Week 6 - Introduction to Mental Health Flashcards
(36 cards)
1
Q
What were the beliefs on mental illness during the ancient Greece period?
A
- Used to think mental illness was due to imbalance of bile/liquids
- Treatment method: Demonological (evil spirits and exorcisms)
2
Q
In what century were asylums introduced?
A
15th century
3
Q
What were the key points in history regarding clinical psychology, during the 20th century?
A
- Shift from biology to psychology; Emil Kraeplin as the founder of modern psychiatry
- Psychodynamics perspective (Freud)
- Humanistic perspective (Rogers)
- Behavioural perspective
- Cognitive perspective
4
Q
What is the definition of mental health?
A
Mental health is a state of well-being in which an individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and is able to make a contribution to his/her community (WHO, 2021)
5
Q
What are the factors influencing mental health?
A
- Social
- Psychological
- Biological
(based on the Biopsychosocial Model of Health)
6
Q
Definition of stigma
A
Negative attitudes and beliefs, that usually come from inaccurate information
7
Q
Definition of Psychopathology
A
Study of symptoms and development of psychological disorders
8
Q
Definition of Psychological Disorder
A
Pattern of behavioral or psychological symptoms
9
Q
Definition of Lifetime Prevalence
A
Likelihood of someone experiencing disorder at some point in their life
10
Q
What is the DSM-5?
A
- A complete list of various disorders and the symptoms/criteria associated with it
- Lists 20 categories of disorders, and covers more than 300 disorders
- Published in 2013
11
Q
What are the different ways to assess disorders?
A
- Unstructured interviews
- Structured interviews
- Projective tests
- Questionnaires
- Neuropsychological testing
12
Q
Explain unstructured interviews
A
- Initially gather information concerning status individual
- Building rapport with client
- Identify areas of consideration for diagnosis
13
Q
Explain structured interviews
A
- Uses similar questions across clients to provide consistency
- Questions are based on criteria taken from DSM-5
14
Q
Give examples of projective tests
A
- Rorschach inkblot test
- Thematic apperception test
15
Q
What are the pros of projective tests?
A
- 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 hypotheses about diagnosis
- Adds to “larger picture” of overall assessment
16
Q
What are the cons of projective tests?
A
- Reliability is questionable, even with scoring guide
- Not great at predicting behaviour long-term
- Does not always help in understanding behaviour
- Clinicians may pursue wrong avenue for diagnosis
17
Q
Examples of questionnaires used to assess disorders
A
- Minnesota Multiphasic Personality Inventory MMPI)
- Beck Depression Inventory (BDI)
- Hamilton Depression Rating Scale (HDRS)
- Generalised Anxiety Disorder Assessment (GAD-7)
18
Q
Examples of neuropsychological testing used to assess disorders
A
- Wechsler Adult Intelligence Scale (WAIS)
- Wechsler Intelligence Scale for Children (WISC)
- Wechsler Preschool and Primary Scale of Intelligence (WPSSI)
19
Q
Explain the Wechsler Tests
A
- Used to assess general level of cognitive functioning
- IQ, verbal comprehension, perceptual reasoning, working memory, processing speed
20
Q
What do diagnostic categories do?
A
- Describe patterns of experiences/behaviours that may be causing distress and/or be seen as difficult to understand
21
Q
Explain Korsakoff’s Syndrome
A
- A memory disorder that results from vitamin B1 deficiency and is associated with alcoholism
- Ability to learn new information is impaired
22
Q
What are the differences between psychiatric and physical diagnoses?
A
- There are not always physical tests for psychiatric diagnoses
- No firm evidence that mental distress is caused by biochemical imbalances, genes or the brain (except some, ex. dementia)
- Our brains are involved in everything we do but not always the cause of abnormal behaviour
- The theory that mental distress is best understood as a kind of physical illness (ex. diabetes, cancer) is not fully supported
23
Q
What are the problems with the DSM?
A
- Over-reliance on ‘medical’ model
- Categories, not dimensions
- Some propose that it should have biological explanations and specific treatments included in it
- People often get more than one diagnosis (Shift categories over time)
- People can have ‘sub-threshold’ problems but experience more impairment than those who meet the full criteria
- Psychiatrists often do not agree on the diagnosis, particularly for common disorders like depression and anxiety
24
Q
What did Regier et al. (1990) find about comorbidity and addiction?
A
- 37% of individuals with alcohol use disorder also have a psychiatric disorder
- 53% of individuals with drug use disorder also had a psychiatric disorder
- 29% of individuals with a psychiatric disorder also had a substance use disorder
25
What are the effects of the overlap between addiction and other disorders?
- Disruption of social or recreational activities
- Social or interpersonal problems
- Hazardous/risky situations
- Failure to fulfill work, school or home obligations
26
Why is comorbidity a problem?
- How do we know which comes first (chicken or egg Q)?
*If addiction is responsible for depression/anxiety due to withdrawal, then the treatment should focus on addiction
*If depression/anxiety is responsible for addiction (coping mechanism/self-medication), treatment should focus on depression/anxiety
*Basically, we have to address the root cause
27
Arguments for Diagnostic Categories
- Fundamental part of clinical psychology
- Helps identify useful inventories
- Validates the patient's experiences
28
How do diagnostic categories help people?
Can help people to:
- Feel like their experiences "make sense"
- Feel less alone
- Feel worthy of (and ask for) help and care
- Feel less guilt or self-blame for their difficulties
- Feel hope for treatment and recovery
- Find a language to explain their difficulties to others
29
What are the possible problems with diagnostic categories?
- Some feel that diagnosis is a barrier to recovery (self-fulfilling prophecy)
- Diagnosis might make people feel 'different' and feel more alone/isolated
- Diagnosis may not capture experiences that have caused current difficulties
30
What are the issues with DSM?
- Includes some conditions that are too "normal" to be considered disorders
- Uses arbitrary cutoffs
- Gender bias
- Insufficient sensitivity to cultural diversity
31
What are the changes being considered to be made in DSM-5?
- Use of biological markers as diagnostic tools
- Rating of disorders/symptoms on a scale
- Dimensional approach toward a disorder
32
What are the new disorders rejected to be added into DSM-5?
- Attenuated psychosis syndrome
- Mixed anxiety-depressive disorder
- Internet gaming disorder
33
What disorders in DSM-5 were revised?
- Bereavement exclusion
- Autism Spectrum Disorder
- Attention-Deficit/Hyperactivity Disorder
(Increased age symptoms from 7 to 12, Min. number of symptoms in adults increased to 5)
- Bulimia Nervosa
(Frequency of binge-eating reduced to once a week)
- Anorexia Nervosa
(Reduction of less than 85% of the body weight)
- Learning disabilities in math, reading and writing were combined as Specific Learning Disorder
- Obsessive Compulsive Disorder removed from Anxiety Disorders to a new category
34
Criticisms of DSM-5
- Many "work group" members quit midway
- Leaders of mental health organizations boycotted the DSM-5; Most vocal critic was Allen Frances (led the development of the previous DSM)
- Diagnostic overexpansion
- Transparency of the revision process
- Background of the DSM-5 authors
- Field trial problems (Testing of DSM-5 was not very unreliable)
- Price is quite high, despite it being required by students and practitioners and etc.
- Breadth of coverage
- Controversial cutoffs
- Cultural issues
- Gender bias
- Little input from practitioners
35
What did Allen Frances say about the DSM-5?
- Changes were unsafe and scientifically unsound
- Medical illnesses were diagnosed as somatic symptom disorder
- DSM-5 will mislabel normal people, promote diagnostic inflation, encourage inappropriate medication use
36
What are the strengths of the DSM-5?
- Emphasis on empirical research
- Use of explicit diagnostic criteria
- A degree of interclinician reliability
- A theoretical language
- Facilitated communications between researchers and clinicians
