Clinical psychologyChapter 1Introduction and historical overviewIntroductionPsychopathology: the field concerned with the nature, development, and treatment of mental disorders.Continually developing and adding new findings.Tries to remain objectiveCloseness to the subject matter adds to its intrinsic fascination.Sigma: the destructive beliefs and attitudes held by a society that are ascribed to groups considered different in some manner, such as people with mental illness.Stigma has four characteristics:A label is applied to a group of people that distinguishes them from othersThe label is liked to deviant or undesirable attitudes by societyPeople with the label are seen as essentially different from those without the label, contributing to an ‘us’ versus ‘them’ mentality.People with the label are discriminated against unfairlyThe treatment of individuals with mental disorders throughout recorded history has not generally been good, and this has contributed to their stigmatization.Mental illness remains one of the most stigmatized of conditions in the twenty-first century. Mental disorder is one disorder that contains several characteristics.The disorder occurs within the individualIt involves clinically significant difficulties in thinking, feeling, or behavingIt involves a dysfunction in processes that support mental functioningIt is not a culturally specific reaction to an eventIt is not primarily a result of social deviance of conflict with societyFour key characteristics that any comprehensive mental disorder definition ought to have:Disability...

Clinical psychology Chapter 3Diagnosis and assessmentIntroductionDiagnosis can be the first major step in good clinical care.Having a correct diagnosis will allow the clinician to describe base rates, causes, and treatment.Hearing a diagnosis can help a person understand why certain symptoms are occurring.Two concepts that play a key role in diagnosis and assessment:ReliabilityValidity Reliability Reliability: consistency of measurement.Inter-rater reliability:The degree to which two independent observers agree on what they have observed.Test-retest reliability:The extent to which people being observed twice or taking the same test twice, receive similar scores.Alternate-form reliability:The extent to which scores on the two forms of the test are consistentInternal consistency reliability:Whether the items on a test are related to one another.Validity Validity: whether a measure measures what it is supposed to measure.Unreliable measures will not have good validity.Reliability does not guarantee validity.Content validity:Whether a measure adequately samples the domain of interest.Criterion validity:Whether a measure is associated in an expected way with some other measure.Concurrent validity: If both variables are measured at the same point in time.Predictive validity:Evaluating the ability to measure to predict some other variable that is measured at the same point in the future.Construct validity:Relevant when we want to interpret a test as a measure of some characteristic or construct that is not observed...

Clinical psychologyChapter 5Mood disordersMood disorders involve disabling disturbances in emotion. The DSM-5 recognizes two broad types of mood disorders:Those that involve only depressive symptomsThose that involve manic symptomsDepressive disorders The cardinal symptoms of depression include profound sadness and/or an inability to experience pleasure.Physical symptoms of depression are also commonFatigue and low energyPhysical aches and painsThese symptoms can be profound enough to convince afflicted persons that they must be suffering from some serious medical condition, even though the symptoms have no apparent physical cause.Although people with depression typically feel exhausted, they may find it hard to fall asleep and may wake up frequently.Other people sleep throughout the day.They may find that foot tasted bland or that their appetite is gone, or that may experience an increase in appetite.Sexual interest disappearsSome may find their limbs feel heavyPsychomotor retardation: thoughts and movements may slowPsychomotor agitation: not being able to sit stillSocial withdrawal is common.Major depressive disorder Major depressive disorder (MDD)An episodic disorder: symptoms tend to be present for a period of time and then clear.Even though periods tend to dissipate over time, an untreated episode may stretch for 5 months or even longer.For a small percentage of people, the depression becomes chronic.Major depressive episodes tend to recur, once a given episode clears, a person is likely to experience another...

Clinical psychologyChapter 7Obsessive-compulsive-related and trauma-related disorders OCD is defined by repetitive thoughts and urges (obsessions) as well as an irresistible need to engage in repetitive behaviors or mental acts (compulsions)Body dysmorphic disorder and hoarding disorder have symptoms or repetitive thoughts and behaviors.People with body dysmorphic disorder spend hours a day thinking about their appearance, and almost all engage in compulsive behaviors such as checking their appearance in the mirror.People with hoarding disorder spend a good deal of their time repetitively thinking about their current and potential future possessions. They also engage in intensive efforts to acquire new objects, and these efforts can resemble the compulsions observed in OCD.For all three conditions, the repetitive thoughts and behaviors are distressing, feel uncontrollable, and require a considerable amount of time.For the person with these conditions, the thoughts and behaviors feel unstoppable.These syndromes often co-occur.Clinical descriptions and epidemiology of the obsessive-compulsive and related disorders Obsessive-compulsive disorder Obsessive-compulsive disorder (OCD) is characterized by obsessions or compulsions.Obsessions: intrusive and recurring thoughts, images, or impulses that are persistent and uncontrollable and often appear irrational to the person experiencing them.For people with OCD, obsessions have such force and frequency that they interfere with normal activities.People with obsessions may also be prone to extreme doubts, procrastination, and indecision.Compulsions:...

Clinical psychologyChapter 9SchizophreniaSchizophrenia: a disorder characterized by disturbances in thought, emotion and behavior.>1% prevalenceSlightly more men than women.Sometimes develops in childhood, but usually appears in late adolescence or early adulthoodpeople with schizophrenia typically have a number of episodes of their symptoms and less severe but still debilitating symptoms between episodes. The range of symptoms in the diagnosis of schizophrenia is extensive, although people with schizophrenia typically have only some of these problems at any given time.No single essential symptom must be present for a diagnosis of schizophrenia.Researchers divided symptoms in threePositive symptomsDelusions, hallucinationsDisorganized symptomsDisorganized behavior, disorganized speechNegative symptomsAvolition, alogia, anhedonia, blunted affect, asocialityDSM-5 criteria of schizophreniaTwo or more of the following symptoms for at least 1 month; one symptom should be either 1, 2, or 3:1. delusions2. hallucinations3. disorganized speech4. disorganized (or catatonic) behavior5. negative symptoms (diminished motivation or emotional expression)Functioning in work, relationships, or self-care has declined since onsetSigns of disorder for at least 6 months; or, if during a prodromal or residual phase, negative symptoms or two or more of symptoms 1-4 in less severe form.Positive symptoms Positive symptoms comprise excesses and distortions, such as hallucinations and delusions.For the most part, acute episodes of schizophrenia are characterized by positive symptoms....

Clinical psychologyChapter 11Eating disorders Anorexia nervousa DSM-5 criteria for anorexia nervousaRestriction of food that leads to very low body weight; bodyweight is significant below normalIntense fear of weight gainBody image disturbanceAmenorrhea: loss of menstrual periodTwo types of anorexia nervosa:Restricting typeWeight loss is achieved by severely limiting food intakeBinge-eating/ purging typeThe person has also regularly engaged in binge eating and purging.Typically begins in the early to middle teenage years, often after an episode of dieting and the occurrence of life stress.Lifetime prevalence: less than one percent10 time more frequent in women than in men.Women with anorexia are frequently diagnosed with depression, obsessive-compulsive disorder, phobias, panic disorder, substance use disorder, and various personality disorders.Men with anorexia nervosa are also likely to have a diagnoses of a mood disorder, schizophrenia, or substance use disorder.Suicide rates are quite high for people with anorexiaPhysical consequences of anorexia nervosa Self-starvation and use of laxatives produce numerous undesirable biological consequences in people with anorexia nervosa.Blood pressure fallsHeart rate slowsKidney and gastriontestinal problemsBone mass declinesSkin dries outNails become brittleHormone levels changeMild anemia may occursome people loose hair, and they may develop lanugo, a fine, soft hair on their bodies.Levels of electrolytes are altered. These are essential to neural transmission, and lowered levels can lead toTiredness...

Clinical psychologyChapter 13Disorders of childhoodMost theories of childhood disorder, consider childhood experience and development critically important to adult mental health. Before making a diagnosis of a particular disorder in children, clinicians must first consider what is typical for a particular age.Some childhood disorders are unique to children.The more prevalent childhood disorders are often divided into two broad domains,Externalizing disordersCharacterized by outward-directed behaviorsAttention-deficit/hyperactivity disorderConduct disorderOppositional defiant disorderInternalizing disordersCharacterized by more inward-focused experiences and behaviorsChildhood anxiety disorderMood disordersChildren and adolescents may exhibit symptoms form both domains.Across cultures, externalizing behaviors are consistently found more often among boys and internalizing behaviors more often among girls, at least in adolescence.Childhood disorders involve an interaction of genetic, neurobiological, and psychological factors. Clinical descriptions, prevalence, and prognosis of ADHD DSM-5 criteria for attention-deficit/hyperactivity disorderEither A or BA. Six or more manifestations of inattention present for at least 6 months to a maladaptive degree and greater that what would...

Clinical psychologyChapter 15Personality disordersThe personality disorders are a heterogeneous group of disorders defined by problems in forming a stably positive sense of self and with sustaining close and constructive relationships.People with personality disorders experience difficulties with their identity and their relationship in multiple domains of life, and these problems are sustained for years.Their personality problems are evident in cognition, emotion, relationships, and impulsive control. The symptoms of personality disorders are pervasive and persistent. The DSM-5 approach to classification In the DSM-5, the 10 different personality disorders are classified in three clusters, reflecting the idea that these disorders are characterized by:Odd or eccentric behaviorDramatic, emotional or erratic behaviorAnxious or fearful behaviorMany people with psychological disorder will also experience a personality disorder.Comorbid personality disorder are associated with more severe symptoms, poorer social functioning, and worse treatment outcomes for may conditions.Diagnostic reliability One issue in assessing personality disorders is whether people can accurately describe their own personalities.Many of the personality disorders may not be as enduring as the DSM asserts.Using structured interviews and multiple informants can improve reliability.Comorbidity Personality disorders tend to be comorbid with each other.Alternative DSM-5 model for personality disorders Reducing the number of personality disorders, incorporating...