Clinical Psychology

psychological disorder

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

syndrome

a collection of symptoms

dysfunctional/maladaptive

interfere with normal day-to-day life (often accompanied by distress)

distressful

causes distress, emotional disturbance

deviant

change from the norm

Philippe Pinel

reformer in France who opposed brutal treatments and said curing the illness requires moral treatments

medical model

concept that diseases have physical causes that can be diagnosed, treated, and in most cases cured (often through treatment in a hospital)

organic disorder

mental disorders due to a medical condition

biopsychosocial approach (clinical psych)

emphasizes that the mind and body are inseparable - negative emotions can contribute to physical illness and physical abnormalities can contribute to negative emotions

stress vulnerability (diathesis-stress) model

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

epigenetics

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

classification

gives overview of symptoms, aims to predict a disorder’s future course, suggests appropriate treatment, prompts research into its causes

5 axes of diagnosis

clinical syndrome; personality/mental retardation; general medical condition; psychosocial/environmental problems; global assessment (0-100)

DSM-5

APA’s Diagnostic and Statistic Manual of Mental Disorders, 5th edition - widely used system for classifying psychological disorders

clinician agreement

likelihood that another mental health worker would independently give the same diagnosis as another clinician

RDoC (Research Domain Criteria)

aims to bring ‘power of modern research approaches in genetics, neuroscience, and behavioral science" to study psychological disorders

insanity (criminal law)

defendants cannot be held accountable for their actions, typically due to a mental disorder

immigrant paradox

recent immigrants are at less risk for mental disorders than people with the same ethnicity born in the country

ADHD (attention deficit hyperactivity disorder)

marked by extreme inattention and/or hyperactivity and impulsivity

Tourette’s disorder

marked by uncontrollable tics

ASD (autism spectrum disorder)

disorder marked by significant deficiencies in communication and social interaction and by rigidly fixed interests and repetitive behaviors

FAS (fetal alcohol syndrome)

physical and cognitive abnormalities in children caused by pregnant woman’s heavy drinking; alcohol has epigenetic effect (leaves chemical marks on DNA that switch genes abnormally on/off)

Down Syndrome

mild to severe intellectual disability and associated physical disorders - caused by an extra copy of chromosome 21

anxiety disorders

characterized by distressing, persistent anxiety or maladaptive behaviors that reduce anxiety

social anxiety disorder

intense fear and avoidance of social situations

generalized anxiety disorder

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

free-floating

not linked to specific stressor or threat

panic disorder

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

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

phobia

persistent, irrational fear and avoidance of a specific object, activity, or situation

OCD (obsessive-compulsive disorder)

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

hoarding disorder

littering one’s space with acquired possessions one can’t let go

body dysmorphic disorder

preoccupation with perceived body defects

trichotillomania

hair pulling

excoriation disorder

excessive skin picking

TBI

traumatic brain injury

PTSD (posttraumatic stress disorder)

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

survivor resiliency

recovering after a severe stress

modern perspectives on anxiety disorders

conditioning, cognition, biology

separation anxiety disorder

have dependency on another person, unable to do things when separated

depressive disorder

condition where a person experiences extreme or inappropriate emotions

MDD (major depressive disorder)

person experiences two or more weeks with five or more symptoms, at least one of which must be either depressed mood or loss of interest or pleasure

persistent depressive disorder (dysthymia)

mildly depressed mood more often than not for two years or more (less severe than MDD)

seasonal affective disorder

person experiences depression but only during certain times of the year (usually during winter - less sunlight)

bipolar 1

person alternates between a stable state and a longer manic state

bipolar 2

person alternates between a stable state, manic state, and depressive state

mania

hyperactive, wildly optimistic state in which dangerously poor judgement is common (excess norepinephrine)

social-cognitive perspective (clinical)

explores how people’s assumptions and expectations influence what they perceive (many depressed people’s intensely negative assumptions lead them to magnify bad experiences and minimize good ones; self-defeating beliefs and negative explanatory style feed depression)

explanatory style

who or what people blame for their failures

rumination

compulsive fretting, overthinking problems and their causes

NSSI (nonsuicidal self-injury)

harming oneself intentionally (may cut or burn skin, hit themselves, insert objects under their nails or skin, or self administer tattoos)

common reasons for NSSI

find relief from intense negative thoughts through distraction of pain, attract attention and possibly get help, relieve guilt by punishing themselves, get others to change their negative behavior, fit in with a peer group

psychotic disorders

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

schizophrenia

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

dopamine hypothesis

high levels of dopamine seem to be associated with schizophrenia

tardive dyskinesia

muscle tremors and stiffness caused by extensive use of antipsychotic drugs

positive symptoms

inappropriate behaviors are present

negative symptoms

appropriate behaviors are absent

hallucinations

false sensory experiences in the absence of sensory input

delusion

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

flat affect

emotionless, no apparent feeling

impaired theory of mind

difficulty perceiving facial expressions and reading others’ states of mind

catatonia

motor behaviors ranging from physical stupor (remaining motionless for hours), to senseless, impulsive actions (continually rocking or rubbing an arm), to severe and dangerous agitation

chronic (process) schizophrenia

form of schizophrenia in which symptoms appear by late adolescence or early adulthood (as people age, psychotic episodes last longer and recovery periods shorten)

acute (reactive) schizophrenia

form of schizophrenia that can begin at any age; frequency occurs in response to a traumatic event

prenatal risk factors for psychological disorders

low birth weight, maternal diabetes, older parental age, oxygen deprivation during delivery, famine

somatic symptom disorders

symptoms take somatic (bodily) form without apparent physical cause

conversion disorder

person experiences very specific, physical symptoms that are not compatible with recognized medical or neurological conditions

illness anxiety disorder

person interprets normal physical sensations as symptoms of a disease (formerly called hypochondriasis)

dissociative disorders

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

fugue state/dissociative fugue

sudden loss of memory or change in identity, often in response to overwhelmingly stressful situation

psychogenic amnesia

person cannot remember things but no physiological basis for the disruption in memory can be identified

DID (dissociative identity disorder)

person exhibits two or more distinct and alternating personalities (formerly called Multiple Personality Disorder)

dissociation

sense of being unreal, of being separated from the body, of watching themselves as if in a movie

skepticisms of DID

DID is an extension of our normal capacity for personality shifts; DID has such a short and localized history (rare outside North America); may result from therapist suggestions

personality disorders

inflexible and enduring behavior patterns that impair social functioning - 3 clusters (A: eccentric/odd behaviors, B: dramatic/impulsive behaviors, C: anxiety)

cluster A personality disorders

eccentric/odd behaviors - paranoid, schizoid, schizotypal

cluster B personality disorders

dramatic/impulsive behaviors - antisocial, borderline, histrionic, narcissistic

cluster C personality disorders

anxiety - avoidant, dependent, obsessive-compulsive

antisocial personality disorder

person exhibits lack of conscience for wrongdoing, even towards friends and family members (antisocial means disruptive)

dependent personality disorder

rely too much on attention and help of others; cannot function without another person

paranoid personality disorder

feel constantly paranoid, persecuted

narcissistic personality disorder

see themselves as the center of the universe; excessive egocentrism and self-love/obsession

histrionic personality disorder

exhibit overly dramatic behaviors (histrionics)

obsessive-compulsive personality disorder

may be overly concerned with certain thoughts and performing certain behaviors, but will not be debilitated to the same extent that someone with OCD would

borderline personality disorder

inappropriate emotional reactions and perceptions of the world

avoidant personality disorder

does not want to put themselves in a situation of embarrassment, criticism, or critique

schizotypal personality disorder

eccentric thought, behavior, and speech

schizoid personality disorder

detachment from emotion and relationships

Rosenhan study

Rosenhan and others claimed they had been hearing voices (sole symptom); were admitted to institutions; when they ceased reporting/exhibiting symptoms, did not get discharged and normal behavior was interpreted as a sign of their disorder

anorexia nervosa

eating disorder in which people starve themselves to below 85% of their normal body weight and refuse to eat

bulimia nervosa

eating disorder in which people eat large amounts of food in a short period of time (binging) and then get rid of the food (purging) by vomiting, exercising excessively, or using laxatives

binge eating disorder

significant binge eating episodes, followed by distress, disgust, or guilt, but without compensatory behavior

substance use disorder

continued substance craving and use despite significant life disruption/physical risk

alcohol use disorder

alcohol use marked by tolerance, withdrawal, and drive to continue problematic use

insomnia

recurring problems in falling/staying asleep

narcolepsy

uncontrollable sleep attacks

sleep apnea

temporary cessations of breathing during sleep and repeated momentary awakenings

night terrors

high arousal and appearance of being terrified

sleep walking/talking

doing normal waking activities while asleep