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Exam 2 Study Guide

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by: Resi Ridner

Exam 2 Study Guide Psy 3080

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Hey yall, this is a full study guide of Abnormal class notes and book notes for the exam on Thursday, November 5th. I hope this helps all who is a little behind in the class and needs some extra st...
Principles of Abnormal Psychology
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This 34 page Study Guide was uploaded by Resi Ridner on Tuesday November 3, 2015. The Study Guide belongs to Psy 3080 at a university taught by Ozbek in Summer 2015. Since its upload, it has received 63 views.


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Date Created: 11/03/15
Abnormal Psychology Exam 2 Study Guide 10/8/2015 Class Notes:  Hans Selye: o Experiment on rats in water (experimentation gave us biorhythms) o Biorhythms:  You have an autonomic nervous system (ANS)  Made up of the sympathetic (arousal) lifts you up  And the parasympathetic ( maintenance) downward slope  We are all on about a 4- hour cycle of biorhythms.  An example for this would be when we are able to go for 4 hours, get a slump, can go 4 more hours, and etc. o Stress:  Intensity- how bad was the stress?  Duration- how long was the stress?  Cumulative- how much was the stress?  Change- what happened to the stress?  For as far up you go with stress, your parasympathetic will go that far down. (think like a pendulum, as far up  as far down) Example:  Each line represents stress: physical, and intellectual.  As far up as each stress line goes up, the slump or recovery goes that far down. (Recovery can mean sleep, or anything that helps you get back to the next 4-hour biorhythm before the next slump.) (The sympathetic is the high hump, and the parasympathetic is the low hump.)  Stress is cumulative.  Researchers can predict what illness you will have based on the amount of stress you have today, and they can also predict what part of the body that illness will be in. (validity of concept)  Individual profile or somatic weakness- today you should know what physical symptoms you are going to have due to your stress level. How does your body show stress? (You should know this)  Examples of symptoms- migraines (cardiovascular), Sleep problems and mood changes (central nervous system), etc.  They can predict your future health level based on the way your body reacts (somatic weakness) to stress.  Life stress changes your genetic code.  Specific weakness- when biological functions react to our stress hormones (woman whose teeth fell out in response to stress to being alone all year because her saliva caused the biological issue, causing her teeth to fall out.)  Evolutionary theory- lifestyle, if we lived the lifestyle that we inherited we would take a nap Class Notes 10/13/15  Psychological reasons (psychoanalytic) for biorhythms: o The physical, symbolic, inner conflict o The physical symptom is symbolic o Ex. Back pain because you can’t “stand” the pressure. Psychoanalytic ties in physical and mental problems.  The Behavioral Model for Biorhythms o The reason we get the sickness that we get, is because we are taught to respond physically this way, either through operant, classical, or modeling.  Cognitive Behavioral Model for Biorhythms o Type- A personality (physical problem=heart attack) o Type-B personality  Socio-cultural model o Cultural overlays affect very basic human processes o Ex. Prince William and prince George, when they were taught not to show their sadness over losing their mother Princess Diana  cultural modeling, or reconstructing  Dissociative disorder –identity disorder (DID): o Human memory:  Episodic memory  State dependent  Emotional  Short- and long term  Working memory o What happened is that people were learning more about memory, and now we know that:  You have to be alert and awake to put in new information  You have to pay attention (motivation)  Whether you learn better orally or visually o Short-term memory:  How long do we have memory before it is transferred to working memory? About 7 to 10 days, possibly during sleep  Transferring from short- term to working memory is when you work to keep the material and you think it is important. o Long- term memory:  When things go to long-term memory, it gets sorted (Each item is placed in its own column)  Memories are stacked chronologically (oldest newest)  Multiple connections through all memories.  The most fragile memories are the newest memories. (Alzheimer’s, concussion, short-term memory loss)  Organic physical basis of memory can be disrupted by concussions, etc. it is something you can’t get back. It is the “fresh” knowledge. o If it is just your name that you can’t remember, it means that there is something blocking it, not that it is lost. You just can’t retrieve it at this time. o A dissociative state is a selective memory loss that can eventually get retrieved.  This is where you are blocking periods of time, it is a partial selective memory loss. You are not completely disrupted psychologically, because for some reason you are only blocking some selective or few things.  This could be a coping mechanism of not being able to retrieve memories that are psychologically traumatizing to one.  Possibly taking different memory banks at different times.  You can get different memory banks depending on which personality state you are in. it can get split at some point (usually at a very traumatic event during childhood.) can be trauma triggered.  Daniel Keys (taught English in a town that Billy Milliton committed murder)  Keys was pretty convinced that Billy Milliton really did have DID personality states.  He had different allergy cues depending on the different personality states he was in  It was very common for people who have DID, with one of the personality states to speak in a different language.  One of his personality states had asthma, while the others didn’t.  We would suspect that this DID came or derived from trauma.  Keys acted oddly different on different days at school. (he was buried alive with a PVC pipe as air, and his step father peed down it  abusive childhood)  They (the different personalities) tend to have different names. Class Notes 10-15-15 Video: The War Within  Identify treatment model being used: o Humanistic- free will and talking treatments o Cognitive- they are digging into the mindset of what they presently think o *Cognitive behavioral- marriage ceremony, task was getting to know each other and understanding their different methods. Questioning the thinking.  What are the (men) afraid of? o Vietnam and the circumstances that happened there o Lived in fear that if they talked about what happened and what they hated, then they would be rejected by their family for talking about those things they hated. Class Notes 10-22-15  Unipolar Depression: o The pure emotion in depression is sadness lasing for at least 2 weeks. (unrelenting) (The pure emotion in anxiety is fear.) o This duration of the stress is built into the very definition of depression. o Unipolar depression= clinical depression  Symptom cluster: agitated depression, symptoms of agitated or vegetative.  Agitated- trouble sleeping, lose weight, etc.  Vegetative-trouble getting up, gain weight, so tired even after tons of sleep, your reaction time slows down (cognitive deficiency), etc. o Gender:  We think 1 in 4 women will end up with depression  that is 25% of our women, and 10% of our men.  We think though through theory, that this smaller percentage in depression in men is because of fewer reports from men due to the “macho” perspective. o Biological-  Treatment (TX): serotonin (modulator), dopamine, norepinephrine, MAO Inhibitors (severely fatal with effects to reactions to other things), ECT, (ENSAM- use of magnets), experimental methods (magnets, Vegas nerve implant)  Somatic Weakness  genetic predisposition (or could just be how we are wired), Diet matters, general surroundings, exercise matters (ex. Lewis and Clark walked 40 miles a day and Lewis never became depressed until he stopped exercising  exercising prevented two years of Lewis’ depression. Is a balancing act though.)  SSRIs- serotonin reuptake inhibitors  We have more depression than we did 30 years ago because our physical labor has decreased. We have desk jobs. We no longer exercise and help our body release serotonin naturally. o Psychoanalytic-  Loss symbolic death  Focus on early childhood and the effects of loss at childhood on adults.  Children who lost something at a young age are at higher risk for unipolar depression when they get older.  Example: death of a loved one, parents’ divorce, unsure a parent loves you “loss of mutual love.” Loss of relationship, moving.  ^ All symbolical “losses” that can trigger a higher risk of unipolar depression as a young adult.  Denial  bargaining  anger  depression  acceptance  Talk therapy- you have to talk about all of your feelings etc. finding some way to express those feelings in a safe place so that you realize that you are just angry at the cause of that loss. o Behavior-  Loss of reinforcement focus  Learned helplessness  “downward spiral”  Seligman gave us the term “learned helplessness” (ex. When you are in a no-end situation, where your only options are to continue to avoid/avoid, avoid/ approach, or approach/approach  learned helplessness = avoid/avoid or depression) -- example: battered women == avoid/avoid no-end situation that was learned helplessness  Treatment- just do it! You force them to do it even if they don’t feel like it or want to. “if they don’t feel like going on a walk, then just do it and go on a walk – you are doing ‘something’ to get yourself out of the box and begin motivating again. o Cognitive-Behavior-  Over-generalization  Arbitrary inference (ex. Plan a party and no one comes because they are too busy, but you think it is because no one likes you)  Downward spiral comes from negative, twisted thinking.  Talk therapy for cognitive-behavior unipolar depression method takes longer, but the relapse period is less than other methods.  Current guidelines says to get the counseling and take medication at the same time.  The talk therapy has a benefit that the drugs don’t have  less relapse o Humanistic-  Because we are human and it is uniquely human to have a need for meaning in our lives, depression is explained as having a loss of meaning.  The existential crisis  Loss of meaning  All talk therapies are emphasizing LOSS as a cause for depression. o Vegetative depression is that shut-down during depression  Bi-Polar o Type I = mania o We think it is norepinephrine is the cause when it becomes unstable o High norepinephrine high energy= type 1 o Low norepinephrine, low energy= type 2 o To get manic is always there if you have type 2 bi-polar disorder, because it is a problem with norepinephrine and serotonin. Chapter 6 Book Notes: Introduction: o Fear is actually a package of responses that are physical, emotional, and cognitive. o Physically, we perspire, our breathing quickens, our muscles tense, and our heart beats faster. o Emotional responses to extreme threats include horror, dread, and even panic, while in the cognitive realm fear can disturb our ability to concentrate and remember and may distort our view of the world. Stress and Arousal: The Fight-or-Flight Response: o The hypothalamus activates two important systems the autonomic nervous system and the endocrine system. o Autonomic nervous system (ANS): the extensive network of nerve fires that connect the central nervous system (the brain and spinal cord) to all the other organs of the body. o Endocrine system: the network of glands located throughout the body. o The ANS and the endocrine system often overlap in their responsibilities. o There are two pathways, or routes, by which these systems produce arousal and fear reactions – the sympathetic nervous system pathway and the hypothalamic-pituitary-adrenal pathway. o When we face a dangerous situation, the hypothalamus first excite the sympathetic nervous system, a group of ANS fibers that work to quicken our heartbeat and produce the other changes that we experience as fear or anxiety. o Parasympathetic nervous system- helps return our heartbeat and other body processes to normal. o Together the sympathetic and parasympathetic nervous systems help control our arousal and fear reactions. o Trait anxiety- A person’s general level of arousal and anxiety because it seems to be a general trait that each of us brings to the events in our lives. o People also differ in their sense of which situations are threatening. Acute and Posttraumatic Stress Disorders: o A traumatic event is one in which a person is exposed to actual or threatened death, serious injury, or sexual violation. o If the symptoms continue longer than a month, a diagnosis of posttraumatic stress disorder (PTSD). o Dx Checklist:  Person is exposed to a traumatic event—death or threatened death, severe injury, or sexual violation.  Person experiences at least one of the following intrusive symptoms: Repeated, uncontrolled, and distressing memories Repeated and upsetting trauma-linked dreams Dissociative experiences such as flashbacks Significant upset when exposed to trauma-linked cues Pronounced physical reactions when reminded of the events.  Person continually avoids trauma-linked stimuli.  Person experiences negative changes in trauma-linked cognitions and moods, such as being unable to remember key features of the event or experiencing repeated negative emotions.  Person experiences significant distress or impairment, with symptoms lasting more than a month. o Re-experiencing the traumatic event: people may be battered by recurring thoughts, memories, dreams, or nightmares connected to the event. o Avoidance: people usually avoid activities that remind them of the traumatic event and try to avoid related thoughts, feelings, or conversation o Reduced responsiveness: people feel detached from detached from other people or lose interest in activities that once brought enjoyment.  Some people experience symptoms of Disassociation- or psychological separation: they feel dazed, have trouble remembering things, or have a sense of derealization (feeling that the environment is unreal or strange). o Increased arousal, negative emotions, and guilt: people with these disorders may feel overly alert (hyper alertness), be easily startled, have trouble concentrating, and develop sleep problems. They may display anxiety, anger, or depression and feel extreme guilt because they survived the traumatic event while others did not. o An acute or posttraumatic stress disorder can occur at any age, even in childhood, and can affect one’s personal, family, social, or occupational life. They may also experience depression. o Women are at least twice as likely as men to develop stress disorders: around 20 percent of women who are exposed to a serious trauma may develop one, compared with 8 percent of men. o Why do people develop acute and posttraumatic stress disorders?  Extraordinary trauma can cause a stress disorder.  The stressful event alone, however, may not be the entire explanation.  Researchers have looked to the survivor’s biological processes, personalities, childhood experiences, social support systems, and cultural backgrounds and to the severity of the traumas.  Investigators have learned that traumatic events trigger physical changes in the brain and body that may lead to severe stress reactions and, in some cases, to stress disorders.  Evidence from brain studies also shows that once a stress disorder sets in, it may lead to further biochemical arousal, and this continuing arousal may eventually damage key brain areas.  Researchers have determined that emotional reactions of various kinds are tied to brain circuits—networks of brain structures that, with the help of neurotransmitters, trigger each other into action to produce various emotions.  A dysfunctional hippocampus may help produce the intrusive memories and constant arousal found in posttraumatic stress disorder.  A dysfunctional amygdala may help produce the repeated emotional symptoms and strong emotional memories common to people with posttraumatic stress disorder.  Some studies suggest that people with certain personalities, attitudes, and coping styles are particularly likely to develop acute ad posttraumatic stress disorders.  Researchers have found that certain childhood experiences seem to leave some people at risk for later acute and posttraumatic stress disorders.  People whose social and family support systems are weak are also more likely to develop acute or posttraumatic stress disorder after a traumatic event.  never given any consolation after the event thus confining them to cope by other less healthy means.  There is a suspicion among clinical researchers that the reates of posttraumatic stress disorder may differ among ethnic groups in the United States. Hispanic Americans seem to be more vulnerable that other racial or ethnic groups. One explanation holds that as part of their cultural belief system, may Hispanic Americans tend to view traumatic event as inevitable and unalterable, a coping response that may heighten their risk for PTSD Another explanation suggests that their culture’s emphasis on social relationships and social support may place Hispanic American victims at special risk when traumatic events deprive them- temporarily or permanently – of important relationships and support systems.  The severity and nature of the traumatic event that a person goes thorugh helps determine whether the person will develop a stress disorder.  Some traumatic events can override even a nurturing childhood, positive attitudes, and social support  Generally, the more severe the trauma and the more direct one’s exposure to it, the higher the likelihood of developing a stress disorder. o Between the lines, personal impact of stress:  33 percent of people who feel they are living with extreme stress  35 percentage of people who report feeling more stress this year than last year  48 percent of people who lie awake at night due to stress  48 percent of people who say stress negatively affects their personal and professional lives  54 percent of people who say stress has caused them to fight with close friends or relatives. o How do clinicians treat acute and posttraumatic stress disorders?  About half of all cases of posttraumatic stress disorders improve within six months.  More than one-third of people with PTSD do not respond to treatment at all even after many years.  Most treatments vary from trauma to trauma, but all the programs share basic goals:  They try to help survivors put an end to their stress reactions  Gain perspective of their painful experiences, and return to constructive living.  Treatment for combat veterans:  Among the most common are drug therapy, behavioral exposure techniques, insight therapy, family therapy, and group therapy.  Typically the approaches are combined as no one of them successfully reduces all the symptoms.  Some studies indicate that exposure treatment is the single most helpful intervention for people with posttraumatic stress disorder. o In virtual reality therapy, PTSD clients use wraparound goggles and jockey sticks to navigate their way through a computer-generated military convoy, battle, or bomb attack in a landscape that looks like Iraq or Afghanistan. o The therapists control the intensity of the horrifying sights, terrifying sounds, and awful smells of combat, triggering very real feelings of fear or panic in the client. (either in gradual steps or in a flooding approach) o After these steps the therapist coaches the PTSD patient in relaxation exercises that help them cope with the memories and situations that haunt them.  A widely applied for of exposure therapy is eye movement desensitization and reprocessing (EMDR) in which clients move their eyes in a rhythmic manner from side to side while flooding their minds with images of the objects and situations they ordinarily try to avoid.  Although drug therapy and exposure techniques bring some relief, most clinicians believe that veterans with PTSD cannot fully recover with these approaches alone: they must also come to grips in some way with their combat experiences and the impact those experiences continue to have. o Psychological debriefing, or critical incident stress debriefing:  A form of crisis intervention that has victims of trauma talk extensively about their feelings and reactions within days of the critical incident.  Often provided to trauma victims who have not yet displayed any symptoms at all, as well as to those who have.  Sessions are often conducted in a group format, while counselors guide the individuals to describe the details of the recent trauma, to vent and relieve the emotions provoked at the time of the event, and to express their current feelings.  The clinicians then clarify to the victims that their reactions are perfectly normal responses to a terrible event, they offer stress management tips, and in some cases, refer the victims to professionals for long-term counseling. o Does psychological debriefing work?  Some clinicians have come to believe that the early intervention programs may encourage victims to dwell too long on the traumatic events that they have experienced.  A number of clinicians also worry that early disaster counseling may unintentionally “suggest” problems to certain victims, thus helping to produce stress disorders.  Given the unsupportive and even contradictory research findings of resent years, the current clinical climate is moving away from the uses of psychological debriefing because it seems to increase PTSD, rather than decrease it.  Dissociative Disorders: o People with PTSD may have symptoms of dissociation along with their other symptoms. (ex. Feel dazed, have trouble remembering things, or have a sense of derealization) o Dissociative disorders: another group of disorders triggered by traumatic events  The memory difficulties and other dissociative symptoms are particularly intense, extensive, and disruptive.  Dissociative reactions are the main or only symptoms.  People with dissociative disorders do not typically have the significant arousal, negative emotions, sleep difficulties, and other problems that characterize acute and posttraumatic stress disorders.  There are also no clear physical factors at work in dissociative disorders. o Memory is a key to this sense of identity, the link between our past, present, and future. Without a memory, we would always be starting over; with it, our life and our identity move forward. o In dissociative disorders, one part of a person’s memory or identity becomes dissociated, or separated, from other parts of his or her memory or identity. o Several kinds of dissociative disorders:  Dissociative amnesia- unable to recall important personal events and information.  Typically an episode of amnesia in this case is directly triggered by a traumatic or upsetting events.  Dissociative amnesia may be: o Localized- (most common type of amnesia) a person loses all memory of event that took place within a limited period of time, almost always beginning with some very disturbing occurrence.  The forgotten period is called the amnestic episode. This is where people may appear confused; in some cases they wander about aimlessly. Experiencing memory difficulties but seem unaware of them. o Selective- (second most common) people remember some, but not all, events that took place during a period of time.  Might remember certain interactions or conversations that occurred during the forgotten time, but not more disturbing events that occurred. o Generalized- person may not remember events that occurred earlier in life.  In extreme cases the person may not even remember their family members and friends. o Continuous (only dissociative amnesia without an end)- forgetting continues into the present.  Forgetting new and ongoing experiences as well as what happened before and during the battle.  Memory for abstract or encyclopedic information usually remains.  Dissociative fugue- here persons not only forget their personal identities and details of their past lives but also flee to an entirely different location. o Their fugue may be brief—a matter of hours or days —and end suddenly. o Or it could last a lifetime  leaving home, taking a new name, and establishing a new identity, new relationships, and even a new line of work. o As people enter therapy, and start to recover their past, so me forget the events of the fugue period. o The majority of people who go through a dissociative fugue regain most or all of their memories and never have a recurrence. o Since fugues are usually brief and totally reversible, those who have experienced them tend to have few aftereffects.  DX Checklist: o Dissociative amnesia:  Person cannot recall important life-related information, typically traumatic or stressful information. The memory problem is more than simple forgetting.  Significant distress or impairment.  The symptoms are not caused by a substance or medical condition.  Dissociative identity disorder (multiple personality disorder)- have two or more separate identities that may not always be aware of each other’s memories, thoughts, feelings, and behavior.  DX Checklist: o Person experiences a disruption to his or her identity, as reflected by at least two separate personality states or experiences of possession. o Person repeatedly experiences memory gaps regarding daily events, key personal information, or traumatic events, beyond ordinary forgetting. o Significant distress or impairment o The symptoms are not caused by a substance or medical condition.  Develops two or more distinct personalities, often called subpersonalities, or alternate personalities, each with a unique set of memories, behaviors, thoughts, and emotions.  At any given time one of the subpersonalities takes center stage and dominates the person’s functioning.  The primary, or host, personality is the personality that seems to appear most often than the others.  The transition from one subpersonality to another, called switching, is usually sudden and may be dramatic.  More often than not, the symptoms actually begin in early childhood, after episodes of trauma or abuse.  Women receive this diagnoses at least 3 times as often as men.  How do subpersonalities interact? o In mutually amnesic relationships- the subpersonalities have no awareness of one another o In mutually cognizant patterns- each subpersonality is well aware of the rest. They may hear one another’s voices and even talk among themselves. Some are on good terms, while others do not get along at all. o One-way amnesic relationships- (the most common) some subpersonalities are aware of others, but the awareness is not mutual.  Those who are aware, called coconscious subpersonalities, are “quiet observers” who watch the actions and thoughts of the other subpersonalities but do not interact with them. o Studies suggest that the average number of subpersonalities per person is high—15 for women and 8 for men.  How do subpersonalities differ? o They exhibit dramatically different characteristics o May also have their own names and different identifying features, abilities and preferences, and even physiological responses. o Identifying features: may differ in features as basic as age, gender, race, and family history, or even physical bases, such as hair color, weight, height, facial features. o Abilities and preferences: it is not uncommon for the different subpersonalities to have different abilities o Physiological responses: researchers have discovered that subpersonalities may have physiological differences, such as differences in blood pressure levels, and allergies.  Depersonalization-derealization disorder- feel as though they have become detached form their own mental processes or bodies or are observing themselves from the outside. o How do Theorists Explain Dissociative Amnesia and Dissociative Identity Disorder?  The Psychodynamic View:  Theorists believe that these dissociative disorders are caused by repression, the most basic ego defense mechanism: people fight off anxiety by unconsciously preventing painful memories, thoughts, or impulses from reaching awareness.  People with this disorder are thought to repress their memories excessively when compared to a person’s norm.  In the psychodynamic view, dissociative amnesia is a single episode of massive repression.  In contrast, dissociative identity disorder is tought t result from a lifetime of excessive repression.  Theorists believe this continuous use of repression is motivated by traumatic childhood events.  Theorists believe that children who experience such traumas may come to fear the dangerous world they live in and take flight from it by pretending to be another person who is looking on safely from afar.  Whenever they experience “bad” thoughts or impulses, they unconsciously try to disown and deny them by assigning them to other personalities.  The Behavioral View:  Behaviorists believe that dissociation grows from normal memory processes such as drifting of the mind or forgetting.  They hold that dissociation is a response learned through operant conditioning.  Behaviorists see dissociation as escape behavior.  But behaviorists in contrast to psychodynamic theorists, that a reinforcement process rather than a hardworking unconscious is keeping the individuals unaware that they are using dissociation as a means to escape.  The behavioral explanation still fails to explain precisely how temporary and normal escapes from painful memories grow into a complex disorder or why more people do not develop dissociative disorders.  State-Dependent Learning: link between state and recall  If people learn something when they are in a particular situation or state of mind, then they are likely to remember it best when they are again in that same condition.  State-dependent learning can be associated with mood states as well: material learned during a happy mood is recalled best when the participant is again happy, and a sat-state learning is recalled best during sad states.  One possibility is that arousal levels are an important part of learning and memory. That is, a particular level of arousal will have a set of remembered events, thoughts, and skill attached to it.  Perhaps people who are prone to develop dissociative disorders have state-to-memory links that are usually rigid and narrow. Maybe each of their thoughts, memories, and skills (different subpersonalities) is tied exclusively to a particular state of arousal, so that they recall a given event only when they experience an arousal state almost identical to the state in which the memory was first acquired.  Self-Hypnosis:  People who are hypnotized enter a sleeplike state where they become very suggestible.  Hypnosis can not only influence people to behave, perceive, and think in ways that would ordinarily seem impossible, but it can also help people remember events that occurred and were forgotten years ago. (psychotherapists use this)  In contrast, it can also make people forget events, and even their personal identities  hypnotic amnesia.  Hypnotic amnesia is close to dissociative disorders because: o Both are conditions in which people forget certain material for a period of time yet later remember it. o In both, the people forget without any insight into why they are forgetting or any awareness that something is being forgotten.  These parallels lead theorists to believe that dissociative disorders may be a form of self-hypnosis in which people hypnotize themselves to forget unpleasant events.  Dissociative amnesia may develop in people who consciously or unconsciously hypnotize themselves into forgetting horrifying experiences that have recently taken place in their lives. o How are Dissociative Amnesia and Dissociative Identity Disorder Treated?  Leading treatments for Dissociative Amnesia are (sometimes people can recover without treatment):  Psychodynamic therapy- therapists guide patients to search their unconscious in the hope of bringing forgotten experiences back to consciousness.  Hypnotic therapy- therapists hypnotize patients and then guide them to recall their forgotten events.  Drug therapy- some injections of barbiturates such as sodium amobarbital (Amytal) or sodium pentobarbital (Pentothal) have been used with dissociative amnesia to regain their lost memories. These drugs are often called “truth serums” but their true effect is to calm people and free their inhibitions, thus helping them to recall anxiety- producing events. (Drugs don’t always work, and if used at all are likely to be combined with other treatment approaches).  How do therapists treat people with dissociative identity disorder? (without treatment, they will never recover)  Therapists usually try to help the clients 1. Recognize fully the nature of their disorder 2. Recover the gaps in their memory 3. Integrate their subpersonalities into one functional personality  Recognizing the disorder: therapists typically try to bond with the primary personality and with each of the subpersonalities. Some therapists try to introduce the subpersonalities to one another by hypnosis, or by having patients look at videos of their other personalities. Group therapy and family therapy also helps to educate patients about their disorder.  Recovering memories: therapists typically use the same approaches applied in dissociative amnesia, including psychodynamic therapy, hypnotherapy, and drug treatment. These techniques work slowly for patients with dissociative identity disorder as some subpersonalities can take the role of “protector” to prevent the primary personality from suffering the pain of recollecting harmful or painful memories.  Integrating the subpersonalities: the final goal of therapy is to merge the different subpersonalities into a single, integrated identity. Integration is a continuous process that occurs throughout treatment until patients “own” all of their behaviors, emotions, sensations, and knowledge. o Fusion is the final merging of two or more subpersonalities. o Many patients distrust this final treatment goal, and their subpersonalities may see integration as a form of death. o Therapists have used psychodynamic, supportive, cognitive, and drug therapies as a means to approach fusion. o Once integration is achieved, further therapy is still needed to maintain the complete personality and to teach social and coping skills that may help prevent later dissociations. o In some case studies therapists report high success rates, but in others patients seem to continue to resist full integration. o Depersonalization-Derealization Disorder:  A dissociative disorder that’s central symptoms are persistent and recurrent episodes of depersonalization (the sense that one’s own mental functioning or body are unreal or detached) and or derealization (the sense that one’s surroundings are unreal or detached.)  Depersonalization:  People feel as though they have come separate from their body and are observing themselves from outside.  Doubling—when your mind seems to be floating a few feet above you  However, throughout the whole experience they are aware that their perceptions are distorted and remain in contact with reality.  Derealization:  Characterized by feeling that the external world is unreal and strange.  Objects may seem to change shape or size  Other people may seem removed, mechanical, or dead.  Transient depersonalization or derealization reactions are fairly common one-third of all people say that on occasion they have felt as though they were watching themselves in a movie.  The actual disorder may be triggered by extreme fatigue, physical pain, intense stress, or recovery from substance abuse.  The disorder tends to be long-lasting; the symptoms may improve and even disappear for a time, only to return or intensify during times of severe stress. Pg. 211-213 summary  also look over chapter 6 graphs and closer looks. Chapter 7 Book Notes Introduction: o Depression is a low, sad state in which life seems dark and its challenges overwhelming. o Mania is a state of breathless euphoria, or at least frenzied energy, in which people way have an exaggerated belief that the world is theirs for the taking (opposite of depression). o Depressive disorders: people suffer only from a depression pattern called unipolar depression in which they have no history of mania and return to a normal or nearly normal mood when their depression lifts. o Bipolar disorder: people have periods of mania that alternate with periods of depression. Unipolar Depression: the depressive disorders: o Depressive disorders have no redeeming characteristics. They bring severe and long-lasting psychological pain that may intensify as time goes by. o Around 9 percent of adults in the US suffer from a severe unipolar pattern of depression in any given year, while as many as 5 percent suffer from mil forms. Around 18 percent of all adults experience an episode of severe unipolar depression at some point in their lives. o The rate of depression is higher among poor people than wealthier people. o Approximately 85 percent of people with unipolar depression recover, some without treatment. At least 40 percent of them have at least one other episode of depression later in their lives. o The symptoms of depression may vary from person to person. The symptoms that often collaborate with one another span five areas of functioning:  Emotional- most people who are depressed feel sad and dejected, describing themselves as feeling “miserable, empty, and humiliated.” Anhedonia- an inability to experience any pleasure at all. A number of depressed people also experience anxiety, anger, or agitation.  Motivational- Depressed people typically lose their desire to pursue their usual activities, and almost all report a lack of drive, initiative, and spontaneity. This state has been described as a “Paralysis of will” It is has been estimated that between 6 and 15 percent of people who suffer from severe depression commit suicide.  Behavioral- Depressed people are usually less active and less productive. They may also move and even speak more slowly  Cognitive- Depressed people hold extremely negative views of themselves They consider themselves inadequate, undesireable, inferior, perhaps evil They even blame themselves for nearly every unfortunate event, even things that have nothing to do with them, and they rarely credit themselves for positive events and achievements. They are very pessimistic, convinced that nothing will improve, and everything is helpless. People with depression frequently complain that their intellectual ability is poor, feeling confused, unable to remember things, easily distracted, and unable to solve even the smallest problems.  Physical- People who are depressed frequently have such physical ailments as headaches, indigestion, constipation, dizzy spells, and general pain. Disturbances in appetite and sleep are common, whether too much or too little. o Diagnosing Unipolar Depression:  A major depressive episode is a period of two or more weeks marked by at least five symptoms of depression, including sad mood and/or loss of pleasure.  Dx Checklist: Major depressive episode: o For a 2 week-period person displays an increase in depressed mood for the majority of each day and/or a decrese in enjoyment or interest across most activities for the majority of each day. o For the same 2 weeks, person also experiences at least 3 or 4 of the following symptoms: considerable weight change or appetite change, daily insomnia or hypersomnia, daily agitation or decrease in motor activity, daily fatigue or lethargy, daily feelings of worthlessness or excessive guilt, daily reduction in concentration or decisiveness, repeated focus on death or suicide, a suicide plan, or a suicide attempt. o Significant distress or impairment  Major depressive disorder o Presence of a major depressive episode o No pattern of mania or hypomania  Persistent depressive disorder o Person experiences the symptoms of major or mild depression for at least 2 years o During the 2 year period, symptoms not absent for more than 2 months at a time o No history of mania or hypomania o Significant distress or impairment  Premenstrual dysphoric disorder: a diagnosis given to certain women who repeatedly have clinically significant depressive and related symptoms during the week before menstruation.  Disruptive mood dysregulation disorder: is characterized by combination of persistent depressive symptoms and recurrent outbursts of severe temper.  What Causes Unipolar Depression? o Episodes of unipolar depression often seem to be triggered by stressful events. o Reactive (exogenous) depression- which follows clear-cut stressful events o Endogenous depression- which seems to be a response to internal factors. o The current explanations of unipolar depression point to:  Biological view-  Could unipolar depression itself have biological causes? Evidence from genetic, biochemical, anatomical, and immune system studies suggests that often it does.  Genetic factors: the four kinds of research are pedigree, twin, adoption, and molecular biology gene studies, which all suggest that some people inherit a predisposition to unipolar depression. o Family pedigree studies select people with unipolar depression as probands (the person who is the focus of a genetic study) to examine their relatives, and see whether depression also afflicts other members of the family. Researchers have found that as many as 30 percent of those relatives are depressed, compared with fewer than 10 percent of the general population. o Researchers have found evidence that unipolar depression may be tied to genes on specific chromosomes. o People with an abnormality of the serotonin transporter gene are more likely than others to display low serotonin activity in their brains and may in turn be more prone to depression.  Biochemical Factors: low activity of two neurotransmitter chemicals, norepinephrine and serotonin, has been strongly linked to unipolar depression. o Research suggests that interactions between serotonin and norepinephrine activity, or between these and other kinds of neurotransmitters in the brain, rather than the operation of any one neurotransmitter alone may account for unipolar depression. o Some studies hint that depressed people have an overall imbalance in the activity of the neurotransmitters serotonin, norepinephrine, dopamine, and acetylcholine. o Serotonin may be a neuromodulator, a chemical whose primary function is to increase or decrease the activity of other key neurotransmitters. o Researchers have also discovered that a person’s endocrine system may play a role in unipolar depression. o Biological researchers are starting to believe that unipolar depression is tied more closely to what happens within neurons than to the chemicals that carry messages between neurons.  Brain anatomy and brain circuits pg. 225  Immune system: o Stress often triggers depression, Justas it leads to poor immune system functioning. o Researchers have found that people with depression display lower lymphocyte activity and increased CRP (C-reactive protein) production and body inflammation. o Depressed people have a higher incidence than other people of migraines, irritable bowel syndrome, chronic fatigue syndrome, rheumatoid arthritis, and other illnesses known to be caused by CRP production and body inflammation. o Antidepressant drugs, medications that help reduce depression for many people, help combat CRP- related inflammation throughout the body.  Psychological view-  Psychodynamic view, pg. 227: the idea that depression may be triggered by a major loss. o Some research suggests that losses suffered early in life may set the stage for later depression. o Although the findings indicate that losses and inadequate parenting sometimes relate to depression, they do not establish that such factors are typically responsible for the disorder.  in the studies read about, only some of the research participants showed depressive reactions. o It is estimated that less than 10 percent of all people who have major losses in life actually become depressed. o Also, many findings in the psychodynamic view are inconsistent, and certain features of the view’s explanation are nearly impossible to test.  Behavioral View: o Behaviorists believe that unipolar depression results from significant changes in the number of rewards and punishments people receive in their lives. o Peter Lewinsohn suggested that the positive rewards in life dwindle for some people, leading them to perform fewer and fewer constructive behaviors. o In a number of studies, behaviorists have found that the number of rewards people receive in life is indeed related to the presence or absence of depression. o Lewinsohn and other behaviorists have further proposed that social rewards are particularly important in the downward spiral of depression. o This claim has been supported by research showing that depressed persons receive fewer social rewards than nondepressed persons and that as their mood improves, their social rewards increase. o The research, though, has limitations: it has relied heavily on self-reports of depressed people, and the studies have been largely correlational and do not establish that decreases in rewarding events are the initial cause of depression.  Cognitive View: o Cognitive theorists believe that people with unipolar depression persistently view events in negative ways and that such perceptions lead to their disorder. o Theory of negative thinking:  Aron beck believes that negative thinking, rather than under-lying conflicts or a reduction in positive rewards, lies at the heart of depression.  Maladaptive thinking is also thought of as a key to depression, but Beck’s theory is the most popular.  According to Beck, maladaptive attitudes, a cognitive triad, errors in thinking, and automatic thoughts combine to produce unipolar depression.  Beck believes that some people develop maladaptive attitudes as children.  Beck suggests that later in these people’s lives, upsetting situations may trigger an extended round of negative thinking.  The cognitive triad:  The individuals repeatedly interpret their experiences  Interpret themselves  And interpret their futures in negative ways that lead them to feel depressed.  According ot beck one common error of logic id depressed people is that they draw arbitrary inferences— negative conclusions based on little evidence.  Depressed people often minimize the significance of positive experiences or magnify that of negative ones.  Automatic thoughts- a steady train of unpleasant thoughts that keep suggesting to them that they are inadequate and that their situation is hopeless.  Beck labels these thoughts “automatic” because they seem to just happen, as if by reflex.  Research has supported Beck’s claim that automatic thoughts are tied to depression.  Negative thinking is indeed linked to depression, but it fails to show that such patterns of thoughts are the cause and core of unipolar depression. o Theory of learned helplessness:  According to Martin Seligman, continuous feelings of helplessness are at the center of a person’s depression.  The learned helplessness theory of depression holds that people become depressed when they think (1) that they no longer have control over the reinforcements (the rewards and punishments) in their lives, and (2) that they themselves are responsible for this helpless state.  Seligman noted that the effects of learned helplessness greatly resemble the symptoms of human depression, and he proposed that people in fact become depressed after developing a general belief that they have no control over reinforcements in their lives.  Researchers suggest that attributions are likely to cause depression only when they further produce a sense of hopelessness in a person.  Sociocultural factors:  Sociocultural theorists propose that unipolar depression is strongly influenced by the social context that surrounds people.  Family-social perspective: o The perspective that a decline in social rewards is particularly important in the development of depression. o Depression has been tied repeatedly to the unavailability of social support such as that found in a happy marriage. o It appears that people whose lives are isolated and without intimacy are particularly likely to become depressed at times of stress. o Studies have also found that depressed people who lack social support remain depressed longer than those who have a supportive spouse or warm friendships.  Multicultural perspective: o Two kinds of relationships have captured the i


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