Clinical Psychology

15-25% of the exam

Factors of identifying a psychological disorder:

• Abnormal thoughts

• Abnormal feelings

• Abnormal behaviors

Diagnostic and Statistical Manual of Mental Disorders (DSM) + International Classification of Diseases (ICD):

• Specialized Training

• Evidenced-based Practice

• Classification System

It is constantly updating to properly diagnose and evaluate mental disorders

Anxiety Disorders

Excessive fear and/or anxiety with disturbances to behavior

Generalized Anxiety Disorder

Persistent and generalized fear (6 months+).

Symptoms include:

• sleep disturbance (ex: insomnia)

• difficulties concentrating

• excessive worrying

Social Anxiety

Fear of being humiliated, judged, and perceived in a social situation.

Symptoms include:

• blush, sweat, or tremble

• rapid heart rate

• self-conscious

• avoid eye contact or interactions with people they don’t know

• avoid public places

Specific Phobia

Extreme fear of objects or situations.

Symptoms include:

• vertigo

• dizziness

• feeling faint

• intense fear when exposed to phobia

• trouble breathing

• increased heart rate

• sweating

• tight chest/difficulties breathing

Panic Disorder

Unanticipated anxiety attack.

Symptoms include:

• chest/stomach pain

• trembling

• chills

• dizzy

• rapid heart rate

• difficulties breathing

Agoraphobia

Characterized by fearing and avoiding places that might cause feelings of helplessness, embarrassment, and entrapment.

Symptoms include:

• fear

• chest pain from rapid heart rate

• lightheadedness

Post-Traumatic Stress Disorder (PTSD)

Develops after experiencing/witnessing a traumatic experience.

Symptoms include:

• flashbacks - reliving the event

• recurring memories or dreams related to the event

• distressing thoughts

• racing heart or sweating

• physical signs of stress

***plus one avoidance symptom:

• avoiding places/events/objects that remind the individual of the event

• avoiding thoughts or feelings related to the event

Obsessive-Compulsive Disorder (OCD)

A mental disorder characterized by a person experiencing uncontrollable and recurring thoughts (obsessions), engaging in repetitive behaviors (compulsions), or both. The symptoms can be time-consuming and cause significant distress or interfere with a person's ability to function in daily life

Symptoms include:

• Obsessions: repeated thoughts, urges, or mental images that are intrusive, unwanted, and make most people anxious.

  (ex: fear of contamination)

• compulsions: repetitive behaviors a person feels the urge to do, often in response to an obsession.

  (ex: excessive cleaning)

***will experience intrusive thoughts if they do not perform their compulsive rituals that relieve them temporarily.

Hoarding Disorder

A mental health condition characterized by persistent difficulty in discarding or parting with possessions, regardless of their value. This leads to excessive accumulation of items, resulting in severe clutter that interferes with their daily lives due to hazardous living conditions.

Learned Association

Experiencing a fearful event can help you develop a fear and it needs to be reinforced to maintain that fear.

Maladaptive Thinking

Past experiences shape our experiences and influence our interpretations and reactions. We can also develop fears from learning or observing others.

Emotional Response

Anxiety happens when you perceive a sense of helplessness and loss of control.

Bipolar I Disorder

Characterized by having more “ups” than “downs”.

Symptoms include:

• energetic

• easily motivated

• irrational

• impulsive

• easily irritated

• talkative/racing thoughts

• excessive appetite for pleasurable activites

• decreased sleep

• high self-esteem

• occasionally depressed and has low energy

Bipolar II Disorder

Characterized by having more “downs” than “ups”.

Symptoms include:

• fatigue

• sense of hopelessness

• depressed

• uninterested

• unmotivated

• trouble sleeping/sleeping too much

• occasionally has high energy

Depression Disorder

Major depression: symptoms last for at least 2 weeks. Typically interferes with daily functions.

Persistent Depressive Disorder: less severe symptoms that last longer (2 years+). — higher self-harm and suicidal rate

Symptoms include:

• persistent sad, anxious, or empty/numb mood

• hopelessness or pessimism

• irritability, frustration, or restlessness

• loss of interest or pleasure in hobbies or activities

• decreased energy, fatigue, “slowed-down”

• difficulty concentrating, remembering

• difficulty sleeping or oversleeping

• physical pain: aches, cramps, digestive issues

Schizophrenia

Acute (periodically): developed in response to a traumatic event.

Chronic (continuously): symptoms appear in late adolescence to early childhood, and are very active/persistent.

Positive Symptoms:

• hallucinations: false perceptions — see, feel, taste, hear, or smell things that only exist in their heads

• delusions: false beliefs

• disorganized speech

  • word salad: jumble mix of random words/phrases

  • selective attention: speech has no logical order

Negative Symptoms:

• flat affect

  • emotionless

  • monotonous

• catatonic stupor

  • not responding to others or the environment

  • mutism

  • repetitive movements

genes

prenatal conditions

excess dopamine

Dissociative Amnesia

One or more episodes of inability to recall important personal information, usually of a traumatic or stressful nature, that is too extensive to be explained by ordinary forgetfulness.

Fugue: a subtype of dissociative amnesia that often includes some form of unexpected travel.

trauma response (childhood)

fantasy-prone people

Attention-Deficit/Hyperactivity Disorder (ADHD)

Symptoms include:

• inattentive

• hyperactivity

• impulsivity

• can co-exist with learning disorders due to attention span

• can co-exist with temper-prone behaviors due to emotional dysregulation

inheritable

genes

abnormal neural pathways

Cycle of Depression

Depression → fatigue/low energy → decreased activity/not productive → increased guilt, hopelessness, and sadness (rumination/self-helplessness: dwelling on negative thoughts and feelings without actively trying to find solutions or move forward).

Autism Spectrum Disorder

Symptoms include:

• repetitive behaviors

• hypefixation

• social deficiencies

  • lacks social cues, facial expressions, social skills, struggles to connect with others

• sensory issues

• stimming

spectrum of severity: requiring support, requiring substantial support, requiring very substantial support

prenatal

genetic mutation

Paranoid Personality Disorder (PPD) - A

• pervasive and unjustifiable suspiciousness and mistrust of others

• reluctant to confide in or become closer to others

• takes offense to anything

Schizoid Personality Disorder - B

Symptoms include:

• lacks interest and desire to form relationships with others

• emotional detachment

• indifferent to criticism or approval

Emotional detachment causes individual to appear cold and distant which affects ability to form and maintain relationships with others

Schizotypal Personality Disorder - B

Symptoms include:

• eccentric thoughts, perceptions, emotions, speech, and behavior

• shows suspiciousness and paranoia

• unusual perceptual experiences

Antisocial Personality Disorder (APD) - B

Symptoms include:

• continuously violates the rights of others

• lacks sympathy

• antisocial tendencies

• deceitful and manipulative to gain profit or pleasure

Borderline Personality Disorder (BPD) - B

Symptoms include:

• unstable in self-image, moods, and behaviors

• can’t handle chronic feelings of loneliness and emptiness

• unstable and intense relationships with others

• impulsive, unpredictable, and self-damaging behaviors

Histrionic Personality Disorder (HPD) - B

Symptoms include:

• excessively overdramatic, emotional, theatrical, and proactive

• craves attention

• emotions are shallow and shift rapidly

Narcissistic Personality Disorder (NPD) - B

Symptoms include:

• unjustified sense of self-importance

• fantasies of success — believes they are entitled to special treatments

• arrogant attitude and behaviors

• lacks empathy

• manipulative

• self-centered

Avoidant Personality Disorder (APD) - C

Symptoms include:

• overly sensitive to negative evaluations; avoids situations/occupations involving social interactions leading to criticism or rejection (fear)

• avoids relationships with others unless guaranteed to be loved conditionally

• unwilling to take risks or engage in new activites out of fear of embarrassment

Dependent Personality Disorder (DPD) - C

Symptoms include:

• allows others to take advantage of their life; submissive, clingy, separation anxiety

• lacks self-confidence

• can not function and manage one's life without relying on others

  • needs advice or reassurance

  • can not make their own decisions

  • can not do things alone

Obsessive-Compulsive Personality Disorder (OCPD) - C

Symptoms include:

• perfectionism interferes with the ability to do tasks

• preoccupied with details, measurements, order, placement, and schedules

Anorexia

An eating disorder that causes people to obsess about weight and what they eat.

• maintaining a below-normal weight by limiting the amount or type of food they eat and exercising too much

• intense fear of gaining weight

• inability to realistically assess your body weight and shape - body dysmorphia

• feels “overweight” despite a thin body frame

• stomachaches

• never feeling hungry or feeling hungry and getting full right away after eating a small portion

• difficulty concentrating or focusing

• malnourished

• reduced bone mass

• fatigue

Bulimia Nervosa

An eating disorder that causes you to eat large amounts of food at one time (binge) and then get rid of it (purge).

• feeling out of control

• feeling guilty or shameful about eating

• frequent visits to the bathroom, particularly after meals

• preoccupied with body image

• throat and stomach ulcers.

• tooth decay and cavities - stomach acid

• esophagus inflammation

• stomach and intestine damage

• arrhythmia

• heart failure

Deinstitutionalization

Reducing stays at mental institutions and replacing it with community based alternatives.

Psychodynamic Therapy

Believed to help people achieve a healthier lifestyle by releasing the energy devoted to id-ego-supergo conflicts.

Free Association

A psychodynamic therapy method where individuals express thoughts and ideas that come to mind without censorship or self-criticism. — Explores the unconscious material and repressed feelings.

Dream Interpretation

A psychodynamic therapy method that explores how dreams reflect unconscious emotions, thoughts, and feelings, or hidden desires.

Resistance

Clients are reluctant or unwilling to engage with the therapeutic process to avoid confronting painful or difficult emotions or experiences.

Transference

The client redirects feelings and desires from one person to another. It can give insight into current relationships.

Person-Centered Therapy

A humanistic therapeutic technique that creates a supportive and non-judgmental environment where people can express their thoughts and feelings freely. It emphasizes the client's self-directed exploration of their thoughts and feelings in a safe, supportive environment. The therapist's role is to foster a relationship of empathy, acceptance, and genuineness, allowing the client to take responsibility for their own growth and self-understanding.

Active Listening

A humanistic therapeutic technique and communication skill where the listener fully engages with the speaker, seeking to understand their message and emotional state. It involves paying close attention and asking clarifying questions to show engagement in the conversation.

Unconditional Positive Regard

A caring, accepting, supportive, and non-judgmental concept in therapy that values a person without any conditions, regardless of their thoughts, feelings, or behaviors, to help clients develop self-awareness and self-acceptance.

Counterconditioning

Used in therapy for phobias, anxiety disorders, OCD, and addiction. Involves pairing the feared stimulus with something positive or neutral.

Systematic Desensitization

Gradually expose yourself to an anxiety-provoking stimulus to eliminate your fear while in a relaxed state. — Subtype of exposure therapy

Aversive Conditioning

Associates unwanted behavior with an unpleasant feeling. It seeks to condition an aversion to something the person should avoid. — Reverse systematic desensitization

Token Economy

People are rewarded after showing a desired behavior.

Biofeedback

Helps individuals gain voluntary control over their physiological function by using electrical pads, electronics, and other devices. The goal is to help people manipulate their body’s system at will.

Dialectical Behavior Therapy

A talking therapy that helps individuals regulate strong and intense emotions. It aims to help people understand and accept their difficult feelings, learn skills to manage them, and make positive changes in their lives.

Rational-Emotive Behavior Therapy (REBT)

Reconstructing irrational, negative, and self-defeating thoughts and beliefs, replacing them with healthier and more rational ones.

Group Therapy

Therapy that offers support and sharing experiences with others who are facing similar challenges.

Benefits: reduces isolation, provides diverse perspectives, and offers social support.

Family Therapy

Therapy that helps to improve communication, strengthen relationships, and enhance problem-solving abilities within the family.

Antipsychotics

• calms patients with psychoses (hallucinations + delusions)

• blocks dopamine activity due to excess dopamine

• side effect: tardive dyskinesia (involuntary facial movements)

• helps schizophrenia symptoms

• chlorpromazine (thorazine)

Antianxiety

• depresses the central nervous system

• calms anxiety and stress by reducing the symptoms of anxiety, OCD, and PTSD

• affects the gaba receptors

• xanax, ativan, SSNRI (serotonin-norepinephrine reuptake inhibitors)

Antidepressants

• increases the level of serotonin and norepinephrine to elevate arousal and reduce feelings of depression and anxiety

• slow acting due to neurogenesis (the process of generating new neurons, or nerve cells in the brain)

• zoloft and paxil block the reabsorption and removal of serotonin from the synapse

• ketamine: fast acting medication that blocks hyperactive receptors and causes a burst of new synapse with a possible side effect (hallucination)

• SSRI: selective serotonin reuptake inhibitor

Lithium

John Cade discovered that lithium helps with mood swings in 1940 when he administered it to a patient with severe mania and showed improvement in less than a week.

• helps those with bipolar disorder

  • helps with mood swings

Electroconvulsive Therapy (ECT)

Patients received anesthesia and muscle relaxants (to prevent injuries caused by the seizures) before being given 30-60 secs of electrical shocks.

• shock-induced seizures calm neural centers where overactivity produces depression

• “rebooting the cerebral computer”

Transcranial Magnetic Stimulation (TMS)

• pulses surge through a magnetic coil held close to the person’s head while they are consciously awake

• repeated pulses of magnetic energy to the brain to stimulate or suppress brain activity

Psychosurgery

Surgery that removes/destroys brain tissue to decrease “misery” and/or tension

• lobotomy: cutting the nerves connecting the frontal lobes

• side effects: personality changes, intellectual impairment, death, apathy, difficulty concentrating, loss of initiative, a diminished capacity for emotional response, brain infections, seizures, and internal bleeding

Eustress

Positive stress that motivates you.

ex: starting a new job or planning a vacation

Distress

Negative stress that causes mental suffering and overall drains you.

Adverse Childhood Experiences (ACEs)

A broad term encompassing various types of traumatic experiences that occur in childhood, potentially leading to negative health and behavioral outcomes later in life.

Hans Selye General Adaptation Syndrome

• alarm:

  • sympathetic branch of the ans (automatic nervous system) releases cortisol + adrenaline

  • reduced body fat

  • organs shrink and body temperature lowers

• resistance:

  • body tries to restore back to default state to function normally (homeostasis)

  • fatigue, increased metabolism, and difficulty sleeping

• exhaustion:

  • body depleted all resources to repair itself

  • weakened immune system = increased susceptibility to illness and potentially chronic health problems.

Tend-and-Befriend Response

• when faced with a perceived threat, humans rely on others for connection and support

• especially seen in women

Subjective Well-Being

How people experience and evaluate their lives and specific domains and activities.

• happiness

• life satisfaction

• positive affect

• negative affect

Resilience

Ability to adapt well in the face of challenging life experiences, such as trauma, tragedy, or significant stress.

Feel-Good, Do-Good Phenomenon

When we feel good, we engage in more altruistic activities (a voluntary form of prosocial behavior in which individuals aim to increase the well-being of others without expecting anything in return).

Virtues and Strengths in Positive Psychology

• Courage: Emotional strengths that involve the exercise of will to accomplish goals in the face of opposition.

• Humanity: Interpersonal strengths that involve tending and befriending others.

• Justice: Civic strengths that underlie healthy community life.

• Temperance: Strengths that protect against excess.

• Transcendence: Strengths that forge connections to the larger universe and provide meaning.

• Wisdom: Cognitive strengths that involve acquiring and using knowledge.

Problem-Focused Coping

Addressing the situation by solving it.

Emotion-Focused Coping

Addressing/managing the emotional response to a stressful situation rather than trying to solve the problem directly.

Stress Impact on Health

• triggers immune system

• body heals slowly

• body diverts energy from the immune system to the muscle and brain because flight-fight response acts up

Aerobic Exercises v Stress

Helps fight heart disease by strengthening the heart, increasing bloodflow,

keeping blood vessels open, and lowering both blood pressure. May also alleviate depression and anxiety.

Mindful Meditation v Stress and Health

• improves immune system functioning

• become relaxed, self-aware, self-accepting

Relaxation v Stress and Health

• improves compassion

• reduced suffering

• body heals faster