Clinical Psych Final (3/5/24) Flashcards
1
Q
Freud’s theories: seduction theory
A
- saw women with ‘hysteria’ that had unexplained physical symptoms like partial paralysis, blindness and dizziness (actually PTSD symptoms)
- assumed that they had been abused by their fathers, not well recieved by the psych ppl
2
Q
Freud’s theories: Oedipus Complex
A
- the women weren’t actually abused but had fantasies about their parent
3
Q
Freud’s theories: drive theory
A
people run on basic drives and relationships are built on them
4
Q
Freud’s theories: psychosexual stages + fixations
A
- oral
- anal
- phallic (Oedipal/Electra)
- latency (non-sexual stage)
- genital
5
Q
Freud’s theories: levels of consciousness
A
- conscious mind
- subconscious mind
- unconscious mind (can’t access)
6
Q
Freud’s theories: personality
A
id: pleasure principle
- primitive aggressive, sexual drives
- primary process thinking: dreams, images, instincts
- Eros: life energy
- Thantanos: death instinct
- libido
ego: reality principle
- the moderator
- secondary process: reality
superego: the ego ideal
- conscience
- guilt
7
Q
Freud’s theories: defense mechanisms
A
1) repression - memories still in the mind but actively forgetting or not thinking about them
2) projection - putting feelings/actions onto someone else
3) reaction formation - expressing the opposite of how you feel
4) displacement/sublimation
- dis: taking the anger out of something else that is unrelated and won’t hurt the relationship
- sub: coming up with a way of protecting yourself without hurting yourself
5) regression - going backwards in development
6) rationalization
7) denial
8) identification - becoming like the thing you are having issues with
8
Q
psychoanalysis techniques: projective assessment
A
supposed to be a clever way to draw out the unconscious and repressed memories
9
Q
psychoanalysis techniques: free association
A
- complete openness in therapy
- therapist sits with their back to the patient and just has them speak
- takes 7 years - view the unconscious
- bring out the id
10
Q
psychoanalysis techniques: transference
A
- client projecting onto the therapist their experiences and relationships
11
Q
psychoanalysis techniques: analysis of resistance
A
- when you get close to the unconscious then the patient will shut down
- might cancel sessions or abruptly start talking about something else
12
Q
psychoanalysis techniques: well-timed interpretation
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interpreting the client’s behavior and helping them figure out why they behave that way
13
Q
psychoanalysis techniques: countertransference
A
- how the therapist feels about the patient
- therapist needs to undergo psychoanalysis as well
- how the therapist feels about that person is often how others feel about the patient
14
Q
psychoanalysis techniques: dream analysis
A
- manifest: what you actually dreamed about
vs - latent content: what your dream means
15
Q
psychoanalysis techniques: secondary gain
A
- a way to interfere with making the next step or moving on from the issues you truly have
16
Q
psychoanalysis process
A
- therapist as expert
- 3-5 times a week for many years
- therapist is neutral to promote transference
- goals:
- insight
- reworking developmental stages
- strengthening ego
- restructuring personality - finishing the process
- no more client resistance
- indication of better functioning
- more stable relationships
17
Q
psychoanalysis adaptations: Anna Freud - child analysis
A
- play therapy: giving children toys and having them play out their experiences
18
Q
psychoanalysis adaptations: Kohut - self-psychology
A
- narcissism
- empathy
- self-object: caregiver relationships affect how you feel about yourself
19
Q
psychoanalysis adaptations: Erikson - psychosocial stages
A
- more evidence for these than Freud’s psychosexual stages
20
Q
psychoanalysis adaptations: object relations
A
focusing more on the actual relationship with parents and how that’s foundational to development
21
Q
CBT: foundations
A
- Watson, Skinner
- Ellis: connecting btw thoughts, feelings and behavior
- Rational Emotive CBT: stress comes from thoughts not the situation itself
- Beck
- automatic thoughts: ideas that just pop into someone’s mind
- people can be trained to become more aware of them
22
Q
CBT model
A
- thoughts, feelings, actions/behaviors: recognizing the connection btw these and working towards positive change
- present centered: focuses on measurable outcomes and relative progress
- thoughts as circular
thoughts about the world → appraisal → predictions → value judgements → thoughts about self → thoughts abt the world etc
23
Q
types of logic flaws
A
- overgeneralization
- negative mental filter
- discount the positive
- magnifying
- emotional reasoning
- blame
- labeling
- should statements
- all-or-nothing thinking
- black and white: grey area = uncertainty
- promotes feelings of failure
- utterly obsessed or completely uninterested - jumping to conclusions
- trying to fortune tell leads to catastrophizing or what if statements
- trying to figure out exactly what’s going to happen in the future without knowing
24
Q
CBT goals
A
- challenge overgeneralization
- look for contrary evidence
- imagining life with a different filter and expand perspective
- stay in the present
- realize that you can’t ever really know what other’s are thinking
- clear communication
- identify and track bad habits
25
CBT general feelings
- depression
- anxiety
- anger
- compromised feelings lead to compromised decisions
- thoughts and feelings are separate
26
CBT interventions
- education
- thought challenging
- reframing
- acceptance
- distraction
- experimentation
- flexibility
- positivity
27
family systems: concept
- system in equilibrium
- systems resist change: homeostasis
- events push system into disequilibrium
- development changes
- life events
- unexpected stresses or traumas
- change by one family member
- circular: parent relationships affect child relationships/development
28
family systems: Bowen - family origin work
- people need to go back to the family origin and not just talk in therapy
29
family systems: Bowen - differentiation
- balance between togetherness and individuality
- autonomous: healthy awareness of self and separateness from family
- undifferentiated: emotional dependence on family system
- fusion or undifferentiated family ego mass
30
family systems: Bowen - intergenerational
- patterns of dysfunction repeat across generations
- people select partners with similar levels of differentiation (no evidence)
- family projection: children have same level of diffentiation as parents
- low differentiation associated with emotional distance in marriage
- anxiety/stress from low differentiation leads to
- marital problems
- psychopathology
31
family systems: Bowen - triangles
- model of parent-child relationships = alliance btw parents
- dysfunctional
- anxiety in one relationship projected onto a 3rd person
- someone is excluded from the relationship by one of the dyads
- alliance btw parent and child instead
- triangulation: communication is indirect, through 3rd person
32
family systems: Bowen - process of therapy
- work with individuals or couples
- genogram or family diagram
- 3+ gens
- make emotional material more cognitive
- indicate patterns: triangles/ coalitions
- detriangulation: detachment from unhealthy patterns
- direct communication
- therapist role
- guide questions to help client come to own conclusions
- therapist must have good family relationships
- focus on objectivity and cognitive methods
- therapist as teacher/director
33
family systems: structural
- marital relationship is primary
- vertical parent-child
- horizontal sibiling
- healthy systems have appropriate alliances and coalitions
- therapist jobs: monitor for alliances
- joining the system temporarily
- working with the whole system
- alliance with the family, not individuals within
- boundaries
- violation of boundaries lead to issues
34
family systems: expressed emotion
- families with intense exchanges of negative emotions are associated with development of psychopathology
35
Dialectical behavior therapy DBT: borderline personality disorder
- not originally the reason DBT was created
- disorder of emotional dysregulation: especially with intense emotions
36
DBT - biopsychosocial
- biopsychosocial model
- physiological: greater arousal to emotional events
- environment further impairs the development of regulatory processes
- maltreatment
- trauma
- unstable family relationships
- invalidating environments: wide range of possibilities
37
BPD - treatment historically
- historically there was no effective treatment
- unable to access CBT bc skills were not for overwhelming emotions
- tendency to go through many therapists because they saw relationships in black/white and quick to anger
38
DBT = **zen** + dialectical + behavioral therapy
- zen
- Western translation of Buddhism and Western mindfulness
- awareness and acceptance of self: identifying judgemental thoughts
- being in the present moment
39
DBT = zen + **dialectical** + behavioral therapy
- dialectical
- interconnectedness: client + therapist relationship is transactional
- thesis, antithesis: statement and it's opposite, synthesis: 2 seemingly contradictory statements can be true at the same time
- balance btw acceptance and change
- rational/logical mind → wise mind ← emotional mind
40
DBT client enhancements
- enhancing client skills and capacities
- enhancing client motivation
- enhancing generalization
- structuring the environment
- enhancing therapist capacities: training and support structures
41
DBT therapies
- group therapy: skills training
- individual therapy: client motivation
- telephone consultation: generalization
- case management: structuring environment
- consultation team: enhancing therapist capabilities
42
stages of DBT
- pre-commitment: getting people to come, recognizing their lives need to change
- stage 1: skill development to reduce self-ham/high risk behaviors
- stage 2: increasing client capacity to experience full range of emotions
- stage 3: development of self-respect
- stage 4: resolve existential issues
43
techniques in DBT
- collaborative, accepting, question asking
- making contracts: commitments to reducing harmful behavior
- change strategies: behavior chain analysis, making lemonade, confrontation
- acceptance strategies
44
attachment theory: Bowlby's 44 juvenile thieves
- looking at children diagnoses with conduct disorder
- wanted to understand why they were behaving like this, found that they all had difficult relationships with their parents
- early quality of care is critical for the development of self and regulation capacities
45
attachment theory: evolutionary component
- previous theories stress the importance of feeding
- Harlow monkey studies
- ethological theory
- attachment promotes survival
- attachment strategies are adaptive
- experience expectant: everyone in the species will form an attachment
- supportive evidence
- cross-species data
- deprivation studies
- patterns found around the world
46
attachment theory: cognitive component - internal working models
early care is important bc it helps develop expectations about self, others, relationships
47
attachment theory: cognitive component - expectations
carries expectations forward in other relationships
- guides how children behave in relationships
- parenting becomes example
48
attachment theory: cognitive component - sense of self
- influences self-confidence, persistence
- consistent with Kohut's self-psychology
- can also align with learned helplessness model
49
attachment and secure base behavior
- secure base
- attachment: proximity seeking, contact
- exploration
- individual differences
- what does infant do when distressed?
50
attachment pathways: secure
- parents reliably respond when baby needs something more often than not
51
attachment pathways: anxious resistant
- reactivity
- clingy bc they know they need to be extra loud for their parents to help them
- unreliable
- results in lower self-confidence
52
attachment pathways: anxious avoidant
- greater levels of alienation
- parents are neglectful of emotional needs
53
attachment pathways: disorganized/insecure
- dissociation
- no coherent strategy for managing attachment
- often found in babies who have been maltreated
54
assessing attachment
- infancy
- strange situation or Q-sort
childhood
- representational measures
adolescence/adulthood
- Adult attachment interview (AAI): establish who raised them, ask them to reflect on their lives from 5-12, establish current attachment style, say 5 words that describe relationships with parent and then ask fro an example of each word
55
attachment risks
- relates to internalizing and externalizing behavior problem beginning in preschool
- relates to peer relationships and social skills
- relates to adult relationships like being a parent
56
developmental psychopathology: normal and abnormal development
- typical and atypical development
- look at consequences of having it or not
- atypical development leads to questions about typcial or normative process
57
salient developmental issues of childhood: infancy
attachment
58
salient developmental issues of childhood: early childhood
self-regulation
peer interaction
59
salient developmental issues of childhood: middle childhood
- peers/friends
- academic competence
60
salient developmental issues of childhood: adolescence
identity
romantic relationships
close friendships
academic competence
61
salient developmental issues of adulthood: early adulthood
establish intimate relationships
establish work
62
salient developmental issues of adulthood: middle adulthood
maintain intimate relationships
focus on next-generation
- peak of career
- empty nest transition
63
salient developmental issues of adulthood: late adulthood
"legacy"
retirement
preparing for end of life
64
developmental pathways: tree analogy
branches in the middle are more normative
the longer you wait and continue down maladaptation the harder it is to bring back
65
developmental pathways: equifinality
- many paths to the same outcome
- people may have the same symptoms or disorders but not have the same path
- how important is the path
66
developmental pathways: multifinality
- many outcomes from the same beginning
- siblings have the same life situation but can end up in very different directions
67
developmental pathways: outcomes as snapshots
- development is always changing therefore whatever the outcome its not permanent and is subject to change
68
developmental psychopathology: risk and resilience
- risk factors make maladaptation more likely
- with enough risks, development declines and positive outcomes are much less likely
- promotive factors are the opposite of risk factors: good for everyone
- protective factors moderate risk and create better outcomes: for those that need it most
69
developmental continuity myth
- development does not move in a straight line up
- trying to identify what diagnoses look like from childhood forward
- internalizing vs externalizing as a diagnoses approach for children
70
therapy techniques for children
- play
- families
- systemic interventions
- use a variety of theoretical approaches
- calibrate approach to child's developmental level
- medication (in some cases)
71
health psychology: stress - GAS
- general adaption syndrome
- initial alarm reaction: fight/flight/freeze
- stage of resistance: can cause physiological damage
- stage of exhaustion: organ system break down
72
health psychology: stress - individual differences
- physiological
- perceptual
- cognitive
- environmental
- life history
- stressor itself
- racism and stress: stress equity
73
health psychology: stress - psychoneuroimmunology
- Yerkes-Dodson curve: brief and manageable stressors build immune functioning
- optimal level of arousal = best performance
- but prolonged stress exposure suppresses immune functioning
74
health psychology: stress - timing
- early development stress is especially disruptive
- coping resources
- ACEs: adverse childhood experiences
- the higher you score on ACEs the higher chances of having mental and medical issues
75
health psychology: stress - protective factors
- coping strategies
- problem-focused
- emotion-focused
- sharing negative feelings: to an extent, varies culturally
- personality: optimism
76
health psychology: stress - protective factors: social support models
- model 1: mediator
Social support → effective coping → wellbeing
- model 2: direct effects
Social support (someone to take you to the doctor) → wellbeing
- model 3: third variable
Social competence → social support and wellbeing
77
risks for CVD
- chronic stress
- poverty
- heightened stress
- less healthcare resources
- food resources
- sedentary life
- smoking
- unhealthy work demands
- racism
- hostility levels
- bidirectional relation btw CVD and depression
78
physical consequences of resilience
- Werner and Smith study in Kauai
- studied children who were doing well after growing up in low-income and low-resourced places
- found that those were were seemingly doing well had physical l health problems
- "skin-deep resilience"
79
psychosocial consequences of chronic illness
- depression
- anxiety
- acting out
- loss of social support due to compassion fatigue
- unhealthy coping behaviors
80
managing chronic illness
- pain management
- biofeedback
- relaxation
- CBT
- validation and accepting the new normal
- diabetes and cystic fibrosis
- interventions w children to build awareness
- adolescents at high-risk due to rebellion/body image concerns
81
psychological consequences of severe physical illness
- trauma model
- five sages of grief model
- reaching acceptance
- coping skills
- decision making
- support networks
- hospice care
82
prevention/intervention: HIV
- public health programs
- prevention for tweens and teens
- risk and transmission education
- empowerment
- consent
- support groups
83
long term maintenance
- achieving short term improvement is easier
- lifestyle changes beyond 1-2 years is low
84
long term maintenance: health belief model and treatment adherence
- perceived susceptibility to illness/severity: more likely to seek treatment if illness is more severe
- how feasible, accessible and successful treatment is perceived
- internal and external cues that influence health behaviors
- demographic and personality variables
85
long term maintenance: interventions
- education about treatment
- modification of treatment plan to make more realistic
- behavior modification: reminders, contracts, relaxation and desensitization
86
competence during a criminal trial
- stand trial: understand proceedings and assist in defense
- make decisions: waive right to attorney, confess
- developmental competence
87
competence during the crime
- NGRI: not guilty by reason of insanity
- GBMI: guilty but mentally ill
- still guilty but required to get treatment while incarcerated
- legal standard: mental illness or disability leads to lack of capacity to know actions were wrong
- Hinckley case shifted burden of proof to defense
88
dangerousness
- likeness of harming others
- likeliness of harming self
- safety to parent
- low base rates
89
civil trials
torts: determine plaintiff's psychological condition/distress
worker's compensation claims: physical to mental, mental to mental, or mental to physical
competency evaluations to make decisions
90
child custody
- legal vs physical: who make decisions vs where child will live
- joint custody is generally default
- evaluation: appointed by judge or parent
- GAL: guardian ad litum, when a child is appointed their own lawyer
91
child custody assessment
- observation of parent-child, interview family members, standardized testing
- diagnoses for parents
- teachers, neighbors etc, document review and full clinical history
92
child custody: outcome
- usually joint custody: often limited
- best predictor of child outcomes is amount of parental conflict
- prepare report and testify
93
child protection
- making the call
- court or state appointed therapy
- parenting assessments
- testimony regarding best interest of the child
- bar is low for safe parenting and high for termination
94
expert witness testimony
- testify about symptoms, behavior, diagnoses
- provide assessment data
- discuss research findings: eyewitness testimony, expertise about a diagnoses
- explain use of testing instruments
- ethical rules guide conclusions: direct assessment of individual
95
special education law
- IDEA: children with diagnoses are meant to receive extra resources
- least restrictive environment (LRE): if children can function in general ed rather than elsewhere then they shld be placed in the least restrictive environment
- educational vs medical diagnosis
96
autopsies and profiling
- help determine case of death or competency to modify a will: has questionable validity
- some research links crimes to certain offender profiles: uncertain validity
97
ethical principles: A
Beneficence and Nonmaleficence (A) - do no harm
98
ethical principles: B
Fidelity and Responsibility (B0 - trustworthy and ethical in relationships
99
ethical principles: C
Integrity (C)- accuracy, honesty, maintaining work standards
100
ethical principles: D
Justice (D) - treatment of clients with fairness and justice
101
ethical principles: E
Respect for People’s Rights and Dignity (E)
102
ethics: confidentiality
- exceptions: harm to self or others
- children and adolescents
- Tarasoff: if someone makes threat against someone else you have to contact that person directly if you know who they are
103
ethics: assessment
- must be in person (video counts), can't be reviewing files
- Trump and the Goldwater rule
- in reports you have to explain what the assessment instrument tells you
- makes limitations of data clear and what data should you include or not
- assessments have implications for people's lives
104
boundaries
- dual relationships
- living in the community where you work
- seeing a friend of a friend
- what about a child's friend
- physical contact
105
ethics: research
- informed consent
- IRB
- who gets credit for work?
- what conclusions can be made and shared
- overgeneralization vs overly cautious
