Chapter Two Flashcards
Contemporary Perspectives on Abnormal Behavior and Methods of Treatment (136 cards)
1
Q
mental illnesses
A
The medical model posits that abnormal behaviors represent symptoms of underlying disorders or diseases that have biological causes
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Q
Neurons
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Makes up the nervous system
Nerve cells that transmit signals or “messages” throughout the body
- Allow us to sense
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Q
Dendrites
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Each neuron has these short fibers that project out from the cell body
Receive messages from adjoining neurons
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Q
axon
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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
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terminals
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The small branching structures at the tips of axons
Axons terminate in small branching structures aptly
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Q
myelin sheath
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insulating layer that helps speed transmission of neural impulses
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Q
how do neurons share messages?
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dendrites or cell body –> axon –> axon terminus –> other neurons
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neurotransmitters
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Induce chemical changes in receiving neurons
Transmit messages from one neuron to another
Changes cause axons to conduct the messages in electrical form
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Q
synapse
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Connection point between neurons
Junction or small gap between a transmitting neuron and a receiving one
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receptor site
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A part of a dendrite on a receiving neuron that is structured to receive a neurotransmitter
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Q
Neurotransmitters to Remember
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acetylcholine, dopamine, norepinephrine, serotonin
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Q
Acetylcholine
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Control of muscle contractions and formation of memories
Reduced levels found in patients with Alzeeimer’s disease
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Q
dopamine
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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
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Norepinephrine
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Mental processes involved in learning and memory
Irregularities linked with mood disorders such as depression
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serotonin
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Regulation of mood states, satiety, and sleep
Irregularities are implicated in depression and eating disorders
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Q
Signs of a dysregulated nervous system:
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Depression
Inappropriate behavior
Irritability
Exhaustion
Poor memory
Poor concentration or attention
Sleep issues
Anxiety and panic
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Q
PARTS OF THE NERVOUS SYSTEM
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central nervous system
peripheral nervous system
- somatic
- autonomic
- sympathetic
- parasympathetic
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Q
central nervous system,
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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
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Peripheral nervous system
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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
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Q
somatic nervous system
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Transmits messages from our sensory organs to the brain for processing, leading to the experience of visual, auditory, tactile, and other sensations
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Q
Autonomic nervous system
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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
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Q
Sympathetic nervous system
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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
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Parasympathetic nervous system
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Replenish energy (ex: digestion)
Activation of the sympathetic nervous system interferes with the parasympathetic control of digestion activity
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Frontal lobe
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important for voluntary movement, expressive language and for managing higher level executive functions
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Prefrontal cortex
Regulates higher mental functions, such as thinking, problem solving, and use of language
Ex: risk behaviors
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Genetics
Nature vs nurture
1. Genes do not dictate behavioral outcomes
2. Genetic factors create a predisposition or likelihood, not a certainty, that certain behaviors or disorders will develop
3. Multigenetic determinism affects psychological disorders
3. Genetic factors and environmental influence interact with each other in shaping our personalities and determining our vulnerability to a range of psychological disorders
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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
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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
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Conscious
Surface of awareness
“Above the surface”
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Preconscious
Memories that are not in awareness but that can be brought into awareness by focusing on them (ex: telephone number)
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Unconscious
Largest part of the mind
Remains shrouded in mystery
Great difficulty to bring memories back
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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
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Pleasure principle
Demands instant gratification of instincts without consideration of social rules or customs or the needs of others
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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
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Reality principle
Considers what is practice and possible, as well as the urgings of the id
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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
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Defense mechanisms
Psychological defenses to prevent socially unacceptable impulses from rising into consciousness
repression, denial, rationalization, displacement, projection, reaction formation, regression, sublimation
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Repression
Banishment of unacceptable urges, wishes, or impulses to the unconscious mind
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Denial
Refusal to accept the reality of a threatening impulse or unsafe behavior
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Rationalization
Self-justifications for unacceptable behavior used as a form of self-deception
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Displacement
Directing one’s unacceptable impulses toward threatening objects onto safer or less threatening objects
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Projection
Attributing one’s own impulses or wishes to another person
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Reaction formation
Taking the opposite stance ot what one truly wishes or believes in order to keep genuine impulses repressed
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Regression
Return of behaviors associated with earlier stages of development, generally during times of stress
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Sublimation
Channeling one’s own unacceptable impulses into more socially appropriate pursuits or activities
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Eros
Basic drive to preserve and perpetuate life
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Libido
Sexual energy that allows eros to fulfill its function
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Erogenous zones
Sexual pleasure zones
Successful movement of libido through zones in development is a successful, happy adult
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Stages of Psychosexual development
1. oral stage
2. anal stage
3. phallic stage
4. latency stage
5. genital stage
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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
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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)
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Phallic stage (3-6)
Phallic region (penis-boys; clitoris-girls) becomes the major erogenous zone (superego develops)
Oedipus or complex complex
Deviancy, sexual dysfunction
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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
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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
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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
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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
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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
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Archetypes
The collective unconscious contains primitive images
Reflect the history of our species, including vague, mysterious, mythical images like the all powerful God
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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
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creative self
A self aware aspect of personality that strives to overcome obstacles and develop an individual’s potential
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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
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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
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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
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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
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Psychosis
Characterized in general by bizarre behavior and thoughts and by fault perceptions of reality, including hallucinations
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Learning Based Models
Abnormal behavior is a result of learning inappropriate or maladaptive behaviors
behaviorism, classical conditioning, operant conditioning, social cognitive theory
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Behaviorism
Focuses on the role of learning in explaining behavior both normal and abnormal
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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
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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
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Reinforcement
Changes in the environment that increase the frequency of preceding behavior
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Positive reinforcers
Rewards
Boost the frequency of behavior
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Negative reinforcers
Increase the frequency of behavior when they are removed
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Punishment
Stimuli that decrease the frequency of the behavior they follow
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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
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modeling
Learning by observation
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expectancies
Beliefs about expected outcomes
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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
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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
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Unconditional positive regard
Prizing children and showing them that they are worthy of love irrespective of their behavior at any given time
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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
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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
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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.
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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
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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
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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
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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
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Types of Psychotherapy
1. Psychodynamic
2. Behavior Therapy
3. Humanistic Therapy
4. Cognitive Therapy
5. Eclectic Therapy
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1. 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
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Psychoanalysis
Method of psychotherapy developed by Freud
First form of psychodynamic therapy
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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
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Free association
Expression of whatever comes to mind without judgment to unblock defenses
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Dream analysis
Analysis of mind content with less barriers
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Transference
Displacement of feelings towards another onto the therapist
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Countertransference
Feelings toward the client by the therapist
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Interpretations
Pairing of connections observed by therapist to support client insight
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Introjection
Feelings or thoughts of others taken on by the client
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2. 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
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Systematic desensitization
Gradual experience of imagined fear/anxiety arousal paired with progressive relaxation techniques
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Gradual exposure
Supported movement through hierarchy of progressively more anxiety inducing stimuli
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Token economy
Increase adaptive behavior with redeemable tokens
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3. 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
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Victor Frankl - Logotherapy
Focused on reach for meaning in life based on experiences in the Holocaust
Paradoxical intention, dereflection, and Socratiic dialogue
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Rogerian/Person-Centered Therapy
Unconditional positive regard
Non-directive
Empathy; genuineness; congruence
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Empathy
The ability to understand someone’s feelings and experiences from that person’s point of view
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Genuineness
The ability to be open about one’s feelings
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Congruence
The coherence or fit among one’s thoughts, feelings, and behaviors
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4. 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)
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Rational emotive behavior therapy (REBT)
Therapists collaboratively dispute irrational beliefs and substitute with better behaviors
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Beck’s cognitive therapy
Helps clients to recognize and change cognitive distortions and test reality
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Cognitive behavioral therapy (CBT)
Identify and correct maladaptive beliefs and negative thoughts with cognitive restructuring and behavior changes
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5. 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
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Technical eclecticism
Drawing on schools without adopting their positions
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Integrative eclecticism
Synthesizing and integrating different schools into a single model
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More than one client?
group therapy; family therapy; couple therapy
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Group therapy
A group of clients meets together with a therapist or a pair of therapists
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Family therapy
The family, not the individual, is the unit of treatment
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Couple therapy
Focuses on resolving conflicts in distressed married or unmarried couples
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Meta-analysis
Averages the results of a large number of studies to determine an overall level of effectiveness
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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
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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
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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
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Psychopharmacology
The field of study that examines the effects of therapeutic or psychiatric drugs
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Anxiolytics
Anti Anxiety drugs
Combat anxiety and reduce states of muscle tension
Reduce CNS activity
Lorazepam, Diazepam
Rebound anxiety
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Rebound anxiety
Many people who regularly use antianxiety drugs that anxiety or insomnia returns in a more severe form once they discontinue the drugs
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Lithium and Anticonvulsive Drugs
Used to treat mania and mood swings in people with bipolar disorder
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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
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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)
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Tricyclic antidepressants (TCAs), Monoamine Oxidase Inhibitors (MAOiS)
Increase availability of Serotonin and Norepinephrine neurotransmitters
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Selective Serotonin Reuptake Inhibitors (SSRIs)
Specifically targets serotonin, blocks reuptake (reabsorption)
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Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)
Targets both Serotonin and Norepinephrine, also by blocking reuptake (reabsorption)
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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
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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
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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
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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
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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
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diathesis
A vulnerability or predisposition to develop the disorder, usually genetic in nature
