A2 Clinical psychology A01 knowledge

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  • Clinical Psychology A2
    • 4 D's of diagnosis
      • Deviance- rare within society, different from norms
      • Dysfunction- significantly interferes with a persons life
      • Distress- how much upset does it cause
      • Danger- either to themselves or others
    • Classification systems
      • ICD
        • Written by: The WHO Version: 10 Used by: guiding diagnosis through the clinical interview Used in: All countires
      • DSM:
        • Written by: The APA Version: 5 Used by: 5 axis( 1-describes major MHD 2- Symptoms 2- medical conditions 4- Psychosocial and environmental 5- Global functioning) Used in: America
    • Schizophrenia
      • Features
        • A psychosis, separate from reality. 1% of the population suffer from it.10+ years less life expectancy (health/suicide). Diagnosed in adolescence to 30 y/o. More likely in poorer, unemplyed/homeless
      • Symptoms
        • 1. Disorganised thinking and speech 2. Abnormal motor behaviour 3. Hallucinations 4. Delusions 5. Negative symptoms
      • Biological explanations
        • Neurotransmitters: A neurotransmitter send messages across the synapse in which they bind to recpetors and pass messages through electricity. Dopamine- helps control the brains reward and pleasure centres and regulate emotional responses
          • Low Dopamine= prone to addiction
          • High Dopamine=links to schizophrenia
        • Genetics: Look at concordance rates between twins to see the likelihood of one twin getting schizophrenia (MZ twins have a 48% of SZ if one twin has it)
      • Non-Biological explanations
        • Social Causation:
          • Social Class-lower class=higher SZ incidents, Unemployment, deprived areas, longer term causes
          • Social Adversity- city living, unemployment and poverty, isolation or overcrowding, crime and drug use/separtion from parents
          • Immigrant population- Afro-Caribbean and black population=higher incidents, Disadvantaged
          • Alien Neighborhood-Higher incidence when ethnic group doesn't dominate neighborhood
      • Biological treatments
        • Drugs: target neurotransmitters. Drugs used to treat schizophrenia=antipsychotic drugs. Each patient is put on one drug at a time. they reduce positive symptoms
          • Typical antipsychotic drugs- well established, bad sideeffects Atypical antipsychotic drugs- newer, fewer sideeffects
          • Side-effects: sleepiness, muscle spasms, low risk of tardive dyskensia
      • Cognitive treatments
        • CBT: uses cognitive and behavioural psychlogy. Addresses the thinking and behaviour involved
          • Ellis: ABC model-change faulty belief system and behaviour
          • 1. Belief modification- delusional thinking challenged    2. Focussing and reattribution- looks at the content of auditory hallucinations 3. Normalising-looking at psychotic experience rationally
    • OCD
      • Features
        • Anxiety disorder. 4th most common mental disorder. Affects all genders and ages. tends to start in childhood/ adolescence. 25% of male sufferers before aged 10. 1.2% of UK and 2% of worldwide
      • Symptoms
        • 1. Obsessions cannot be ignored       2. Time consuming  3. No substance misuse        4. No other disorder        5. Check for a tic disorder
      • Biological explanation
        • Faulty circuit: Orbitofrontal cortex-alerts the brain to potential worries in the enviroment. Cingulate Gyrus- connects thalamus to orbitofrontal cortex. Caudate Nucleus- inhibits actions of globus palidus fibres (GPF). GPF- acts as a braking mechanism/ Thalamus- contaisn primitive checking and cleaning behaviours
      • Non-Biological explanation
        • Cognitive model: Pace et al, 6 cognitive variables
          • 1.High focus on responsibility 2.Over importance of thoughts 3.Excessive focus on controlling ones own thoughts 4.Overestimating threats 5.Difficulty in tolerating uncertainty 6.Requiring perfectionn
      • Treatments
        • CBT: First choice, goal orientated, short term, changes thought patterns that cause anxiety, aim to change the beliefs that are triggered though the intrusive thoughts (similar to SD)
        • Drugs: second choice, Antidepressants, Beta-blockers, Benzodiazepines

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