What is Nosology and one method of classification?
The study of how medicine classifies illnesses
- one method = cause (typically for physical/medical illnesses but difficult with mental)
How are mental disorders classified?
According to Symptoms… descriptive/symptom based approach
What are two key issues of symptom based classification?
Symptom overlap and Heterogeneity
What is symptom overlap?
Some symptoms are common to many mental illnesses, challenge discerning diving lines between different mental disorders
What is Heterogeneity?
Individuals with the same diagnosis may have very different symptoms and present differently… wide variety of symptoms for each disorder… DSM criteria only require some of the noted criteria ->makes it difficult to explain behaviours and determine best treatments
What is OCD?
A manifestation of anxiety revolving around obsessive and intrusive thoughts
- obsessions = disruptive, anxiety producing thoughts and/or mental images - uncontrollable thoughts
- compulsions = repetitive actions of thoughts performed in order to relieve anxieties
- presence of obsessions, compulsions, or both
- often thought as chronic or persistent, but can be treated
- avoidance
What is PTSD?
- typically after single traumatic event (wide range) or repeated trauma over time
- symptoms brought on by trauma
What are the symptoms of PTSD?
- dissociative episodes (flashbacks) associated with triggers
- nightmares
-negative moods
-sleep disruption
-tension
What are some similarities of OCD and PTSD?
- anxiety
- attempts to avoid triggers
- OCD may manifest after experience of trauma
- similar treatments (CBS and exposure based therapies)
What are some differences of OCD and PTSD?
- obsessions and compulsions are very different from flashbacks
- OCD not always triggered by a traumatic incident
What is somatic symptom disorder?
Describes individuals who have anxiety and/or a fixation on somatic symptoms… may or may not have a diagnosis for a physical illness that is causing symptoms… ‘excessive and abnormal’ psychological reaction to physical symptoms
What is illness anxiety disorder?
Excessive worry about the possibility of becoming ill…
How do these disorders around health demonstrate a complex link between physical and mental health?
Who determines when health concerns are excessive = traditionally a clinician but what about patient perspective
- might these diagnoses pathologies people who have medically unexplained illnesses? perhaps there is a real yet unknown medical condition at root of the symptoms?
What are the two clinical perspectives about knowledge?
- Positivist Framework
- Constructivist perspective
What is the Positivist Framework?
- Scientific knowledge always improving
- mental health/illness as objective and concretely knowable (one reality)
- assumes we will discover the nature of mental health and best way to diagnose and treat
What is the Constructivist perspective?
- knowledge is fluid, contingent, contextual
- unanswered questions will not be easily solved or solved at all
- understanding based on social reality
- what is agreed upon is subject to change and consensus reached not by best evidence but culture, scientific trends…
If we were to divide a disorder into subtypes what would be the difference?
causes, levels of functioning, treatment options different for each
What is symptom dimension approach?
Possible to have several types of symptoms (representing potential subtypes) at varying levels of severity
What is a conceptual issue about creating subtype categories?
Not based on empirical evidence but researchers’ assumptions (rationally rather than empirically derived)
What is the Yale Brown Obsessive Compulsive scale?
- comprehensive symptom checklist
-7 types of obsessions - 6 types of compulsions
What is the autogenous vs reactive symptom model?
Autogenous symptoms = self generated triggers (sexual or aggressive thoughts) vs Reactive symptoms- responses to external stimuli (triggers regarding contamination or symmetry)
What is the core dimensions model?
- defines dimensions based on symptom theme
- Harm avoidance - thoughts and actions to avoid harm
- Fear of incompleteness - one’s actions or intentions have not been correctly achieved
What are two defining symptoms of PTSD?
- hyper-arousal - being highly vigilant and alert
- re-experiencing of events related to the trauma
What is PTSD-DS
- Dissociative subtype
- Dissociation - psychobiological defence mechanism where normal integration of consciousness, memory, identity, perception, emotion, body representation, motor control, behaviour is disturbed
- can provide temporary psychological escape in times of extreme trauma or stress
- severity in part due to cognitive impairment with dissociation
