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This is the summary of the Lecture 3: Depression and mood disorders. In this lecture, the following chapters were discussed: Chapter 7 Davey (2021)
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Lectures Mental Health Module
Lecture 1: Introduction Psychopathology & Psychodiagnostics
This is the summary of the Lecture 1: Introduction Psychopathology & Psychodiagnostics. In this lecture, the following chapters were discussed: Chapter 1 Davey (2021) and Chapter 1 to 4 of Luteijn & Barelds (2019)
Lecture 1
Psychopathology & Psychodiagnostics
Psychodiagnostics
- By collecting information about client and their environment:
- The goal is to design the best approach to problems and interests of the client
- And to evaluate our approach (during and after the treatment)
Characteristics of clinical diagnosis:
- Theory development of problematic behaviour
- Operationalisation and its subsequent measurements
- Application of relevant diagnostic methods
The diagnostic process:
1. Application
- 1. Analysis of the request
- Information about the referrer
- Type and content of request
- Referrer’s knowledge about client
- 2. Analysis of request for help
2. The diagnostic reflection
- Studying file data
- Weigh information
- Take into account own bias, knowledge, preferences
- When needed: literature search, and refer to a colleague
3. Diagnostic scenario
- Collect all questions
- Formulate preliminary theory about client
- Relate problems to questions --> there are 5 basic questions from which all questions can be summarized
- 1. Recognition --> What?
- E.g. To what extent does Greg suffer from feelings of
disconnection?
- E.g. To what extent does Greg suffer from feelings of
- 2. Explanation --> Why?
- E.g. To what extent can Greg's exposure to a traumatic event in
the past explain his flashbacks?
- E.g. To what extent can Greg's exposure to a traumatic event in
- 3. Prediction --> What will happen in the future?
- E.g. To what extent will the symptoms get better in the future?
- 4. Indication --> How can problems be solved?
- E.g. Can exposure therapy reduce the symptoms?
- 5. Evaluation --> Did it work?
- E.g. To what extent has exposure therapy reduced the
symptoms?
- E.g. To what extent has exposure therapy reduced the
- 1. Recognition --> What?
4. Diagnostic research
- Select research tools considering:
- Questions that need to be answered
- The tools are suited to measure what you aim to measure --> come up with testable predictions, to make sure you don’t fall into confirmation bias
- Efficiency
5. Reporting
- First aim: summarise diagnostic process, answering the 5 questions
- Second aim: effective communication about client
- Diagnostic quality
- Psychodiagnostics defined as:
- Diagnostic frames of reference or theories
- Individual
- Development --> Freud theories
- Context --> If context influences client’s problematic behaviour
- The three frames of references can be tested in test theory models and statistical methods
- Diagnostic frames of reference or theories
- Psychodiagnostics defined as:
Lecture 2: Classifying Mental Health
This is the summary of the Lecture 2: Classifying Mental Health. In this lecture, the following chapters were discussed: Chapter 2.1 Davey (2021)
Lecture 2
Classification systems
Why do we classify? It’s a common language
- Disorder: the condition the person is experiencing
- Diagnosis: Conceptualization of this disorder
We classify to:
- Evaluate person faster
- Be able to group disorders and accumulate info about them
- Quickly make decision on appropriate treatment.
Classification efforts:
Diagnostic and Statistical Manual for Psychiatric Disorders(DSM)
- For psychiatric disorders. It is the main one used globally. The main focus is to classify mental disorders
- Emerged 1917 for psychotic disorders, thus it only contained disorders that needed treatment
- DSM that was published 1952 --> dysfunctional behaviours: gave a terminology for behaviours outside of the norm, but did not explain how to diagnose
- DSM III developed criteria to diagnose. They used an axes system of 5 different dimensions to describe clients
- DSM-5 combined axes system, and list of scales
International Statistical Classification of Diseases and Related Health Problems (ICD)
- First formal classification system for mental disorders
- Main focus is not to diagnose, but to help countries reduce burden of disease
- Diagnostic criteria similar to DSM
Psychodynamic Diagnostic Manual (PDM)
- Understanding of the client as a whole
- Life-long approach: diagnosis dependent on developmental stages
- Not as evidenced
Level of Personality Organization:
- 1st thing assessed is the level of personality organisation --> how the person has come together
- Identity: do they have stable identity?
- Object relations: do they have stable relationships?
- Level of defences: coping mechanisms differ in their benefits and maturity
- Psychotic level: delusional projection, psychotic denial, psychotic distortion
- Borderline level: splitting, projective identification, idealization/devaluation, denial, acting out
- Neurotic level: repression, reaction formation, intellectualization, displacement, undoing
- Healthy level: anticipation, self-assertion, sublimation, suppression, altruism, and humour
- Reality testing: ability to appreciate conventional notions of what is realistic
P-Axis: Personality Syndromes
- A list of labels to differentiate mental disorders --> influence on treatment choice
- It discusses phenomenon as opposites: depending on defences, you’ll have one or the other label, and they’ll be opposite
- Sometimes client’s experience is similar as the description from DSM, but other times is not the case. Then, a psychoanalysis approach can help to understand their experience better. For instance, when someone is escaping as a defence mechanisms, and this produces symptoms of mental health disorder, then psychoanalysis can be useful.
M-Axis: profile of mental functioning
- Classify client in terms
Lecture 3: Depression and mood disorders
This is the summary of the Lecture 3: Depression and mood disorders. In this lecture, the following chapters were discussed: Chapter 7 Davey (2021)
Lecture 3
Depression and mood disorders
“Though I am often in the depths of misery, there is still calmness, pure harmony and music inside me” Vincent van Gogh
What is a mood disorder?
“A mood disorder is not just a diagnosis”
- Mental health disorder affects person’s emotional state
- Symptoms that last relative long periods
- Long-term deficits in social, functional, cognitive areas
Diagnostics:
- Two groups of mood disorders, with many subtypes
- 1. Depressive disorders
- 2. Bipolar disorders
- Diagnostics:
- Language that professionals speak. Helps communication, comparison, prediction, and treatment planning
- It does not give meaning to patience experience
- It does not give causal explanations
Etiology of mood disorders
- Diathesis-stress models: stressful experiences trigger disorders in people who are vulnerable
- Depression: (potential) genetic predisposition + psychological stressors
- Bipolar: a more pronounced genetic component
Risk factors:
Depression:
- Social and environmental factors
- Gender
- Neurobiological factors
- Stressful life events
- Long-term health issues
- Ethnic minority? Not always, when it comes to global results
- Negative emotionality (e.g. rumination, neuroticism)
Bipolar:
- Genetics
- Drug/alcohol use
- Stressful life events
- Neurobiological factors (e.g. neurotransmitters)
- Cognitive deficits (related to difficulties in
emotion regulation)
The diagnostic process:
- Interview, observe, and use of instruments
- History, level of functioning (how well client functions in daily life --> e.g. functioning depression, nonfunctioning depression)
- Clinical interview protocols (semi-structured, disorder-based)
- Questionnaires for screening --> not in-depth analysis, general classification of client’s symptoms
- Special challenges:
- Interviewing depressed patients: time-consuming, due to their slow/passivity attitude
- In (hypo) mania: they don’t want to talk to you, they feel great. There is no experienced problem.
Treatments of mood disorders:
- Talk therapies
- Medication
- Other treatments:
- Electroconvulsive therapy (ECT): was one of the most invasive treatments, but it has adapted. Now it seems to be really effective for severe persistent depression (when nothing else worked)
- Transcranial magnetic stimulation (TMS): pulses of magnetic energy to increase brain activity at a specific location
- Light therapy: supplementing natural sunlight with artificial light to treat SAD
Prognosis of mood disorders:
- Recurring or ongoing symptoms --> dependent on:
- The severity of the condition
- How early is it’s diagnoses (and whether something has been done for treatment)
- Whether it was treated properly
- Comorbidity
Lectures Mental Health Module
In this bundle, I include the summaries of lectures that I participated for the module Mental Health in the year 2023-2024. The bundle includes the following lectures:
- Lecture 1: Introduction Psychopathology & Psychodiagnostics
- Lecture 2: Classifying Mental Health
- Lecture 3: Depression and mood disorders
- Lees verder over Lectures Mental Health Module
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