ap psychology: abnormal/clinical psych unit

abnormal disorder requirements

threatens self or others. ←→ interferes with ability to live

it deviates cultural norms - eccentricity

approaches to mental health disorders

→ biopsychosocial model

→ biomedical model

cause

→ result of biological, mental, and social interactions

→ biological disease

prognosis

→ manageable

→ curable

wellness

→ proper function

→ absence of psychopathology/mental health disorder

DSM-5 (Diagnostic and Statistical Manual of Mental Disorders)

they tell you the:

→ diagnostic criteria (what you need in order to be diagnosed with a certain disorder)

→ prevalence (frequency)

→ age of onset

→ cultural issues

they don’t tell you:

→ treatment

lost of awareness

dissociation

→ it is limited to specific external reality

OR

→ limited to internal reality

fantasy prone reality

when some people have the ability to fantasize a whole different reality and feel like what is happening in that reality is real

dissociative disorders

→ dissociative amnesia(“i don’t remember”) - blocking out the trauma so you don’t have to remember………….fungue state(“who am i”) - very very rare, comes randomly, stops randomly

→ depersonalization-derealization disorder (“is this real?”) - “alien control”, feels are though someone else is in control

→ dissociative identity disorder - has multiple identities which all have distinct traits and they all serve different purposes

Herbert Spiegel and the Case of Sybil

the therapist of Sybil unintentionally put the idea of different identities into Sybil’s head

‘Eye roll test’

the higher your eye roll is on the chart, the more you are hypnotizable

schizophrenia symptoms: positive

→ Presence of behaviors, doesn’t mean “good”

• Inappropriate emotions

• hallucinations (most of the time audio, rarely seeing stuff)

• delusions

• paranoia

• disorganized thoughts & speech

schizophrenia symptoms: negative

→ absence of behaviors, doesn’t mean “bad”

• catatonia: lack of movement

• flat affect: lack of emotions

schizophrenia possible causes

• high dopamine levels

• enlarged brain ventricles

which disorder is most likely to be inherited genetically from one generation to the next?

schizophrenia

diathesis stress model

genetic predispositions and environmental stressors interact and play a factor in how likely a person will be to develop a disorder

major depressive disorder

• sadness

• lost of interest/pleasure

• difficulty concentrating

• feeling of worthlessness or guilt

• more or less sleep

• weight loss/loss of appetite

• restlessness or inactivity

according to the DSM-5, how long do you need to wait to see if it is major depressive disorder?

over a 2 week time period

which disorder is the most common?

major depressive disorder

when are some possibilities major depressive disorder could occur?

• post-partum depression (giving birth to a child)

• seasonal affective disorder (SAD) IN THE WINTER

positive attributional style: most likely will see good things that happen to them as…?

internal, stable, global

positive attributional style: most likely will see bad things that happen to them as…?

external, temporary, specific

negative attributional style: most likely will see good things that happen to them as…?

external, temporary, specific

negative attributional style: most likely will see bad things that happen to them as…?

internal, stable, global

bipolar disorder

• depressive episodes

• manic episodes

symptoms of manic episodes

• high amounts of energy and euphoria

• lack of sleep

• racing thoughts

• rapid speech

• difficulty focusing

• excessive spending and/or gambling

cyclothymic

far less extreme and lasts shorter than bipolar disorder

what is the second most common disorder?

generalized anxiety disorder

anxiety disorders

• generalized anxiety disorder

• specific phobia

• panic disorder

generalized anxiety disorder

→ ongoing

→ low levels of anxiety

specific phobia

→ irrational fear

panic disorder

→ panic attacks (extreme dread ←→ sympathetic nervous system ←→ brief and occasional)

obsessive compulsive disorder

• obsessions

• compulsions

  compulsions intended to alleviate obsessions

obsessions

→ thoughts (invasive ←→ anxiety invoking ←→ irrational or bizarre)

compulsions (more common)

→ behaviors (ritualistic ←→ repetitive ←→ hard to hold back)

post-traumatic stress disorder

stressor

→ intrusion (flashbacks, involuntary memory of event, nightmares)

→ avoidance of reminders

→ cognitive and mood alterations (sadness/inability to be happy, amnesia, guilt)

→ arousal and reactivity (hyper vigilance, difficultly sleeping, problems concentrating)

feeding and eating disorders

• anorexia nervosa

• bulimia nervosa

• binge eating disorder

anorexia nervosa

→ typically underweight

→ restriction of caloric intake

→ undue influence of body weight or shape (same as bulimia nervosa)

bulimia nervosa

→ typically normal weight to overweight

→ compensation strategy for consumption

→ food consumption larger than others would usually eat in similar setting (same as binge eating disorder)

→ sense of lack of control while eating (same as binge eating disorder)

binge eating disorder

→ typically normal weight to obese

→ distressed by consumption but no compensation

→ food consumption larger than others would usually eat in similar setting (same as bulimia nervosa)

→ sense of lack of control while eating (same as bulimia nervosa)

neurodevelopmental disorders

disorders that affect ones’s development whether socially, cognitively, or etc.

• autism spectrum disorder

• intellectual disability

autism spectrum disorder

→ social communication deficits (could be that they’re nonverbal or talks a lot and not realize that the other person is not interested)

→ restricted repetitive pattern (behaviors, interests)

intellectual disability

→ intellectual functioning deficits (academic learning, learning from experience)

→ adaptive functioning deficits (independent living, communication)

attention deficit hyperactivity disorder (ADHD)

• inattention

  → difficulty with focus

  → trouble concentrating

  → easily distracted

  → lacking organization

• hyperactivity

  → fidgety

  → difficulty sitting still

  → impulsive

  → talks excessively

disruptive, impulsive-control, and conduct disorder

usually characterized during childhood

behavior problems leading to trouble with adults

• oppositional defiant disorder

• conduct disorder

oppositional defiant disorder

they don’t want to be told what to do

→ vindictiveness (wanting to get revenge after feeling like you’ve been wronged)

→ argues with authority

→ anger with authority

conduct disorder

doing it for them and doesn’t care who they hurt

specific to anyone under 18

after 18, it changes to antisocial personality disorder

→ lack of regard, empathy, or remorse

→ harm to others

→ theft

→ deceitfulness

somatic symptom and related disorder

• somatic symptom disorder

• illness activity disorder

• factitious disorder

• conversion disorder

somatic symptom disorder

“this pain is too much for me!”

→ multiple persistant physical complaints

→ maladaptive thoughts and behaviors relating to it (they are always thinking about it)

illness activity disorder

“this pain is a sign of something much worse!”

→ somatic symptoms absent or mildly present (but convinced they have it)

→ high anxiety about health

factitious disorder

→ fakes physical or psychological illness (not doing it to get out of work, get money, scam people) → typically doing it for sympathy or attention (go out of their way to do it)

conversion disorder

altered motor or sensory function (sometimes because of a psychological reason) → no known physical cause

gender dysphoria

→ experienced/expressed gender (current) → incongruence → distress (main characteristic, without this it’s not really DSM-5 level classified because it’s a distress that needs to be addressed)

→ assigned gender (birth) → incongruence → distress (main characteristic, without this it’s not really DSM-5 level classified because it’s a distress that needs to be addressed)

sex

biological indiction of male or female (reproductive capacity)

gender

public lived role as male or female - biological and social

personality disorders

→ behaviors → function impairment

→ stable over time

→ deviates from cultural expectations

→ endurring pattern

→ pervasive and inflexible

number of personality disorders

three

• cluster a - odd/eccentric

• cluster b - diametric/emotional/erratic

• cluster c - anxious/fearful

cluster a - odd/eccentric

→ paranoid

→ schizoid (no desire for social interaction)

→ schizotypal (eccentric thinking and behaviors (unusual behaviors and expression of irrational beliefs))

cluster b - diametric/emotional/erratic

→ antisocial (person has no regard for other people (like some CEDs, serial killers)

→ borderline (strong abrupt emotional sniffs: close and distant to others (“get away from me; please don’t go”)

→ histrionic (attention-seeking, flirtatious, and need for approval)

→ narcissistic (exaggerated, self-importance)

cluster c - anxious/fearful

→ dependent (being over-reliant on people)

→ avoidant (do want relations but afraid of rejection)

→ obsessive-compulsive (rigid way of living that hates change “their way or the highway”)

challenges in therapy

• transference/countertransference

• spontaneous recovery

• regression to the mean

• placebo effect

transference

when the client starts to project their feelings/problems to the therapist

countertransference

when the therapist starts to project their feelings/problems to the client.

romantic feelings leads to losing license and maybe prison time

spontaneous recovery

where you just get better, problem resolves itself

main problem: “is it the therapy that worked?”

regression to the mean

a person has a mean/average and they can do things below or above that average but eventually they come back to that average.

placebo effect

you believe you’re getting better, you feel better

approach to therapy

→ eclectic approach (a mixture/combination of things)

→ medication

→ psychodynamic

→ behavioral

→ humanistic

→ cognitive

biomedical appraoches

• electroconvulsive therapy (ECT)

• lobotomy

• psychotropics (medications)

electroconvulsive therapy (ECT)

• it’s effective

• used for depression

• major side effect: memory loss

lobotomy

• frontal lobe is severed from limbic system

• not done anymore (rarely)

• for people with schizophrenia

• to limit uncontrollable emotions

• side effects: lose personality, lose movement, everything is lost about them

psychotropics (medication) for

→ depression

→ anxiety

→ ADHD

→ bipolar

→ schizophrenia

what medication(s) does depression have?

• SSRI

• Prozac

• Zoloft

• MAOi (breakdown of serotoin)

what medication(s) does anxiety have?

• Benzodiazepines (GABA inhibited)

• Valium (Diazepam)

• Xanax

what medication(s) does ADHD have?

• Ritalin

• Adderall (stimulant)

what medication(s) does bipolar have?

• Lithium

what medication(s) does schizophrenia have?

• Thorazine (chlorpromazine haldol)

1794 - Brief History of mental health therapy

Philippe Pinel - Father of Psychology suggests treatment for illness

1840 - Brief History of mental health therapy

Dorothea Dix - Calls for establishment of mental health hospitals

1963 - Brief History of mental health therapy

Community Mental Health Act Passed

1973 - Brief History of mental health therapy

David Rosenhan - “On being sane, in insane places”

Psychoanalysis

Also called Psychodynamic

the idea that our past experiences shape our present, and that many mental processes are unconscious

free association - talk about whatever then you stumble upon the problem and have a '“a-ha” moment and “everything gets better” → also takes a long time

which therapy uses free association?

psychoanalysis/psychodynamic

humanistic therapy

• client-centered & non-directive

• therapist won’t say a lot, client will lead

• there is an understanding between the client and therapist (congruence)

• uses active listening, unconditional positive regard, empathy

• carl rogers was a main person on this idea

behavioral therapies

• counterconditioning

• flooding

• systematic desensitization

• overexposure

• aversion therapy

• token economy

counterconditioning

incorporate a pleasant stimulus in order to help with a specific phobia

ex: using bowling as a relaxing component in order to get over a fear of dogs

• mary cover jones

flooding

when the specific phobia is put all around you; you’re being exposed at max intensity and so you eventually have to get used to being around that phobia/fear

• least popular

systematic desensitization

in order to improve a fear of a specific phobia, relaxation techniques are being taught so fear decreases; gradually exposed to fears

• ANXIETY HIERARCHY

• most popular

• joseph wolpe

overexposure

too many of something at a time, the habit becomes unpleasant

so much of something, that you eventually get tired/sick of it

• type of aversion therapy

aversion therapy

for example: you take smoking and associate that with something you don’t like and you don’t feel the urge to smoke so much anymore

habit is paired with something unpleasant and habit becomes unpleasant

token economy

you take desirable behaviors (like not smoking) and reward the behavior by giving a token, the token can then be exchanged for something else

cognitive therapy

• to fix faulty thoughts

• fix the thought processes that are irrational

  ex: “the world is always a horrible place” → “the world can be mean at times, but it has many great things to offer.”

cognitive-behavioral therapy

CBT is used for thoughts (“nothing is going my way..”), behaviors (avoids others), and emotions (sadness)

it’s the interaction of all three and how they work together

• most popular

• used for depression and anxiety

• aaron beck

• albert ellis: rational emotive behavior therapy