Clinical Psych Notes PDF

Topic 1: Clinical Psychology Lecture 1: Introduc.on to Mental Health and Disorder Name and describe what mental health is Mental health is a state of mental well-being that enables people to cope with the stresses of life, realise their abili8es, learn well and work well, and contribute to th...

Topic 1: Clinical Psychology Lecture 1: Introduc.on to Mental Health and Disorder Name and describe what mental health is Mental health is a state of mental well-being that enables people to cope with the stresses of life, realise their abili8es, learn well and work well, and contribute to their community. Mental illness is “a clinically diagnosable disorder that significantly interferes with an individual’s cogni8ve, emo8onal or social abili8es”, according to the Australian Federal Department of Health and Aged Care. Name and describe what psychological disorder is and what it is not The DSM-5-TR broadly define mental disorder as “a syndrome characterised by clinically significant disturbance in an individual’s cogni8on, emo8on regula8on, or behaviour that reflects a dysfunc8on in the psychological, biological, or developmental processes underlying mental func8oning. Mental disorders are usually associated with significant distress or disability in social, occupa8onal, or other important ac8vi8es”. A mental disorder is NOT “an expectable or culturally approved response to a common stressor” or “socially deviant behaviour and conflicts that are primarily between the individual and society… unless the deviance or conflict results from a dysfunc8on in the individual” Describe and explain key features of diagnos8c and case formula8on The DSM-5-TR is a diagnos8c tool that is primarily categorical (disorder diagnoses) with some dimensional components (e.g. symptom severity ra8ng). Diagnosis is based on clinical interviews, text descrip8ons and diagnos8c criteria that looks at current symptoms, and ruling out disorder due to a general medical condi8on or substance use. Case formula8on looks at biopsychosocial factors such as predisposing risk factors, precipita8ng risk factors, perpetua8ng risk factors, and protec8ve factors. Name and describe different approaches to thinking about and classifying mental disorder Freud believed that mental illness stems from unresolved unconscious mo8ves and conflicts, such as repressed childhood experiences and desires. B.F. Skinner believed that mental disorders are a result of maladap8ve learned behaviours, Aaron T. Beck developed the cogni8ve-behavioural model, that looks at the link between thought, emo8on and behaviour and how they interact to poten8ally lead to disordered mindsets. Describe and explain why classifying mental disorder is difficult/complex Compare, contrast and explain different approaches to thinking about and classifying mental disorder and the pros and cons of each Lecture 2: Mental Illness S.gma Describe what s8gma is S8gma originated in Ancient Greece, where they would physically brand criminals, slaves or traitors to be iden8fied as undesirable, and be avoided by the general populus. Iden8fy various s8gma processes Public S8gma refers to s8gma exhibited by the public towards people with mental disorders. It tends to manifest in stereotyped aXtudes and beliefs, prejudicial affec8ve responses, and discriminatory behaviours. Structural S8gma refers to ingrained s8gma at the societal level that is maintained by ins8tu8ons through policy, law and prescribed ideologies. Perceived s8gma refers to an individuals’ percep8on of public s8gma that is dis8nct from one’s own beliefs. This can be experienced by anyone but is especially prevalent in those with lived experience of mental illness. Can lead to more severe symptoms. Experience s8gma refers to the experience of having been the target of expressed nega8ve stereotypes, prejudice and discrimina8on. This can contribute to a withdrawal from society and leads to greater an8cipa8on of s8gma. An8cipated s8gma is the extent to which individuals living with mental illness expect to experience stereotyping, prejudice, and discrimina8on. O[en leads to a withdrawal from society. Understand the significance of s8gma for individuals with lived experience Corrigan’s model shows that becoming aware of stereotypes and s8gma is dangerous. If one agrees with the general principle of a stereotype that could poten8ally apply to them, they see themselves in a nega8ve light, which then damages their self-esteem. Describe methods to research and reduce s8gma The Na8onal Survey of Mental-Health Related S8gma and Discrimina8on used vigne]es describing different mental health problems and saw how much par8cipants then agreed with public s8gma statements about the disorder. Social Distance Scales can also measure s8gma in rela8on to a person’s willingness to interact with people with mental illness in different contexts with varying levels of in8macy. The Australian Na8onal S8gma Report Card aimed to understand how Australians living with mental illness experience s8gma and discrimina8on they asked people about different aspects of their lives and how much s8gma and discrimina8on they faced/witnessed. Rela8onships with friends and family was the worst, followed by social media. It also showed that over 80% at least somewhat have stopped trying to make or keep friends. Contact and educa8on are the best ways to reduce s8gma. If the educa8on is bad, it can increase s8gma Lecture 3: Depression and Anxiety Name and explain what mood and affect are Mood refers to a person’s sustained experience of emo8on Affect refers to the immediate experience and expression of emo8on. Mood disorders involve a depression or eleva8on of mood as the primary disturbance Name and explain the core features of MDE and MDD The Major Depressive Episode (MDE) criteria involve five or more DSM-5 listed symptoms being present for 2 or more weeks. They involve a depressed mood, anhedonia, change in appe8te/weight, change in sleep, fa8gue, worthlessness, lack of concentra8on, recurrent thought of death/suicide. Major Depressive Disorder (MDD) involves an MDE that is not be]er explained by another diagnosis Describe and explain the core features of PD, GAD and PTSD Panic Disorder (PD) involves recurrent, unexpected panic a]acks that involve at least four of: heart palpita8ons, swea8ng and trembling, shortness of breath, chest pain, nausea, dizziness, fear of losing control or dying, etc. The a]acks are followed by one or more months of significant change in behaviour and persistent worry about another panic a]ack. Generalised Anxiety Disorder (GAD) involves excessive anxiety occurring more days than not for over 6 months. The anxiety is associated with at least three of: restlessness, fa8gue, difficulty concentra8ng, irritability, muscle tension and sleep disturbance. Describe and explain basic prevalence rates of the above disorders All are far more prevalent in women and are highest between the ages of 16-24 with ~30% of people experiencing any 12-month anxiety disorder at that age and ~13% experiencing any 12- month mood disorder Compare, contrast and explain different approaches to explaining depression The Tripar8te Model of Depression and Anxiety (Clark & Watson, 1991) suggests that a combina8on of low posi8ve affect and high nega8ve affect lead to depressive symptoms, while nega8ve affect and anxious arousal lead to anxiety symptoms. Hi-Top and the Unified Protocol for Transdiagnos8c Treatment of Emo8onal Disorders lays out the various processes that lead to mental disorders, with most anxiety/mood disorders being caused by internalising and fear/distress. Biopsychosocial model. The Behavioural Model suggests that low rate of operant behaviour and low rate of reinforcement lead to depression. Beck’s Cogni8ve Model of Depression looks at nega8ve events that establish nega8ve schemas (beliefs, rules and assump8ons) at how the ac8va8on of schema leads to nega8ve automa8c thoughts (NAT) that are cogni8ve ‘fuel’ for depression. Also the nega8ve triad: a cogni8ve pa]ern involving nega8ve thoughts about the self, world and future. ABC Model: A = ac8va8ng event, B = Belief, C = Consequence Cogn8ve paradigm: Thought, emo8on and behaviour. Lecture 4: Schizophrenia Spectrum Disorders Name and explain what the term psychosis refers to The term ‘psychosis’ is an umbrella term meaning ‘out of touch with reality’. At the disorder level, psychosis refers to a group of disorders that can be dis8nguished based on symptom configura8on, dura8on and rela8ve pervasiveness. The term ‘schizophrenia’ means ‘split mindedness’ or ‘a mind torn asunder’. Compare, contrast and explain various schizophrenia spectrum disorders The diagnos8c criterion for schizophrenia requires a 1-month period in which at least two of delusions, hallucina8ons, disorganised speech, disorganised or catatonic behaviour and nega8ve symptoms for a significant por8on of the 8me. Con8nuous signs of disturbance for at least 6 months. Describe and explain posi8ve and nega8ve symptoms Posi8ve symptoms are addi8ve to normal experience: hallucina8ons, delusions, clanging, circumstan8ality, flight of ideas, derailment, incoherence, pressure of speech Nega8ve symptoms are a deficit in normal func8on: avoli8on (lack of mo8va8on), alogia (poverty of speech), anhedonia, affec8ve fla]ening, ina]en8on Describe and explain the History of the concept of schizophrenia o Benedict Augus8ne Morel (1860) described ‘demence precoce’ based on observa8ons of individuals displaying a set of symptoms and experiencing early onset and deteriora8ng course. o Emil Kraepelin (1898) described ‘demen8a praecox’, s8ll emphasising early onset and deteriora8ng course but differen8ated from other forms of psychosis by emphasising hallucina8ons, delusions, nega8vism, a]en8onal difficul8es, stereotypies, and emo8onal dysfunc8on o Paul Eugen Bleuler (1908/11) coined the term ‘schizophrenia’ and disagreed with characterising the disorder as a demen8a. He focused on the symptoms of associa8on (cogni8on), affec8vity, ambivalence and au8sm (withdrawal from reality) o Scheider (1959) emphasised ‘first rank symptoms’ of hearing one’s voice out loud, hallucinatory voices, hallucinatory running commentary, soma8c hallucina8ons, thought withdrawal, thought inser8on, thought broadcas8ng, delusion percep8ons, made feeling, made ac8ons, and made impulses. The problem with this is that a number of these symptoms overlap with other disorders Compare, contrast and explain various ae8ological theories of psychosis o Expressed Nega8ve Emo8on: form of family communica8on characterised by high levels of cri8cism, hos8lity and emo8onal over-involvement. o Stress-vulnerability model o Biological models § Seems to be a gene8c predisposi8on. If both parents are schizophrenia, there’s a ~35% chance the child will develop it. § Structural abnormali8es in the brain § Lack of dopamine Lecture 5: Personality and Disorder Describe and explain how personality acts as a vulnerability for disorder Personality is what makes you uniquely you. Some personality types are more suscep8ble to mental health issues generally. Personality can be somewhat gene8c, and some genes lead to greater vulnerability. Name and describe Diatheses for various disorders Most mental disorder involve the combined ac8on of a personality vulnerability (aka. Diatheses) and environmental stress. Depression: dependency, autonomy, self-cri8cism, pessimist a]ribu8onal style Schizophrenia: social anhedonia, physical anhedonia, perceptual aberra8on, magical thinking Also, perfec8onism and anorexia, hypomanic temperament and bipolar disorder, thought-ac8on fusion and OCD, and anxiety sensi8vity and panic disorder Name and describe various personality disorders Cluster A or the ‘odd’ cluster: e.g. Paranoid personality disorder, which involves a pervasive distrust and suspiciousness of others. Suspicion of exploita8on or harm, doubts of loyalty, reads hidden messages, holds grudges etc. Cluster B or the ‘drama8c’ cluster: e.g. narcissis8c personality disorder, which involves a pervasive feeling of grandiosity, need for admira8on, lack of empathy, sense of en8tlement etc. Cluster C or the ‘anxious’ cluster: e.g. avoidant personality disorder, which involves a pervasive pa]ern of social inhibi8on, feelings of inadequacy, hypersensi8vity to nega8ve evalua8on, unusually reluctant to take risks. Describe and explain stress-diathesis models of disorder Describe and explain DID and different approaches to explaining it Involves someone having 2 or more personali8es that switch and leads to no8ceable changes in affect, behaviour, consciousness, memory, percep8on, cogni8on, and/or sensory-motor func8oning. It’s a somewhat controversial diagnosis and there has been an apparent explosion of cases and symptoms can alter quite significantly. The dominant theory for explaining this is that the dissocia8on is a self-defence method or coping strategy during trauma8c stress and pa8ents end up becoming so rehearsed and skilled at this defence that they construct alter personali8es. Another theory suggests that therapists can cause split personali8es by sugges8ng to a pa8ent that they are a certain way, and the pa8ent somewhat becomes that person.