Abnormal Psychology Exam 1 Flashcards
Psychological disorder
psychological dysfunction with an individual associated with distress or impairment in functioning and a response that diverges from what is typical or culturally anticipated
Psychological Dysfunction
A breakdown in cognitive, emotional, or behavioral functioning
-The more dysfunctional behaviors and feelings are, the more likely they are to be considered abnormal
-Every type of dysfunction does not lead to a disorder
Dysfunctional distress
When a person is much more distressed than others would be
-Distress is a normal reaction in some situations
Impairment
must be pervasive and/or significant
Statistical infrequency
how unusual the behavior must be?
Cultural Norms
consider “normalcy” relative to behavior of others in same cultural context
-cultural perspective remains a crucial reference point
-different with genders
-different with generations
Psychopathology
Scientific study of psychological dysfunction
Ph.D. Clinical and counseling psychologist
trained in research and delivering treatment
Psy. D Clinical and counseling “Doctor of Psychology
trained in delivering treatment
M.D. Psychiatrist
investigate the nature and causes of psychological disorders
-biological point of view -> diagnosis -> treatment
-First earn MD then specialize psychiatry in Residency Training (3-4 years)
Psychiatric nurses
specialize in psychological disorders
-MD or PhD
-Hospitals; treatment team
Licensed clinical social worker
trained in delivering treatment
-MD
-treat after focus on family problems
Marriage & family therapists and mental health counselors
employed for clinical services by hospitals or clinics
-under supervision of a doctoral-level clinician
1-2 years MD
Scientist Practioner
scientific approach to clinical work by mental health professional
Mental health professional functioning as a scientist-practitioner (hint: CEC of science)
Consumer of science, Evaluator of science, and Creator of science
Mental health professional functioning as a scientist-practitioner: Consumer of science
-enhancing the practice
-use the most current diagnosis & treatment
Mental health professional functioning as a scientist-practitioner: Evaluator of sciece
-determining the effectiveness of the practice
-accountability to patients, government agencies, and insurance companies bring obligation to demonstrate effectivity of treatments
Mental health professional functioning as a scientist-practitioner: Creator of sciece
-conducting research that leads to new procedures useful in practice
-clinics or hospitals
Three categories make up the study of Psychological disorders (hint: CCT)
Clinical description, Causation (etiology), Treatment and outcome
Clinical description
details of the combination of behaviors, thoughts, and feelings of an individual that make up a disorder
-begins with a presenting problem
-aim: distinguish clinically significant dysfunction from common human experience
Presenting problem
specific issue and reason person came in for
Prevalence
the number in the population with the disorder
Incidence
the number of new cases during a given period of time
Set ratio
the percetage of women to men with the disorder
Onset of disorders include (vs.)
Acute vs. Insidious onset
Acute onset
when a disorder occurs suddenly
Insidious onset
when a disorder occurs gradually over an extended period of time
Course
the individual pattern followed by a disorder
Course of disorders include (3)
episodic, time-limited, or chronic course
Episodic course
recover and reoccurrence, may repeat throughout a lifetime
Time-limited course
improve without treatment in a relatively short period with little to no risk of reoccurrence
Chronic course
long-time, sometimes lifetime
Prognosis
the anticipated course of a disorder
2 types of Prognosis (hint: GG)
Good and Guarded
Good prognosis
probably recover
Guarded prognosis
probable outcome doesn’t look good
Developmental psychology
study of changes in behavior overtime
Developmental psycopathology
study of changes in abnormal behavior
Etiology
the study of origins; why a disorder begins
-biological, psychological, and social dimensions
Treatment development includes
how can we help alleviate psychological suffering
-pharmacological, psychosocial, and combined treatments
-the effectiveness of certain drugs may help lead to understanding the Etiology
Three dominant traditions have existed in the past to explain abnormal behavior
Supernatural, Biological, and Psychological
Supernatural explanation of abnormal behavior
the supposed agents outside our bodies and in the environment that influence our behavior, thinking, and emotions
-ex: divinities, demons, spirits
-Battles of “good” vs “evil”
-Treatments included exorcism, torturer, and religious rituals
Since what era was the Biological and Psychological explanations brought
Since the era of Ancient Greece, the mind (“soul”) considered separate from the body
-mind can influence the body and vice versa
Exorcism
various religious rituals were performed
Competing view that coexisted with supernatural tradition was
“Insanity”
-caused by emotional stress, not supernatural forces
-Depression and Anxiety recognized mental illness
-treatments: rest, sleep, healthy environment, baths, potions
Saint Vitus’s Dance/Tarantism
-example of mass hysteria in the past
-Middle ages in Europe
-Groups of people simulataneously compelled to run out to streets, dance, shout, rave, and jump in patterns
Mob Psychology
the type of shared response
-Moder mass hysteria
Emotion contagion
the experience of an emotion seems to spread to those around us
-Modern mass hysteria
What did Paracelsus suggest?
suggested that mental health problems are affected by pull of moon and stars
-led to the term of “lunatic”
Who was Hippocrates (460-377 BC)?
father of modern Western medicine
-Mental disorders understood as physical disease
-Hysteria “the wandering uterus”
Linked abnormality with brain chemical imbalances
Foreshadowed modern views
Hysteria “the wandering uterus”
psychological symptoms were a result of the uterus moving around in the body
Who extended Hippocrates’ work?
Galen (129-198 AD)
Humoral theory of disorders
functioning is related to having too much or too little of four key bodily fluids (humors)
-Blood (heart), Phlegm (brain), Black bile (spleen), Yellow bile (liver)
-ex: Depression caused by too much black bile
-treatment: changing environmental conditions (e.g. reducing heat) or bloodletting/vomiting
General paresis (late stage syphilis) and the biological link with madness
-psychological and behavioral symptoms
-caused by a bacterium
-bolstered the view that mental illness = physical illness
Who was John P. Grey and the reformers?
psychiatrist who believed mental illness had physical roots
-emphasis on rest, diet, and proper room temperature and ventilation
-championed biological tradition in the U.S
-led to reforms of hospitals to give psychiatric patients better care
The development of biological treatments included
Insulin shock therapy, Electric shock, Crude surgery, and Medications (ex: tranquilizers)
Insulin shock therapy
occassionally given to stimulate appetite in psychotic patients who were not eating, but also calmed them down
-abandoned due to often resulting in prolonged coma or even death
Electric shock
mild & modest electric shock to the head produced a brief convulsion and memory loss (amnesia) but otherwise did little harm
Crude surgery
surgery of the brain (removing a piece)
Medication increased in availability in the mid-20th century
Neuropletics and minor tranquilizers
Neuropletics
-major tranquilizers
-now called antipsychotics
-used to treat anxiety
-used less due to many side effects
Minor tranquilizers were prescribed for
anxiety and related disorders
Consequences of the Biological Tradition
-overall, mental illness understood to have physical roots
-increased hospitalization
-mental illness often seen as “untreatable” condition
-improved diagnosis and classification
-increased role of science in psychopathology
Who was the father of classification?
Emil Kraepelin
Moral therapy
-treated institutionalized patients as normally as possible in a setting that encouraged and reinforced normal social interaction
-many opportunities for appropriate interactions and behavior
-restraint and seclusion were eliminated
-declined in use due to the size and composition of the institutionalized population
Issue between Moral therapy and immigrants
-large numbers of people were immigrating to the U.S.
-if institutionalized, thought not to “deserve” moral therapy
-not given moral treatments even when they were sufficient hospital personnel
Mental hygiene movement
focused on providing care to everyone who needed it, causing a large influx in patients
-Dorothea Dix (1802-1887) campaigned endlessly to reform treatment of insanity
(she informed American public of these abuses)
Psychoanalytic theory
constructed on the development and structure of our personalities
Information on Franz Anton Mesmer & Hypnosis
Animal magnetism/Mesmerism
= identify and tap various areas of body where it was “blocked”, suggesting strongly they were cured
Who tested and concluded that Mesmerism/Animal magnetism was just strong suggestion
Benjamin Franklin
The emergence of psychoanalysis was brough by
Freud and Breur
-believed to have discovered the unconscious mind and its apparent influence on the production of psychological disorders
-later found many of Freud’s beliefs were incorrect
Catharsis
release of emotional material
Insight
a fuller understanding of current emotions and earlier events
Psychoanalytic Theory: Superego
-type of thinking: Conscience
-driven by: Moral principles
-purpose is to counteract the potentially dangerous aggressive & sexual drives
Psychoanalytic Theory: Ego (mediator)
-type of thinking: Logical; rational
-driven by: reality principle (act realistically)
-logic and reason
-secondary process
Psychoanalytic Theory: Id
-type of thinking: illogical; emotional; irrational
-driven by: pleasure principle (max pleasure, eliminating conflict/tension)
-sexual and aggressive feelings or energies
-primary process
(own way of processing information)
(emotional, irrational, illogical)
(preoccupied with sex, aggression, and envy)
-Libido= energy or drive
-Thanatos= death instinct
Defense mechanisms
Ego’s(logic) attempt to manage anxiety resulting from id(emotional) and superego(morals) conflict
-include Denial, Displacement, Projection, Rationalization, Reaction formation, Repression, and Sublimation
Denial
refusing to acknowledge aspects of reality apparent to others
Displacement
transferring discomfort-inducing feelings or responses from one object or person to another less threatening one
Projection
false attributions of one’s unaccetable feelings, impulses, or thoughts to another individual or obejct
Rationalization
concealing true motivations through elaborate, reassuring or self-serving yet incorrect explanations
Reaction formation
substituting behavior, thoughts, or feelings totally opposite to unacceptable ones
Repression
blocking disturbing wishes, thoughts, or experiences from conscious awareness
Sublimation
redirecting potentially maladaptive feelings or impulses into socially acceptable behavior
Psychosexual stages of development
-satisfying drive for physical pleasure
-theory: conflicts arise at each stage and must be resolved
-include Oral, Anal, Phallic, Latency, and Genital stages
-ex: Oral 0-2 ages need for food
Controversial genital stage from Psychosexual stages of development
-boys conflict -> Oedipus Rex & Castration anxiety
-girls conflict -> Electra complex
-not based on fact
Ego psychology (Anna Freud)
defensive reactions of the ego determine behavior
-Abnormal behavior develops when the ego is deficient in regulating such functions as delaying & controlling impulses or marshalling appropriate normal defenses to strong internal conflicts
Self-psychology (Heinz Kohut)
focused on the formation of self-concept and the crucial attributes of the self that allow an individual to progress toward health or neurosis
Neurosis
a psychological disorder thought to result from unconscious conflicts & the anxiety they cause
What did Carl Jung do?
-rejected focus on sexual drives (Freud)
-emphasized spiritual and religious drives
-introduced collective unconscious
Collective unconscious
wisdom accumulated by society and culture that is stored deep in individual memories & passed down from generation to generation
-emphasized enduring personality traits
What did Alfred Adler focus on?
feelings of inferiority and the striving for superiority
Both Carl Jung and Alfred Adler
-strong drive towards actualization
-basic quality of human nature is positiveA
Actualization
realizing one’s full potential
Object relations
the study of how children incorporate the images, the memories, and sometimes the values of a person who was important to them and to whom they were emotionally attached
-important people
Introjection
process of incorporation
Psychoanalytic psychotherapy
-Free association, Dream analysis, and Analysis of transference
-very time consuming
-little evidence of effectiveness
Free association
patients say whatever comes to mind without the usual socially required censoring
-reveal emotionally charged material that may be repressed (painful or threatening to consciousness)
Dream Analysis
therapist interprets the content of dreams, reflecting primary-process thinking of the id and symbolic aspects of unconscious conflicts
-help patient gain insight into the nature of conflicts
Transference
patients come to relate to the therapist like they did to important figures in their childhood, particularly their parents
Countertranference
therapist project own personal issues & feelings, usually positive, onto patient
Psychodynamic Psychotherapy
derived from psychoanalytic approach
-focus on affect and the expression of emotions
-exploration of attempts to avoid topics or engage in activities that hinger the progress of therapy
-identification of patterns in actions, thoughts, feelings, experiences, and relationships
-emphasis on past experiences
-focus on interpersonal experiences
-emphasis on therapeutic relationship
-exploration of wishes, dreams, or fantasies
Humanistic theory: Abraham Maslow
hierarchy of needs, beginning with our most basic physical needs and ranging upward to needs for self-actualization, love, and self-esteem
Humanistic theory: Carl Rogers
humanistic therapy emphasizing unconditional postiive regard, empathy, and innate tendency towards growth
-Person-centered therapy
Person-centered therapy
therapist takes a passive role, few interpretations as possible
-give individual a chance to develop during course of therapy, unfettered by threats of self
Self-actualizing
process emphasized in humanistic psychology in which people strive to achieve their highest potential against difficult life experiences
Unconditional positive regard
acceptance by the counselor of the client’s feelings and actions without judgment or condemnation
Empathy
sympathetic understanding of an individual’s point of view
Pavlov and Classical Conditioning
learning in which a neutral stimulus is paired with a response until it elicits that response
-Any person or object associated with the unconditioned response (UCS) acquires the power to elicit the same response, when elicited by conditional stimulus (CS) it becomes a conditioned response (CR)
Stimulus generalization
the response generalizes to similar stimuli
Watson and the rise of Behaviorism
psychology is a purely objective experimental branch of natural science with goals of prediction and control of behavior
Behavior therapy
therapy methods based on the principles of learning as applied to clinical problems
-it consists specific behaviors rather than interferred conflicts as legitimate targets for change
-Joseph Wolpe
Systematic desensitization
individuals were gradually introduced to the objects or sitituations they feared, so their fear could decline
-nothing bad would happen in the prescence of the fear
Operant conditioning
behavior operates on the environment
-Learning in which behavior changes as a function of what follows the behavior (reinforcement with reward or punishment)
-influenced by Watson and Thordike (LAw of effect)
Law of effect
behavior is either strengthened (likely to be repeated more frquently) or weakened (likely to occur less frequently) depending on the consequences of behavior
Shaping
a process of reinforcing successive approximations to a final behavior or a set of behaviors
Behavioral model’s impact
+greatly contributed to the understanding and treatment of psychopathology
-incomplete and inadequate to account for what we now know about psychopathology
(fails to account for development of psychopathology across the lifespan)
One-dimension models
-explain behavior in terms of a single type of cause
-could mean a paradigm, schoool, or conceptual approach
-tend to ignore information from other areas
-Ex: explaining a disorder as the result of family history alone
Multidimensional integrative approach
approach to the study of psychopathology that holds psychological disorders as always being the products of multiple interacting causal factors
-interdisciplinary, eclectic, and integrative system
-influences: biological, behavioral, emotional, social & cultural, developmental, and environmental
Each person has how many chromosomes and pairs
46 chromosomes in 23 pairs
Abnormalities in chromosomes contribute to what sydrome?
Down syndrome
Autosomes
first 22 chromosomes that provide programs/directions for body/brain development
Sex chromosomes
the 23rd pair of chromosome
-female: XX
-male: XY
Genes
long deoxyribonucleic acid (DNA) molecules, the basic physical units of heredity that appear as locations on chromosomes. A single gene is a subunit of DNA that determines inherited traits in living things.
Genome
the complete set of genetic instructions/genes; DNA contains this
Coding DNA
the DNA sequence that defines a gene
Genetic locus
the specific location on a chromosome that codes for a gene
Alleles
alternative or variant forms of genes
Polymorphism
different forms of alleles
-SNP: when one nucleotide replaces another
Dominant allele
one pair of genes that strongly influences a particular trait
Recessive allele
must be paired with another to determine a trait
-ex: color blindness- recessive allele on x-chromosome
sickle cell disease- recessive autosomal allele
Genotype
set of genes that are passed down
-each pair of alleles
Phenotype
observable characteristics
-how the environment interacts with genes
Quantitative genetics
examines the contribution of genes that coded for dimensional traits (phenotypes)
Molecular genetics
examines the actual structure of genes with increasingly advanced technology
Polygenic traits
a trait influenced by many genes
-no single set of genes linked to a disorder, never a one-to-one correlation with mental health disorders
-behavior and development is almost always this with rare exceptions (ex: single-gene determinants like Huntington’s disease)
Behavioral genetics
the study of how genes and environment interact to influence psychological traits
Monozygotic twin
identical (1 egg), 100% of genes
Dizygotic twin
paternal (2 eggs), 50% of genes
Gene-environment interactions
the genetic structure of cells actually changes as a result of learning experiences
-the environment may occassionally turn on certain genes
-Eric Kandel (1983)
Diathesis-stress model
disorders are the result of underlying risk factors combining with life stressors that cause a disorder to emerge
-the greater the underlying vulnerability, the less stress is needed to trigger a disorder
Diathesis
inherited tendency (vulnerability/predisposition)
Reciprocal gene-environment model (Gene-Environment Correlation Model)
a hypothesis that people with a genetic pre-disposition for a disorder may also have a genetic tendency to create environmental risk factors that promote the disorder.
(personality traits)
Epigenetics
the study of factors other than inherited DNA sequence, such as new learning or stress, that alter the phenotypic expression of genes
Telomeres
certain structures that cap the ends of chromosomes to protect the chromosome from deteriorating or getting entangled with neighboring chromosomes
-length positively correlated with lifespan and might be a marker for aging
-stress exposure associated with shortening
What do the environmental effects of early parenting do?
they seem to override any genetic contribution to be anxious, emotional, or reactive to stress
-Suomi, 1999 Rheuses monkey experiment
-Francis et al. 1999 Foster rat mother experiment
Neuroscience
the study of the nervous system and its role in behavior, thoughts, and emotions
Central Nervous System
-Brain- sorts for whats relevant (checks memory) and implants right reaction
-Spinal cord- sending messages to and from the brain to the body
Peripheral Nervous System
Somatic Nervous System (SNS)
Autonomic Nervous System (ANS)Ne
What do neurons do?
control thoughts and actions
What do dendrites do?
receive messages
What do axons do?
transmits electrical impulses to other neurons
Synapses
multiple connections to other nerve cells made by one
Action potentials
short periods of electrical activity at membrane of neuron, responsible for transmission of signals
Terminal button
the end of an axon
Synaptic cleft
the space between the terminal button of one neuron & the dendrite of another
Functions of neurotransmitters
chemical messangers that transmit messages between enurons
-cross synaptic cleft beween nerve cells
Some neuron transmitters are primarily..
excitatory or inhibitory
Excitatory neurotransmitters
causing excitation/activating; increase likelihood of connecting neuron to fire
Inhibitory neurotransmitters
causing inhibition/suppressing; decreasing likelihood of connecting neuron to fire
Main neurotransmitters
Glutamate
Gamma aminobutryric acid (GABA)
Serotonin (5-HT)
Norepinephrine
Dopamine
Agonists
chemical substance that effectively increases the activity of a neurotransmitter by imitating its effects
Antagonists
decrease or block a neurotransmitter
Inverse agonists
produce effects opposite of neurotransmitter production
Glutamate
exhibitory transmitter that “turns on” many different neurons, leading to action
GABA
inhibitory transmitter
-its molecules attach themselves to receptors of specialized neurons
-reduce overall arousal and to temper our emotions
What two neurotransmitters are known as the “Chemical brothers” and why?
Glutamate and GABA
-they work in concert to balance functioning in the brain
-fast acting
Serotonin (5-Hydroxytryptamine)
-influence behavior heavily
-regulates behavior, moods, and thought processses
-low activity levels => less inhibition, instability, impulsivity, overreact
-make us vulnerable without direct causation (other influences compensate for low)
Selective-Serotonin reuptake inhibitors (SSRIS)
-effects seratonin more directly
-used to treat a number of psychological disorders
Norepinephrine neurotransmitters
-monoamine class
-stimulates alpha-adrenergic and beta-adrenergic receptors
-block the receptors so response to surge of norepinephrine is reduced
Norepinephrine neurotransmitters’ circuits
-major one in hindbrain, controls bodily functions (ex: respiration)
-emergency reactions & alarm responses when danger
-acts generally to regulate & moderate action behavioral tendencies & not directly involved in specific behavior patterns or disorders
Dopamine neurotransmitter
-implicated in Schizophrenia and addiction
-also some indicate role in depression & ADHD
-block specific dopamine receptors, lowering dopamine activity
Dopamine neurotransmitters’ circuits
-merge and cross with seratonin circuits at many points, influence many same behaviors
(balance each other out)
-dopamine => exploratory, outgoing, pleasure-seeking
-seratonin=> inhibition & constraint
L-Dopa
dopamine agonist
Locomotor system
one of the systems dopamine switches
-regulates the ability to move in a coordinated way
-turned on, influenced by seratonin activity
What functions does the three divisions of the brain handle?
Autonomic Nervous System functions
-ex: breathing, sleeping, and moving around in a coordinated way
Focus of Cerebellum
motor coordination
What does Reticular activating system contribute to ?
to the processes of arousal and tension
What does the Midbrain do?
it coordinates movement with sensory input and contains parts of reticular activating system
What do the Thalmus and Hypothalmus do?
regulate behavior and emotion
What does the Pituitary gland produce?
a variety of regulatory hormones
The Limbic System
the border (edge of center of brain)
-helps regulate emotional experiences and expressions, and to some extent, our ability to learn & control our impulses
-also involves with the basic drives (ex: sex, aggression, hunger, and thirst)
What does the Basal Ganglia control?
motor activity
Left hemisphere functions
verbal and other cognitive processes (respond)
R hemisphere functions
perceiving the world and creating images
(analyze)
What is the split up of the Autonomic Nervous system?
Sympathetic and Parasympathetic Nervous system
Primary of ANS
-regulate cariovascular system (heart & blood vessels)
-regulate endocrine system (pituitary, adrenal, thyroid, gonad glands)
- various functions (aiding digestion, regulating body temperature)
Sympathetic Nervous System
mobilizing the body during times of stress or danger by rapidly activating the organs and glands under its control
-heart beats faster
-respiration increases
-adrenal glands are stimulated
Parasympathetic system
balances sympathetic system
Somatic nervous system
-controls muscles
-voluntary movement
What does the Thyroid gland produce
thyroxine
-energy metabolism & growth
What does the Gonadal gland produce?
sex hormones
Hypothalmic-pituitary-adrenocortical axis (HPA axis)
cortical part of adrenal glands produces epinephrine and stress hormone cortisol
Learned helplessness
Martin Seligman’s theory that people become anxious and depressed when they make an attribution that they have no control over the stress in their lives (whether or not they do in reality)
Observational learning (modeling)
learning through observation and imitation of the behavior of other individuals and consequences of that behavior
Prepared learning
an ability that has been adaptive for evolution, allowing certain associations to be learned more readily than others
Implicit memory
a condition of memory in which a person cannot recall past events despite acting in response to them (contrast with explicit memory)
-can be selective for only certain events
Explicit memory
a conscious memory for events
Blind sight
some people who are blind can still sense objects that would be in their visual field even if they do not experience sight
Emotion
the pattern of action elicited by an external event and a feeling state, accompanied by a characteristic physiological response
-to elicit or evoke action
-action tendency different from affect and mood
Components of emotion
behavior, physiology, and cognition
Components of emotion: Emotion & Behavior
-basic patterns of emotional behavior (freeze, escape, approach, attack) that differ in fundamental ways
-emotional behavior is a means of communication
Components of emotion: Cognitive aspects of emotion
-appraisals, attributions, and other ways of processing the world around you that are fundamental to emotional experience
Components of emotion: Physiology of emotion
-emotion is a brain function involving (generally) the more primitive brain areas
-direct connection between these areas and the eyes may allow emotional processing to bypass the influence of higher cognitive processes
How do cultural factors influence behavior?
the form and expression
Gender effects
men and women may differ in emotional experience and expression
-may be related to gender roles: certain ways of coping with emotion are more acceptable for men or women
Effect of social support
-low social support related to mortality, disease, and psychopathology
-freqeuncy and quality important
-social support especially important in the elderly
Problems with social stigma
-may limit the degree to which people express mental health problems
-may discourage treaetment seeking
Clinical assessment
systematic evaluation and measurement of psychological, biological, and social factors in an individual presenting with a possible psychological disorder
Diagnosis
degree of fit between symptoms and diagnostic criteria
Purpose of assessment
-making diagnosis
-making predictions
-planning treatments
-evaluating treatments
-evaluating the effectiveness or treatment programs
Three concepts that are key to the usefuleness of an assessment
reliability, validity, and standardization
Reliability
the degree of consisency of a measurement
Inter-rater reliability
consistency betwee scores generated by different evaluators
-design devices and conduct research on them to ensure more than two others report the same
Test-retest reliability
consistency in scores when test is administered repeatedly
-stable across time
Validity
does the test measure what it is supposed to
Concurrent (descriptive) in validity
comparison of results of one assessment with another measure known to be valid
Predictive in validity
how well the assessment predicts outcomes
Standardization
process by which a certain set of standards or norms is determined for a technique to make its use consistent across different measurements
-for testing, scoring, evaluating data
-ex: comparing scores between others like you (hispanic vs hispanic, girl vs girl)
Clinical interview
-the core of clinical work
-when specific problem started and identify other events
-address multiple domains such as presenting problem, current and past behavior, detailed history, attitudes and emotions
Mental status exam
involves systematic observation of an individual’s behavior
-appearnace and behavior, thought processes, mood and affect, intellectual functioning, sensorium
Mental status exam: Appearance and behavior
-overt physical behavior, dress, general appearance, posture, facial expression
Mental status exam: Thought processes
rate or flow of speech, continuity (ideas having connection)
Mental status exam: Mood and affect
mood= predominantly feeling state
-ex: pervasive? temporary?
affect= one’s behavior holding appropriate reactions according to the situation
Mental status exam: Intellectual functioning
vocabulary, abstracts, metaphors, etc.
Mental status exam: Sensorium
awareness of our surroundings
-if do, “clear” and “oriented times three” (=person, place, and time)
Types of clinical interviews
unstructured, structured, and semistructured
Unstructured clinical interviews lack
a systematic format
Structured clinical interviews include
standardized questions
Semistructured clinical interviews include
-standardized questions
-deviate from set questions to address specific issues
Physical examination
-helpful in diagnosing mental health problems
-many problems presenting as disorders may have a clear relationship to a temporary toxic state
Understanding and ruling out physical etiologies includes
-lack of nutrients
-medication issues (ex: withdrawal symptoms)
-physical disorders (ex: hyperthyrodism produces symptoms consistent with anxiety)
Behavioral assessment
uses direct observation to assess formally an individual’s thoughts, feelings, and behavior in specific situations or contexts
-target behaviors are identified and observed with the goal of determining the factors that seem to influence them (antecedents and consequences)
-may use analogue settings that are similar to real-life settings (ex: simulated situations or hypnosis)
-Helpful for young children, non-verbal people, sometimes people withold information, or different interpretations
ABCs of Observation
Antecedent (what happened before)
Behaviors
Consequence (what happened afterward)
-purpose is to identify any discernible behavior patterns and then design a treatment based on these patterns
Formal observation
-involves identifying specific behaviors that are observable and measurable (operational)
-may involve checklists or behavior rating scales
Self-monitoring
-involves an individual monitoring their own behavior
-essential when it comes to private behavior
-Ex: smoker who is trying to quit records the number of cigarates and the situations when doing so
Reactivity
knowing you are being observed can change behavior
-distorting any observational data
Psychological testing
specific tools to detmine cognitive, emotional, or behavioral responses may associate with a specific disorder and more tools that assess longstanding personality features
Psychological testing types
Projective tests
Personality tests
Intelligence tests
Neuropsychological tests
Neuroimaging
Psychological testing: Projective tests
-rooted in psychoanalytic tradition
-require high degree of inderence in scoring and interpretation
theory:
-used to assess unconscious processess
-project aspects of personality onto ambiguous test stimuli
EX:
-Rorschach Inkblot test
-Thematic Apperception Test
-Sentence completion test
Strenghts and weaknesses of Projective tests
+may be useful icebreakers
+one way to gather qualitative data
-hard to standardize
-reliability and validity data tend to be mixed
Psychological testing: Personality inventories
self-report questionnaires that assess personal traits
Minnesota Multiphasic Personality Inventory (MMPI)
-true or false
-Empirical approach (collection & evaluation)
-easy to administer and score
-includes validity scales to detect lies, defensiveness, and infrequent responses
-excellent reliability (-> programed with interpretation of results)
Psychological testing: Intelligence testing
-originally developed to identify children who would benefit from additional help in school
Intelligence quotient
mental age divided by chronological age and then multiplied by 100 (original calculation)
Deviation IQ
estimates how much a child’s performance in school will deviate from the average performance of others of the same age
Is IQ the same as Intelligence?
NO
Intelligence involves more than is typically measured in an IQ test, including the ability to adapt to the environment, the ability to generate new ideas, and the ability to process information efficiently
Psychological testing: Neuropsychological tests
measure abilities in areas such as receptive and expressive language, attention and concentration, memory, motor skills, perceptual abilities, and learning & abstraction
-allow the clinician to make inferences about brain functioning and organic damage
Examples of projective tests
-Rorschach Inkblot test
-Thematic Apperception Test
-Sentence completion test
Examples of Neuropsychological tests
Bender Visual-Motor Gestalt test
-simple screening instrument, easy to administer and detect possible problems
Luria-Nebraska Neuropsychological battery
Halstead-Reitan Neuropsychological battery
-rhythm test, strength of Grip test, and Tactile performance
Psychological testing: Neuroimaging
pictures of the structure and function of the brain
-structural and functional imaging methods
Neuroimaging structural imaging methods
-Computerized Axial Tompgraphy (CAT) scan or CT scan
-Nuclear Magnetic Resonance Imaging (MRI)
Neuroimaging functional imaging methods
-Poistron emission tomography (PET) scan
-Single photon emission computed tomography (SPECT)
-Functional MRI (fMRI) and blood-oxygen-level-dependent (BOLD) fMRI
Psychophyiological assessment
measure changes in indicators of nervous system functioning that reflect emotional or psychological events (ex: EEG)
-used in assessment of PTSD and sexual dysfunctions & disorders
-physiological measure form the basis of biofeedback
-requires expertise to administer
Electroencephalogram (EEG) measures
electrical activity in the brain
Electrodermal responding measures
sweat gland activity
Classification
any effort to construct groups or categories and to assign objects or people to these categories on the basis of their shared attributions or relations
Taxonomy
classification of entities for scientific purposes
Nosology
application of a taconomic system to psychological or medical phenomena or other clinical areas
Nomenclature
the names or labels of the disorders that make up the nosology
Classical (or pure) categorical approach
assumes that every diagnosis has a clear underlying pathophysiological cause and that each disorder is unique
-because each disorder is fundamentally different from every other, we need only one set of defining criteria
-quite useful in medicine but inappropriate for psychological disorders, which have multiple interacting causes
Classification issues include which 3 approaches?
Classical categorical approach
Dimensional approach
Prototypical approach
Dimensional approach
notes the variety of cognitions, moods, and behaviors with which the patient presents and quantifies them on a scale
-quantifies multiple variables onto a scale
Prototypical approach
identifies certain essential characteristics of an entity so it can be classified, but also allows certain nonessential variations that don’t necessarily change the classiciation
-allows in nonessential variables
Classification issues must be
reliable and valid
-unreliable classification systems are subject to clinician bias
-construct validity, predictive validity, and content validity
Construct validity
criteria are consistently associated and distinct from those for other diagnostic categories
Predictive validity
tells the clinician what is likely to happen with the prototypical patient
Content validity
criteria reflect the way most experts in the field think about the disorder
Comorbidity
the presence of two or more disorders in an individual at the same time
Evaluation of DSM-5
-“fuzzy” categories associated with comorbidity
-emphasis on reliability can undercut validity
-methods constructing a nosologu of mental disorders have a way of perpetuating definitions that may be fundamentally flawed
-subject to misuse
(diagnostic labels may have negative connotations that contribute to stigma)
-It is a product of data-informed consus meeting
-As society changes, diagnoses may be eliminated or added
Three main topics for research on psychopathology
-The nature of the problems people report
-The causes/etiology of psychopathology
-Treatment evaluation
Hypothesis
an educationed guess
-hypotheses in science are formulated so that they are testable
Null hypothesis
the prediction that there is no relationship between the studied phenomena
Variable
a factor or characteristic that can vary within an individual or between individuals
Independent variable
factors affecting the dependent variables
-manipulated by the researcher
Dependent variable
what is being measured
Internal validity
extent to which results of a study are due to the independent variable
External validity
extent to which results of a study are generalizable to the population its studying
Ways to increase internal validity by minimizing confounds
-use of control groups
-use of randomization procedures
-Use of analogue models
Control group
a group of individuals in a study who are similar to the experimental subjects in every way but are not exposed to the treatment received by the experimental group
-allows for a comparison of the differential effects of the treatment
Randomization
method for placing individuals into research groups that assures each an equal chance of being assigned to any group
-eliminating any systematic differences across groups
Case study method
extensive observation and detailed description of a single client
-foundation of early historic developments in psychopathology
Limitations of a Case study method
-lacks scientific rigor and suitable controls
-internal validity is typically weak
-often entails numerous confounds
Correlational research
assess the degree to which levels of certain variables are linked to levels of other variables
-statistical relation between two or more variables
-no independent variable is manipulated
-range from -1.0 to 1.0
-Negative vs positive correlation
-necessary in situations where you can’t manipulate variables
Limitations of Correlational research
Causation & Directionality
Positive correlation
association between two variables in which one increases as the other increases (and vice versa)
-both going in the same direction
Negative correlation
association between two variables in which one increases as the other decreases
(opposite directions)
Directionality
possibility that when two variables, A and B, are correlated variable A causes variable B or variable B causes variable A.
-order of correlation
Epidemiological research
-type of correlational research
-often incolves surverys of large groups to get picture of population
-study of the incidence, distribution, and consequences of problem(s) in one or more populations
Nature of experimental research
-manipulate IV
-observe effects on DV
-attempt to determine causal relationships
-premium on internal validity
Clinical trial
experiment designed to evaluate the effectiveness of a treatment
Randomized clinical trials
experiments exploying participant randomization in wach experimental group
Controlled clinical trials
experiments using control conditions for comparison
Randomized controlled trial
highlighting both control groups and randomization in treatment outcome research
Control group
provides comaprison point
-often matched to demographics of experimental group
Placebo control group
some participants are given an inactive treatment (ex: sugar pill), but participants don’t know know which treatment they are getting
Double-blind
participants and assessors are unaware of what kind of treatment participants are getting
Placebo effect
something changes because the participant expects the change to occur
-ex: expecting to feel netter when taking an inactive pill
Comparative Treatment Research includes what two types of research
Process and Outcome research
Process research
focus on the mechanisms underlying behavior change
Outcome research
focus on determining the positive, negative, or both results of the treatment
Single case design
research tactic in which an independent variable is manipulated for a single individual, allowing cause-and-effect conclusions but with limited generalizability (contrast with case study method)
-rigorous study of single cases
-manipulate timing and nature of experimental conditions
-frequent repeated measurement of outcomes is critical
Single-case experiemental designs include
Withdrawal and Multiple baseline design
Withdrawal design
removing a treatment to note whether it has been effective.
-In single-case experimental designs, a behavior is measured (baseline), an independent variable is introduced (intervention), and then the intervention is withdrawn.
-Because the behavior continues to be measured throughout (repeated measurement), any effects of the intervention can be noted. Also called reversal design.
Multiple baseline design
A single-case experimental design in which measures are taken on two or more behaviors or on a single behavior in two or more situations
-A particular intervention is introduced for each at different times
-If behavior change is coincident with each introduction, this is strong evidence the intervention caused the change
Family studies
-if there is a genetic influence, expect to see the trait more in first-degree relatives compared to second-degree
Familial aggregation
tendency of a disorder to run in families
Issue of shared environment in family studies
families usually live together, so similarities may be due to environmental factors as well as genetics
Adoption studies
-one way to separate the effects of the environment
-siblings separated after birth: show similarities even if in different environments?
-are adopted children more similar to their birth parents (genetics) or adoptive parents (environment)?
Genetic linkage studies
study that seeks to match the inheritance pattern of a disorder to that of a genetic marker
-this helps researchers establish the location of the gene responsible for the disorder
-occur in groups of people who all have the trait of interest
Association studies
research strategies for comparing genetic markers in groups of people with and without a particular disorder
-occur in people with and without the trait of interest
Genetic markers
certain genes whose location is known
-compare against the trait being studied
Health promotion
increasing healthy behavior in entire population
-even people not at risk for developing disorders
Universal prevention
target specific risk factors but not specific people
Selective prevention
targets groups of people at risk
Indicated prevention
targets specific individuals who are showing early signs of a disorder
Time-based research strategies include
Cross-sectional designs and Logitudinal designs
Cross-sectional designs
take a cross section of the population at different age groups
-compare cohorts
Cohorts
participants in each age group of a study with a cross-sectional design (age groups)
Longitudinal designs
study one group of people overtime
-have to take into account specific experiences of the generation being studied (cross-generational effect)
Value of cross-cultural research
-overcoming ethnocentric views
-increases understanding of etiologies, symptom presentation, and treatments
Difficulties in cross-cultural research
-definitions of abnormal behavior
-variance in presentation
-availability of valid assessment instruments may be limited
Research ethics
determine the degree to which science and research participants should be prioritized
-determined by institutional review boards (IRBs) & the APA ethics code
->oversee the rights of human subjects participatin in research
->make sure research and data are handled responsibly
Ethical principles
Informed consent
ethical requirement whereby research subjects agree to participate in a study only after they receive full disclosure about the nature of the study and their own role in it
