AP Unit 8: Clinical Psychology (Myers Unit 12)

a syndrome marked by a clinically significant disturbance in an individual’s cognition, emotion regulation, or behavior.

the concept that diseases, in this case psychological disorders, have physical causes that can be diagnosed, treated, and, in most cases, cured, often through treatment in a hospital.

the study of environmental influences on gene expression that occur without a DNA change.

the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition; a widely used system for classifying psychological disorders.

a psychological disorder marked by extreme inattention and/or hyperactivity and impulsivity.

Key Indicators:

1. Inattention

2. Hyperactivity: Excessive fidgeting, restlessness, or an inability to stay seated when it is expected.

3. Impulsivity (Can’t wait their turn, blurting out answers before questions are finished, acting without considering consequences, etc.)

4. Executive Functioning Challenges (difficulties with skills like organization, time management, and planning)

5. Emotion regulation issues

6. Impaired working memory

7. Poor Academic or Occupational Performance although very capable (not always, but can be a factor)

psychological disorders characterized by distressing, persistent anxiety or maladaptive behaviors that reduce anxiety.

Key Indicators:

1. Persistent symptoms present for at least six months

2. Excessive worry

3. Specific triggers

4. Physical Symptoms: rapid heartbeat, sweating, trembling, shortness of breath, dizziness, gastrointestinal issues

5. Intense negative response to stress

6. Panic attacks

intense fear and avoidance of social situations. (Formerly called social phobia.)

• Become extremely anxious in social settings where others might judge them, such as parties, class presentations, or even eating in public.

an anxiety disorder in which a person is continually tense, apprehensive, and in a state of autonomic nervous system arousal.

• Marked by excessive and uncontrollable worry that persists for six months or more.

• Concentration is difficult as attention switches from worry to worry.

• Their tension and apprehension may leak out through furrowed brows, twitching eyelids, trembling, perspiration, or fidgeting from autonomic nervous system arousal.

an anxiety disorder marked by unpredictable, minutes-long episodes of intense dread in which a person may experience terror and accompanying chest pain, choking, or other frightening sensations; often followed by worry over a possible next attack.

• recurrent panic attacks

  • symptoms such as palpitations, sweating, trembling, shortness of breath, chest pain, nausea, dizziness, or a feeling of unreality.

• worry about future attacks

• must persist for at least a month

fear or avoidance of situations, such as crowds or wide open places, where one has felt loss of control and panic.

an anxiety disorder marked by a persistent, irrational fear and avoidance of a specific object, activity, or situation.

Phobia vs. Fear

1. Intensity and Irrationality

   • Phobia is more intense and irrational. Oftentimes a phobia elicits a disproportionate level of fear and anxiety compared to the actual threat

2. Duration

   • Phobias are more persistent and enduring, even when individual recognizes their fear is irrational they cannot control it unless treated.

3. Impact on life

   • Phobias significantly impact daily life and decision making as people will actively avoid certain situation, places, or activities, which can sometimes be impossible.

4. specificity

   • Phobias are always tied to a specific stimulus while fears can be broaderobsessive-compulsive disorder (OCD)

a disorder characterized by unwanted repetitive thoughts (obsessions), actions (compulsions), or both.

• Obsessive thoughts are unwanted and so repetitive it may seem they will never go away. Compulsive behaviors are often responses to those thoughts

  • Thoughts and behaviors are time-consuming

  • Cause clinically significant distress

  • Impairment in social, occupational, or other areas of social functioning

Example:

• Checking to see if the hair straightener is unplugged is normal, checking it 10 times in 10 minutes because you fear something bad may happen is not.

Obsessions may include themes such as contamination, harming others, symmetry, or intrusive sexual or religious thoughts, among others. Compulsions may involve behaviors such as handwashing, checking, counting, arranging, or mental rituals such as praying or repeating words silently.

in OCD, intrusive and unwanted thoughts, images, or urges that cause distress. They are persistent and lead to compulsive behaviors.

in OCD, repetitive behaviors or mental acts that a person feels driven to perform in response to an obsession, aiming to reduce distress or prevent a feared event.

a disorder characterized by haunting memories, nightmares, hypervigilance, social withdrawal, jumpy anxiety, numbness of feeling, and/or insomnia that lingers for four weeks or more after a traumatic experience.

• Usually affect survivors and witnesses of accidents, disasters, and violent and sexual assaults

• The higher the distress, such as the level of physical torture suffered by prisoners of war, the greater the risk for posttraumatic symptoms

Symptoms

• Exposure to a traumatic event

• The re-experiencing of the traumatic event (nightmares, flashbacks, memories)

• Intense psychological distress or physiological reactions to cues that resemble the traumatic event

• Avoiding thoughts, feelings, or conversations related to the trauma, as well as avoiding places, people, or activities that may trigger memories of the event.

• Negative alterations in cognition and mood (Persistent negative emotions, negative beliefs of expectations, decreased interest in activities, social detachment, hard time experiencing positive emotions)

• Arousal and Reactivity (not always): Irritability, aggression, reckless or self-destructive behavior, hypervigilance, exaggerated startle response, problems with concentration, and sleep disturbances.

a disorder characterized by difficulty falling or staying asleep, causing distress or impairment, at least 3 nights a week for 3 months, despite adequate opportunity to sleep.

Symptoms

• Feeling unsatisfied with amount or quality of sleep (trouble falling asleep, staying asleep, or returning to sleep)

• Sleep disruption causes distress or diminished everyday functioning

• Happens three or more nights each week

• Occurs during at least three consecutive months

• Happens even with sufficient sleep opportunities Independent from other sleep disorders (such as narcolepsy)

• Independent from substance use or abuse

• Independent from other mental disorders or medical conditions

a disorder in which a person experiences, in the absence of drugs or another medical condition, two or more weeks with five or more symptoms, at least one of which must be either (1) depressed mood or (2) loss of interest or pleasure.

Symptoms

• Feelings of sadness, hopelessness, and loss of interest in most activities

• Changes in appetite or weight, sleep disturbances, fatigue, feelings of worthlessness or guilt, difficulty concentrating, thoughts of death or suicide

• Problems in thinking, concentrating, or making decisions

• repetitive thoughts of death and suicide

• Reduced energy levels

• Must have episodes that last from weeks to months

a disorder in which a person alternates between the hopelessness and lethargy of depression and the overexcited state of mania. (Formerly called manicdepressive disorder.)

Symptoms

• Presence of Manic or Hypomanic Episodes

• Presence of Major Depressive Episodes that last at least 2 weeks

• Alternation between depressive and manic/hypomanic episodes

• Must cause clinically significant distress or impairment in social, occupational, or other important areas of functioning

a hyperactive, wildly optimistic state in which dangerously poor judgment is common.

Symptoms:

• elevated mood

• increased energy levels

• racing thoughts

• impulsivity and risky behavior

• decreased need for sleep

• Grandiosity and perceived invincibility

compulsive fretting; overthinking our problems and their causes.

What is it?

• Such behavior, though painful, is not fatal.

• Inidividuals may cut or burn their skin, hit themselves, insert objects under their nails or skin, or self-administer tattoos.

• The goal is NOT suicide. Usually people who engage are suicide gesturers, not attempters. (However can escalate into suicide attempts)

• People who engage in NSSI tend to experience bullying, harassment, and other life stress

Why?

• Find relief from intense negative thoughts through the distraction of pain.

• Attract attention and possibly get help.

• Relieve guilt by punishing themselves.

• Get others to change their negative behavior (bullying, criticism).

• Fit in with a peer group.

a disorder characterized by delusions, hallucinations, disorganized speech, and/or diminished, inappropriate emotional expression.

Diagnosis Requirements:

• Presence of 2 or more of the following symptoms:

  • Delusions

  • hallucinations

  • disorganized speech

  • Grossly disorganized or catatonic behavior

    • Catatonic behavior involves a marked decrease in reactivity to the environment, which can include immobility, rigidity, or repetitive, purposeless movements.

  • Diminished and Inappropriate Emotions

• Continuous signs of disturbance persist for at least six months, with at least one month of active-phase symptoms (i.e., delusions, hallucinations, disorganized speech) present.

• Must significantly impair social, occupational, or other important areas of functioning

a group of disorders marked by irrational ideas, distorted perceptions, and a loss of contact with reality.

Diagnosis Requirements:

1. Presence of one or both of the following symptoms:

   • Hallucinations

   • Delusions

2. Symptoms must be present for a significant portion of time during a one-month period

3. Must significantly impact the individual's functioning.

false sensory experiences, such as seeing something in the absence of an external visual stimulus.

a false belief, often of persecution or grandeur, that may accompany psychotic disorders.

(also called process 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.

(also called reactive schizophrenia) a form of schizophrenia that can begin at any age; frequently occurs in response to a traumatic event.

Behaviors or experiences that are added to a person's usual way of functioning, such as hallucinations or delusions. Involve the presence of abnormal experiences or behaviors that are not typically seen in healthy individuals. They "add" to a person's experiences or behavior.

Examples: Hallucinations, delusions, disorganized thinking or speech

Deficits or disruptions in normal emotions and behaviors, such as lack of motivation, social withdrawal, and reduced speech. Involve the absence or reduction of normal behaviors, experiences, or functions. They represent a diminution or "loss" of typical functioning.

Examples: Reduced emotional expression or blunted affect, Reduced motivation, Decreased ability to experience pleasure or enjoyment, social withdrawal

a psychological disorder in which the symptoms take a somatic (bodily) form without apparent physical cause. (Formerly called somatoform disorder; see conversion disorder and illness anxiety disorder.)

Basically having symptoms that can’t be scientifically explained.

Diagnosis Requirements:

1. The individual experiences one or more physical symptoms that are distressing and/or disruptive to daily life. These symptoms may be specific (e.g., pain, fatigue, gastrointestinal distress) or nonspecific (e.g., general discomfort).

2. The individual experiences disproportionate and persistent thoughts, feelings, or behaviors in response to the somatic symptoms, such as excessive worry, anxiety, or preoccupation with their health or the severity of their symptoms.

3. The symptoms are persistent, typically lasting for six months or longer.

4. The symptoms cause significant impairment in social, occupational, or other important areas of functioning, or they lead to excessive use of healthcare resources (e.g., frequent doctor visits, unnecessary medical tests or procedures).

5. The somatic symptoms cannot be fully explained by another medical condition

Clinicians rate the severity of SSD based on the patients experience with the cognitive symptoms rather than the physical ones.

a disorder related to somatic symptom disorder in which a person experiences very specific, physical symptoms that are not compatible with recognized medical or neurological conditions. (Also called functional neurological symptom disorder.)

anxiety/stress → physical symptom → symptom unexplained by medical testing

For example: As a result to a stressful event a patient may all of a sudden develop impaired balance or loss of sensation in their finger

Diagnosis Requirements:

1. One or more symptoms of altered voluntary motor or sensory function: Examples include weakness or paralysis, abnormal movements, loss of sensation, or episodes resembling seizures.

2. Clinical findings: There must be evidence of incompatibility between the symptom and recognized neurological or medical conditions. (unable to be explained because there is no medical condition that exists to explain it)

3. Clinically significant distress or impairment: The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

4. Not feigned or intentionally produced: The symptoms are not intentionally produced or feigned ( the patient is not faking it)

a disorder related to somatic symptom disorder in which a person interprets normal physical sensations as symptoms of a disease. (Formerly called hypochondriasis.)

• excessive worry or preoccupation with having a serious illness despite minimal or no medical evidence to support the presence of such an illness.

controversial, rare disorders in which conscious awareness becomes separated (dissociated) from previous memories, thoughts, and feelings.

a rare dissociative disorder in which a person exhibits two or more distinct and alternating personalities. (Formerly called multiple personality disorder.)

Diagnosis requirements:

1. Alter Personalities (Alters): The distinct identities in DID are often referred to as "alters." Each alter may have its own age, gender, mannerisms, voice, and even physical abilities.

2. Switching: Switching refers to the sudden transition from one alter to another. Switching may occur spontaneously, triggered by stress, trauma reminders, or internal conflicts.

3. 🌟 Amnesia: Individuals may experience partial or complete amnesia for events, behaviors, or experiences associated with different alters.

4. Trauma and Etiology: DID is often associated with a history of severe childhood trauma or abuse, particularly repeated and prolonged trauma that occurs during sensitive developmental periods. Traumatic experiences may lead to the fragmentation of identity as a coping mechanism to protect the individual from overwhelming emotions or experiences.

5. Comorbidity: Depression, anxiety disorders, post-traumatic stress disorder (PTSD), substance use disorders, and other dissociative disorders.

inflexible and enduring behavior patterns that impair social functioning

includes paranoid, schizoid, and schizotypal personality disorders. Individuals in this cluster often display odd or eccentric behaviors and have difficulties forming social relationships.

includes personality disorders characterized by dramatic, emotional, impulsive, or erratic behavior. Examples include borderline, narcissistic, histrionic, and antisocial personality disorders.

includes personality disorders characterized by anxious and fearful behavior. It includes Avoidant, Dependent, and Obsessive-Compulsive Personality Disorders.

a personality disorder characterized by unstable moods, behavior, and relationships.

Symptoms

• Unstable relationships

• Impulsive behavior

• Intense fear of abandonment

• Mood swings

• Chronic feelings of emptiness

• Suicidal thoughts or self-harming behavior

a personality disorder characterized by odd behaviors, beliefs, and difficulties with social interactions and forming relationships.

Symptoms:

• Ideas of reference (excluding delusions of reference).

• Odd beliefs or magical thinking that influences behavior and is inconsistent with subcultural norms.

• Unusual perceptual experiences, including bodily illusions.

• Odd thinking and speech.

• Suspiciousness or paranoid ideation.

• Inappropriate or constricted affect.

a personality disorder in which a person (usually a man) exhibits a lack of conscience for wrongdoing, even toward friends and family members; may be aggressive and ruthless or a clever con artist.

Symptoms:

• Disregard for right and wrong

• Persistent lying or deceit

• Lack of empathy

• Impulsivity

• Aggressiveness

• Irresponsibility

• Lack of remorse

• Risky behaviors

Note: antisocial in this case means ‘disruptive’ not necessarily ‘unsociable’

a personality disorder characterized by an inflated sense of self-importance, a constant need for admiration, and a lack of empathy for others.

Symptoms:

• Grandiosity

• Need for admiration

• Lack of empathy

• Sense of entitlement

• Exploitative behavior

• Envy of others

• Arrogant attitude

a personality disorder characterized by extreme sensitivity to rejection, feelings of inadequacy, and social inhibition.

Symptoms:

• Hypersensitivity to negative evaluation

• Avoidance of social interactions

• Feelings of inadequacy

• Fear of criticism or rejection

• Reluctance to take risks or try new activities

a personality disorder characterized by an excessive need to be taken care of, difficulty making decisions, expressing disagreement, fear of being alone, and seeking new relationships urgently when one ends.

Symptoms:

• Excessive need to be taken care of

• Difficulty making everyday decisions

• Difficulty expressing disagreement

• Fear of being alone

• Urgent seeking of new relationship when one ends

a personality disorder characterized by a preoccupation with orderliness, perfectionism, and control, at the expense of flexibility and efficiency.

Symptoms:

• Preoccupied with details, rules, lists, order, organization, or schedules.

• Shows perfectionism hindering task completion.

• Excessively devoted to work, neglecting leisure and friendships.

• Overconscientious about morality, ethics, or values.

• Unable to discard worthless objects.

• Reluctant to delegate tasks or collaborate.

• Miserly spending habits, hoarding money.

• Displays rigidity and stubbornness.

an eating disorder in which a person (usually an adolescent female) maintains a starvation diet despite being significantly underweight; sometimes accompanied by excessive exercise.

an eating disorder in which a person’s binge eating (usually of high-calorie foods) is followed by inappropriate weight-loss promoting behavior, such as vomiting, laxative use, fasting, or excessive exercise.

significant binge-eating episodes, followed by distress, disgust, or guilt, but without the compensatory behavior that marks bulimia nervosa