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Psychology 361

by: Shalitta Bond

Psychology 361 375

Shalitta Bond
GPA 3.0
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Jennifer Langdon
Class Notes




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This 10 page Class Notes was uploaded by Shalitta Bond on Friday August 19, 2016. The Class Notes belongs to 375 at Towson University taught by Jennifer Langdon in Fall 2016. Since its upload, it has received 7 views. For similar materials see in Criminology and Criminal Justice at Towson University.

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Date Created: 08/19/16
Psychology 361 Deviance Not all deviance is bad. Not universal- definition of deviance varies from culture to culture. Ex. Kissing on cheeks vs. hand shaking, nudity, hearing voices, facial tattoos -Defines, what is appropriate and not appropriate. -Context is import (surroundings) why people behave in deviant ways Dysfunctional/ Harm To expand our definition, the behavior should also be dysfunctional or harmful. -Culturally relative, that changes over time. *Homosexuality was once a disorder -Context: sometimes, putting self harm’s way can be heroic Disability/ Distress -Disturbance cause clinically significant disability/ distress. They are upset and it causes problems, and pain. (Doesn’t feel good) Disability: no longer able to function they way that they want. You can’t do what you want. Exceptions…. -Psychopaths may feel no distress, but do cause a lot of distress in others. Substance abuse/ eating disorders - People may feel more distressed when abstaining from behaviors. Categorical Vs. Continuum Abnormal behavior occurs on a continuum from mild to severe, or Normal to abnormal. -However DSM uses categorical approach. -We must decide where to draw the line. 47% of adults meet a disorder. Historical perspectives Early supernatural theories Prehistoric: -Animistic spirits caused disease Trephination (8000 BCE) -Emerging worldviews: Babylonians (1700’s BCE)- demonic causes, exorcised via plant-based medicine Chinese (300 BCE)- weather, stress, imbalance with Tao- acupuncture, herbs Europeans (medieval times)- witchcraft, demonic possession- torture, exorcism Biological perspectives: Egyptians (1600 BCE)- medical Papyrus - “Book of hearts” detailed mental dx’s Greeks: Hippocrates (460-377 BCE) - Mental health disorders due to the problems of the within the body, and brain, classification of disorders -Abnormal levels among the bodily fluids - 4 humors TX: exercise, rest, blood letting, purging, change in diet to restore balance of fluids. Muslim culture: Avicenna (980-1037 AD) 40 medical textbooks -Medical science approach to mental disorders -Scientific study of insomnia, mania, paralysis, stroke, epilepsy and depression Western approaches of past few centuries -Middle ages- witch hunts Renaissance (1400-1600s)- return to more scientific attitude -More attempts at classification of pathology Asylums (1600’s) -Designed to remove the mentally ill from public and or prisons -Physical tx’s aimed too calm and subdue, seen now as harsh and excessive 1700-1800’s: Treatment reform Paradigm shifts…. Pinal (French), Tuke (British) “Moral treatment” -Some patients improved, but not a cure for serious pathology Dorothea Dix (American), campaigned for separate, state-founded psychiatric hospitals -Emphasis on a medical (disease) model of psychological disorders As a result in the US people with mental illness finally received medical treatment. (Institutionalized for life) Regulate symptoms Major psychological Models of the 20 Century Waves of theoretical models in the field -Behavior -Cognitive -Psycho -Biological/ Neurological Repression, you don’t remember. Behavioral Theory -Toss out what we can’t see, and only study behavior. - Learning theories, all behaviors occur as a result of learning from our environment. Classical conditioning (Pavlov, Watson) -Based on association A: relationship between a stimulus and something that follow. (US, CS) Advertisements = classical conditioning -Pavlov’s classical experiment Classical conditioning terminology Unconditional stimulus- UCS (Food, sex, puff of air, pain) React to that condition… Unconditional Response- UCR (Automatic, Salivate, blink) Conditioned Stimulus- CS (Something unrelated/neutral. Bell) Conditioned response- CR (Learned behavior, salivate to the sound of the bell) Operant conditioning (Thorndike, Skinner) -Behavior is shaped-reinforcement, punishment Increased positivity, decrease negativity -Learn that your actions lead to consequences Operant conditioning Terminology Reinforcement- anything that increases a behavior -Positive: add something good, in order to increase their behavior -Negative: remove something bad, to increase their behavior Punishment- anything that decrease a behavior -Positive: add something bad -Negative: take away something good Cognitive theory Aaron beck, Albert Ellis - Study of mental operations - How do thoughts influence feelings and behaviors - Automatic thoughts - “ABC Model” (Ellis) A: Active, seeing an event that occurred B: beliefs, of the event C: consequence, how do you feel? -Negative emotions affect a person in the wrong way. Cognitive distortions -Irrational beliefs that lead to emotional disturbances Page 29 Biological Model -Psychopathology is result of biological (neurological) problems -Genetic predisposition (ex. depression) Brain: differences in structure or chemistry -Neurons, synapses, neurotransmitters -Structural differences (ex. hippocampus) -“Biological scarring” 0Observe through use of technology such as CT scan & MRI -Vs. PET & fMRI (functional) Sociocultural Models Psychopathology must be understood within context of social and cultural forces -It can influence the risk of developing psychopathology (ex. Gender, race, SES) -Expression [internalize: Women, Externalize: Men] psychopathology -Pathoplastic: Shapes the type of symptoms you have Ex. Emotional symptoms vs. physical Pathodiscriminaiting: culture determines which symptoms that are consider abnormal Ex. homo, alcoholism Behavior in a mental process 1.Biological influences -Genetic mutations, medical conditions (change in brain chemistry, brain damage) 2. Psychological influences -Emotional (negative explanatory style, learned helplessness) 3. Social- Cultural influences - Family, expectations (traumatic/ negative events, cultural expectations) Chapter three Classification, Assessment & Diagnosis Assessment Goal: Identify the problem (if any) Diagnosis Goal: Label the problem Psychometric properties of test Is our test any good? Reliability, and Validity Reliability: if RELIABLE, test will always provide same answer Validity: If VALID, actually measures what it says it does Sensitivity and Specificity Sensitivity: if Truth= yes, then Test=yes Specificity: if Truth= no, then Test= no Ex. Pregnancy test Diagnosis [DSM] Diagnostic statistical manual of mental disorder -Descriptive manual of mental disorders -American Psychiatric Association (APA) -Provides common language for clinicians, researchers, insurance companies, legal system, etc. -Dx’s given in numerical code (300.03) -Some critiques of newest edition Types of assessment tools -Interviews -Personality tests -Neuropsychological tests Diagnostic interview 1. Used to determine diagnosis 2. Performed face to face 3. History, background information, current problems -Ask clients to report on own symptoms -Determines if they meet dx criteria Types of clinical interviews -Structures Vs. Unstructured Can cover all disorders vs. only certain dx’s -SCID-all clinical dx’s -ADIS & IPDE- only anxiety or personality Personality tests Focus more on personality traits/styles rather than clinical diagnoses -Can be objective, self-report EX. NEO_PI_3 -Projective Rorschach inkblot test (what do you see?) How they feel in the inside can then determine how they feel when looking at pictures. -Thematic apperception test (TAT) pictures Neuropsychological test Measure intellectual abilities, cognitive impairments, brain damage, etc. -Neuropsychological batteries: precise measure of our brain -Test of cognitive abilities EX. Stanford-Binet, WAIS_IV (measures intelligence) Psychophysiological assessments Measures physiological functions EX. Breathing, heart rate, skin conductance -Observe brain/ nervous sx structure -Magnetic resonance imaging (MRI) (spinning hydrogen atoms) -Depicts structure of brain -Function (fMRI) makes you do something to see effects -Blood flow (BOLD effect) Epidemiology- who gets it? Prevalence: 4.2-5.7 percent lifetime prevalence 2.2 percent in adolescents, 6.2 percent in adults -Twice as high in women than men -Age of onset, early 30’s High comorbidity: -Approx. 3.8 comorbid diagnoses -60% has a personality disorder Course: chronic and resistant to change (most difficult to treat) Etiology- Where does GAD come from? Genetics -Anxiety disorders show some heritability Neurochemistry & function -Abnormalities in serotonin (5-HT) system -Stronger amygdala responding to emotional stimuli (ex. fear) -Developmental explanations Relationships issues with caregivers Psychological models -Psychodynamic -Anxiety as a result of repressed psychic conflict -Displacement for larger (unconscious) fears Cognitive- behavioral -Intolerance of uncertainty -Feels unacceptable and leads to distress, avoidance Emotion regulation- Worrying in order to be emotionally braced for the worst -Avoidance of natural emotional responses to bad events Contrast avoidance theory of worry GAD’s experience emotional hyperactivity Great activity to shift from positive to a negative emotion -Negative emotional contrast - Worry leads to heightened negative affect, which is sustained If something bad happens people don’t react as strongly because already negative emotional state. Panic ATTACK You must have had a panic attack to have a panic disorder -Discrete period with abrupt surge of intense apprehension, fear, terror. Associated with feeling of impending doom and urge to escape 4 or more physical symptoms: 1. Pounding heat 2. Dizziness 3. Choking sensation 4. Chest pains 5. Sweating 6. Nausea 7. Depersonalization 8. Chills Person often has fear of: -Having a heart attack/ dying -Loosing control “Going crazy” Can appear suddenly, and without warning, peaks within minutes, then gradually subsides PANIC Disorder -Experience Repeated panic attacks -At least some of which are unexpected (Out f blue) -Other could be expected-“Situational-bound” -1 or more months of worry about having another panic attack, and or trying to avoid future attacks -Fear of the attacks actually become more maladaptive Agoraphobia- fear of being trapped in situation that would be hard to escape if they have panic attack -Leads to avoidance, or need safety cues Panic attack Cycle 1. Misinterpreting sight changes and bodily sensations 2. Feeling scared and anxious 3. Pounding of heart, shortness of breath, etc. 4. “I’m having a panic attack” 5. Panic attack 6. Fear of future panic attacks Epidemiology -Prevalence/ Demographics 4-5% lifetime prevalence HIGHER RATES FOR WHITES & AMERICAN INDIANS LOWER FOR AFRICAN AMERICANS, LATINOS, AND ASIAN AMERICANS Age of onset- early 20’s, and 30’s Gender PD w/ comorbid agoraphobia (75-90% female) PD w/o comorbid agoraphobia (60-75% female) Genetic Those with 1 degree relatives are 8x more likely Where does it come from? Neurobiological Model -Hypersensitive CO2 receptors -Problems synthesizing GABA could lead to anxiety vulnerability (Down regulate) Psychological model -Fear or fear- conditioned fear of internal sx’s (fearful of own responses) -Lack of control “Diathesis- Stress” Model st Major life events precede majority of 1 attacks But not everyone develops PD, suggest underlying diathesis (vulnerability) Social Anxiety Disorder Fear of embarrassment/ humiliation in situations where one’s behavior might be scrutinized Leads to tremendous anxiety in such situations -Anticipation of the situation -Or person avoids the situation (negatively reinforced) Not limited to public performance situations Ex. grocery shopping, eating in public, using public restrooms Can lead to avoidance of public situations, impairment in work/social life -Its different form agoraphobia: fear that they can have a panic attack, and judgment. Afraid of the panic Cognitive Behavioral Models Person has cognitive distortions regarding own performance as well as scrutiny of others. -High threat perception, misinterpret ambiguous social cues -Behaviors can lead to self-fulfilling prophecy -Avoidance is negatively reinforced Techniques for treating anxiety (ALL) Behavioral Exposure: approach feared and avoided stimuli Through repeated exposures to feared stimuli anxiety lessens through habituation -Applied relaxation (Reciprocal inhibition) -Systematic desensitization -Fear hierarchy (sequence of fear, levels) Expose them to reach a level of mastery so they can feel confident Cognitive (A-B-C model) -Identify and challenge cognitive distortions -Hypothesis testing (did you freak out? Did you survive?) Psychodynamic -What underlying conflict does the fear represent? Treatment approaches for GAD (worry) -Cognitive-Behavioral Model -Understand cognitive distortions around worry -Understand the function of worry -Relaxation training Exposure Emotional contrast theory Treatment expose for panic Interceptive expose -Induce panic attacks (shortness of breath) -Reduce conditioned fear assoc. w/ internal cues -Relaxation training Psycho-pharm Directly targets internal physical symptoms But can be habit-forming & never learn to confront the fear TREATMENT -Exposure plus relaxation techniques -Expose them to social situations (safely) Cognitive restructuring Group therapy Social skills training Obsessive-Compulsive disorder (OCD) Made up of obsessions Recurrent and intrusive ideas, thoughts, images impulses Ex. Contamination, fear of harm to self or others, forbidden thoughts, symmetry Feels inappropriate, intrusive- cause anxiety And compulsions Repetitive behaviors/actions (can be mental actions) governed by specific rules, that person feels compelled to perform. Ex. hand washing, checking, rituals (tapping/ touching) mental acts (Counting, repeating phrases) ordering Function of compulsions Reduces anxiety although person often recognizes it is excessive/ unnecessary -Negative reinforcement Person feels driven to perform them, even if know they are non- sensual Considered diagnosable when it significantly interfered with daily life -Compulsions take 1 hours cause distress/ impairment in functioning Epidemiology Prevalence/Demographics -2.5% (lifetime) 1-2.3% (in children) Age of onset-bimodal: -Preadolescence (M=10 years) and early adulthood (19.5 years) -More boys than girls in youth Gender Men=Women But men more checkers, women more cleaners Comorbidity Approx.. 90% of those with OCD have at least 1 other disorder (depression) Etiology -Psychodynamic models Fixation at what stage? Anal: do I have control or not?


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