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Abnormal Psychology - Coggle Diagram

- - - - Patients have full awareness of their treatment
    - - Combative treatments: goes against thought-processes
    - - Customised specifically to the patient (not the same with all patients)
        
        Cultural adapted psychotherapy eg. Chinese Taoism treatment for depression
- - - - Evaluate one or more treatments related to mental disorders.
      - To what extent does culture affect treatment?
      - Evaluate studies into treatment for mental disorders.
      - Discuss research methods used to investigate treatments into mental disorders. (meta-analyses, outcome studies, intervention, or strengths and limitations of both)
      - Discuss ethical considerations related to treatment.
      - Discuss the effectiveness of treatment
      - Discuss/evaluate/contrast the effectiveness of one or more treatments related to mental disorder.
      - Explain psychological treatment with reference to one study.
      - Explain biological treatment with reference to one study.
      - Compare and contrast biological and psychological treatment.
- - - - DSM - American Psychiatric association (5th revision) EMIC (for Americans), ETIC if applied internationally
        
        Determined mainly through American psychiatrists
      - ICD - World Health Organisation (11th revision) ETIC
        
        Takes into account multicultural factors (ETIC)
      - CCMD - Only within Chinese territory, focusing on mental issues within Chinese culture EMIC
      - Strengths and limitations of classification systems
        
        Strengths
        
        Help guide research: The diagnostic checklists help ensure that different groups of researchers are studying the same disorder
        
        The DSM eliminates a lot of guesswork. Proper diagnosis and treatment of mental illness can be identified through checklists
        
        Limitations
        
        Oversimplifies human behavior - doesn’t take into account the complex nature of each individual
        
        Fails to recognise that culture is dynamic
        
        there is an element of subjectivity
        
        STUDY: Bolton (2002) :
        
        The DSM was used to diagnose depression, however, the information from the DSM was different to how the local people perceived depression. In this case, using the DSM to diagnosis indicates an etic approach to diagnosis.
        
        Later on, Bolton then worked with a non-profit organization that set up a program to address the psychological aftermath of the Rwandan genocide to determine the correct diagnosis for depression.--> emic approach --> considering symptoms that are specific to an individual's home culture
        
        Risks of misdiagnosis:
        
        Recieving incorrect treatment
        
        Deterioration of mental health due to incorrect treatment
      - Clinician: Temerlin, Ford and Widiger - confirmation bias
  - - - Ideal mental health: sense of identity, self-esteem, balanced relationship, having control, managed stress well - need to tick off all of the list to be considered normal -> subjective
      - Deviation from social norms: how well someone fits a behaviour the majority present. What is considered normal changes over time.
        
        Single mothers
        
        Homosexuality
      - Deviation from statistical norm: any behaviour that deviates from the majority and is statistically rare is classified as abnormal
        
        Who decides what is the social norm? Cultures have different behaviours which they consider normal/abnormal.
        
        prevalence rate may play a role in people who are statistically infrequent
        
        How do we classify what is abnormal? With e.g continuous data there is a problem with deciding when results are considered pass the benchmark for abnormal. Often mental issues are statistically rare but would it be because there are fewer people with the issue or is it because it goes undiagnosed (which could influence what is considered normal)
      - The use of a mental health criterion: established communication framework between clinicians in terms of its universality of the criteria of symptoms
        
        ignores cultural and individual differences of expressing symptoms
  - - - clinical interviews may be used - however relies a lot on clinician and client rapport
        
        demand characteristics and self reported symptoms by client may be present
      - Validity: misdiagnosis, self-fulling fallacy
        
        STUDY: Rosenhan - validity in diagnosis. Clinicians often assume you have a mental illness if you are seeking help
    - - May be a result of mental illness stigmatisation.
    - - Influence reliability: interviews, questionnaires, interrater
      - Criterion reliability: whether the criteria used twice gets the same outcomes
      - STUDY: Becks
      - Inter-rater reliability: different clinicians can diagnose patients using the same criteria, and the same diagnosis should be produced.
        
        STUDY: Nicholls et al. (2002) :
        
        Investigated inter-rater reliability within diagnosis and showed that neither the ICD-10 nor the DSM-IV had good inter-rater reliability for the diagnosis of eating disorders in children. 81 patients aged 7-16 years who were suffering from eating problems were studied and diagnosed using the DSM-IV, the ICD-10, and a system developed by Great Ormond Street Hospital specifically for children.
        
        While classification systems can potentially help characterise mental illness --> not always reliable --> factors such as age difference may influence the reliability of diagnosis as individuals from different age groups may experience mental issues differently. By developing their own system in the hospital, they were able to increase the inter-rater reliability by up to 88%.
    - - Confirmation bias (Impacts validity within diagnosis)
        
        STUDY: Rosenhan (1973) :
        
        Rosenhan’s research shows that diagnosis can be reliable but not valid due to anchoring bias and the labeling theory which eventually leads to confirmation bias. These factors play a role in the reduction of validity in diagnosis. This study shows that validity within diagnosis can be very low as normal people are diagnosed with a mental illness due to confirmation bias. If a person is in a mental hospital, it indicates that they have a mental illness. As a result, clinicians will seek every possible symptoms (even normal behavior) that confirms their assumptions.
      - Culture bias (imposed etic): Reducing subjectivity and operationalising mental health issues by relying on classification systems such as the DSM and ICD can lead to invalid diagnosis as these systems can be culturally biased.
        
        STUDY: Bolton (2002)
- - - - Parker et al (2001) - Chinese Malaysian expressed somatic symptoms vs Australian experience more mood-related symptoms
    - - country: war and conflict
      - -> 19% prevalence in Lebanon Beirut
        
        -> 16.4% prevalence in France Paris
        
        -> 2.9% prevalence in South Korea
        
        -> 1.5% prevalence in Taiwan
        
        De Vaus et al. - 20% of Americans will experience depression in their lifetime while only 2% of Chinese people experience it in their lifetime
        
        -> 20% prevalence rate America
      - Worldwide: 5.5% (females) and 3.2% (males)
    - - clinician biases - confirmation bias - gender bias
      - Alloy: cognitive triad and developing symptoms of depression
  - - - Overgeneralise, magnify issues
      - Joiner et al. (1996): Questionnaires for students before mid-term exams. Results: higher negative thinking and poorer performance on tests --> more behavioral symptoms of depression
  - - - Twin studies, family studies
        
        Sullivan et al. (2000): twin/family studies on major depressive disorders (meta-analysis)
        
        Kendler: twins study
        
        Weismann et al. : family studies
        
        Ethical considerations in investigating the impacts of environment/genetics of twins by separating them
      - Caspi 2003 - The effects of having 2 short allelles on 5-HTT gene on depression
    - - Serotonin hypothesis: drugs work. Correlational of how low serotonin levels can be balanced by drugs
    - - Limitation: results are mainly correlational
  - - - Protective factors (Decrease risk of depression)
        
        Familial bonds / Friend groups
      - Vulnerability factors (Increase risk of depression)
        
        Loss of parent or guardian
        
        Unemployment
        
        Taking care of more than 3 children
      - Provoking agents (ongoing stress)