Abnormal Midterm Review

Question 1

What is abnormal Psychology

Answer 1

The field devoted to the scientific study of abnormal behavior to describe, predict, explain, and change abnormal patterns of functioning

Question 2

Workers in the field may be:

Answer 2

Clinical scientists, Clinical practitioners

Question 3

“The Four Ds”

Answer 3

Deviance, Distress, Dysfunction, Danger

Question 4

Deviance

Answer 4

– Different, extreme, unusual, perhaps even bizarre

Question 5

Distress

Answer 5

– Unpleasant and upsetting to the person

Question 6

Dysfunction

Answer 6

– Interfering with the person’s ability to conduct daily activities in a constructive way

Question 7

Danger

Answer 7

– Posing risk of harm

Question 8

Deviance from what?

Answer 8

From behaviors, thoughts, and emotions that differ markedly from a society’s ideas about proper functioning

Question 9

Social Norms

Answer 9

Explicit and implicit rules for proper conduct

Question 10

exeptions to social norms

Answer 10

Social context, some times some behaviors are okay, while in others it is not okay

Question 11

Danger

Answer 11

being dangerous is the exception rather than the rule

Question 12

Treatment/Therapy

Answer 12

is a procedure designed to change abnormal behavior into more normal behavior

Question 13

Features of therapy

Answer 13

Sufferer, healer, series of contacts

Question 14

Sufferer

Answer 14

A sufferer who seeks relief from the healer

Question 15

Healer

Answer 15

A trained, socially acceptable healer, whose expertise is accepted by the sufferer and his or her social group

Question 16

Series of Contacts

Answer 16

A series of contacts between the healer and the sufferer, through which the healer, often with the aid of a group, tries to produce certain changes in the sufferer’s emotional state, attitudes, and behavior

Question 17

Anceint methods of treatment

Answer 17

The cure for abnormality was to force the demons from the body through trephination and exorcism

Question 18

who changed view on illnesses?

Answer 18

Hippocrates believed and taught that illnesses had natural causes

Question 19

Somatogenic Perspective

Answer 19

Abnormal functioning has physical causes

Question 20

Psychogenic Perspective

Answer 20

Abnormal functioning has psychological causes

Question 21

effects of the psychotrophic drugs

Answer 21

These discoveries led to deinstitutionalization and a rise in outpatient care

Question 22

Clinical researchers face certain challenges that make their investigations particularly difficult:

Answer 22

Measuring unconscious motives
Assessing private thoughts
Monitoring mood changes
Calculating human potential

Question 23

Clinical researchers must consider

Answer 23

the cultural backgrounds, races, and genders of the people they study

Question 24

must always ensure

Answer 24

the rights of their research participants, both human and animal, are not violated

Question 25

Clinical researchers try to

Answer 25

discover laws, or principles, of abnormal psychological functioning

Question 26

nomothetic understanding

Answer 26

General or universal laws or truths

Question 27

scientific method

Answer 27

systematically collect and evaluate information through careful observations

Question 28

Case Study

Answer 28

Provides a detailed, interpretative description of a person’s life and psychological problems
Can be a source of new ideas about behavior
May offer tentative support for a theory
May challenge a theory’s assumptions
May inspire new therapeutic techniques
May offer opportunities to study unusual problems

Question 29

limitations of the Case Study

Answer 29

Reported by biased observers
Relies on subjective evidence
Has low internal validity
Provides little basis for generalization
Has low external validity

Question 30

Correlational Method

Answer 30

the degree to which events or characteristics vary with each other
Measures the strength of a relationship
Does not imply cause and effect

Question 31

Correlational Method and The Experimental Method

Answer 31

Do not offer richness of detail
Do allow researchers to draw broad conclusions
Preferred method of clinical investigation
Typically involve observing many individuals
Researchers apply procedures uniformly
Studies can be replicated
Researchers use statistical tests to analyze results

Question 32

Advantages of the correlational method:

Answer 32

Has high external validity
Can generalize findings
Can repeat (replicate) studies on other samples
Difficulties with correlational studies:
Lack external validity
Results describe but do not explain a relationship

Question 33

Experimental Method

Answer 33

An experiment is a research procedure in which a variable is manipulated and the manipulation’s effect on another variable is observed
Manipulated variable = independent variable
Variable being observed = dependent variable
Causal relationships can only be determined through experiments

Question 34

double-blind design

Answer 34

both experimenters and participants are kept from knowing which condition of the study participants are in
Often used in medication trials

Question 35

models or paradigms

Answer 35

the perspectives used to explain events

Each spells out basic assumptions, gives order to the field under study, and sets guidelines for investigation

Question 36

Models of Abnormality

Answer 36

Biological Model, Psychodynamic Model, Behavioral Model, Cognitive Model, Humanistic Model, Sociocultural Model,

Question 37

Biological Model

Answer 37

Adopts a medical perspective
Main focus is that psychological abnormality is an illness brought about by malfunctioning parts of the organism
Typically focused on the brain

Question 38

Sources of biological abnormalities

Answer 38

genetics

Question 39

inheritance plays a part in

Answer 39

mood disorders, schizophrenia, Alzheimer’s disease, and other mental disorders

Question 40

types of biological treatment

Answer 40

Drug therapy
Electroconvulsive therapy (ECT)
Neurosurgery

Question 41

Neurosurgery

Answer 41

roots in trephination
Much more precise than in the past
Considered experimental and used only in extreme cases

Question 42

Strengths

Answer 42

Enjoys considerable respect in the field
Constantly produces valuable new information
Brings great relief

Question 43

Weaknesses

Answer 43

Can limit, rather than enhance, our understanding
Too simplistic
Evidence is incomplete or inconclusive
Treatments produce significant undesirable (negative) effects

Question 44

Psychodynamic Model

Answer 44

Based on belief that a person’s behavior (whether normal or abnormal) is determined largely by underlying dynamic psychological forces of which she or he is not consciously aware

Question 45

three UNCONSCIOUS forces

Answer 45

Id – guided by the Pleasure Principle
Instinctual needs, drives, and impulses
Sexual; fueled by libido (sexual energy)
Ego – guided by the Reality Principle
Seeks gratification, but guides us to know when we can and cannot express our wishes
Ego defense mechanisms protect us from anxiety
Superego – guided by the Morality Principle
Conscience; unconsciously adopted from our parents

Question 46

Strengths:

Answer 46

First to recognize importance of psychological theories and treatment
Saw psychological conflict as important source of psychological health and abnormality
First to apply theory and techniques systematically to treatment – monumental impact on the field

Question 47

Weaknesses:

Answer 47

Unsupported ideas; difficult to research
Non-observable
Inaccessible to human subject (unconscious)

Question 48

Behavioral Model

Answer 48

Operant conditioning
Modeling
Classical conditioning
All may produce normal or abnormal behavior

Question 49

Modeling

Answer 49

Individuals learn responses by observing and repeating behavior

Question 50

Classical conditioning

Answer 50

Learning by temporal association
When two events repeatedly occur close together in time, they become fused in a person’s mind; before long, the person responds in the same way to both events

Question 51

Behavioral Therapy

Answer 51

Aim to identify the behaviors that are causing problems and replace them with more appropriate ones
May use classical conditioning, operant conditioning, or modeling
Therapist is “teacher” rather than healer

Question 52

Pyschodynamic Therapies

Answer 52

All seek to uncover past trauma and inner conflicts

Therapist acts as a “subtle guide”

Question 53

Classical conditioning treatments

Answer 53

systematic desensitization for phobia

Question 54

Strengths

Answer 54

Powerful force in the field
Can be tested in the laboratory
Significant research support for behavioral therapies

Question 55

Weaknesses

Answer 55

Too simplistic
Behavioral therapy is limited
Downplays role of cognition
New focus on self-efficacy, social cognition, and cognitive-behavioral theories

Question 56

Cognitive Theory

Answer 56

Maladaptive thinking is the cause of maladaptive behavior
Several kinds of faulty thinking:
Faulty assumptions and attitudes
Illogical thinking processes

Question 57

Cognitive Therapies

Answer 57

People can develop a new way of thinking to prevent maladaptive behavior
The goal of therapy is to help clients recognize and restructure their thinking
Therapists also guide clients to challenge their dysfunctional thoughts, try out new interpretations, and apply new ways of thinking in their daily lives
Widely used in treating depression

Question 58

Strengths

Answer 58

Very broad appeal
Clinically useful and effective
Focuses on a uniquely human process
Theories lend themselves to research
Therapies effective in treating several disorders

Question 59

Weaknesses:

Answer 59

Precise role of cognition in abnormality has yet to be determined
Singular, narrow focus
Overemphasis on the present
Limited effectiveness

Question 60

Humanistic Theory

Answer 60

Believes in the basic human need for unconditional positive regard
If present, leads to unconditional self-regard
If not, leads to “conditions of worth”
Incapable of self-actualization because of distortion – do not know what they really need, etc.

Question 61

Humanistic Therapy

Answer 61

“client-centered” therapy
Therapist creates a supportive climate:
Unconditional positive regard
Accurate empathy
Genuineness

Question 62

Strengths:

Answer 62

Taps into domains missing from other theories
Emphasizes the individual
Optimistic
Emphasizes health

Question 63

Weaknesses:

Answer 63

Focuses on abstract issues
Difficult to research
Not much influence
Weakened by disapproval of scientific approach

Question 64

Sociocultural Model Strength

Answer 64

Added greatly to the clinical understanding and treatment of abnormality
Increased awareness of labeling
Clinically successful when other treatments have failed

Question 65

Weaknesses

Answer 65

Research is difficult to interpret
Correlation ? causation
Model unable to predict abnormality in specific individuals

Question 66

biopsychosocial model

Answer 66

Abnormality results from the interaction of genetic, biological, developmental, emotional, behavioral, cognitive, social, and societal influences

Question 67

Diathesis-stress approach

Answer 67

Diathesis = predisposition (bio, psycho, or social)

Question 68

Assessment

Answer 68

collecting relevant information in an effort to reach a conclusion

Question 69

Clinical assessment

Answer 69

used to determine how and why a person is behaving abnormally and how that person may be helped
Also may be used to evaluate treatment progress
Focus is idiographic

Question 70

Characteristics of Assessment Tools

Answer 70

To be useful, assessment tools must be standardized and have clear reliability and validity

Question 71

To standardize

Answer 71

technique is to set up common steps to be followed whenever it is administered
One must standardize administration, scoring, and interpretation

Question 72

Reliability refers to

Answer 72

the consistency of a test
A good test will always yield the same results in the same situation
Two main types:
Test–retest reliability
Interrater reliability

Question 73

Test-retest

Answer 73

– Yields the same results every time it is given to the same people

Question 74

Interrater

Answer 74

– Different judges independently agree on how to score and interpret a particular test

Question 75

Validity refers to

Answer 75

the accuracy of a test’s results

A good test must accurately measure what it is supposed to measure

Question 76

Three Specific Types

Answer 76

Three specific types:
Face validity
Predictive validity
Concurrent validity

Question 77

Face validity

Answer 77

– a test appears to measure what it is supposed to measure; does not necessarily indicate true validity

Question 78

Predictive validity

Answer 78

– a test accurately predicts future characteristics or behavior

Question 79

Concurrent validity

Answer 79

– a test’s results agree with independent measures assessing similar characteristics or behavior

Question 80

Clinical Interviews

Answer 80

Focus depends on theoretical orientation

Can be either unstructured or structured

Question 81

unstructured interviews

Answer 81

clinicians ask open-ended questions

Question 82

structured interviews

Answer 82

clinicians ask prepared questions, often from a published interview schedule

Question 83

Limitations

Answer 83

May lack validity or accuracy
Individuals may be intentionally misleading
Interviewers may be biased or may make mistakes in judgment
Interviews, particularly unstructured ones, may lack reliability

Question 84

Projective tests

Answer 84

Require that clients interpret ambiguous stimuli
Mainly used by psychodynamic practitioners
Most popular:
Rorschach Test
Thematic Apperception Test
Sentence Completion Test
Drawings

Question 85

Projective tests

Strengths and weaknesses

Answer 85

Helpful for providing “supplementary” information
Have rarely demonstrated much reliability or validity
May be biased against minority ethnic groups

Question 86

Personality inventories

Answer 86

Designed to measure broad personality characteristics
Focus on behaviors, beliefs, and feelings
Usually based on self-reported responses
Most widely used: Minnesota Multiphasic Personality Inventory
For adults: MMPI (original) or MMPI-2 (1989 revision)
For adolescents: MMPI-A

Question 87

Personality inventories

Strengths and weaknesses

Answer 87

Easier, cheaper, and faster to administer than projective tests
Objectively scored and standardized
Appear to have greater validity than projective tests
Measured traits often cannot be directly examined – how can we really know the assessment is correct?
Tests fail to allow for cultural differences in responses

Question 88

Response inventories

Strengths and weaknesses

Answer 88

Have strong face validity
Rarely include questions to assess careless or inaccurate responding
Not all have been subjected to careful standardization, reliability, and/or validity procedures (Beck Depression Inventory and a few others are exceptions)

Question 89

Psychophysiological tests

Answer 89

Measure physiological response as an indication of psychological problems
Includes heart rate, blood pressure, body temperature, galvanic skin response, and muscle contraction
Most popular is the polygraph (lie detector)

Question 90

Neurological and neuropsychological tests

Answer 90

Neurological tests directly assess brain function by assessing brain structure and activity
Examples: EEG, PET scans, CAT scans, MRI
Neuropsychological tests indirectly assess brain function by assessing cognitive, perceptual, and motor functioning
Most widely used is Bender Visual-Motor Gestalt Test

Question 91

Intelligence tests

Answer 91

Designed to indirectly measure intellectual ability
Typically comprised of a series of tests assessing both verbal and nonverbal skills
General score is an intelligence quotient (IQ)
Most popular: Wechsler Adult Intelligence Scale (WAIS) and Wechsler Intelligence Scale for Children (WISC)

Question 92

Intelligence Tests

Weaknesses

Answer 92

Performance can be influenced by nonintelligence factors (e.g., motivation, anxiety, test-taking experience)
Tests may contain cultural biases in language or tasks

Question 93

Naturalistic and analog observations

Answer 93

Naturalistic observations occur in everyday environments
Can occur in homes, schools, institutions (hospitals and prisons), and community settings
Most focus on parent–child, sibling–child, or teacher–child interactions
Observations are generally made by “participant observers” and reported to a clinician
If naturalistic observation is impractical, analog observations are used in artificial settings

Question 94

Naturalistic and analog observations

Strengths and weaknesses

Answer 94

Reliability is a concern
Different observers may focus on different aspects of behavior
Validity is a concern
Risk of “overload,” “observer drift,” and observer bias
Client reactivity may also limit reliability
Observations may lack cross-situational validity

Question 95

Multiaxial

Answer 95

Uses 5 axes (branches of information) to develop a full clinical picture
People usually receive a diagnosis on either Axis I or Axis II, but they may receive diagnoses on both

Question 96

two fundamental problems weaken the DSM

Answer 96

Basic assumption that disorders are qualitatively different from normal behavior
Reliance on discrete diagnostic categories

Question 97

What distinguishes fear from anxiety

Answer 97

Fear is a state of immediate alarm in response to a serious, known threat to one’s well-being
Anxiety is a state of alarm in response to a vague sense of threat or danger
Both have the same physiological features – increase in respiration, perspiration, muscle tension, etc.

Question 98

Is the fear/anxiety response adaptive

Answer 98

Yes, when the “fight or flight” response is protective
However, when it is triggered by “inappropriate” situations, or when it is too severe or long-lasting, this response can be disabling
Can lead to the development of anxiety disorders

Question 99

Sociocultural Perspective Anxiety Disorder

Answer 99

According to this theory, GAD is most likely to develop in people faced with social conditions that truly are dangerous
Although poverty and other social pressures may create a climate for GAD, other factors are clearly at work
Most people living in “dangerous” environments do not develop GAD

Question 100

Psychodynamic Perspective Anxiety Disorders

Answer 100

Controlled studies have typically found psychodynamic treatments to be of only modest help to persons with GAD
Short-term psychodynamic therapy may be beneficial in some cases

Question 101

Humanistic Perspective Anxiety Disorders

Answer 101

Theorists propose that GAD, like other psychological disorders, arises when people stop looking at themselves honestly and acceptingly
Lack of “unconditional positive regard” in childhood leads to “conditions of worth” (harsh self-standards)
These threatening self-judgments break through and cause anxiety, setting the stage for GAD to develop
Practitioners using this “client-centered” approach try to show unconditional positive regard for their clients and to empathize with them

Question 102

Cognitive Perspective Anxiety Disorder

Answer 102

suggested that GAD is caused by maladaptive assumptions

Question 103

Albert Ellis identified

Answer 103

basic irrational assumptions:
It is a dire necessity for an adult human being to be loved or approved of by virtually every significant person in his community
It is awful and catastrophic when things are not the way one would very much like them to be
When these assumptions are applied to everyday life and to more and more events, GAD may develop

Question 104

Aaron Beck

Answer 104

GAD constantly hold silent assumptions that imply imminent danger:
A situation/person is unsafe until proven safe
It is always best to assume the worst

Question 105

Metacognitive theory

Answer 105

Developed by Wells; holds that the most problematic assumptions in GAD are the individual’s worry about worrying (meta-worry)

Question 106

Intolerance of uncertainty theory

Answer 106

Certain individuals believe that any possibility of a negative event occurring means that the event is likely to occur

Question 107

Avoidance theory

Answer 107

Developed by Borkovec; holds that worrying serves a “positive” function for those with GAD by reducing unusually high levels of bodily arousal

Question 108

cognitive therapy

Answer 108

Changing Maladaptive Assumptions

Helping clients understand the special role that worrying plays, and changing their views and reactions to it

Question 109

Biological Perspective Anxiety Disorder

Answer 109

GAD is caused by biological factors, but then there is the issue of shared environment

Question 110

GABA inactivity

Answer 110

Benzodiazepine receptors ordinarily receive gamma-aminobutyric acid (GABA, a common neurotransmitter in the brain)
GABA carries inhibitory messages; when received, it causes a neuron to stop firing
In normal fear reactions:
Key neurons fire more rapidly, creating a general state of excitability experienced as fear or anxiety
A feedback system is triggered; brain and body activities that reduce excitability
Some neurons release GABA to inhibit neuron firing, thereby reducing experience of fear or anxiety
Malfunctions in the feedback system are believed to cause GAD
Possible reasons: Too few receptors, ineffective receptors
Benzodiazepine receptors ordinarily receive gamma-aminobutyric acid (GABA, a common neurotransmitter in the brain)

Question 111

How do phobias differ from these “normal” experiences?

Answer 111

More intense and persistent fear
Greater desire to avoid the feared object or situation
Distress that interferes with functioning

Question 112

Social Phobias

Answer 112

Severe, persistent, and unreasonable fears of social or performance situations in which embarrassment may occur
May be narrow -– talking, performing, eating, or writing in public
May be broad – general fear of functioning poorly in front of others
In both cases, people rate themselves as performing less adequately than they actually do
Severe, persistent, and unreasonable fears of social or performance situations in which embarrassment may occur
May be narrow -– talking, performing, eating, or writing in public
May be broad – general fear of functioning poorly in front of others
In both cases, people rate themselves as performing less adequately than they actually do

Question 113

Cuase of Phobias

Answer 113

Phobias develop through conditioning (most widely accepted explanation)
Once fears are acquired, the individuals avoid the dreaded object or situation, permitting the fears to become all the more entrenched
Phobias develop through modeling
Observation and imitation
Phobias are maintained through avoidance
A behavioral-evolutionary explanation
Called “preparedness” because human beings are theoretically more “prepared” to acquire some phobias than others
Model explains why some phobias (snakes, spiders) are more common than others (faces, houses)

Question 114

Treatments for Specific Phobias

Answer 114

Systematic desensitization
Teach relaxation skills
Create fear hierarchy
Pair relaxation with the feared objects or situations
Since relaxation is incompatible with fear, the relaxation response is thought to substitute for the fear response
Other behavioral treatments:
Flooding
Forced nongradual exposure
Modeling
Therapist confronts the feared object while the fearful person observes

Question 115

Treatments for Social Phobias

Answer 115

Overwhelming social fear
Address behaviorally with exposure
Lack of social skills
Social skills and assertiveness trainings have proved helpful
Unlike specific phobias, social phobias are often reduced through medication (particularly antidepressants)
Several types of psychotherapy have proved at least as effective as medication
People treated with psychotherapy are less likely to relapse than people treated with drugs alone
One psychological approach is exposure therapy, either in an individual or group setting
Another treatment option is social skills training, a combination of several behavioral techniques to help people improve their social functioning
Therapist provides feedback and reinforcement

Question 116

Panic Disorder

Answer 116

Panic, an extreme anxiety reaction, can result when a real threat suddenly emerges
The experience of “panic attacks,” however, is different
Panic attacks are periodic, short bouts of panic that occur suddenly, reach a peak, and pass
Sufferers often fear they will die, go crazy, or lose control
Attacks happen in the absence of a real threat

Question 117

Panic Disorder: The Biological Perspective

Answer 117

Neurotransmitter at work is norepinephrine
Irregular in people with panic attacks
Research suggests that panic reactions are related to changes in norepinephrine activity in the locus ceruleus
Research conducted in recent years has examined brain circuits and the amygdala as the more complex root of the problem
It is possible that some people inherit a predisposition to abnormalities in these areas

Question 118

Drug therapies

Answer 118

Antidepressants are effective at preventing or reducing panic attacks
Function at norepinephrine receptors in the panic brain circuit
Bring at least some improvement to 80% of patients with panic disorder
Approximately 50% recover markedly or fully
Improvements require maintenance of drug therapy
Some benzodiazepines (especially Xanax [alprazolam]) have also proved helpful

Question 119

Panic Disorder: The Cognitive Perspective

Answer 119

Misinterpreting bodily sensations
Panic-prone people may be very sensitive to certain bodily sensations and may misinterpret them as signs of a medical catastrophe; this leads to panic
Why might some people be prone to such misinterpretations?
Experience more frequent or intense bodily sensations
Poor coping skills
Lack of social support
Unpredictable childhoods
Overly protective parents

Question 120

Cognitive therapy

Answer 120

May use “biological challenge” procedures to induce panic sensations
Induce physical sensations, which cause feelings of panic:
Jump up and down
Run up a flight of steps
Practice coping strategies and making more accurate interpretations

Question 121

Obsessive-Compulsive Disorder

Answer 121

Made up of two components:
Obsessions
Persistent thoughts, ideas, impulses, or images that seem to invade a person’s consciousness
Compulsions
Repetitive and rigid behaviors or mental acts that people feel they must perform to prevent or reduce anxiety

Question 122

Compulsions

Answer 122

“Voluntary” behaviors or mental acts
Feel mandatory/unstoppable
Most recognize that their behaviors are irrational
Believe, though, that catastrophe will occur if they do not perform the compulsive acts
Performing behaviors reduces anxiety
ONLY FOR A SHORT TIME!
Behaviors often develop into rituals

Question 123

OCD: The Psychodynamic Perspective

Answer 123

The battle between the id and the ego
Three ego defense mechanisms are common:
Isolation: Disown disturbing thoughts
Undoing: Perform acts to “cancel out” thoughts
Reaction formation: Take on lifestyle in contrast to unacceptable impulses
Freud believed that OCD was related to the anal stage of development
Period of intense conflict between id and ego
Not all psychodynamic theorists agree

Question 124

OCD: The Behavioral Perspective

Answer 124

Learning by chance
People happen upon compulsions randomly
In a fearful situation, they happen to perform a particular act (washing hands)
When the threat lifts, they associate the improvement with the random act
After repeated associations, they believe the compulsion is changing the situation
Bringing luck, warding away evil, etc.
The act becomes a key method to avoiding or reducing anxiety

Question 125

Behavioral therapy

Answer 125

Exposure and response prevention (ERP)
Clients are repeatedly exposed to anxiety-provoking stimuli and are told to resist performing the compulsions
Therapists often model the behavior while the client watches
Homework is an important component
Treatment is offered in individual and group settings
Treatment provides significant, long-lasting improvements for most patients
However, as many as 25% fail to improve at all, and the approach is of limited help to those with obsessions but no compulsions

Question 126

OCD: The Cognitive Perspective

Answer 126

Overreacting to unwanted thoughts
To avoid such negative outcomes, they attempt to “neutralize” their thoughts with actions (or other thoughts)
Neutralizing thoughts/actions may include:
Seeking reassurance
Thinking “good” thoughts
Washing
Checking

Question 127

OCD: The Biological Perspective

Answer 127

Two additional lines of research:
Abnormal serotonin activity
Evidence that serotonin-based antidepressants reduce OCD symptoms; recent studies have suggested other neurotransmitters also may play important roles
Abnormal brain structure and functioning
OCD linked to orbitofrontal cortex and caudate nuclei
Frontal cortex and caudate nuclei compose brain circuit that converts sensory information into thoughts and actions
Either area may be too active, letting through troublesome thoughts and actions

Question 128

The state of stress has two components:

Answer 128

Stressor – event that creates demands
Stress response – person’s reactions to the demands
Influenced by how we appraise both the event and our capacity to react to the event effectively
People who sense that they have the ability and resources to cope are more likely to take stressors in stride and respond constructively

Question 129

Autonomic nervous system (ANS)

Answer 129

An extensive network of nerve fibers that connect the central nervous system (the brain and spinal cord) to all other organs of the body

Question 130

Endocrine system

Answer 130

A network of glands throughout the body that release hormones

Question 131

hypothalamus

Answer 131

The features of arousal and fear are set in motion by it

Question 132

The Fight-or-Flight Response

Answer 132

When we face a dangerous situation, the hypothalamus first excites the sympathetic nervous system, which stimulates key organs either directly or indirectly
When the perceived danger passes, the parasympathetic nervous system helps return body processes to normal
The second pathway is the hypothalamic-pituitary-adrenal (HPA) pathway
When confronted by stressors, the hypothalamus signals the pituitary gland, which stimulates the adrenal cortex to release corticosteroids – stress hormones – into the bloodstream

Question 133

trait anxiety

Answer 133

Some people are usually somewhat tense; others are usually relaxed
Differences appear soon after birth

Question 134

state anxiety

Answer 134

Situation-based (example: fear of flying)

Their sense of which situations are threatening

Question 135

Psychological Stress Disorders

Answer 135

During and immediately after trauma, we may temporarily experience levels of arousal, anxiety, and depression
For some, symptoms persist well after the trauma
These people may be suffering from:
Acute stress disorder
Posttraumatic stress disorder (PTSD)
The event usually involves actual or threatened serious injury to self or others
The situations that cause these disorders would be traumatic to anyone (unlike other anxiety disorders)

Question 136

Victimization and stress disorders

Answer 136

People who have been abused or victimized often experience lingering stress symptoms
Research suggests that more than 1/3 of all victims of physical or sexual assault develop PTSD
A common form of victimization is sexual assault/rape
Around 1 in 6 women is raped at some time during her life
Psychological impact is immediate and may be long-lasting
One study found that 94% of rape survivors developed an acute stress disorder within 12 days after assault

Question 137

Why Do People Develop a Psychological Stress Disorder

Answer 137

extraordinary trauma can cause a stress disorder
However, the event alone may not be the entire explanation
To understand the development of these disorders, researchers have looked to the:
Survivors’ biological processes
Personalities
Childhood experiences
Social support systems/cultural backgrounds
Severity of the traumas

Question 138

Biological and genetic factors

Answer 138

Traumatic events trigger physical changes in the brain and body that may lead to severe stress reactions and, in some cases, to stress disorders
Some research suggests abnormal neurotransmitter and hormone activity (especially norepinephrine and cortisol)
Evidence suggests that other biological changes and damage may also occur (especially in the hippocampus and amygdala) as a stress disorder sets in
There may be a biological/genetic predisposition to such reactions

Question 139

General goals of Treatment

Answer 139

End lingering stress reactions
Gain perspective on traumatic experiences
Return to constructive living

Question 140

Treatment of Psychological Stress Disorders

Answer 140

Drug therapy
Antianxiety and antidepressant medications are most common
Behavioral exposure techniques
Reduce specific symptoms, increase overall adjustment
Use flooding and relaxation training
Use eye movement desensitization and reprocessing (EMDR)
Insight therapy
Bring out deep-seated feelings, create acceptance, lessen guilt
Often use family or group therapy formats; rap groups
Usually used in combinations

Question 141

Ulcers

Answer 141

Lesions in the wall of the stomach that result in burning sensations or pain, vomiting, and stomach bleeding
Experienced by 20 million people at some point in their lives
Causal psychosocial factors:
Environmental pressure, anger, anxiety, dependent personality style
Causal physiological factors:
Bacterial infection

Question 142

Asthma

Answer 142

A narrowing of the body’s airways that makes breathing difficult
Affects up to 20 million people in the U.S. each year
Most victims are children at the time of first attack
Causal psychosocial factors:
Environmental pressures, troubled family relationships, anxiety, high dependency
Causal physiological factors:
Allergies, a slow-acting sympathetic nervous system, weakened respiratory system

Question 143

Insomnia

Answer 143

Difficulty falling asleep or maintaining sleep
Affects 35% of people in the U.S. each year
Causal psychosocial factors:
High levels of anxiety or depression
Causal physiological factors:
Overactive arousal system, certain medical ailments

Question 144

Chronic headaches

Answer 144

Frequent intense aches of the head or neck that are not caused by another physical disorder
Tension headaches affect 40 million Americans each year
Migraine headaches affect 23 million Americans each year
Causal psychosocial factors:
Environmental pressures; general feelings of helplessness, anger, anxiety, depression
Causal physiological factors:
Abnormal serotonin activity, vascular problems, muscle weakness

Question 145

Hypertension

Answer 145

Chronic high blood pressure, usually producing no outward symptoms
Affects 65 million Americans each year
Causal psychosocial factors:
Constant stress, environmental danger, general feelings of anger or depression
Causal physiological factors:
10% caused by physiological factors alone
Obesity, smoking, poor kidney function, high proportion of collagen (rather than elastic) tissue in an individual’s blood vessels

Question 146

Coronary heart disease

Answer 146

Caused by blockage in the coronary arteries
Includes angina pectoris (chest pain), coronary occlusion (complete blockage of a coronary artery), and myocardial infarction (heart attack)
Leading cause of death in men older than 35 years and women older than 40 years in the U.S.
Causal psychosocial factors:
Job stress, high levels of anger or depression
Causal physiological factors:
High level of cholesterol, obesity, hypertension, the effects of smoking, lack of exercise

Question 147

Psychoneuroimmunology

Answer 147

Researchers now believe that stress can interfere with the activity of lymphocytes, slowing them down and increasing a person’s susceptibility to viral and bacterial infections
Several factors influence whether stress will result in a slowdown of the system, including biochemical activity, behavioral changes, personality style, and degree of social support

Question 148

Somatoform disorders

Answer 148

problems that appear to be medical but are due to psychosocial factors

Question 149

Dissociative disorders

Answer 149

patterns of memory loss and identity change that are caused almost entirely by psychosocial factors rather than physical ones

Question 150

somatoform and dissociative disorders have much in common:

Answer 150

Both may occur in response to severe stress
Both have traditionally been viewed as forms of escape from stress
A number of individuals suffer from both a somatoform and a dissociative disorder
Theorists and clinicians often explain and treat the two groups of disorders in similar ways

Question 151

Somatoform Disorders

Answer 151

People with a somatoform disorder do not consciously want, or purposely produce, their symptoms
They believe their problems are genuinely medical

There are two main types of somatoform disorders:
Hysterical somatoform disorders
Preoccupation somatoform disorders

Question 152

Hysterical Somatoform Disorders

Answer 152

People with hysterical somatoform disorders suffer actual changes in their physical functioning
These disorders are often hard to distinguish from genuine medical problems
It is always possible that a diagnosis of hysterical disorder is a mistake and that the patient’s problem has an undetected organic cause

Question 153

Conversion disorder

Answer 153

In this disorder, a psychosocial conflict or need is converted into dramatic physical symptoms that affect voluntary or sensory functioning
Symptoms often seem neurological, such as paralysis, blindness, or loss of feeling
Most conversion disorders begin between late childhood and young adulthood
They are diagnosed in women twice as often as in men
They usually appear suddenly and are thought to be rare

Question 154

Somatization disorder

Answer 154

People with somatization disorder have many long-lasting physical ailments that have little or no organic basis
Also known as Briquet’s syndrome
To receive a diagnosis, a patient must have a range of ailments, including several pain symptoms, gastrointestinal symptoms, a sexual symptom, and a neurological symptom
Patients usually go from doctor to doctor in search of relief
This disorder lasts much longer than a conversion disorder, typically for many years
Symptoms may fluctuate over time but rarely disappear completely without psychotherapy

Question 155

Pain disorder associated with psychological factors

Answer 155

Patients may receive this diagnosis when psychosocial factors play a central role in the onset, severity, or continuation of pain
Although the precise prevalence has not been determined, it appears to be fairly common
The disorder often develops after an accident or illness that has caused genuine pain
The disorder may begin at any age, and more women than men seem to experience it

Question 156

Hysterical vs. medical symptoms

Answer 156

It can be difficult to distinguish hysterical disorders from “true” medical conditions
Studies across the world suggest that as many as one-fifth of all patients who seek medical care may actually suffer from somatoform disorders
Physicians sometimes rely on oddities in the patient’s medical picture to help distinguish the two
For example, hysterical symptoms may be at odds with the known functioning of the nervous system, as in cases of glove anesthesia

Question 157

Hysterical vs. factitious symptoms

Answer 157

Hysterical somatoform disorders are different from patterns in which individuals are purposefully producing or faking medical symptoms
Patients may be malingering—intentionally faking illness to achieve external gain (e.g., financial compensation, military deferment)
Patients may be manifesting a factitious disorder—intentionally producing or faking symptoms simply out of a wish to be a patient

Question 158

Factitious Disorder

Answer 158

Munchausen syndrome is the extreme and chronic form of factitious disorder
In Munchausen syndrome by proxy, a related disorder, parents make up or produce physical illnesses in their children

Question 159

Preoccupation Somatoform Disorders

Answer 159

Preoccupation somatoform disorders include hypochondriasis and body dysmorphic disorder
People with these problems misinterpret and overreact to bodily symptoms or features
Although these disorders also cause great distress, their impact on one’s life differs from that of hysterical disorders

Question 160

Hypochondriasis

Answer 160

People with hypochondriasis unrealistically interpret bodily symptoms as signs of serious illness
Often their symptoms are merely normal bodily changes, such as occasional coughing, sores, or sweating
Although some patients recognize that their concerns are excessive, many do not

Question 161

Body dysmorphic disorder (BDD)

Answer 161

People with this disorder, also known as dysmorphophobia, become deeply concerned over some imagined or minor defect in their appearance
Most often they focus on wrinkles, spots, facial hair, swelling, or misshapen facial features (nose, jaw, or eyebrows)
Most cases of the disorder begin in adolescence but are often not revealed until adulthood
Up to 5% of people in the U.S. experience BDD, and it appears to be equally common among women and men

Question 162

Causes Somatoform Disorders

The psychodynamic view

Answer 162

Today’s psychodynamic theorists take issue with Freud’s explanation of the Electra conflict
They continue to believe that sufferers of these disorders have unconscious conflicts carried from childhood

Question 163

Causes Somatoform Disorders

The psychodynamic view

Answer 163

Psychodynamic theorists propose that two mechanisms are at work in the hysterical disorders:
Primary gain: hysterical symptoms keep internal conflicts out of conscious awareness
Secondary gain: hysterical symptoms further enable people to avoid unpleasant activities or receive sympathy from others

Question 164

Causes Somatoform Disorders

The behavioral view

Answer 164

Behavioral theorists propose that the physical symptoms of hysterical disorders bring rewards to sufferers
May remove individual from an unpleasant situation
May bring attention from other people
In response to such rewards, people learn to display symptoms more and more
This focus on rewards is similar to the psychodynamic idea of secondary gain, but behaviorists view the gains as the primary cause of the development of the disorder

Question 165

Causes Somatoform Disorders

The cognitive view

Answer 165

Some cognitive theorists propose that hysterical disorders are a form of communication, providing a means for people to express difficult emotions
Like psychodynamic theorists, cognitive theorists hold that emotions are being converted into physical symptoms
This conversion is not to defend against anxiety but to communicate extreme feelings

Question 166

Causes Somatoform Disorders

A possible role for biology

Answer 166

The impact of biological processes on somatoform disorders can be understood through research on placebos and the placebo effect
Placebo: substances with no known medicinal value
Treatment with placebos has been shown to bring improvement to many—possibly through the power of suggestion or through the release of endogenous chemicals
Perhaps traumatic events and related concerns or needs can also trigger our “inner pharmacies” and set in motion the bodily symptoms of hysterical somatoform disorders

Question 167

How Are Somatoform Disorders Treated

Answer 167

People with somatoform disorders usually seek psychotherapy only as a last resort
Individuals with preoccupation disorders typically receive the kinds of treatments applied to anxiety disorders, particularly OCD:
Antidepressant medication
Exposure and response prevention (ERP)

Question 168

Treatments for hysterical disorders

Answer 168

often focus on the cause of the disorder and apply the same kind of techniques used in cases of PTSD, particularly:
Insight – often psychodynamically oriented
Exposure – client thinks about traumatic event(s) that triggered the physical symptoms
Drug therapy – especially antidepressant medication
Other therapists try to address the physical symptoms of the hysterical disorders, applying techniques such as:
Suggestion – usually an offering of emotional support that may include hypnosis
Reinforcement – a behavioral attempt to change reward structures
Confrontation – an overt attempt to force patients out of the sick role
Researchers have not fully evaluated the effects of these particular approaches on hysterical disorders

Question 169

Dissociative Disorders

Answer 169

When such changes in memory lack a clear physical cause, they are called “dissociative” disorders
In such disorders, one part of the person’s memory typically seems to be dissociated, or separated, from the rest
Keep in mind that dissociative symptoms are often found in cases of acute or posttraumatic stress disorders
When such symptoms occur as part of a stress disorder, they do not necessarily indicate a dissociative disorder (a pattern in which dissociative symptoms dominate)
On the other hand, research suggests that people with one of these disorders also develop the other as well

Question 170

Dissociative amnesia may be:

Answer 170

Localized (circumscribed)—most common type; loss of all memory of events occurring within a limited period
Selective—loss of memory for some, but not all, events occurring within a period
Generalized—loss of memory beginning with an event, but extending back in time; may lose sense of identity; may fail to recognize family and friends
Continuous—forgetting of both old and new information and events; quite rare in cases of dissociative amnesia
All forms of the disorder are similar in that the amnesia interferes primarily with episodic memory (one’s autobiographical memory of personal material)
Semantic memory—memory for abstract or encyclopedic information—usually remains intact
Clinicians do not known how common dissociative amnesia is, but many cases seem to begin during times of serious threat to health and safety

Question 171

Dissociative Fugue

Answer 171

People with dissociative fugue not only forget their personal identities and details of their past lives but also flee to an entirely different location
For some, the fugue is brief—a matter of hours or days—and ends suddenly
For others, the fugue is more severe: people may travel far from home, take a new name and establish new relationships, and even a new line of work; some display new personality characteristics

Question 172

Dissociative Identity Disorder (Multiple Personality Disorder)

Answer 172

At any given time, one of the subpersonalities dominates the person’s functioning
Usually one of these subpersonalities—called the primary, or host, personality—appears more often than the others
The transition from one subpersonality to the next (“switching”) is usually sudden and may be dramatic
Most cases are first diagnosed in late adolescence or early adulthood
Symptoms generally begin in childhood after episodes of abuse
Typical onset is before age 5
Women receive the diagnosis three times as often as men

Question 173

How do subpersonalities interact?

Answer 173

The relationship between or among subpersonalities varies from case to case
Generally there are three kinds of relationships:
Mutually amnesic relationships—subpersonalities have no awareness of one another
Mutually cognizant patterns—each subpersonality is well aware of the rest
One-way amnesic relationships—most common pattern; some personalities are aware of others, but the awareness is not mutual
Those who are aware (“co-conscious subpersonalities”) are “quiet observers”

Question 174

How do subpersonalities differ?

Answer 174

Subpersonalities often display dramatically different characteristics, including:
Vital statistics
Subpersonalities may differ in features as basic as age, sex, race, and family history

Abilities and preferences
Although encyclopedic knowledge is not usually affected by dissociative amnesia or fugue, in DID it is often disturbed
It is not uncommon for different subpersonalities to have different abilities, including being able to drive, speak a foreign language, or play an instrument

Question 175

How do subpersonalities differ?

Answer 175

Subpersonalities often display dramatically different characteristics, including:
Physiological responses
Researchers have discovered that subpersonalities may have physiological differences, such as differences in autonomic nervous system activity, blood pressure levels, and allergies

Question 176

How common is DID?

Answer 176

The number of people diagnosed with the disorder has been increasing
Although the disorder is still uncommon, thousands of cases have been documented in the U.S. and Canada alone
Two factors may account for this increase:
A growing number of clinicians believe that the disorder does exist and are willing to diagnose it
Diagnostic procedures have become more accurate
Despite changes, many clinicians continue to question the legitimacy of the category

Question 177

Explain Dissociative Disorders

The psychodynamic view

Answer 177

Psychodynamic theorists believe that dissociative disorders are caused by repression, the most basic ego defense mechanism
People fight off anxiety by unconsciously preventing painful memories, thoughts, or impulses from reaching awareness

Question 178

Explain Dissociative Disorders

The behavioral view

Answer 178

Behaviorists believe that dissociation grows from normal memory processes and is a response learned through operant conditioning:
Momentary forgetting of trauma leads to a drop in anxiety, which increases the likelihood of future forgetting
Like psychodynamic theorists, behaviorists see dissociation as escape behavior
Also like psychodynamic theorists, behaviorists rely largely on case histories to support their view of dissociative disorders
While the case histories support this model, they are also consistent with other explanations…

Question 179

Explain Dissociative Disorders

State-dependent learning

Answer 179

If people learn something when they are in a particular state of mind, they are likely to remember it best when they are in the same condition
This link between state and recall is called state-dependent learning
This model has been demonstrated with substances and mood and may be linked to arousal levels
It has been theorized that people who are prone to develop dissociative disorders have state-to-memory links that are unusually rigid and narrow; each thought, memory, and skill is tied exclusively to a particular state of arousal, so that they recall a given event only when they experience an arousal state almost identical to the state in which the memory was first acquired

Question 180

How Are Dissociative Disorders Treated

Answer 180

People with dissociative amnesia and fugue often recover on their own
Only sometimes do their memory problems linger and require treatment
In contrast, people with DID usually require treatment to regain their lost memories and develop an integrated personality
Treatment for dissociative amnesia and fugue tends to be more successful than treatment for DID

Question 181

How do therapists help individuals with DID?

Answer 181

Therapists usually try to help the client by:
Recognizing the disorder
Once a diagnosis of DID has been made, therapists try to bond with the primary personality and with each of the subpersonalities
As bonds are forged, therapists try to educate the patients and help them recognize the nature of the disorder
Some use hypnosis or video as a means of presenting other subpersonalities
Many therapists recommend group therapy
Therapists usually try to help the client by:
Recovering memories
To help patients recover missing memories, therapists use many of the approaches applied in other dissociative disorders, including psychodynamic therapy, hypnotherapy, and drug treatment
These techniques tend to work slowly in cases of DID
Integrating the subpersonalities
The final goal of therapy is to merge the different subpersonalities into a single, integrated entity
Integration is a continuous process; fusion is the final merging
Many patients distrust this final treatment goal and many subpersonalities see integration as a form of death
Once the subpersonalities are integrated, further therapy is typically needed to maintain the complete personality and to teach social and coping skills to prevent later dissociations

Question 182

Depersonalization Disorder

Answer 182

The central symptom is persistent and recurrent episodes of depersonalization, which is a change in one’s experience of the self in which one’s mental functioning or body feels unreal or foreign
People with depersonalization disorder feel as though they have become separated from their body and are observing themselves from outside
This sense of unreality can extend to other sensory experiences and behavior
Depersonalization is often accompanied by derealization—the feeling that the external world, too, is unreal and strange
The disorder occurs most frequently in adolescents and young adults, hardly ever in people older than 40
The disorder comes on suddenly and tends to be long-lasting
Relatively few theories have been offered to explain depersonalization disorder and little research has been conducted on the problem

Question 183

Mood Disorders

Answer 183

Most people with a mood disorder experience only depression
This pattern is called unipolar depression
Person is no history of mania
Mood returns to normal when depression lifts
Others experience periods of mania that alternate with periods of depression
This pattern is called bipolar disorder

Question 184

How Common Is Unipolar Depression

Answer 184

Women are at least twice as likely as men to experience severe unipolar depression
Lifetime prevalence: 26% of women vs. 12% of men
Among children, the prevalence is similar among boys and girls

These rates hold true across socioeconomic classes and ethnic groups
Approximately 50% recover within six weeks and 90% within a year, some without treatment
Most will experience another episode at some point

Question 185

Diagnosing Unipolar Depression

Answer 185

Marked by five or more symptoms lasting two or more weeks
In extreme cases, symptoms are psychotic, including
Hallucinations
Delusions
Criteria 2: No history of mania

Question 186

Major depressive disorder

Answer 186

Criteria 1 and 2 are met
Dysthymic disorder
Symptoms are “mild but chronic”
Depression is longer lasting but less disabling
Consistent symptoms for at least two years
When dysthymic disorder leads to major depressive disorder, the sequence is called “double depression”

Question 187

What Causes Unipolar Depression

Answer 187

Stress may be a trigger for depression
People with depression experience a greater number of stressful life events during the month just before the onset of their symptoms
Some clinicians distinguish reactive (exogenous) depression from endogenous depression, which seems to be a response to internal factors
Today’s clinicians usually concentrate on recognizing both the situational and the internal aspects of any given case

Question 188

What Causes Unipolar Depression? The Biological View: Genetic factors

Answer 188

Family pedigree, twin, adoption, and molecular biology gene studies suggest that some people inherit a biological predisposition
Researchers have found that as many as 20% of relatives of those with depression are themselves depressed, compared with fewer than 10% of the general population
Twin studies demonstrate a strong genetic component:
Concordance rates for identical (MZ) twins = 46%
Concordance rates for fraternal (DZ) twins = 20%
Adoption studies also have implicated a genetic factor in cases of severe unipolar depression
Using techniques from the field of molecular biology, researchers have found evidence that unipolar depression may be tied to specific genes

Question 189

What Causes Unipolar Depression? The Biological View

Biochemical factors

Answer 189

NTs: serotonin and norepinephrine
In the 1950s, medications for high blood pressure were found to cause depression
Some lowered serotonin, others lowered norepinephrine
The discovery of truly effective antidepressant medications, which relieved depression by increasing either serotonin or norepinephrine, confirmed the NT role
Depression likely involves not just serotonin nor norepinephrine… a complex interaction is at work, and other NTs may be involved

Question 190

What Causes Unipolar Depression? The Biological View
Biochemical factors
Endocrine system / hormone release

Answer 190

People with depression have been found to have abnormal levels of cortisol
Released by the adrenal glands during times of stress
People with depression have been found to have abnormal melatonin secretion
“Dracula hormone”
Other researchers are investigating whether deficiencies of important proteins within neurons are tied to depression

Question 191

What Causes Unipolar Depression? The Biological View
Biochemical factors
Model has produced much enthusiasm but has certain limitations

Answer 191

Relies on analogue studies: depression-like symptoms created in lab animals
Do these symptoms correlate with human emotions?
Measuring brain activity has been difficult and indirect
Current studies using modern technology are attempting to address this issue

Question 192

What Causes Unipolar Depression? The Psychological Views

Psychodynamic view

Answer 192

Link between depression and grief
When a loved one dies, an unconscious process begins and the mourner regresses to the oral stage and experiences introjection – a merging of his/her own identity with that of the lost person
For most people, introjection is temporary
If grief is severe and long-lasting, depression results
Those with oral stage issues (unmet or excessively met needs) are at greater risk for developing depression
Some people experience “symbolic” (or imagined) loss
Newer psychoanalysts (object relations theorists) propose that depression results when people’s relationships leave them feeling unsafe and insecure

Question 193

What Causes Unipolar Depression? The Psychological Views

Behavioral view

Answer 193

Depression results from changes in rewards and punishments people receive in their lives
Lewinsohn suggests that the positive rewards in life dwindle for some people, leading them to perform fewer and fewer constructive behaviors, and they spiral toward depression
Research supports the relationship between the number of rewards received and the presence or absence of depression
Social rewards are especially important

Question 194

What Causes Unipolar Depression? The Psychological Views

Cognitive views

Answer 194

Negative thinking
Beck theorizes four interrelated cognitive components combine to produce unipolar depression:
Maladaptive attitudes
Self-defeating attitudes are developed during childhood
Beck suggests that upsetting situations later in life can trigger an extended round of negative thinking
This negative thinking typically takes three forms, called the cognitive triad:
Individuals repeatedly interpret (1) their experiences, (2) themselves, and (3) their futures in negative ways, leading to depression
Depressed people also make errors in their thinking, including:
Arbitrary inferences
Minimization of the positive and magnification of the negative
Depressed people experience automatic thoughts

Question 195

Learned helplessness

Answer 195

There has been significant research support for this model
Human subjects who undergo helplessness training score higher on depression scales and demonstrate passivity in laboratory trials
Animal subjects lose interest in sex and social activities
In rats, uncontrollable negative events result in lower serotonin and norepinephrine levels in the brain
Recent versions of the theory focus on attributions
Internal attributions that are global and stable lead to greater feelings of helplessness and possibly depression
Example: “It’s all my fault” [internal]. “I ruin everything I touch” [global] “and I always will” [stable].
If people make other kinds of attributions, this reaction is unlikely
Example: “She had a role in this also” [external], “the way I’ve behaved the past couple weeks blew this relationship” [specific]. “I don’t know what got into me – I don’t usually act like that” [unstable].

Question 196

What Causes Unipolar Depression? The Sociocultural View

The Multicultural Perspective

Answer 196

Two kinds of relationships have captured the interest of multicultural theorists:
Gender and depression
A strong link exists between gender and depression
Women cross-culturally are twice as likely as men to receive a diagnosis of unipolar depression
Women also appear to be younger, have more frequent and longer-lasting bouts, and to respond less successfully to treatment

Question 197

artifact theory

Answer 197

The artifact theory holds that women and men are equally prone to depression, but that clinicians often fail to detect depression in men

Question 198

hormone explanation

Answer 198

The hormone explanation holds that hormone changes trigger depression in many women

Question 199

life stress theory

Answer 199

The life stress theory suggests that women in our society experience more stress than men

Question 200

body dissatisfaction theory

Answer 200

The body dissatisfaction theory state that females in Western society are taught, almost from birth, to seek a low body weight and slender body shape – goals that are unreasonable, unhealthy, and often unattainable

Question 201

lack-of-control theory

Answer 201

The lack-of-control theory picks up the learned helplessness research and argues that women may be more prone to depression because they feel less control than men over their lives

Question 202

self-blame explanation

Answer 202

The self-blame explanation holds that women are more likely than men to blame their failures on lack of ability and to attribute their successes to luck – an attribution style that has been linked depression

Question 203

rumination theory

Answer 203

The rumination theory holds that people who ruminate when sad – keep focusing on their feelings and repeatedly consider the causes and consequences of their depression – are more likely to become depressed and stay depressed longer

Question 204

Bipolar Disorders

Answer 204

People with a bipolar disorder experience both the lows of depression and the highs of mania
Many describe their lives as an emotional roller coaster

Question 205

Five main areas of functioning may be affected:

Answer 205

3. Behavioral symptoms
   Very active – move quickly; talk loudly or rapidly
   Flamboyance is not uncommon
   Cognitive symptoms
   Show poor judgment or planning
   Especially prone to poor (or no) planning
   Physical symptoms
   High energy level – often in the presence of little or no rest

Question 206

What Causes Bipolar Disorders?

Answer 206

Neurotransmitters
This apparent contradiction is addressed by the “permissive theory” about mood disorders:
Low serotonin may “open the door” to a mood disorder and permit norepinephrine activity to define the particular form the disorder will take:
Low serotonin + Low norepinephrine = Depression
Low serotonin + High norepinephrine = Mania

Question 207

Low serotonin + High norepinephrine =

Answer 207

Low serotonin + Low norepinephrine = Depression

Question 208

Low serotonin + Low norepinephrine =

Answer 208

Low serotonin + High norepinephrine = Mania

Question 209

Treatments for Unipolar Depression

Answer 209

Approximately one-third of people with unipolar depression (major depressive or dysthymic disorder) enter treatment in a given year
In addition, many other people in therapy experience depressed feelings as part of another disorder – thus, much of the therapy being administered today is for unipolar depression

Question 210

Treatments for Unipolar Depression: Psychological Approaches

Psychodynamic therapy

Answer 210

Believing that unipolar depression results from unconscious grief over real or imagined losses, compounded by excessive dependence on other people, psychodynamic therapists seek to bring these issues into consciousness and work through them
Psychodynamic therapists use the same basic procedures for all psychological disorders:
Free association
Therapist interpretation
Review of past events and feelings
Despite successful case reports, researchers have found that long-term psychodynamic therapy is only occasionally helpful in cases of unipolar depression
Two features may be particularly limiting:
Depressed clients may be too passive or weary to fully participate in clinical discussions
Depressed clients may become discouraged and end treatment too early when treatment is unable to provide quick relief
Short-term approaches have performed better than traditional approaches

Question 211

Treatments for Unipolar Depression: Psychological Approaches

Behavioral therapy

Answer 211

Lewinsohn, whose theory tied a person’s mood to his/her life rewards, developed a behavioral therapy for unipolar depression in the 1970s:
Reintroduce clients to pleasurable activities and events, often using a weekly schedule
Appropriately reinforce their depressive and nondepressive behaviors
Use a contingency management approach
Help them improve their social skills

Question 212

Treatments for Unipolar Depression: Psychological Approaches

Cognitive therapy

Answer 212

Beck’s cognitive therapy – which includes a number of behavior techniques — is designed to help clients recognize and change their negative cognitive processes
This approach follows four phases and usually lasts fewer than 20 sessions
Phases:
Increasing activities and elevating mood
Challenging automatic thoughts
Identifying negative thinking and biases
Changing primary attitudes
Over the past three decades, hundreds of studies have shown that cognitive therapy helps unipolar depression
Around 50%–60% of clients show a near-total elimination of symptoms
It is worth noting that a growing number of today’s cognitive-behavior therapists disagree with Beck’s proposition that individuals must fully disregard negative cognitions
This treatment has also been used in a group therapy format

Question 213

Electroconvulsive therapy (ECT)

Answer 213

The discovery of the effectiveness of ECT was accidental and based on a fallacious link between psychosis and epilepsy
The procedure has been modified in recent years to reduce some of the negative effects
For example, patients are given muscle relaxants and anesthetics before and during the procedure
Patients generally report some memory loss
ECT is clearly effective in treating unipolar depression
Studies find improvement in 60%–70% of patients
The procedure seems particularly effective in cases of severe depression with delusions, but it has been difficult to determine why ECT works so well
Although effective, the use of ECT has declined since the 1950s because of the memory loss caused by the procedure, the frightening nature of the procedure, and the emergence of effective antidepressant drugs

Question 214

Antidepressant drugs: MAO inhibitors

Answer 214

Originally used to treat TB, doctors noticed that the medication seemed to make patients happier
The drug works biochemically by slowing down the body’s production of MAO
MAO breaks down norepinephrine
MAO inhibitors stop this breakdown from occurring
This leads to a rise in norepinephrine activity and a reduction in depressive symptoms
About half of patients who take these drugs are helped by them

Question 215

Antidepressant drugs: Tricyclics

Answer 215

Hundreds of studies have found that depressed patients taking tricyclics have improved much more than similar patients taking placebos
Drugs must be taken for at least 10 days before such improvement is seen
About 60%–65% of patients find symptom improvement
Most patients who immediately stop taking tricyclics upon relief of symptoms relapse within one year
Patients who take tricyclics for five additional months (“continuation therapy”) have a significantly decreased risk of relapse
Patients who take antidepressant drugs for three or more years after initial improvement (“maintenance therapy”) may reduce the risk of relapse even more
Tricyclics are believed to reduce depression by affecting neurotransmitter (NT) reuptake mechanisms
To prevent an NT from remaining in the synapse too long, a pump-like mechanism recaptures the NT and draws it back into the presynaptic neuron
The reuptake process appears to be too effective in some people, drawing in too much of the NT from the synapse
This reduction in NT activity in the synapse is thought to result in clinical depression
Tricyclics block the reuptake process, thus increasing NT activity in the synapse

Question 216

Second-generation antidepressant drugs

Answer 216

A third group of effective antidepressant drugs is structurally different from the MAO inhibitors and tricyclics
Most of the drugs in this group are labeled selective serotonin reuptake inhibitors (SSRIs)
These drugs act only on serotonin (no other NTs are affected)
This class includes fluoxetine (Prozac) and sertraline (Zoloft)
Selective norepinephrine reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors are also now available
The effectiveness and speed of action of these drugs is on par with the tricyclics, yet their sales have skyrocketed
Clinicians often prefer these drugs because it is harder to overdose on them than on other kinds of antidepressants
There are no dietary restrictions like there are with MAO inhibitorss
They have fewer side effects than the tricyclics
These drugs may cause some undesired effects of their own, including a reduction in sex drive

Question 217

Treatments for Unipolar Depression: Biological Approaches

Brain stimulation

Answer 217

As one third or more of people with unipolar depression are not helped by any of the treatments discussed previously, clinical investigators continue to search for alternative approaches, including:
Vagus nerve stimulation
Transcranial magnetic stimulation
Deep brain stimulation

Question 218

Treatments for Bipolar Disorder: Lithium and Other Mood Stabilizers

Answer 218

The use of lithium (a metallic element occurring as mineral salt) and other mood stabilizers has dramatically changed this picture
Lithium is extraordinarily effective in treating bipolar disorders and mania
Determining correct dosage for a given patient is a delicate process
Too low = no effect
Too high = lithium intoxication (poisoning)
All manner of research has attested to the effectiveness of lithium and other mood stabilizers in treating manic episodes
More than 60% of patients with mania improve on these medications
Most individuals experience fewer new episodes while on the drug
Findings suggest that the mood stabilizers are also prophylactic drugs, ones that actually help prevent symptoms from developing
Mood stabilizers also help those with bipolar disorder overcome their depressive episodes to a lesser degree
Researchers do not fully understand how mood stabilizing drugs operate
They suspect that the drugs change synaptic activity in neurons, but in a different way from that of antidepressant drugs
Although antidepressant drugs affect a neuron’s initial reception on NTs, mood stabilizers seem to affect a neuron’s second messengers
Another theory is that mood stabilizers correct bipolar functioning by directly changing sodium and potassium ion activity in neurons

Question 219

Treatments for Bipolar Disorder: Adjunctive Psychotherapy

Answer 219

Psychotherapy alone is rarely helpful for persons with bipolar disorder
Mood stabilizing drugs alone are also not always sufficient
30% or more of patients don’t respond, may not receive the correct dose, and/or may relapse while taking it
As a result, clinicians often use psychotherapy to as an adjunct to lithium (or other medication-based) therapy
Therapy focuses on medication management, social skills, and relationship issues
Few controlled studies have tested the effectiveness of such adjunctive therapy
Growing research suggests that it helps reduce hospitalization, improves social functioning, and increases clients’ ability to obtain and hold a job

Question 220

How Do the Treatments for Unipolar Depression Compare?

Answer 220

Findings from a number of research studies suggest that:
Cognitive, cognitive-behavioral, interpersonal, and biological therapies are all highly effective treatments for mild to severe unipolar depression
Although cognitive, cognitive-behavioral, and interpersonal therapies may lower the likelihood of relapse, they are hardly relapse-proof
Findings from a number of research studies suggest that:
These various trends do not always carry over to the treatment of depressed children and adolescents
Among biological treatments, antidepressant drugs and ECT appear to be equally effective for reducing depression, although ECT seems to act more quickly
In addition, the newly developed brain stimulation treatments seem helpful for some severely depressed individuals who have been repeatedly unresponsive to drug therapy, ECT, or psychotherapy

Question 221

Which of the following is an analogue study?

Answer 221

Studying the effects of stress in nonhumans

Question 222

external validity refers to the extent to which the results of a study

Answer 222

apply to the subjects and situations other than the ones studied

Question 223

the following experiment is conducted to study the causes of aggression in children. Holf the children eat a sugared cereal; the remaining half eat cornflakes. The number of aggressive acts displayed by the children in one-hour play period after breakfast is then recorded. In this experiment:

Answer 223

The type of ceral is the independent variable, and the number of aggressive responses is the dependent variable

Question 224

The ability to generalize results from a study of certain individuals to other individuals not studied is called:

Answer 224

external validity

Question 225

Imagine that a longitudinal study found tat children raised by schizophrenics are more likely to commit crimes later. This resuslts tells us that:

Answer 225

Children of schziphrenics are at higher risk for criminal behavior

Question 226

Describing the number of cases of mental retardation in the children of older mothers in 2005 would be a legitimate goal for a(n) _______ study:

Answer 226

Epidemiological

Question 227

Various obstacles interfere with the study of abnormal psychology. All of the follwing are examples except:

Answer 227

Most clinicians oppose the scientific study of their discipline

Question 228

Dr. Time required half of a group of health volunteers to study a passage for 1 hour. The other half of the participants studied for 15 minutes. Dr. Time then administered a test of their memory of details from the passage. What was the dependent variable?

Answer 228

The results of the memory test

Question 229

There were ten new cases of schizophrenia in a small town in the Midwest this week. This observation refers to the _______ of schizophrenia in this small population.

Answer 229

incidence

Question 230

Experiments are consistent with the _____ aproach.

Answer 230

nomothetic

Question 231

Which of the following research pairs are most logically similar?

Answer 231

natural experiment and quasi-experiment

Question 232

Which of the following is not true about the obstacles that clinical scientists face in studying pschological disorders?

Answer 232

humans have unusually stable (unchanging) moods and behavior

Question 233

The major advantage of a correlational study over a case study is that it:

Answer 233

has better external validity

Question 234

Case studies are useful for

Answer 234

studying unusual problems

Question 235

In a multiple-baseline design involving the treatment of two problem behaviors, when the first behavior is treated (but not the second), what does one expect to happen to the second behavior?

Answer 235

it should stay the same

Question 236

what is the term for studies that have the strucutre of expeirments except that they use groups that already exist, instead of reandomly assigning participants to control and experimental groups?

Answer 236

quasi-experiments

Question 237

Which of the following types of research is most likely to involve nonhuman participants?

Answer 237

analogue experiment

Question 238

A researcher randomly divides young women suffering from anorexia into two groups. Participants in Group A receive psychotherapy and drug treatments; participants in Group B receive attention (but no therapy) and a “sugar pill.” The researcher then compares participants in the two groups on relief of anorexia symptoms.

Answer 238

experiment

Question 239

Using generally accepted standards, what is the change that a statistically significant result is due to chance?

Answer 239

5 percent

Question 240

Internal validity reflects how well a study:

Answer 240

Rules out the effects of all causes excpet those being studied

Question 241

The form of correlational research that seeks to find how many new cases of a disorder occur in a group in a given time period is termed:

Answer 241

epidemiological (incidence)

Question 242

Challenges faced by clinical reserachers include all of the follwing expect:

Answer 242

there are very few graduate students trained in clinical research

Question 243

The finding that women have higher rates of anxeity and depression than men in the United States is most likely due to _______ research.

Answer 243

Epidemiological

Question 244

Which of the following is the best example of the nomothethic approach?

Answer 244

Review of records to see if Autism runs in families in the United States

Question 245

If an epidemiological study shows that eating disorders are more common in Western countries than in Eastern ones, we can appropriately ocnclude:

Answer 245

nothing about the cause of such a finding

Question 246

A case study differs from a single-subject experiment because single-subject experiments involve:

Answer 246

observation of a subject before and after independent variable manipulation

Question 247

The number of new cases of a disorder in the population that emerge in a particular time interval is called the

Answer 247

incidence

Question 248

in order to justify experiments with animals, reserachers must:

Answer 248

balance the suffering of the animals with the knowledge to be gained

Question 249

the incidence of HIV+ results on campus tells you:

Answer 249

the number of new HIV+ cases measured in a time period

Question 250

The prevalence of sexual dysfunction in older men seen at a clinica tells you the:

Answer 250

total number of older men with sexual dysfunction at the clinic

Question 251

Which of the following correlations is momst likely to be statistically significant?

Answer 251

(-).80 based on a sample of 100 people

Question 252

If you were to graph the relationship between the number of negative life events experienced in the last month and that person’s perception of stress, you would prabably find a(n):

Answer 252

upward-sloping line (to the right).

Question 253

The idea that children from a single-parent families show more depression than those from two-parent families is a(n):

Answer 253

hypothesis

Question 254

In correlational research, external validity is established when:

Answer 254

the smaple is representative of the larger population

Question 255

All of the follwing are merits of the correlational method except:

Answer 255

provides individual information

Question 256

When more than one research method produces similar results, we:

Answer 256

can have more confidence in the results

Question 257

A reseracher reandomly divides young women suffering form anorexia into two groups. Participants in Group A receive psychotherapy and drug treatments; participatns in Group B receive attention (but no therpay) and a “sugar pill”. The researcher then compares participatns in the two groups on relief of anorexia symptoms.

Answer 257

placebo study

Question 258

if you were a schizophrenic living in the first half of the twentieth century and had a mother who was thought to be schizophrenogenic, she would have been seen as:

Answer 258

cold and domineering

Question 259

Imagine that there is a statistically significant result foun in an experimntal research project. The most appropriate conclusion would be that:

Answer 259

differences in the dependent variable are likely due to the independent variable

Question 260

A psychologist does a study of an individual invovling a hsitory, tests, and interviews of associates. A clear picture is constructed of this individual so that the bahavior is better understood. This study is a(n)

Answer 260

case study

Question 261

experimenters are generally willing to:

Answer 261

subject animals to more discomfort than humans

Question 262

Which of the following is a limitation of the case study?

Answer 262

it does not result in a high external validity

Question 263

If researchers studied Vietnam veterans for 30 years after their return, the study would be:

Answer 263

longitudinal

Question 264

Imagine that you are doing an ABAB reversal design study in which you are measuring level of depression with and without the addition of an exercise program. What is the first “A” in the study?

Answer 264

no exercise

Question 265

Which of the following is an example of an idiographic approach to knowledge?

Answer 265

a clinical evaltuion of an individual

Question 266

Freud’s study of Little Hans involved:

Answer 266

letters sent to Freud by Hans’ father

Question 267

In an experiment on the effects of two new drugs on mood, neither the patients, researchers, nor those who are evaluating mood know which drug the patients are getting. The study is a ______ blind.

Answer 267

triple

Question 268

Research shows that the result of lobotomies was:

Answer 268

irreversible brain damage and withdrawal.

Question 269

Which of the following is the best way for clinicians to come to an understanding of abnormal behaivor?

Answer 269

to rely on findings that have been supported by multiple research methods

Question 270

A researcher is interested in the effects of a new drug for testing anxeity nd decided to study it in rats by conditioning the fear of a high-pitched noise and then testing rats’ reactions with and without the drug. This is an example of a(n):

Answer 270

analogue experiment

Question 271

A response inventory that asks individuals to provide detailed information about their typical thoughts and assumptions is a(n):

Answer 271

cognitive inventory

Question 272

Racine has recently broken up with her boyfriend and at the same time lost her job. Which axis of DSM-IV-TR would these factors be included undr?

Answer 272

Axis IV

Question 273

The intial problem in stuying the effectiveness of psychotherapy is:

Answer 273

defining what it means for a treatment to be successful

Question 274

Which of the following tests is likely to have the lowest reliability?

Answer 274

the draw-a-person Test

Question 275

A high school bully constantly ignores other’s rights, and appears not even to realize that others do have rights. A likely DSM-IV-TR partial diagnosis for this bully would be:

Answer 275

antisocial personality disorder on AXIS II

Question 276

Clinical interviews are the preferred assessment technique of many practitioners. One particular strength of the interview process is:

Answer 276

the chance to get a general sense of the client

Question 277

Deciding that a client’s psychological problems reperesent a particualr disorder is called

Answer 277

diagnosis

Question 278

the assessment instrument most likely to be used to detect brai nabnormalities is the:

Answer 278

neuropsychological test

Question 279

If a clinician wanted to know more detailed information about a person’s functioning is a specific area, the clinician would use:

Answer 279

a response inventory

Question 280

Of the following, who is most at risk for misinterpreting a cultural response as pathology?

Answer 280

a dominant-culture assessor

Question 281

How does an MRI make a picutre of the brain?

Answer 281

It relies on the magnetic properties of the atoms in the cells scanned

Question 282

Dr. Ross and Dr. Carman agree that Suzette if suffering from posttraumatic stress disorder. Their judgement is said to have:

Answer 282

reliability

Question 283

When a person has organic brain impairment, that person would most likely have difficulty completing:

Answer 283

the Bender-Gestalt test

Question 284

The most legtimate criticism of intelligence tests concerns their:

Answer 284

cultural fairness

Question 285

Which of the following would be most likely to have been in therapy at some pint in their lives?

Answer 285

women with a postgraduate education

Question 286

A campus newspaper publishes an “exam anxiety” test, which was put together by the newspaper staff one evening just before their publishing deadline. Despidte its hasty construction, the test most likely has:

Answer 286

face validity

Question 287

Compared to projective tests, personality inventories generally have:

Answer 287

greater reliability and greater validity

Question 288

Studies of diagnostic conclusions made by clinicians show that:

Answer 288

they pay too much attention to some information and too little to other information

Question 289

if a person responds to a TAT card by relating to the main character and applying his or her own concerns, the person is said to be identifying with the:

Answer 289

hero

Question 290

Youssef is the kind of person who breaks laws and rules with no feeling of guilt and is emotionally shallow. He would probably score high on the MMPI-2 scale called:

Answer 290

psychopathic deviate

Question 291

One of the assumptions of a functional analysis is that:

Answer 291

abnormal behaviors are learned

Question 292

Which category of clinical tests tends to have the best standardization, reliability, and validity?

Answer 292

intelligence tests

Question 293

Which of the follwing is a reson to question the validity of clinical interviews?

Answer 293

clinicians might overemphasize pathology

Question 294

A test is constructed to identify people who will develop schizophrenia. Of the 100 people the test identifies, 93 show signs of schizophrenia within five years. The test may be said to have high:

Answer 294

predictive validity

Question 295

If your friend had her brain waves recorded in order to measure electical activity, she most likely had a(n):

Answer 295

EEG

Question 296

The technique that uses X-rays of the brain taken at different angles to create a static picture f the strucutre of the brain is called:

Answer 296

computerized axial tomography

Question 297

The controversy among clinicians concerning suicide sites on the internet pits ______ against ________

Answer 297

risk to patients; freedom of speech

Question 298

The knowledge that the person a clinician is about to interview has already been diagnosed as haiving an anxiety dsorder could lead to:

Answer 298

observer bias

Question 299

What kind of validity is most important to clinicnas in ealuating the utility of a classfication system?

Answer 299

predictive validity

Question 300

The major focus of a clinical practitioner when dealing with a new client is to gather what type of infomration?

Answer 300

idiographic

Question 301

Georgeis consumed with concern that his house will burn down. Before he leaves, he makes sure that all his applicances are unplugged. He often has to go back home and check to make he did not leave any plugged in. Which MMPI-2 scale would he most likely score high on?

Answer 301

psychasthenia

Question 302

Which of the following tests is a personality inventory?

Answer 302

MMPI-2

Question 303

If a graph shows the years of the twentieth century along the horizontal axis, and confidence in assessment of abnormality–from low to confidence to high confidence–going up the vertical axis, then confidence in assessment of abnormality over the past 50 years would be a(n):

Answer 303

“U”-shaped function–high then low then high

Question 304

A patient complains of a phobia. Two lines of questioning y the clinician concern the specific object of the phobia and what the person does when he or she confronts that object. This clinicna’s orientation is probably:

Answer 304

behavioral

Question 305

A cluster of symptoms that go together and define a mental disorder is called a:

Answer 305

syndrome

Question 306

a clinicnan has developed a new assessment tool. Clients write stories about their problems, then two different judges independently evaluate the stories in terms of how lgically they are written. For this assessment technique to be useful, there must be:

Answer 306

high interrate raliability

Question 307

A clinician intervier says, in part, “How do you feel about yourself today? How do you feel about what’s going on in your life?” Most likely, that clinical interviewr’s orientation is:

Answer 307

humanistic

Question 308

Which of the following is an inaccurate belief that many clinicians appear to have?

Answer 308

Clinicians using their own logic are more accurate than statistical analyses

Question 309

While someone is watching. Jennifer actually eats fewwer sweets than usual. This tendency to decreas a behavior while being observed is an exampole of:

Answer 309

reactivity

Question 310

If a enw test for anxeity is normed on individuals who are waiting to take introdcutory psychlogy final exams, the new test is surely lacking:

Answer 310

adequate standardization

Question 311

A panel of psychologists and psychiatrists evaluates the test results and clinical interviews of a client in a sanity hearing. They all arrive at the same diagnosis. The panel has high:

Answer 311

interrater reliability

Question 312

An adult frequenly displays symptoms of depression at home, but seldom does so at work. In this case, clinical observations of this person at home would lack:

Answer 312

external validity

Question 313

Which of the following is designed to disclose a patient’s thoughts and assumptions?

Answer 313

cognitive inventory

Question 314

The most effective treatment for phobias is

Answer 314

behavioral therapy

Question 315

Patients recieveing therapy for a pscyhological problem, on average, experience imporvement greater than _____ of peole with similar problems who do not receive treatment.

Answer 315

75%

Question 316

If you received the diagnoses of both social phobias and agorophobia, your diagnoses would be:

Answer 316

comorbid

Question 317

The singlem ost effective treatment for schizophrenia is

Answer 317

drug therapy

Question 318

Dr. Martin has just asked a potential clinet to talk about herself. After she responsds, the doctor’s next question is based on some interesting point she brought up. There are few constraints on the conversation. Dr. Martin has just:

Answer 318

conducted an unstrucutred interview

Question 319

Imagine that you are asked to give a scientific opinion on the use of polygraphic evidence. Your best resopnse would be

Answer 319

although they are widely used, they are not particularly valid

Question 320

A clinician has developed a test that requried test takes to tell sotreis about a seirs of pictures of city skilying. Most likely, this new test is a:

Answer 320

Projective test

Question 321

All of the following are considered traditional psychophysiological disorder except

Answer 321

cancer

Question 322

Some people are stimulated by exciting, potentially dangerous activities that terrify others. These varying reaction represented differnces in:

Answer 322

State anxiety

Question 323

At the outset of a(n) _______, fear of losing control leads to hyperventilation leads to a fear of suffocation, fear of suffocation leads to a feeling that the stiatuion is very dangerous and that the person is losing control.

Answer 323

Panic Attack

Question 324

If you wanted a drug to improve the functioning of GABA, you would choose:

Answer 324

A benzodiazepine

Question 325

The effect of norepinephrine and corticosteroids on a body experiencing stress is:

Answer 325

initially to stimulate the immune system, then to inhibit it

Question 326

Exposure and resonse prevention as treatment for obsessive-compulsive disorder:

Answer 326

does not work as well for those who have obsessions but no compulsions

Question 327

Which of the following would you not find on the Social Readjustment Rating Scale?

Answer 327

exercise

Question 328

Surveys show that in the U.S., the typical female victim of rape

Answer 328

is not tested for HIV, and has long term health problems

Question 329

All of the following are biological treatments for generalized anxiety except:

Answer 329

rational emotive therapy

Question 330

Of the following, the most serious limitation of the Social Readjustment Rating Scare is that it:

Answer 330

Deos not take into account the stresses of diverse populations

Question 331

A person with posttraumatic stress disorder who is having flashbacks is:

Answer 331

reexperiencing the traumatic event

Question 332

The organ most releated to controlling emotional memories and “turning off” the bod’s arousal is the

Answer 332

hippocampus

Question 333

A flash flood hits a smal appalachian community. Those providing critical incident stress debriefing intervention would

Answer 333

provide short-term counseling services

Question 334

Which of the following statemtns best describes the raltionship between biology and stress?

Answer 334

Arousal generated by trauma leads to stress disorders, which may produce more brain changes

Question 335

Cognitive researchers have found that lives full of anxiety most often are associated with:

Answer 335

unpredictable negative eents

Question 336

Which phase of the general adaptation syndrome is assumed to invovle activation of the sympathetic nervous system?

Answer 336

alarm

Question 337

which of the following is an example of a narrow social phobia?

Answer 337

fear of public speakiing

Question 338

Jethro hates his mother-in-law and can’t seem to stop imagining her lying in apool of blood, in pieces. These thoughts are interfering with his daily life. He is exhibiting:

Answer 338

obsessive images

Question 339

What type of drug is alprazolam (Xanax)

Answer 339

benzodiazepine

Question 340

Which of the follwing convinces researchers that panic disorder is biologically different from generalized anxity disorder?

Answer 340

differencces in the brain circuitry in the two disorder

Question 341

College studetns who are so anxious that they can’t functioni unless their clothes are arranged by color and type in their closts are xperiencing a(n):

Answer 341

obsessive-compulsive disorder

Question 342

Imagine that researchers investigating panic disorder gave you a drug that caused you to hyperventilate and your heart to beat rapidly. You would have been given a(n):

Answer 342

biological challenge test

Question 343

The part of the body that releases hormones into the bloodstream is the ______ system.

Answer 343

endocrine

Question 344

Mindfulness-based cognitive therapy

Answer 344

Receives support in therapy application for wide range of disorders, including generazlied anxeity disorder

Question 345

If someone were to correlate scores on the Social Readjustment Rating Scale with the number of phsycial (health) complaints, one would most likely find:

Answer 345

a significant positive correlation

Question 346

A returning combat veteran with a stress disorder would most likely be in ________ to help change dysfunctional attitudes and styles of interpreation that resulted from the trauma

Answer 346

cognitive therapy

Question 347

When was acute stress disorder as a result of combat (called “shell sock”) first recognized?

Answer 347

after World War I

Question 348

At what point is distress the greatest after a rape?

Answer 348

withink one month after the assault

Question 349

Apparently, people develop phobias more readily to such objects as spiders and the dark than they do to such objects as computers and radios. This observation supports the idea of:

Answer 349

Preparedness

Question 350

According Freud, obsessive-compulsive disorders have their origin in the ____ stage of development.

Answer 350

Anal

Question 351

Rene Descartes’s mind-body dualism is

Answer 351

inconsistent with modern views of the relatinship between the mind and bodily illnesses

Question 352

Research using the Social Adjustment Rating Scale indicates that:

Answer 352

The greater the life stress, the greater the illness

Question 353

For a typical U.S. soldier serving in Iraw or Afghanistan, which one of the following would most characterize that soldier’s vulnerability to a stress disorder?

Answer 353

The soldier would have about a 50/50 chance of having seen a budy killed or seriously wounded

Question 354

Which of the following statements most accurately reflects what we know from recent studies?

Answer 354

phobias usually are a result of classcial conditioning

Question 355

one who is experiencing a panic disorder would most likely also be phobic about:

Answer 355

leaving home

Question 356

If you have a high level of C-reactive protein, we know that:

Answer 356

you are at greater risk for heart disease, stoke, and other illness.

Question 357

Please flex your biceps. Now release your biceps. Now flex your thigh. Now release it.” These statements might be made by a therapist using:

Answer 357

muscle relaxation therapy

Question 358

Which of the follwing relfects the most common obsessive thought?

Answer 358

if I touch that doorknob, I will be dirty and contaminated

Question 359

A person who is restless, keyed up, and on edge for no apparent reason is experiencing:

Answer 359

free-floating anxiety

Question 360

The relationship between income and rate of generalized anxiety disorder is:

Answer 360

negative–the higher the income, the lower the rate of generalized anxiety disorder

Question 361

Combat veterans in a therapy group express a great deal of guilt and rage. Most likely, the vetrans are in a:

Answer 361

rap group

Question 362

Posttraumatic stress disorders:

Answer 362

last longer than a month

Question 363

Jan s very fearful of speaing in pblic and will do evertyhing she can to avoid that behavior. If her fear is judged to be phobic, the most accurate diagnosis would be:

Answer 363

narrow social phobia

Question 364

Maxine started worrying about cleanliness when her first child was born. That worry has intensified and she cannot stop thinking athat germs lurk everywhere . She is exhibiting a(n):

Answer 364

obsessive idea

Question 365

Helping survivors talk about their feelings and fears regarding a disaster is designed to:

Answer 365

Help people express anxiety, anger, and frustration

Question 366

A friend asks you whether to try relaxation training or biofeedback to reduce anxiety. Based upon present research, your best answer is:

Answer 366

Try either one; they’re both modestly effective.

Question 367

Which of the following therapies is an effective long-term, nonpharmocological treatment for panic attack that involves teaching patients to interpret their physical sensations accurately?

Answer 367

cognitive

Question 368

A professor who becomes anxious unless students sit in alphabetical order, turn in their papers in alphabetical order, nadl eave tests in the same order is experiencing a(n):

Answer 368

obsessive-compulsive disorder

Question 369

A person who witnessed a horrible accident and then ebcame unusually anxious and depressed for 3 weeks is probably experiencing:

Answer 369

acute stress disorder

Question 370

Alberto has been workign 18 hours a day trying to keep his business afloat. He has high blood pressure, an ulcer, and has just been takne to the hospital with the chest pains. He is in Selye’s stage of:

Answer 370

exhaustion

Question 371

Which of the following is true about research on the effectivenss of cognitive therapy for treating unipolar depresion?

Answer 371

Hundreds of studies show its effectiveness

Question 372

A woman who is in conflict with her husband over whether she should have a career or stay at home fulltime to care for their children is experiencing

Answer 372

interpersonal role dispute

Question 373

Recent research indicates that behaviroal therapy is the treatment of choice:

Answer 373

over placebo tretament

Question 374

Clients who tend to see everything that occurs as either all right or all wrong, with nothing in between, needd to focus on wich phase of Beck’s treatment for depression?

Answer 374

identifying negative thinking and biases

Question 375

Which phase of the genral adaptation syndrome is assumed to invovle activation of the parasympathetic nervous system?

Answer 375

resistance

Question 376

Apparently tricylclics work by:

Answer 376

blocking the reuptake of norepinephrine and serotinin

Question 377

The use of ECT was prompted by the discovery that psychotic people:

Answer 377

rarely had epilepsy

Question 378

People who talk rapidly, dress flamboyanlty, and get involved in dangerous activities are showing _____ symptoms of mania.

Answer 378

behavioral

Question 379

Increasing pleasant activitis is most likely to be a part of a _______ therapy program.

Answer 379

behavioral

Question 380

Which of the following medication/side effect pairings is correct?

Answer 380

MAO inhibitors cuasing diatery restrictions

Question 381

Which theoretical orientation would support the finding that there is a significant relationshi between positive life events and feelings of life satisfaction and happiness?

Answer 381

behavioral

Question 382

arron’s persistent feelings of sadness and impeding doom dominate his life. Every time he says anything even a little positivee to his therapist, the therapist smiles. Otherweise the therapist has a stone face. This therapist is probably using some variation of:

Answer 382

behavioral therapy

Question 383

Electroconvulsive therapy

Answer 383

appears to be msot effective in treating unipolar depression

Question 384

Which of the following is not an example of a biological treatment for depression?

Answer 384

contignency management

Question 385

A person who becomes depressed because of several recent tragic events would be experiencing depression

Answer 385

exogenous

Question 386

Which of the following is true about unipolar depression?

Answer 386

most people recover from depression, but experience a recurrence

Question 387

Although iniitally thought to be due to an excessive amount of a particular neurotransmitter, mania has been found to be due to low levels of which neurotransmitter?

Answer 387

serotoniin

Question 388

Mnay of today’s cognitive-behavioral therapists would agree that

Answer 388

negative cognitions should be accepted, not necessarily eliminated

Question 389

Researchers have found that the sleep cycle in depressed people is

Answer 389

reversed

Question 390

Biochemical explanation for bipolar disorder center on all of the following except

Answer 390

hormonal functioniong

Question 391

Which of the following would a psychodynamic therapist be most likely to say about studied regarding the effectiveness of psychodynamic therapy for depression?

Answer 391

the therapy des not lend itself to empirical research

Question 392

The most common form of mood disorder is

Answer 392

uniponlar depression

Question 393

A key to preventing relapse of unipolar depression appears to be:

Answer 393

continue the therapy, no matter its type, after the sympotoms have gone

Question 394

Which theoretical orientation would support the finding that Western experience more psychological symptoms of depression?

Answer 394

sociocultural

Question 395

All of the following are types of major depressie disorder expet:

Answer 395

posttraumatic

Question 396

Which of the following are people most likely to do to improve their mood?

Answer 396

talk to friens/ family

Question 397

People experiencing mani:

Answer 397

want excitement and comopanionship

Question 398

Dna is depressed and has been for a while. He, his twin brother, his mother, nad his father all participate in a fmily pedigree Study. Identify the proband(s) in his study.

Answer 398

Dana

Question 399

Researchers were searching for drugs to treat schizophrenia when they came across imipramine, which aleviated the symptoms of depression, although it was not effective against schizophrenia. It became the first of a class of drugs, all sharing a similar molecular structure, called:

Answer 399

tricyclics

Question 400

Assume a researcher develops something called the “Sick Neuron” theory which proposes that the “poor health” of neurons leads to unipolar depression. Based upon research, the substance most likely to be imipolicated in the theory as making neurons “sick” is:

Answer 400

Brain-derived neurotrophic factor (BDNF)

Question 401

The chief differnce betwee nlearned helplessness created in laboratory settings and real-life depression is that:

Answer 401

laboratory depression is more likely to be accompanied by anxiety

Question 402

The clinician who would be most likely to say, “Tell me about how your parents cared for and protect you” is a:

Answer 402

Psychodynamic clinician

Question 403

The hormone most closely associated with the noset of seasona affective disorder is

Answer 403

melatonin

Question 404

The experience of a lack of desire to engage in sexual activity with one’s sopuse would be considered a(n) ______ symptom of depression

Answer 404

motivational

Question 405

in general, object relations theorist follow which theoretical perspective?

Answer 405

psychodynamic

Question 406

after a couple has divorced, you learn that one of them is suffering form depression. Most likely:

Answer 406

a troubled marriage led to the depression

Question 407

If biochemical ibmabalce were the cuase of a person’s depression, the latest research would lead us to expect that person to have:

Answer 407

an abnormality in the activity of certain neurotransmitters, especially serotinin nad neorepinephrin

Question 408

the person associated with developing a cognitive theory of depression basedo n negative and maladaptive thinking was:

Answer 408

BECK

Question 409

Clients who test their assummtpin about what is cuasing their depression are working in which phases of Beck’s treatment program?

Answer 409

changing primary attitudes

Question 410

Seasonal affective disorder is thought to be due to

Answer 410

increased levels of melatonin

Question 411

If your therapist concentrated on helping you recognize and change negavite thoughts and thus improve your mood, yor therapist would be using

Answer 411

cognitive therapy

Question 412

Therapists who treat African American clints for depression need to be aware that their clients are

Answer 412

less likely to receive newer second-gerneation drugs

Question 413

Judtih is currently experiencing a period of sadness that interferes with her ability to go to work and to take care of her children. It has lasted now for three weeks, and hse has experienced similar episodes in the past. What type of major depression would she most likely be diagnosed with?

Answer 413

recurrent

Question 414

A person experiencing unpoilar depression writes the following in an activity schedule, “go to store; doctor’s appointment; visit museum; read novel; clean room.” What treatment approach is this perosn most likely recieiving?

Answer 414

cognitive therapy

Question 415

The treatments that are most likely to work in the broadest of cases of depression are

Answer 415

cognitive, interpersonal, and biological

Question 416

A baby who was seperated from its mother at brith, and who subsequently became withdrawn, sad, and tearful, could be experiencing

Answer 416

anaclitic depression

Question 417

A talented artist is expericing severe bipolar disorder. In terms of artistic output only, the best thing that artist could do is:

Answer 417

seek treatment: psychological distubance is not necessary ofr godo artistic output.

Question 418

Which of the following is important in using contingency management effectively?

Answer 418

make sure that thep erson receives reinforcement for engaging in postivie activities.

Question 419

Lithium has been found to

Answer 419

enhance the effectiveness of antidepressant drugs in treating unipolar depression

Question 420

Interpersonal psychotherapists believe that therapy must address

Answer 420

role transitions in relationships