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Questions and Answers
What is the primary disturbance in mood disorders?
Which combination of symptoms characterizes a Major Depressive Episode (MDE)?
What is a core feature of Generalised Anxiety Disorder (GAD)?
Which of the following symptoms is NOT associated with Panic Disorder (PD)?
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What is a primary characteristic of mental health?
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Which statement best describes a psychological disorder?
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What is NOT a criterion for a mental disorder according to DSM-5-TR?
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Which factor is NOT considered in case formulation?
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What aspect of mental disorders does B.F. Skinner's theory emphasize?
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How does Aaron T. Beck's cognitive-behavioral model primarily explain mental disorders?
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What type of diagnostic approach does the DSM-5-TR primarily use?
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Which component is a focus in understanding mental disorders according to the biopsychosocial model?
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What age group has the highest prevalence of 12-month anxiety disorders?
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Which model explains depression through a combination of low positive affect and high negative affect?
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Which cognitive aspect is involved in Beck’s Cognitive Model of Depression?
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What does the term ‘psychosis’ primarily refer to?
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What is a requirement for a schizophrenia diagnosis?
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According to the ABC Model, what does 'B' stand for?
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Which of the following best describes the Hi-Top approach?
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What does the negative triad in Beck’s model refer to?
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What relationship aspect was identified as having the most significant stigma and discrimination for Australians living with mental illness?
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Which of the following symptoms is NOT a criterion for Major Depressive Episode (MDE)?
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What is the minimum duration required for symptoms to qualify for Generalised Anxiety Disorder (GAD)?
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In Panic Disorder (PD), what is a typical behavioral change that may occur following a panic attack?
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How can poor quality education regarding mental illness impact stigma?
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What are considered positive symptoms in schizophrenia?
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Which symptom is classified as a negative symptom?
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Who coined the term 'schizophrenia'?
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What did Emil Kraepelin emphasize in his description of 'dementia praecox'?
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Which of the following is NOT considered a first rank symptom according to Schneider?
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What theory suggests that high levels of criticism and emotional over-involvement can contribute to psychosis?
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What aspect of personality is considered a vulnerability for disorders?
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Which factor is associated with a higher likelihood of developing schizophrenia if both parents have the disorder?
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Which personality disorder is characterized by a pervasive distrust and suspicion of others?
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Which diathesis is associated with depression?
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In the context of personality disorders, which cluster is referred to as ‘anxious’?
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What does the stress-diathesis model suggest about the development of mental disorders?
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Which of the following represents a common misconception regarding dissociative identity disorder (DID)?
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Which personality trait is associated with the diathesis for obsessive-compulsive disorder (OCD)?
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What is a characteristic of narcissistic personality disorder?
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Which psychological phenomenon is suggested as a coping strategy during traumatic stress, possibly leading to alter personalities in DID?
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Study Notes
Introduction to Mental Health and Disorder
- Mental health is a state of well-being that enables individuals to cope with life's stresses, utilize their abilities, learn effectively, contribute to their community, and work productively.
- Mental illness is a clinically diagnosable disorder significantly impacting an individual's cognitive, emotional, or social abilities.
- The DSM-5-TR defines mental disorder as a syndrome characterized by a significant disturbance in an individual's cognition, emotional regulation, or behavior, reflecting a dysfunction in the psychological, biological, or developmental processes underlying mental functioning.
- Mental disorders are typically associated with significant distress or disability in social, occupational, or other important activities.
- A mental disorder is not an expectable or culturally approved response to a common stressor, nor is it socially deviant behavior and conflicts primarily between the individual and society.
- The DSM-5-TR is a diagnostic tool predominantly categorical (disorder diagnoses) with some dimensional components (e.g., symptom severity rating).
- Diagnosis relies on clinical interviews, textual descriptions, and diagnostic criteria that assess current symptoms while ruling out disorder due to a general medical condition or substance use.
- Case formulation examines biopsychosocial factors like predisposing risk factors, precipitating risk factors, perpetuating risk factors, and protective factors.
Different Approaches to Understanding Mental Disorder
- Freud believed that mental illness originates from unresolved unconscious motives and conflicts, like repressed childhood experiences and desires.
- B.F. Skinner believed that mental disorders result from maladaptive learned behaviors.
- Aaron T. Beck developed the cognitive-behavioral model, linking thoughts, emotions, and behaviors and how they interact to potentially lead to disordered mindsets.
- The Australian National Stigma Report Card aimed to understand how Australians with mental illness experience stigma and discrimination.
- It found that relationships with friends and family are most affected by stigma and discrimination, followed by social media. The report revealed over 80% of those surveyed have stopped trying to make or maintain friendships due to stigma.
- Contact and education are the best ways to reduce stigma. However, inadequate education can exacerbate stigma.
Mood and Affect
- Mood refers to a person's sustained experience of emotion.
- Affect refers to the immediate experience and expression of emotion.
- Mood disorders involve a depression or elevation of mood as the primary disturbance.
Core Features of MDE and MDD
- The Major Depressive Episode (MDE) criteria involve five or more DSM-5 listed symptoms present for two or more weeks. These symptoms include depressed mood, anhedonia, change in appetite/weight, change in sleep, fatigue, worthlessness, lack of concentration, and recurrent thoughts of death/suicide.
- Major Depressive Disorder (MDD) involves an MDE that is not better explained by another diagnosis.
Core Features of PD, GAD, and PTSD
- Panic Disorder (PD) involves recurrent, unexpected panic attacks with at least four of the following symptoms: heart palpitations, sweating and trembling, shortness of breath, chest pain, nausea, dizziness, fear of losing control or dying, etc. The attacks are followed by at least one month of significant behavioral change and persistent worry about another panic attack.
- Generalized Anxiety Disorder (GAD) involves excessive anxiety occurring more days than not for over six months. The anxiety is associated with at least three of the following: restlessness, fatigue, difficulty concentrating, irritability, muscle tension, and sleep disturbance.
- Prevalence rates for PD, GAD, and PTSD are significantly higher in women and peak between the ages of 16-24. Approximately 30% of people experience any 12-month anxiety disorder at that age, and ~13% experience any 12-month mood disorder.
Different Explanations of Depression
- The Tripartite Model of Depression and Anxiety (Clark & Watson, 1991) suggests that a combination of low positive affect and high negative affect leads to depressive symptoms, while negative affect and anxious arousal lead to anxiety symptoms.
- Hi-Top and the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders outline the various processes that lead to mental disorders, with most anxiety/mood disorders being caused by internalizing and fear/distress
- The Behavioural Model proposes that low rates of operant behavior and low rates of reinforcement contribute to depression.
- Beck's Cognitive Model of Depression looks at negative events that establish negative schemas (beliefs, rules, and assumptions). The activation of these schemas leads to negative automatic thoughts (NAT) that serve as "fuel" for depression. It also includes the negative triad: a cognitive pattern involving negative thoughts about the self, the world, and the future.
- ABC Model: A = activating event, B = belief, C = consequence
- Cognitive paradigm: thought, emotion, and behavior
Psychosis
- The term 'psychosis' is an umbrella term meaning 'out of touch with reality'. At the disorder level, psychosis refers to a group of disorders distinguishable based on symptom configuration, duration, and relative pervasiveness.
- The term 'schizophrenia' means 'split mindedness' or 'a mind torn asunder'.
Schizophrenia Spectrum Disorders
- The diagnostic criterion for schizophrenia requires a one-month period in which at least two of the following are present for a significant portion of the time: delusions, hallucinations, disorganized speech, disorganized or catatonic behavior, and negative symptoms. Continuous signs of disturbance for at least six months are also required.
Positive and Negative Symptoms
- Positive symptoms are additive to normal experience: hallucinations, delusions, clanging, circumstantiality, flight of ideas, derailment, incoherence, pressure of speech.
- Negative symptoms are a deficit in normal function: avolition (lack of motivation), alogia (poverty of speech), anhedonia, affective flattening, inattention.
History of Schizophrenia
- Benedict Augustine Morel (1860) described 'demence precoce' based on observations of individuals displaying a set of symptoms and experiencing early onset and deteriorating course.
- Emil Kraepelin (1898) described 'dementia praecox', still emphasizing early onset and deteriorating course, but differentiated from other forms of psychosis by emphasizing hallucinations, delusions, negativism, attentional difficulties, stereotypies, and emotional dysfunction.
- Paul Eugen Bleuler (1908/11) coined the term 'schizophrenia' and disagreed with characterizing the disorder as a dementia. He focused on the symptoms of association (cognition), affectivity, ambivalence, and autism (withdrawal from reality).
- Schneider (1959) emphasized 'first-rank symptoms', which include hearing one's voice out loud, hallucinatory voices, hallucinatory running commentary, somatic hallucinations, thought withdrawal, thought insertion, thought broadcasting, delusion perceptions, made feelings, made actions, and made impulses. However, a number of these symptoms overlap with other disorders.
Aetiological Theories of Psychosis
- Expressed Negative Emotion: form of family communication characterized by high levels of criticism, hostility, and emotional over-involvement.
- Stress-vulnerability model.
- Biological models:
- Seems to be a genetic predisposition. If both parents have schizophrenia, there is a ~35% chance the child will develop it.
- Structural abnormalities in the brain.
- Lack of dopamine.
Personality as a Vulnerability for Disorder
- Personality is what makes you uniquely you. Some personality types are more susceptible to mental health issues generally. Personality can be somewhat genetic, and some genes lead to greater vulnerability.
Diatheses for Various Disorders
- Most mental disorders involve the combined action of a personality vulnerability (i.e., diatheses) and environmental stress.
- Depression: dependency, autonomy, self-criticism, pessimistic attributional style.
- Schizophrenia: social anhedonia, physical anhedonia, perceptual aberration, magical thinking.
- Perfectionism and anorexia.
- Hypomanic temperament and bipolar disorder.
- Thought-action fusion and OCD.
- Anxiety sensitivity and panic disorder.
Personality Disorders
- Cluster A or the 'odd' cluster: e.g., Paranoid personality disorder, which involves a pervasive distrust and suspiciousness of others. Suspicion of exploitation or harm, doubts of loyalty, reads hidden messages, holds grudges, etc.
- Cluster B or the 'dramatic' cluster: e.g., Narcissistic personality disorder, which involves a pervasive feeling of grandiosity, need for admiration, lack of empathy, and sense of entitlement, etc.
- Cluster C or the 'anxious' cluster: e.g., Avoidant personality disorder, which involves a pervasive pattern of social inhibition, feelings of inadequacy, hypersensitivity to negative evaluation, and unusual reluctance to take risks.
Stress-Diathesis Models of Disorder
- These models explain how a combination of a predisposition to a disorder (diathesis) and a stressful event can trigger the onset or exacerbation of a mental health condition.
DID and Explanations
- DID involves someone having two or more personalities that switch, leading to noticeable changes in affect, behavior, consciousness, memory, perception, cognition, and/or sensory-motor functioning.
- It's a somewhat controversial diagnosis, and there has been an apparent explosion in cases, and symptoms can alter quite significantly.
- The dominant theory for explaining DID is that dissociation is a self-defense method or coping strategy during traumatic stress, and patients become so practiced and skilled at this defense that they construct alter personalities.
- Another theory suggests that therapists can cause split personalities by suggesting to a patient that they are a certain way, and the patient somewhat becomes that person.
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Description
Explore the foundations of mental health and mental disorders in this quiz. Understand concepts related to well-being, mental illness, and the criteria set by the DSM-5-TR. Test your knowledge on how these disorders impact individuals' lives and well-being.
