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Clinical Psychology Flashcards

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1
Q

Mental disorder/psychopathology

A

Persistent disturbance or dysfunction in behavior, thoughts, or emotions that causes significant DISTRESS and IMPAIRMENT

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2
Q

Medical model of mental disorders

A

Like physical illnesses, mental illnesses have biological and environmental causes, defined symptoms, and cures

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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

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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)

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5
Q

The ICD

A

USA uses DSM but many other countries use WHO’s International Classification of Diseases (ICD)

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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)
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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

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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)

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9
Q

Comorbidity

A

Co-occurrence of 2+ diseases in a person

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10
Q

Anxiety disorder

A
  • Anxiety is the predominant feature
  • Significant comorbidity w depression
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11
Q

4 main types of anxiety disorder

A

Phobic disorders, panic disorders, social anxiety disorder, Generalized Anxiety Disorder (GAD)

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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
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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

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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
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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

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16
Q

Social anxiety disorder

A

Fear of social situations –> worry and diminished day-to-day func

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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
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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
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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
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20
Q

Mood disorder

A
  • Mood disturbance as predominant feature
  • 2 main forms: depression/depressive disorders and bipolar disorder
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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
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22
Q

PDD

A
  • Persistent depressive disorder
  • Same cog and physiological symptoms as depression; less severe but lasts longer (2+ yrs)
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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
Q

Depression biopsychosocial contributing factors

A

Biological: genetics, neurotransmitters (esp serotonin and NE)

Psychological: negative thoughts contribute to depression

Social: stressful life events, interpersonal factors

26
Q

Caspi et al study on serotonin transporter gene

A
  • 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
27
Q

Beck’s cognitive model of depression

A

States that biases in how info is processed and remembered leads to + maintains depression

28
Q

Helplessness theory

A

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
Q

Negative schema

A
  • 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
Q

Bipolar disorder

A
  • 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
31
Q

Bipolar I vs II disorder

A

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

32
Q

Rapid cycling bipolar disorder

A
  • At least 4 mood episodes (either manic/hypomanic or depressive)
  • Esp difficult to treat
33
Q

Schizophrenia

A

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
Q

Schizophrenia positive symptoms

A
  • 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
Q

Schizophrenia negative symptoms

A
  • 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
Q

Schizophrenia cognitive symptoms

A
  • 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
Q

Psychotherapy

A

Ineraction btw sanctioned clinician and someone suffering from a psychological problem; VERY broad term

38
Q

Eclectic psychotherapy

A

Involves drawing techniques from different forms of therapy; very adaptable depending on the client and the problem

39
Q

Psychoanalytic therapy

A
  • 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
Q

Psychodynamic therapy

A
  • 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
Q

Existential-humanistic therapy

A
  • 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
Q

Person-centered therapy

A
  • 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
Q

Gestalt therapy

A
  • 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
Q

Cognitive behavior therapy (CBT)

A
  • 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
Q

Psychopharmacology

A

Study of effect of drugs and mind on behavior

46
Q

Antipsychotic medicine

A

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
Q

Conventional vs atypical antipsychotics + which is more commonly used

A

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
Q

Antianxiety medications

A
  • 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
Q

Antidepressant medications (4 main types)

A

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
Q

True or false: antidepressant meds work right away

A

FALSE

Unlike antianxiety meds, antidepressants can take up to a month to have an effect

51
Q

Mood stabilizers

A
  • Can help suppress swings btw mania and depression in those w BPD
  • Can also help w depression
52
Q

Is medication better than psychotherapy or vice versa?

A
  • 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
Q

Electroconvulsive therapy (ECT)

A
  • 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
Q

Transcranial magnetic stimulation (TMS)

A
  • 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
Q

Deep brain stimulation (DBS)

A
  • 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

Psych 10 (12 decks)

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