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Clinical Psychology

Purpose of Course  showclose

DISCLAIMER: This course is designed to address the fundamentals of clinical psychology. It will NOT provide the education or experience needed for the diagnosing and treating of mental disorders.

This course will cover the basic concepts of clinical psychology, or the study of diagnosing, treating, and understanding abnormal and maladaptive behaviors. We frequently refer to these behaviors—which include depression, anxiety, and schizophrenia—as mental diseases or disorders. While you might have a general understanding of these disorders, this course will cover each in great detail.

Many of you are likely familiar with the idea of therapy, whether because you or someone you know has been in therapy, or because you have seen it in popular TV shows or movies. Because many approaches to therapy draw from research on clinical populations—that is, populations suffering from some sort of mental disorder—therapy is closely related to the field of psychopathology. Although this class will not teach you how to conduct therapy—see PSYCH404, or Psychotherapy for an in-depth look at the subject—it will provide you with a solid understanding of the etiology and symptoms of a number of disorders.

Much of the information in this course is based on the Diagnostic and Statistical Manual IV-TR (DSM), the industry standard for both clinical psychologists and psychiatrists who reference it frequently in order to diagnose mental disorders. A new version of this manual is due to be published soon, and it will likely challenge some commonly held ideas about certain disorders. This brings up an important point about clinical psychology: few issues in the field have hard-and-fast answers. Much is left up to debate and subjective opinion. As such, rather than providing you with step-by-step directions, this course has been designed to provide you with in-depth, current information about mental disease and related aspects.

We will begin this course by reviewing the historical context from which clinical psychology emerged, and defining the major roles clinical psychologists fill and the tasks in which they engage. We will then discuss current paradigms and classification methods before learning about individual disorders, their treatments, and common explanations concerning their origins. We will conclude with an introduction to methods of intervention.

Course Information  showclose

NOTE: This course is best viewed using Internet Explorer or Mozilla Firefox web browser. Course resources and information might not load properly using other web browsers (e.g., Google Chrome, Safari).

Welcome to PSYCH205: Clinical Psychology. General information on the course and its requirements can be found below.
 
Primary Resources: This course is composed of a range of free, online materials. However, the course makes primary use of:
  • University of Houston: Professor Edward Sheridan’s Lecture Series, Clinical Psychology; and
  • The United States Department of Health and Human Services’ MentalHealth: A Report of the Surgeon General (1999).
Requirements for Completion: In order to complete this course, you will need to work through each unit and all of its assigned materials. Pay special attention to Units 1 and 2, as these lay the groundwork for understanding the more advanced, exploratory material presented in the later units. You will also need to complete:
  • The Final Exam
Note that you will only receive an official grade for the Final Exam. However, in order to adequately prepare for this exam, you will need to work through all of the materials in the course.
 
In order to pass this course, you will need to earn a 70% or higher on the Final Exam. Your score on the exam will be tabulated following its completion. If you do not pass the exam, you may take it again, after a 14-day wait period.
 
Time Commitment: This course should take you a total of 60.25 hours to complete. Each unit includes a time advisory that lists the amount of time you are expected to spend on each subunit. These advisories are intended to help you plan your time accordingly. It might be useful to take a look at these advisories and to determine how much time you have over the next few weeks to complete each unit, and then to set goals for yourself. For example, unit 1 should take 9.5 hours to complete. Perhaps you can sit down with your calendar and decide to complete subunit 1.1 (a total of 2.5 hours) on Monday night, half of subunit 1.2 (a total of 3.5 hours) on Tuesday night, the rest of subunit 1.2 (a total of 3.5 hours) on Wednesday night, etc.
 
Tips/Suggestions: Please take comprehensive notes on each resource for the course. These notes will serve as a useful review as you study for your Final Exam. The Final Exam is closed book and you be asked to adhere to the course honor code policy.

Learning Outcomes  showclose

Upon successful completion of this course, you will be able to:
  • describe the historical context of the emergence of clinical psychology;
  • identify the differences between mental health professionals in the broad field of clinical psychology;
  • identify the subspecialty areas within clinical psychology (e.g., community psychology, health psychology, and neuropsychology);
  • define the main tasks of the clinical psychologist and explain how the contributions of this subspecialty fit into or relate to the broader field of psychology;
  • define the criteria for what is considered abnormal versus normal and explain how these definitions fit into the notion that psychopathology exists on a continuum;
  • compare/contrast the different types of psychotherapy treatments;
  • discuss the ethical considerations related to the practice of psychotherapy;
  • list the main diagnostic features of a variety of mental disorders (e.g., mood disorders, schizophrenia, etc.);
  • identify the potential factors that can contribute to the instigation and persistence of mental illness for individuals across the lifespan (e.g., children, adults, and older adults);
  • identify the clusters of symptoms which manifest in mental illness; and
  • describe the components of the biopsychosocial model of disease.

Course Requirements  showclose

In order to take this course, you must

√    have access to a computer;

√    have continuous broadband Internet access;

√    have the ability/permission to install plug-ins or software (e.g. Adobe Reader or Flash);

√    have the ability to download and save files and documents to a computer;

√    have the ability to open Microsoft files and documents (.doc, .ppt, .xls, etc.);

√    have competency in the English language;

√    have read the Saylor Student Handbook; and

√    have completed the following courses listed in the Core Program of the Psychology Discipline: PSYCH101: Introduction to Psychology; PSYCH201/MA121: Introduction to Statistics; PSYCH202B: Research Methods Lab; PSYCH203/BIO101: Introduction to Molecular and Cellular Biology; and, PSYCH204/BIO102: Introduction to Evolutionary Biology and Ecology.

Unit Outline show close


Expand All Resources Collapse All Resources
  • Unit 1: An Introduction to Clinical Psychology as a Subspecialty  

    This unit will introduce you to the profession of Clinical Psychology and the concept of abnormal behavior. Unit 1 will first discuss the major tasks that clinical psychologists perform, including psychotherapy, research, and assessment. You will then work toward an understanding of how clinical psychologists think about people and the problems they experience, and how their approach is unique. You will learn, for example, that clinical psychologists tend to focus on describing, explaining, predicting, and changing human behavior. Lastly, you will learn about the historical context in which the concept of mental health developed, and discover how clinical psychology emerged from the broader field of psychology. 

    Unit 1 Time Advisory   show close
    Unit 1 Learning Outcomes   show close
  • 1.1 Introduction to Clinical Psychology  
  • 1.1.1 What Is Clinical Psychology?  

    Clinical psychology is a broad field that covers abnormal psychology and psychopathology, personality development, psychological testing, and psychotherapies.

    Refer to Dr. Edward Sheridan's Lecture 1A for additional information.

  • 1.1.2 How Does Clinical Psychology Compare to Other Mental Health Professions?  

    Clinical psychology is different from other mental health professions in terms of required education, licensing examinations, timeframe for degree completion, degree types, and career paths.

    Refer to Dr. Edward Sheridan's Lecture 1A for additional information.

  • 1.1.3 The Skills and Activities of Clinical Psychologists  

    Clinical psychologists have various skills and engage in many activities, including academia, research, and private practice.

    Refer to Dr. Edward Sheridan's Lectures 1A and 1B for additional information.

  • 1.1.4 Historical Emergence of Clinical Psychology and Major Developments  

    The historical emergence of and major developments in clinical psychology are evident in a variety of events, including the effects of world wars, the establishment of the APA, and the creation of major divisions and fields of study.

    Refer to Dr. Edward Sheridan's Lecture 1B for additional information.

  • 1.1.5 Scientist-practitioner Model versus Practitioner-scholar Model  

    There is much debate over the Scientist-practitioner Model (i.e., research) vs. the Practitioner-scholar Model (i.e., psychotherapy) as to which model accurately reflects the structure of the clinical psychology field.
               
    Refer to Dr. Edward Sheridan’s Lecture 1C and The United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 1: Introduction and Themes,” pages 3–11 for additional information.

  • 1.2 The Process of Diagnosis, Assessment, and the Clinical Interview  
    • Lecture: YouTube: University of Houston: Professor Edward Sheridan’s Lecture Series, Clinical Psychology: “Lecture 5B–Lecture 8A”

      Link: YouTube: University of Houston: Professor Edward Sheridan’s Lecture Series, Clinical Psychology: "Lecture 5B–Lecture 8A" (YouTube)

      Instructions: Start the video at 11:25 seconds and watch the lecture until the end.  Second, please click on the link for the lecture titled “Lecture 6A,” and watch this video. Please follow these steps to watch all of “Lecture 6B,” “Lecture 6C,” “Lecture 7A,” “Lecture 7B,” “Lecture 7C,” and “Lecture 8A.” Each video is approximately 40–55 minutes long. These lectures cover the topics outlined in Subunits 1.2.1–1.2.5. 
       
      Watching these lectures and pausing to take notes should take approximately 7 hours.
       
      Terms of Use: Please respect the copyright and terms of use displayed on the webpage above.

  • 1.2.1 Assessment  

    Clinical psychology assessments include a variety of measures, including interviews, testing, observations, building relationships, identifying symptoms, obtaining life history and background information, and gathering data for diagnoses, all of which help to adequately establish a comprehensive representation of an individual’s life and life issues and determine means of treatment.

    Refer to Dr. Edward Sheridan's Lecture 5B and 6A for additional information.

  • 1.2.2 Diagnosis  

    Diagnosing of mental illness uses information gathered during assessment to determine type, severity, and treatment of illness. 

    Refer to Dr. Edward Sheridan's Lecture 5B, 6A, and 6B for additional information.

  • 1.2.3 Semi-Structured Clinical Interview  

    The semi-structured clinical interview focuses on the client, and what he or she wishes to disclose during therapy, whereby the therapist listens, allows the client to disclose whatever he/she wishes, and then reflects back what has been discussed.

    Refer to Dr. Edward Sheridan’s Lectures 6A, 6B, and 6C for additional information.

  • 1.2.4 Formal Psychological Testing (e.g., intelligence and personality tests)  

    Formal psychological testing, such as intelligence and personality testing, can be a very helpful screening instrument regarding clinical assessment and diagnoses.

    Refer to Dr. Edward Sheridan’s Lectures 7A and 7B for additional information.

  • 1.2.5 Projective Assessments  

    Projective assessments focus on subjective scoring and analysis, such as with the Rorschach inkblot test and thematic apperception test. These subjective measures can be interpreted as deep aspects or projections of an individual’s personality.

    Refer to Dr. Edward Sheridan’s Lectures 7C and 8A for additional information.

  • The Saylor Foundation’s “Unit 1 Assessment”  
    • Assessment: The Saylor Foundation’s “Unit 1 Assessment”

      Link: The Saylor Foundation’s “Unit 1 Assessment”

      Instructions: Complete this unit assessment. For each question, pick the best possible answer. The correct answers will be displayed when you click the "Submit" button.

      You must be logged into your Saylor Foundation School account in order to access this quiz.  If you do not yet have an account, you will be able to create one, free of charge, after clicking the link.

      Completing this assessment should take approximately 15 minutes.

  • Unit 2: The Fundamentals of Mental Health and Mental Illness  

    This unit will provide you with an overview of mental illness, its manifestations, and its diagnoses. It will also cover the topic of etiology (the causes or origin of mental illness) and identify the factors that may influence and contribute to the development of mental illness. You will study methods of mental illness prevention and treatment—two primary concerns in the clinical psychology practice. Next, this unit will address the current state of the mental health services delivery system in the United States, as it is important to understand the context within which treatment delivery takes place. Finally, this unit will work to define recovery, the goal of intervention. What constitutes recovery? How do you know when it has been achieved?

    Unit 2 Time Advisory   show close
    Unit 2 Learning Outcomes   show close
    • Lecture: iTunesU: "What Is Abnormal?” and “What Is Abnormal?”

      Link: iTunesU: "What is Abnormal?” and “What is Abnormal?”

      Instructions: 
       
      Terms of Use: Please respect the copyright and terms of use displayed on the webpage above.

      The Saylor Foundation does not yet have materials for this portion of the course. If you are interested in contributing your content to fill this gap or aware of a resource that could be used here, please submit it here.

      Submit Materials

  • 2.1 Abnormal Psychology  
  • 2.1.1 The Nature of Mental Disorders  

    The nature of mental disorders can be difficult to ascertain. Scientific vs. socially constructed aspects indicate multiple components of mental disorder development. As such, there is no single, agreed upon operational definition of mental disorder etiology.

    Refer to the “Nature of Psychopathology and Abnormal Psychology” article for additional information.

  • 2.1.2 Mental Disorders as Statistical Deviance  

    Mental disorders as statistical deviance involve comparing an individual’s behavior to the frequency of occurrence of the same behavior in the general population. However, there are issues with this definition, specifically social norms, subjectivity, and extreme sides of a normal curve.

    Refer to the “Nature of Psychopathology and Abnormal Psychology” article for additional information.

  • 2.1.3 Mental Disorders as Social Deviance  

    Mental disorders as social deviance states behavior is deemed abnormal if it deviates from social standards, values, and the norms of an individual’s culture. However, there are issues with this definition, specifically little to no objective validity, the timeframe of acceptable behavior can change, and there are different morals/standards among disparate culture groups.

    Refer to the “Nature of Psychopathology and Abnormal Psychology” article for additional information.

  • 2.1.4 Mental Disorders as Maladaptive Behavior  

    Mental disorders as maladaptive behavior attempts to classify as mental disorders those behaviors that are dysfunctional (i.e., effectiveness/ineffectiveness of a behavior in dealing with challenges or accomplishing goals). However, there are issues with this definition since there are four different types of maladaptive behaviors and each type has inherent issues.

    Refer to the “Nature of Psychopathology and Abnormal Psychology” article for additional information.

  • 2.1.5 Dimensional versus Categorical Models of Mental Disorders  

    Mental disorders can be compared using dimensional (i.e., continuum) or categorical (i.e., polarized) models. That is, mental disorders are just extreme variations of normal psychological phenomena/problems. However, there are issues with this definition, such as there is large scientific support but it doesn’t mesh with real world instances.

    Refer to the “Nature of Psychopathology and Abnormal Psychology” article for additional information. 

  • 2.1.6 Mental Disorders as Social Constructions  

    Mental disorders as social constructions state disorders are products of history and culture and should be defined in a universal, scientific construct. However, there are issues with this definition such that it implies the construct is fake or unimportant.

    Refer to the “Nature of Psychopathology and Abnormal Psychology” article for additional information.

  • 2.2 Manifestations of Mental Illness  
  • 2.2.1 Anxiety  

    Anxiety is the most readily accessible and easily understood of all mental disorders, since it is a vitally important physiological response to dangerous situations. There are seven common signs of acute anxiety, and anxiety can also manifest in more severe mental disorders such as OCD or PTSD.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 2: The Fundamentals of Mental Health and Mental Illness,” pages 40–41 for additional information.

  • 2.2.2 Psychosis  

    Psychosis can be described as disturbances of perception and thought process. Determining if an individual suffers from psychosis varies with cultural context. A more prominent type of psychosis is schizophrenia whereby individuals suffer from hallucinations and/or delusions, in addition to other various positive and negative symptoms.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999):  “Chapter 2: The Fundamentals of Mental Health and Mental Illness,” pages 41–42 for additional information.

  • 2.2.3 Disturbance of Mood  

    Mood disturbances can be difficult to define due to scientific problems in quantifiable measurement as well as cultural differences. There are many common signs of mood disorders with those signs characteristically manifesting as either a sustained feeling of sadness or sustained elevation of mood.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 2: The Fundamentals of Mental Health and Mental Illness,” pages 42–43 for additional information.

  • 2.2.4 Disturbance of Cognition  

    Disturbances of cognition refer to difficulties in the ability to organize, process, and recall information. This can occur in a variety of disorders such as dementia, depression, or schizophrenia.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999):  “Chapter 2: The Fundamentals of Mental Health and Mental Illness,” pages 43 for additional information.

  • 2.2.5 Other Symptoms  

    Although anxiety, psychosis, mood disturbances, and cognitive impairments are the most common of mental disorders, other somatic and/or physical symptoms or impairment of impulse control can manifest in an individual.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999):  “Chapter 2: The Fundamentals of Mental Health and Mental Illness,” pg. 43 for additional information.

  • 2.3 Diagnosis and Epidemiology of Mental Illness  
  • 2.3.1 Diagnosis of Mental Illness  

    Diagnosing mental illness can be difficult due to categories being broad, heterogeneous, and overlapping. Given these issues, a systematic approach (i.e., DSM IV) has been developed to standardize mental illness classification.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 2: The Fundamentals of Mental Health and Mental Illness,” pages 43–45 for additional information.

  • 2.3.2 Overview of Etiology  

    The precise cause of mental disorders is not known but broad etiological aspects have been identified (e.g., biological, psychological, social/cultural factors). The manifestation of mental disorders is an interaction amongst these broad aspects.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 2: The Fundamentals of Mental Health and Mental Illness,” pages 49–50 for additional information.

  • 2.3.3 Biopsychosocial Model of Disease  

    The Biopsychosocial Model of Disease is a framework developed by George L. Engle that states biopsychosocial factors are involved in the causes, manifestation, course, and outcome of health and disease. However, there are issues with this model including degree of factorial influence, degree of interaction, and variation across individuals and life spans.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 2: The Fundamentals of Mental Health and Mental Illness,” pages 50–51 for additional information.

  • 2.3.4 Understanding Correlation, Causation, and Consequences  

    Correlation determines mental illness risk factors but does not mean causation. The consequences of mental illness are considered later outcomes of a disorder.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 2: The Fundamentals of Mental Health and Mental Illness,” pages 51–52 for additional information.

  • 2.3.5 Biological Influences on Mental Health and Mental Illness  

    The biological influences on mental health and mental illness are varied, including genetics, infections, physical trauma, nutrition, hormones, and toxins.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 2: The Fundamentals of Mental Health and Mental Illness,” pages 52–53 for additional information.

  • 2.4 Psychosocial Influences on Mental Health and Mental Illness  
  • 2.4.1 Psychodynamic Theories  

    Psychodynamic theories assert that behavior is the product of underlying conflicts over which people are not aware, and these deviant behaviors influence mental health and mental illness. Note especially how Sigmund Freud’s work contributes to a historical perspective of mental health theory and treatment approaches.
     
    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): Chapter 2: The Fundamentals of Mental Health and Mental Illness,” pages 55–56 for additional information.

  • 2.4.2 Behavior and Social Learning Theories  

    Behavior and social learning theories assert that personality is the sum of an individual’s observable responses to the outside world. Note especially, views from Watson and Skinner (i.e., rejection of the existence of underlying conflicts and unconscious, operant conditioning), Pavlov (i.e., classical conditioning), and Bandura (i.e., social learning theory).

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 2: The Fundamentals of Mental Health and Mental Illness,” pages 56–57 for additional information.

  • 2.4.3 The Integrative Science of Mental Illness and Health  

    The integrative science of mental illness and health focuses on understanding how findings from different mental health field disciplines have many common threads. There has been a progressive movement to promote linkages between various areas and principles.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 2: The Fundamentals of Mental Health and Mental Illness,” pg. 57 for additional information.

  • 2.5 Overview of Development, Temperament, and Risk Factors  
  • 2.5.1 Physical Development  

    The physical development of our nervous system provides the foundation for mental function (i.e., cognition, mood, and intentional behavior). Note the four overarching findings/organizing principles extrapolated from research that categorize neuronal development and the implications these findings have on mental health and mental illness.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999):  “Chapter 2: The Fundamentals of Mental Health and Mental Illness,” pages 57–59 for additional information. 

  • 2.5.2 Psychological Development: Piaget  

    Jean Piaget’s theory on psychological development focuses on cognitive development as a process, where each stage of development precedes a previous stage in a fixed pattern.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999):  “Chapter 2: The Fundamentals of Mental Health and Mental Illness,” pg.59 for additional information.

  • 2.5.3 Psychological Development: Erik Erikson  

    Erik Erikson’s psychoanalytic developmental theory is an expansion of Freud’s original theory of psychosexual development. Erikson supports the notion that development unfolds throughout the lifespan whereby each life stage presents its own challenges and opportunities for growth.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 2:  The Fundamentals of Mental Health and Mental Illness,” pages 59–60 for additional information.

  • 2.5.4 John Bowlby  

    John Bowlby’s attachment theory of development is a reinterpretation of Freud’s original theory of psychosexual development. Bowlby theorized that attachment has a biological basis in need for survival.

    Refer to The United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 2:  The Fundamentals of Mental Health and Mental Illness,” pg. 60 for additional information.

  • 2.6 Overview of Prevention  
  • 2.6.1 Definition of Prevention  

    Preventing an illness from occurring is better than treating an illness after onset, and this notion has been the foundation in multiple fields, including those specific to mental health and mental illness. Note that there are varying levels of prevention from primary, secondary, and tertiary and there are also issues with these definitions (e.g., different meanings to different people and different fields of health).

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 2: The Fundamentals of Mental Health and Mental Illness,” pages 62–63 for additional information.

  • 2.6.2 Risk Factors and Protective Factors  

    Understanding the concepts of risk and protective factors is central to many prevention programs. Risk factors increase an individual’s likelihood of illness or disease development whereas protective factors increase an individual’s likelihood of not developing an illness or disease. Note the differentiation and interaction of these factors and how they affect the identifications and treatment in a population.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 2: The Fundamentals of Mental Health and Mental Illness,” pages 63–64 for additional information.

  • 2.7 Mental Health Services  
  • 2.7.1 Patterns of Use  

    The settings for individuals using mental health services include institutional, community-based, and home-based options. Note the percentage of people who use mental health services and where received (e.g., general sector, specialty sector).

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999):  “Chapter 2: The Fundamentals of Mental Health and Mental Illness,” pages 73–75 for additional information.

  • 2.7.2 History of Mental Health Services  

    The origins of mental health services in the United States can be traced back to colonial America and has progressed through the years, influenced by national and international wars, urbanization, and health care reform. Examine the historical origins of mental health services systems, the origins of treatment, and policy interventions/measures.            

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 2: The Fundamentals of Mental Health and Mental Illness,” pages 75–80 for additional information.

  • 2.7.3 Overview of Recovery  

    Recovery from mental illness has a substantial impact on various populations, including consumers and families, mental health research, and service delivery. Note how the promotion of recovery process impacts each section and issues with the recovery process, such as problems with definitions and measurements.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999):  “Chapter 2: The Fundamentals of Mental Health and Mental Illness,” pages 97–100 for additional information.

  • 2.7.4 Mental Health and Mental Illness across the Lifespan  

    Mental health and mental illness should be considered as continuing across the lifespan, since they are dynamic, ever-changing phenomena influenced by developmental stages and society.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999):  “Chapter 2: The Fundamentals of Mental Health and Mental Illness,” pages 102–104 for additional information.

  • Assessment: The Saylor Foundation’s “Unit 2 Assessment”  
    • Assessment: The Saylor Foundation’s “Unit 2 Assessment”

      Link: The Saylor Foundation’s “Unit 2 Assessment”

      Instructions: Complete this unit assessment. For each question, pick the best possible answer. The correct answers will be displayed when you click the "Submit" button.

      You must be logged into your Saylor Foundation School account in order to access this quiz.  If you do not yet have an account, you will be able to create one, free of charge, after clicking the link.

      Completing this assessment should take approximately 15 minutes.

  • Unit 3: Mental Health Treatment  

    You have now learned about the fundamentals of clinical psychology as well as the concepts of mental health and illness. As you have learned, clinical psychologists often work to treat mental illness and human distress through psychotherapy. In this unit, you will learn more about the factors that contribute to treatment outcomes such as client, treatment, and therapist variables. In addition, you will learn about different types of psychotherapy treatments and begin to think critically about the risks and benefits associated with each. 

    Unit 3 Time Advisory   show close
    Unit 3 Learning Outcomes   show close
  • 3.1 Introduction to Mental Health Treatment  
  • 3.1.1 Introduction to the Range of Treatments  

    Mental disorders can be treated using psychosocial and/or pharmacological methods. Review each method and compare/contrast the range of treatments available under each (e.g., psychodynamic, behavior and humanistic therapies under psychodynamic treatment, and mechanisms of action and complementary/alternative treatment under pharmacological therapy).

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 2: The Fundamentals of Mental Health and Mental Illness,” pages 64–70 for additional information. 

  • 3.1.2 Issues in Treatment  

    There are many issues surrounding mental health treatment that affect successful implementation of therapies, including placebo response, benefits and risks of clinical trials, gaps between efficacy and effectiveness, and multiple barriers to individuals seeking help. 

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999):  “Chapter 2: The Fundamentals of Mental Health and Mental Illness,” pages 70–73 for additional information. 

  • 3.2 Psychotherapeutic Treatments  
    • Reading: Shippensburg University: Professor George C. Boree’s History of Psychology: “Part 4: The 1900s”

      Link: Shippensburg University: Professor George C. Boree’s History of Psychology: “Part 4: The 1900s” (PDF)
       
      Instructions: Please click on the link above, select the link to download the PDF file entitled “Part 4: the 1900s,” and read this chapter. Please note that this reading will cover both the history and concepts related to each respective theory within clinical psychology.

      This reading covers the topics outlined for 3.2.1–3.2.7. Please note that although this reading overlaps with the initial reading, it will provide you with a more in-depth analysis of the pros/cons of each psychotherapeutic treatment.
       
      Reading this text and taking notes should take approximately 8 hours.
       
      Terms of Use: Please respect the copyright and terms of use displayed on the webpage above.

      The Saylor Foundation does not yet have materials for this portion of the course. If you are interested in contributing your content to fill this gap or aware of a resource that could be used here, please submit it here.

      Submit Materials

    • Activity: Rider University: Professor John Suler’s Teaching Clinical Psychology Homepage: "Which Treatment is Best?"

      Link: Rider University: Professor John Suler’s Teaching Clinical Psychology Homepage: "Which Treatment is Best?" (HTML) 

      Instructions: Please click on the above link and complete the exercise, which will help you apply your knowledge to real life, hypothetical scenarios.

      Completing this activity should take approximately 15 minutes.

      Terms of Use: Please respect the copyright and terms of use displayed on the webpage above. 

    • Activity: Rider University: Professor John Suler’s Teaching Clinical Psychology Homepage: "The Way I Think"

      Link: Rider University: Professor John Suler’s Teaching Clinical Psychology Homepage: "The Way I Think" (HTML)

      Completing this activity should take approximately 15 minutes.

      Instructions: Please click on the above link and complete this exercise, which will give you some insight into cognitive therapeutic techniques. It will also increase your own level of self-awareness, which is crucial to a clinician’s ability to help his or her clients. Please take the opportunity to learn more about yourself and to look at your written responses in a curious, non-judgmental manner.
       
      Terms of Use: Please respect the copyright and terms of use displayed on the webpage above. 

  • 3.2.1 Psychoanalysis  

    Before Sigmund Freud was considered the psychoanalytic therapist, several individuals developed the field as a precursor to Freud’s thinking, including Franz Anton Mesmer, Philippe Pinel, and Jean-Martin Charcot. These psychoanalytic predecessors not only influenced Freud (i.e., conscious vs. unconscious mind, including id, ego, and superego), but also influenced the teachings of Carl Jung (i.e., personal and collective unconscious) and Alfred Adler (i.e., striving).

    Refer to Professor George Boree’s History of Psychology: “Part 4: The 1900s” pages 9–32 for additional information.

  • 3.2.2 Behaviorism  

    Behaviorism focuses on what’s observable (i.e., the environment and behavior) rather than what’s available to the individual (i.e., perceptions, thoughts, images, feelings). Several people have contributed to this branch of psychotherapeutic treatments including Ivan Pavlov (i.e., classical conditioning), Edward Thorndike (i.e., “puzzle boxes”), John Watson (i.e., “Little Albert” conditioning experiment), William McDougall (i.e., “anti-Watson” stance), Clark Hull (i.e., operationalization of variables), E.C. Tolman (i.e., cognitive behaviorism), and B.F. Skinner (i.e., operant conditioning).

    Refer to Professor George Boree’s History of Psychology: “Part 4: The 1900s” pages 33–54 for additional information. 

  • 3.2.3 Gestalt Psychology  

    Gestalt psychology was founded by Max Wertheimer, whereby the focus was on psychology as a “unified or meaningful whole.” Wertheimer’s protégés, Wolfgang Kohler and Kurt Koffka, continued the Gestalt phenomenon that includes several laws (i.e., pragnanz, closure, similarity) and additional principles (i.e., figure-ground, insight learning, productive thinking, isomorphism) describing the theoretical concepts behind the psychology. Kurt Lewin’s topological theory and Kurt Goldstein’s holistic view of brain function further contributed to the Gestalt notion.

    Refer to Professor George Boree’s History of Psychology: “Part 4: The 1900s” pages 55–70 for additional information.

  • 3.2.4 Phenomenological Existentialism  

    Phenomenological existentialism is a psychology that emphasizes our creative processes more so than our adherence to laws. Franz Brentano expounded on this notion using “intentionality or immanent objectivity.” Other notable phenomenological existentialists include Carl Stumpf, who focused on the psychology of music, Edmund Husserl, who investigating the nature of the experience itself, Martin Heidegger, who discussed the meaning of existence, and Jean-Paul Sartre who said “existence precedes essence.”

    Refer to Professor George Boree’s History of Psychology: “Part 4: The 1900s” pages 71–81 and Dr. Edward Sheridan’s Lectures 3A–3C for additional information.

    • Lecture: University of Houston: Professor Edward Sheridan’s Lecture Series, Clinical Psychology: “Lecture 3A–3C”

      Link: University of Houston: Professor Edward Sheridan’s Lecture Series, Clinical Psychology: “Lecture 3A–3C”
       
      Instructions: First, please click on the webpage linked here entitled “Lecture 3A.” Please start the video at 41 minutes and 25 seconds, and watch to the end. Next, click on the webpage entitled “Lecture 3B” and watch it. Follow the same instructions for Lecture 3C but end the video at 48 minutes and 50 seconds. These lectures also cover the topic outlined for subunit 3.2.4. 
       
      Watching these lectures and pausing to take notes should take approximately 2 hours.
       
      Terms of Use: Please respect the copyright and terms of use displayed on the webpage above.

  • 3.2.5 Modern Medicine and Physiology  

    Modern medicine and physiology focuses on numerous aspects of progression related to the psychology field including technology and the brain (e.g., CT scan, EEG, PET scan), pharmacological discoveries that target individual neurotransmitters, genetics and genetic influences on the human genome, and historical implications of lobotomies on behavior.

    Refer to Professor George Boree’s History of Psychology: “Part 4: The 1900s” pages 82–88 for additional information. 

  • 3.2.6 The Cognitive Movement  

    The cognitive movement came about in the latter half of the 20th century, influenced by the advent of the computer. This movement had several advocates, such as Norbert Wiener, whose focus was on cybernetics (i.e., “self-steering”), Alan Turing, who invented the “Turing Machine” (or the first description of the modern computer and its comparison to the workings of the human mind), Ludwig von Bertalanffy, who created the “open system” (or a holistic epistemology that allowed systems theory to be applied to multiple contexts), Noam Chomsky, who specialized in linguistics and generative grammar, Jean Piaget, who focused on the development of cognition/cognitive psychology, Donald Hebb, who created a new version of “connectionism” related to neurological theory and behavior, George Miller, who invented “information chunks,” and Ulric Neisser, who vocally criticized the cognitive psychology movement.

    Refer to Professor George Boree’s History of Psychology: “Part 4: The 1900s” pages 89–98 for additional information.

  • 3.2.7 Future Directions in Clinical Psychological Theory  

    Future directions in clinical psychology theory are progressing from logical positivism (i.e., all knowledge is based on empirical observation assisted by the use of logic and mathematics) to postmodernism (i.e., there is no objective reality or ultimate truth we have direct access to, rather truth is a matter of perspective or point-of-view).

    Refer to Professor George Boree’s History of Psychology: “Part 4:  The 1900s” pages 110–115, Dr. Ksenija Kolundzija’s “Core Constructs of the Transtheoretical Model of Behavior Change,”
    Professor John Suler's Teaching Clinical Psychology Homepage: “Which Treatment is Best?,” and Professor John Suler’s Teaching Clinical Psychology Homepage: “The Way I Think” for additional information.

  • The Saylor Foundation’s “Unit 3 Assessment”  
    • Reading: The Saylor Foundation’s “Unit 3 Assessment”

      Link: The Saylor Foundation’s “Unit 3 Assessment”

      Instructions: For each question, pick the best possible answer. The correct answers will be displayed when you click the "Submit" button.

      You must be logged into your Saylor Foundation School account in order to access this quiz.  If you do not yet have an account, you will be able to create one, free of charge, after clicking the link.

      Completing this assessment should take approximately 15 minutes.

  • Unit 4: Related Subspecialties of Clinical Psychology  

    The previous units addressed the general goals of clinical psychology: to understand, prevent, and alleviate psychological distress and promote psychological well-being. As this is a rather broad set of goals, and there are a multitude of factors that contribute to the etiology, prevention, and alleviation of distress, several subfields of clinical psychology have emerged. These fields have made significant contributions to our understanding of the complexities and nuances of mental health and illness. In this unit, you will learn about the various subdisciplines within the field of clinical psychology. Although these sub-fields may be closely related to other disciplines, they fit nicely into the study of human behavior as it relates to mental health and illness, and they represent the cutting edgeof clinical science. You will also take a look at child psychology, which is closely related to the field of clinical psychology.

    Unit 4 Time Advisory   show close
    Unit 4 Learning Outcomes   show close
  • 4.1 Related Fields/Subspecialties of Clinical Psychology  
  • 4.1.1 Community Psychology  
  • 4.1.2 Health Psychology  
  • 4.1.3 Neuropsychology  
  • 4.1.4 Forensic Psychology  
  • 4.1.5 Pediatric and Child Psychology Overview  
  • 4.2 Children and Mental Health: Normal Development  
  • 4.2.1 Theories of Development  

    Development is a lifelong process composed of a series of stages (i.e., functioning as an individual and with others/maturation). Various theories of development, such as intellectual (i.e., Piaget’s stage constructed theory) and behavioral (i.e., observation and measurement), focus on how each affects childhood changes in self and the environment.

    Refer to The United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 3: Children and Mental Health,” pages 123–125 for additional information.

  • 4.2.2 Social and Language Development  

    Social and language development in children is influenced by a number of factors, including the parent-child relationship (e.g., Bowlby’s attachment), language origins (i.e., dependent upon both biological and socio-environmental factors), and relationships with other children (e.g., effects of peer relationships and development).

    Refer to The United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 3: Children and Mental Health,” pages 125–127 for additional information.

  • 4.2.3 Temperament  

    Children are active participants in environmental input and the importance of their involvement is reflected in their temperament (i.e., inherent/intrinsic traits affecting relationships and interactions).

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 3: Children and Mental Health,” pg. 127 for additional information.

  • 4.2.4 Developmental Psychopathology  

    There are various concepts and assumptions that affect our understanding of children’s mental health and illness, including developmental psychopathology. Childhood psychopathology arises from complex, multi-layered interactions between numerous factors such as biological, psychological, genetic, and environmental components, and the manner or extent of those interactions over time.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 3: Children and Mental Health,” pages 127–128 for additional information.

  • 4.3 Children and Mental Health: Risk factors, Prevention, and Mental Disorders  
  • 4.3.1 Risk Factors  

    There are numerous biological and psychosocial risk factors that increase a child’s susceptibility for mental disorder development. Biological factors include family and genetics whereas psychosocial factors include stressful life events, childhood maltreatment, and peer/sibling influences. Furthermore, the interaction between the two types of risk factors can greatly increase a child’s development of mental disorders.

    Refer to The United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 3: Children and Mental Health,” pages 129–132 for additional information.

  • 4.3.2 Prevention  

    Prevention of childhood mental disorder development incorporates multiple aspects such as risk reduction, prevention of onset, and early intervention. Numerous prevention programs and strategies also contribute to the deterrence of mental disorder development in children.            

    Refer to The United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 3: Children and Mental Health,” pages 132–136 for additional information.

  • 4.3.3 General Categories of Mental Disorders  

    The conceptual framework of categorizing mental disorders includes understanding how mental disorders unfold in not only children and adolescents but also in adults, as biological, psychological, and socio-environmental constructs change across the life span.

    Refer to The United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 3: Children and Mental Health,” pages 136–137 for additional information.

  • 4.3.4 Assessment and Diagnosis  

    Assessment and diagnosis of mental disorders in children have several primary objectives such as determining unique functional characteristics of the individual and diagnosing signs/symptoms suggesting the presence of a mental disorder.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 3: Children and Mental Health,” pages 137–138 for additional information.

  • 4.3.5 Evaluation Process  

    The evaluation process of determining mental disorder affliction includes gathering information from multiple sources, conducting observations, and initiating additional testing/questioning.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 3: Children and Mental Health,” pages 138–139 for additional information.

  • 4.3.6 Treatment Strategies  

    Treatment strategies in assisting children with mental disorders include psychotherapy and psychopharmacology. Note the advantage and disadvantages of using each strategy.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 3: Children and Mental Health,” pages 139–142 for additional information.

  • 4.4 Older Adults and Mental Health: Developmental Approach  
  • 4.4.1 Normal Life-Cycle Tasks  

    Normal life-cycle tasks for the aging population indicate that a better diet, physical fitness, and health care have improvedmental health in the aging population. Chronic disability prevalence trends indicate a decline in disability in the older population, but there is always some disability associated with normal aging processes.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 5: Older Adults and Mental Health,” pages 335–337 for additional information.

  • 4.4.2 Cognitive Capacity with Aging  

    Cognitive capacity with aging undergoes some loss, and there is variability in not only the type of loss experienced (i.e., intelligence, language, learning, memory) but also in the causes (e.g., genetics, psychosocial factors, comorbidities). However, to mitigate the effects of diminishing cognitive capacity, individuals can make active decisions to avoid disease and disability, sustain high cognitive and physical function, and engage in life.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 5: Older Adults and Mental Health,” pages 337–338 for additional information.

  • 4.4.3 Change, Human Potential, and Creativity  

    Research indicates there is a capacity for constructive change later in life, and this capacity to change can even occur in the face of mental illness. Older individuals who display flexibility in behavior or attitudes can significantly decrease their chance for developing a mental disorder. Though we all experience adversity and/or chronic health problems, our potential for change can ensure good health is retained through new social, psychological, educational, or recreational pathways.

    Refer to The United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 5: Older Adults and Mental Health,” pages 338–339 for additional information.            

  • 4.4.4 Coping with Loss and Bereavement  

    Many older adults experience multiple losses with aging (e.g., loss of social status, self-esteem, physical capacities, family/friends due to death). Coping mechanisms, whether informal (i.e., friends and family) or formal (i.e., mental health professionals), can assist older individuals in managing loss and bereavement.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 5: Older Adults and Mental Health,” pages 339–340 for additional information.

  • 4.5 Older Adults and Mental Health: Assessment, Diagnosis, and Treatment  
  • 4.5.1 Assessment and Diagnosis  

    Older adults experience many of the same mental disorders as younger adults, but the prevalence, nature, and course of each illness can be very different. Adequately assessing and diagnosing mental illness in the aging population involves consideration of particular characteristics including clinical presentation, high comorbidity with other medical disorders, skewed symptom reporting, patient vs. provider barriers, and stereotypes about normal aging.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 5: Older Adults and Mental Health,” pages 340–341 for additional information.

  • 4.5.2 Prevention  

    Prevention of mental illness in the older population is important in preserving health. Primary prevention (i.e., preventing a disease before it occurs) can be applied to late-onset disorders, whereby treatment-related prevention can impede relapse or recurrence of a disorder. Likewise, excess disability prevention focuses on reducing functional impairment, particularly in those with more severe and/or persistent mental disorders, while premature institutionalization prevention aims to delay the institutional placement of older individuals until absolutely necessary.            

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 5: Older Adults and Mental Health,” pages 341–343 for additional information.

  • 4.5.3 Treatment  

    Treatment of mental illness in the aging population includes multiple components, each with issues related to treatment selection. Issues with pharmacological interventions (e.g., side effects risk, polypharmacy, treatment compliance) vs. psychosocial interventions (e.g., symptom relief, health behavior promotion, new methods to service delivery) should be considered when treating mental disorders in older individuals.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 5: Older Adults and Mental Health,” pages 343–346 for additional information.

  • The Saylor Foundation’s “Unit 4 Assessment”  
    • Assessment: The Saylor Foundation’s “Unit 4 Assessment”

      Link: The Saylor Foundation’s “Unit 4 Assessment”

      Instructions: Complete this unit assessment. For each question, pick the best possible answer. The correct answers will be displayed when you click the "Submit" button.

      You must be logged into your Saylor Foundation School account in order to access this quiz.  If you do not yet have an account, you will be able to create one, free of charge, after clicking the link.

      Completing this assessment should take approximately 15 minutes.

  • Unit 5: Anxiety Disorders  

    Now that you have a broad understanding of the whats and hows of clinical psychology and mental health treatment, this unit will discuss the mental illnesses that clinical psychologists most commonly focus on understanding and treating. Over the course of the next few units, you will learn about some common disorders, their specifications, and their treatments. In this unit, you will take a close look at anxiety disorders. Anxiety can be a normal, natural, and appropriate reaction to a stressful situation, but this sort of anxiety is not the anxiety present in an anxiety disorder. An anxiety disorder often involves anxiety that is either disproportionate to the situation at hand, or is the result of an otherwise benign situation. In this unit, you will look at different types of anxiety disorders and their respective behaviors, etiologies, and treatments as they relate to specific populations across the lifespan. First, this unit will address information regarding anxiety disorders in adults. Second, the unit will address issues specific to anxiety disorders in children. Finally, you will learn how anxiety disorders are manifested and treated in older adults.

    Unit 5 Time Advisory   show close
    Unit 5 Learning Outcomes   show close
  • 5.1 Types of Anxiety Disorders  
  • 5.1.1 Diagnoses  

    Anxiety disorders are the most common occurring mental disorders in the adult population. In order to better understand the various types of anxiety disorders (i.e., panic attacks, panic disorder, agoraphobia, specific phobias, social phobias, GAD, OCD, acute and PTSD), it is necessary to understand each illness and symptom manifestation to properly diagnose the correct disorder.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 4: Adults and Mental Health,” pages 233–237 for additional information, as well as the related articles from the National Institute of Mental Health on panic disorder, social anxiety disorder, generalized anxiety disorder, and obsessive-compulsive disorder, as well as Dr. Judd Marmor’s article on “Anxiety and Worry as Aspects of Normal Behavior.”

  • 5.1.2 Etiology of Anxiety Disorders  

    The etiology of anxiety disorders likely involves a combination of life experiences, psychological traits, and genetic factors. Acute stress reactions to anxiety and the physiological systems involve focus on the fight or flight response. Likewise, there are new views on the anatomical and biochemical bases of anxiety (e.g., HPA axis system, internal/external triggers) and neurotransmitter alterations (complexity of serotonin, norepinephrine, GABA, CRH, and cholecystokinin), in addition to psychological views (i.e., differences between psychoanalytic and psychodynamic theories, and behavioral and cognitive theories).

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 4: Adults and Mental Health,” pages 237–241 for additional information, as well as the related articles from the National Institute of Mental Health on panic disorder, social anxiety disorder, generalized anxiety disorder, and obsessive-compulsive disorder, and Dr. Judd Marmor’s article on “Anxiety and Worry as Aspects of Normal Behavior.”

  • 5.1.3 Treatment of Anxiety Disorders  

    Anxiety disorders are treated with counseling/psychotherapy (e.g., cognitive-behavioral therapy), pharmacotherapy (e.g., benzodiazepines, antidepressants, buspirone), or a combination of both (i.e., using multimodal therapies and future implications in treatment).

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 4: Adults and Mental Health,” pages 237–241 for additional information, as well as the related articles from the National Institute of Mental Health on panic disorder, social anxiety disorder, generalized anxiety disorder, and obsessive-compulsive disorder, and Dr. Judd Marmor’s article on “Anxiety and Worry as Aspects of Normal Behavior.” Drs. Gorini and Riva’s article on “The Potential of Virtual Reality as Anxiety Management Tool: A Randomized Controlled Study in a Sample of Patients Affected by Generalized Anxiety Disorder” and Hobart and William Smith College Center for Counseling and Student Wellness’s “Relaxation Techniques” are equally informative regarding treatment techniques.

  • 5.2 Anxiety Disorders in Children  
  • 5.2.1 Separation Anxiety Disorder  

    Separation anxiety disorder in children can develop through identified and unidentified causes/risk factors, associated symptoms, and manifestations. The prevalence and remission rates of this disorder are high, and there may be a relational predisposition to panic disorder or agoraphobia.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 3: Children and Mental Health,” pages 160–161 for additional information.

  • 5.2.2 Generalized Anxiety Disorder  

    Children with generalized anxiety disorder worry excessively about events and situations. This undue worry can lead to overly conforming perfectionism or approval-seeking behavior.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 3: Children and Mental Health,” pg. 161 for additional information.

  • 5.2.3 Social Phobia  

    Children with social phobia have a persistent fear of embarrassment in social situations. Symptom manifestation may be difficult to determine as young children may have trouble articulating their fears. There is a lifetime prevalence of this disorder though it may become less severe or completely remit.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 3: Children and Mental Health,” pages 161–162 for additional information.

  • 5.2.4 Obsessive-Compulsive Disorder  

    Obsessive-compulsive disorder is characterized by repetitive behaviors or obsessions that often attempt to displace obsessive thoughts. There is a strong familial component of this disorder as noted by twin studies, as well as evidence suggesting Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections (PANDAS) affect development.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 3: Children and Mental Health,” pages 162–163 for additional information.

  • 5.2.5 Treatment of Anxiety  

    There is relatively little research on the efficacy of psychodynamic and behavioral therapies in the treatment of anxiety in children.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 3: Children and Mental Health,” pg. 162 for additional information.

  • 5.3 Anxiety Disorders in Older Adults  
  • 5.3.1 Prevalence of Anxiety  

    Older adults can experience various types of anxiety later in life. Phobic anxiety disorders are more common during this phase and worry or nervous tension (rather than specific anxiety syndromes) might be more significant. There are several disorders (e.g., PTSD) that have been less studied in the aging population.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 5: Older Adults and Mental Health,” pg. 364 for additional information.

  • 5.3.2 Treatment of Anxiety  

    The treatment of anxiety in older adults can range in variability including the use of pharmacotherapies. Benzodiazepines are used to treat acute and chronic anxiety (although there is an issue with toxicity) and buspirone is an anxiolytic that is comparable to that of benzodiazepines in terms of efficacy.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 5: Older Adults and Mental Health,” pages 364–365 for additional information.

  • The Saylor Foundation’s “Unit 5 Assessment”  
    • Assessment: The Saylor Foundation’s “Unit 5 Assessment”

      Link: The Saylor Foundation’s “Unit 5 Assessment”

      Instructions: Complete this unit assessment. For each question, pick the best possible answer. The correct answers will be displayed when you click the "Submit" button.

      You must be logged into your Saylor Foundation School account in order to access this quiz.  If you do not yet have an account, you will be able to create one, free of charge, after clicking the link.
      Completing this assessment should take approximately 15 minutes.

  • Unit 6: Mood Disorders and Suicide  

    This unit will present different mood disorders, their etiologies, and their treatments across the lifespan. You will learn that though depression is the most common and the most widely known mood disorder, there are several others. In addition, this unit will present information regarding how mood disorders manifest in childhood, adulthood, and older adulthood, and the various treatment issues for these specific populations. This unit will also address suicide, a detrimental outcome that is closely tied to mood disorders, and an issue that is of major concern within clinical psychology.

    Unit 6 Time Advisory   show close
    Unit 6 Learning Outcomes   show close
  • 6.1 Mood Disorders in Adults  
    • Reading: United States Department of Health and Human Services’ MentalHealth: A Report of the Surgeon General (1999): “Chapter 4: Adults and Mental Health”

      Link: United States Department of Health and Human Services’ MentalHealth: A Report of the Surgeon General (1999): “Chapter 4: Adults and Mental Health” (PDF)
       
      Instructions: Please click on the above link and read the section entitled “Mood Disorders.” If you would like, you can download the PDF version by scrolling down to the bottom of the page, clicking on “Contents,” and then selecting the PDF version of “Chapter 4: Adults and Mental Health,” which includes the section on mood disorders. Please note that the pages in the PDF bar at the top of the document do not match the pages in the table of contents section on the first page. 

      This reading covers all topics listed under subunit 6.1. The empirical journal article listed under subunit 6.1.2 will enrich your understanding of diagnostic issues related to mood disorders in adults.

      Reading this text and taking notes should take approximately 1.5 hours.

      Terms of Use: This material is part of the public domain. 

  • 6.1.1 Complications and Comorbidities  

    There are many complications and comorbidities associated with mental health in adults. Suicide (attempted and completed) is a major complication of adult mood disorders, and anxiety, depression, substance abuse, personality disorders, and medical illnesses (e.g., hypertension) are major comorbidities.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 4: Adults and Mental Health,” pages 244–245 for additional information.

  • 6.1.2 Assessment, Diagnosis, and Syndrome Severity  

    Assessing/diagnosing mood disorders in adults involves differentiating among multiple illnesses including major depressive disorder, dysthymia, bipolar disorder, and cyclothymia. This differential diagnosis includes distinguishing causes such as medical conditions or medications that may influence mood disorder development and syndrome severity.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 4: Adults and Mental Health,” pages 245–251 and Drs. Stensland, Schultz, and Frytak’s article on “Depression Diagnosis Following the Identification of Bipolar Disorder: Costly Incongruent Diagnoses” for additional information.

  • 6.1.3 Etiology of Mood Disorders  

    The etiology of mood disorders is not thoroughly understood, but there are several aspects that influence mental illness development. Biological (e.g., abnormal neurotransmitter concentrations, monoamine hypothesis), genetic (e.g., relational in heredity, environment, values/beliefs), and psychosocial (e.g., stressful life events, cognitive factors, temperament/personality, gender) factors all influence adult mood disorder development.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 4: Adults and Mental Health,” pages 251–257 for additional information.

  • 6.1.4 Treatment of Mood Disorders  

    The treatment of mood disorders is complex because it involves various stages. These stages (i.e., acute, continuation, and maintenance) apply to both pharmacotherapies and psychosocial therapies.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 4: Adults and Mental Health,” pages 257–261 for additional information.

  • 6.1.5 Specific Treatments for Episodes of Depression and Mania  

    Specific treatments for episodes of depression and mania target symptom patterns rather than specific disorders. Regardless of the type of treatment for depression and mania (i.e., pharmacotherapies or psychosocial therapies), there are issues with service delivery, such as insurance benefits or management strategies.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 4: Adults and Mental Health,” pages 261–269 for additional information.

  • 6.2 Suicide  
  • 6.2.1 Risk Factors for Suicide  

    Suicide risk factors vary with age, ethnicity, family history of mental disorders/substance abuse, and family violence, as well as additional aspects. These factors can occur in combination and also change over time. Research evidence has indicated that a change in neurotransmitter levels (e.g., serotonin) is a risk for suicide.

    Refer to the National Institute on Mental Health’s “Suicide in the US: Statistics and Prevention” article for additional information.

  • 6.2.2 Suicide in Different Groups  

    Suicide risks are different for different groups of people. Comparing women and men, men are at a higher risk for suicide. Suicide in children/young people is also different depending upon age (e.g., young adults ages 20–24 are more likely to commit suicide than adolescents ages 15–19). Older adults are also likely to die by suicide, although this measurement is disproportionate to the national average. There are also significant differences in suicide risk among ethnicities.

    Refer to the National Institute on Mental Health’s “Suicide in the US: Statistics and Prevention” article for additional information.

  • 6.2.3 Prevention and Treatment  

    Prevention of suicide should include treatment of major risk factors (e.g., mental or substance abuse disorders) and psychotherapy should be tailored to the individual. Pharmacotherapies should also be used to treat risk factors, and improvement in primary-care providers’ ability to recognize suicidal ideations should be emphasized.

    Refer to the National Institute on Mental Health’s “Suicide in the US: Statistics and Prevention” article for additional information.

  • 6.3 Mood Disorders in Children  
  • 6.3.1 Conditions Associated with Depression  

    There are many conditions in children and adolescents, such as anxiety disorders, anti-social disorders, and substance abuse disorders, that are associated with depression. These conditions, whether they occur individually or in combination, may indicate that depression is a response to the associated disorder, and that can increase the risk of suicide.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 3: Children and Mental Health,” pages 150–151 for additional information.

  • 6.3.2 Prevalence  

    The prevalence of depression and associated conditions in children and adolescents is variable and dependent on numerous factors, including age, symptom presentation, ethnicity, and gender.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 3: Children and Mental Health,” pages 151–152 for additional information.

  • 6.3.3 Course and Natural History  

    The course and natural history of depression and suicide in children and adolescents are influenced by age of onset and the effect of progression to adulthood. There is also a high risk of these individuals developing other mental disorders.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 3: Children and Mental Health,” pages 152–153 for additional information.

  • 6.3.4 Causes  

    There are many speculated causes of childhood and adolescent depression, but precise factors are not known. There is research evidence that family/genetic factors, gender differences, biological factors, cognitive factors, and risk factors for suicide/suicidal behavior all contribute to depression development.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 3: Children and Mental Health,” pages 153–155 for additional information.

  • 6.3.5 Consequences  

    The focus of both major depressive and dysthymic disorder is initial personal distress (e.g., death in the family, bullying). This initial distress can then lead to the impairment of many life aspects.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 3: Children and Mental Health,” pg. 155 for additional information.

  • 6.3.6 Treatment  

    Various options are available for treating mental disorders in children and adolescents. However, there are significant differences among treating depression, bipolar disorder, and suicide in this age group using pharmacological and psychosocial therapies.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 3: Children and Mental Health,” pages 155–160 for additional information.

  • 6.4 Mood Disorders in Older Adults  
  • 6.4.1 Diagnosis  

    Depression in older adults often goes undiagnosed and untreated so it is crucial to accurately differentiate between conditions such as major and minor depression. It is also important to recognize that late onset depression can manifest disparate clinical characteristics. There are also prevalence and incidence patterns and issues with definitions and procedures to consider when diagnosing depression in older adults. Likewise, there are many barriers to diagnosing and treating depression including the complexity of medical/psychosocial contexts. Depression in older individuals should also be viewed across the lifespan in terms of progression, recurrence, and remission, and somatic illness interactions should be considered as reciprocal.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 5: Older Adults and Mental Health,” pages 346–350 for additional information.

  • 6.4.2 Consequences  

    The consequences of depression in older adults include increased mortality from suicide and somatic illness, as well as a large economic burden due to various factors such as excess disability and frequent visits to medical facilities for treatment.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 5: Older Adults and Mental Health,” pages 350–351 for additional information.

  • 6.4.3 Etiology  

    The etiology of depression in older individuals is not fully understood, but biological and psychosocial factors, in addition to other risk factors such as persistent insomnia, grief, or structural/neuroanatomical abnormalities, influence development of the disorder.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 5: Older Adults and Mental Health,” pg. 351 for additional information.

  • 6.4.4 Treatment  

    Numerous treatments are available to assist older adults in dealing with depression. Pharmacological therapies (e.g., tricyclics, SSRIs, multimodal therapy), electroconvulsive therapy, and psychosocial therapies (e.g., cognitive behavioral, problem solving, interpersonal, psychodynamic, and reminiscence) are all valid treatments for depression in the aging population.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 5: Older Adults and Mental Health,” pages 352–356 for additional information.

  • The Saylor Foundation’s “Unit 6 Assessment”  
    • Assessment: The Saylor Foundation’s “Unit 6 Assessment”

      Link: The Saylor Foundation’s “Unit 6 Assessment”

      Instructions: Complete this unit assessment. For each question, pick the best possible answer. The correct answers will be displayed when you click the "Submit" button.

      You must be logged into your Saylor Foundation School account in order to access this quiz.  If you do not yet have an account, you will be able to create one, free of charge, after clicking the link.

      Completing this assessment should take approximately 15 minutes.

  • Unit 7: Schizophrenia  

    Schizophrenia is among the most debilitating of mental diseases. It can lead to sustained hallucinations and delusions, among other symptoms, and ultimately cause an individual to lose all touch with reality. People with this disorder are typically unable to maintain a normal lifestyle without the assistance of both therapy and medical intervention. The disorder is particularly painful because it often develops during an individual’s late teens or early 20s, seemingly robbing a life in its prime. Sadly, these individuals make up a substantial portion of the nation’s homeless population, making it almost impossible for them to receive appropriate help. Schizophrenics often have a co-morbid problem with substance abuse, as they frequently use drugs to self-medicate. This unit will discuss different types of schizophrenia and their respective symptoms, etiologies, and treatments.

    Unit 7 Time Advisory   show close
    Unit 7 Learning Outcomes   show close
  • 7.1 Schizophrenia in Adults  
  • 7.1.1 Overview  

    Schizophrenia is categorized as a profound disruption in cognition and emotion that affect fundamental human attributes (e.g., language, thought, perception, affect, sense of self). The disorder is characterized by a wide array of symptoms (including positive and negative manifestations), and there are issues with diagnostic complications and cultural variance that influence diagnosis and development. Given these aspects, the prevalence of schizophrenia in the general population can be skewed,

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 4: Adults and Mental Health,” pages 269–273 and MTV’s True Life link “I Have Schizophrenia” for additional information.

  • 7.1.2 Course and Recovery  

    Studying the course of and recovery from schizophrenia is difficult due to various complications, such as the changing natures of diagnosis, treatment, and social norms. There is also variability in disorder progression and recovery due to multiple influences (e.g., disease heterogeneity, biological/genetic vulnerability, neurocognitive impairments, personal/social issues). However, even with variability, it is possible to generalize long-term course and recovery of schizophrenia due to longitudinal research outcomes, and even gender and age of onset.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 4: Adults and Mental Health,” pages 269–273 for additional information.

  • 7.1.3 Etiology  

    As with other mental illnesses, a definitive cause of schizophrenia has yet to be determined, but there are a number of factors that can contribute to its development. Research indicates there may be an interaction between genetic predisposition (endowment) and environmental upheaval (disturbances during brain development). There is ample support for both genetic (i.e., family, twin, adoption studies, brain anatomical abnormalities, and abnormal levels of dopamine) and environmental (i.e., prenatal stressors, prenatal poverty, poor nutrition, and chronic stresses) factors that influence schizophrenia development.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 4: Adults and Mental Health,” pages 276–279 for additional information.

  • 7.1.4 Interventions/Treatments  

    Interventions/treatments for schizophrenia have advanced in recent years, with service being linked to clinical phases of the disorder (i.e., acute, stabilizing, maintenance, and recovery) and optimal treatments including a combination of antipsychotic medications with psychosocial interventions. There is also increased awareness of how ethnicity and culture influence treatment
    response so clinicians are utilizing ethnopsychopharmacology in providing the best management of the disorder.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 4: Adults and Mental Health,” pages 279–285 and Drs. Kopelowicz, Liberman, and Wallace’s article “Psychiatric Rehabilitation for Schizophrenia” for additional information.

  • 7.2 Schizophrenia in Older Adults  
  • 7.2.1 Schizophrenia in Late Life  

    Schizophrenia can occur later in life although it is more commonly thought of as an illness in young adulthood. The diagnostic criteria are the same across the lifespan and there are noted similarities of the disorder in younger and older adults, such as delusions, hallucinations, disorganized speech, and disorganized behavior.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 5: Older Adults and Mental Health,” pg. 365 for additional information.

  • 7.2.2 Prevalence and Cost  

    The prevalence and cost associated with schizophrenia in the aging population focuses on prevention compared to the general population and the high economic burden of the illness as related to other mental disorders.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 5: Older Adults and Mental Health,” pages 365–366 for additional information.

  • 7.2.3 Late-Onset  

    Individuals with late-onset schizophrenia exhibit some of the same attributes (e.g., similar risks, clinical presentation, treatment response and course) as those who developed the disorder earlier on in life. However, there are significant gender differences in that women are more likely to develop late-onset schizophrenia than are men.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 5: Older Adults and Mental Health,” pg. 366 for additional information.

  • 7.2.4 Course and Recovery  

    While it is difficult to determine actual course and recovery of individuals with schizophrenia, research suggests that early interventions, especially with antipsychotics, result in better long-term outcomes. It is important to consider studies by Kraepelin, Eyler-Zorrilla et al., and Klapow et al. when determining course and recovery of schizophrenia in the aging population.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 5: Older Adults and Mental Health,” pg. 366 for additional information.

  • 7.2.5 Etiology  

    Etiological implications of late-onset schizophrenia include neurodevelopmental (i.e., physical developmental defects), childhood maladjustment, genetic contributions, and a possible neurobiological subtype of schizophrenia. Various models (i.e., diathesis-stress and multiple insult) also clarify etiological influences of the disorder.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 5: Older Adults and Mental Health,” pages 366–367 for additional information.

  • 7.2.6 Treatment  

    Treatment of late-onset schizophrenia presents some challenges including problems/barriers with pharmacotherapies, and compliance with problem-solving therapy, interpersonal psychotherapy, and psychodynamic therapy.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 5: Older Adults and Mental Health,” pg. 367 for additional information.

  • The Saylor Foundation’s “Unit 7 Assessment”  
    • Assessment: The Saylor Foundation’s “Unit 7 Assessment”

      Link: The Saylor Foundation’s “Unit 7 Assessment”

      Instructions: Complete this unit assessment. For each question, pick the best possible answer. The correct answers will be displayed when you click the "Submit" button.

      You must be logged into your Saylor Foundation School account in order to access this quiz.  If you do not yet have an account, you will be able to create one, free of charge, after clicking the link.

      Completing this assessment should take approximately 15 minutes.

  • Unit 8: Age-related Disorders: Children and the Elderly  

    Most disorders can arise at any time during a person’s lifetime, though they may be statistically more common at one stage or another. However, certain disorders only develop within specific age ranges, making age diagnostically significant. This unit will take a look at individuals at risk for age-related disorders at both ends of the age spectrum: children and the elderly. You will learn about disorders frequently seen in either childhood or late adulthood and identify their courses of action, etiologies, and treatments.

    Unit 8 Time Advisory   show close
    Unit 8 Learning Outcomes   show close
  • 8.1 Disorders of Childhood: Symptoms, Etiology, and Treatment  
    • Reading: United States Department of Health and Human Services’ MentalHealth: A Report of the Surgeon General (1999): “Chapter 3: Children and Mental Health”

      Link: United States Department of Health and Human Services’ MentalHealth: A Report of the Surgeon General (1999): “Chapter 3: Children and Mental Health” (PDF)
       
      Instructions: Please click on the above link and read the section entitled “Attention Deficit/Hyperactivity Disorder” and all the subsections under the section entitled “Other Mental Disorders in Children and Adolescents,” with the exception of “Anxiety Disorders,” as you have already read this subsection. If you would like, you can download the PDF version by scrolling down to the bottom of the page, clicking on “Contents,” and then selecting the PDF version of “Chapter 3: Children and Mental Health,” which includes the sections listed above. Please note that the pages in the PDF bar at the top of the document do not match the pages in the table of contents section on the first page. 

      This reading covers Subunits 8.1.1–8.1.5.

      Reading this text and taking notes should take approximately 1 hour.
       
      Terms of Use: This material is part of the public domain. 

  • 8.1.1 Attention Deficit/Hyperactivity Disorder  

    Attention Deficit/Hyperactivity Disorder (ADHD) is characterized by inattention and hyperactivity-impulsivity. These symptoms usually occur together and onset of symptom presentationoccurs frequently and in multiple settings. Prevalence of the disorder is difficult to determine due to differences in diagnostic criteria, but it has been noted that boys are more likely to develop ADHD than girls. Exact etiological causes of ADHD are unknown although there are implications of neurotransmitter deficits, genetics, prenatal complications, as well as environmental exposure to toxins. Treatments for ADHD include pharmacological therapies, such as psychostimulants, and psychosocial therapies, as well as multimodal therapies. However, there are treatment issues such as overprescribing of stimulants and safety concerns of long-term stimulant use.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 3: Children and Mental Health,” pages 142–150 for additional information.

  • 8.1.2 Autism  

    Autism is the most prevalent developmental disorder in children. Etiological causes are rooted in structural brain abnormalities, genetic predisposition, and cognitive deficits in neural circuitry. Treatment for autism focuses on promotion of social and language development, applied behavioral methods, and antipsychotics.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 3: Children and Mental Health,” pages 163–164 for additional information.

  • 8.1.3 Disruptive Disorder  

    Disruptive disorders are a collection of behaviors rather than patterns of mental dysfunction. There are several disorders that are classified as a disruptive disorder, including opposition defiant disorder (ODD) and conduct disorder. The etiology of these disorders is not fully known, although there are implications that the cause may be a combination of various biological and psychosocial components. Psychosocial intervention is effective in treating disruptive disorder but there is no consistent pharmacotherapy.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 3: Children and Mental Health,” pages 164–166 for additional information.

  • 8.1.4 Substance Use Disorders in Adolescents  

    Causality or prediction of substance use disorders in adolescents is not well known, but research indicates a significant co-occurrence of alcohol and other substance use disorders with mental disorders. Research also indicates that multi-systemic family therapies are an effective treatment for substance use disorders.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 3: Children and Mental Health,” pages 166–167 for additional information.

  • 8.1.5 Eating Disorders  

    Eating disorders (e.g., anorexia nervosa, bulimia) typically arise during adolescence, but there are age-of-onset and gender differenceswith these mental disorders. Females are disproportionately affected by eating disorders and age of onset is mid- to late-teens. The etiology of eating disorders is not precisely known, but there are implications that a combination of genetic, neurochemical, psychodevelopmental, and sociocultural factors affect development. Various psychotherapies and pharmacotherapies are used to treat eating disorders.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 3: Children and Mental Health,” pages 167–168 for additional information.

  • 8.2 Older Adults and Alzheimer’s Disease  
  • 8.2.1 Assessment and Diagnosis  

    Assessment and diagnosis of Alzheimer’s is difficult due to the lack of biological markers, subtle onset, and the need to exclude other dementia causes. It is important to differentiate between mild cognitive impairment (i.e., age-related cognitive decline) and the necessary characteristics for Alzheimer’s diagnosis (e.g., memory impairment combined with an additional impairment such as language or executive functioning, and impairments in social and occupational functioning). This disease is associated with a range of cognitive and behavioral symptoms and the course of the disease implicates a gradual decline in function over the course of the illness. The prevalence and incidence rates of Alzheimer’s are significantly high (i.e., “graying of America), and result in a high cost/economic burden for managing the disease.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 5: Older Adults and Mental Health,” pages 356–360 for additional information.

  • 8.2.2 Etiology  

    The etiology of Alzheimer’s is not completely understood, but there are indications that the disease results from a combination of genetic and environmental aspects. More specifically, biological factors, such as chromosomal mutations, plaques, and neuronal/synaptic losses, greatly increase Alzheimer’s development.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 5: Older Adults and Mental Health,” pages 360–361 for additional information.

  • 8.2.3 Protective Factors  

    While there are many suspected causes of Alzheimer’s, there are also many protective factors that may delay disease onset. Factors such as specific allele expression, use of certain medications (i.e., nonsteroidal anti-inflammatory drugs and estrogen), interference of histopathological changes (e.g., therapies to decrease plaque aggregates or neuronal cell death), and understanding the role of acetylcholine (as this neurotransmitter is implicated in Alzheimer’s pathogenesis), may all contribute to delaying the progression or preventing the development of the disease.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 5: Older Adults and Mental Health,” pages 361–362 for additional information.

  • 8.2.4 Treatment  

    Pharmacological and psychosocial therapies are both used to treat Alzheimer’s. Pharmacological therapies include acetylcholine inhibitors and therapeutic medications for behavioral symptoms. Psychosocial therapies include techniques used to preserve cognitive functioning and assist patients and caregivers in managing the disease.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 5: Older Adults and Mental Health,” pages 362–364 for additional information.

  • The Saylor Foundation’s “Unit 8 Assessment”  
    • Assessment: The Saylor Foundation’s “Unit 8 Assessment”

      Link: The Saylor Foundation’s “Unit 8 Assessment”

      Instructions: Complete this unit assessment. For each question, pick the best possible answer. The correct answers will be displayed when you click the "Submit" button.

      You must be logged into your Saylor Foundation School account in order to access this quiz.  If you do not yet have an account, you will be able to create one, free of charge, after clicking the link.

      Completing this assessment should take approximately 15 minutes.

  • Unit 9: Issues and Ethics in Psychological Intervention  

    This final unit does not deal directly with mental disorders, but rather with other important issues directly tied to the effectiveness of mental health interventions. The unit will begin by discussing the role of culture in therapy and current inequities in treatment. Next, it will cover the importance of confidentiality without which clinical and counseling psychologists might not be effective. At the close of this unit, you should have a general sense of the ethical issues involved with treatment both in respects to equality of treatment across cultural groups and in the ethical issues surrounding confidentiality.

    Unit 9 Time Advisory   show close
    Unit 9 Learning Outcomes   show close
  • 9.1 Culture and Psychology  
  • 9.1.1 Introduction to Cultural Diversity and Demographics  

    Since the U.S. mental health system is not well equipped to adequately meet the needs of racial/ethnic minorities, several issues arise in terms of cultural diversity and mental health services. There are problems with classifications and identification with culture/cultural identity, differences in economic/social/political status, and various coping styles regarding life problems.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 2: The Fundamentals of Mental Health and Mental Illness,” pages 80–83 for additional information.

  • 9.1.2 Family and Community as Resources  

    Many individuals use family and community as resources for managing mental health and mental illness. However, there are racial/ethnic differences in family solidarity and support systems, and also group disparities in treatment.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 2: The Fundamentals of Mental Health and Mental Illness,” pages 83–86 for additional information.

  • 9.1.3 Barriers to Treatment Delivery  

    There are many treatment barriers racial and ethnic minority groups encounter when seeking assistance for mental health and mental illness management. Barriers result from cultural, financial, organizational, and diagnostic differences, as well as help-seeking behavior, mistrust, stigma, cost, and clinician bias.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 2: The Fundamentals of Mental Health and Mental Illness,” pages 86–88 for additional information.

  • 9.1.4 Improving Treatment for Minority Groups  

    Given there are numerous barriers for minority groups seeking mental health support and mental illness treatment, improvements must be made in order to adequately assist minority groups. Treatment programs should engage in ethnopsychopharmacology, offer minority-oriented services, and understand cultural competence.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 2: The Fundamentals of Mental Health and Mental Illness,” pages 88–91 for additional information.

  • 9.1.5 Rural Mental Health Services  

    In addition to minority-group barriers to seeking mental health and mental illness treatment, there are also issues regarding rural mental health services. In comparison to urban mental health services, rural individuals experience geographic, cultural, and political barriers that can interfere with their receiving of mental health treatment.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 2: The Fundamentals of Mental Health and Mental Illness,” pg. 92 for additional information.

  • 9.2 Confidentiality  
  • 9.2.1 Ethical Issues Regarding Confidentiality  

    There are many standards regarding confidentiality and ethical practices involved in mental services treatment. It is important to understand that confidentiality is not an absolute value and many policies and laws provide support for ethical considerations involving confidentiality.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 7: Confidentiality of Mental Health Information: Ethical, Legal, and Policy Issues,” pages 437–439 for additional information.

  • 9.2.2 Values Underlying Confidentiality  

    The values underlying confidentiality examine reducing stigma, fostering trust, and protecting privacy as principles of confidentiality.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 7: Confidentiality of Mental Health Information: Ethical, Legal, and Policy Issues,” pages 439–440 for additional information.

  • 9.2.3 Research on Confidentiality and Mental Health Treatment  

    Research on confidentiality and mental health treatment supports underlying assumptions that individuals seeking treatment may be less likely to ask for help or disclose sensitive information for fear of privacy not being kept.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 7: Confidentiality of Mental Health Information: Ethical, Legal, and Policy Issues,” pages 440–441 for additional information.

  • 9.2.4 Current State of Confidentiality Law  

    The current state of federal and state confidentiality laws illustrates the need for change. At present, there is a lack of legal framework/national standards for confidentiality of health care information. Likewise, there are differences in state laws.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 7: Confidentiality of Mental Health Information: Ethical, Legal, and Policy Issues,” pages 441–442 for additional information.

  • 9.2.5 Exceptions to Confidentiality  

    Given that there are differences in state confidentiality laws, each state can thus create exceptions to confidentiality. These exceptions may include consent by individual in treatment, disclosure to client/other providers/payers/families/law enforcement agencies/third parties, and disclosure for reporting and research.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 7: Confidentiality of Mental Health Information: Ethical, Legal, and Policy Issues,” pages 442–445 for additional information.

  • 9.2.6 Federal Confidentiality Laws  

    Any individual seeking mental health or mental illness treatment risks discrimination, invasion of privacy, or even criminal prosecution if that information is disclosed to third parties. In an effort to mitigate these issues, federal confidentiality laws protect patients’ rights while they are receiving treatment (e.g., Americans with Disabilities Act). However, there are certain situations (e.g., disclosure to law enforcement where a crime was committed) when information must be released.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 7: Confidentiality of Mental Health Information: Ethical, Legal, and Policy Issues,” pages 446–447 for additional information.

  • 9.2.7 Potential Problems with the Current Legal Framework  

    There are many problems with our current legal framework regarding protection of health care information. There is a lack of uniformity (e.g., state vs. federal differences), lack of reform provisions, preemption, separation of legal standards for mental health confidentiality, and substance/alcohol use confidentiality issues.

    Refer to the United States Department of Health and Human Services’ Mental Health: A Report of the Surgeon General (1999): “Chapter 7: Confidentiality of Mental Health Information: Ethical, Legal, and Policy Issues,” pages 447–449 for additional information.

  • The Saylor Foundation’s “Unit 9 Assessment”  
    • Assessment: The Saylor Foundation’s “Unit 9 Assessment”

      Link: The Saylor Foundation’s “Unit 9 Assessment”

      Instructions: Complete this unit assessment. For each question, pick the best possible answer. The correct answers will be displayed when you click the "Submit" button.

      You must be logged into your Saylor Foundation School account in order to access this quiz.  If you do not yet have an account, you will be able to create one, free of charge, after clicking the link.

      Completing this assessment should take approximately 15 minutes.

  • Final Exam  

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