Psych - Clinical Psychology Uniy

Intern’s Syndrome

The tendency to believe one is experiencing the symptoms of a disease one is studying

Abnormality

Criteria: deviance, distress, dysfunction

Stigma

A negative set of beliefs that a group or society holds about something, leading to discrimination and shame

Rosenham Study on Institutions

Highlights important questions about institutionalization, labeling, and self-fulfilling prophecies

• Sends in 8 fake patients, 7 labelled as schizophrenic and averaged a stay of 19 days even though they were faking

Self-Fulfilling Prophecy

A belief or expectation that works to bring about its own fulfillment; believing that it will happen contributes to it happening

Confirmation Bias

We tend to look for information that supports what we already think, and ignore information that does not

Pseudopatients

Did three month study, where fake patients were meant to go in to see if institutions could diagnose those who were faking when they looked for it

• Over 3 months had 193 patients, identified 41 people as fakers when really none were

DSM-5

A book used to classify and diagnosis disorders

• Book does not include any etiology or possible treatments for these disorders

ICD

International version of the DSM-5

Major Depressive Disorder

• Also known as clinical depression

Persistent Depressive Disorder

• Depressed mood that lasts for two years

RI

Reuptake inhibitor (biomedical treatment)

SSRIs/SNRIs

• Medication given as antidepressant

• Not habit forming (do NOT become addictive)

Prozac and Zoloft

Example of antidepressant

Effects of Antidepressant

Improved mood, sleep, and appetite; decreased negative thinking

Serotonin and Norepinephrine agonist

How antidepressants work?

Mood related disorders and OCD

What disorders do antidepressants work for?

Antipsychotic

• Class of neuroleptics

• Effects: Reduced hallucinations, thought disorder, withdrawal, and emotional flatness

Thorazine

Example of Antipsychotic (for schizophrenia)

Dopamine Antagonist

How does an antipsychotic work?

Antianxiety

• Classes as benzodiazepines

• Effects: sedation, muscle relaxation, decreased anxiety

Valium and Xanax

Examples of antianxiety medication

Anxiety related disorders

What disorders do antianxiety meds help?

GABA agonsit

How does antianxiety medication work

Antimanic

• Example: Eskalith

• How they work: unknown

• Effects: Reduced manic excitment

Bipolar Disorder

What disorder medication contains lithium and carbonate?

ECT

• Shock therapy

• Invasive but only side effect is short-term memory (STM) loss

• Used for depression

Deep Brain Stimulation

• DBS

• Rare, as it involves surgery

• Keeps flow of electricity to that part of the brain

• Could be a treatment for persistent depression

Transcranial Magnetic Stimulation

• TMS

• Runs magnet over brain

Etiology

Refers to the history and possible causes of a disorder

Psychoanalytic/Psychodynamic Etiology

• Repressed trauma in early childhood, and unconscious conflicts

• Inability to live up to goal of superego and balance all parts of conscious and unconscious brain

• Regression

Psychoanalytic/Psychodynamic Treatment

• Psychoanalysis (analyzing you)

• Stream of consciousness, free association

• Dream journal

Behavioral Etiology

• Conditioning, reinforced

• Social learning

Behavioral Treatment

• Applied behavior analysis (modify behavior)

• Counterconditioning (token economy)

Humanistic Etiology

• Real vs Ideal self

• No UPR, but conditions of worth

• Loss of free will and self-actualization

Humanistic Treatment

• Person centered therapy (not a patient, but a client)

• Reflective listening and empathy

• Non-directive - you are in charge of fixing you and your problems

Cognitive Etiology

• Self defeating, irrational thoughts

• Learned helplessness, external locus of control, pessimistic explanatory style

Cognitive Treatment

• Confront and change those thought patters

• Cognitive Restructuring

Criticisms of biological perspective

• Overuse

• Addiction and side effects

• We don’t now why some of the drugs work

Biopsychosocial

Biological + Psychological + Social-cultural Influences together cause disorder

• ex. depression: genetic predisposition + learned helplessness + traumatic/negative events → depressed mood

Comorbidity

In this case, means having 2 social disorders at the same time (concurrent)

Rumination

Women are more likely to focus/think about one thing and could be reason for increased rates of depression in women

Bipolar I

Extreme depression to mania

Bipolar II

• Depression to mania

• Hypomanic = milder form of mania

PET Scan

What technology can show how quickly a person can go from depressed to manic state of brain using a glucose shot?

Rapid Cycling

People can go from depressed to manic state in 1 day

Bipolar Disorder

Which disorder has the strongest biological presdisposition?

Symptoms of Schizophrenia

• Wide range of what people act/feel/do, but it is not multiple personalities

1. Delusion

2. Hallucinations

3. Word Salad

Dopamine Hypothesis

Etiology of Schizophrenia

• Result of too much of a chemical

• Also, genetic predisposition plays a large role

Positive and Negative Symptoms

What are the different types of symptoms for schizophrenia

• ex. Hallucinations, delusion, and word salad

• ex. Flat affect, avolition (stop doing motivated activities - like showering), social withdrawl

Englarged Ventricles

Different etiology for schizophrenia, involved prefrontal love dysfunction

Diathesis Stress Model

• Etiology for many disorders

• Diathesis (biological predisposition) + Stress (environmental stress) → development of the disorder

Antipsychotic Side Effects

• Sexual dsyfunction, significant weight gain, tardive dyskinesia

Tardive dyskinesia

• Uncontrollable muscle movement

• Mostly permanent

Acute Schizophrenia

• Onset of Schizophrenia

• Sudden and severe emergence of symptoms

• More like to respond to meds and treatment

Chronic Schizophrenia

• Onset of shizophrenia

• Slow decline w/persistent, hard-to-treat symptoms

Dissociative Disorders

• Rare and somewhat controversial

• Involve some memory disruption w/out injury

• Typically linked to stress/trauma

Dissociative Identity Disorder

• Used to be known as multiple personality disorder

• Many personalities (avg. went from 3 to 12)

• Blew up on tiktok

Memory Trace

One personality is aware of all the others (not usually the host)

DID Etiology

90% have history of severe absure

• Perhaps severe abuse leads you to compartmentalize your identity to cope, so you believe the abuse happened to someone else

Physiological changes in alter

• Brain wave activity, resting HR, blood pressure, respiration, visual acuity, blood flow in the brain, handedness, allergies

DID Treatment

• CBT (cognitive behavioral therapy)

• Drug do NOT work, must uncover trauma and learn to cope

• Try to merge personalities together

Paranoid PD

Pervasive, unwarranted suspiciousness and mistrust; overly sensitive, often envious; causes difficulties in relationships

• more common in males

Schizoid PD

Aloof, detached, poor capacity for forming social relationships; shy, withdrawn behavior, restricted range of emotions, condidered “cold”

• More common in males

Schizotypal PD

• Eccentric behavior and dress, magical thinking, perceptual distortions (sensing things that are not there)

• Difficulties with social interactions, as they often feel anxious and uncomfortable, may lead to few close relationships

Histrionic PD

Excessively dramatic and emotional; seeking attention and tending to overreact; egocentric, shallow relationships, often flamboyant, prioritize excitment even at own personal risk

• More common in females

Narcisistic PD

Unrealistically self-important; manipulative; lacing empathy; expects social treatment; can’t take criticism

• May not see personality as a problem

• More common in males

Borderline PD

Emotionally unstable; impulsive; unpredictable; irritable; prone to boredom

• Substance abuse and self harm, fear of abandonment, and poor sense of self

• More common in females

Antisocial PD

Used to be called sociopaths or psychopaths. Violate other people’s rights without guilt or remorse. Manipulative, exploitative, self-indulgent, irresponsible, can be charming. Commit disproportionate number of violent crimes

• More common in males

Avoidant PD

Excessively sensitive to potential rejection, humiliation; desires acceptance but is socially withdrawn'

• avoidance of social interactions for fear of being judged

• Treatment: therapy

Dependent PD

Excessively lacking in self-confidence; subordinates own needs; allows others to make all decisions, fear of rejection so will comply with others

• More common in females

Obsessive-Compulsive PD

• Usually preoccupied with rules, schedules, details; extremely conventional; serious, emotionally insensitive

• Lifelong disorder that disrupts thoughts, behavior, and mood, and generally doesn’t recognize their behavior as problematic

Obsessions

Repetitive thoughts

Compulsions

Repetitive behaviors

Etiology of Personality Disorders

• Biological: abnormalities in brain regions, imbalances of neurotransmitters, and hormonal imbalances

• Biological, genetic, social, cultural, behavioral, or cognitive sources

Agoraphobia

Fear of public, open, “no escape” places where you could panic and feel trapped

• Fear of panic attack in public, might cause people to stay home if fear is overwhelming

Social Anxiety Disorder

• Strong fear of being judger by others and of being embarassed

Treatment for Phobias

• Systematic Desensitization

• Flooding

• Modeling

• Virtual reality therapy (VRT)

Systematic Desensitization

Classical conditioning technique in which the therapist induced the patient to approach a phobic stimulus gradually in imagination

Exposure techniques

Classical conditioning tenchniques in which the therapist presents the patient with the phobic stimulus in real life, either all at once (flooding), or gradually (graded exposure)

Operant Techniques

Therapist alters operant behaviors by redesigning rewards and punishments, as in a token economy

Psychoanaylsis

Patient lies on a couch and free associates three to fives times a week

Psychodynamic Psychotherapy

The patient sits face to face with the therapist once to three times a week

Generalized Anxiety Disorder

Excessive worry about many areas of life

• Restlessness, can’t concentrate, muscle tension, irritability

Taijin kyofusho

Fear of embarrassing others

Neurodevelopmental Disorders

• Symptoms: focus on whether person is exhibiting behavior appropriate for age or maturity range - affect social, intellectual, academic, and/or personal functioning

• Associated w/central nervous system

ADHD

• Problems w/paying attention or being overly impulsive → affects everyday functioning and development

Autism Spectrum Disorder

• Characterized by receptive behavior and challenges w/social communication and interaction, also heightened sensitivity to sensory input