Understanding Mental Illness and Clinical Assessment

These flashcards focus on key terms and definitions related to mental illness, clinical assessment, and the DSM classification system as discussed in the lecture notes.

Psychotherapy

A treatment for mental health issues that involves scientifically validated methods and a collaborative therapist-client relationship.

what is thomas insels perspective on disorders

• we need to consider them as brain disorders instead.

• we should also detect brain changes early, so we can intervene sooner and possibly prevent later behavioral symptoms.

reliability

interrater reliability and test-retest reliability

validity

• the assessment tools should accurately measure what they are meant to measure.

• face validity (an assessment tool looks valid),

• concurrent validity (scores on one test compare to scores on a similar test), and

• predictive validity (a test accurately predicts what will happen in the future);

standardization

apply consistent procedures and norms of the assessment administration

observation assessments

• naturalistic (observing someone in their environment) or laboratory observation (observing someone in a controlled setting), leading to the gathering of the behavioural data.

reactivity

recording behaviour in a laboratory can change the behaviour

cross-sectional validity

• behaviours in one situation can be different in another

psychological tests

• focus on assessing personality, emotions, interests

• projective tests like the Rorschach (inkblot) test and

• the Thematic Apperception Test, in which individuals write a story about 20 cards and give details about their stories

• Personality inventories are used to assess what patients feel, believe or behave like, through the sortation of cards, based on how much they apply to them;

neurological tests

• used to discover possible cognitive impairments or brain activity changes.

• To do so, caregivers use PET (studies the brain’s chemistry using an injection),

• MRI (shows 3D images of the brain using magnets) and

• CT scans (takes X-rays of the brain at different angles);

clinical interviews

• face-to-face encounters between mental health professionalists and clients that aim to gather information about the client’s life history, personality, attitudes and behaviour.

• Mental status examination: used to evaluate which areas need to be examined further.

• It lacks reliability, especially when it is used in an unstructured interview.

behavioural assessment

• focuses on measuring target behaviors, which is behavior we want to change. The behavior either needs to be increased or decreased:

• To do this, professionals use the ABCs of behavior:

• Antecedents: events or stimuli that trigger a behavior;

• Behaviors: what someone does, says, thinks, or feels;

• Consequences: the outcome of behavior that reinforces repeatment or discourages it.

intelligence tests

• used to investigate cognitive functioning through tasks like measuring verbal and nonverbal skills.

• These tests cannot predict future behaviors.

key changes in dsm-tr

• Greater attention to risk factors like racism and discrimination;

• Use of non-stigmatizing language;

• Gender inclusivity;

• More information on suicidal thoughts in specific disorders;

dsm on culture

• now includes cultural formulation interviews, allowing clinicians to incorporate a patient’s cultural background into their diagnosis

• also describes how culture affects the symptoms and expression of disorders.

• For example, anxiety disorders manifest differently in Japan compared to Western countries.

• The manual includes nine cultural concepts of distress, such as: shenjing shuairuo (China) - presentation of weakness, fatigue, negative emotions and sleep problems; and taijin kyofusho (Japan) – intense fear of offending others with body odor or appearance

a diagnosis consists of what elements

• Diagnostic criteria and descriptions – guidelines for making a diagnosis.

2. Subtypes

3. Specifiers – additional details that differentiate severity,

4. Primary diagnosis – when multiple diagnoses are present, the main focus of treatment;

5. Provisional diagnosis – used when not enough information is available for a full diagnosis, but it is likely that all criteria will eventually be met.

critiques of the dsm-5

• may pathologize normal behaviours

• disorders may be divided too finely;

• The distinctions between some diagnoses are unclear;

• boundaries between diagnoses may be arbitrary;

• Adding a general “psychopathology” component (p factor) to describe how different disorders are interconnected

• A dimensional classification system, which assesses symptom severity instead of rigid categories, could help.

• Improving diagnostic reliability

• Enhancing construct validity – Some DSM categories do not fully predict clinical features

ICD

• serves several global purposes

• The classification functions as a system for comparing mortality and morbidity data collected across different countries, regions, and time periods.

• It strives to make the data interoperable and reusable across various domains

pros of diagnosis

• provides a framework for understanding and treating mental health conditions

cons of diagnosis

• may lead to stigma and labeling

• can oversimplify complex experiences

• risks misdiagnosis and inappropriate treatment

• limits individual understanding of their condition

signs that one should seek help

• persistent feelings of sadness, anxiety, or hopelessness -

• experiencing significant changes in mood or behavior -

• difficulty functioning in daily life or maintaining relationships