Abnormal Psychology Final Exam Study Guide
Abnormal Psychology Final Exam Study Guide PSYC 3560
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This 12 page Study Guide was uploaded by Ashlyn Masters on Friday April 29, 2016. The Study Guide belongs to PSYC 3560 at Auburn University taught by Dr. Fix in Spring 2016. Since its upload, it has received 45 views. For similar materials see Abnormal Psychology in Psychlogy at Auburn University.
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Date Created: 04/29/16
**FYI- most of CH 16 and 17 are from lecture, not textbook** (Chapter 10) – Personality Disorders 1. What are Personality Disorders? • Long-standing pattern of maladaptive behaviors, thoughts and feelings • Pervasive and inflexible, stable, and causes distress/impairment 2. Cluster A Personality Disorders (what are the common features?) • A.K.A. – odd-eccentric disorders • Common features o Unusual ways of relating and thinking, but no delusions or hallucinations o May be paranoid, speak in odd eccentric ways • Paranoid PD o Suspiciousness and mistrust of others o Tendency to see self as blameless o On guard for perceived attacks by others o Interpersonal behavior—withdraw or act aggressively/arrogantly • Schizoid PD o Impaired social relationships o Inability and lack of desire to form attachments to others o Not anxious o Interpersonal behavior—withdrawn, show little emotion in interpersonal interactions • Schizotypal PD o Peculiar thought patterns (superstitious thinking, ideas of reference) o Oddities of perception and speech that interfere with communication and social interaction (unusual perceptual experiences) § “Magical thinking” o Including what disorder is it most closely related to (genetically) § Schizophrenia 3. Cluster B Personality Disorders (what are the common features?) • A.K.A. – dramatic-emotional disorders • Histrionic PD o Self-dramatization and theatricality o Over-concern with attractiveness (controls others through seduction and emotional manipulation) o Discomfort if not the center of attention o Physical appearance used to draw attention o Unsatisfying relationships- partners get tired providing so much attention • Narcissistic PD o Grandiosity o Preoccupation with receiving attention o Self-promoting o Lack of empathy o Sense of entitlement o Bragging • Antisocial PD (ASPD) o Violates social norms and values o Criminal offenses o Poor impulse control o Sensation seeking o History of conduct problems as a child o Psychopathy- not all people an ASPD are psychopaths § 80% with psychopathy meet criteria for ASPD § Two dimensions: § Affective interpersonal factor • Lack of remorse and guilt, callousness/lack of empathy, glib and superficial charm, inflated and arrogant self-appraisal § Impulsive antisociality factor (similar to antisocial PD) • Antisocial, impulsive and socially deviant lifestyle (poor behavioral control and parasitic lifestyle) o Developmental pathways (Figure 10.4 on page 361 in textbook) § § I don’t know for sure that this chart is what she’s referring to… § Prospective studies have shown children with an early history oppositional defiant disorder are most likely to develop ASPD as adults § Second early diagnosis that is often a precursor to adult psychopathy or ASPD is ADHD • Borderline PD o Most commonly diagnosed PD o Impulsiveness o Rocky interpersonal relationships o Fear of abandonment o Inappropriate anger o Drastic mood shifts o Chronic feelings of bore o ***Non-suicidal self-injury and/or suicidal behavior*** o Transient, stress-related paranoid ideation or severe dissociative symptoms 4. Cluster C Personality Disorders (what are the common features?) • A.K.A. – anxious-fearful disorders • Avoidant PD o Hypersensitivity o Shyness o Insecurity in social interaction and initiating relationships o What anxiety disorder is it most closely related to? § Social Anxiety Disorder • Dependent PD o Difficulty separating in relationships o Discomfort at being alone o Subordination of needs in order to keep others involved in a relationship o Indecisiveness • Obsessive-Compulsive PD o Excessive concern with order, rules and trivial details o Perfectionism often interferes with accomplishments o Lack of expressiveness and warmth o Difficult relaxing and having fun o No true obsessions or compulsive rituals o Rigid with schedule o Stubborn, upset about changes o Difference between OCD and OCPD § People with OCD have insight, meaning they are aware that their unwanted thoughts are unreasonable. People with OCPD think their way is the “right and best way” and usually feel comfortable with such self-imposed systems of rules. 5. What factors make PDs very difficult to treat? • Relatively enduring, pervasive, inflexible patterns of behavior and inner experience • Many different goals of treatment and some are more difficult to achieve than others 6. What leads to worse outcome? • I’m not sure the answer to this question. If you figure it out, feel free to contact me and I will let the rest of the class know. 7. Types of treatments for PDs (most research [and most of this info] on BPD) • Cognitive Therapy & Cognitive Behavioral Therapy o Greatest promise of more effective treatment for ASPD • DBT o Type of cognitive/behavioral therapy specifically adapted for BPD • Medications (only mildly beneficial) o Controversial o Antidepressant medications considered most safe and useful o Sometimes low doses of antipsychotic medication o Mood-stabilizing medications 8. Generally speaking, understand causal factors for PDs as well as prevalence rates (including gender differences) • Rough lifetime estimate: 10-13% will meet criteria for a PD Personality Disorder Prevalence Gender Ratio Estimate A- Paranoid 0.5-2.5% Males > females A- Schizoid <1% Males > females A- Schizotypal 3% Males > females B- Histrionic 2-3% Males = females B- Narcissistic 1% Males > females B- Antisocial 1% females, 3% males Males > females B- Borderline 2% Females = males C- Avoidant 0.5-1% Males = females C- Dependent 2% Males = females C- Obsessive-Compulsive 1% Males > females (2:1) 9. What is the genetic predisposition often observed in studies? • I’m not sure the answer to this question. If you figure it out, feel free to contact me and I will let the rest of the class know. Bonus tool for studying personality disorders: ...imagine a party where all the people had PERSONALITY DISORDERS Donna danced into the party and immediately became the center of attention. With sweeping gestures of her arms and dramatic displays of emotion, she boasted about her career as an actress in a local theater group. During a private conversation, a friend inquired about the rumors that she was having some difficulties in her marriage. In an outburst of anger, she denied any problems and claimed that her marriage was "as wonderful and charming as ever." Shortly thereafter, while drinking her second martini, she fainted and had to be taken home. William wandered into the party, but didn't stay long. The "negative forces" in the room were unsettling to his "psychic soul-spot." The few guests he spoke to felt somewhat uneasy being with this aloof "space cadet." Sherry paraded into the party drunk and continued to drink throughout the night. Laughing and giggling, she flirted with many of the men and to two of them expressed her "deep affection." Twice during the evening she disappeared for almost half an hour, each time with a different man. After a violent argument with one of them, because he took "too long" to get her a drink, she locked herself into the bathroom and attempted to swallow a bottle of aspirin. Her friends encouraged her to go home, but she was afraid to be alone in her apartment. Winston spent most of the time talking about his trip to Europe, his new Mercedes, and his favorite French restaurants. People seemed bored being around him, but he kept right on talking. When he made a critical remark about how one of the woman was dressed - and hurt her feelings - he could not apologize for his obvious blunder. He tried to talk his way around it, and even seemed to be blaming her for being upset. Peter arrived at the party exactly on time. He made a point of speaking to every guest for five minutes. He talked mostly about technology and finance, and avoided any inquiries about his feelings or personal life. He left precisely at 10 PM because he had work to do at home. Before entering, Doreen watched the party for several minutes from outside through the window. Once she went in, she seemed very uncomfortable. When people tried to be nice to her, she looked guarded and distrustful. People quickly became uncomfortable with her habit of finding fault with everything little thing you said or did. She seemed to be picking fights with people. She didn't stay very long at the party. Harold wasn't invited to the party. No one really knows him very well because he rarely talks. In fact, he spends most of his time alone at home reading. Suggested answers: Donna=histrionic, William=schizotypal, Sherry=borderline, Winston=narcissistic, Peter=compulsive, Doreen=paranoid, Harold=schizoid Lecture 13 (Chapter 13) – Schizophrenia and Other Psychotic Disorders 1. What is schizophrenia? • Disorder characterized by hallucinations, delusions, disorganized speech and behavior, as well as problems in self-care and general functioning 2. Be familiar with the three categories of symptoms (listed below) 3. Positive Symptoms (what is meant by positive symptoms?) • Positive symptoms: something is being added to the person’s experience • Delusions: erroneous belief that is fixed and firmly held despite contradictory evidence o Thought broadcasting: worried people can hear their thoughts o Persecution: someone trying to hurt them/coming after them o Reference: they think a message is directed specifically toward them o Thought insertion/withdrawal: the belief that people can insert/withdraw thoughts into their head • Hallucinations: a sensory experience that seems real but occurs in the absence of any real stimulus o Auditory- 75% o Visual- 40% 4. Negative Symptoms (what is meant by negative symptoms?) • Negative symptoms: something is being taken away from the person’s experience • Flat affect: not displaying much emotion • Alogia: poverty of speech (reduction in the amount of speech) • Asociality: interpersonal impairments • Apathy: decreased interest 5. Disorganized Symptoms • Disorganized speech - be able to identify them if given clear example o Loose associations (tangential speech) § Words/phrases that may seem illogical § E.g., “Here is your medication, Patient X” Response: “Blue” § “He went to the ballpark and bought Frank’s beer belly home in a bag of grass seed.” o Clang associations (kind of like a poet) § “Eating wires setting fires” § "You are very cute. A cute mute, who sings in a suit, while eating his fruit." o Neologisms § Looks like a real word § “Detone” “flowable” o Word Salad (combining words into a sentence that don’t form sentences) § The sheep languished blue trains suffer § Windows books dogs hands run • Disorganized Behavior o Disruption in goal directed activity o Cannot maintain hygiene o Disregard for safety o Unusual dress • Catatonic Behavior o Absence of all movement, speech o Rigidity, hold unusual postures without seeming discomfort 6. DSM-5 Criteria for schizophrenia (which symptoms are necessary for diagnosis; how long must symptoms persist?) • 2 or more of the following for at least one month o Delusions (90%) o Hallucinations o Disorganized speech o Disorganized or catatonic behavior o Negative symptoms • Social/occupational impairment • Total disturbance at least 6 months 7. Onset of schizophrenia (and gender differences) • Early adulthood o Men typically get it earlier and more severe than women o Rapid in small number of cases, but slow, insidious onset in most cases • Suggested role of estrogen o Estrogen is seen as a protective factor 8. Know what factors are associated with relatively better and poorer prognosis (e.g., negative symptoms, etc.) • Better prognosis o Good premorbid functioning o Acute onset o Later age of onset o Being female (estrogen protective) o Treatment with antipsychotic medication o Good inter-episode functioning o No family history of schizophrenia • Poorer prognosis o Negative symptoms 9. Be familiar with deinstitutionalization and its effects on individuals with serious mental illnesses • Deinstitutionalization movement involves closing down mental hospitals and treating persons with severe mental disorders in community programs • Some speak of the “abandonment” of chronic patients to a cruel and harsh existence • Homeless shelters in metropolitan communities have become a “makeshift alternative” to inpatient mental health care • Increased the rates of suicide among people with mental illness 10. Know what the other psychotic disorders are and be able to identify them if given a case example: • Schizoaffective Disorder: combination of schizophrenia and mood disorder o Major Depressive Episode or a Manic Episode o During same period of illness, there have been delusions of hallucinations for at least 2 weeks in the absence of prominent mood symptoms • Schizophreniform Disorder: like schizophrenia but only 1-6 months duration o Two (or more) of the following, each present for a significant portion of time during a 1 month period § Delusions, hallucinations, disorganized speech o No MDEs or manic episodes have occurred concurrently with active-phase symptoms • Delusional Disorder: delusions, but otherwise normal behavior o Presence of one or more delusions for at least a month o Halluciations, if present, are not prominent and are related to the delusional theme • Brief Psychotic Disorder: usually lasts only a matter of days o Presence of one of more of the following symptoms § Delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior o Duration of an episode of the disturbance is between 1 day and 1 month, with eventual full return to premorbid level of functioning 11. Types/themes of delusions • Erotomanic type: belief that another person is in love with them • Grandiose type: conviction of having some great (but unrecognized) talent or having made some important discovery • Jealous type: one’s spouse or lover is unfaithful • Persecutory type: belief that she/he is being conspired against, cheated, spied on, followed, poisoned or drugged, maliciously maligned, harassed, or obstructed in the pursuit of long-term goals • Somatic type: bodily functions or sensations • Mixed type: no one delusional theme predominates • Unspecified type: cannot be clearly determined or is not described in the specific types 12. Biological causal factors from text, including: • Understand the role of family history (e.g., parents, twin studies) o Schizophrenia concordance rates for identical twins are consistently found to be significantly higher than those for fraternal twins or ordinary siblings o Not solely a genetic disorder • Prenatal factors (and what they have in common)- all have to do with the mother o Viral infection o Rhesus incompatibility o Early nutritional deficiency o Maternal stress • Dopamine and glutamate hypotheses o Dopamine hypothesis: too much dopamine o Glutamate hypothesis: deficiency/defect in the receptor that glutamate stimulates 13. Treatment outcome (different prognosis depending on presenting symptoms) • Interesting fact: patients who live in less industrialized countries tend to do better overall than patients who live in more industrialized nations • Factors implicated in early deaths: long-term use of antipsychotic medications, obesity, smoking, poor diet, use of illicit drugs, lack of physical activity Chapter 16: Therapy (Psychological Treatment) 1. Have familiarity with the following: • The four common factors of psychological treatment o Client/extra-therapeutic o Therapeutic relationship o Placebo, hope and expectancy o Models/techniques • PRIDE skills o Praise appropriate behavior § Labeled praise: include specifics in the praise • “I really appreciate it when you clean your room” • “Thank you for following directions” § Unlabeled praise: simple praise (not as beneficial) • “Good” • “Thanks” • “Great job” § Benefits • Increases good behavior and self-esteem • Adds warmth to relationships • Feels good to give/receive compliment o Reflect appropriate talk § Repeat/paraphrase what child says, but don’t “parrot” them § Example: • Child: I made a star • Parent: Yes, you made a star § Benefits • Allows child to lead the conversation • Shows the child that you’re listening • Shows that you “get” what the child is saying • May help the child develop better communication skills o Imitate appropriate play § Meant for younger children, where it is intended to help the parent focus attention on the child § Also shows approval for their activity § Example • Child: I’m making a sun in the sky • Parent: I’m going to put a sun in my picture too § Benefits • Opportunity to teach social skills o Describe appropriate behavior § Play-by-play § Example • Child: goes to get a red block • Parent: You’re grabbing the red block § Benefits • Reinforces good behavior with positive attention • May promote self-awareness o Enthusiasm § Let them know that what they did was great § Smile, laugh, talk, brag about them where they can hear you § Benefits • Reinforces appropriate behavior • Builds rapport • Behavioral activation o Focus is on changing behavior in some way o Could be helpful for things such as depression and social anxiety • How might we measure behavior/well-being in a client? (think pain levels, stress levels, etc.) o Smiley face scales (happy, smiley face up to angry face) • For the above treatments, be familiar with why and in which situations they may be helpful • Thinking errors and how to counteract them o All or nothing o Overgeneralization o Minimization o Mind reading o “Should haves” o Labeling o Personalization o Blaming others Chapter 17: Contemporary and Legal Issues in Abnormal Psychology 1. What is forensic psychology? • Application of psychology and psychological principals to methods, theory and practice of law • Types: research, assessment, clinical 2. Factors that could affect forensic assessment • Attorneys may teach clients about malingering, test responses, test materials • Attorneys may try to influence test findings through interactions with the psychologist • Debate about whether raw data should be included in forensic neuropsychological reports • Recent rulings that a representative does not need to be present during testing, particularly if a third party might influence test results • False confessions • False eyewitness reports • Issues with anatomically detailed dolls 3. Race and the legal system • 1 in every 106 white males age 18 or older is incarcerated • 1 in every 36 Hispanic males age 18 or older is incarcerated • 1 in every 15 Black males age 18 or older is incarcerated • Why? o Differential offending hypothesis o Differential selection hypothesis o Combination of both § Need to further examine other legal and extralegal factors • Reasons racial/ethnic minorities are disproportionately overrepresented in the criminal justice system o County-level factors (percent of racial/ethnic minorities, income gap for racial/ethnic minorities) o Individual factors (swiftness of decision making, biases) o Policies o Neighborhood factors (housing laws, violence exposure, education) 4. Death penalty (basic information about it - is it an effective deterrent?) • I’m not sure the answer to this question. If you figure it out, feel free to contact me and I will let the rest of the class know. Information wasn’t in the lecture or the textbook that I could find 5. The insanity defense • Insanity: can’t distinguish between right and wrong • Psychosis: can’t differentiate between what’s real and what’s not real • Not guilty by reason of insanity (NGRI) o The claim that you’re not legally responsible for your actions because you did not possess your full mental capacity at the time of the crime o Used to be more common and less controversial § Today, fewer than 2% of capital cases use this defense 6. Insanity defense • Insanity: legal term • Mental illness: medical/psychological term • Mental illness can lead to insanity 7. Civil commitment (what criteria need to be met for this to happen) • To be involuntarily hospitalized, an individual must be: (starred are required, need one or both of the other two) o Dangerous to themselves or others o Incapable of providing for their basic physical needs and/or o Unable to make responsible decisions about hospitalization o In need of treatment or care in a hospital • Still have rights to refuse treatment while inpatient 8. Assessment of dangerousness à how good are we at predicting? • Duty to warn (Tarasoff) o The Tarasoff decision set precedent for therapists’ duty-to-warn § Client stated intent to kill his ex-girlfriend § Therapist notified authorities but not the ex-girlfriend § Client killed her; her parents successfully sued for not warning her o Some confusion exists about which situations merit warning
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