Mental Health Disorders Quiz

Defining Psychopathology

• Deviation from Social Norms:
  • Definition: Behavior that differs from cultural and societal norms.
  • Examples: Public nudity, hearing voices in cultures where it's not acceptable.
  • Expanded Examples: Introversion may be viewed as a concern in Western societies but valued in some Asian cultures, while behaviors from the past, like witch hunts, demonstrate how deviations can be sometimes unjustly pathologized.
  • Critiques:
    • Cultural relativity—what is considered normal varies significantly across cultures.
    • Not all deviations are indicative of a pathology. Artists and innovators often defy established norms.
    • Risks stigmatizing non-conformity, such as neurodiversity
  • Deviation from Statistical Norms:
    • Definition: A condition is considered abnormal if it's rare within a population (e.g., extreme IQ).
    • Expanded Examples: High IQ, physical attributes like excessive height, and savant skills in autism. It also includes behaviours that fall outside the typical functioning range, even if they might be beneficial.
    • Critiques:
      • Arbitrary thresholds for defining abnormality. Not all unusual traits are pathological (e.g., exceptional talent).
      • Positive deviations may not necessitate intervention.
  • Maladaptive Behaviour and Dysfunction:
    • Focus: Impairment in daily functioning or harm.
    • Examples: Difficulty maintaining employment or relationships due to obsessive behaviors.
    • Context: Widely used in DSM-5 and clinical practice. -Considerations: Behaviors can range from mild to severe with some exhibiting adaptive functions despite the negative consequences.
  • Distress and Disability:
    • Focus: Personal suffering and functional impairment.
    • Examples: Those who silently struggle with depression vs. individuals outwardly expressing their symptoms.
    • Recognition: Includes subjective experiences alongside observable impairment in functionality.

Historical Models of Psychopathology

• Ancient Greeks (Hippocrates):
  • Humorism: Imbalance of body fluids (e.g., excessive black bile = melancholia)
  • Treatments: Bloodletting, dietary adjustments, rest, and exercise.
• Demonology:
  • Belief: Mental illness = possession by demons
  • Expanded Examples: Varying cultural practices of "spirit possession" vs. exorcism
  • Treatments: Exorcisms, purging, and isolation
• Asylums (1700s-1900s):
  • Treatment as inmates: Often inhumane conditions.
  • Interventions: Physical methods and moral therapy (order and discipline)
• Deinstitutionalization (1950s-1970s): -Introduction of milieu therapy and psychotropic medications. - Shift to community-based care, including programs like the Clubhouse Model for schizophrenia care.

Stigma

• Types:
  • Social Stigma: Negative perception of mental illness.
  • Self-Stigma: Internalized societal stereotypes about mental illness by individuals
• Origin:
  • Historical fear and misunderstanding of mental illness.
  • Negative portrayals in media (e.g., associating mental illness with violence)
  • Misrepresentation in education and public discourse
• Expanded Impact:
  • Examples of effective anti-stigma campaigns (e.g., Time to Change, Beyond Blue).
  • Cultural variations in attitudes towards mental health support (e.g., seeking help may be seen as dishonorable.)

Biological Models

• Genetics:
  • Mental health disorders are influenced by multiple genes.
  • Examples: Twin studies showing a 50% concordance rate for schizophrenia in identical twins.
• Neuroscience:
  • Focus: Brain abnormalities (structural/functional).
  • Examples: abnormal levels of dopamine in schizophrenia or serotonin deficits in depression.
• Limitations:
  • Overemphasis on biology can ignore psychosocial influences and cultural contexts
  • Ethical concerns regarding over-medicalization and excessive focus on pharmacological intervention.

Psychological Approaches

• Psychodynamic:
  • Focus: Unconscious conflicts stemming from early experiences.
  • Techniques: Free association, dream analysis, transference-focused therapy.
• Behaviorism:
  • Principle: Abnormal behavior is a result of faulty learning.
  • Techniques: Classical conditioning (systematic desensitization, exposure therapy), and operant conditioning (token economies, reinforcement).
• Cognitive:
  • Focus: Changing irrational thoughts and cognitive distortions.
  • Examples: Challenging automatic thoughts (e.g., "I'm a failure")
• Humanist-Existential:
  • Principles: Emphasis on personal meaning, self-actualization, and freedom.
  • Examples: Grief counseling emphasizing acceptance and growth.

Diagnosis and Classification

• DSM-5 vs. ICD:
• Comparison: Autism classification in DSM-5 vs.ICD (single spectrum vs. separate categories).
• Advantages of DSM-5: Improves diagnostic precision. Widely used
• Advantages of ICD: Wider applicability for global healthcare systems.
• Additional Information:
  • Diagnostic advantages: facilitates communication among professionals, guides treatment and research, provides a framework
  • Critiques: symptoms may be subjective, cultural biases in symptom expression, significant overlap between disorders

Assessment Methods

• Clinical Interviews: Unstructured vs. structured interview methods.
• Tests: Psychological tests (e.g., MMPI-2, WAIS), neuropsychological tests, and projective tests (e.g., Rorschach).
• Clinical Observation: Direct monitoring of behaviour in naturalistic settings.

Formulation-Based Approaches

• Process:
  • Gathering data about problems and context
  • Hypothesis creation (theory-based) about underlying mechanisms.
  • Exploring causes and contributing factors
• Core Clinical Competency:
  • Assessment: Comprehensive information gathering (interviews, tests, observation)
  • Formulation: Creating hypotheses linking theory to practice and tailoring to individual needs.
  • Intervention: Tailored treatment based on theory and patient needs
  • Evaluation: Assessing outcomes of intervention
  • Research: Evidence-based practice for quality care

Anxiety Disorders (DSM-5)

• Specific Phobias: Intense fear of specific objects or situations.
• Social Anxiety Disorder: Fear of unfamiliar situations or social scrutiny.
• Panic Disorder: Recurrent panic attacks and persistent anxiety regarding these attacks
• Agoraphobia: Fear of places where escaping would be difficult.
• Generalised Anxiety Disorder (GAD): Excessive and uncontrollable worry in various aspects (e.g., family, health, work etc.).
• Prevalence: 28% of people report experiencing anxiety symptoms.

Fear vs. Anxiety

• Fear: Response to an immediate, defined threat.
• Anxiety: Apprehension about future threats.

Generalized Anxiety Disorder (GAD)

• DSM-5 Criteria: Excessive worry about two or more areas for more than three months.
• Associated symptoms: Restlessness, muscle tension, difficulty concentrating.
• Distress or impairment: Significant impact on daily functioning.
• Prevalence: 0.5% in the UK; 5.7% in the US. More common in women and peak onset is typically between 35-59 years of age.
• Etiology:
  • Genetics: Anxiety has inheritable components
  • Brain Regions: Dysfunction in amygdala and prefrontal cortex
  • Neurotransmitter Imbalance: Imbalances in serotonin, norepinephrine, and GABA.
  • Environmental Factors: Stressful events and parenting styles (e.g., attachment style)
• Psychological theories
  • Pathological Worrying: Worry serves as a distraction from emotions
  • Cognitive Mechanisms: Attention to threats and difficulty disengaging.
  • Trait Characterisitcs: Those who are intolerant of uncertainty are more prone to GAD.

Panic Disorder and Agoraphobia

• Panic Disorder: Characterized by recurrent, unexpected panic attacks.
• Agoraphobia: Intense fear of specific situations or places where escape might be difficult or help unavailable during panic attacks.

Eating Disorders

• Types:
  • Unspecified Feeding and Eating Disorder (UFED)
  • Anorexia Nervosa (AN): Restriction of energy intake, leading to low body weight, intense fear of weight gain, and distorted body image.
  • Bulimia Nervosa (BN): Cycles of binge eating with compensatory behaviors like self-induced vomiting.
  • Binge Eating Disorder (BED): Recurrent binge-eating episodes with no compensatory behaviors.
  • Avoidant/Restrictive Food Intake Disorder: Lack of interest/discomfort with eating or types of food.
  • Pica: Consumption of non-food items. -Rumination Disorder: Repeated regurgitation of food.

Mood Disorders

• Unipolar Disorders:
• Major Depressive Disorder (MDD): Severe depressive episode lasting more than two weeks with at least 5 symptoms.
• Persistent Depressive Disorder (PDD): Chronic depression lasting at least 2 years, less severe than MDD.
• Premenstrual Depressive Disorder: Depressive symptoms tied to menstrual cycles.
• Bipolar Disorders:
• Bipolar I: Full manic episodes and possible depressive episodes.
• Bipolar II: Hypomanic episodes and possible depressive episodes.
• Cyclothymia: Chronic milder shifts between hypomania and mild depression.

(NOTE: The following is an incomplete outline and more needs to be added to each Disorder to form complete notes. In addition, many headings are repeated throughout the material)

Personality Disorders

• Definition: Enduring patterns of inner experience and behaviour that deviate markedly from cultural expectations, are inflexible across various situations, and cause distress or impairment of social, occupational, or other functioning.
• Personality Traits vs. Disorders
  • Egodystonic vs Egosyntonic:
    • Egodystonic: Thoughts, impulses, and behaviours are in conflict with the individual's ideal self-image.
    • Egosyntonic: Behaviors and thoughts align with the individual's self-perception (e.g., many PDs). -Traits vs. States:
    • Mental states are temporary, emotional or cognitive conditions.
    • Personality traits are stable over time and context. Extreme traits become disorders.

Substance Use Disorders (SUD)

• DSM-5 Criteria: Clinically significant impairment or distress with two or more symptoms within 12 months.
• Prevalence and Epidemiology: - High rates(60% prevalence) in alcohol usage. - General Trend: Declining rates among younger groups - High comorbidities with other mental health conditions
• Characteristics of Substances: - Psycholeptic(e.g., calming), or Psychoanaleptic (e.g., stimulating) or Psychodysleptic (perception-altering).

PTSD

• Exposure to Trauma:
  • Direct exposure or witnessing to severe injury or sexual violence.
• Intrusive Symptoms:
  • Unwanted or distressing memories, nightmares, flashbacks, or dissociative reactions to trauma-related cues.
• Persistent Avoidance:
  • Avoiding trauma-related thoughts, memories, or feelings: Avoiding places, objects, activities, or people that serve as reminders of trauma.
• Negative Cognitions and Mood:
  • Impairment in recalling events, distorted beliefs about oneself/world, negative emotions (fear, guilt), detachment from others, and inability to feel positive emotions.
• Arousal and Reactivity:
  • Hypervigilance, exaggerated startle responses, irritability/aggression, reckless/self-destructive behaviours, difficulty concentrating.

Complex PTSD

• In addition to the standard PTSD symptoms, individuals experience:
  • Emotional dysregulation (anger, numbness, shame)
  • Negative self-cognition (worthlessness),
  • Relational difficulties.

ADHD (Attention-Deficit/Hyperactivity Disorder)

• Core Symptom Clusters:
  • Inattention (difficulty concentrating, easily distracted)
  • Hyperactivity (constant movement, talking excessively)
  • Impulsivity (blurting out answers, difficulty waiting)
• DSM-5 Criteria: At least six symptoms in the inattention and/or hyperactivity/impulsivity categories for at least six months. Impairments impact daily functioning.
• Prevalence & Demographics:
  • 5% prevalence among children (lower in adults due to trajectories).
  • Gender Differences: Boys are diagnosed more often .
• Comorbidities:
  • Overlap with other conditions (e.g., ODD, CD, anxiety/depression, and substance use disorders).
• Developmental Impact:
  • Academic difficulties, social challenges, and emotional issues.

Test your knowledge on various mental health conditions, specifically focusing on Generalized Anxiety Disorder (GAD) and panic disorder. This quiz covers symptoms, treatment methods, and significant historical models in psychopathology. Challenge yourself to identify key concepts and their implications in mental health care.