Psych Mental Health Exam

The 4 D’s of Abnormality

Deviance: Strays from what we consider the “norm”

Distress: Causes the individual discomfort

Dysfunction: Interferes with many aspects of their life

Danger: Harm to self, not necessarily others

Historical Explanations of Mental Illness

• Supernatural: Driven by demonic possession, curses, or planetary alignments.

• Mind (Psychological): Driven by unconscious conflicts, trauma, or maladaptive learning.

• Biological (Somatogenic): Driven by physical illness, brain abnormalities, or chemical imbalances

Key Historical Figures

Hippocrates: Ancient Greek physician, viewed mental illness as a natural biological imbalance of bodily humors.

Johann Weyer: First physician to specialize in mental illness, argued that accused witches were actually suffering from mental disorders.

Philippe Pinel: French physician who ordered the unchaining of patients and advocated for "moral treatment" (humane care).

Dorothea Dix: American reformer who lobbied state legislatures for the creation of state-supported mental hospitals offering moral treatment.

DSM Historical Milestones

• DSM-I (1952): First standardized classification system heavily influenced by psychodynamic theory.

• DSM-II (1968): Introduced childhood disorders.

• DSM-III (1980): Introduced PTSD; shifted to an explicit, descriptive diagnostic approach.

• DSM-5 (2013) & DSM-5-TR (2022) Updates: Consolidated Autism Spectrum Disorder (ASD); added Gambling Disorder; raised the age limit for ADHD symptoms; added Prolonged Grief Disorder in TR; updated inclusive diagnostic terminology.

DSM Pros

● Standardization of language and criteria

● Reliability

● Direction for treatment

● Validation

DSM CONS

• Stigmatization

● Pathologizing

● Reliance on medical model

● No universal idea of mental health

Cultural Relativism

● Our idea of what constitutes “normal” from “abnormal” behavior is shaped by our culture

● One culture may view a set of behaviors as “normal,” whereas another culture may view that as “abnormal”

Cultural encapsulation

Lack of awareness of different cultures having different views of what is “normal” is

Culture-Bound Syndromes

● “Symptoms that are considered to be a recognizable disease only within a specific society or culture”

● In the DSM-5, there are currently 9 “cultural concepts of distress,” or culture-bound syndromes included

Cultural Understandings of Etiology

● Influence of Spiritual/Religious Beliefs

• Collectivist vs. Individualistic cultures

A.S.K. Model of Cultural Competence:

• Awareness: Understanding one's own cultural biases, values, and assumptions.

• Skills: Developing culturally tailored intervention strategies and communication methods.

• Knowledge: Acquiring specific understanding of diverse client groups' worldviews and histories

Socioeconomic Status and Intelligence (IQ) Poverty and Mental Illness

• Typically, 2-9x more mental illness across low-SES, with an average of about 3x more mental illness

• Prevalence Link: Mental illness is roughly 3 times more prevalent among populations living in poverty.

Directionality?

● Theory 1: Social causation: the conditions of

poverty precede mental illness

• Poverty » Mental Illness

● Theory 2: Downward drift: Mental illness precedes the “drift” into lower SES

• Mental Illness » Poverty

Mediators That Explain the Link

Hopelessness, severe stress, social insecurity, shame, and environmental hazards that link economic status to mental distress.

IQ as an Individual Differences Variable:* look into this

Measures cognitive capabilities relative to age norms.

Historical Concerns : IQ

○ Validity

○ Cultural applicability

○ Misuse

Stereotype Threat:

awareness of negative stereotype about a group in a domain produces

suboptimal performance.

The Wechsler Intelligence Scale for Children (WISC)

1. Verbal Comprehension

2. Visual Spatial

3. Fluid Reasoning

4. Working Memory

5. Processing Speed

Cultural Vulnerability:

Verbal Comprehension tasks are the most vulnerable to cultural and linguistic bias.

Personality

One’s characteristic patterns of behaving, thinking, and feeling

Personality Assessment Types

Objective Tests

● Based on theory, logical content, and empirical methods

● Susceptible to faking- good or faking bad

● Minnesota Multiphasic Personality Disorder (MMPI-3), 16 Personality Factor Questionnaire (16PF), Myers-Briggs Type Indicator (MBTI)

Projective Tests

● Based responses to ambiguous stimuli

● Less susceptible to faking

● Reliability and validity concerns

● Rorschach Inkblot Test, Thematic Apperception Test

OCEAN

• Openess to experience

• Conscientiousness

• Extraversion

• Agreeableness

• Neuroticism

Spectrum Model

Suggests personality traits and psychopathology lie on the same continuous spectrum (e.g., extreme neuroticism is anxiety).

Vulnerability- Predisposition Model

• Model A: A specific trait directly increases vulnerability to a mental illness (e.g., Neuroticism » Anxiety).

• Model B: Traits interact with external stress to trigger illness (e.g., Neuroticism + Stress » Anxiety).

• Model C: Early pathology alters personality traits long-term (scar model).

Personality Disorder Clusters:

• Cluster A (Odd/Eccentric): Paranoid, Schizoid, Schizotypal.

• Cluster B (Dramatic/Erratic/Emotional): Antisocial, Borderline, Histrionic, Narcissistic.

• Cluster C (Anxious/Fearful): Avoidant, Dependent, Obsessive-Compulsive Personality Disorder.

Gender Prevalence in Women

Major Depressive Disorder, Anxiety Disorders, Eating Disorders,

Equal Prevalence in Gender

Bipolar Disorder, Schizophrenia, Obsessive-Compulsive Disorder.

Internalizing vs Externalizing

• Women show higher rates of internalizing symptoms (anxiety, distress, withdrawal)

• Men show higher rates of externalizing symptoms (substance abuse, aggression, conduct problems).

Diagnostic Bias:

Autism & ADHD: Historically underdiagnosed in girls due to diagnostic criteria framed around male presentations and mask-wearing behaviors.

Borderline Personality Disorder vs. PTSD: Women with trauma backgrounds are disproportionately diagnosed with BPD over trauma-based diagnoses.

Minority Stress Model:

Elevated mental health struggles among gender and sexual minorities stem from chronic social stigma, prejudice, discrimination, and structural oppression rather than intrinsic dysfunction