Unit 8 Clinical Psychology Defining Psychological Disorders *clinical psychologists” or “academic psychologists” are concerned with how psychological disorders are defined and diagnosed, and what treatments are recommended for these disorders”* Abnormal psychology: the study of people who suffer from psychological disorders. Common characteristics of disorders: 1. Maladaptive (harmful)/ disturbing to the individual. 2. Disturbing others 3. Unusual, (not shared by many num of pop.) 4. Irrational (doesn’t make sense) Insanity - to differentiate the people who can hold entirely responsible for their crimes (the same) and those who can not (with psychological disorder). Ex: Not Guilty by Reason of Insanity (NGRI) Diagnostic and Statistical Manual of Mental Disorders (DSM) - book psychologist use to determine mental disorders. (With symptoms ex_) - Does not include much causes (etiology) or treatment, because diff perspectives argu. - Psychoana (uncon conflic & tra. event) , behaviorist (history of reinforcement, env), cognitive (harmful way of thinking), humanistic (failure to strive toward potential/feeling, self-esteem/concept). Biosocial (dysfunctional society) Categories of Disorders Anxiety disorders Phobia - an intense unwarranted⽆根据的 fear of a situation or an object. 1. Claustrophobia (fear of enclosed spaces) 2. Agora 集会 phobia (fear of open, public spaces) 3. Arachnophobia (fear of spiders) Generalized Anxiety Disorder (GAD) - experiences constant, low-level anxiety. Panic disorder - suffers acute episodes of intense anxiety without any apparent provocation eat physmalprobonabuseofanyideation physicaland related disorder) Somatoform disorders 觉得⾃已有病障碍（somatic躯体的 symptom *occur when a person manifests a psychological problem through a physiological symptom Conversion 转变 disorder : report their concerns seriously but they’re fine cause Ifblondeheblond Dissociative disorder 解离症 - involve a disruption in conscious processes 1. Dissociative amnesia 解离遗忘症 - when a person cannot remember things and no physiological basis for the disruption in memory can be identified 2. Organic amnesia - biologically induced 3. Dissociative identity disorder <multi-personality disorder> - when a person has several personalities rather than one iterated personality. - childhood trauma/ abuse 4. Dissociative fugue: A subtype of dissociative amnesia in which patients construct new identities and personal histories for themselves Depressive disorders - experience extreme or inappropriate emotions 1 Major depressive disorder (Unipolar depression) - the common mood disorder, long duration Seasonal affective disorder (SAD) - people experience depression but only during certain times of the year, usually winter with less sunlight. Aaron Beck - cognitive theorist, believed depression results from unreasonably negative ideas that people have about themselves, their world, and their futures- Cognitive triad. Martin Sligman : Learned helpnessness - when one’s prior experiences have caused that person to view him/herself as unable to control aspects of the future that are controllable. Bipolar 躁郁症 and Related Disorders （Manic Depression) - involve feelings of high energy, some feel heightened sense of confidence and power, others feel anxious and irritable. Appeared with depression. Schizophrenic Disorders 精神分裂症 - symptom : disordered, distorted thinking demonstr. through delusions, hallucinations, disorganized language, unusual affect, motor behavior. + Inappropriate effect 1. 2. 3. 4. 5. 6. my Positive symptoms = excesses in behavior, thought or mood. Negative Symtoms = correspond to deficits such as flat affect or catatonia. Neologisms 新词 - make up their own words Clang Associations ⾳联 - string together a series of nonsense words that rhyme Flat effect - consistently have no emotional response at all Catatonia - motor problem, remain motionless in storage postures for hours at a time with waxy flexibility E E Delusions - beliefs that have no basis in reality Ex: win Nobel Prize 1. Delusions of persecution 迫害- belief that people are out to get you 2. Delusions of grandeur 壮丽 - belief that you enjoy greater power/influence than you do Hallucinations - perception in the absence of any sensory stimulation Ex: see my name on newspaper headline e Cause: 1. Dopamine hypothesis - high levels of dopamine cause Schizophrenic disor. - to lower dopamine level, extensive use of drugs could cause tardive dyskinesia 异动症 - muscle tremor颤抖 and stiffness 2. Enlarged brain ventricles, or genetic relationship - biological basis 3. Double binds捆 - when a person is given contradictory messages Ex: mom tells to un but also ask why there’s no friends near . always study 4. Diathesis-stress model 素质-应激模型 - enviro. stressors can provide the circum. Under which a biological predisposition for illness can express itself Personality Disorders - inflexible and enduring behavior patterns that impair消弱 social man functioning 1. Antisocial personality disorder - have little regard for other people’s feelings. View the world as a hostile place where people need to look out for themselves. 2. Dependent personality disorder - rely too much on the attention and help of others 3. Paranoid personality disorder 被害妄想 - feel persecuted 2 4. Narcissistic personality disorder - seeing oneself as the center of the universe 5. Histrionic personality disorder 柔弱娇做(drama) - over dramatic behavior (histrionics) 6. Obsessive - compulsive personality disorder - overly concerned with certain thoughts. And perform certain behaviors, but not to the extent as OCD Obsessive-compulsive disorder (OCD) - when persistent, unwanted thoughts (obsessions) cause someone to feel the need (compulsion) to engage in a particular action Post-traumatic stress disorder (PTSD) - involves flashbacks or nightmares following a person’s involvement in or observation of an extremely troubling event such as a war or natural disaster. Paraphilias / psychosexual disorders - sexual attraction to an object, a person, or an activity not usually seen as sexual. pedophilia - attraction to children/ Zoophilia- to animals/ Fetishism - to objects, (shoes. Voyeur- people who sexually aroused by watching others engage in sexual behavior masochist- aroused by having pain inflicted upon him or her sadist- aroused by inflicting pain on someone else is a. Interestingly Feeding and eating disorders anorexia nervosa 神经性厌⻝症- a form of self- starvation loseweight bulimia - a fear of food and fat and a distorted body image. But doesn’t lose much weight. binge-eating disorder - involves eating very large quantities of food in a short time while experiencing feelings of loss of control. Substance-related and addictive disorders - a diagnosis made when the use of such substances or behaviors like gambling regularly negatively affects a person’s life. Neurodevelopmental disorders- deal with deviations from typical social development. autism spectrum disorder - seek out less social and emotional contact than do other children. tend to be hypersensitive ⾼度灵敏to sensory stimulation, exhibit intense interest in objects not viewed as interesting by most (rubber bands) ; engage in simple, repetitive behaviors (e.g., flipping things). Attention-deficit/hyperactivity disorder (ADHD) 多动症 - have difficulty paying attention or sitting still. Alzheimer’s disease - form of dementia, a deterioration of cognitive abilities, often seen most dramatically in memory. The David Rosenhan Study: The Influence of Labels David Rosenhan - psychologists who gathered a bunch of people and all reported the symptoms of Schizophrenia, get into the hospital, behaves normally, but all behaviors are interpreted as a sign of the disorder Unit 8 Treatment of Psychological Disorders History Trephining - early treatment that was supposed to let harmful spirits escape, 头上钻孔 Hippocrates & Galen - biological causes 3 eat puke Disinstitutionalization 去机构化 - a phenomenon that more people were released from mental institutions because of the development of drugs, save money/ Drawback: former patients unable to care for themselves. Some ended up homeless and delusional. Schiz. Preventative efforts - if psy prob. can be treated proactively 先发制⼈的, or before they become severe, the suffering of the client as well as the cost of providing care can be reduced. 1. Primary prevention - efforts attempt to reduce the incidence of societal prob. joblessness/homelessness that can give rise to mental health issues. 2. Secondary prevention - involv. working with people at-risk of developing specific prob. Ex: counseling people lived in area that has experienced trauma 3. Tertiary prevention - aim to keep people’s mental health issues from becoming more severe. Ex: work with earthquake survivor who already suffered disorder. Types of Therapy Psychotherapy treatment + somatic躯体的 treatment (drugs) Patients + clients Psychoanalysis - Sigmund Freud *Symptoms are outer manifestation of deeper problems* Symptom substitution - after a person is successfully treated for one psychological disorder, that person begins to experience a new psychological problem. Hypnosis , Free associate - say waterer comes to mind without thinking, dream analysis *all of these tech. rely heavily on interpretations of therapist.* Manifest content - want ha the patient reports about their dream. Latent (/hidden) content - revealed only as a result of the therapist’s interpretative work. Resistance - when patients disagree with their therapists’ interpretations, aremu seen as a sign of resistance. The blocking from consciousness of anxiety -laden material. Transference - patients begin to have strong feelings toward their therapists during ther. A further technique to reveal the source of the problem. Psychodynamic - see unconscious as an important element to understanding a person’s difficulties, but are more likely to use a variety of techniques associated with other perspec. Insight therapies - highlight the importance of the patients/clients gaining an understand. of their problems. patients sentences p repeat Listencarefully Humanistic therapies (support, goal, self-actualize: active listening) Free will - belief that peop. with it are capable of controlling their own destinies. Determinism - opposite belief. holds that people have no influence over what happens to them and that their choices are predetermined by forces outside of their control. Carl Rogers: client-centered therapy (person-centered therapy) non-directive Unconditional positive regard - blanket acceptance and support of a person regardless of what s/he says or does. Gestalt therapy - Fritz Perls: want their clients to integrate all of their actions, feelings, and thoughts into a harmonious whole. stress the importance of the present Essential therapies - humanistic therapies that focus on helping clients achieve a subjectively meaningful perception of their lives. - help them formulate a vision of their lives as worthwhile. Clients diff. Cause by lost/fail to develop level purpose I Resp a Behavioral therapies UupResponse Pleasantstimu Plea Counterconditioning - Mary Cover Jones (classical cond) - unpleasant conditioned response is replaces with a pleasant one. Ex: bring toys when kid go in hospital. Systematic desensitization - Joseph Wolpe : teaching client to relate the feelings of anxiety with relaxation. 1. Relax 2.Anxiety hierarchy 3. Covert desensitization / 4 Ethan UnpRespChabot E Stoma Uup n again Cognitive Therapies (attributional style) dad howeverattribute Aaron Beck - cognitive therapy, often seen in depression. Explained by Cognitive triad (beliefs about themselves, worlds, futures) Expose confront Momus tyg impolsion (imagine fear-inducing stimuli) 4. Vivo desensitization (client confronts the actual feared objects or situations) Flooding - having client address most frightening scenario first. Aversive conditioning - involves pairing a habit a person wishes to break (eg, smoking) with an unpleasant stimulus (eg. Electric shock) Token economy - desired behaviors are identified and rewarded with tokens代币. - operant conditioning, BF S 41 1 Cognitive Behavioral Therapy ( CBT ) - combination of cognitive therapy and behavioral then therapy Rational emotive behavior therapy (REBT) - Alter Ellis ,look to expose and confront the dysfunctional thoughts of their clients. occurs not just on how and what clients think but also on what they do. Often challenge people’s irrational, self-defeating attitudes and assumptions.Ex: give assignments, speak to public, realize no damage, cured In 2 Group Therapy (family therapy, self-study groups ) Pepressbe Somatic therapies - see cause of psycho. disorders in organic causes (hormones…) Psychopharmacology (Chemotherapy化学疗法) - drug therapy 1. antipsychotic drugs (Thorazine / Risperdal / Haldol) for Schizophrenia - side effect tardive dyskinesia (类似帕⾦森） 2. Treat unipolar depression - tricyclic antidepressants, monoamine oxidase (MAO) inhibitors, and serotonin selective reuptake inhibitor (most notably Prozac). All can increase the activity of serotonin 3. Lithium- used to treat the manic phase of bipolar disorder. 4. Antianxiety drugs - barbiturates ( depressants - Miltown, benzodiazepines /Xanax, Valium/ ) Paxil - depression and anxiety Electroconvulsive therapy (ECT) 1. Unilateral ECT- run current through only one hemisphere 2. Bilateral - both. Side effect is loss of memory. But more effective Psychosurgery - involves purposeful destruction of part of the brain to alter a person’s behavior. Ex: early psychosurgery Prefrontal lobotomy - an operation involved cutting the main neurons leading to the frontal lobe of brain. Last resort, bc debate. Eclectic therapies - therapeutic orientations can be combined in effective ways. tsentiff Go I Jpy Kinds of Therapists Psychiatrists - medical doctors, the only therapists permitted to prescribe medication in most U.S. states. Clinical psychologists - earn doctoral degrees (PhDs) with four or more years of study. training involves an internship during being overseen by a more experienced professional. Counseling therapists - help people whose problems are less severe than those that bring people to clinical psychologists. Psychoanalysts - people specifically trained in Freudian methods. They may or may not hold medical degrees. 5 Mserotonin Rumination 沉思- compulsive fretting烦躁的; overthinking about out problems and their causes , leads to depression. Rumination theory - the tendency to keep focusing on one's feelings when depressed and to consider repeatedly the causes and consequences of that depression (social cognitive) Chronic Schizophrenia - a form of schizophrenia in which symptoms usually appear by late adolescence or early adulthood. As people age, psychotic episodes last longer and recovery periods shorten Acute Schizophrenia - a form of schizophrenia that can begin at any age, frequently occurs in response to an emotionally traumatic event, and has extended recovery periods Illness anxiety disorder - A disorder in which a person interprets normal physical sensations as symptoms of a disease. (hypochondriac疑病症患者). 把感受到的感觉当作病的症状 Coversion disorder- 不存在的感觉跟症状 Insight therapy - therapies that aim to improve psychological functioning and increase client's awareness of underlying motives and defenses. Medical model - view of mental illness as due to a physical disorder requiring medical treatment-biological transcranial electrical stimulation经颅电刺激 - administers a weak current to the scalp Deep brain stimulation - electrical stimulation applied through surgically implanted electrodes; used to treat some anxiety and mood disorders Resilience 恢复⼒ - the personal strength that helps most people cope with stress and recover from adversity and even trauma EMDR (Eye movement desensitization and reprocessing) - A psychotherapy in which the patient recalls a traumatic event while undergoing bilateral stimulation, such as moving their eyes from side to side or listening to tones delivered to one ear and then the other, in order to reduce anxiety. Schizotypal personality disorder - eccentric / intense discomfort for social relationships Schizoid personality disorder - avoid social activities 6
