Diagnosis
- label for a syndrome assigned to the person
Classification System
- nomenclature or nosology
- set of definitions of syndromes
- rules for determining when the symptoms are part of each syndrome
a. DSM-5 (APA, 2013)
- specific and concrete criteria
- descriptive, not explanatory
- Atheoretical
- categorical vs dimensional classification
b. ICD-10 (WHO, 1990)
Cultural Concepts of Distress (APA, 2013)
- ways of cultural groups experience, understand, and communicate suffering, behavioral problems, or troubling thoughts and emotions
a. Cultural Syndromes
- symptoms that co-occur among individuals in specific cultural groups
- recognized locally as coherent patterns of experiences
b. Cultural Idioms of Distress
- ways of expressing distress (may not involved symptoms) but provide shared ways of experiencing and talking about personal or social concerns
c. Cultural Explanations
- labels, attribution, or features
- indicate cultural recognized meaning or etiology
What's New on DSM-5?
- adopt nonaxial approach in diagnosis
- diagnosis includes clinical syndrome (in case of co-morbidity) and general medical condition of the patient
- separate notations for psyhosocial and contextual factors to separate functioning status from the diagnosis
- Disability Assessment Schedule or WHODAS can be used to assess functioning
Issues:
- reifying diagnosis
- category vs continuum
- validity and reliability
- differentiating mental disorders
- cultural issues
Perspective and Causal Factors in Abnormal Psyhology
1) Etiology
a. Distal Cause - occurs early in life
b. Proximal Cause (precipitating cause) - condition that triggers a disorder
c. Reinforcing Cause (perpetuating cause) - tends to maintain maladaptive behavior that is already occuring
2) Diathesis-Stress Model
- developing disorder that can derive from biological, psyhological, or sociocultural factors.
- mental disorder a product of stressors
- distal causal interact with proximal causal
a. Risk Factors - influences an individual to develop psyhological problems
b. Protective Factors - influences an individual to lessen the impact of stress (resilience)
3) Biological Viewpoint
- mental disorders are diseases
- disorders from central nervous system, autonomic nervous system, or the endocrine system
- can be inherited or caused by some pathological causes
a. Neurotransmitter and Hormonal Imbalances
b. Genetic Vulnerabilities - chromosomal abnormalities or faulty genes
c. Constitutional Liabilities - physical handicap or temperament
d. Brain Dysfunction and Neural Plasticity
e. Physical Deprivation or Disruption
4. Psychosocial Viewpoint
- disorders are affected by early experiences, social influences, and psyhological processes
a. Psychodynamic Perspective
a1. Classical Psychoanalysis - anxiety, ego defense mechanisms, fixation
- ego psychology (Ana Freud)
- Object Relations Theory (Klein, Winnicott, Mahler)
- Interpesonal Perspective (Erickson, Sullivan, Bowlby)
b. Behavioral Perspective
- learning maladaptive behavior influenced by environmental condition
b1. Generalization
b2 Discrimination
b3. Observational Learning
c. Cognitive-Behavioral Perspective
- distorted thoughts and information processing lead to maladaptive emotions and behavior
c1. Attributional Style
d. Humanistic Perspective
- lack of personal values, growth, and self-actualization
e. Existential Perspective
- failure to deal with despair and frustration
- meaningless freedom
f. Family Systems Perspective
- dysfunctional family
5) Psychosocial Causal Factors
a. Schema and self-schema
- assimilation and accommodation
b. Early deprivation of Trauma
c. Inadequate Parenting Styles
d. Marital Discord or Divorce
e. Maladaptive Peer Relationships
6)Sociocultural Viewpoint
- affected by the social and cultural context
a. Social Roles (e.g. gender roles)
b. Pathogenic Societal Influences (e.g. socioeconomic status, prejudice, discrimination, social change, uncertainty, etc.)
7) Biopsychosocial Viewpoint
Interventions
1) Biologically-based Therapies
a. Electroconvulsive Therapy (ECT)
- 70 to 130 voltz
- 10 to 30 session
- induce seizures
b. Neurosurgery / Psychosurgery
c. Psychopharmacotherapy
- antipsyhotic drugs (major tranquilizers)
- antidepressant drugs
- antianxiety drugs / anxiolytics (minor tranqulizers)
- Lithium (mood stabilizers)
d. Psychological Therapies
d1. Psychodynamic Therapy
d2. Behavior Therapy
d3. Cognitive-Behavioral Therapy
d4. Humanistic-Phenomenological / Existential Therapy
d5. Interpersonal Therapy
d6. Family Therapy
