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1.6c- Clinical Psychology- Normal or abnormal- Full Summary
- Instelling
- Erasmus Universiteit Rotterdam (EUR)
Full extensive summary of 1.6C- Clinical Psychology at Erasmus university. English version. Good luck!
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Problem 1- Just scared? – 1.6C- Normal or Abnormal- Clinical Psychology- 2020/2021Literature:
1. Butcher, J. N., Mineka, S., & Hooley, J. M. (2014). Abnormal psychology (16th ed.). Boston: Pearson.
2. Davey G. (2014). Psychopathology: Research, Assessment & Treatment in Clinical Psychology (2nd ed). British Psychological Association and John Wiley &
Sons LTD.
3. Bridley & Daffin (2020). Abnormal psychology (2nd ed.). Washington State University.
What is the DSM-5?
Diagnostic and Statistical Manual of Mental Disorders: current mental disorder classification system.
Global definitions - mental health problems - specific symptom lists/criteria for each disorder.
‘Medical model’ category system of mental disorders: attempt to label and describe patterns.
Criticism: try categorize what is subjective, defining what lacks clear boundaries
What separates anxiety from normal fear?
Fear: adaptive response, prepares body for threat. Related to real or perceived threat. Activates fight or
flight.
Anxiety: response to a vague sense of threat/ anticipation of future threat. Prepares for fight and flight.
General causal factors (of fear/anxiety): all anxiety disorders share hallmark symptoms of excessive fear/
worry related to behavioral disturbances(negative when disrupts daily living).
Lang’s tripartite model= fear/panic/anxiety comprised of neural network of 3 loosely coupled components:
1. Physiological component: chronic arousal,
2. Cognitive (subjective) component: distress, unable to predict the future,
3. Behavioral component: avoidance, wanting to escape situation.
Etiology(causes) of anxiety disorders 1
Biological Psychological Sociocultural
Genetics: Cognitive Anxiety disorders: living
5-HTTLPR gene(serotonin Anxiety related/panic disorders= in poverty, experiencing daily
transporter) reduces serotonin dysfunctional thought patterns. stressors, and increased
activity = increase in anxiety-related exposure to traumatic events.
personality traits. Maladaptive assumptions: Sociocultural influences(e.g.
Interaction between genetics interpreting events as dangerous gender, discrimination)
and stressful environmental or overreacting to potentially important due to
influences = more anxiety stressful events, contributes to epidemiological nature of the
disorders than genetics alone. overall heightened anxiety level. disorder.
In combo with biological
Neurobiological: predisposition to anxiety= likely o Women diagnosed with
Brain structures responsible for contribute to the development of anxiety disorders more often: a
anxiety responses: anxiety symptoms trend throughout entire lifespan.
Amygdala: stores memories of
emotional events. o Accumulation of large One potential explanation:
Initiates a reaction to ready the body number influence of social pressures on
for fight or flight response. of learned fears= develops women. Women more
Hippocampus and Prefrontal cortex general anxiety disorder(GAD). susceptible to experience
determine if threat is real or Stimulus generalization, tendency traumatic experiences
imagined. of conditioned stimulus to evoke throughout life, may contribute
Determined no threat is similar responses to other to anxious appraisals of future
present= amygdala sends calming conditions, a fear of one events. Women more likely to
response to HPA axis, reduces level of item(dog) generalizes other items use emotion-focused coping:
,fear. If threat is present= amygdala (all animals). Fears grow= may increase levels of stress
activated- producing fear response. generalized anxiety will hormones = susceptible to
present(as opposed to a specific develop anxiety symptoms.
Locus coeruleus specific to phobia). Less effective in reducing
panic disorder. “on-off” switch for distress than problem-focused
norepinephrine neurotransmitters. Locus coeruleus: coping:
Increased activation= panic-like
symptoms. Individuals with panic o A combo of genetic,
disorder may have hyperactive locus environmental, and social factors
coeruleus (see image →) may explain why women tend to
= susceptible to experience more be diagnosed more often with
intense and frequent physiological anxiety-related disorders.
arousal than average. Also specific to
panic disorder: o Exposure to
discrimination and prejudice,
Corticostriatal- (ethnic minorities/
thalamocortical (CSTC) Anterior cingulate cortex & marginalized groups), impact
circuit/ fear-specific circuit: major orbitofrontal cortex individual’s anxiety level.
contributor to panic symptoms. Contribute to negative
Frightening object or situation= interactions= negatively affect
amygdala activated= sends fear and an overall decline in mental
response to anterior cingulate cortex health.
and the orbitofrontal cortex (see
image →). Additional projection of Repeated exposure to 2
amygdala to hypothalamus activates discrimination and prejudice=
endocrinologic responses to fear, fear responses and avoid social
releasing adrenaline and cortisol to situations to protect oneself
help prepare the body to fight or emotionally.
flight.
What are the different (criteria for) anxiety disorders and subtypes?
What are biological/psychological/sociocultural causal factors, epidemiology, treatment?
What is the prevalence of anxiety disorders in the general population (e.g. gender)?
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, Specific phobias
Causal factors Epidemiology (study/analysis of DSM-5 criteria
distribution, patterns, determinants of health and
disease conditions in populations).
Behavioral Prevalence rate is 7-9% within A. Striking fear of anxiety for a specific
Specific/social phobias: USA in a lifetime. object or situation. Can be
Classical conditioning – two events multiple/specific phobias. Immediate
occur close together become strongly Teenagers & younger children fear when phasing phobias face to face.
associated with one another, despite more prone to develop(excl. In children this is demonstrated by
lack of causal relationship. blood injection phobia) crying, a tantrum, freezing, or clinging
Criticism: not all trauma causes to a person.
phobia/ Not all phobias are caused by 2:1 ratio of females to male
trauma diagnosis with different types of B. Phobic object/situation almost
phobias: always causes immediate fear of
Modeling -Blood injection equal. --Animals, anxiety.
Specific/social phobias: individual situational and environment Amount of fear/ proximity of
acquires fear though observation and more prevalent in women. object=situation varies.
imitation. Maintenance of phobias due
to avoidance feared item/social Comorbidity(simultaneous C. Phobic object/situation actively
setting, prevents individual from presence of 2 or more medical avoided or experienced with intense
learning that object/situation should conditions). fear of anxiety.
not be feared. Child/teen at increased risk for
additional D. Fear of anxiety is out of proportion 3
Evolutionary: Phobic extinction in psychopathology(specify: anxiety compared to real danger &
humans has proven to be difficult. disorders, depressive disorders, sociocultural context
substance-related disorders and
Psychoanalytic: somatic symptom disorders). E. Fear, anxiety or avoidant behavior is
Id= there is a fear being suppressed; persistent and present for more than 6
manifests in a phobia as cover up. months
5-HTTLPR gene F. Fear, anxiety or avoidance behavior
causes clinically significant anxiety or
reduction in social, occupational, or
other important areas of functioning.
Disorder cannot be better explained by
symptoms of other mental disorders.
Social phobia/ Social anxiety disorder(SAD)
Causal factors Epidemiology DSM-5 criteria
Cognitive biases: 12% lifetime prevalence A. Striking fear of anxiety for one or more social
Belief people will judge you. situations in which an individual becomes
Perception is negative. Bias→ Equal among all ages. exposed to possible scrutiny from others.
makes you act embarrassing→ Significant decrease in
, people react according to diagnosis among older B. Individual is afraid that he will behave in a way or
anticipation. (vicious cycle) individuals. show symptoms of anxiety that be evaluated negatively
Conditioning Higher diagnosis rate in C. Social situations almost always cause immediate fear
females. of anxiety. In children fear shown by crying, tantrums,
Evolutionary perspective: freezing, cringing, or being unable to speak in social
evolutionary origin of social Develops in early situation.
fears lies in a dominance- adolescence/adulthood
submissiveness system. D. Social situations are avoided or experienced with
Comorbidity: intense fear of anxiety.
Being exposed to trauma. If Anxiety-related disorders,
no control= more prone to Major depressive disorder, E. Fear of anxiety is out of proportion compared to
not develop confident and substance- sociocultural context
behavior. related(likely connected to
self-medicating efforts e.g. F. Fear, anxiety or avoidant behavior is persistent and
Genetic and temperament: consume more alcohol to has been present for more than 6 months.
Neurotic(mental, emotional, alleviate anxiety)
or physical reactions that are disorders. G. Fear, anxiety, or avoidant behavior causes clinically
drastic and irrational) and Avoidant personality significant anxiety or one impairment in social
introvert. disorder. functioning, professional functioning, or other
important areas of functioning.
Behavioral inhibition:
tendency to experience
distress and to withdraw from
H. Fear, anxiety or avoidance behavior is not
attributable to the physiological effects of
4
unfamiliar situations, people, a substance (e.g.: drugs / medicine) or other medical
or environments. condition
I. Fear, anxiety, or avoidant behavior cannot be better
explained by symptoms of anxiety
other mental disorders/conditions.
No diagnosis: Situations in which individuals experience
anxiety toward a real threat, such as bullying or
ostracizing, would not be diagnosed with social anxiety
disorder as the negative evaluation and threat are real.
Agoraphobia:
Causal factors Epidemiology DSM-5 criteria
33-43% heritability 1.7% lifetime prevalence A. Striking fear of anxiety for 2 (or more) of the following 5
(the proportion of a situations:
Temperament: population who, at some 1. Use public transport
neurotic. point in life has ever had the 2. They are in open spaces
characteristic). 3. They are in closed spaces
4. Standing in line or in a crowd
Females twice as likely to be 5. Being out of the house
diagnosed.
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