DSM- 5
Classification system for psychological disorders and a guideline for diagnosis
What is the DSM-5
- Driven by Freudian psych (ID and Superego)
- Finds childhood trauma (unconscious cause) + change behaviour
- Therapist must construct a narrative via behavioural patterns
- Encourages transference to examine unconscious
What is Psychoanalysis/Psychodynamic Theory?
- helps client become aware of their thoughts, feelings, behaviours, feelings + take responsibility
- focusing -- shifting attention to how they currently feel while describing a past event
- empty chair technique -- roleplay, imagine the other person + how an interaction with them would go
What is Gestalt Therapy
- Typical -- blocks dopamine receptors (+)
- Atypical -- blocks dopamine AND serotonin (+/-) receptors
Used for: schizophrenia, bipolar, depression
Effectiveness: very effective for schizophrenia
Side Effects/Limitations -- not great for (-) symptoms, not long term
What are antipsychotics
Co-occurrence of 2 or more disorders in one person, common when using the DSM-5
What is comorbidity?
- Client put in a radically accepting environment to use the therapist as a mirror to reach radical self (follows humanistic theory)
- Therapist is a supporter, client must make their own conclusions
- Gloria Tapes
What is Person-Centered Therapy
- Clients misremember initial symptoms as worse than they were
- Clients may feel better because they like their therapist, not actually better
Why is self report unreliable
- Benzos -- increase GABA, reduce brain activity --> most commonly administered
- Beta blockers -- block norepinephrine, help with physical effects
- buspirone -- increases serotonin, good for comorbid anxiety + depression
Used for: anxiety, PTSD, OCD,
Effectiveness: high
Side effects/limitations: builds high drug tolerance, strong withdrawal symptoms, only alleviates symptoms
What are Anxiolytics/ Anti-anxiety medications?
- Animals
- Natural environment
- Blood/injection/injury
- Situational
- Other
What are the phobic disorder classifications in the DSM-5
(it doesn't care about specific names)
- used to treat severe mental disorders not responding to psychological treatment or medication
- induces a brief seizure
- primarily for severe depression, someonetimes bipolar
What is Electroconvulsive Therapy (ECT)?
- Conditions usually improve on their own + people seek help when symptoms are at their worst
- Is the treatment effective or is it natural improvement?
What is natural improvement
- SSRI -- increase serotonin in the brain
- SNRI -- increases norepinephrine AND serotonin
- Buproprion -- increases norepinephrine AND dopamine
Used for: depression, anxiety, addiction, OCD, PTSD
Effectiveness: high
Limitations: takes a while to kick in, must increase dosage over time
What are Antidepressants
- Atheoretical (do you have it or not)
- Impairment in daily function
- Medical/environmental/deviancy exclusion
- Criteria/Decision Rule -- specific criteria + order of questions asked to make a diagnosis, removes bias
- Updates every 8-12 years (updates, cultural shifts)
What are features of the DSM-5
- focuses on emotional regulation, accepting thoughts, building self compassion through radical positivity
- hands on frequent training --> group sessions, in-vivo coaching
- mindfulness meditation, distress tolerance, interpersonal effectiveness (reaching out), emotional regulation
What is DBT
1. Behavioural -- behaviours are from automatic maladaptive behaviours, replace them with adaptive ones
2. Cognitive -- Symptoms + behaviours are from automatic bad thoughts, replace them with good ones
3. Combined -- makes CBT, focus on accepting thoughts first instead of just changing them
What are the 3 waves of therapy movements
- Mineral salts/lithium – decreases epinephrine (M) and increases serotonin (D), most common
- Anticonvulsants – increase GABA (M) and norepinephrine (D)
Effectiveness: high in correct doses for some
Limitations/Side Effects: must constantly monitor dosage, kidney + thyroid damage
What are mood stabilizers for Bipolar?
- Comorbidity
- Cultural Bias
- Categorical -- you have it or you don't, no room for varying severity
- Focuses on symptoms, not causes
What are criticism of the DSM-5
- teach skills to replace maladaptive behaviour/thoughts with more positive ones
- deals with symptoms, not causes
- short term, targeted, often given homework outside of sessions
- classical conditioning (something = something, ex: alcohol + pill = sick, alcohol = sick)
- operant conditioning (risks/rewards associated with stimulus) --> usually behaviour = reward
- exposure + response prevention -- expose client to arousing stimulus + prevent them from acting --> realize nothing bad will happen
- cognitive restructuring -- replace negative thoughts with good ones
- thought journals
What is CBT (cognitive behaviour therapy)
Gold standard for treatment studies:
- Active/Treatment Group -- treated
-Active Control -- placebo
- Inactive Control -- nothing, measures natural improvement
Retest after 3 months
How is a RCT/Treatment Outcome Research trial set up
- Selectively release norepinephrine, serotonin, dopamine ⇒ boosts attention, wakefulness, persistence
- Used for: ADHD, eating disorders, depression
Effectiveness: High, probably over prescribed
Side effects/Limitations: Commonly abused, addictive
What are psychostimulants?