Learn: Comprehensive Guide to Mental Disorders: Diagnosis, Models, and Treatments

Mental illness

Unusual thoughts, behaviors, or emotions that cause significant distress and/or impairment

Mental disorders

A category of mental illness

treatment planning, communication, research studies, and billing

Why are mental disorders important to identify?

Categorical assessment

Assessment where a person is diagnosed as either having or not having a specific disorder

Dimensional assessment

Assessment where a person's symptoms are measured on a range or scale of severity

One-dimension approach to diagnosis

approach on a scale from healthy to severe that identifies the level of mental illness

Three-dimension approach to diagnosis

approach on Internalizing, externalizing, and psychosis

The DSM

Diagnostic and Statistical Manual of Mental Disorders

Two parts of a diagnosis

Disorder and specifiers

Predict the future course of each person's illness

What should a diagnostic system do?

1890s Emil Kraepelin

Split dementia praecox from manic-depressive psychosis

Early to mid-1900s era

Era of state mental hospitals

DSM-1 and DSM-2 limitations

Unreliable and based on psychoanalytic theory

Atheoretical, checklists, and improved reliability and validity

DSM-3 was innovative for these 4 reasons

Overlapping symptoms, comorbidity, and low reliability

Three limitations of the DSM

Biological model

The body and brain are malfunctioning

Psychological model

The mind is creating unwanted thoughts, emotions, and behaviors

Sociocultural model

Relationships and social structures contribute to distress

Biopsychosocial model

Mental illness is shaped by interactions between biological, psychological, and social factors

Neurons, brain regions, brain circuits, brain networks

Brain processes

Two types of hormones

Stress hormones and sex hormones

Stress hormones

The HPA axis releases cortisol and other hormones that prepare the body for threats

Sex hormones

Estrogen, progesterone, and testosterone

Heritability

Correlation between genetic relatedness and diagnosis

Highly heritable percentage

70-80%

Moderately heritable percentage

30-40%

Types of medications

Antianxiety, antidepressants, mood stabilizers, antipsychotics, and stimulants

Cognitive-behavioral and psychodynamic models

The two psychological models

Cognitive-behavioral model

The conscious mind; thoughts, emotions, and behaviors are connected

Behaviorism

People seek rewards and escape or avoid unpleasant experiences

Cognitive-behavioral techniques

Change thoughts and behaviors

Cognitive restructuring

"Talk back" to automatic negative interpretations

Change thoughts

Changing thoughts can change feelings, behaviors, and symptoms

3rd-wave cognitive-behavioral therapies

Acceptance and commitment therapy and dialectical behavior therapy

3rd-wave cognitive-behavioral therapies use

Notice thoughts, emotions, and urges and choose how to respond

Psychodynamic model

The unconscious mind; things we are unaware of or cannot easily access

Freud's main idea

Unconscious physiological forces and past experiences influence behavior

Defense mechanisms

Manage conflict between the id, ego, and superego

Psychopathology

Too much conflict between the id, ego, and superego

Id

Pleasure principle

Ego

Reality principle

Superego

Morality principle

Psychodynamic therapy

Become aware of unconscious influences and consciously choose healthier behaviors

Dysfunctional behaviors

Pursue basic drives and defend the self from perceived threats

Catharsis

Relief through insight

Sociocultural therapies focus

Close relationships and communities

Cultural responsiveness

Increase awareness of minority stress, prejudice, and stereotypes; view culture as a strength; examine your own and dominant culture's impact

Biological model strengths

Widely used, researched, available, and effective for some people

Biological model weaknesses

Trial and error, neglects psychological mechanisms, expensive, and can have side effects

Cognitive-behavioral model strengths

Widely used, intuitive, easy to research, and effective

Cognitive-behavioral model weaknesses

Mainly designed to address current symptoms

Psychodynamic model strengths

Highlights relationship dynamics, development, and hidden functions of dysfunctional behavior

Psychodynamic model weaknesses

Theories and concepts are difficult to observe, measure, and research

Sociocultural model strengths

Can be effective when other approaches fail

Sociocultural model weaknesses

Difficult to research and individual application can be unclear

Equifinality

Different starting paths can lead to the same outcome

Multifinality

The same starting condition can lead to different outcomes

Mental illness model

Mental illness exists in the mind and brain, is part of the natural world, can be studied scientifically, is defined by diagnostic criteria, and should be treated by humane mental health professionals

Madness

Disturbance of reason, intellect, and emotions

Spiritual and physical causes

Premodern causes of madness

Spiritual causes

Madness was believed to be caused by spirits, gods, deities, demons, or witchcraft

Physical causes

Body fluids were believed to cause mental activity, and imbalance caused madness

Theory of the four humors

Blood, yellow bile, black bile, and phlegm

Rationalism

The belief that reason and logic are the main ways to gain knowledge and understand human behavior

Empiricism

The belief that knowledge comes primarily from observation and experience

Psychiatry

The medical field focused on understanding, diagnosing, and treating mental illness

Humanitarianism

The belief that people with mental illness should be treated with compassion, dignity, and humane care

Moral treatment

The belief that the environment can make people sick

Asylum

A place of refuge designed as a calm therapeutic community for doctors and patients

Overcrowding

Caused moral treatment to become custodial care

Philosophers

Developed new ways to analyze and observe the mind

Humanitarians

Tried to improve conditions for people with mental illness by housing them in asylums

Psychiatrists

Systematically observed patients to classify symptoms, understand causes, and develop medical treatments

Mental hygiene

Movement that emphasized prevention of mental illness

Psychoanalysis

Movement that introduced outpatient talk therapy outside the asylum

Clinical psychology

Movement showing that mental illness can be scientifically understood and treated outside the asylum

Social work

Movement that provided community support for marginalized people

Deinstitutionalization

Large-scale effort to close asylums and move treatment into the community

Reliable

Consistent measurement

Test-retest reliability

Stable results over time

Interrater reliability

Consistent results across researchers

Standardization

Can improve reliability

Valid

Accurate measurement

Types of interviews

Structured, semi-structured, and unstructured

Structured interviews

Used for a consistent, standardized diagnosis

Semi-structured interviews

Provide consistency and flexibility

Unstructured interviews

Explore a person's concerns in depth

Naturalistic observations

Study behavior in a person's natural environment

Analogue observations

Study behavior in a controlled or created situation

Self-monitoring

A person records their own behaviors, feelings, or thoughts

Types of clinical tests

Self-report, neuropsychological, intelligence, and projective

Self-report test

A person reports their own thoughts, feelings, or behaviors

Neuropsychological test

Tests brain functioning through specific mental tasks

Intelligence test

Tests cognitive abilities such as reasoning, memory, and problem-solving

Projective test

Uses ambiguous stimuli to reveal underlying thoughts, feelings, or personality characteristics

Depression is sadness that

Does not fit the facts, is self-reinforcing, and/or is resistant to change

Major depressive episode

Depressed mood and/or decreased interest or enjoyment most of the day, nearly every day, for 2 weeks

Anhedonia

Decreased interest or enjoyment of activities

Major depressive disorder

Major depressive episodes with no mania or hypomania

Persistent depressive disorder

Depressive symptoms for 2+ years that do not go away for 2+ months at a time, with no mania or hypomania