Psych 3331 Abnormal Psych Class Notes Week 4
Psych 3331 Abnormal Psych Class Notes Week 4 Psych 3331
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This 8 page Class Notes was uploaded by Casey Kaiser on Saturday September 17, 2016. The Class Notes belongs to Psych 3331 at Ohio State University taught by Thomas Valentine in Fall 2016. Since its upload, it has received 6 views.
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Date Created: 09/17/16
Psych 3331 Abnormal Psych Class Notes Week 4 9/12 The Behavioral Model: Grounded in the idea that abnormal behaviors are learned o Through viewing models o Can result from classical or operant conditioning Modeling - individuals learn responses by observing other individuals and repeating their behavior There is a lot of research going on about whether or not viewing violent media may cause abnormal behavior Operant conditioning Learning is controlled by consequences of a behavior Classical Conditioning When you learn via association between two events that occur repeatedly close together in time o Pavlov's Dogs - Dogs presented with the unconditioned stimulus (food), and has an unconditioned response (salivation). You can present a neutral stimulus (metronome), and there will be no conditioned response If you expose the dog to a metronome and food, the dog will display the unconditioned response (salivate) After repeatedly exposing the dog to metronome and food, eventually you can expose the dog to the metronome (conditioned stimulus) and the dog will have a conditioned response (salivation) Goal - identify behaviors that are causing person's problems and try to replace them with more appropriate ones with conditioning or modeling Sample treatment technique - Systematic desensitization: a behavioral treatment, for clients with phobias so they can learn to react calmly instead of with intense fear o Step 1 - practice relaxation skills o Step 2 - construct fear hierarchy, picture - put scary thing in the room - etc.. o Step 3 - confront each item on hierarchy while in state of relaxation Pros of behavioral model Can be tested in a lab Research shows principles of learning can induce clinical symptoms Shown to be effective in treating various disorders o Baby Albert - got an infant to fear things like rabbits and Santa by pairing them with a loud sound, he then associated the "nice" things with an unpleasant stimulus Cons Just because we can manufacture these symptoms in a lab environment does not mean we can generalize them to the outside world Improvements in therapist's office do not always go beyond the therapy sessions or extend to real life situations Hypothetical Patient Angela: What would we focused on in Angela if we were using the behavioral model First off, focus on her behaviors that may cause her depressive disorder A therapist would try to determine which behaviors brought out the depressive disorder and what behaviors are being maintained Would ask what activities they used to enjoy that they may not do anymore - and gradually get her to return to her previous ways (behavioral activation) Humanistic-Existential Model Central tenet: goals of self-awareness, strong values, a sense of meaning in life, and freedom of choice are central to human functioning Tom says this model is kind of fruity, happy go lucky kind of model Created in the 1940s, became very popular in the 60s and 70s Humanists and existentialists share focus on human existence, however there are differences between them Humanists Believe humans are born with a natural tendency to be friendly, cooperative, and live to their full potential o Self-actualization, we want to fulfill our potential for goodness and growth Carl Rogers - pioneer for this humanistic model Carl Rogers thought that abnormal behaviors began in infancy Early unconditional positive regard -> unconditional self-regard -> better positioned to self-actualize o If you are raised by parents who treat you as if you have value, meaning, and are important no matter how you act - it will lead you to believe the same thing about yourself, therefor you are more likely to self- actualize Repeated lack of positive regard early in life -> "conditions of worth" (I have worth in some situations but in other situations I am worthless) -> problematic functioning o If the unconditional positive regard is inconsistent then your view of the positive regard will be skewed, "do I always have worth?" and lead to problems Client-centered therapy Therapists try to create a supportive climate in which clients feel able to look at themselves honestly and acceptingly o Therapists must display: Unconditional positive regard - full warmth and acceptance Accurate empathy - skillful listening and restating so the client feel like they are heard Genuineness - sincere communication Goal is to help the client reach a state where they see their full potential and free them from their insecurities that are preventing them from self- actualization Gestalt Therapy Still trying to get the client to accept themselves and help them meet their potential o Using.. o Skillful frustration - therapist refuses to meet the client's expectations/demands to help them see how often they try to manipulate other into meeting their needs o Role playing - getting patients in tune with feeling emotions that they are not comfortable with, the goal is to accept uncomfortable feelings and have them express their emotions fully o Rules - use "I" language rather than "it" language, stay in the here and now, what matters is the present time and how things are effecting the person now Existentialists Agree that humans must have accurate self-awareness and live meaningful lives in order to be well-adjusted BUT do not believe that people are naturally born this way or inclined to live positively but think that people have freedom to choose to live with meaning or not o Hiding from responsibility and choice -> anxiety, frustration, boredom, alienation, depression, and empty inauthentic life Existential therapy Encourages clients to address these issues, they try to get them to accept responsibility for their lives and the problems they are experiencing Pros of humanistic-existential model Self-acceptance, personal values, personal meaning, and personal choice are certainly lacking in many individuals with psychopathology Optimistic tone - a lot of people seek this when they go into therapy View of clients as individuals who have yet to fulfill potential, can be very comforting Rogers paved way for psychologists to provide services to people with mental illness - IMPORTANT! Cons Too abstract to thoroughly study (use of empirical research is in fact rejected by many proponents of this model) Weak research support We can borrow some things from this model to apply to other models but that is about it How can we help Angela using this model? Maybe she is hiding from responsibility - she needs someone to help her find value in her academic work, or help her find a path that is more fulfilling for her The Cognitive Model Central tenet: cognitive processes are at the center of behaviors, thoughts, and emotions Proposed by Albert Ellis and Aaron Beck in the early 60s Cognitive therapists believe abnormal functioning comes from Inaccurate/disturbing assumptions and attitudes Illogical thinking processes How can you overcome abnormal functioning? Develop more functional ways of thinking Cognitive therapy Help patient realize what thinking processes they have that are contributing to their disorder and then help them change those thinking processes o Recognize negative thoughts o Challenge dysfunctional thoughts o Develop more functional interpretations o Apply the new ways of thinking to everyday life Walk through their thinking processes and challenge the anxious thoughts and work on the thinking in that area, come up with alternative ways of thinking and apply them to day to day life Pros Lends well to research Research supports idea that people with disorders have dysfunctional thinking Impressive performance in treating a number of conditions Cons Changing thinking might not be sufficient Significant, long-lasting cognitive change does not occur for everyone We are more than just our conscious thoughts - we need more than changing thinking Maybe it is better to accept thoughts than to try and change them 9/14 The Biological Model Central tenet: abnormal behavior has a basis in the body and physical processes (problems in brain anatomy or chemistry, etc..) Neurons - cells that communicate with one another o Transmits info throughout the body o Large groups in the brain form brain regions - they communicate with one another more than in the other regions Neuron anatomy Dendrites - receive messages from other neurons Messages then go into / through the cell body or soma And then into the axon After the message is passed along the axon it reaches the axon terminal (also known as nerve endings) Messages are passed along from neuron to neuron They communicate chemically, inside each neuron it is electrically charged but from neuron to neuron messages are transferred through neurotransmitters Messages can be excitatory or inhibitory Excitatory messages tell neurons to fire and continue firing from neuron to neuron Inhibitory messages tell neurons to not fire This model would say that certain neurotransmitters, or levels or neurotransmitters, are off and can lead to certain mental disorders Ex: depression has been linking to low activity of serotonin and norepinephrine The Endocrine System: Neurotransmitters vs. hormones o Not the same thing, neurotransmitters are on the neuronal level and hormones are released by endocrine glands Endocrine glands work with neurons to control vital bodily activities o They release hormones into the blood stream and alter body organs Abnormalities in neurotransmitters and / or hormones Genetics - inherited by parents, brain structure and function have hereditary basis' Evolution - there are arguments that some mental health conditions are adaptive Viral infections - they have been linked to some mental illnesses, based on mothers being sick while pregnant Life experiences - what you do can change your biology and how your brain works Treatments: Drug therapy - psychotropic medications o Antianxiety drugs o Antidepressants o Mood stabilizers o Antipsychotics Electroconvulsive therapy - where seizures are induced in patients, typically used in treating treatment-resistant depression Psychosurgery - used to be done through trephination or lobotomies, now done through ablation (not super different than lobotomies, but we are a lot better at these things today) Others - neuromodulation treatments (transcranial magnetic stimulation, deep brain stimulation, etc.. ) Pros Treatments can be quite effective - really great health care advances for people with schizophrenia Substantial amount of research Cons Reductionism - people who cling to this model do not like to accept that you cannot solely treat disorders based on biological things Side effects of medication can be pretty severe Over-prescribing? Medication management is a problem often, sad :( The Sociocultural Model Central tenet: abnormal functioning is driven by the society and culture in which you live The family-social perspective and the multicultural perspective The family-social perspective Believe the first step to explaining abnormal behavior is to look into family relationships, friendships, social interactions, and community Therapists would be paying attention to social labels and roles, communication and structure in the family Social labels and roles: Labels tend to stick with people, often people do not like the label they have but learn to accept them as they become a part of their identity They see people treating them differently based on the label they have, whether it is a label of mental illness or otherwise Social networks: Deficiency in social connections may be causing psychological dysfunction - whether you have very few relationships or relationships that are not as warm Family structure and communication: Family systems can produce abnormal functioning o "enmeshed" structure - over-involvement of family members can make independence in life difficult o "disengaged" structure - these boundaries between family members can cause difficulty in support and things like so Treatments: Family therapy - the family is being treated as a unit, not just one person o Based on family systems theory, therapist will help members identify harmful patterns and roles and how to change them Couple therapy - focuses on structure and communication between two people who are in a long-term relationship Community treatments Multicultural Perspective Different cultures within larger societies have different values and beliefs Pressures based on ethnic, racial, etc.. Minorities can cause abnormalities Treatment considerations Ethnic and racial minority groups o Make less use of mental health services o Stop therapy sooner o Show less improvement in clinical treatment The effectiveness can be improved by o Increasing therapist sensitivity to cultural issues o Including these groups more often Pros Family, society, culture do have influences on behavior Treatment formats can be effective Cons Very little experimental work in this area, mostly correlational Inability to predict abnormality in specific individuals (i.e., not all members of a minority group develop abnormalities 9/16 The Biopsychosocial Approach We need to integrate across models and not just focus on one single model We need to take a lot of things into consideration in order to understand a person Biopsychosocial theorists use a "diathesis", a biological, psychological, or sociocultural predisposition to develop a disorder Diathesis + stress = disorder You need either a biological, social, or psychological diathesis mixed with either a biological, social, or psychological stressor to develop a disease o Ex. ELS - early life hood stress, a maladaptive upbringing, and then later in life someone in your family gets sick, so you develop depression where someone who did not have a maladaptive upbringing may not experience depression What do clinical psychologists use in the real world? Use an eclectic approach - using some approaches for some people and different approaches for others, not different ones for a single person Cognitive approaches Behavioral approaches Often they will mix the cognitive and behavioral approaches 9/16 Pt. 2 Clinical Assessment - done to figure out if, why, and how someone is behaving abnormally. Once we have done a treatment we use assessment to figure out if treatment is working What makes a good assessment? It will be standardized - meaning the test is administered to a large group of people first and that performance then serves as a standard / norm that individual's scores can be measured against. o The norm is the standard bell curve shape we all know It will be reliable - meaning the assessment will always yield similar results in the same situation o Test-retest reliability must be high - assessment yields similar results every time it is given to the same people o Interrater reliability must also be high - judges independently agree on how to score and interpret assessments It will be valid - meaning the assessment, if good, will be accurate in measuring what it is supposed to measure, you have to have reliability if you have validity o Face validity - the extent to which a measure seems to measure what it is supposed to measure o Predictive validity - the extent to which a measure can predict future characteristics or behavior o Concurrent validity - the extent to which the results of a measure correspond to a previous measure for the same construct Meeting with your first patient, what do you do? Ask them why they are there Ask if there have been significant changes in their life lately Ask if they have had experience with therapy in the past Ask when they noticed the symptoms starting Ask about other symptoms she may be having - appetite, sleeping habits, enjoyment Ask what their goals of therapy are - what do they want to get out of the therapy? This is called a clinical interview A face to face meeting that is used to collect detailed information about a client's problems, feelings, lifestyle, relationships, personal history, and expectations for therapy Interview questions will be focused on whatever model the therapist practices with o Psychodynamic - needs and memories of past o Behavioral - stimuli that trigger responses and their consequences o Cognitive - assumptions and interpretations that influence the clientini There are two very broad types of clinical interviews Structured interview - has very specific questions that have been standardized Unstructured interview - these are favored by psychodynamic and humanistic therapists, more open ended questions, general questions
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