Chapter Two Flashcards
Contemporary Perspectives on Abnormal Behavior and Methods of Treatment
mental illnesses
The medical model posits that abnormal behaviors represent symptoms of underlying disorders or diseases that have biological causes
Neurons
Makes up the nervous system
Nerve cells that transmit signals or “messages” throughout the body
- Allow us to sense
Dendrites
Each neuron has these short fibers that project out from the cell body
Receive messages from adjoining neurons
axon
Projects trunklike from the cell body
The long, thin part of the neuron along which nerve impulses travel
Can extend as long as several feet if they are conveying messages between toes and the spinal cord
terminals
The small branching structures at the tips of axons
Axons terminate in small branching structures aptly
myelin sheath
insulating layer that helps speed transmission of neural impulses
how do neurons share messages?
dendrites or cell body –> axon –> axon terminus –> other neurons
neurotransmitters
Induce chemical changes in receiving neurons
Transmit messages from one neuron to another
Changes cause axons to conduct the messages in electrical form
synapse
Connection point between neurons
Junction or small gap between a transmitting neuron and a receiving one
receptor site
A part of a dendrite on a receiving neuron that is structured to receive a neurotransmitter
Neurotransmitters to Remember
acetylcholine, dopamine, norepinephrine, serotonin
Acetylcholine
Control of muscle contractions and formation of memories
Reduced levels found in patients with Alzeeimer’s disease
dopamine
Regulation of muscle contractions and mental processes involving learning, memory, and emotions
Irregularities in dopamine transmission in the brain may be involved in the development of schizophrenia
Norepinephrine
Mental processes involved in learning and memory
Irregularities linked with mood disorders such as depression
serotonin
Regulation of mood states, satiety, and sleep
Irregularities are implicated in depression and eating disorders
Signs of a dysregulated nervous system:
Depression
Inappropriate behavior
Irritability
Exhaustion
Poor memory
Poor concentration or attention
Sleep issues
Anxiety and panic
PARTS OF THE NERVOUS SYSTEM
central nervous system
peripheral nervous system
- somatic
- autonomic
- sympathetic
- parasympathetic
central nervous system,
Consists of the brain and the spinal cord
Forming the body’s master control unit responsible for controlling bodily functions and performing higher mental functions, such as sensation, perception, thinking, and problem solving
Peripheral nervous system
Made of up nerves that:
Receive and transmit sensory messages to the brain and spinal cord
Transmit messages from the brain or spinal cord to the muscles, causing them to contract, and to glands, causing them to secrete hormones
two branches:
- somatic and autonomic
somatic nervous system
Transmits messages from our sensory organs to the brain for processing, leading to the experience of visual, auditory, tactile, and other sensations
Autonomic nervous system
Emotional processing
Regulates the glands and involuntary processes such as heart rate, breathing, digestion, and dilation of the pupils of the eyes, even when we are sleeping
2 branches:
- sympathetic and parasympathetic
Sympathetic nervous system
Involved in the processes that mobilize the body’s resources during physical exertion or responses to stress, such as when drawing energy from store reserves to prepare a person to deal with imposing threats or dangers
Parasympathetic nervous system
Replenish energy (ex: digestion)
Activation of the sympathetic nervous system interferes with the parasympathetic control of digestion activity
Frontal lobe
important for voluntary movement, expressive language and for managing higher level executive functions
Prefrontal cortex
Regulates higher mental functions, such as thinking, problem solving, and use of language
Ex: risk behaviors
Genetics
Nature vs nurture
- Genes do not dictate behavioral outcomes
- Genetic factors create a predisposition or likelihood, not a certainty, that certain behaviors or disorders will develop
- Multigenetic determinism affects psychological disorders
- Genetic factors and environmental influence interact with each other in shaping our personalities and determining our vulnerability to a range of psychological disorders
Epigenetics
Examines how environmental factors such as stress and exposure to infectious organisms influence how our genetic coding, or genotype, expresses itself in the development of our physical and behavioral trains, or phenotype
Psychological Perspective
Freud and Psychoanalysis
Roots of psychological problems involve unconscious motives and conflicts that can be traced back to childhood
conscious, preconscious, unconscious
id, ego, superego
defense mechanisms
eros, libido, erogenous zones
stages of psychosexual development
fixation
Conscious
Surface of awareness
“Above the surface”
Preconscious
Memories that are not in awareness but that can be brought into awareness by focusing on them (ex: telephone number)
Unconscious
Largest part of the mind
Remains shrouded in mystery
Great difficulty to bring memories back
Id
Original psychic structure, present at birth
“I’m going to eat this whole cake”
Repository of our basic drives and instinctual impulses, including hunger, thirst, sex, and aggression
Pleasure principle
Pleasure principle
Demands instant gratification of instincts without consideration of social rules or customs or the needs of others
Ego
Develops during the first year to organize responsible ways of coping with frustration
“I’ll have a slice or two of cake”
Reality principle
Reality principle
Considers what is practice and possible, as well as the urgings of the id
Superego
Develops from the internalization of the moral standards and values of our parents and other key people in our lives
“I can’t have any cake”
Serves as as conscience, or internal moral guardian, which monitors the ego and passes judgment on right and wrong
Defense mechanisms
Psychological defenses to prevent socially unacceptable impulses from rising into consciousness
repression, denial, rationalization, displacement, projection, reaction formation, regression, sublimation
Repression
Banishment of unacceptable urges, wishes, or impulses to the unconscious mind
Denial
Refusal to accept the reality of a threatening impulse or unsafe behavior
Rationalization
Self-justifications for unacceptable behavior used as a form of self-deception
Displacement
Directing one’s unacceptable impulses toward threatening objects onto safer or less threatening objects
Projection
Attributing one’s own impulses or wishes to another person
Reaction formation
Taking the opposite stance ot what one truly wishes or believes in order to keep genuine impulses repressed
Regression
Return of behaviors associated with earlier stages of development, generally during times of stress
Sublimation
Channeling one’s own unacceptable impulses into more socially appropriate pursuits or activities
Eros
Basic drive to preserve and perpetuate life
Libido
Sexual energy that allows eros to fulfill its function
Erogenous zones
Sexual pleasure zones
Successful movement of libido through zones in development is a successful, happy adult
Stages of Psychosexual development
- oral stage
- anal stage
- phallic stage
- latency stage
- genital stage
Oral stage (0-12m)
Infants achieve sexual pleasure by sucking their mothers’ breasts and by mouthing anything that happens to be nearby (ego develops)
Sucking biting
- Smoking, dependency, aggression, overeating
Anal stage (1-3)
Child experiences sexual gratification through contraction and relaxation of the sphincter muscles that control elimination of bodily waste (bowel control)
Orderliness, messiness (OCD)
Phallic stage (3-6)
Phallic region (penis-boys; clitoris-girls) becomes the major erogenous zone (superego develops)
Oedipus or complex complex
Deviancy, sexual dysfunction
Oedipus or complex complex
Children develop unconscious incestuous desires for the parent of the opposite sex and begin to view the parent of the same sex as a rival
Latency stage (7-11)
A period of late childhood during which sexual impulses remain in a latent state
Interests become directed toward school and play activities
Immaturity and an inability to form fulfilling relationships as an adult
Genital stage (puberty)
Beginning with puberty
Reaches fruition in mature sexuality, marriage, and the bearing of children
Inability to balance basic urges against the need to conform to reality/social norms
Fixation
Too little or too much gratification leads to this
A constellation of personality traits associated with a particular stage of psychosexual development
What leads to abnormal behavior through Freud
Carl Jung
Believed an understanding of human behavior must incorporate self awareness and self direction as well as impulses of the if and mechanisms of defense
What is abnormal?: Undifferentiated self
Archetypes
Archetypes
The collective unconscious contains primitive images
Reflect the history of our species, including vague, mysterious, mythical images like the all powerful God
Alfred Adler
Believed in self awareness plays a major role in the formation of personality
Spoke of a creative self
What is abnormal?: undifferentiated self
creative self
A self aware aspect of personality that strives to overcome obstacles and develop an individual’s potential
Karen Horney
Stressed the importance of child–parent relationships in the development of emotional problems
When parents are harsh or uncaring, children come to develop a deep seated form of anxiety - basic anxiety
Children who harbor deep seated resentment toward their parents may develop a form of hostility - basic hostility
Ego psychology
Heinz Hartmann
Posits that the ego has energy and motives of its own
Choices to seek an education, dedicate oneself to art and poetry, and further humanity are not merely defensive forms of sublimation
Erik Erison
Developmental theory
Posits that our personalities continue to be shaped throughout adulthood as we deal with the psychosocial challenges or crises we face during each period of life
Margaret Mahler
Objects relation theory
- Focuses on how children come to develop symbolic representations of important others in their lives, especially their parents
What is abnormal?: Failure to develop a distinctive and individual identity from primary caregivers, attachment wounds
Psychosis
Characterized in general by bizarre behavior and thoughts and by fault perceptions of reality, including hallucinations
Learning Based Models
Abnormal behavior is a result of learning inappropriate or maladaptive behaviors
behaviorism, classical conditioning, operant conditioning, social cognitive theory
Behaviorism
Focuses on the role of learning in explaining behavior both normal and abnormal
Classical conditioning
Conditioning in which the conditioned stimulus (such as the sound of a bell) is paired with and precedes the unconditioned stimulus (such as the sight of food) until the conditioned stimulus alien is sufficient to elicit the response (such as salivation in a dog)
Can explain phobias after traumatic experiences
Operant conditioning
Responses are acquired and strengthened by their consequences
A method of learning that uses rewards and punishment to modify behavior. Through operant conditioning, behavior that is punished will rarely occur
Can explain abnormal behaviors occurring as something previously rewarded (sexual advances in appropriate settings) or normal behaviors begin punished (emotional repression as expression had previously been punished)
reinforcement, positive reinforcers, negative reinforcers, punishment
Reinforcement
Changes in the environment that increase the frequency of preceding behavior
Positive reinforcers
Rewards
Boost the frequency of behavior
Negative reinforcers
Increase the frequency of behavior when they are removed
Punishment
Stimuli that decrease the frequency of the behavior they follow
Social cognitive theory
Knowledge acquisition can be directly related to observation in social settings, lived experiences, outside influences like media (modeling)
A learning based theory that emphasizes observational learning and incorporates roles for cognitive variables in determining behavior
modeling
expectancies
modeling
Learning by observation
expectancies
Beliefs about expected outcomes
Humanistic Models
Humans are inherently drawn to self actualization
Abnormal behavior is a response to roadblocks in reaching self actualization
unconditional positive regard; conditional positive regard
self actualization
To become all we are capable of being
Believed that people have an inborn tendency to strive to become all they are capable of being
Unconditional positive regard
Prizing children and showing them that they are worthy of love irrespective of their behavior at any given time
Conditional positive regard
When parents accept children only when they behave in the way the parents want them to behave
Children may learn to disown all the thoughts, feelings, and behaviors their parents have rejected
compare and contrast (un) and conditional positive regard
Children who grow up with conditional positive regard become alienated from their true self and thus develop abnormal patterns
Normal parts of them are treated as ‘bad’ and distort self concept; child (and later adult) sees this normal part as ‘bad’ and is denied
Cognitive Models
Humans can be viewed as computers via information processing
Abnormal behavior results from distorted and self-defeating thinking/faulty information processing
The thought or belief, not the event, is the issue
Activating Event → Belief → Consequences
Cognitive distortions of “thinking errors” lead to issues
- All or nothing thinking
- Anticipating negative outcomes
- Fortune telling
- Catastrophizing
Etc.
Sociocultural Perspective
Sociocultural Impacts of Mental Health
“Abnormality” as understandable responses to a society that fails us
“Abnormality” as a convenient label for someone who doesn’t fit social norms
Continued exposure to these systems creates immense stress that impacts the body and mental health
- Bronfenbrenner
minority stress theory; social causation model; downward drift hypothesis
Minority Stress Theory
Posits that those with minority identities experience increased levels of stress based on compounded experiences of prejudice, discrimination, stigma, rejection, lack of support, and internalized stigma
Increased levels are linked to increased risk of depression, anxiety, and PTSD
Social causation model
Holds that people from lower socioeconomic groups are at greater risk of severe behavior problems because living in poverty subjects them to a greater level of social stress than that faced by more well to do people
Downward drift hypothesis
Suggests that problem behaviors, such as alcoholism, lead people to drift downward in social status, thereby explaining the link between low socioeconomic status and severe behavior problems
Types of Psychotherapy
- Psychodynamic
- Behavior Therapy
- Humanistic Therapy
- Cognitive Therapy
- Eclectic Therapy
- Psychodynamic
Focus on relational work, support client self-awareness, and understanding of the influence of the past on present behavior
Therapeutic relationship is key
Psychoanalysis; free association; dream analysis; transference; countertransference; interpretations; introjection
Psychoanalysis
Method of psychotherapy developed by Freud
First form of psychodynamic therapy
psychodynamic therapy
General term referring to forms of psychotherapy based on the Freudian tradition that seeks to help people gain insight into and resolve the dynamic struggles or conflicts between forces within the unconscious mind believed to lie at the root of abnormal behavior
Free association
Expression of whatever comes to mind without judgment to unblock defenses
Dream analysis
Analysis of mind content with less barriers
Transference
Displacement of feelings towards another onto the therapist
Countertransference
Feelings toward the client by the therapist
Interpretations
Pairing of connections observed by therapist to support client insight
Introjection
Feelings or thoughts of others taken on by the client
- Behavior Therapy
Focus on changing behavior (is brief - few weeks)
Using principles of conditioning (both conditional and operant) on human behavior
Systematic desensitization; gradual exposure; token economy
Systematic desensitization
Gradual experience of imagined fear/anxiety arousal paired with progressive relaxation techniques
Gradual exposure
Supported movement through hierarchy of progressively more anxiety inducing stimuli
Token economy
Increase adaptive behavior with redeemable tokens
- Humanistic Therapy
Focus on subjective, conscious, in the moment experiences
Free will, human potential, and self-discovery
Creates conditions of warmth and acceptance in the therapeutic relationship that help clients become more and more aware and accepting of their true selves
Victor Frankl - Logotherapy; Rogerian/Person-Centered Therapy; empathy; genuineness; congruence
Victor Frankl - Logotherapy
Focused on reach for meaning in life based on experiences in the Holocaust
Paradoxical intention, dereflection, and Socratiic dialogue
Rogerian/Person-Centered Therapy
Unconditional positive regard
Non-directive
Empathy; genuineness; congruence
Empathy
The ability to understand someone’s feelings and experiences from that person’s point of view
Genuineness
The ability to be open about one’s feelings
Congruence
The coherence or fit among one’s thoughts, feelings, and behaviors
- Cognitive Therapy
Focused on correcting faulty thinking, distorted beliefs, and self defeating attitudes
Usually short term → 8-10 sessions
Rational emotive behavior therapy (REBT); Beck’s cognitive therapy; Cognitive behavioral therapy (CBT)
Rational emotive behavior therapy (REBT)
Therapists collaboratively dispute irrational beliefs and substitute with better behaviors
Beck’s cognitive therapy
Helps clients to recognize and change cognitive distortions and test reality
Cognitive behavioral therapy (CBT)
Identify and correct maladaptive beliefs and negative thoughts with cognitive restructuring and behavior changes
- Eclectic Therapy
Incorporates principles and techniques from different therapeutic orientations that they believe will produce the greatest benefit in treating a particular client
Technical eclecticism; Integrative eclecticism
Technical eclecticism
Drawing on schools without adopting their positions
Integrative eclecticism
Synthesizing and integrating different schools into a single model
More than one client?
group therapy; family therapy; couple therapy
Group therapy
A group of clients meets together with a therapist or a pair of therapists
Family therapy
The family, not the individual, is the unit of treatment
Couple therapy
Focuses on resolving conflicts in distressed married or unmarried couples
Meta-analysis
Averages the results of a large number of studies to determine an overall level of effectiveness
Nonspecific treatment factors
The client’s expectations of improvement as well as features of the therapist–client relationship, that include the following:
Empathy, support, attention
Therapeutic alliance
Working alliance
Sociocultural Barriers to Mental Health Treatment
Barriers in physical access to care
Language, institutional cultural, economic
Historical exploitation in healthcare systems
Lack of culturally competent providers
Family / group stigma
Mental health literacy
Different understandings of illness or health
Mistrust or fear of treatment
Different understandings of illness or health
Cultural traditions that don’t match with the white-rooted bases of psychotherapy
Biomedical Therapies
Psychopharmaceuticals
Serve to help control systems, not cure, of disorders by impacting neurotransmitter systems in the brain
Anxiolytics; Antipsychotics; Lithium and Anticonvulsive Drugs; Antidepressants
Psychopharmacology
The field of study that examines the effects of therapeutic or psychiatric drugs
Anxiolytics
Anti Anxiety drugs
Combat anxiety and reduce states of muscle tension
Reduce CNS activity
Lorazepam, Diazepam
Rebound anxiety
Rebound anxiety
Many people who regularly use antianxiety drugs that anxiety or insomnia returns in a more severe form once they discontinue the drugs
Lithium and Anticonvulsive Drugs
Used to treat mania and mood swings in people with bipolar disorder
Antipsychotics
Disrupt or block dopamine’s ability to bind to its receptor
Thorazine, Risperdal, Abilify
Neuroleptics
Commonly used to treat the more flagrant features of schizophrenia and other psychotic disorders
Antidepressants
Have beneficial effects in treating depression and some other psychological disorders as well, including panic disorder, social phobia, obsessive compulsive disorder, and bulimia
- Tricyclic antidepressants (TCAs), Monoamine Oxidase Inhibitors (MAOiS)
- Selective Serotonin Reuptake Inhibitors (SSRIs)
- Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)
Tricyclic antidepressants (TCAs), Monoamine Oxidase Inhibitors (MAOiS)
Increase availability of Serotonin and Norepinephrine neurotransmitters
Selective Serotonin Reuptake Inhibitors (SSRIs)
Specifically targets serotonin, blocks reuptake (reabsorption)
Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)
Targets both Serotonin and Norepinephrine, also by blocking reuptake (reabsorption)
Electroconvulsive Therapy
Electric shocks cause chemical and cellular changes in the brain that causes changes to the molecules and cells of the brains of people with depression, helping relieve severe depression
Transcranial magnetic stimulation (TMC)
Applies a series of short magnetic pulses to stimulate nerve pulses to stimulate nerve cells and influence activity in areas of the brain associated with depressive symptoms
Psychosurgery
No longer used–breaks the connection between the frontal lobe and the thalamus
While it did include calm, they also caused significant changes in personality, such as empathy and social disinhibition, and sometimes death
Lobotomies; ice pick through the eye and the brain
Psychedelic Assisted Therapy
Some types of psychedelic drugs, such as psilocybin and MDMA (ecstasy), in conjunction with talk therapy, work by encouraging the growth of new connections between neurons in the brain
It also can allow access to secondary consciousness
After use, the mind is far more open to treatment
Diathesis-stress model
Model holds that certain psychological disorders, such as schizophrenia, arise from a combination or interaction of a diathesis with stressful life experiences
Diathesis + stress → development of disorder
diathesis
A vulnerability or predisposition to develop the disorder, usually genetic in nature
