Personality, Clinical And Health Psychology (6461PI005)
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Universiteit Leiden (UL)
This is a summary of the book Introduction to Personality, Clinical & Health Psychology (1st edition). Leiden University Custom Edition 2018, McGrawHill (ISBN 978-1526869951), which is part of the literature for the first-year Psychology course Personality, Clinical & Health Psychology.
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Personality, Clinical And Health Psychology (6461PI005)
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Chapter 1: looking at abnormality
Cultural relativism: the view that there are no universal standards or rules for labelling a behavior
abnormal; instead, behaviors can be labelled abnormal relative to cultural norms.
Gender and culture influence the ways people
- Express symptoms (feeling like a divine power, but based on religious background either
Mohammed or Jesus)
- Are willing to admit to certain types of behavior or feelings (cultural norms might prohibit
expression of anger)
- Are treated in a way that is acceptable or helpful for people exhibiting abnormal behaviors.
The four D’s
- Dysfunctional
- Distress
- Deviant: uncommon (influenced by cultural norms)
- Dangerous
Types of theories to explain abnormal behavior:
- Biological theories: breakdown of systems in the body
o Egypt/Greek: wandering uterus would interfere with other organs causing hysteria.
Kahun Papyrus: oldest writing on abnormal behavior.
o Hippocrates: 4 categories: epilepsy, mania, melancholia and brain fever
o General paresis: a disease that leads to paralysis, insanity and death.
o Benjamin Rush: excessive blood in the brain causes psychological abnormality
- Supernatural theories
o Trephination: drilling in skull to release evil spirits
o China: yin and yang. When out of balance it would cause insanity. Vital air in the
body would flow to a place linked with emotion (heart=joy). Evil winds and ghosts.
o Witchcraft and asylums: middle ages.
o Carl Jung (student of Freud) said that there was a collective unconscious: wisdom of
a society accumulated in the memories of individuals.
- Psychological theories: result of trauma or chronic stress
o Mesmerism: Mesmer was the first to develop a psychoanalytic theory. He treated
hysterical disorders (lose functioning or feeling) by putting the patients in a bath in
darkness with chemicals and music playing. Affected body parts had iron rods and he
passed by everyone touching them believing he realigned people’s magnetic fluids
through his own. > hypnosis
o Psychodynamic theories suggest that all behaviors, thoughts, and emotions are
influenced by unconscious processes.
▪ Freud’s psychoanalysis: two basic drives: sexual drive/libido and aggressive
drive. The preconscious is intermediate between the unconscious and the
conscious.
, ▪ Object relations: early relationships create images/representations of
ourselves and others which we carry out throughout adulthood and they
affect other relationships.
▪ Self psychology and relational psychology emphasize the unconscious
dimensions of our relationships with one another throughout our life.
Psychic epidemics: a phenomenon in which large numbers of people engage in unusual behavior that
appear to have a psychological origin.
> tarantism: acute pain attributed to the bite of a tarantula
> spirit possession
18th and 19th century: mental hygiene movement: people developed problems because they had
become separated from nature and had succumbed to the stresses imposed by the rapid social
changes. Moral treatment: treatment including lots of rest and serene scenes.
Phenothiazenes: drugs that allowed many people freedom from mental hospitals (mid 20th century)
Deinstitutionalization: patients rights movement argued that mental patients can recover more fully
if they are integrated into the community with the support of community-based treatment facilities.
- John Kennedy: community mental health movement: provided coordinated mental health
services to people in community mental health centers.
- Halfway houses offer people with long-term mental health problems the opportunity to live
in a structured supportive environment as they try to re-establish normal lives.
- Day treatment centers allow people to obtain treatment during the day but live at home at
night.
- Dorothea Dix: training mental health professionals, establishing 30 mental hospitals, and
clean-up mental hospitals.
- Philipe Pinel: freedom to walk around asylums by the patients
Managed care: (US) a collection of methods for coordinating care that ranges from simple
monitoring to total control over what care can be provided and paid for.
Clinical social workers: master’s degree in social work and focus on helping people with psychological
problems overcome social conditions that are contributing to their problems.
licensed mental health counsellors: graduate training in counselling beyond bachelor’s degree
Chapter 2: theories and treatment of abnormality
Theory: a set of ideas that provides a framework for asking questions about a phenomenon.
Therapy: a treatment based on a theory that addresses those factors the theory says cause the
phenomenon.
Biopsychological approaches: recognize that it is often a combination of biological, psychological and
sociocultural factors (risk factors) that results in the development of psychological symptoms.
> transdiagnostic risk factors increase risk for multiple types of psychological problems
> diathesis-stress model: when the risk factor and the stress come together in the same individual
making the full-blown disorder emerge.
,Biopsychological approaches:
- Brain dysfunction: (fig 3 pag 27;fig 5+6 pag 28) can result form injury and diseases that cause
brain deterioration. Also environment and psychological factors can play a role.
o cerebral cortex is involved in advanced thinking processes.
o Thalamus directs incoming information from sense receptors to the cerebrum.
o Hypothalamus regulates eating, drinking and sexual behavior, and basic emotions
o Limbic system: regulate instinctive behaviors
▪ Amygdala: emotions like fear
▪ Hippocampus: memory
- Biochemical imbalances: the process of reuptake occurs when the initial neuron releasing
the neurotransmitter into the synapse reabsorbs the neurotransmitter, decreasing the
amount left in the synapse. Degradation occurs when the receiving neuron releases an
enzyme into the synapse that breaks down the neurotransmitter into other biochemicals.
o When one of these processes malfunction there may be abnormally high or low
levels of neurotransmitter in the synapse.
o There may also be not enough or too much receptors resulting in different
neurotransmitter amounts. (serotonin, dopamine, norepinephrine)
o Endocrine system: system of glands that produces chemicals called hormones
released directly into the blood. Hormone carry messages throughout the body. The
pituitary is the master gland and produces the largest number of different hormones
and it lies just below the hypothalamus. There is a balance between this system and
neurotransmitters (HPA-axis that works improperly causes difficulty in coping with
stress.
- Genetic abnormalities: behavioral genetics studies genetics of personality and abnormality.
Alterations in structure or number of chromosomes/genes can cause major defects. When a
disorder is polygenic it takes multiple genetic abnormalities coming together in one
individual to create a specific disorder. Genes also interact with the environment:
o Genetic factors influence the environments we choose
o Environment may act as a catalyst for a genetic tendency
o Epigenetics: show that environments can affect the expression of genes
Treatments
- Drugs: antipsychotic drugs reduce symptoms of psychosis. Antidepressant drugs: reduce
symptoms of depression (SSRI’s/SNRI’s). lithium is used as a mood stabilizer in bipolar
disorder, like anticonvulsants used for mania. Antianxiety drugs induce relaxation and sleep.
- Electroconvulsive therapy and brain stimulation: effective in depression (not schizophrenia).
rTMS=repetitive transcranial magnetic stimulation. Deepbrain stimulation: electrodes in
brain. Vagus nerve stimulation: electrodes attached to vagus nerve (that carries info to the
rest of the brain.
- Psychosurgery
Behaviorisme: the study of the impact of reinforcements and punishments on behavior. Pavlov’s
classical conditioning. Watson (Little Albert) and Skinner (box) operant conditioning:
- Continuous reinforcement schedule: most quickly learned behaviors by being paired with the
reward or punishment everytime the behavior is emitted
- Partial reinforcement schedule: reward or punishment occurs only sometimes in response to
the behavior. Extinction is more difficult.
, Bandura: social learning theory:
- Modelling: learning new behaviors from imitating behavior from important models
- Observational learning: observes rewards and punishments given to others.
- Behavioral therapies focus on identifying reinforcements and punishments that contribute
to the maladaptive behavior (behavioral assessment)
o Systematic desensitization therapy: extinguishing anxiety responses to stimuli by
learning relaxation exercises and building a stress-causing hierarchy working your
way to the top.
▪ Modelling: watching the therapist do it
▪ Imaginative
▪ En vivo exposures
Cognitive psychology: study of the cognition (thoughts or beliefs shape our behavior and the
emotions we experience).
>> Bandura: self-efficacy beliefs: people’s beliefs about their ability to execute the behaviors
necessary to control important events.
Causal attribution can influence our behavior because they impact the meaning we give to events
and our expectations for similar events in the future and they also influence our emotions and self-
concept.
> global attributions: broad beliefs about ourselves, our relationships and the world.
- Cognitive therapies help clients identify and challenge their negative thoughts and
dysfunctional belief systems. Also more effective problem-solving techniques are learned.
They can be combined with behavioral techniques – cognitive-behavioral therapy; CBT.
- Psychodynamic therapies: help clients recognize their maladaptive coping strategies and the
sources of their unconscious conflicts.
o Free asscociation: talk freely about material where there is resistance from the
client.
o Transference: talking to the therapist as if he/she were an important person in the
clients’ early development.
o By working through and going over painful memories clients are able to understand
them eventually reaching catharsis.
o Interpersonal therapy (IPT): focus on clients’ patterns of relationships with
important people in his or her life. In comparison with psychodynamic therapies, the
therapist is more directive and structuring.
Humanistic theories are based on the assumption that humans have an innate capacity for goodness
and for living a full life. Self-actualization: fulfilment of their potential for love creativity and
meaning.
- Humanistic therapy: helps clients discover their greatest potential through self-exploration.
Client-centered therapy (CCT): The therapist provides the optimal conditions to heal the
client instead of being an authority. Reflection is used: method of response in which the
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