PSYC2214 Study Guide - Final Guide: Sleep Disorder, Panic Attack, Solitude
PSYC2214 – ADULT PSYCHOPATHOLOGY – CHELSEA GRAY: 21954282
LECTURE 1 - Assessment and Diagnosis of Psychopathology:
Examples:
• A lady claims to have multiple vision of the mother of god (Mary) and her son, Jesus Christ as well as of angels and saints, who appear in bursts of light,
showers of gold dust and puffs of rose scented air → is this abnormal behaviour? Is she hallucinating? Is this accepted? In her community they may all
be Christian and believe that this actually could happen and would not be considered abnormal behaviour
• Secretive sect may have had plans for biological weapons, Japanese man wears a special head wear device that he says allowed him to receive brain-
wave patterns → is this abnormal? Is he delusional? Perhaps this is more abnormal than our fist case.
• ) am a cyborg, ) dont use technology, ) dont wear it, ) am technology, he had a device implanted into his head → is this abnormal? Or is this eccentric?
Democracy as a mental illness:
• Wang Wanxing → in prison from 1992 – 2005
• 1992 → Tianamen square
• According to the authorities, my husband is suffering from political monomania. When ) asked what that is, im told that you have to be mad to want to
protest on Tianamen Square
• Protestors jailed and sometimes put in psychiatric facilities because they are mad
• Abnormality is hard to define and is commonly defined by society and norms
DSM-5 & DSM-5 TR:
• No definition adequately specifies precise boundaries for the concept of a mental disorder
• The diagnosis of a mental disorder should have clinical utility. It should help clinicians with determining:
o Prognosis
o Treatment plans
o Potential treatment outcomes
• Diagnosis is not equivalent to a need for treatment
DSM-5 (2013):
• Harmonization between DSM and ICD
• Transition toward a dimensional approach
• Rigid categories do not capture clinical experience or scientific observations
• Many symptoms occur at varying degrees of severity in a number of disorders
• From yes/no approach to mental health to a how much/severe (based on number of symptoms and/or level of distress and interference with
functioning)
• Boundaries between normality and pathology vary across cultures → important to keep in mind given we live in very multicultural
countries/areas/societies
What is a mental disorder? → DSM-5:
• A clinically significant disturbance in cognition, emotion regulation or behaviour
• Reflects a dysfunction in the psychological, biological or developmental processes underlying mental functioning
• Causes clinically significant distress or impairment in social, occupational or other important areas of functioning → unless it inhibits their functioning
it is generally not classed as a mental disorder as they have the ability to adjust and change their life around the problem
What is NOT a mental disorder? – DSM-5:
• An expectable or culturally approved response to a common stressor or loss (e.g. the death of a loved one)
• Socially deviant behaviour (e.g. political, religious or sexual) and conflicts that are primarily between the individual and society
The Rosenhahn Study (1969-1972)
• Labeling from a disorder → you are no longer known as a person, you are known as a person with a disorder, a person with depression or anxiety, etc.
• Study concerned about labeling
• Try get admitted to an asylum and pretend they have problems and then stop acting like they have a mental illness and see what happens
• They went to a director who agreed to help them and they wrote down everything they saw and everything that was said to them or by someone and all
their interactions
• They wanted to see how long it took for staff to catch on that there was nothing wrong with them
• They had to discontinue the study because no staff actually picked up they werent actually mentally ill → actually wrote down on their reports that
they aggressively took notes which made them seem more mentally ill (haha)
• Other patients knew they didnt belong there, but the staff did not
• What where the symptoms Rosenhahn and his student exhibited at the time of admission to the hospital? → Empty, dull and thud
• How much time per day did an individual patient have contact with staff? → 6.5 mins a day!!
• How much contact did patients have with outside visitors? → Rosenhahns wife visited 4/7 times
• Could it happen today?
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PSYC2214 – ADULT PSYCHOPATHOLOGY – CHELSEA GRAY: 21954282
Indonesia Shame:
• Mentally ill chained to beams on dirty floors by sewers → stripped naked
Prevalence of mental disorders in Australia:
• Nearly half of the population will experience a mental disorder in their lifetime (45%)
• Any 12 month disorder (20%) and only 1/3 of these people use mental health services
Assessment of abnormal behaviour:
• Our ability of treating a disorder is directly related to our skill of identifying it
• All assessment techniques must have:
o Reliability (e.g. test-retest, inter-rater)
o Validity (e.g. construct, predictive, concurrent)
• Assessment is an ongoing process
Some consumer tips:
• Know the purpose of assessment
• Ask for published info on reliability and validity
• Ask for comprehensive feedback in language you understand
• Different tests:
o Ink pictures → tap into subconscious processes → not high validity
o Personality tests
• There used to be a multi-axial diagnostic process in the DSM → just mentioned because we may come across this in articles
• Now all disorders are in a single combined section
• If associated medical conditions are thought to cause the symptom features, then a separate diagnosis is given
• If medical condition is not causal, the might give a diagnosis
• Now in a separate section called other conditions that may be in the focus of clinical attention features relational, occupational, educational, economic
& abuse problems
• Replaces with a global measure of disability used by the WHO and included in the for further study section → internet gaming disorder, persistent
complex bereavement disorder, nonsuicidal self injury, suicide behaviour disorder
Case example:
• 60 y.o
• Living and working on farm
• Worked with disabled people all her life
• Had a lapse in surgery → cant lift anything, cant do anything
• Developed depression
• Never been depressed before she became dependent on others
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PSYC2214 – ADULT PSYCHOPATHOLOGY – CHELSEA GRAY: 21954282
LECTURE 2 – Approaches to psychotherapy:
Psychotherapy – what is it?
• Encompass many approaches and techniques, so pinning down a complete and clear definition is challenging. But here is a broad one:
o The application of specialised techniques to the treatment of mental disorders or to the problems of everyday adjustment
• Requires specialised techniques to treat disorders, its not just a chat about how they are going to be okay
• Someone who has psychotherapy must have a diagnosis
• You can be sad or anxious but if it affects your every day life and you cannot adjust, then it becomes a disorder → impairment to everyday functioning
Treatment of mental illness & adjustment problems:
• Many kinds of psychotherapies, sometimes vastly different ways of thinking about:
o What causes symptoms or problems
o What maintains symptoms or problems
o What can help or resolve the symptoms or problems
• Biomedical models
• Psychological models
o Psychodynamic models
o Social/interpersonal models
o Behavioural models
o Cognitive-behavioural models
• Models are like a compass that guides us through, they give us a basis of knowledge
Examples:
• Andy → psychomotor retardation (diminished body movement due to a lack of motivation), he moves his hands a bit but he has a low voice, doesnt
really move, reasonably bright and able to verbalise his feelings and dilemmas, he has self-judgment, feels behind in life, doesnt display a lot of
emotion, Anhedonia (loss of interest in every day things), dissatisfied with relationships, alcohol and drug abuse, lives with parents, not enjoying life –
sitting down all day, youngest of children, siblings and father have substance abuse problems, wants to increase activity level, family tells him he
will fail, he feels trapped
o Symptoms/problems → primary depression (feeling sad, loss of pleasure in activities, social withdrawal, increased sleep)
o Other considerations → anxiety, relationships with family and GF, vulnerability for return to substance abuse
Biomedical models:
• Findings of genetic influence in a number of psychological disorders. That is, some individuals have a biological vulnerability to developing certain
disorders
• Focus on neural functioning and especially the role of neurotransmitters and neurohormones in mood and behavioural symptoms
• What is the contribution of a biomedical model?
o What causes and maintains depression? → To over-simplify, a change of serotonin, a depletion, an imbalance of serotonin with other
neurotransmitters (norepinephrine, dopamine)
o What can help or resolve depression? → Increase availability of serotonin at the synapse and/or restore the appropriate balance of serotonin
with other neurotransmitters
• Use of medications:
o SSRIS - selective serotonin reuptake inhibitors
o Tricyclic antidepressants – TCA
o Monoamine oxidase inhibitors – MAO)s
• Other biomedical interventions:
o Electroconvulsive therapy (ECT) - very good success rate, patient can only be referred if they have tried and failed two different
antidepressants
o Transcranial magnetic stimulation (TMS) – magnets to try and change certain wavelengths and stimulate the brain
o Rationale for efficacy is less clear
Psychodynamic models:
• A group of approaches, including classical psychoanalysis and a variety of conceptually related psychodynamically-informed psychotherapies (i.e.
object relations)
• Role of early experience/trauma, unconscious drives, conflict and unhealthy repression in causing symptoms
• Lack of insight maintains symptoms
• (ow might psychoanalytic theory explain Andys problems?
o Early traumatic childhood experiences have been repressed (e.g. rage at father, fear of father feeling of helplessness in relationship to him led
to repression – that is feeling rage at father produces too much anxiety and conflict – its easier to turn the feeling inward
• Depression results from anger turned inward
• Depression is maintained by lack of insight and lack of catharsis
• To improve or cure depression, make the unconscious, conscious
• Facilitate insight into repressed anxieties and conflicts and their relationship to early childhood experiences
• Allow a cathartic recall and expression of the traumatic memory
• Change of personality rather just alleviate symptoms
• Techniques meant to access unconscious material and conflicts → free association (just say what comes to mind), dream analysis, Freudian slips of the
tongue (i.e. calling your wife your mother), noticing aspects of the therapeutic relationship (transference and counter-transference, resistance
• Techniques to foster insight → interpretation & confrontation
• As insight increases, symptoms resolve
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Document Summary
Lecture 1 - assessment and diagnosis of psychopathology: In her community they may all be christian and believe that this actually could happen and would not be considered abnormal behaviour. Or is this eccentric: wang wanxing in prison from 1992 2005 (cid:498)according to the authorities, my husband is suffering from (cid:494)political monomania(cid:495). When ) asked what that is, im told that you have to be mad to want to protest on tianamen square(cid:499) Protestors jailed and sometimes put in psychiatric facilities because they are (cid:494)mad(cid:495) Abnormality is hard to define and is commonly defined by society and norms. No definition adequately specifies precise boundaries for the concept of a mental disorder. The diagnosis of a mental disorder should have clinical utility. Diagnosis is not equivalent to a need for treatment. Rigid categories do not capture clinical experience or scientific observations: many symptoms occur at varying degrees of severity in a number of disorders.