Clinical Psychology Flashcards
(55 cards)
1
Q
Mental disorder/psychopathology
A
Persistent disturbance or dysfunction in behavior, thoughts, or emotions that causes significant DISTRESS and IMPAIRMENT
2
Q
Medical model of mental disorders
A
Like physical illnesses, mental illnesses have biological and environmental causes, defined symptoms, and cures
3
Q
Disorder vs disease vs diagnosis
A
Disorder: common set of signs (OBJECTIVELY observed indicators) and symptoms (SUBJECTIVELY reported thoughts, behaviors, emotions)
Disease: known pathological process affecting the body
Diagnosis: determination of whether a disorder or disease is present
4
Q
The DSM
A
- DSM = Diagnostic & Statistical Manual of Mental Disorders
- Standardization of diagnoses; classification system for each known mental disorder, symptoms/diagnostic criteria, etc
- Most recent release is DSM-5 + DSM-5-TR (test revision)
- Used to use roman numerals to number them but now use arabic numbers so we can do updates to the same version (5.1, 5.2, etc) –> publish updates more frequently instead of every 20 yrs
Drawbacks:
- May feel like “labeling”
- Can be problematic if just “below” the cutoff
- Doesn’t acc for subjective experience (ppl can experience things in different ways)
5
Q
The ICD
A
USA uses DSM but many other countries use WHO’s International Classification of Diseases (ICD)
6
Q
The RDoC
A
- Research Domain Criteria project
- Initiative aiming to guide classification of mental disorders by focusing on underlying processes
- Addresses growing concern that research findings on biopsychosocial factors that appear to cause psychopathology don’t neatly map onto DSM/ICD diagnoses
- Can help explain comorbidity
- Not meant to replace DSM/ICD in any way, but serve as a guide+ inform future revisions
- CONSTRUCT: biopsychosocial processes that, at extremes, can give rise to mental disorders (e.g. fear, anxiety)
7
Q
Biopsychosocial model of causation
A
States that mental disorders are the result of interactoins btw biological, psychological, and social factors
Biological: genetics, epigenetics, chem imbalances, brain structure
Psychological: maladaptive learning + coping, biases, dysfunctional attitudes
Social: poor socialization, stress life experience, cultural and social inequities
8
Q
Diathesis-stress model
A
- Specific theory within biopsychosocial model; DESCRIBES how the biological, psychological, and social factors interact w each other
- States that a person may be predisposed to a psychological disorder that remains unexpressed unless triggered by stress
- Diathesis –> stress –> psychological disorder
Diathesis: the predisposition (e.g. brain structure, hormones, genes)
Stress: the catalyst (e.g. abuse, loss, onset of physical illness)
9
Q
Comorbidity
A
Co-occurrence of 2+ diseases in a person
10
Q
Anxiety disorder
A
- Anxiety is the predominant feature
- Significant comorbidity w depression
11
Q
4 main types of anxiety disorder
A
Phobic disorders, panic disorders, social anxiety disorder, Generalized Anxiety Disorder (GAD)
12
Q
Phobic disorders + 2 main types
A
- Persistent, excessive fear and avoidance of spceific objects, activities, or situations
- Ppl w phobic disorders recognize the fear is irrational but can’t prevent it from interfering w everyday function
- 2 main types: specific and social phobia
13
Q
Specific vs social phobia
A
Specific phobia: irrational fear of particular object or situation that markedly INTERFERES w everyday func
Social phobia: irrational fear of public humiliation or embarrassment
- Could be specific situations like public speaking or eating in public, but could also include general social situations involving interacting w unfamiliar ppl
- Social phobia dependent on subjective experience, not physiological response
14
Q
Preparedness theory
A
- Subtype of diathesis-stress model focusing on fear and phobias specifically
- Ppl evolutionarily predisposed to fear objects we’re supposed to avoid – supported by heritability
- Temperament (e.g. shyness) + neurological factors may also play role
15
Q
Panic disorder & agoraphobia
A
Panic disorder: sudden occurrence of multiple physiological and psychological symptoms that contribute to stark feeling of terror (i.e. panic attacks)
- Acute symptoms can last a few mins and include shortness of breath, heart palpitations, sweating, dizziness
- Occasional panic attack not sufficient for diagnosis; must cause significant dread and anxiety + IMPAIRMENT in person’s life
- Intense anxiety and avoidance related to attack for at least 1 mo
Agoraphobia: specific phobia involving public places
- Often comorbid w panic disorder
- Not frightened of public places themselves but afraid that smthn terrible will happen and they won’t be able to escape or get help
16
Q
Social anxiety disorder
A
Fear of social situations –> worry and diminished day-to-day func
17
Q
Generalized Anxiety Disorder (GAD)
A
- Chronic excessive worry abt everyday things that is out of proportion to the specific cause of worry
- Generalized bc worries aren’t focused on a particular threat
- At least 6 mo of excessive anxiety + symptoms like fatigue, restlessness, irritability, conc problems
- Mild-modest heritability
- Unpredictable experiences in childhood increase risk of developing GAD
18
Q
PTSD
A
- Post-traumatic stress disorder
- Caused by exposure to traumatic event
- Chronic psychological arousal, recurrent unwanted thoughts or images of the trauma, avoidance of things that call the traumatic event to mind for 1+ mo
- Most evident in soldiers returning from war; not everyone develops PTSD –> supports preparedness theory
- Cortical regions: heightened amygdala activity, smaller hippocampus
19
Q
OCD
A
- Obsessive-Compulsive Disorder
- Obsessive thoughts and/or compulsions that seem irrational or nonsensical
- Obsession: intrusive, obsessive thoughts that produce anxiety
- Compulsion: repetitive, often ritualistic behavior to remedy intrusive thoughts; may cause relief, but only temporarily
- Classified separately from anxiety disorders bc researchers believe it has a distinct cause maintained by different neural circuitry than anxiety disorders
- Obsession suppression can backfire
- Take up significant amt of time (1+ hrs/day)
- Cause significant distress or impairment in func
- Moderate-strong heritability
20
Q
Mood disorder
A
- Mood disturbance as predominant feature
- 2 main forms: depression/depressive disorders and bipolar disorder
21
Q
MDD
A
- Major depressive disorder/unipolar depression
- Severely depressed mood and/or inability to experience pleasure
- Must have either depressed mood, anhedonia (reduced pleasure in things that used to cause joy), or both + other symptoms
- Symptoms must last 2+ wks + cause significant distress or impairment in function
22
Q
PDD
A
- Persistent depressive disorder
- Same cog and physiological symptoms as depression; less severe but lasts longer (2+ yrs)
23
Q
Double depression
A
- MDD and PDD co-occur
- Moderately depressed mood that persists for 2+ yrs; punctuated by periods of MDD
24
Q
SAD
A
- Seasonal affective disorder
- Recurrent depressive episodes in a seasonal pattern
- Episodes tend to begin in fall or winter and remit in spring due to lower light lvls in colder seasons
25
Depression biopsychosocial contributing factors
Biological: genetics, neurotransmitters (esp serotonin and NE)
Psychological: negative thoughts contribute to depression
Social: stressful life events, interpersonal factors
26
Caspi et al study on serotonin transporter gene
- Serotonin (5-HT) transporter gene that faciliates serotonin reuptake
- One allele is longer (l), one is shorter (s)
- Gene itself is not related to depression, but it seems to make indivs more sensitive to life stressors (gene x env interaction)
- Study examined s/s, l/l/, and s/l combo of alleles
- As # of stressful life events increased, odds of MD episode increased BUT s/s had much higher prob than l/l
--> shorter allele correlated w depression
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Beck's cognitive model of depression
States that biases in how info is processed and remembered leads to + maintains depression
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Helplessness theory
Ppl prone to depression automatically attribute neg experiences to causes that are:
- INTERNAL (e.g. my bad math grade = I'm stupid)
- STABLE (e.g. I'll always be stupid)
- GLOBAL (e.g. I'll fail in all future life endeavors)
29
Negative schema
- Deeply ingrained neg beliefs abt oneself, the world, etc
- Caused by combo of genetic vulnerability + neg early life events in ppl w depression
- Seeing the world thru "gray glasses"
30
Bipolar disorder
- Cycles of mania and depression
- Manic phase must last 1+ wks to fit DSM reqs
- Depressive phase often indistinguishable from MDD
- Depressive episodes tend to last longer than manic episodes (5mo vs 3mo)
- Has one of the highest rates of heritability
- Can be hard to ID -- risk factors and symptoms also associated w MDD, autism, schizophrenia, and ADHD
- Biological: genetics (twin studies)
- Psychosocial: life stressors + positive life events can lead to more manic episodes
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Bipolar I vs II disorder
Bipolar I: person experiences at least 1 depressive episode and at least 1 manic episode
Bipolar II: person experiences at least 1 depressive episode followed by HYPOMANIC episode -- elevated mood but lower intensity than mania
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Rapid cycling bipolar disorder
- At least 4 mood episodes (either manic/hypomanic or depressive)
- Esp difficult to treat
33
Schizophrenia
Psychotic disorder; characterized by profound disruption of basic psychological processes, distorted perception of reality, blunted emotion, and more
- Diagnosed when 2+ symptoms emerge during continuous period of 1+ mo and signs persist for 6+ mo
- Often has onset from 20-29
- Ppl w schizophrenia do not know their perception is disordered
- 3 types of symptoms: positive, negative, cognitive
- Hereditary + prenatal (e.g. toxins in mom's blood) and perinatal env also affect prognosis
- Social factors include family env and severely disturbed fams
- Dopamine hypothesis: schizophrenia involves excess of DA activity -- largely proven to be inaccurate
- Enlarged ventricles (cavity in brain) -- suggests loss of brain-tissue mass
34
Schizophrenia positive symptoms
- Things ADDED when disease is present
- Hallucinations, delusions, disorganized speech, disorganized behavior
HALLUCINATIONS: false perceptions
- Can involve any of the senses
- ~65% report hearing voices repeatedly -- voices are negative, scolding, etc; can sound like they're internal or external
- Auditory hallucinations accompanied by activation of Broca's area
DELUSIONS: false beliefs that are often bizarre and grandiose but maintained despite irrationality
- Delusions of identity (e.g. person thinks they're Ariana Grande)
- Delusions of persecution (e.g. person believes the CIA is conspiring to harm them)
DISORGANIZED SPEECH: in verbal communication, ideas shift rapidly and incoherently
- Different than Wernicke's aphasia bc they understand the question
DISORGANIZED BEHAVIOR: behavior inappropriate for situation or ineffective in attaining goals
- E.g. childlike silliness, disheveled appearance
- Can also be motor disturbances like strange movements and bizarre grimacing
35
Schizophrenia negative symptoms
- LOSS of normal function
- Anhedonia, amotivation, alogia, flat effect, catatonic behavior
ANHEDONIA: things that used to make you happy don't anymore
AMOTIVATION: no motivation to do the things you like
ALOGIA: decrease in speech + delayed speech response
FLAT EFFECT: flattening of emotion; apathy
CATATONIC BEHAVIOR: marked decrease in all movement; or increase in muscle rigidity
- Ppl in CATATONIA may actively resist movement or become unresponsive/unaware of their surroundings
- Those doing drug therapy might also exhibit moto symptoms as a side effect
36
Schizophrenia cognitive symptoms
- Can be present BEFORE onset of distinct schizophrenia symptoms
- Difficulty w attention, executive func, problem-solving, working memory
- Least noticeable of the symptoms but often plays large role in keep ppl w schizophrenia from achieving high lvl of func (making friends, keeping a job)
37
Psychotherapy
Ineraction btw sanctioned clinician and someone suffering from a psychological problem; VERY broad term
38
Eclectic psychotherapy
Involves drawing techniques from different forms of therapy; very adaptable depending on the client and the problem
39
Psychoanalytic therapy
- Patient does most of the insight
- Main goal of bringing repressed material to the surface
- Focuses on how unconscious thoughts and early childhood experiences influence behavior
- Rooted in Freud
40
Psychodynamic therapy
- Therapist actively works w patient to increase self-awareness
- Emphasis on understanding emotional patterns in real-time (unlike psychoanalytic therapy, which focuses on the unconscious and past)
- Rooted in Freud
41
Existential-humanistic therapy
- Assumes human nature is generally positive
- Emphasizes natural tendency of each indiv to strive for personal improvement
- Assumes that psychological problems stem from feelings of alienation and loneliness
Ex: Person-centered therapy, Gestalt therapy
42
Person-centered therapy
- Type of existential-humanistic therapy
- Therapist tends to be more PASSIVE and just paraphrase the client's words back at them to show support; goal is NOT to uncover repressed conflicts
43
Gestalt therapy
- Type of existential-humanistic therapy
- Therapist ACTIVELY helps client become aware of their own thoughts, behaviors, etc and to take responsibility for them
- Emphasis on stuff occurring at that moment in the therapy session
44
Cognitive behavior therapy (CBT)
- Teach ppl new/more constructive ways of thinking and acting (e.g. was the event really negative, or was it neutral and your interpretation was negative?)
- Often involves homework (e.g. exposure exercises, diary, etc)
- Can be better for long-term than
45
Psychopharmacology
Study of effect of drugs and mind on behavior
46
Antipsychotic medicine
Ex: chlorpromazine/Thorazine for schizophrenia
- Reduces psychotic symptoms (e.g. hallucinations)
- Blocks DA receptor sites + some also affect 5-HT ssystem
- Treats some positive symptoms but not the negative ones
47
Conventional vs atypical antipsychotics + which is more commonly used
Conventional: blocks DA receptors
Atypical: blocks DA AND serotonin receptors
ATYPICAL antipsychotics more commonly used as frontline today; conventional antipsychotics usually involve having to take another medication to address side effects
48
Antianxiety medications
- Drugs that help reduce a person's experience of fear or anxiety
- Commonly benzodiazepines -- class of drugs that increases GABA (primary inhibitory neurotransmitter)
- Doctors are cautious when prescribing bc of potential for abuse
49
Antidepressant medications (4 main types)
MAOIs, TCAs, SSRIs, SNRIs
- Antidepressants not recommended for ppl w BPD bc the antidepressant effect may inadvertently trigger manic episode
1) MAOIs
- Monoamine oxidase inhibitors
- Inhibits enzyme from breaking down neurotransmitters like DA, NE, and serotonin in synapse
2) TCAs
- Tricyclic antidepressants
- Blocks reuptake of NE and serotonin
3) SSRIs
- Selective serotonin reuptake inhibitors
- Inhibits reuptake of serotonin in synaptic cleft
- Can also help treat anxiety and eating disorders
4) SNRIs
- Serotonin & norepinephrine reuptake inhibitors
- Blocks reuptake of NE and serotonin but has less severe side effects than TCAs
50
True or false: antidepressant meds work right away
FALSE
Unlike antianxiety meds, antidepressants can take up to a month to have an effect
51
Mood stabilizers
- Can help suppress swings btw mania and depression in those w BPD
- Can also help w depression
52
Is medication better than psychotherapy or vice versa?
- Not necessarily -- depends on condition being treated
- For schizophrenia, medication is more effective, but for mood and anxiety disorders, meds and psychotherapy can be equally helpful
- One issue is that the 2 treatments are often provided by 2 different ppl --> lots of coordination required btw psychologists and psychiatrists
53
Electroconvulsive therapy (ECT)
- Shocks delivered to brain via electrodes on scalp
- Primarily used to treat severe depression that hasn't responded to medication; has also been shown to be effective in treating BPD
54
Transcranial magnetic stimulation (TMS)
- Powerful pulsed magnet placed over person's scalp to alter neuronal activity
- Can treat depression
- New but exciting -- non-invasive + fewer side effects than ECT, but just as effective
55
Deep brain stimulation (DBS)
- Small battery-powered device implanted in brain to deliver elec stim to specific areas of the brain
- Has worked for severe depression, OCD, and tremor for Parkinson's
