Mental & Physical Health Practice Flashcards

Defining and Classifying Psychological Disorders

Clinical Psychology: Defined as the branch of psychology that assesses, diagnoses, treats, and prevents mental, emotional, and behavioral disorders. It utilizes various therapeutic methods and interventions to improve individuals' mental health and well-being.
Psychology Student Syndrome: A phenomenon where psychology students studying abnormal behavior become convinced they have a mental disorder. * Warning: Students should not attempt to diagnose friends, family, themselves, or acquaintances. Proper diagnosis requires comprehensive assessment and professional certification. * Overgeneralization: Students should avoid assuming they understand all aspects of a disorder based on limited classroom knowledge; real-life cases are more complex. * Oversimplification: Mental health issues and treatments are multifaceted; effective treatment plans are personalized. * Privacy: Disclosing personal or family mental health information during class should be avoided to maintain boundaries.
The Criteria for Psychological Disorders (The 3 D's): Behavior might be considered psychologically disordered if it is: 1. Deviant: Abnormal behavior, thoughts, and emotions that differ markedly from a society’s ideas about proper functioning. Behavior is categorized as different, extreme, unusual, or bizarre. * Example: An individual engaging in animated, loud public conversations with invisible entities daily, despite feedback that it is disruptive and unusual. 2. Distressing: The reporting of internal pain and discomfort associated with emotions, thoughts, or behaviors. * Example: Intense, prolonged periods of fear and anxiety disproportionate to actual events, accompanied by heart palpitations, leading to feelings of hopelessness and social avoidance. 3. Dysfunctional: Interfering with the ability to conduct daily activities constructively. This includes an inability to care for oneself, participate in social interactions, or work productively. * Economic Impact: Across the $\text{U.S.}$ economy, serious mental illness causes $\$193.2\,\text{billion}$ in lost earnings each year. * Example: A person spending hours daily on rituals like checking door locks, consistently causing lateness for professional and social engagements.
Stigma: The negative stereotypes and social disapproval directed at individuals with mental disorders. This often leads to discrimination and barriers to care. Consequences include: * Discrimination: Unfair treatment and reduced opportunities. * Social Isolation: Others avoiding or shunning the individual. * Employment Challenges: Perceptions of lower competence in hiring or promotions. * Worsening Mental Health: Increased feelings of shame and hopelessness. * Reluctance to Seek Help: Fear of being labeled or judged. * Reduced Self-Esteem: Diminished self-worth from internalizing stereotypes. * Limited Access to Resources: Reduced funding for services and research. * Harassment and Violence: Becoming targets of verbal or physical abuse.

Diagnostic Systems and Models

Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR): A comprehensive classification system used by mental health professionals to diagnose and categorize mental disorders. It provides standardization for diagnosis. * Criticisms: It is criticized for "casting too wide a net" (e.g., Disruptive Mood Dysregulation Disorder) and for being too subjective regarding percentage differences in symptoms.
International Classification of Diseases (ICD): A classification system for medical diseases published by the World Health Organization ( $\text{WHO}$ ) containing a section for mental health disorders. * It is used by most countries outside of the $\text{U.S.}$ and serves as the basis for the $\text{DSM}$ .
Diathesis-Stress Model: Emphasizes that the development of mental disorders is the joint action of genetic predisposition (diathesis) and environmental stress. * Combinations: 1. Low predisposition-low stress. 2. Low predisposition-high stress. 3. High predisposition-low stress. 4. High predisposition-high stress.
Biopsychosocial Model: The perspective that biological, psychological, and social-cultural factors all interact to produce specific psychological disorders.

Neurodevelopmental Disorders

Definition: A group of disorders beginning in the developmental period, characterized by symptoms affecting behavior, learning, and development, specifically looking at age-appropriate maturity levels.
Attention-Deficit/Hyperactivity Disorder (ADHD): Characterized by persistent patterns of inattention and/or hyperactivity-impulsivity that interfere with functioning or development. * Symptoms: Difficulty maintaining focus, starting projects without finishing them, interrupting others, impulsive decision-making (e.g., large purchases), and a chaotic home environment.
Autism Spectrum Disorder (ASD): Characterized by persistent challenges in social communication and interaction, along with restricted, repetitive patterns of behavior, interests, or activities. * Symptoms: Struggling with eye contact, not responding to one's name, distress at unexpected changes in routine, and intense focus on specific interests (e.g., trains, historical dates). * Notes: Individuals may possess exceptional abilities in their area of specific interest.

Schizophrenia Spectrum Disorders

Definition: Disorders characterized by psychosis (disconnection from reality), involving delusions, hallucinations, disorganized thinking/speech, and negative symptoms.
Positive Symptoms (Inappropriate behaviors present): * Delusions: False beliefs strongly held despite contrary evidence. * Delusions of Persecution: Believing one is being targeted or harassed. * Delusions of Grandeur: Belief in exceptional abilities, wealth, or fame. * Delusions of Reference: Believing hidden messages are sent via media (newspaper, $\text{TV}$ , etc.). * Hallucinations: False sensory experiences without external stimuli. Auditory hallucinations (hearing voices) are most common. * Disorganized Thinking/Speech: Incoherent speech patterns. "Word salad" refers to a jumble of words lacking logical connection. * Disorganized Motor Behavior: Erratic movements or bizarre postures. * Catatonia (Excitement): Purposeless motor activity or agitation.
Negative Symptoms (Appropriate behaviors absent): * Flat Affect: Severe reduction in emotional expressiveness (monotonous voice, lack of facial expressions). * Alogia: Reduced speech output. * Anhedonia: Inability to experience pleasure. * Avolition: Lack of motivation to perform self-directed activities (e.g., self-neglect). * Catatonia (Stupor): Lack of movement or response to the environment.
Cognitive Symptoms: Poor executive functioning, trouble focusing, and working memory problems.
Anosognosia: A “lack of insight,” where the person is unaware they have the illness.
Etiology (Causes): * Genetics: Researchers estimate $\text{79\%}$ of schizophrenia risk is genetic. * Environmental: Prenatal exposure to the flu or famine, obstetric complications, or childhood psychosocial stress. * Brain Structure: Decreased thalamus size may lead to hallucinations; abnormalities in the medial temporal lobe and hippocampus affect focus and regulation. * Dopamine Hypothesis: Suggests the disorder is linked to an imbalance (excessive activity) of dopamine in the brain.

Anxiety and Related Disorders

Generalized Anxiety Disorder (GAD): Persistent, uncontrollable worry about daily life for $\text{6\,months}$ or more. * Characteristics: "Free-floating anxiety" with no definite trigger. Physical symptoms include jitteriness, sleep deprivation, furrowed brows, and trembling due to autonomic nervous system arousal. $\text{2/3}$ of diagnosed individuals are women. It is rare after age $\text{50}$ .
Specific Phobia: Intense, irrational fear of a specific object or situation. * Acrophobia: Persistent fear of heights. * Arachnophobia: Irrational fear of spiders.
Agoraphobia: Intense fear of being in situations where escape might be difficult or help unavailable (e.g., crowds, public transportation).
Panic Disorder: Recurrent, unexpected panic attacks (sudden episodes of intense fear peaking within minutes). * Affects approximately $\text{3\%}$ of the population. * Symptoms: Heart palpitations, dizziness, sensations of choking, derealization (unreality), and depersonalization (detachment from oneself).
Social Anxiety Disorder: Persistent fear of social situations where scrutiny or embarrassment might occur.
Culture-Bound Anxiety Syndromes: * Ataque de nervios: "Attack of nerves" observed in Caribbean/Iberian backgrounds; involves screaming, crying, and physical shaking during family stress. * Taijin Kyofusho (TKS): Fear of offending or embarrassing others through one's appearance or bodily functions; common in Japanese and Korean cultures.
Obsessive-Compulsive Disorder (OCD): Characterized by obsessions (recurrent unwanted thoughts) and compulsions (repetitive behaviors performed to reduce anxiety). * Common Obsessions: Fear of contamination, need for symmetry, intrusive violent thoughts. * Common Compulsions: Excessive washing, repeated checking (locks/stoves), ordering items.
Hoarding Disorder: Persistent difficulty discarding possessions regardless of value, leading to cluttered, unusable living areas.

Depressive and Bipolar Disorders

Major Depressive Disorder (MDD): Classified by the presence of at least $\text{5}$ of $\text{9}$ symptoms over a $\text{2-week}$ period. * Symptoms: Depressed mood, diminished interest (anhedonia), significant weight change, insomnia/hypersomnia, fatigue, feelings of worthlessness, recurrent thoughts of death.
Persistent Depressive Disorder (Dysthymia): Chronic depressed mood lasting for at least $\text{2\,years}$ , where symptoms are less severe but longer-lasting than $\text{MDD}$ .
Bipolar I Disorder: Characterized by at least one full manic episode. * Mania Symptoms: Euphoria, decreased need for sleep (rested after $\text{3\,hours}$ ), racing thoughts, inflated self-esteem (grandiosity), and reckless behavior.
Bipolar II Disorder: Characterized by at least one hypomanic episode (lasting at least $\text{4\,days}$ , less severe than full mania) and one major depressive episode.
Etiology/Risk Factors: * Biological: Genetic risk increases if relatives have the disorder ( $\text{1\,in\,2}$ for identical twins with $\text{MDD}$ ; $\text{7\,in\,10}$ for Bipolar). Neurotransmitters involved include Serotonin and Norepinephrine (which is overabundant in mania and scarce in depression). * Social-Cognitive: Negative explanatory style, rumination (overthinking), and magnifying the bad.
Suicide and NSSI: * Suicide Stats: Highest among whites and Native Americans. Men are more likely to end their lives; women are more likely to attempt. Highest rates among ages $\text{45-64}$ and $\text{85+}$ . Highest in April and May. * Nonsuicidal Self Injury (NSSI): More common in adolescent females. Used to find relief from intense negative emotions, attract attention, or relieve guilt.

Dissociative, Trauma, and Eating Disorders

Dissociative Amnesia: Inability to recall important autobiographical information, usually traumatic. * Dissociative Fugue: Sudden, unexpected travel away from home with an inability to recall the past and confusion about personal identity.
Dissociative Identity Disorder (DID): Presence of two or more distinct personality states, resulting in memory gaps. Often associated with severe childhood trauma.
Posttraumatic Stress Disorder (PTSD): Persistent stress following a traumatic event. Symptoms: flashbacks, avoidance of reminders, heightened reactivity (exaggerated startle response), and emotional numbness.
Anorexia Nervosa: Restricted food intake, intense fear of weight gain, and distorted body image. Physical symptoms include hair loss, constant coldness, and cessation of menstrual cycles.
Bulimia Nervosa: Recurrent binge eating followed by compensatory behaviors (vomiting, laxatives, excessive exercise) occurring at least once a week.

Personality Disorders

Definition: Enduring, pervasive, and inflexible patterns of behavior that deviate from cultural expectations, beginning in adolescence/early adulthood.
Cluster A (Odd/Eccentric): * Paranoid: Pervasive distrust and suspicion; interpreting motives as malevolent. * Schizoid: Detachment from social relationships; restricted emotional expression; preference for solitary activities. * Schizotypal: Acute discomfort in close relationships; cognitive/perceptual distortions (e.g., belief in special messages from $\text{TV}$ ); eccentric behavior.
Cluster B (Dramatic/Emotional/Erratic): * Antisocial: Disregard for and violation of the rights of others; lack of remorse. * Psychopath: Nature-based, charming, manipulative, intelligent, organized crimes. * Sociopath: Nurture-based, erratic, volatile, uneducated, spontaneous crimes. * Borderline: Instability in relationships, self-image, and emotions; intense fear of abandonment; impulsivity and suicidal gestures. * Histrionic: Excessive emotionality and attention-seeking; need for approval; dramatic speech with little detail. * Narcissistic: Grandiose sense of self-importance; need for admiration; lack of empathy; sense of entitlement.
Cluster C (Anxious/Fearful): * Avoidant: Social inhibition and hypersensitivity to negative evaluation; desire for connection but paralyzed by fear of rejection. * Dependent: Submissive and clinging behavior; excessive need to be taken care of; difficulty making decisions without reassurance. * Obsessive-Compulsive Personality Disorder (OCPD): Preoccupation with orderliness, perfectionism, and control at the expense of flexibility and efficiency.

Treatment of Psychological Disorders: Principles and Insight Therapies

Deinstitutionalization: The mid-20th-century movement to transition patients from psychiatric hospitals to community-based services. Unintended consequences included homelessness and incarceration due to underfunded community resources.
Ethical Principles: * Nonmaleficence: The principle of "do no harm." * Fidelity: Maintaining trust, honesty, and confidentiality in the therapeutic relationship. * Integrity: Adherence to moral and ethical standards (e.g., using valid assessment tools). * Respect for Rights & Dignity: Honoring privacy and self-determination.
Therapeutic Alliance: The collaborative and trusting relationship between therapist and client, crucial for positive outcomes.
Cultural Humility: Ongoing self-reflection and learning about clients' cultural backgrounds.
Insight Therapies: * Psychodynamic Therapy: Based on Sigmund Freud's premise of unconscious conflicts and repressed memories. * Free Association: Patient speaks freely to uncover unconscious thoughts. * Dream Analysis: Interpreting latent (symbolic underlying) content vs. manifest (storyline) content. * Humanistic/Person-Centered Therapy: Developed by Carl Rogers; non-directive approach. * Unconditional Positive Regard: Attitude of complete acceptance and support. * Active Listening: Fully concentrating, restating, and validating the client’s feelings.

Action Therapies

Cognitive Therapies: Focus on identifying and changing maladaptive or illogical thinking. * Cognitive Restructuring: Replacing negative thoughts with realistic ones. * Cognitive Triad: Negative views of oneself, the world, and the future.
Behavioral Therapy: Based on principles of learning (conditioning). * Applied Behavior Analysis (ABA): Uses reinforcement to improve specific behaviors (e.g., social skills in $\text{ASD}$ ). * Exposure Therapy: Gradually exposing individuals to feared stimuli. * Systematic Desensitization: Created by Joseph Wolpe; uses deep relaxation and an anxiety hierarchy. * Aversion Therapy: Associating unwanted behavior (e.g., smoking) with an unpleasant stimulus (e.g., electric shock). * Token Economy: Earning tokens for desired behaviors that are exchanged for rewards. * Biofeedback: Using electronic monitoring of physiological processes (heart rate, muscle tension) to gain voluntary control over them.
Cognitive-Behavioral Therapy (CBT): An integrative approach combining insight and action. * Dialectical Behavior Therapy (DBT): Focuses on emotional regulation, distress tolerance, and mindfulness. * Rational-Emotive Behavior Therapy (REBT): A directive, confrontational approach to identify and change irrational beliefs for universal self-acceptance.

Biomedical Therapies

Psychopharmacology: Treating symptoms through medication affecting brain chemistry (effectiveness typically upwards of $\text{80\%}$ ). * Antipsychotics: * Typical (e.g., Haldol): Primarily treat positive symptoms; higher risk of Tardive Dyskinesia (involuntary repetitive movements). * Atypical (e.g., Risperdal, Zyprexa, Seroquel, Abilify): Treat both positive and negative symptoms with fewer motor side effects. * Antidepressants: * SSRIs (e.g., Prozac, Zoloft, Celexa, Lexapro): Increase serotonin; well-tolerated. * SNRIs (e.g., Effexor): Increase serotonin and norepinephrine. * NDRIs (e.g., Wellbutrin): Increase norepinephrine and dopamine. * Mood Stabilizers: Lithium is commonly used for Bipolar Disorder. * Antianxiety Drugs: * Benzodiazepines (e.g., Xanax, Valium, Ativan): Quick relief by enhancing $\text{GABA}$ ; habit-forming. * Azapirones (e.g., Buspar): Non-sedative, lower dependency risk, slower onset.
Medical Procedures: * Transcranial Magnetic Stimulation (TMS): Pulsating magnetic coil over the prefrontal cortex; treats depression with minimal side effects. * Electroconvulsive Therapy (ECT): Sending electric currents through the brain to induce a brief seizure. * Used for treatment-resistant or suicidal depression. * Treatment duration: $\text{6-12\,weeks}$ . * Effectiveness: $\text{70-90\%}$ ; benefits may be short-lived. * Psychosurgery: Targeted surgical alteration of brain tissue. * Lesioning: Targeted small damage (e.g., for epilepsy focal points). * Deep Brain Stimulation (DBS): Implanting electrodes for $\text{OCD}$ . * Lobotomy: Severing connections in the prefrontal cortex (historically used for uncontrollable patients, now largely abandoned).

Questions & Discussion

Warm-up Topic 5.3.A: In a study reviewing the $\text{DSM-5-TR}$ to assess reliability and validity by synthesizing findings from numerous existing research sources, what is the research method? * Response: The research method is a meta-analysis, as it involves reviewing and synthesizing data from multiple studies.
Warm-up Topic 5.4.E: In an investigation of Panic Disorder, researchers observed individuals in natural environments (homes, public spaces) to witness panic attacks without any manipulation. * Response: The method used is naturalistic observation, defined by observing participants in their natural environments without intervention.
Warm-up Topic 5.5.A: A study exploring psychodynamic therapy collected data via participant accounts and associations regarding free association during therapy sessions. * Response: The research technique was a survey (using open-ended qualitative data collection).
Warm-up Topic 5.5.D: A study on Virtual Reality Exposure Therapy ( $\text{VRET}$ ) for height phobias used random assignment to a treatment or control group and measured fear levels using assessments. * Response (A): The independent variable is the type of intervention (VRET vs. no treatment). * Response (B): The dependent variable is the level of fear experienced. * Response (C): Confounding variables may include prior therapy exposure, baseline anxiety, or motivation levels.
Warm-up Topic 5.5.G: A study on a new antidepressant used a double-blind procedure where neither participants nor researchers knew who received the medication vs. the placebo. * Discussion (A): The researchers ensured unawareness through a double-blind procedure. * Discussion (B): This approach reduces bias and placebo effects. A limitation is that participants may guess their group if they experience specific side effects, affecting internal validity.