Week 1-4 Notes
Popular in Clinical Psychology
Popular in Psychlogy
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Date Created: 10/09/15
82715 Thursday August 27 2015 621 PM 0 First reaction papers are based on articles on syllabus Second reaction papers are any article that is relatively recent and from a clinical psychollt good papers integrate information taught in class APA style double spaced times new roman cover sheet references Clinical Psychology Focuses on intellectual emotional biological psychological social and be across the life span in varying cultures and at all socioeconomic levels 0 Mental Health Professions 0 Clinical amp Counseling Psychologists 39 Health 39 Neuropsychology 39 Forensic 39 ChildPediatric 39 Community 0 Psychiatrists 0 Social Workers 0 Psychiatric Nurses Clinical PsvchoIOgists focus on psychopathology PhD or PsyD 1 year clinical internship Health Psychological factors in physical diseases Neuronsvchooav Patients with brain iniurv rehabilitation strategies Alzheimer39s Huntington39s ng journal havioral aspects of human functioning 5 disease Parkinson39s disease etc Forensic Psychological evidence for judicial purposes deciding whether client has mental capa ChidPediatric Children in clinical or medical settings treatment and prevention of psychopath Community Understanding quality of life of individuals communities and society public healt treatment natural disasters shootings etc Counseling PsvchoIOgists focus on coping with stressors PhD 1 year clinical internship Social Workers Masters in Social Work Emphasize group and social processes public policy social organization and assistance Can perform therapy Psychiatrists Medical school Psychiatric residency Use of psychotherapy as well as medication Psychiatric Nurses RN plus masters in psychiatric nursing Special emphasis is given to psychopharmacology Study for compare and contrast on test 0 The 4 D39s of Mental Disorder 0 Statistical Deviance 39 Consider unusualrare disorders 39 However many conditions related to mental disorders are not unusual subs1 39 Some rare conditions are not a mental disorder very high intelligence 0 Biological Disadvantage 39 Mental disorders are those that interfere seriously with individual reproducti city judgment etc Iology h approach to prevention and a nce abuse ve capacities depressiona nxiety 39 Some disorders meet this schizophrenia MR others do not 0 Unexpected Distress or Disability 39 Behavior causes distress or disability that is not expected 39 However some conditions causing distress or disability are not disorders po 0 Harmful Dysfunction 39 quotHarmfulquot based on social norms depending on culture examplehallucinati 39 Dysfunctional the failure of our quotmental mechanismquot to perform its intendec 0 Mental Disorder Definition 0 Asyndrome characterized by clinically significant disturbance in an individual39s cog that reflects a dysfunction in the psychological biological or developmental proces Mental disorders are usually associated with significant distress or disability in sociz activities 0 An expectable or culturally approved response to a common stressor or loss such mental disorder Socially deviant behavior eg political religious or sexual and 0 individual and society are not mental disorders unless the deviance or conflict resu as described above 0 Brief History of Abnormal Behavior 0 Ancient Greeks Naturalistic Views 39 Hippocrates proposed imbalances in four essential bodily fluids III Blood III Phlegm III Yellow bile III Black bile 39 Emphasized role of stress diet heredity and head injury 0 Middle Ages Religious Views 39 Used supernatural explanations 39 Exorcisms food deprivation and torture considered main forms of quottreatmer 39 Witch hunts often targeted the mentally ill 0 Renaissance Establishment of asylums 39 Reaction against persecution 39 Paracelsus stars and planets cause abnormal behavior 39 Asylums established conditions deplorable 39 Reform movement promoted humane treatment 0 Post Renaissance Systematic observation 39 Scientific study of the mentally ill began at asylums h u 39 I l I l II 39II verty discrimination ons l function student parent employee nition emotion regulation or behavior ses underlying mental functioning al occupational or other important as the death of a loved one is not a onflicts that are primarily between the lts from a dysfunction in the individual 1tquot I SyStematIc ooservatlon or large numbers or mentally 39 Classification systems and theories of abnormal behavior developed 0 Models of Abnormal Behavior 0 Psychodynamic 39 Freud human behavior is strongly influenced by unconscious psychological p 39 Personality composed of3 parts III dprimitive drives libido thanatos III Egotempers id39s drives III Superego source of conscience Stages of Psychosexual Development o Behaviorist 39 Founded by John Watson to predict and control behavior 39 Concentrated purely on observable behavior 39 Learning through conditioning and modeling 39 Classical Conditioning III Developed by Ivan Pavlov III Occurs when an unconditioned stimulus and a conditioned stimulus arl conditioned response which is similar to the unconditioned response 39 Operant Conditioning III Thorndike39s Law of Effect Behaviors associated with satisfying consequences are strengtheI whereas those linked to unsatisfying consequences are weakenet III BF Skinner established the principles of operant conditioning ampcoinec Discriminative Stimulus The information our environment provi responses will be rewarded ignored or punished Operant Response The voluntary responses which produce reini Reinforcing Stimulus The rewarding or punishing consequences III Modeling Albert Bandura developed social learning theory from classical aI Focuses on observational learning a mode of learning in which c behaviors without actually engaging in the behavior at that time n Humanicfir erCESSES e repeatedly paired to produce a ned and more likely to be repeated d and less likely to be repeated 1 the following terms des us about the likihood that our lorcement or punishment of the opera nt response nd operant conditioning the watches others engaging in various V I IVIIIIUIIIIUUIV 39 Developed as a reaction against the psychodyna mic and behavioral models 39 Focuses mostly on healthy individuals others were negative only focused or 39 Emphasizes the uniqueness and worth of each individual 39 Carl Rogers III Proposed the personcentered theory of personality based on One39s perceptions of the world 0 Biology Learning 39 Abraham Maslow III Described the process of selfactualization Each person achieves hisher unrealized potential despite the ine 0 Cognitive 39 Albert Bandura III Ushered the cognitive revolution Selfef cacy People39s beliefs about their ability to exercise contr Attribution Ajudgment about a person behavior object or situ Schema A body of knowledge that an individual has stored in mi 39 Take into account thoughts and feelings 39 Consider the individual a more active participant in the environment 39 Have become very popular in the past few decades 0 Biological i unhealthy individuals avitable frustration of life 39ol over events that affect our lives Iation emory 9315 Thursday September 3 2015 632 PM 0 Biological Model 0 Historically linked to medicine 0 Rests on the assumption that both normal and abnormal behaviors are the result of complex interactions between various bodily systems 0 Of particular interest is the function of the nervous system 0 The nervous system is composed of neurons Neurons o Specialized cells that receive information from sensory receptors and then transmit messages to other neurons muscles and glands Most commonly studied neurotransmitters o Dopamine Alzheimer39s Parkinson39s o Serotonin o Norepinephrine Genes 0 Basic units of heredity Arranged in a specific order along with chromosomes IdenticalMonozygotic twins share 100 of genes FraternalDizygotic twins share 50 of genes Any pair of sibling share 50 of genes OOOO Biopyschosocial Model 0 AKA diathesis stress model 0 Examines interactive effects of biological and environmental factors Define models Comparecontra st models Poacnnc 39Fnr haulna a Pliao39nnclir cudom ICCIJUI IQ IUI I ICI VII I6 CI UICIEI IVle JYJLCI I I 0 To plan treatments 0 To conduct research 0 As a means of communication How one diagnoses 0 Signs observations the clinician makes 0 Symptoms conditions the client reports 0 Using clinical interviewing and other assessment tools and techniques Brief History of Diagnostic Systems 0 1930s Superintendents of state hospitals establish a common system 0 WWII High number of military personnel dismissed bc of mental disorders 0 1946 First draft of DSM o 1952 DMSI published 39 About 100 diagnoses listed 39 Vague descriptions 39 Diagnoses based on psychoanalytic concepts 39 Notorious for unreliability o 1968 DMS published 0 1970s Better research methods on diagnoses o 1987 Minor revisions made DSMIIIR published 0 1994 DSMIV published 39 Better reliability 39 More sensitive to sociocultural issues 0 2000 DMS IVTR published TRtext revision 0 The Multiaxial System of the DSM 0 Axis I Clinical disorders MDD 0 Axis II Personality disorders amp mental retardation Mild mental retardation 0 Axis III General medical conditions Seizures 0 Axis IV Psychosocial and environmental problems Family discord educational or occupational problems legal problems etc 0 Axis V Global Assessment of Function 39 Not as useful as led to be DSM5 0 Published in 2013 0 Fewer diagnoses 39 Increases use of subtypesspecifiers o Multiaxial system dropped 0 ICD International Classifications of Disorders WHODAS o Assesses difficulty in functioning 0 Ratings none 0 to extremely 5 Advantages of Diagnosing 0 Communication 0 Identification of etiology 0 Brief summary of problems Fnl IY39CD an l nl I39I39I AMD U MUDquot QC CII IU UULDUI I IC 0 Prescribes treatment Disadvantages of Diagnosing o Stigmatizing o Invalid or inappropriate 0 May discourage further assessment 0 Focus on pathology Mood Disorders A conscious state of mind or predomina nt emotion 0 May include cognitive and behavioral manifestations o Characterized by mood disturbances o Tend to occur in episodes 0 Symptoms change from previous functioning typically depression or mania Distinction between mood disorders Unipolar One end of affective spectrum major depression Bipolar Both ends of affective spectrum manic mixed or hypomanic depression Dysthymia Relatively chronic depressed mood that is less severe but longer lasting than major depression longer lastingless chronic Cyclothymia Extended period in which the person experiences hypomanic and depressive symptoms 91015 Thursday September 10 2015 631 PM 0 Statistics Point prevalence Percentage of the population with a disorder within a particular period of time Lifetime prevalence Percentage of individuals who have ever had a specific disorder at any tin Depression is more relevant in females at point and lifetime prevalence Lifetime prevalence of depression is higher than point prevalence in both genders Biological Factors 0 O 0 Genetic factors are supported by family twin and adoption studies Both unipolar and bipolar depression are hereditary Severe depression in an individual increases likeliness of relatives developing a mood disorder Concordance rate for depression 39 40 in M2 twins I 10 in DZ twins Concordance rate for bipolar disorder 39 7080 for M2 twins I 10 20 for DZ twins The more relatedthe higher chance of developing both depressionbipolar Link between neurobiochemical factors 39 Imbalances in norepinephrine NE serotonin 5HT and dopamine DA pla a role in depression 39 Certain endocrine diseases are linked to depression Beck39s Cognitive Distortion Model 0 O 0 Very influential in study of depression Belief39s and selfknowledge organized into schema Cognitive triad of negative schemas r Il 16 O I Negative View or the self 39 Negative view of the world 39 Negative view of the future Depressed individuals engage in automatic negative thoughts that bias view of self the world and the future Automatic thoughts show content specificity by focusing on experiences of loss anc failure HelplessnessH opelessn ess Model 0 O O Seligman39s model which started as a conditioning model Proposed that exposure to uncontrollable aversive situations develops depression rooted in feeling helpless Model was transformed by Abramson into an attributional model Certain cognitive distortions affect interpretation of causes of events in one39s life Characterized by 3 types of attributions about negative events 39 Internal caused by own failings 39 Stable causes are constant 39 Global causes have broad and general effects Cannot account for the cause of depression 0 Life Events Model 0 Findings suggest life events relate to development of depression especially if there have been previous episodes 0 0 Combined biological environmental and personal factors that lead to depression States that biological vulnerability diathesis interacts with life stressors to produce depression Must have diathesis to have depression doesn39t matter on stress level Diathesis wno stress no depression Diathesis wstress depression Threshold High diathesis m W Low diathesis For people with a high diathesis it doesn t take a lot of stress to go over threshold 0 Gender Differences 0 There are no gender differences in depression until adolescence 0 Women diagnosed with depression twice as often as men society norms postpartum depression hormones Other Differences o Hispanics and Blacks are less likely to be depressed than Whites but complicated I SES 0 Marriedpartnered individuals less likely than singledivorced people Seelev et al 2009 Equi nality Mulitiple pathways by which a person can develop a disorder Cognitive Vulnerability Model Negative cognitions serve as a risk factor which in combinatior with stressful life events increase the risk for depression StressBuffering Model Social support protects people from the risks posed by stressful life events 0 The most predictive risk factors included I Existing depressive symptoms I Poor school functioning I Poor family functioning I Low parental support I Bulimic symptoms I Delinquency 0 Important points I Classification Tree Analysis atechnique to evaluate interactions between ris factors interactions revealed between 4 factors marked with I The findings suggest that there are different pathways by which adolescent girls develop depression Anxiety Disorders 0 Historically psychiatric disorders divided into neuroses and psychoses o Neuroses are milder considerable discomfort some maladaptive behavior but in contact with reality 0 Psychoses involve major disturbance such as loss of contact with reality delusions hallucinations thought disorder DSMS Anxiety Disorders 0 Panic Disorder 39 With or without Agoraphobia fears 39 Separation Anxiety Disorder 39 Phobias III Animal III Natural environment III Bloodinjection injury needles surgery III Situational airplanes enclosed places I Social Anxiety Disorder formerly social phobia 39 Generalized Anxiety Disorder DSMS Formerly Anxiety Disorders 0 Trauma and Stressorrelated Disorders 39 Posttraumatic Stress Disorder 39 Acute Stress Disorder 0 Obsessive Compulsive and Related Disorders I OCD 39 Hoarding Anxiety Disorders 0 Tend to occur more often in women than in men ratio of approximately 21 0 Lifetime prevalence for any anxiety disorder 288 Panic Attack 0 Discrete period with sudden onset of intense apprehension fearfulness or terror often associated with feelings of impending doom 0 During these attacks symptoms such as shortness of breath palpitations chest pa or discomfort choking or smothering sensations and fear or quotgoing crazyquot or losing control are present o If with Agoraphobia characterized by both unexpected panic attacks and agoraphobia o If without Agoraphobia characterized by recurrent unexpected panic attacks about which there is persistent concern CognitiveBehavioral Model of Anxiety 0 Various cognitive and behavioral theories of anxiety share features 0 Barlow proposed integrative model from cognitive behavioral and psychology of in emouon Distinction between fear and anxiety Fear 39 A primitive basic emotion occurring automatically when threatened with rea or perceived danger 39 An action tendency defined by quotfight or flightquot response 39 Experienced as a strong urge to escape from a threatening situation Anxiety 39 A blend of different emotions including anger excitement and fear itself 39 A fragmented cognitiveaffective process with sense of unpredictability or uncontrollability over potentially negative or harmful events 39 Associated with chronic physiological arousal 39 Experienced as apprehension 39 Characterized by selffocused attention that increases arousal and awareness of threatrelated stimuli I Clinical manifestation of fear 39 Not a true alarm triggered by real danger 39 False alarmdanger is only perceived I Differs from anxiety in 2 ways III Specific thoughts III Physiological response 39 Panic disorder results form catastrophic misinterpretation of normal bodily sensations 39 Misinterpreted sensations may be normal physical sensations but also may include bodily changes in response to excitement or anger 39 Sensations are perceived as much more dangerous than they really are 39 Research shows that panic patients misinterpret bodily sensations catastrophically 91715 Thursday September 17 2015 626 PM Exam 50 from lecture 30 from Pomerantz text 20 from Oltmanns and research articles Short Essay Questions Have list ahead of time Sampled from lecture and readings that we discussed in class Make sure to read questions carefully Oltmanns Know themes General issues experienced and treatments given 0 Speci c phobia Clinically significant anxiety provoked by exposure to a specific feared object or situation often leading to avoidance behavior Common but rarely result in diagnosis due to insufficient impairment or distress Reported prevalence varies according to types of phobias studied General prevalences 1 year 9 ifetime approx 11 0 Social Anxiety Disorder social phobia Clinically significant anxiety provoked by exposure to some social or performance situations often leading to avoidance behavior Prevelence rates also vary widely 1 year 12 Lifetime approx 13 o Generalized Anxiety Disorder GAD At least 6 months of persistant and excessive anxiety and worry I Involves quotfree floating anxietyquot or anxiety not attached to anything specific I Individuals often report a lifetime of generalized anxiety with no specific trigger for onset I Prevelence 1 year 3 Lifetime 5 I People with GAD very likely to have other disorders I National Comorbidity Study 90 of those with GAD have comoridity with another disorder Comorbidity Two or more disorders cooccur in one individual An entire body of research has examined comorbidity bw depression and anxiety 0 Tripartite Model Influential model by Watson and Clark I Before this model researchers were unable to distinguish depression from anxiety with psychological instruments I 3 Components III General distress Negative Affectivity Pervasive negative emotionality and selfconcept 0 High NA individuals tend to be distressed upset and have negative view of self 0 Low NA individuals are relatively content secure and satisfied with self 0 A mixture of depression and anxiety III Anhedonia Lack of experiencing pleasure 0 More depression related III Anxious arousal Physiological symptoms of anxiety sweaty palms palpitations More anxiety related o Hierarchical Model 39 Further research shows that anxious arousal only contributes to panic disorder not all anxiety disorders 39 Reformulated model hierarchical model ofanxiety and depression I Each disorder has III One or more general components that are shared with other disorders III One or more specific components that are unique to each disorder 0 Substance Use Disorders 0 Substance Abuse SA 39 Became a focus of study in mental asylums in 1800s 39 Lifetime Prevelences III 6 for opiods to 13 for alcohol III 146 for any substance use disorder 39 Gender Ratiosapproximately 21 MzF 39 Categories of Drugs of Abuse III Stimulants Cocaine amphetamine methamphetamine caffeine nicotine III Sedatives Opiates Opium morphine heroin barbiturates anxiolytics alcohol III Hallucinogens LSD ecstasy mescaline marijuana o Binge Drinking I No universal definition usually defined by frequency quantity and consequences of use 39 Harvard School of Public Health College Alcohol Study III Men 5 drinks in a row III Women 4 drinks in a row Nelson et al 39 VVISCUHSIH lllgllESL dUUIL Ulllge Ul39lllKlllg l39dLe Utah lowest for both adult and college binge drinking rates 0 Correlation between binge drinking for college and adults 43 0 Where one lives predicts binge drinking by college students 0 Effects of Alcohol 0 Biphasic effect 39 Initial effect is stimulating 39 After blood alcohol levels peak and begin to decline it acts as a depressant 0 Individual experiences of effects of alcohol are modified by expectations 0 Those with family history of alcoholism tend to have fewer effects from consumption of alcohol 0 Research on family history and heritibility led to subtyping 0 Type 1 More common lower heritabilty begin drinking later in life higher risk of developing liver or other problems 0 Type II Less common higher heritability begin drinking earlier in life tend to experience fewer physical effects 0 Why are drugs addictive 0 Reinforcement 39 Positive reinforcement Substance elicits positive feelings euphoria energy results from increased synaptic activity in dopamine paths I Negative Reinforcement Eliminates distress helps people calm down reduces craving results form stimulating natural opiates pain relievers in the nervous system
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