Popular in Abnormal Psychology
Popular in Psychlogy
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PSY 240 Abnormal Psychology First Test Studv Guide Introduction and historv 1 Know the definition of psychopathology abnormal psychology and all its parts Psychopathology the scientific study of psychological disorders Behavioral cognitive emotional dysfunctions Unexpected in cultural context Personal distress Substantial impairment in function What are the 3 major historical traditions in psychopathology How do they differ The Supernatural Tradition Etiology devil witchcraft sorcery The Biological Tradition Etiology physical disease and psychosocial factors The Psychological Tradition Etiology Social cultural factors and learning What do hysteria mass hysteria mob psychology and emotion contagion mean Hysteria exaggerated or uncontrollable emotion or excitement especially among a group of people Mass hysteria collective delusions of threats to society that spread rapidly through rumors and fear Mob psychology how the psychology of a crowd differs from and interacts with that of the individuals within it Emotional contagion the tendency to feel and express emotions similar to and in uenced by those of others What important events bolstered the biological tradition of psychopathology Hippocrates syphilis and the early consequences of believing that psychological disorders are biologically caused Know the major function of the four neurotransmitters discussed in class Glutamate amp Gamma aminobutyric acid GABA Glutamate excitatory transmitter turns on many different neurons leading to action GABA inhibitory transmitter inhibits regulate the transmission if information and action potentials Serotonin 5HT Regulates our behavior moods and thought processes low levels associated with aggression suicide impulsive overeating and excessive sexual behavior Norepinephrine Stimulation of alpha and beta adrenergic receptors Fight or ight response Dopamine Associated with exploratory outgoing pleasure seeking behaviors Implicated in schizophrenia too much Parkinson s disease too little Balances serotonin 6 What was moral therapy Humane treatment with friendly socializing positive reinforcement individual therapy amp productive work 7 Know what the following people are famous for Albert Bandura Dorothea DiX Sigmund Freud Ivan Pavlov Philip Pinel and BF Skinner Albert Bandura Social learning AKA Modeling Bobo doll eXperiment Dorothea DiX Mental Hygiene Movement moral therapy Sigmund Freud Psychoanalysis Id Ego Superego Ivan Pavlov Classical Conditioning dog experiment Phillip Pine in charge of insane asylum introduced humane treatment BF Skinner Operant conditioning positive negative reinforcement rat maze 8 Be able to compare and contrast the behavioral cognitive humanistic psychoanalytic approaches within the psychological tradition Behavioral learning has occurred when you can see changes in behavior The behavioral learning model learning is the result of conditioning Cognitive learning is an internal process in which information is integrated or internalized into one s cognitive or intellectual structure Learning occurs through internal processing of information Humanistic learning as a function of the whole person and believe that learning cannot take place unless both the cognitive and affective domains are involved The individual s capacity for self determination is an important part of humanist theory Psychoanalytic conscious vs unconscious defense mechanisms 9 Know the differences among the different types of mental health professionals Clinical and counseling psychologists PhD PsyD conduct research into the causes and treatment of psychological disorders and diagnose asses and treat these disorders Psychiatrists MD can prescribe medication Psychiatric social workers MSW also treat disorders often concentrating on family problems Psychiatric nurses MN MSN PhD specialize in the care and treatment of patients with psychological disorders usually in hospitals Marriage and family therapists MA MS MFT provide clinical services by hospitals or clinics Mental health counselors MA MS 10 Understand the concept of scientist practitioner Health professionals that take a scientific approach to their clinical work 11 What part of the world continued the psychological tradition during medieval times The Islamic countries of the Middle East The first mental hospital was established in Baghdad in AD 792 12 According to object relations theorists what is an object A piece of psychic structure that formed from the person s eXperiences with the important caretakers in earlier life 13 What is unconditional positive regard Acceptance by the counselor of the client s feelings and actions without judgment or condemnation l4 Understand classical and operant conditioning Classical stimulus based Operant reinforcement based 15 What are the important contributions of the behavioral humanistic and psychoanalytic approaches Behavioral systematic and more scientific approach to psychological aspects of psychopathology Humanistic very little contributions theories of interpersonal relationships therapist client relationship but it had little interest in doing research and that would discover and or create new knowledge focused on non quantifiable eXperiences of the individual Psychoanalytic remains unproven but it outlined the working of the mind id ego and superego defense mechanisms psychosexual development The Integrative Model of PsvchopathOIOgV 1 What point did the instructor attempt to make by reading the poem quotThe Blind Men and the Elephantquot The poem illustrates how perception is based on what a person is able to see or touch The poem warns the reader that preconceived notions and perceptions can lead to misinterpretation 2 Know and understand the systems model ie equifinality holistic multifinality reciprocal causation Equifinality the end product can come from several causes delirium can be caused by fever infection injury Multifinality the same event can lead to different outcomes Butterfly effect Reciprocal Causality something can be both a cause and an effect Holistic opposite of reductionism looking at things from a small scale levels of analysis 3 Understand the diathesis stress model In the diathesis stress model the greater the underlying vulnerability the less stress is needed to trigger a disorder 1 Disorder ff 39 39 l I Streeeor i M Life events I long bouts oi ll etreeeor I drinlti rig in I college I Genetic vulnerability Diatheeie P l l 2 doesn t become alcoholic Person ill becomee alcoholic t Weldsworth Gengage Learning 4 Understand reciprocal gene environment Genes shape how we create our environments r 7 quote e11 3 Eloodainiuwainjection phobia T 7 7 u I Eioodiniuryinjection phobia seeing blood Tendency toward 1 impuleiveneee attracte situations that might involve blood Genetic tendencyI to develop bloodinjurviniection pl39robia Person A has genetic vulnerability to develop bloodinjuryinjection phobia v Wadsworth Cengage Learning 5 Understand the cross fostering studies Researchers took newly born rat pups of fearful and easily stressed mothers and placed them for rearing with calm mothers Other young rats remained with their easily stressed mothers The rats raised by the calm and supportive mothers grew up more calm and supportive despite their genetic influences 6 Understand the principle of prepared learning The biological tendency of animals to recognize and use certain cues more than others and to associate some combinations of unconditioned and conditioned stimuli more readily than others Know the function of the following major parts of the brain the amygdala hypothalamus the lobes of the corteX the cerebellum the limbic system and the brain stem Situations involving Situations involving 39 seeing lblood Person B doee not have genetic vulneral iiiilistiir to develop bloodinjuryinjection phobia Amygdala limbic system structure that is involved in many of our emotions and motivations particularly those that are related to survival almond shaped Hypothalamus involved with regulating behavior and emotion Lobes temporal lobe associated with recognizing various sights and sounds and with long term memory storage parietal lobe associated with recognizing various sensations of touch and monitoring body positioning occipital lobe associated with integrating and making sense of various visual inputs frontal lobe area responsible for higher cognitive functions such as thinking and reasoning and planning for the future Cerebellum controls motor coordination Limbic system includes the hippocampus cingulate gyrus septum and amygdala helps regulate our emotional experiences and expressions and our ability to learn and control our impulses Brain stem lower and more ancient part of the brain handles most of the essential automatic functions such as breathing sleeping and being coordinated 8 Understand the autonomic nervous system including the parasympathetic and the sympathetic Autonomic nervous system regulates the cardiovascular system and the endocrine system and to perform various other functions including aiding digestion and regulating body temp Sympathetic nervous system primarily responsible for mobilizing the body during times of stress or danger by rapidly activating the organs and glands under its control Parasympathetic nervous system takes over after the sympathetic nervous system has been active for a while normalizing our arousal and facilitating the storage of energy by helping the digestive process 9 What is the HPA axis What does it do The hypothalamicpituitaryadrenal axis HPA is a complex set of direct influences and feedback interactions among three endocrine glands the hypothalamus the pituitary gland and the adrenal glands The interactions among these organs constitute the HPA axis a major part of the neuroendocrine system that controls reactions to stress and regulates many body processes including digestion the immune system mood and emotions sexuality and energy storage and expenditure 10 Know the parts of neurons and the basics of transmission from one neuron to the next The Neuron Soma Dendrites receive messages in the form of chemical impulses from other nerve cells Axon transmits electrical impulses to other neurons Axon terminals Communication Chemicalelectrical signals through neurotransmitters 11 Synaptic cleft The space between the axon of one neuron and the dendrite of another 12 What was learned from the Baxter et al 1992 studies in which cognitive behavior therapy was given to people with OCD Baxter and his colleagues learned that psychological treatment was powerful enough to alter circuit activity in the brain without the use of drugs or surgery 13 What was learned from the Insel et al 1986 study of rhesus monkeys reared with either a sense of control or without a sense of control and then injected with a drug known to usually produce anxiety Monkeys that were raised with a sense of control over their lives displayed signs of anger and aggressiveness when administered a benzodiazepine inverse agonist while monkeys that were raised without a sense of control over their lives displayed signs of severe anxiety and panic within the same situation This demonstrated a significant interaction between neurotransmitters and psychosocial factors 14 Is the impact of the environment on the brain the same at different stages of life Yes the structure of our nervous system is constantly changing as a result of learning and experience even in old age This plasticity helps us adapt more readily to our environment 15 EXTRA CREDIT Draw and label the diagram of systemic causation in psychology Very brie y explain the diagram A systemic cause may be one of a number of multiple causes It may require some special conditions It may be indirect working through a network of more direct causes Diagnosis and Assessment 1 What are categorical dimensional and prototypical approaches to classification Which one is used by DSM S Categorical approach method found on the assumption of clearcut differences among disorders each with a different known cause Dimensional approach method of categorizing characteristics on a continuum rather than on a binary either or or all or none basis Prototypical approach system for categorizing disorders using both essential defining characteristics and a wide range of variation on other characteristics DSM 5 based on prototypical approach 2 How many axes did DSM IV TR have What are valid criticisms of DSM IV TR DSM IVT R had 5 axes Criticisms Fuzzy categories some individuals not quite fit any diagnosis Comorbidity if you qualify for one diagnosis you also qualify for another diagnosis Favored reliability over validity Some diagnoses may have had racial or gender bias Inertia amp politics How many axes are there in DSM 5 What organization produces it Removed Multi aXial System Produced by the World Health Organization Understand how culture affects psychopathology and how DSM 5 deals with it Cultural Formulation Ethnic and cultural identity Culture s conceptualization of distress Culture perspectives on stressors vulnerability amp resilience Cultural formulation of Clinician Patient relationship What description best characterizes DSM 5 DSM 5 is a framework of working hypotheses to guide diagnoses What are reliability standardization and validity with respect to assessment Reliability measurement consistency Some of the many types of reliability Testretest is measured consistently over time Internal consistency do different parts of the same instrument produce the same result Interrater do two or more raters produce the same results Validity does the assessment measure what it s designed to Some of the many types of validity Concurrent or descriptive do scores agree with another instrument measuring the same construct Predictive ability to predict the future Construct assesses what it is supposed to and not anything else gt ltvague Content assesses all important aspects gt ltspecific Face does instrument seem reasonable to the person being assessed Know what each of the basic forms of assessment are behavioral assessment and observation clinical interview neuro imaging physical exam psychological tests projective tests personality tests IQ tests and neuropsychological tests and psychophysiological measurement Clinical interview Structured interview pre planned interview for every patient Mental Status Exam I Appearance I Behavior normal or abnormal I Thought processes do they make sense I Mood and affect calm hostile I Intellectual functioning attention to grammar or sentence structure I Sensorium oriented times 3 seemingly stupid questions what day of the week is it Physical exam Diagnose or rule out physical etiologies I Toxicities I Medication side affects I Allergic reactions I Metabolic conditions Behavioral assessment and behavioral observations direct observation to assess formally an individual s thoughts feelings and behavior in specific situations or contexts Behavioral Observation I formal vs informal I self monitoring vs others observing I reactivity Psychological Tests Projective Tests I Presentations of ambiguous stimuli I Projection of personality and the unconscious I Psychoanalytic roots Examples I Rorschach Inkblot Test I Thematic Apperception Test Personality Inventories I Minnesota Multiphasic Personality Inventory Neuroimaging Images of Brain Structure I Computerized axial tomography CATCT I X rays of brain I Pictures in slices Magnetic resonance imaging MRI I Strong magnetic field I Improved resolution Utility locating tumors injuries structural or anatomical abnormalities Psychophysiological EEG brain wave activity alpha and delta waves Cardiorespiratory heart rate and respiration Electrodermal galvanic skin response Electromyography muscle tension Know and understand the parts of the mental status exam See number 7 What does comorbid mean Comorbidity is the presence of one or more additional disorders or diseases co occurring with a primary disease or disorder The Anxiety Disorders 1 Be able to compare and contrast anxiety and fear Anxiety a negative mood state characterized by bodily symptoms of physical tension and by apprehension about the future Fear an immediate alarm reaction to danger 2 What general strategy should parents follow to have mentally healthy children Model securely and successfully dealing with the world Functions as a secure home base 3 Given a brief description be able to say what type of anxiety disorder trauma related and obsessive compulsive related disorders the person has Or given a disorder be able to say what signs symptoms and qualifiers are important 4 In which disorder is worry centrally important Generalized anxiety disorder 5 Know and fully comprehend the causes of each of the anxiety disorders as they are currently understood Generalized psychological vulnerability sense that events are Lilli lCOl ltFOlllablle unpredictable Glass is half empty 0 Tendency toward Irritable lack 0t selfsconfidence Driven 6 Low selfesteem 439 inability to cope 0 Hypecl iondriae Nonclinieal panic IE Wadsworth Cengage Learning 10 7 Genataliizedbiologieai 7 v uine irability Generalizedpaychoibgieai vulnerability intense cognitive processing Avoidance of imagery Restricted autonomic response Inadequate problemsolving skills Generalized anxiety disorder Cengage Learning Understand the connection between agoraphobia and panic disorder Panic Disorder Panic attacks Abrupt very intense feardiscomfort peaking quickly often pounding heart breathing difficulties sweating experience of going crazy or having a heart attack anxiety of future panic attacks amp introceptive or behavioral avoidance of panic attacks Causes distress or impairment Agoraphobia Persistent fear of specific situations that is due to concern that might not escape or receive help if has a panic attack The situation always elicits fear and is avoided Causes distress or impairment What neurotransmitter system is associated with both anxiety and depression The neurotransmitters gamma aminobutyric acid serotonin and norepinephrine are all thought to be involved in the development of anxiety disorders Fundamentally What is the basic psychological experience of GAD Excessive anxiety and worry occurring more days then not for at least 6 months Difficulty controlling the worry Anxiety associated with restlessness fatigue lack of focus irritability muscle tension and lack of sleep Clinically significant distress or impairment Disturbance not due to drugs and is not explained by another disorder Understand the basics of the cognitive behavioral matrix 10 11 12 13 14 15 16 17 11 Understand how introceptive cues bring on a panic attack Interoceptive avoidance avoidance of situations or activities such as exercise that produce internal physical arousal similar to the beginnings of a panic attack What basic process is different in blood injury injection phobia from other specific phobias Victims experience fainting and a drop in blood pressure What difficulty specific to the Vietnam War did Vietnam War veterans have that contributed to PTSD 67 of the Vietnam War prisoners developed PTSD How is the alarm reaction in panic disorder different from that in PTSD The alarm reaction is much the same in both panic disorder amp PTSD but the alarm is false in panic disorder while in PTSD the initial alarm is true Understand thought action fusion Thoughtaction fusion is when clients with OCD equate thoughts with the specific actions or activity represented by the thoughts What medical and psychological strategies and techniques are generally useful for treating each of the anxiety trauma related and obsessive compulsive related disorders Medications SSRIs 60 benefit High relapse when discontinued Neurosurgery Cingulotomy 30 benefit Cognitive behavioral therapy Exposure with response prevention 86 benefit Reality testing What aspect of CBT treatment is common to all the anxiety disorders CBT focuses on particular problems and aims to overcome them Why did I ask you not to think about pink elephants When told not to think about something you more often than not will think about it Somatic Svmptom and Dissociative Disorders U 10 12 What is a common aspect of all the somatic symptom and related disorders Somatic body related symptoms causing significant distress or impairment Typically seen in medical settings Given a brief description be able to say what type of disorder the person has Or given a disorder be able to say what signs symptoms and qualifiers are important Know and fully comprehend the causes of each of the disorders as they are currently understood What treatment for somatic symptom disorder helps to reduce the cost of the disorder Gatekeeper Physician reduce visits to numerous specialists and reinforce appropriate use of medical services coordinated with all the other doctors involved with the patient Recognize and understand normal dissociative experiences What is depersonalization What is derealization Depersonalization the sense of being detached from one39s body and is often referred to as an quotout of bodyquot experience Derealization the feeling that the world is not real or looking foggy or far away Understand the words alter host iatrogenic and switch as they apply in DID Alters the different personalities or identities in DID Host main personality who identifies with the person39s real name Iatrogenic induced inadvertently by a physician or surgeon or by medical treatment or diagnostic procedures Switch the transition from one personality to another What is the relationship between DID and schizophrenia hint the answer is they are absolutely unrelated Compare and contrast malingering and factitious disorders Malingering is fabricating or exaggerating the symptoms of mental or physical disorders for a variety of quotsecondary gainquot motives Factitious disorders are conditions in which a person deliberately and consciously acts as if he or she has a physical or mental illness when he or she is not really sick Factitious disorder by proxy is when a person acts as if a person in their care has an illness when they do not At this point what can be said about the validity of DID as a diagnosis and the possibility of faking DID How might malingering be detected Studies that suggest DID is valid People have forgotten childhood abuse Williams 1994 Documented differences in eye movements GSR EEG brain imaging among alters 13 11 Know the results and implications of the studies by Bruck by Ceci and by Williams regarding memory In Buck s study 35 3 year old girls were given a genital exam and 35 were not Each girl was asked to describe where the doctor had touched her shortly after Approximately 60 of those who were touched in the genital region refused to indicate this and approximately 60 of the children in the control group indicated being touched even though it did not happen In Ceci s study preschool children were asked to think about actual events they had experienced as well as fake events for 10 weeks In one study 58 of the preschool children described the fictitious event as if it had happened another 25 described the fictitious event as real the majority of the time and 27 when told that their story was false claimed it to be true In William s study 129 women with documented histories of being sexually abused as children were interviewed 38 did not recall the incidents that were reported to the police at least 17 years earlier 12 What do we know about the accuracy of recovered memories Memories are malleable and easily distorted particularly in some individuals with certain personality traits and characteristics such as vivid imaginal capabilities and openness to unusual ideas Sample Test Items The following multiple choice items are examples of the type of items that might appear on the first test Hopefully they will give you an idea of the types of questions that will 14 be on the test Answers are in a separate document on Blackboard Try to answer these questions yourself before looking at the answers 1 One of the results of the discovery that the disease syphilis and the disordered behavior that results from it are both caused by the same biological microorganism was 8 the mental hygiene movement was established which attempted to provide as sterile bacteria free environment as possible for people suffering from psychological disorders individuals diagnosed with syphilis were referred to psychologists and psychiatrists instead of internists mental health professionals began to think that other psychological disorders are caused by microorganisms and that biological cures might be possible mental health professionals adopted a genetic model which has since received partial support from further scientific research 2 Tim owns a cat who licks her quotchopsquot when she hears cellophane cat food packets being opened This is not a response she or her wild ancestors learned in the jungle According to a classical conditioning account the cellophane sound has become 8 990quot a conditioned response a conditioned stimulus an instrumental operant an unconditioned response an unconditioned stimulus 3 According to the principle of prepared learning humans 8 b 4 9969 are genetically programmed to learn certain things inherit a capacity to learn certain things that were beneficial to the survival of the species are ready to learn by the age of siX tend to learn socially sanctioned norms and roles rather than socially inappropriate behaviors and thought processes are able to learn many things cats cannot learn but also are unable to learn the some things cats can learn hich of the following is true If either a diathesis or a stressor is present a disorder will develop If both a diathesis and a stressor are present a disorder will develop The smaller the diathesis the greater the stress needs to be to produce a disorder The larger the diathesis the greater the stress needs to be to produce a disorder 5 The mental status exam does NOT directly involve a b c determining whether the condition is due to a medical problem determining mood and affect observing a person s appearance 15 d noting the presence of delusions hallucinations or ideas of reference 6 Ross has episodes in which he suddenly experiences horrible fear his heart feels like it will pound through his chest and he finds it so difficult to breath he is afraid he will choke to death After about 15 minutes things return to normal Between episodes he is filled with apprehension for the next one For what diagnosis might Ross qualify a GAD b OCD c PTSD d panic disorder e specific phobia 7 In the treatment you offer most of your client with anxiety disorders you seek to relax muscle tension and reduce blood pressure and heart rate The exception is a blood injection injury phobia b social phobia c panic disorder plus agoraphobia d panic disorder by itself 8 Juanita believes that her feet are too big for her body and often complains that she will never have a normal social life because of her disgusting disability She has begun to be absent from work instead choosing to spend exorbitant amounts of money and time shopping for foot binding shoes She might have a body dysmorphic disorder conversion disorder dissociative fugue generalized anxiety disorder somatic symptom disorder 9905 9 While both factitious disorder and malingering have feigned symptoms that are under voluntary control they differ in that the goal of factitious disorder is whereas the goal of malingering is a to present oneself in a more favorable light to avoid social punishment or responsibility b to avoid social punishment or responsibility to present oneself in a more favorable light c to manipulate the system to gain a desired end to assume the sick role d to assume the sick role to manipulate the system to gain a desired end 10 The model for the causes of somatic symptom disorder suggests an endless loop of increasing psychopathology What aspect of systems theory does this loop illustrate a Holism 16 b Equifinality C Multifinality d Reciprocal causality 11 Forty seven year old Lenny who began smoking at age 16 has been diagnosed with stage 3 lung cancer He is very upset and very afraid he may die soon leaving his wife and children without a primary breadwinner He also spends much of his free time reading about lung cancer and its treatment His doctor suggests an aggressive course of chemotherapy but admits even then that Lenny s prognosis is not good Lenny probably qualifies for a Conversion disorder b Illness anXiety disorder Somatic symptom disorder All of the above None of the above 090 12 What does iatrogenic mean a A disorder caused by treatment b A form of treatment which is unusually effective but has many or very serious side effects c Perceiving the world as distorted d Psychologically detaching one s sense of self from one s body and what is happening to it Study hard and the Night before the test Sleep Well PSY 240C Abnormal Psychology Second Test Study Guide Mood Disorders and Suicide 1 Given a brief description be able to say what type of mood disorder or episode the person has Or given a disorder be able to say what signs symptoms and qualifiers are important Depressive Disorders sad empty or irritable mood with cognitive and somatic changes that significantly reduce a person s functioning Major Depressive Disorder depressed mood andor loss of interest or pleasure change in weight sleep or motor activity or fatigue poor concentration indecisiveness feels worthless or frequent thoughts of death or suicide Persistent Depressive Mood Disorder Dysthymia gt 2 years of depressed mood most days in addition to mood extremes of appetite ampor sleep fatigue low self esteem poor concentration indecisive feels hopeless No manic or hypomanic episode Disruptive Mood Dysregulation Disorder starting between 6 amp 10 years old extreme temper outbursts gt 3 timesweek inconsistent with developmental level in at least 2 settings Generally irritable or angry between outbursts Lasts gt 12 months No bipolar intermittent explosive or oppositional defiant disorder Premenstrual Dysphoric Disorder In the week before menses better within days of beginning menses amp minimal a week after marked mood swings irritable depressed or anxious decreased interest concentration difficulties lethargy being overwhelmed breast tenderness feeling bloated change in appetite or sleep Significant distress or impairment What laboratory test reliably and accurately detects depression There isn t any What do anhedom39a catatonic and melancholic mean Anhedonia loss of pleasure or interest in everything Catatonic absence of movement Melancholic includes anhedonia very morose large amounts of guilt Understand the overlap between anxiety and depression Anxiety disorders accompany depression in about 13 12 of elderly patients particularly generalized anxiety disorder and panic disorder and when they do patients are more severely depressed Know and fully comprehend the causes of each of the mood disorders as they are currently understood What is the permissive hypothesis Serotonin is hypothesized to regulate other neurotransmitter systems decreased serotonin activity may allow these systems to act in unusual and erratic ways Depression arises when low serotonin levels promote low levels of norepinephrine Know about attributions and hopelessness with respect to depression Learned helplessness Martin Seligman s theory that people become anxious and depressed when they make an attribution that they have no control over the stress in their lives whether or not they do in reality Know Beck39s cognitive triad What does he say about cognitive errors and negative schemas Depressive cognitive triad thinking errors in depressed people negatively focused in three areas themselves the self is worthless their immediate world the world is unfair and their future the future is hopeless What are the likely reasons for the higher rate of depression in women compared with men Reasons for a higher rate of depression in women than in men may be in uenced by perceptions of uncontrollability due to differences in the sex roles assigned to men and women in our society Women experience more discrimination poverty sexual harassment and abuse than do men They also earn less respect and accumulate less power 10 Know the basic strategies and techniques for successfully treating each of the mood disorders Medications a number of medications are effective treatments for depression Antidepressants four basic types of antidepressant medications are used to treat depressive disorders selectiveserotonin reuptake inhibitors SSRIs mixed reuptake inhibitors tricyclic antidepressants and monoamine oxidase MAO inhibitors Lithium carbonate is another type of antidepressant drug that has side effects often more serious than those of other antidepressants However it is often effective in preventing and treating manic episodes and is most often referred to as a moodstabilizing drug Electroconvulsive Therapy ECT may be used when someone does not respond to medication or in an extremely severe case Consists of brief electrical currents temporary seizures and 6 to 10 treatments Psychological treatments psychotherapy 11 Understand and be able to distinguish how to treat depression using the behavioral cognitive cognitivebehavioral and interpersonal forms of psychotherapy Cognitive therapy clients are taught to examine carefully their thought processes while they are depressed and to recognize depressive errors in thinking Behavioral therapy has shown that increased activities alone can improve self concept and lift depression Cognitivebehavioral includes the CognitiveBehavioral Analysis System of Psychotherapy CBASP which integrates cognitive behavioral and interpersonal strategies and focuses on problem solving skills particularly in the context of important relationships Interpersonal therapy focuses on resolving problems in existing relationships and learning to form important new interpersonal relationships 12 What is a major problem with medication and patients with bipolar disorder Antidepressants can induce manic episodes even in individuals without preexisting bipolar disorder 13 What is ECT and when is it most likely to be used Electroconvulsive Therapy ECT may be used when someone does not respond to medication or in an extremely severe case 14 15 16 17 18 19 Know about the connection between bipolar disorder and creativity During the early stages of a manic episode people can be very happy productive and creative There is some evidence that many wellknown creative people suffer or have suffered from bipolar disorder Speculation gene that promotes creativity also promotes depression Which ethnic group has the highest suicide rate in the USA Caucasians What differences exist between men and women with respect to suicide In every country around the world except China males are 4 times more likely to commit suicide than females Males generally choose far more violent methods such as guns and hanging females tend to rely on less violent options such a drug overdose Also more men commit suicide during old age and more women during middle age What neurotransmitter process is related to suicide Low levels of serotonin may be associated with suicide and with violent suicide attempts usually because of and associated increase of impulsivity What are the major risk factors and the major protective factors for suicide Risk factors history of suicide stated intent detailed plan neglects looks lethal means impulsivereckless socially isolated final arrangements sudden unexpected happiness Protective factors good social support proven coping skills strongly religious has dependents mental health resources What should you do and say or not do and not say to someone you think might be suicidal 1 Take the person seriously and treat herhim as a normal human being 2 Express concern and ask direct questions Is heshe suicidal Does heshe have a plan Pay attention show you care even if you don t know herhim well Acknowledge the person s feelings in a nonjudgmental way Reassure the person that things can get better Help find alternatives Do NOT promise confidentiality Get help If possible don t leave the person alone until heshe is with a professional Take care of yourself omsowaw 20 What are suicide contracts Do they work as intended A nosuicide contract is a promise not to do anything remotely connected to suicide without contacting the mental health professional first Feeding and Eating Disorders 1 Given a brief description be able to say what type of eating disorder the person has Or given a disorder be able to say what signs symptoms and qualifiers are important Including being able to distinguish key features from somewhat less important ones What percent of people with anorexia die as a result of the disorder or through suicide 8 10 Up to 20 die as a result of their disorder with slightly more than 5 dying within 10 years From 20 to 30 of anorexiarelated deaths are suicides Know and fully comprehend the causes of anorexia bingeeating and bulimia as they are currently understood In which cultures are eating disorders most prevalent Eating disorders are most prevalent in Western countries Why are eating disorders so much more prevalent in women than men The strongest contributions to etiology stem from sociocultural rather than psychological or biological factors Be aware of some of the indicators that increasing levels of thinness are considered the norm in Western society Support through proana anorexia and promia bulimia websites and social networks How do the body images of men and women differ 2 25 3 35 4 45 5 ll 2 25 3 35 4 45 5 ll Male s ideal Male s current Male s attractive Female s attractive Female s current Male s attractive Female s attractive Female s ideal How do the body images of normal college women and college women with distorted body image differ till 39 l l Other attractive a a distorted b normal Ideal Attractive Current I I I I I I I I l I l l l I I I l I I I I I l l I Other Ideal Attractive attractive 17 Current me Zellnar Hameer Adls US81 Know indicators that a person might develop an eating disorder Low sense of personal control Low selfconfidence Perfectionistic attitudes Preoccupation with food and appearance Mood intolerance Distorted body image Know the basic strategies and techniques for successfully treating each of the eating disorders Which are most successful What are the basic goals of all these strategies Drug treatments ineffective for anorexia nervosa but may be useful for some people with bulimia Cognitivebehavior therapy CBT targets problem eating behaviors targets dysfunctional thoughts most successful Interpersonal psychotherapy IPT seeks to improve interpersonal functioning 11 Know the results of the study comparing CBT IPT and BT for treating bulimia Fairbum Jones Peveler Hope amp O39Connor 1993 The investigators found that for those who completed treatment CBT was significantly superior to IBT At the end of treatment 45 recovered with CBT while only 8 recovered with IPT The investigators also concluded that CBT is the preferred psychological treatment for bulimia nervosa because it worked significantly faster 12 How does the fact that a person with anorexia has gained weight rapidly while in treatment affect the person39s prognosis Initial weight gain is a poor predictor of longterm outcome in anorexia Without attention to the patient s underlying dysfunctional attitudes about body shape as well as interpersonal disruptions in her life she will almost always relapse 13 Know the patterns of disordered eating often seen in people who are obese Binge eating disorder BED Night Eating Syndrome Associated with obesity 13 of daily calories consumed Patients are awake Not binge eating Schizophrenia and other Psvchotic Disorders Be able to recognize and distinguish the types of schizophrenic symptoms and the other psychotic disorders 1 Schizophrenia Spectrum and Other Psychotic Disorders Delusions Hallucinations Disorganized Thinking Speech Abnormal Motor Behavior and Negative Symptoms e g avolition diminished emotional expression Schizophrenia For gt 1 month delusions hallucinations or disorganized speech perhaps also grossly disorganized or catatonic behavior or negative symptoms Some signs of these must exist for gt 6 months Specify if with catatonia also used with other disorders and after 1 year course Severity of each of 8 primary symptoms is rated on a 0 to 4 scale Schizophreniform Disorder Similar to schizophrenia but continuous signs have lasted only 1 to 6 months Specify whether with or without good prognostic features Brief Psychotic Disorder Similar to schizophrenia but need only 1 symptom and duration is 1 day to lt 1 month Specify if with or without stressors if with postpartum onset or with catatonia Schizoaffective Disorder As for schizophrenia but also a major depressive including depressive mood or manic episode delusions or hallucinations 2 2 weeks without mood episodes but mood episode is present for most of the duration of the schizophrenic symptoms Delusional Disorder Never schizophrenic but 2 1 month delusion Other than impact from the delusion functioning is okay Specify erotomanic grandiose jealous persecutory somatic mixed or specified type and if bizarre content Recognize delusions of grandeur and persecutory delusions Grandeur overestimation of one s abilities usually impossible Persecution thoughts that one is being persecuted when one is not Know the deficit and motivational views of delusions Motivational People develop stories to deal with or relieve some anxiety or stresshelp them make sense of the world Deficit Delusions result from brain dysfunction that creates these disordered cognitions or perceptions In what part of the brain do auditory hallucinations originate and what does this suggest Broca s area active during auditory hallucinations People who are hallucinating are actually listening to their own thoughts Recognize affective attening alogia avolition catatonia catatonic immobility cognitive slippage inappropriate affect loose associations prodromal phase residual phase and waxy exibility Avolition or apathy lack of initiation and persistence Alogia relative absence of speech Asociality avoiding others Anhedonia lack of pleasure Affective attening little expressed emotion Catatonia lack of movement or response to external stimuli Cognitive slippage exhibited by groups of objects being categorized in an over generalized manner loose associations Waxy exibility smooth even resistance to being moved Inappropriate affect display of emotions that do not properly fit a circumstance such as smiling in reaction to a tragedy Which class of medication reduces positive symptoms but does not have much impact on negative symptoms Neuroleptic medications With what neurochemical have positive symptoms of schizophrenia been associated What evidence supports this association Dopamine Evidence Antipsychotic drugs neuroleptics often effective in treating people with schizophrenia are dopamine antagonists partially blocking the brain s use of dopamine They can produce negative side effects similar to those in Parkinson s disease a disorder caused by insufficient dopamine V The drug Ldopa a dopamine agonist used to treat people with Parkinson s produces schizophrenialike symptoms in some people V Amphetamines which also activate dopamine can make psychotic symptoms worse in some people with schizophrenia 8 If one of a pair of identical twins has schizophrenia what is the probability that the other twin will also 48 9 Understand the results of research on degree of relationship and probability for having schizophrenia Monozygotic twins O spfringroi39lwo pencils Iirrithi schizophrenia Dizygloiic iwiins i i Sibiinlgs with 1 schizophrenic parent Half Siblings Grandchildren Nephewnieces Unoleslaunts First cousins third degree Spouses of patien s I Generai population 39 i i i D 5 1110 15 20 25 3839 35 40 45 50 Percentage at risk swamm Cengage Learning 10 Know about the Genain sisters and the concept of unshared environments Same genetics and environment general Differences V Ages of onset V Symptoms V Diagnoses V Courses V Outcomes Unshared environments even identical siblings can have different prenatal and family experiences and can therefore be exposed to varying degrees of biological and environmental stress 11 Know and understand the research and theory on expressed emotion EE Expressed emotion hostility criticism and over involvement demonstrated by some families toward a family member with a psychotic disorder This can often contribute to the person s relapse 12 What are extrapyramidal symptoms What about tardive dyskinesia Extrapyramidal symptoms serious side effects of neuroleptic medications resembling the motor difficulties of Parkinson s disease They include akinesia and tardive dyskinesia Tardive dyskinesia involuntary motor movements especially in the face and tongue 13 What is deinstitutionalization and what are its effects on people with schizophrenia Deinstitutionalization is the systematic removal of people with severe mental illness or intellectual disability from institutions like psychiatric hospitals Failure to provide 14 15 16 17 18 appropriate treatment and ongoing followup care for patients discharged from hospitals has sent many individuals with the severest forms of mental illness spinning through an endless revolving door of hospital admissions and readmissions jails and public shelters How successful is social skills training with patients who are schizophrenic The challenge of teaching social skills is to maintain the effects over a long period The more time and effort given to these services the more likely the improvement What is needed to have an integrated approach for treating schizophrenia Collaborative psychopharmacology using antipsychotic medications to treat the main symptoms of the disorder as well as other medications for secondary symptoms such as depression Assertive community treatment providing support in the community Family psychoeducation educating family members about the disorder and its management helping them to reduce stress and tension in the home and providing social support Supportive employment providing support before and during employment so that the person can find and keep a meaningful job Illness management and recovery having the individual become an active participant in treatment Integrated dualdisorders treatment treating coexisting substance abuse What is Theory of Mind and what does it have to do with schizophrenia The term Theory of Mind refers to the capacity to infer one39s own and other persons39 mental states and behaviors Schizophrenic patients lack this ability What is assertive community treatment A program that involves using a multidisciplinary team of professionals to provide broadranging treatment across all domains including medication management psychosocial treatment and vocational training and support What is the relationship between schizophrenia and dissociative identity disorder None thsical Disorders and Health PsvcholoaV 1 4 What percent of deaths in the USA can be attributed to lifestyle choices What are these negative lifestyle choices 50 of deaths can be attributed to smoking poor eating habits lack of exercise insufficient injury control Know the General Adaptation Syndrome Anxiety disorder characterized by intense uncontrollable unfocused chronic and continuous worry that is distressing and unproductive accompanied by physical symptoms of tenseness irritability and restlessness Know about the process involving CRF HPA and cortisol The activity of the endocrine system increases when we are stressed primarily through the activation of the hypothalamicpituitaryadrenocortical HPA axis The corticotrophinreleasing factor CRF is secreted by the hypothalamus and stimulates the pituitary gland which activates the adrenal gland which then secretes the hormone cortisol along with other related hormones is known as a stress hormone Understand about perceptions of control and stress 5 10 11 12 Our feelings range from depression to anxiety to stress to excitement depending partly on our sense of control and ability to cope Know the continuum of responses to stressors See p 321 52012 Cengage Learning Understand the general process of how the immune system functions and dysfunctions How does stress affect the immune system The immune system protects the body from any foreign materials that may enter it Direct evidence has linked a number of stressful situations to lowered immune system functioning How does HIVAIDS affect the immune system How does stress affect HIVAIDS HIVAIDS is a virus that lowers the efficiency of the immune system High levels of stress and low social support can exacerbate the progression of the virus Know the basic results of the study conducted at UM by Antoni et al 1991 Men with HIV who received cognitivebehavioral stressmanagement treatment showed significantly lower post treatment levels of anxiety anger and perceived stress than those in the control group indicating that that the treatment was effective What is the relationship between Type A and CHD How does it vary by culture and gender Coronary heart disease CHD is a blockage of the arteries supplying blood to the heart muscle People with Type A personality usually exhibit excessive competitiveness timepressured impatience accelerated speech and anger and are at a higher risk for CHD and cardiovascular disease than those with Type B personalities Studies have shown that individuals in Western cultures have type A personalities more than individuals in cultures like Japan and Hawaii What factor was isolated from Type A that was the key to the relationship in 9 above What related phenomena were later added to this key factor Anger continued to emerge as presenting increased cardiovascular risk Know what biofeedback is and how it is believed to work on tension headaches Biofeedback is a selftraining mindoverbody technique developed in the 1940s It39s a method in which you consciously control a body function that normally is regulated automatically by the body like skin temperature heart rate or blood pressure Tension headaches caused by tightened head muscles is reduced when biofeedback is used to relax those muscles What is the difference between relaxation and meditation There are many different ways to just relax either through specific techniques designed to achieve just that and others where you simply find yourself feeling relaxed through doing something pleasurable like sitting in the sun walking in the park or listening to music By contrast meditation is an exercise you practice in your head to train your mind to be more aware of the here and now When you meditate relaxation isn t the goal but 13 14 15 16 17 18 19 10 more of a wonderful side effect Also compared with relaxation meditation offers you much greater benefits such as better selfknowledge clarity of thought focus and wellbeing to name just a few Understand how the stressful events record p 335 Fig 914 is used A stressful events record is used to keep track of when where and how an individual reacts to stressors Know under what circumstances and why denial is a positive coping mechanism For a really bad diagnosis a little denial at the beginning is a good thing because it calms you down no jump to major catastrophe Short term denial is good long term denial is bad Typically what changes in behavior do people make when they learn they are HIV positive One group becomes hostile and tries to spread the disease while the other group becomes depressed What is benefit finding Benefit finding refers to an individual39s perception that major positive changes have occurred as a result of challenging life events such as major illness or trauma What psychosocial factors contribute to patient improvement and to patient worsening Unhealthy eating habits lack of exercise and smoking are three of the most common behaviors that put us at risk for a number of physical disorders in the long term Many programs are being implemented to develop effective behavior modification procedures that improve diet increase adherence to drug and medical treatment programs and develop optimal exercise programs How do placebos lower pain Pain induced gt placebo given gt brain imaging shows broad areas of brain affected and the endogenous opioid system endorphins is activated this suppresses pain gt spur chemical changes in your brain that reduce pain What were the conclusions of the Stanford Three Community Study Results indicate that the interventions were markedly successful at reducing risk factors for CHD in the three communities
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