Abnormal Psychology Review Exam 1
Abnormal Psychology Review Exam 1 PSY 4343
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This 17 page Study Guide was uploaded by Yesenia Notetaker on Tuesday September 20, 2016. The Study Guide belongs to PSY 4343 at University of Texas at Dallas taught by Dr. Amy Pinkham in Fall 2016. Since its upload, it has received 7 views. For similar materials see Abnormal Psychology in Psychology (PSYC) at University of Texas at Dallas.
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Date Created: 09/20/16
08/22/16 - Abnormality What is Abnormal? o The Four D's -> not always have all 4 Deviant Social Norm o Most people don't do it Stimming (+ context: autistic) Costumes (+ context: non-Halloween) Statistically Deviant o 2 Standard Deviations outside mean/average IQ's Can be good or not. Being normal can also not be good (context) Distressing Self o Self-Harm behavior/thought Other o Loved ones, usually Presence of distress o Motivates treatment seeking behaviors Absence of distress o Lacking empathy, pain, hunger, etc. Dysfunctional Impairment, not working o Usually a criterion for diagnosis Dangerous Self o Self-harm Other o Collaterals Case Example: Claire o Fulfills all four D's Deviant Many people do not react this way Distressing More than one episode Dysfunctional Every day life not working Dangerous Self-harm and others 08/22/16 - Abnormal Behavior in Historical Context The Supernatural Model: Mental Illness as a Stigma. o Characteristics Those with mental illness are weak or bad Mental patients often separated from society Treatment: Discipline, punishment o Components People feel ostracized and embarrassed when seeking treatment for psychological distress Media depiction of mental illness has a large impact. Early Biological Explanations o Hippocrates Classified mental illness Mania Melancholia Phrenitis Believed normal brain function depended on four humors, or fluids of the body Blood o Changeable temperament Black bile o Melancholia Yellow bile o Irritability o Anxiousness Phlegm o Sluggish o Dull Basic premise foreshadowed aspects of contemporary thought Human behavior is markedly affected by bodily structures or substances and that odd behavior is produced by some kind of physical imbalance or damage Dark Ages: Supernatural Model returns o Witch Persecution Noteworthy: More healthy than mentally ill people were tried, contrary to possible belief. o Lunacy trials Noteworthy: English hospital made for the sole purpose of 'protecting the mad' and 'Lunacy trials' determined a person's insanity, judgement that allowed the Crown to become the individual's guardian. Evolution of Contemporary Thought o Psychological Approaches Psychoanalytic Model Freud and Jung Characteristics Behavior determined largely by underlying psychological forces of which the person is not consciously aware o The Psyche o Unconscious Internal forces are dynamic Abnormal symptoms result of conflicts between forces Deterministic Assumption o All of your behavior is determined by your past experiences (not your learning) Internalized, in your unconscious, driving current behavior The unconscious exists o The Psychic Apparatus (1900-1915) All driven by central, internal drives Primary internal drive is Sexual Satisfaction o Unable to satisfy, causes abnormal behavior Consciousness Awareness of surroundings Preconscious Ideas not thinking about, but are readily accessible Barrier Does not allow the ideas in unconscious move forward Unconscious Largest part of psyche o The Psychic Apparatus (1923) Modified previous theory All driven by central, internal drives o Primary internal drive is Sexual Satisfaction Added aggression Consciousness o Awareness of surroundings Preconscious o Ideas not thinking about, but are readily accessible Barrier o Does not allow the ideas in unconscious move forward Unconscious o Largest part of psyche Iceberg Model Ego o Tip of iceberg Consciousness Ideas, thoughts, and feelings of which we are aware o Just below the water Preconscious Material that can be easily recalled Deep o Unconscious Well below the surface of awareness o Superego Ego ideal, moral guardian Psyche Id - It o Instinctual drives Sex and aggression o Pleasure principle Satisfy these urges o Primary process thinking Scattered Ego - I o Reality principle Realistic way of approaching the world Helps you behave socially acceptable Keeps you from acting from aggressive impulses o Defense mechanism Unconscious processes that prevent our knowledge of intolerable thoughts or anxieties; allow venting of these conflicts indirectly Repression o Not allowing painful or dangerous thoughts to become conscious Denial o Refusing to acknowledge the existence of an external source of anxiety Projection o Attributes own unacceptable impulses, motives, or desires to others Rationalization o Creates socially acceptable reason for an action that actually reflects unattractive motives o Secondary process thinking Rational, problem solving Superego – over I o Conscience Moral attitudes, what is right and wrong Culturally influenced Develops over time UNRESOLVED CONFLICTS = ABNORMAL BEHAVIOR When we can't defend o Parapraxes - 'Slips' Occur when the unconscious sexual and aggressive drives break through due to the failure of ego defenses They are not premeditated, they are leaked o Wit - jokes A controlled release of the id Regression in service of the ego for the means of venting the id impulses Freud's Developmental Stages Each stage of development focuses on a different sexually erogenous zone of the body o Can go three ways Successful resolution Fixation Getting stuck in a stage Regression Completing the stage, but regressing when dealing with anxiety o Libidinal or erogenous zones Oral stage (0-1) Dependency and reliability of caregivers Anal stage (1-2,3) Learning control and order o Your body o environment Phallic or Oedipal stage (3-6) Development / emergence of understanding there are different sexes, and they can help receive sexual gratification Castration Anxiety -> Oedipus complex o Want mom, dad is jealous, he will cut off my penis Penis envy -> Electra complex o I don't have a penis, dad can give me his Latency stage (6-12) Sexual desire diminishes, interact with same sex peers Genital stage (puberty) Adult sexual interest o If phallic stage was properly resolved Heterosexual relationships o Homosexuality? Psychodynamic Therapy Role of analyst: blank screen o Listen o Point out Freudian slips o Point out Inconsistency Free association o Say whatever comes to your mind when I say [insert word] Foundation of Talk Therapy If we let people talk without a filter, they could come around to their issue Dream analysis o Represents the unconscious and the id o Manifest content What you remember from your dream o Latent content What it means Resistance o On the part of the client o If client resists to talk about something, that is what they need to focus on Transference o Client behaves towards therapists as the behave toward a known person that causes conflict/anxiety Catharsis o Venting o Reaction to a bad experience that makes you feel better Assessing the Psychodynamic Model Groundbreaking contributions o First theory to state that normal and abnormal behavior may stem from same process o First theory to utilize psychological (rather than biological) treatments Enduring components o Defense mechanisms = coping mechanisms o Developmental view: childhood events shape our adult personalities o Memories can be repressed o Therapeutic alliance Work together with your therapist The better the relationship, the harder you work in therapy Weak Points o Concepts difficult to define and research o Extremely outdated view of women's psychological health o Behavioral Model Skinner Watson Focuses on behaviors – the responses an organisms makes to its environment Behaviors are learned Abnormal behavior: o Learning how to deal with the world in a maladaptive way. Two main ways of learning Classical conditioning (Pavlov) o Learning by a temporal association o Pairing of neutral stimulus with a nonneutral stimulus leads one to respond to the neutral stimulus as would respond to nonneutral stimulus Pavlov's dog Operant conditioning (skinner) o Rewarding or punishing a response until the person learns to repeat or avoid the response in anticipation of positive or negative consequences Reinforcement: increases performance of behavior Punishment: decreases performances of behavior Behavioral principles Reinforcement: increase behavior o Positive reinforcement Increase behavior by presenting something positive ot desirable o Negative reinforcement Increase behavior by removing something negative or undesirable Punishment: decrease behavior o Positive punishment Decrease behavior by presenting something aversive o Negative punishment Decrease behavior by removing something positive Shaping o Reinforcing successive approximations of a desired response until that response is gradually achieved Extinction o Decrease behavior by unpairing (a) unconditioned and conditioned stimuli or (b) behavior and reinforcement Generalization o Transferring a conditioned response from the conditioned stimulus to a similar stimuli Discrimination o Learning to confine a response to a particular stimulus, and not to a similar stimuli Modeling o Learning by observing others, without experiencing conditions of classical or operant conditioning directly Behavioral Treatments Exposure o Expose the person to their fears Systematic Desensitization o Exposure in a gradual way (Wolpe) Differential Reinforcement of Behaviors o Behavioral shaping o Getting people to do what you want them to do Assessing the behavioral model Groundbreaking contributions o The idea of translation The idea that work on animals can apply on humans o Carefully executed research We can measure behavior It is observable and quantifiable Enduring components o Treatment methods Particularly for anxiety o Learning theories Weak points o Overly simplistic view of human behavior o No evidence that improper learning indicated in etiology of disorders o Cognitive models Reaction to behaviorism Too simplistic Ignores working mind (cognition) Ignores free will Cognition – the mental processing of stimuli Basic tenet – abnormal behavior is a product of a mental functioning Etiology of abnormal functioning Results from problems with cognition o Negative emotions stem from negative thoughts o Illogical thinking processes Inaccurate assumptions Automatic thoughts Maladaptive attitudes Cognitive Therapies Cognitive restructuring (Beck) o We try to alter the way the person views himself, the world, and the future Rational emotive behavior therapy o Much more emphasis on the rational part Techniques o Hypothesis testing Disprove hypothesis o Reattribution training Change the way somebody looks at the situation o Decatastrophizing Talking about the worst case scenario and saying, is it really that bad? Cognitive-Behavioral Model Arose out of refinements in cognitive models Behavior and cognition intertwined Cognition as learned response (behavior) Assessing the Cognitive Model Groundbreaking contributions o Thoughts directly influence behavior and emotion Enduring components o Cognitive techniques widely used in therapy o Numerous efficacious treatments Proven to work o Multiple influences affect mental health Weak points o Causality unclear 08/22/16 - Integrative Approach Multidimensional Model o Systemic: multiple influences interact o Includes Biological factors Genes o Long molecules of DNA Double Helix structure Located on chromosomes 46 in 23 pairs Pairs 1-22 – body and brain development Pair 23 – biological sex o X-y chromosome -> male o X-x chromosome -> female o Single Gene Determinants vs. Polygenic Influences Single Gene Determinants – one gene determines it Huntington's PKU Attached earlobes Hitchhikers thumb Down's Syndrome Polygenic Influences – many genes determine it Psychopathology Identical Twin concordance rate – if one twin has it, how likely it is that the other twin does o Environment Interactions Diathesis – Stress Model Diathesis (Genetic) – a tendency to express traits and behaviors -> Vulnerability Stress (Environmental) - life events or contextual variables -> triggers expression of traits and behaviors Research example (Hariri et al., 2005) o Some people have amygdalae that are more reactive than others o Compared brain scans Reciprocal Gene - Environment Model Genes shape how we create our environments Our traits may influence the likelihood of engaging in activities or seeking out situations that could trigger our vulnerabilities o Drug addiction Being vulnerable to drug addiction makes you more likely to be exposed. o Antisocial behavior Are these models too strong? Environment and early learning o Cross-fostering studies Breed traits over generations, and at the end, switch off-spring Neonatal development o Studies of instinct Natural selection – systems that are selected for and not particular genes The Nervous System o 2 branches Central Nervous system Brain o Brain Stem – basic functions o Forebrain – higher cognition Limbic system –emotion expression – hippocampus, cingulate gyrus (specifically anterior cingulate), septum, amygdala Basal ganglia – caudate nucleus – motor function and reward processing Cerebral Cortex -> Frontal – thinking and reasoning activities -> Temporal – sight and sound recognition, long-term memory storage -> Parietal – touch recognition -> Occipital – integrates visual input o Spinal cord Peripheral Nervous System Somatic Branches o Voluntary muscles and movement Autonomic Branches o Sympathetic (activating) - get going Induce a state of panic to augment realization and decide to fight or flee (or freeze) o Parasympathetic (normalizing) - calm back down Because we cannot remain in state of panic, takes up too much resources o Both (cardiovascular system, body temperature, endocrine system, digestion) o Neurons Dendrites Pick up signal Soma Cell nucleus Decides if Neuron will fire or not Axon Propagate signal unto axon terminal Synapse Release neurotransmitters into synaptic cleft in vesicles Neurotransmitters o Chemicals that are released from the axon of a nerve cell Binding – binds to post-synaptic neuron Reuptake – gets reutilized, picked up by pre- synaptic neuron, or broken down for reuse o Functions Agonists – increases the activity of a neurotransmitter by mimicking its effect Inverse agonists – increase the activity of the opposite neurotransmitter Antagonists – inhibits the activity of a neurotransmitter by either blocking or closing the binding site o 4 Main Neurotransmitters GABA -> Glutamate – excitatory -> GABA – inhibitory -> usually linked to anxiety disorders -> Benzodiazepines Serotonin (5HT) -> Linked to Behavior and Mood -> SSRI treatment Norepinephrine -> Linked to Panic, alarm response, grieving, respiration -> Beta Blockers to prevent adrenaline response Dopamine -> Linked to reward, turning neurons on and off, Schizophrenia people have too much, Parkinson's have too little Adjacent dendrites of different neurons pick up this neurotransmitter and process starts again Psychological factors Behavior Cognition Interpersonal factors Relationships Culture Developmental factors Changes over time Emotions Action Tendencies Short lived, temporary states Useful o Fight or flight/fear Cardiovascular Cortical o Love Distinct from mood and affect o Mood – prolonged emotional experience o Affect – general emotional presentation Components of Emotion o Emotion and Behavior Basic patterns of emotional behavior (freeze, escape, approach, attack) that always differ in fundamental ways Emotional behavior is a means of communication o Cognitive Aspects of Emotion Appraisals, attributions, and other ways of processing the world around you that are fundamental to emotional experience o Physiology of Emotion Emotion is a brain function involving (generally) the more primitive brain areas Direct connection between these areas and the eyes may allow emotional processing to bypass the influence of higher cognitive processes -> ventral stream (cognitive process -> dorsal stream) Emotions in Psycopahtology o Timing of emotional responses Panic Inappropriate affect o Degree and duration of emotional responses Bereavement Mania Depression At least two weeks, all day every day o Absence of emotional responses Flat affect Blank, wooden expression Antisocial Personality Disorder People report they don't feel the same level of emotion that others do Cultural and Social/Interpersonal Influences in psychopathology Cultural o Influence the expression of psychopathology o Gender roles Specific phobias are more prevalent in females – females could be more likely to admit – not 'manly' to be afraid – also, men are exposed more. Eating disorders are more prevalent in females – stronger cultural influence because of media, universal influences where females are more assaulted by the 'ideal body image' Social/interpersonal o Affects longevity Having more friends or dependents o Affects mental health More friends -> less depression -> less physical illness -> :D Death/loss -> depression/anxiety Both influence treatment o Likelihood of seeking treatment o Likelihood of staying in treatment 09/07/16 - Clinical Assessment and Diagnosis What is Assessment o The process of gathering and integrating information about the way the person thinks (cognitive model) feels (emotions) behaves (behavioral model) in order to form a judgement about that person o Clinical assessment – systematic evaluation and measurement of psychological, biological, and social factors o Diagnosis – the degree of fit between symptoms and predefined criteria Why clinical assessment? o To describe Helps with diagnosis, treatment planning, treatment evaluation Assess whether or not they are actually showing improvements Communication when transferring patients o To predict Gain an understanding of future functioning Predictability of future behaviors based on past behaviors Prevent relapse by analyzing past behaviors that led to a relapse Characteristics of a good assessment o Reliability The degree to which measures are consistent Types Internal consistency – across items o All items are measuring a single construct Test-retest – across time o Results should not change between assessments, unless an intervention Inter-rater reliability – across raters o Two people giving the same grades Alternate form reliability – across versions o Two versions of the same test give the same results o Validity Whether or not a test is measuring what it is intended to measure Types Face validity – makes sense o Appears to measure correctly Content validity o Adequately covers the construct Includes all the areas that the construct overlaps in Criterion validity – relating to other outcomes o Predictive validity Predicts future behavior o Concurrent validity Agrees with measures from other assessment techniques given at the same time CONSTRUCT VALIDITY – the sum total of all other validity labels -> OVERALL o Standardized The test is administered and scored the same way across individuals Differences in results attributed to differences in individuals assessed rather than to testing procedures Provides normative population data Assessment procedures o The initial review Presenting problem What problem are you dealing with that I can help you with General personal information Information about the self Brief family/school/work/social history Are there important people? Has something happened? Is this a new or recurring problem? o Mental status exam Appearance and behavior Manageability? Erratic behavior? Substance? Side effects? Anxiety? etc Thought processes Listening to what they say and how they are saying it Mood and affect Feelings and emotions Intellectual functioning Change the way to address them Sensorium Orientation o Person – know who you are o Place – know where you are o Time – know when you are Types of assessment o Clinical interviews Unstructured Structured o Physical exams Make sure treatment is appropriately targeted o Behavioral observations Naturalistic observation In your environment Structured observation Therapist manipulating situation Self-monitoring Keep track of things, diet, instances of targeted behavior Can be an intervention in and of itself Reactivity: the person's response to having to self-monitoring o Clinical tests Projective Require that subjects interpret vague stimuli Thought that people project their emotions and thoughts into the stimuli Your personal experiences will shape how you interpret the stimuli o Rorschach o Thematic Apperception Test Looks for themes through cards Non-reliable, non-standardized, of questionable validity Personality inventories Range of questions regarding behavior, beliefs, and feelings – does it apply to you? Examples include MMPI, PAI o MMPI -> 567 Hipochondriasis, depression, hysteria, psychopathic deviance, masculinity-femininity test, paranoia, psychasthenia, schizophrenia, hypomania, social introversion Intelligence For IQ Neurological/neuropsychological Assess specific targeted functions, and compared performance across domains, to get a clue about potential brain damage o Memory, language, etc Neuroimaging ERP, structuralMRI, functionalMRI, (bloodflow and oxygenation show that part of brain has done some work) Psychophysiological Measuring functions of the nervous system. o Clinical interviews Unstructured Interview format in which the clinician asks questions spontaneously based on issues that arise o Follows flow of conversation, responding to the person and the symptoms he/she may have Advantage o Personal o Developing rapport Disadvantages o Less valid and reliable because they are not standardized o Getting off-topic o Requires expertise to catch things Structured Interview format in which the clinician asks prepared questions Strengths o Standardized o Reliable o Requires less training Disadvantages o Not flexible o Conflicting motivation between building rapport and finishing questions Semi-structured interview -> sidebar Hybrid between the two.. Limitations of interviews Omissions Lies Interviewer might have some bias Classification o Purpose Treatment planning - Gathered much information to be able to decide whether or not you need a diagnosis Talk about prognosis – what to do after treatment Communication – between therapists Research purposes o Diagnostic and statistical manual of mental disorders (4 edition..) Atheoretical assumption Manual takes no stance on what causes the disorders Does patient meet criteria Prototypical approach Allows for non-essential variation within the diagnosis Not everyone experience the same illness in the same way, but the diagnosis is the same Based on a prototype, a general idea of what illness looks like, and as long as patient resembles the prototype, the diagnosis is given o Things the DSM have Multi-axial system Five axes of DSM-4 o Axis 1 - Major disorders Depression, etc. o Axis 2 - Stable, enduring problems Personality disorders, intellectual disability o Axis 3 - Related medical disorders Obesity, cancer o Axis 4 - Psychosocial and environmental problems Being fired, living below poverty line, have no friends, no social support, o Axis 5 - Global assessment of functioning A number between 1 and 100 DSM-5 o Diagnosis – any things that used to fall on axes 1-3 o Notations – any things that used to fall on axis 4 o Disability – now use the WHO disability assessment schedule Different index, more standardized, how much dysfunction or disability is this person experiencing "WHODAS" write on assignment! o Diagnostic process Diagnostic criteria Compare to all the information gathered about the individual Differential diagnosis If they fit one diagnosis, if they fit two or more at the same time (co-morbidity) Final diagnosis This is the more comprehensive diagnosis Case formulation Actually write a paragraph or two, where we consider what could be causing the problem, treatment options, incorporating everything to the person as a whole and see how the diagnosis falls together o Classification issues Diagnosis reliability Overlap between diagnosis Make it easier for clinicians to be reliable from DSM-4 to DSM-5 Diagnostic validity High co-morbidity between several illnesses, so sometimes, they could be considered as not different at all. Cultural manifestations of disorders Limited ability to consider culture Gender and race diagnosis bias Women diagnosed with depression more than men African American diagnosed more with schizophrenia than with bipolar disorder than Caucasians Categorical vs dimensional approaches Current system is categorical o Do you fall into this category (illness) or not o Not much leeway for having 'a little bit of a category' Dimensional system is o On this category, the symptoms are this severe, having rating that indicate severity
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