Chapter 2 Notes and Vocab
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Date Created: 09/08/16
Understanding and treating mental disorders Chapter 2 Notes One-dimensional models of mental disorders Model o Attempts to describe a phenomenon that cannot be directly observed o Models are limited and cannot explain every aspect of a disorder; human behaviors are complex Models of psychopathy o Biological, psychological, social, and socio-cultural Multipath model Considers the multitude of factors that are associated with each disorder: holistic Assumptions of the multipath model: o Multiple pathways and influences contribute to the development of any single disorder o Not all dimensions contribute equally The multipath model The four dimensions and possible pathways of influence Aspects of the multipath model Many disorders are heterogeneous Different combinations within the four dimensions may influence development of a particular condition o Within each dimension, distinct theories exist Same triggers or vulnerabilities may cause different disorders Dimension one: biological factors Lobes of the human brain: o Frontal, temporal, parietal, occipital o Frontal lobe controls all higher mental functions Prefrontal cortex helps manage attention, behavior, and emotions o Limbic system (subcortical): Role in emotions, decision-making, and memories Multipath implications Biological explanations are best considered in the context of other factors Most individual differences result from a combination of genetic and environment variations; diathesis-stress model o People do not inherit a particular abnormality but rather, a predisposition to develop illness o Environmental factors (stress) may activate the predisposition (diathesis), resulting in a disorder Biochemical processes within the brain and body The brain is composed of: o Neurons (nerve cells) Dendrites, cell body, axon, axon terminals o Glia cells that act in supporting roles: Build myelin, synthesize action of nearby neurons, clean up debris Synaptic transmission Major Neurotransmitters and their functions Acetylcholine (ACH) - influences attention and memory, dream and sleep states, and muscle activation; has excitatory and inhibitory effects Dopamine - influences motivation and reward-seeking behaviors; regulates movement, emotional responses, attention, and planning; has excitatory and inhibitory effects Epinephrine (adrenaline) and norepinephrine (noradrenaline) - excitatory functions including regulating attention, arousal and concentration, dreaming, and moods; as a hormone influences physiological reactions related to stress response (constricted attention, blood flow, heart rate, etc.) Glutamate - major excitatory neurotransmitter involved in cognition, memory, and learning Gamma-aminobutyric acid (GABA) - major inhibitory neurotransmitter' calms the nerves; regulates mood and muscle tone Serotonin - inhibitory effects regulate temperature, mood, appetite, and sleep; reduced serotonin can increase impulsive behavior and aggression Cortisol - steroid hormone released in response to stress Ghrelin - stimulates hunger and boosts the appeal of food Leptin - suppresses appetite Melatonin - regulates circadian sleep and wake cycles Oxytocin - neuropeptide hormone influencing lactation and complex social behavior (including nuturing and bonding) Major neurotransmitters and their associated disorders ACH - Alzheimer's disease Dopamine - attention/deficit/hyper-activity disorder; autism; depression; schizophrenia; substance use disorders; Parkinson's disease Epinephrine - anxiety and stress disorders; sleep disorders Glutamate - Alzheimer's disease; autism; depression; OCD; schizophrenia GABA - anxiety disorders; attention deficit/ hyperactivity disorder; bipolar disorder; depression; schizophrenia Serotonin - depression; suicide; OCD; PTSD; eating disorders Cortisol - anorexia nervosa; depression; stress-level disorders Ghrelin - eating disorders; obesity Melatonin - bipolar disorder; depression; particularly seasonal depression; schizophrenia, OCD Oxytocin - autism; anxiety; schizophrenia Neuroplasticity Ability of the brain to evolve and adapt o The brain reacts to environmental circumstances by making new neural circuits and pruning old ones o "Neurons that fire together, wire together." o Chronic stress results in negative changes in brain activity Exercise can produce positive changes Genetics and heredity Heredity - genetic transmission of traits Chemical compounds outside the genome control gene expression o Whether genes are "turned on" or "turned off" Genetic mutations Epigenetics - environmental factors trigger biochemical processes that affect gene expression Biology-based treatment techniques Psychopharmacology - study of effects of psychotropic medications Medication categories: o Antianxiety drugs - benzodiazepines (valium, XANAX) o Antipsychotics - chlorpromazine o Antidepressants - SSRI's (fluoxetine) o Mood stabilizers - lithium Other biological approaches Electroconvulsive therapy (ECT) o Induces small seizures with electricity or magnetism o Used to treat depression only as a last resort treatment o Mechanism of action is not exactly known o May strengthen serotonin signaling and increases the release of norepinephrine and dopamine o Common side effects: confusion and retrograde memory loss for events surrounding the period of ECT treatment, and mild muscle aches after walking o Still fairly common - about 100,000 people per year Neurosurgical and brain stimulation treatments: o Psychosurgery (removing parts of the brain); very uncommon today o Repetitive transcranial magnetic stimulation o Deep brain stimulation Biological therapies Psychosurgery o Originally used to control patients o Historically, the prefrontal lobotomy was used but is now viewed as inappropriate o Walter Freeman performed 3439 lobotomies in the 1940's and 1950's o Modern neurosurgery may still be used for serve cases of OCD and epilepsy Criticism of biological models and therapies Drugs are not always effective Drugs do not cure mental illness Side effects and interactions are possible Dimension two: psychological factors Four major perspectives: o Psychodynamic o Behavioral o Cognitive o Humanistic-existential Psychodynamic models o The components of personality: Id - pleasure and principle Ego - realistic and rational Superego - moral considerations (conscience) o Psychosexual stages: Freud proposed that human personality largely developed during first five years of life o Defense mechanisms: Protect us from anxiety Contemporary psychodynamic theories o Adler and Erickson Suggested that the ego has adaptive abilities and can function separately from the id o Bowlby and Mahler Proposed that the need to be loved, accepted, and emotionally supported is of primary importance in childhood Therapies based on the psychodynamic model o Psychoanalysis Objective - uncover material blocked from consciousness Free associating Dream analysis Effect of experiences with early attachment figures Long-term analysis; 2-5 years, with 3-5 sessions per week The client lies on a couch and the therapist sits out of view from the client The behavioral perspective o Behaviorism All behavior is a product of learning experiences Strict behaviorists claim there is not such thing as personality; tis implies inborn factors which affect behavior beyond the effects of learning experiences John Watson - "Give me a dozen healthy infants, well- formed, and my own specified world to bring them up and I'll guarantee to take any one at random and train him to become any type of specialist I might select - doctor, lawyer, merchant-chief, and yes even beggar man and thief, regardless of his talents, penchants, tendencies, abilities, vocations, and race of his ancestors." o Behavioral models Concerned with the role of learning in development of mental disorders Three paradigms: Classical conditioning (Ivan Pavlov) Operant conditioning (B.F. Skinner) Observational learning (Albert Bandura) o The behavioral perspective Classical conditioning A type of learning which associates a natural, automatic response with different stimulus Ivan Pavlov Associated with fear responses, such as in phobias Systematic desensitization - a treatment for phobias based on classical conditioning Operant conditioning Based on the idea that behaviors may be modified by their consequences B.F. Skinner Basic principles: Reinforcement strengthens a behavior Punishment weakens a behavior Social learning theory Much of our personality is learned, and this learning takes place in social situations Albert Bandura - the role of observational learning; the Bobo Dolly Study Behavioral therapies Exposure therapy Flooding Systematic desensitization Social skills training Behavioral modification Token economy (point systems) Biofeedback Relaxation training Modeling Criticisms of behavioral models - they neglect inner determinants of behavior Cognitive-behavioral models Thoughts profoundly affect emotions and behaviors Beck and Ellis ABC theory of emotional disturbance A is an event C is a person's reaction B are the person's beliefs about A, which causes the reaction to C Third wave cognitive-behavioral therapies o Attention to emotions can reduce their power to create distress o Mindfulness Conscious attention to the present o Dialectical behavior therapy (DBT) Supportive and collaborative therapy Reinforce positive actions o Acceptance and commitment therapy (ACT) Humanistic models Humans need unconditional positive regard Person-centered therapy focuses on facilitating conditions that allow clients to grow and fulfill their potential; Carl Rogers Maslow's concept of self-actualization: o The inherent tendency to strive for full potential Humanistic therapies o Communicating respect, understanding, and acceptance are more important than techniques o Unconditional positive regard fosters self-acceptance o Self-growth aids in present and future problem solving o The relationship between client and therapist is critically important to outcome Dimension three: social factors Social-relational models: o Healthy relationships are important for human development and functioning o When relationships are dysfunctional or absent, individuals are more vulnerable to mental distress Family, couples, and group perspectives o Family systems model: Behavior of one family member affects entire family system Characteristics: Personality development is strongly influenced by family characteristics Mental illness reflects unhealthy family dynamics and poor communication Therapist must focus on family system, not just an individual Social-relational treatment approaches o Conjoint family therapeutic approach: Stresses importance of teaching message-sending and message-receiving skills to family members o Strategic family approaches: Consider family power struggles and move towards more healthy distribution o Structural family approaches Recognize family in relation to level of involvement with each other Couples and group therapy o Couples therapy Aimed at helping couples understand and clarify their communication, needs, roles, and expectations o Group therapy Initially strangers; share certain life stressors Provides supportive environment Allows therapist to observe patient's actual social interactions Dimension four: sociocultural factors Emphasizes importance of several factors in explaining mental disorders: o Race o Ethnicity o Gender o Sexual orientation o Religious preference o Socioeconomic status o Other factors Gender factors o Higher prevalence of depression, anxiety, and eating disorders among women o Women experience greater stress in certain areas: Lower wages, less decision-making power Expectations of combining chores, childcare, and paid work o Exposure to sexual harassment, interpersonal violence Socioeconomic class o Lower socioeconomic class associated with: Limited sense of personal control Poorer physical health Higher incidence of depression o Life in poverty subjects people to multiple stressors Immigration and acculturative stress o Acculturative stress: Associated with challenges of moving to a new country Loss of social support Hostile reception Educational and employment challenges Most common among first generation immigrants and their children Race and ethnicity o Two early inaccurate, biased models: Inferiority model Deficit model o Multicultural model Emerged in the 1980's and 1990's A contemporary view that emphasizes the importance of considering a person's cultural background and related experiences when determining normality and abnormality Sociocultural conditions in treatment o Multicultural counseling is the "fourth force" in psychology o Multicultural counseling is assuming greater importance as our populating becomes more diverse o Cultural factors, such as family experience and degree of assimilation, are important in assessment and intervention Chapter 2 Vocabulary Etiology - the cause or origin of a disorder Model - an analogy used by scientists, usually to describe or explain a phenomenon or process they cannot directly observe Multipath model - a model that provides an organizational framework for understanding the numerous influences on the development of mental disorders, the complexity of their intersecting components, and the need to view disorders from a holistic framework Impulsivity - a tendency to act quickly without careful thought Protective factors - conditions or attributes that lessen or eliminate the risk of a negative psychological or social outcome Cerebral cortex - the outermost layers of brain tissue, covers the cerebrum Neuron - a nerve cell that transmits messages throughout the body Prefrontal cortex - the outer layer of the prefrontal lobe responsible for inhibiting instinctive responses and performing complex cognitive behavior such as managing attention, behavior, and emotions Executive functioning - mental processes that involve the planning, organizing, and attention required to meet short-term and long-term goals Limbic system - the group of deep brain structures associated with emotions, decision making, and memory function Amygdala - the brain structure involved with physiological reactivity and emotional memories Hippocampus - the brain structure involved with the formation, organization, and storing of emotionally relevant memories Autonomic nervous system (ANS) - a system that coordinates basic physiological functions and regulates physical responses associated with emotional reactions Hypothalamus - the brain structure that regulates bodily drives, such as hunger, thirst, and sexual response, and body conditions, such as body temperature and circadian rhythms Hypothalamic-pituitary-adrenal (HPA) axis - a system activated under conditions of stress or emotional arousal Pituitary gland - a gland that stimulates hormones associated with growth, sexual reproductive development, metabolism, and stress responses Hormones - regulatory chemicals that influence various physiological activities, such as metabolism, digestion, growth, and mood Adrenal gland - a gland that releases sex hormones and other hormones, such as cortisol, in response to stress Glia - cells that support and protect neurons Neural circuits - the signal-relaying network of interconnected neurons Dendrite - a short, root-like structure on the neuron cell body that receives signals from other neurons Axon - an extension on the neuron that cell body that sends signals to other neurons, muscles, and glands Myelin - white, fatty material that surrounds and insulates axons Myelination - the process by which myelin sheaths increase the efficiency of signal transmission between nerve cells White matter - brain tissue comprised of myelinated nerve pathways Gray matter - brain tissue comprised of the cell bodies of neurons and glia Neurotransmitter - any of a group of chemicals that help transmit messages, between neurons Synapse - a tiny gap that exists between the axon of the sending neuron and the dendrites of the receiving neuron Reuptake - the reabsorption of a neurotransmitter after an impulse has been transmitted across the synapse Neuroplasticity - the process by which the brain changes to compensate for injury or to adapt to environmental changes Heredity - the genetic transmission of person characteristics Trait - a distinguishing quality of characteristic Genes - segments of DNA coded with information needed for the biological inheritance of various traits Genotype - a person's genetic makeup Phenotype - observable physical and behavior characteristics resulting from the interaction between the genotype and the environment Gene expression - the process by which information encoded in a gene is translated into a specialized function or phenotype Genetic mutation - an alteration in a gene that changes the instructions within the gene; some mutations result in biological dysfunction Alleles - the gen pair responsible for a specific trait Epigenetics - a field of biological research focused on understanding how environmental factors influence gene expression Psychopharmacology - the study of the effects of medications on thoughts, emotions, and behaviors Psychotropic medications - drugs that treat of manage psychiatric symptoms by influencing brain activity associated with emotions and behavior Psychotic symptoms - loss of contact with reality that may involve disorganized thinking, false beliefs, or seeing or hearing things that are not there Extrapyramidal symptoms - side effects of antipsychotic medications that can affect a person's gait, movement, or posture Psychodynamic model - model that view disorders as the result of childhood trauma or anxieties and that hold that many of these childhood-based anxieties operate unconsciously Defense mechanism - in psychoanalytic theory, an ego-protection strategy that shelters the individual from anxiety, operates unconsciously, and distorts reality Psychoanalysis - therapy whose goals are to uncover repressed material, to help clients achieve insight into inner motivations and desires, and to resolve childhood conflicts that affect current relationships Free association - a psychoanalytic therapeutic technique in which clients are asked to say whatever comes to mind for the purpose of revealing their unconscious thoughts Dream analysis - a psychoanalytic technique focused on interpreting the hidden meanings of dreams Behavioral models - models of psychopathology concerned with the role of learning in abnormal Classical conditioning - a process in which stimuli are learned through association Unconditioned stimulus (USC) - in classical conditioning, the stimulus that elicits an unconditioned response Unconditioned response (UCR) - in classical conditioning, the unlearned response made to an unconditioned stimulus Conditioned stimulus (CS) - in classical conditioning, a previously neutral stimulus that has acquired some of the properties of another stimulus with which it has been paired Conditioned response (CR) - in classical conditioning, a learned response to a previously neutral stimulus that has acquired some of the properties of another stimulus with which it has been paired Extinction - the decreases or cessation of a behavior due to the gradual weakening of a classically or operantly conditioned response Operant conditioning - the theory of learning that holds that behaviors are controlled by the consequences that follow them Operant behavior - voluntary and controllable behavior, such as walking or thinking, that "operates" on an individual's environment Reinforcer - anything that influences the frequency or magnitude of a behavior Positive reinforcement - desirable actions or rewards that increase the likelihood that a particular behavior will occur Negative reinforcement - increasing the frequency or magnitude of a behavior by removing something aversive Observational learning theory - the theory that suggests that an individual can acquire new behaviors by watching other people perform them Modeling - the process of learning and observing models (and later imitating them) Exposure therapy - a treatment approach based on extinction principles that involves gradual or rapid exposure to feared objects or situations Systematic desensitization - a treatment technique involving repeated exposure to a feared stimulus while a client is in a competing emotional or physiological state such as relaxation Mindfulness - nonjudgmental awareness of thoughts, feelings, physical sensations, and the environment Psychological flexibility - the ability to mentally and emotionally adapt to situational demands Humanistic perspective - the optimistic viewpoint that people are born with the ability to fulfill their potential and that abnormal behavior results from disharmony between a person's potential and self-concept Self-actualization - an inherent tendency to strive toward the realization of one's full potential Family systems model - an explanation that assumes that the family is an interdependent system and that mental disorders reflect processes occurring within the family system Acculturative stress - the psychological, physical, and social pressures experienced by individuals who are adapting to a new culture Multicultural model - a contemporary view that emphasizes the importance of considering a person's cultural background and related experiences when determining normality and abnormality Universal shamanic tradition - the set of beliefs and practices from non-Western indigenous traditions that assume that special healers are blessed with powers to act as intermediaries or messengers between the human and spirit worlds
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