Exam #2 Study Guide
Exam #2 Study Guide PSY 250
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This 9 page Study Guide was uploaded by Jacobi Johnson on Friday October 2, 2015. The Study Guide belongs to PSY 250 at Central Michigan University taught by Deskovitz, Mark in Fall 2015. Since its upload, it has received 162 views. For similar materials see Abnormal Psychology in Psychlogy at Central Michigan University.
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Date Created: 10/02/15
Exam 2 Studv Guide Chapter 4 Clinical Assessment Basic Elements Psychological assessment a procedure by which clinicians using psychological tests observation and interviews develop a summary of the client39s symptoms and problems To assess someone is to examine their psychological makeup In order to assess someone you may use comparison against the normS presenting probem major symptoms and behavior the client is experiencing how does the individuals symptoms fit into the DSM5 This assessment is often directly related to the following clinical diagnosis the process through which a clinician arrives at a general summary classification of the patient s symptoms by following a clearly defined system such as the DSM5 Clinical knowledge of a person39s type of disorder can help in planning and managing the appropriate treatment Formal diagnosis is often required for insurance claims Social and behavioral history is a crucial factor things like a patients cultural background social support groups their views on mental illness religious background etc has a lot to do with the way they are now Cultural competence the need to be informed of the issues involved in multicultural assessment Professional orientation affects the work that you do and the therapy that you utilize could be psychoanalytical humanistic cognitive behavioral etc Trust and rapport is crucial to have with a client Everything used must have a measure of reliability the degree to which an assessment measure produces the same result each time it is used to evaluate the same thing validity the extent to which a measuring instrument actually measures what it is supposed to measure Standardization a process by which psychological test is administered scored and interpreted in a consistent or standard manner Assessment is an ongoing process and may be important at multiple points during treatment not just the beginning TVIoes of Assessment General physical exam Often the issue might not be psychological but instead a medical issue ex low motivation and bad mood could be due to a thyroid issue This is done to ensure this is not the case Neurological exam EEG assesses brain waves and may reveal a dysrhythmia an irregular pattern that can aid in reaching a diagnosis Brain scansMRIS gives an image of the brain but doesn39t measure brain function MRls are beginning to be used more than CAT scans as the picture is clearer the procedure a lot more simple and eliminates the ionizing radiation a patient must endure fMRl a functional look at brain that tracks ongoing psychological activity such as sensations images and thoughts PET scan tells a researcher how an organ is functioning by providing a metabolic portrait that tracks natural compounds The downsides is the pictures are low quality and the cost is expensive Neuropsychological exam Series of exams that involves the use of various testing devices to measure a person39s cognitive perceptual and motor performance as clues to the extent and location of brain damage HalsteadReitan battery for adults can give a researcher an indeX of impairment Includes the Halstead category test the textual performance test the rhythm test the speech sounds perception test and the finger oscillation task Psychosocial assessment The main form psychiatrists use to assess patients consists of interviews structured interviews follow a set of predetermined questions while unstructured interviews do not Unstructured interviews are used less often behavior observation body language responses mood etc psychological tests intelligence tests What is intelligence It is often debated and defined differently Crystallized intelligence 50 cemented concepts and ideas Fluid intelligence GF the ability to learn on the fly One s level of intelligence correlates with things in life and that is why it is important to assess Wechsler Adult Intelligence Scale WAISIV very popular intelligence test Updates in IQ tests are important Studies show our intelligence is growing by 3 IO points each decade people are getting smarter with more access to information achievement testing used to determine any intellectual disabilitycognitive impairment personality tests projective relies on various ambiguous stimulus such as inkblots or fake pictures rather than on explicit verbal questions Through their interpretation of these ambiguous materials people reveal a good deal about their personal preoccupations conflicts motives coping techniques and other personality characteristics Rorschach lnkblot Test developed in 1921 39 If a patient is seeing things most people don t see that iS the indication of deviant thinking Considered dated now TAT thematic apperception tests what happened in these pictured situations what will happen Sentence completion tests My biggest fear is My mother ism HouseTreePerson objective structured questionnaires selfreport inventories or rating scales some questions seem almost identical but slightly different and this is done to test the truth of the response to test if faking good or faking bad rating scales On a scale of 1 to 10 how happy have you been in the past two weeks Minnesota Multiphasic Personality Inventory MMPl2 considered the prototype and standard of this class of instruments uses 10 scales to give a clear reading on one s personality and psychological state others such as the PSY5 PAI or MCMI mentioned in class Integrating Data and Classifvinq Behavior We must aim to eliminate any type of bias or assumptions and avoid premature evaluations 1 potential cultural bias of the instrument or clinician 2 influence of theoretical orientation of the clinician 3 underemphasis on the external situation 4 insufficient validation 5 inaccurate data or premature evaluation There are 3 ways of classifying abnormal behavior the categorical dimensional and prototypal Categorical defines abnormal behavior into categories then used to give a diagnosis such as in the DSM5 Dimensional People have definable dimensions that create a unique profile of behavior that should be analyzed in order to give an official diagnosis and treatment Prototypal Using a prototype the clinician should compare the client and use that as the basis for diagnoses Comorbiolity when two or more disorders occur at the same time symptoms descriptions or complaints of what s wrong Signs objective observations made by the clinician either indirectly or directly There are often gender differences in diagnosis prevalence and the symptoms shown It is important to remember the diagnosis is not a label Chapter 5 Stress and Adiustment Disorders m Stress affects all aspects of the body Health psychology concerned with the effects of stress and other psychological factors in the development and maintenance of physical problems a subspecialty within behavioral medicine When we experience or perceive challenges to our physical or emotional wellbeing that exceeding our coping resources and abilities the resulting psychological condition is referred to as stress Stress can occur in both negative ex a loss of a job and positive situations ex a wedding When stress gets to be too much it can be considered distress Stressors external demands or challenges Crisis used to refer to times when a stressful situation threatens to exceed or exceeds the adaptive capacities of a person or group 0 Coping strategies ways to deal With stress Factors predisposing people to stress a family history of depression or the patient having depression themselves the short version of the 5HTTLPR gene pg 131 the amount of stress experienced in one s life etc Stress tolerance a person s ability to withstand stress without becoming seriously impaired Resilience healthy psychological and physical functioning after a potentially traumatic event Characteristics of Stress Severity how intensely does the stressor affect the patient S life things that are more severe death of a loved one job loss a serious illness etc are more likely to cause intense stress Chronicity how long does it last The longer the stressor operates the more severe its effects Timing How does this line up with other factors in the patient S life Stressors often have cumulative effects so if many are occurring at one time that could be extremely difficult for the patient Expectedness How expected is stressor Especially with death expecting something to happen may lessen the negative effects Controllability How controllable is it Helplessness may add to stress Stress and the Stress Resoonse Sympatheticadrenomedullary SAM system designed to mobilize resources and prepare for a flight or flight response Stress response begins in the hypothalamus which stimulates the sympathetic nervous system The adrenal gland begins to secrete adrenaline and noradrenaline which increases the heart rate and causes the body to metabolize glucose more rapidly Hypothalumuspituitaryadrenal HPA system also stimulates the sympathetic nervous system which stimulates the hypothalamus to secrete corticotrophinreleasing hormone CRH This hormone stimulates the pituitary gland which then secretes adrenocorticotrophic hormone ACTH This causes the adrenal cortex to produce stress hormones called glucocorticoids The main glucocorticoid in humans in cortisol Cortisol is a good hormone to have in the body at certain times It prepares the body for flight or flight as well as inhibiting immune response so escape has priority over healing this is called immunosuppression But cortisol can damage brain cells in the long run especially in the hippocampus Aostatio oao the biological cost of adapting to stress Psychoneuroimmunology the study of the interaction between the nervous system and the immune system It is proven that the brain and the immune system are closely related and affected by each other Immune system the police force or protector of the body leukocytes or lymphocytes white blood cells that provide the front line of defense for the immune system B oe matures in the bone marrow T oe matures in the thymus an important endocrine gland Antigens foreign bodies such as viruses and bacteria or internal invaders such as tumors and cancer cells cytokines small protein molecules that serve as chemical messengers and allow immune Stress is linked to suppression of the immune system Depression is also associated with a compromised immune system Stress and Mental Health Adjustment disorder a problem coping with a stressor in one s life can come with depression anxiety etc most people suffer from this at some point in their lives adjustment disorders are not chronic something like that would be indicative of another mental disorder PTSD Posttraumatic stress disorder extreme stress experienced for at least 1 month after a traumatic event Wasn t always as prevalent as it was now Symptoms intrusive thoughts or memories avoidance of things that remind them of the stressor negative cognitions and mood extreme reactivitystartled response PTSD prevalence 68 lifetime 97 for women and 36 for men Men are more likely to experience combat trauma PTSD women are more likely to experience attacks such as rape kidnapping or robbery PTSD Distinguishing acute stress disorder and PTSD acute stress disorder is like a shorter version of PTSD Causal factors certain occupations put someone more at risk for PTSD ex being a soldier or a firefighter mental health disorders such as anxiety or depression prior to the incident family history of disorders low levels of social support or substance abuse higher cognitive abilities may protect against PTSD Prevention and Treatment of Stress Disorders How do you prevent PTSD No one willingly goes through something awful So how do we avoid stressors in life Treatment exposure based cognitive behavioral therapy stress inocuIation therapy gradual exposure to the stressor relaxation techniques medication crisis intervention etc LSD for PTSD Chapter 6 Panic Anxietv Obsessions etc Fear and Anxietv Resoonse Patterns Fear an alarm reaction that occurs in response to immediate danger symptoms scared or endangered feelings increase heart rate and breathing and a strong urge to escape and flee present in panic disorders and specific phobias Anxiety general feelings of apprehension about possible future danger symptoms negative mood worry about possible future danger physical tension and an urge to avoid future danger present with generalized anxiety disorder social anxiety disorder and OCD A little worry can be beneficial A college student who is slightly concerned for a test may be motivated to do better than one who expects a good grade When anxiety becomes too much however it is no longer beneficial and becomes debilitating 2529 lifetime prevalence rates of anxiety disorders in general Overview of Anxietv Disorders Specific phobias strong or persistent disabling fear that is triggered by the presence of a specific object or situation 12 lifetime prevalence rate Causal factors psychological phobias can often be learned behaviors Classical conditioning may have been a factor seeing someone experience trauma or experiencing trauma yourself such as being bit by a dog or being hurt on a bike will make you averse to the thing or situation biological genetic and temperamental variables Phobias are considerably more common in women The age of onset for phobias varies widely but often originates in childhood Treatment In order to cure a phobia a patient must build up a tolerance to the stimuli using exposure therapy Social phobias disabling fear of one or more specific social situations 12 lifetime prevalence rate Causal factors psychological like specific phobias social phobias may be caused by classical conditioning Evolutionary context is provided in dominance hierarchies the patient may see themselves at the bottom of said hierarchy Cognitive biases and perceptions of uncontrollability and unpredictability may also be a factor biological behavioral inhibition a characteristic that shares similarities with neuroticism and introversion may be a key personality factor Estimates suggest that about 30 of the variance in liability is due to genetic factors Social phobias are also more common in women about 60 of sufferers are female Social phobias begin in early or middle adolescence but certainly by early adulthood Treatment Cognitive restructuring techniques may be used to reshape thoughts that may be leading to the phobia Medication such as Moms and SSRl s may be used in conjunction with therapy Panic Disorders recurrent unexpected panic attacks 47 lifetime prevalence rate Causal factors psychological Panic disorders can be manifested by an increased level of neuroticism Classical conditioning may have played a role as well biological According to family and twin studies panic disorder has a moderate heritable component Increased activity in the amygdala plays a role as well Agoraphobia fear of one s environment often comes hand in hand with a panic disorder Panic disorders often start in the late teenage years average age of onset being 2434 years of age It can however begin later especially for women Panic disorder is about twice as prevalent in women than in men People with panic disorders often suffer from another disorder as well comorbidity Treatment Antianxiety medications may be used to lessen the stress and panic a patient expenences Cognitive restructuring techniques 39 Generalized Anxiety Disorders GAD excessive anxiety and worry for at least 6 months 3 prevalence rate in a 1 year period and 57 lifetime prevalence rate Symptoms irritability sleep disturbances distress Causal factors psychological perceptions of uncontrollability and unpredictability are huge with GAD biological there is some level of genetic vulnerability GAD is twice as common in women than in men Treatment Antianxiety medications may be used to lessen the stress and panic a patient expenences Cognitive behavioral treatment and cognitive restructuring techniques Obsessive Compulsive Disorder recurrent and persistent thoughts and repetitive behavior 12 prevalence rate in a one year period and 23 lifetime prevalence Causal factors psychological Mowrer s two process theory of avoidance learning biological biological factors may be more strongly implicated in OCD than in other anxiety and panic disorders Treatment medication such as antipsychotics for severe OCD they may consider a lobotomy Actual answers to the test s questions 7 B unstructured interviews 41 D both a and b 55 A 16 Potential test t0pics clinical assessment professional orientation rapport imaging techniques cat scans MRI fMRl s intelligence tests Weschler Rorschach projective test MMPI 2 scales validity scale f scale validity and reliability stress disorders PTSD and it s treatments prevalence rates symptoms of a panic attack 39 OCD physiological effects of stress extra credit
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