Adult Psychopathology

models of illness/disability

• moral model

• medical model

• social model

moral model of illness/disability

punishment for wrongdoing

more common in history but manifests in drug blame

medical model of illness/disability

biological cause

social model of illness/disability

lack of support/resources led to mental health issue

supernatural explanation for illness

illness = punishment for sin

treatment for supernatural explanation

exorcism and banishment

early biological explanations for illness

body/brain pathology, humor theorytre

treatment for early biological explanations of illness

bloodlifting and induced vomit

psychoanalytic explanations of illness - unifying theory

failed to adapt to environment

treatment for psychoanalytic explanations of illness

analysis via talk therapy

Pinel and Dorthea Dix

worked for humane treatment of patients in asylum

biological interventions in asylums

lobotomy, electroconvulsive therapy

psychoanalysis

founded by freud

psychodynamic theory

psychological issues result from unconscious forces and defense mechanisms that arise in response to them

psychoanalytic treatment

help recognize conflicts and origins to change patterns

why was the DSM made

WW2 brought need for standardized nomenclature for soldiers

2 categories in DSM1

neurosis: short term

personality disturbance: long term

antipsychiatry

moement against psychiatry

Thomas Szaz

antipsychiatry

wrote The Myth of Mental Illness

claimed mental illness was a reaction to an insane society and psychiatrists were mental police

David Rosenhan Study

team enters psychiatry hospitals reporting symptom of hearing voices then acted normal once admitted

observed effects that normal behavior was not flagged

deinstitutionalization

mass cut to mental hospitals in 1960s-80s

many were released into community with the idea that community treatment was better than institutionalization

homosexuality as a mental illness in DSM 1 and 2

fear of opposite sex caused by traumatic parent child relationship

medicalization

criticism from psychiatry: views of psychiatry as unscientific

ex: DSM3 with diagnosis on symptoms

psychological theories

idea that there is a lack of evidence fro psychoanalysis

developed by Aaron Back in 1960s

developed into CBT

modern diagnostic systems 2 categories

categorical: criteria for diagnosis separates into groups

dimensional: define symptoms on continuum of healthy to severe

example of a categorical diagnosis system

DSM and ICD (intl classification of diseases)

pros and cons of categorical diagnostic system

pros: easy to communicate, current healthcare structure

cons: heterogeneity, comorbidity, issue of validity, lack of diagnosis for some

comorbidity

having more than one disease

research domain criteria (RDoC)

dimensional diagnostic system made by natl institute of mental health to define dimensions suitable for research target

views mental health in terms of domains of human neurobehavioral functioning

hierarchal taxonomy of psychopathology (HiTOP)

dimensional diagnostic system that generates data driven framework to classify mental disorders

groups at different levels: symptoms, traits, spectra

aim to connect structure and fit current diagnoses into structure

pros and cons of dimensional diagnostic systems

pros: better alignment w evidence of continuum, captures fundamentals

cons: harder to communicate, incompatible w current healthcare system, less clarity on treatment

research process for DSM

identify disorder of interest

compare those w and w/o disorder

research process for RDoC

define domain of analysis

recruit those in domain

study processes on basic level

research process for HiTOP

define level of specificity and dimensions of interest

recruit range in specified domains

treatment process for DSM

clinical interview

diagnosis

treatment

treatment process for RDoC

test to determine extent of dysfunction in domains

treat to normalize

hypothetical

treatment process for HiTOP

clinical interview or self report

determine elevation on higher and lower order domains

broad to specific interventions to target elevated