Definition of a mental disorder
A condition causing real suffering or significant impairment.
Must be understood in cultural + social context.
Risk: diagnostic labels can be used as power tools to exclude or control.
Biological/Medical Model – Core Idea, concepts,Typical Interventions
Disorders arise from genetic, neurochemical, or brain dysfunction.
Heritability, neurotransmitters, brain circuits.
Pharmacotherapy, ECT.
Psychodynamic Model
Symptoms express unconscious conflicts between drives and control mechanisms.
Id–Ego–Superego, defense mechanisms, transference.
Psychoanalysis, insight-oriented therapy.
Maladaptive behaviors are learned through conditioning.
Classical/operant conditioning, reinforcement, extinction.
Exposure, behavior modification.
Cognitive Model
Dysfunctional thoughts/beliefs produce distress.
Cognitive distortions, schemas, automatic thoughts.
Cognitive restructuring, CBT
Humanistic Model
Distress arises from blocked self-actualization or incongruence between self and experience.
Authenticity, unconditional positive regard, self-concept.
Person-centered therapy, experiential therapy.
Systemic Model
Symptoms maintain relational or family balance within a system.
Circular causality, homeostasis, family roles.
Family therapy, communication analysis.
DSM-5-TR
Categorical;
defines discrete disorders based on symptom clusters.Examples: MDD, Schizophrenia.
Origin: USA (APA).
Structure:
Descriptive, symptom-based categories.
global classification of all diseases incl. mental disorders.Examples: Bipolar I, PTSD.
Origin: WHO.
Structure: Similar to DSM but broader; includes physical conditions.
HiTOP
Dimensional; organizes psychopathology into continuous dimensions.
Example: depression/anxiety → internalizing spectrum.
Focus: Empirical, hierarchical
.Dimensions:
Internalizing, externalizing,
thought disorder,
detachment,
antagonism.
Goal: Better reliability, reflect continuous traits.
RDoC
Dimensional;
studies disorders through functional domains (cognition, arousal, valence).
Example: fear/reward systems across diagnoses.
Focus: Neurobiological + behavioral.
Dimensions:
Negative/positive valence,
cognition,
arousal,
social processes.
Goal: Bridge neuroscience and clinical research.
Contextual;
focuses on power, threat, meaning, response instead of diagnostic labels.
Focus:
Meaning-centered,
social-contextual
Power,
threat,
meaning,
response.
Goal: Replace diagnosis with understanding of lived experience.
Difference between explanatory models and classification systems?
Explanatory = Why disorder occurs (causes).
Classification = How disorders are grouped/described (symptoms).
Advantages of categorical systems (DSM/ICD)
Clear criteria,
communication,
treatment planning,
research standardization.
Limitations of categorical systems
High comorbidity,
rigid categories,
cultural limitations,
risk of labeling.
Advantages of dimensional systems (HiTOP/RDoC)
Continuity,
severity,
reduces comorbidity
, aligns with data.
Limitations of dimensional systems
Less intuitive clinically,
harder for billing
, RDoC overly biological.
How does PTMF differ from DSM/ICD?
Focuses on meaning + context rather than symptoms;
explains distress through power and threat,
not diagnostic categories.
Systemic model reinterpretation of symptoms?
Symptoms serve relational functions (maintaining homeostasis) in the family system.
Why is it helpful to know multiple models?
No single model fits all patients;
improves assessment, case formulation, cultural sensitivity, treatment planning.
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