Summary Study Guide PBL Reporting Phases Clinical Psychology

Clinical Psychology Study Guide
Problem 1
Models of distress:
 The Biomedical Model: the view that your depression is based in your
biology.
o The illness is in the brain/mind
o See Scheme
 The Psychosocial model: mental health problems are seen as psychological
in nature, by adverse life events and circumstances
o Illness caused by events, it is the result of life experiences
o Illness are easier to understand in this model
o The problem is attributed to barriers in society instead of biological
disorders
 The Biopsychosocial Model: combination of the biomedical and the
psychosocial model. Some causes of illness are biological but life
experiences can aggravate the condition. E.g. you could be predisposed to
become depressed but you become (or don’t become) depressed because of
certain circumstances
o The Diathesis Model: explains behaviour as a pre-dispositional
vulnerability to get over life experiences (stressful experiences)
 Distress = All of the different kinds of difficult or unusual experiences
associated with the hundreds of psychiatric diagnoses currently employed. 3
main forms/characteristics:
o A strong or overwhelming emotional state of various kinds that
disrupts everyday life and prevents people from functioning
o Ritual and repetitive patterns of acting that create anxiety if not carried
out (e.g. of hygiene)
o Experiences of seeing and hearing things that other people do not see
or hear, or holding beliefs that are considered by others to be unusual/
extreme (always conceptualized in cultural norms → the definition of
distress differs cross-culturally)
 See sources for other models
 Limitations of the use of models: too much focus on the relevant given
perspective but not enough on what the person is feeling, misleading
causality. Dimensional vs categorical: run the risk of labelling too much
(categorical) or not enough (dimensional)

Mental health & Definitions of ‘normal’
 Different definitions of normal:
o Medical definition = normal is activities that contribute to your health
and well-being. Abnormal is endangering life or well-being that could
cause damage to life or tissues and organs.
 Does not take into account the psychiatric well being
o Social definition = Actions or experiences approved or disapproved
for that time, place and cultural norms
o Statistical definition = looks at whether you are normal relative to the
population
 Mental well being = state of wellbeing in which every individual realizes
his/her own potential, can cope with normal stresses of life, can work
productively and fruitfully and is able to make a contribution to his/her own
community

,  What does normal actually mean? Normal and abnormal do not provide an
objective basis for explaining psychopathology/mental illnesses. They did not
rely on these concepts in the book because the definitions are unclear and
not consistent. These terms imply discrimination and stigma.

Role of Language
 Language is very important because it is linked to stigma and discrimination.
Words used: service user, system survivor, client, patient, consumer, and
recovery, recipient
o Patient = implies a passive position where someone puts themselves
in the hands of experts to be fixed. Mainly used in medical
terminology.
o Recovery = ongoing process - not done after receiving treatment.
o System survivor = when the person experiences an unhelpful
treatment
o Recipient = unwillingly admitted
o Consumer and client : are interchangeable
 Client is used by the specialists (such as psychologists)
 Consumer and recipient are differentiable by the willingness of
the person (being admitted or not, respectively)
o Service user: more used in the UK
 The word “patient” is the most liked word, because:
o Some patients might want to be acknowledged as being ill
o Patients is closer to the problem
o Patients want their mental disorder to be treated like a physical one
 Limitation to current treatment norm: Depression is usually conceived as a
biological problem - people are usually given pills instead of looking at the
entire picture. We treat depression as a biological disorder instead of a larger
phenomenon
 People prefer to be labelled with a medical term, otherwise some might think
that you are incapable of functioning like you are supposed to, or incapable of
handling the stresses of life. There is less stigma on the idea of having a
medical disease.
 Being labelled as sick has benefits within the system: at work for example (if
the person gets more time off but is still paid the same)
 Prescription rate for antidepressive is increasing → pharmaceutical
companies have incentives to make more drugs and create a larger patient
pool.
 Distinction between disease, illness, sickness:
o Disease = objective, physical, pathological origin, process, signs
o Illness = subjective feeling, experience of unhealth, symptoms
o Sickness = external and public label put upon you by society

Depression
 No definition in the sources, it was narrowed down as mourning and
melancholy because depression is a vague term for a variety of states.
o Melancholy = mood of self-absorbed sadness. It is different from
depression as you maintain your good thinking abilities.
 Very ancient term
o Mourning = getting over a loss
o They are more precise concepts that can help to shed light on the
processes we use to get over losses

, o Accide: mixture of misery, boredom and disgust due to a loss of faith
in god. Failure to perform tasks.
 4 humours (Hypocrates) :
o Yellow, black, sanguine, phlegm
o An excess of black bile referred to being sick
 Cross Cultural differences:
o Western societies: emphasize more on the cognitive aspects of
sadness and worry, which also explains the way they look at mental
experiences
o Collectivistic societies: being outside of a group can be traumatic -
people blame themselves and not the group, they look at at physical
and somatic aspects
o Importance of power-relationships, family dynamics etc
o Kleinman on illness and disease: a disease is biologically constant,
illness is culturally specific - experts should always work with illnesses
and not diseases in order to understand the symptoms of the person
as being dependent on their individual culture
 Causes of depression:
o Gender: women are more likely than men to become depressed
because of domestic violence, economic status, unfulfillment of
emotional needs,social pressure, biological factors
 Emotion work: a sociological concept that refers to the ways
people are sometimes expected to manage, cultivate, refine
and sipay their emotions in line with expectations
o Social inequality: two explanations
 Inequality is difficult which causes sadness and worry
 Dose-response relationship: social inequalities impair
relationships inducing a downward spiral → sadness affects
your way of behaving, which affects your relationships to
others, which affects your sadness and behaviour etc etc
o Family and childhood: relationship within the family. Factors could
be the stability of your childhood, help from the family, managed
expectations (too high expectations sometimes cause problems later
in life)
o Life events: stressful events, trauma, war, giving birth etc. Loss and
danger usually lead to anxiety, loss and humiliation usually lead to
depression
 Depressive disorders (bold = need to know the essential feature and criteria):
o Disruptive Mood Dysregulation Disorders
o Major Depressive Disorder
 Essential feature: a period of at least 2 weeks during which
there is either depressed mood or no interest in nearly all
activities
 Sense of worthlessness and hopelessness
 9 criteria (must have 5 out of the 9):
 Depressed mood
 Loss of interest of pleasure in most or all activities
 You need to have one of these 2 above, present
most of the day nearly every day for at least 2
weeks
 Change in appetite or weight
 Insomnia or hypersomnia
 Psychomotor agitation or retardation
 Fatigue or loss of energy