Term
| what are the two extremes of the spectrum in terms of defining mental illness? |
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Definition
1. the medical model
2. the social labeling theory |
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Term
| what is the medical model theory of mental illness? |
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Definition
| Mental disorders are psychological and behavioral impairments resulting from diseases of the central nervous system |
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Term
| what is the social labeling theory of mental illness? |
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Definition
| “Mental disorder” is a sociopolitical fiction—a label applied by the powerful majority to justify disempowering and controlling those whose behavior threatens the cultural status quo |
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Term
| what three people/sources have made important (noteworthy) attempts at defining 'mental illness'? |
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Definition
1. DSM (currently DSM-IV, revised)
2. Jerome Wakefield
3. Widiger and Trull |
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Term
| how do widiger and trull define mental illness? what does it mean to say that their definition doesnt look at mental illness as "us vs. them"? |
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Definition
| an involuntary, organismic impairment in psychological functioning which hinders their ability to in their ability to adapt flexibly to stress, to make optimal life decisions, to fulfill desired potentials, or to sustain meaningful or satisfying relationships. We are all a little crazy, mental illness is just a matter of degree, type and time of life. |
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Term
| _________ and _____________ are the two most salient features of wakefields definition of mental illness |
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Definition
| dysfunction (a mental mechanism has failed to perform a function for which it evolved), harmful (depends on cultural context) |
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Term
| in wakefields definition of mental illness (harmful/dysfunction) is a scientific term and (harful/dysfunction) is a value term |
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Definition
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Term
| what are some of the main controversies that stem from with the DSM-IV's definition of mental illness? |
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Definition
1. 'clinical significance' is determined by psychiatrists and a social construct (on the other side, serves to avoid pathologizing everything)
2. "must not be merely an expectable and culturally sanctioned response to an event" again tries to avoid over-pathologizing BUT if nomal and expected cant be a pathology? (think about colds) |
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Term
| true or false: mental disorders lack specific etiologies |
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Definition
| true. multiple contributory factors lead to mental disorder |
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Term
| _________ is a cause or origin on a disease or disoder |
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Definition
|
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Term
| true or false: persons with the same diagnosis may have different etiologies |
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Definition
|
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Term
| true or false: persons with different diagnoses always have different etiological factors |
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Definition
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Term
| ___________ is a predisposition or vulnerability to a disorder which is typically based in genetics, pre- or peri-natal conditions, or early experiences |
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Definition
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Term
| in the diathesis-stress model, stress is considered to be any event that... |
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Definition
| triggers the onset of a pathology |
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Term
|
Definition
a relatively common (≥1% pop.) allelic variant Allelic differences range from a single DNA nucleotide (SNPs)
to many kilobases and may have 2 to dozens of different alleles |
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Term
| _________, _________, and _________ are three sources of genetic diversity |
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Definition
| polymorphisms, mutations, copy number variations (CNVs) |
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Term
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Definition
| a change in DNA structure resulting in an abnormal number of gene copies within the cell |
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Term
| _______ CNVs arise after the splitting of the zygote and account for genetic differences between MZ twins |
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Definition
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Term
| what are the two major models for genetic transmission of liability / vulnerability to a disorder? |
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Definition
1. single major locus or medelian model
2. complex, quantitative or polygenic model |
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Term
| ____________ transmission results in discrete binary phenotypes |
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Definition
| single major locus (or mendelian) |
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Term
| true or false: mendelian transmission can account for the genetic component of many mental disorders |
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Definition
| false. it can account for very few. |
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Term
| what is the key feature of the additive model of polygentic transmission? |
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Definition
| Liability bestowed by multiple genes, each making an equal and independent contribution to overall liability. |
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Term
According to additive polygenic transmission an individual whose liability exceeds a hypothetical ______________________
expresses the disorder |
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Definition
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Term
| In the additive polygenic transmission model homozygosity is (relevant/irrelevant) to liability |
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Definition
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Term
| True or false: In polygenic transmission risk alleles may be common in the population even though the disorder is relatively rare |
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Definition
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Term
| The probability of expressing a polygenic disorder or condition is a function of _____________ and ______________ |
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Definition
| how closely one is related to an affected individual (called a proband or index case), the severity of the probands condition |
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Term
| what are the four major ideas of the polygenic multi-factorial threshold (PMFT) model? |
|
Definition
1. Liability bestowed by additive genes + additive environmental factors
2. Genetic and environmental liabilities in combination manifest as a
normal distribution
3. Persons whose overall liability exceeds a hypothetical threshold value express the disorder
4. Assumes gene / environment independence |
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Term
|
Definition
| interaction between genes produces synergistic effect |
|
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Term
| what are some problems with the polygenic additivity model? |
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Definition
1. some genes may play bigger role (be more potent) than others (not all equal)
2. genes are not always independent in their effects |
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Term
| True or false: Genes and environments may have synergistic effects on a geneotype |
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Definition
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Term
| what is meant by "gene-environment correlation" and what are the three different types? |
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Definition
| Genotype may influence the type of environment to which one is exposed, confounding (entangling) with gene and environmental effects. Three types are passive, evocative and active. |
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Term
| Define passive, evocative and active gene-environment correlation |
|
Definition
1.Passive. Parent / sibling shared genotype may affect the child’s developmental environment
2.Evocative. A person’s heritable traits may shape other’s reactions to him or her
3. Active. A person’s heritable traits may lead him or her to seek out or create certain environments |
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Term
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Definition
| Experience-associated changes in gene expression, not structure, which persist through cell division. |
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Term
| True or false: Some epigenetic modifications are heritable |
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Definition
|
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Term
| what are the three major mechanisms of epigenetics? |
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Definition
1. DNA methylation
2. Histone modification
3. Micro RNA (miRNA) regulation |
|
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Term
|
Definition
| (Micro RNA) Short (M = 22 nt) sequences of non-coding RNA which bind to complementary segments of mRNA and inhibit translation. |
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Term
| ___________ is any adaptive demand that taxes one’s physiological or psychological coping resources. Situations imparting these demands are called _______________ |
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Definition
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Term
| Stress triggers responses designed to meet the demand and maintain or restore internal equilibrium. This dynamic process is called _______________ |
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Definition
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Term
| what are two important allostatic response systems? |
|
Definition
1. The Sympathetic-Adrenomedullary (SAM) system
2. The Hypothalamic-Pituitary-Adrenocortical (HPA) axis |
|
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Term
| What is the allostatic load? |
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Definition
| The degree to which the SAM and HPA systems are being called upon to maintain equilibrium |
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Term
| The _______ is equivalent to the sympathetic branch of the autonomic nervous system |
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Definition
| SAM system (sympathetic-adrenomedullary) |
|
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Term
| where does the SAM system originate? |
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Definition
|
|
Term
| the target-organ nt in the SAM (with a few exceptions) is ________________ |
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Definition
|
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Term
| what happens when the adrenal medulla is activated as part of the SAM system? |
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Definition
| it releases epinepherine (adrenaline) and some NE into the system which enhances SNS activity and stimulates glucose release |
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Term
| the HPA axis is activated by ___________ |
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Definition
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Term
when the HPA axis is activated the Paraventricular nucleus of hypothalamus
releases _______________ into portal vessels |
|
Definition
| corticotropin-releasing hormone(CRH) |
|
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Term
| Anterior pituitary responds to CRH release by releasing _________________ into general circulation |
|
Definition
| adrenocorticotrophic hormone (ACTH) |
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Term
| ACTH stimulates adrenal cortex to release ____________________ |
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Definition
|
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Term
| explain the cortisol feedback loop |
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Definition
CORT feedback on receptors in pituitary, hippocampus, and hypothalamus inhibits
further CRH release |
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Term
| cortisol levels have a _______________ rythm |
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Definition
| diurnal (peak in AM, late PM nadir) |
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Term
| How does stress-related CORT release support fight-or-flight responses? |
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Definition
1. Enhances SAM activity
2. Increases blood glucose
3. Enhances immune responses (e.g. promotes inflammation)
4.Enhances emotional memory formation |
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Term
| when can cortisol have a negative effect? |
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Definition
frequent bursts or chronic elevations of CORT impair immune system and reduce
growth and plasticity of brain cells (especially in the hippocampus) |
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Term
|
Definition
| a discrete natural category |
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Term
|
Definition
1) the classification of disorders or diseases; 2) a
particular example of such a classification scheme (e.g., the
DSM-IV is a nosology)
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|
|
Term
describes nosological organizing principles,
in order of value (etiology, pathophysiology, description) |
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Definition
|
|
Term
| What do psychiatric nosologies rest on? |
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Definition
descriptions of the objective
behavior (signs) and subjective experience (symptoms) of
patients |
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Term
| the score at which someone is considered to have a mental illness is called a ____________ |
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Definition
| cut point, cutting score or threshold score |
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Term
| a _______________ is the percentage of truly ill persons in the sample |
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Definition
|
|
Term
| what does the sensitivity of a test tell you? |
|
Definition
| the percent of ill persons diagnosed as ill (% of true positives) |
|
|
Term
| what does the specificity of a test tell you? |
|
Definition
| the percent of well persons diagnosed as well (% true negatives) |
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|
Term
| the ______________ tells you the percent of true positives among test positives |
|
Definition
| positive predictive value |
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|
Term
| the _______________ tells you the percent of true negatives among test negatives |
|
Definition
| negative predictive value |
|
|
Term
| what does the overall accuracy of a test tell you? |
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Definition
| the percent of correct test results, but taken alone this tells you NOTHING about the efficacy of the test |
|
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Term
| Optimal placement of a cutting score is a joint function of what two things? |
|
Definition
1. the probability of each possible diagnostic outcome: PTP, PTN, PFP, PFN; and . . .
2. the utility (i.e., cost or benefit) associated with each of those
outcomes: UTP, UTN, UFP, UFN (where UFP and FN are negative) |
|
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Term
| How do you determine the expected utility of a diagnostic procedure? |
|
Definition
(∑UiPi) - Uadm
EU = (UTP × PTP) + (UTN × PTN) + (UFP × PFP) + (UFN × PFN) – Uadm |
|
|
Term
| what is a fixed-rule diagnostic system? |
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Definition
| one in which cutting scores are identical for all situations and settings. |
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