clinical psychology exam 1 PSYC 4375

efficacy

evidence show cause and effect in the lab

experiments/RCTs

an experiment in which research participants are randomly assigned to one of two treatment conditions

quasi experiments

involves independent variables that the researcher cannot entirely control (ex demographics, men, gamers, bpd)

 Quasi-experiments are less scientifically sound than experiments

 Variables may be hypothesized to have causal effects but not evidenced

ABAB design

A) measure a baseline

B) measure treatment

A) measure the withdrawal of treatment

B) and measure the re-introduction of treatment

meta-analysis

Introduced by Smith, Glass, and Miller (1980),

review technique by which groups of studies are statistically combined and compared

The primary finding was that psychotherapy was clearly effective, with the average

person receiving therapy 80% better off than people with similar problems who did not receive therapy

demand characteristics

clues or signals in an experimental setting that hint to participants about the experimenter’s expectations, leading them to behave in a certain way to match these expectations

sample characteristics

it must be free from bias, its units must be independent of each other, it must represent the population it is drawn from, and it must be large enough to produce reliable results.

Estimated annual cost of mental illness in canada

$63 billion

Mental Health Commission of Canada

focus on research and advocacy

nonprofit with hpv and non gov members

have an advisory board

creates 2007

effectiveness

evidence show cause and effect in real world, generalizability

ethical principles

1) respect dignity of persons (informed consent, bias consideration, work to improve their condition)

2) responsible caring (dont cause ahrm)

3) integrity in relationships (allll professional relationships cuz all will affect client)

4) responsibility to society

types of psychology related work

clinical, counseling, professional (exit early specialize later), school counsellor, clinical neurospychology, RCC, Psychiatry, Psychiatric Nurse (specialized training for nurse, frontline crisis intervention), clinical social worker

Emile Kraepline

1856

link psychology to biology

Alpha vs Beta test

alpha = for readers (verbal test)

beta = for non readers

Lightner Witmer

1907

first used term clinical psychology

“treatment, education, and management of interpersonal issues”

Philippe Pinel

1745-1826)

Introduced humane treatment of the mentally ill in

France

Advocated for the moral treatment movement,

emphasizing kindness and care

William Tuke

1732-1822

Founded the York Retreat in England, promoting

compassionate care for the mentally ill

Pioneered a model of moral treatment focused on

dignity and respect

David Wechsler

Developed

intelligence scales for different age

groups significantly influencing

psychological assessment practices

Hans Eyesenck (1916-1997

Questioned whether psychotherapy produced

better outcomes than no treatment

• His 1952 review challenged assumptions

about psychotherapy effectiveness

• Stimulated more rigorous psychotherapy-

outcome research

Harmful dysfunction theory

considers both scientific data and social impacts and causes

two eyed seeing with biological science and environmental sociocultural

Mutual Recognition Agreement for

psychologists

Between ten provincial licensing associations plus gov of NWT

may allow license to be equivocated and work in new province

Core competencies

 Interpersonal relationships

 Assessment & Evaluation

 Consultation & intervention

 Research

 Ethics

 Supervision

Psy.D. programs in Canada

BC cutting edge and operating off of the Boulder modal (most common. you must be a researcher and a practitioner) except for Adler which uses the Vail modal

no psychology doctorate “professional school” has received accreditation from the CPA. Only two uni programs have.

Practicum

The initial supervised training in the

provision of psychological services that is a

requirement of the doctoral degree usually completed

part-time

hundreds of hours

Internship/residency

he period of supervised training

in the provision of psychological services that is a

requirement of the doctoral degree usually completed

over one-year, full-time

1600 + hours

Scientist-Practitioner (Boulder) Model

This model is used more than any other

 Typically makes up traditional Doctor of Philosophy

(PhD) programs

 Graduates should be capable of producing

research and using empirical evidence to guide

clinical services

Practitioner-Scholar (Vail) Model

PsyD programs usually accept many more students than PhD

programs

 However, some PsyD programs still require substantial

research

 Graduates become research consumers who are informed by

science in their provision of service but do not need the

skills to conduct research

Criticisms about overdiagnosis and the DSM-5/DSM-5-TR

Harder for people to be considered well

 Almost anyone can be diagnosed with a mental disorder

 Could raise questions of validity

and of over-diagnosis in general:

Harmful medication side effects

 Unnecessary therapy that undermines coping skills

 Risks to self-image due to stigma

 Risks to self-efficacy and overall wellness

 Influence on how health insurance companies consider the person

 Influence on how Courts view the person

Categorical approach

A disorder is considered present or absent

Dimensional approach

Symptoms or characteristics vary along a continuum

The Medical Model:

Treats mental disorders as identifiable clinical entities

 Disorders are traditionally defined categorically

 Diagnosis is based on recognizable clusters of signs and symptoms

 Historically influenced DSM development

DSM in 1952

introduced by the APA

3 major categories of psychological disorder:

 Neurosis involves chronic distress but without delusions or

hallucinations, characterized by anxiety, depression, or other

emotional and behavioural symptoms that significantly impair

daily functioning

 Psychosis is a severe mental disorder in which a person loses

contact with reality, experiencing delusions, hallucinations, and

disorganized thinking that profoundly impair their ability to

function and interact with the world

 Character disorders were broadly defined and included a range of

behavioural patterns that were chronic and ingrained, manifesting

as pervasive, maladaptive personality traits

five axis

axis I: all categories of disorder excluding retardation and personality

axis II: mental retardation and the ten personality disorders

axis III: general medical conditions that may significantly affect axis I or II

axis IV: directa diagnostician to consider social and environmental context of disorder

axis V: Rates patients adaption to social relationships, job, leisure

DSM Work Group

review disorder listed on previous DSM and considered proposals for revision

cultural syndroms/diagnoses described in DSM-5-TR chapter – Culture and Psychiatric
Diagnosis

ataque de nervios - latine, symptoms of intense emotional upset

daht syndrome - south asian, young men attribute psyche symptoms to semen loss

hikikomori - japanese, protracted and severe social withdrawal

HiTOP model (hierarchical taxonomy of psychopathology)

dimensional and hierarchical model that groups problematic symptoms and traits into diagnostic terms, subfactors, and a higher order dimension (tiered structure)

RDoC (Research Domain Criteria model)

dimensional model based on fundamental ideas that emphasize biology (ex. defining psychopathology biologically)

ICD (international classification of diseases and related health)

one section of ICD 10 addresses mental and behavioural disorders

international development and field testing ensure relevance across countries ans populations

free online

ICD-10-CM

USA clinical modification of ICD

ICD diagnostic codes are coordinated w DSM terminology where possible

limitations of DSM and ICD

1) defining abnormality, where is the boundary, what is medicalized

2) diagnostic reliability. clinicians don’t always agree. even if they do doesnt mean diagnosis is valid

3) heterogeneity problems

4) diagnostic validity. why are they seperate disorders when symptoms overlap and bio markers are limited

5) comorbidity and sub-clinical problems

6) categorical vs dimensional differences

eminence based practice

authority, experience, and opinion of practices rather than scientific evidence (bad)

faulty reasoning

argument based on flawed premise, leading to incorrect conclusions

false dilemma

presents only two options when more alt exist

golden mean fallacy

asserts that the most valid or correct position is a compromise or middle ground between two extremes regardless of merit of argument

affirming the consequent

logical fallacy that assumes if the consequence of a condition is true then the condition itself must be true (if a then b. b, therefore a)

appeal to ignorance

a proposition is true because it has not been proven false or false because it has not been proven true

heterogeneity problems

monothetic criteria = everyone must show the same required features

polythetic criteria= different combinations of symptoms can produce same diagnosis

dissemination strategies

efforts to promote therapies that have demonstrated effectiveness in treatment studies to large number of clinician

moderation

occurs when the relationship between two variables changes depending on the level of a third variable known as the moderator

mediation

a situation where the relationship between two variables is explained by a third variable, the mediator

intervention

attempt to decrease or eliminate an undesirable outcome that has already occurred (as opposed to prevention)

classification system

allows for the organization, description, and
relationships of subject matter

purposes of classification/diagnosis

1) lists the essential aspects of a disorder

2) reflects current conceptualization

3) provides a common language for clinicians

4) indicates etiology

5) indicates prognosis (courses and outcomes)

6) informs abt comorbid conditions

7) guides treatment

8) provides key terms for a literature review

9) required for insurance reimbursement and access to special services

DSM

Ensures consistency in diagnosis across different health care settings
and professionals
 Guides clinicians in diagnosing mental health conditions
 Helps in developing treatment plans and understanding prognosis
 Facilitates research on mental health by providing clear definitions
and criteria
 Used to track prevalence and incidence of mental disorders

DSM-5-TR defines mental disorder as

“clinically significant disturbance” in “cognition, emotion regulation, or behaviour” that indicates a
“dysfunction” in “mental functioning” that is “usually associated with significant distress or disability” in work, relationships, or other areas of functioning