Samenvatting Development and Mental Health 2
Lecture 1: General information and introduction
The life-span developmental perspective
= some things that are normal at a certain age or stage are not normal at another.
Health and illness
Categorical Typological Dimensional
Classification of mental disorders
Positive
= communication standardized, organization and reduction of information, efficient,
basis of accumulation, instructions for clinical diagnostics and therapy, explicit
classification is better than implicit classification.
Negative
= typologies can hide basic dimensions, confusion of description and explanation,
seeing diagnosis as an existing entity, losing information due to labels, stigmatizing
due to labelling.
Validity
1. Face validity: the test appears to measure what it is supposed to measure
2. Content validity: test assesses all important aspects of a phenomenon
3. Concurrent validity: similar results as the test that measures the same aspect
4. Predictive validity: predicts future of thoughts and behaviour it is supposed to
5. Construct validity: measures the psychological construct it is supposed to measure
Reliability
1. Test-retest reliability: produces similar results when given at two different points
2. Alternate form reliability: different versions of the same test produce similar results
3. Internal reliability: different parts of the same test produces similar results
4. Inter-rater reliability: two or more judges come to similar conclusions when
administering and scoring a test for the same people
1
,Chapter 1: Looking at Abnormality
Extraordinary people
Psychopathology = the study of abnormal thoughts, behaviour and feelings.
Defining abnormality
Mental illness
= Collections of problems in thinking or cognition, in emotional response or
regulation, and social behaviour.
Biological factors are associated with these issues
A singular disease underlying the symptoms is unlikely
Cultural norms
= the context or circumstances surrounding a behaviour, influence whether a
behaviour is considered abnormal or not.
Cultural relativism = the view that there are no universal standards or rules
for labelling a behaviour abnormal; instead, behaviours can be labelled
abnormal only relative to cultural norms.
The four Ds of abnormality
1. Dysfunction (interference with daily life)
2. Distress
3. Deviance (hearing voices, hallucinations)
4. Dangerousness (suicidal gestures, excessive aggression)
Abnormality is subjective = the continuum model of abnormality
Historical perspectives on abnormality
The three theories to explain abnormal behaviour
1. Biological (breakdown of systems in the body)
2. Supernatural (curses, demonic possession, personal sin)
3. Psychological (traumas, chronic stress)
Ancient theories
Prehistory (exorcisms)
Stone and middle ages (trephination; hole in the skull)
Ancient China (Yin and Yang; balance reduces illness)
Ancient Greek and Romans
Plato and Socrates: great literary and prophetic gifts
Hippocrates: imbalance of the body’s four humours:
1. Blood
2. Phlegm
3. Yellow bile
4. Black bile
Medieval views
Witchcraft
Psychic epidemics
Moral treatment in the eighteenth and nineteenth centuries
Mental hygiene movement = people developed problems because of
separation from nature.
Moral treatment = abnormality cured by restoring dignity and tranquillity.
2
,The emergence of modern perspectives
The beginnings of modern biological perspectives
= the importance of brain pathology in psychological disorders was emphasized.
Emil Kraepelin: classifying symptoms into discrete disorders
Richard Krafft-Ebing: general paresis
= he connected psychological symptoms to a biological cause
The psychoanalytic perspective
= Franz Anton Mesmer believed that people have a magnetic fluid in the body that
must be distributed in a particular pattern in order to maintain health (mesmerism).
Bernheim and Liebault: removed hysteria through hypnosis
Breuer and Freud: a paper consisting discoveries about hypnosis, the
unconscious and the therapeutic value of catharsis (= encouraging patients to
talk about their problems while under hypnosis, which led to a great
upwelling and release of emotion).
The analysis of Breuer and Freud led to the development of psychoanalysis.
The roots of behaviourism
Ivan Pavlov developed methods and theories for understanding behaviour in terms of
stimuli and responses rather than in terms of the internal workings of the
unconscious mind.
Classical conditioning
1. Before conditioning: food (US) -> salivation (UR)
2. Before conditioning: whistle (NS) -> no salivation (NCR)
3. During conditioning: whistle + food -> salivation (UR)
4. After conditioning: whistle (CS) -> salivation (CR)
Behaviourism (Thorndike and Skinner)
= study of the impact of reinforcements and punishments on behaviour.
Behaviour followed by positive consequences is more likely to be repeated.
The cognitive revolution
= thought processes that influence behaviour and emotion.
Self-efficacy beliefs
= the beliefs about the ability to execute the behaviour necessary to control
important events. People prone to disorder are plagued by irrational negative
assumptions about themselves and the world (Aaron Beck).
Modern mental health care
Deinstitutionalization
The patients’ rights movement (integration in a community)
Community mental health movement (community mental health centres)
Halfway houses
Day treatment centres
Managed care
= collection of methods for coordinating care that ranges from simple monitoring to
total control over what care can be provided and paid for.
3
, Chapter 3: Assessing and Diagnosing Abnormality
Standardization
= important to improve validity and reliability and is to prevent extraneous factors from
affecting a response and thus the outcome of the test.
Clinical interview
Initial interview: mental status exam, appearance and behaviour
Structured interview: a series of questions about the symptoms
Symptom questionnaire: quick way to determine symptoms
e.g. the Beck Depression Inventory (BDI), critics argue that it does not clearly
differentiate between the clinical syndrome of depression and the general distress
that may be related to an anxiety disorder or to several other disorders.
Personality inventories: asses ways of thinking, feeling and behaving to gather
information about well-being, self-concept, attitudes and beliefs, ways of coping.
e.g. the Minnesota Multiphasic Personality Inventory (MMPI-2)
Behavioural observation: assess deficits in skills and ways of handling
Self-monitoring: keep track of the numbers of times per day they engage in a specific
behaviour and the conditions under which this behaviour occurs.
e.g. smoking, eating, compulsive behaviour
Intelligence tests: intellectual strengths and weaknesses, particularly when mental
retardation or brain damage is suspected, to identify gifted children and children with
intellectual difficulties or evaluate adults’ capabilities for certain jobs.
Neuropsychological tests: detect specific cognitive deficits such as memory problems.
e.g. The Bender-Gestalt Test
Brain-Imaging Techniques: identify brain abnormalities
Computerized tomography, Positron-emission tomography, Single photon
emission computed tomography, Magnetic resonance imaging
Psychophysiological tests: detect changes in the brain and nervous system
e.g. an electroencephalogram (EEG)
Projective tests: the idea that people will interpret a stimulus in line with their
current concerns and feelings, relationships with others and conflicts and desires.
e.g. the Thematic Apperception Test (TAT)
Challenges in assessment
Resistance to providing information (legal cases)
Evaluating children cannot describe feelings or associated events very well
Evaluating individuals across cultures (language misunderstandings, cultural biases,
stereotypes, cultural aspects, religion)
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5)
Reifying diagnoses: the underlying biological, psychological and social causes of a
disorder can get neglected.
Category or continuum: the DSM-5 retains categorical systems for most diagnoses.
Differentiating mental disorders: comorbidity is often present
Addressing cultural issues: cultural variation in presentation of symptoms, distinct
ways of conceptualizing, different believes about the degree of suffering.
Beware that labelling a patient can lead to a self-fulfilling prophecy.
4
Lecture 1: General information and introduction
The life-span developmental perspective
= some things that are normal at a certain age or stage are not normal at another.
Health and illness
Categorical Typological Dimensional
Classification of mental disorders
Positive
= communication standardized, organization and reduction of information, efficient,
basis of accumulation, instructions for clinical diagnostics and therapy, explicit
classification is better than implicit classification.
Negative
= typologies can hide basic dimensions, confusion of description and explanation,
seeing diagnosis as an existing entity, losing information due to labels, stigmatizing
due to labelling.
Validity
1. Face validity: the test appears to measure what it is supposed to measure
2. Content validity: test assesses all important aspects of a phenomenon
3. Concurrent validity: similar results as the test that measures the same aspect
4. Predictive validity: predicts future of thoughts and behaviour it is supposed to
5. Construct validity: measures the psychological construct it is supposed to measure
Reliability
1. Test-retest reliability: produces similar results when given at two different points
2. Alternate form reliability: different versions of the same test produce similar results
3. Internal reliability: different parts of the same test produces similar results
4. Inter-rater reliability: two or more judges come to similar conclusions when
administering and scoring a test for the same people
1
,Chapter 1: Looking at Abnormality
Extraordinary people
Psychopathology = the study of abnormal thoughts, behaviour and feelings.
Defining abnormality
Mental illness
= Collections of problems in thinking or cognition, in emotional response or
regulation, and social behaviour.
Biological factors are associated with these issues
A singular disease underlying the symptoms is unlikely
Cultural norms
= the context or circumstances surrounding a behaviour, influence whether a
behaviour is considered abnormal or not.
Cultural relativism = the view that there are no universal standards or rules
for labelling a behaviour abnormal; instead, behaviours can be labelled
abnormal only relative to cultural norms.
The four Ds of abnormality
1. Dysfunction (interference with daily life)
2. Distress
3. Deviance (hearing voices, hallucinations)
4. Dangerousness (suicidal gestures, excessive aggression)
Abnormality is subjective = the continuum model of abnormality
Historical perspectives on abnormality
The three theories to explain abnormal behaviour
1. Biological (breakdown of systems in the body)
2. Supernatural (curses, demonic possession, personal sin)
3. Psychological (traumas, chronic stress)
Ancient theories
Prehistory (exorcisms)
Stone and middle ages (trephination; hole in the skull)
Ancient China (Yin and Yang; balance reduces illness)
Ancient Greek and Romans
Plato and Socrates: great literary and prophetic gifts
Hippocrates: imbalance of the body’s four humours:
1. Blood
2. Phlegm
3. Yellow bile
4. Black bile
Medieval views
Witchcraft
Psychic epidemics
Moral treatment in the eighteenth and nineteenth centuries
Mental hygiene movement = people developed problems because of
separation from nature.
Moral treatment = abnormality cured by restoring dignity and tranquillity.
2
,The emergence of modern perspectives
The beginnings of modern biological perspectives
= the importance of brain pathology in psychological disorders was emphasized.
Emil Kraepelin: classifying symptoms into discrete disorders
Richard Krafft-Ebing: general paresis
= he connected psychological symptoms to a biological cause
The psychoanalytic perspective
= Franz Anton Mesmer believed that people have a magnetic fluid in the body that
must be distributed in a particular pattern in order to maintain health (mesmerism).
Bernheim and Liebault: removed hysteria through hypnosis
Breuer and Freud: a paper consisting discoveries about hypnosis, the
unconscious and the therapeutic value of catharsis (= encouraging patients to
talk about their problems while under hypnosis, which led to a great
upwelling and release of emotion).
The analysis of Breuer and Freud led to the development of psychoanalysis.
The roots of behaviourism
Ivan Pavlov developed methods and theories for understanding behaviour in terms of
stimuli and responses rather than in terms of the internal workings of the
unconscious mind.
Classical conditioning
1. Before conditioning: food (US) -> salivation (UR)
2. Before conditioning: whistle (NS) -> no salivation (NCR)
3. During conditioning: whistle + food -> salivation (UR)
4. After conditioning: whistle (CS) -> salivation (CR)
Behaviourism (Thorndike and Skinner)
= study of the impact of reinforcements and punishments on behaviour.
Behaviour followed by positive consequences is more likely to be repeated.
The cognitive revolution
= thought processes that influence behaviour and emotion.
Self-efficacy beliefs
= the beliefs about the ability to execute the behaviour necessary to control
important events. People prone to disorder are plagued by irrational negative
assumptions about themselves and the world (Aaron Beck).
Modern mental health care
Deinstitutionalization
The patients’ rights movement (integration in a community)
Community mental health movement (community mental health centres)
Halfway houses
Day treatment centres
Managed care
= collection of methods for coordinating care that ranges from simple monitoring to
total control over what care can be provided and paid for.
3
, Chapter 3: Assessing and Diagnosing Abnormality
Standardization
= important to improve validity and reliability and is to prevent extraneous factors from
affecting a response and thus the outcome of the test.
Clinical interview
Initial interview: mental status exam, appearance and behaviour
Structured interview: a series of questions about the symptoms
Symptom questionnaire: quick way to determine symptoms
e.g. the Beck Depression Inventory (BDI), critics argue that it does not clearly
differentiate between the clinical syndrome of depression and the general distress
that may be related to an anxiety disorder or to several other disorders.
Personality inventories: asses ways of thinking, feeling and behaving to gather
information about well-being, self-concept, attitudes and beliefs, ways of coping.
e.g. the Minnesota Multiphasic Personality Inventory (MMPI-2)
Behavioural observation: assess deficits in skills and ways of handling
Self-monitoring: keep track of the numbers of times per day they engage in a specific
behaviour and the conditions under which this behaviour occurs.
e.g. smoking, eating, compulsive behaviour
Intelligence tests: intellectual strengths and weaknesses, particularly when mental
retardation or brain damage is suspected, to identify gifted children and children with
intellectual difficulties or evaluate adults’ capabilities for certain jobs.
Neuropsychological tests: detect specific cognitive deficits such as memory problems.
e.g. The Bender-Gestalt Test
Brain-Imaging Techniques: identify brain abnormalities
Computerized tomography, Positron-emission tomography, Single photon
emission computed tomography, Magnetic resonance imaging
Psychophysiological tests: detect changes in the brain and nervous system
e.g. an electroencephalogram (EEG)
Projective tests: the idea that people will interpret a stimulus in line with their
current concerns and feelings, relationships with others and conflicts and desires.
e.g. the Thematic Apperception Test (TAT)
Challenges in assessment
Resistance to providing information (legal cases)
Evaluating children cannot describe feelings or associated events very well
Evaluating individuals across cultures (language misunderstandings, cultural biases,
stereotypes, cultural aspects, religion)
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5)
Reifying diagnoses: the underlying biological, psychological and social causes of a
disorder can get neglected.
Category or continuum: the DSM-5 retains categorical systems for most diagnoses.
Differentiating mental disorders: comorbidity is often present
Addressing cultural issues: cultural variation in presentation of symptoms, distinct
ways of conceptualizing, different believes about the degree of suffering.
Beware that labelling a patient can lead to a self-fulfilling prophecy.
4
