Mental health and wellness final units 6-10

According to the lecture, what is a diagnosis?

is a name for a pattern of symptoms.

• it helps clinicians communicate and begin treatment, but it is based on symptoms rather than underlying biology.

Why are diagnostic labels considered incomplete?

Because they are built from observable symptoms rather than biological causes

• Two people with the same diagnosis may have completely different biological mechanisms, histories, and treatment responses.

What is the central limitation of symptom-based diagnoses?

They describe what symptoms are present, but they do not necessarily explain:

• Why those symptoms developed

• What biological mechanisms caused them

• Which treatment will work best

• How similar two patients actually are biologically

What is the DSM used for?

It defines mental disorders using specific symptom criteria that determine whether someone meets diagnostic requirements

How does the DSM determine whether someone has a disorder?

It uses standardized symptom checklists with a yes/no decision process based on whether enough required symptoms are present

What does the ICD classify?

It classifies all diseases, including both physical illnesses and mental disorders

How does the ICD diagnose mental disorders?

It relies on clinical diagnostic guidelines, including:

• Essential features

• Associated symptoms

• Clinical context

• Functional impairment

• Differential diagnosis

• Course and duration

• Clinical judgment

What is one major similarity between the DSM and ICD?

Both diagnose mental disorders primarily using symptoms, rather than biological tests or biomarkers.

What is one major difference between the DSM and ICD?

DSM

• Published by APA

• Uses standardized symptom criteria

• Checklist approach

ICD

• Published by WHO

• Uses clinical diagnostic guidelines

• Places greater emphasis on clinical judgment and context

What is heterogeneity?

refers to the wide variety of presentations that exist within the same diagnosis

• People can receive the same diagnosis while having very different symptom combinations and experiences

Why does heterogeneity occur?

Because diagnostic systems often require only a minimum number of symptoms, allowing many different symptom combinations to qualify for the same diagnosis.

How is depression an example of heterogeneity?

requires 5 of 9 possible symptoms, meaning many different combinations of symptoms can lead to the same diagnosis

Why is heterogeneity a challenge for diagnosis?

It suggests that one diagnostic label may group together people whose disorders are biologically and clinically quite different, reducing the precision of diagnosis and treatment

What is comorbidity?

is the presence of more than one diagnosis in the same person at the same time.

Is comorbidity rare?

No

• The lecture emphasizes that it is very common and is the rule rather than the exception

Why does comorbidity challenge diagnostic categories?

If mental disorders were truly separate categories, they should not overlap so frequently

• High rates of overlap suggest disorders may share common underlying mechanisms.

What are fuzzy boundaries?

refer to the difficulty of drawing a clear line between having a mental disorder and not having one

• Symptoms exist along a continuum rather than as simple "present" or "absent."

Why are fuzzy boundaries a problem for diagnosis?

Because two individuals who fall just above and just below a diagnostic cutoff may be almost identical, yet only one receives a diagnosis.

According to the lecture, do symptoms occur as "on/off" categories?

No

• Symptoms occur in degrees of severity, but categorical diagnoses impose an artificial yes/no boundary

Why do categorical diagnoses create artificial divisions?

Because they force continuous variations in symptom severity into fixed categories, even though mental health exists on a spectrum

What does HiTOP stand for?

Hierarchical Taxonomy of Psychopathology

• It is an evidence-based alternative to traditional categorical diagnostic systems such as the DSM.

• Instead of placing people into simple diagnostic categories it measures psychopathology along dimensions of severity

What is the primary goal of HiTOP?

aims to provide a more accurate understanding of mental disorders by describing symptoms along continuous dimensions instead of forcing people into rigid diagnostic categories

What is the difference between a categorical model and a dimensional model?

Categorical Model (DSM/ICD)

• Yes or no diagnosis

• Person either has the disorder or does not

• Fixed diagnostic categories

Dimensional Model (HiTOP)

• Measures how much of a symptom a person has

• Symptoms exist on a continuum

• Produces an individualized profile rather than one label

According to HiTOP, how are symptoms organized?

Symptoms are grouped according to how they naturally cluster together in real data, rather than according to predefined diagnostic categories.

Why is HiTOP considered evidence-based?

Because its dimensions are based on patterns observed in real research data, rather than solely on expert-created diagnostic categories

How does HiTOP address heterogeneity?

Instead of placing every person with the same diagnosis into one category, it creates an individualized symptom profile that better captures each person's unique presentation.

How does HiTOP address comorbidity?

Overlapping symptoms are represented on shared dimensions, rather than forcing clinicians to assign multiple separate diagnoses

How does HiTOP address fuzzy diagnostic boundaries?

Because symptoms are measured continuously, it avoids creating arbitrary cutoffs that separate people who are actually very similar

According to the lecture, why is HiTOP thought to better reflect real mental health?

Because mental difficulties naturally exist on continua rather than in rigid categories, making it closer to how psychological problems actually appear in real life

What are neurodevelopmental disorders (NDDs)?

are conditions that emerge during development and affect brain functioning.

Which disorders are listed as examples of neurodevelopmental disorders?

Autism

ADHD

OCD

Why are neurodevelopmental disorders useful for studying diagnostic labels?

Because they are officially classified as separate disorders while sharing many common characteristics, making them ideal for testing whether diagnostic labels truly reflect biological differences.

What overlapping features do autism, ADHD, and OCD share?

Attention difficulties

Repetitive behaviours

Social difficulties

Which groups were included in the POND study?

Autism

ADHD

OCD

Typically Developing (TD) children

What was the major finding of the POND study?

The different diagnostic groups did not differ significantly from one another in their brain networks

Why was the POND study important?

It suggested that traditional diagnostic labels may not accurately represent underlying biological differences

What is clustering?

is a statistical technique that allows data to organize itself into natural groups based on similarity, without assigning diagnostic labels beforehand.

How is clustering different from traditional diagnosis?

Traditional diagnosis

• Categories are assigned first.

• Researchers compare groups afterward.

Clustering

• No diagnostic labels are used initially.

• Natural biological groupings emerge from the data itself.

What would researchers expect if diagnostic labels perfectly reflected biology?

The clusters created from biological data would line up almost perfectly with diagnostic categories.

What does it mean when clusters do NOT match diagnoses?

It means the diagnostic labels are missing important biological structure and do not fully capture how people naturally differ

What conclusion did clustering support in Study 1?

Biological similarity extends beyond diagnostic labels, meaning individuals with different diagnoses may actually be biologically more similar than expected.

What did Study 2 investigate?

examined how the brain's Multisensory Integration Network (MSN) differed when analyzed using traditional diagnoses versus data-driven clusters

Why was the sensory integration network studied?

Because sensory differences are commonly observed in autism, ADHD, and even typically developing children

What happened when researchers compared participants by diagnosis?

Only small differences were found, and the diagnostic groups looked quite similar.

What happened when researchers analyzed participants using clusters instead?

The groups became much more distinct, showing clearer biological differences than traditional diagnostic categories revealed

What major limitation of HiTOP did the review identify?

Much of the existing HiTOP research has also relied on nonrepresentative samples, meaning it may still fail to capture the experiences of many cultural groups

Besides nonrepresentative samples, what else does HiTOP currently overlook?

The lecture states that HiTOP currently leaves out important social and environmental factors, even though these strongly influence mental health

According to the lecture, what kinds of research tend to be favored?

Research tends to favor:

• Quantitative methods

• Universal explanations

• Individual-focused research

These approaches often receive more attention and funding.

What kinds of research are more likely to be marginalized?

• Qualitative research

• Context-focused research

• Minority-focused research

These studies are often published less frequently, cited less often, and receive less funding.

Why might symptom checklists miss certain people?

Because symptom checklists developed within one culture may not recognize culturally different expressions of distress, increasing the risk of misunderstanding or misdiagnosis.

What are "epistemically excluded" groups?

These are communities that have been left out of the process of creating scientific knowledge

• Their experiences are underrepresented in research and diagnostic systems.

According to the lecture, why can the same behaviour have different meanings?

Because behaviour must be understood within its social, cultural, and environmental context

• The same action may represent illness in one situation but a normal response in another.

What is stigma?

refers to the negative beliefs, emotions, and behaviours directed toward people with mental illness, creating additional harm beyond the illness itself

What is public stigma?

refers to society's negative attitudes and reactions toward people with mental illness

What is self-stigma?

occurs when individuals with mental illness internalize society's negative beliefs and begin applying those stereotypes to themselves

What are the three stages through which stigma develops?

1. Stereotype

2. Prejudice

3. Discrimination

The lecture summarizes this as: A belief becomes an emotion becomes an action.

What is a stereotype?

is a generalized belief about a group of people, such as believing that individuals with mental illness are dangerous or incompetent.

What is prejudice?

occurs when someone accepts a stereotype and develops negative emotional reactions such as fear or pity toward the group

What is discrimination?

occurs when stereotypes and prejudice lead to harmful actions, such as avoiding, excluding, or refusing to hire someone because of mental illness.

According to the lecture, what are two common stereotypes about people with mental illness?

• People with mental illness are dangerous.

• People with mental illness are incompetent.

The lecture emphasizes that both stereotypes are largely inaccurate, as most individuals with mental illness fit neither description

Where do many stereotypes about mental illness come from?

The lecture explains that media portrayals often reinforce inaccurate stereotypes by depicting people with mental illness as violent, unpredictable, or incapable.

• Repeated exposure causes these portrayals to become accepted as "common sense."

Can health professionals hold stigmatizing beliefs?

Yes

• The lecture notes that health professionals are not immune to stigma and may also hold inaccurate stereotypes, meaning diagnostic labels can have social as well as clinical consequences

According to the lecture, is simply educating people enough to reduce stigma?

No

• The lecture states that providing facts alone is often insufficient to meaningfully reduce stigma

What is the most effective way to reduce stigma?

Direct contact with people who have lived experience of mental illness.

• Personal interaction helps challenge stereotypes more effectively than statistics alone.

Is stigma permanent?

No

• The lecture emphasizes that stigma is learned, meaning it can also be unlearned through positive experiences and education

According to the lecture, what are the benefits of diagnostic labels?

Improve access to care.

Help clinicians communicate.

Connect people with communities and support.

Validate a person's experiences.

Provide relief by giving a name to what they are experiencing.

What are the potential harms of diagnostic labels?

Stigma.

Oversimplifying a person's experience.

Focusing on the diagnosis instead of the individual.

Missing important biological, psychological, cultural, and environmental differences

According to Kas et al. (2025), what is the major limitation of today's diagnostic system?

Modern diagnoses rely primarily on clinical assessments of symptoms and do not routinely incorporate biological or quantitative behavioural data, meaning people with different biology may receive the same diagnosis.

What is precision psychiatry?

is an approach that aims to match treatment to the individual person rather than simply treating the diagnostic label

What is precision medicine?

Precision medicine tailors diagnosis and treatment to each individual's unique characteristics rather than assuming all people with the same diagnosis should receive identical care.

Which field is used as an example of successful precision medicine?

Cancer treatment

• where molecular profiles are used to guide individualized treatment decisions.

What three kinds of information does precision psychiatry aim to integrate?

Symptoms

Biology

Behaviour

According to the lecture, what causes mental disorders?

Mental disorders arise through continuous two-way interactions between brain biology and the environment

• Neither biology nor environment alone provides the complete explanation.

What are biotypes?

are biologically meaningful subgroups that exist within a traditional diagnosis

• They are identified using data-driven methods rather than symptom checklists alone.

What is a biomarker?

is a measurable biological indicator that provides information about a person's mental disorder

What examples of biomarkers are discussed?

Blood tests

Brain imaging (MRI)

Smartphone-generated behavioural data

According to Kas et al. (2025), can precision psychiatry succeed without biomarkers?

No

What have researchers discovered about depression and anxiety?

Using data-driven methods, researchers identified multiple biologically distinct subgroups (biotypes) within traditional depression and anxiety diagnoses.

What does the discovery of depression biotypes suggest?

It suggests that a single diagnosis like depression may actually represent several biologically different disorders that require different treatments.

Do mental illnesses run in families?

Yes

• The lecture states that heritability is real, meaning mental illnesses often run in families because genetic factors contribute to risk.

• However, inherited risk is not the same as certainty that someone will develop the disorder.

What does polygenic mean?

means that a disorder is influenced by many different genes, each contributing only a very small amount of risk

• No single gene is responsible for causing the disorder.

Why are mental illnesses considered polygenic?

Because there is no single "depression gene," "schizophrenia gene," or "addiction gene."

Instead, risk is spread across many genes that only become meaningful when combined with one another and with environmental experiences.

What does the phrase "Genes load the dice—they don't decide the roll" mean?

Genes increase or decrease a person's probability of developing mental illness, but they do not determine the final outcome

Environmental experiences, life events, and brain changes all influence whether a disorder develops.

What is a Gene × Environment interaction?

means that the effects of genes depend on the environment a person experiences

• The same genetic predisposition may increase or decrease risk depending on factors such as stress, trauma, caregiving, or social support

What analogy does the lecture use to explain Gene × Environment interaction?

"Same seed, different soil and sunlight."

Just as the same seed grows differently depending on where it is planted, the same genes can lead to different outcomes depending on environmental conditions.

What is epigenetics?

efers to changes in gene activity caused by life experiences without changing the DNA sequence itself

• Experiences can switch genes "on" or "off," influencing how they function

Does epigenetics change a person's DNA?

No.

• It changes how genes are expressed, not the underlying DNA sequence itself.

What analogy does the lecture use to explain DNA?

is like a book.

• The words in the book (genetic code) remain the same throughout life

What analogy is used to explain epigenetics?

is like a highlighter or sticky notes inside the book.

• The highlighter determines which pages are emphasized and read more closely without changing the words themselves

In the lecture analogy, what represents the "reader"?

Life experiences

• Experiences such as stress, trauma, caregiving, and social connection determine which parts of the genetic "book" become highlighted

What was the traditional research approach for studying mental illness?

Researchers compared the average brain activity or structure of people with a diagnosis to healthy controls and searched for one brain region that consistently differed between groups.

Why did the traditional approach create a problem?

Because people with the same diagnosis often look very different from one another, making it difficult for one "broken brain region" to explain everyone's symptoms.

What was the purpose of Segal's study?

To determine whether mental illnesses are better understood through individualized brain differences rather than group-average brain regions.

What is normative modeling?

is a personalized method that compares each person's brain to what is expected for someone of the same age and sex, rather than comparing them only to a group average

What analogy does the lecture use to explain normative modeling?

A child growth chart.

Just as doctors compare a child's height to what is typical for their age, researchers compare a person's brain measurements to what is expected for someone of the same age and sex

What is a person-specific deviation map?

A person-specific deviation map shows how much each brain region differs from what would normally be expected for someone of the same age and sex

What was the first major finding of Segal's study?

Brain deviations are highly individualized at the regional level.

• Although most patients showed unusual brain regions, the specific location of those deviations differed greatly from person to person

What was the second major finding of Segal's study?

Although abnormal brain regions differed across individuals, those different regions often connected to the same brain circuits and networks

What was the third major finding?

Brain abnormalities showed convergence at the network level, supporting the idea that psychiatric disorders involve disruptions in large-scale brain networks rather than isolated brain regions.

According to the lecture, what is depression fundamentally?

is a circuit imbalance, not damage to a single brain region. It reflects an imbalance between emotional processing systems and cognitive control systems.