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Introduction to Psychology

by: Brody O'Hara

Introduction to Psychology psych 202

Brody O'Hara
GPA 3.5
Introduction to Psychology
Patricia Coffey

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Introduction to Psychology
Patricia Coffey
Class Notes
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This 22 page Class Notes was uploaded by Brody O'Hara on Thursday September 17, 2015. The Class Notes belongs to psych 202 at University of Wisconsin - Madison taught by Patricia Coffey in Summer 2015. Since its upload, it has received 41 views. For similar materials see Introduction to Psychology in Psychlogy at University of Wisconsin - Madison.


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Date Created: 09/17/15
Part 1 Notes complete Introduction to Personality Stress amp Health and Psychopathology What is the relationship between personality and social psychology Social Psychology Emphasizes Personality psychology emphasizes Together What is Personality Characteristics emotions thoughts and behaviors that are relatively stable ver time and across circumstances Personality Trait D OPNF D P i Characteristics of the person a dispositional tendency to act in a certain way over time 3 How have scientists studied personality a Freudian lpsychodynamic approach i The role of unconscious influences on personality ii ID unconscious pleasure center iii Superego dictated from societyparents complete restraint iv Ego mediationbalancing of ID and Superego v Introduced the concept of unconscious defense mechanisms Denial repression projection rationalization reaction formation displacement sublimation b The Narrative Approach i Dan McAdams personality researcher 1 To understand people need to understand their personal narratives of their whole lives a tell me about your lifequot c Humanistic Approach i Phenomenology rejects Freudskinner ii Selfactualization encouraged iii Theorists 1 Maslow selfactualization 2 Carl Rogers unconditional positive regard promotes fully functioning persons 4 Major systems of personality trait description a Eysenck Posits three superordinate personality traits i Emotional stability vs instability neuroticism ii Extraversion vs introversion iii Psychoticism impulsivity and aggression iv Organizes related subordinate traits and habitual and specific response systems 1 Splits people into groups of melancholic choleric sanguine and phlegmatic b The Big Fivequot most dominant quot I 39 ic OCEANCANOE ii Openness to experience 1 Imaginative vs down to earth 2 Independent vs conforming 3 Variety vs conforming iii Conscientiousness 1 Organizeddisorganized 2 Carefulcareless iv Extraversion 1 Social retiring 2 Fun lovingsober 3 Affectionatereserved v Agreeableness 1 Softheartedruthless 2 Trustingsuspicious vi Neuroticism 1 Worriedcalm 2 Insecuresecure c Psychometric research on the big fivequot i Consistencystability increases with time ii Conscientiousness increases with time older people are more reliable Biological basis of Personality a Personality is rooted in Genetics i Data on Psychobiological Perspectives 1 Twin studies anchor heritability estimates a Monozygotic twins concordances gt dizygotic twins concordances 2 Heritability estimates a 4060 of population differences in diverse personality traits achievement aggression emotional wellbeing stress reactivity shyness etc are estimated to be attributable to genetic differences among individuals ii Adoption studies showthat adopted siblings are no more alike than randomly selected people based on their psychology than randomly selected people and their personalities are not similar to their adopted parents 1 This indicates that there are specific genes for personality b Temperaments are evident in infancy i Activity level ii Emotionability iii Sociability iv Shy children are inhibited introverted from birth based on Kagan s research c Personality is linked to specific neurophysiological mechanisms i Arousal and extraversionintroversion 1 Theory Differences in cortical arousal explain differences between extraverts and introverts a Cortical arousal is regulated by ascending reticular activating system ARAS b Extraverts are under arousedquot c lntroverts are hyper arousedquot d We desire our optimal level of arousal e Sensationseeking involves impulsiveness which is a neurochemical deficiency ii Neurophysiology of extraversion Gray s Behavioral approach system BAS A a Behavioral Activation System BAS G0 I Neurochemistry 1 Greater dopamine receptor activation reward 2 Dopamine positive affect 3 Specific gene involved in dopamine reception novelty seeking willing to try newthings b Behavioral lnhibition System BIS STOP Neurochemistry Heightened frontal lobe activity Amygdala fearanxiety Heightened activation if neutral face due to fear of rejection Extraverts have a stronger BAS QWN More influenced by rewards than punishment Act impulsively with strong reward regardless of punishment d lntroverts have a stronger BIS Chronic anxietyarousal Avoid situations with negative potential outcomes Personality is adaptive Examples of some traits a Selfefficacy Bandura 9 i What we do matterscreates change ii More likely to actively feel better b OptimismPessimism i Optimists tend to be healthier c Type A vs Type B personalities 39 A achievement oriented demanding more health issues ii B Relaxed easygoing d Neuroticismemotional stability selfdialogue strategic self presentation ii Behavioral confirmation depressed people ineptitude e Extraversionintroversion f Hardiness i Ability to thrive through hardships ability to rise and meet challenges g Shyness h Narcissism i Stressreactivity EysanckKagan s thoughts about responsivity to stress 7 DSMlV s Perspective on Normal and Abnormal Psychopathological Dimensions of Personality Traits a DSMIV stands for Diagnostic and statistical manual of the American psychiatric associationquot b Standardized nomenclature of psychopathology used in the business of mental health in North America c Definition of Personality Disorder i An enduring pattern of inner experience and behavior that has 5 characteristics Deviates markedly from the expectations of the individual s culture Pervasive and inflexible An onset in adolescence or early adulthood Stable over time Leads to either significant personal distress or impairment in social occupational role functioning SHPP N ii Personality disorders are 1 Maladaptive inflexible 2 Clusters and patterns of specific traits 3 Evident by the time of early adulthood 4 Cause clinically significant distressimpairment in social occupational or other important areas of functioning 8 Antisocial personality disorder and Psychopathy a Both involve combinations of personality traits and socially deviant behaviors but are distinct disorders b Antisocial personality pervasive pattern of disregard for and violation of the rights of others i Law violations deceit impulsivity etc ii Behavior based iii Prevalence 75 end up in prison c Psychopathy Prevalence more extreme than quot ii Ken and Barbie Killers example iii Focused more on personality notjust antisocial iv a fundamental incapacity for love or true friendshipquot v Mask of Sanityquot book about high psychopathy impairment vi Hare Psychopathy Checklist Glibnesssuperficial charm Grandiose sense of selfworth Need for stimulation Pathological lying Conningmanipulative Lack of remorse Shallow affect Callouslack of empathy NP QPP N vii Psychopathy occipital cortex activation viii Two theories of Psychopathy Lykken s Lowfear hypothesis Poor fear conditioning lnsensitive to punishment cues Poor socialization because of a lack of fear Poor attachment because they don t need comfort Newman s Response Modulation Hypothesis More specific than Lykken s lnsensitivity to punishment cues when peripheral lnsensitive to emotionally neutral cues as well as fear Immediate acting on urges lack of response modulation thus behavior is not regulated e Amygdala differs because it does not attend to the cues so there is no activation 9 Stroop Test tests theorieshypotheses 10 DSMlV s Narcissistic Personality Disorder a a pervasive pattern of grandiosity in fantasy or behavior need for admiration and lack of empathy beginning by early adulthood and present in a variety of contexts as indicated by 5 or more of the followingquot i Grandiose sense of selfimportance ii Preoccupation with fantasies of unlimited success power brilliance beauty or ideal love iii Belief heshe is special and unique can only be understood by or should associate with other specialhighstatus people iv Requires excessive admiration v Sense of selfentitlement unreasonable 09 575 N99 5794 expectations of favorable treatmentautomatic compliance of expectations VI Interpersonally exploitative vii Lacks empathy is unwilling to recognize or identify with the feelings and needs of others viii Often envious of others or believes others are envious of himher ix Arrogance haughty behaviorattitude 11 Personality Disordered condition video clip 12 Personality Traits and Stress and Health a Personality traits are dispositional b Personality and stress interact and shape the stress experience c Stress anything that challenges our resources good or bad d Hans Selye distinguished between stressors and stress Videoclip i Stressors cause stress response 1 External loss of job relationship problems 2 Internal chronic selfcriticism depressive thinking unstable emotionality chronic circulating stress hormones ii Stress nonspecific response of the organism to any pressure or demand 1 Physiological stress responses cortisol levels a Elevated stress hormones chronic physical tension 2 Psychological stress responses internal stressors A and discussion of Lazarus lower down iii Stress total response of mindbody to whatever stressors you experience iv General Adaptation Syndromequot GAS 1 3 phases of physiological stress response a Alarm b Resistance c Exhaustion d Note multiple neurobiological and hormonal response processes are mobilized activated and engaged for various lengths of time e All life events represent potential stressors and are appraised i 3 kinds of appraisals 1 Harm a damaging event has occurred 2 Threat a potential future harm is approaching 3 Challenge events appraised as opportunities rather than threats 4 Harm and Threat appraisals induce psychological stress f Stressreactivity is an individual difference factor trait i Some people may be more disposed to perceive events as hassles ii Some people are more likely to have greater HPA hypothalamicpituitaryadrenal activation and sympathetic nervous system activation iii If high stress reactive there is a high physiological response g Other common traits that relate to stress 39 Optimismpessimism ii Type Avs Type B iii Hardiness iv Stress reactivity h Study Type A vs Type B and heart disease i 3500 men free of heart disease followed for 8 years ii Personality traits can predict heart disease iii Type A personality was as strong a predictor of heart disease as smoking high cholesterol or blood pressure i Seligman s Optimism Work i Optimism pessimism continuum ii Trait related to cognitive appraisals and behavioral coping strategies iii Treatment is typically focused on cognitivebehavioral factors related to depression stress etc iv 3 dimensions to explanatory style for GoodBad events Permanence Resist helplessness if bad events are temporary the essence of hope Optimists believe good things are permanent Pervasiveness Resist helplessness if bad events are specific to the situation rather than iversal Opposite for good events I m smart Personalization lnternal vs external Bad things are our fault or the situations fault Low selfesteem lnternal style for bad event v Optimism The trait of optimism is association with the empirical findings Less illness symptoms in college and beyond More active approach to stressproblem solving Higher levels of academic success and performance Immune system functioning is higher Optimists respond to stressors with smaller increases in blood pressure Cardiac patients with minimal optimism more hopelessness have higher rates of new heart attacks and are twice as likely to die than people with low hopelessness j HardinessStress resistant A ovwwvgwwvw 7quot099579 i Hardiness is a trait of people who demonstrate 1 Commitment sense of purposeinvolvement with work and family 2 Challenge openness to new experiences and a desire to embrace them 3 Control belief that one has the powerto influence important future outcomes selfefficacy vs helplessness 4 Example a Stressor math test Appraisal of threat panic Appraisal of challenge arousalfocus k Hardinessoptimism reflect low stressreactivi l Persons with right prefrontal cortical activation pessimistic helpless people have higher stress reactivity m Coping i Emotion focused 1 Try to prevent an emotional response to stress 2 Avoidance minimizing and abusing substances ii Problem focused coping 1 Take direct steps to minimize a stressor iii Positive reappraisal 1 Focus on good in the current situation iv Best way to cope 1 Depends on stressor and time frame a Problem focused in best in long term emotions b Emotion focused may be best in the short term or if uncontrollable n Coping through managing emotions i Both psychotherapy and mediation target reappraisal of our experiences along with developing new coping skills ii Therapy and stress management target positive emotional modulation 0 Mindfulness is a stress management and cognitive reappraisal approach i Acceptance trust patience non judgment letting go beginner s mind I don t know nonstriving not goallessness p Practicing seeing events as challenges and the self as capable of managing ability to cope is likely to reduce stress i High stress can become lower stress and even positive challenge if attitudes and habits of behavior and emotional processing change 1 More likely to succeed with help social support that is of high quality 13 Dispositional Filtering Processes a Healthpromoting filters i Positive affectiveneural circuitry ii Low stress reactivity iii Dispositional optimism iv Optimistic explanatory style v High hardiness vi High emotional stability nonneurotic vii High selfefficacy b Healthinhibiting filters i Negative affective styleneural circuitry ii High stress reactivity iii Dispositional pessimism iv Pessimistic explanatory style v Low hardiness vi Low emotional stability neurotic vii Low selfefficacy 14 Data on Psychobiological Perspectives a Twin studies anchor heritability estimates I Monozygotic twins concordances gt dizygotic twins concordances b Heritability estimates i 4060 of population differences in diverse personality traits achievement aggression emotional wellbeing stress reactivity shyness etc are estimated to be attributable to genetic differences among individuals Vocabulary 1 Personality the characteristic thoughts emotional responses and behaviors that are relatively stable in an individual over time and across circumstances 2 Personality traits a characteristicdispositional tendency to act in a certain way over time and across circumstances 3 Psychodynamic theory Freudian theory unconscious forces such as wishes and motives influence behavior Psychosexual stage according to Freud the developmental stages that correspond to the pursuit of satisfaction of libidinal urges ld psychodynamic theory component of personality that is completely submerged in the unconscious and operates according to the pleasure principle 6 Superego psychodynamic theory internalization of societal and parental standards of conduct Ego psychodynamic theory the component of personality that tries to satisfy the wishes of the id while being responsive to the dictates of the superego 8 Humanistic approaches approaches to studying personality that emphasize personal experience and belief systems proposes that people seek personal growth to fulfill their human potential 9 Personality types discrete categories based on global personality characteristics 10 Trait approach an approach to studying personality that focuses on the extent to which individuals differ personality dispositions 11 Five factortheory the idea that personality can be described using five factors openness to experience conscientiousness extraversion agreeableness and neuroticism 12 ldiographic approaches personcentered approaches to studying personality that focus on individual lives and how various characteristics are integrated into unique persons 13 Nomothetic approaches approaches to studying personality that focus on how people vary across common traits 14 Projective measures personality tests that examine unconscious processes by having people interpret ambiguous stimuli 15 Objective measures relatively direct assessments of personality usually based on information gathered through selfreport questionnaires or observer ratings 16 Situationism the theory that behavior is determined more by situations than by personality traits 17 lnteractionists theorists who believe that behavior is determined jointly by underlying dispositions and situations 18 Temperaments biologically based tendencies to feel or act in certain ways 19 Behavioral approach system BAS the brain system involved in the pursuit of incentives or rewards 20 Behavioral inhibition system BIS the brain system that is sensitive to punishment and therefore inhibits behavior that might lead to danger or pain 21 Selfserving bias the tendency for people to take personal credit for success but blame failure on external factors part 2 notes complete Axis Mental Psychopathological Conditions and Treatment 1 Categories of Mental Disorder a Axis I i Clinical disorders and other conditions that may be a focus of clinical attention schizophrenia mood disorders sleep disorders eating disorders etc ii Treatable to a degree b Axis H i Mental retardation and personality disorders antisocialparanoidborderline personality disorder ii Permanent c Axis III i General medical conditions that may be relevant to medical disorders cancer epilepsy obesity parkinsons etc d Axis IV i Psychosocial and environmental problems that might affect the diagnosis treatment and prognosis of mental disorders unemployment divorce legal problems poverty etc 2 David Rosenhan s Being sane in insane placesquot 3 Critique and impact on development of DMS s a Impact of study on the DSM and diagnostic practice i Single symptoms are inadequate bases for diagnosis ii DSM s subsequently articulated detailed diagnostic criteria Mental Disorders must be assessed before diagnosis Assessment uses structured and unstructured interviews Assessment utilitzed behavioral information Assessments profit from psychological testing information ValueDanger of labels Facilitates professional communication Shorthand descriptionimplied meaning from label Can stigmatize selffulfilling prophecies Mental disorders have many causes Family and sociocultural factors Cognitivebehavioral factors Biological factors The Diathesisstress model integrates multiple perspectives i general framework for explaining the causes etiology of psychopathological conditions Diathesis predisposing factors a Genetics personality traits environment early and prolonged stressors and stress responses resulting in emotionally and behaviorally maladaptive circuits in the brain 2 Stress precipitating factors triggering factors slowesaoswsnmwe a Stressful major life events associated with the onset of psychopathological symptoms of adulthood 7 The legal system has its own definition of psychopathology a DSM helps clinicians categorize mental disorders b insanity is a legal term related to the judgments or jurors and judges of the criminal responsibility of a defendant c MUST LACK i Capacity to control behavior AN DOR ii Capacity to appreciate wrongfulness Public misconception vvaaay less insanity pleas occur than the public believes Neurotic disorders nonpsychotic disorders No delusions or hallucinations No markedly impaired reality testing Operationally absence of markedly impaired reality Anxiety as the root of seemingly different disorders There are different types of anxiety disorders Anxiety disorders have cognitive situational and biological components Different types 957950957 i Phobic Disorder fears Agoraphobia fear of panic attacks Social phobia Specific phobias PM ii Generalized Anxiety Disorder 1 Excessive anxiety and worry more days than not for 6 months 2 Person finds it difficult to control the worry 3 Anxietyworry associated with at least 3 of the following symptoms a Restlesslnessfeeling keyed up or on edge b Being easily fatigued c Difficulty concentrating or mind going blank d lrritability e Muscle tension f Sleep disturbance iii Panic disorder panic attacks 1 With and without agoraphobia iv Obsessive compulsive Disorder 1 Obsessions worry about germs 2 Compulsions behavior washing hands v Post traumatic stress disorder d Sportswriter video clip i Symptomatology divorce leads to drinking anxiety symptoms are a sign of agoraphobia drinks to help with anxiety i39 Diagnoses panic disorder with agoraphobia iii Etiology iv Treatment e CognitiveSituationBiological components i Consider COD 1 Causes a Caudate nucleus diysfunction basal ganglia impulse suppression can be caused by a strep infection More common in women Anxious thoughts calmed by compulsions Link between panic disorder and agoraphobia 1 Panic seems to be biologically driven 10 Mood Disorders a Bipolar Disorders i ManicHypomanic episodes ii Bipolar disorders including depression i Cyclothymia hypomanic no major I depression b Depressive Disorders i Dysthymic Disorder dysthymia neurotic depression 1 Chronic 2 years duration low grade depression doesn t meet criteria for Major Depressionquot albeit still serious as indicated by 2 or more of the following Poor appetiteovereating b lnsomniahypersomnia c Low energyfatig ue d Low selfesteem e f 5 Poor concentration or difficulty making decisions Feelings of hopelessness ii Major Depressive Episodequot 1 Profound persistent period of depression that exists for two or more weeks as indicated by a Depressed mood b Markedly diminished interest and pleasure c Significant weight lossgain d lnsomniahypersomnia e Psychomotor agitation or psychomotor retardation f Fatigue or loss of energy g Feelings of worthlessness and excessive guilt h Diminished ability to think concentrate and make decisions Recurrent thoughts of deathsuicide c Psychotic Features as Specifier i Hallmarks of psychosis delusions and hallucinations in general Marked impairment in reality testingquot ii Presence of psychotic features in mood disorders is seen in I A 1 I I nu y l I a 39 of utter worthlessness manic delusions of grandeur unlimited power and influence 2 Hallucinations typically auditory d Bipolar Disorder i Cyclothymia 1 2 year duration of numerous alternating periods of hypomanic lowlevel symptoms and depressive symptoms shy of major depressive episodes ii Bipolar Disorder without psychotic features Present mental state can be principally a manic episodequot or mixed episodequot or a major depressive episodequot 2 The point diagnosis is bipolar as long as there has been a past history of mania 3 Specifically if currently depressed with a history of manic episodes the diagnosis becomes bipolar disorder depressedquot iii What is a Manic Episodequot 1 Manic mood episodes show as a distinct period of abnormally and persistently elevated expansive andor irritable mood indicated by 3 or more of the following lnflated self esteem or grandiosity Decreased need for sleep More talkative than usual or pressure to keep talking Flight of ideas or subjective experience that thoughts are racing Distractibility attential too easily drawn to unimportantirrelevant external imuli Increase in goaldirected activity or psychomotor agitation Excessive involvement in pleasurable activities that have a high potential for painful consequences buying sprees sexual indiscretions etc 2 The mood disturbance is sufficiently severe to cause a marked impairment in occupational functioning or in usual social activities or relationships with others or to necessitate hospitalization to prevent harm to self or others or there are psychotic features enmngovw 3 Note this criterion distunguistes hypomanic episodes from manic episodes a In hypomanic episodes there is NOT marked impairmentquot NOR are there EVER psychotic featuresquot b In manic episodes there is ALWAYS marked impairmentquot and sometimes psychotic features Thus the Sx s are more secere and more interfering with adaptive functioning iv Hypomanic Episodes 1 Restless consumed with confidence energized 2 Not as prone to the gloom following mania 3 Can be problems a view is better on the edge but it is easy to lose your balancequot v Mixed Episodes Alternation between mood states within an episode Special case of rapid cyclingquot vi Latiffa Goddess of Wind and Rain NA example 1 Symptoms couldn t sit still restless thoughts delusions of grandeur couldn t sleep at night 2 Diagnosis Bipolar Disorder with Manic Features most genetic based disorder 3 Etiology and treatment medication vii Bipolar l 1 Hx history of manic episodes 2 Hx of depressive episodes for most viii Bipolar ll 1 Hx of hypomanic episodes 2 Hx of major depressive episodes IX Mixed Episode Meets criteria for Manic Episode and Major Depressive Episode nearly every day for at least a one week period x Woman with psychomotor retardation 1 Observations creepy not engaged no motivation slow speech long silences slow information processing physically slowblunted Diagnosis bipolar disorder current disorder depression xi Quote I don t want to live in your slow motion reality xii Specifying psychotic features in bipolar disorder current episode manic 1 Criteria for Manic Episode and Bipolar l disorder 2 Mood Pervasive distinctly elevated expansiveirritable context of immense grandiosity 3 Behavioral indicators grandiosity lack of sleep pressure of speech flight of ideas distractability agitation increased goalsplans excessive risk taking 4 Can include psychosis xiii I m Brilliantquot clip 1 Hovers near the threshold for bipolar disorder manic with psychotic features in the clip he is in and just out of a Manic episode 2 Hint focus on whether the grandiosity is genuinely delusionalpsychotic xiv Unipolarbipolar mood disorders 1 There is wide variability between persons in the course of the disorders 11 What causes mood disorders a Cognitive situational and biological components i Depression is caused bya combination of factors 1 Biological components twin studies show 4x higher rates in MZ twins 2 Medications targeting norephinephrine and serotonin modulate mood suggests role of neurotransmitters b Etiologycausation of mood disorders i DiathesisStress Models Predominate 1 Not doomed by genes but they are important 2 Genetic Predisposition data a Concordance much higher between MZ twins than DZ for unipolar and bipolar twins with bipolar more concordant than unipolar c How do genetic dispositions affect the neurobiology of mood in unipolar and bipolar patients i Unipolar neurotransmitter deficiencies genetically regulated ii Bipolar norepinephrine excess d Conclusion i Genetic dispositions are influential but twin studies show that environment plays a role 30 of occurrences are not genetic in M2 twins ii Genetic dispositions are much more strong influential in Bipolar than Unipolar disorder e In sum i Bipolar disorder has a strong biological base ii MZ concordance gt 70 iii Genetic research suggests polygenic causation iv Kay Jamison champion of combining medication and psychotherapy application of diathesisstress model 12 Seasonal Affective Disorder SADS a Further support for biological basis for depression 13 What about stress a Situational components i Negative reactions of others to depressed persons can produce rejection and isolation in a downward spiralquot ii Social support may buffer and protect vulnerable persons Cognitive components i Expectations of uncontrollability pessimistic cognitive styles Expectationsbeliefs are 0 variables in the SOR social learning model 2 Bandura s selfefficacy low motivation low expectation for controlling pleasure and happiness low effort 3 Treatment goal after expectations through exploring rationality of cognitions and altering behavior to change reinforcement probabilities ii Beck s Cognitive Triadquot focuses on negative and irrational views of self present and future as causes 1 3 distortions in rational processing a Negative view of self b Negative vew of world c Negative view of future iii errors in logicquot magnify depressive negativity iv Seligman s learned helplessness model sees stable and global attributions of no control as causes v People who are pessimistic self blaming thought patterns are more likely to develop to depressive traits more vulnerable vi Research with TempleUW Madison students 1 Pessimism is a risk factor Optimism is a protective factor indicating resilience c Conclusions i Genetic and nongenetic factors are influential predisposing factors ii Stress is an influential triggering factor but who experiences stress is influeved by hassles and cognitive and personality dispositions 14 Typical Approaches to Psychotherapy a Freud s psychoanalysispsychodynamic theories i Anger turned inwards the punishing role of the harsh superego ii Goal insight make the unconscious conscious expand the ego s control iii Hovx 1 Free association analysis of transference and dream analysis b Humanisticexistential approaches i Carl Rogers Abraham Maslow c Behavioral Learning Theory i An insufficiency of contingencies of positive reinforcement SR model ii Goal change behavioral responses to increase reinforcement of nondepressed behavior d CognitiveSocial Learning Theories i Basic idea emotionsmoods are caused by cognitive processes perception thinking cognitive appraisal underlying reasoning processes etc ii Depression and depressive mood episodes result from irrational thinking irrational beliefs and irrational cognitions iii Seligman s ABC Model borrowed from Ellis see below iv Summary 1 For Seligman Beck and Ellis emotional disorders depression in particular result from irrational distortions in the cognitive processing of events Events don t cause depression thinking about them does See ABC s 3 Given the cause AKA cognitive distortion the treatment targets cognitive distortions through disputationreappraisal ABCDE a Adversity belief consequence dispute evaluate again e Eclecticism trend toward timelimited disorder speci c therapy 15 Changing from Pessimism to Optimism a The ABC s Albert Ellis i Adversity what to do when encountering it ii Beliefs thoughts become beliefshabits iii Consequences beliefs cause behaviors results iv Says a musterbatory cognitive style underlies human neurotic suffering ln orderto be happy I must v We make ourselves miserable by thinking disturb ourselves with internal sentences involving many musts should oughts demands and commands b Learn to argue with oneself c Remember if the cost of failure is high optimism may not be the best strategy 16 Biological Therapies are necessary for some disorders a Psychotropic medications affect neurotransmitter processes b Antianxiety drugs affect GABA neurotransmitter c Depression drugs affect serotonin and norepinephrine works 60 of the time i MAO inhibitors inhibit enzymatic deactivation of NE and Seratonin ii Trycyclics inhibit reuptake of norepinephrine iii SSRl s block serotonin reuptake d Antipsychotic drugs affect dopamine 17 Psychotherapy vvithvvithout therapy also matters a Psychotherapy focused on depressive thinking and behavior i hows 60 efficacy in reducing acute symptoms ii Shows far greater ef cacy in reducing relapse than medications alone 18 Electroconvulsive Therapy a Works in severe cases why 19 Effective treatments for depression a SASD responds to phototherapy b Exercise helps depression c ECT is the single most effective treatment for severe depression and it saves lives negative public views notwithstanding 20 Treatment for bipolar disorder a Medication lithium carbonate has unique antimanic properties with 80 positive response in actively manic patients also reduces depressions b Adjunctive psychotherapy for Medication management ii Family and social relationships iii Education iv Problem solving and reality testing c Goodwin and Jamison 1990 pharmacotherapy behavioral family management in bipolar i Relapse within 9 months on meds alone 61 ii Relapse within 9 months on meds therapy 10 d Lithium is most effective for bipolar disorder i Only 20 of bipolar patients who maintain meds relapse ii Lithium stables mood but the mechanisms are unclear and the effect is greater on mania than depression iii Many patients discontinue medication possibly due to the intoxicating pleasurequot of manic states 21 In Sum Most Effective Treatments a Treatments that focus on behavior and cognition are superior for anxiety disorders i For specific phobias the sources of anxiety are better addressed with cognitive behavioral approaches than medication ii Systematic desensitization uses fear hierarchiesquot to help people learn to manage dimensions of fear iii Virtual treatments can reduce fear responses iv SSRl s help social phobia but cognitive and behavioral methods are treatments of choice v Panic disorder treatments often combine medication and GET but relapse is less with CBT vi COD anxiety disorder most effective treatment 1 0CD treatments blend medication and GET with a focus on exposure and response prevention b Many effective treatments for depression ECT for severe i MAO inhibitors tricyclics and SSRl s provide relief to 6070 of depressed persons ii CBT are just as effective and target the irrational thoughts that accompany depression c Lithium most effective for bipolar d Pharmacological treatments are superior for schizophrenia e Common factors enhance treatment 39 Psychotherapy helps and common underlying factors contribute to all psychological approaches Calling therapists 2 Catharsis and confession 22 Schizophrenia a Overview i Disorganized thinking delusionalgrandioseparanoid formation of ideas disturbances in mood absentinappropriate ii Manners that are inexplicable iii Purposeless aimless disorder v Abnormalities in thinkingmovement behavior perception v Global impairment of highest psychological functions v39 Rule of 14s people with symptoms and their results b Both Positive and Negative Symptoms 39 Positives excesses in functioning 1 Delusions completely extremenonaccepted viewsbeliefs that are strongly held a Persecution most common b Reference complex thought process linking abstract concepts thinks TVradio are giving messages c grandeur identity often occur together d Guilt e Control often w persecution stealingplacement of thoughts 2 Hallucinations actual sensory experiences that occur actually feelinghearing the hallucination 3 Loosening of associations thoughts aren t completecoherent ideas are not associated with one another 4 Disorganized and inappropriate behavior person may not be able to maintain cleanlinesseatingyellingscreaming ii Negatives deficits in functioning worse prognosis 1 Real lack of emotional reciprocity emotional connections become hard 2 Isolation withdrawal apathy extreme lack of motivation blunted emotional expression c Disordered thought in 2 forms i Formal Thought Disorder 1 Derailedincoherent speech evident in some subtypes of schizo 2 Word Salad in writingspeech if you were to take a page you wrote cut out each individual word and scramble it you have word salad NOT CONTROLLABLE WITH MEDS ii Disorder of Thought Content Delusions 1 Delusions can be extremely wellorganizedcoherent can be hard to control with meds due to complex belief systems a Can calm the person down or to help them cope with their beliefs however iii Note A usually involves B but B doesn t often entail A d Disordered Mood i Paranoia can lead to unprovoked anger doesn t look like maniadepression ii If mood disturbance is present it usually presents as flat or innapropriate 1 If there is significant depressionmania the diagnosis probably shifts from szhizo toward a Schizoaffective disorder schizo and mood disorders are present mania if the mania gets under control then they become simply schizo b Psychotic mood disorder Note remember Mood Congruent e Subtypes i Paranoid Type 1 Preoccupation with one or more delusions persecutiongrandiose generally or frequent auditory hallucinations 2 None of the following is prevalent a Disorganized speechbehavior b Flatinappropriate effect 3 Sometimes it is hard to tell if they are just delusional takes time to listen ii Disorganized Type A All of the following are prominent a Disorganized SpeechBehavior b Flatinappropriate affect iii Catatonic Type 1 People stop moving possibly nonverbal Essentially lack of movement or echoing of the last spoken word lack of engagement with environment Scared stiffquot theory iv Undifferentiated Type 1 Criteria not met for the other types similar to paranoid but not quite 2 May be delusional but not paranoid may be ordered delusion may hallucinate but not paranoid type hallucinations a 3 Schizo Cases David Crazy dude with the glasses 1 Flat affect No lnnapropriate behavior No Incoherent No Paranoid Yes Hallucinating Not actively 2 Diagnosis Paranoid type Wellorganized delusions ii Ms Leonard 2 Little movement but not catatonically so 1 Looking all around slow with responses indicates auditory hallucinations 3 Diagnosis acute schizophrenic paranoia with hallucinations and delusions believes she is preggo 4 Looks different from David due to blunted emotions and little energy Ms Wilcox 1 Emotionally relatively normal 2 No auditory hallucinations 3 Wellgroomed seems normal until she speaks classic with paranoid type 4 Was well until a strong stressor occurred death of mother also quite common 5 Very suspicious something is out to get her death of mother other bad occurrences are all blamed 6 Stabbed herself thinking it will save others Tormented feelings lead to suicide v R si ual Type 1 No present prominent delusions hallucinations formal thought disorder or catatonic behaviors 2 Continuing evidence of disorder in milderforms 3 Leftover when someone has had a previous schizo episode but some evidence of the disorder exists in mild forms abnormal suspicions in remission with blunted thoughts lack of motivation not presenting themselves normally etc f What causes Schizo i Primarily a brain disorder Link with marijuana and other drugs Possible link more likelyjust brings out existing condition Genetics studies show heritability and polygenic causation Anatomical studies show diverse structural abnormalities ln brain but the abnormalities can exist without having the disorder it is more ommon to occur however Dopamineglial cells may be involved in causation Diminishing dopamine can help lower schizo symptoms ii Etiology Role of Genetic Disposition 1 Not 100 concordance in MZ twins demonstrates that nongenetic environmental factors have a causal force iii Envioronmental Factors influence Schizo weomwwwe 1 Stress is implicated 2 Environmental spread of a schizovirus has been hypothesized a Higher concordance in latesplitting MZ twins 60 compared to earlysplitting MZ twins 1030 supports viral theory iv Etiology Dopamine Dysfunction 1 Mechanism of action of typical antipsychotic medication is as dopamine antagonists 2 These data are part of the support fortheorythat schizo etiology is linked to dopamine excessesdopamine receptor dysfunctions v Schizo in ldentical Twins 1 When twins differ only the one with schizo typically has enlarged fluid filled cranial cavities some nongenetic factor is thus at work vi Study of Adopted children with schizo mothers 1 Psychologically healthy families vs adopted children w families that were disturbed 2 In healthy families none became psychotic 3 ln disturbed families 11 became psychotic 41 had severe psychological disorders 4 Urban stress vii Clip of woman with schizo and her brain viii Etiology structurally disorganized pyramidal neurons on hippocampus 1 One hypothesis suggests that schizo may be caused by a virus that attacks the 39 39 sensory quot 2 Damage to hippocampus would account for schizo patients vulnerability to sensory overload ix Etiology Familycommunication 1 Heated debate whether disturbed family medication is a cause of schizo 2 Schizo mothers create ego dispositions towards schizo in offpring predispositions poorly supported 3 However Expressed Emotionquot EE shows reliable effects on the probability of a discharged schizo patient going through relapse g Pharmacology treatments are superior for schizo i Haloperidol and chlorpromazine revolutionized schizo treatment ii Significant sedativemotor side effects similar to Parkinson s make treatment unpleasant Tardive dyskinesia iv Clozapine v Medication reduces hallucinations and bizarre interpersonal behaviors in most may manage but does not eradicate delusional thoughts h Family therapy for schizo i Family systems approaches recognize that the individual change is contextual so attempt to engage the whole system ii Studies of schizo families show high levels of EE are associated with risk for relapse reducing EE reduces relapse i Social skills training schizo clip 23 Childhood Disorders a ADH D i Disruptive impulse control disorder ii Children w ADHD may be restless impulsive inattentive making it difficult to follow orders and maintain friendships iii In the US 11 of males and 4 of girls have ADHD iv Etiology 1 M2 twin concordance 55 a Genetic environmental factors 2 Research suggests impairment in the connection of frontal lobes and limbic system 3 Current research focuses on frontal lobes and basal ganglia regulation of motor behaviorimpulse control v Across lifespan 1 In past not diagnosed until after children entered school 2 Important to consider developmental appropriateness of schooldaycare for very young children 3 It was thought that children outgrow ADHD a Studies today suggest a continuance into adulthood causing academiccareer difficulties vi Treatment variety of approaches 1 Ritalin targets underactive brains and reduces negative behavior a Side effects lack of longterm efficacy limit utility I Sleep problems reduced appetite body twitches temporary growth suppression b CNS stimulant c Increase in positive behaviors decrease in negative d Risk of abuse children buyingselling stimulants 2 Behavioral treatments though time consuming augment medication and help social skills academics and family relationships 3 Evidence indicates that although stimulants are beneficial short term benefits may not be longterm 4 Medication therapy works better than either alone therapy aids in long term meds in short term b Autism i Characterized by deficits in social interaction impaired communication and restricted interests ii 36 out of 1000 children iii Males outnumber females 31 iv Lack of awareness of others 1 Dramatic increase of 556 from 19911997 a Likely due to greater awareness of symptoms and willingness to apply the diagnosis to a wider spectrum of behaviors Asperger s syndrome a Highfunctioning autism in which children of normal intelligence have specific deficits in social interaction such as having an underdeveloped theory of mind Core symptoms a Early symptoms are often overlooked by caretakers b Severe impairments in both verbalnonverbal communication c Children are very aware of surroundings and may tantrum if changes are made d Play activities are restricted and stereotyped 4 Primarily a biological disorder a MZ concordance 7090 strong genetic factor b Brain growth during first 2 years very fast slows abnormally during adolescence 5 Recent research a Reports that injections of oxytocin dramatically reduced symptoms of autism b Identification of four blood proteins involved in brain development in 97 of tested autistic children but in none of healthy controls c Identification of antibodies in 11 of mothers of autistic children that aren t present in mothers of healthy controls v treatment Developed by lvor Lovaas Based on principles of operant conditioning Min of 40 hours of treatment per week One of the best knownmost effective treatments for autistic children Drawbacks Time commitment Financialemotional drains on family Other children may feel jealousneglected Biological Treatments SSRl s have been tried because P P PP P QPP N Reduce compulsions in OCD patients Autism involves compulsive and repetitive behavior Some evidence indicates abnormal serotonin metabolism in autistic children More recent research focused on oxytocin v Prozac has reduced repetitive motor behavior and self injury and improves social interactions vi Prognosis 1 Long term is poor a Studies indicate that of adults with autism had severe social difficulties and were unable to live and work independently 2 Generalization of skills must be taught explicitly vii Video on behavioral treatment 1 ABA is time intensive but raises IQ by 20 points on average 2 Long term prognosis is poor Without treatment 24 Adolescent depression treatment a Controversial b SSRI Prozac is effective in treating adolescent depression i Comined group had best outcomes CBT alone was similar to Prozac alone 81 for both 86 combined c Fewer than 30 of children with mental health problems receive any kind of treatment Twice as many of those taking SSRl s reported suicidal thinking as those taking a placebo i None of the children or adolescents committed suicide 24 ii All treatment groups experience reduction in suicidal thoughts compared with baseline iii Prescribing drugs wout CBT cost effective but not in the best interest of depressed children e FDA voted in 2004 to require manufacturers to add a warning of depression risks to their labels Vocabulary 1 Psychopathology a disorder of the mind 2 Etiology factors that contribute to the development of a disorder 3 Multiaxial system the system used in the DSM that provides assessment along 5 axis describing important mental health factors 4 Assessment in psychology examination of a person s mental state to diagnose possible psychological disorders 5 Dissociative ldentity Disorder DID the occurrence of 2 or more distinct identities to the same individual Diathesis Stress Model a diagnostic model that proposes that a disorder may develop when an underlying vulnerability is coupled with a precipitating event 7 Family systems model a diagnostic model that considers symptoms within an individual as indicating problems with the family Sociocultural model a diagnostic model that views psychopathology as the result of the interaction between individuals and their cultures 9 CognitiveBehavioral Approach a diagnostic model that views psychopathology as the result of learned maladaptive cognitions 10 Generalized Anxiety Disorder a diffuse state of constant anxiety not associated with any specific objectevent 11 Panic Disorder an anxiety disorder characterized by sudden overwhelming attacks of terror 12 Agoraphobia an anxiety disorder marked by fear of being in situations in which escape may be difficult or impossible 13 OCD an anxiety disorder characterized by frequent intrusive thoughts and compulsive actions 14 Major Depression A disorder characterized by severe negative moods or a lack of interest in normally pleasurable activities 15 Dysthemia a form of depression that is not severe enough to be diagnosed as major depression 16 Bipolar Disorder a mood disorder characterized by alternating periods of depression and mania 17 Learned helplessness model a cognitive model of depression in which people feel unable to control events around them 18 Schizophrenia a mental disorder characterized by alterations in perceptions emotions thoughts or consciousness 19 Positive symptoms symptoms of schizophrenia such as delusions and hallucinations that are excesses in behavior 20 Negative symptoms symptoms of schizophrenia marked by deficits in functioning such as apathy lack of emotion and slowed speechmovement 21 Delusions false personal beliefs based on incorrect inferences about reality 22 Hallucinations false sensory perceptions that are experienced without an external source 23 Loosening of associations a speech pattern among schizophrenic patients in which their thoughts are disorganized or meaningless 24 Disorganized behavior acting in strangeunusual ways indcluding strange movement of limbs bizarre speech and inappropriate selfcare such as failing to dress properlybathe 25 Borderline Personality Disorder A personality disorder characterized by identity affective and compulsive disturbances 26 Antisocial Personality Disorder a personality disorder marked by a lack of empathy and remorse 27 Autism a developmental disorder involving deficits in social interaction impaired communication and restricted interests 28 ADHD a disorder characterized by restless inattentive and impulsive behaviors 29 Psychotherapy a generic name given to formal psychological treatment 30 Biological therapies treatment based on medical approaches to illness and to disease 31 lnsight a goal of some types of therapy a patient s understanding of hisher own psychological processes 32 Clientcentered therapy an empathic approach to therapy encourages personal growth through greater self understanding 33 Cognitive therapy treatment based on the idea that distoreted thoughts produce maladaptive behaviors and emotions 34 Cognitive restructuring a therapy that strives to help patients recognize maladaptive thought patterns and replace them with ways of viewing the world that are more in tune with reality 35 Cognitive Behavioral Therapy CBT a therapy that incorporates techniques from behavioral therapy and cognitive therapy to correct faulty thinking and change maladaptive behaviors 36 Exposure a behavioral therapy technique that involves repeated exposure to an anxietyproducing stimulussituation 37 Expressed emotion EE a pattern of interactions that includes emotional over involvement critical comments and hostility directed toward a patient by family members 38 Psychotropic Medications drugs that affect mental processes 39 Antianxiety drugs a class of psychotropic medications used for the treatment of anxiety 40 Antidepressants a class of psychotropic medications used to treat depression 41 Antipsychotics a class of drugs used to treat schizophrenia and other disorders that involve psychosis 42 Electroconvulsive Therapy ECT a procedure used to treat depression involves administering strong electrical currents to the patient s brian 43 Dialectical Behavior Therapy DBT a form of therapy used to treat borderline personality disorder 44 Applied Behavioral Analysis ABA an intensive treatment for autism based on operant conditioning That information should cover everything there is to know about this test good luck to everyone


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