AP Psych. Unit 8: Clinical Psychology

Disorder Criteria

consist of deviant, distressful, and dysfunctional behavior patterns

DSM V

Described: used by psychologists and psychiatrists to diagnose a disorder but NOT how to treat a disorder

Strengths: Provides a common language and has high reliability

Rosenhan's Study

Conducted: a group of people faked hearing voices and were immediately admitted into a hospital and WRONGLY diagnosed with schizophrenia

Significance: demonstrated how labeling people with a disorder can be problematic because the label is more important than the symptoms

Medical Model on Disorders

assumes that psychological disorders are mental illnesses that need to be diagnosed on the basis of their symptoms and cured through therapy.

Weakness: does not recognize the importance of the environment.

BioPsychoSocial Model on Disorders

Assumes that disorders are influenced by genetic predispositions and physiological states (biological), inner psychological dynamics (thoughts), and social and cultural circumstances (environment).

Strength: recognizes the importance of the environment

Psychoanalytic Perspective on Disorders

Disorders are caused by conflicts in the unconscious mind that are repressed from early childhood

Behavioral Perspective on Disorders

Disorders are learned from the environment with reinforcement and conditioning.

Biological Perspective on Disorders

Disorders are caused by physiological issues such neurotransmitter imbalances, differences in brain structure, and inherited predispositions

Cognitive Perspective on Disorders

Disorder are caused by faulty, illogical, and negative ways of thinking

ADHD

Neuro-developmental disorder

Description: person struggles with inattention, hyperactivity, and/or impulsivity.

Autism

Neuro-developmental disorder

Description: difficulty in communicating and forming relationships with other people and in using language and abstract concepts

Intellectual Impairment

Neuro-developmental disorder

Description: IQ is below 70 and problems with functioning all by your self

Specific Phobia

Anxiety disorder

Description: irrational fear of a specific object or situation

Social Anxiety Disorder

Anxiety disorder

Description: an intense fear of being scrutinized by others,and is shyness taken to an extreme.

Panic Disorder

Anxiety disorder

Description: a minutes-long episode of intense dread in which a person experiences terror and accompanying chest pain, choking, or other frightening sensations.

Agoraphobia

Anxiety disorder

Description: You fear being in public places and being unable to escape

Generalized Anxiety Disorder

Anxiety disorder

Description: a person is continually tense, apprehensive, and in a state of autonomic nervous system arousal.

Biological Causes of Anxiety

genetically inherited, and lacks the neurotransmitter GABA

PsychoSocial Causes of Anxiety

Fear Conditioning: classically conditioned to fear something

Observational Learning: observed others and developed the same fear

Obsessive Compulsive Disorder (OCD)

Defined: uncontrollable thoughts cause anxiety which forces the person to develop repetitive behaviors to combat the anxiety

Examples: washers, confessors, symmetry & precision making, checkers, and counters

Body Dismorphic Disorder

Defined: Excessive concern of body image; concern of a perceived defect in body image

Hoarding

Defined: Feel the need to save everything because of some anxiety provoking thought

very similar to OCD

Post Traumatic Stress Disorder (PSD)

Described: Individuals suffer nightmares and other types of emotional distress from a traumatic past experience or set of experiences and avoid anything that will trigger recall of event.

Post Traumatic Growth

Some people grow after experiencing PSD (Post Traumatic Stress Disorder) with an increased appreciation of life, more meaningful relationships, Changed priorities, and a Richer spiritual life

Somatic Symptom Disorder

Described: Person is physically sick due to excessive anxiety (thoughts, feelings, or behaviors)

Illness Anxiety Disorder

Described: Preoccupation with having or acquiring a serious illness and any pain signals a serious illness or disease

Examples: "If I cough, I have cancer"

Conversion Disorder

Described: Emotional difficulties convert into loss of a specific function and their is no medical explanation for this

Examples: Weakness, loss of sensation, numbness, blindness, paralysis

BioPsychoSocial Causes of Somatic Disorders

Biological: None

Psychological: Anxiety provoking thoughts (most common cause)

Social: a stressful environment

Dissociative

splitting apart significant aspects of awareness, memory, or identity

Dissociative Amnesia

Described: an inability to remember facts or details surrounding a traumatic event that cannot be explained by physical means.

Dissociative Identity Disorder

Described: a controversial diagnosis of a psychological disorder that manifests itself in the presence of two or more alternate personalities in the same body that may or may not be aware of each other's existence.

Example: Sybil

Depersonalization Disorder

Feel disengaged and withdrawn from yourself and your surroundings (out of body experience).

Example: Alice in Wonderland

BioPsychoSocial Causes of Dissociative Disorders

Biological: None

Psychological: Repression Defense Mechanism (most common reason)

Social: A traumatic experience

Major Depressive Disorder

Mood Disorder

Described: characterized by extreme sadness, lethargy, sleep disturbances, pessimistic thinking, and loss of interest in life for a period of two weeks

Persistent Depressive Disorder (Dysthymia)

Mood Disorder

Described: Chronic, low grade, depression with similar symptoms to depression that occurs most days and lasts for two or more years

Example: Charlie Brown

Bipolar Disorder

Mood Disorder

Described: mood swings from euphoric, manic stages to depressed (from one "pole" to the other and not just happy to sad).

Episodes last one to many days

Cyclothymic Disorder

Mood Disorder

Described: a history with mild depression to slight mania or hyperactivity (milder form of bipolar disorder)

Seasonal Affective Disorder

Defined: Major depressive episode caused by the dark, cold, winter months

Starts in Fall & Winter and leaves in Spring & Summer

Post Partum Depression

Mood Disorder

Description: Major depressive disorder suffered by mother following childbirth, typically arising from the combination of hormonal changes, psychological adjustment to motherhood and fatigue

Ranges from mild to severe

Biological Causes of Mood Disorders

Genetically Inherited

Depression has a lack of the Serotonin & Norepinephrine (Neurotransmitters)

Bipolar has high levels of Glutamate

PsychoSocial Causes of Mood Disorders

Psychological Causes: Self-Defeating Beliefs, Learned Helplessness, Pessimism & Vicious Circle

Social Causes: stressful events, stressful relationships, & chronic stress

Schizophrenia

Described: A severe disorder characterized by disorganized and delusional thinking, disturbed perceptions, and inappropriate emotions and actions

Symptoms: Hallucinations, Delusions, disorganized speech, negative symptoms, grossly disorganized behavior or catatonic behavior

Delusions

symptom of schizophrenia

defined: falsely held belief that persists in spite of compelling contradictory evidence.

Hallucinations

symptom of schizophrenia

Defined: Sensory experience without stimulation including Seeing, feeling, tasting or smelling things that aren't there

Auditory hallucinations are the most common & voices often tell the person to hurt themselves

Biological Causes of Schizophrenia

Genetically Inherited

Viral Infection theory: mother was sick during pregnancy

Old father had mutated sperm

Excessive amounts of neurotransmitter Dopamine

Low activity in the frontal lobe and a smaller hypothalamus

PsychoSocial Causes of Schizophrenia

Unhealthy families or stressful environments

Diathesis Stress Model

People inherit a predisposition or diathesis that increases their risk for schizophrenia

Stressful experiences trigger schizophrenic episodes

Paranoid Personality Disorder

Described: a person has a long-term pattern of distrust and suspicion of others

Narcissistic Personality Disorder

Described: people have an inflated sense of their own importance, a deep need for admiration and a lack of empathy for others.

Anti-social Personality Disorder

Described: a person has a long-term pattern of manipulating, exploiting, or violating the rights of others.

Borderline Personality Disorder

Described: the person is afraid of being abandoned and it causes intense mood swings, impulsive behaviors, and severe problems with self-worth.

Avoidant Personality Disorder

Described: a person has a lifelong pattern of extreme shyness, feelings of inadequacy, and sensitivity to rejection.

Dependent Personality Disorder

Described: a person has a pervasive pattern of being dependent on other people

How common are disorders

26% of Americans suffer from diagnosable mental disorders and the highest reported rates are in the USA

Most common disorders are mood disorders, specific phobias, and social phobia

Relation between Poverty & Psychological Disorders

Poverty can lead to a psychological disorder

Psychological problems can lead to poverty

Insight Therapies

a type of psychotherapy in which the therapist helps their patient understand how their feelings, beliefs, actions, and events from the past are influencing their current mindset.

Behavioral Therapies

A type of psychotherapy that focuses on changing or reducing the occurrence of some maladaptive behavior

Bio-medical Therapies

Use a prescribed medication or medical procedure that acts directly on the patient's nervous system

Eclectic Approach

The type treatment used will depend on the client's problems

Psychoanalytic Therapy

Assumption: Problems stem from unconscious conflicts that usually date back to childhood experiences

Aim: help patients gain insight into unconscious conflicts

Evaluation: old, outdated, and lacks empirical evidence

People: Freud

Free Association

Patient lays on couch freely exposes thoughts, feelings, and mental images going on in their mind

Therapist must encourage the flow of associations to provide clues to what the unconscious is hiding

Dream Analysis

Patient describes the "manifest content" of the dream

Therapist uncovers the "latent content" of the dream

Transference

The patient projects or transfers unresolved conflicts and feelings onto the therapist (Could be love or hatred of a parent)

Therapist helps patients gain insight by reliving painful past relationships

Psychodynamic Therapy

Similarity to Psychoanalysis because they try to enhance self-insight by focusing on "unconscious forces" that and childhood experiences

Differs from Psychoanalysis because they talk face to face and don't meet as much

Humanistic Therapies

Assumption: Problems stem from obstacles that block personal growth and potential

Aim: Focus on the present time (here and now)

Evaluation: Unstructured, vague and subjective leaving it with little empirical proof

People: Rogers

Client Centered Therapy

Refer to people as "clients" and not patients

Non-directive Approach where therapist listens without judgment and refrains from directing the client

Unconditional Positive Regard

Important element of client centered therapy developed by Carl Rogers

Blanket acceptance and support of a person regardless of what ether person says or does.

Active Listening

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

Empathy

recognizing the clients feelings and reflecting it back to the client

Behavioral Therapies (aka Behavior Modification)

Assumption: Problems stem from destructive behaviors

Aim: Use learning principles to replace problem behaviors with constructive behaviors

Evaluation: Effective but minimizes emotions

People: Wolpe, Cover-Jones

Counterconditioning

Using classical conditioning principles to create a new conditioned stimulus

Includes exposure and aversive therapies

Systematic Desensitization

Three Step Process: (1) learn progressive relaxation, (2) build an "anxiety hierarchy", (3) combine steps 1 and 2

Flooding

A behavioral technique used to treat phobias in which the client is presented with the feared stimulus until the associated anxiety disappears.

Bell and Pad Treatment

A behavior therapy technique used to treat nighttime bedwetting by conditioning arousal from sleep in response to bodily signals of a full bladder

Aversive Conditioning

use of something unpleasant, or a punishment, to stop an unwanted behavior

Token Economy

A system whereby participants earn generalized conditioned reinforcers (e.g., tokens, chips, points) as an immediate consequence for specific behaviors; participants accumulate tokens and exchange them for items and activities from a menu of backup reinforcers.

Cognitive Therapies

Assumption:Faulty thoughts, such as negative self-talk and irrational beliefs, cause psychological problems

Aims: change the faulty thoughts and replace with better ones

Evaluation: Effective but minimizes emotions

People: Ellis & Beck

Rational Emotive therapy (RET) or Rational Emotive Behavioral Therapy (REBT)

Albert Ellis's cognitive therapy to eliminate emotional problems through the rational examination of irrational beliefs.

Negative Cognitive Bias

Aaron Beck found depressed people consistently distort their experiences in a negative cognitive way

Cognitive Behavioral Therpay

a popular integrative therapy that combines cognitive therapy with behavior therapy

Group Therapy

A group of 3-10 people meet to discuss similar problems, role play new behaviors, and receive instant feedback

Evaluation: Effective (financially & psychologically) and people realize they are not alone in their problems

Family Therapy

Views an individual's unwanted behaviors as influenced by, or directed at, other family members

hopes to identify unhealthy patterns and create new healthy rules & interactions

Couples counseling is very similar

Placebo Effect

Defined: you believe it works due to the power of the mind

Clients' and therapists' believe the treatment will work and therefore it does

Regression towards the mean

Defined: the tendency for unusual events (including emotions) to return to their average state

Example: When things hit bottom, going to a therapist is more likely to be followed by improvement than by further descent.

Meta Analysis

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

Effective Therapies

No one therapy has been shown to be best in all cases but some therapies are better suited for particular disorders

Most _________ __________ are when the problem is clear cut

Evidence Based Practice

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

In short, available therapies are rigorously evaluated and then applied by clinicians who are mindful of their skills and of each patient's unique situation.

Shared Elements of Therapy

Hope, New perspective, and an empathetic, caring relationship

EMDR

therapist waves a finger inferno of the eyes of the client to unlock and reprocess previously frozen traumatic memories

Light Exposure Therapy

a client is exposed to daily doses of light that mimics outdoor light

used to fight against seasonal affective disorder (SAD)

Psychopharmacology

Assumption: biological causes exists for the disorders or behaviors

Aims: provide the right medication

Evaluation: helpful but medicine cannot solve all problems

Neuroleptics

prescription drugs used to reduce symptoms

Tardive Dyskinesia

involuntary movements of the facial muscles, tongue, and limbs; a possible neurotoxic side effect of long-term use of antipsychotic drugs that target certain dopamine receptors

Anti-Anxiety Drugs

How it works: treats anxiety by increasing the level of GABA and therefore depress the activity in the central nervous system

Popular Drugs: Xanax, and Valium

Negative Side Effects: addictive and only reduces symptoms in the short term

Typical Anti-Psychotic Drugs

How it works: treat schizophrenic hallucinations and paranoia by reducing dopamine activity

Popular Drugs: Thorazine

Negative Side Effects: tardive dyskinesia

Atypical Anti-Psychotic Drugs

How it works: treat all schizophrenic symptoms by blocking dopamine & serotonin

Popular Drugs: Abilify

Negative Side Effects: less harmful than typical ones

Mood Stabilizing Drugs

How it works: used to treat bipolar disorder by stabilizing Glutamate levels in order to stabilize current and future moods

Popular Drugs: Lithium & Depakote

Negative Side Effects: small difference between appropriate and toxic dosage level

SSRI

How it works: Treats depression by preventing the reuptake of serotonin

Popular Drugs: Prozac, Zoloft, and Paxil

Advantages: milder side effects making it the most popular anti-depressant

Lobotomy

A now-rare psychosurgical procedure once used to calm uncontrollably emotional or violent patients. The procedure cut the nerves that connect the frontal lobes to the emotion-controlling centers of the inner brain.

Electroconvulsive Therapy (ECT)

a biomedical therapy for severely depressed patients in which a brief electric current is sent through the brain of an anesthetized patient