Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
109 Cards in this Set
- Front
- Back
|
Biomedical model according to Deacon?
|
It is an eliminative reductionist philosophy that state that mental disorders are biologically based brain diseases and emphasizes Rx treatment to target presumed biological abnormalities. (chemical imbalances are the problem!)
|
|
|
Three core tenets of Deacon’s biomed model
|
1) mental disorders are caused by bio abnormalities principally located in the brain. 2) there is no meaningful distinction between mental diseases and physical diseases. 3) Biological treatment is emphasized (ie pills)
|
|
|
How does deacon view clinical psych (therapy) with his model?
|
View it as an alternative to the biomedical paradigm but has been largely shaped by this model.
|
|
|
Problems with DSM5
|
controversial new diagnoses, lowering thresholds, lowering reliability standards, Rx industry financial conflicts of interest among task force members
|
|
|
Pros and Cons of Biomedical Model by Deacon
|
pro: led to development of empirically supported treatments (RCTS, which has enhanced internal validity. Con: neglected treatment process, inhibited treatment innovation and dissemination, and divided field along scientist and practitioner, and RCTs have poor external validity
|
|
|
Deacon’s core message
|
there is a mental health crises and there needs to be a discussion and critical dialogue on the weaknesses of promoting and adhering to the biomedical model
|
|
|
Pros of diagnosis
|
It is consistent and provides continuity across time and doctors
|
|
|
Social control
|
pathological assumptions about different things, such as slavery
|
|
|
Rites of Passage for Kids
|
autonomy, risk taking, substance use, and sexuality
|
|
|
Deacon (2013) How are mental disorders seen by lay P’s?
|
They are often believed to be caused by biology, but scientists have not be able to identify a bio cause
|
|
|
What was found by the CDC to be the most prevalently report disorder by parents?
|
ADHD was found by the CDC to be the most prevalent parent reported current diagnosis among kids ages 3-17 followed by conduct problems, anxiety, depression, autism, and Tourette’s
|
|
|
Kazdin (2011) what is the most important advancement in psychological interventions?
|
The growing importance and understanding of evidence based treatments (EBTs)
|
|
|
According to Kazdin (2011) what is on key aspect that psychology has forgotten
|
The goal of psychology is to decrease the overall rates and prevalence of mental illness, and improve psychological functioning at the societal level
|
|
|
What do we need to do to solve the rising rate of mental illness?
|
Not get more professionals, but consider different ways of delivering treatment to more people. So this means becoming more open to the ideas of utilizing nonprofessionals in our work
|
|
|
What is Multifinality?
|
Developmental psychopathology concept that refers to the process by which certain environments, experiences, or characteristics increase risk for different psychopathologies in kids of adults. Or, Multifinality is where kids experience the same or very similar trauma (or courses of trauma), but experience different outcomes. An example would be Siblings in same home with same upbringing, end up in different places. So basically Contrasting how similar trajectories end up in very different places
|
|
|
What is Equifinality?
|
Equifinality is where kids experience different trauma or courses and experience similar or the same outcomes. This is similar to kids who grow up in completely different environments yet experience the same type of outcome
|
|
|
What is a trajectory?
|
Often seen in Multifinality, where kids will have similar pathways, or trajectories, so a pathway?
|
|
|
What is the transaction?
|
Basic idea→ you come preloaded with certain risks, and your environment can be potential stress and can impact the develop of mental illnesses. They are often oversimplified Vs. between variables, Inner (temperament. biology), Relational (contextual), Reactional (stress, trauma)→example, comes from tumultuous family background ,
|
|
|
What is a transactional model?
|
A model that provides contextual evidence of how we can intervene, so like MST
|
|
|
What does Marshall (2011) promote?
|
We need to consider very part of an individual when conceptualizing their case, ie. Biology, family, peers, early childhood experiences, are going to play a major systemic role in the development and eventual treatment of a mental disorder
|
|
|
Nolen-Hoeksema (2011) main point?
|
Basically that transdiagnostic models for mental illness helps us to identify the processes that underly multiple psychopathologies
|
|
|
Nolen-Hoelsema (2011), what are the limits of current transdiagnostic models?
|
They fail to explain why individuals with similarly faulty processes develop different disorders, they do not address the plasticity of the symptom patterns in patients (so Multifinality), limited research on the mechanisms linking certain factors to the disorders
|
|
|
Nolen-Hokesema (2011), what are distal factors?
|
a distal risk factor doesnot directly cause symptoms but only influences symptomsvia mediating proximal factors. As such, a distalrisk factor is distant from the expression of symptoms both inprobability and mechanism. It is important to note that exposureto a distal risk factor does not necessarily mean that subsequentpsychopathology will follow. Those factors that have a lot of causal mechanisms intervening to lead to overall psychopathology, such as environmental factors or congenital biological abnormalities
|
|
|
Nolen-Hokesema (2011) what are proximal factors?
|
Those factors that have relatively few causal mechanisms that lead to overall psychopathology, so it nots something that just happens to you, and is more likely to be seen as a direct cause. These are bio factors leading to emotional, cognitive, or behavioral tendencies, basic cognitive factors, stable psychological individual difference factors
|
|
|
What do distal factors do to create proximal risk factors?
|
They shape response to the environment, shape negative beliefs, condition specific behaviors
|
|
|
What do proximal factors do to lead to actual disorder development?
|
Raise concerns or themes in thinking (anxious person starts becoming worried about things), shapes responses (person experiencing a panic attack in a certain situation creates avoidance of that situation), and creates reward value of stimuli (depressed person experience less positive rewards from interacting with people, and begins withdrawing socially)
|
|
|
Why do we care about impairment?
|
We care about impairment because it affects overall life and it something we should be looking at more so than diagnostic systems. These systems do not cover all of the areas that impairment can result from such as stress, relationships problems, etc. Because of this, diagnostic systems are restrictive for classification—thus indicating that although an individual has depression by impairment, but they are one symptom short of the criteria, it doesn’t mean they are any less impaired. Thus, we should care more about the degree of impairment versus the actual diagnosis
|
|
|
Which is better, top-down or bottom up thinking, and why?
|
Bottom up is better for kids because it is looking at the range of symptoms and working up towards a diagnosis but treating, versus only seeing the diagnosis and missing areas of impairment in top-down
|
|
|
Limits of DSM classification?
|
Atheoretical, etiology often not known, loss of data through RTCs, static, subclinical populations still exists and make up the majority of individual, NOS, and comorbidity exists
|
|
|
What did Bronfenbrener create?
|
The ecological system theory
|
|
|
What is the ecologifcal systems theory?
|
It basically is explaining how we should expand the presenting problem to explore the potential multiple systems of influence. This includes the microsystem, the mesosystem, the exosystem, the macrosystem, and chronosystem. It is very useful is helping to conceptualize the best option for treating dysfunctional families
|
|
|
How is MST different from a traditional model of therapy?
|
You would target all the multiple systems impacting the child’s behavior, instead of utilizing traditional diagnosis and treating only the symptoms. Additionally, it wouldn’t just assume that behavior is pathological. Instead it would look to see if there are reasons that are systemic and are acting as barrier.
|
|
|
What are the different systems of the EST standing for?
|
The microsystem is the family, school, peers, neighborhood of kid, the mesosystem is the extended family, mass media, health services, the exosystem is the economic system, the education system, the political system, the macrosystem are overarching beliefs and cultural values the child lives in , and the chronosystem is the dimension in time the child lives in
|
|
|
What is the transactional model?
|
This type of model provides a contextual model of how we can intervene with families, so in essence, provides exploration of all the outside influences that impact the presentation of the disorder
|
|
|
What is the MST (multisystemic theory) about?
|
Acknowledges multiple influences on the child and allowing you to be mindful of these influences on disorder presentation. So basically it is model that allows up to be case managers for dysfunctional families with troubled you by allowing use to provide practical help that targets influences from multiple systems.
|
|
|
How many states is spanking allowed in?
|
Spanking is allowed in 23 states, and that southerners approve of spanking the most.
|
|
|
What did Kadzin & Blaise find about spanking?
|
That there really is no hard and fast true about whether it is bad or not. The best method, they propose is to proactively punish kids
|
|
|
What is the navigator model?
|
The navigator model promotes that mental health care providers should advocate and navigate tricky health care operations with their client. Their role is to assess the needs of client and enable appropriate assessment and treatment in a timely way, offer guidance on which serves will be most helpful to the client, provide some appropriate evidence based tx as needed, track trajectory of patients across clinics and associated outcomes, and help kids access the right level of care and ensure continuity of care, and improve communication between professionals
|
|
|
How is navigation better than case management?
|
Navigation is high level function than case management and generally, navigators are there throughout treatment whereas case managers only get involved when things start getting really bad
|
|
|
When should you not make a diagnosis?
|
When you cannot find any evidence for impairment
|
|
|
What do base rates do that are helpful?
|
Knowing the base rates as a clinician are helpful with referral question as they allow for more precise and knowledge treatment and diagnosis
|
|
|
What are the 3Ps?
|
Prediction, Prescription, and Process
|
|
|
What does Prediction mean in assessment ?
|
Does the assessment predict the criteria of interest? You have to consider that what you’re finding might simply be a correlation between two assessments, so you should use multiple; you also need to know that it involves concurrent criterion validity—indicating that when assessments are correlated that most likely indicate how many sessions a child may need and what type of tx; finally it helps with prognosis and seeing if the treatment will positively impact the impairment
|
|
|
What does Process mean in assessment?
|
So basically utilizing an empirical approach that will best suit your client, such as a process orientated procedure that assess how well the prescription is working
|
|
|
What does Prescription mean in assessment?
|
Assessment guides choices about treatment; Help with attribution of treatment interaction, so basically what you would prescribe as the best course of treatment for your individual client. Examples of this could be the various types of projects that have come about to help find suitable models for specific issues such as the Project Match for alcoholism
|
|
|
What is an ecologically valid assessment?
|
This is when the assessment remembers the impacts of real-world environments, and is conducted within the environment, instead of in a lab
|
|
|
The Nature of impairment is important why?
|
Because we need to know exactly what is going on, and as to what is being impaired, so we can best fit the treatment to the client. Especially when they are presenting symptoms that are similar to a variety of diagnosis. You need to know so you best provide treatment most appropriate
|
|
|
What did Achenbach say about divergence and convergence of perspective?
|
Basically, he is saying that it is important, although lower correlations in that, there is no gold standard to assess for converging information of a child’s behavior by multiple different sources. This is because the child sees these individuals in different environments and as such, may display different behavior. It’s important because it shows that we should look at the child and see their multiple symptoms and apply treatment to decrease impairment vs. trying to obtain a diagnosis, coming up short, and then not providing proper treatment to the kid.
|
|
|
Achenbach found in his study?
|
That there was significantly higher correlation for 6-11 yr olds that adolescents and externalizing symptoms were much more agreed upon than internalizing (or over controlled)
|
|
|
Youngsterm, what reasons does he give for the decrease in psychologists and students learning about assessment?
|
1) There is a clear linkage between tools and practices, although they have great psychometric props, there is poor validity in guiding treatment, 2) emergence of managed care meaning that there is a erosion of serve reimbursement and a challenge to demonstrate the cost effectiveness of assessment, 3) the history of assessment has been based on convention and habit vs. tools for a specific purpose, so that validity of tests is against each other and not towards some external criterion. Additionaly, the most popular measures are incumbent and not retaining strong evidence of validity
|
|
|
What does prediction mean?
|
What assessment tools should be used to measure the development of psychopathology? Means demonstrating concurrent correlations as well as showing associations with criteria that are separated by time.
|
|
|
What does Prescription mean?
|
Assessment should guide choices about treatment, and can lead to a prescription of a type of treatment, sometimes referred to as treatment matching between a diagnosis and an intervention
|
|
|
What does process mean in the context of assessment?
|
They can measure process, of the clinical outcomes of the clients symptoms. This could be through quantifying the degree of change occurring as the result of treatment, can also measure variables that are informative about the mechanisms for growth and change, and finally, can be used to detect variables that will changes the prognosis or response to treatment
|
|
|
What does Iatrogenic mean? |
the condition caused by treatment or diagnostic procedures. can be a harmful affect of diagnosis |
|
|
What does pathognomonic mean? |
Indicative of a particular disorder, and not just of a medical issues. Such as autism vs. encopresis |
|
|
An approach to bottom up could be? |
a factor analysis where you try to find correlations among items. Once you get a sense of these symptoms clusters, you can then perform a quantitative associaton where we describe syndroms |
|
|
What are some methodological flaws with base rates? |
sampling and instrumentation |
|
|
What should we do as therapist who utilize assessment? |
1) adopt a multi-method approach 2) write good intake reports to preserve unique features of the individual 3) do no engage in cookie cutter approach to assessment 4) avoid labels 5) capture the essence of the individual 6) remain open to revision and use a dynamic process |
|
|
What did calkin find to support interactional conclusions? |
that secure attachment can buffer a child from adverse outcomes even in the presence of the problematic genotype. So basically, secure attachment can moderate the role of psychopathic traits. However, being easily stress is associated with worse outcomes with insecure attachments |
|
|
How should we conceptualize kids? |
We should not use oversimplified diagnosis as the key to tx. We should look for a locus of focus, and then also be able to know about the transaction between variables that includes, inner, relational, and reactional |
|
|
What has the biomedical model era been characterized by? |
A lack of clinical innovation and poor mental health outcomes, and the increased adoption of drug trail methodology in psychotherapy research |
|
|
What is the biopsychosocial model approach? |
A new approach emphasizing the fact that we should look at mental illness through multiple explanatory perspectives and emphasizes that different levels of analysis are important. It also accepts that mental disorders are higher order disturbances in multi-level mechanisms, thus indicating that symptoms have multiple influential factors |
|
|
What is the leading cause of disability in US kids? |
mental illness |
|
|
How much has autism increased in the last few decades ? |
4 times since last checked |
|
|
What are surveillance efforts? |
the systematic and ongoing collection of data followed by the interpretation and dissemination of data to encourage public health action, to inform prevention, classification, and research $ allocation |
|
|
How do surveillance systems vary? |
1) by what is measured 2) by the sample pool 3) by the source of info (so from the child or the parent about child) 4) the way the data is collected 5) the sample size 6) the periodicity of the data collection (so is it annual or not?) |
|
|
What are the most prevalent mental illnesses in children ages 3-17? |
1) ADHD 2) conduct disorder 3) anxiety 4) depression 5) autism 6) Tourette syndrome |
|
|
What are the three common reasons for referring a kid to a practitioner? |
1) eating problems 2) sleeping problems 3) toileting problems |
|
|
What are the two things that we, as practitioners, are trying to reduce? |
Burden and impairment |
|
|
Why is adolescence a tumultuous period, and reasons why mental disorders tend to start popping up, especially for girls? |
there are biological changes such as hormones, there are cognitive changes because they are able to understand and perceive there world through different explanations, emotionally because of changes ins expectations, social groups, and behaviorally |
|
|
What is DST? |
It emphasizes the shared contributions of genes, environment, and epigenetic factors on developmental processes. The developmental system derives its meaning form the context of the entire system without elevation of one system over another |
|
|
What are the proponents of DST? |
The explanandum--how the organisms comes to be constructed and the explanus, or the entire developmental system itself including bio and enviro factors-- |
|
|
cumulative risk? |
the more bad experiences, the great risk for negative outcomes |
|
|
TOp-down? |
so using a diagnosis to look at the child's environment or using it explain symmptoms |
|
|
bottom-up? |
there are a bunch of things going on in his environment (school probs, interpersonal probs) looking at all these areas and then informing diagnosisi |
|
|
physiogmony? |
trying to read character off of someone's facial expressions |
|
|
What is the Martha Mitchell Effect |
when a psychiatrist, psychologist, or other mental health clinician mistakes the patient's perception of real events as delusional and misdiagnoses accordingly. |
|
|
What is a problem with diagnosis? |
stigma increasing self-fulfilling prophecy. living up to expectations of diagnosis |
|
|
Social changes increase of |
1) risk and 2) child maltreatment 3) lifelong consequences |
|
|
pathology as a continuum? how do you describe it? |
we look at the differences not the deficits. we describe symptoms on a continuum |
|
|
what is the reliable change index? |
So measures the differences between an individuals pre and post test scores--but makes sure to adjust for error. so a way to accurately adjust for differences |
|
|
parental influences on child? |
warmth (attachment), biology (genes), basic needs (food, shelter, clothing), structure (parenting style) |
|
|
What was the Refrigerator mom referring too? |
unidirectional or single variables to blame for dx development. So not considering the full context of the child |
|
|
CDC what we should be looking for when diagnosing |
serious deviations cognitively, environmentally, and socially |
|
|
What is the cost of childhood mental illness? |
247 billon |
|
|
According to Kazdin how have we increase the qualitative of research? |
more RCTs, more followups and more manuals |
|
|
According to Kazdin what we have done? |
decreasing prevalence of mental illness and increasing psychological functioning at a societal level |
|
|
What is a person-power problem? |
not having enough professionals to serve the increasing number of individuals dealing with mental illness |
|
|
What are ways to reach more people? |
technology, media, Math, self help books |
|
|
Benjet & Kazdin, controversies of spanking? |
60% of parents approve of spanking |
|
|
Three types of opinions for spanking? |
pro--spare the rod spoil the child conditional--depends on the situation anti--spanking leads to aggression |
|
|
What does spanking cause short term? |
causes negative affect |
|
|
Spanking outcomes based on ethnicity? |
1) AF.Americans pos and neg benefits found 2) white kids negative findings |
|
|
What is the goal of parenting and discipline? |
positive reinforcement, so positive parenting |
|
|
Reasons why actually studying spanking is hard |
methodology conceptual and operational definitions assessment methods time sequence confounding variables |
|
|
overton's framework of levels of development (competence procedural system) |
competence is about the underlying mechanisms that drives the system and activity (individual factors) procedure is the contextual associated systems (ie the environment) so to identify the disorder you need to find the breakdown between these because they work together, and when they don't that indicates a disorder overall context and genes play a role |
|
|
relational developmental systems theory |
recognizes the dynamic complexity of developmental processes and exposes the inadequacy of split approaches, which emphasize simple interaction and the elevationof one level of analysis over another. |
|
|
What is the explananadum? |
The phenomena or impairment that need to be explained. |
|
|
What is the explanas? |
the explanation for the phenomena or impairment or the context the impairment or individual is in |
|
|
Piaget, how is he important? |
he proposed that although we all live in this world, we all have different perceptions of this world which is necessary and important for our understanding |
|
|
equilibration, define. |
When someone is out of sorts for a kid, the kid does two things 1) assimilation is where people fit the environment into previously learned definition or understanding 2) accommodation you adapt your thinking to incoming info Piaget came up with this |
|
|
intraindividual variation |
falls under relational developmental system approach--you do this so you can see how they deviate from normal people is concerned with the construction and development of the individual organism over its life span |
|
|
The navigator model is helpful for: |
track patients over time, have defined end point of that time, helped intervene with health services, targets a defined set of health services, identify and overcome patient level barriers (transport, health illiteracy, financial), reduce delays and increase access to care , provide psychosocial support try to overcome systemic barriers by advocating for clients with providers and provide patients with material to educate on problems and questions they could use |
|
|
Five key cornerstones for early intervention |
1) raise awareness to decrease stigma 2) being youth family friendly, be approachable 3) use multi-modal approaches 4) need involvement from medium to long term treatment 5) evaluation needs to be included to detect outcome |
|
|
inconsistencies between developmental psychopathology and common practice?? |
quality of disturbance meaning that although we would like dichotomous, but continuous presentation is reality static classification is easier, but dynamic is really what we see we would hope that homogeneous presentation would always happen, but most often heterogeneous is the reality (we would want depression to always present the same way, but in reality it NEVER does) |
|
|
Achenbach, what were P's better at having convergence at? |
under-controlled symptoms--people have easier time seeing it and ranking it because you can seeing |
|
|
achenbach recommends what the best way to do full assessments? |
self-reports or observer reports, biomedical assessment, standardized language of cognitive and motor functioning, data from parents and teacher |
|
|
The difference between the transactional model and the transdiagnostic model? |
transactional models is specific to the child, Nolen (transdiagnostic) more broadly looking for factors that lead across the situation transdiagnostic takes into account comorbidity and identifies multiple processes |
|
|
limits of transdiagnostic |
1) same vulnerable produce different pathologies 2) doesn't address mechanism plasticity of symptom presentation 3) need more research |
