Psychopathology

What is Psychopathology the study of?

The scientific study of mental disorders including their theoretical underpinnings, etiology, progression, symptomatology, diagnosis, and treatment

The single most common disorder

Major depression disorder

Defining abnormality

The 4 Ds

Deviance

Different from cultural norms

Distress

Emotional suffering

Dysfunction

Interferes with daily life

Dangerousness

Risk of harm of self/others

Continuum model

Normal to abnormal (not just “yes/no”)

Historical views

Supernatural (witchcraft, possession)

Biological (Hippocrates: brain imbalance)

Psychological (Freud, moral treatment)

Modern approaches

Deinstitutionalization, cultural relativism

What are transdiagnostic risk factors? What are some examples?

Trauma, childhood maltreatment, exposure to violence, poverty, executive functioning deficits, high neuroticism, etc.

How can we understand psychopathology?

1. Biological approaches

2. Psychological approaches

3. Sociocultural approaches

Biological theories

Genetics, brain structure, neurotransmitters

What is a neurotransmitter that could potentially explain why SSRIs work, and how the lack or surplus of this NT could influence disorders

Glutamate

Psychodynamic theory

Unconscious conflicts

Behavioral theory

Conditioning (classical/operant)

Cognitive theory

Distorted thinking patterns

Humanistic theory

Drive for growth, self actualization

Biopsychosocial model

Integrates all perspectives

Treatments for psychopathology

Medications (antidepressants, antianxiety, antipsychotics)

Psychotherapy (CBT, psychodynamic, humanistic)

Brain stabilization

• electroconvulsive therapy (ECT)

• Repeated transcranial magnetic stimulation

• Deep brain stimulation

• Vagus nerve stimulation

What are some concerns about diagnoses today?

Reliability = consistency ; Validity = accuracy

Types of reliability

• test-retest

• Alternate form

• Internal

• Interrate or interjudge

Types of validity

• face

• Content

• Construct

• Predictive

• Concurrent

Assessment tools

• Clinical interview, self-report, behavioral observation

• Neuroimagining (MRI, fMRI), cognitive tests, psychophysiological measures

DSM system

Categorical diagnosis, specifiers, comorbidity

Issues

Stigma, cultural bias, differential diagnosis

How can a diagnosis both hurt and help a person?

• generates community

• Removes long-term self-blame

• Can label someone

• Can group them into a stigmatizing stereotype

Anxiety vs fear

Worry about the future vs an immediate threat

Generalized anxiety disorder

Chronic worry

Panic disorder

Unexpected panic attacks

Agoraphobia

Fear of situations with escape difficulty

Specific phobias

Irrational fear of an object/situation

Social anxiety disorder

Fear of negative evaluation

Obsessive-compulsive disorder

Obsessions = intrusive thoughts ; compulsions = repetitive behaviors

PTSD

Intrusive memories, avoidance, hyperarousal

Acute stress disorder

Shorter duration (under 1 month)

Treatments of trama disorders

CBT (exposure therapy), SSRIs, relaxation training

Somatic symptom disorder

Physical symptoms w/ distress

Illness anxiety disorder

Fear of serious illness

Conversion disorder

Neurological symptoms w/o medical cause

Factitious disorder

Faking illness for attention

Dissociative amnesia

Memory loss

Dissociative identity disorder

Multiple identities

Depersonalization/derealization

Detachment from self/reality

Causes of dissociative disorders

Trauma, stress, maladaptive coping

Treatments for dissociative disorders

CBT, stress reduction, indebita integration

Major depression disorder

2+ weeks of depressed mood and loss of interest

Persistent depressive disorder (dysthymia)

Chronic depression (2+ years)

Disruptive mood dysregulation disorder

Kids w irritability and temper outbursts

Causes of depression disorders

Biological - neurotransmitters( serotonin, norepinephrine), hormones, genetics

Psychological - cognitive distortions, learned helplessness, rumination

Social - stress, lack of support

Treatments for depression disorders

SSRIs, CBT, interpersonal therapy, ECT

Suicide risk factors

Past attempts, mental illness, hopelessness, impulsivity

Protective factors of suicide

Social support, treatment access, problem-solving skills

Which of the following is NOT one of the “4 D’s” of abnormality?

Development

The idea that abnormal behavior lies on a spectrum with normal behavior is called:

Continuum model

Freud’s theory that unconscious conflicts drive abnormal behavior is part of which model?

Psychodynamic

Which treatment is most directly based on the behavioral model?

Exposure therapy

A test that gives the same results each time is said to have high:

Reliability

What is the term for when two or more disorders occur together?

Comorbidity

Which disorder is defined by excessive worry occurring more days than not for at least 6 months?

Generalized anxiety disorder

Which symptom combination best describes obsessive-compulsive disorder (OCD)?

Intrusive thoughts + repetitive behaviors

A person has unexplained blindness after a stressful event, but no medical reason is found. This is most likely:

Conversion disorder

A person suddenly cannot remember large portions of their past, often after trauma. This is:

Dissociative amnesia

Which of the following is NOT a symptom of Major Depressive Disorder (MDD)?

Periods of mania

Which is the strongest predictor of future suicide attempts?

Past suicide attempts

What is the difference between a panic attack and an anxiety attack?

Panic attack is 0-100 no reason/trigger, very hard to treat

Anxiety attack is increase in anxiety symptoms, debilitating

How do we assess and diagnose mental illness?

• clinical interviews

• Symptom questionnaire

• Personality inventories

• Brain imaging

• Psychophysiological tests

• Projective tests (ink blot)

Understand why there should be cultural considerations when diagnosing?

Answer

Should diagnoses be given on a categorical system or a continuous system?

Answer