w2: Research in Clinical Psych

Question 1

why research?

Answer 1

• to build theories on development of disorders
• to design interventions based on those theories
  -to evaluate the efficacy of these interventions
  -to promote evidence-based practice

Clinical psychologist = scientist-practitioner

Question 2

What is research?

Answer 2

Research is a systematic investigation to discover facts or deepen understanding of a topic.
—> rooted in the scientific method to study human behaviour- biological and social science focus.
= enhance human understanding

Question 3

The scientific method:

Answer 3

purpose: pursue knowledge through systematic observation ensuring findings are replicable and testable.

• reproducible under controlled conditions by other researchers.
• precise measurements, detailed descriptions of methods
• objectivity, precise measurements, and replicability
• standardised data collection

Question 4

Theory

Answer 4

a structured framework that explains phenomena, relationships, or processes based on empirical evidence and logical reasoning. It is a testable concert or set of ideas that helps describe, predict and understand aspects of behaviour, cognition, or mental health.

Question 5

theory characteristics

Answer 5

1. Framework for understanding: provides way to organise observations and findings.
   Ie. CBT theory explains the link between thoughts, emotions and behaviours.
2. Based on data and hypotheses: grounded in empirical research.
3. Testability: theory generates testable hypotheses, can be confirmed or refuted.
4. Predictive power: can predict future behaviours or outcomes based on known behaviours.
5. Dynamic nature: are refined or rejected based on evidence. ie. Freud psychoanalytic theory being modified and replaced by newer, evidence-based approaches.

Question 6

Role of theory in clinical psychology:

Answer 6

1. Research guidance - guide development of research questions and hypotheses
   -> Beck’s cognitive theory of depression led to studies testing effectiveness of cognitive restructuring.
2. Treatment development- help design interventions targeting specific mechanisms- behavioural theories and exposure therapy.
3. Understanding psychopathology - can explain causes (aetiology) and maintenance of mental disorders. - biological theories- genetic predisposition ie schizophrenia.
4. Practical Application: translate research findings into real-world clinical applications. ie. using reinforcement from behavioural theory to encourage positive behaviours.

Question 7

Goal in Clinical Psychology Research:

Answer 7

Focuses on identifying, defining and categorising events and relationships related to psychopathology

goal
1.Description
2.Prediction- predict outcomes or identify risk factors that increase likelihood.
3.Control - understanding causal relationships to influence and alter behaviour to cognition for therapeutic purposes.
4.Understanding

—> how is this done:

Question 8

Experimental psychopathology

Answer 8

utilises controlled experiments to explore mechanics underlying mental disorders and to test hypotheses systematically.

Features high internal validity, as it often isolates variables to establish causation, it may lack external validity due to laboratory settings.

• how various factors contribute to mental health conditions - deepen knowledge.

Question 9

Experimental methods used in experimental psychopathology

Answer 9

1.Case Study (single-case experiment),
2.correlational design/ studies
3.prospective / longitudinal design
4.case-control study
5.treatment outcome study- randomised controlled trials, non random allocations/ quasi-experiment design.

Question 10

Case Study:

Answer 10

an in depth investigation of a single individual, group, or event to explore specific aspects of psychopathology.

Key characteristics:
- focus on individual case- unique presentation of psychopathological symptoms.
- rich qualitative data- about patients mental state, life history, environment.
- often used to generate new hypotheses.
- lack of generalisability

• Applications:
  ◦ Useful for rare conditions (e.g., dissociative identity disorder).

advantages:
- hypothesis generation
- exploration of rare disorders
- challenge existing theories
limitations:
- Low internal validity
- low external validity
- observer bias

Question 11

Single-Case Experiment

Answer 11

observers and measures behaviour before and after an experimental manipulation in one participant.

Design: ABA Designs:
A: Baseline (no treatment)
- behaviour is observed and mesured before any intervention is applied.

B: Intervention/ experimental manipulation.
- treatment is introduced and effects on behaviour are monitored.

A: Return to Baseline.
- intervention is withdrawn to see if behaviour returns to baseline.
- confirm if intervention was responsible for changes

Question 12

Correlational Design/ Studies:

Answer 12

Research design aimed at identifying relationships or associations between two ore more variables.
- does not establish causation just correlation

Application: to explore relationships - ie. between anxiety, body dissatisfaction and eating disorders.
How correlational analysis works:
- data collection through measures
- analysis took - statistical software to calculate correlation coefficient r, and the statistical significance p.

advantages:
- solves problem of low external validity - can be used in both clinical and non-clinical populations
- high replicability
- mapping relationships
- exploring associations
limitations:
- no causation - correlation does not imply causation
- does not solve internal validity problem
- lack of mechanistic insight - don’t’ know why variables are correlated.

Question 13

Internal Validity

Answer 13

refers to the extent to which a study can establish a causal relationship between the IV and the DV.

Question 14

External validity

Answer 14

refers to the extent to which the findings of a study can be generalised to other settings, populations.

Question 15

Prospective/ Longitudinal Design:

Answer 15

Longitudinal studies: measures the same participants at multiple time points, often over years or entire lifetime- track changes and relationships over time.

Prospective designs: similar to longitudinal studies but focus on collecting data at two or more specific points in time- ie. time 1, time 2. To predict future changes in variables

Question 16

Key features in longitudinal and prospective design:

+ advantage and limitations

Answer 16

1. Time-order relationships: allow researchers to observe whether one variable at time 1 predicts changes in another variable between time 1 and time 2.
   - ie. Negative attribution style in time 1 predicts more depressive symptoms in time 2
2. Identifying risk factors: helps determine which variables are predictors or risk factors for future outcomes.
3. Advantage over cross-sectional designs (which don’t provide insight into causation or temporal relations but rather a snapshot). -> longitudinal and prospective track changes over time

Advantages:
- temporal clarity - determine whether one variable precedes another in time - strong evidence causal relationship
- risk factor identification - pinpoints early indicators of disorders.
- dynamic insight- tracks how variables change over time.

Limitations:
- causation still uncertain- causation requires experimental confirmation
- confounding variables - other unmeasured factors may contribute to results
- resource intensive- requires long term participants retention and significant time and funding.

Question 17

Case-Control Study:

Answer 17

A case-control study is a type of observational research design. Involves comparing individuals with a specific condition or outcome to individuals without the condition to identity factors that may contribute to the condition.

Key features:
1. Group comparison- condition vs healthy control
2. Retrospective design- look back in time to examine exposure to risk factors or predictors.
3. Data collection - interviews, medical records, self-reports.
4. Outcome focus- assess associations b/w risk factors and development of the condition - not establish causation

advantages:
- clinically very feasible - study rare conditions or outcomes.
- efficiency- requires less resources and time
limitations:
- recall bias, selection bias
- no causal interference
- confounding variables

Question 18

type of case-control studies.

Memory Specificity Training (MeST)

Answer 18

Psychological intervention designed to improve the ability to recall specific detailed autobiographical memories. - specifically for ppl with a overgeneralisation memory style - linked to many psychiatric conditions

features:
- focuses on retrieving specific events tied to specific place and time.
- overgeneral memory = I always feel sad, instead of being able to give specific memory
- participants presented with cue works -happy, sad-need to provide specific memories associated with them.

Application:
- address over general memory in depression, PTDS, anxiety
- improving emotional processing- enhances ability to access positive, specific memories.

Relevance to case-controls study:
- research: see if over general memory is more prevalent in the case group than control
- evidence base for MeST- individuals with overgeneralisation memory might be suggested to undertake MeST
- evaluating its function- see if the use of MeST improved depression at time 2

Question 19

Treatment Outcome Study:

Answer 19

Designed to evaluate the effectiveness of an intervention or therapy for specific condition.

Key features:
1. Evaluation of interventions
2. Comparison groups: treatment group and control group.
3. Outcome measure - specific metrics for symptom
4. Study design:

• randomised control trials (RTC)
• non random allocation/ quasi-experiment design
  -randomised multiple base line

Question 20

treatment outcome study

Radomised control trials (RCT)- gold standard

Answer 20

randomly assigned to treatments to control group to minimise bias
- randomisation, balances groups- helps distribute confounding variables
- minimises bias, causal interference, internal validity.
- limitations- cost and resource intensive, ethical concerts of withholding medication, limited external validity.

Question 21

treatment outcome study

non random allocation/ quasi-experiment design

Answer 21

non random assignment is used when randomisation is not feasible.
- groups made based on pre-existing characteristics or other non-random criteria.
- confounding variables, selection bias, no causal interference.

Question 22

treatment outcome study

Randomised multiple baseline design

Answer 22

Single-case experimental design where treatment is applied to different behaviours, participants or settings at stagnated time points.
—> allows to observe changes specific to intervention while controlling for time-related factors

Key features:
1. Staggered introduction of interventions - treatment begins at different times for each participant
2. Baseline phase- multiple baseline measurements are collected before intervention - stable pattern of behaviour established.
3. Within participant comparison.
4. Randomisation to redice bias.

Question 23

Analogue Studies

Answer 23

used to study processes and phenomena that closely resemble those found in clinical populations.

Used in experimental psychopathology to model clinical processes in controlled, simplified settings.

Aim to model aspects of mental disorders or treatment in a simplified way.

Studying stress-induction in healthy participants to understand anxiety mechanisms.

Question 24

Clinical Trials

Answer 24

experiments that test the effectiveness of treatment such as comparing psychotherapy and medication.

Directly related to treatment outcome

studies.
Purpose: Tests the effectiveness of interventions (e.g., psychotherapy vs. medication) in real-world or controlled clinical settings.

Example: A randomised controlled trial (RCT) comparing CBT to antidepressant medication for depression.

Question 25

Natural Experiments

Answer 25

observe effect of naturally occurring events in behaviour and psychopathology. - study populations exposed to uncontrollable events.

They focus on naturally occurring events (e.g., trauma, disasters) and their impact, often to explore the psychological effects rather than evaluate specific treatments.

Example: Observing the mental health outcomes of populations exposed to a natural disaster.

Question 26

Systematic Review

Answer 26

structured process of gathering, evaluating and synthesising research to answer a specific question using explicit and standardised methods.

Example: Reviewing RCTs on PTSD therapies to identify best practices.

Question 27

meta-analysis

Answer 27

statistical technique that aggregates data from multiple studies to assess the strength and consistency of findings.

Example: A meta-analysis examining the effectiveness of mindfulness-based therapy across dozens of clinical trials.

Question 28

mediators and moderators

Answer 28

• mediators: variable that explains the mechanics linking the IV and the DV. If moving the mediators eliminates the IV-DV relationship, mediator account effect
  ie. coping strategies
• moderators: a variable that influences the strength of the IV-DV relationship
  ie. client-therapist relationship

Question 29

Qualitative/Quantitative

Answer 29

• qualitative= reply on verbal data instead of statistical analysis.
  +ve:
• rich data- deep insight into subjective experience
• flexibility, may guide future research
  -ve
• subjectivity
  -limited generalisability
• quantitative, precise measurement and statistical analysis.

Question 30

Factors influencing choice of research

Answer 30

Nature of research question:
Causal relationship —> experimental design
Correlations or description —> qualitative or observational design

Population characteristics
- large, generalisable samples —>quantitative methods
- advanced stages —> quantitative methods

Question 31

ethical concerns

Answer 31

Informed consent
Causing distress or withholding benefits
Privacy and confidentiality

Question 32

Social constructionism !! Alternative framework in clinical psychology

Answer 32

• proposes that reality is socially constructed with no universal truths.
• individual constructs unique realities
• emphasises analysis language and social interaction and history of the patient as a key to understanding their experience.
• case-to-case approach

While the scientific method still remains dominant, to effectively treat patients, clinical psychology must account for individual differences and subjective realities.

Question 33

Key responsibilities of a Clinical Psychologist:

Answer 33

1. diagnosis and treatment
2. therapeutic interventions
3. monitoring and evaluation
4. research contributions
5. consultation and collaboration

Question 34

Key responsibilities of a Clinical Psychologist:

Diagnosis and assessment:

Answer 34

Conduct comprehensive psychological assessments to diagnose mental health condition using:
- clinical interviews
- standardised psychological tests
- behavioural observations
ie. assessing client for depression using diagnostic tools like the Beck Depression Inventory.

Question 35

Key responsibilities of a Clinical Psychologist:

Therapeutic interventions:

Answer 35

Develop and deliver treatments tailored to individuals needs, including:
- psychotherapy: CBT, dialectical behavioural therapy (DBT), acceptance and commitment therapy ACT.
- trauma inventories: techniques such as exposure therapy or memory specificity training MeST for PTSD.
- family or group therapy: a dress relational and systemic issues

Question 36

Key responsibilities of a Clinical Psychologist:

. Monitoring and evaluation:

Answer 36

• regularly assess client progress to ensure treatment effectiveness.
• use feedback-informed care, adapting interventions based on measurable outcomes

Question 37

Key responsibilities of a Clinical Psychologist:

Research contributions:

Answer 37

Contribute to research byL
- refining theories of psychopathology (ie. understanding how cognitive biases affect anxiety)
- evaluating the efficacy of new interventions through methods like randomised controlled trials (RCTs)
- publishing findings to advance the field of psychology,

Question 38

Key responsibilities of a Clinical Psychologist:

consultation and collaboration:

Answer 38

Collaborate with multidisciplinary teams, including psychiatrists, social workers and occupational therapists, to provide holistic care.

Question 39

Important of evidence-based practice (EBP)

Answer 39

EBP is the cornerstone of clinical psychology. It integrates clinical expertise, patients values and the best available research to guide decision-making in mental health care.

Question 40

core principles EBP

Answer 40

1. Best research evidence:
   Clinical decisions are informed by findings from high quality studies, such as RCTs and meta-analyses.
   ie. using CBT for anxiety- been validated through numerous trials.
2. Clinical expertise:
   - psychologist apply their training and experience to interpret research and adapt interventions to individual clients.
3. Client preferences and values
   Treatment plans are personalise to align with the clients unique needs, cultural back groud and goals.

Question 41

Benefits
+ challenge EBP

Answer 41

1. Improved treatment outcomes- reducing symptoms and improving functioning
2. Cost-effective- resources are allocated to treatment supported by research, avoiding unproven or ineffective methods.
3. Enhanced professional credibility: reinforces psychology as a science-based discipline within the broader field of healthcare.

challenges:
- applicability to diverse populations- research findings may not generalise to all cultural or demographic groups - must fit individual context
- bridiging research and practice - may face challenges translating research findings into real-world clinical settings.

Question 42

Classifying Psychopathology

Answer 42

• Purpose of Classification: Classification is crucial for understanding psychopathology causes, optimizing treatment, and structuring mental health services. It also aids in legal and societal obligations, like assessing fitness for trial or educational needs.

Question 43

DSM-5 - development and purpose

Answer 43

Development:

1952: DSM-I (106 diagnoses), based on ICD by WHO.
Iterative improvements to refine diagnostic criteria (DSM-II to DSM-5).
DSM-5 (2013): Includes ~300 disorders, organised into categories like neurodevelopmental disorders, anxiety, and mood disorders.
Purpose:

Provides a common language for mental health professionals.
Essential features for diagnosis, differential diagnosis guidelines, and associated features.
Notable Changes in DSM-5:

Combined Axes I–III into a single axis.
Inclusion of dimensional assessments for some disorders.
New categories, e.g., Binge-Eating Disorder.

Question 44

• Problems with DSM

Answer 44

Symptom-Based Focus:

Relies on observable behaviours, not underlying causes.
Risks superficial treatment strategies.
Stigma and Over-Medicalisation:

Diagnostic labels can lead to stigma and misapplication.
Over-diagnosis of normal emotions (e.g., mild neurocognitive disorders).
Comorbidity:

Disorders often co-occur (e.g., anxiety and depression).
Challenges discrete categorisation of illnesses.
Cultural and Contextual Bias:

Limited consideration of cultural symptom expressions and social factors.

Question 45

Defining and diagnosing psychopathology:

Answer 45

The DSM 5 tries to differentiate between deviant behaviours and what is considered mental illness. Two main factors are **distress and disability **as important defining characteristics.

Distress: the chronic experience of pain or distressing emotions

Disability: the impact of distress on normal functioning. It is considered a mental illness when it effects daily functioning.

Question 46

DSM-5: 4 main objectives

Answer 46

1. provide sufficient criteria for diagnosis
2. means for distinguishing true psychopathology from non-disorder human behaviour (ie. sadness, depression)
3. criteria that can be applied systematically
4. criteria should be theoretically neutral.

DSM-5 provides
essential features- must have, define the disorder
associated features- usually accompany disorder
diagnostic criteria- list of symptoms

Question 46

comordibity

Answer 46

the occurence of two or more distinct disorders at one time

Question 47

hybrid disorders

Answer 47

disorders that contain elements of a number of different disorders

Question 48

Clinical Assessment Methods

Answer 48

Purpose:

Gather information on symptoms, causes, and maintaining factors.
Develop prognosis and treatment plan.
Assessment Tools:

Clinical Interviews: Unstructured, semi-structured, structured (e.g., SCID-5).

**Questionnaires: **Beck Depression Inventory (BDI), symptom checklists.
**Psychological Tests: **Rorschach Inkblot, WAIS-IV for IQ.

Neuroimaging: fMRI and PET scans for brain function.
Principles:

Reliability: Test-retest, interrater, and internal consistency.
Validity: Predictive, construct, and concurrent validity.

Question 49

Clinical Interviews

Answer 49

• Clinical interviews involve conversations aimed at gathering information about a client’s symptoms, history, and circumstances.
• Approach varies with the clinician’s orientation:
  o Psychodynamic: Focus on childhood history and emotional responses.
  o Behavioural: Examine symptom-environment relationships.
  o Cognitive: Identify assumptions or beliefs influencing the client’s problems.

Skills Required for Effective Interviews
* Establishing rapport and trust.
* Convincing clients of the value of the theoretical approach.
* Showing empathy to encourage disclosure.
Challenges
* Clients may withhold information due to embarrassment, legal concerns, or lack of self-awareness.
* Skilled interviewers must infer reliable information for diagnosis and treatment planning.

Question 50

clinical interview type

Structured Interviews

Answer 50

Structured interviews offer standardisation to improve diagnostic reliability. Key structured tools include:
1. Structured Clinical Interview for DSM-5 (SCID-5)
o A branching interview based on DSM-5 criteria.
o Ensures higher reliability in diagnosis by guiding the sequence of questions based on client responses.

2. Mini Mental State Examination (MMSE)
   o A 10-minute structured test assessing cognitive and mental functioning, particularly useful for detecting dementia.

Question 51

limitations clinical interview

Answer 51

1. Low Reliability:
   o Different clinicians may obtain inconsistent information based on factors such as interviewer demeanour, race, or attire.
   o Clients respond differently to warm versus cold interviewers.
2. Biases in Clinicians:
   o Primacy Effect: Over-reliance on first impressions.
   o Recency Effect: Priority given to recently presented information.
   o Influence of irrelevant client characteristics (e.g., race or gender).
3. Client Deception:
   o Intentional misleading or lying, often in cases of personality or sexual disorders, complicates accurate diagnosis

Question 52

Psychological Tests

Answer 52

Psychological tests are highly structured tools used to gather information about individuals. Unlike interviews, these tests typically involve written questionnaires, verbal administration, or computer-based formats

Question 53

Advantages of Psychological Tests

Answer 53

• specific assessment
• structured response
• standardisation
• rigorous testing for validity and realiability
• psychomatric approach- assumes stable underlying traits

Question 54

psychological tests personality

Answer 54

personality:
* Minnesota Multiphasic Personality Inventory (MMPI):
o Consists of 567 self-statements rated as ‘true,’ ‘false,’ or ‘cannot say.’
o Measures mood, physical concerns, social attitudes, psychological symptoms, and well-being.
- cut off score for psychopathology

• Big Five Inventory-2 (BFI-2):
  o Measures personality across five domains: extraversion, agreeableness, conscientiousness, neuroticism, and open-mindedness.

Question 55

psychological tests- specific trait inventory

Answer 55

• Assess single traits or psychopathologies, such as anxiety, depression, or OCD.
• Example: Obsessive Belief Questionnaire (OBQ):
  o Measures cognitive constructs related to OCD, such as:

 Intolerance of uncertainty
 Overestimation of threat
 Perfectionism
o Definition: Hypothetical constructs are inferred traits (e.g., intolerance of uncertainty) measured indirectly through related behaviours or responses

Question 56

psychological test- projective test

Answer 56

• Present ambiguous stimuli for clients to interpret.
• Examples:

o Rorschach Inkblot Test:
 Involves interpreting symmetrical inkblots.
 Can detect thought disorders like schizophrenia but relies heavily on clinician interpretation.

o Thematic Apperception Test (TAT):
 Consists of 30 ambiguous images where clients create stories to reveal emotional states and relationships.

• Limitations:
  o Low reliability and validity.
  o Susceptible to cultural biases.
  o Time-intensive for administration and scoring.

Question 57

psychological test - CAT

Computerised Adaptive Testing (CAT)

Answer 57

• Tests administered and scored via computer.
• Benefits:
  o Customises questions based on client responses.
  o Reduces response bias and saves time.
• Applications:
  o Effective in diagnosing anxiety, depression, and other mental health issues.

Question 58

psychological test- intelligence

Answer 58

• Definition: IQ (Intelligence Quotient) Tests estimate intellectual ability, often for diagnosing learning disabilities or developmental issues.
• Example: Weschler Adult Intelligence Scale (WAIS-IV):
  o Measures skills such as vocabulary, arithmetic, and reasoning.
• Strengths:
  o High internal consistency and test-retest reliability.
  o Standardised with a mean score of 100 and standard deviation of 15 or 16.
• Limitations:
  o Cultural Bias:
   Assumes middle-class norms, disadvantaging some socio-economic or ethnic groups.
  o Static Snapshot:
   IQ tests may not reflect learning potential.
  o Flynn Effect:
   IQ scores increase over time, affecting diagnostic thresholds.

Question 59

psychological test- neurological impairment test

Answer 59

• Assess cognitive, perceptual, and motor deficits caused by brain injuries or degenerative conditions.
• Tools:
  o Adult Memory and Information Processing Battery (AMIPB):
   Measures memory and processing speed.
  o Halstead–Reitan Neuropsychological Test Battery:
   Evaluates sensory, cognitive, and motor functions.
  o Positron Emission Tomography (PET):
   Measures brain structure and function.

Question 60

4 Biologically Based Assessments

Psychophysiological Tests

Answer 60

1. Electrodermal responding (GSR/SCR)- identifies sweat gland activity - identifiy anxiety stimuli
2. EMG- electrical imoulse in muscles to assess physical response
3. ECG- heart rate to detect physiological response

Question 61

4 Biologically Based Assessments

Neuroimaging Techniques

Answer 61

1. CAT- X-ray in 3D image of brain- detecting tumours
2. PET- measures brain metabolism, assessing functions in task
3. SPECT- 3D image of neuron activity
4. MRI- magnetic field to create image of brain- mapping activity during task

Question 62

Clinical Observation

Answer 62

Clinical observation involves directly watching a client’s behaviour to supplement interviews and tests.

1. ABA chart
2. analogue observation
3. self-observation/ self monitoring

Question 63

Cultural Bias

Answer 63

when assessment methods, developed in specific cultural contexts, fail to accurately evaluate individuals from different backgrounds.

causes:
- differing manifestation of symptoms// what is considered normal
- language barrier
- cultural beliefs
- client-clinician dynamics
- stereotype and confirmation bias- confirmation bias.

Question 64

Addression Cultural Bias

Answer 64

1. Improving assessment tools
2. structured interview
3. cultural competency training
4. DSM guidelines

Question 65

Case Formulation

Answer 65

Case formulation refers to the process of using clinical information to develop a psychological explanation of a client’s problems and creating a plan for therapy.

components:
- listing clients problems
- describing underlying psychological mechanisms
- expaining the generation of problem
- identifying precipitating events
- linking events and mechanism
- developing a treatment plan

Question 66

Types of Therapies

Answer 66

Biological: Medications like SSRIs, benzodiazepines, antipsychotics. Focus on symptom relief.

Psychodynamic: Resolves unconscious conflicts (e.g., free association, dream analysis).

Behavioural: Focus on observable behaviours using conditioning techniques (e.g., systematic desensitisation).

Cognitive: Reframe dysfunctional thoughts and beliefs (CBT).
Humanistic: Personal growth and client-centred approaches (empathy, positive regard).

Social/Family: Systemic therapies address relational dynamics.

Question 67

Advantages of Case Formulation

Answer 67

1. Individualised Understanding:
   o Provides a flexible, personalised explanation of the client’s unique problems, even when they do not fit standard diagnostic categories.
2. Collaborative Process:
   o Engages the client in understanding their issues, fostering mutual respect and cooperation.
3. Theoretical Basis:
   o Grounded in established psychological theories rather than symptom descriptions alone.
4. Incorporation of History:
   o Considers personal, social, and family background, including exposure to risk factors.
5. Tailored Treatment Strategies:
   o Enables customised interventions suitable for complex cases.
6. Improved Outcomes:
   o Empirical evidence suggests better therapeutic outcomes when using case formulation approaches compared to standard diagnosis-based methods.

Question 68

Purpose of Classification in Mental Health

Answer 68

1. Knowledge Sharing: Enables professionals to share information about mental health issues systematically.
2. Targeted Support: Ensures sufferers receive appropriate interventions for their specific problems.

Question 69

Introduction of Psychopathology

Answer 69

refers to psychological disorders or symptoms that significantly disrupt an individual’s emotional, cognitive, or behavioural functioning. It can manifest as:

• Emotional symptoms: anxiety, depression, guilt, worthlessness.
• Cognitive symptoms: feeling of lack of control
• Behavioural symptoms: self-harm, substance abuse
  these symptoms often cause personal distress and impairs daily functioning

Question 70

Characteristics of Effective Treatments

Answer 70

1. Relief from Distress:
   o Alleviate the emotional and physical distress caused by symptoms.
2. Self-Awareness and Insight:
   o Help clients understand the origins and nature of their problems.
3. Coping and Problem-Solving Skills:
   o Equip clients with strategies to manage future challenges.
4. Identification and Resolution of Causes:
   o Address underlying issues, whether behavioural, cognitive, or experiential.

Question 71

Therapies and Their Characteristics

Answer 71

1. Palliative Effect:
   o Definition: The reduction of symptom severity and associated distress without necessarily addressing the root causes.
   o Example: Drug treatments often alleviate symptoms but rarely promote insight or long-term behavioural change.
2. Insight-Oriented Therapies:
   o Focus: Understanding the causes of problems (e.g., psychodynamic psychotherapy).
   o Limitation: Insight does not always lead to behavioural change or coping skill development.
3. Behavioural Therapies:
   o Focus: Changing problematic behaviours.
   o Limitation: May not address the deeper causes or provide insight into the problems

Question 72

Theoretical Approaches to Treatment:

Psychodynamic Approaches

Answer 72

Psychodynamic therapies aim to:
* Uncover unconscious conflicts that cause psychopathology.
* Identify the early life events that contributed to these conflicts.

• Free Association:
  o Definition: A technique where the client verbalises all thoughts and feelings to uncover unconscious associations.
• Dream Analysis:
  o Definition: Analysing dreams to interpret unconscious beliefs and conflicts.
• Interpretation:
  o Definition: The psychoanalyst helps the client understand and address unconscious conflicts revealed through these techniques.

Question 73

Theoretical Approaches to Treatment:

Behavioural Therapies

Answer 73

Core Principles
Behavioural therapies focus on:
* Treating symptoms as behavioural problems rather than signs of hidden causes.
* Addressing faulty learning that leads to maladaptive behaviours.
* Using conditioning principles to “unlearn” problematic responses.
Conditioning: a form of associative learning on which behaviours therapies are based
Faulty learning: a view that the symptoms of psychological disorders are acquired through the learning of pathological responses.
Behaviour analysis: an approach to psychopathology based on the principles of operant conditioning (also known as behaviour modification).

Question 74

Therapies Based on Classical Conditioning

Answer 74

Extinction
* Definition: Disrupting the association between anxiety-provoking stimuli and trauma to “unlearn” emotional responses.
* Examples:
o Flooding:
 Definition: Direct, repeated exposure to distressing stimuli to extinguish fear.
o Systematic Desensitisation:
 Definition: Gradual exposure to fear-inducing stimuli combined with relaxation techniques.
o Counterconditioning:
 Definition: Pairing anxiety-inducing stimuli with a response incompatible with anxiety (e.g., relaxation).
o Reciprocal Inhibition:
 Definition: Eliminating anxiety by associating the anxiety-inducing cue with a response that cannot coexist with anxiety.

Aversion Therapy = a treatment based on classical conditioning which attempts to condition an aversion to a stimulus or event which the individual is inappropriately attracted.
* Definition: Conditioning an aversion to stimuli that elicit inappropriate attraction (e.g., pairing alcohol with sickness).
* Applications: Treating addictions, compulsions, and distressing behaviours.
* Limitations: Often yields short-lived effects and limited evidence for long-term effectiveness.

Question 75

Therapies Based on Operant Conditioning

Answer 75

Core Concepts
* Operant conditioning involves influencing behaviour by manipulating its consequences.
o Reinforcement increases behaviour frequency.
o Punishment decreases behaviour frequency

ie. 3. Response Shaping:
o Definition: Gradual reinforcement of behaviours approximating the desired target behaviour.
o Application: Useful for individuals with limited behavioural repertoires (e.g., severe intellectual disabilities).
4. Behavioural Self-Control:
o Definition: Applying operant conditioning principles personally to modify one’s own behaviour.
o Example: Programmes addressing overeating, smoking, and other maladaptive behaviours.

Question 76

Cognitive Therapies

Answer 76

adressess:
* Cognitive Factors in Psychopathology:
o Dysfunctional thinking or schemas about the self, the world, and the future can cause and maintain psychopathology.
o Anxiety disorders often involve a bias toward processing threatening information or interpreting ambiguous information negatively.

Beck’s Cognitive Therapy
* Developed by Aaron Beck to treat depression.
* Based on the negative schema theory:
o Depressed individuals hold negative views of themselves, the world, and the future (negative triad).
* Process:
o Engage clients in objectively assessing their beliefs.
o Demonstrate how their schemas are irrational and biased.
o Replace negative schemas with rational alternatives.

Cognitive Behaviour Therapy (CBT)
* Definition:
o CBT combines cognitive and behavioural techniques to change dysfunctional thoughts and behaviours.
* Core Characteristics:
o Keeping a diary to track events, thoughts, and feelings.
o Identifying and challenging irrational or biased thoughts.
o Homework, such as behavioural experiments, to test new thoughts.
o Training in new ways of thinking and responding to triggering situations

Question 77

Humanistic therapies

Answer 77

Humanistic therapies aim to address the whole person rather than just their symptoms, focusing on self-awareness, personal growth, and emotional well-bein

Key Characteristics
* Emphasise a personal therapist-client relationship.
* Take a holistic approach, considering the client’s entire life and experiences.
* Encourage clients to make decisions and solve problems independently.
* Advocate for reciprocal and empathetic relationships between therapist and client.

• Focus:
  o Immediate conscious experience.
  o Developing independence, self-direction, and self-growth.
• Key Elements:
  o Empathy:
   Understanding and experiencing the client’s feelings.
   Demonstrating unconditional positive regard (valuing the client without judgment).
  o Non-directive Approach:
   The therapist acts as an understanding listener rather than prescribing solutions.
• Goal:
  o Help clients accept themselves, resolve conflicts, and achieve self-worth.

Question 78

Family Therapy

Answer 78

Family therapy is an intervention involving family members to address psychopathology that arises from relationship dynamics within the family.
* Purpose:
1. Improve communication between family members.
2. Resolve specific conflicts, such as disputes between adolescents and parents.
3. Apply systems theory to understand and reshape complex family relationships into those expected of a well-functioning family unit.

Question 79

Approaches Used in Family Therapy

Answer 79

Family therapists are eclectic, employing various techniques depending on the issue:
* Cognitive-Behavioural Methods: Focus on altering thought and behaviour patterns within family interactions.
* Psychodynamic Approaches: Explore unconscious dynamics and past relationships influencing current family dynamics.
* Systemic Analysis: Examines how relationships and interactions sustain problems and how to reconfigure them.

Question 80

Drug Treatments for Depression

Answer 80

1. Tricyclic Antidepressants:
   o Developed in the 1960s.
   o Increase norepinephrine and serotonin availability for synaptic transmission.
2. Monoamine Oxidase Inhibitors (MAOIs):
   o Effective for individuals with major depression unresponsive to other antidepressants.
   o Also prescribed for panic disorder and bipolar depression.
3. Selective Serotonin Reuptake Inhibitors (SSRIs):
   o “Designer drugs” such as fluoxetine (Prozac), sertraline (Lustral), and citalopram (Cipramil).
   o Selectively block serotonin reuptake, reducing depressive symptoms.
4. Serotonin–Norepinephrine Reuptake Inhibitors (SNRIs):
   o Block the reuptake of both serotonin and norepinephrine.
   o Effective and well-tolerated, especially for anxiety-based symptoms

Question 81

Drug Treatments for Anxiety

Answer 81

1. Benzodiazepines:
   o Includes drugs like Valium.
   o Increases gamma-aminobutyric acid (GABA) levels, reducing anxiety symptoms.
   o Limited to short-term use due to dependence risks and cognitive side effects (e.g., memory lapses, drowsiness).
2. SSRIs and SNRIs:
   o Now the first choice for anxiety-based problems.
   o Effective and well-tolerated compared to benzodiazepines.
   o Associated with fewer withdrawal symptoms.
   Effectiveness
   * Benzodiazepines offer only symptom relief, with symptoms often returning upon cessation.
   * SSRIs and SNRIs provide a longer-term solution with fewer side effects.

Question 82

Drug Treatments for Psychosis

Answer 82

Antipsychotics
1. First-Generation Antipsychotics:
o Developed in the 1940s and 1950s.
o Reduce positive symptoms (e.g., hallucinations, delusions).
o Less effective for negative symptoms (e.g., apathy, social withdrawal).
o Side effects: Extrapyramidal effects (tremors, slurred speech), blood sugar issues.
2. Second-Generation Antipsychotics:
o Introduced in the 1970s and 1980s.
o Improve both positive and negative symptoms.
o Fewer extrapyramidal side effects.
o Marginal improvement in cognitive deficits.
Effectiveness
* Antipsychotics enable many individuals with schizophrenia to achieve relatively normal functioning.
* Long-term use prevents worsening of symptoms but does not cure psychosis.
Challenges
* High dropout rates due to side effects (e.g., over half discontinue within a year).
* Limited innovation in developing a “third generation” of antipsychotics.

Question 83

Problems with Drug Treatments

Answer 83

1. Over-Medicalisation:
   o Mild symptoms may be unnecessarily treated as medical conditions.
   o Encourages reliance on medication over understanding psychological causes.
2. Dependency:
   o Long-term use may foster belief in unchangeable symptoms, discouraging insight into psychological factors.
3. Relapse Risk:
   o While effective in the short term, drug treatments may increase vulnerability to relapse upon discontinuation.
   o Drug tolerance effects and lack of psychological insights contribute to this issue.
4. Side Effects:
   o Side effects across various drug types (e.g., weight gain, cognitive effects) often lead to non-compliance.

Question 84

Combination Treatments

Answer 84

• Combining drug treatments with psychological therapies (e.g., Cognitive Behaviour Therapy) often yields better long-term outcomes.
• Example: CBT complements antidepressants by addressing psychological and behavioural factors contributing to depression and anxiety