Please enable JavaScript.

Coggle requires JavaScript to display documents.

SUSS PSY 203 ABNORMAL PSYCHOLOGY STUDY UNIT 1 (CHAPTER 2: AN INTEGRATIVE…

- - - - Terms to note
        
        2. Distress or impairment
        
        occurs when a person is extremely upset (i.e. prolonged periods of anxiety).
        
        Appropriatment to situation
        
        Degree of impairment
        
        Individual versus others (Egosyntonic, Egodystonic)
        
        3. Atypical
        
        or not culturally expected response refers to those behaviours
        or attitudes that do not occur in a society very frequently (i.e. against the social rules and norms)
        
        Violation of social norms
        
        Deviations from Average
        
        1. Psychological dysfunction
        
        is a breakdown in cognitive, emotional, or
        behavioural functioning.
        
        For example, if you are out on a date with a loved one, it should be an emotionally enlightening experience. But if you experience severe, irrational fear all evening though there is nothing to be afraid of, and this persists on every date, your emotions might not be functioning properly.
        
        Behavioural Dysfunction i.e. Cant stop certain behaviours. OCD.
        
        Emotional Dysfunction Easily triggered emotionally.
        
        Cognitive Dysfunction Common in depression as they cannot actively focus in conversation. Forgetful - Cognitively difficult to remmber.
  - - - Clinical and Counselling Psychologists
        
        Clinical and counselling psychologists receive the PhD degree (or sometimes an Ed.D., Doctor of Education, or Psy.D., Doctor of Psychology) and follow a course of graduate-level study (Approx 5 years) which includes research training in the causes and treatment of psychological disorders and to diagnose, assess, and treat these disorders.
        
        Also, programs in professional schools of psychology, where the degree is often a Psy.D., focus on clinical training and de-emphasize or eliminate research training.
        
        In contrast, PhD programs in universities integrate clinical and research training Psychologists with other speciality training, such as experimental and social psychologists, concentrate on investigating the basic determinants of behaviour but do not assess or treat psychological disorders.
        
        Counselling psychologists tend to study and treat adjustment and vocational issues encountered by relatively healthy individuals.
        
        Clinical psychologists usually concentrate on more severe psychological disorders.
      - Psychiatrists
        
        Psychiatrists first earn an M.D. degree in medical school and then specialise in psychiatry during residency training (Approx 3 to 4 years).
        
        Psychiatrists also investigate the nature and causes of psychological disorders, often from a biological point of view; make diagnoses; and offer treatments.
        
        Many psychiatrists emphasise drugs or other biological treatments, although most use psycho-social treatments as well
        
        Psychiatric nurses
        Psychiatric nurses have advanced degrees such as a master’s or even a PhD and specialize in the care and treatment of patients with psychological disorders, usually in hospitals as part of a treatment team.
        
        Psychiatric social workers
        Psychiatric social workers typically earn a master’s degree in social work as they develop expertise in collecting information relevant to the social and family situation of the individual with a psychological disorder. Social workers also treat disorders, often concentrating on family problems associated with them.
      - Marriage and family therapists and mental health
        
        Counsellors marriage and family therapists and mental health counsellors typically spend 1–2 years earning a master’s degree and are employed to provide clinical services by hospitals or clinics, usually under the supervision of a doctoral-level clinician.
    - - 2. Evaluator of science
        
        They evaluate their own assessments or treatment procedures to see whether they work.
        
        They are accountable not only to their patients but also to the government agencies and insurance companies that pay for the treatments, so they must demonstrate clearly that their treatments work.
      - 3. Enhance the filed of science
        
        Practitioners might conduct research, often in clinics or hospitals, that may result in medical break-through and the discovery of new disorders and/or treatments.
      - 1. Consumer of science
        
        They may keep up with the latest scientific developments in their field and therefore use the most current diagnostic and treatment procedures.
        
        In this sense, they are consumers of the science
    - - 2. Causation (Aetiology)
        
        Aetiology refers to factors or dimensions that cause psychological disorders.
        
        Such factors include biological, psychological, and social dimensions.
      - 3. Treatment and Outcomes
        
        Treatment can include psychological, psychopharmacological, or a combination of the two.
      - 1. Clinical Description
        
        represents the unique combination of behaviours,
        thoughts, and feelings that constitute a specific disorder
        
        The word clinical refers both to the types of problems or disorders and to the activities connected
        with assessment and treatment
        
        Presents/Presenting Problem
        
        is a traditional shorthand way of
        indicating why the person came to the clinic.
        
        also the first step in determining clinical description
        
        Statistical data
        
        One important function of the clinical description is to specify what makes the disorder different from normal behaviour or from other disorders.
        
        Prevalence refers to the number of people in the collective population experiencing the disorder.
        
        Incidence refers to the number of new cases of a disorder occurring during a specific period of time (e.g., a year)
        
        Course
        
        refers to the pattern of the disorder over time and can be described as chronic, episodic, or time-limited.
        
        Episodic course refers to patterns of disorder in which the individual is likely to recover within a few months only to suffer a relapse later. (i.e. Mood Disorder)
        
        Time-limited refers to patterns of disorder that will improve without treatment in a relatively short period.
        
        Chronic course refers to patterns of disorder that they tend to last a long time, sometimes a lifetime (i.e. Schizophrenia)
        
        Onset
        
        refers to the age at which an individual acquires, develops, or first experiences a condition or symptoms of a disease or disorder.
        
        Acute onset refers to disorders that begin suddenly
        
        Insidious onset refers to disorders that develop gradually over time.
        
        Prognosis
        
        refers to the anticipated course of a disorder.
        
        i.e. if we conclude that, “the prognosis is good,” meaning the individual will probably recover,
        
        but if we tell the patient “the prognosis is guarded,” this means the probable outcome doesn’t look good (It is as good as telling him: GG)
  - - - Hippocrates and Galan
        
        The Greek physician Hippocrates (460-377 B.C.) presumed that psychological disorders could be as a result of brain or hereditary disease, while recognising the importance of psychological and interpersonal factors in psychopathology.
        
        Hippocrates also coined the term hysteria and believed the cause to be due to a wandering uterus, and the cure marriage and pregnancy.
        
        A Roman physician Galen (129-198 A.D.) expanded upon the work of Hippocrates, and the Hippocratic-Galenic approach to psychopathology extended to the 19th century
      - Syphilis and the assumption of cause and cure.
        
        During the 19th century, syphilis was discovered to be a cause of general paresis (a disorder characterised by both behavioural and cognitive symptoms). Eventually, scientists discovered that syphilis could be cured by penicillin.
        
        Many mental health professionals then assumed that comparable causes and cures might be discovered for all psychological disorders.
      - Deinstitutionalisation
        
        John P. Grey, an American psychiatrist, believed that insanity was due to physical causes and that mentally ill patients should be treated like the physically ill.
        
        Reformers, such as Dorothea Dix, stated that the treatment of those with mental illness should parallel the treatment of those with physical illness. As a result, mental hospital conditions improved significantly and many advocated the practice of “deinstitutionalisation”.
      - Development of Biological Treatments
        
        Biological treatments for mental disorders in the 1930s (such as insulin, ECT, and brain surgery) were periodically administered to persons with psychoses to calm them (leading to insulin shock therapy and lobotomy).
        
        In addition, Joseph von Meduna thought that schizophrenia was rare in persons with epilepsy; hence, the deliberate induction of brain seizures was soon considered useful.
      - Drugs
        
        The first effective drugs for treating severe psychotic disorders emerged in the 1950s.
        
        The consequences of the early biogenic approach to psychopathology included an ironic tendency not to pursue new drug treatments.
        
        This is largely due to the adverse side-effects.
      - Enhancing diagnosis and classification
        
        Emil Kraepelin became a dominant figure in the field of diagnosis and classification. A central theme of his approach was that separate, discriminately valid syndromes could be culled, each comprising different symptoms, course, and onset
        
        By the end of the 1800s, a scientific approach to psychological disorders and their classification was developed further as a search for biological causes and medicalised/humane treatments
    - - 1. Psychoanalytic Theory
        
        Sigmund Freud, the founder of psychoanalytic therapy, focused on tapping into the unconscious through catharsis, free association, and dream analysis.
        
        Freud viewed psychological disorders as psychic conflicts stemming from the conflict between the id and the superego. He formulated an elaborate theory ofego defence mechanism, illustrating how the ego mediates these conflict and diffuses the id.
        
        Although Freud’s followers steered from his path in many ways, Freud’s influence can still be felt today
        
        Psychoanalytic theory is intertwined into psychodynamic therapy. The goal of this approach is to help a person understand the true nature of his/her intrapsychic conflicts and psychological problems.
        
        Theories that stem from psychoanalytic includes Anna Freud’s self-psychology), Melanie Klein and Otto Kernberg’s object relations, Carl Jung’s collective unconscious
        
        Carl Jung would later champion the humanistic approach.
        
        2. Humanistic Perspective
        
        Jung and Adler broke sharply with Freud over the nature of humanity. Freud had a relatively pessimistic view of human nature while Jung and Adler emphasized the positive, optimistic side of human nature. They believed that men strive to reach their fullest potential or Self-actualizing.
        
        Nevertheless, they retained many of the principles of psychodynamic thought. Their general philosophies were adopted in the middle of the century by personality theorists and became known as humanistic psychology.
        
        Theories and methods stemming from this view include Maslow’s Hierarchy of needs and Carl Roger’s Person-centered theory.
      - 3. Behavioural Perspective
        
        The behavioural, cognitive-behavioural, or social learning model was derived from a purely objective scientific approach to the study of psychopathology.
        
        One of the earlier figures that contributed to this perspective was Pavlov and his theory of classical conditioning.
        
        John B.Watson developed this theory further and formulated the school of behaviourism.
        
        While Watson demonstrated that fear could be learnt (through his ‘Little Albert’ experiment), his student Mary C. Jones demonstrated the opposite. Jones demonstrated the successful treatment of fear through extinction in her ‘Peter’experiment.
        
        Two decades later, Joseph Wolpe would use these studies and develop the systematic desensitization therapy.
        
        B. F. Skinner developed the field of behaviour analysis and concepts related to operant conditioning. Though Skinner was not a behaviour therapist, many of his technologies and concepts form the core of several contemporary behaviour therapies
      - Moral Therapy: Rise and Fall
        
        Refers to the practice of allowing patients to be treated in settings as
        normal as possible to encourage and reinforce social interaction.
        
        Originated by French psychiatrist Philippe Pinel and his former patient Jean-Baptiste Pussin, it would eventually spread to Britain (through William Tuke) and America (through Benjamin Rush). This saw the emergence of well maintained, humane and therapeutic mental institutions.
        
        Several factors led to its fall including the inability to cope with increasing numbers of patient and the view that that mental illness was caused by brain pathology and, therefore, was incurable
    - - Deviant behaviour
        
        Deviant behaviour has been considered as a reflection of the battle between good and evil (i.e. Disorders are as a result of witchcraft/ sorcery/ Demonic possesion)
        
        Treatments for Possession
        
        Treatments included exorcisms, in which various religious rituals were performed in an effort to rid the victim of evil spirits.
      - Stress and Melancholy
        
        An equally strong opinion, even during this period, reflected the enlightened view that insanity was a natural phenomenon, caused by mental or emotional stress, and that it was curable
        
        Common treatments were
        rest, sleep, and a healthy and happy environment
        
        These conflicting crosscurrents of natural and supernatural explanations for mental disorders are represented more or less strongly in various historical works
      - Mass Hysteria
        
        Is characterised by outbreaks of strange behaviour on a grand scale. This led individuals in the Middle Ages to conclude that their beliefs about possession were correct
        
        Modern Mass Hysteria
        
        Mass hysteria may simply demonstrate the phenomenon of emotion contagion, in which the experience of an emotion seems to spread to those around us.
        
        May esclate into a state of panic, affecting whole communities.
      - Astrology
        
        Paracelsus, a 16th century Swiss Physician, introduced the idea that the movement of the moon and stars affected people’s psychological functioning;
        
        This theory inspired the use of the word lunatic to describe those who exhibited behavioural disorders. Many of his views still persist today.
- - - - Psychological contribution
      - Developmental contribution
      - Biological contribution
      - Social contribution
  - - - Nature of Genes
        
        Genes are long molecules of deoxyribonucleic acid (DNA) located at various chromosomal sites within the cell nucleus. Problems sometimes develop when the normal contingent of 46 human chromosomes (arranged in 23 pairs) is disturbed.
        
        Genes seldom determine our physical development in any absolute way and the same is true for psychopathology. Much of human development and behaviour is polygenic (i.e., influences by many genes that individually exert a tiny effect).
        
        Interaction of Genes and the Environment
        
        The process of learning may change the genetic structure of cells as theorised by Eric Kandel.
        
        This may occur when environmental processes activate dormant genes and when there are changes in the brain’s biochemical functioning. This understanding sets the basis for the exploration of gene-environment interactions as they relate to psychopathology.
        
        Two models have received the most attention:
        
        The diathesis-stress model
        
        Reciprocal gene-environment model
        
        Reciprocal gene-environment
        model
        
        A.K.A Gene-environment correlation model states that people have a genetically determined tendency to create the very environmental risk factors that trigger genetic vulnerabilities.
        
        For example, people with a genetic vulnerability to developing a certain disorder, such as blood–injection–injury phobia, may also have a personality trait—let’s say impulsiveness— that makes them more likely to be involved in minor accidents that would result in their seeing blood.
        
        Epigenetics/Epigenome
        
        Genes are turned on or off by cellular material that is located just outside of the genome and that external factors (i.e. stress, nutrition) can affect this epigenome, which is then immediately passed down to the next generation and maybe for several generations.
        
        The genome itself isn’t changed, so if the stressful or inadequate environment disappears, eventually the epigenome will fade.
        
        Diathesis-stress model
        
        Under this model, individuals inherit tendencies to express certain traits or behaviours, which may then be activated under conditions of stress. Each inherited tendency is a diathesis, which means, a condition that makes someone susceptible to developing a disorder.
        
        i.e. A person who has a diathesis or a vulnerability to alcoholism may end up triggering this tendency during clubbing resulting in an alcohol addiction problem while his or her friend who does not share the same tendencies may not end up with alcohol addiction despite engaging in the same activity.
    - - Nervous system
        The entire network of neurons in the body, including the central nervous system, the
        peripheral nervous system, and their subdivisions.
        
        Central Nervous system (CNS)
        
        Composed of the brain and spinal cord, the central nervous system (CNS) serves as the body’s “command centre" in that it receives, process, and issues responses to stimulus.
        
        Major neurotransmitters implicated in psychopathology include norepinephrine (or noradrenaline), serotonin, dopamine, and gamma-aminobutyric acid (GABA).
        
        Major Neurotransmitters
        
        Serotonin (5HT) is concentrated in the midbrain and connected to the cortex; thus, producing widespread effects on behaviour, mood, and thought processes.
        
        Norepinephrine (also known as noradrenaline) is also part of the endocrine system and important in psychopathology. Norepinephrine stimulates alpha-adrenergic and beta-adrenergic receptors causing vasoconstriction and vasodilation respectively.
        
        Gamma-aminobutyric acid (GABA) reduces postsynaptic activity which, in turn, inhibits several behaviours and emotions, particularly anxiety
        
        Dopamine has been implicated in schizophrenia and may act by “switching on” various brain circuits that inhibit or facilitate emotions or behaviour. Dopamine and serotonin circuits cross at many points and seem to balance one another.
        
        Brain
        
        The brain consists of several parts. Including the lower brain stem (i.e. is the most primitive part which is responsible for most of the automatic functions necessary for survival) and the forebrain which is responsible for more advanced cognitive processing.
        
        The forebrain is divided into two hemispheres. The left hemisphere seems to be chiefly responsible for verbal and other cognitive processes. The right hemisphere seems to be better at perceiving the world around us and creating images. The hemispheres may play differential roles in specific psychological disorders.
        
        When studying areas of the brain for clues to psychopathology, most researchers focus on the frontal lobe of the cerebral cortex, as well as on the limbic system and the basal ganglia.
        
        Psychosocial Influences on Brain Structure and Function
        
        Psychological treatments may be powerful enough to modify brain circuits; for example, the treatment of OCD via exposure and response prevention (a form of cognitive therapy) can result in the normalisation of brain function.
        
        Similar studies have replicated this finding in depression and specific phobias; it is possible that both medications and psychotherapy change brain functioning but in different areas of the brain.
        
        Some key sturctures
        
        The limbic system, which figures prominently in much of psychopathology helps regulate our emotional experiences and expressions and, to some extent, our ability to learn and to control our impulses. It is also involved with the basic drives of sex, aggression, hunger, and thirst
        
        The basal ganglia, is believed to control motor activity because damage to these structures may make us change our posture or twitch or shake. It is also linked to obsessive-compulsive disorder.
        
        The frontal lobe consist of the prefrontal cortex which this is the area responsible for higher cognitive functions Key structure in information processing and response.
        
        Peripheral Nervous System (PNS)
        PNS connects the CNS with the rest of the body through nerves.
        It ferries incoming signals from external stimuli detected by sense organ to the brain and outgoing signals from the brain to the organ on how to respond.
        
        Somatic Nervous System
        
        A division of the PNS that carries sensory information from sense organs to the CNS and also sends
        voluntary messages to the body’s skeletal muscle
        
        Damage in this area might make it difficult for us to engage in any voluntary movement, including talking
        
        Sensory Nervous System (Afferent)
        Sends information from the sense organs to the CNS.
        
        Motor Nervous System (Efferent)
        
        Sends information from the CNS to the relevant muscles in responses to information received from Sense Nervous System.
        
        Autonomic Nervous System
        
        Regulates the cardiovascular system, endocrine system (e.g., pituitary, adrenal, thyroid, and gonadal glands) and aids in digestion and regulation of body temperature.
        
        Parasympathetic Division
        
        The part of the autonomic nervous system that monitors the routine
        operations of the internal organs and returns the body to calmer functioning after arousal by the sympathetic division.
        
        Though it has an opposing action, the parasympathetic division works cooperatively with the sympathetic system.
        
        Sympathetic Division
        
        The part of the autonomic nervous system that sends messages to internal organs and glands that help us respond to stressful and emergency situations. AKA the “fight-or-flight” system.
  - - - Learned Helplessness
        
        learned helplessness is a concept which occurs when a being encounters conditions over which they have no control (i.e. their behaviour has no effect on their environment), creating a sense of “helplessness” leading to depression.
        
        People become depressed if they “decide” or “think” they can do little about the stress in their lives, this attribution precipitates depression.
      - Social Learning
        
        Albert Bandura observed that organisms can learn by watching others in their environment (modelling or observational learning).
        
        He emphasised the importance of the social context in learning; that is, much of what we learn depends on our interactions with people around us
      - Prepared Learning
        
        According to the concept of prepared learning, we have become highly prepared for learning about certain types of objects or situations over the course of evolution because this knowledge contributes to the survival of the species.
        
        This concept attributes learning to biology and genetics.
        
        i.e. we are more likely to learn to fear snakes or spiders than rocks.
      - Learned Optimism
        
        if people faced with considerable stress and difficulty in their lives nevertheless display an optimistic, upbeat attitude, they are likely to function better psychologically and physically (Think: Internal locus of control).
    - - Blindsight/unconscious vision.
        
        The ability to accurately identify objects in the absence of visual abilities.
        
        Lawrence Weiskrantz relates to a case in which a young man lost his vision during a surgical procedure despite which, was able to reach out and accurately touch his physician’s hand thereafter.
        
        This phenomenon extends to normal individuals who, when provided with hypnotic suggestions that they are blind, are able to function visually but have no awareness or memory of their visual abilities.
        
        This condition, which illustrates a process of dissociation between behaviour and consciousness, is the basis of the dissociative disorders.
      - Implicit memory
        
        is apparent when someone clearly acts on the basis of things that have happened in the past but can’t remember the events. (i.e. memory stored in the unconscious)
        
        an example of implicit memory at work is the story of Anna O., the classic case first described by Breuer and Freud to demonstrate the existence of the unconscious. It was only after therapy that Anna O. remembered events surrounding her father’s death and the connection of these events to her paralysis.
  - - - Emotion in Psychopathology
        
        Anger
        
        Sustained anger and hostility appear to be closely related to the development of heart disease. This may occur because the heart's rhythm is disturbed when one is experiencing anger thus the heart could not efficiently function and pump blood through the body.
        
        Suppression of emotions
        
        Suppression of almost any kind of emotional response (e.g., anger or fear) increases sympathetic nervous system activity and may contribute to psychopathology.
        
        Emotions affect cognitive processes, and many basic emotions (e.g., fear, anger, sadness or distress, excitement) seem to play a direct role in psychological disorders (e.g., anxiety, depression, mania) and may even define them
    - - Culture
        
        In many cultures, individuals may suffer from fright disorders, exaggerated startle responses, and other observable fear reactions (e.g., voodoo, the evil eye). Although fear and phobias are universal, what we fear is strongly influenced by our social environment.
      - Interpersonal
        
        Social relationships and contacts appears to strongly corelate to mortality. Social relationships seem to protect individuals against adverse physical and psychological effects.
        
        Having pets may also be a buffer against disorder.
        
        Conversely, older persons with few meaningful contacts and little social support report high levels of depression and unsatisfactory quality of life.
        
        Psychological disorders carry a substantial social stigma in our society. This may be related to differences in seeking psychological help.
      - Gender
        
        Gender exerts a strong and puzzling effect on psychopathology. Females are at higher risk of developing kinds of phobias (e.g., insect, small animal phobias) and eating disorders, whereas social phobias affect men and women equally.
        
        These substantial differences have to do with, at least in part, cultural expectations and gender roles in society. (e.g., it is expected of men to have control over their fears and not to exhibit them freely)
- - - - Clinical assessment is the systematic evaluation and measurement of psychological, biological, and social factors in an individual presenting with a possible psychological disorder.
      - Diagnosis is the process of determining whether a person’s problem(s) meets all the criteria for a psychological disorder according to the DSM-5.
    - - 2. Validity is the degree to which a technique measures what it is designed to measure. (i.e. whether a technique assesses what it is supposed to)
        
        Concurrent or descriptive validity refer to comparing the results of an assessment measure under consideration with the results of others.
        i.e., if the results from a standard, but long, IQ test were essentially the same as the results from a new, brief version, we may conclude that the brief version had concurrent validity.
        
        Predictive validity refer to how well your assessment tells you what will happen in the future.
        i.e., does it predict who will succeed in school and who will not (which is one of the goals of an IQ test).
        
        Face validity refer to whether the test items look reasonable and valid at first
        glance
      - 3. Standardisation is the process by which a set of standards or norms is established for a technique to ensure its consistency across different measurements. The standards might apply to the procedures of testing, scoring, and evaluating data.
        
        The weight of standardisation falls more on the skills or psychologist.
        
        i.e. In IQ test there is one component that test memory retention, If a practitioner admister teh test not inaccordance with the test (i.e. u assist your patient,) then you are not using standard law.
      - 1. Reliability is the degree to which a measure remains consistent.
        
        Inter-rater reliability refers to consistency across two or more raters. When the same device is used by different people, the results would be differnt.
        
        Test-retest reliability refers to consistency across time. I.e. if the tool is administered across or replicated across several times it maintains results then its realiability.
  - - - The Mental Status exam
        
        In essence, the mental exam involves the systematic observation of a client’s behaviour across 5 domains.
        
        3. Mood and affect
        
        Mood is the predominant feeling state of the individual. (i.e. feeling happy).
        
        Affect, by contrast, refers to the feeling state that accompanies what we say at a given point I.e. Smiling when we talk about what we love. That affect is appropriate.
        
        Example of inappropriate affect would be if someone were to be laughing while talking about his family’s funeral.
        
        Example of Blunt or flat affect is when the person speaks about a myriad of emotional events without exhibiting any change of affect.
        
        4. Intellectual functioning
        
        Clinician makes a rough estimate of others’ intellectual functioning just by talking to them.
        
        i.e. does the client have a reasonable vocabulary and memory?
        
        2. Thought processes
        
        Clinician notes rate and flow of speech, clarity, content
        of speech and ideas.
        
        i.e. are there signs of 'delusions of persecution', in which someone thinks people
        are after him and out to get him all the time
        
        5. Sensorium
        
        Sensorium refers to our general awareness of our surroundings (i.e., general awareness of place, time, knowledge of self).
        
        i.e. If the patient knows who he is and who the clinician is and has a good idea of the time and place, the clinician would say that the patient’s sensorium is “clear” and is “oriented times three” (to person, place, and time).
        
        1. Appearance and behaviour.
        
        The clinician notes any overt physical behaviours, including dress, general appearance, posture, and facial expression.
        
        i.e. slow and effortful motor behaviour, sometimes referred to as psychomotor retardation, may indicate severe depression.
      - Unstructured VS Semi-structured
        
        Unstructured clinical interviews are not standardised with respect to procedure and content and follow no systematic format. (i.e. custom fit according to the patient).
        
        Semi-structured clinical interviews contains questions that have been carefully phrased and tested to elicit useful information in a consistent manner, but also allow room for clinicians to depart from the format with additional questions of interest.
        
        The disadvantage is that it robs the interview of some of the spontaneous quality of two people talking about a problem. Also, if applied too rigidly, a semistructured interview may inhibit the patient from disclosing useful information.
    - - Behaviour
        i.e. the immediate response to the antecedent.
      - Consequences
        i.e.what happened afterwards (duh)
      - Antecedents
        i.e what happened just before the behavior
    - - Personality inventories
        
        These are self-report questionnaires that assess personality traits.
        
        What is necessary from these types of tests is not whether the questions necessarily make sense on the surface but, rather, what the answers to these questions predict.
        
        i.e. If we find that people who have schizophrenia tend to respond “true” to “I have never been in love with anyone,” then it doesn’t matter whether we have a theory of love and schizophrenia.
        
        What matters is if people with certain disorders tend, as a group, to answer a variety of questions in a certain way, this pattern may predict who else has this disorder.
        
        The most widely used personality inventory is the Minnesota Multiphasic Personality Inventory (MMPI and MMPI-2).
      - Intelligence tests
        
        Intelligence tests were initially developed to predict how well persons would do in school (in doing so, identify slow learners who require special attention).
        
        One of the biggest mistakes is to confuse IQ with intelligence. Does a lower-than-average IQ score mean a person is not intelligent? Not necessarily. First, there are numerous reasons for a low score. For example, if the IQ test is administered in English and that is not the person’s native language, the results will be affected.
      - Projective tests
        
        Projective tests arose out of the psychoanalytic tradition and cover methods in which ambiguous stimuli are presented to a person who is asked to state what he or she sees.
        
        The theory here is that people project their own personality and unconscious fears onto other people and things—in this case, the ambiguous stimuli—and, without realizing it, reveal their unconscious thoughts to the therapist
        
        Rorschach Inkblot test
        
        The Rorschach Inkblot test that was developed by Hermann Rorschach to study perceptual processes and to diagnose psychological disorders.
        
        Currently, the Rorschach contains ten inkblot pictures that serve as ambiguous stimuli.
        
        Thematic Apperception Test (TAT)
        
        The Thematic Apperception Test (TAT) is the best known projective test, developed in 1935 by Morgan and Murray.
        
        The TAT consists of 31 cards depicting less ambiguous pictures. The test taker is asked to tell a dramatic story about what they see in the picture.
        
        TAT has limited reliability, validity, and standardisation procedures.
    - - Examples of neuropsychological tests include screening devices such as the Bender Visual-Motor Gestalt (test involves copying lines and shapes seen on a series of cards), and more sophisticated batteries of tests that can provide precise determinations of organic brain damage such as the Luria-Nebraska Neuropsychological Battery and the Halstead-Reitan Neuropsychological Battery
    - - Brain structure can be assessed using computerised axial tomography (CAT or CT scan) and/or magnetic resonance imaging (MRI). Although neuroimaging procedures are useful for identifying damage to the brain, only recently, they have been used to determine structural or anatomical abnormalities that might be associated with various psychological disorders.
      - Brain function examine the actual functioning of the brain by mapping blood flow and other metabolic activity. This can be assessed using positron emission tomography (PET) or single photon emission computed tomography (SPECT).
    - - Example of a Psychological assessment
        If a patient exhibit signs of memory loss or exhibit bizarre, trance-like behaviour, it would be important to administer the electroencephalogram (EEG). Measuring electrical activity in the head related to the firing of a specific group of neurons reveals brain wave activity.
        
        In a normal, healthy, relaxed adult, waking activities are characterized by a regular pattern of changes in voltage termed alpha waves.
        
        If frequent delta wave activity (irregular wave patterns associated with deep sleep) occurred during the waking state, it might indicate dysfunction of localized
        areas of the brain.
  - - - Nomothetic strategy
        
        is used to determine a general class of problems to which the presenting problem belongs. Associated with diagnosis
        
        Diagnosis is useful for obtaining information about psychological profiles, aetiology, and treatment. The clinician may be able to use psychiatric diagnosis to help establish a prognosis, or likely future course of a disorder under certain conditions
        
        Classification
        
        refers to any effort to construct groups or categories and to assign objects or people to these categories on the basis of their shared attributes or relations.
        
        It is a nomothetic strategy.
        
        Taxonomy
        
        refers to classification in a scientific context, and usually takes the form of describing entities for scientific purposes (e.g., rocks, insects, or in psychology behaviours).
        
        Nosology
        
        refers to the application of a taxonomic system to psychological or medical phenomena.
        
        Nomenclature
        
        refers to the names or labels of the disorders that make up the nosology (e.g., anxiety or mood disorders).
        
        The nosological system used by most mental health professionals is the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).
        
        The DSM-5 is used worldwide and clinicians refer to the DSM to identify whether a person meets criteria for a specific psychological disorder in the process of making a diagnosis.
        
        DSM: The early years
        
        Only in the late 1960s did systems of nosology
        begin to have some real influence on mental health professionals.
        
        At that point, the Psychologist and psychiatrist were using DSM II and ICD 8. But due to the lack of precision, both manuals were not widely accepted
        
        Here, Homosexuality is listed as a psychopathaology. but its not present in DSM 3 on
        
        1 more item...
        
        Approaches to Classification
        
        Classical categorical approach
        
        This approach to classification assumes that every diagnosis has a clear underlying pathophysiological cause, such as a bacterial infection or a malfunctioning endocrine system, and that each disorder is unique.
        
        Because each disorder is fundamentally different from every other, we need only one set of defining criteria, which everybody in the category has to meet.
        
        Classical categorical approaches are quite useful in medicine but it is clearly inappropriate to the complexity of psychological disorders
        
        Dimensional approach
        
        This approach notes the variety of cognition, moods, and behaviours with which the patient presents and quantify them on a scale.
        
        For example, on a scale of 1 to 10, a patient might be rated as severely anxious (10), moderately depressed (5), and mildly manic (2) to create a profile of emotional functioning (10, 5, 2).
        
        This approach was unsatisfactory because most theorists have not been able to agree on how many dimensions are required to effectively diagnose a disorder
        
        Prototypical approach
        
        This approach is a categorical approach that combines, in part, the features of the other approaches. This approach identifies certain essential characteristics of an entity for purposes of classification, but it also allows certain nonessential variations that do not necessarily change the classification.
        
        For example, if someone were to ask you to describe a dog, you could easily give a general description (the essential, categorical characteristics), but you might not exactly describe a specific dog. Dogs come in different colours, sizes, and even species (the nonessential, dimensional variations)
        
        While it is relatively user-friendly, this system is not perfect because there is a greater blurring at the boundaries of categories, and some symptoms apply to more than one disorder.
      - Idiographic strategy
        
        is used to determine what is unique about an individual’s personality, cultural background, or circumstances. Associated with assessment.