PSYC 2300 Exam One Outline
PSYC 2300 Exam One Outline PSYC 2300
Popular in Abnormal Psychology
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This 31 page Study Guide was uploaded by Liana Sandell on Friday September 23, 2016. The Study Guide belongs to PSYC 2300 at University of Connecticut taught by Dr. Inge-Marie Eigsti in Fall 2016. Since its upload, it has received 224 views. For similar materials see Abnormal Psychology in Psychology (PSYC) at University of Connecticut.
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PSYC 2300 Exam One Outline September 22, 2016 Liana Sandell 2016 The ﬁrst exam is next week on Tuesday September 27, 2016 Major Themes 1. difference between abnormal and infrequent 2. where in the body do they manifest 3. how is mental illness treated 4. when does it occur 5. what to do Professions associated with psychology 1. clinical psychologist (trained for both research and practice) 2. counseling psychologist (focus on adjustments and milder problems) 3. psychiatrists (MD, they prescribe medicine) 4. social work (MSW) 5. marriage and family 6. school (not permitted to give diagnoses in most states) Three Criteria for Abnormality 1. impaired functioning 2. distress 3. is it atypical a. does it deviate from the average b. how is it culturally deﬁned c. is it out of personal control Historical and Theoretical Perspectives Disorder: Clinical Presentation 1. what is the presenting problem 2. what are the symptoms Disorder Description Factors 1. prevalence (how common is it) 2. incidence (describes number of new cases per year) 3. sex ratio (is it more prominent in males or females or both) 4. lifetime course (how long does it last) a. acute/onset (comes on strong and sudden) b. insidious onset (gradually coming into place) c. waxing and waning (times when you are great and other times when you are not) d. chronic (constantly returning and is long lasting) e. progressive (symptoms become increasingly worse) f. episodic (has different phases ex. bipolar disorder focuses on two emotions mania or severe depression) g. time limited (effects you for only a period of time ex. anxiety) 5. prognosis (do I have a kind of illness that will get better, or will the symptoms reoccur, how long will they last?) The Supernatural (middle ages) 1. mind and body division a. your spirit and your soul are separate from your body 2. planetary movements a. phases of the moon and planets have an effect of peoples behaviors 3. devil possession/exorcisms a. idea that an individual can be inhabited and taken control of 4. witch craft a. people have supernatural powers (torture) 5. psychic epidemics and mass hysteria (collective illusions of threat) a. middle ages (mass dancing mania was held in the hopes of removing the plague and curing those who were ill) b. 2011 Leroy NY (epidemic of tourettes at a school which spread to 8 individuals. it turned out that those individuals were the ones whose families had been most involved in taking about symptoms) Etiology (study of causation) 1. biological 2. physical Biological (ancient to modern time) 1. hippocrates and the idea that the brain is the source of abnormal behaviors also known as somatogenesis. he was an important ﬁgure in the ﬁeld of medicine (460-377 BCE) 2. galen and the idea that there are four ﬂuids which give rise to emotion he called it the balance of humors (129-198 AD) a. blood (sanguine or positivity and optimism) b. phlegm (phlegmatic or not easily moved) c. black bile (mellancholy or sad) d. yellow bile (choleric or angry) 3. balance of winds (ancient china) a. the idea of ying and yang if these were not balance you would be mentally unstable 4. observation and classiﬁcation to capture a disorder a. by writing down ﬁndings and observations we can begin to make classiﬁcations b. symptoms go along with disorders c. behavior changes of sailors (delusions of grandeur, persecution) termed general paresis were later linked to the infection syphillis and brain damage d. ﬁndings by emil kraeplin 5. syndromes: clusters of symptoms that coexist with each other 6. discovery of antipsychotic drugs in the 1950s (phenothiazine) a. accidentally found b. originally made to treat tuberculosis 7. gall and phrenology (1758-1828) a. linked certain parts of the brain with functions b. touch someones head and “feel” these different areas c. you could also tell what they were good at The Psychological 1. plato and rational discussion a. let us talk about our problems in a rational discussion to gain control of them 2. early asylums are centers for housing to get mentally ill away and not to treat them 3. moral treatment movement asked what if we were to treat people ethically? a. lead by benjamin rush (united states) and phillipe pinel (france) b. showed improvements of patients 4. dorthea dix (founder of social work) and the mental hygiene movement which advocated for same treatment for mentally ill a. too many people to treat well b. overcrowding and poor outcome Psychological: Current era 1. psychodynamic model of behavior (freud) a. discovery of unconscious and conscious thoughts b. catharsis c. not widespread in the US 2. behaviorism a. studies behavior only without regard to internal mental states b. your mind is a black box c. operant conditioning (reinforcement and shaping behavior) d. classical conditioning (chemotherapy and generalization of the feelings of sickness to everything in the recovery room) 3. patient civil rights a. mental patients will have more satisfying lives if they are incorporated into communities b. community based support 4. cognitive revolution a. mental events exist and are relevant to behavior Emotions: fear 1. emotions are immediate responses 2. mood states are more persistent and have a longer effect Fear 1. ﬁght or ﬂight response 2. lobster boat example in class a. man falls off the boat during a storm this is when ﬁght or ﬂight kicks in, he stayed calm and is still alive 3. multiple physiological changes a. blood ﬂow b. breathing rate c. digestion 4. powerful feelings a. persistent anger b. hostility c. risk factors for cardiovascular disease 5. cognitive components Biological inﬂuences 1. the human brain a. interacts with certain cognitions, emotional functions and disorders b. many different ways to look at this studied through 1. surgery 2. post mortem 3. photograph 4. fMRI Biological inﬂuences on psychopathology 1. neuroanatomy 2. neurochemistry 3. genes and their biological and environmental interaction The neuron 1. four major parts a. cell body (soma) b. dendrite c. axon d. synapse e. terminal buttons 2. nerve impulse a. moves down axon b. synapse c. Small gap between terminal axon and dendrites of adjacent neuron Synaptic Transmission 1. neurotransmitters a. released from presynaptic neuron into the synapse (inhibitory or excitatory) b. taken up by postsynaptic neuron receptors 2. reuptake a. reabsorption of excess neurotransmitter by the presynaptic neuron Genes: protein machines 1. genomes are “brought to life” by expression according to directions embedded in DNA 2. proteins embody the end product of this expression 3. proteins drive many cellular functions a. build cellular structures b. digest nutrients c. metabolic functions d. mediate information flow within and among cells DNAand the genome 1. somatic cells have 23 chromosome pairs (packets of DNAstrands) 2. DNAstrands are strings of molecules (genes) a. three strings makes a codon (one specific amino acid) 3. gene: a specific sequence of nucleotides which build proteins (made of amino acids) the average gene uses 1000 amino acids to code 1 protein Variability: genotype to phenotype 1. some genes (homobox) job is to turn genes on or off a. the timing of this varies (example is puberty which sometimes happens earlier for some individuals than others) 2. genes combine and mutate at different rates depending on the local environment 3. Is your genome a blue print? no a. you can have two twins with a similar blueprint, but a different outcomes because of something they were exposed to as a fetus (different local environments) b. Phenotypes are true emergent properties of gene-gene interaction (gene- environment interaction as well) Genes and environments interact 1. genes influence environments a. smart people chose more cognitive stimulating activities 1. environments influence genes a. early stress in development can cause puberty to emerge earlier Behavioral genetics 1. study of the effects of genetic inheritance on behaviors a. family (pedigree) studies b. twin studies c. adoption studies Twin studies (McClearn 1997) 1. studies of twin comparing MZ (paternal and identical with 100% shared DNA) and DZ (fraternal and not identical 50% shared DNA) a. found heritability and shared influence of IQ (62%) and memory (52%) 2. showed that genetic factors contribute to risk for essentially all psychological illnesses but more than half the risk involved non genetic factors Sociocultural influences 1. there are cultural norms and pressures a. showing fear (phobia) b. maintain a think body shape (bulimia nervosa) c. beliefs about what bodies can do (koro) a. belief about generals being retracted into your body d. alcohol consumption (alcoholism) Social networks 1. hurricane kartrina and reduced recidivism rates (reoffending once being released) a. typical when individuals are released from prison, the rates of recidivism are high but recidivism rates for those around hurricane katrina were lower. why is this? b. individuals in these areas had to start over because they lost everything, they had to make new social networks, the individuals who had originally been in these networks were removed 2. friendships are protective Classification Classification systems 1. turns groups of symptoms into a diagnosed disorder, but why do we do this? a. plan treatment (we do not want to treat each symptom separately, not all symptoms are exactly the same) b. offers comfort to individual c. communication among staff d. social support (internet and in person) e. research opportunity f. insurance reasons 2. if you meet diagnostic criteria, then you fit into diagnostic category 3. the primary system (US) is the Diagnostic and Statistical Manual of Mental Disorders (DSM) a. now in the 5th edition b. based on work of emil kraepelin c. overlaps with international classification of disease (ICD) and world health organization (WHO) Diagnostic Systems 1. categorical (like the DSM) a. gives you a straight forward answer b. does frank have an anxiety disorder, yes or no? c. based on medical model d. there are arbitrary cutoffs for abnormality (how many symptoms classifies a disorder) 2. dimensional a. it falls on a range b. how anxious is frank on a scale of 0 to 100? Diagnostic Challenges: cultural variability 1. Impact a. how a patient describes symptoms b. responds to treatment c. relates to heath treatment provider Powerpoint examples Taiwan▯ hsieh-ping: a brief trance state during which one is possessed by an ancestral ghost. Symptoms include tremor, disorientation and delirium, and visual or auditory hallucinations. Japan▯ taijin kyofusho: intense fear that one's body, body parts, or bodily functions are displeasing, embarrassing, or offensive in appearance, odor, facial expressions, or movements. Korea▯ shin-byung: characterized by anxiety and somatic complaints (general weakness, dizziness, fear, loss of appetite, insomnia, and gastrointestinal problems), followed by dissociation and possession by ancestral spirits. NorthAfrica▯ zar: Spirit possession. Symptoms may include dissociative episodes with laughing, shouting, hitting the head against a wall, singing, or weeping. Individuals may show apathy and withdrawal, refusing to eat or carry out daily tasks. SubsaharanAfrica▯ bouf deliriante: sudden outburst of agitated and aggressive behavior, marked confusion, and psychomotor excitement; sometimes accompanied by hallucinations, paranoia. Caribbean▯ falling out or blacking out: episodes characterized by sudden collapse and fainting, often with hysterical blindness. LatinAmerica▯ ataque de nervios: uncontrollable shouting, attacks of crying, trembling, heat in the chest rising to the head, and verbal or physical aggression. United States, Canada, and Western Europe: anorexia nervosa: severe restriction of food intake, associated with morbid fear of obesity. Other methods may also be used to lose weight, including excessive exercise. NativeAmericans: ghost sickness: preoccupation with death and the deceased, sometimes associated with witchcraft. Symptoms may include bad dreams, weakness, feelings of danger, loss of appetite, fainting, dizziness, fear, anxiety, hallucinations, loss of consciousness, confusion, feelings of futility, and a sense of suffocation In different cultures, these are some different disorders, but to a US provider, they may sound like a diagnosis that we already have Reliability of classification 1. kappa is the chance of two professionals having the same diagnostic 2. how consistent are the judgements we make? (if we bring patients to two different clinicians what are the chances their findings will be the same) a. inter rater reliability (agreement between clinicians) b. test retest reliability (how similar are the assessments over time) Effects of classification 1. positives a. homogeneous groups for research b. facilitate communication about disorders c. treatment planning 2. negatives a. what happens if people are mis diagnosed? b. self fulfilling prophecy (if we believe something will happen it has a better chance of actually coming true) c. social stigma d. health insurance (excluded because people think it will be expensive) e. not explained, only labeled “on being insane in insane places” david rosenhan 1. experiment where he and healthy colleagues claimed that they were hearing noises (symptoms of schizophrenia) 2. 7 of the 8 friends were diagnosed with schizophrenia 3. the length of their stay averaged from 7-52 days (average of 19 days) 4. classiLication at discharge was “schizophrenia in remission” 5. behaviors that were normal were interpreted in light of their diagnosis a. standing in the dining hall early was thought to be a sign of schizophrenia when in reality there is not much to do 6. one given, labels stick “Lirst people” language 1. focus of the person and not on the illness or disability they may have 2. describe what the person has and not what he or she is (not the schizophrenic but the man with schizophrenia) DSM 5 diagnosis 1. components a. clinical syndromes b. psychosocial and environmental stressors yt i l ibas id fo tnetxe . c 2. cross cutting dimensional symptoms measured a. sleep b. appetite Are disorders shaped by time and place or culture? 1. cultures may have a “symptom repertoire” a. koro in southeast asia Case study: anorexia 1. hong kong a. complaints of “bloated stomach, not dieting, no fear of being fat until death of a girl on 11/24/1994 b. “thinner than a yellow Llower, weight loss book was found in the school bag, girl drops dead on the street c. reporters diagnosed using DSM symptoms (anorexia nervosa) d. by the end of the 1990’s between 3 to 10% of women report symptoms e. by 2007 90% of “anorexic” patients reported the fear of becoming fat more likely to have a disorder if you are part of a culture that has certain preferences and talks about them constantly The US 1. published the DSM manual 2. publishes top scholarly journals 3. most research funded 4. market most drugs 5. has a strong inLluence on the notions of what is a disorder Illness as a “brain disease” (Mehta 1997) 1. confederate (individual pretending to be a subject) and subject exchange biographical information 2. confederate reports experience of a mental disorder because of “things that happened to me as a child” or because “its a disease like any other which effected my biochemistry” 3. subject teaches confederate button press (two kinds of shocks, mild and strong) Results 1. biochemistry group received more intense shocks 2. this suggests that viewing mental illness as a disease may be more frowned upon (stigmatized) Relevant stigma: relapse rates 1. schizophrenia is a severe mental illness with a waxing and waning course (aside from taking medicine) 2. patients in developing countries have a lower rate of relapse rates by as much as 2/3 3. americas idea of “boot straps” hold the client entirely responsible for their recovery (if you work hard you will get better) 4. data from “spirit possession” in zanzibar (schizophrenia) a. idea that you can calm these spirits with acts of kindness b. patients who experience this support show lower relapse rates c. during remission the patient is “himself” Research Methods Franz Mesmer and hypnotism 1. mesmerism by tapping on certain parts of peoples bodies to remove “animal magnetism” (undetectable and activated by mesmerized object) that were trapped. he suggested this would cure them 2. reasons why it may have “worked” a. he created a certain atmosphere using dark robes, wearing Llowing robes, and a dark room b. he was conLident in what he was doing and his personality was forceful c. . the placebo effect d. gave rise to the use of hympotism Hypnotism exists (raz) 1. Linding that posthypnotic proposal eliminated the stroop effect for 16 highly suggestible subjects and 16 less suggestible control subjects 2. resulted in the 16 highly suggestible subjects showing no problems while the less suggestible individuals show much difLiculty 3. stroop test: reading and color experiment Evidence based perspective on diagnosis and treatment (why) 1. spurious corrections (false assumption that two variables are correlated when they are not) a. young children who sleep with the lights on are more likely to develop myopia later in life b. power lines and childhood leukemia c. texas sharp shooter (shoots and then later paints a target on the tightest cluster of shots) Case in point: autism and vaccinations 1. lancet report says that 12 children who were vaccinated “subsequently” exhibited symptoms of autism (andrew wake7ield, 1998) 2. report of correlation by cherry picking Cost of inaccurate research 1. MRR vaccine and autism (drops in vaccinations) 2. herd immunity is when 90% of parents vaccinate children the 10% are unlikely to get illness because it is not prevalent enough Measles cases 1. 1958-2012 a. there has been a sharp drop in the number of measles cases 2. 1998 a. wakeLield study is published 3. wakeLield paper is retracted, he loses license Research contributes to 1. clinical description (epidemplogy, symptoms, lifecourse) 2. causation (etiology) 3. treatment and outcomes Stay away from temptation to make simple corrections and anecdotes (stories/tales) 1. dog walking vs. neighbors perspective 2. seizure leads to immunization (think if order was switched) The scientiLic method 1. describe (formulate a question) 2. predict (form hypothesis) 3. control (test) 4. understand (draw conclusions) Types of experiments 1. case studies a. focuses on single patient b. helpful for rare and new disorders c. low validity 2. correlated a. relationship between two variables b. correlated (hotdog) c. not correlated (cloud) d. correlations doesn't mean causation Experimental studies are better 1. tests for casual relationship between variables a. random assessment b. manipulation of independent variable c. manipulation of dependent variable Issues in research: reliability (how consistent is the measure) 1. test retest reliability across time assessment a. tested now and then in two months 2. interrater reliability (across judges) a. assessment by one person and then another Validity (how true something is) 1. how well do they generalize to other people or settings 2. how well am i measuring what i would like to measure Controlling confounding factors: 1. use a control group 2. keep variables constant 3. representative sample 4. control confounds (variables that are outside of the main focus) 5. replicate Lindings in other groups Placebo effects 1. effects due to expectations and not actual treatment 2. the hawthorne effect a. a person who knows that they are in the treatment group is more likely to follow procedures because they think they are in the more powerful group 3. control by using double blind procedures Example 1. knee surgery on 90 individuals in each group (sham surgery, and active surgery) a. active surgery was no better than sham 2. hemodyalisis and schizophrenia a. sham group showed improvement and the active dialysis group was worse (by chance or luck) Experimenter effects: clever hans with humans (stanton 1942) 1. subjects hear 20 nonsense words and have to repeat them and 20 new words 2. 3 groups of testers which all ask “tell me if you have heard this word before” a. uninformed (sample list of words) b. correct list (old words are bold and new words have plain font) c. incorrect list (old words are plain and new words bold) 4. subjects new word choices are effected by what the experimenter thought were the new words Assessment Psychological assessment 1. used to determine cognitive, emotional and personality and behavioral factors in psychopathology (study of scientiLic mental disorders) 2. techniques a. clinical interview b. psychological tests c. behavioral observation How to assess functioning 1. mental status exam (efLicient and quick) a. probes appearance, behavior b. though process c. mood and affect d. intelectual functioning e. insight, judgement and safety f. orientation 2. screeners a. quickly and cheaply assess many people and those who fail receive an in depth evaluation b. CHAT (childhood autism test) 3. cognitive IQ tests a. identity cognitive strengths and weaknesses b. identity if someone has a loss of functioning c. strengths 1. good reliability 2. criterion validity 3. predict later functioning d. an IQ score doesn't measure intelligence, it just gives us one piece of information IQ sample items 1. picture similarities 2. picture vocabulary 3. deLinitions Nonverbal that are tested 1. block design 2. matrix reasoning (matching shapes to others) Multiple Intelligences theory (howard gardner) 1. he proposed there should be tests for other aspects besides verbal and nonverbal a. linguistic b. logical/mathematical c. spatial (where is my car?) d. musical (repeating songs) e. bodily/kinesics (ability to join into sports games or physical activities) f. interpersonal (making friends) g. naturalist (survival) Schema of intelligence (robert sternberg) 1. Three forms of intelligence a. analytic (solve problems using nonverbal and verbal together) b. problem solving (look at a maze and doing comparisons) c. creativity (the ability to create something novel) Cultural bias in assessment 1. some measures are more likely than others 2. sensitivity on clinicians part is important a. language b. rapport c. patients ability to understand goals d. understanding relevant cultural factors Assessing executive functions (allow you to control behaviors and plan) 1. stroop tests a. it is hard to stop yourself from reading the word instead of saying the color because it is so engrained 2. tower of Hanoi (tests planing) a. give a person starting state and ask them to place doughnuts in a certain Linal sate b. there are three doughnuts that increase in size c. rules a. cant have bigger doughnut on top of smaller one b. one movement at a time Psychophysiological assessment 1. focuses on physical (biological) changes that company psychological events a. skin conductance (GSR and sweating) b. heart rate (EKG) c. brain electrical activity (EEG) d. functional MRI scan (which parts of your brain are reacting) 2. personality tests a. structured b. easy to administer c. often standardized d. susceptible to client bias (approach you have can inLluence scores) e. MMPI or Millon are examples f. MMPI sample items (connectedness vs. alienation) a. i Lind it hard to keep my mind on task b. i wish i could be as happy as others c. i easily become impatient with others g. are you face valid or opaque? a. are you a nice person yes or no (face valid and measures exactly what you are testing for) b. if you saw a hurt puppy would you take it to the vet (opaque and your question is not as obvious ) 3. projective tests a. least often used b. rorsach-like stimuli (see a picture and ask what do you think of this) c. looks at unconscious, and implicit associations 4. projective sentence completion (used with teens) a. characteristics a. unconstricted b. susceptible to examiner bias c. poor reliability d. poor validity Treatment Early treatments 1. documentary in class a. hydrotherapy (patient sprayed with water to stimulate) b. wet pack (patient wrapped in wet sheet) c. continuous bath (sedation at 98F) d. hot box e. insulin therapy for schizophrenia (shocks) f. wet shock (drooling during seizure) g. dry shock (full brain seizure) h. metrosol seizure therapy i. lobotomy many have been temporarily effective, not because the procedure effects them but because they were exhausted Maslow Hierarchy of needs (maslow) 1. there is a hierarchy of needs and we must take care of the primary ones before the higher up ones a. physiological (health, food, shelter) b. safety c. social d. esteem e. self actualization Common elements of psychotherapy 1. intense personal and conLiding relationship 2. providing information about problem/clients behavior 3. success experiences and support 4. the placebo effect (if you think it will work, chances are it will) Forms of psychotherapy 1. psychoanalytic therapy (freud and the unconscious) 2. couple/marital 3. cognitive behavior a. operant b. systematic desensitization Client centered (humanistic) 1. people must be understood from their own point of view 2. psychological disorders arise when people do not appreciate their own words 3. therapists job is to be non judgmental and help guide their clients to reLlection Psychoanalytic therapy 1. no control group 2. only been tested 4 times Couples and marital therapy 1. focus on improving communicaiton 2. better at relieving relational stress than individual counseling 3. not always effective (depression and low frequency of sex are indicators) Cognitive therapy 1. helps clients recognize irrational thoughts 2. substitues these maladaptive cognitions with healthier behaviors 3. homework (daily process) Cognitive behavior therapy 1. involves thoughts but also the changing of behaviors as well 2. challenges schemes (the groups of ideas an individual holds about something) 3. shown to a. improve depression b. comparable to drug therapy c. involved more of an upfront time investment Behavior Therapy 1. skill training or behavior rehearsal a. assertiveness training (shy) b. parental skill training (parents rewarding and punishing) c. communication training (couples) 2. exposure and response prevention a. gradually helps someone get over fears through slow exposure 3. progressive muscle relaxation a. tighten muscles for 5 to 10 seconds and tricks body into being relaxed Operant methods 1. involves rewards for desirable behaviors and extinguishing undesirable behaviors 2. effective for many behaviors Chasing a therapist 1. get a referral 2. understanding job titles a. psychiatrist (medical background, focused on psychopharalogical approaches) b. psychologist (degree in the psychological Lield, MS) c. clinical social worker (more speciLic focus, and training) 3. know what you are paying for Cultural issues in therapy 1. cultural diversity is a norm in our society 2. unproven assumption that you work better with people who are similar to you in cultural or ethnic background a. this is not true, it is based on solely the client and therapist relationship 3. must be sensitive to background Psychopharmachology 1. medications are useful treatments 2. work better paired with other support 3. difLiculties a. side effects b. compliance (followig presecription) c. non responders (no beneLit) d. relapse following discontinuation (symptoms return after stopping medication) Special Considerations: Childhood development (Article in Husky CT Scerif & Karmiloff-Smith, 2005) 1. linking speciLic genes to psychological functions a. this is the idea that there is one gene for a speciLic function (one gene for math) 2. The hope: for a disorder involving change in gene a, examine the psychological process X; if X is change, gene a must be responsible 3. The case of WS (williams syndrome) a. rare disorder involving the deletion of 25 genes on chromosome 7Q b. adults with WS have a. strengths in language and face processing and vocabulary b. weaknesses in visa-spatial cognition and processing numbers c. initial hope to associate deleted genes with impaired domains c. however, infants with WS have a. language delays compared to infants with severe cognitive delays (DS) b. understand quantity as well as infants with DS 4. This shows us that one area of the brain is not associated with one function (processes interact with each other) 5. During development processes interact with one another (there is no gene for language) a. genes impact multiple factors b. example: FMPR protein (fragile X syndrome) collaborates with distinct proteins in fetal vs. adult neurons c. fox P2 localizes differently with collaborating proteins Challenges for assessing and treating children 1. disorders arise and change with time 2. disruption of early functions impacts later growth and development 3. risk of pathologizing normative behavior that is annoying or disruptive (regarding something as abnormal) 4. risk of missing subtle signs in less verbal individuals 5. seeing child through parents eyes Determining a concerning behavior from an annoying one 1. dependent on age a. thumb sucking is normal until age 5 b. sitting still c. whining d. illegal or delinquent behavior e. messy room 2. these behaviors tend to stop on their own 3. punishment may be appropriate but not effective in stopping behaviors 4. when we are trying to Ligure out if a behavior is concerning or not we use the same criteria to diagnose adults a. impaired functioning b. distress c. atypical 5. beware of the “slippery slope fallacy” a. example is a messy room will lead to the complete downfall of my child Child Violence: nature vs. nurture in class video 1. tries to understand why children do violent things 2. often can be prevented 3. brain images When should a parent seek professional help 1. consider the context, age matters a. stealing at 5 versus steering at 13 b. separation anxiety at 5 versus at 13 2. consider impairment (is it hurting the child or the family) a. hitting others may not be a problem at 5 but what if the child gets kicked out of preschool because of this 3. consider historical context a. schools no tolerance policies b. bringing a gun to school versus bringing a antique knife for a project 4. consider danger and risk a. child talking about killing themselves b. children do commit suicide and can be depressed Parent/teachers/adults should look for 1. behavior change 2. signs of stress following traumatic event 3. impairment to child or family functioning 4. harming self or others Child and adolescent therapy 1. play therapy a. talk and play techniques which involves indirect sharing b. use toys to talk about what is actually going on 2. behavioral a. timeout b. operant conditioning 3. cognitive behavioral therapy a. teaching child coping skills a. identifying problems b. planning c. thinking out loud b. tools to think before acting 4. family therapy a. family all meets together Social and legal issues 1. constitutional freedoms a. outlines the powers of the government to assure maximum freedom for citizens b. conLlict is to protect the society as a whole while also protecting individual rights (wanting to drive on the left side of the road) 2. rights of the mentally ill a. the right to be treated while incarcerated b. right to have their status reassessed c. refusal of treatment d. treatment in the least restrictive environment a. case of donaldson who was held for 15 years 3. commitment procedures a. civil commitment a.is when someone who is mentally ill and dangerous is conLined to a mental hospital (danger to self and others) b. during the late 19 century women used to be committed by their husbands for having different political views c. most often initiated by policemen, family, judges, teachers, and friends b. commitment justiLications a. legal determination of mental illness b. judged to be a danger to themselves and others (there is no evidence that mental illnesses relate to violence) c. unable to care for themselves d. has not committed a crime e. laws vary by state b. criminal commitment a. someone is mentally ill who has already committed a crime is conLined to an institution DeLining mental illness 1. not psychiatric or psychological term 2. severe emotional and thought disturbances that impact health and safety 3. not synonymous with DSM 5 Protections for committed mental patients 1. two psychiatrist certiLicates (two have to sign off) 2. right to written notiLication to counsel 3. right to jury decision regarding commitment 4. protection against self-incrimination 5. right to treatment or right to refuse 6. more recently a. court order assisted outpatient treatment which is required for the individual to remain in the community Predicting future violence is difLicult 1. accurate only at a grip level but not for an individual 2. psychologists can predict dangerousness only in a short term Competence to stand trial 1. insanity defense applies to the mental state of the person at the time of crime 2. competency assess whether a person is able to stand trail in a sufLicient mental state a. able to communicate with attorney b. rational and factual understanding c. incompetent persons are placed in institutions before trials Societies role in mental illness 1. more restrictions on involuntary commitments leads to change (1960 1970s) 2. deinstitutionalization leads to an increase in homeless mentality in ill individuals (more likely for african american and whites) 3. mental illness is criminalized (untreated individuals end up in criminal justice system) Mental illness video 1. man with mental illness that talk to himself turns violent and destructs property 2. he doesn't want to be committed 3. he is brought to an institution and when he is safe he is let out 4. continuous circle Criminal commitment 1. metal procedure for conLining someone who was found not guilty of a crime by reason of insanity to a psychiatric hospital a. evaluation also determines ability to stand trial 2. can be found guilty, not guilty, or not guilty by reason of insanity (how big is the loop hole) a. cases with NGRI pleas 9% b. cases that get off as NGRI 27% c. currently some 28% prison inmates have severe mental illnesses 3. m’naghten case a. individual attempts to assassinate british prime minister but accidentally kills prime ministers secretary (genuinely thought he was saving people) b. led to the 1843 decree that people are not responsible for a criminal act if they do not know what they are doing, or don’t know it was wrong 4. mens rea says that there must be proof of capacity to understand nature of behavior and therefore of criminal intent 5. duty to warn (Tarasoff 1976) a. college woman was being pursued by a graduate ta, she rejected him and he killed her. Later parents sue school because therapist had called school to warn them that she may be in danger; the problem was she wasn’t warned b. psychologist is responsible for not only his/her patients but to the other individuals who may be endangered
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