Clinical Psychology: Psychological Disorders

Clinical Psychology Overview

  • Clinical Psychology: Field focused on psychological disorders.

  • Psychopathology: Study of psychological disorders.

Definitions of Psychological Disorders

  • Psychological Disorders: Persistently harmful thoughts, feelings, and actions that are:

    • Deviant: Deviates from social norms within a culture.

    • Distressful: Unpleasant or upsetting to the individual or others.

    • Dysfunctional: Interferes with daily life functioning.

DSM-5-TR (Diagnostic and Statistical Manual of Mental Disorders)

  • Structured Clinical Interview: Conducted with patients about behaviors and symptoms.

  • Diagnosis: Based on consensus on clusters of symptoms in 20 categories (e.g., Depressive Disorders, Anxiety Disorders).

  • Benefits:

    • Facilitation of research and treatment.

  • Drawbacks:

    • Stigma associated with labels and viewing disorders as fixed.

Diathesis-Stress Model

  • Model Overview: Psychological disorders arise from a combination of inherent vulnerability (diathesis) and environmental stressors.

  • Graph Overview: High vs. low levels of stress affecting disorder manifestation.

Medical Student Syndrome

  • Phenomenon: Medical students report symptoms of diseases they study, similarly psychology students may experience symptoms of psychological disorders.

Anxiety-Related Disorders

Generalized Anxiety Disorder (GAD)

  • Characteristics:

    • Unrealistic, excessive, persistent anxiety not linked to a specific situation.

  • Symptoms:

    • Emotional: Tension, nervousness.

    • Physical: Racing heart, shaking.

    • Cognitive: Bias towards negative information, difficulty focusing.

Who and Why? (GAD)

  • Lifetime Prevalence: 5%, more common in women.

  • Genetics: Moderately heritable (~30-40%).

  • Triggers: Stress convergence, fear of loss of control.

Panic Disorder

  • Characteristics:

    • Discrete instances of fear without predictable context; includes strong physical symptoms like heart palpitations and nausea.

Who and Why? (Panic Disorder)

  • Lifetime Prevalence: 4%, more frequent in women.

  • Age of Onset: 18-34 years.

  • Heritability: 30-40%. Patients uniquely interpret physiological responses as catastrophic.

Obsessive-Compulsive Disorder (OCD)

  • Characteristics:

    • Obsessions: Unwanted, persistent thoughts (e.g., contamination).

    • Compulsions: Compelled actions to relieve anxiety (e.g., checking, cleaning).

Who and Why? (OCD)

  • Lifetime Prevalence: 2%, similar rates across genders, often arises in adolescence.

  • Heritability: 40-50%. Related to brain activity changes involving glucose consumption.

Anxiety Treatment Strategies

  • Therapy Options:

    • Relaxation techniques (important for panic disorder).

    • Systematic Desensitization / Exposure Therapies.

    • Cognitive-Behavioral Therapy.

  • Medications:

    • Xanax, Prozac: Reduce CNS activity.

Mood-Related Disorders

Major Depression

  • DSM-5 Criteria:

    1. Depressed mood.

    2. Loss of interest in activities.

    3. Significant changes in weight/appetite.

    4. Sleep disturbances.

    5. Severe psychomotor changes.

    6. Fatigue.

    7. Feelings of worthlessness/guilt.

    8. Impairment in thinking or decision-making.

    9. Suicidal thoughts/actions.

Who and Why? (Major Depression)

  • Lifetime Prevalence in Canada: 12%, more common in women.

  • Onset: Often between 15-19 years.

  • Heritability: 40-50%. Involvement of neurotransmitters such as norepinephrine and serotonin.

Bipolar Disorder

  • Characteristics: Alternates between episodes of depression and mania.

    • Mania: High energy and activity, potential irritability, inflation of self-esteem.

Who and Why? (Bipolar Disorder)

  • Lifetime Prevalence: 2%, typically manifests in adolescence or early adulthood.

  • Heritability: 70-90%.

Mood Disorder Treatments

  • Medications:

    • Antidepressants (e.g., Prozac) for depression.

    • Lithium carbonate for bipolar disorder.

  • Alternative Treatments:

    • Aerobic exercise, Cognitive-behavioral therapy, Electroconvulsive therapy.

Schizophrenia

  • Definition: Involves disorganized and delusional thinking, disturbed perceptions; not multiple personalities.

  • Features:

    • Thought disturbances, Delusional thinking, Hallucinations, Emotional disturbances.

  • Positive Symptoms: Added experiences that others do not have (e.g., hallucinations).

  • Negative Symptoms: Absence of things that others have (e.g., flat affect).

Who and Why? (Schizophrenia)

  • Prevalence: ~1% of the population.

  • Heritability: 80%.

  • Environmental Influences: Prenatal conditions, birth complications.

Neurological Changes in Schizophrenia

  • Dopamine hypothesis: Excessive dopamine activity; medications often target dopamine receptors.

Treatments for Schizophrenia

  • Antipsychotic medications: Treat psychosis symptoms, but can have significant side effects.

Personality Disorders

  • Overview: Longstanding, pervasive behavior patterns that deviate from norms.

  • Clusters:

    • Cluster A: Odd or eccentric behaviors (e.g., Paranoid, Schizoid).

    • Cluster B: Dramatic or erratic behaviors (e.g., Antisocial, Borderline).

    • Cluster C: Anxious or fearful behaviors (e.g., Avoidant, Obsessive-Compulsive).

  • Histrionic Personality Disorder: Manipulative, attention-seeking behavior.

  • Borderline Personality Disorder: Instability in mood and relationships, impulsivity.

  • Antisocial Personality Disorder: Violation of rights, deceitful behavior.