AP Psych Unit 8: Clinical Psychology

Psychopathology

Psychopathology

Study of the origin, development, manifestations of mental/behavioral disorders

Etiology

Apparent cause or development of an illness

Prognosis

Probable course of an illness

Anxiety disorders

• panic disorder

• generalized anxiety disorder

• phobias

• obsessive-compulsive disorder

• post-traumatic stress disorder

Panic disorder

• repeated attacks of intense anxiety

• severe chest pain

• tightness of muscles

• choking

• sweating

3 of these in a 6-month period would be bad

Treated w/ antidepressants

Low levels of serotonin

Generalized anxiety disorder

Must occur for 6 months and include chronic anxiety

• trouble sleeping

• hypervigilant

• tense

• difficult concentrating

Too little GABA

Treated w/ benzodiazepines

Phobias

Intense, irrational fear to specific stimuli

Obsessive-compulsive disorder

Cycle of obsessions and compulsions

Treated w/ antidepressants

Too little serotonin

Hoarding disorder

Persistent difficulty discarding or parting w/ possessions due to a perceived need to save them

PTSD

Result of some trauma experienced

• reexperience the event in nightmares

• flashbacks

• hyperalertness, guilt, difficulty concentrating

Behavioral perspective of anxiety

Anxiety responses are acquired through classical conditioning and maintained through operant conditioning

Cognitive perspective of anxiety

Attributes anxiety to misinterpretation of harmless situations as threatening

Biological perspective of anxiety

Attributes some to an imbalance of NTs

Evolutionary perspective of anxiety

Attributed to natural selection for enhanced vigilance that operates ineffectively in the absence of real threats

Somatic symptom disorder (SSD)

• pain

• high anxiety about having a disease

• symptoms for 6 months

Illness anxiety disorder (IAD)

• preoccupation w/ a serious medical/health condition w/ either no or mild symptoms

Conversion disorder

• loss of some bodily function

• no physical damage to the affected area

• symptoms last as long as the anxiety is present

Freud’s perspective of somatic disorders

Bottled up emotional energy that is transformed into physical symptoms

Behaviorist perspective of somatic disorders

Learned and maintained because they result in awards

Cognitive perspective of somatic disorders

Rewards enable individuals to avoid some unpleasant situation, provide an explanation for failure, or attract concern/sympathy

Dissociative amnesia

Loss of memory for a traumatic event/period that is too painful for the individual to remember.

• becomes upset when being stimulated to remember

• slowly will remember it again

Dissociative fugue

Memory loss for anything having to do with personal memory, flight from the person’s home, establishing a new identity

• caused by abundant stress or an immediate danger of some news coming out that would be embarrassing

Dissociative identity disorder

Two or more distinct personalities present in an individual

Common in victims of physical/sexual abuse when they were younger

Amnesia during other personalities

Major depressive disorder

• intense depressed mood

• reduced interest/pleasure in activites

• loss of energy

• problems making decisions

• sad, hopeless, discouraged, isolated, rejected

• changes in eating/sleeping/motor patterns

Seasonal affective disorder

Subtype of depression that recurs, usually during winter months

Premenstrual dysphoric disorder

• marked affective lability

• marked irritability

• anger

• increased interpersonal conflicts

• markedly depressive mood

• self-deprecating thoughts

• marked anxiety, tension, feelings of being “keyed up”

• change in appetite

• bloating, weight gain, joint/muscle pain

at least five of these symptoms

Selective serotonin reuptake inhibitors (SSRIs)

Prozac, Zoloft, Paxil

Bipolar disorder

• mood swings alternating between periods of major depression and mania

• manic: inflated ego, little need for sleep, excessive talking, impulsivity

• rapid cycling: short mania, long depression

Psychosis

reality distortion evidenced by highly disordered through process

Schizophrenia

• hallucinations, delusions

• disorganized thought

• disorganized motor behavior

• negative symptoms

• catatonia

• delusions of persecution

• delusions of reference

• delusions of grandeur

excess dopamine, anti-psychotic drugs

Delusions

Fixed beliefs that are maintained even when compelling evidence to the contrary is presented

Hallucinations

False sensory perceptions, like the experience of seeing, hearing, or perceiving

Delusions of persecution

Others are so threatened that these other people plot against them

Delusions of reference

Misinterpret occurrences as directly relevant to them

Delusions of grandeur

Attention is because of their specialness and that they are world leaders

Schizophrenia w/ catatonic symptoms

• disordered movement patterns

• immobile stupor

• frenzied/exciting behavior

Positive schizophrenia symptoms

• disorganized speech, thought, order

• disorganized behavior

• thought blocking

• loosening of associations

• tangentiality

Negative schizophrenia symptoms

• Alogia

• Flat affect

• poor attention

• anhedonia

• loss of social interest

• attentional deficits

Biological causes of schizophrenia

• positive symptoms: excessively high levels of dopamine

• negative symptoms: lack of glutamate

• abnormalities in numerous brain regions

Diathesis-stress model

People predisposed to schizophrenia will be more vulnerable to stressors than other people

Behaviorist view of schizophrenia

Reinforcement of bizarre behavior

Humanist view of schizophrenia

Lack of congruence between the public self and actual self

Psychoanalytic view of schizophrenia

Fixation at the oral stage and a weak ego

Catatonia

presence of behavior/movement traits

• immobility

• wavy flexibility

• posturing

• rigidity

• staring

• grimacing

• mutism

• echolalia

• catatonic excitement

Personality disorders

• odd/eccentric

• dramatic/emotionally problematic

• chronic fearfulness/avoidant

Attention-deficit/hyperactivity disorder

• difficulty paying attention

• difficulty controlling behavior

• hyperactivity

• easily distracted, misses details, forgets things, gets bored

• impulsivity

Types of ADHD

1. predominantly hyperactive-impulsive

2. predominantly inattentive

3. combined hyperactive-impulsive and inattentive

Odd/eccentric personality disorders

1. paranoid

2. schizoid

3. schizotypal

Dramatic/emotionally problematic

1. histrionic

2. narcissistic

3. borderline

4. antisocial

chronic fearfulness/avoidant

1. avoidant

2. dependent

3. obsessive/compulsive

Paranoid personality disorder

• pervasive, unwanted suspiciousness

• mistrust

• overly sensitive

• often envious

Schizoid personality disorder

• poor capacity for social relationships

• withdrawn behavior

• considered “cold”

Schizotypal personality disorder

• odd thinking

• suspicious

• hostile

Histrionic personality disorder

• excessively dramatic

• seeking attention

• tending to overreact

• egocentric

Narcissistic personality disorder

• unrealistically self-important

• manipulative

• lacking empathy

• expects special treatment

• can’t take criticism

Borderline personality disorder

• emotionally unstable

• impulsive

• unpredictable

• irritable

• prone to boredom

Antisocial personality disorder

• sociopath/psychopath

• violate other people’s rights

• no remorse

• manipulative

• self-indulgent

• disproportionate amount of crimes

Avoidant personality disorder

• sensitive to potential rejection

• humiliation

• desires acceptance

• socially withdrawn

dependent personality disorder

• excessively lacking in self-confidence

• subordinates own needs

• allows others to make all decisions

Obsessive compulsive personality disorder

• rules, schedules, details

• extremely conventional

• serious

• emotionally insensitive

Autism spectrum disorder

previously four different disorders

1. autistic disorder

2. Asperger’s disorder

3. childhood disintegrative disorder

4. persuasive developmental disorder

ADS Symptoms

• lack of responsiveness to other people

• impairment in verbal/nonverbal communications

• very limited activities/interests

Neurocognitive disorders

Decline from a previous level of neurocognitive function

Alzheimer’s disease

brain neurons progressively die

• loss of memory, reasoning, emotion, control of bodily functions

Delirium

• impaired attention

• lack of awareness of the environment

• loss of recent memory or orientation

• disorganized speech, mumbling

• change in sleep-wake cycle, change in emotional states, worsening of behavioral problems

Psychiatrist

(MD)

only one who can prescribe medicine and perform surgery

Clinical psychologist

(PhD or PsyD)

often work with psychiatrists

Counseling psychologists

(PhD, EdD, PsyD, or MA in counseling)

Less severe mental heath problems, provide a supporting ear to all parties and help clarify feelings of individuals

Psychoanalysts

Follow teaching of Freud and practice psychoanalysis/psychodynamic therapies

Clinical/psychiatric social workers

(MSW or DSW)

Deinstitutionalization

Removed patients that were not considered a threat from mental hospitals in the 1950s

consequence: homeless people, most have schizophrenia

Meta-analysis

Systematic statistical method for synthesizing the results of numerous research studies

Insight therapies

• psychoanalysis

• psychodynamic therapy

• interpersonal psychology

• humanistic client-centered

• Gestalt psychotherapy

Psychoanalysis Therapy

1. Client sits in several sessions every week for 2-3 years

2. Free association —> unconscious thoughts become accessible

3. Dream interpretation

4. Resistance —> sign that the client has reached an important issue

5. Catharsis —> relief of anxiety

Free association

The therapist asks the client to say whatever comes to mind

Hypnosis

Reveals hidden conflicts, similar to Freudian slips

Resistance

Blocking of anxiety-provoking feelings and experiences

Transference

Client may respond to the analyst as though they are a significant person in their life

Catharsis

Release of emotional tension after remembering or reliving an emotionally charged experience frmo the past

Psychodynamic psychotherapy

Shorter in duration, less frequent, client sits up and talks to the therapist

Interpersonal psychotherapy

Aims to enable people to gain insight into the causes of their problems

Humanistic therapies

Client-centered therapies + Gestalt therapy

Problems arise because the client’s inherent goodness and potential to grow emotionally have been stifled by external psychosocial constraints

Client-centered therapy

• unconditional positive regard

• empathy

• client’s inner strength surfacing so personal growth can occur

Carl Roger’s therapy

Greater the difference between ideal self and real self —> discongruence

• unconditional positive regard

• active listening

Active listening

echoing, restating, seeking clarification of what the client says and acknowledging feelings

Gestalt therapy

Push clients to decide whether they will allow past conflicts to control their future or whether they will choose right now to take control of their own destiny

Directive in questioning and challenge clients to help them become ware of their feelings and problems

Dream interpretations

Role playing —> client expresses their true feelings

Gestalt psychology

Emphasized that people organize their view of the world to make meaning

Goal of behavior therapy

Extinguish unwanted behavior and replace it with more adaptive behavior

Systematic desensitization

Anxiety response is inhibited by an incompatible relaxation response

Reconditioning so that the crucial conditioned stimulus elicits the new conditioned response

1. progressive relaxation

2. anxiety hierarchy

3. student imagines fears, therapist pairs w/ relaxation

Flooding

Extinguishes the conditioned response

Client directly confronts anxiety-provoking stimulus

Aversive conditioning

client associates discomfort with behaviors she wants to stop, antabuse

Antabuse

Paired with alcohol (CS) to elicit nausea (CR)

Behavior modification

Client selects a goal, and receives a small reward as they get closer

Token economies

Positive behaviors are reinforced with secondary reinforcers

Social skills training

Operant conditioning, Albert Bandura

1. modeling

2. behavioral rehearsal

3. shaping

Modeling

Client is encouraged to observe socially skilled people in order to learn appropriate behaviors

Behavioral rehearsal

Client practices appropriate social behaviors through role-playing

Biofeedback training

Giving the individual immediate reformation about the degree to which they are able to change anxiety-related responses and therefore lessen physiological arousal

Cognitive-behavior therapy

Helps clients change both the way they think and the way they behave

Rational Emotive Therapy (RET)

Albert Ellis

Psychological problems result from self-defeating thoughts

ABCs of treatment