Clinical Psychology Exam Review: Disorders and Treatments

Posted on May 5, 2026 in Psychology

Sleep Disorders and Treatment

  • Sleep efficiency: Percentage of time asleep while in bed. Healthy is ≥85%; below this is in the insomnia range.
  • Parasomnias: Abnormal events during sleep.
  • Dyssomnias: Issues with sleep quantity, timing, or quality.

3P (Spielman) Model

  • Predisposing: Pre-existing biological, psychological, or social vulnerabilities (e.g., neuroticism).
  • Precipitating: Acute stressor or illness triggering onset.
  • Perpetuating: Coping behaviors that maintain insomnia (e.g., excess time in bed, napping, catastrophizing).

CBT-I (First-Line Treatment)

  • Sleep hygiene: Habits and environment to promote sleep.
  • Stimulus control: Retraining the bed for sleep only.
  • Sleep restriction: Limiting time in bed to actual sleep time (based on a sleep diary).
  • Relaxation: Progressive Muscle Relaxation (PMR) and wind-down routines.
  • Cognitive: Challenging catastrophic thoughts and setting realistic expectations.
  • Note: CBT-I is superior to medication for long-term results; combining them can reduce CBT-I durability.

Measurement

  • Sleep diary, informant report, polysomnography, and actigraphy.

Mood Disorders: Unipolar

Episode Types

  • Major Depressive Episode (MDE): 5+ symptoms for ≥2 weeks (must include depressed mood OR anhedonia). Symptoms include mood, anhedonia, appetite, sleep, psychomotor, fatigue, worthlessness/guilt, concentration, and death/suicidality.
  • Manic Episode: Elevated/euphoric mood for ≥1 week + 3+ of: grandiosity, decreased sleep, pressured speech, racing thoughts, distractibility, increased activity, or risky behavior. Must impair functioning.
  • Hypomanic Episode: Same criteria for ≥4 days, noticeable but NOT impairing. If psychotic features are present, it is classified as manic.

Major Depressive Disorder (MDD)

  • ≥1 MDE, NO manic/hypomanic episodes. Specifiers: melancholic, psychotic, atypical (mood reactivity), catatonic, seasonal, or peripartum.
  • Relapse: Return after short remission.
  • Recurrence: New episode after full remission.

Persistent Depressive Disorder (PDD)

  • Depressed mood most days for ≥2 years (1 year in children) + 2+ of: poor appetite/overeating, insomnia/hypersomnia, low energy, low self-esteem, poor concentration, or hopelessness.
  • Double depression: MDE on top of PDD.

Causal Factors

  • Beck’s cognitive triad: Negative views of self, world, and future.
  • Reformulated helplessness: Pessimistic attributional style + negative events.
  • Hopelessness theory: Expectation of inevitable bad outcomes.
  • Interpersonal effects: Lack of social support and poor social skills increase risk.
  • Biological: Neurotransmitter disruption (NE, serotonin, dopamine), HPA dysregulation (increased cortisol), and genetic factors.

Mood Disorders: Bipolar

DisorderKey Feature
Bipolar I≥1 full manic episode; depression usually present.
Bipolar IIHypomanic + MDE; no full mania. More common than Bipolar I.
CyclothymiaHypomanic + depressive symptoms for ≥2 years; does not meet full criteria.
  • Rapid cycling: ≥4 episodes/year.
  • Adherence: High non-adherence; antidepressants can precipitate mania. Lithium is effective but has side effects (lethargy, cognitive slowing, weight gain).

Suicide and NSSI

  • NSSI: Deliberate self-harm without intent to die.
  • Joiner’s model: Perceived burdensomeness + thwarted belongingness lead to suicidal desire. Acquired capability (from pain/provocation) leads to a lethal attempt.

Eating Disorders

AN, BN, and BED Criteria

  • Anorexia Nervosa (AN): Restriction leading to low body weight, intense fear of weight gain, and body image disturbance.
  • Bulimia Nervosa (BN): Recurrent binges and compensatory behaviors (vomiting, laxatives, fasting, exercise) ≥1x/week for 3 months.
  • Binge Eating Disorder (BED): Recurrent binges (≥1x/week, 3 months) without compensatory behaviors.

Cognitive Biases in EDs

  • Overvaluation of weight/shape: Self-worth excessively tied to body weight/shape.
  • Body image disturbance: Distorted perception of actual body size.
  • “Normative” body dissatisfaction: Widespread dissatisfaction among women in Western cultures; a risk factor for clinical EDs.

Personality Disorders

  • Big 5 (OCEAN): Openness, Conscientiousness, Extraversion, Agreeableness, Neuroticism.
  • Cluster A (Odd/Eccentric): Paranoid, Schizoid, Schizotypal.
  • Cluster B (Dramatic/Erratic): Histrionic, Narcissistic, ASPD, BPD.
  • Cluster C (Anxious/Fearful): Avoidant, Dependent, OCPD.

BPD Biopsychosocial Theory

  • Bio: Emotional vulnerability. Env: Invalidating environment. Tx: DBT is first-line.

Substance-Related Disorders

  • Tolerance: Need for increased amounts for the same effect.
  • Withdrawal: Physical symptoms with abstinence.
  • DSM-5 SUD Criteria: ≥2 of 11 criteria in 12 months (Mild: 2–3, Moderate: 4–5, Severe: 6+).

Schizophrenia and Psychotic Disorders

  • Criteria A: ≥2 symptoms for ≥1 month (Delusions, Hallucinations, Disorganized speech, Disorganized/catatonic behavior, Negative symptoms).
  • Positive symptoms: Excess/distortion (delusions, hallucinations).
  • Negative symptoms: Absence/deficit (blunted affect, avolition).
  • Causes: Strong genetic link, dopamine/glutamate dysregulation, and brain structure changes (enlarged ventricles, connectivity loss).
  • Expressed Emotion (EE): Criticism, hostility, and emotional overinvolvement predict relapse.