Abnormal Midterm Review Flashcards
What is abnormal Psychology
The field devoted to the scientific study of abnormal behavior to describe, predict, explain, and change abnormal patterns of functioning
Workers in the field may be:
Clinical scientists, Clinical practitioners
“The Four Ds”
Deviance, Distress, Dysfunction, Danger
Deviance
– Different, extreme, unusual, perhaps even bizarre
Distress
– Unpleasant and upsetting to the person
Dysfunction
– Interfering with the person’s ability to conduct daily activities in a constructive way
Danger
– Posing risk of harm
Deviance from what?
From behaviors, thoughts, and emotions that differ markedly from a society’s ideas about proper functioning
Social Norms
Explicit and implicit rules for proper conduct
exeptions to social norms
Social context, some times some behaviors are okay, while in others it is not okay
Danger
being dangerous is the exception rather than the rule
Treatment/Therapy
is a procedure designed to change abnormal behavior into more normal behavior
Features of therapy
Sufferer, healer, series of contacts
Sufferer
A sufferer who seeks relief from the healer
Healer
A trained, socially acceptable healer, whose expertise is accepted by the sufferer and his or her social group
Series of Contacts
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
Anceint methods of treatment
The cure for abnormality was to force the demons from the body through trephination and exorcism
who changed view on illnesses?
Hippocrates believed and taught that illnesses had natural causes
Somatogenic Perspective
Abnormal functioning has physical causes
Psychogenic Perspective
Abnormal functioning has psychological causes
effects of the psychotrophic drugs
These discoveries led to deinstitutionalization and a rise in outpatient care
Clinical researchers face certain challenges that make their investigations particularly difficult:
Measuring unconscious motives
Assessing private thoughts
Monitoring mood changes
Calculating human potential
Clinical researchers must consider
the cultural backgrounds, races, and genders of the people they study
must always ensure
the rights of their research participants, both human and animal, are not violated
Clinical researchers try to
discover laws, or principles, of abnormal psychological functioning
nomothetic understanding
General or universal laws or truths
scientific method
systematically collect and evaluate information through careful observations
Case Study
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
limitations of the Case Study
Reported by biased observers Relies on subjective evidence Has low internal validity Provides little basis for generalization Has low external validity
Correlational Method
the degree to which events or characteristics vary with each other
Measures the strength of a relationship
Does not imply cause and effect
Correlational Method and The Experimental Method
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
Advantages of the correlational method:
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
Experimental Method
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
double-blind design
both experimenters and participants are kept from knowing which condition of the study participants are in
Often used in medication trials
models or paradigms
the perspectives used to explain events
Each spells out basic assumptions, gives order to the field under study, and sets guidelines for investigation
Models of Abnormality
Biological Model, Psychodynamic Model, Behavioral Model, Cognitive Model, Humanistic Model, Sociocultural Model,
Biological Model
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
Sources of biological abnormalities
genetics
inheritance plays a part in
mood disorders, schizophrenia, Alzheimer’s disease, and other mental disorders
types of biological treatment
Drug therapy
Electroconvulsive therapy (ECT)
Neurosurgery
Neurosurgery
roots in trephination
Much more precise than in the past
Considered experimental and used only in extreme cases
Strengths
Enjoys considerable respect in the field
Constantly produces valuable new information
Brings great relief
Weaknesses
Can limit, rather than enhance, our understanding
Too simplistic
Evidence is incomplete or inconclusive
Treatments produce significant undesirable (negative) effects
Psychodynamic Model
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
three UNCONSCIOUS forces
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
Strengths:
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
Weaknesses:
Unsupported ideas; difficult to research
Non-observable
Inaccessible to human subject (unconscious)
Behavioral Model
Operant conditioning
Modeling
Classical conditioning
All may produce normal or abnormal behavior
Modeling
Individuals learn responses by observing and repeating behavior
Classical conditioning
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
Behavioral Therapy
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
Pyschodynamic Therapies
All seek to uncover past trauma and inner conflicts
Therapist acts as a “subtle guide”
Classical conditioning treatments
systematic desensitization for phobia
Strengths
Powerful force in the field
Can be tested in the laboratory
Significant research support for behavioral therapies
Weaknesses
Too simplistic
Behavioral therapy is limited
Downplays role of cognition
New focus on self-efficacy, social cognition, and cognitive-behavioral theories
Cognitive Theory
Maladaptive thinking is the cause of maladaptive behavior
Several kinds of faulty thinking:
Faulty assumptions and attitudes
Illogical thinking processes
Cognitive Therapies
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
Strengths
Very broad appeal Clinically useful and effective Focuses on a uniquely human process Theories lend themselves to research Therapies effective in treating several disorders
Weaknesses:
Precise role of cognition in abnormality has yet to be determined
Singular, narrow focus
Overemphasis on the present
Limited effectiveness
Humanistic Theory
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.
Humanistic Therapy
“client-centered” therapy Therapist creates a supportive climate: Unconditional positive regard Accurate empathy Genuineness
Strengths:
Taps into domains missing from other theories
Emphasizes the individual
Optimistic
Emphasizes health
Weaknesses:
Focuses on abstract issues
Difficult to research
Not much influence
Weakened by disapproval of scientific approach
Sociocultural Model Strength
Added greatly to the clinical understanding and treatment of abnormality
Increased awareness of labeling
Clinically successful when other treatments have failed
Weaknesses
Research is difficult to interpret
Correlation ? causation
Model unable to predict abnormality in specific individuals
biopsychosocial model
Abnormality results from the interaction of genetic, biological, developmental, emotional, behavioral, cognitive, social, and societal influences
Diathesis-stress approach
Diathesis = predisposition (bio, psycho, or social)
Assessment
collecting relevant information in an effort to reach a conclusion
Clinical assessment
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
Characteristics of Assessment Tools
To be useful, assessment tools must be standardized and have clear reliability and validity
To standardize
technique is to set up common steps to be followed whenever it is administered
One must standardize administration, scoring, and interpretation
Reliability refers to
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
Test-retest
– Yields the same results every time it is given to the same people
Interrater
– Different judges independently agree on how to score and interpret a particular test
Validity refers to
the accuracy of a test’s results
A good test must accurately measure what it is supposed to measure
Three Specific Types
Three specific types:
Face validity
Predictive validity
Concurrent validity
Face validity
– a test appears to measure what it is supposed to measure; does not necessarily indicate true validity
Predictive validity
– a test accurately predicts future characteristics or behavior
Concurrent validity
– a test’s results agree with independent measures assessing similar characteristics or behavior
Clinical Interviews
Focus depends on theoretical orientation
Can be either unstructured or structured
unstructured interviews
clinicians ask open-ended questions
structured interviews
clinicians ask prepared questions, often from a published interview schedule
Limitations
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
Projective tests
Require that clients interpret ambiguous stimuli
Mainly used by psychodynamic practitioners
Most popular:
Rorschach Test
Thematic Apperception Test
Sentence Completion Test
Drawings
Projective tests
Strengths and weaknesses
Helpful for providing “supplementary” information
Have rarely demonstrated much reliability or validity
May be biased against minority ethnic groups
Personality inventories
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
Personality inventories
Strengths and weaknesses
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
Response inventories
Strengths and weaknesses
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)
Psychophysiological tests
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)
Neurological and neuropsychological tests
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
Intelligence tests
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)
Intelligence Tests
Weaknesses
Performance can be influenced by nonintelligence factors (e.g., motivation, anxiety, test-taking experience)
Tests may contain cultural biases in language or tasks
Naturalistic and analog observations
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
Naturalistic and analog observations
Strengths and weaknesses
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
Multiaxial
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
two fundamental problems weaken the DSM
Basic assumption that disorders are qualitatively different from normal behavior
Reliance on discrete diagnostic categories
What distinguishes fear from anxiety
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.
Is the fear/anxiety response adaptive
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
Sociocultural Perspective Anxiety Disorder
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
Psychodynamic Perspective Anxiety Disorders
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
Humanistic Perspective Anxiety Disorders
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
Cognitive Perspective Anxiety Disorder
suggested that GAD is caused by maladaptive assumptions
Albert Ellis identified
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
Aaron Beck
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
Metacognitive theory
Developed by Wells; holds that the most problematic assumptions in GAD are the individual’s worry about worrying (meta-worry)
Intolerance of uncertainty theory
Certain individuals believe that any possibility of a negative event occurring means that the event is likely to occur
Avoidance theory
Developed by Borkovec; holds that worrying serves a “positive” function for those with GAD by reducing unusually high levels of bodily arousal
cognitive therapy
Changing Maladaptive Assumptions
Helping clients understand the special role that worrying plays, and changing their views and reactions to it
Biological Perspective Anxiety Disorder
GAD is caused by biological factors, but then there is the issue of shared environment
GABA inactivity
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)
How do phobias differ from these “normal” experiences?
More intense and persistent fear
Greater desire to avoid the feared object or situation
Distress that interferes with functioning
Social Phobias
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
Cuase of Phobias
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)
Treatments for Specific Phobias
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
Treatments for Social Phobias
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
Panic Disorder
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
Panic Disorder: The Biological Perspective
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
Drug therapies
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
Panic Disorder: The Cognitive Perspective
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
Cognitive therapy
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
Obsessive-Compulsive Disorder
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
Compulsions
“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
OCD: The Psychodynamic Perspective
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
OCD: The Behavioral Perspective
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
Behavioral therapy
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
OCD: The Cognitive Perspective
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
OCD: The Biological Perspective
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
The state of stress has two components:
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
Autonomic nervous system (ANS)
An extensive network of nerve fibers that connect the central nervous system (the brain and spinal cord) to all other organs of the body
Endocrine system
A network of glands throughout the body that release hormones
hypothalamus
The features of arousal and fear are set in motion by it
The Fight-or-Flight Response
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
trait anxiety
Some people are usually somewhat tense; others are usually relaxed
Differences appear soon after birth
state anxiety
Situation-based (example: fear of flying)
Their sense of which situations are threatening
Psychological Stress Disorders
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)
Victimization and stress disorders
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
Why Do People Develop a Psychological Stress Disorder
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
Biological and genetic factors
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
General goals of Treatment
End lingering stress reactions
Gain perspective on traumatic experiences
Return to constructive living
Treatment of Psychological Stress Disorders
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
Ulcers
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
Asthma
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
Insomnia
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
Chronic headaches
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
Hypertension
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
Coronary heart disease
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
Psychoneuroimmunology
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
Somatoform disorders
problems that appear to be medical but are due to psychosocial factors
Dissociative disorders
patterns of memory loss and identity change that are caused almost entirely by psychosocial factors rather than physical ones
somatoform and dissociative disorders have much in common:
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
Somatoform Disorders
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
Hysterical Somatoform Disorders
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
Conversion disorder
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
Somatization disorder
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
Pain disorder associated with psychological factors
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
Hysterical vs. medical symptoms
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
Hysterical vs. factitious symptoms
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
Factitious Disorder
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
Preoccupation Somatoform Disorders
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
Hypochondriasis
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
Body dysmorphic disorder (BDD)
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
Causes Somatoform Disorders
The psychodynamic view
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
Causes Somatoform Disorders
The psychodynamic view
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
Causes Somatoform Disorders
The behavioral view
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
Causes Somatoform Disorders
The cognitive view
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
Causes Somatoform Disorders
A possible role for biology
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
How Are Somatoform Disorders Treated
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)
Treatments for hysterical disorders
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
Dissociative Disorders
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
Dissociative amnesia may be:
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
Dissociative Fugue
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
Dissociative Identity Disorder (Multiple Personality Disorder)
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
How do subpersonalities interact?
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”
How do subpersonalities differ?
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
How do subpersonalities differ?
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
How common is DID?
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
Explain Dissociative Disorders
The psychodynamic view
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
Explain Dissociative Disorders
The behavioral view
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…
Explain Dissociative Disorders
State-dependent learning
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
How Are Dissociative Disorders Treated
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
How do therapists help individuals with DID?
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
Depersonalization Disorder
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
Mood Disorders
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
How Common Is Unipolar Depression
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
Diagnosing Unipolar Depression
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
Major depressive disorder
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”
What Causes Unipolar Depression
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
What Causes Unipolar Depression? The Biological View: Genetic factors
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
What Causes Unipolar Depression? The Biological View
Biochemical factors
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
What Causes Unipolar Depression? The Biological View
Biochemical factors
Endocrine system / hormone release
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
What Causes Unipolar Depression? The Biological View
Biochemical factors
Model has produced much enthusiasm but has certain limitations
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
What Causes Unipolar Depression? The Psychological Views
Psychodynamic view
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
What Causes Unipolar Depression? The Psychological Views
Behavioral view
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
What Causes Unipolar Depression? The Psychological Views
Cognitive views
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
Learned helplessness
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].
What Causes Unipolar Depression? The Sociocultural View
The Multicultural Perspective
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
artifact theory
The artifact theory holds that women and men are equally prone to depression, but that clinicians often fail to detect depression in men
hormone explanation
The hormone explanation holds that hormone changes trigger depression in many women
life stress theory
The life stress theory suggests that women in our society experience more stress than men
body dissatisfaction theory
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
lack-of-control theory
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
self-blame explanation
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
rumination theory
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
Bipolar Disorders
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
Five main areas of functioning may be affected:
- 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
What Causes Bipolar Disorders?
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
Low serotonin + High norepinephrine =
Low serotonin + Low norepinephrine = Depression
Low serotonin + Low norepinephrine =
Low serotonin + High norepinephrine = Mania
Treatments for Unipolar Depression
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
Treatments for Unipolar Depression: Psychological Approaches
Psychodynamic therapy
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
Treatments for Unipolar Depression: Psychological Approaches
Behavioral therapy
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
Treatments for Unipolar Depression: Psychological Approaches
Cognitive therapy
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
Electroconvulsive therapy (ECT)
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
Antidepressant drugs: MAO inhibitors
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
Antidepressant drugs: Tricyclics
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
Second-generation antidepressant drugs
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
Treatments for Unipolar Depression: Biological Approaches
Brain stimulation
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
Treatments for Bipolar Disorder: Lithium and Other Mood Stabilizers
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
Treatments for Bipolar Disorder: Adjunctive Psychotherapy
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
How Do the Treatments for Unipolar Depression Compare?
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
Which of the following is an analogue study?
Studying the effects of stress in nonhumans
external validity refers to the extent to which the results of a study
apply to the subjects and situations other than the ones studied
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:
The type of ceral is the independent variable, and the number of aggressive responses is the dependent variable
The ability to generalize results from a study of certain individuals to other individuals not studied is called:
external validity
Imagine that a longitudinal study found tat children raised by schizophrenics are more likely to commit crimes later. This resuslts tells us that:
Children of schziphrenics are at higher risk for criminal behavior
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:
Epidemiological
Various obstacles interfere with the study of abnormal psychology. All of the follwing are examples except:
Most clinicians oppose the scientific study of their discipline
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?
The results of the memory test
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.
incidence
Experiments are consistent with the _____ aproach.
nomothetic
Which of the following research pairs are most logically similar?
natural experiment and quasi-experiment
Which of the following is not true about the obstacles that clinical scientists face in studying pschological disorders?
humans have unusually stable (unchanging) moods and behavior
The major advantage of a correlational study over a case study is that it:
has better external validity
Case studies are useful for
studying unusual problems
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?
it should stay the same
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?
quasi-experiments
Which of the following types of research is most likely to involve nonhuman participants?
analogue experiment
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.
experiment
Using generally accepted standards, what is the change that a statistically significant result is due to chance?
5 percent
Internal validity reflects how well a study:
Rules out the effects of all causes excpet those being studied
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:
epidemiological (incidence)
Challenges faced by clinical reserachers include all of the follwing expect:
there are very few graduate students trained in clinical research
The finding that women have higher rates of anxeity and depression than men in the United States is most likely due to _______ research.
Epidemiological
Which of the following is the best example of the nomothethic approach?
Review of records to see if Autism runs in families in the United States
If an epidemiological study shows that eating disorders are more common in Western countries than in Eastern ones, we can appropriately ocnclude:
nothing about the cause of such a finding
A case study differs from a single-subject experiment because single-subject experiments involve:
observation of a subject before and after independent variable manipulation
The number of new cases of a disorder in the population that emerge in a particular time interval is called the
incidence
in order to justify experiments with animals, reserachers must:
balance the suffering of the animals with the knowledge to be gained
the incidence of HIV+ results on campus tells you:
the number of new HIV+ cases measured in a time period
The prevalence of sexual dysfunction in older men seen at a clinica tells you the:
total number of older men with sexual dysfunction at the clinic
Which of the following correlations is momst likely to be statistically significant?
(-).80 based on a sample of 100 people
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):
upward-sloping line (to the right).
The idea that children from a single-parent families show more depression than those from two-parent families is a(n):
hypothesis
In correlational research, external validity is established when:
the smaple is representative of the larger population
All of the follwing are merits of the correlational method except:
provides individual information
When more than one research method produces similar results, we:
can have more confidence in the results
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.
placebo study
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:
cold and domineering
Imagine that there is a statistically significant result foun in an experimntal research project. The most appropriate conclusion would be that:
differences in the dependent variable are likely due to the independent variable
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)
case study
experimenters are generally willing to:
subject animals to more discomfort than humans
Which of the following is a limitation of the case study?
it does not result in a high external validity
If researchers studied Vietnam veterans for 30 years after their return, the study would be:
longitudinal
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?
no exercise
Which of the following is an example of an idiographic approach to knowledge?
a clinical evaltuion of an individual
Freud’s study of Little Hans involved:
letters sent to Freud by Hans’ father
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.
triple
Research shows that the result of lobotomies was:
irreversible brain damage and withdrawal.
Which of the following is the best way for clinicians to come to an understanding of abnormal behaivor?
to rely on findings that have been supported by multiple research methods
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):
analogue experiment
A response inventory that asks individuals to provide detailed information about their typical thoughts and assumptions is a(n):
cognitive inventory
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?
Axis IV
The intial problem in stuying the effectiveness of psychotherapy is:
defining what it means for a treatment to be successful
Which of the following tests is likely to have the lowest reliability?
the draw-a-person Test
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:
antisocial personality disorder on AXIS II
Clinical interviews are the preferred assessment technique of many practitioners. One particular strength of the interview process is:
the chance to get a general sense of the client
Deciding that a client’s psychological problems reperesent a particualr disorder is called
diagnosis
the assessment instrument most likely to be used to detect brai nabnormalities is the:
neuropsychological test
If a clinician wanted to know more detailed information about a person’s functioning is a specific area, the clinician would use:
a response inventory
Of the following, who is most at risk for misinterpreting a cultural response as pathology?
a dominant-culture assessor
How does an MRI make a picutre of the brain?
It relies on the magnetic properties of the atoms in the cells scanned
Dr. Ross and Dr. Carman agree that Suzette if suffering from posttraumatic stress disorder. Their judgement is said to have:
reliability
When a person has organic brain impairment, that person would most likely have difficulty completing:
the Bender-Gestalt test
The most legtimate criticism of intelligence tests concerns their:
cultural fairness
Which of the following would be most likely to have been in therapy at some pint in their lives?
women with a postgraduate education
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:
face validity
Compared to projective tests, personality inventories generally have:
greater reliability and greater validity
Studies of diagnostic conclusions made by clinicians show that:
they pay too much attention to some information and too little to other information
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:
hero
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:
psychopathic deviate
One of the assumptions of a functional analysis is that:
abnormal behaviors are learned
Which category of clinical tests tends to have the best standardization, reliability, and validity?
intelligence tests
Which of the follwing is a reson to question the validity of clinical interviews?
clinicians might overemphasize pathology
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:
predictive validity
If your friend had her brain waves recorded in order to measure electical activity, she most likely had a(n):
EEG
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:
computerized axial tomography
The controversy among clinicians concerning suicide sites on the internet pits ______ against ________
risk to patients; freedom of speech
The knowledge that the person a clinician is about to interview has already been diagnosed as haiving an anxiety dsorder could lead to:
observer bias
What kind of validity is most important to clinicnas in ealuating the utility of a classfication system?
predictive validity
The major focus of a clinical practitioner when dealing with a new client is to gather what type of infomration?
idiographic
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?
psychasthenia
Which of the following tests is a personality inventory?
MMPI-2
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):
“U”-shaped function–high then low then high
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:
behavioral
A cluster of symptoms that go together and define a mental disorder is called a:
syndrome
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:
high interrate raliability
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:
humanistic
Which of the following is an inaccurate belief that many clinicians appear to have?
Clinicians using their own logic are more accurate than statistical analyses
While someone is watching. Jennifer actually eats fewwer sweets than usual. This tendency to decreas a behavior while being observed is an exampole of:
reactivity
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:
adequate standardization
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:
interrater reliability
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:
external validity
Which of the following is designed to disclose a patient’s thoughts and assumptions?
cognitive inventory
The most effective treatment for phobias is
behavioral therapy
Patients recieveing therapy for a pscyhological problem, on average, experience imporvement greater than _____ of peole with similar problems who do not receive treatment.
75%
If you received the diagnoses of both social phobias and agorophobia, your diagnoses would be:
comorbid
The singlem ost effective treatment for schizophrenia is
drug therapy
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:
conducted an unstrucutred interview
Imagine that you are asked to give a scientific opinion on the use of polygraphic evidence. Your best resopnse would be
although they are widely used, they are not particularly valid
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:
Projective test
All of the following are considered traditional psychophysiological disorder except
cancer
Some people are stimulated by exciting, potentially dangerous activities that terrify others. These varying reaction represented differnces in:
State anxiety
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.
Panic Attack
If you wanted a drug to improve the functioning of GABA, you would choose:
A benzodiazepine
The effect of norepinephrine and corticosteroids on a body experiencing stress is:
initially to stimulate the immune system, then to inhibit it
Exposure and resonse prevention as treatment for obsessive-compulsive disorder:
does not work as well for those who have obsessions but no compulsions
Which of the following would you not find on the Social Readjustment Rating Scale?
exercise
Surveys show that in the U.S., the typical female victim of rape
is not tested for HIV, and has long term health problems
All of the following are biological treatments for generalized anxiety except:
rational emotive therapy
Of the following, the most serious limitation of the Social Readjustment Rating Scare is that it:
Deos not take into account the stresses of diverse populations
A person with posttraumatic stress disorder who is having flashbacks is:
reexperiencing the traumatic event
The organ most releated to controlling emotional memories and “turning off” the bod’s arousal is the
hippocampus
A flash flood hits a smal appalachian community. Those providing critical incident stress debriefing intervention would
provide short-term counseling services
Which of the following statemtns best describes the raltionship between biology and stress?
Arousal generated by trauma leads to stress disorders, which may produce more brain changes
Cognitive researchers have found that lives full of anxiety most often are associated with:
unpredictable negative eents
Which phase of the general adaptation syndrome is assumed to invovle activation of the sympathetic nervous system?
alarm
which of the following is an example of a narrow social phobia?
fear of public speakiing
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:
obsessive images
What type of drug is alprazolam (Xanax)
benzodiazepine
Which of the follwing convinces researchers that panic disorder is biologically different from generalized anxity disorder?
differencces in the brain circuitry in the two disorder
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):
obsessive-compulsive disorder
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):
biological challenge test
The part of the body that releases hormones into the bloodstream is the ______ system.
endocrine
Mindfulness-based cognitive therapy
Receives support in therapy application for wide range of disorders, including generazlied anxeity disorder
If someone were to correlate scores on the Social Readjustment Rating Scale with the number of phsycial (health) complaints, one would most likely find:
a significant positive correlation
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
cognitive therapy
When was acute stress disorder as a result of combat (called “shell sock”) first recognized?
after World War I
At what point is distress the greatest after a rape?
withink one month after the assault
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:
Preparedness
According Freud, obsessive-compulsive disorders have their origin in the ____ stage of development.
Anal
Rene Descartes’s mind-body dualism is
inconsistent with modern views of the relatinship between the mind and bodily illnesses
Research using the Social Adjustment Rating Scale indicates that:
The greater the life stress, the greater the illness
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?
The soldier would have about a 50/50 chance of having seen a budy killed or seriously wounded
Which of the following statements most accurately reflects what we know from recent studies?
phobias usually are a result of classcial conditioning
one who is experiencing a panic disorder would most likely also be phobic about:
leaving home
If you have a high level of C-reactive protein, we know that:
you are at greater risk for heart disease, stoke, and other illness.
Please flex your biceps. Now release your biceps. Now flex your thigh. Now release it.” These statements might be made by a therapist using:
muscle relaxation therapy
Which of the follwing relfects the most common obsessive thought?
if I touch that doorknob, I will be dirty and contaminated
A person who is restless, keyed up, and on edge for no apparent reason is experiencing:
free-floating anxiety
The relationship between income and rate of generalized anxiety disorder is:
negative–the higher the income, the lower the rate of generalized anxiety disorder
Combat veterans in a therapy group express a great deal of guilt and rage. Most likely, the vetrans are in a:
rap group
Posttraumatic stress disorders:
last longer than a month
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:
narrow social phobia
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):
obsessive idea
Helping survivors talk about their feelings and fears regarding a disaster is designed to:
Help people express anxiety, anger, and frustration
A friend asks you whether to try relaxation training or biofeedback to reduce anxiety. Based upon present research, your best answer is:
Try either one; they’re both modestly effective.
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?
cognitive
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):
obsessive-compulsive disorder
A person who witnessed a horrible accident and then ebcame unusually anxious and depressed for 3 weeks is probably experiencing:
acute stress disorder
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:
exhaustion
Which of the following is true about research on the effectivenss of cognitive therapy for treating unipolar depresion?
Hundreds of studies show its effectiveness
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
interpersonal role dispute
Recent research indicates that behaviroal therapy is the treatment of choice:
over placebo tretament
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?
identifying negative thinking and biases
Which phase of the genral adaptation syndrome is assumed to invovle activation of the parasympathetic nervous system?
resistance
Apparently tricylclics work by:
blocking the reuptake of norepinephrine and serotinin
The use of ECT was prompted by the discovery that psychotic people:
rarely had epilepsy
People who talk rapidly, dress flamboyanlty, and get involved in dangerous activities are showing _____ symptoms of mania.
behavioral
Increasing pleasant activitis is most likely to be a part of a _______ therapy program.
behavioral
Which of the following medication/side effect pairings is correct?
MAO inhibitors cuasing diatery restrictions
Which theoretical orientation would support the finding that there is a significant relationshi between positive life events and feelings of life satisfaction and happiness?
behavioral
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:
behavioral therapy
Electroconvulsive therapy
appears to be msot effective in treating unipolar depression
Which of the following is not an example of a biological treatment for depression?
contignency management
A person who becomes depressed because of several recent tragic events would be experiencing depression
exogenous
Which of the following is true about unipolar depression?
most people recover from depression, but experience a recurrence
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?
serotoniin
Mnay of today’s cognitive-behavioral therapists would agree that
negative cognitions should be accepted, not necessarily eliminated
Researchers have found that the sleep cycle in depressed people is
reversed
Biochemical explanation for bipolar disorder center on all of the following except
hormonal functioniong
Which of the following would a psychodynamic therapist be most likely to say about studied regarding the effectiveness of psychodynamic therapy for depression?
the therapy des not lend itself to empirical research
The most common form of mood disorder is
uniponlar depression
A key to preventing relapse of unipolar depression appears to be:
continue the therapy, no matter its type, after the sympotoms have gone
Which theoretical orientation would support the finding that Western experience more psychological symptoms of depression?
sociocultural
All of the following are types of major depressie disorder expet:
posttraumatic
Which of the following are people most likely to do to improve their mood?
talk to friens/ family
People experiencing mani:
want excitement and comopanionship
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.
Dana
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:
tricyclics
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:
Brain-derived neurotrophic factor (BDNF)
The chief differnce betwee nlearned helplessness created in laboratory settings and real-life depression is that:
laboratory depression is more likely to be accompanied by anxiety
The clinician who would be most likely to say, “Tell me about how your parents cared for and protect you” is a:
Psychodynamic clinician
The hormone most closely associated with the noset of seasona affective disorder is
melatonin
The experience of a lack of desire to engage in sexual activity with one’s sopuse would be considered a(n) ______ symptom of depression
motivational
in general, object relations theorist follow which theoretical perspective?
psychodynamic
after a couple has divorced, you learn that one of them is suffering form depression. Most likely:
a troubled marriage led to the depression
If biochemical ibmabalce were the cuase of a person’s depression, the latest research would lead us to expect that person to have:
an abnormality in the activity of certain neurotransmitters, especially serotinin nad neorepinephrin
the person associated with developing a cognitive theory of depression basedo n negative and maladaptive thinking was:
BECK
Clients who test their assummtpin about what is cuasing their depression are working in which phases of Beck’s treatment program?
changing primary attitudes
Seasonal affective disorder is thought to be due to
increased levels of melatonin
If your therapist concentrated on helping you recognize and change negavite thoughts and thus improve your mood, yor therapist would be using
cognitive therapy
Therapists who treat African American clints for depression need to be aware that their clients are
less likely to receive newer second-gerneation drugs
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?
recurrent
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?
cognitive therapy
The treatments that are most likely to work in the broadest of cases of depression are
cognitive, interpersonal, and biological
A baby who was seperated from its mother at brith, and who subsequently became withdrawn, sad, and tearful, could be experiencing
anaclitic depression
A talented artist is expericing severe bipolar disorder. In terms of artistic output only, the best thing that artist could do is:
seek treatment: psychological distubance is not necessary ofr godo artistic output.
Which of the following is important in using contingency management effectively?
make sure that thep erson receives reinforcement for engaging in postivie activities.
Lithium has been found to
enhance the effectiveness of antidepressant drugs in treating unipolar depression
Interpersonal psychotherapists believe that therapy must address
role transitions in relationships
