Abnormal Flashcards
(85 cards)
1
Q
Components of disorders
A
- Dysfunction
- Disturbance
- Disability
- Distress
- Violation of norms
- Statistical infrequency
2
Q
Early views
A
- Demonology
- Biological (e.g. excess fluids)
- Bethlehem asylum
3
Q
Paradigm
A
Conceptual framework or general perspective (shapes what people investigate and find)
4
Q
Biological paradigm (explaining)
A
- Mental health legislation
- Classification
- Scientific method
- Medical tech
- Pharmacological and physical treatment
- Reductionist
- Stigma
- Discounts environmental influences
- Side effects of medications
- Medications are not necessarily treating the problems
5
Q
Psychoanalytic paradigm (explaining)
A
- Extremely influential
- Legitimised psychotherapy (talking cure)
- Inspired other models
- No longer top choice
- Untestable central concepts
6
Q
Behavioral paradigm (explaining)
A
• Lead to important developments (behavioural treatment approach)
- Difficult to trace reinforcement history due to complex nature of MHPs
- Neglects cognitive aspect
7
Q
Cognitive paradigm (explaining)
A
• Led to CBT
- Dysfunctional thoughts could be a symptom rather than a cause
- Little insight into the development of such thoughts and beliefs
8
Q
Cognitive-Behavioural paradigm (explaining)
A
Hot Cross Bun Model: Cycle between thoughts, behaviour, physical response and feelings (links to specific situation and environment)
9
Q
Humanistic paradigm (explaining)
A
- Lead to widely used therapeutic approach
- Evaluations of own behaviour well described
- Overly optimistic
- Difficult to evaluate some concepts
10
Q
Aims of treatment
A
- Relief from distress
- Self awareness and insight
- Coping and problem solving skills
- Identify and resolve underlying causes
11
Q
Treatment is affected by:
A
- Theoretical orientation and training of practitioner
2. Nature of psychopathology
12
Q
Features of treatment
A
- Instilling hope
- Gaining new perspective
- Genuine empathy
- Trusting, caring relationship
- Clear and positive communication
13
Q
Drug treatment
A
- Antidepressants
- Antipsychotic
- Anxiolytic
14
Q
Psychodynamic treatment
A
- Free association
- Transference
- Dream analysis
15
Q
Humanistic treatment
A
- Enable acceptance of responsibility
- Faster awareness of subjective experiences
- Fulfill potential for personal growth
16
Q
Person-centred treatment
A
- Congruence
- Empathy
- Positive regard
17
Q
Cognitive-behavioural treatment
A
- ABC model
- REBT
- Beck’s cognitive therapy
18
Q
Diagnosis
A
Classification of symptoms and signs of disorders
- Important for: treatment, good clinical care
- Correct diagnoses can be used for: description of base rates, causes, treatments
19
Q
Emil Kraepelin
A
- First use of classification systems
- Dementia praecox: chemical imbalance
- Manic-depressive psychosis: irregular metabolism
20
Q
Negatives of diagnosis
A
- Worry of others knowing
- Fear of another episode
- Stigma (but Lilienfeld et al. (2010) found that labelling reduced stigma because disorder was seen as an explanation for certain behaviour)
- Categorization and losing sight of uniqueness
21
Q
Positives of diagnosing
A
- Some are comforted by diagnosis (used to cope and explain)
- Paves a way to take steps to deal with problems
- Helps with referrals and communication between different professionals
- Helps to allocate funding for research etc.
22
Q
ICD-10
A
- Expanded to include mental disorders in 1948
* Mental and behavioural disorders in Chapter V (codes F00-F99)
23
Q
DSM-5
A
- Section I: introduction
- Section II: diagnostic criteria and codes
- Section III: emerging measures and models, cultural aspects, future research
24
Q
Aim of clinical assessment
A
Chart cognitions, emotions, personality, behavior
25
Uses of clinical assessment
- Diagnosis
- Therapeutic intervention
- Monitor effects of treatment
- Research
26
Clinical interviews
Interpersonal encounter to gather information
* Unstructured nature
* Interviewer bias
* Reliability
* Merit of information provided by client
27
General psychological tests
* Rigid response requirements
* Rigorously tested
* Standardization
* Assess client specific traits
28
Personality inventories
* Utility of validity scales: clinical validity
* Internal reliability
* Time consuming to administer
29
Specific inventory
* Useful research tool
* Some good psychometric properties
* Diagnostic and theoretical value
* Some underdeveloped
* Many fail to have validity scales
30
Projective tests
e.g. Rorschach inkblot test, thematic apperception test, sentence completion test
* Use over the years has declined (link to psychodynamic approach)
* Cultural bias traditionally
* Reliability
* Clinical training
* Can infer pathology in absence of other evidence
31
Intelligence and neurological impairment tests
* Intelligence is a construct- concept too narrow
* Cultural bias
* Measurement of capacity to learn?
32
Biologically based assessments
* Allows assessment of contextual factors
* Ecologically valid
* Provides workable solutions
* Provides supplementary info
* Overcomes recall bias
* Time consuming
* Observer effect and expectations
* Inter-observer reliability
33
Anxiety disorders
* Excessive aroused state (apprehension, uncertainty, fear)
* Out of proportion, constant, distressful
* Characteristics: physiological, cognitive biases, dysfunctional beliefs, specific early experiences
34
Specific phobias definition
Excessive, unreasonable, persistent fear triggered by specific object or situation
35
Specific phobia etiology
* Psychoanalytic: defence by id; symbolic relevance of fear; avoiding confrontation with actual issue
* Behavioural: classical conditioning
* Evolutionary: biological preparedness
* Risk factors: genetic vulnerability, neuroticism, negative cognition, propensity towards fear conditioning
* Multiple: mix of classical conditioning, disgust, misinterpretation of bodily sensation
36
Panic disorders definition
* Panic attacks, not specifically explained by specific situation
* Anxiety about recurrent panic attack
37
Panic disorders etiology
* Neurobiological: Importance of locus coeruleus in fear circuit (source of norepinephrine; related to stress)
* Classical conditioning: conditioning of anxiety (anticipatory) leads to panic attacks (actually in progress) as response
38
Panic disorder treatment
* Tricyclic antidepressants and benzodiazepines
* CBT
* Typical programme includes: education, breathing training, cognitive restructuring therapy, interoceptive exposure, prevention of safety behaviour
39
OCD key features
* Repetitive, intrusive, uncontrollable thoughts or urges (Obsessions)
* Repetitive behaviours or mental acts that the person feels compelled to perform (Compulsions)
40
OCD etiology
* Inflated responsibility
* Thought suppression
* Cognitive-Behavioural
41
OCD perspectives
* Psychoanalytic: ego trying to fend off anxiety through compulsions; reaction formation
* Behavioural: operant response through negative reinforcement
* Cognitive: compulsions help to gain sense of control
42
OCD treatments
* Exposure and ritual prevention
* CBT
* SSRIs
43
Depression
Characteristics:
- Feelings
- Behavioural symptoms
- Motivational deficits
- Cognitive features
- Physical symptoms
44
MDD diagnosis
5 or more out of 9:
- Depressed mood
- Diminished interest or pleasure
- Significant weight loss or gain
- Insomnia or hypersomnia
- Fatigue
- Feeling worthless
- Low ability to concentrate or think
- Thoughts of death or suicide
45
MDD Psychodynamic perspective
* Response to loss of loved one or symbolic loss
| * Led to introjection: regression and directing feelings to self
46
MDD Behavioral perspective
* Lack of appropriate positive reinforcement
| * Reassurance seeking can increase eliciting of negative responses from others
47
MDD Social perspective
* Link to interpersonal difficulties: withdraw, irritable, no joy from interacting with others
* Childhood adversity
* Negative life event
48
MDD Cognitive perspective
* Beck: biased ways of thinking; negative triad
* Learned helplessness and attribution
* Hopelessness theory
* Rumination theory
49
MDD Biological perspective
* Genetics
* Low serotonin and norepinephrine
* Overactivity of HPA axis
* Low striatum activity
50
MDD treatment
* Drugs
* Electro convulsive therapy
* Social skills training
* Behavioral activation
* Cognitive therapy
* Mindfulness based cognitive therapy
51
Bipolar
Bipolar I: needs manic and depressed
Bipolar II: hypomanic instead of manic
Cyclothymic: not manic or depressed to same extent but chronic
52
Bipolar etiology: Biological
* Genetics
* Serotonin and dopamine receptors
* High striatum activity
* Heightened amygdala activity
53
Bipolar etiology: Social
* Reward sensitive
| * Sleep deprivation
54
Bipolar treatments
Lithium carbonate
55
Schizophrenia
Characterized by disordered thinking, in which ideas are not logically related; faulty perception and attention; lack of emotional expressiveness; and disturbances in behaviour
56
Psychotic symptoms
1. Distortions of perception and reality
2. Disorganized speech and thought
3. Disorders of motor behaviour
57
Schizophrenia positive symptoms
- Delusions
| - Hallucinations
58
Schizophrenia negative symptoms
- Avolition: motivation
- Asociality: relationships
- Anhedonia: pleasure
- Blunted affect: emotional display
- Alogia: speech
59
Schizophrenia disorganized symptoms
- Disorganized speech
| - Disorganized behavior
60
Course of schizophrenia
Prodromal (pre) > Active (full-blown symptoms) > (50% go back and forth) < Residual (gradual recovery; cease to show positive symptoms)
61
Schizophrenia etiology: Diathesis-stress
Interaction between genes (biological predisposition) and environment (environmental stresses)
62
Schizophrenia etiology: Biological
- Genetics
- NTs
- Enlarged ventricles
63
Schizophrenia etiology: Psychodynamic
* Freud: regression to ego state and primary narcissism
| * Schizophrenogenic mother who is cold rejecting, distant and dominating
64
Schizophrenia etiology: Person-centered
Loss of ability to differentiate between self and non-self leads to becoming disorientated and passive
65
Schizophrenia etiology: Behavioral
* Psychotic behaviours may be rewarded through operant reinforcing
* Explains maintenance well but not acquisition
66
Schizophrenia etiology: Familial factors
* Communication deviance
| * High expressed emotions
67
Schizophrenia treatment
* Social skills training
* Family based programs
* CBT
* Antipsychotic drugs
68
Personality disorders
Fixed, ingrained, pervasive way of dealing that deviate from cultural expectations and cause disruption and hardship
69
Cluster A: Odd/eccentric
* Schizotypal
* Paranoid
* Schizoid
70
Cluster B: Emotional/ dramatic/ erratic
* Antisocial
* Borderline
* Histrionic
* Narcissistic
71
Cluster C: Anxious/ fearful
* Avoidant
* Dependent
* Obsessive compulsive
72
BPD
* Intense emotionality
* Unstable identity, self image, interpersonal relationships, affects
* Impulsivity
73
BPD conceptualization and treatment
1. Lack of direction: general equivalence diploma examination
2. Feelings of depression or anxiety-provoking situations: cognitive therapy- mood diary; compare actual outcome with best, worst and most likely
3. Poor impulse control: time delay procedures
4. Excessive and poorly controlled anger: time delay procedures
74
BPD etiology: Social
- Childhood abuse, neglect, rejection
- Inconsistent or loveless parenting
- Parental substance/ alcohol abuse, promiscuity, etc.
- Lack of protective factors
75
BPD etiology: Biological
- More for specific traits
- Genetics
- NTs: serotonin, dopamine
- Deficits in frontal lobe (and connection with amygdala)
- Increased amygdala activation
76
BPD etiology: Psychological
- Object relations theory
- Splitting
- Diathesis-stress theory
77
BPD treatment
- Dialectical behaviour therapy (Linehan)
| - Drugs: anxiolytic, antidepressants, atypical antipsychotics
78
BPS code of ethics and conduct (2009)
1. Respect
2. Competence
3. Responsibility
4. Integrity
79
BACP ethical framework (2016)
1. Being trustworthy
2. Justice
3. Beneficence
4. Autonomy
5. Non-maleficence
6. Self-respect
80
Ethical issues within therapist
- Competence/ diligence
- Fitness to practice
- Personal safety
81
Ethical issues arising through work
- Perceived power balance
- Respect for autonomy
- Contracting and informed consent
- Quality of relationship
- Confidentiality
- Dual relationship
82
Persistent contact from former client
- Nature of contact
- Intrusion of privacy
- Stalking or harassment: assess level of threat
- Examine the end: who decided, referral, door open
- Responsibility to avoid harm for former clients and self too
- Links to BPS code of responsibility (protection) and integrity (personal boundaries)
- Links to BACP framework: Self-respect (care for self)
83
Client with serious suicidal thoughts and feelings
- Establish level of intent
- Links to BPS code of respect (confidentiality), competence (ethical decision making), responsibility (protection)
- Confidentiality
- Client autonomy
- Legality
84
Dual relationships
- Level of involvement
- Type of relationship
- Links to BPS code of competence (ethical decision making), responsibility (termination or continuity of care), integrity (personal boundaries)
85
Ethical decision making if supported by:
* Parameters
* Research evidence
* Legal guidance
* Peer/ supervisor advice
* Guidance from relevant bodies
