2. – Understanding psychopathology:
• What parameters we use to make judgements around normality and
abnormality What is ‘normal’
- Being like the majority?
- Autonomous functioning? Able to function as we would expect for
someone of their age and background should
- Accurate reality perception? Are they through their senses perceiving
what is around them accurately, seeing and hearing things around
them, or seeing and hearing things around them that others can’t,
appraisals of what is going on around them
- Regulated moods? Respond as we would expect to situations and
stimuli in the environment around them, respond happy/sad
3. - Adequate interpersonal relationships? Able to maintain relationships,
interact with other people as we would expect So…..What is
‘abnormal’? What is psychopathology?
Norm violation:
- individuals who violate the norms of behaviour, consider them as
presenting in an abnormal way
Personal distress
- would expect someone who is experiencing psychopathology/mental
illness would be distressed by that situation - know that not everyone
who suffers from mental health is distressed by those difficulties
4. Brief history of treatment of individuals experiencing mental
illness:
• A threat to public order
- A disused convict barracks with doctors who were themselves convicts
- established for people who were viewed as unmanageable in the broad
community
- be able to have a place to manage people who were seen as a threat to public
- “mental health largely became a concern when it threatened public order and
governments were particularly prominent in the management of the insane”
- focus was not on the treatment of individuals, but rather managing public order
- Early treatments were ‘moral’ failings or ‘physical’ problems
- Early admissions: 2/3 police, 1/3 family members who couldn’t care for relatives
5. • Inhumane treatments:
- Early approaches were largely focused on maintaining the safety of the public
- weren’t focused on improving the wellbeing of the individual who was
incarcerated
- Little emphasis was placed on the well-being and/or recovery of the individual
with the disorder
- treatments were ineffective, people with mental illness were excluded from
society due to threat of public order
- Further developments in treatment and the anti-psychiatry movement created
interest in psychosocial interventions
6. What is a ‘mental disorder’?
• “clinically significant disturbance in an individual’s cognition, emotion regulation
or behaviour…usually associated with significant distress or disability in social,
occupational or other important activities”
• - What does not define a mental disorder o “an expectable or culturally approved
response to a common stressor or loss, such as the death of a loved one, is not a
mental disorder.”
Considerations for mental disorders:
Mental
- Is the disorder really ‘mental’? - What else would we call it…? - what do we mean
by mental - calling it a mental disorder limits us to what is fundamental/essential to
these disorders - Suggestion to call it a brain-mind disorder
7. • Clinical problems
- Clinically significant behavioral problem or physiological syndrome or
pattern occurring in an individual
- problematic because framing mental disorder around clinically
significant behaviour/problems doesn’t create room for us to think
about non clinically significant problems, biases our thinking
- Argument that clinically significant is a classifier that characterizes the
problem, syndrome, or pattern and is a separate assessment
- Adding ’clinically significant’ is tautological; it doesn’t create room for
nonclinically significant problems, syndromes, or patterns
8. • Distress
- Distress comes in lots of different ‘flavors’
– lots of different ways distress can manifest, contextualizing distress is
problematic because what level of distress might be considered
important when diagnosing a disorder; adding ‘clinically significant’
helps to put it at the right end of the continuum for diagnosis -
Increased risk…? Risk factors are not disorders
• Context - can’t diagnose a disorder without considering the
background of the pt - need to be aware of the context of the
individual before jumping to any conclusions
9. • Different factors
- Behavioral
- Psychological or
- Biological
- whilst we don’t know the specific cause of mental disorders, we know
that there is not a single cause and can be a combination
- Creates multiple possible categories of dysfunction
- Underlying psychobiological suggests a single common cause (even
though the cause is actually unknown).
10. Mental Disorders are difficult to instact:
- if an individual has a certain disorder, is there a chance that they will
meet the criteria for another disorder
- these disorders overlap
- comorbidity is the rule rather than the exception
- we expect that if someone meets the diagnostic criteria for one
disorder, they are highly going to meet a diagnostic criteria for another
- symptoms that characterize mental illnesses are often not unique to a
single mental health disorder
11. • - mental disorders are not only fuzzy in their comorbidity at the broad
level, but also when you draw down to looking at symptoms
• - symptoms are not necessarily symptoms of one mental disorder - in
the diagnostic criteria itself, a lot of ways to meet the criteria for a
mental disorder
12. • Why Diagnose or Classify Psychopathology?
• Diagnoses:
- Facilitate Communication: among clinicians, between science and
practice
- Facilitate Care: contained concepts allows for the identification of
treatment and effectiveness of treatment, and prevention of mental
disorders, description of experience, possible etiology and prognosis.
- Research: test treatment efficacy and understand etiology -
Information Management: measure and pay for care and helpful in
terms of planning mental health services
13. Terminology: Descriptive psychopathology
• Signs
-Objective findings observed by a clinician in the behaviour or presentation
of the individual
- Tachycardia
- Pressured speech
- Poor eye contact
• Symptoms
-subjective complaints reported by a patient, only they can confirm this –
-Low mood
- Anxiety
- Paranoia
14. Syndrome:
-signs, symptoms and events that occur in a particular pattern and indicate
the existence of a disorder
- Bipolar disorder
- Depression
Disorder:
- A syndrome which can be discriminated from other syndromes;
- To be labelled a disorder means there is a distinct course to the syndrome
and the age and gender characteristics of the disorder have been described
to some extent. In some cases prognosis may also be known.
- in psychology we use disorders
15. Disease:
- For a disorder to be labelled a disease, there has to be indications of
abnormal physiological processes or structural abnormalities (e.g.,
Parkinson’s Disease)
- don’t have clear underlying biological processes in psychology
16. Assessment of Psychopathology:
- Pen and paper tests
– checklist of symptoms relating to DSM
- Clinical interviews
- Behavioural assessment
- Activity Diaries such as in area of substance use and try to understanding
pattern
- Psychological tests
- Medical tests
- Psychophysiological tests
- Neuropsychological tests
