Week 1-An introduction to Clinical Psychology

Question 1

What’s Clinical Psychology?

Answer 1

The aim is to decrease psychological distress and boost psychological wellbeing

Question 2

What methods can be used in clinical assessments and what do they lead to?

Answer 2

1.Psychometric tests to interviews

2.Direct observation

This leads to counselling, therapy and advice

Question 3

Give terms for mental health problems

Answer 3

-Psychopathology

-Mental illness

-Mental health problem

-Mental distress

They all provide different perspectives on mental health problems

Question 4

What terms are used to describe those experiencing mental distress?

Answer 4

-Patients

-Recipients

-Psychiatric system survivors

-Clients, consumers, service users (UK)

Again provide different perspectives

Question 5

Why does language matter?

Answer 5

-Mental distress has stigma and discrimination in various settings (71% would move next door to someone with depression whereas it was 41% for someone with schizophrenia, British Social Attitudes Survey, 2015)

-Negative stereotypes and media portrayals asssociated

-Low employment rates + increased risk for verbal abuse, physical harassment and victimisation

Question 6

What is mental distress according to Cromby et al., p. 6?

Answer 6

Experiences associated with diagnostic categories and with the work of professions e.g., clinical psychology, psychiatrists, social work and nursing.

Question 7

Give 4 examples of what mental distress is

Answer 7

1.Emotions that disrupt everyday life + functioning

2.Habitual and repetitive behaviours creating anxiety if not carried out

3.Seeing and hearing things others don’t

4.Holding beliefs considered unusual and/or extreme

Question 8

What can be “classed” as abnormal?

Answer 8

-Something that worsens health and wellbeing

-Something that’s disapproved in certain times and places (but can be changed)

-Something that’s unusual in the population

Question 9

Define Persistent Complex Bereavement Disorder (PCBD) + State Symptoms

Answer 9

The patient has experienced the death of a loved one at least 6 months ago and is experiencing longer than expected:
-Intense and persistent yearning for the deceased

-Frequent preoccupation with the deceased

-Intense feelings of emptiness and loneliness

-Recurrent thoughts that life is meaningless or unfair without the deceased

-A frequent urge to join the deceased in death

(can vary based off cultural norms)

Question 10

Give 5 symptoms of PCBD that need to have 2 experienced in the past month

Answer 10

1.Feeling shocked, numb or stunned since the death

2.Feelings of disbelief and inability to accept loss

3.Rumination about the circumstances OR consequences of the death

4.Experiencing pain that the deceased suffered, or hearing/seeing the deceased

5.Intense reactions to reminders or memories of the deceased

Question 11

What 3 symptoms of PCBD can cause substantial distress for the sufferer or impact significantly on areas of functioning and cannot be attributed to other causes?

Answer 11

1.Anger or bitterness about the death

2.Trouble trusting or caring about others

3.Avoidance of reminders about the deceased OR seeking out reminders to feel close to the deceased

Question 12

True or false: Many people experience a DSM-defined disorder at least once during their lifetime

Answer 12

True as said by Kessler et al. (2015)

Question 13

How did Moffit et al. (2010) measure mental distress in New Zealand?

Answer 13

-N=1037

-Measured diagnoses of anxiety, depression and cannabis and alcohol dependence

-Then compared to national surveys

Question 14

What were Moffit et al’s (2010) findings?

Answer 14

-Study had a 2x higher prevalence rates for all DSM diagnoses compared to national surveys

-Therefore experience of DSM diagnoses is far more common than thought

Question 15

What are varying ideas of mental distress influenced by?

Answer 15

-Cultural and social norms (time and place, socioeconomic status, gender, ethnicity etc.,)

-Individual psychologist opinions on what classes as normal and abnormal

-Ideas reflect views on human nature and social order instilled by social, economic, educational and religious backgrounds

Question 16

What does WEIRD stand for? (what our psychology is)

Answer 16

Western
Educated
Industrialised
Rich
Democratic

-most psychological research based off WEIRD societies (Henrich et al., 2010)

-unrepresentative and limits our understanding of adverse experiences and mental distress

Question 17

What is meant by individualistic orientation?

Answer 17

-Our area still largely sees the behaviour of abstract individuals as the response to a given environment

-It conceptualises the causes of mental distress as within rather than from outside forces

Question 18

Explain the case of Dora by Sigmund Freud

Answer 18

-persisted frequent coughs and headaches and was uncomfortable by her father’s (Herr K) friends advances

-Freud concluded these were hysterical symptoms of her disguised desires for him and she actually enjoyed the attention

-She quit therapy driving Freud to enrich his diagnosis with labels of vengeful, disagreeable and untruthful

Question 19

What was neurasthenia in the 19th century + suggested treatment?

Answer 19

-A mental disorder with aspects from today such as chronic fatigue, depression and premenstrual syndrome

Treatment:
-Compulsory bed rest

-Forced deprivation of mental stimulation

-Isolation from adult company

-Constant heavy feeding

Question 20

Give an example of an abnormal social norm in the 1980s

Answer 20

-Homosexuality was classed as a mental disorder in the DSM

-Evelyn Hooker and Alfred Kinsey provided evidence-based support for gay rights activists and lobbying support in the APA, leading to a poll held by members of the association in 1973

Question 21

How can some diagnostic categories be more related to social issues rather than mental disorders providing an example?

Answer 21

Leslie Camhi (1993) argued the diagnosis of kleptomania originated in parallel with the invention of large department stores

For example:
Lower class woman who stole=thief
Higher class woman who stole=mentally ill

Question 22

Name the 3 models of mental illness and what they are

Answer 22

1.Psychological model: Thought patterns, personality and learning

2.Sociological model: Inequality and poverty, family dynamics, trauma and abuse

3.Biomedical model: Body structure and functioning, genetics, neurotransmitters, hormones, brain structure and functioning

Question 23

What does Paul Applebaum, American Psychiatric Association (APA) president 2002-2003 say about the biomedical view?

Answer 23

“Our brains are biological organs by their very nature. Any [mental] disorder is in its essence a biological process

I.e., psychological phenomena can be fully reduced to biological causes

Question 24

What’s the Chemical Imbalance Theory?

Answer 24

Mental disorders are caused by an imbalance of neurotransmitters in the brain

-Important cultural uses

-Reduces uncertainty about the cause of mental distress

Question 25

What is a benefit and limitation of drugs? (short, cheap mental health treatments)

Answer 25

B: Quicker and cheaper solution than in-depth long-term therapy.

L: Often limited to superficial improvements

Question 25

Why are drug treatments often limited to superficial improvements?

Answer 25

-Promotion of psychotropic medication

-Research funding

-Selective reporting on research results

Question 26

Why is there an expensive effort to market these drug products?

Answer 26

-Leads to over-optimistic expectations

-Encourages taking medication for minor difficulties

-Promotes the idea that most psychological are caused by the brain or bodily malfunctions

-Discourages investing time and effort into psychotherapy

Question 27

What are categorical models for mental distress?

Answer 27

-Assumes an objective difference between mental health (an abnormal experience) and mental illness (an abnormal experience) and are seen as separate categories

-Diagnostic categories can be reliably identified by trained professionals (based on diagnostic manual with a outlined criteria for mental illness)

Question 28

What do most Western mental health professionals use to classify and diagnose disorders?

Answer 28

Diagnostic and Statistical Manual of Mental Disorders (DSM; latest edition: DSM-5-TR, published in March 2022), a publication by the American Psychiatric Association (APA)

Question 29

What are the 3 major components of the DSM?

Answer 29

1.Diagnostic classification

2.Diagnostic criteria sets

3.Descriptive texts

Question 30

What’s diagnostic classification in the DSM?

Answer 30

An official list of recognised mental disorders including a diagnostic code for each diagnosis.

Question 31

What are diagnostic criteria sets in the DSM?

Answer 31

A set of diagnostic criteria indicates symptoms that must be present + for how long for each disorder

Question 32

What does the descriptive text include in the DSM?

Answer 32

-Prevalence

-Development and course

-Risk and Prognostic factors (biomarkers)

-Culture-Related Diagnostic Issues

-Gender-Related Diagnostic Issues

-Functional Consequences

-Differential Diagnosis

-Comorbidity

Question 33

What perspective does the diagnostic manual take + the benefits for clinical practice and research?

Answer 33

A disease perspective catching abnormalities within categories

Benefits:
-Permits the accumulation and synthesis of knowledge and experience

-Provides professionals with a common knowledge (lingua franca)

Question 34

What are the limitations of the DSM for clinical practice and research?

Answer 34

-Reflects the social prejudices of the predominantly White, male etc., people responsible for its writing and update

Influenced by the pharmaceutical industry:
-Emphasis on biological and heritable aspects

-Psychiatric conditions are defined by a list of symptoms that mimic the style of biomedical diagnostic categories, and even in the terms (disease, symptom, patient, syndrome, relapse, etc. )

-The growing number of diagnostic categories reflects that more and more behaviours formerly regarded as eccentricities, sins, crimes or ordinary life worries are being regarded as diseases or conditions

Question 35

What is the dimensional model of individual differences?

Answer 35

-Mental illness arises out of psychological vulnerabilities and environment provocations that vary in degree NOT kind

-Assumes there isn’t a sharp dividing line between mental health and illness

-Majority of UK clinical psychologists use dimensional models in their practice

-Incorporated in DSM-V-TR to some extent

Question 36

What is the difference between categorical models and dimensional model of individual differences?

Answer 36

CM: Abnormalities can be separated into different categories BUT they admit dimensional variation within categories.

DM: Mental illness arises out of psychological vulnerabilities and environmental provocations that vary in degree rather than in kind BUT quantitative variation can be simplified into categorical distinctions.