Clinical Psychology PDF

**Clinical Psychology** Mental Disorders What determines a mental illness? Maladaptive: impaired ability to function which causes distress to the individual and/ or others Poorly understood in society -- stigma At any one time, 1 in 4 people have a mental health problem Causes of mental disord...

**Clinical Psychology** Mental Disorders What determines a mental illness? Maladaptive: impaired ability to function which causes distress to the individual and/ or others Poorly understood in society -- stigma At any one time, 1 in 4 people have a mental health problem Causes of mental disorders A diagram of a problem Description automatically generated with medium confidence Classification of disorders  DSM 5: changes "Non-axial assessment" Removal of first 3 axes Separate notations (assessment) for other two axes - Psychosocial and environmental factors - Disability New chapters: e.g. trauma and stressor related disorders New diagnoses: e.g. hoarding disorder, binge eating disorder Revised diagnoses: autism spectrum disorder - Includes what was formerly known as autistic disorder, Asperger's syndrome, pervasive developmental disorder and childhood disintegrative disorder DSM: Strengths and Weaknesses (of giving people a labelled diagnosis) Strengths: - Guides prognosis and treatment - Provides a wsay of objectively classifying abnormal behavipur that might otherwise seem random or worse (evil/ possessed) Weaknesses - High comorbidity -- behaviours consistent with more than one diagnosis - Low reliability: too many disorders - Categories vs dimensions (ill/not ill vs behaviours that varies on a continuum) - Political & social influence (homosexuality was once a mental disorder) - Stigma -- how other people see them and how they view themselves **Treatment of mental disorders** **Earliest approaches** - Mental illness seen as being occupied by demons, spirits (sometimes also the divine) - Prehistoric treatment: Trephining = hole in the skull to release evil spirits - In general treatment of mentally ill resembled torture more than actual help - Beginnings of modern treatment: Mesmer in late 18^th^ century: mesmerism = hypnosis **Current treatments** **Eclectic**: use of whatever treatment best fits - Dependant on patient and particular time - Also includes combination of approaches - Focus on how to best solve clients problems **Psychoanalysis/ psychodynamic therapy** Basic assumptions: unconscious conflicts of competing demands of the id, ego, superego; originating often in early childhood, biological urges (sex, aggression) Goal of therapy: bring unconscious conflicts into consciousness, resolve conflict through insight Method: - Traditional Psychoanalysis: free association, dream analysis, interpretation of resistance (self-censoring of patient), transference (projecting of powerful emotions/ attitudes onto therapist) memory and manner of speech - Modern psychoanalysis: focus more on social and interpersonal experiences, present life, ego Evaluation: - Time intensive - Often open-ended - Requires much dedication of patient - Difficult to estimate effectiveness **Humanistic Therapy** Client centred therapy (Carl Rogers) Basic assumption: people are good and have innate worth; psychological problems = blockage of growth Goal of therapy: patient gains understanding of their unique potential for personal growth and self-actualisation Method: - Client-centred therapy -- client decides what to talk about, no judgement by therapist - Client is focus of therapy - Unconditional positive regard - Make incongruence (difference between patients rel self and ideal self) noticeable to client through reflection/ rephrasing or mirroring of client statements ("so what you're saying is...) Evaluation: - Generally effective - Client-statements of progress might have been inflated through positive reinforcement Behavioural and Cognitive behavioural therapies Basic assumptions: behavior controlled by environment, peoples cognitions, and ccombination of both Goal of therapy: change maladaptive behaviour (and thinking patterns) Method: - Manipulate environment variables - Restructure thinking patterns - Correct faulty thinking/ irrational beliefs Examples: Systematic desensitization (behavioural) & Cognitive behavioural therapy Systematic Desensitisation  Cognitive Behavioural therapy A black text on a white background Description automatically generated Biological treatments Electroconvulsive therapy (ECT) - Used only short-term for severe depression; right hemisphere only (minimise damage to verbal memories) Psychosurgery: Brain surgery in absence of organic damage (e.g. prefrontal lobotomy) - Mostly discontinued Drug therapy - Antipsychotics, antidepressants etc **Specific mental disorders** Anxiety Disorders Anxiety = apprehension/ doom accompanied by physiological reactions (e.g. accelerated heart rate) Most common psychological disorders Common types: - OCD - Panic disorder - PTSD - Phobias - Generalised anxiety disorder Obsessive Compulsive Disorder  Phobia Irrational fears of specific objects or situations A close up of a text Description automatically generated Somatoform disorders = Disorders where the symptoms suggest a medical condition but there is no evidence of such found by a physician  A white background with black text Description automatically generated Personality disorders Definition - Enduring inflexible behaviour patterns - Respond inappropriately but unaware of problem - Differs from social expectations - Impaired functioning, distress to self/ others Treatment for personality disorders tends to be difficult Cluster A: eccentric - Paranoic, schizoid. Schizotypal -- odd behaviour akin to schizophrenia Cluster B: dramatic - Antisocial; borderline, histrionic, narcissistic Cluster C: anxious - Avoidant, dependant, obsessive compulsive - Fearful behaviour but few direct links to axis I anxiety disorders Schizophrenic disorders A white background with black text Description automatically generated Subtypes of schizophrenia - Paranoid: delusions of grandeur/ Persecution/ control, hallucinations, very suspicious of others, intelligent, grand schemes - Disorganised: disturbed thought, verbally incoherent (word salad). Inappropriate affect (e.g. laughing at sad news) - Catatonic: psychomotor disturbances (e.g. waxy flexibility, catatonic postures) - Undifferentiated: meet diagnostic criteria but do not conform to any specific subtype Heritability of schizophrenia  Mood disorders Psychological disorders of emotion, characterised by an elevation or lowering of a person's mood Extreme types - Mania - Depression - Bipolar A list of black text Description automatically generated with medium confidence  A black text on a white background Description automatically generated