Clinical Psychology: Psychological Disorders Flashcards
Trephination
An early therapy for mental disorders that involved cutting a hole in the skull.
Subsyndromal Disorders
Versions of psychological disorders that don’t meet the DSM-5-TR criteria for diagnosis but that may nonetheless cause significant problems.
Rapport
A client’s sense of trust in, respect for, and comfort with the treatment provider.
Cultural Competence
An understanding of how clients’ cultural backgrounds shape their beliefs, values, and expectations for therapy.
Culturally Appropriate Therapy
Therapy that is conducted in a manner that is sensitive to the client’s cultural background and expectations.
Hysteria
An older term for a group of presumably psychogenic disorders that include a wide variety of physical and psychological symptoms. The term used today is conversion disorder.
Psychogenic
Resulting from a psychological cause rather than from organic damage to the nervous system.
Free Association
A method used in psychoanalytic therapy in which the patient says anything that comes to mind, no matter how apparently trivial, embarrassing, or disagreeable.
Resistance
In psychoanalysis, a patient’s self-censorship or avoidance of certain topics.
Psychoanalysis
A method of therapy, developed by Sigmund Freud, asserting that clinical symptoms arise from unconscious conflicts rooted in childhood.
Interpretations
In psychoanalysis, explanations of how various thoughts, feelings, and behaviours are linked to prior experiences.
Transference
The tendency to treat one person as if they possess the traits or characteristics of another more familiar person. For example, in psychotherapy, clients might respond to a therapist in ways that resemble the dynamic they have with major figures in their own lives.
Psychodynamic Approaches
Therapeutic approaches that derive from psychoanalytic theory which asserts that clinical symptoms arise from unconscious conflicts rooted in childhood.
Ego Psychology
A school of psychodynamic thought that emphasizes the skills and adaptive capacities of the ego.
Object Relations
A school of psychodynamic thought that emphasizes the real (as opposed to fantasized) relationships an individual has with important others.
Interpersonal Therapy (IPT)
A form of therapy focused on helping patients understand how they interact with others and then learn better ways of interacting and communicating.
Humanistic Approach
An approach to therapy centred around the idea that people must take responsibility for their lives and actions.
Client-Centred Therapy
A form of humanistic therapy, pioneered by Carl Rogers, in which the therapist’s genuineness, unconditional positive regard, and empathic understanding are crucial to therapeutic success. Also known as person-centred therapy, client-centred therapy seeks to help clients accept themselves as they are without pretense or self-imposed limits.
3 Crucial Factors For a Therapist’s Success
1) Genuineness
2) Unconditional Positive Regard
3) Empathic Understanding
Motivational Interviewing
A brief, nonconfrontational, client-centred therapy designed to change specific problematic behaviours such as alcohol or drug use.
Gestalt Therapy
A form of humanistic therapy, pioneered by Fritz Perls, that aims to help patients integrate inconsistent aspects of themselves into a coherent whole by increasing self-awareness and self-acceptance. Involves hot seat and empty chair techniques.
Experiential Therapies
The collective term for modern humanistic therapies.
Emotion-Focused Therapy (EFT)
A therapeutic approach that emphasizes the importance of emotional awareness and expression. It aims to help individuals identify, understand, and process their emotions to improve well-being and interpersonal relationships.
Behavioural Approaches
A family of therapeutic approaches based on the idea that problematic behaviours are the result of learning.
Exposure Techniques
Behavioural techniques designed to remove the anxiety connected to a feared stimulus through repeated approach towards the feared stimulus.
In Vivo Exposure
A key step in the behavioural treatment of a phobia in which the individual is exposed to the phobic stimulus in the real world or through interactive computer programs.
Token Economies
A behavioural therapy technique based on operant conditioning in which patients’ positive behaviours are reinforced with tokens that they can exchange for desirable items.
Contingency Management
A behavioural therapy in which certain behaviours are reliably followed by well-defined consequences.
Modelling
A behavioural therapy technique based on observational learning in which patients learn new skills or change their behaviour by watching and imitating another person.
Vicarious Reinforcement
A form of modelling in which the learner acquires a conditioned response merely by observing another participant being conditioned.
Cognitive Approaches
A family of therapeutic approaches based on the idea that maladaptive behaviours arise due to errors in thinking.
Rational Emotive Behavioural Therapy
A form of cognitive therapy, pioneered by Albert Ellis, in which the therapist actively challenges the patient’s irrational beliefs.
Cognitive Therapy
An approach to therapy that tries to change patients’ habitual modes of thinking about themselves, their situation, and their future.
Negative Cognitive Triad
Three types of dysfunctional beliefs related to oneself (I am unlovable), the world (It’s a cruel world out there), and the future (Things are only going to get worse).
Cognitive Restructuring
A set of cognitive therapy techniques for changing a person’s maladaptive beliefs or interpretations through persuasion and confrontation.
Cognitive-Behavioural Therapy (CBT)
A hybrid form of psychotherapy focused on changing the patient’s habitual interpretations of the world and ways of behaving. It combines cognitive and behavioural approaches to therapy.
Third Wave Therapies
The latest generation of cognitive-behavioural therapies, including acceptance and commitment therapy as well as mindfulness-based stress reduction.
Group Therapy
A form of therapy in which two or more patients meet with one or more therapists at a time.
Telehealth
The use of telephone, videoconferencing, Internet, and streaming media technologies to support health care at a distance.
Cybertherapy/Web-Based Therapy
A nontraditional form of therapy in which the therapy is conducted over the Internet.
Psychotropic Medications
Medications that control, or at least moderate, the symptoms of some psychological disorders.
Typical Antipsychotics
First-generation antipsychotic medications that block the neurotransmission of dopamine.
Flat Affect
Diminished or absent facial expressions of emotion.
Atypical Antipsychotics
Newer antipsychotic medications that block the neurotransmission of dopamine but have enhanced benefits in terms of limiting or eliminating negative symptoms.
Deinstitutionalization
A movement that began in the 1950s that aimed to provide better, less expensive care for chronically mentally ill individuals in their own communities rather than at large, centralized hospitals.
Antidepressant
A medication intended to treat the symptoms of depression.
Selective Serotonin Reuptake Inhibitor (SSRI)
A medication (such as Prozac, Zoloft, and Paxil) that increases serotonin turnover in the brain and is widely used to treat depression, eating disorders, anxiety disorders, and many other disorders.
Atypical Antidepressant
A medication that works in various ways on serotonin, norepinephrine, and dopamine systems to combat the symptoms of depression.
Placebo Effect
The influence of a patient’s beliefs and expectations in bringing about a cure.
Mood Stabilizer
A medication (such as lithium) that treats manic, mixed, or depressive states.
Anxiolytic
A type of drug that alleviates the symptoms of anxiety. Also called a tranquilizer.
Benzodiazepine
A common type of drug (such as Xanax, Klonopin, and Ativan) used to treat anxiety disorders.
Rebound Effect
When people stop taking the medication their symptoms are worse than before they started taking the meds.
Beta Blocker
A medication that controls autonomic arousal and thereby decreases the negative spiral that occurs when an anxious person feels even more anxious when sensing a bodily response to an anxiety-producing situation.
Psychosurgery
Brain surgery performed to alleviate symptoms of psychological disorders that cannot be alleviated using psychotherapy, medication, or other standard treatments. The surgery removes sections of the brain or disconnects them from each other.
Lobotomy
A type of psychosurgery in which the neurosurgeon severs some or all of the connections between subcortical brain structures such as the thalamus and the frontal lobes.
Electroconvulsive Therapy (ECT)
A biological treatment, mostly used for cases of severe depression, in which a brief electric current is passed through the brain to produce a convulsive seizure.
Vagal Nerve Stimulation
An emerging biological treatment for depression that involves electrically stimulating the vagus nerve with a small battery-powered implant.
Deep Brain Stimulation (DBS)
The insertion of an electrode deep in a patient’s brain to alter the activity of specific brain regions (ex. To treat depression or obsessive-compulsive disorder).
Repetitive Transcranial Magnetic Stimulation (rTMS)
An emerging biological treatment for depression that involves applying rapid pulses of magnetic stimulation to the brain from a coil held near the scalp.
Spontaneous Improvement
Clinical improvement not associated with a clinical intervention.
Wait-List Control Condition
In randomized controlled trials, a control condition in which patients receive delayed treatment rather than no treatment. Before being treated, they are compared to patients treated earlier.
Double-Blind Study
A study in which participants are assigned to experimental conditions while keeping both the participants and the researchers unaware of who is assigned to which group.
Common Factor
A factor related to therapy outcome that is common to many different types of treatment (ex. therapeutic alliance).
Meta-Analysis
A statistical technique for combining the results of many studies on a particular topic.
Empirically Supported Treatment (EST)
A clinical method that research has shown to be effective for treating a given disorder.
Dodo Bird Verdict
An expression used to summarize the comparative effectiveness of different forms of psychotherapy. With regard to psychotherapy, the verdict means that all the major forms of psychotherapy are equally effective.
Therapeutic Alliance
The relationship between therapist and client that helps many clients feel hopeful and supported.
Eclecticism
An approach to treatment that deliberately weaves together multiple types of therapy.
Dialectical Behaviour Therapy (DBT)
An eclectic therapy for treating borderline personality disorder, pioneered by Marsha Linehan, that includes elements of cognitive, behavioural, humanistic, and psychodynamic therapies.
Psychopathology
Study of psychological disorders.
Psychological Disorders
Persistently harmful thoughts, feelings, and actions that are deviant, distressful, and dysfunctional.
Deviant
Deviates from social norms (in a particular culture).
Distressful
Unpleasant or upsetting to the individual (or others).
Dysfunctional
Interferes with functioning in daily life.
Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR)
Structured clinical interview with patient about behaviours and symptoms. Diagnosis based on consensus on clusters of symptoms. There are 20 categories of psychological disorders.
Benefits of Diagnostic Labels
Facilitation of research and treatment.
Drawbacks of Diagnostic Labels
Stigma, view of disorders as fixed and enduring, and view of disorders as discrete/categorical.
Psychological Disorders Arise From a Combination Of
1) Inherent Vulnerability (diathesis)
2) Environmental Stressors
Generalized Anxiety Disorder
Characterized by worry. Is unrealistic/excessive/persistent anxiety not linked to any specific situation/stressor. Symptoms are feeling tense, nervous, on edge, a racing heart, motor tension/shaking, bias for negative information, and less ability to focus. Is twice as likely to occur in women, tends to appear before the age of 30, 5% lifetime prevalence, is moderately related to genetics (30-40% heritable), is often triggered by a convergence of stresses, and is associated with a loss of control (worrying gives a false sense of control).
Panic Disorder
Characterized by panic. Is a discrete instance of fear with no predictable context/situation. Symptoms are heart palpitations, trembling, shortness of breath, tingling, dizziness, and nausea. Symptoms are misinterpreted cognitively. Is twice as likely to occur in women, tends to appear at 18 to 34 years-old, 4% lifetime prevalence, 30-40% heritable, and is a physiological response.
Obsessive-Compulsive Disorder (OCD)
Characterized by unwanted thoughts and dysfunctional actions. Similar rates in men and women, tends to appear at 18 to 34 years-old but can appear in childhood, 2% lifetime prevalence, 40-50% heritable, is biological due to elevated glucose consumption in the brain (frontal regions and overactivity of brain regions), and thoughts and behaviours reflect fixed action patterns.
Obsessions
Persistent and unwanted thoughts, ideas, or images that are not intentionally produced. Common ones are contamination, something bad happening, and symmetry.
Compulsions
Actions that people feel compelled to do to relieve anxiety that are non-functional and ritualistic. Common ones are checking, cleaning, and repetition.
Strategies to Interrupt the Cycle of Anxiety
1) Relaxation (especially panic disorder)
2) Systematic Desensitization/Exposure Therapies
3) Cognitive-Behavioural Therapy
Drugs to Treat the Biological Explanations For Anxiety
1) Xanax (depresses CNS activity)
2) Prozac (depresses CNS activity)
Feeling Blue
Extremely temporary (not a disorder).
Persistent Depressive Disorder (Dysthymia)
Mild but long-lasting depression, 2 years or more.
Major Depressive Disorder
Intense negativity every day (worthless, disinterested, sad), 2 weeks or more. 12% lifetime prevalence in Canadian adults, it is twice as likely to occur in women and is more severe in women, found more often than before in young people (15 to 19 years-old), 40-50% heritable, and involves neurotransmitter dysregulation (norepinephrine, serotonin, and dopamine).
Rumination
Repetitive thinking or dwelling on negative feelings.
Bipolar Disorder
Alternation between depression and mania (hyperactive, euphoric, optimistic). No significant differences across genders, most commonly diagnosed in adolescence/early adulthood (12 to 25 years-old), 2% lifetime prevalence, 70-90% heritable, and involves dopamine regulation (hyperactive reward processing network (underlies mania)).
Mania
State of high excitement and energy with physical (high energy, activity, decreased eating, and sleeping), emotional (elation, exhilaration, and irritability/anger), and cognitive changes (racing thoughts (distractible) and inflated self-esteem (special abilities)). Leads to engagement in pleasurable behaviours that may lead to painful outcomes.
Mood Disorder Drug Therapies
1) Anti-depressants for depression (increases amount/activity of key neurotransmitters ex. serotonin and norepinephrine). Is a gradual effect, full effect often requires weeks.
—> Prozac
—> Zoloft
—> Selective Serotonin Reuptake Inhibitors (SSRIs)
2) Lithium carbonate for bipolar (mood stabilizing).
Mood Disorder Drug Alternatives
1) Aerobic exercise (helps calm anxiety, uplift the depressed).
2) Cognitive-behavioural therapy.
3) Electroconvulsive therapy.
Schizophrenia
A disorder involving disorganized and delusional thinking, disturbed perceptions, and inappropriate emotions and actions. Progressive, irreversible mental deterioration (used to be considered as premature dementia). A split from reality, NOT multiple personalities. Idiosyncratic thoughts and associations that interfere with the ability to maintain a logical and consistent train of thought. Higher rates among low education and low SES, is more severe in men, is typically diagnosed late adolescence/early adulthood, affects 1% of the population, is 80% heritable (genetic markers ex. eye movement dysfunction), and has environmental influences (prenatal environment, influenza during second trimester, and birth complications, oxygen).
Word Salad
Real words but they don’t fit together.
Delusions
False beliefs that have no basis and that are not influenced by reality.
Types of Delusional Thinking
1) Delusions of Grandeur (belief in special powers or characteristics ex. I am Joan of Arc, Jesus, Harry Potter, and etc.).
2) Delusions of Persecution (ex. people are plotting against me and mistreating me).
3) Delusions of Reference (ex. people are making secret reference to me, the instructor keeps lecturing about me personally).
4) Thought Insertion (ex. people are putting thoughts in my head and controlling my actions).
Hallucinations
Reports of sensory stimulation when no such stimulation is present.
Types of Hallucinations
1) Auditory Hallucinations (voices that talk to or about the schizophrenic person, tells the person what to do, or criticises the person’s actions. The voices are unwanted and confusing. Is the most common type of hallucination).
2) Visual Hallucinations (visions of persons or objects perceived to be present).
3) Tactile, Taste, and Somatic Hallucinations (ex. tiny bugs crawling all over the skin).
Flat Affect and Behaviour
Flat facial expression, speaks in a monotone voice, and catatonic behaviour. Strongly predicts a poor prognosis.
Disorganized Behaviour
Difficulty controlling emotions/expressing inappropriate emotions, rapid shift in emotional expression, peculiar dress, and frenzied behaviour (ex. running haphazardly and shouting nonsensically).
Positive Symptoms
Added experiences that others don’t have ex. thought disturbances, delusional thinking, and hallucinations. Are associated with better outcomes.
Negative Symptoms
Absence of things that other people have ex. flat affect/behaviour, social withdrawal, and lack of pleasure/motivation.
Neurodevelopmental
Stems from early brain abnormalities.
Neurological Changes in Schizophrenic Patients
1) Enlarged ventricles (filled fluid cavities in the brain) (occurs before onset of disease but not all patients show enlarged ventricles).
2) Frontal Lobe Activity (reduced blood flow in the frontal regions of the brain, especially working memory. More common when negative symptoms are present).
3) Impaired top-down processing (frontoparietal network).
4) Emphasis on integration of bottom-up sensory stimuli (ex. people with schizophrenia are not fooled by the hollow mask illusion).
5) Dysfunction in glutamate transmission (issue with production or sensitivity. Some antipsychotic drugs ex. haloperidol increases glutamate activity).
Dopamine Hypothesis
Schizophrenia is caused by excessive dopamine activity in the brain. Classic antipsychotic drugs block dopamine receptors. However, some patients have low dopamine activity in some cortical regions.
Antipsychotic Drugs
Treats symptoms of psychosis including delusions, hallucinations, and disorganized thinking. Is less effective in treating the negative symptoms. Common side effects are headaches, dizziness, anxiety, weight gain, tremors, blurred vision, and etc.
Tardive Dyskinesia
A irreversible neurological disorder that results in involuntary movements usually occurring in the face and jaw.
Personality Disorders
Longstanding, pervasive, and inflexible patterns of behaviour that deviate from cultural norms and impair social and occupational functioning. It often co-exists with disorders like schizophrenia, mood, and/or anxiety disorders. It affects the ability to form stable relationships and to function adaptively in society.
Personality Disorders Clusters
1) Odd or Eccentric Behaviours
—> Paranoid
—> Shizoid
—> Schizotypal
2) Dramatic, Emotional, or Erratic Behaviours
—> Antisocial
—> Borderline
—> Histrionic
—> Narcissistic
3) Anxious or Fearful Behaviours
—> Avoidant
—> Dependent
—> Obsessive-Compulsive
Histrionic Personality Disorder
Pattern of attention-seeking and exaggerated emotional displays. Dramatic behaviour to get attention. Is often manipulative, sexually provocative, and seductive. Shallow, rapidly shifting emotions are seen as insincere. A focus on physical appearance and is uncomfortable when not the center of attention. 2-3% prevalence and is more common in women (especially if divorced or separated).
Borderline Personality Disorder
Pervasive instability of mood, relationships, and self-image. Unstable sense of self and chronic feelings of emptiness. Frantic efforts to avoid abandonment. Alternate between idealization and devaluation of loved ones. Rapid, intense shifts into negative emotions and difficulty controlling anger. Impulsivity in overspending, excessive sexual activity, and self-mutilating (self-harm). 1-2% prevalence and is more common in women than men. Amongst criminals, BPD traits are predictive of extreme violence.
Antisocial Personality Disorder
Pattern of disregarding and violating the rights of others. Lack of conformity to social norms and legal standards. Repeated violation of the law. Deceitful. Manipulate others for personal gain. Poor judgment and impulse control. Lack of empathy and remorse. 3% prevalence in males and 1% prevalence in females. More common in younger than older adults. More common for low-socioeconomic status. Often co-exists with substance abuse.
