Transcript Psychopathology - Terri L. Weaver, Ph.D.

Psychopathology
Conceptualization
• Classification/Taxonomy
– Goals
– Benefits
– Costs
Conceptualization, contd
• Etiology
– What is the cause of a particular disorder.
– Multiple pathways
• Phenomenology
– Presentation/appearance/manifestation
– Symptoms
– Signs
Science versus Practice
• Differences in Approach
• Approach for the Class
Krueger and Markon
• Assumption of DSM
– Atheoretical
– Categorical Organization
• Clean lines between members who are within a
category
• Homogeneous nature of members in a category
• Categories are nonoverlapping
Hierarchical Model
• http://www.pubmedcentral.nih.gov/articlere
nder.fcgi?artid=2288576
• Empirical Model
• Organized by Two Broad Correlated
Dimensions
• Internalizing Conditions: Distress/Fear
• Externalizing Conditions: Disinhibition
Behavior Genetics
• Examines genetic and environmental influences
on the expression of psychopathology
• Phenotypic patterns are also reflected in the
etiologic/risk factor patterns for these disorders
• Assist in identifying etiology
• Particular genes connote risk for general
internalizing/externalizing
• Increase in prevention, treatment,
conceptualization and categorization
Personality
• Organizes broad areas of human individual
differences
• Internalizing~neuroticism
• Externalizing~unconscientiousness and
disagreeableness
• Negative emotionality ----Internalizing
• Neg emotionality plus Disinhibition --Externalizing
Maser et al.
• Proposed Paradigm Shifts of DSM-V
• http://www.psych.org/dsmv.asp projected
for May, 2012
• Proposed themes for paradigmatic change
– Inadequate use of dimensions
– Failure to recognize subthreshold pathology
– Signs and Symptoms and their weighting
Mixed Categorical/Dimensional
System
• Broad categories with dimensional
characterization
• Adding dimensions illuminates symptom
severity and impairment
• Enhances reliability and validity
• Allows for categories with increasing
homogeneity
Subthreshold Psychopathology
• NOS categories
• Arbitrary distinctions
• Impairment and Distress associated with
subthreshold levels
Symptom Weighting
• Criterion symptoms are chosen for diagnosis but
don’t encompass all symptoms
• Some symptoms define a disorder: depressed
mood, lack of interest, dur >2 weeks
• Some symptoms denote severity of a disorder:
suicidality, worthlessness, inability to concentrate
• In current system symptoms are artificially equal
in weight
Comorbidity
• Over 50% of individuals with one diagnosis carry
more than one
• 23% of individuals with a psychiatric diagnosis
have three or more
• Tendency to split diagnostic categories rather than
combine resulting in more fragmentation
• Kruger and Markon would argue for broader
rather than increasingly narrow categories
Spectrum View of
Psychopathology
• Defined by dimensions
• Captures a broad array of similar DSM-IV
disorders and related symptoms with the
assumption that their etiologies overlap (see
Kruger and Markon model)
• See example: social phobia, avoidant
personality disoder, selective mutism, and
separation anxiety disorder