Chapter 7: (7.1-7.3) Serious Mental Illness

precision faster side effects

Identifying genetic variants that increase risk for the development of a psychiatric disorder may: increase ___________ in diagnosis and treatment and aid in the development of treatments that work _______ and have fewer ______ _________ in medicines.

mental illness

Patterns of thinking, emotion, or behavior (or a combination) that interfere with social relationships, occupations, or other important areas of life, and which persist for an extended time and cause substantial problems and/or distress.

thinking emotion behavior

Mental illness is when people experience patterns of ________, _________, and/or ___________ that interfere with social relationships, occupations, or other important areas of life, and which persist for an extended time and cause substantial problems and/or distress.

interfere with important areas of life

Patterns of thinking, emotion, or behavior (or a combination) that ___________ ________ _________ __________ __________ __________, and which persist for an extended time and cause substantial problems and/or distress.

extended time problems distress

Mental illness is when people experience patterns of thinking, emotion, or behavior (or a combination of these) that interfere with social relationships, occupations, or other important areas of life, and which persist for an ___________ _______ and cause substantial ____________ and/or _________.

comorbidity

The simultaneous presence of multiple disorders in a person.

10 15

In 2017 it was estimated that between __ percent and

__ percent of people worldwide experienced one or more mental illness

Disability-Adjusted Life Years

(DALYs) A measure of disease burden that estimates the number of years lost to illness, disability, or premature death. Mental illnesses account for approximately 7 percent of DALYs worldwide

no

Is it necessary to qualify for a diagnosis of mental illness to experience negative impacts of poor mental health?

half

Even though mental illness can have dramatic impacts on people's lives, it is estimated that

fewer than _____ of those who have a mental illness receive mental health services

mental health services

Typically consist of talk therapies, medications, and social services, and may take place in a residential facility, or in the context of outpatient visits.

precision medicine

an approach to disease treatment and prevention that accounts for individual variation in genes and environment; not successful or common in Mental health yet

risk alleles

gene variants that confer increased risk for a particular trait or disorder

protective alleles

Genetic variants that are associated with decreased risk for a disorder.

genetic risk

The sum of alleles that increase the probability of developing a disorder (i.e., risk alleles) and those that decrease the probability (i.e., protective alleles)

environmental risk

Non-genetic risk factors such as childhood trauma, exposure to substances like cannabis, or social factors such as insecure parental attachment, or discrimination.

diathesis-stress model

A model of disease risk whereby an individual's vulnerability to develop a mental illness is a function of their genetic risk (i.e., diathesis) and exposure to adverse life events (i.e., stress).

differential sensitivity hypothesis

A model of disease risk in which people carrying certain genotypes are more sensitive to both negative and positive environmental exposure than are those carrying other genotypes.

differential sensitivity hypothesis

Which model explains why risk alleles are still prevalent in the population, despite possibly disadvantaging those that have them?

sensitivity alleles

Proposed by differential sensitivity hypothesis to be genetic variants that are responsive to both negative and positive exposures; they might be neutral with respect to selection overall and therefore found to have intermediate frequencies.

Qualitative quantitative

_____________ traits are likely determined by few genetic variants, whereas _____________ traits are likely determined by many genetic variants in combination with environmental influence.

Diagnostic and Statistical Manual of Mental Disorders

DSM Handbook used primarily in the US as a guide for diagnosing mental illness

International Classification of Diseases

ICD; Handbook used worldwide as a guide for diagnosing mental illness. Used in this Book; on its 11th revision

heterogeneity

Diagnostic systems may be good for treatment and diagnosis, but they may not reflect the ____________ of the underlying causal structures of mental illnesses.

reification

an error of treating an abstract concept as though it has a real, material, biological existence; doesn't account for the fact that phenotypes may just be artifacts of the diagnostic system

levels of analysis

Pathways from genes to behaviors involve molecules, cells, circuits, physiology, and are impacted by social and cultural factors. Each of these levels can be studied using techniques and methods suited for that level, which may not translate across levels. Such complexity presents serious challenges to understanding causal heredity-behavior relations.

genes molecules cells circuits physiology behavior

Behavior genetics general levels of analysis (smallest to largest, each one builds into the next, each one is influenced by environment and may change across development)

indirect

Any association between genetic variation and individual differences in behavior must be _________. To cause individual differences in behavior, genetic variants must affect biology at some level of analysis.

Research Domain Criteria

(RDoC) The National Institute of Mental Health effort to understand mental illness risk by studying endophenotypes; Consists of 6 domains of function; developed because current diagnostic categories do not well reflect underlying biology

endophenotypes

The general idea is that there are internal (i.e., not immediately visible) phenotypes that may be considered risk factors for developing the disorder, and that these so-called _____________ are influenced by fewer genes, and therefore may be simpler genetically than the disorder.

risk indicators

Traits that are predictors of a disorder.

closer

It is possible for two people with completely different symptoms to meet criteria for the same diagnosis. Therefore, focusing on traits (endophenotypes) that are some number of levels of analysis "________" to the genes, rather than on the diagnosis, may be a more fruitful approach to genetic analysis

intermediate phenotype

A term that is sometimes used as a synonym for endophenotypes, but because it is less precise, it should be avoided.

causal correlated

a risk factor is ________ while a risk indicator is __________. An endophenotype can be either, and it is difficult to distinguish in human subjects.

additive function

Qualitative diagnoses can be an ________ __________ of the number of quantitative endophenotypes (traits) meet diagnostic threshold. Insufficient number/variety of traits or insufficient severity in enough traits can prevent diagnosis.

RDoC domains

1. negative valence systems

2. positive valence systems

3. cognitive systems

4. systems for social processes

5. arousal/regulatory systems

6. sensorimotor systems

units of analysis

methods that can be used to assess constructs across levels of analysis

no definitive

In other words, there appears to be __ __________ answer to the question of whether mental illnesses are qualitative or quantitative traits.

dysfunction, distress, deviance

The 3 D's of clinical psychology

copes

That's all a symptom is. It's a way, a common way that someone _______ with whatever they're feeling, thinking, or is happening inside of them.

pleiotropy

What does high comorbidity (e.g being more likely to have 2 diagnoses than 1) mean genetically? likely ____________

an unlit bomb

What is the metaphor for the diathesis stress model?

dandelions and orchids

What is the differential sensitivity hypothesis metaphor?

disordered functioning

Psychology has a bias, and it is that we study ________ _____________. We study half of the graph and generalize to the rest.

dandelions

Grows equally well in a perfect garden as in a crack in some concrete. The idea here is that this is a person who is not remarkably susceptible to the environment.

orchids

A risk-reward type of flower. In perfect conditions, you get a beautiful bloom. But if conditions are bad, you're gonna get crap. They're more influenced by the environment, for better or for worse.

draw a line second standard deviation

What do diagnostic manuals do to determine diagnosis? they _______ ___ ________ on the normal distribution of symptoms, often at the _______ __________ _________