Psychopathology Midterm

Mental Disorder

a syndrome characterized by clinically significant disturbance in an individual’s cognition, emotion regulation, or behavior that reflects a dysfunction in the psychological, biological, or developmental processes underlying mental functioning.

Classification

An overarching taxonomy of mental illness

Diagnosis

The clinical act of placing an individual within a category of that taxonomy based on a constellation of signs and symptoms.

Signs

objective, observable indicators of a condition (e.g., crying or psychomotor retardation),

Symptoms

subjective, self-reported indicators (e.g., feelings of worthlessness or suicidal ideation)

Syndrome

Constellations of signs and symptoms that dependably co-occur across individuals (e.g., ASPD, where signs like unlawful acts and symptoms like lack of remorse covary, though the underlying etiology and pathology remain poorly understood)

Disorder

Syndromes that cannot be readily explained by other conditions. (e.g., OCD can only be diagnosed if its symptoms cannot be better accounted for by another condition like a specific phobia, anorexia nervosa, or trichotillomania)

Disease

Disorders in which both the underlying pathology (pathophysiology) and etiology (causation) are reasonably well understood (e.g., Alzheimer's disease or Sickle-cell anemia).

Statistical Model

Equates mental disorder with statistical rarity

Subjective Distress Model

Distinguishes disorder based on psychological pain and distress.

Biological Model

Defines disorder in terms of biological or evolutionary disadvantage, such as a reduction in longevity or genetic fitness (ability to pass on genes).

Harmful Dysfunction Model (Wakefield, 1992)

A hybrid definition asserting that all mental disorders are socially devalued ("harmful") breakdowns of evolutionarily selected systems ("dysfunctions"). (e.g., panic disorder represents a socially devalued false alarm of the evolutionary fight-or-flight response)

Roschian Analysis (Eleanor Rosch)

Argues that "disorder" is intrinsically undefinable because it lacks defining (singly necessary and jointly sufficient) features. Instead, the concept of disorder is organized around clear-cut "prototypes" (e.g., schizophrenia or panic disorder).

The Biopsychosocial Model

a holistic framework that views health and illness as the result of a dynamic interaction between biological, psychological, and social factors

The Diathesis-Stress Perspective

mental health disorders develop from an interaction between a person's inherent vulnerability and environmental life stress

Kindling Model (Post & Weiss, 1998)

Posits that while early episodes of an illness (e.g., depression or mania) require significant external stressors to be triggered, later episodes are generated autonomously as "one episode begets the next," reducing the threshold of stress required for subsequent relapse

Categorical Diagnostic Systems

A system that classifies clinical presentations based on the assignment to discrete categories. A person either meets the threshold criteria for a diagnosis (e.g., meets 5 out of 9 symptoms) or they do not (their symptoms are considered subclinical).

Dimensional Diagnostic Systems

A system that rates symptom presentations on a continuous spectrum or gradient of severity rather than placing them into rigid bins. It measures continuous traits that differ in degree, not in kind (such as height, blood pressure, or introversion)

The Attenuation Paradox

the psychometric phenomenon where trying to maximize the internal consistency (reliability) of a diagnostic scale by selecting highly similar, narrow items can paradoxically decrease its validity because it fails to capture the full, multifaceted breadth of the actual clinical construct

Provisional Diagnosis

Used when there is a strong presumption that the full criteria for a disorder will eventually be met, but insufficient information is currently available to make a definitive diagnosis (e.g., a patient is currently unable to provide an adequate history, but an informant is expected).

Depressive Episode

Involves a depressed mood, anhedonia (loss of interest or pleasure), or both, present most of the day, nearly every day for two weeks

Symptoms of a Depressive Episode

Depressed Mood, Anhedonia, Appetite/Weight Changes, Sleep Disturbance, Psychomotor Changes, Fatigue, Worthlessness/Guilt, Cognitive Impairment, Suicidal Ideation

Manic Episode

A distinct period of abnormally and persistently elevated, expansive, or irritable mood AND abnormally and persistently increased goal-directed activity or energy for at least 1 week

Symptoms of a Manic Episode

Inflated Self-Esteem or Grandiosity, Decreased Need for Sleep, Pressured Speech, Flight of Ideas / Racing Thoughts, Distractibility, Increased Goal-Directed Activity / Agitation, Excessive High-Risk Involvement

Hypomanic Episodes

A distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased activity or energy that is clearly different from non-depressed baseline mood for at least 4 days

Major Depressive Disorder (MDD)

Disorder characterized by one or more major depressive episodes in the absence of any history of manic or hypomanic episodes

Persistent Depressive Disorder (PDD)

Represents a consolidation of the DSM-IV diagnostic categories of chronic major depressive disorder and dysthymic disorder

Prolonged Grief Disorder

Disorder characterized by the continued presence, for at least 12 months after the death of a loved one (6 months in children/adolescents), of intense yearning/longing for the deceased and/or persistent preoccupation with thoughts or memories of the deceased

Bipolar I Disorder

Characterized by the lifetime occurrence of at least one full manic episode

Bipolar II Disorder

Characterized by at least one current or past hypomanic episode AND at least one major depressive episode, with no history of a manic episode

Cyclothymic Disorder

A chronic, fluctuating mood disturbance involving numerous periods of hypomanic symptoms and periods of depressive symptoms that are less severe / subsyndromal (do not meet full criteria for a hypomanic or major depressive episode)

Panic Attacks

An abrupt surge of intense fear or intense discomfort that reaches a peak within minutes, during which time at least 4 of 13 physical and cognitive symptoms occur (palpitations, sweating, trembling,

Generalized Anxiety Disorder (GAD)

Characterized as the "basic" anxiety disorder due to intense, unfocused, chronic, and uncontrollable anxiety/worry (apprehensive expectation) occurring more days than not for at least 6 months across multiple life domains (e.g., work, school, health, finances, minor daily matters).

Panic Disorder

Requires recurrent unexpected panic attacks AND at least 1 month of persistent concern or worry about additional panic attacks or their consequences (e.g., losing control, having a heart attack, "going crazy"), AND/OR a significant maladaptive change in behavior designed to avoid attacks (e.g., avoidance of exercise or unfamiliar locations)

Agoraphobia

Marked fear or anxiety about at least two of five situations:

1. using public transportation

2. being in open spaces

3. being in enclosed places

4. standing in line or being in a crowd

5. being outside of the home alone

Specific Phobia

Clinically significant, marked fear or anxiety about a specific object or situation (phobic stimulus), which almost always provokes immediate fear/anxiety, is actively avoided or endured with intense distress, is out of proportion to actual danger, and persists for 6 months or more.

Social Anxiety Disorder (formerly, Social Phobia)

Marked fear or anxiety about one or more social situations where the individual is exposed to possible scrutiny by others (e.g., conversations, being observed, public performance). The individual fears acting in a way or showing anxiety symptoms that will be negatively evaluated (humiliated, embarrassing, leading to rejection, or offending others). Persistent for 6 months or more.

Obsessive-Compulsive Disorder (OCD)

a long-lasting mental health condition featuring a cycle of unwanted intrusive thoughts that drive repetitive behaviors

Obsessions

Recurrent, persistent, intrusive, and unwanted thoughts, urges, or images that cause marked anxiety or distress (common themes: contamination, aggressive impulses, somatic concerns, need for symmetry/exactness).

Compulsions

Repetitive overt behaviors (washing, checking, ordering) or covert mental acts (counting, praying, repeating words silently) driven by rigid rules or performed to neutralize obsessions and reduce distress.

Posttraumatic Stress Disorder (PTSD)

a mental health condition that's caused by an extremely stressful or terrifying event — either being part of it or witnessing it

Symptoms of PTSD

Intrusion (Recurrent intrusive distressing memories, trauma dreams, flashbacks, or intense psychological/physiological reactivity to trauma reminders), Avoidance (Avoidance of internal distressing memories/thoughts/feelings OR external reminders), Negative Alterations in Cognitions/Mood (Dissociative amnesia, persistent exaggerated negative beliefs about self/world, distorted self/other blame, persistent negative emotional states, anhedonia, detachment, or inability to experience positive emotions), Arousal/Reactivity (Irritable/aggressive behavior, reckless or self-destructive behavior, hypervigilance, exaggerated startle response, concentration problems, or sleep disturbance)

Substance Use Disorders

A maladaptive pattern of use leading to impairment or distress, in at least 2 of the following, occurring within 12 months

Substance Intoxication

A reversible substance-specific syndrome of maladaptive behavioral or psychological changes due to the recent ingestion of or exposure to a substance that acts upon the CNS

Withdrawal

Maladaptive behavioral change with physiological & cognitive effects that occurs when concentration of a substance declines in the body after heavy & prolonged use

Schizophrenia

a severe, chronic brain disorder that affects how a person thinks, feels, and behaves, causing a loss of touch with reality

Positive Symptoms of Schizophrenia

Delusions, Hallucinations, Disorganized Thinking / Speech, Grossly Disorganized or Abnormal Motor Behavior

Negative Symptoms of Schizophrenia

Avolition or Apathy, Alogia, Anhedonia, Affective Flattening

Prodromal Phase

the early pre-psychotic period marked by subtle cognitive, behavioral, and emotional changes that occur before a full psychotic episode

Residual Phase

the stage that follows an active psychotic episode, where severe symptoms like hallucinations and delusions fade, but milder or negative symptoms remain