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Third Year Modules > Abnormal > Flashcards

Abnormal Flashcards

1
Q

Components of disorders

A
  • Dysfunction
  • Disturbance
  • Disability
  • Distress
  • Violation of norms
  • Statistical infrequency
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2
Q

Early views

A
  • Demonology
  • Biological (e.g. excess fluids)
  • Bethlehem asylum
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3
Q

Paradigm

A

Conceptual framework or general perspective (shapes what people investigate and find)

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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
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5
Q

Psychoanalytic paradigm (explaining)

A
  • Extremely influential
  • Legitimised psychotherapy (talking cure)
  • Inspired other models
  • No longer top choice
  • Untestable central concepts
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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
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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
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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)

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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
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10
Q

Aims of treatment

A
  • Relief from distress
  • Self awareness and insight
  • Coping and problem solving skills
  • Identify and resolve underlying causes
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11
Q

Treatment is affected by:

A
  1. Theoretical orientation and training of practitioner

2. Nature of psychopathology

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12
Q

Features of treatment

A
  1. Instilling hope
  2. Gaining new perspective
  3. Genuine empathy
  4. Trusting, caring relationship
  5. Clear and positive communication
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13
Q

Drug treatment

A
  1. Antidepressants
  2. Antipsychotic
  3. Anxiolytic
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14
Q

Psychodynamic treatment

A
  1. Free association
  2. Transference
  3. Dream analysis
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15
Q

Humanistic treatment

A
  1. Enable acceptance of responsibility
  2. Faster awareness of subjective experiences
  3. Fulfill potential for personal growth
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16
Q

Person-centred treatment

A
  1. Congruence
  2. Empathy
  3. Positive regard
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17
Q

Cognitive-behavioural treatment

A
  • ABC model
  • REBT
  • Beck’s cognitive therapy
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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
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19
Q

Emil Kraepelin

A
  • First use of classification systems
  • Dementia praecox: chemical imbalance
  • Manic-depressive psychosis: irregular metabolism
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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
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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.
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22
Q

ICD-10

A
  • Expanded to include mental disorders in 1948

* Mental and behavioural disorders in Chapter V (codes F00-F99)

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23
Q

DSM-5

A
  • Section I: introduction
  • Section II: diagnostic criteria and codes
  • Section III: emerging measures and models, cultural aspects, future research
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24
Q

Aim of clinical assessment

A

Chart cognitions, emotions, personality, behavior

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25
Q

Uses of clinical assessment

A
  • Diagnosis
  • Therapeutic intervention
  • Monitor effects of treatment
  • Research
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26
Q

Clinical interviews

A

Interpersonal encounter to gather information

  • Unstructured nature
  • Interviewer bias
  • Reliability
  • Merit of information provided by client
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27
Q

General psychological tests

A
  • Rigid response requirements
  • Rigorously tested
  • Standardization
  • Assess client specific traits
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28
Q

Personality inventories

A
  • Utility of validity scales: clinical validity
  • Internal reliability
  • Time consuming to administer
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29
Q

Specific inventory

A
  • Useful research tool
  • Some good psychometric properties
  • Diagnostic and theoretical value
  • Some underdeveloped
  • Many fail to have validity scales
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30
Q

Projective tests

A

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
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31
Q

Intelligence and neurological impairment tests

A
  • Intelligence is a construct- concept too narrow
  • Cultural bias
  • Measurement of capacity to learn?
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32
Q

Biologically based assessments

A
  • 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
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33
Q

Anxiety disorders

A
  • Excessive aroused state (apprehension, uncertainty, fear)
  • Out of proportion, constant, distressful
  • Characteristics: physiological, cognitive biases, dysfunctional beliefs, specific early experiences
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34
Q

Specific phobias definition

A

Excessive, unreasonable, persistent fear triggered by specific object or situation

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35
Q

Specific phobia etiology

A
  • 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
Q

Panic disorders definition

A
  • Panic attacks, not specifically explained by specific situation
  • Anxiety about recurrent panic attack
37
Q

Panic disorders etiology

A
  • 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
Q

Panic disorder treatment

A
  • Tricyclic antidepressants and benzodiazepines
  • CBT
  • Typical programme includes: education, breathing training, cognitive restructuring therapy, interoceptive exposure, prevention of safety behaviour
39
Q

OCD key features

A
  • Repetitive, intrusive, uncontrollable thoughts or urges (Obsessions)
  • Repetitive behaviours or mental acts that the person feels compelled to perform (Compulsions)
40
Q

OCD etiology

A
  • Inflated responsibility
  • Thought suppression
  • Cognitive-Behavioural
41
Q

OCD perspectives

A
  • 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
Q

OCD treatments

A
  • Exposure and ritual prevention
  • CBT
  • SSRIs
43
Q

Depression

A

Characteristics:

  • Feelings
  • Behavioural symptoms
  • Motivational deficits
  • Cognitive features
  • Physical symptoms
44
Q

MDD diagnosis

A

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
Q

MDD Psychodynamic perspective

A
  • Response to loss of loved one or symbolic loss

* Led to introjection: regression and directing feelings to self

46
Q

MDD Behavioral perspective

A
  • Lack of appropriate positive reinforcement

* Reassurance seeking can increase eliciting of negative responses from others

47
Q

MDD Social perspective

A
  • Link to interpersonal difficulties: withdraw, irritable, no joy from interacting with others
  • Childhood adversity
  • Negative life event
48
Q

MDD Cognitive perspective

A
  • Beck: biased ways of thinking; negative triad
  • Learned helplessness and attribution
  • Hopelessness theory
  • Rumination theory
49
Q

MDD Biological perspective

A
  • Genetics
  • Low serotonin and norepinephrine
  • Overactivity of HPA axis
  • Low striatum activity
50
Q

MDD treatment

A
  • Drugs
  • Electro convulsive therapy
  • Social skills training
  • Behavioral activation
  • Cognitive therapy
  • Mindfulness based cognitive therapy
51
Q

Bipolar

A

Bipolar I: needs manic and depressed
Bipolar II: hypomanic instead of manic
Cyclothymic: not manic or depressed to same extent but chronic

52
Q

Bipolar etiology: Biological

A
  • Genetics
  • Serotonin and dopamine receptors
  • High striatum activity
  • Heightened amygdala activity
53
Q

Bipolar etiology: Social

A
  • Reward sensitive

* Sleep deprivation

54
Q

Bipolar treatments

A

Lithium carbonate

55
Q

Schizophrenia

A

Characterized by disordered thinking, in which ideas are not logically related; faulty perception and attention; lack of emotional expressiveness; and disturbances in behaviour

56
Q

Psychotic symptoms

A
  1. Distortions of perception and reality
  2. Disorganized speech and thought
  3. Disorders of motor behaviour
57
Q

Schizophrenia positive symptoms

A
  • Delusions

- Hallucinations

58
Q

Schizophrenia negative symptoms

A
  • Avolition: motivation
  • Asociality: relationships
  • Anhedonia: pleasure
  • Blunted affect: emotional display
  • Alogia: speech
59
Q

Schizophrenia disorganized symptoms

A
  • Disorganized speech

- Disorganized behavior

60
Q

Course of schizophrenia

A

Prodromal (pre) > Active (full-blown symptoms) > (50% go back and forth) < Residual (gradual recovery; cease to show positive symptoms)

61
Q

Schizophrenia etiology: Diathesis-stress

A

Interaction between genes (biological predisposition) and environment (environmental stresses)

62
Q

Schizophrenia etiology: Biological

A
  • Genetics
  • NTs
  • Enlarged ventricles
63
Q

Schizophrenia etiology: Psychodynamic

A
  • Freud: regression to ego state and primary narcissism

* Schizophrenogenic mother who is cold rejecting, distant and dominating

64
Q

Schizophrenia etiology: Person-centered

A

Loss of ability to differentiate between self and non-self leads to becoming disorientated and passive

65
Q

Schizophrenia etiology: Behavioral

A
  • Psychotic behaviours may be rewarded through operant reinforcing
  • Explains maintenance well but not acquisition
66
Q

Schizophrenia etiology: Familial factors

A
  • Communication deviance

* High expressed emotions

67
Q

Schizophrenia treatment

A
  • Social skills training
  • Family based programs
  • CBT
  • Antipsychotic drugs
68
Q

Personality disorders

A

Fixed, ingrained, pervasive way of dealing that deviate from cultural expectations and cause disruption and hardship

69
Q

Cluster A: Odd/eccentric

A
  • Schizotypal
  • Paranoid
  • Schizoid
70
Q

Cluster B: Emotional/ dramatic/ erratic

A
  • Antisocial
  • Borderline
  • Histrionic
  • Narcissistic
71
Q

Cluster C: Anxious/ fearful

A
  • Avoidant
  • Dependent
  • Obsessive compulsive
72
Q

BPD

A
  • Intense emotionality
  • Unstable identity, self image, interpersonal relationships, affects
  • Impulsivity
73
Q

BPD conceptualization and treatment

A
  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
Q

BPD etiology: Social

A
  • Childhood abuse, neglect, rejection
  • Inconsistent or loveless parenting
  • Parental substance/ alcohol abuse, promiscuity, etc.
  • Lack of protective factors
75
Q

BPD etiology: Biological

A
  • More for specific traits
  • Genetics
  • NTs: serotonin, dopamine
  • Deficits in frontal lobe (and connection with amygdala)
  • Increased amygdala activation
76
Q

BPD etiology: Psychological

A
  • Object relations theory
  • Splitting
  • Diathesis-stress theory
77
Q

BPD treatment

A
  • Dialectical behaviour therapy (Linehan)

- Drugs: anxiolytic, antidepressants, atypical antipsychotics

78
Q

BPS code of ethics and conduct (2009)

A
  1. Respect
  2. Competence
  3. Responsibility
  4. Integrity
79
Q

BACP ethical framework (2016)

A
  1. Being trustworthy
  2. Justice
  3. Beneficence
  4. Autonomy
  5. Non-maleficence
  6. Self-respect
80
Q

Ethical issues within therapist

A
  • Competence/ diligence
  • Fitness to practice
  • Personal safety
81
Q

Ethical issues arising through work

A
  • Perceived power balance
  • Respect for autonomy
  • Contracting and informed consent
  • Quality of relationship
  • Confidentiality
  • Dual relationship
82
Q

Persistent contact from former client

A
  • 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
Q

Client with serious suicidal thoughts and feelings

A
  • Establish level of intent
  • Links to BPS code of respect (confidentiality), competence (ethical decision making), responsibility (protection)
  • Confidentiality
  • Client autonomy
  • Legality
84
Q

Dual relationships

A
  • 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
Q

Ethical decision making if supported by:

A
  • Parameters
  • Research evidence
  • Legal guidance
  • Peer/ supervisor advice
  • Guidance from relevant bodies

Third Year Modules (6 decks)

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