Chapter 1 Study Guide Monday, September  11, 2017 3:58 PM

What is abnormal behavior?

Key Terms:

Abnormal behavior = a behavior that is inconsistent with the individual's  

-

development, cultural, and societal norms and creates emotional distress or  interferes with daily functioning

Behavioral genetics = the field of study that explores the role of genes and  

-

environment in the transmission of behavioral traits

- Behaviorism = Behavior (normal or abnormal) is learned and can be unlearned

Biopsychosocial perspective = the idea that biological, psychological, and social  

-

factors probably contribute to the development of abnormal behavior and that  different factors are important for different individuals  Don't forget about the age old question of progitive

Classical conditioning = A form of learning in which a conditioned stimulus (CS)  

What is behavioral genetic?

-

is paired with an unconditioned stimulus (UCS) to produce a conditioned  response (CR).  

Culture = shared behavior patterns and lifestyles that differentiate one group of  Don't forget about the age old question of What is legally enforceable contract?

-

people from another

Diathesis-stress model = the idea that psychological disorders may have a  

-

biological or psychological predisposition (diathesis) that lies dormant until  environmental stress occurs and the combination produces abnormal.  Dimensional approach = allows understanding of how abnormal behavior varies  We also discuss several other topics like low road vs high road psychology

-

in severity over time, perhaps increasing and decreasing, or how behaviors  change from one disorder to another

- Neuron = a nerve cell found throughout the body, including the brain

What is classical conditioning?

Neuroscience = the structure and function of the nervous system and the  

-

interaction of that system and behavior

Neurotransmitter =  chemical substances that are released into the synapse and  

-

transmit information from one neuron to another

Operant conditioning = A form of learning in which behavior is acquired or  

-

changed by the events that happen afterward.  

Psychoanalysis = a theory of abnormal behavior originated by Sigmund Freud  

-

that was based on the belief that many aspects of behavior were controlled by  unconscious innate biological urges that existed from infancy

- Reinforcement = increases frequency of behavior - Punishment = decreases frequency of behavior If you want to learn more check out hitler's descendants not allowed to procreate

Scientist-practitioner approach = when providing treatment, psychologists rely  

-

on research findings

               unconscious innate biological urges that existed from infancy

- Reinforcement = increases frequency of behavior

- Punishment = decreases frequency of behavior

Scientist-practitioner approach = when providing treatment, psychologists rely  

-

on research findings Don't forget about the age old question of abnormal psychology notes

Sociocultural model = The idea that abnormal behavior must be understood  

-

within the context of social and cultural forces (like gender roles, social class,  and interpersonal resources)

- Synapse = a space between neurons

- Trephination = using a circular instrument to cut away sections of the skill

Viral infection theory = the theory that during the prenatal period or shortly  

-

after birth, viral infections could cause some psychological disorders

Application of terms/concepts:

Criteria for abnormal behavior: Behavior that is inconsistent with the  

-

individual's developmental, cultural, and societal norms and creates emotional  distress or interferes with daily functioning

Factors to be considered when defining and treating abnormal behavior

-

○ Age, development, maturity, culture, SES, sex, race, ethnicity Differences between categorical and dimensional approaches: Don't forget about the age old question of carrie bradshaw claims that when it comes to buying shoes, "price is no object." if this is true, then her demand for shoes is

-

Categorical approach = Assumes that a person either has a disorder or  

○

does not

Issues:

▪

▪ Symptoms rarely fall neatly into just one category

Symptoms often are not of sufficient severity to determine  

▪

that they represent a disorder

□

With insurance companies, you have to have a  diagnosis to get treatment

□ Short term treatment without diagnosis is hard to get

Dimensional approach = allows understanding of how abnormal behavior  

○

varies in severity over time, perhaps increasing and decreasing, or how  behaviors change from one disorder to another

Advantage: Behavior changes over time, this approach allows us to  

▪

account for those changes

Abnormal behavior explained across history -

○

Ancient Egyptians  

Ancient cultures, such as ancient Egypt, believed in spirits who  

▪

controlled the environment and aspects of a person's behavior Trephination = method used to create a hole in the skull to release  

▪

the evil spirits

Modern day Surgeons release  pressure when brain is swelling  

▪

by putting hole in skull

▪ Kind of on the right track

Trephination = method used to create a hole in the skull to release  

▪

the evil spirits

Modern day Surgeons release  pressure when brain is swelling  

▪

by putting hole in skull

▪ Kind of on the right track

Greeks and Romans

○

▪ Melampus of Pilus introduced organic model of illness

Hippocrates (460 - 377 BC) = father of medicine

▪

▪ First to identify hallucinations, delusions, melancholia, mania

Introduced the term hysteria (we now call it conversion  

▪

disorder)

□ Thought it was due to a wandering uterus

Believed that environmental factors and/or physical factors  

▪

created an imbalance in four bodily humors

Middle Ages and Renaissance ○

Influence of the Roman Catholic Church

▪

▪ Negative behaviors are the work of the devil Witchcraft evolved as a popular theory

▪

Over 200,000 accused; 100,000 put to death; 80-85% were  

▪

women

Mass hysteria spreads ▪

Emotional contagion = sharing and transferring moods among  

▪

members of a group

Nineteenth Century

○

▪ Philippe Pinel proposed that mental illnesses were often curable

Removal of patients from "warehouse" asylums into specialized  

▪

facilities devoted to the care and treatment of the mentally ill Advocated moral treatment

▪

▪ Use of respect, kindness, religion, and vocation

Other key founders: Benjamin Rush, Dorothea Dix, Emil Kraepelin,  

▪

Josef Breuer

Reasons for admission graphic

▪

▪ Bad company, asthma, business nerves, masturbation, etc  

We didn't have a good grasp on what mental illness was, how  

▪

to treat it, etc

Major differences between each of the models/ theories listed in the textbook..  

-

Each theory explains abnormal behavior … major persons associated with these  theories

○

Biological model

Assumes that abnormal behavior results from biological processes  

○

of the body, particularly the brain

○ Genetic and hereditary factors Modern Psychoanalytic model

○

Aree that much of mental life is unconscious and ersonalit  ○

○

Biological model

Assumes that abnormal behavior results from biological processes  

○

of the body, particularly the brain

○ Genetic and hereditary factors Modern Psychoanalytic model

○

Agree that much of mental life is unconscious and personality  

○

patterns begin to form in adulthood

○ Carl Jung and analytic therapy ○ Alfred Adler and individual psychology

More contemporary models

○

□ Ego psychology

□ Object relations theory

Behavioral model

○

○ Behavior a product of individual's learning history

Acknowledge that biology interacts with the environment to  

○

influence behavior

○ B.F. Skinner used animals to demonstrate operant conditioning Cognitive model

○

Abnormal behavior is a result of distorted cognitive (mental)  

○

processes

Aaron Beck - originator of cognitive theory

○

□

Three types of negative thoughts in people with depression:  negative view of self, the world, and the future

○ Change cognitive distortions, improve mood and behavior ○ The way people think

Humanistic model

○

Based on phenomenology = one's subjective perception of the  

○

world is more important than the actual world

People are good and motivated to self-actualize (reach their fullest  

○

potential)

Carl Rogers

○

□

Abnormal behavior originates from incongruence between  actual self and self image

□ This limits a person's ability to achieve his or her full potential ○ Still around, but rare

Sociocultural model  

○

○

Abnormal behavior must be understood  within  the context of  social and cultural factors

▪ Gender roles

▪ Socioeconomic status  (SES)

▪

Interpersonal support

□ Family/friends they can call on for help ▪

Race and ethnicity

▪ Gender roles

▪ Socioeconomic status  (SES)

▪

Interpersonal support

□ Family/friends they can call on for help ▪

Race and ethnicity

□

Culture-bound syndromes = diseases/illnesses that  are specific to that area of the world/that  culture ◆ Symptoms are very specific

◆

Biopsychosocial model  

-

We don't see those symptoms outside  of that  culture

○

Biopsychosocial model

○

Acknowledges  that each individual case is unique so no single  model can fully explain the abnormal behavior

▪

Diathesis-stress model = psychological disorders start  with a genetic predisposition  for a disorder that is latent  until a stressful event  

□

Biological and/or psychological vulnerability  (diathesis) + stress  (environmental factors) =  distress and/or dysfunction

□

Distress and/or dysfunction -> psychological  disorder

Chapter 2 Study Guide Monday, September  11, 2017 3:55 PM

Key Terms:

ABAB, or reversal = a type of single case design where A represents a baseline  

-

phase and B represents a treatment phase; 2 phases are alternated to examine  their impact on behavior

Brain stem = a part of the brain located at its base that controls fundamental  

-

biological functions such as breathing

Case study =  a comprehensive description of an individual (or group of  

-

individuals) that focuses on the assessment or description of abnormal behavior  or its treatment

Central nervous system = one part of the human nervous system that includes  

-

the brain and the spinal cord

Cerebral cortex = the largest part of the forebrain; contains structures that  

-

contribute to higher cognitive functioning including reasoning, abstract thought,  perception of time, and creativity

- Comorbidity = refers to the presence of more than one disorder

control group = the comparison group for an experimental study in which the  

-

variable to be studied is absent

- Correlation = the relationship between variables

Dependent variable = the variable in a controlled experiment that is assessed to  

-

determine the effect of the independent variable  

- Efficacy =  research designs that attempt to maximize internal validity

Effectiveness research =  research that maximizes external validity. Participants  

-

are more similar to the types of patients treated in routine care; emphasis is  given to the cost-benefit ratio of treatment; and results are representative of  treatment in the real world

Endocrine system = a system in the body that regulates bodily functions but  

-

uses hormones rather than nerve impulses to do so

Epigenetics = studies heritable changes in gene expression caused by  

-

environmental exposure

Forebrain = a part of the brain that includes the limbic system, basal ganglia,  

-

and cerebral cortex

Hippocampus = the brain region that is part of the limbic system that also has a  

-

role in memory formation

Hormones = chemical messengers that are released into the bloodstream and  

-

act on target organs

           ,  ,  

-

and cerebral cortex

Hippocampus = the brain region that is part of the limbic system that also has a  

-

role in memory formation

Hormones = chemical messengers that are released into the bloodstream and  

-

act on target organs

Incidence =  number of new cases that emerge in a given population during a  

-

specified period of time

Independent variable =  the variable in a controlled experiment that the  

-

experimenter controls

Left hemisphere = the region of the brain primarily responsible for language and  

-

cognitive functions

Limbic system = umbrella term for several brain structures that are important  

-

for the study of abnormal psych; the brain region involved with the experience  of emotion, the regulation of emotional expression, and the basic biological  drives such as aggression, sex, and appetite

Longitudinal design = a research design in which participants are assessed at  

-

least 2 times and often more over a certain time interval

Midbrain =  a portion of the brain stem that coordinates sensory information  

-

and movement; includes the reticular activating system, the thalamus, and the  hypothalamus

- Neuroanatomy = the brain structure

- Neurotransmitters =  chemicals that relay signals between 2 neurons

Peripheral nervous system =  one part of the human nervous system that  

-

includes the sensory-somatic nervous system (controls sensations and muscle  movements) and the autonomic nervous system (controls involuntary  movements)

Prevalence = the number of cases of a disorder in a given population at a  

-

designated time

Placebo control = the group in a clinical  trial that receives  treatment which is  

-

similar to the experimental  treatment but without the active ingredients Random assignment = the most critical  feature of a randomized controlled  

-

design in which each participant has an equal probability of being assigned to  each experimental or control condition

Right hemisphere = the region of the brain associated with creativity, imagery,  

-

and intuition

- Single-case design = experimental study with an individual Application of terms/concepts:  

Describing the 2 parts of the nervous system:

-

○ Central nervous system (CNS) = brain and spinal cord

○

Peripheral nervous system (PNS) = somatic nervous system  that  controls sensation, muscle movement, and the autonomic nervous  system (more controlling involuntary  functions)

Describing the 2 parts of the nervous system:

-

○ Central nervous system (CNS) = brain and spinal cord

○

Peripheral nervous system (PNS) = somatic nervous system  that  controls sensation, muscle movement, and the autonomic nervous  system (more controlling involuntary  functions)

Describing the 2 parts of the peripheral nervous system -

○

Sensory-somatic nervous system - controls voluntary movement,  feel hot/cold

○

Autonomic nervous system - controls involuntary behaviors

▪

Sympathetic nervous system = activates a state of physical  readiness

□ Fight or flight response

▪

Parasympathetic nervous system = returns body  to resting  state

□ Rest and digest response

Basic structure of the neuron and how neurons communicate with one another.  

-

Neurotransmitters function in regard to mental illness

○ Soma = cell body

○

Dendrites = branches that come off of soma and receive info from  other neurons

○ Axon and axon terminals = branch that sends info to other neurons

○

Synapses = gap between  the axon of the sending neuron and the  dendrite of the receiving neuron

Parts of brain implicated in memory and emotion functioning and other  

-

complex mental processes

○

Forebrain

▪

Limbic system

□

Amygdala (deals with control of emotions), cingulate  gyrus, and hippocampus  (important for memory,  implicated in Alzheimer's disease)

◆ Deals mainly with emotions and impulses

□ Hippocampus : memory

What we know about the two hemispheres and the types of information they  

-

process

Left hemisphere = the region of the brain primarily responsible for  

○

language and cognitive functions

Tends to process information in parts, sequentially, and uses both  

▪

language and symbols (including numbers)

Right hemisphere = the region of the brain associated with creativity,  

○

imagery, and intuition

Processes the world in a more holistic manner, a spatial context  ▪

Tends to process information in parts, sequentially, and uses both  

▪

language and symbols (including numbers)

Right hemisphere = the region of the brain associated with creativity,  

○

imagery, and intuition

Processes the world in a more holistic manner, a spatial context  

▪

(the relationship of an object to other objects around it), and is  more associated with creativity, imagery, and intuition

○

Each has 4 lobes:

Temporal lobe = associated with understanding auditory and verbal  

▪

information, labeling of objects, and verbal memory

Parietal lobe = integrates sensory information from various sources  

▪

and may be involved with visuospatial processing (when you  imagine rotating a 3D object in space)

Occipital lobe = located at the back of the skull; center of visual  

▪

processing

Frontal lobe = seat of reasoning, impulse control, judgment,  

▪

language, memory, motor function, problem solving, and sexual and  social behavior that sends messages to the bodily organs via  hormones

How is the endocrine system involved in behavior and mental illness? -

○

Endocrine system regulates bodily  functions using hormones  produced by glands

○

Hormones are chemical messengers released directly into  the  bloodstream

○

Pituitary gland = the "master gland" that controls many endocrine  functions

Define and describe the information they can provide and their limitations: -

Case study

○

▪ Provides detailed narratives of behavior and treatment

Benefits

▪

□ Can examine rare phenomenon

□ Can generate hypotheses

□ Illustrates important clinical issues

Limitations

▪

□ Does not allow us to draw conclusions about causes □ Cannot be generalized  to rest of the population

○

Single-case design

Individuals are part of both experimental and control conditions

▪

▪ Can lead to causal inference

Design strategies

▪

ABAB, or reversal

▪

□ A condition = baseline condition

□ B condition = experimental condition, intervention

▪ Can lead to causal inference

Design strategies

▪

ABAB, or reversal

▪

□ A condition = baseline condition

□ B condition = experimental condition, intervention □ Often used in schools with problematic kids Multiple baseline studies

▪

□

Often used with kids with intellectual  disabilities who  hurt themselves

□ May implement treatment in school then at home Limitations  

▪

▪ Results are not generalizable

Do not address the impact of individual differences (e.g., age,  

▪

sex, ethnicity)

Group level research

○

▪ Correlation studies

▪ Examines the relationship between variables or conditions ▪ Correlation coefficient indicates direction and strength of a  relationship

▪ Positive correlation = when X goes up, Y also goes up

▪ Negative correlation = when X goes up, Y goes down

▪ Correlation = 0 means no relation

▪ Correlation = 0 curvilinear relation

□ Like a bell curve in a way

▪ The coefficient ranges from -1.0 to 1.0

□

The closer the coefficient is to zero, the weaker  the it is

□

The sign of the coefficient tells us whether the  correlation is positive or negative

▪ Correlation is not causation

▪ Website about correlations between random things

Ex: correlation between per capita cheese consumption  

▪

and number of people who died by becoming tangled in  their bedsheets

▪ Controlled group designs

▪ Experimental group = exposed to treatment

▪ Control group = comparison group

▪ Independent variable = controlled by the researcher, the  variable we manipulate

Ex: in our medication trial, the independent variable  

▪

would be getting the pill vs getting the placebo

▪ Dependent variable = the outcome measure that is assessed

Ex: in our medication trial example, the dependent  ▪

variable we manipulate

Ex: in our medication trial, the independent variable  

▪

would be getting the pill vs getting the placebo

▪ Dependent variable = the outcome measure that is assessed

Ex: in our medication trial example, the dependent  

▪

variable would be whether their depression symptoms  got better or worse

▪ Random assignment = each participant has an equal chance of  being assigned to either group

We want our groups to be as equal as possible in every  

▪

way except whether they get the pill or the placebo

▪ Other considerations of randomized control trials ○ Analogue vs clinical  sample

▪ Clinical sample = when people in study actually have  diagnosis you're interested in

□ Usually preferable

□ Hard to come by

□ expensive

Analog study = if you have 2 groups of people who don't  

▪

have depression but are studying depressive symptoms

○ Internal vs external validity

▪ Internal validity = degree to which the study itself  allows us to say that our independent variable caused  changes in our dependent variable

□

Randomized assignment allows us to prove  internal validity

External validity = how generalizable  our findings are to  

▪

the general population outside of our study

○ Effectiveness vs efficacy research

Efficacy studies tend to happen in lab, tend to have a lot  

▪

of internal validity, happen first (does this treatment  work in a well controlled environment)

Effectiveness studies come afterwards to see if this  

▪

treatment will work in the real world

○ Placebo control  

Without knowing it, we react to the idea of taking  

▪

medication and think it makes us better

○ Clinical vs statistical significance

▪ Statistical significance = tells us whether something  happened by chance

□

The bigger the study, the easier it is to find  statistical significance

Clinical significance = does it matter for patients in the  

▪

real world

▪ Statistical significance = tells us whether something  happened by chance

□

The bigger the study, the easier it is to find  statistical significance

Clinical significance = does it matter for patients in the  

▪

real world

Population studies

○

▪ Epidemiology = examines disease patterns in populations and the  factors that influence these patterns

○ Prevalence = total number of cases in a given population at a  designated time

▪ Point prevalence = # of individuals with disorder at a  

given time

□ Ex: number of adults with depression at this time

▪ Lifetime prevalence = # of individuals who develop  

disorder over the course of their lifetime

□

Ex: number of adults who experience  depression  over the course of their lifetime

○ Incidence = number of new cases that emerge ▪ Epidemiological research designs

Observational epidemiology = documents the presence of  

○

disorders

Experimental epidemiology = scientist manipulates exposure  

○

to either causal or preventive factors

Ex: putting Fluoride in tap water to prevent tooth  

▪

diseases  

Twin studies definition and usefulness -

Examines the difference between monozygotic (MZ or identical) twins and  

○

dizygotic (DZ or fraternal) twins

Biological difference: MZ twins came from a single fertilized egg  

○

that later split, DZ twins came from separately fertilized eggs

○ MZ twins for the most part have 100% the same DNA ○ DZ twins only share ~50% of their genes

Behavioral differences between MZ twins allow for examination of  

○

environmental influences

MZ twins separated in infancy allow comparison of genetics and non  

○

shared environmental factors

Controlled group designs and why they're helpful/important

-

○ Experimental group = exposed to treatment

○ Control group = comparison group

Independent variable = controlled by the researcher, the variable we  

○

manipulate

Ex: in our medication trial, the independent variable would be  

▪

getting the pill vs getting the placebo

   =    ○ Control group = comparison group

Independent variable = controlled by the researcher, the variable we  

○

manipulate

Ex: in our medication trial, the independent variable would be  

▪

getting the pill vs getting the placebo

Dependent variable = the outcome measure that is assessed ○

Ex: in our medication trial example, the dependent variable would  

▪

be whether their depression symptoms got better or worse

Random assignment = each participant has an equal chance of being  

○

assigned to either group

We want our groups to be as equal as possible in every way except  

▪

whether they get the pill or the placebo

Common problems (current and past) in research in regard to poor diversity of  

-

research samples

Samples often restricted

○

○ Much medical research into the 1980s excluded women

Older adults may be excluded due to the complex interactions due  

○

to aging

○ Most research is with white individuals, often in college National Institutes of Health (NIH) and other agencies now require all  

○

grant applications to target traditionally underrepresented groups

Differences between cross-sectional and longitudinal designs

-

○ Cross-sectional design = participants assessed once for a specific variable

Longitudinal design = includes at least 2, often more, measurement  

○

periods with the same individuals at different times

Chapter 3 Study Guide

Monday, September  11, 2017 5:36 PM

Key Terms:

- Behavioral observation = the measurement of behavior as it occurs by someone  other than the person whose behavior is being observed  

- Clinical assessment = the process of gathering information about a person and  his or her environment to make decisions about the nature, status, and  treatment of psychological problems

- Clinical interviews =  conversations between an interviewer and a patient, the  purpose of which is to gather information and make judgments related to  assessment goals

- Clinical significance = an observed change that is meaningful in terms of clinical  functioning  

- Comorbidity = the presence of more than one disorder

- Diagnosis = the identification of an illness

- Diagnostic and Statistical Manual = a classification of mental disorders originally  developed in 1952; has been revised over subsequent years and is a standard of  care in psychiatry and psychology

- Differential diagnosis =  a process in which a clinician weighs how likely it is that  a person has one diagnosis instead of another

- Intelligence test = a test that measures intelligence  quotient (IQ) - Interrater agreement =  the amount of agreement between 2 clinicians who are  using the same measure to rate the same symptoms in a single patient - Normative comparisons =  a method of interpreting assessment data that  involves comparing a person's score with the scores of people who are  representative of the entire population (with regard to characteristics  such as  age, sex, ethnicity, education, and geographic region) or with the scores of a  subgroup who are similar to the person being assessed

- Personality test = a psychological test that measures personality characteristics - Projective tests = a test derived from psychoanalytic theory in which people are  asked to respond to ambiguous stimuli

- Reliability = the extent to which a psychological assessment instrument  produces consistent results each time it is given  

- Test-retest reliability = the extent to which a test produces similar scores over  time when given to the same individuals

- Screening = an assessment process that attempts to identify psychological  problems or predict the risk of future problems among people who are not  

-            produces consistent results each time it is given  

- Test-retest reliability = the extent to which a test produces similar scores over  time when given to the same individuals

- Screening = an assessment process that attempts to identify psychological  problems or predict the risk of future problems among people who are not  referred for clinical assessment

- Self-monitoring = a procedure within behavioral assessment in which the  patient observes and records his or her own behavior as it happens - Sensitivity = describes the ability of the screener (or the instrument) to identify  a problem that actually exists

- Specificity =  percent of the time the screener accurately identifies the absence  of a problem

- Structured interview = a clinical interview in which the clinician asks a standard  set of questions, usually with the goal of establishing a diagnosis

- Unstructured interview = a clinical interview in which the clinician  decides what  questions to ask and how to ask them

- Validity = the degree to which a test measures what it is intended to assess

Application of terms/concepts:

- Purpose of a clinical assessment

○ gathering information to make decisions about psychological problems - Steps:

○ Referral questions

Usually get a phone call from parent or individual who is  

▪

having a problem and psychologist thinks of possible   psychological disorders or biological problems that are  causing the problem

○ Assessment procedures

Can be biological, personality traits, emotional  

▪

functioning, behavior patterns

○ Integrate the data and develop preliminary answers

Based on this information, the psychologist comes up  

▪

with a possible diagnosis/answer

- Primary goals of assessment:

○ Screening

○ Diagnosis and treatment planning

○ Outcome evaluation

- Characteristics of a good assessment instrument

○ Standardization = perform assessments so that normative or self

reference comparisons are possible

- Normative comparisons = compare a score with a similar sample of  

people

○ Bell curve distribution

'

○ Standardization = perform assessments so that normative or self reference comparisons are possible

- Normative comparisons = compare a score with a similar sample of  people

○ Bell curve distribution

- Self-referent comparisons = compare responses with the person's  prior performance

○ Reliability = consistency, or how well the measure produces the same  results each time

- Test-retest reliability = assesses the consistency of scores across  time

- Interrater agreement = measure of consistency between two  different raters

○ Validity = degree to which a test measures what it's intended to measure - Construct validity = how well a measure accurately assesses a  particular construct

○ How well does the IQ test measure intelligence?

- Criterion validity = how well a measure correlates with other  measures

○ How well are 2 measures of depression yielding similar  

results?

- Predictive validity = ability of a measure to predict performance at a  future time

○ Ex: SAT and ACT are supposed to predict how well a student is  going to do in college

Clinical interviews

-

○ Can be used at all levels of assessment

○ Unstructured interviews = interviewer doesn't have a predetermined set  of questions and adjusts line of questioning based on client's answers - Open-ended and closed-ended questions

- Benefit: flexibility

- Limitation: potential unreliability

○ Structured interviews = predetermined question set

- Semistructured interviews = use unstructured questions after the  standard questions

- Limitation: less flexibility

- Different psychological tests purport to measure and their purposes ○ Personality tests = measure personality characteristics ○ Objective personality tests

Examples: Minnesota Multiphasic Personality Inventory  

▪

(MMPI), Millon Clinical Multiaxial Inventory (MCMI)

▪ Usually paper and pencil

Set of questions that are meant to elicit  types of personality  ▪

○ Objective personality tests

Examples: Minnesota Multiphasic Personality Inventory  

▪

(MMPI), Millon Clinical Multiaxial Inventory (MCMI)

▪ Usually paper and pencil

Set of questions that are meant to elicit  types of personality  

▪

traits

○ Projective personality tests

Examples: Rorschach Inkblot Test, Thematic Apperception  

▪

test (TAT)

▪ Unstructured and open-ended

○ General tests of psychological functioning

○ Ex: General Health Questionnaire

○ Tests for specific symptoms = measure specific types of symptoms such as  depression or anxiety

○ Ex: Beck Depression Inventory-II (BDI-II)

○ Cognitive functioning tests

○ Neuropsychological testing = detects impairment in cognitive  functioning (e.g., language, memory, attention/concentration,  motor skills)

Ex: Wisconsin Card Sort Test, Bender Visual Motor Gestalt  

▪

Test

○ Intelligence tests = produce an intelligence  quotient, or IQ, score ▪ IQ is based on person's mental age compared to his/her age matched peers

□

Ex: Stanford-Binet Intelligence Scale, Weschler Adult  Intelligence Scale

▪ Discussion about what intelligence is

▪ IQ doesn't measure all the traits we have

□ Athletic ability

□ Musical ability

□ Emotional intelligence

- How the behavioral assessment techniques differ

i. Functional analysis = a strategy of behavioral assessment in which a  clinician attempts to identify causal links between problem behaviors and  environmental variables; also called  behavioral analysis or functional  assessment  

1) Look at antecedents and consequences of behavior

ii.

Self-monitoring = a procedure within behavioral assessment in which the  patient observes and records his or her own behavior as it happens iii.

Behavioral observation = the measurement of behavior as it occurs by  someone other than the person whose behavior is being observed  

1)

Behavioral avoidance tests = the behavioral assessment strategy  used to assess avoidance behavior by asking a patient to approach a  feared situation as closely as possible

patient observes and records his or her own behavior as it happens iii.

Behavioral observation = the measurement of behavior as it occurs by  someone other than the person whose behavior is being observed  

1)

Behavioral avoidance tests = the behavioral assessment strategy  used to assess avoidance behavior by asking a patient to approach a  feared situation as closely as possible

- How the DSM is used

○ Factors that should be considered when making a mental illness diagnosis ▪ Varies by sex, ethnicity, race, age

○ How diagnostic systems can be harmful

1) Not all people with the same diagnosis have the same symptoms 2) May have developed symptoms different ways  

- How dimensional and categorical  systems of classification differ ○ Dimensional systems  

▪ Suggests that people with disorders are not qualitatively distinct  from people without disorders

▪ Suggests that symptoms of what are now disorders are simply  extreme variations of normal experience

▪ Heterogeneity = the issue of multiple symptoms within diagnostic  categories

▪ Difficult to implement

○ Categorical systems

▪ Either the patient has the disorder or he/she doesn’t

Chapter 4 Study Guide Friday, September  15, 2017 11:47 AM

Key Terms:

Agoraphobia = a fear of being in public places or situations where escape might  

-

be difficult or help unavailable if a panic attack occurs  

Anxiety = a common emotion characterized by physical symptoms, future

-

oriented thoughts, and escape or avoidance behaviors

Anxiety disorders = a group of disorders characterized by heightened physical  

-

arousal, cognitive/subjective distress, and behavioral avoidance of feared  objects/situations/events. Anxiety proneness.  

- Exposure =  

Fight or flight = a general discharge of the sympathetic nervous system  

-

activated by stress or fear that includes accelerated heart rate, enhanced  muscle activity, and increased respiration.

Generalized anxiety disorder = frequent, excessive, out-of-proportion worry;  

-

Worry about future events, past transgressions, financial status, and the health  of oneself and loved ones

- Panic attack =  discrete period of intense fear and physical arousal

Panic disorder = at least one panic attack and person worries about having more  

-

attacks

Parasympathetic nervous system = the part of the autonomic nervous system  

-

that counteracts the effects of system activation by slowing down heart rate  and respiration, returning the body to a resting state.  

Posttraumatic stress disorder = the emotional distress that occurs after an event  

-

involving actual or threatened death, serious injury, or a threat to physical  integrity and that leads to avoidance of stimuli associated with the trauma,  feelings of emotional numbness, and persistent symptoms of increased  sympathetic nervous system arousal.  

Selective serotonin reuptake inhibitors = a group of medications that selectively  

-

inhibit the reuptake of serotonin at the presynaptic neuronal membrane,  restoring the normal chemical balance; drugs thought to correct serotonin  imbalances by increasing the time that the neurotransmitter remains in the  synapse

Separation anxiety disorder = persistent, excessive anxiety concerning  

-

separation from an attachment figure

Social anxiety disorder = fear of social situations and perceived scrutiny by  

-

others

            synapse

Separation anxiety disorder = persistent, excessive anxiety concerning  

-

separation from an attachment figure

Social anxiety disorder = fear of social situations and perceived scrutiny by  

-

others

- Specific phobia =  intense fear or anxiety about a specific object or situation

Sympathetic nervous system = The part of the autonomic nervous system that  

-

activates the body for the fight-or-flight response. When activated, the  sympathetic nervous system increases heart rate and respiration, allowing the  body to perform at peak efficiency.

Trait anxiety = a personality trait that exists along a dimension; those individuals  

-

high on this dimension are more "reactive" to stressful events and therefore  more likely, given the right circumstances, to develop a disorder; aka anxiety  proneness

Worry = the apprehensive (negative) expectations or outcomes about the future  

-

or the past that are considered to be unreasonable in light of the actual  situation

Application of terms/concepts  

Parts of the nervous system involved in anxiety response -

anxiety is a future-oriented response

○

▪ Can be associated with decreased level of physical reactivity ▪ Thought patterns of imagining the worst possible outcome Sympathetic nervous system (SNS)

○

◆ Increases heart rate/respiration

◆ Allows use of all available resources to escape

Parasympathetic nervous system (PNS)  

○

◆ Slows down heart rate and respiration

◆ Returns body to resting state

Typical anxiety is differentiated from anxiety disorders by  

-

○ It has to impair daily function and be out of proportion worry

Some factors to consider when trying to identify/determine those  

○

experiencing an anxiety disorder

Developmental age

◆

▪ Cognitive development, not actual chronological age

◆ Presence of functional impairment

Sociodemographic factors

◆

▪ Sex, race/ethnicity, and socioeconomic status

Major symptoms associated with disorders  -

○

Panic disorder

Concern over what panic attack may indicate

◆

○ "Am I losing my mind?"

○ "Am I developing a heart condition?"

Major symptoms associated with disorders  

-

○

Panic disorder

Concern over what panic attack may indicate

◆

○ "Am I losing my mind?"

○ "Am I developing a heart condition?"

◆ Change behavior to avoid situations associated with attack ◆ Person has had panic attacks before and is afraid of future attacks Agoraphobia  

○

◆ Fear of inability to escape

◆ Fear the embarrassment of physical symptoms

Some places people tend to be afraid of if they have agoraphobia:  

◆

the mall, concerts, school bus, planes, subway, etc

○ Places where they cannot get out of the situation quickly

◆ Often develops after a panic disorder Generalized anxiety disorder

○

Worry about future events, past transgressions, financial status, and  

◆

the health of oneself and loved ones

◆ Lasts at least 6 months

Physical and cognitive symptoms ◆

Physical - feel on edge, keyed up, difficulty concentrating,  

○

headaches, trouble sleeping

○ Cognitive - worry

Social anxiety disorder

○

◆ Intense fear that others will detect anxiety  

Social situations that create distress: speaking, eating, drinking, or  

◆

writing in the presence of others, engaging in social interactions,  and initiating conversations

Symptoms he describes:

◆

Freezing up - difficulty communicating, "almost rendered  

▪

mute"

Believes people are watching him closely waiting for him to  

▪

fail

▪ Heart racing ▪ Sweating ▪ Stammering

Worried someone will ask a question that will make him  

▪

appear ignorant or stupid

▪ Difficulty breathing

▪ Tries to use humor as his "social grease"

▪ Has a plan for how the conversation will go Specific phobia

○

Criteria:

◆

○ Significant emotional distress

▪ Tries to use humor as his "social grease"

▪ Has a plan for how the conversation will go Specific phobia

○

Criteria:

◆

○ Significant emotional distress

○ Impairs an aspect of life functioning

Types

◆

○ Animal phobias (Ex: arachnophobia)

○ Natural environment phobias (Ex: fear of weather)

Blood-injection-injury phobias (Ex: fear of getting a shot at the  

○

doctor's)

○ Situational phobias (Ex: claustrophobia, fear of heights) ○ Other (unrelated to other groups)

Physical symtpoms

◆

○ Increase in parasympathetic activity instead of sympathetic ○ Blood pressure spikes then drops

○ Helps explain why some people faint

Separation anxiety disorder

○

◆ Worry about being harmed or about caregiver being harmed  PTSD

○

◆

Classic sypmtoms

Intrusion (reexperiencing of event aka flashbacks, person  

○

feels as if it's happening to them again)

Negative cognitions and mood

○

▪ Shame and survivor's guilt

○ Hyperarousal/hyperviligance ○ Exaggerated startle response

Persistent avoidance of situations or objects associated with  

○

trauma

○ Difficulty sleeping

Panic attack vs panic disorder -

Panic attack  

○

◆ Develops abruptly

◆ Symptoms peak within minutes

◆ Somatic (physical) and cognitive symptoms

◆

Types of attacks

Expected panic attacks-triggered by something in the  

○

environment that the person is aware of

▪ Ex: someone afraid of elevators forced to ride one Unexpected panic attacks - person is going about their day  

○

and they suddenly have a panic attack, usually don't figure  out trigger until afterwards

People often mistake a panic attack for a heart attack and go to the  ◆

▪ Ex: someone afraid of elevators forced to ride one Unexpected panic attacks - person is going about their day  

○

and they suddenly have a panic attack, usually don't figure  out trigger until afterwards

People often mistake a panic attack for a heart attack and go to the  

◆

hospital

◆ Can occur at any point for anybody Panic disorder

○

Concern over what panic attack may indicate

◆

○ "Am I losing my mind?"

○ "Am I developing a heart condition?"

◆ Change behavior to avoid situations associated with attack ◆ Person has had panic attacks before and is afraid of future attacks Major theories applied to anxiety disorders

-

○

Biological

Family and genetic studies:

◆

○ Anxiety disorders run in families

○ Concordance rate twice as high for monozygotic twins  

Genetic vulnerability factor (trait anxiety or anxiety  

○

proneness)

◆

Neuroanatomy:

Differences in brain functioning ○

Amygdala, limbic and paralimbic systems, prefrontal  

▪

cortex may become activated

Reduced connectivity between limbic system and  

▪

prefrontal cortex

▪ Importance of serotonin, GABA

Temperament and behavioral inhibition: ◆

Temperament = individual behavioral differences that are  

○

present at birth or at a very early age

Behavioral inhibition = a temperamental feature associated  

○

with withdrawal from novel people, objects, or situations

◆

▪

Treatment

Children with behavioral inhibition more likely to have  childhood anxiety disorders

○

Medication

○

▪

▪

Psychological

Selective serotonin reuptake inhibitors (SSRIs) to  correct serotonin imbalance

□ Prozac, Luvox, and Zoloft

Benzodiazepines increase GABA effectiveness □ Valium and Xanax

Behavioral theories of fear acquisition: ◆

Acuisition of fear throuh classical  conditionin ○

○

▪

Psychological

□ Prozac, Luvox, and Zoloft

Benzodiazepines increase GABA effectiveness □ Valium and Xanax

Behavioral theories of fear acquisition: ◆

Acquisition of fear through classical  conditioning

○

▪ Explanation for onset of anxiety  

Person pairs stimulus with anxious response ▪

□

Child who pairs fear with being bitten by a dog  will be anxious around all dogs

Vicarious learning theory

○

▪ Learning through observation

▪ Previous positive experiences  considered protective  Information transmission

○

▪ Instruction that a situation or object should be feared  

Cognitive theories of fear acquisition: ◆

Inaccurate interpretation of internal or external events ○

Misinterpretation of ambiguous situations as  

▪

dangerous/bad

▪ Maladaptive thinking

Fear of fear model

○

▪ Hypersensitivity to bodily sensations ▪ Vicious cycle of worry

Anxiety sensitivity

○

◆

▪

Treatments

Belief that anxiety symptoms will result in negative  consequences

Behavioral and cognitive-behavioral treatment: ○

Behavioral therapy (BT) and cognitive-behavioral  

▪

therapy (CBT) most successful psychosocial treatment

▪ Use of exposure - in vivo and imaginal exposure

Combination of exposure and other treatments most  

▪

effective  

□ Social skills training (SST)

□ Cognitive restructuring

Mindfulness

▪

□

Trying to be aware of the present moment and  not being judgmental about one's thoughts

Acceptance and commitment therapy ▪

□

Determining what your values are and making  sure your actions are aligned with those values

Exposure and avoidance in relation to anxiety disorders -

Exposure = the crucial ingredient in behavior therapy in which a person  

○

learns to overcome fears by actual or imagined contact with the feared  

Acceptance and commitment therapy ▪

□

Determining what your values are and making  sure your actions are aligned with those values

Exposure and avoidance in relation to anxiety disorders -

Exposure = the crucial ingredient in behavior therapy in which a person  

○

learns to overcome fears by actual or imagined contact with the feared  object or event  

a) In vivo or imaginal exposure

a.

Avoidance can be negatively reinforced

a)

In the in-class example, Steve chose to go to the restroom when he  felt uncomfortable in a conversation, and he felt better after  avoiding that uncomfortable situation

"Things to Think About Before Tuesday" portion of  the end of Thursday's class

Friday, September  15, 2017 12:13 PM

- Difference between validity and reliability

○ Reliability = consistency in measuring something

▪ Test-retest reliability

▪ Interrater agreement

○ Validity = are you testing what you want to test (ie, does an IQ test actually test  intelligence?)

▪ Several types

- Correlations  

○ Positive correlation means as one variable goes up, the other variable goes up ○ Negative correlation means as one goes up, the other variable goes down ○ Possible range: -1 to +1

Magnitude of correlation coefficient: bigger the number, the stronger the  

○

correlation

○ Sign tells us whether the correlation is positive or negative

- Diathesis-stress model

○ Diathesis = biological predisposition, something we're born with in our genes ○ Stressor = something from the environment (ex: losing a job, getting a divorce)

Individuals who have the diathesis and experience a stressor is what leads to  

○

the development of a mental illness

- Neurons

○ Receives information from another neuron = dendrites

○ Dendrites send information to cell  body

○ Axon sends info away

○ Synapse = area between neurons

○ An electrical  signal is what actually goes down the neuron

○ At the axon buttons, neurotransmitters (chemicals) are released  - Psychoanalysis involves id, ego, superego and unconsciousness - Cognitive model is all about the way we think

- Behaviorism explains that mental illness is learned from our environment - Sociocultural model feels it Is important to understand one's culture and background - Sensitivity vs specificity

Sensitivity = accurately predicts that a disease is there when it is there, true  

○

positives

='

- Behaviorism explains that mental illness is learned from our environment - Sociocultural model feels it Is important to understand one's culture and background - Sensitivity vs specificity

Sensitivity = accurately predicts that a disease is there when it is there, true  

○

positives

Specificity = accurately predicts that a disease is not present when there isn't  

○

one, true negatives

- Breakdown of different nervous systems ○ Central nervous system

○ Peripheral nervous system

▪ Somatic sensory nervous system

▪ Autonomic sensory system

□ Sympathetic nervous system

□ Parasympathetic nervous system

- Broad general reasons we give assessments: ○ Screening

○ Diagnosis and treatment planning

○ Outcome evaluation