PSYCH257 TEST 1

psych257 w/ dr. sutherland at sju. history of clinical psych, defining psychopathology, modern day integrative approaches.

What are the 4 etiological explanations for mental illness in history?

supernatural, biological, psychological and social

Supernatural view

spirit/demon possession, divine punishment or witchcraft

supernatural view treatments

exorcisms, trephination or prayer/religious rituals

Who is the father of western medicine?

Hippocrates

What were Hippocrates’ biological views on mental illness

deficiency/excess of 1 of 4 important body fluids (blood, yellow bile, black bile and phlegm)

biological view (middle ages)

mental asylums that housed undesirables, bloodletting, chained to walls, filthy conditions and exhibitions

psychogenic view

hospital models, protests for better conditions, scientific approach to treatment

Wilhelm Wundt

experimental psychologist, first psych lab in germany, studied sensation and perception and laid groundwork for applied clinical interventions

Lightner Witmer

student of wundt, founded first psych clinic and applied psych findings in treatment

How did the World Wars affect clinical psych?

emergence of psychotherapy ad consideration of diagnostic methods and therapeutic approaches, psychological screening for recruits

Francis Summer

first black man to earn phd in psych, focused on black psych and advocate for addressing racial bias in psych testing

Albert Sidney Beckham

one of first clinical psychologists, pioneered school psych

Inez Beverly Prosser

first black woman to earn phd in psychology, studied impact of segregation in schools, advocated for safe school spaces for black children

Braulio Alonso

counseling psych for latinx students, advocated educational and counseling equity

Freud and Breuer pioneered what?

psychoanalytic theory

psychoanalytic theory

unconscious fears and desires create conflicts between id, ego and superego

treatments for psychoanalytic theory

hypnosis and free association

humanistic theory

carl rogers, derived from hierarchy of needs and focused on emotional validation and therapist-client connection

humanistic treatment

client draws out their perspective which is validated through genuine empathy through a simulation of a healthy relationship

what is a main concern about humanistic theory?

possible lack of professionalism and boundaries, therapist must be emotionally detached

behavioural model

skinner and watson, abnormal behaviour derives from learned behaviour

operant conditioning

specific consequences associated with voluntary behaviour, positive/negative reinforcement/punishment

what is negative reinforcement?

strengthens a behaviour that removes negative outcome (e.g. sunscreen)

what is positive reinforcement?

something introduced that rewards behaviour (e.g. candy)

what is a punishment?

something introduced that decreases behaviour

what is observational learning?

learning by watching others

classical conditioning

created associations between stimuli which evoke learned responses (pavlov)

how does classical conditioning affect mental health?

can create phobias if certain stimuli are associated with fear even just once

classical conditioning treatments

extinction (unpairing sitmuli) and exposure therapy

cognitive/psychological view on mental illness

disorders are seen as conscious biased/distorted thoughts that aren’t realistic/accurate which cause distress

treatment for psychological view

challenge biased thoughts with evidence (Beck)

3 common features of mental disorder descriptions

Dysfunction, Distress/Impairment, Deviance

Dysfunction

cognitive, emotional or behavioural breakdown in functioning

Distress/Impairment

highly disturbed by the problem/interferes w/ social, occupational or daily functioning

Deviance

different from the average/norm or is an unusual behaviour/action for the client

biopsychosocial model

targets certain factors, genes/brain structures, behavioural/cognitive patterns, emotional experiences and relationships, social structures/barriers

polygenetic disorders

cannot point out specific genes that relate to major psych disorders (except Alzheimer’s)

diathesis-stress model

genetic predisposition to a disorder exposed to enough stress triggers development of said disorder

reciprocal gene environment model

genetic traits influence level of stress experienced which triggers a disorder

Epigenetics

the environment affects how genes work and these modifications can be passed down through generations despite not being exposed to the same stressors

frontal lobe

executive function, decision-making, short-term memory, impulse control and emotional regulation

3 main parts of limbic system

amygdala, hippocampus, hypothalamus

limbic system

emotional regulation, fear response and memory formation

disorders linked to dysfunctions of frontal lobe

depression, anxiety, ADHD

disorders linked to limbic system dysfunction

anxiety, PTSD, depression

serotonin

regulates mood, appetite, sleep

dopamine

reward, motivation and pleasure systems

norepinephrine

alertness, arousal, stress

disorder from low levels of serotonin

depression

disorders linked to dopamine dysregulation?

schizophrenia, addiction, Parkinson’s

disorders linked to norepinephrine imbalances?

anxiety, depression

Neuroplasticity

brain’s wiring is flexible and can be restructured

4 examples of psychological interventions

alter neural pathways associated with negative thinking, increase prefrontal cortex activiy, enhance control over limbic system, reduce activity in amygdala

Types of Pharmacotherapy (medication)

Selective Serotonin Reuptake Inhibitors, Antipsychotics, Neurochemical Stimulants, Benzodiazepines

Clinical Assessment

observations, tests and interviews who info helps to draw conclusions about client issues/symptoms

What are the 3 key concepts of assessment?

Reliability, Validity and Standardization

Interrater Reliability

Ensuring two different assessors share consistent results

Test-retest Reliability

Client results are similar when retested

Face Validity

If the assessment tool looks valid

Standardization

Guidelines for consistent use, scoring and interpretation of assessment tools

What are the 2 main approaches of Clinical Diagnosis

Categorical and Dimensional Theory

Categorical Theory

inflexible categorized disorders that are broken down into specific boxes

Dimensional theory

Disorders seen as continuum with varying degrees of severity and difficulty with symptoms

What are 2 examples of dimensional assessment tools?

Cloniger’s 7 factor model (novelty-seeking, harm avoidance, eward dependence, persistence, self-directedness, cooperativeness, self-transcendence) and Millon’s 3 polarities (pleasure, active, self)

What is one pro and one con about the dimensional theory

pro: Dx reliability and stability, eliminate boundary disputes, gather more patient info, easier to target symptoms in therapy regardless of label

con: restructure Dx systems, cut off points, dimension disputes

DSM-5-TR

Disorder classification system used in NA, provides symptom descriptions about specific disorders and is non-theoretical

What does the TR mean in DSM-5-TR?

Text Revision; introduced prolong grief disorder, updated diagnostic criteria for clarity and included culturally sensitive language which addresses discriminination

Strengths and Criticisms of the DSM-5-TR?

strengths: common language diagnostic criteria, consistent Dxing, structured categories for studying, allows for multiple treatment options

Criticisms: not up-to-date, overinfluenced by drug industry, can’t provide entire biopsychosocial view, doesn’t give directions for Tx

Differential Diagnosis

Different disorders with overlapping systems which may present similarly

What’s the purposes of a Psychological Assessment?

Clinical treatment ( understand client, predict behaviour, plan treatment and evaluate its outcome) and Research reasons (using Dx’d clients in research studies)

Examples of Clinical Assessment tools

Physical exams, Psychological tests, Behavioural assessment, Psychophysiological assessment (heart rate monitor), Neuropsychological tests (cognitive, motor/movement), Neuroimaging (MRI/CT) and Clinical interviews

Who can diagnose clients in Ontario? How do they diagnose?

Psychiatrists, Clinical Psychologists, Nurse Practitioners and Physicians. They compile data, identify patterns and symptom frequency/severity/daily impact then refer to DSM