Mental Health and Wellbeing
What are the effects of receiving a diagnosis? - Answer-Positive effects include:
-Gives people access to services and support
-Helps people make sense of their feelings
-Reduces self-blame
Negative effects include:
-stigma
-sense of defeat,
-people feel diffe...
Mental Health and Wellbeing
What are the effects of receiving a diagnosis? - Answer-Positive effects include:
-Gives people access to services and support
-Helps people make sense of their feelings
-Reduces self-blame
Negative effects include:
-stigma
-sense of defeat,
-people feel different
What are mental health problems? - Answer-Mental health problems are recurring
patterns of human experience that are not statistically abnormal (1/5 people
experience them).
Abnormal psychology aligns with the diagnostic classification/ biomedical point of
view that we want to move away from and the term itself is stigmatising
What are diagnoses? - Answer-Discrete entities that recurring and reliable patterns
of human experiences are attempted to be categorised and classified into.
The aims of diagnoses are to ensure that people are talking about the same
phenomena and so to increase reliability, but it rests on the assumption that
diagnosis will lead to understanding of mechanism, cause and treatment
What are the two main classification systems? - Answer-- Diagnostic & Statistical
Manual of Mental Disorders (DSM-5). American: APA. Very highly influential across
the world
-International Classification of Diseases (11th edition) World Health Organisation
What are Task Forces? - Answer-Psychological committees that describe mental
health difficulties in terms of criteria (symptoms) required for diagnosis
What are some of the critiques of Diagnostic Systems and DSM-5 in particular? -
Answer-- Unlike other branches of medicine where we study symptoms to identify
diseases and thus causes of symptoms, in psychiatry, the biological causes of
psychiatric disorders is limited. We don't know if the recurring patterns in behaviour
are actually discrete things. Unlike other branches of medicine, there is not test to
see if someone has a disorder or not. The definitions are only based on clusters of
symptoms as opposed to what they are caused by unlike cancer. High reliability but
low validity.
- The search for biological causes of psychological disorders has not delivered
anything particularly convincing
- The proliferation of mental disorders has led to the medicalisation of normal human
experience eg grief after bereavement could mean you are diagnosed wit
depression. The section in dsm-4 that prevented grieving people from being
diagnosed with depression was removed in dsm-5. Now people will be put on drugs
as opposed to having their friends and family help them
-minor changes to criteria can lead to more diagnoses, making it look like the
prevalence of a condition fluctuate rapidly over time eg in ADHD, and autism after
, DSM-4. The incorporation of Asperger's Syndrome within Autism Spectrum poses
problems for longitudinal studies.
- over 60% of the DSM task forces had some financial links with pharmaceutical
companies. Their incentives are then questionable?
-The fact that the DSM-5 is a published book means it provides significant income to
the APA and as the publication of the DSM-5 was being delayed, and thus in a rush
for publication, they compromised on sufficient testing of the new criteria. This might
lead to mis-diagnosis which is dangerous as it puts people on drugs who might not
need to be. This risks over-diagnosis and diverting attention away from people who
need the most help.
-loss of meaning and
What is a formulation? - Answer-An attempt to use psychological information to
understand the origins, mechanisms and maintenance of a persons problems- why
does this person have this particular problem at this time in their life?
-It's a collaborative process with the patient and
-never be imposed
-meant to find meaning which diagnosis does not
-helps to find points of intervention (other agencies like police too)
It's a suggested alternative to diagnosis. Not the opposite, however, as it can go
hand in hand with a diganosis. Eg if the patient feels it is the right thing to do. CBT
formulation can also work around a syndrome.
General formulation - Answer-integrate ideas from different theories and different
perspectives.
-An example is the 5 P's formulation.
1. Presentation of the Problem
2. Predisposing Factors (contextual what has lead them to be more vulnerable to
problem)
3. Precipitating Factors (what triggered the onset?)
4. Perpetuating Factors (ongoing features that are leading to the problem eg
harassment)
5. Protective factors (what do they do to reduce the problem eg social network)
Theory Specific Formulation and example - Answer-More strongly linked to a specific
theory, and harder to integrate different elements (not good at identifying whether
other agencies should get involved). Can be limited to a diagnosed syndrome, But
can be more precise and transdiagnostic (no diagnosis necessary)
Eg CBT formulation
1. Early life events-> 2. Core beliefs -> 3.conditional assumptions and ways of living
(eg if i keep quiet it will be ok)
critical incident activates this
4.Negative automatic thoughts --> 5. behaviours & 6. Emotions & Psychological
symptoms
What are the benefits of CBT - Answer-CBT formulation is a theory-specific
formulation.
It specifies where interventions can be made eg how we can change our core beliefs
or tackle our behaviour.
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