Abnormal Psychology Week 8 Day 1 Notes
Abnormal Psychology Week 8 Day 1 Notes Psyc 2500
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This 7 page Class Notes was uploaded by lucy allen on Tuesday March 1, 2016. The Class Notes belongs to Psyc 2500 at University of Denver taught by Dr. Jennifer M Joy in Fall 2016. Since its upload, it has received 21 views. For similar materials see Abnormal Psychology in Psychlogy at University of Denver.
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Date Created: 03/01/16
-review: -EMDR -dissociative disorders -dissociative amnesia -dissociative identity disorder (multiple personality disorder) Psychosis -a state defined by a loss of contact with reality -may e substance induced or caused by brain injury, but most psychosis appears in the form of schizophrenia -hallucinations: false sensory perceptions -delusions: false beliefs Schizophrenia -effects every 1/100 people worldwide -heightened rate for risk of suicide -increased risk of physical (often fatal) illness -appears in all socioeconomic groups, but is more frequently in the lower levels -equal numbers of men and women are diagnosed -men have an earlier onset than women (~23 vs. ~29 years) -people who develop schizophrenia were in various classes but fall down to a lower class -downward drift theory: hypothesis that potentially it is not more prominent of a disorder in lower SEC but people fall lower with it -symptoms -positive symptoms: considered an addition to what we typically see -delusions -delusions of control: by others or through thoughts -in granger: god-like, above all else -disordered thinking and speech -loose associations (derailment) -something may sound like another thing, changes direction of conversation -or may be words with multiple meanings misused -neologisms (made-up words) -perseveration: stuck on a word or thought, ignoring the rest of the intended conversation -clang (rhymes) -can be a real word we made up a meaning for -heightened perceptions: tuned into and overwhelmed by one sensory stimulus, preventing full engagement in the rest of the situation -hallucinations: hearing voices (auditory), can come through any of our senses (can be a feeling, smell, etc.) -inappropriate affect: (affect = emotion), inappropriate emotional response, face does not match the intended emotion -ex: ghost-busters joke in person #1 of video -flat affect is a type of inappropriate affect -ex: patient 4 laughing when talking about suicide and brain tumors, does not match what is expected -negative symptoms: pathological deficits, characteristics that are lacking in an individual -poverty of speech: lack of content in responses, can be persevering on a word, etc. -restricted (flat) affect -loss of volition: loss of motivation or directedness -social withdrawal: can happen in a variety of ways -psychomotor symptoms: awkward movements (tic-like, in the face), repeated grimaces, odd gestures -may take extreme forms, collectively called catatonia -stuck in a particular position because muscles have become so rigid -ex: patient 4, twirling hair Video- Four Patients with Schizophrenia -patient one -I’m not crazy, i have things to do, I’d like to leave -turned himself in, wanted to kill himself -racing thoughts -negative symptom: flat effect: decreased outward expression of emotional state -delusion: paranoid, "somebody might be trying to kill me" -patient two -patient three -years ago I didn’t have this new mental problem, I don't know what it is and its scary -those people at seven eleven are always on their phones talking about me, calling hospitals -there are a lot of doctors at seven eleven, they wanna kill me or do something to me -has a hard time concentrating on things -can't remember last time they were happy or had a good day -"I do have a brain problem, but I don't have a brain tumor hahahaha" -patient four -"people have called me here to electrocute me, kill me or put me in jail" -keeps playing with his hair -"the picture has a headache" -tangentiality* -40-50% of patients attempt suicide, and 10-15% succeed Course of Schizophrenia -usually first appears between the late teens and mid 30s -childhood schizophrenia can occur, usually very severe -many sufferers seem to experience three phases: prodromal, active, residual -prodromal: beginning behaviors tend to take place -noticing interactions are slightly different than normal, may stay in this stage for a long time because they are still relatively functional -schizophrenic break: moving from prodromal phase to active phase -active: impedes functioning -residual: go back more to a functional space -each phase of the disorder may last for days or years -ex: schizophrenic kid, in prodromal stage for a long period of time -kids are used to him, know how to interact with him -"recovered" = in the residual stage and functional, 1/4 schizophrenics recover -a fuller recovery from the disorder is more likely in people: -with good premorbid functioning (prior to onset) -whose disorder was triggered by stress -with abrupt onset -with later onset (during middle age) -who receive early treatment Diagnosing Schizophrenia -symptoms of psychosis continue for six months or more -deterioration in their word, social relations and ability to care for themselves -Type I Schizophrenia is dominated by positive symptoms -Type II Schizophrenia is dominated by negative symptoms -antipsychotic mediations tend to decrease positive symptoms but don't do much with negative symptoms -believe negative symptoms are due to structural abnormalities or physical injury while positive symptoms are chemically induced Theorists' Explanations -biological explanations have received the most research support -a diathesis-stress relationship may be at work -nature and nurture pair together -without predisposition, the triggers will not induce onset of schizophrenia -with predisposition, triggers may not be encountered to trigger the onset -psychological perspective is explained by behavioral and cognitive stances Biological Views -the more closely related they are to the person with schizophrenia, the greater their likelihood for developing the disorder -general population: 1% -second degree relatives: 3% -1st degree relatives: 10% -fraternal twin: 17% -identical twins: 48% -dopamine hypothesis: abnormality in dopamine levels (excessive amounts) cause psychotic symptoms -based on the effectiveness of antipsychotic medications -support for this hypothesis -Parkinson’s patients have the tics, Parkinson’s is caused by increased dopamine -people who take high doses of amphetamines (increase dopamine) show similar psychosis -challenges -by the discovery of a new type of antipsychotic drug ("atypical"): more effective than traditional antipsychotics and bind to D-1 (dopamine) receptors and to serotonin receptors -other studies suggest that negative symptoms may be related to abnormal brain structure, rather than to dopamine over activity -positive symptoms: chemical aspects -negative symptoms: structural aspects -brain scans found people with schizophrenia have enlarged ventricles -smaller temporal and frontal lobes -smaller amounts of grey matter -abnormal blood flow to certain brain areas -viral problems -possible that biochemical and structural brain abnormalities seen in schizophrenia result from exposure to viruses before birth Psychological Views -cognitive view -agree that biological factors produce symptoms -furthered by faulty interpretation and a misunderstanding of symptoms -research support is limited -by me explaining my (seemingly real) experience and them denying it, I feel like people are more out to get me, and more symptoms develop -behavioral view -operant conditioning and reinforcement -this view is considered (at best) a partial explanation -instead of denying the voices I am hearing, I should accept the voices -when I am responding in loose associations, I am getting attention, and I am reinforced by this attention Sociocultural Views -sociocultural theorists believe that three main social forces contribute to schizophrenia: -multicultural factors: nature? nurture? -although the overall prevalence is stable, the course and outcome of schizophrenia differs between countries -genetic differences from population to population? -psychosocial environments of developing countries tend to be more supportive than developed countries? -social labeling: do we become the disorder we were set to have? -family dysfunction -double bind communication: -when your behavior does not match what you are trying to say (mixed messages) -overly critical families, overly involved in analysis of behaviors of the person Video #2: Elyn Saks -"imagine having a nightmare when you're awake" -restraints cause death -Elyn is pro-psychiatry but anti-force -"the less medicine, the less defective" Treatment of Schizophrenia and Other Severe Mental Disorders -it is important to keep in mind that throughout much of the 20th century, the label "schizophrenia" was assigned to most people with psychosis 1950's: Institutional Approaches -milieu therapy: comes from humanistic perspective -allowing people to have more independence and responsibility -institutions can help patients make clinical progress by creating a social climate (milieu) that promotes productive activity, self- respect and individual responsibility -token economy programs: comes from behavioral perspective -patients are rewarded when they behave in socially acceptable ways and are not rewarded when they behave unacceptably -earlier strategies: better than institutionalization without strategy, but not great -phenothiazines: antihistamines used during surgical procedures, found to decrease positive symptoms -conventional antipsychotic drugs (thorazine) -research ahs shown that antipsychotic drugs reduce symptoms in at least 65% of patients diagnosed with schizophrenia -also cause major motor issues -tics, writhing of muscles -tardive dyskinesia: people who had been on these conventional antipsychotics for about a year, develop many tics and writhing muscle movements that in many cases never went away Newer Antipsychotic Drugs -in recent years, new antipsychotic drugs have been developed -ex: Clozaril, Risperdal, Zyprexa, Seroquel, Abilify, Geodon -these new drugs are called 'atypical' because their biological operation differs from that of conventional antipsychotics -serious problems -risk of agranulocytosis, life-threatening drop in WBCs -also may cause weight gain, dizziness and significant elevations in blood sugar Psychotherapy -helping to relieve their thought and perceptual disturbances -most helpful forms include cognitive-behavioral therapy and two broader sociocultural therapies (family and social therapy, often combined) -family therapy -those who live with relatives who display high levels of expressed emotion are at greater risk for relapse than those who live with more positive or supportive families -attempts to address emotional and stress related issues, create more realistic expectations and provide psychoeducation about the disorder -social therapy -practice advice, problem solving, decision making, social skills training, medication management, employment counseling, financial assistance and housing -reduces rehospitalization -cognitive-behavioral realm: we work on acceptance -seek to change how individuals view and react to their hallucinatory experiences -new-wave cognitive-behavioral therapies also help clients to accept their streams of problematic thoughts -prevents anxiety from thinking they are not supposed to experience hallucinations New Practices -music therapy -social skills training through poetry -more group-based and art-based therapy gaining support
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