PSYCH 10 - Clinical Psychology

DSM - Diagnostic and Statistical Manual of mental Disorders (DSM-V)

Persistent disturbance or dysfunction in behavior, thoughts, or emotions that causes significant distress or impairment

• # of symptoms required for diagnosis

Medical Model

Psychological disorders have biological and environmental causes, symptoms, and possible cures.

Benefits to diagnostic labels

• Helps communicate between practitioners

• Allows for greater standardization of diagnoses

• Can guide practitioners in selecting the “most effective” treatment option

Drawbacks to diagnostic labels

• Stigma, lower self-esteem, feelings of helplessness

• Can be problematic if just “below” cut off

• Systematic diagnosis of mental illness can be difficult

Changes over time - DSM

• With attitudes: Before 1973 the DSM classified homosexuality as a mental disorder

• With advances in research

Research Domain Criteria Project (RDoC)

• Views mental disorders as a result of differences/dysfunction in normal psychological processes

• Focus on studying basic processes/underlying causes of disorders

• Can help explain comorbidity

Anxiety

Negative mood state accompanied by bodily symptoms such as increased heart rate, muscle tension, a sense of unease, and apprehension about the future.

Generalized Anxiety Disorder

Excessive worry about everyday things that is out of proportion to the specific causes of worry

• at least 6 months of excessive anxiety

• May be accompanied by: difficulty concentrating, muscle tension, fatigue, sleep problems

• Worry can be reinforced

Panic Disorder

Recurrent unexpected panic attacks

• intense anxiety and avoidance related to the attack for at least 1 month

  • causes significant distress or interference with life

  • Shallow breathing, sweating, dizziness, upset stomach

Agoraphobia

Fear of public places

Specific Phobia

specific irrational fear of a specific object or situation that substantially interferes with the person’s ability to function

5 Major Subtypes of Phobias

Blood-injury-injection, situational type (planes, elevators), natural environments (storms, heights, water). animal type, other

Preparedness Theory

People are predisposed toward certain fears

Little Albert - Learned Phobias

John B Watson and Rosalie Rayner demonstrate classical conditioning in humans surrounding learned fears or phobias

• Goal - show emotional responses can be learned rather than inherited

  • Neutral Stimulus (NS) - white rate (no fear)

  • Unconditioned Stimulus (UCS) - loud, frightening noise

  • Unconditioned Response (UCR) - fear/startle reaction to the noise

  • Conditioned Stimulus (CS) - white rate (after pairing with noise)

  • Conditioned Response (CR) - fear of white rat

• Each time Albert reached for the white rat, Watson made a loud noise

• After several pairings, Albert began to cry and show fear just at the sight of the white rate; even without the noise.

Social Anxiety Disorder

Fear of social situations which lead to worry and diminished day- to day functioning

Post-Traumatic Stress Disorder (PTSD)

Exposure to a traumatic event, chronic psychological arousal, recurrent unwanted thoughts or images of trauma and avoidance of things that call the traumatic event to mind

• more than 1 month

Obsessive Compulsive Disorder

• Obsessive thoughts and/pr compulsions that seems irrational or nonsensical

• Take up significant amount of time (1 hr)

• Causes significant distress or impairment of function

Loop of OCD

A cycle of obsessive thoughts that leads to compulsive behaviors, reinforcing anxiety and the need to perform rituals to alleviate distress.

• Obsessions - unwanted distressing thoughts, urges, mental images

• Anxiety - distress, fear, worry - false alarm - feels inclined to act

• Compulsions - any behaviors performed to help make the anxiety go away

• Relief - temporary

Unipolar Disorders (Depression)

Major Depressive Disorder (MDD)

• one or more major depressive episodes but no history or manic or hypomanic episodes

Major Depressive Episode (5/9 symptoms)

• Depressed mood

• Anhedonia

• Weight loss or increase in appetite

• Insomnia/hypersomnia

• Agitation/psychomotor retardation

• Fatigue/loss of energy

• Worthlessness, excessive or inappropriate guilt

• Diminished ability to concentrate or indecisiveness

• Recurrent thoughts of death, suicidal ideation or attempt

  • If symptoms occur for at least 2 weeks and cause significant distress or impairment in function

Contributions to Depression

Prevalence of 18%

• Biological

  • Genetics - twin studies

  • Neurotransmitters - serotonin

• Psychological

  • Attribution style: pessimistic attribution style

• Social

  • Stressful life events

  • Interpersonal factors

  • SES

• Gene x environment interactions

Bipolar Disorder

Characterized by cycles of abnormal, persistent high mood (mania) and low mood (depression)

• Mania - lasts 1 week

  • Decreased need for sleep

  • Talkativeness

  • Racing thoughts

  • Reckless behavior

Contributions to Bipolar Disorders

Prevalence = 2.5%

• Biological

  • Genetics - twin studies

• Psychosocial

  • Life stressors

  • Positive life events

    • more manic episodes after life events in which goal is attained

• Associated with Newton, Van Gogh, Lincoln

Schizophrenia

2 of the following for at least 1 month

• Delusions - false beliefs (persecutory, grandiose, referential)

• Hallucinations - perceptual experiences that occur even when there is no stimulus in outside world generating those experiences

  • Can be auditory, visual, olfactory, gustatory or somatic

• Disorganized speech - speech that is difficult to follow because answers do not clearly follow questions or one sentence does not logically flow from another

• Disorganized behavior - behavior or dress that is outside the form for almost all subcultures. Odd dress, odd makeup, or unusual rituals

• Negative symptoms - social withdrawal, logia (poverty of speech), anhedonia, flat affect

• Larger ventricles

• Reduced overall brain volume

Risk Factors for Schizophrenia

Prevalence = 1%

• Biological Factors - genetics and neurotransmitter/dopamine abnormality

• Environmental Factors - issues during pregnancy

Schizophrenia is NOT

Dissociative Identity Disorder - occurrence of two or more distinct identities in the same individual along with memory gaps in which the person does not recall everyday events.

Psychoanalytic/Psychodynamic Therapy

Goals

• Reduce inner conflict by giving patients insight into their unconscious thoughts and feelings

• Reveal how childhood experiences have shaped the individual

Cognitive Behavioral Therapy (CBT)

Goal: teach people new, more constructive ways of thinking and acting

• Homework to practice techniques learned in therapy

Biomedical Therapies

Psychopharmacology - the study of the effect of drugs on the mind and behavior

Antipsychotic Medication

Chlorpromazine (Thorazine)

• Blocks dopamine receptor sites

• Treats positive symptoms

Antidepressant Medication

Selective serotonin reuptake inhibitors (SSRIs)

• treat anxiety and eating disorders

Combining Therapies

involves the integration of different therapeutic approaches, such as psychotherapy and medication, to enhance treatment effectiveness.