Unit 8 Test Review Sheet: Clinical Psychology

Psychological disorder

A syndrome (collection of symptoms) marked by a “clinically significant disturbance in aj individuals cognition, emotion regulation, or behavior.” When thoughts, emotions, or behaviors are deviant, distressful, and *dysfunctional, psychiatrists and psychologists label them disordered.

The DSM-V

The american Psychological Association’s Diagnostic and Statistical Manual of Mental Disorders (5th edition), a widely used system for classifying psychological disorders
The DSM-V came out in May 2018

A.It defines diagnostic process and 20 clinical syndromes (categories of disorders)

What critics of the DSM-V argue

critics of the DSM-V argue that diagnostic labels can stigmatize a person by biasing others’ interpretations and perceptions of past and present behaviors and by affecting the ways people react to the labeled person

Generalized anxiety disorder (GAD) 

An anxiety disorder in which a person is continually tense, apprehensive and in a state of autonomic nervous system arousal
-excessive worry for at least 6 months or more.
A. people w/ it are continually tense and jittery, worried abt various bad things that might happen and plagued by muscular tension, agitation and sleeplessness.

1. ⅔ of people w/ this condition are women

2. One of the worst characteristics of GAD is that the person can’t identify, and therefore can’t deal with or avoid, its cause.

Panic Disorder

an anxiety disorder marked by unpredictable minutes — long episodes (panic attacks) of intense dread in which a person experiences terror and accompanying chest pain, choking or frightening sensations, often followed by worry over a possible next attack.
A. 3% of people have panic disorder and panic attacks are recurrent.
B. Many w/ panic disorder develop agoraphobia — fear or avoidance of situations in which escape might be difficult or one has felt loss of control and panic.
Ex. People may avoid being outside the home, in a crowd, on a bus, on an elevator, in a theater, in malls, or trains

Agoraphobia

it’s an anxiety disorder characterized by intense fear and avoidance of places or situations where escape might be difficult or help unavailable if panic-like symptoms were to occur.

Phobias

an anxiety disorder marked by a persistent, irrational fear and avoidance of a specific object, activity or situation.

Social Anxiety Disorder

intense fear of social situations, leading to avoidance of such. Have an intense fear of being scrutinized by others.
-potentially embarrassing situations are difficult. Ex. public speaking, eating in public, or dating

Obsessive Compulsive Disorder (OCD)

a disorder characterized by unwanted repetitive thoughts (obsessions) and/or repetitive ritual actions (compulsions) often involving checking, organizing, counting or cleaning something that reduced the anxiety that one’s obsessions produce
A. obsessive thoughts and compulsive behaviors cross the fine line btw normality and disorder when they become so persistent that they interfere w/ everyday living and cause the person distress
Ex. Checking to see if the door is locked is normal; checking ten times is not
Ex. Washing your hands is normal; washing so often that your skin becomes raw is not
- OCD affects 2-3% of people
- Symptoms usually show before age 18 and often affect people in their late teens or twenties

Post Traumatic Stress Disorder (PTSD)

a disorder characterized by haunting memories, nightmares, social withdrawal, jumpy anxiety, and/or insomnia that lingers for four weeks or more after a traumatic experience
A, 4% of people who experience natural disasters, and 50% of those kidnapped, held captive, tortured, or raped experienced PTSD
B. Abt ½ of adults experience at least one traumatic event in their lifetime, but only 1 in 10 women and 1 in 20 men develop PTSD

2, Suffering can lead to post-traumatic growth — an increased appreciation for life, more meaningful relationships, increased personal strength, changed priorities and richer spiritual life

The learning perspective for explaining anxiety disorders

A. Classical & operant conditioning - researchers hv linked general anxiety w/ classical conditioning of fear
B. Observational learning - we might also learn fear through observational learning — by observing others’ fears
C. Cognition - our interpretations and irrational beliefs can also cause feelings of anxiety Ex. Whether we interpret the creaky sound in the old house simply as the wind or as a possible knife-wielding intruder determines whether we panic

Somatic symptom disorder

a psychological disorder in which the symptoms take a somatic (bodily) form w/o apparent physical cause. It’s the expression of psychological stress through physical symptoms.

Ex. A person who has a psychological problem like depression but experiences explicable physical symptoms like paralysis.

Ex. A women who becomes dizzy and nauseated in the late afternoon - shortly before she expects her husband home. Doctors could not identify a physical cause and suspect her symptoms have an unconscious psychological origin, possibly triggered by her mixed feelings about her husband.

- Although the symptoms may be psychological in origin, they are genuinely felt.

Conversion Disorder (also known as functional neurological symptom disorder)

People experience a change in or loss of physical functioning in a major part of the body for which there is no known medical cause.

Ex. All of a sudden a person may develop the inability to see at night or move their legs with no medical explanation.

-The disorder is further complicated because many who have it, show little concern about their symptoms.

Illness Anxiety Disorder (formerly called hypochondia)

a person’s unrealistic preoccupation w/thoughts that he or she has a serious disease

-people w/ it become absorbed by minor physical symptoms and sensations, convinced that the symptoms indicate a serious medical illness.
-people maintain their erroneous beliefs despite reasurance from doctors that there is nothing physically wrong w/ them

Dissociative Disorders

Disorders in which conscious awareness becomes separated (dissociated) from previous memories, thoughts and feelings.
-Daydreaming is a common form of dissociation
-When dissociation occurs as a way to avoid stressful events or feelings, it is considered a sign of a psychological disorder

Dissociative Amnesia

a sudden loss of memory usually following a particularly stressful or traumatic event

Dissociative Fugue

forget personal information and past events but also suddenly relocate from home or work and take on a new identity (has no recollection during fugue)

Dissociative Identity Disorder (DID)

a rare dissociative disorder in which a person exhibits two or more distinct and alternating personalities. Also called “multiple personality disorder”
A. Each personality is different from eachother in several ways
B. People diagnosed w/ this disorder usually were physically, sexually and/or psychologically abused during childhood
C. They dissociate as a way to dealing w/ anxiety

Depersonalization disorder

people w it describe feeling as though they are outside of their bodies, observing themselves at a distance

Explanations for dissociative disorders

1. Psychoanalytic Theory - people dissociate in order to repress unacceptable urges

2. Learning Theorists - dissociate from stressful events by selectively forgetting them, therefore reducing the anxiety

3. There is no convincing evidence that either biological or genetic factors play a role in the development of dissociative disorders

Major Depressive Disorder

a disorder in which a person experiences, in the absence of drugs or medical condition, 2 or more wks w 5 or more symptoms, at least one of which must be either 1) depressed mood or 2) loss interest or pleasure in most activities

A.check notes for the 9 symptoms

B. with or w/o therapy, episodes of major depression usually end and people temporarily or permanently return to their previous behavior patterns

Bipolar disorder

a disorder in which the person alternates between the hopelessness and lethargy of depression and the overexcited state of mania (formerly called maniac depressive disorder)
A. During the manic phase of bipolar, the person is typically overtalkative, overactive and elated; has little need for sleep; and shows fewer sexual inhibitions
B. One of mania’s maladaptive symptoms is grandiose optimism and self-esteem, which may lead to reckless investments, spending sprees and unsafe sex
C. It is as maladaptive as major depression, but not as common
D. It afflicts as many men as women

The depressed brain — neurotransmitters connected to depression

A. The biochemical key is neurotransmitters:
1) Norepinephrine - a neurotransmitter that increases arousal and boosts mood, is scarce during depression and overabundant during mania.
2) Serotonin - is scarce during depression.
- Drugs that relieve depression tend to increase norepinephrine or serotonin by either blocking their reuptake (like Prozac, Zoloft and Paxil do w serotonin) or their chemical breakdown
B. The left frontal lobe, which is active during periods of mania, is likely to be inactive during depressed states

Schizophrenia

a psychological disorder characterized by delusions, hallucinations, disorganized speech, and/or diminished or inappropriate emotional expressions

- it’s the biggest example of a psychotic disorder - psychological disorders marked by loss of contact w/ reality, irrational ideas and disturbed perceptions

A. People w schizophrenia make up 1% of the population
-21 million people worldwide
B. it typically strikes as young people are maturing into adults (but can occur at any age).
- Men tend to be struck earlier, more severely and slightly more often than women. 60% of schizophrenics are men

Symptoms of Schizophrenia

1. Distubed Perceptions and Beliefs

A. The thinking of a person with schizophrenia is fragmented, bizarre and distorted by delusions - false beliefs, often of persecution (someone is after them) or grandeur (they are superior to others).
- Many psychologists believe disorganized thoughts result form a breakdown in selective attention. Schizophrenics cannot filter out competing sensory stimuli. Therefore an irrelevant stimulus or an extraneous part of the preceding thought easily distracts them

B. A schizophrenic may perceive things that aren’t there - hallucinations (sensory experiences w/o sensory stimulation).

- The hallucinations are usually auditory & often take the form of voices making insulting statements or giving orders. Less commonly, people see, feel & taste or smell things that aren’t there

2. Disorganized Speech - jumbled ideas may make no sense even withtin sentences (word salad).

3. Diminished and Inappropriate Emotions
A. The emotions of schizophrenia are often very inappropriate

B. Motor behaviors may also be innapropriate

personality disorders

psychological disorders characterized by inflexible(unchanging) and enduring behavior patterns that impair social functioning

schizoid personality disorder (eccentric or odd behaviors)

emotionally disengaged. Have no interest in relationships w/other people bc they lack normal emotional response

Narcissistic Personality disorder

exaggerates their own importance, aided by success fantasies. Need admiration. They find criticism hard to accept, often reacting w rage or shame

Borderline personality disorder

have an unstable identity, unstable relationships and unstable and impulsive emotions. Is defined by an unstable sense of self.

antisocial personality disorder

the most troubling and heavily researched personality disorder. sometimes called sociopaths or psychopaths. A personality disorder in which the person exhibits a lack of conscience for wrong doing, even toward friends and family members. May be aggressive & ruthless or a clever con artists, or worse.
A. 3% of men, 1% of women. Is typically a male whose lack of conscience is evident before age 15, as he begins to lie, steal, fight or display unrestrained sexual behavior.
-about half of such children become anti-social adults
-many are clever con-artists bc they have no morals & are intelligent
-typically do not feel guilt or remorse for their behavior and fear very little, and in some cases can be killers. Ex. Henry Lee Lucas

psychotherapy (psychological therapy)

treatment involving psychological techniques; consists of interactions between a trained therapist and someone seeking to overcome psychological difficulties or achieve personal growth

Biomedical therapy

prescribed medications or procedures that act directly on the person’s physiology

The eclectic approach to therapy

an approach to psychotherapy that, depending on the client’s problems, use techniques from various forms of therapy

psychoanalysis

Freud’s therapeutic technique. Freud believed the patient’s free associations, resistances, dreams and transferences–and the therapist’s interpretation of them–released previously repressed feelings, allowing the patient to gain self-insight.

Aims of psychoanalysis

To bring repressed childhood impulses, conflicts and feelings into conscious awareness where the patient can deal with them.

free association

you say aloud whatever comes to your mind from moment to moment, which may be a childhood memory, a dream or recent experience.

resistance

During free association the psychoanalyst looks for resistance: the blocking from consciousness of anxiety laden material. Blocks in the flow of your free associations

Ex.editing your thoughts as you speak (omitting what seems trivial, irrelevant or embarrassing), you may pause before saying something, or you may make a joke or change the subject to something less threatening.

• the analyst will make you aware of your resistances and then interpret their meaning, providing insight into your underlying wishes, feelings and conflicts.

Transference

During free association, one may ehibit transference: the patient transfers to the analyst emotions linked with other relationships (such as love or hatred of a parent or other important person) giving the client a chance to work through them with the analyst’s help.

Humanistic therapies

humanistic therapists focus on client’s present and future experiences, on conscious rather than unconscious thoughts and on taking responsibility for one’s feeling sand actions

Humanistic therapy [client-centered therapy]

a humanistic therapy developed by Carl Rogers in which the therapist uses techniques such as active listening within a genuine accepting, empathetic environment to facilitate client’s growth. (Also called person-centered therapy).

-the therapist listens w/o judging or interpreting, and refrains from direction the client toward certain insights, a strategy labeled nondirective therapy
-Active listening - emphatethic listening in which a listener echoes, restates and clarifies.

• given a nonjudgemental enviroment that provides unconditional positive regard (a caring, accepting, nonjudgemental attitude, which Carl rogers believed would help clients develop self-awareness and self-acceptance), ppl may accept even their worst traits and feel valued and whole.

behavior therapy

therapy that applies learning principles to the elimination of unwanted behaviors
Ex. To treat phobias or sexual disorders behavior therapists do not delve deeply below the surface looking for the inner causes. They view maladaptive symptoms, such as anxiety, as learned behaviors that can be replaced w constructive behaviors. (Attempt to change behaviors through new learning).

counterconditioning

behavior therapy procedure that pairs the trigger stimulus with a new response that is incompatible with fear. Ex. Replacing a boy’s fear of rabbits by associating the rabbit with the pleasurable, relaxed response of eating candy.

2 Counterconditioning techniques:

A) Exposure therapies - behavior techniques that treat anxieties by exposing people (in imagination or actuality) to the things they fear and avoid
Ex. Systematic Desensitization - a type of counterconditioning that associates a pleasant relaxed state with gradually increasing anxiety-triggering stimuli —commonly used to treat phobias
Ex. Virtual Reality Exposure Therapy - an anxiety treatment that progressively exposes people to simulations of their greatest fears, such as airplane flying, spiders or public speaking

B) Aversive Conditioning - a type of counterconditioning that associates an unpleasant state (such as nausea) w/ an unwanted behavior (such as drinking alcohol).
Ex. To treat nail biting, one can paint the fingernails w/ a yucky tasting nail polish.
Ex. To treat alcoholism, an aversive therapist offers the client appealing drinks laced w/ a drug that produces severe nausea. It tries to make the person’s reaction go from positive to negative

• the problem is that ppl know that outside the therapist’s office they can drink without the fear of nausea.

Operant Conditioning therapies (behavior therapy)

operant conditioning therapies are based on the principle that voluntary behaviors are strongly influenced by their consequences. Behavior modification procedures enforce desired behaviors and withhold reinforcement for, or punish, undesired behaviors

Cognitive therapies

attempt to teach ppl to think in more adaptive ways on the assumption that thoughts intervene between an event and our emotional reactions to it

Rational-Emotive Behavior Therapy (REBT)

a confrontational cognitive therapy, developed by Albert Ellis that vigorously challenges people’s illogical, self-defeating attitudes and assumptions

Meta-analysis

is a statistical technique used to combine and analyze the results from multiple independent studies on the same topic.

Light Exposure Therapy

to counteract winter depression people spend time each morning in front of a box that emits intense light that mimics natural outdoor light

Antipsychotic Drugs

such as chlorpromazine (sold as Thorazine), lessen responsiveness to irrelevsnt sitmuli. They provide the most help to schizophrenia patients experiencing positive symptoms, such as auditory hallucinations and paranoia.

- Schizophrenic patients with negative symptoms don't respond as well to antipsychotic drugs, but a newer drug, clozapine (clozaril) does sometimes help with negative symptoms of apathy and withdrawal.

A. The molecules of antipsychotic drugs are similar enough to molecules of the neurotransmitter dopamine to occupy its receptor sites and block its activity.

- The finding that most antipsychotic drugs block dopamine receptors reinforces the idea that an overactive dopamine system contributes to schizophrenia.

B. Antipsychotic drugs are powerful. Thorazine can produce sluggishness, tremors and twitches similar to those of Parkinson's disease (which is due to too little dopamine).
Long-term use of these medications can also produce tardive dyskinesia - involuntary movements of the facial muscles, tongue and limbs.
New generation antipsychotic drugs (ex. clozapine, Risperdal and Zyprexa have fewer side effects but increase risk of diabetes and obesity.

Antianxiety Drugs

like xanax or Ativan depress central nervous system activity

A. Can cause psychological dependence - the immediate relief reinforces a person's tendency to take drugs when anxious.

B. Can cause physiological dependence - when heavy users stop taking them, they may experience withdrawal symptoms, like increased anxiety or insomnia.

C. *** The new standard drug treatment for anxiety disorders is antidepressants (ex. treat OCD).

Antidepressants

sometimes lift people up from a state of depression.
- Are increasingly being used to successfully treat anxiety disorders, OCD & PTSD.
A. They increase the availability of norepinephrine or serotonin, neurotransmitters that elevate arousal and mood and appear scarce during depression.
Ex. Prozac partially blocks the reabsorption and removal or serotonin from synapses.

- Because they slow the synaptic vacuuming up of serotonin, Prozac, Zoloft and Paxil are called selective-serotonin-reuptake inhibitors (SSRIs).

B. Antidepressants do not work right away - although their influence on neurotransmission does occur within hours, their full psychological effect often requires 4 weeks.

Lithium

Lithium is a medication commonly used to treat Bipolar Disorder. It works by stabilizing mood swings and reducing the intensity of manic episodes

Electroconvulsive Therapy (ECT)

a biomedical therapy for severely depressed patients in which a brief electric current is sent through the brain of an anesthetized patient.

Repetitive transcranial magnetic stimulation (rTMS)

Alternatives to ECT - Depressed moods also seem to improve when repeated pulses surge through a magnetic coil held close to a person's skull. The magnetic energy penetrates only to the brain's surface. The painless procedure called repetitive transcranial magnetic stimulation (rTMS) is performed on wide-awake clients for 20-30 minutes for 2-4 weeks.

-Unlike ECT, the rTMS procedure produces no seizures, memory loss or other side effects.

Psychosurgery

surgery that removes or destroys brain tissue in an effort to change behavior.

-Because its effects are irreversible, it is the most drastic and the least-used biomedical intervention for changing behavior.

Lobotomy

- a now rare psychosurgical procedure once used to calm uncontrollably emotional or violent patients. The procedure cut the nerves that connect the frontal lobes to the emotion-controlling centers of the inner brain.

- Although the intention was simply to disconnect emotion form thought, the effect was often more drastic. A lobotomy usually decreased the person's misery or tension, but also produced a permanently lethargic, immature, uncreative person.

- Today lobotomies are history and other psychosurgery is used only in extreme cases.

Ex. If a patient suffers uncontrollable seizures, surgeons can deactivate the specific nerve clusters that cause or transmit the convulsions.

-MRI-guided precision surgery is also occasionally done to cut the circuits involved in severe OCD.