psychopathology notes unit 1

psychopathology

the scientific study of mental difficulties or disorders, including their explanations, causes, progression, symptoms, assessment, diagnosis and treatment

50% of workers in this field

clinical practitioners and or clinical scientist

how is psychopathology defined

using the four Ds but there is no universally accepted definition

4 D’s

deviance, distress, dysfunction, and danger

deviance

behavior, thoughts, and emotions that are marked as “different”/ “unusual” because they differ from a society’s ideas and proper functionings

• social norms aren’t followed (explicit and implied rules for proper conduct)

judgments of psychopathology

depend on specific contexts or circumstances, especially when trying to see if there behavior is deviant

distress

unpleasant and upsettlng for the person

• not all examples of psychopathology have distress (subjective)

• different levels

dysfunction

interfering with the persons daily functioning or ability to conduct daily activities in a constructive way

• taken within a cultural context( ex. physical impairments doesn’t indicate psychopath)

• ex. not being productive for long period of time

danger

posing risk of harm to oneself or others

• behavior that is consistently careless, hostile, or confused maybe placing self or others at risk

• this is the exception rather than the rule; most present no immediate danger

elusive nature of psychopathology

each society selects general criteria for defining psychopathology and then uses those criteria to judge particular cases

advocate for mental health disorders

Szasz

continuum

what mental health difficulties occur on

around 50% of population

how many people experience serious psychological disturbances

treatment

also known as therapy, is a procedure designed to change pathological behavior into more functional behavior

three components of therapy

1. individual who seeks relief from a therapist

2. trained socially accepted therapist whose expertise is accepted by the individual and his/her social group

3. series of contacts between the therapist and the individual through which change is produced

outpatient care

primary mode of treatment

severe treatment

typically short term hospitalization and then outpatient psychotherapy and medication in community settings via the community mental health approach

revolving door

people in and out if hospital because the community follow up isn’t always strong and present (60% of people with severe disturbances)

models of paradigms

perspective used to explain events

• influences what is observed the questions asked, info sought and how info is interpreted

biological model

adopts a medical perspective

• psychopathology is an illness brought about by malfunctioning parts of the organism

• focuses typically on the brain

areas of focus and study in the biological model

brain autonomy, brain chemistry, and brain circuitry

evolution and genetics

sources of psychopathology in biological model

evolution

looks at a combination of adaptation behaviors of the past, genes, and the interaction between genes and current environment events

• prepadrenss hypothesis and fear responses

genetics

inheritances play a role in several disorders in most cases serve; tends to combine to influence our actions and reactions

biological model treatments

drug therapy, electric therapy (ETC), and psychosurgery

Strengths of the biological model

considerable respect in the field, constantly produces new valuable information, can bring great relief for some

limitations of the biological model

limits rather than enhances our understanding, treatments produce undesirable side effects

cognitive behavioral model

focused on elements of human functioning that are readily observable and or reportable

• tends to be present-focused, empirically based, action oriented and structured

cognition → ←emotions →←behaviors

what the cognitive behavioral model is interested in

therapy of thoughts and behaviors saw well as how they impact emotions

behavioral model

aims to identify behaviors that are causing the individual problems, “how were the problems learned?”

• all may produce functional or dysfunctional behavior

serval forms of conditioning in behavioral model

operant, modeling and classical

operant conditioning

humans and animals learn to behave in certain ways as result of reinforcement whenever they do so

reinforcement

increases the likelihood that the behavior will reoccur

postive reinforcement

addition of receiving a a positive experience as a reward

negative reinforcement

removal of a negative experience as a reward

example of reinforcement

Mom wants you to eat your veggies

positive- gives you a cookie if you do so

negative- you don’t have to do dishes

punishment

decreases the likelihood that the behavior will reoccur

positive- adding something undesirable

negative- taking away something desirable

modeling

individuals learn response by observing and repeating behavior

-ex the language you use around your friends mirror theirs

classical conditoning

when two events repeatedly occur close together in time they become paired in a persons mind, before long th person responds in the same way to both events

• temporal association

behavioral therapies

seeks to replace problem behaviors with more adaptive ones (we can learn something different)

cognitive model

faulty thinking, argues clinicians must ask questions about assumptions, attitudes, and thoughts of a client

• fault assumptions and attitude

• illogical thinking process (overgeneralization and jumping to conclusions)

cognitive therapies

seeks to help the cielnt change their thinking patterns

Becks cognitive therapy

goals is to help clients recognize and challenge their thinking

• therapist guide clients to challenge their dysfunctional thoughts tru out new interpretations and apply new ways of thinking in their daily lives (first used to treat depression)

Sigmund Freud

is the father of psychodynamic theory and psychoanalytic therapy

ID

Present from the beginning and guided by
the Pleasure Principle, wanting to obtain pleasure or gratification. Includes
instinctual needs, drives, and impulses. Fueled by our sexual energy

ego

Guided by the Reality Principle, seeks gratification but guides us to know when we can and cannot express our id impulses. It grows out of id and recognizes that it isn’t always acceptable to express some desires outright, uses defense mechanisms to protect us from the impulses of the id and anxiety that it causes

super ego

Considered our moral center. It is value-driven and grows out of the ego around age 5. It is
our sense of right and wrong, or our conscience, adopted from our parents. The superego uses guilt as a tool to indicate wrong.

psychodynamic therpies

free association, therapist interpretation, catharsis, working through

free association

The individual describes any thought, feeling, or image that comes to mind, even if it seems
unimportant, in efforts to tap into the unconscious

therapist interpretation

interpret resistance, transference, and dreams to better understand the unconscious

catharsis

reliving of past repressed feelings to settle internal conflicts and overcome problems

oral stage (age 0 months- 18 month)

• Erogenous zone: Mouth (sucking, biting, swallowing).

• Key task: Weaning (from breast/bottle).

• Fixation outcomes:

  • Oral receptive (dependency, gullibility, overeating, smoking).

  • Oral aggressive (hostility, sarcasm, nail-biting).

anal stage (18 months to 3)

• Erogenous zone: Anus (toilet training).

• Key task: Control over elimination.

• Fixation outcomes:

  • Anal retentive (excessively orderly, stubborn, perfectionist).

  • Anal expulsive (messy, careless, destructive, disorganized

pahllic (3 to 5 years old)

• Erogenous zone: Genitals.

• Key conflicts:

  • Oedipus complex (boys desire mother, rivalry with father).

  • Electra complex (girls desire father, rivalry with mother).

• Resolution: Identification with same-sex parent → development of superego (morals).

• Fixation outcomes: Vanity, recklessness, difficulty with authority, relationship issues.

latency (5-12 years old)

• Erogenous zone: Dormant (sexual impulses repressed).

• Focus: Social interactions, school, hobbies, friendships.

• Key development: Learning, cultural values, communication skills.

• Fixation: Usually none (stage of relative calm).

genital

• Erogenous zone: Genitals (mature sexual interest).

• Focus: Healthy sexual relationships, balance of love and work.

• Successful resolution: Ability to form intimate, lasting relationships.

• Fixation: If earlier conflicts unresolved, may struggle with relationships or fulfillment.

electra

A girl’s unconscious desire for her father and rivalry with her mother.

oepidus

A boy’s unconscious desire for his mother and rivalry with his father (phallic stage, ages 3–6)

assessment

collecting relevant information in an effort to reach a conclusion

• in everyday life: how you decide what to wear; daily schedule, weather along with mtutiple other factors

clinical assessment

used to better determine how and why a person is behaving in a dysfunctional manner, and how that persons may be helped

• should be used to evaluate treatment progress

idiographic

focus of clinical assessment (individual person)

assessment tools

standardized, reliable and valid

standardized

technique is to set up common steps to be followed whenever an assessment is administered

• includes the assessments administration, scoring, and interpretation

reliability

refers to the consistency of a test or research results

• a good test will always yield the consistency results in the same situation

test related reliability

yields the same results each time it us given to the same people ( highly correlated)

• implies nothing in clients changed so results shouldn’t change

interrupter reliability

different judges independently agree on how to score and interpret a particular test ( you determine in the tests is the same as other people)

validity

refers to the accuracy of s test and its results

a good test should accurately measure or test what it is supposed to measure

face validity

a test accurately predicts future characteristics or behavior

predictive validity

a test appears to measure what it is supposed to measure; does not necessarily indicate true validity

concurrent validity

a tests result agree with other independent measures assessing smilier characteristics or behavior

assessments 3 categories

clinical interviews, tests, and observations

specific assessments

depend on the clients needs and the clinicians theoretical perspective

clinical interviews

face to face encounters used to collect detailed information about a client

• can be structure or unstructured

unstructured clinical interviews

open ended questions

structured clinical interviews

prepared questions from a published interviews schedule, very specific

clinical interviews limitations

may lack validity or accuracy

• on the part of the client (not reporting accurately)

interviews may be biased or may make mistakes in judgement (accuracy and constancy)

interviews, particularly unstructured ones, may lack reliability

diagnosis

made through using assessment data and conceptualization, determines that a persons problems reflect a particular disorder or syndrome

• influenced by their theoretical perspective or orientation

• classification system

diagnostic classification system

lists of categories, disorders, and symptom descriptions with guidelines for assignment

• DSM 5

• medical model and focus of clusters of symptoms

statistical manual for the use of institutions for the insane

• published in1918

• first attempt at a formal, standardized classification of psychopathology

• 22 diagnostic categories

diagnostic and statistical manual of mental disorders

• 102 diagnostic categories, based on psychodynamic etiological (1952)explanations

• reaction rather then disorders

• limited bearing on psychiatric practice

DSM ll (1968)

slightly less psychodynamic influence with increased attention paid to systemic categorization and specificity

• disorders rather than reactions

• 182 diagnostic categories

DSM-lll (1980)

promoted by negative cirque of psychiatry and improved treatment

• szasz

• 265 categories

• removed homosexuality; included ptsd and add

• multi axial system for more comprehensive depictions

• NIMH field trails and interrupter reliability tested

DSM-IV

a) criteria for diagnoses b) key clinical features( how often, course, risk), and c) related features by research that are often but not always present

DSM-5

attempt tp better represent mental health problems as on a continuum

• categories were created, deleted, reorganized and combined

• new diagnostic system

categorical

name or type of disorder

dimensional

rating of severity and dysfunction

can diagnosis and labeling cause harm

misdiagnosis is always a concern, labeling and stigma

• because of these problems some clinicians would like to cease the practice of diagnosis

Stewart and El-Mallakh

misdiagnosis of bipolar disorder in a small substantial sample size

• people who were diagnosed with it at the time were looked at again months later and were found with no symptoms

cognitive behavioral model limits

causality is difficult to show, doesn’t help everyone, focus is too narrow

cognitive behavioral model strengths

very broad appeal, constructs lend themselves to research/can be tested in a laboratory, clinically useful and effective, lots of research support for a huge range of disorders

existential view

emphasis on self-determination, choice, and individual responsibility (first ones to do so)

focus on authenticity

humanist view

emphasis on people as friendly, cooperative, and constructive

focus not drive to self actualization

rogers humanistic theory and therapy

Rogers Humanistic Theory and Therapy

basic need for unconditional positive regard

unconditional postive regard is received

leads to unconditional self-regard

increased likelihood of self actualization

unconditional postive regard is not received

leads to “conditions of worth”

• IF you mean these conditions you’re worthy

incapable of self actualization

increased likelihood of mental illness

client centered therapy

therapist creates a supportive climate (unconditional positive regard, accurate empathy, and genuineness)

• characteristics of a good therapist but you have to build on top of it

humanistic-existential model strengths

taps into domains missing from other theories

emphasizes the individual

optimistic

emphasis on health( just because someone doesn’t have a disorder mean they are living well)

humanistic-existential model limits

focuses on abstract issues (difficult to research)

weakened by disapproval of scientific approach