Clinical Psychology

psychopathy

scientific study of mental disorders & the different types of maladaptive behaviors

what did early civilizations use to treat disordered behavior?

trephining (involved drilling holes into skull to release evil spirits \[demonology\])

Who laid the groundwork for the idea that disorders were caused by physical sources and not supernatural?

Hippocrates

What did Hippocrates believe were the cause of disorders?

An imbalance in the 4 “humors”-

blood, black bile, yellow bile, and phlegm

Did europe return to demonology at one point?

Yes: during the medieval times

What did the enlightenment cause people to start believing about the cause for mental illness?

People returned to thinking that the reason was physical causes

What were people’s hypothesis in the early 1900s for the cause of mental illness?

That there is a dysfunction in the frontal lobe

Who won a Nobel Prize for creating lobotomies?

Vegas Moniz

Did lobotomies work?

They did reduce aggression because of the severe emotional + intellectual deficits

What is one big commonality through history about how people with mental illness are treated?

Throughout history, those with mental illness are treated very badly and even denied access to treatment

What do most modern treatments focus on?

Medicine and counceling

Does abnormal behavior always equate to psychological disorders?

no.

What is the criteria for mental disorders?

\-atypical behavior

\-inference to daily life

\-cause personal distress

What is clinical diagnosis based primarily on?

The Diagnostic and Statistic Manual of Mental Disorders (DSM) and most recent edition is DSM-5

what was the 1st edition of the DSM emphasizing most?

The Freudian Psychodynamic approach

What approach did the DSM-3 use?

(1980) Biomedical approach

What does the DSM-5 include now?

\-more disorders added & some removed

\-improved criteria for diagnosis

What must psychologists respect?

Clients’ right to confidentiality.

an exception to the right of confidentiality is when…

someone is threatened

What does the legal system recognize?

the insanity defense

what do most jurisdictions ask?

Can the defendant differentiate between right and wrong at the same time of the action

Can psychologists & other experts talk to lawyers, judges, juries, etc.?

yes

Etiology

cause of medical conditions

Psychodynamic model

focus on UNCONSCIOUS mind (now it is to focus on defense mechanisms)

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ex: DID disorder, which is developing alt personas, may be a form of repressing childhood abuse/other traumatic events

Behavorial model

behaviors, including maladaptive ones, are learned

\-classical & operant condition + social learning theory

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ex: illness anxiety disorder (previously called hypochondria) is when a child rarely gets attention until they are sick, so it is considered positive reinforcement of love/attention when sick

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\-this model can be used to understand phobias. conditions & SLT may be explanations

Humanistic model

poor self-concept, inability to be one’s authentic self (recall: conditions of worth)

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ex: depression

-an individual who experiences incongruence when their family isn’t accepting of their true selves

Cognitive model

examining ways of thinking & how irrational maladaptive thoughts can lead to disorders

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ex: Intermittent explosive disorder (outbursts of rage)

-affected person’s cognitive process to irrational views minor issues as major ones

What are these 4 models (Cognitive, Psychodynamic, Behavorial, and Humanistic) help explain?

the causes of many disorders

what should these 4 models (Cognitive, Psychodynamic, Behavorial, and Humanistic) NOT explain?

Serious disorders such as major depression or schizophrenia

Biological/medical model

Biological causes of disorders

\-focuses on genetics, dysfunction in brain’s neurotransmitter system, etc.

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\-research shows the link between psychological disorders & neurological ones

be sure to be wary of _____ when using these models

over reliance

Diathesis - Strauss model

combination of biological and environmental factors

\-Biology puts people at various levels of risk of developing psychological disorders

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\-Diathesis: predisposition of biological vulerability to a paticular disorder

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\-Stressors: environmental events that can trigger the onset of a disorder

\-Protective factors- steps that can be taken to DECREASE the likelihood of the disorder presenting itself

these models (Cognitive, Psychodynamic, Behavorial, and Humanistic, Biological, and Diathesis-Strauss) focuses on

the INDIVIDUAL

what does the sociocultural model emphasize?

societal + cultural influences

\-culture is a STRONG factor in psychology, including disorders

what does the DSM-5 reflect on in the area of psychological disorders?

it reflects greater awareness to cultural influences

are some disorders specific to certain cultures?

yes

ex: Taijin Kyofusho- a social anxiety disorder, specifically to Japan in which a person experiences intense fear that their body/bodily function will embarrass others

Biopsychosocial model

integrated model that combines ALL approaches we have discussed

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\-thorough approach towards explaining, diagnosing, & treating psychological disorders

What do Depressive and Bipolar disorders have in common?

symptoms + they both USED to be classified under “mood disorders” but now DSM-5 separated them

Depressive and bipolar disorders overlap with which disorder?

Schizophrenia

Just because there is an overlap in symptoms, it doesn’t guarantee that

someone with depressive disorder will get schizophrenia

What are bipolar disorders seen as between depressive & psychotic disorders?

a “bridge”

Which category are depressive disorders in?

General category

does depression exist in DSM-5?

No; when people say depression, they are usually referring to major depressive disorder.

What is the most common psychological disorder in the world?

Major depressive disorder

what are the symptoms of MDD? (major depressive disorder)

\-sustained depressive mood

\-diminished interest/pleasure in activities

\-change in appetite/weight

\-sleep disturbance

\-fatigue

\-slowing of physical & emotional reactions

\-problems w/ concentration

\-feelings of worthlessness/guilt

\-persistent thoughts of death & suicide

What symptoms may show if MDD is severe?

psychotic symptoms, though most cases do not include psychotic features

Diagnosing DD (depressive disorder) requires…

\-at least 5 symptoms over a 2-week period

\-one of the symptoms HAS to be a depressed mood or diminished interest in activities

Persistent depressive disorder

depressed mood lasted for over 2 YEARS

\-this is a mild form of depression

\-no suicidal thoughts

symptoms of PDD (persistent depressive disorder)

\-lack of fatigue

\-low self-esteem

\-feeling hopeless

\-lack of interest in activities which were previously enjoyed

Disruptive mood dysregulation disorder (DMDD)

this is a childhood condition which involves frequent temper outbursts which are severe & persistent

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\-outbursts happen 3 or more times ina week

\-bt/wn outbursts, the child is angry & irritable

why was DMDD (disruptive mood dysregulation disorder) added to DSM-5?

Children were wrongfully diagnosed as bipolar even though they were not bipolar

For confirmation of DMDD in a child, you need:

\-for symptoms to be present in at least 2 settings

\-symptoms present for a year or more

\-child must be at least 6 years old

what do Bipolar and related disorders involve moving from?

depressive episodes to manic episodes

manic

state of abnormally heightened emotions + very high energy

\-this does NOT mean that the person experiencing this is always happy

what do manic episodes include?

\-significantly less sleep

* “flight of ideas” speech
* delusional behavior
* Feelings of grandiosity

what is a common misconception about manic and depressive episodes?

that they switch moment to moment

how long do manic and depressive episodes last?

weeks, months, and even years

What do bipolar I and bipolar II have in common?

both feature severe depressive episodes

What is one difference between bipolar I and bipolar II?

Bipolar II has less severe MANIC episodes

cyclothymic disorder

* a milder version that both bipolar disorders
* key characteristics: chronic (must last MORE than 2 YEARS)

how can the diathesis-stress model explain the causes of depressive + bipolar disorders?

* environmental factors include:

\-intense & prolonged stress

\-traumatic events

\-death of a loved one

what are some reasons on why some people experience trauma & stressor related disorders?

* lack of social support
* childhood trauma
* additional stress after the event
* family history

what are some examples of traumatic events?

* military combat
* violent crime
* sexual/physical assault
* kidnapping
* natural disasters

symptoms of trauma & stressor-related disorders

* inability to experience pleasure (anhedonia)
* intense sense of unease (dysphoria)
* externalized anger & aggression

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\-disorders in this category were previously listed as anxiety disorders but now have been separated out

when do symptoms develop with Acute Stress Disorder?

shortly after witnessing a traumatic event and lasts LESS THAN A MONTH

symptoms of Acute Stress Disorder

* uncontrollable flashbacks or nightmares
* sleep disturbances
* hypervigilance
* problems processing the event

What was PTSD previously called?

“shell shock”

How long/when does PTSD last/ develops?

lasts more than a month AND/OR develops 6 or more months after event

symptoms of PTSD

* Reliving traumatic event- usually very intense
* psychological distress when encountering similar stimuli
* can lead to avoidant behaviors
* arousal issues- easy to startle, high levels of aggression, reckless behavior

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\-cognitive distortions, like amnesia, may be a sign of PTSD

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how can PTSD be managed and treated?

therapy and medication, but still needs to be taken seriously!

what do dissociative disorders include?

disruptions in memory, consciousness, identity, perception, or behavior

* often caused by defense mechanisms to trauma

what was DID previously called?

multiple personality disorder

a presence of at least\` 2 identities must be significant enough to

alter function

are separate identities completely diff. from each other IN DID?

yes.

how do separate identities differ from each other?

ages, mannerisms, and unique brain functioning which soon leads the person to have alt moods, behavior, consciousness, etc.

dissociative amnesia

inability to remember parts of the past

what is dissociative amnesia triggered by?

ONLY PSYCHOLOGICAL FACTORS

localized amnesia

inability to remember events in a specific stretch of time

most common form of amnesia

localized amnesia

selective amnesia

loss of specific memories

generalized amnesia

total loss of memory of one’s life

most rare form of amnesia

generalized amnesia

what is somatic symptom & related disorders caused by?

psychological stress but their effects are physical!

somatic-symptom disorder

extreme anxiety abt physical symptoms being a more serious illness

conversion disorder

“conversion” of extreme anxiety into physical conditions

* physical conditions are REAL but there is no medical cause
* ex: symptoms may consist of paralysis, tremors, loss of sensation, & seizures in extreme cases

illness anxiety disorder

fear of becoming seriously ill

* person may: constantly seek medical care, perform self-examinations, live in a state of anxiety
* physical symptoms do NOT have to be real, BUT THE FEAR DOES!!

factitious disorder

person falsely reports (or exaggerates) symptoms to get medical attention

* some may even purposely induce symptoms
* emotional disturbance: a need to be seen as “sick” to receive sympathy
* not seeking financial gain!

is factitious disorder imposed on another a more harmful version of factitious disorder?

yes, since it involves deliberate falsification (or even actual harm) on someone else to gain attention and sympathy

anxiety

feeling of unease; that something bad will happen

Generalized anxiety disorder (GAD)

feelings of dread w/o specific causes, excessive anxiety and it is uncontrollable and dysfunctional

symptoms of Generalized Anxiety Disorder

* restlessness, fatigue,irritability, inability to concentrate, sleep disturbances, and muscle tension
* need at least 3 to be diagnosed
* other PHYSICAL symptoms include problems with the gastrointestinal part of your body and headaches

panic disorder

* sudden and severe feeling of extreme anxiety
* Panic episodes can be repetitive
* arrive quickly and can reach peak in a matter of minutes

symptoms of a panic disorder

* Accelerated heart rate, sweating, trembling, chest pain, feelings of choking, nausea, dizziness, and numbness or tingling
* Fear of losing control is also common


* Panic episodes can be made worse by a concurrent worry it is associated with a life threatening condition (such as a heart attack)

specific phobia

* overwhelming, unreasonable, and persistent sense of fear of a stimulus
* Lasting and severe
* Person often goes out of their way to avoid stimulus
* They may recognize it is irrational and yet still can’t control it
* An estimated 6-8% of people have specific phobias

agoraphobia

* - fear of being in a situation where there is no easy escape or possible help
* Can include panic attacks
* May avoid: open, crowded, or enclosed spaces
* Movie theaters, malls, public transportation, large lines, or crowds, etc.
* Most extreme cases of agoraphobia result in a person being unwilling to leave their home

social anxiety disorder

* - anxiety about social situations
* Intense fear of criticism and embarrassment
* Additional fear that showing anxiety will lead to judgment
* Avoid social situations, especially where center of attention

what do obsessive-compulsive & related disorders cause?

reptitive thoughts, distress, and compulsive behaviors

obsessions are …. while compulsions are ….

THOUGHTS

BEHAVIORS

BDD (body dysmorphic disorder)

*  obsessive preoccupation with physical appearance
* Might show: compulsive grooming, frequent checking of appearance in mirrors and reflections
* Disrupts function in everyday life

what do people with OCD recognize their “rituals” as?

irrational

* Also know they interrupt daily life
* Inability to stop
* In severe cases, thoughts of death and suicide can become a symptom