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exam 4 study guide

by: Emily sunshine

exam 4 study guide PSYCH 2510

Emily sunshine
GPA 3.6

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these notes cover everything on exam 4
Abnormal Psychology
Julianne Ludlam
Study Guide
chapter14, Chapter15, Chapter16, chapter17
50 ?




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This 11 page Study Guide was uploaded by Emily sunshine on Monday February 1, 2016. The Study Guide belongs to PSYCH 2510 at University of Missouri - Columbia taught by Julianne Ludlam in Spring 2016. Since its upload, it has received 8 views. For similar materials see Abnormal Psychology in Psychlogy at University of Missouri - Columbia.


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Date Created: 02/01/16
ABNORMAL PSYCHOLOGY EXAM 4  Psychosis- a state of being profoundly out of touch with reality. (can’t perceive/respond to environment) o Can talk many forms (delusions, hallucinations)  Schizophrenia- a disorder marked by psychosis and a decline in adaptive functioning. COURSE & EPIDEMIOLOGY (SCHIZOPHRENIA): o Occurs in 1 out of every 100 people (Equal in men and women) o Age of onset: 28 years’ old o Lifetime prevalence: 1% o Financial impact: 62.7 billion in U.S. alone (found in lower socioeconomic groups) o Human impact: affects human potential, disrupts families, and leads to suicide. o Phases:  Prodromal- symptoms not obvious, person begins to deteriorate  Withdraws socially  Speaks in vague/odd ways  Develops strange ideas  Expresses little emotion  Active- symptoms are apparent  Residual- return to prodromal- like functioning and may have some mild neg. symptoms o Racial Discrepancy: African Americans= more likely to have than Caucasians.  Result of misdiagnosis based on racial bias. (more likely to be assessed in state hospitals)  Also related to SES and higher rates of poverty. o Violence: people with psychosis are more likely to harm themselves  (people with mental disorders like schizophrenia were 3-4 times more likely to be a victim of a violent crime) CAUSES (SCHIZOPHRENIA): Diathesis stress model: o Originally developed as an explanation of schizophrenia o This model has the most support in research o People with a biological predisposition will develop schizophrenia only if certain events or stressors are also present. Biological Factors: o Genetics: play a role  No single gene, but possibly several genes contribute (POLYGENIC) o Biochemical abnormalities:  Dopamine hypotheses: the theory that schizophrenia results from excessive activity of neurotransmitter dopamine.  LINKED TO POSITIVE (TYPE 1) SYMPTOMS o Structural brain abnormalities:  Enlargement of ventricles; damage and tissue less in several areas  LINKED TO NEGATIVE (TYPE 2) SYMPTOMS Environmental/ Sociocultural factors: o Expressed emotion: high level of over involvement/ criticism  may contribute to relapse TREATMENT (SCHIZOPHRENIA): Past Treatments: o Institutionalization: restraint, food, shelter  could worsen symptoms (social breakdown syndrome) Pharmacological treatment: o Antipsychotic drugs- reduce symptoms 65%  Conventional/ typical antipsychotics-  treated only positive symptoms  major side effects: o Extrapyramidal symptoms- disturbing-moving problems (similar to Parkinson) o Tardive dyskinesia- more difficult, appears 1 year after start of meds… ticks in tongue, neck, extremities o Neuroleptic malignant syndrome- muscle rigidity, altered consciousness, fever, improper functioning of the autonomic nervous system  Atypical/ second generation antipsychotics-  Considered FIRST LINE of treatment (AKA: considered better)  reduce positive symptoms and may have some impact on negative symptoms  SAFER SIDE EFFECTS  Major side effects: o Agranulocytosis- fatal reduction in white blood cells Psychological treatments: o Milieu therapy- humanistic approach, institutions can help patients recover by creating a climate that promotes self- respect, individual responsible behavior, and meaningful activity.  More helpful than token  Residential treatment setting o Token economy program- a person’s desirable behaviors are reinforced systematically throughout the day by the awarding of tokens that be exchanged for goods/privileges  (operant conditioning)  Encourages self-care skills  Residential treatment setting o Psychotherapy:  CBT (and ACT): how to accept and not let something effect you Make sense of hallucinations and change how they view/react to them/ make them less powerful.  Family Therapy: educate family members and so they can help/support.  Social skills/ social therapy: Work on problem solving, decision making, social skills, etc. Help them find work/housing/healthcare  Schizophreniform: symptoms between 1 and 6 months  Brief Psychotic Disorder: symptoms less than 1 month  Delusional Disorder: nonbizarre delusions, without other symptoms lasting at least 1 month  Schizoaffective Disorder: symptoms of both schizophrenia and a mood disorder Positive/type 1 symptoms: later onset of symptoms, more likely to show improvement with meds, and prominent positive symptoms o Delusions: Fixed/ false beliefs  Persecution- believe they are being plotted against  Reference- attach special meaning to the actions of others or to objects/events (EX: arrows on street signs are the direction you should take, or watching the news b/c of hidden meaning the reporter is saying)  Grandeur- believe self is great inventor, savior, empowered person, etc.  Control- belief that feelings, thoughts, actions are controlled by others (ex: the U.S. is controlling thoughts using spies through satellites) o Hallucinations: (MOST COMMON) abnormal sensory experiences perceived as real. Broca’s area and auditory cortex= active during hallucinations.  Tactile- tingling, burning, shock  Auditory- usually this, hearing voices/noises/sounds  Somatic- something inside the body (EX: snake is crawling in their stomach)  Visual- colors, clouds, people, etc.  Gustatory- food/drinks taste strange to them  Olfactory- smell odors such as poison and smoke that no one else smells  Command- ordering person to do things (usually dangerous) o Disorganized speech/thought: severe disruptions in the process or form of speech/thinking not necessarily the content. THIS IS VIRTUALLY IMPOSSIBLE TO FAKE/ SHOWS UP FIRST  Lose associations (derailment)- rapid shift from one topic to another (believes it makes sense)  Neologisms- made up words that typically only have meaning to person using them.  Perseveration- repeat words/statements over and over again.  Clang associations- rhyming to describe things  Word salad o Disorganized behavior: Negative/type 2 symptoms: o Restricted affect: show less emotion then most people  avoid eye contact  expressionless face  monotonous voice  (some show none= flat affect) o Anhedonia: general lack of pleasure/enjoyment o Avolition: apathy (lack of energy/interest)  Experienced by people who have had schizophrenia for years  Sits on couch… does cook, clean, shower, etc. o Alogia: reduction of quality of speech/speech content (social withdraw)  Psychomotor Symptoms: strange motoric behaviors, many people move slowly and make awkward, repeated movements.  Catatonia- a pattern of extreme psychomotor symptoms found in some forms of schizophrenia and may include rigidity or posturing. o Catatonic rigidity: maintain rigid, upright posture o Catatonic posturing: awkward, bizarre positions CHILDHOOD AND ADOLESCENCE ANXIETY & MOOD PROBLEMS: Anxiety- often influenced by parent problems/ temperament o Behavioral and somatic symptoms common:  Often imaginary objects/events  Often triggered by current events o Separation anxiety:  panic when separated from home  can lead to school phobia/ school refusal  4-10% of all children Depressive and bipolar o TADS findings?  Neither antidepressants alone nor cognitive-behavioral therapy alone was as effective for teenage depression as was a combination of antidepressants and cognitive- behavioral therapy.  Antidepressants alone tended to be more helpful to depressed teens than cognitive-behavioral therapy alone.  Cognitive-behavioral therapy alone was barely more helpful than placebo therapy. o Controversy regarding bipolar disorder in children and DSM response? o Problem with higher rates of bipolar disorder in children? OPPOSITIONAL DEFIANT DISORDER & CONDUCT DISORDER: **COMMONLY BOYS** ODD- frequent & persistent pattern of angry/irritable/argumentative/defiant behavior, or vindictiveness o Chronic problem that impedes development and has neg. impacts on self/others o Must be for at least 6 months CD- repetitive and persistent pattern of behavior involving the consistent violation of the rights of others and significant age- appropriate norms. o Especially criminal behavior in children/adolescence o Aggression towards people and animals, theft, destruction, etc. Treatment: o Parent management training- behavioral program focused on problematic parenting practices  Used primarily with school aged children  Includes family therapy sessions o Parent interaction therapy- parents are taught to be consistent/predictable  Good for preschool children o Video modeling- use video tools in family intervention  Good for very young children ELIMINATION DISORDER: Enuresis- repeated voiding of urine into ones clothing/bed  Encopresis- repeated passage of feces into inappropriate places (floor, clothing, etc.) age 4+ NEURODEVELOPMENTAL DISORDERS (3 of them) 1. ADHD: defined by impairing levels of inattention and disorganization and/or hyperactivity/impulsivity **COMMONLY BOYS**  Must have at least two different settings  African American/ Hispanics with attention/hyperactivity problems= less likely than white children to be… o Assessed for ADHD o Receive an ADHD diagnosis o Receive treatment for ADHD o Be treated with most promising meds  Treatment- o Biological- medications that stimulate the CNS (enhance transmission of dopamine/NE)  Methylphenidate (Ritalin, Concerta)  Amphetamine and dextroamphetamine (Adderall)  Atomoxetine (Strattera)- non stimulant medication o Behavioral- operant conditioning methods  For parents- incorporates family symptoms with behavioral and cognitive components  Appropriate reinforcement and punishments in home  Correcting parental assumptions about child and parenting  For teachers- tracking on-task behavior, academic performance  Issuing rewards or removing privileges 2. AUTISTM SPECTRUM DISORDER: group of disorders marked by impaired social interactions and unusual communications, as well as restricted or rigid behaviors, interests, and activities. **COMMONLY BOYS** (Used to be Asperger’s)- Identical to autism except involves no significant delay in language TWO MAJOR DEFICITS 1. Deficit in communication and social interaction  Communication- no/delayed speech, stereotypic (patterned, repetitive) stilted or mechanical. Abnormal pitch, intonation, rate. nonverbal impairments  Reciprocity and relatedness- little to no social interactions, interest, or sharing of emotion  Comprehension- abstract concepts, indirect requests, complex social cues 2. Restricted, repetitive patterns in behaviors, interests, and activities  “stereotypes” or repetitive, purposeless behavior patterns  Preservation; narrow, intense focus on certain activities/routines  Limited imaginary play  Unusual motor movements, self-stimulatory behaviors, self- injurious behaviors TERMS TO KNOW: o Echolalia- the exact echoing of phrases spoken by others o Stereotyped speech/ behavior- society often views the symptoms of ADHD as medical problems when exhibited by white American children but as indicators of poor parenting, lower IQ, substance use, or violence when displayed by African American and Hispanic American children o Pronominal reversal- confusion of pronouns Etiology o Brain abnormalities- potential problem in the cerebellum o Mind/Mind-blindness- problem with developing “theory of mind”  Having great difficulty taking part in make-believe play, using language in ways that include the perspectives of others, developing relationships, or participating in human interactions. 3. INTELLECTURAL DISABILITY: intellectual AND adaptive functioning deficits, in conceptual, social, and practical domains. **COMMONLY BOYS** Intelligence (IQ)-  Typically measured by standardized tests  IQ <70 is guideline Adaptive functioning-  Conceptual: academic, like memory, language, reading  Social: interpersonal comm., social judgement  Practical: personal care, job responsibilities Most common severity level and SES-related prevalence? Primary causes-  Difference in causes for mild vs. moderate-profound?  IQ based o Mild (55-70) o Moderate (40-55) o Severe (25-40) o Profound (<25)  Causes for Fragile X- gene on the X chromosome breaks apart  Causes for Down Syndrome-a genetic form of intellectual disability caused by the presence of 3 chromosomes rather st than the usual two on the 21 pair (Most common biological disorder) Criticisms of IQ tests for diagnosis- Low IQ scores are often associated with poverty AGING AND COGNITION Geropsychology: subdicipline that addresses of aging Ageism: Treatment of Neurocognitive Disorders: o Depression in the elderly- o How well do they respond?- not as effective because metabolism works diff. when someone is older  Anxiety in the elderly- o Generalized anxiety disorder= most common! Psychotic disorders in the elderly- o How common is schizophrenia in the elderly? NOT COMMON  Symptoms less with age  Uncommon for new cases to emerge o Which psychotic disorder=most common? Delirium/ dementia Substance use disorders in the elderly o What is the recent controversy about meds in nursing homes?- misuse of powerful medications in nursing homes Delirium o Definition: alteration in consciousness; a transient cognitive disorder involving disruptions in attention and changes in cognitive capacity (such as memory loss, disorientation, or language problems) o Etiology: usually substances or physical illness/problem o Onset: quickly/acute; rapidly developing; typically reversible o Presentation: wandering attention; hallucinations possible; labile moods (change rapidly); variable activity level  Major Neurocognitive Disorder- decline in cognitive functioning is substantial and interferes with the ability to be independent  Minor Neurocognitive Disorder- decline in cognitive functioning is modest and does not interfere with the ability to be independent PERSONALITY DISORDERS: Personality traits- Personality- unique and long-term patterns of inner experiences and outward behaviors Personality disorder- the flexibility of personality is missing o Stable, longstanding patterns that are inflexible and cause impairment/distress CLUSTER A DISORDERS- “odd or eccentric” display behaviors similar to, but not as extensive as schizophrenia o Paranoid-  Deep distrust and suspicion of others  Angry distrustful approach to interpersonal relationships  More men than women o Schizoid-  Persistent avoidance of social relationships and limited emotional expression  Appears a lot like autism- hard to diagnose without milestone records o Schizotypal-  A range of interpersonal problems, marked by extreme discomfort in close relationships, odd ways of thinking, and behavioral eccentricities  CLOSEST TO SCHIZOPHRENIA  More men than women  Biological Explanations- Excessive dopamine Enlarged brain ventricles Smaller temporal lobes Loss of grey matter Genes CLUSTER B DISORDERS- “dramatic, emotional, or erratic” behaviors make it hard to have relationships that are truly giving and satisfying. o Antisocial-  General pattern of disregard for the violation of other people’s rights.  Sociopaths/psychopaths  Linked to substance abuse & adult criminal behaviors  Must be at least 18  4x more likely in men  Behavioral explanation- Symptoms may be learned through modeling/imitation  Cognitive explanation- Attitudes that trivialize the importance of other people’s needs Difficulty recognizing a point of view other than their own  Biological explanation- Low serotonin Deficient functioning of frontal lobes Less anxiety o Borderline-  Repeated instability in interpersonal relationships, self- image, mood, and by impulsive behaviors  Mood swings can last hours or days  More women than man  Psychodynamic explanation- Loss of self esteem Increased dependence Inability to cope with separation/sexual abuse  Biological explanation- Overly reactive amygdala Under-active prefrontal cortex Lower brain serotonin activity Abnormalities in the 5-HTT gene (serotonin transporter) o Histrionic- extremely emotion and continually seeks to be the center of attention  Lack of a sense of self  Vain, self-centered, demanding  Unable to delay gratification for long o Narcissistic- marked by a broad pattern of grandiosity, need for admiration, and lack of empathy  More men than women CLUSTER C DISORDERS- “anxious or fearful behaviors” o Avoidant- consistent discomfort and restraint in social situations, overwhelming feelings of inadequacy, and extreme sensitivity to negative evaluations  Similar to social anxiety disorder o Dependent- characterized by a pattern of clinging and obedience, fear of separation, and an ongoing need to be taken care of o Obsessive compulsive- an intense focus on orderliness, perfectionism, and control that the individual loses flexibility, openness, and efficiency What is the correct personality disorder? 1. Violation of the rights of others- ANTISOCIAL 2. Marked grandiosity- NARCISSISTIC 3. Social hypersensitivity- AVOIDANT 4. Minimal social contact- SCHIZOID 5. Ideas of reference- SCHIZOTYPAL 6. Identity/relationship instability- BORDERLINE 7. Distrust and suspiciousness of others- PARANOID 8. Perfectionism and control- OBSESSIVE COMPULSIVE 9. Emotionality and attention seeking- HISTRIONIC 10. Submissiveness and clinging- DEPENDENT


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