Psychopathology test 1

Psychopathology

study of symptoms, causes of mental disorders, and available treatments

What exactly do clinicians do?

• Describe behavior

• Explain behavior

• Predict behavior

• Modify behavior

Describe behavior

Psychodiagnosis: attempt to describe, assess, and understand the client’s situation or experience of a disorder

Explain behavior

Etiology: What is the cause?

Can result from interactions among various biological, psychological, social and sociocultural factors

Predict behavior

various risk factors for violent behaviors (ex. having social support vs being in isolation)

Modify behavior

psychotherapy aims to improve a person’s behavioral, emotional, or cognitive state

What is abnormal?

outside norms, don’t do things others “should”, isolation, inability to feel

Components of a mental disorder

• involves significant disturbance in thinking, emotional regulation, or behavior caused by a dysfunction in the basic psychological, biological, or developmental processes involved in normal development

• causes significant distress or difficulty with day-to-day functioning

• not merely a culturally experienced response to common stressors or losses or a reflection of political or religious beliefs that conflict with societal norms

Aspects of judging psychopathology

• Distress

• Deviance

• Personal dysfunction

• Dangerousness

Distress

Anosognisia: inability to recognize the presence of a mental health illness

Deviance

how far is the symptom from the norm

Personal dysfunction

how the person lives life prior to symptoms

Dangerousness

likeness of someone engaging in harmful/reckless decisions

Cultural considerations in abnormal behavior

• Culture

• culture relativism

• culture universality

Culture

learned behaviors that people transmit to the next group

Culture relativism

cultures varying in what they define as normal/abnormal

Culture universality

symptoms of mental disorders that are the same in all cultures/society

Prejudice

belief in negative stereotypes

discrimination

action based on prejudice

self-stigma

undermines self-worth and self efficacy

social stigma

belief that mentally ill are somehow responsible for their condition

What are ways to reduce stigma?

• NAMI (National Alliance of Mental Illness)

• public disclosure for mental health conditions

• sensitivity with language used

• educating people

Trephining

A process done where doctors drill holes in a patient’s skull in order to release evil spirits

One dimensional models

• overly simplistic

  • create false dichotomy

  • neglect possibility of variety of circumstances contributing to mental disorders

  • fail to recognize reciprocal interactions of various contirbuting factors

Biopsychosocial model

• biological, psychological, social factors

• does not focus on how these factors interact to produce illness

• provide little guidance on treatment

• neglect culture

• neglect sociocultural influences (ex. poverty, discrimination)

Multipath model

• holistic framework of viewing mental disorders

• multiple pathways and influences contribute to the development of a disorder

• biological, social, sociocultural, psychological dimensions

Biological dimension

• family history, genetics, brain anatomy

The human brain

• Forebrain (cerebral cortex)

• midbrain

• hindbrain

• limbic system

Cerebral cortex

manages attention, behavior, emotions

Midbrain

basic functions (hearing, vision, sleep-wake cycles)

Hindbrain

instinctive functions (survival, bodily functions)

Limbic system

emotions, decision-making, memories

Dopamine

influences motivation and reward-seeking behaviors; emotions

Epinephrine/norepinephrine

excitatory functions (attention, arousal)

also affects reactions to stress

Seretonin

regulates temp, mood, appetite, sleep

cortisol

hormone released in response to stress

melatonin

regulates circadian sleep and wake cycles

What medication is given for a person experiencing depression?

SSRIs

Antidepressants

anxiety, depression

Antianxiety

panic, anxiety

Antipsychotics

psychosis, sleep

Mood stabilizers

mania, mood fluctuations

Pharmogenetics

looking at someone’s DNA to see how their body reacts

Electroconvulsiev therapy

induces mini seizures to restart production of neurotransmitters

Psychological factors

• personality

• cognition

• emotions

• learning

• self-

Psychodynamic models

• Freud

  • 3 components of personality

    • Id: instinctives, seeks pleasure

    • Ego: rational and realistic part

    • Superego: moral compass

  • Psychosexual stages

  • defense mechanisms (protect oneself)

• Psychoanalysis

  • free association

  • dream analysis

  • transference

Behavioral models

• Classical conditioning

  • stimulus/response association

  • naturally occurring response is paired w/ previously learned signal

• Operant conditioning

  • reinforcement

  • voluntary behavior is modified by its consequences

• observational learning

  • modeling

  • learn new things by watching others

Cognitive behavioral models

• Focus on observable behaviors

• link psychopathology w. irrational & maladaptive assumptions and thoughts

Irrational cognitive process (theory of emotional process)

• active event

• belief about oneself as a result

• emotional and behavioral consequences of the belief

Rational intervention

• disputing intervention (counteracts the negative belief)

• new effective philosophy (I can do this)

• new feelings (its ok to feel upset I can do it)

Social factors

relationships (family, friends, romantically, community)

Social-relational models

when relationships are dysfunctional, clients can be more symptomatic

family systems models

behavior of one family member impacts the entire family

Sociocultural factors

race, gender, sexual orientation, religion, socioeconomic status, ethnicity

Gender

Higher prevalence of many mental health conditions for women, more subjected to stress

Immigration & acculturtive stress

• hostile reactions from govt. and public

• loss of social support

• loss of power and status

• racism/deportation

race & ethnicity

• does not assume that patients share common traits to the group

• all behaviors considered from a cultural perspective

Amicus curiae

• Friend of the court

• filing brief summarizing research that can impact legal decisions

Criminal commitment

Incarceration of someone having committed a crime

Criminal law

• some lack the ability to assist in own defense

• although they may be guilty, their mental state at the time exempts them from legal responsibility

• ex. murder, tresspassing

Competency to stand trial

• defendant’s mental state at the time of post-arrest psychiatric eval

• defendant must have factual and rational understanding

• must be able to rationally consult w. counsel

• cannot be confined solely on the grouds of incompetency

Insanity defense vs competency to stand trial

• Insanity defense

  • innocent by reason of insanity, refers to mental state at time of crime

• Competency to stand trial

  • mental state at time of psychiatric examination after arrest and before trial

Civil commitment

• action is required when people who are severely disturbed behave in a way that poses threat to themselves or others

• involuntary confinement of a person judged to be a danger to self/others (even though they haven’t officially committed a crime)

Negative consequences of civil commitment

• major interruption in a person’s life

• loss of self-esteem and self-concept

• dependency on others

• possible loss/restriction of freedom

Criteria for commitment

• clear and imminent danger to self/others

• inability to care for self

• inability to make responsible decisions

Procedures for commitment

• petition court for examination

• if judge determines request is valid, mental health eval is ordered

• formal hearing held

• finite period of treatment is ordered

Assessing dangerousness

• violence is a function of context and a person’s characteristics

• best predictor of dangerousness is past criminal conduct or history of violence/aggression

• defiinition of dangerousness is unclear

Confidentiality

ethical standard that protects clients from disclosure of information w/o their consent

privileged communication

therapists legal obligation to protect privacy & prevent disclosure of confidential info w/o client’s permission

exemptions from privileged communication

• right to request privileged info to be shared

• therapist has reason to believe that a client presents a danger to themselves/others

Duty to warn

• mental health professionals break confidentiality when clients pose clear/imminent danger to the other person

• 18 is the cutoff for a therapist to physically intervene

Sexual relationships w/ clients

• can have relationship with client 2 years after termination of therapy