Clinical Psychology Case Studies

Clinical Case: Jack and Felicia

• Jack's father was worried about people like Jack being violent, and the landlord admitted not wanting any trouble.
• Felicia had attention deficit/hyperactivity disorder (ADHD) and was diagnosed by a psychologist in 4th grade.
• She experienced difficulties in elementary school, including:
  • Not being able to sit still or follow directions
  • Blurring out answers when it wasn't her turn
  • Making mistakes on class papers
  • Being teased by other girls
• Felicia began seeing a psychologist and taking medication (Ritalin), which helped her:
  • Concentrate better
  • Not blurt out things as much
  • Learn to deal with teasing from others
• Now in high school, Felicia is much happier and has:
  • A good group of close friends
  • Better grades than ever before

Insidious Onset, Course, and Prognosis

• Insidious onset: a disorder that comes on slowly and doesn't have obvious symptoms at first.
• Episodic course: a disorder that has a few months of recovery and improves on its own shortly.
• Chronic course: a disorder that lasts a long time or is persistent.
• Good prognosis: a positive outcome, while guarded prognosis is an outcome in doubt.
• Fair prognosis: a moderate outcome, and poor prognosis: a negative outcome.

Causation, Treatment, and Outcome

• Etiology: the study of what contributes to the development of psychopathology, including biological, psychological, and social dimensions.
• Treatment development: how to help alleviate psychological suffering, including pharmacological, psychosocial, and/or combined treatments.
• Treatment outcome research: studying how to know if a treatment has been effective.

Historical Conceptions of Abnormal Behavior

• The supernatural tradition:
  • Mass hysteria: a phenomenon where a group of people experience intense emotions and behaviors, often due to suggestion or contagion.
  • Emotion contagion: when people experience an emotion that seems to spread to those around them.
  • Mob psychology: when people in a group are influenced by a single idea or suggestion.
• The biological tradition:
  • Greek physician Hippocrates: abnormal behavior as a physical disease.
  • Psychological disorders can be treated like any other physical disease.

Psychoanalytic Theory

• Melanie Klein, Otto Kernberg, and object relations theory:
  • Emphasized how children incorporate (introject) objects, including significant others and their images, memories, and values.
• Later developments in psychoanalytic thought:
  • The "Neo-Freudians": Jung, Adler, Horney, Fromm, and Erickson, who departed from Freud's ideas.
  • Jung emphasized the "collective unconscious", while Adler focused on inferiority and striving for superiority.

Psychoanalytic Psychotherapy

• The "talking" cure:
  • Unearth hidden intrapsychic conflicts.
  • Therapy is often long-term.
  • Techniques include free association and dream analysis.
• Examine transference and counter-transference issues.
• Little evidence supports the efficacy of psychoanalytic psychotherapy.

Humanistic Theory

• Major themes:
  • People are basically good.
  • Humans strive toward self-actualization.
  • Person-centered, unconditional positive regard.
• Major players: Abraham Maslow and Carl Rogers.
• Person-centered therapy:
  • Therapist conveys empathy and unconditional positive regard.
  • Minimal therapist interpretation.
• No strong evidence that purely humanistic therapies work to treat mental disorders.

The Behavioral Model

• Derived from a scientific approach to the study of psychopathology.
• Classical conditioning (Pavlov; Watson):
  • A form of learning.
  • People learn associations between neutral stimuli and stimuli that already have meaning.
• Operant conditioning (Thorndike; Skinner):
  • People learn to repeat or decrease behaviors based on the consequences that follow them.
• Example of classical conditioning: developing an association between the taste of tuna salad and nausea.

The Beginnings of Behavior Therapy

• Challenged psychoanalysis and non-scientific approaches.
• Early pioneers: Mary Cover Jones and Joseph Wolpe.
• Behavioral therapy tends to be time-limited and direct.
• Strong evidence supports the efficacy of behavioral therapies.

An Integrative Approach

• Psychopathology is multiply determined.
• Unidimensional accounts of psychopathology are incomplete.
• Must consider reciprocal relations among biological, psychological, social, and experiential factors.
• Defining abnormal behavior is complex, multifaceted, and evolving.
• Science of psychopathology is evolving, and the supernatural tradition no longer has a place in it.