Clinical Psychology

Intro to Psych

what is clinical psychology?

research focused on understanding, assessing and treating mental behavioural health problems

it combines practice, consultation, education and research

what is mental health?

our emotional, psychological and social well-being

a state in which individuals realise their abilities, cope with everyday stresses, work productively and contribute to their communities

focus on functioning well and maintaining balance

what is mental disorder?

a clinically significant disturbance in an individual’s cognition, emotional regulation or behaviour

usually associated with distress or impairment in important areas of functioning

APA definition of mental disorder

clinically significant disturbances in cognition, emotion regulation or behaviour

reflects dysfunction in psychological, biological or developmental processes

significant distress or disability in social, occupational or other important activities

what is the continuity/ dimensionality approach?

psychological difficulties likely exist on a spectrum and vary in terms of frequency, severity and levels of distress

individuals can move across the continuum depending on stress, support or life circumstances

the historical context of aetiology (cause) and treatment?

early beliefs (pre 17th century): mental illness was largely seen as a result of supernatural forces/ demonic possession. treatment to release spirits was known as trephination of the skull

17th-18th century: rise of asylums, such as Bethlem Hospital, which emphasised containment rather than treatment

19th century: reform and humanitarian movements. growing awareness of the poor asylum conditions, leading to more advocacy for humane care

psychodynamic: hidden, unresolved conflicts in the unconscious mind, the consequences of repressed traumatic circumstances. psychoanalysis, dream analysis

behaviourism: mental disorders arise as a result of learning processes, conditioning rather than inner conflict

cognition: dysfunctional cognitions underlie mental disorders, distorted thinking and maladaptive beliefs

biology: genetic components, neurochemical imbalance, brain structure and function

20th century: the Biopsychosocial model, regarded as the dominant framework for psychiatry and medicine

what is the diathesis stress model?

underlying vulnerability/ predisposition + stress = mental disorder

what are classification systems?

a comprehensive list of disorders, with a description of the symptoms of each disorder and guidelines for assigning individuals to a disorder

what is each disorder assumed to have its own of?

origins

symptoms

course and outcomes

the ICD?

the global standard for classifying all health conditions

predominately used by the NHS

the DSM?

focuses exclusively on mental disorders with detailed diagnostic criteria for each condition

mainly used in the USA

symptoms vs syndrome?

symptoms: a single sign or experience of illness. on its own, a symptom does not necessarily indicate a specific disorder, because many symptoms occur across different conditions

syndrome: a collection or pattern of symptoms that tend to occur together. when these cluster in a recognisable way, they can point towards a particular disorder

benefits of diagnostic classification for clinicians?

quickly identify potential aetiology, likely course of disorder, potentially suitable and effective treatments, creates a common language to discuss psychological disorders, creates structure to mental health services

benefits of diagnostic classifications for individuals?

increases understanding go what is happening to them and why, normalises their experience, identifies helpful treatments, identifies person as ‘unwell’ so they can seek help, be exempted from certain activities and removes blame

what are the limitations of diagnostic classification?

culturally biased

oversimplified

stigma

no shades of grey (individuals either meet or do not meet the criteria, how do you define cut offs?)

depression?

approx 332 million people in the world have depression

more women are affected by depression

can lead to suicide

what is the diagnostic criteria for depression?

5 or more of the following symptoms present over a 2 week period, at least one must be a depressed mood, or loss of interest/ pleasure

depressed mood for most of the day

diminished interest or pleasure in all activities

significant weight loss/ gain

insomnia or hypersomnia

psychomotor agitation (restlessness)

fatigue or loss of energy

feelings of worthlessness or excessive or inappropriate guilt

diminished ability to think/ concentrate

recurrent thoughts of death, recurrent suicidal ideation without a plan, suicide attempt or specific plan for suicide

generalised anxiety disorder?

panic disorder, social anxiety disorder, separation anxiety disorder, selective mutism

persistent and excessive worrying about daily activities/ events

4.4% of global population experience

what is the diagnostic criteria for GAD?

excessive anxiety/ worry that occurs most days for at least 6 months, individuals find it difficult to control the worry. anxiety and worry are associated with 3 symptoms

restlessness/ feeling on edge

easily fatigued

difficulty concentrating/ mind going blank

irritability

muscle tension

sleep disturbance

specific phobias?

type of anxiety disorder

specific to an object/ situation

often developed during adulthood

what is the diagnostic criteria for specific phobias?

fear, anxiety or avoidance must be persistent for 6 months or more

phobic stimulus provokes immediate fear/ anxiety

disproportionate reaction to danger posed

actively avoided/ endured with intense anxiety

fear, anxiety to avoidance causes clinical significant distress or impairment in social, occupational or other important areas of functioning

OCD?

affects 1-3% of the global population

classified as an anxiety disorder

comprised of obsessions and compulsions

obsessions: recurrent intrusive thoughts, images or impulses. distressing and unwanted even when recognised as irrational, usually accompanied by intense feelings of fear, disgust, or doubt

compulsions: repetitive behaviours/ thoughts to neutralise the obsession, they are time consuming

what is the diagnostic criteria for OCD?

obsessions, compulsions or both

obsessions defined as recurrent and persistent that are experienced as intrusive, unwanted and causing marked anxiety/ distress

compulsions defined as repetitive behaviours or mental acts that are in response to obsessions

o’s and c’s are time consuming or cause clinically significant distress

disturbance are nit better explained by another mental disorder

what is cognitive behavioural therapy?

psychotherapy

maladaptive cognitions, emotions and behaviours reinforce cycle of distress

cognitive behavioural model: event- cognition- emotion

techniques: thought diaries, cognitive restructuring, exposure and response prevention, behavioural activation, behavioural experiments

what is exposure therapy?

based on principles of classical conditioning (behaviourism)

paced in various ways: graded exposure, flooding, prolonged, systematic desensitisation

effective in many ways: habituation, extinction, self-efficacy, emotional processing