Unit 8 - Clinical psychology

joseph wolpe

joseph wolpe

Used classical conditioning theory in psychotherapy and introduced Systematic Desensitization and concepts of reciprocal inhibition which he applied to reduce anxiety. In treatment he paired relaxation with an anxiety -provoking stimulus until the stimulus no longer produced anxiety.

albert ellis

pioneer in Rational-Emotive Therapy (RET), focuses on altering client's patterns of irrational thinking to reduce maladaptive behavior and emotions

Mary cover-jones

psychologist; systemic desensitization; maintained that fear could be unlearned; Little Peter experiment

aaron beck

a cognitive psychologist; Contributions: father of Cognitive Therapy, created Beck Scales-depression inventory, hopelessness scale, suicidal ideation, anxiety inventory, and youth inventories

carl rogers

a humanistic psychologist; Contributions: founded client-centered therapy, theory that emphasizes the unique quality of humans especially their freedom and potential for personal growth, unconditional positive regard

deep brain stimulation (DBS)

a thin electrode is surgically implanted in the brain and connected to an implanted pulse generator that various electrical currents can be delivered to brain tissue adjacent to the electrode

→ invaluable treatment for motor disturbances

SSRIs (selective serotonin reuptake inhibitors)

(antidepressant) drugs that interfere with the serotonin transport in the brain’s synapses and can work to elevate mood

used to treat depression, ocd, schizophrenia, bipolar disorder, and ptsd

ex: Zoloft, Prozac, Lexapro, Paxil, Celexa

tricyclics

a class of medications used to manage and treat major depressive disorder (MDD) - function by inhibiting the reuptake of neurotransmitters, such as serotonin and norepinephrine, which can modulate mood, attention, and pain in individuals

lithium

a salt that is prescribed for its ability to stabilize the mania associated with bipolar disorder

MAOIs (monoamine oxidase inhibitors)

antidepressants that function by increasing the amounts of serotonin and norepinephrine, as well as blocking MAO (monoamine oxidase), which breaks down many neurotransmitters

→ one of the first class of pharmaceuticals used to treat depression; these reduce the action of the enzyme monoamine oxidase, which breaks down monoamine neurotransmitters (including norepinephrine, epinephrine, dopamine, and serotonin) in the brain

benzodiazepines

(antianxiety drugs) a psychoactive drug and depressant that works as GABA agonists

prescribed to treat anxiety, insomnia, agitation, and seizures

(Valium, Librium) a class of drugs prescribed for anxiety; has calming effects and can be addictive, but less dangerous than the barbiturates

barbiturates

(antianxiety drugs) tranquilizers that suppress the activity of the central nervous system (reduce neural activity and slow body functions)

prescribed to reduce anxiety, induce sleep, and prevent seizures

*depressants such as sleeping pills and painkillers

another class of drug for anxiety; has sedative, calming effects. These drugs can be addictive and carry risk of overdose

atypical antipsychotics

second generation antipsychotics - serotonin receptor antagonist

blocks serotonin receptors

newer drug, do not create tardive dyskinesia

conventional (or typical) antipsychotics (aka neuroleptics)

first-generation antipsychotics - dopamine receptor antagonists (DRA)

*DRA: a type of drug which blocks dopamine receptors by receptor antagonists (a type of receptor ligand/drug that blocks or dampens a biological response by binding to and blocking a receptor rather than activating it, interfering with the natural operation of receptor proteins)

tardive dyskinesia

a late onset neurological disorder that results from the use of antipsychotic drugs - involuntary movements (of the facial muscles, tongue, limbs) in the person months or even years after beginning certain medications

regression toward the mean

the tendency for extremely high or extremely low scores to become more moderate (i.e. closer to the mean) upon retesting over time

Ellis ABC system (ELLIS)

(cognitive-behavioral therapy) teaches people how their beliefs cause their emotional and behavioral responses:

A - stands for activating event or adversity

B - refers to one’s irrational belief (about “A”)

C - belief leads to the emotional and behavioral consequences

cognitive triad (BECK)

a cognitive model developed by aaron beck to describe the cause of depression; he proposed that three types of negative thoughts lead to depression: thoughts about the self, the world/environment, and the future

cognitive restructuring

a technique used in cognitive therapy (and cognitive behavior therapy) to help the client identify their self-defeating beliefs or cognitive distortions, refute them, and then modify them so that they are adaptive and reasonable

in vivo

(behavior therapy) a type of systematic desensitization (exposure therapy), generally used for treating individuals with phobias, obsessive-compulsive disorder, and other anxiety disorders, in which the client directly experiences anxiety-provoking situations or stimuli in real-world conditions

virtual reality exposure therapy

(behavior therapy) a counterconditioning technique that treats anxiety through creative electronic simulations in which people can can safely face their greatest fears, such as airplane flying, spiders, or public speaking sys

humanistic therapy

a therapy that focuses on boosting patient’s self fulfillment via growth in self-awareness and self-acceptance

adopts a holistic approach that focuses on free will, human potential, and self-discovery

psychological disorder

(abnormal) a syndrome marked by clinically significant disturbance in an individual’s cognition, emotion regulation, or behavior

congruence (ROGERS)

(humanistic therapy) a state in which a person’s ideal self and actual experience are consistent or very similar

bipolar 1

(bipolar) individuals experience more severe highs (mania) and may not have depressive episodes

bipolar 2

(bipolar) individuals experience a less severe high (hypomania), their diagnosis includes depressive episodes

psychotherapy

treatment involving psychological techniques; consists of interactions between a trained therapist and someone seeking to overcome psychological difficulties or achieve personal growth

neurotic disorder

a psychological disorder that is usually distressing but that allows one to think rationally and function socially

psychosis

A severe mental condition in which there is disorganization of the personality, deterioration in social functioning, loss of contact with, or distortion of reality

a withdrawal from reality marked by hallucinations and delusions, disturbed thought and emotions, and personality disorganization

characterized by loss of contact with reality and relationship with other people causing social maladaptation

causes: genetic, biomedical, environmental

insight therapies

therapies that aim to improve psychological functioning by increasing a person’s awareness of underlying motives and defenses

exposure therapies

(behavior therapy) behavioral techniques that treat anxieties by exposing people (in imaginary or actual situations) to the things they fear and avoid

ex: systematic desensitization, virtual reality

biomedical therapy

prescribed medications or procedures that act directly on the person’s physiology

biopsychosocial approach

the idea that psychological disorders reflect genetic predispositions and psychological states, inner psychological dynamics, and social/cultural circumstances (emphasizes that the mind and body are inseparable)

ex: basis/tendencies of disorders may vary from culture to culture (japan vs us)

- influences include biological (evolution, individual genes, brain structure and chemistry), psychological (stress, trauma, learned helplessness, mood-related perceptions and memories), and social-cultural (roles, expectations, definitions of normality and disorder)

diathesis-stress model (stress vulnerability model)

a model that suggests that individual characteristics combine with environmental stressors to increase/decrease the likelihood of developing a psychological disorder

supported by epigenetics

epigenetics

the study of environmental influences on gene expression that occur without a DNA change

insanity

in criminal law means that defendants cannot be held accountable for their actions, typically due to a mental disorder (not a psychological or medical term - legal system term)

DSM

the American psychiatric association’s diagnostic and statistical manual of mental disorders; a widely used system for classifying psychological disorders

pros: standardization of terminology and categorization, aids with research direction

cons: may overly medicalize conditions, not always reliable (much space for interpretation in certain broad definitions), labels (can be self-fulfilling and subjective)

competency

the ability to exert control over one's life, to cope with specific problems effectively, and to make changes to one's behavior and one's environment, as opposed to the mere ability to adjust or adapt to circumstances as they are

a measurable pattern of knowledge, skill, abilities, behaviors, and other characteristics that an individual needs to perform work roles or occupational functions successfully

disorganized word salad

(schizophrenia) jumbled ideas that make no sense, even within sentences

David Rosenhan

conducted a study where he and seven others went to hospital admissions office to falsely complain about hearing voices but answered all other questions (other than identity and occupation) truthfully…

→ all eight healthy people were misdiagnosed with disorders

anxiety disorders

(category) psychological disorders characterized by distressing, persistent anxiety or manipulative behaviors that reduce anxiety

generalized anxiety disorder (GAD)

an anxiety disorder in which a person is continually tense, apprehensive, and in a state of automatic nervous system arousal

panic disorder

an anxiety disorder marked by unpredictable, minutes-long episodes of intense dread in which a person may experience terror and accompanying chest pain, choking, or other frightening sensations; often followed by worry over a possible next attack

agoraphobia

(anxiety) fear or avoidance of situations, such as crowds or wide open places, where one has felt loss of control or panic

phobia

an anxiety disorder marked by a persistent, irrational, fear and avoidance of a specific object, activity, or situation

obsessive compulsive disorder (OCD)

a disorder characterized by unwanted repetitive thoughts (obsessions), actions (compulsions), or both

post-traumatic stress disorder (PTSD)

a disorder characterized by haunting memories, nightmares, hyper-vigilance, social withdrawal, jumpy anxiety, numbness or feeling, and/or insomnia that lingers for four weeks or more after a traumatic experience

*categorized under trauma and stressor related disorders

hoarding disorder

a disorder characterized by persistent difficulty getting rid of or parting with possessions due to a perceived need to save items

• attempts to part with possessions create considerable distress and lead to decisions to save them

*categorized under obsessive compulsive and related disorders

body dysmorphic disorder

a disorder characterized by excessive preoccupation with an imagined defect in physical appearance or markedly excessive concern with a slightly physical anomaly

*categorized under obsessive compulsive and related disorders

mood disorders

a class of disorders that involve gross changes in mood

ex: major depressive, bipolar

major depressive disorder

a mood disorder in which a person experiences, in the absence of drugs or another medical condition, two or more weeks with five or more symptoms, at least one of which must be either (1) depressed mood or (2) loss of interest or pleasure

bipolar disorder

a mood disorder in which a person alternates between the hopelessness and lethargy of depression and the overexcited state of mania (formally called manic-depressive disorder)

persistent depressive disorder (aka dysthymic disorder)

a mood disorder characterized by chronic low-level depression that is not as severe, but may e longer lasting than major depressive disorder

seasonal affective disorder (SAD)

a mood disorder associated with episodes of depression during winter months

mania

(mood disorder) a hyperactive, widely optimistic state in which dangerously poor judgment is common

schizophrenia

a disorder characterized by delusions, hallucinations, disorganized speech, and/or diminished, inappropriate emotional expression

psychotic disorders

a group of disorders marked by irrational ideas, distorted perceptions, and a loss of contact with reality

hallucinations

(schizophrenia) false sensory experiences, such as seeing something in the absence of external visual stimuli

delusion

(schizophrenia) a false belief, often of persecution or grandeur, that may accompany psychotic disorders

somatic symptom disorder

a psychological disorders in which the symptoms take a bodily form without apparent physical cause

conversion disorder

a disorder related to somatic symptom disorder in which a person experiences very specific, physical symptoms that are not compatible with recognized medical or neurological conditions (also called functional neurological symptom disorder)

illness anxiety disorder

a disorder related to somatic symptom disorder in which a person interprets normal physical sensations as symptoms of a disease

dissociative disorders

controversial, rare disorders in which conscious awareness becomes separated from previous memories, thoughts, and feelings

dissociative identity disorder (DID)

a rare dissociative disorder in which a person exhibits 2+ distinct and altering personalities (formally known as multiple personality disorder)

personality disorders

inflexible and enduring behavior patterns that impair social functioning

paranoid

(odd-eccentric personality disorders, cluster a) irrational and mistrust of others - constantly suspicious of others with a near inability to trust due to constant fear

schizoid

(odd-eccentric personality disorders, cluster a) lack of interest in social relationships - social detachment is present due to a lack of many emotions

schizotypal

(odd-eccentric personality disorders, cluster a) odd behavior or thinking - a pervasive pattern of cognitive or perceptual distortions, eccentricities of behavior, or discomfort in close relationships

borderline

(dramatic personality disorders, cluster b) instability in relationships, self-image, identity and behavior - unstable relationships full of distrust and/or idealization, issues with abandonment fears, emotions such as emptiness and anger at inappropriate times, paranoia, and impulsiveness

histrionic

(dramatic personality disorders, cluster b) pervasive attention-seeking behavior; shallow or exaggerated emotions - characterized by a strong need for attention from others, and manifests in dramatic, exaggerated, and potentially overly flirtatious actions and behaviors

narcissistic

(dramatic personality disorders, cluster b) pervasive pattern of grandiosity; need for admiration and lack of empathy - a mental disorder characterized by an inflated sense of self-importance, deep need for admiration, lack of empathy for others, and troubled relationships

antisocial personality disorders

(dramatic personality disorders, cluster b) a personality disorder in which a person (usually a man) exhibits a lack of conscious for wrongdoing, even toward friends and family members; may be aggressive and ruthless or a clever con artist (formally known as psychopath)

avoidant

(anxious/fearful personality disorders, cluster c) social inhibition; feelings of inadequacy - low self-esteem, fear of rejection, and fear of judgement

dependent

(anxious/fearful personality disorders, cluster c) pervasive psychological dependence on others - helpless, submissive, and incapable of taking care of themselves, trouble making simple decisions

obsessive-compulsive

(anxious/fearful personality disorders, cluster c) rigid conformity to rules and moral codes; excessive orderliness; perfectionism (control to the point of satisfaction and exclusion of leisurely activities and friendships) - a mental health condition that causes an extensive preoccupation with perfectionism, organization, and control which interfere with completing tasks and maintaining relationships

social anxiety disorder

intense fear and avoidance of social situations (formally called social phobia)

moral movement (dorthea DIX)

a form of psychotherapy from the 19th century based on the belief that a person with a mental disorder could be helped by being treated with compassion, kindness, and dignity in a clean, comfortable environment that provided freedom of movement, opportunities for occupational and social activity, and reassuring talks with physicians and attendants

deinstitutionalization

the replacement of long-stay psychiatric hospitals with smaller, less isolated community-based alternatives for the care of mentally ill people

pros: family involvement, no changes to rights/responsibilities, live full lives

cons: unemployment amongst psychiatric facility patients, deinstitutionalized individuals without familial/financial support often ended up homeless

eclectic approach

an approach to psychotherapy that uses techniques from various forms of therapy

psychoanalysis (FREUD)

Sigmund Freud’s therapeutic technique; Freud believed the patient’s free associations, resistances, dreams, and transferences - and the therapist’s interpretations of them - released previously repressed feelings, allowing the patient to gain self insight

resistance

in psychoanalysis, the blocking from consciousness of anxiety-laden material

interpretation

in psychoanalysis, the analyst’s noting supposed dream meanings, resistances, and other significant behaviors and events in order to promote insight

transference

in psychoanalysis, the patient’s transfer to the analyst of emotions linked with other relationships (such as love or hatred for parent)

psycho-dynamic therapy

therapy deriving from the psychoanalytic tradition; views individuals as responding to unconscious forces and childhood experiences, and seeks to enhance self-insight

active listening (ROGERS)

(humanistic therapy) empathetic listening in which the listener echoes, restates, and clarifies (a feature of roger’s client-centered therapy)

client-centered therapy (ROGERS) (person-centered therapy)

a humanistic therapy, developed by Carl Rogers, in which the therapist uses techniques such as active listening within an accepting, genuine, empathetic environment to facilitate client’s growth

unconditional positive regard (ROGERS)

(humanistic therapy) a caring, accepting, nonjudgmental attitude, which Carl Rogers believed would help clients develop self-awareness and self-acceptance

behavior therapy (behavior modification)

therapy that applies learning principles to the elimination of unwanted behaviors

counter-conditioning (COVER, JONES)

behavior therapy procedures that use classical conditioning to evoke new responses to stimuli that are triggering unwanted behaviors; include exposure therapies and aversive conditioning

systematic desensitization (WOLPE)

(behavior therapy) a type of exposure therapy that associates a pleasant relaxed state with gradually increasing anxiety-triggering stimuli, commonly used to treat phobias

aversive conditioning

(behavior therapy) a type of counterconditioning that associates an unpleasant state (such as nausea) with an unwanted behavior (such as drinking alcohol)

token economy

(behavior therapy) an operant conditioning procedure in which people earn a token for exhibiting a desired behavior and can later exchange tokens for privileges or treats

cognitive therapy

therapy that teaches people new, more adaptive ways of thinking; based on on the assumption that thoughts intervene between events and our emotional reactions

rational emotive behavior therapy (aka REBT) (ELLIS)

a confrontational cognitive therapy, developed by albert ellis, that vigorously challenges people’s illogical, self-defeating attitudes and assumptions

cognitive-behavioral therapy (CBT)

a popular integrative therapy that combines cognitive therapy (changing self-defeating thinking) with behavior therapy (changing behavior)

group therapy

(cognitive-behavioral therapy) therapy conducted with groups rather than individuals, providing benefits from group interaction

family therapy

(cognitive-behavioral therapy) therapy that treats people in the context of their family system; views an individual’s unwanted behaviors as influenced by, or directed at, other family members

meta-analysis

a procedure for statistically combining the results of many different research studies

evidence-based practice

clinical decision making that integrates the best available research with clinical expertise and patient characteristics and preferences

resilience

the personal strength that helps most people cope with stress and recover from adversity and even trauma