Psyc 3560 (abnormal psyc) FINAL study guide
Psyc 3560 (abnormal psyc) FINAL study guide PSYC 3560
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This 22 page Study Guide was uploaded by Kennedy Finister on Saturday June 25, 2016. The Study Guide belongs to PSYC 3560 at Auburn University taught by Dr. Fix in Spring 2016. Since its upload, it has received 8 views. For similar materials see Abnormal Psychology in Psychlogy at Auburn University.
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Date Created: 06/25/16
(Chapter 11) – Substance Use Disorders General terms: Tolerance The need for increased amounts of a substance to achieve the desired effect o Results from biochemical changes in the body that affect the rate of metabolism and elimination of the substance from the body Intoxication The pathological state produced by a drug, serum, alcohol, or any toxic substance; poisoning. Acute alcoholism. Withdrawal Physical symptoms such as sweating, tremors and tension that accompany abstinence from the drug Abuse Generally involves an excessive use of a substance resulting in: 1. Potentially hazardous behavior such as driving while intoxicated 2. Continues use despite a persistent social, psychological, occupational or health problem Dependence Includes more severe forms of substance use disorders and usually involves a marked physiological need for increasing amounts of a substance to achieve desired effects o Individual will show tolerance for a drug and or experience withdrawal symptoms when the drug is unavailable Mesocorticolimbic dopamine pathway (MCLP) AKA: "pleasure pathway" • substance abuse involves neurochemical stimulation of the _____ _____ _____ pathway. o This is the center of psychoactive drug activation in the brain. • functions as control of emotions, memory, and gratification. • stimulaton produces great pleasure and has strong reinforcing properties Standard Drink Sizes wine 5oz o usually 12% alcohol liquor 1.5 oz o usually 40% alcohol beer 12 oz o usually 5% alcohol Substance Use Disorder symptoms Alcohol Use Disorder Consequences of chronic alcohol use (psychological and physical) o Physical When large mounts of alcohol are ingested the liver may be seriously over worked and suffer irreversible damage like cirrhosis of the liver (a disorder that involve extensive stiffening of the blood vessels) Alcohol has no nutritional value so an excessive drinker can suffer form malnutrition. Since drinking impairs the body’s ability to utilize nutrients, nutritional deficiency cant be made up by popping vitamins o Psychological Alcohol withdrawal delirium Happens following a prolonged drinking spree when the person enters a state of withdrawal. Symptoms o Disorientation for time and place (may mistake hospital for church or jail, wont recognize friends/family, etc) o Vivid hallucinations, particularly of small fast moving animals such a snakes and rats o Acute fear in which animal hallucinations may change in form, size, color in terrifying ways o Extreme suggestibility, in which a person can be made to see almost any animal if its presence is merely suggested o Marked tremors of the hands, tongue and lips o Perspiration, fever, a rapid an weak heartbeat, a coated tongue/foul breath Lasts 36 days followed by deep sleep Death rate as a result of convulsions, heart failure and other complications once approximated 10% but has remarkably reduced Alcohol Amnestic Disorder Outstanding symptoms a memory defect which is sometimes accompanied by falsification of events o May not recognize pictures, faces, rooms, and other objects that they have just seen, although they may feel that these objects/people are familiar o Tend to fill memory gaps with reminiscences and fanciful tails that lead to unconnected and distorted associations. o Individuals appear to be delirious, delusional, and disoriented for time and place but ordinarily their confusion and disordered actions are closely related to their attempts to fill memory gaps Societal consequences of chronic alcohol use o Heavy drinkers suffer from chronic fatigue, oversensitivity, and depression o Impaired reasoning, poor judgment, gradual personality deterioration Leading to increasing less responsibility, loses pride in personal appearance, neglect friends and family, becomes touchy, irritable, and unwilling to discuss the problem. Making It hard to maintain a job Causal factors in alcohol use disorders (as well as other drugs), including psychosocial and sociocultural factors o Biological Although there are genetic influences, precise relationships are not well understood Most children don’t develop substance use disorders Geneenvironment interaction? Learning plays an important role o Classical conditioning à alcohol becomes associated with certain cues. For example, if you always watch football while drinking, when a football game starts on tv, you may feel an urge to drink. o Operant conditioning à perceived positive consequences of drinking (e.g., increase popularity) may make that behavior more likely to recur o Psychosocial Parenting Lack of stable family relationships and parental guidance Lack of monitoring o parents who abuse alcohol are less likely to monitor well, so this oculd partially explain why alcoholism runs in families Chaotic environments Family involvement and parental modeling can serve as a protective factor even when other risk factors are present. Expectations of social success Many people especially young adults expect that alcohol use will lower tension, anxiety and increase sexual desire and pleasure in life Teens will begin drinking as a result of expectations that using alcohol will increase their popularity and acceptance Marital and other intimate relations Adults with less intimate and supportive relationships tend to show greater drinking following sadness or hostility than those with close peers and with more positive relationships. Excessive drinking often begins during crisis periods in marital or other intimate personal relationships o Sociocultural Social events in Western culture often revolve around alcohol Often seen as a tension reducer, alcohol use before and during meals The incidence of alcoholism is minimal among Muslims and Mormons, whose religious views prohibit the use of alcohol The incidence of alcoholism is high among Europeans (15% in France) Treatment of alcohol use disorders, including Medications (e.g., Antabuse, Naltrexone) AA, CBT, MI o Many alcohol abusers don’t seek treatment until they’ve hit rock bottom o Objectives generally include detoxification, physical rehabilitation, control over alcohol abuse behavior, and the individuals realizing that he or she can cope with the problems of living and lead a much more rewarding life without alcohol o Anatabuse Drug that causes violent vomiting when followed by ingestion of alcohol may be administered to prevent an immediate return to drinking more expensive than more affective treatments o Naltrexone An opiate antagonist that helps reduce the craving for alcohol by blocking the pleasureproducing effects of alcohol Particularly effective with individuals who have a high level of craving o Cognitive Behavioral Therapy Combines intervention with social learning theory and modeling behavior. Often referred as the “skills training procedure” Usually aimed at younger problem drinkers who are considered to be at risk for developing more severe drinking problems because of an alcohol abuse history in their family or their current heavy consumption Drug Use Disorders Be familiar with the different classes of drugs (i.e., sedatives, stimulants, opiates, hallucinogens) o Sedatives Agents that have a soothing, calming, or tranquilizing effect; reducing or relieving anxiety, stress, irritability, or excitement Examples: Barbiturates o Act as depressants , slow down the action of the central nervous system and significantly reduce performance on cognitive tasks o Shortly after taking one and individual experiences a feeling of relaxation in which tensions seem to disappear, followed by a physical and intellectual lassitude and tendency toward drowsiness and sleep o Excessive doses result in paralysis of the brain and death o Opiates narcotic sedatives that depress activity of the central nervous system, reduce pain, and induce sleep. Examples: Morphine Heroine o Highly addictive o More dangerous and faster acting/more intensely than morphine o Commonly introduced to the body by smoking, snorting, eating or thru injection of a needle o Starts off with a rush that lasts up to 60sec followed by a high that lasts 46 hours. o Withdrawal Can be easy and done without assistance Can be agonizing with symptoms including Runny nose, teary eyes, perspiration, restlessness, increased respiration rate, and intense desire for the drug. And as time goes on it leads to chills/flushing, excessive sweating, vomiting, diarrhea, headache, pain in extremities and insomnia. Symptoms usually on the incline by day 4 and gone by day 8 o Stimulants drugs that 'stimulate' the central nervous system. In other words, they increase the activity in your brain. Though each stimulant has unique effects, all stimulants increase your heart rate, blood pressure, and body temperature. Examples: Cocaine o Plant derivative Been around since ancient times. Used to be extremely expensive but prices decreased in 80s led to increase in cocaine o Crack cocaine = cocaine processed to freebase for smoking (sniffing, swallowing, injecting) o 46 hours euphoria o Physiological dependence acute tolerance (within a session of multiple administrations of drug). chronic tolerance à can develop Withdrawal – depression. Fatigue, disturbed sleep, increase dreaming. Seems to be shortlived Meth o Euphoric effects similar to other stimulants (e.g., cocaine) o Crystal/ice – smoked, snorted, swallowing, injecting – effects almost instant if smoked or injected o Metabolized slower than cocaine so longer lasting o Becoming more popular because cheap and easy to manufacture Cooked in large quantities o Negative effects Withdrawal can be severe Destroys dopamine receptors Permanent brain damage Psychotic behavior Caffeine Nicotine o Highly addictive but associated with little social or functional impairment o Negative effects Craving, irritability, frustration, anger, anxiety, difficulty concentrating, headaches, insomnia o Hallucinogens mindaltering drugs that are commonly known as psychedelics examples: LSD o Very potent hallucinogen o Results in ~8 hours of Change in sensory perception Mood swings Feelings of depersonalization and detachment Depersonalization à feeling detached from your body Derealization à feeling that the external world is strange & unreal Trips and flashbacks involuntary recurrence of perceptual distortions or hallucinations weeks or even months after the individual has taken the drug – relatively rare Ecstasy (MDMA) o Hallucinogenic and stimulant properties o Tablets vary widely in strength, and often contain other drugs o positives Rush, feeling of calm energy/wellbeing, intensified feelings, colors, sounds Empathy, sensation of understanding/accepting others o Negatives Nausea, sweating, clenched teeth, muscle cramps, blurred vision o Memory impairment and depression indicated, yet longterm effects unknown Marijuana o most frequently used illicit drug à 34.9% high school students used within the last 12 months o Minority group members & EA (European Americans) have similar rates of use; minorities much more likely to be incarcerated o Seconds to minutes for onset – lasts a couple of hours o Subspecies Cannabis indica Physical high Strong analgesic effect Couchlocking Origin: Morocco, Afghanistan, Nepal, Turkey Size: shorter plants (3 ft) Cannabis sativa Mental high Increased creativity Origin: Colombia, Mexico, Thailand, African nations Size: taller plants (6 ft) o Effects: Mild euphoria, sense of wellbeing, pleasant relaxation Intensification of senses, distorted sense of time Shortterm memory deficits Higher doses can lead to talkativeness, hilarity or anxiety and depression Lethargy, passivity, functional impairment Typical effects for each type of drug o Sedatives Reduce tension Facilitate social interaction “block out” feelings or events o Opiates Alleviate physical pain Induce relaxation and pleasant reverie Alleviate anxiety/tension o Stimulants Increase feelings of alertness and confidence Decrease feelings of fatigue Stay awake for long periods of time Increase endurance Stimulate sex drive o Hallucinogens Induce changes in mood, thought, and behavior “expand” ones mind induce stupor Potential consequences of chronic use o Sedatives Physiological and psychological dependence. Brain damage and personality deterioration o Opiates Lowering ethical/moral values Life is centered around obtaining and using drugs so the individual is forced to lie, steal and associate with undesirable contacts to maintain supply. Some even turn to petty theft/prostitution. Inadequate diet Leading to poor health and increased susceptibility to diseases/physical ailments Unsterile equipment Lead to liver damage from hepatitis or gain of the AIDS virus Women who use during pregnancy can have a premature baby who is also addicted to heroin, vulnerable to a number of diseases and go thru withdrawal symptoms o Stimulants Cocaine Acute toxic psychotic symptoms may occur including frightening visual, auditory, and tactual hallucinations similar to those in acute schizophrenia Employment, family, psychological, and legal problems are all more likely to occur o Result from the considerable amount of money required to feed the habit & the increased sexual activity leads to trading sex for drugs Pregnant women are at risk for birthing premature kids, losing their kids, or maltreating their kids Methamphetamine Increasing levels of dopamine in the brain, long term uses can produce structural changes Discontinuing the drug can result in problems learning, memory, & cognitive dysfunction o Hallucinogens LSD Trips can be traumatic, thoughts and visions are menacing/terrifying. Can cause someone to commit suicide, jumping off high building, setting themselves aflame, etc Flashbacks o Involuntary recurrence of perceptual distortions or hallucinations weeks or months after drug is taken Marijuana Induces memory dysfunction & a slowing of information processing Why is it difficult to estimate prevalence rates for drug use disorders? o Underestimated because many people with these problems don’t seek help o Issues with good/bad distinction – many legal drugs used for medical reasons can also have adverse side effects and be habit forming (i.e. painkillers, etc) o Also, people can use illegal substances without developing a problem (e.g., occassional pot smoker) Cannabis controversy (reasons for & against legalization or decriminalization of marijuana) o Should marijuana be legalized or not? It is in 14 states and DC Is medical weed a legitimate pharmaceutical treatment? Is it a gateway drug? Problems Unregulated availability o Just about anyone can get a “prescription” for the drug by walking into one of the many treatment centers and talking to a sale person Using medical weed in the work setting o Number of people have lost jobs or not offered a position due to drug screening o For legalization Medicinal marijuana several states now approve use of marijuana for chronic conditions such as MS Prohibition does not stop consumers from consuming drugs No risk of overdose or extremely impaired judgment Starting to become more accepted, people less concerned, especially in certain regions like the west coast and in Canada based on fact that unlike other drugs, not related to risk of overdose or extremely impaired judgment, minimal acute side effects Collapse in the illegal drug industry, and a reduction in crimes Make money off of taxes $53 million in CO Causal factors o Sedatives Young people experiment Older people use them as “sleeping pills” o Opiates Most frequent Pleasure, curiosity, peer pressure Others Desire to escape life stress, personal maladjustment, and sociocultural conditions Treatment in general (not for specific disorders) o Approaches/components Detoxification Motivation building (often involves feedback) Feedback – normative feedback, feedback on own deteriorating health – smokers shown ultrasound of hardened arteries Cognitivebehavioral therapy Relapse prevention Group therapy, support groups (e.g., NA) Medications, replacement therapies (e.g., methadone, nicotine patch) Methadone – similar to heroine and just as addictive but less psychological impairment Treatment dropout and relapse rates generally high Ch. 12 – Sexual Variants & Dysfunctions What theme is most present for Sexual/Gender Disorders (hint: determining abnormality)? o Distress or victim? = disorder Sociocultural influences on sexuality o Sexual “standards” of one’s culture tend to drive what is considered acceptable or not o Examples: Abstinence Theory (1800s) People believed that masturbation was a metal health issue & ejaculation was going to make men weaker & red meat would enhance sex drive Dr. John Harvey Kellogg urged people to eat more cereals and nuts so he invented Kellogg’s Cornflakes. o Anti masturbation food Ritualized homosexuality in the Sambia Tribe 2 beliefs o sexual practices are semen conservation and female population semen is important for many things like physical growth, strength and spirituality. And it takes many inseminations to impregnate a woman they didn’t think semen was easily replenished by the body so it must be conserved or obtained somewhere else o young males practice semen exchange with each other. Oral sex as young boys and after puberty they can take on the penetrative role inseminating other boys not until men are well past puberty do they make the transition to heterosexuality. o They may begin having sex with women and still participate in oral sex (fellatio) with other younger boys until they have their first child. Then all homosexual behavior ends. o Some sexual standards are culturally consistent Men: greater emphasis on partner’s attractiveness Taboos against incest Psychiatry/psychology and homosexuality o Not too distant past homosexuality was a taboo topic o In 1973 homosexuality was removed from the DSM where it had previously been classified as a sexual deviation Homosexual people being mentally ill was relatively tolerant compared to some earlier views that they were criminals and in need of incarceration 16 century King Henry VIII declared homosexuality a felony punishable by death. Not until 1861 was the maximum penalty lowered to 10yrs imprisonment Freud’s attitude was rather progressive for his time and is well expressed in his “letter to an American mother” (1935) 1950 view of homosexuality as sickness began to be challenged by scientists and homosexual people themselves. Alfred Kinsey’s finding that homosexual behavior was more common than had been previously believed Studies demonstrated that trained psychologists could not distinguish the psychological test results of homosexual subjects from those of heterosexual o Homosexual people do appear to have elevated risk for some mental problems like higher anxiety rates and depression but that could be explained by stressful life events related to societal stigmatizing of homosexuality What are paraphilias? (generally speaking) o Unusual sexual interests but do not cause harm either to the individual or to others Paraphilia vs. paraphilic disorder o Paraphillas only become disorder if they cause harm. Victim or distress? DISORDER o Disorder Recurrent, intense sexually arousing fantasies, sexual urges or behaviors that generally involve 1. Nonhuman objects 2. The suffering or humiliation of oneself or ones partner 3. Children or other nonconsenting persons Be able to identify the 8 paraphilic disorders recognized by the DSM5 (and know the information presented in class about each disorder, including causal factors and treatment) o Fetishistic Disorder Over a period of at least 6 months Fantasies, urges, or behaviors involving inanimate objects or highly specific focus on nongenital body parts to obtain sexual gratification Must cause significant distress or impairment Examples – undergarments, shoes, feet Fetish objects are not limited to articles of clothing used in cross dressing or devices specifically designed for sexual pleasure (vibrator) Becomes a problem when person starts to pay people to like feet, videoing peoples feet in public shower, spending a lot of money and time around fetish o Transvestic Disorder Heterosexual men – fantasies, urges, or behaviors involving crossdressing Must cause significant distress or impairment in social, occupational or other important areas of functioning Becomes a problem when they cant become sexually aroused without dressing as a woman Embarrassing how do you explain that to your wife? So it often leads to cheating Not a drag queen Drag queens perform for fun or its their job. Not a problem 3% of men have engaged in some crossdressing; however, most do not meet a diagnosis Most (83%) are married o Keep crossdressing secret, or try to 87% are heterosexual o Voyeuristic Disorder Fantasies, urges, or behaviors involving the observation of an unsuspecting person who is undressing or engaged in sexual activity – aka “peeping toms” Sexually aroused by creepin on people when they don’t know. Can be anywhere from watching them watch tv or to changing in their room Distress/impairment OR acted upon such urges with a non consenting person One of the most common disorders Often no resulting criminal behavior Why not just use pornography? Most likely lacks the excitement associated with watching someone unsuspecting Course 1. Young males find viewing the body of a female sexually stimulating 2. Privacy and mystery that have traditionally surrounded sexual activities tend to increase curiosity about them 3. Males feel shy and inadequate in his relations to a female he may accept this, which satisfies his curiosity and to some extent his sexual need without the trauma of actually approaching a female Avoids the rejection and lower self esteem o Exhibitionistic Disorder Fantasies, urges, or behaviors involving exposure of one’s genitals to others in inappropriate circumstances and without consent Distress/impairment OR acted upon such urges Element of “shock” of the unsuspecting person is arousing to such individuals Must experience arousal Commonly cooccurs with voyeurism Begins at a young age Most common disorder to have victims & reported to police Typically an ordinarily young or middle aged female who is not known to the offender although children and teens may also be targeted o Sexual Sadism Disorder Fantasies, urges, or behaviors involving the infliction of psychological or physical pain on another individual Themes – dominance, control, humiliation Distress/impairment OR acted upon such urges with a non consenting person Serial killers/rapists – are often “extreme” sadists Comorbid disorders Narcissistic, schizoid, or antisocial personality disorders o View people in a different way. Especially non empathetic o Sexual Masochism Disorder Fantasies, urges, or behaviors involving the real act of being humiliated, beaten, bound, or otherwise made to suffer. Causes clinically significant distress/impairment 515% of people enjoy this voluntarily Autoerotic asphyxia – “selfstrangulation” – leads to 5001,000 accidental deaths/year More common in men Typically have a history of sexual abuse/rape and has become a learned behavior. They’ve associated pain and humiliation with sexual pleasure from young age. They assume that how its supposed to be o Frotteuristic Disorder Fantasies, urges, or behaviors involving touching or rubbing against a nonconsenting person Distress/impairment OR acted on such urges Typically begins age 1525 Often a gradual decline in frequency of such behaviors or urges Less likely to be noticed, can be seen in contact sports like basketball, football or at music festivals where everyone is crowded touching and dancing around o Pedophilic Disorder Fantasies, urges, or behaviors involving the sexual activity with a prepubertal child (generally age 13 or younger) Distress/Impairment OR Acting upon urges Perpetrator is at least 16 years old and at least 5 years older than the victim Many engage in work with children or youth so that they have extensive access to children Studies show that adolescent and adult men with pedophilia are much more likely to have been sexually or physically abused as children Victims can be male or female Typically girls between 8 & 11 Hebephilia Aroused by pubescent children (children in early stages of puberty) Pedophilic Disorder vs. Child sexual abuse Pedophilic disorder à sexual interest in children (believed to be inborn, not a choice) Child sexual abuse à acting on these interests (is a crime) o Sexual interaction with children frequently involves manual or oral contact with a child’s genitals; penetration is much rarer o Which is most commonly reported to police? Exhibitionist o Which is believed to be most common overall? voyeuristic Gender Dysphoria? o Discomfort with one’s sexrelevant physical characteristics or with one’s assigned gender o Course Children with Gender Dysphoria usually become welladjusted adults Most identify as gay/lesbian, some go on to be transgender Society is more concerned about males with Gender Dysphoria o More common in males (5:1) o Less accepted for males than girls to have dysphonia because he crossgender behavior for girls is better tolerated In children, the desire to be of the other gender must be present and verbalized For many adults with Gender Dysphoria, course is chronic unless they receive sex reassignment surgery What is Transsexualism? o Transsexualism Refers to adults with Gender Dysphoria who desire to change their sex, and surgical advances have made this goal, although expensice, partially feasible Very rare Difference in sex and gender for at least 6 months Strong heritable component (67%) Much less common than childhood gender dysphoria o Treatment Psychotherapy is not effective in treating transsexualism Sex reassignment is the only know treatment to be effective Transsexuals who want and are awaiting surgery are given hormone treatment o Males Estrogens to facilitate breast growth, skin softening and shrinking of muscles o Females Testosterone , which suppresses menstruation, increases facial/body hair and deepens voice. Before they are eligible they must live for many months with hormonal therapy and they generally must live at least a year as the gender they wish to become o If they pass they undergo surgery and take hormones indefinitely male female transsexuals o neo vagina is sexually functional & usually undergo extensive electrolysis to remove their beards and body hair. And learn to heighten the pitch of their voice female male transsexuals o given mastectomies and hysterectomies and often have other plastic surgeries to alter various facial features. Only a subset seek an artificial penis because techniques are still primitive and its not capable of normal erections an would have to rely on artificial supports anyway 87% of male to female and 97% female to male transsexuals report satisfactory outcomes Four phases of human sexual response 1. Desire a. Consists of fantasies about sexual activity or a sense of desire to have sexual activity 2. Excitement/arousal phase a. Characterized by both a subjective sense of sexual pleasure and by physiological changes that accompany this subjective pleasure i. Including penile erection in the male and vaginal lubrication and clitoral enlargement in the female 3. Orgasm a. There is a release of sexual tension and a peaking o sexual pleasure 4. Person has a sense of relaxation and wellbeing What are disorders of sexual dysfunction? (generally speaking) o Sexual desire & arousal disorders Male hypoactive sexual desire disorder Little or no sex drive or interest Situational rather than life long Erectile disorder Difficulty obtaining/maintaining an erection Causal factors o Can be result of being on antidepressants o Consequence of aging o Vascular disease which results in decreased blood flow to penis or diminished ability of the penis to hold blood to maintain erection o Diseases that affect nervous system such as MS can cause this Female sexual interest/arousal disorder Little or no sex drive or interest and/or reduced sexual excitement/pleasure Causal factors o Prior or current depression or anxiety disorders & their medications o Age o History of unwanted sexual experiences (rape) o Psychological factors Low relationship satisfaction, daily hassles, and worries and increased disagreements and conflicts, low self esteem, etc Most common amongst females Treatment: Sometimes meds or psychotherapy o Orgasmic disorders Premature ejaculation Onset of ejaculation with minimal sexual stimulation o Average duration of time is 15 strokes or 15 sec Consequences o Failure of the partner to achieve satisfaction o Embarrassment from the early ejaculating man with disruptive anxiety about reoccurrence on future occasions Most common dysfunction of males up to 59yrs Causal factors o Unknown o Maybe increased anxiety or increased penile sensitivity and higher levels of arousal to sexual activity Delayed ejaculation Delay on almost all occasions Only about 310% of men Causal factors o Physical problems such as MS or the use of certain medications such as SSRIs Female Orgasmic Disorder Delay of orgasm following appropriate sexual stimulation Causal factors o Some women may feel fearful and inadequate in sexual relations o Woman may be uncertain whether her partner finds her sexually attractive and this may lead to anxiety and tension which then interfere with her sexual enjoyment o She may feel inadequate or experience sexual guilt (especially in religious women) because she is unable to have an orgasm or does so infrequently o Biological Intake of SSRIs Genital anatomy Prevalence Fairly common Difficult to define abnormal o e.g. premature ejaculation Treatment Psychoeducation about sexuality/anatomy, masturbation, behavioral therapy, cognitive therapy, and meds o Sexual pain disorder GenitoPelvic Pain/Penetration Disorder (one or more of the following) Difficulties with vaginal penetration Pain during intercourse Fear/anxiety about pain related to vaginal penetration Tensing/tightening of pelvic floor muscles during penetration Causal factors Physical o Acute or chronic infections or inflammations of the vagina or internal reproductive organs, vaginal atrophy that occurs with aging, scars from vaginal tearing or insufficiency of sexual arousal Diagnosed in females only Treatment banning intercourse, training vaginal muscles (vaginal dilation), CBT, relaxation, surgery Chapter 16: Therapy (Psychological Treatment) Have familiarity with the following: The four common factors of psychological treatment PRIDE skills (Know what they are and in what situations they are or are not appropriate) o Praise appropriate behavior Types of praise: Labeled praise o “I really appreciate it when you clean your room,” “Thank you for following directions.” Unlabeled praise o “Good,” “Thanks,” “Great job.” Benefits of praise: Increases good behavior Increases selfesteem Adds warmth to relationship Feels good to give/receive compliment o Reflect appropriate talk Repeat or paraphrase what child says Not parroting Allows child to lead the conversation Shows the child that you are 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 Opportunity to teach social skills o Describe appropriate behavior Playbyplay Reinforces good behavior with positive attention May promote selfawareness o Enthusiasm Be excited! Let them know that what they did was GREAT! Reinforces appropriate behavior Builds rapport Smile, laugh, talk, brag about them where they can hear you o Parenting Skills that can be Applied Anywhere by Anyone Ignoring Ignore benign bad behaviors that serve only to get your attention Don’t inadvertently reward bad behavior with your attention Ignore: tantrums, whining, pleading, crying, grouchiness, cussing, arguing o Completely ignore o Make sure you can really ignore it… When you can’t ignore Aggressive, destructive behavior Be calm, unemotional, direct Tell them what they did wrong, the consequence, and what to do in the future Establish consequences of good and bad behavior well ahead of time Behavioral activation o Focus is on changing behavior in some way How might we measure behavior/wellbeing in a client? (think pain levels, stress levels, etc.) For the above treatments, be familiar with why and in which situations they may be helpful Thinking errors and how to counteract them o Common in the general population All or nothing Overgeneralization Minimization Mind reading “Should haves” Labeling Personalization Blaming others
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