Popular in abnormal psychology
verified elite notetaker
Popular in Psychlogy
This 54 page Bundle was uploaded by sabrina on Tuesday March 22, 2016. The Bundle belongs to 366 at Arizona State University taught by Laniphier in Spring 2016. Since its upload, it has received 163 views. For similar materials see abnormal psychology in Psychlogy at Arizona State University.
Reviews for Abnormal Notes
Report this Material
What is Karma?
Karma is the currency of StudySoup.
You can buy or earn more Karma at anytime and redeem it for class notes, study guides, flashcards, and more!
Date Created: 03/22/16
Chapter 1 01/14/2016 ▯ Abnormal behavior: behavior that is inconsistent with the individuals developmental, cultural, and societal norms, and creates distress or interferes with daily functioning Abnormal means “away from normal” Normal becomes statistical average and any deviation becomes “abnormal Goodness of fit: understanding behavior within a specific context ▯ Culture: shared behavioral patterns and lifestyles that differentiate one group from another Culture –bound syndrome: originally described abnormal behaviors that were specific to certain group or location ▯ Dangerous Behavior: Most people with psychological disorders do not engage in dangerous behavior Dangerous behavior alone is not enough to label abnormality Eccentricity: eccentric behavior may violate social norms but is not always negative or harmful to others ▯ General Population About 47% of adults in U.S. suffer from psychological disorder at some point in their lives Most commonly reported disorders in U.S. are anxiety and depression o More than 20% of adults will suffer from depression o More than 14% will suffer from alcohol dependence o More than 28% will suffer from anxiety ▯ Influences Personal characteristics (sex, race, ethnicity) o Women- anxiety depression o Men- alcohol/ drug abuse o Whites and African Americans suffer equally from most types of disorders o Hispanics more likely to have mood disorders than non- Hispanic whites Socioeconomic status: defined by family income, educational achievement o Disorders occur most frequently among those with lowest incomes and education o Downward drift: impairment that results from psychological disorder (inability to sleep, addiction) leads to job loss or limited educational achievement o By age 16 one of three children and adolescents (36%) has suffered from disorder o Developmental trajectory: common symptoms of disorder vary according to persons age ▯ History of abnormal behavior Trephination: cutting away sections of skull, sometimes used for treatment of abnormal behaviors Greeks believed the gods controlled abnormal behavior o Hippocrates: Produced diagnostic classification system and model to explain abnormal behavior Believed that abnormal behaviors resulted from environmental, and physical factors that created imbalance in four bodily humors (yellow bile, black bile, blood, phlegm) In medieval Europe demons were source of all evil Emotional contagion: defined by automatic mimicry of expressions of one person by another o This caused mass hysteria Johann Weyer: first to specialize in treatment of mental illness o Asylums, madhouses, extreme practices Philippe Pinel and Quaker William Tuke: changed approach to treatment Memoir on Madness Moral treatment: kindness and occupation Dorthea Dix: poor treatment of ill to public attention ▯ Psychoanalysis A theory that attempts to explain both normal and abnormal behavior o Sigmund Freud: Believed roots of abnormal behavior were established in first 5 years o Psychoanalytic Theory: Structure of the mind Id: basic instinctual drives, source of psychic energy (libido) always unconscious Ego: develops when id comes into contact with reality, conscious and unconscious components Superego: imposes moral restraint on Id’s impulses, partly conscious partly unconscious Stages of psychosocial development Oral phase: sucking chewing (1-1.5) Anal phase: toilet training (1.5-3) Phallic stage: psychosexual energy on genital area (3-5) Latency phase: disinterested in opposite sex Genital phase: mature stage o Psychoanalytic therapy Free association: tells analyst everything in mind, from sitting in front of analyst Dream analysis: recount dreams Insight: brining troubling material to consciousness Interpretation: analyst opinions Lengthy Not well funded Low validity and reliability Edible complex/Electra complex Does not work well for children ▯ Behaviorism Based on principles that consider all behavior to be learned as result of experiences or interactions with environment Ivan Pavlov o Classical conditioning ucs, cs, ucr,cr John B Watson o Little albert Operant conditioning o punishment o Reinforcement: going to increase behavior Positive: giving something for purpose of rewarding action Negative: removal of something unpleasant (seatbelt alarm) Skinner: operant conditioning Albert Bandura: vicarious conditioning (observational learning) Fix conditions Biological Models Biological model assumes that abnormal behavior results from biological process of the body particularly in brain Brain scans, neuroscience Behavioral genetics o Sir Francis Galton, Hereditary Genus Fix with a pill ▯ Psychological Models Emphasizes how environmental factors such as family and cultural factors may influence the development and maintenance of abnormal behavior ▯ Cognitive Model Abnormal behavior is result of distorted cognitive processes, not internal forces or external events Individuals world view ▯ Humanistic Model Based on phenomenology Believe that people are basically good and are motivated to self- actualize, abnormal behaviors occur when there is a failure in self- actualization Carl Rogers: client therapy Must show empathy to the client Genuineness/congruence Unconditional positive regard (therapist has respect for client as a human being) Ideal self Actual self When they overlap have greatest mental health When they are far apart psychopathology occurs ▯ Sociocultural Models Abnormal behavior must be understood within the context of social and cultural forces such as gender roles, social class, and interpersonal resources ▯ Biopsychosocial Model Acknowledges that many different factors contribute to development of abnormal behavior o Biological Genes, hormones, sex, sns/pns (fight or flight), neuro- (chemistry,anatomy,functioning), age, race o Psychological Behaviors, emotions, cognitions o Social gender ethnicity socioeconomic status interpersonal relationships Diathesis-stress model: begins with assumption that psychological disorders may have a biological basis o Predisposition outcome toward specific pathology o Must have stress in mode for pathology to present itself o More similar to multifinality Transactional, systemic, integrated model ▯ ▯ Equifinality: all pathways lead to same outcome ▯ Multifinality: same starting point can lead to multiple end points Risk factors: increase likelihood of psychopathology ▯ Resilience factors: in face of risk they protect a person from psychopathology ▯ Psychopathology: a behavior, emotion or cognition that is deviant from [gender, sex, culture, age, developmental, societal, cohort] in terms of its [frequency, intensity or duration] that causes distress to self or others and/or impairment in some important area of functioning [social, occupation, education] Behavior: Age: chronological vs. developmental Cohort: cultural generation gap ▯ Considering Abnormality Categorical: you meet all criteria in order to be diagnosed with psychopathology Dimensional: we all have levels of intensity for certain pathologies o ▯ Abnormal: Different Deviant: statistically deviant from the norm on low end Dangerous: with intent of harming self or other, involuntary hospitalization Dysfunctional: inability to function within society ▯ Primary: is the disorder in itself ▯ Secondary: comes as result of some other thing ▯ *Categorical perspective from DSM ▯ ▯ Transactional: each and every aspect of model impacts all other aspects of the model Cognition: I have a snake phobia Emotion: my thought might lead to emotional reaction of fear or anxiety Behavior: which could both lead to my behavior of avoidance ▯ 5 models: ▯ Diathesis-stress model: begins with assumption that psychological disorders may have a biological basis Predisposition outcome toward specific pathology Must have stress in mode for pathology to present itself More similar to multifinality ▯ Equifinality: all pathways lead to same outcome ▯ Multifinality: same starting point can lead to multiple end points Risk factors: increase likelihood of psychopathology Resilience factors: in face of risk they protect a person from psychopathology ▯ Linear model ▯ X---------- Y ▯ Third variable models Moderating model o Third variable changes relationship between other variables Mediating model o Responsible for relationship between other two variables ▯ Ex: Moderating ▯ X- female child Y- quality of father daughter relationship ▯ Third Variable: Fathers accessibility Family Daughters age ▯ Ex: Mediating ▯ X- age Y- quality of driving skills ▯ Third Variable: experience ▯ ▯ Translational research: scientific approach that focuses on communication between basic science and applied clinical research “the bench”- study disease at molecular or cellular level “bedside” clinical level ▯ *goal of most research is to publish and use data for new hypotheses and understanding ▯ *individual and group level, where most scientific injury happens in abnormal psych ▯ Ethics: Research must be conducted following “Belmont Report” ethics o Respect for persons o Beneficence, must secure persons well-being, protect from harm o Justice, fairness in distribution o Institutional Review Board (IRB) must approve all research conducted on humans ▯ Cellular Research: Human nervous system o Central nervous system Brain/spinal cord Neuron Soma-cell body, soma contains nucleus Dendrites- extend from soma like fingers Axon-fiber transferring information Axon terminal-form synapses, points of communication Brain stem-oldest part of brain, controls biological function associated with living (breathing) Hindbrain o base of stem, consists of medulla, pons and cerebellum. These regulate breathing, heartbeat, motor controls Cerebellum lesion- leads to disorders of fine movement, balance and motor learning Midbrain o Coordinating center that brings sensory information together with movement o Reticular activating system, regulates sleep and arousal Thalamus o Brains relay station, directs nerve signals to cortex Hypothalamus o Homeostasis, regulate blood pressure, body temp, body weight Forebrain o Limbic system: deals with emotions and impulses (aggression, sex, appetite) Amygdala Cingulate gyrus Hippocampus Memory formation (Alzheimer’s) o Basal ganglia: base of forebrain, inhibits movement Parkinson’s (rigidity tremor) Bradykinesia (slow movement) Huntington’s disease o Cerebral cortex Largest part of forebrain, divided into two hemispheres- 4 lobes Left: language, cognitive functions, process linear and logical manner Right: spatial context, creativity, imagery, intuition Temporal: auditory/visual Parietal: sensory information, visuospatial Occipital: back of skull, center of visual processing Frontal: impulse control, judgment, language, memory, motor function, problem solving, sexual/social behavior Corpus callosum: connects two hemispheres Reasoning, abstract thought, perception of time, creativity o Peripheral nervous system Sensory-somatic NS: cranial nerves, control sensation and muscle movement Autonomic NS: Sympathetic NS: involuntary movement, activate body for readiness (stimulates heartbeat, blood pressure, dilates pupils, arousal) Parasympathetic NS: returns body functions to resting levels Endocrine system: Uses hormones to regulate body functions Pituitary gland, adrenal, thyroid hormones, pancreas o Genes: Human Genome Project Gregor Mendel Law of Segregation: individual receives one of two elements from each parent Law of independent assortment: states that alleles (variations) of one genes assort independently from the alleles of other genes Behavioral Genetics: study of relationship between genetics and environment in determining individual differences in behavior Family, twin and adoption studies Molecular genetics: Genome wide linkage analyses o Researchers narrow search for genes from entire genome to specific areas on specific chromosomes Candidate gene association o Compare specific genes in a large group of individuals who have specific trait or disorder with well-matched group who do not have trait or disorder o One or few genes studied at a time o Cases: people with disorder o Control: people without Genomewie association studies o Uses large sample of cases and well- matched controls, unlike candidate studies thousands are tested for same study Epigenetics: focuses on heritable changes in expression of genes not caused by changes in actual DNA but by environment ▯ Individual Level: Case study o Detailed narrative of abnormal behavior and its treatment o Sometimes quantitative measurements o Does not allow conclusions on cause of behavior o Nothing is manipulated by observer o Pros: Generate hypotheses for group studies Allow participants involved in research Illustrate important clinical issues that are not apparent in group based report o Cons: Not causes of behavior because no control groups o Single-case designs: One individual Test for causality ABAB Unethical at times to remover treatment Look at multiple behaviors or context ▯ Group Level: Correlational methods o Correlation is not causation Controlled group designs o Analogue sample: people who have characteristics of interest and resemble treatment seeking populations not clinical services o Clinical sample: people seeking services for specific problem Statistical significance: mathematical probability that after treatment, changes that occurred in the treatment group didn’t occur by chance (quantitative) o .05-.01 Clinical significance: whether significant finding have practical or clinical value (qualitative) Cross-sectional design: o Snapshot in time o Assessed once for specific variable under investigation o Cause and effect rarely determined Longitudinal design: o Takes place over time o Includes at least two or more measurement periods with same individual ▯ Population Level: Epidemiology (broadest level) o Disease patterns in human populations and factors that influence o Occurrence of psychological disorder by time, place, persons o Prevalence: total number of cases of a disorder in given population at designated time Point prevalence: number of individuals at specified point in time Lifetime prevalence: number of individuals in population known to have particular disorder some point in life Incidence- number of new case o Observational epidemiology o Experimental epidemiology: manipulates exposure to either causal or preventative factors ▯ Nature vs. Nurture Nature-BIO Nurture- Social Monozygotic-identical Dizygotic- fraternal ▯ Polygenetic foundation: Most pathologies More than one gene ▯ Anxiety disorder: Physical stimulation- SNS/PNS Future oriented thoughts o Scared/fearful-present oriented Behavioral escape/avoidance ▯ **Features that create pathology may not be same factors that maintain pathology Clinical assessment: series of steps designed to gather data about a person and his environment in order to make decisions about the nature, status and treatment of psychological problems Always begins with set of referral questions in response (from patient or someone close) After completed psychologist develops answers to the preliminary questions and tells family and patient of his findings Screenings: can help identify people who may be unaware of their problems or reluctant to mention them, and for those who need further evaluation o Identify potential psychological problems or predict the risk of future problems if someone is not referred for further assessment or treatment o Sensitivity: describes the ability of the screener to identify a problem that actually exists o Specificity: indicates percent of time that the screener actually accurately identifies the absence of the problem o False positives: occur when screening instrument indicates a problem where no problem exists o False negatives: instances where the screening tool suggests that there is no depression when the patient is actually depressed Diagnosis: refers to identification of an illness o Differential diagnosis: when they attempt to determine which diagnosis clearly describes patients symptoms o Diagnostic assessments are more extensive then screens provide more thorough understanding o Etiology o Select most beneficial treatment for patient Can be repeated at regular intervals during treatment to monitor progress ▯ Functional analysis of symptoms: Behavioral psych Identifies relations between situations and behaviors (what happens before during and after certain problem behaviors, moods, or thoughts) ▯ Outcome evaluation: Same measures must be consistently measured over course of treatment To evaluate whether effective both degree of change and patients level of functioning must be assessed o Degree: how much patients symptoms have been reduced Reliable change index: frequently used ▯ Assessment Standardization: o Normative: require comparing a persons score with the scores of a sample of people who are representative of entire population Standard deviation: measure tells us how far away from the mean(average) a particular score is. o Self-referent comparison: equate responses on various instruments with patient’s own prior performance, used to examine course of symptoms over time, treatment outcome. Reliability: instruments consistency or how well produces same result each time o Test-retest: consistency of scores across time o Interpreter agreement: measures that depend on clinician judgment o Validity: degree to which a test measures what it is intended to measure Internal Validity: measure how strongly we can believe our findings from our study are accurate Reduced as confounds are introduced External Validity: how far and to which populations we can apply the findings of our study Generalization Construct validity: reflects how well a measure accurately assesses particular concept Criterion validity: assesses how well measure correlates with other measures that assess same or similar constructs Concurrent: assesses the relationship between two measures that are given at same time Predictive validity: ability of a measure to predict performance for future date Clinical prediction: relies on clinicians judgment Statistical prediction: results when clinician uses data from large groups of people to make a judgment about specific individual Used in practice of evidence-based medicine ▯ *many factors affect clinician’s choice of assessment, but most important factors are patient’s age and developmental status ▯ *cultural-fair assessments ▯ *psychologist must adhere to American Psychological Association code of ethics psychologist must only use test for which they have received training informed consent ▯ Assessment Instruments Goals of assessment o Self-report measures: patients evaluate own symptoms o Clinician-rated measures: clinician rates symptoms o Subjective responses: what patients perceive o Objective responses: what can be observed o Structured: same set of questions per patient o Unstructured: questions vary across patients o Test battery: when number of tests are given together Clinical interviews: o Consist of conversation between and interviewer and patient, purpose to gather information and make judgments related to assessment goals o Unstructured interviews: clinician decides what questions to ask and how Benefit of flexibility Limitation is potential unreliability Increase rapport o Structured interview: same questions per patient Semi-structured interview: after standard question clinician uses less structured supplemental questions to gather more info Used in Scientifically based clinical practice and research Increase reliability Less flexibility ▯ Psychological tests: Personality: measures personality characteristics o Depends on whether one is assessing a healthy population or clinical sample o Minnesota Multiphasic Personality Inventory: 1943, Hathaway/McKinley pencil-and-paper test empirical keying: developed statistical analyses to identify items and patterns of scores that differentiated various groups (only differentiated items were retained) o MMPI: Includes statistical scales to evaluate number of test taking behaviors Lie scale: identifies people who many not wish to describe themselves accurately MMPI-2: has 567 items and 9 validity scales and ten clinical subscales Concerns with ethnic minority samples objective o Million Clinical Multiaxial Inventory: 175 item true-false inventory 8 personality styles schizoid, avoidant, dependent, histrionic, narcissistic, antisocial, compulsive, passive- aggressive 3 pathological personality syndromes schizotypal, borderline, paranoid 9 symptom disorders scales anxiety, somatoform, hypomanic, dysthymia, alcohol abuse, drug abuse, psychotic thinking, psychotic depression, psychotic delusions adequate reliability and validity Projective tests: o Low reliability- general interpretations o Low validity o Good for developing repor (open up) Rorschach inkblot test: Comprehensive system: breaks inkblot tests into complex matrix of variables that are interpreted and scored Subjective Exner scoring system general Thematic apperception test: 31 cards only 20 are used based on patients age and sex asked to make up story about images on cards subjective test specific, no scoring system CAT- for children, uses animals in situations Sentence Competence Theory Must complete sentence stem Draw a Person Projective measure o General tests of psychological functioning Global Assessment Functioning Scale (GAF): Rating assigned by clinician stating patients overall well being (0-100) Captures symptom severity and level of impairment General Health Questionnaire: Gives snapshot of mental health status over previous weeks and can provide meaningful change score 4 point scale, degree of deviation from individuals usual experience o Neuropsychological testing: Tests detect impairment in cognitive functioning using simple and complex tasks to measure language, memory, attention, concentration, motor skills, perception, abstraction, and learning abilities Halstead-Reitan Neuropsychological Battery: Evaluate presence of brain damage Wisconsin Card Sorting Test: Set shifting: ability to think flexibility as the goal of the task changes Frontal lobe test Useful for schizophrenia, brain injuries, neurodegenerative diseases (Parkinson’s) Bender visual Motor Gestalt: Detect problems in visual-motor development in children and general brain damage and neurological impairment Luria-Nebraska Neuropsychological Battery: Similar to Halstead-Reitan but more precise measure of organic brain damage Uses unstructured qualitative method, generating 14 scores o Intelligence Test: Wechsler Adult Intelligence test Most commonly used Four index scores Verbal comprehension index (VCI) Working memory index (WMI) Perceptual reasoning index (PRI) Processing speed index (PSI) Combination of scores = IQ Do not and cannot reflect all types of intelligence o Test for specific symptoms Brief Psychiatric Rating Scale Clinician-administered scale assesses many different psychological symptoms Beck Depression Inventory-II Depressive symptoms 21 questionnaire Beck Anxiety Inventory Anxiety symptoms 21 questionnaire ▯ Behavioral Assessment: Functional analyses: o Ultimate goal of behavioral assessment o Clinician attempts to identify casual links between problem behaviors and contextual variables Begins with interview Self-monitoring: patient observes and records behavior as its happening Behavioral observation: someone other than patient observes behavior Event recording: monitoring each episode of identified behavior Behavioral avoidance test: asses phobias by asking patient to approach feared situation ▯ Psychophysiological Assessment: Measures brain structure, function and nervous system activity EEG: o least invasive o only measure that directly assesses electrical activity in brain o cannot determine functioning in specific brain region biofeedback: use of electronic devices to help people learn to control body functions outside of conscious awareness. ▯ Diagnosis DSM system of classification is most common in U.S. International Classification of Diseases (ICD) used in Europe and other places Developmental, demographic, and cultural variables affect nature and experience of abnormal behavior ▯ ▯ Comorbidity True presence of more than one pathology (disorder) in a person at the same time Very high rate ▯ Collateral contacts: getting patient to allow doctor to talk to another person to gather more information on patient ▯ Mental status exam: Gross motor/ Fine motor Mentally stable (confident, calm) Memory Speech o Rhythm, rate, fluency Language o Receptive (understanding) o Expressive (Content, grammar) Mood o Affect: how you feel in moment (temperature) Attention/ concentration Auditory/visual hallucinations Insight/judgment Cognitive ability Hygiene Orientation (person,place,time) ▯ FAB: Functional Analyses of Behavior Antecedent (what comes before/triggers behavior) Behavior Consequence ▯ FID: frequency, intensity, duration ▯ SRI: self-report inventory IQ test: measure cognitive ability Present intelligence AA: Academic Achievement test: neuro-psych assessment Past oriented construct Relationship between brain and behavior o Attention o Concentration o Memory o Visual special abilities o Fine motor skills ▯ Error of omission: failure to do it Error of commission: failed to do it correctly ▯ Control groups: Placebo Waitlist Treatment as usual ▯ Quiz one: ▯ Book suggests abnormal behavior include emotional distress and functional impairment ▯ Antecedent behavior consequence: functional analysis of behavior ▯ Prevalence/incidence ▯ Clinical significance-Meaningful improvements for functional impairment ▯ Diathesis- Presence of predisposition to a disease ▯ ▯ Emotions: Physiological response Cognitive symptoms or subjective distress o Ex: specific thoughts, ideas, images or impulses, worry Avoidance or escape o Ex: overdoing (over sanitizing), avoiding stimulant o Offer temporary relief o Negative reinforcement ▯ Anxiety: common emotion characterized by physical symptoms (faster heartbeat, tension) and thoughts or worries that something bad will happen Future oriented response (new situation, anticipate life-changing event) Body and mind affected by experience Anxiety disorders more common among females ( 3 to 1) ( cultural/gender) Develop early in life, avg. age of 11 Equal frequency across (Hispanics, non-Hispanic blacks, non- Hispanic whites) Amygdala and insula Serotonin: regulates mood, thoughts, behavior, o Selective serotonin reuptake inhibitors: increase serotonin in neural synapses Prefrontal cortex and caudate nucleus convert sensations into thoughts and actions o Panic Panic attack: abrupt surge of intense fear or discomfort reaching a peak in minutes along with four or more physical symptoms Expected: response to situational cue or trigger, or anticipation to feared situation Out of the Blue: unexpected, false alarm Panic disorder: had at least one panic attack and worries for more Ataque de Nervios; cultural variant of panic disorder , Latino Agoraphobia: fear of marketplace, exposure to situations including Public transportation Open spaces Enclosed spaces Standing in line/being in crowd Outside the home alone Many develop after they develop panic disorder Sever persistent o Generalized Anxiety Excessive anxiety and worry for at least six months Low levels of SNS arousal more common in adults, starts late teens/twenties more common in minorities o Social Anxiety (social phobia) Fear of situations that may involve scrutiny from others Speaking, eating, drinking, writing in presence of others Performance only specified Detected as early as age 8, avg. 11/13 Chronic Both sexes affected equally Taijin kyofusho- Asian variant, young men o Selective Mutism Most common in children Failure to speak in specific social situations o Specific fear Anxiety about specific object or situation leading to disruption in daily activities Fear of some aspect of situation itself Phobia should be applied when Significant emotional distress (even if able to engage) Functional impairment Develop common during childhood (7) Blood injection Injury Rather than SNS being activated Parasympathetic NS dominates response Fear of needles, blood, physical injury Vasovagal syncope: bradycardia (slow heart rate) hypotension (low blood pressure) o Separation Anxiety Primarily preadolescent children ▯ Obsessive Compulsive (OCD) Obsessions (recurrent, persistent, intrusive thoughts) Compulsions (repetitive behavior) o Negative reinforcement Extensive, time consuming, stressful Chronic More common in boys (children), men and women are equal (adults) ▯ Body Dysmorphic Disorder Sometimes can cause delusions, lead to sucicide Adolescents ▯ Hoarding Difficulty discarding or parting with obsessions, regardless of value ▯ Trichotillomania Hair pulling out ▯ Excoriation Skin picking Diagnosed when cannot stop ▯ PTSD Begins with traumatic event Intrusion: re-experiencing through memories Negative alterations in cognitions and mood: inability to feel emotions Can happen anytime after an event with actual or threatened death Causes distress, behavioral avoidance Can re-experience through nightmares, flashback (wakefulness) Children re-experience through play Hypervigilence (constantly on guard) ▯ *In children fears exist along developmental hierarchy. ▯ Nervous System Central Nervous System: brain, spinal cord Peripheral Nervous System: all other nerves o Sympathetic: activated by stress or fear Fight or Flight General discharge of Sympathetic Nervous System You recognize threatening situation, Hypothalamus sends message to Adrenal Glands to release Adrenaline. o Parasympathetic : returns body to resting state ▯ Temperament/ Behavioral Inhibitions Jerome Kagan o Behavioral inhibition- later leads to disorder, 20% children ▯ Psychodynamic theories Freud: free-floating (generalized anxiety) resulted from conflict with id and the ego , result from sexual or aggressive impulses Conditioning theory o fear acquisition All approaches assume that anxiety disorders result from inaccurate interpretations of internal or external events (people process info differently) o Fear of fear model After the first panic attack person becomes sensitive and interprets any bodily change as an attack o Anxiety sensitivity: belief that anxiety symptoms will result in negative consequences Vicarious learning: observing Information transmission: person instructs that a situation or object should be feared ▯ Psychosurgery: Cingulotomy: OCD, inserting propes in top of skull called cingulated bundle Capsulotomy: gamma knife surgery (radiation treatment), lesions in brain tissue ▯ Psychological treatments Free association/dream interpretation ▯ Behavioral and Cognitive Behavioral treatment Psychosocial treatments of choice for anxiety disorders Combines exposure with cognitive restructuring in attempt to change negatives Does not enhance efficacy Exposure: facing the fear o In vivo exposure: real life experiences o Imaginal: instructing person to imagine feared event o Social skills training: group setting paired with exposure o Relaxation training: GAD, decrease physical arousal o Biofeedback: combines monitoring physical behaviors (blood pressure, rate) with relaxation training ▯ Treatment: Biological perspective o Selective serotonin reuptake inhibitors Decreasing anxiety Primary go to medication Prozac, Zoloft o Benzos Acute onsets of anxiety Psychological perspective o Interpersonal therapy Helps manage role transition, social conflicts, or anything interpersonally based that causes anxiety for individual Not social intervention, it’s a cognitive intervention o Behavioral/cognitive intervention Most successful interventions for anxiety disorder Exposure plus response prevention (response is behavioral avoidance, activation SNS, compulsion) Imagination, virtual reality, flooding Guided imagery all senses Social perspective ▯ ▯ Abnormal Behavior Definition ▯ Biopsychosocial model Systemic Transactional Integrative Able to compare model to others ▯ Behavioral: Classical conditioning: UCS, CR, CS o UCS(unconditioned stimulus) produces o UCR (unconditioned response) o CS (conditioned stimulus), neutral, does not produce UCR o UCS is repeatedly paired with CS resulting in UCR o After multiple pairings CS alones is capable of eliciting CR (conditioned response) operant conditioning: what comes after behavior o primary reinforcer: food, water, attention o secondary reinforcer: acquired value b/c they are associated with primary (money) ▯ Cognitive: Proposes abnormal behavior is result of distorted mental processes, not internal forces or external events, way we think and perceive affects emotions and behaviors o generalizing o maladaptive cognition (uni-directional) ▯ Psychoanalytic Freudian Focuses on understanding past experiences ▯ Biological Psychiatrist ▯ Humanistic Based on phenomenology: ones subjective perception of the world is more important than actual world, people are good and self- actualize o Carl Rogers, therapist factors Genuineness: therapist relates to person in open honest way Unconditional positive regard Empathy Client-centered therapy o Gestalt ▯ Multifinality/ equifinality ▯ Diathesis stress model- psychological disorders may have biological basis similar/different to multi and equifinality ▯ Resilience protect from psychopathology in face of risk ▯ Risk factors increase likelihood of pathology ▯ ▯ Mediating: responsible for apparent relationship ▯ Moderating: changes relationship ▯ Diagnosis Categorical perspectives Dimensional perspective Process of assessment o Referral question o Ends with diagnosis o Always looking for cause (etiology) of disorder o Factors that determine treatment o Assessment methods ▯ Biopsychosocial Referral to general practitioner Neuro imaging Mental status exam**** Clinical interview (3 levels) o Reliability Intereliability: similarity between two practitioner Test retest: how overtime Validity: (p.81) Accurate Self report, IQ test, test of academic achievement Self monitoring Neuro psych measures- relationship of brain and behavior Personality measures o Objective : MMPI, NEO (no interpretation) o OCEAN factors Subjective: Rosharch, thematic test, sentence completion, CAT, Functional Analysis of Behavior (method) ▯ Behavioral observation Naturalistic Experimental ▯ Comorbidity What is one reason may occur? o There is a large gap between the time mental disorder begins and time they seek treatment o DSM has increased in size ▯ False positive: instrument indicates disorder when there is none ▯ False negatives: instances in which screening tool suggests there is no disorder when there is ▯ Prevalence/incidence ▯ Research methods: Case study o One person o High on neither internal or external validity Twin study o Dizygotic/monozygotic o Trying to identify what is genetic and what is environment Multi-case design o Baseline, assess behavior o Apply intervention o Remove intervention o Reapply Correlation does not equal causation ▯ Random assignment: Analogue sample: people who have characteristics of interest and resemble treatment seeking populations but not seeking clinical service Clinical sample: people seeking services for specific problem ▯ Independent variable: experimenter controls ▯ Dependent variable: one you measure ▯ Confound: threat to internal validity Internal validity: extent to which study design allows conclusions that the intervention caused changes in the outcome External validity: generalize findings to situations and people outside experimental setting Efficacy research attempts to maximize internal validity ▯ Blind and double blind: Blind: patient Double blind: patient and researcher, to remove bias ▯ Statistical significance: mathematical probability that after treatment, changes that occurred in treatment were due to treatment ▯ Clinical significance: whether significant findings have practical or clinical value (whether patients functioning is improved as result of treatment and whether there are still any symptoms of disorder) ▯ Levels of intervention Longitudinal: takes place over time, same individuals at different times Cross-sectional: snap shot in time, assessed once for specific variable ▯ Anxiety: All arousals of symptoms Three pillars ▯ ▯ ▯ No ancient theories ▯ No dates ▯ No names ▯ ▯ Guide four questions: Risk Benefits Confidential Opinion (will they judge me?) ▯ Obsession: Repetitive, unwanted, intrusive, and often egodistonic Thought, unobservable Causes anxiety ▯ Dissociative Disorders Disruption in the usually integrated functions of consciousness, memory, identity, emotion, perception, body representation, motor control and behavior Steinberg o Depersonalization: detachment from ones body o De-realization: feeling of unfamiliarity or unreality about ones physical or interpersonal environment o Amnesia: inability to remember personal information o Identity confusion: unclear about ones personal identity o Identity alteration: assuming an alternate identity Dissociative amnesia: inability to recall important information of personal nature o When occurring after stressful/traumatic event it is psychological not biological Localized amnesia: failure to recall events that occur during certain time Generalized amnesia: total inability to recall ones life Selective amnesia: forgot some elements of traumatic experience o Reversible o Can be accompanied by dissociate fugue: purposeful travel or bewildered wandering associated with identity amnesia Fugue means flight Dissociative Identity Disorder o Do not recognize alters before therapy o Psychological factors: Failure of normal development process of personality integration o Sociocultural model states DID is iatrogenic disorder developing from cues from media and therapists and personal experiences/observations Depersonalization/derealization disorder o Periods of dissociation are frequent and severe ▯ Somatic (of the body) symptom and related disorders: Somatic symptom disorder o Person must have physical symptoms that are medical conditions o No medical conformation o Symptoms will distress and disrupt life o Excessive thoughts feelings or actions related to physical symptoms o Symptoms for min 6 months, but not same single symptom present needed Illness anxiety disorder o Having or acquiring a serious illness o Does not need to have any physical symptoms, or if so mild o Hypervigilance about health and well being o Lots of health checking behaviors o Fear of illness, doctors, hospital Conversion disorder o Functional neurological symptom disorder o All symptoms are neurologically based ( motor or sensory domains) o Pseudo- fake/false o Symptoms do not match medical results ▯ ***first three, person does not intentionally produce the symptoms Factitious disorder o Deliberately create physical symptoms in themselves or others to assume sick role and receive reinforcement o Imposed on self- intentionally producing symptoms in self o Imposed on another-intentionally producing symptoms on others Punishable by law Mother on daughter most common Malingering: o Symptoms intentionally produced o People who malinger do so for purpose of compensation or to avoid negative event ▯ ▯ How is illness anxiety disorder different from specific phobia? Somatic has more intense physical symptoms SSD more use of medical personnel IID less concerned with symptoms then what symptoms mean ▯ Health Psychology: uses principles and methods of psychology to understand how attitudes and behaviors influence health and illness ▯ Health psychologist: study how people develop positive and negative health habits, how stress and health are related, and which psychological variables affect the onset and treatment of medical illness ▯ Health: state of mental, social and physical well-being, not just in the absence of illness ▯ Behavioral medicine: interdisciplinary field (not just psych) that studies the relation between behavioral and biomedical science and medical psychology. Medical psychology: study and practice of psychology as it relates to health, illness and medical treatment. ▯ Biopsychosocial model: suggests that complex interactions among biological, psychological, and social factors determine health. In contrast to biomedical model, which explains illness soley as biological process ▯ Mind-body dualism: René Descartes, mind and body may interact but function independently ▯ ▯ Freud: linked mind and body to explain hysteria (conversion disorder) Hysteria: condition he believed that unconscious psychological conflicts caused unexplained physical complaints (physical weakness, paralysis) Psychological and social variables influence the treatment of medical disease, especially chronic medical illness (diabetes and hypertension which develop slowly and persist for a lifetime) o Doctor-patient relationship o Expectations for treatment outcomes o Psychological coping and adjustment ▯ Stress: any negative emotional experience that is accompanied by biochemical, physiological, cognitive and behavioral responses that attempt to change or adjust to the stressor. Stressor: any event that produces tension or another negative emotion such as fear, that prepares organism for “fight or flight” o Physical (medical disease, injury) o Environmental (natural disaster) o Interpersonal-social (breakup, conflict between family) o Psychological (realization that exam is tmw instead of day after) Characteristics of an event affect the probability that is will produce stress Perceived stress is more likely if an event has a negative outcome, but positive outcomes can also produce stress More likely when event is perceived as uncontrollable, unpredictable or ambiguous, or when there’s an impact on major are of life ▯ Appraisal process: After stressful event, interactive Occurs when person assess whether he or she has the resources or coping skills to deal with the event. Primary appraisal: person assess harm or threat Secondary appraisal: person identifies available skills to cope with or overcome possible negative outcomes Coping strategies o Problem-focused: taking action to manage problem that is creating stress (gathering information, comparing courses of action, making decisions, resolving conflicts) More effective for managing stress o Emotion-focused: person focuses on managing emotional distress that results form a stressor rather than trying to change the situation that creates the stress Positive: changing thoughts to decrease distress Others include drinking, avoidance ▯ Types of stress Acute: occurs when potentially threatening event and the associated reaction last for only a brief time (burglary) Chronic: develops when threatening event continues over time (excessive work demands, long-term poverty) and or when person consistently feels inadequate to deal with ongoing negative outcomes Major life events that affect the way a person lives Under any of these conditions the perceived or actual inability to cope resuls in stress reactions with symptoms of “flight or fight” response ▯ Responses: Adaptive: help person react quickly and positive to potentially harmful events Detrimental: responses disrupt functions ( stress about class project lead to sleep and missed class) o Also can cause poorer health Sympathetic-adrenomedullary system (SAM) o “revved” up feeling, increased adrenal gland stimulation results in secretion of epinephrine and norepinephrine. o Continuous and long-term SAM can suppress immune functioning and produce changes in blood pressure, heart rate Hypothalamic-pituitary-adrenocortical (HPA) o During stress hypothalamus increases corticotrophin- releasing factor (CRF) which causes increased secretion of adrenocorticotropic hormone (ACTH) and increased cortisol Increased cortisol helps body store carbs, reduce inflammation, and return body to steady state after stress Repeated HPA can change daily cortisol patterns, compromising immune functioning and impairing memory and concentration ▯ Stress and immune system: Specific immune system: responses protect us against infections and diseases, can result from natural or artificial processes. o Natural: immunities are acquired through milk, or result of having particular disease (chicken pox only once) o Artificial: acquired through vaccination or inoculations Nonspecific immune system: responses offer general protection against infections and diseases in four ways o Anatomical barriers: skin, and mucous membranes, prevent microbes from entering body o Phagocytosis: production of more white blood cells that destroy invaders. T-lymphocytes (T-cells) secrete chemicals that attack and kill invading microbes. Some killer (Tc) some helper (TH) and natural killer (NK) B-lymphocytes (B-cells) secrete antibodies or toxins into the blood to kills invading bacteria and viruses o Inflammation: at site of infection allows more white blood cells to move in and attack pathogens Psychoneuroimmunology: study of relations among social, psychological and physical responses. Stress suppresses ability of immune system to function adequately and increases susceptibility to bacteria and viruses Overall wounds heal slower, chronic disease progress more rapidly, vaccines are less effective Stress increases epinephrine and cortisol le
Are you sure you want to buy this material for
You're already Subscribed!
Looks like you've already subscribed to StudySoup, you won't need to purchase another subscription to get this material. To access this material simply click 'View Full Document'