GRE® Psychology Clinical: Clinical and Abnormal Part 2

1. delusions

2. hallucinations

3. disturbed or innapropriate emotional responses to environmental stimuli

Process schizophrenia; his prognosis is poor, as it shows a long-term deterioration.

1. Stupor

2. Catalepsy

3. Waxy flexibility

4. Mutism (do not count toward diagnosis is the individual has aphasia)

5. Negativism

6. Posturing

7. Mannerism

8. Stereotypy

9. Agitation not influenced by external stimuli

10. Grimacing

11. Echolalia (mimicking another's speech)

12. Echopraxia (mimicking another's movements)

Eugene Bleuler

Bleuler identified the lack of coherence between emotion and thought and the breaking away from reality characteristic of psychotic illness.

A catatonia symptom in which the body can be moved into new positions and will stay there instead of going limp.

Flat; inappropriate

The lifetime risk for completed suicide for individuals who have schizophrenia or schizoaffective disorder is approximately 5%.

In other words, 1 in 20 people who have schizophrenia or schizoaffective disorder die by suicide.

Approximately 20% will attempt suicide one or more times.

Negative Reinforcement

Intermittently, an individual who has OCD will experience temporary spontaneous reduction of obsessive thoughts. Whatever action the individual was taking at the time, typically an action aimed at reducing the distress or preventing the feared harm/negative consequence, will be associated with the temporary alleviation of the symptom, i.e., negative reinforcement. (This leads to the development of habit-driven rituals.)

obsessive-compulsive disorder

No

Research indicates that the more times one checks, the less certain one is! (Did I lock the door? Did I unplug the toaster?). This seems to be the case because the more times one checks, the distinctive the memory is for having checked!

BDD is an OCD-spectrum disorder in which:

• The individual is preoccupied with an imagined defect in appearance (or if there is a real appearance-related issue, the individual's concern is out of proportion to the issue),

• The preoccupation results in impairment in occupational/social functioning.

• The preoccupation is not better accounted for by an eating disorder

Individuals with BDD often have multiple cosmetic surgeries.

Pulling out one's hair.

In the DSM-5, trichotillomania is recognized as an OCD-spectrum disorder. (Previously it was considered an impulse control disorder.)

• A negatively-valenced, basic emotion.

• Focuses one's attention on a specific stimulus.

• Activates the sympathstic nervous system, readying the body for fight, flight, or freeze responses, so one can respond quickly to a potentially dangerous situation.

• Also is negatively-valenced.

• It is a mood, so it is of longer duration than an emotion.

• Future-oriented, focusing on potential future harm, rather than addressing an immediate threat.

1. Threat Hypervigilance

2. Uncertainty Intolerance

generalized anxiety disorder

post-traumatic stress disorder

Social Anxiety Disorder | (previously called social phobia)

Social Anxiety Disorder is one of the Anxiety Disorders.

The individual has marked fear or anxiety about 2 or more of the following:

1. Using public transportation;

2. Being in open spaces;

3. Being in enclosed spaces;

4. Standing in line/being in a crowd;

5. Being outside of the home alone

The individual avoids such situations/must have a companion to do/or are endured only with great distress; these situations almost always provoke fear or anxiety; fear is out of proportion both with actual risk and sociocultural norms; symptoms cause clinically significant distress or impairment.

If a medical disorder co-occurs (e.g., IBS, the fear, anxiety, or avoidance is clearly excessive), and the condition is not better explained by symptoms of another disorder.

Agoraphobia often co-occurs with Panic Disorder, though not always.

specific phobias

Specific objects or situations that provoke anxiety.

persistent; irrational

No. Most people who have had a panic attack do not develop Panic Disorder.

3-6% of people have had a panic attack.

The DSM-5 describes panic attacks as "an abrupt surge of intense fear or intense discomfort that reaches a peak within minutes."

1. Palpitations/pounding heart/accelerated heart rate;

2. Sweating;

3. Trembling/shaking;

4. Short of breath/feel as if being smothered;

5. Feel as if choking;

6. Chest pain/chest discomfort;

7. Nausea or abdominal distress;

8. Feeling dizzy/unsteady/light-headed/faint;

9. Chills or snsations of heat;

10. Parasthesias (numbness/tingling);

11. derealization/depersonalization;

12. fear of losing control/fear of going crazy;

13. Fear of dying

1. The individual experiences recurrent, unexpected panic attacks.

2. For at least 1 month following one of the panic attacks, the individual has experienced significant worry/concern about future panic attacks (having them &/or their significance) and/or makes a significant maladaptive change in behavior related to the panic attacks (e.g., avoiding going to unfamiliar situations or avoiding exercise)

Symptoms affecting the motor or sensory body systems that are real to the patient but have no apparent medical cause.

This is now a rare diagnosis, though it was a relatively common diagnosis during the first part of the twentieth century.

This is a mental illness in which the patient may feel as though s/he is living outside his/her body, but still retains contact with reality.

In this disorder, an individual seeking medical help or attention for another person in his or her care has intentionally, deliberatelly caused or simulated symptoms of an illness or of illnesses in the other person. Typically, it is a parent causing symptoms in her or his own child.

It is a very dangerous disorder; an estimated 10% of children who are victims of someone who has Factitious Disorder Imposed on Another die from the abuse (Hall et al., 2000).

Hidden camera evidence often is required in order to diagnose the disorder.

Hypochondriasis

somatoform disorder

• Hypochondriasis –Person actually believes he or she has an illness (based on bodily symptoms)

• Factitious Disorders –Motive is internal; to assume the role of a sick person (or to do so by proxy); to gain the attention (and sympathy) of medical professionals

• Malingering –Motive is external; e.g., to obtain compensation, to evade police or legal action; the individual can stop having symptoms if having symptoms is no longer useful

Somatoform disorder

• zoophilia is sexual attraction to animals

• pedophilia is sexual attraction to children

• fetishism is sexual arousal stemming from objects or situations

Paraphilia (or psychosexual disorder) is marked by the sexualization of objects, people, or activities that are not generally considered sexual.

A set of criteria used to assess the likelihood of an individual committing suicide.

dysfunction; altered

dissociative amnesia

The sufferer will assume a new identity because he (or she) does not remember his (or her) old identity.

Dissociative Identity Disorder (DID); two

No.

The validity of DID is highly controversial. Some psychologists do not consider DID a true disorder, but rather a culture-bound manifestation of one or more other disorders.

The most famous DID case is a patient known as Sybil. There was a best selling book (and later, a very popular movie) about Sybil. It was after the release of the book that DID (then Multiple Personality Disorder) became a common diagnosis, and even then, a small minority of therapists made the vast majority of the diagnoses of DID.

Many years later, it was revealed that the book was inaccurate and the case not as described. This is a truly shocking case of ethical misconduct.

For further information on the Sybil scandal, please see a NY Times article here and [an NPR article here](
http://www.npr.org/2011/10/20/141514464/real-sybil-admits-multiple-personalities-were-fake).

• often diagnosed in childhood

• inability to focus on demanding tasks

• lack of organization

• problems adhering to instructions

• excessive movement

• impulsivity

motor tics; vocal tics

• Retrograde amnesia, one loses memories that occurred before the traumatic event.

• Anterograde amnesia, one loses memories occurring after the traumatic event.

1. anterograde

2. retrograde

Regulates the body's response to stress through hormone secretion.

The Hypothalamic-Pituitary-Adrenal (HPA) axis is crucial for the stress response, releasing cortisol to help manage stress and maintain homeostasis.

True

Acute stress can enhance cognitive and physical performance by increasing alertness and energy levels. However, chronic stress can have detrimental health effects.

Problem-focused coping

Problem-focused coping involves tackling the source of stress directly, such as time management or seeking social support to reduce stress.

Approach-approach conflict

Approach-approach conflict arises when an individual is faced with two appealing choices, requiring a decision between them.

It involves choosing between two undesirable options.

Avoidance-avoidance conflict is stressful because neither option is appealing, leading to procrastination or indecision.

Chronic

Chronic stress results from persistent stressors and can lead to health problems like anxiety, depression, and cardiovascular disease due to prolonged activation of the stress response.

Managing emotions related to stress rather than the stressor itself.

Emotion-focused coping includes strategies like meditation, exercise, or talking with friends to alleviate emotional distress.

Cortisol

Cortisol, often called the 'stress hormone', helps mobilize energy and suppress non-essential functions in a fight-or-flight situation, aiding in stress management.

• DSM: Focuses primarily on mental disorders, used mainly in the United States.

• ICD: Covers all health conditions, including mental and physical disorders, used internationally.

The DSM (Diagnostic and Statistical Manual of Mental Disorders) is published by the American Psychiatric Association, while the ICD (International Classification of Diseases) is published by the World Health Organization. The ICD is more globally recognized and facilitates international data comparison.

False

The DSM-5 abandoned the multiaxial system used in previous editions (DSM-IV) and adopted a dimensional approach to better capture the complexity of mental disorders.

Consistency of a measurement across time and different situations.

Reliability refers to the degree to which an assessment tool produces stable and consistent results. It is crucial for ensuring that a diagnosis or measurement is accurate over repeated trials or assessments.

categorical; dimensional

The categorical approach is like a checklist of symptoms to determine if a disorder is present, while the dimensional approach considers the severity and variation of symptoms across a spectrum.

The extent to which a test measures what it claims to measure.

Validity ensures that a test is accurately assessing the intended construct or diagnosis. It is essential for the credibility and usefulness of psychological assessments.

A method where a psychologist gathers information through direct conversation with the patient.

Clinical interviews can be structured, semi-structured, or unstructured to gather qualitative and quantitative data.

provide accurate information about themselves.

Self-report assessments are widely used due to their efficiency, but they can be biased by the individual's self-perception and honesty.

False

Observation can be subjective, as it often involves the interpretation of behaviors by the observer, which may be influenced by their biases.

• Reliability

• Validity

• Standardization

Reliability refers to consistency, validity to accuracy, and standardization to uniform procedures in testing.

Validity refers to the accuracy of a test in measuring what it claims to measure.

A test can be reliable without being valid, but a valid test must be reliable.

• Projective tests use ambiguous stimuli to elicit responses revealing unconscious desires.

• Objective tests use structured, specific questions with fixed responses.

Projective tests, like the Rorschach Inkblot Test, are open-ended, whereas objective tests, like the MMPI, have clear answers.

The process of administering and scoring a test under consistent conditions.

Standardization ensures that test scores are comparable across different individuals and settings.

An approach to understanding the development of psychological disorders that emphasizes the interplay between biological, psychological, and social factors.

Developmental psychopathology is a framework that views disorders within the context of normal development, aiming to identify how various factors interact over time to influence the emergence of disorders.

modified

Gene-environment interaction suggests that certain environments can influence the expression of genes, leading to different outcomes in individual development and behavior.

True

The diathesis-stress model is a psychological theory that explains behavior as both a result of biological and genetic factors ('diathesis') and life experiences ('stress').

Risk Factors:

• Family history of mental illness

• Exposure to trauma

Protective Factors:

• Strong social support

• Effective coping strategies

Risk factors increase the likelihood of developing disorders, whereas protective factors help shield against them. Both types of factors can vary in impact at different life stages.

It refers to the idea that the accumulation of multiple risk factors increases the likelihood of adverse developmental outcomes.

Cumulative risk highlights that the presence of numerous risk factors can have a greater impact than a single risk factor, emphasizing the importance of considering the overall context of an individual's life in developmental psychopathology.

Serotonin

Serotonin is crucial for mood balance and is a target in many antidepressant treatments, such as SSRIs, which increase serotonin levels in the brain.

False

Dopamine also plays key roles in motor control, motivation, arousal, and executive functions. Imbalances are associated with disorders such as Parkinson's disease and schizophrenia.

amygdala

The amygdala is part of the limbic system and plays a critical role in emotional reactions, decision-making, and memory processing.

• MRI (Magnetic Resonance Imaging)

• fMRI (Functional Magnetic Resonance Imaging)

MRI provides detailed images of brain structures, while fMRI measures brain activity by detecting changes associated with blood flow.

Cortisol

Cortisol helps regulate metabolism, reduce inflammation, and control blood sugar levels. Chronic stress and prolonged cortisol release can lead to various health issues.

SSRIs primarily increase serotonin levels in the brain by inhibiting its reuptake.

SSRIs are commonly prescribed for depression and anxiety disorders. By preventing serotonin reuptake, more serotonin is available in the synaptic cleft, enhancing mood and emotional regulation.

False

Atypical antipsychotics target both dopamine and serotonin receptors, which helps reduce symptoms of schizophrenia and bipolar disorder with fewer side effects compared to typical antipsychotics.

• Psychodynamic therapy focuses on unconscious processes.

• Humanistic therapy emphasizes personal growth and self-actualization.

Psychodynamic therapy often explores childhood experiences and unconscious conflicts, whereas humanistic therapy is centered on the individual's capacity for self-awareness and personal development.

Benzodiazepines

Benzodiazepines enhance the effect of the neurotransmitter GABA, which has calming effects on the brain, making them effective for short-term management of anxiety.

• Greater integration with daily life

• Reduced stigma

• Continuity of care

Community care allows individuals to receive treatment while maintaining their social ties and daily routines, potentially leading to better long-term outcomes and a reduction in the stigma associated with hospital stays.

• Incidence refers to the number of new cases of a disease that develop in a specific period.

• Prevalence is the total number of cases, both new and existing, in a population at a given time.

Incidence helps identify risk factors for a disease, while prevalence shows how widespread the disease is. Understanding both is crucial for public health planning and resource allocation.

True

Lifetime prevalence measures how many people have ever had the condition at any point in their lives, providing a comprehensive picture of the burden of the condition over time.

• Age

• Sex

• Socioeconomic Status (SES)

These demographic factors are crucial in understanding who is most at risk for certain psychological conditions, guiding targeted interventions and prevention strategies.

Comorbidity is the occurrence of two or more disorders or illnesses in the same person, simultaneously or sequentially.

Comorbidity can complicate diagnosis and treatment, as symptoms of one disorder may exacerbate or mask those of another. It also highlights the need for integrated treatment approaches.

Population-based; clinical

Population-based samples provide insights into the general prevalence and demographics of disorders, while clinical samples help understand disorders' characteristics in patients seeking treatment.

To prevent the onset of mental health disorders by reducing risk factors and enhancing protective factors.

Primary prevention aims to reduce the incidence of mental health problems before they occur, often through community-wide education and health promotion.

Secondary

Secondary prevention targets individuals who are at high risk or are showing early signs of mental health disorders, aiming to minimize their impact.

False

Tertiary prevention focuses on reducing the impact of an ongoing mental health disorder by helping individuals manage symptoms and improve quality of life.

Universal prevention programs target the entire population, regardless of individual risk levels.

Universal programs aim to provide widespread interventions that benefit all individuals, unlike selective and indicated programs which focus on specific at-risk groups or individuals.

• Stigma surrounding mental health

• Lack of funding and resources

• Limited access to trained professionals

Barriers can hinder the implementation and effectiveness of prevention strategies, often requiring targeted efforts to overcome.

Improving mental health outcomes for populations through preventive and promotional interventions.

Public mental health strategies include policies and programs designed to enhance mental well-being and reduce the prevalence of mental disorders on a societal level.

• Biological

• Psychological

• Social

The biopsychosocial model considers the complex interaction of biological, psychological, and social factors in understanding health and illness.

True

The Health Belief Model suggests that personal beliefs about health conditions, perceived benefits, and barriers to action influence health-related behaviors.

perceived behavioral control

Perceived behavioral control refers to an individual's perception of their ability to perform a given behavior and is a key predictor of behavioral intention.

Theory of Planned Behavior

The Theory of Planned Behavior posits that intention is the primary driver of behavior, influenced by attitudes, subjective norms, and perceived behavioral control.

• Weakens the immune system

• Increases risk of cardiovascular disease

• Contributes to mental health disorders

Chronic stress can lead to a range of health problems, as it affects the body's ability to fight off illness and maintain homeostasis.

Meditation

Mind-body interventions, like meditation, aim to promote relaxation and reduce stress by focusing the mind and fostering a state of calm.

Social support

The Health Belief Model focuses on individual-level factors such as perceived susceptibility, severity, benefits, and barriers, rather than external factors like social support.

True

The biopsychosocial model provides a comprehensive framework for understanding both physical and psychological health issues by considering a wide range of influencing factors.

A mental disorder or illness that is specific to a particular cultural or ethnic group.

Culture-bound syndromes are influenced by cultural beliefs and practices and may not be recognized as disorders in other cultures.

True

Stigma, including fear of judgment and discrimination, can discourage individuals from seeking mental health treatment, impacting recovery and well-being.

Women

Women are about twice as likely as men to experience depression, potentially due to biological, social, and psychological factors.

Gender differences

Gender differences affect how disorders are expressed and experienced, influencing diagnosis and treatment approaches.

• Language barriers

• Cultural norms and values

• Different expressions of psychological distress

Cross-cultural assessments must account for these factors to avoid misdiagnosis and ensure culturally competent care.

Increased isolation

Stigma can lead to social withdrawal, making individuals feel isolated and less likely to seek support or treatment.

Koro

Koro is characterized by an intense fear of the genitals retracting and disappearing, leading to death, and is primarily found in Southeast Asian cultures.

False

Women are more frequently diagnosed with anxiety disorders, which may be due to a combination of genetic, hormonal, and psychosocial factors.