Summary Clinical Psychology
Week 1 – Intodruction
Cluster of symptoms defined by syndrome operationalized by diagnosis, which is not
otherwise explained by…. and causes an impairment in functioning or noticeable distress to
person or others
Substance use disorder;
1. Substance use causing impairment in functioning or noticeable distress
2. At least 1 out of 10 symptoms
Severity: 2-3 – mild, 4-5 – moderate, > 5 – severe
Most addictive substances;
1. Heroin
2. Cocaine
3. Nicotine
4. Barbiturates
5. Alcohol
Two-factor theory (Mowrer); tries to explain onset and maintenance of anxiety
1. Classical conditioning; causing onset of anxiety something happens and leads to
distress causing anxiety for event/object etc
2. Operant conditioning; causing maintenance avoidance leads to relief of negative
emotions
Explains why exposure is helpful; not getting relief by avoidance, but experiencing
relief after confrontation
Mental state exam (MSE); (semi-)structured assessment and observation of persons mental
state
- Orientation
- Insight and judgement
- Appearance
- Thought processes and content
- Behaviour
- Speech
- Mood and affect
- Memory and concentration
Week 2 – Chronic somatic disease
>> Relation between chronic disease and mental health problems:
- Gender differences; biological disposition, social, disease risk, kinds of conditions
More in women
- Ethnical differences; culture, expression of mental health, help seeking, social
support and biological differences
Less often in Asians
> Bidirectional relationship; both mental- or somatic disease may cause the other
o Chronic disease causes 2-3x higher risk on depression
o Depression causes 3x higher change on chronic disease
, > Comorbid risk factors; risk factors for both developing mental- and somatic disease
e.g. childhood adversity, stress, low SES, health behaviours
Consequences of comorbidity; vicious circle, longer recovery, higher symptom burden, more
functional impairment, lower quality of life, higher costs, premature mortality
Integrated care as solution; focus on total person on different levels, both mental and
physical on prevention, diagnoses and treatment
HIV and depression; high comorbidity due to stigma, neurobiological changes and depression
as higher risk on getting HIV (different sexual orientation, drug use etc)
Mental health in refugees; due to lots of stressors, causing anxiety, PTSD and depression
Stress-sensitization; impact increases with number of stress stimuli, more sensitive to
stressors
Hormesis; adaptive responses to moderate exposure and maladaptive responses on high
level exposure (little stress – improvement of performance, much stress – decrease in
performance)
Three hit hypothesis; 1. genetic disposition, 2. early life environment/experiences and 3.
later life environment/experiences
> e.g. person who grew up in violent environment, will do better in violent
environment later in life then person who grew up in ‘normal’ environment due to resilience
Allostatic load; homeostasis recovery after stressor – more frequent stressors, leads to
higher homeostatic baseline
Kindling; threshold (e.g. depression) becomes smaller per episode
Week 1 – Intodruction
Cluster of symptoms defined by syndrome operationalized by diagnosis, which is not
otherwise explained by…. and causes an impairment in functioning or noticeable distress to
person or others
Substance use disorder;
1. Substance use causing impairment in functioning or noticeable distress
2. At least 1 out of 10 symptoms
Severity: 2-3 – mild, 4-5 – moderate, > 5 – severe
Most addictive substances;
1. Heroin
2. Cocaine
3. Nicotine
4. Barbiturates
5. Alcohol
Two-factor theory (Mowrer); tries to explain onset and maintenance of anxiety
1. Classical conditioning; causing onset of anxiety something happens and leads to
distress causing anxiety for event/object etc
2. Operant conditioning; causing maintenance avoidance leads to relief of negative
emotions
Explains why exposure is helpful; not getting relief by avoidance, but experiencing
relief after confrontation
Mental state exam (MSE); (semi-)structured assessment and observation of persons mental
state
- Orientation
- Insight and judgement
- Appearance
- Thought processes and content
- Behaviour
- Speech
- Mood and affect
- Memory and concentration
Week 2 – Chronic somatic disease
>> Relation between chronic disease and mental health problems:
- Gender differences; biological disposition, social, disease risk, kinds of conditions
More in women
- Ethnical differences; culture, expression of mental health, help seeking, social
support and biological differences
Less often in Asians
> Bidirectional relationship; both mental- or somatic disease may cause the other
o Chronic disease causes 2-3x higher risk on depression
o Depression causes 3x higher change on chronic disease
, > Comorbid risk factors; risk factors for both developing mental- and somatic disease
e.g. childhood adversity, stress, low SES, health behaviours
Consequences of comorbidity; vicious circle, longer recovery, higher symptom burden, more
functional impairment, lower quality of life, higher costs, premature mortality
Integrated care as solution; focus on total person on different levels, both mental and
physical on prevention, diagnoses and treatment
HIV and depression; high comorbidity due to stigma, neurobiological changes and depression
as higher risk on getting HIV (different sexual orientation, drug use etc)
Mental health in refugees; due to lots of stressors, causing anxiety, PTSD and depression
Stress-sensitization; impact increases with number of stress stimuli, more sensitive to
stressors
Hormesis; adaptive responses to moderate exposure and maladaptive responses on high
level exposure (little stress – improvement of performance, much stress – decrease in
performance)
Three hit hypothesis; 1. genetic disposition, 2. early life environment/experiences and 3.
later life environment/experiences
> e.g. person who grew up in violent environment, will do better in violent
environment later in life then person who grew up in ‘normal’ environment due to resilience
Allostatic load; homeostasis recovery after stressor – more frequent stressors, leads to
higher homeostatic baseline
Kindling; threshold (e.g. depression) becomes smaller per episode
