etiological theory of social construction

1. hereditary (genes) 2. innate (gene mutation) 3. congenital (in utero- virus cause schizophrenia?) 4. constitutional (after birth, learning, micro biome passings- depression)
*****accumulative effects 1+2+3+4
*1-3 = neurobiological disease
*4 = psychoanalytic learning, cognitive humanistic/existential
**psychiatrically disabled indiv tend to come from low SES!- less resources

29

3 models of culture and biology

1.Sociocultural Model
2. Medical/Disease Model
3. Neuroscience Model

30

Sociocultural Model

(Labeling Theory) Psychopathology is a social institution. Definition of abnormal behavior depends on which society is doing the defining. Deviant behavior very common, but some forms come to the attention of the mental health professions and become labeled as mental disorders. Once labeled, the individual is placed in the SOCIAL ROLE of the mentally ill person. Individuals are then rewarded for staying in that role and punished for leaving it (Thomas Scheff).

31

Disease Model

. Psychopathological illnesses have specific symptoms, which can be reduced to specific biological causes (biogenic). This view has been challenged by some. The most vocal and strident critic has been Thomas Szasz who argues that mental illness is a creation of the medical profession and that most forms of mental illness are in fact "problems in living". It is in fact a conflict between an individual and society, and that the sick label deprives individuals of responsibility for their behavior and impedes their return to normal behavior.

32

The Neuroscience Model

This a more enlightened version of the biological or medical model which views biological factors as necessary but not sufficient contributors to the etiology of many, if not most, forms of abnormal behavior.

33

3 psychological Models

1. Psychodynamic models
2. humanistic existential models = Assumes that abnormal behavior results from a failure to accept oneself, to take responsibility for one's actions and to pursue personal goals. To some extent, the H-E approach views psychopathology as a function of what is uniquely human (i.e, the capacity to think about ones own thinking, foresight and insight, including awareness of ones eventual death, the notions of volition, intentionality, consciousness and the awareness of other minds). By contrast, the behavioral models assume that lower animals can "learn" most of the forms of psychopathology found in humans.
*free will, volition, consciousness
*
3. Behavioral and Cognitive Behav Perspective

34

Neuroscience perspective

-behavioral genetics - how much due to environment and learning and how much due to genes?
-23 pairs of chromosome; 22 autosomes +1 pair of sex chromosomes
-mitochondrial DNA = only get from mom
-uses genetic studies: family studies, twin studies, adoption studies

35

Polygenic trait

many genes determine expression

36

monogenic trait

one gene determines the expression

37

genotype vs phenotype

-geno = genes coding; phenotype = appeared expression

38

Nervous system

Central ----- Peripheral
Brain/SC------Somatic/ Autonomic
-------------------------------Symp(*)/Para

39

4 lobes of brain

parietal - sensory integration (
temporal - auditory
occipital - sight
frontal - personality (acting/deciding)

40

Limbic System

hippocampus - wraps around inside of brain - when damaged = memory problems (storing and retrieving; ST -> LT); implicated in schizophrenia - apoxia (deprivation of oxygen to this area)
amygdala

41

Hypothalamus

send signals to pituitary gland -- implicated in anxiety and mood disorders

42

aphasia

happens with damage to broca's area

43

2 types of transmission in the NS

electrical signals and chemical