AP Psychology Unit 8: Clinical Psychology

- If the behavior is harmful & dysfunctional.
- & Judged to be atypical, maladaptive (harmful/justifiable), disturbing, & unjustifiable.

- Disorders were considered "evil spirits", and used barbaric treatments like draining your blood, drilling holes in your skull, etc.

- By the 1800's, disorders were seen as sicknesses that have physical causes, that can be diagnosed, treated, & sometimes cured.
- Disorders should be diagnosed from symptoms & treated with therapy.
- Asylums were replaced with hospitals.

- Our body, our mind, & our environment/society.
- Both nature & nurture taken into consideration when diagnosing mental disorders.

- A large manual developed by the APA, new version released every 10-20 years.
- Used to define the diagnosis process & organizes categories of mental disorders
Criticism: Diagnostics are too wide & cover too large of a range, encouraging more diagnosis.

- Displayed how eight subjects checked themselves into a hospital, and displayed normal behavior and symptoms during a Psychological observation.
- All eight subjects were misdiagnosed with different disorders, & often their normal behavior was diagnosed as symptoms.

- The tendency and belief that being labeled as a certain type of person (the troubled kid, the smart kid, etc) would result in the person displaying actions that fit into that label.
Ex: If a kid is labeled as being the troubled kid, he's going to act in rebellious ways.

- Are not dangerous, 9 in 10 subjects with disorders (that do not abuse alcohol or drugs) are not dangerous.

Marked by distressing, persistent anxiety of dysfunction anxiety-reducing behaviors.

- Person is unexplainably & continuously tense & uneasy in a stable of autonomic nervous system around. Always in a state of arousal.
- High breathing rates, fast heartbeat, tense muscles, fidgeting, twitching eyelids, perspiration, sleeplessness, agitation.
- Person CANNOT identify the cause of the anxiety, & therefore cannot avoid it or solve it.
- Unknown cause of personal anxiety.

- Sudden, minute-long episodes of intense dread & terror, causes damage, & disappears. Not always extrinsically expressed.

- Chest pain, choking sensations, shortness of breath, etc.

- After several panic attacks: Person can develop fear of getting them, resulting in having a panic disorder. Scared of panic attacks.

- Can lead to agoraphobia, fear or avoidance of public places.

- Persistent, irrational fears of a specific object or situation that heavily disrupts behavior. Scared of one specific thing or broader.
- Some phobias can easily avoid the stimulus (like heights & insects), but others not so much (like social crowds).
- Social Phobia: The intense fear of being scrutinized by others.

Obsessions: Unwanted repetitive thoughts resulting in...
Ex: Concern with dirt & germs, something terrible happening, etc.
Compulsions: Actions made due to unwanted thoughts.
Ex: Object symmetry, order, exactness, etc.
- One CAUSES the other.

- Persistent mental & emotional stress occurring at a result of a severely traumatic or emotional event.
- Often effects combat veterans, prisoners of war, accident & disaster survivors, etc.
Symptoms: Nightmares, flashbacks, social withdrawal, anxiety & insomnia.
- Often leads to alcoholism & other destructive behaviors as coping mechanisms.
- Behavior is based off of a traumatic event.

Behavioral:
Fear Conditioning: Conditioned to react with fear in response to a stimulus. (Like little Albert being scared of furry animals).
Stimulus Generalization: Feel anxiety about conditioned stimulus, resulting in generalizing your fear of one specific object/event to other things.
Reinforcement: Removing the stimulus to reduce anxiety.
Observational Learning: Learning fears by seeing the presented stimulus be feared by others.

Biological:
Natural Selection: Fears help us avoid danger & survive.
Genes: 17 genes connected to anxiety, can be genetic too.
Physiology: Over-arousal of brain functions can cause anxiety in brain areas involved.

Psychological disorder characterized by emotional extremes, high or lows.

- Occurs when at least five signs of depression last two or more weeks & are not caused by drugs or medical condition.
- Often considered the "common cold" of psychological disorders, is the number one reason people seek mental health services, women affected more than men.

- Fluctuation between mania & depression phase, super highs and super lows.

Mania Phase: Over talkative, overreacted, elated, & unrealistically optimistic. All the high!!! Opposite of depression.

Followed by...

Depressive Phase: All feelings of being low, sad, less talkative, not energetic, etc.

- Depression is present more in certain seasons than others, most commonly in the fall & winter. Also affected by lack of natural light during these seasons & can affect neurotransmitters & sleep cycles.

- A mild form of depression that lasts longer than two years.

Disorganized thinking: Thinking is fragmented.
- Delusions: False beliefs that a person truly believes id true. Become paranoid. "The government is watching me." or, "I am Jesus Christ."
Disturbed Perceptions: May perceive things that are not physically there.
Hallucinations: Usually auditory, like hearing voices in someone's head. Sensing something that doesn't exist.
- Inappropriate emotions & actions. Ex: Laughing at a funeral, random yelling, etc.
- Symptoms usually start showing in early 20's into adulthood, affects both males & females.

- A zombie-like state of emotion & movement.

Paranoid: Delusion & hallucinations, paranoid due to false beliefs & things.
Disorganized: Disorganized speech & behavior, or flat or inappropriate emotion.
Catatonic: Immobility or excessive movement, extreme negativism, or parrot-like repeating of another's speech or movements.
Undifferentiated: Many & varied symptoms.
Residual: Withdrawal, after hallucinations & delusions have disappeared.

Excessive dopamine, Abnormal brain tissue, Low activity in frontal lobes.
Genetic: Genes influence the production of dopamine & myelin in the brain & neurotransmitters.

- Physiological disorders in which the symptoms take a somatic (bodily) form with apparent physical cause. Linked w/anxiety disorders.

Symptoms: Vomiting, dizziness, blurred vision, difficulty swallowing, & twitches.
- All are physiological symptoms, although NOTHING is biologically disordered.

Anxiety disorder where genuine physical symptoms occur, with NO physiological basis or cause.
- Ex: Vomiting out of anxiety, yet not bodily cause of being sick.

- A person interprets normal physical sensations as symptoms of a disease.
- People thinking they have a disease due to one symptom.
Ex: Seeing someone cough makes you think they have covid.

- Disruptions or breakdowns of memory, consciousness, awareness, identity and/or perception. Disassociating from current moment, identity, & reality.

- Aka multiple personalities disorder.
- A person exhibits two or more distinct personalities, yet there's one that seems more like them than the others.
- Some believe DID patients are susceptible to hypnosis, and mainly due to childhood trauma & repressed emotions in childhood.

Sudden memory loss for important personal info often following a traumatic event but w/out any clear brain injury.
- Unable to remember personal information & dissociating certain memory from your life.

- Usually in high times of stress/trauma.
- A person temporarily loses sense of personal identity & physically wonders off & travels away from their homes or work.
- Many black out during this stage & forget where they are in their time and point.

- Inflexible and enduring behavior patterns that impair social functioning.

- Social detachment present, & lack of many emotions.
- Little pressure or desire to form close relations occurs as well. Lack of feelings & emotions.

- A person acts constantly suspicious of others with no ability to trust others due to constant fear.
- Inability & trust issues towards others.

- A person has delusions & is seen as eccentric with their thoughts, behaviors, or speech.
Ex: A person believing they have powers. Overlap with schizophrenia.

- Disregard of another person's emotions and beliefs via manipulation or violation of other individuals without any remorse.
- Typically male, in serial killers & criminals. Lack of remorse for hurting people, but enjoying it too.

- A person's emotions rapidly shift regarding themselves & others.
- See the world very black and white, with no grey area. Very one-sided regarding beliefs & behavior.
- Behavior may be impulsive & reckless as a result of emotional extremes.

- Personality disorder characterized by excessive emotionality and preoccupation with being the center of attention; emotional shallowness; overly dramatic behavior.
- Person is dependent on social acceptance & approval.

- Person refuses to believe they are in the wrong and believe they don't have a problem.
- Makes it very hard to treat patience with NPD because they refuse to accept there's something wrong.

- Person has low self-esteem out of fear of rejection & fear of judgement.
- Leads to person avoiding social activities out of fear.

- A person's perceived risk of abandonment, isolation, rejection, and/or criticism is present. Causes anxiety-inducing behavior.
- Dependent on other people & things to keep them mentally afloat.

- A person has thoughts of perfection & the want to be perfect.
- Attempts to achieve perfect, less intense than OCD.
- More therapy-based, not as much medication.

- Aims to teach people new, more constructive ways of thinking.
- The way we thinking effects how we feel, how we feel effects how we behave.

- Works to reverse beliefs about oneself and certain events.
- Making catastrophes seem smaller than they actually are.
- Turning things into words, then addressing them.

- Uses integrative therapy to alter the way we think, and act. Used for treatment of anxiety.
Ex: ABC's - A: Activating, Event B: Belief, C: Consequence

- Created by Albert Ellis
- Exposure and confronting dysfunctional thoughts of the client. Rationalizing your thoughts and emotions.
- Changing our mindset on certain thoughts will change our behavior and response.

- Used for people with similar struggles as a way to connect with one another.
- Allows for all to feel supported and not alone.

- Treats family as a system, allows for better understanding of family functioning & allows for family members to better understand one another.

Hans Eysenck: Launched a study to look at the effectiveness of research.

Regression towards the mean: Tendency for extreme outliers to fall back toward the average.

Meta Analysis: Procedure for statistically combining results of many different research studies, used to get accurate results.

Other therapies with questioned effectiveness, some using the Placebo Effect & pseudo-therapists.

- "Pushing Energy Fields" in your brain into balance. Not scientifically accurate, usually useful only given the placebo effect.

- Works to desensitize traumatic events (often used for PTSD) using & triggering eye movement.
- Attempts to break down long-term potentiation memories to revert people back to the proper neural pathway.
- Makes brain focus on other stimuli other than traumatic events.

- Those with SAD are effected back lack of amount of light.
- Exposes patients to light to increase feelings of arousal & happiness.

- Physically changing a person's brain functioning by altering a person's brain chemistry via drugs or effecting it's circuity with ECT shock, magnetic impulses, or psycho-surgery.

- After taking a high dosage of prescription over a long period of time, people develop involuntary repetitive tick-like movements in the facial muscles, that are not voluntary.

- Study on how drugs affect our mind and behavior.
- Lessened number of people in mental hospitals due to less brain function with meditation.
- To evaluate effectiveness of a new drug, double-blind procedures must be used.

- Drugs used to treat those with Schizophrenia & other forms of drought disorder.
- Clozapine & Thorazine: Blocks receptor sites & activity. Like dopamine.

- Drugs used to control anxiety & agitation.
- Reduce nervous system activity to reduce anxiety.
- Xanax & Ativan: Depress & inhibit CNS activity.
- D-Cycsloserine: Facilitates extinction of learned fears, works with PTSD patients.

- Used to treat depression, anxiety & OCD.
- Increase availability of norepinepherine & serotonin.
- Prozac: Blocks resorption of serotonin, stays in synapse.
- Cognitive therapy used to prevent risk of relapse.

- Used to aid those with bipolar disorder.
- Lithium (Simple Salt) & Depakote: Originally used to treat epilepsy, but also effective in control of manic episodes.

- Used for severely depressed patients that uses electric currents throughout the brain. Used to shake up synapses & rewire the brain.

- More gentle ways to start up neural activity, uses magnetic stimulation.
- Uses repeated pulses of magnetic energy to the brain, instead of electrical currents. More gentle.

- Stimulated the limbic system, by Helen Mayberg.
- Drills hole inside the bring, and cause pulses inside limbic system.

- Outdated and not used as much anymore, physically destroys brain tissue inside the brain that causes depression, anxiety, etc.

- Developed by Egas Moniz
- Procedure that cuts the nerves connecting the frontal lobe to emotion, controlling centers of the inner brain.

- Advocated for construction of mental hospitals & helped influence treatment of psychological disorders.
- Influenced process of treating people's mental health just as much as their physical health.

Psychotherapy: Use psychological techniques, CANNOT prescribed medication to patients.
Biomedical Therapy: Used by psychiatrists, can prescribe medications & medical treatments.

Freud's therapeutic technique - believed that free association, dreams, defense
mechanisms, etc. released repressed feelings.
Aimed at bringing these repressed memories from childhood and emotions that have been buried to the surface

Patient transfer their feelings of love or emotion into their relationship with their therapist.
- Ex: Patient developing feeling of love or admiration toward their therapist.

- Modernized therapies to include Neo-Freudians.
- Focusing on themes across relationships to try to understand patient's current symptoms.
- Could include looking back at childhood to identify patterns or issues.

A brief, psychodynamic psychotherapy that focuses on current relationships and looks for the underlying/root cause of issues.
- Mainly used to cure depression.

- Aims to boost self-fulfillment by helping grow in self-awareness & acceptance.
- Focuses on present & future instead of the past, and aims yo help those become the best version of themselves.

Developed by Carl Rogers
- Non-directive therapy where a therapy listens without judgement or interruption, allowing client to feel unconditionally accepted.
- Promoting growth over identifying illness.
- Goal is to guide people to heal.

Paraphrasing - Repeat what client is saying.
Invite Clarification - "How scary! Tell me more!"
Reflect Feelings - (That's so hard, I'm so sad for you).

- Focuses on finding the overall purpose & subjective meaningful perception of our own lives.
- Derived from an existential crisis, figuring our why we're here and what is our purpose.

Developed by Fritz Perls
- Emphasis on "The Whole"
- Focuses on increasing a person's understanding of their own self-awareness and control over their own lives.

- Focuses on identifying negative behaviors or stimuli causing the problem, and eliminating them through unlearning principles.
- To make you not scared, not sad, etc.
- Uses conditioning, reinforcement, observational learning, stimulus-response relationship, etc.

- Creating a new behavior to create new responses to stimuli, eliminating unwanted behavior.
- Can be used to treat symptoms, but not to treat the underlying cause.

Exposing patients to the phobic stimulus gently, in a slow and reassuring way. Allows for patient to slowly desensitize their reaction to the stimulus.
- Moving up through the hierarchy of fear. The safer method of the exposure therapies.

Full, automatic exposure to stimulus (flooding in the stimulus) rapidly without any gentle or light approach.

- Using a negative response to a positive stimulus to reduce a patient's action towards stimulus.
Ex: Adding chilly powder to your nails (negative response) to avoid biting your nails (positive stimulus).

- An operant conditioning procedure, in which people earn a "token" or other form of mental/physical currency to reward a stimulus.
- Good behavior is rewarded with tokens, and usually exchanged for a prize in a classroom setting.