Fulufhelo

• Psychopathology


  The scientific study of psychological disorders
• Abnormal behaviour


  Any behaviour that deviates from social and statistical norms, that is maladaptive and causes personal distress
• Psychological or mental disorder


  A psychological dysfunction within an individual that is associated with distress or impairment in functioning and a response to this deviates from the person's culture
• Criteria for a mental disorder

  • Statistical deviance
  • Maladaptiveness
  • Personal distress
• Statistical deviance


  Making use of statistical norms of behaviour and experience to determine what is normal. Anything that falls far from the norm would be considered abnormal.
• Maladaptiveness


  Focus on the degree to which certain behaviours or experiences are maladaptive to the self or others. Behaviours that prevent the individual from adjusting or adapting for the good of the individual or the group are defined as abnormal.
• Personal distress


  Psychological disorders are accompanied by distress and suffering. However, distress is not sufficient alone to define abnormality and it does not always imply abnormality because all people at some point in their lives experience distress.
• Classifications of mental disorders

  • International Classification of Diseases (ICD)
  • Diagnostic and Statistical Manual of Mental Disorders (DSM-5)
• ICD


  • Produced and published by the WHO, includes a section on mental, behavioural and neurodevelopmental disorders, aimed at primary care practitioners and used worldwide
• DSM-5


  • Produced and published by the APA, focuses on mental disorders and clinically useful categories and criteria to optimise healthcare and health statistics, provides a means for the profession to communicate about clinically recognisable conditions, facilitates objective assessment of symptoms, outlines prognosis and causes, and provides a structured way to diagnose mental disorders
• The borders between DSM diagnostic categories and normality can be fuzzy and particular diagnostic entities can often be specified by numerous possible conditions and symptoms which means that some of the symptoms overlap with each other causing patients to be diagnosed with a number of disorders
• DSM-5 focus on diagnostic validity and the ICD focus on clinical utility
• Constructs remain fuzzy and complex, with fuzziness emerging at the borders between different disorders and between normality and psychopathology, remaining a matter of clinical judgement rather than easily resolved diagnostic biomarkers
• Important and widely used diagnoses are heterogeneous and may ultimately turn out to represent multiple conditions, with genome wide association studies indicating overlap in genetic risk factors consistent with complexity and multiple genes contributing to the risk of any mental disorder
• Dimensional model


  Recognises that mental disorders lie on a continuum ranging from disturbed to normal behaviour and that mental disorders may evolve overtime through various stages of the disorder, so a patient would be identified in terms of their position on a specific dimension of cognitive or affective capacity, rather than being placed in a categorical box
• Holistic model


  Considers pharmacological treatments and social and spiritual treatments on a similar level, recognising the biopsychosocial underpinnings of disorders and the role and context in which the symptoms are experienced, targeting these in an integrated way
• John Hopkins model (perspectival model)


  Different mental disorders have different natures, and identifies four perspectives that can be used to identify the distinctive characteristics of mental disorders: disease, dimensions, behaviours, and life story
• Reliability


  The degree to which a measurement is consistent, that is two or more assessors will get the same results when using the same assessment tool, and how stable the results of the assessment are over time
• Validity


  The degree to which the tool or technique assesses or measures what is supposed to assess
• Standardisation


  The process of determining specific norms and requirements for an assessment technique to make certain that it is used in a consistent manner across assessment situations
• Basic steps in the diagnostic process

  1. Ask the patient what is wrong to establish the presenting problem

  2. Focus on observable signs during the interview

  3. Rule out medical conditions that could explain the problem

  4. Perform a neurological examination

  5. Conduct a mental status examination

  6. Make a firm diagnosis through a process of identification and elimination
• Clinical interview


  Allows the diagnostician to obtain a detailed description of the presenting problem, detailed history of the patient's life, information about attitudes, emotions and behaviour, family history, and when the problem started
• Mental Status Examination (MSE)


  A systematic observation of the patient's behaviour, encompassing appearance and behaviour, thought processes, mood and affect, intellectual functioning, and sensorium
• Behavioural assessment


  Makes use of direct observation in order to assess formally an individual's thoughts, feelings and behaviours in a specific context, focusing on what happened before the behaviour, the behaviour itself, and the consequences
• Core ethical values and standards

  • Respect for persons
  • Best interests or well-being (non-maleficence)
  • Best interests or well-being (beneficence)
  • Human rights
  • Autonomy
  • Integrity
  • Truthfulness
  • Confidentiality
  • Compassion
  • Tolerance
  • Justice
  • Professional competence and self-improvement
  • Community
• Challenges to ethical behaviour include professional disrespect, confidentiality and forensic reports, inappropriate relationships with clients, selection assessment, fees, advertising, and competence
• Aetiology


  The study of the cause of disorders, which guides the clinician in understanding a patient's symptoms and making decisions regarding treatment, but does not provide direct answers because human behaviour is highly complex and disorders are often multi-factorial
• Psychologist should charge a patient

  Strictly according to the actual duration of the therapy session and according to the agreed fees
• Advertising for professional services


  There are strict guidelines
• Competence of professionals


  They should be careful not to act outside their level of competence as this may lead to harm to the client
• Self-assessments on pg. 75-76; 96-97; 157-158
• Aetiological models
• Aetiology


  The study of the cause of disorders
• Understanding aetiology guides the clinician in understanding a patient's symptoms and making decisions regarding treatment
• Aetiology does not provide us with direct answers about the causes of disorders because:

  • Human behaviours is highly complex
  • Disorders are more often than not caused by multiple factors
  • Casual factors change over the lifespan
  • Different casual routes exist for the same disorder
  • The same casual route may develop into different disorders
• Reasons why the study of aetiology of disorders is important:

  • Treatment and management of disorders is often informed by the aetiology of the disorder
  • A better understanding of the aetiology can also inform categorisation and classification of disorders
  • Studies of aetiology stimulates further research
• Equifinality


  When sets of different circumstances lead to the same disorder
• Multifinality


  When sets of similar beginnings lead to different disorders
• Biomedical perspectives


  • This model claims that all mental illnesses have a biological cause
• Biological abnormalities understood to occur in four different areas

  • Genetic predisposition
  • Abnormal functioning of neurotransmitters
  • Endocrine dysregulation
  • Structural abnormalities in the brain