Clinical Psychology Questions

What is the ideal outcome of treatment according to Freud?

strengthening of EGO

Describe the connection between Data-Phenomenon-Theory

The data are raw observations about a phenomenon, which are stable features or observations of the world, a theory describes how a phenomenon comes about.

Explain the concept of Hormesis

adaptive response of organisms/cells to moderate exposure and a maladaptive response to intense exposure. it is basically (functional) adaptation to new (high-level stress) exposure

What is an example of Hormesis?

newborn mouse opening its eyes 2 weeks earlier than it should because its mother isn't present; the high stress levels indicated danger due to the mothers disappearance. It serves as a functional adaptation for the baby mouse in case of danger, it can see and protect itself.

Which theory fits this phenomenon: "people who abuse alcohol, very often don't like drinking alcohol"

Incentive-sensitization theory

Explain the three-hit concept of vulnerability and resilience

It is an interaction of genetic factors (hit 1) with early-life environmental factors (hit 2) exposed to later life environments (hit 3) which may compromise mental functions & increase the risk of psychiatric functions.

Explain the concept of Kindling

Stress sensitisation. The same stressful experience experienced multiple times over time creates a lower threshold and its impact increases as well → linear growth

What is the difference between the stress-inoculation theory and the cumulative stress model (classic diathesis-stress model)?

The stress-inoculation theory: if you expose yourself to a moderate stressor you can train yourself to be more resilient
the cumulative stress model: with cumulative stressors across a lifespan it can exceed a certain threshold which enhances the risk of the development of psychopathy in at-risk individuals.

How can the Social Learning Theory be implemented in Addiction?

in addiction people often learn this behavior by for example observing your parents drink in social situations and thus thinking that is normal.

Explain the heroin overdose mystery

overdose is not an accurate wording, because overdosing depends on the environment rather than the amount of drugs. Someone who uses x amount of drugs at home and is used to it, can OD in a completely new environment with that same amount of drugs.

How can our ability to learn also make us addicted? Which theory applies here?

Due to classical conditioning; we can learn from others to use alcohol to calm our nerves, but if you are nervous every day you easily abuse alcohol every day to calm down, this is a learned coping mechanism which is very harmful.

What did Lee Robins and colleagues find in their research on heroin addiction and how?

That the concept of addiction was a social construct. They found out because half of the veterans were addicted to heroin but only 12 percent got re-addicted.

Why is the prevalence for chronic diseases lower in Asians?

because there are cultural differences, expression of mental health problems are different, help seeking differs, social support differs, and there are biological differences too.

What comes first? Chronic disease or mental illness?

bidirectional relationship: depression can lead to diabetes and diabetes could lead to depression

What do you think are the consequences of the comorbidity between chronic illness and mental disorders (e.g. regarding symptoms, costs...)?

High symptoms burden, more functional impairment, lower quality of life, expensive costs, premature mortality

What are the 4 important assumptions underlying the CBT approach to treating addictive behavior?

1. it is learnt behavior

2. it emerges in an environmental context

3. it is developed & maintained by particular thought processes and patterns.

4. CBT can be integrated well with other approaches as different approaches tend towards similar outcomes.

What are the most comorbid mental health problems with substance abusers?

Anxiety and Depression disorders

What are the main treatment techniques used in CBT for GAD?

Homework, psychoeducation, relaxation training, Exposure, cognitive restructuring

What are the four main components which need to be taken into consideration when delivering Relapse Prevention?

1. current cognitive functioning

2. attentional ability

3. memory

4. executive functioning

Aside from psychoeducation, what other two elements are involved in Clark's CT panic control treatment?

1. reconstructing misinterpretations

2. exposure therapy

Why is age a consideration in the treatment of specific phobia?

gait and balance decline with age, and older adults are at an increased risk for fall.

What is the difference between selective mutism and separation anxiety disorder?

In separation anxiety, anxiety occurs when anticipating or separating from home (or major attachment figures), whereas in SM, there is a consistent failure to speak in specific social situations despite speaking in other situations. Children with SM are often willing to engage through nonverbal communication.

What effect do safety behaviors have on individuals with Panic Disorder or Agoraphobia?

safety behaviors --> anxiety sensitivity --> aversion to somatic sensations associated with anxiety-inducing situations/experiences --> interoceptive avoidance. A decrease in safety behaviors is associated with a decrease in anxiety.

What is decentering in CBT? (Book chapter on Anxiety disorder)

ability to observe thoughts and feelings as objective events rather than identifying those thoughts, feelings and beliefs to oneself

Name two core cognitive features of anxiety.

1. catastrophizing

2. overestimating the likelihood of negative outcomes

What is Mowrer's theory of Fear and Avoidance?

Acquisition of fear through classical conditioning. Avoidance of fear stimulus is reinforced through operant conditioning (avoidance → reduces anxiety → safety behaviours --> cycle)

Why are diagnoses pragmatic summaries and can not be equivalent to mental disorders?

because they facilitate treatment selection, communication and prognosis, but they are based on data. Mental disorders can be described by diagnoses, which are arbitrary due to their descriptive nature

Why are diagnoses not natural kinds?

because diagnoses are constructs, not observations, used in clinical situations → not natural. Diagnoses don't have sharp boundaries --> overlap or comorbidity

Niko Tinbergen says that a behavior/emotion is understood when you understand its development, ... (name the other 3)

1. underlying mechanisms

2. functions

3. evolution

Explain the gateway theory with examples of substances

refers to legal substances (nicotine and alcohol) as a gateway for the progressive use of soft drugs (prescription drugs and cannabis) to more illicit substances (cocaine and heroin)

What is the incentive-sensitization theory?

drug addiction is an excessive amplification of psychological 'wanting', triggered by cues, without an amplification of 'liking'

Name the 3 things that are believed to maintain PTSD symptoms

1. features of trauma memories

2. negative meanings of trauma

3. avoidance

There are six ingredients of effective Trauma-focused psychological treatments. Give 3.

1. Psychoeducation

2. exposure

3. emotion regulation (4) dealing with a range of emotions (5) changing memories (6) changing personal meanings

What is the difference between perceived internal threat and perceived external threat?

External threat: result from appraisals about impending danger, leading to excessive fear
internal threat: result from negative appraisals about one's behavior, emotions or reactions during the trauma

Which cognitive strategies do people with PTSD have that maintain it and perceived threat? Name 2.

1. Rumination

2. avoidance of reminders (3) substance use (4) safety behavior (5) suppression of memories

Which three factors does CT-PTSD target?

1. appraisals

2. memory characteristics

3. cognitive/behavioral strategies

There are 3 steps in updating trauma memories, which are they?

1. identifying threatening personal meanings

2. Identifying updating information

3. Active incorporation of the updating information in to the hot spots

What is the difference between imaginal reliving and prolonged exposure therapy (PET)?

imaginal reliving: the therapist will only assess the memory 2-3 times
PET: more sessions are devoted to reliving the traumatic event.

What are 'hot spots?'

the parts in a traumatic experience that have been misinterpreted and that have to be updated to change negative appraisal beliefs

What can you do if your client is still reexperiencing symptoms even after successfully updating their hot spots and discrimination of triggers? And how does it work?

imagery transformation techniques; the client transforms the trauma image into a new image that signifies the trauma is over.

Why would you call psychosis an 'addition' to reality instead of 'loss of touch with reality?'

because one may experience a lot of positive symptoms; as non-existent entities add to ones reality.

Name three more mental health conditions where psychosis may occur

1. delusional disorder

2. schizoaffective disorder

3. major depressive disorder (4). bipolar disorder (5). psychosis due to substance use or medical conditions

What are limitations in the effectiveness of CBTp?

1. does not work if the client has too much paranoia

2. Medication is almost always necessary

3. does not work if comprehension/attention/memory/language/motivation are severely impaired.

Describe the general cognitive model:

event --> automatic thought (AT) or belief (AB) --> influenced by a core belief about oneself, others, and/or the future --> an emotional and physiological reaction --> can have behavioral consequences

What framework can destigmatize psychotic symptoms? give one example

Normalization of psychotic symptoms; people who buy a lottery ticket often experience grandiosity as they think they will win

In CBTp the therapist uses guided discovery using socratic questioning, what is this type of questioning and what is the goal?

probing questions meant to stimulate critical thinking to elicit challenging ideas

What is the difference between ego-dystonic and ego-syntonic?

ego-dystonic: is incongruent with ones desires
ego-syntonic: is congruent with ones desires

What are the three analyzed sub-categories of schizophrenia?

1. Hallucinations/delusions

2. negative symptoms

3. disorganisation

What is the Alice in Wonderland syndrome?

affects

1. visual perception (metamorphopsia)

2. hearing and the sense of touch

3. sense of time

4. perception of one's own body and its parts (body image distortion)

Why are there more risks for psychosis in the city?

less social cohesion, less social control, socio-economic disparities, more stimulation, relative high drug use and pollution

There are twp hypotheses why paternal age increases risk of psychosis. Name them and give a short explanation

1. Novo mutation hypothesis: increase in age --> more mutations --> potential error in the baby's DNA

2. selection into late fatherhood; more desirable men are picked first --> the less desirable ones are 'left over'

Describe Plagiopsia, Macropsia and achromatopsia

Plagiopsia: all vertical lines seem slanted
Macropsia: object seems larger than it is in real life Achromatopsia: inability to see colour

What are the 3 main causes of suicide?

1. Prior suicidal thoughts and behaviors

2. Psychopathology

3. Suicidal thoughts and behaviour exposure (in media)

Name two symptoms of depression

1. Anhedonia

2. Insomnia (3). loss of appetite (4). Memory and concentration difficulties

Explain two general stress-theories

1. Stress-sensitization theory: the impact of stressors increases with successive stimuli

2. allostatic load: the accumulating wear and tear on the body (3.) Hormesis: adaptive responses of cells/organisms to moderate exposure and maladaptive responses on high-level/intense exposure (4.) Kindling: After and episode the threshold for depression will be lower and lower

What is the corona phenomenon?

seeing contours around an object

What are the two main processes that drive a sense of threat?

1. negative appraisals

2. Characteristics of trauma memories

What is meant by the ‘thought suppression experiment’?

The idea that suppressing mental images has paradoxical effects

What are the 3 steps in updating trauma memories?

1. identifying personal meanings through imaginal reliving, narrative relieving and content discussion.

2. Identifying updating information

3. Active incorporation of updating info into hot spots

there are 8 core treatments in CBT for PTSD, name 4:

1. Case formulation

2. Reclaiming/rebuilding life assignment

3. Changing problematic appraisals

4. Update trauma memories (5). Discrimination training with triggers of reexperiencing (6). Site visit (7). Dropping unhelpful behaviors and cognitive processes (8). Blueprint