Chapters 1 And 3 Flashcards
Abnormal psychology
Concerned with understanding the nature, causes, and treatments of mental disorders
Family aggregation
Whether a disorder runs in families
Nomenclature
A naming system
Stigma
Disgrace
Stereotype
Automatic beliefs concerning other people that we unavoidably learn as a result of growing up in a particular culture
Epidemiology
The study of the distribution of diseases, disorders, or health-related behaviours in a given population.
Mental health epidemiology: study of distribution of mental disorders
Prevalence
Refers to the number of active cases in a population during any given period of time. Usually expressed as percentages.
Different types of prevalence estimates: point prevalence; 1-year prevalence; lifetime prevalence
Point prevalence
Refers to the estimated proportion of actual, active cases of a disorder in a given population at a given point in time
1-year prevalence
Covers a much larger time period than point prevalence, so usually figure is larger (ex count everyone who experienced depression at any point in time throughout an entire year). Would include people who had recovered before point prevalence assessment as well as those whose disorders didn’t begin until after point prevalence estimate
Lifetime prevalence
Estimate of number of people who have had a particular disorder at any time in their lives. Estimates tend to be higher because includes both currently ill and recovered individuals
Incidence
Refers to number of new cases that occur over a given period of time (typically one year). Tend to be lower than prevalence estimates because excludes pre-existing cases
Comorbidity
Term used to describe presence of 2 or more disorders in the same person. Especially high in people who have severe forms of mental disorders
DALY
Disability adjusted years of life. One DALY can be thought of as the loss of one year of otherwise “healthy” life
Outpatient treatment
Requires that a patient visit a mental health facility practitioner, but does not have to be admitted to hospital or stay there overnight
Acute
Short in duration
Chronic
Long in duration
Etiology
Causes of disorders
Case study
Detailed accounts of patients, anecdotal accounts. Info subject to bias because writer of case study selects what info to include and what info to omit. Material in case study often only relevant to individual being described (low generalizability). The conclusions we can draw are very narrow and may be mistaken. But good way to illustrate clinical material and provide limited support for theory or challenge to ideas. Can also serve as stimulus for research/new ideas/rare clinical conditions
Low Generalizability
Not able to draw conclusions about other cases even when those cases involve people with similar abnormality
Self-report data
May involve questionnaires and interviews. Limitations: can sometimes be misleading because people will lie, misinterpret the question, or desire to present themselves in favourable light
Observational approaches
When info is collected in way that does not involve asking people directly. Refers to careful scrutiny of conduct and manner of specific individuals. Ex: direct observation, collecting info about bio variables, brain imaging,
Hypothesis
Effort to explain, predict, or explore something. Frequently determines therapeutic approaches used to treat particular clinical problem
Sampling
Technique used to study people with disorders who fit a particular type of criteria. Try to select people who are representative of the much larger group of individuals to be studied. Want smaller sample to mirror larger group (underlying population) in all important ways (severity and duration of disorder and demographics). Ideally, our research sample would be randomly selected from the larger population of people with the disorder, which is important for ensuring that every person in that population would have an equal chance of being included in our study
Samples of convenience
When researchers study groups of people who are easily accessible to them and who are readily available (ex college students)
Online sampling
Using approaches such as Amazon’s mechanical Turk (MTurk), which is online labour market connecting people who complete surveys for small payment. Not representative of general population, workers tend to be younger, over educated, underemployed, less religious and more liberal than people in general population (ex in USA, blacks and hispanics underrepresented and asians over represented in MTurk relative to general population)
External Validity
Extent to which we can generalize findings beyond study itself
Internal validity
Reflects how confident we can be in the results of a particular given study. Extent to which a study is methodologically sound, free of confounds, or other sources of error, and able to be used to draw valid conclusions
Comparison/control group
Used to test a hypothesis. A group of people who do not exhibit the disorder being studied but who are comparable in all other major respects to the criterion group. Typically is psychologically healthy or normal according to certain specified criteria.
Criterion group
People with disorder being studied
Correlational research
Involves studying world as it is. Does not involve manipulation of variables. Researcher selects certain groups of interest, then compares groups on variety of different measures (ex studying differences between people with a particular disorder and those without). Used to study different groups of patients as they are at the time of the study.
Positive correlation
When measures vary together in a direct, corresponding manner
Negative correlation
Inverse relationship between variables of interest
Correlation coefficient
Measures the strength of a correlation. Denoted by symbol r, runs from 0-1. Number closer to 1 represents stronger association between 2 variables. + or - sign indicates direction of association between variables.
Statistical significance
Probability that correlation would occur purely by chance is less than the number shown (ex p < 0.05 means prob it would occur purely by chance is less than 5 out of 100). Correlations that have p < 0.05 are considered to be statistically significant and worthy of attention. Statistical significance is influenced by magnitude/size of correlation between 2 variables, but also by sample size. Correlations based on very large samples can be very small and still reach statistical significance, but correlations drawn from small samples need to be very large to reach statistical significance
Effect size
Used to avoid problems inherent in just focusing on statistical significance and to facilitate comparison of results across different studies. Effect size reflects size of association between 2 variables independent of the sample size. Effect size of 0= no association between variables. Because is independent of sample size, can be used as common metric and is valuable when wanting to compare strength of findings across different studies. If effect size is same across studies, can conclude that studies had similar findings, regardless of significance in one study vs other
Meta-analysis
Statistical approach that calculates and combines effect sizes from all studies. Each study can be thought of as being equivalent to individual participant in conventional research design. Because it uses effect sizes, meta-analysis is better way to summarize research findings than is possible with literature review
Third variable problem
Unknown third variable might be causing 2 events to happen at same time
Retrospective research
Looking back in time. Try to collect info about how patients behaved early in lives with goal of identifying factors that might have been associated with what went wrong later. Challenge with this technique is potential for memories to be faulty and selective. This method also invites biased procedure, unconscious or otherwise (as invites investigators to discover what they already presume they will discover concerning background factors)
Prospective research
Looking ahead in time. Identify individuals who have a higher-than average likelihood of becoming psychologically disordered and to focus research on them before disorder manifests. When hypothesis correctly predicts behavioural problems that group of individuals will later develop, are much closer to establishing causal relationship
Longitudinal design
Study that follows people over time and tries to identify factors that predate onset of disorder
Direction of effect problem
Correlational research doesn’t allow us to draw conclusions about directionality
Experimental research
Approach must be used in order to draw conclusions about causality and resolve questions of directionality. Scientists control all factors but one (dependent variable)
Independent variable
Factor that is manipulated in experimental research design
Dependent variable
Outcome of interest in experimental research design. If observed to change as manipulated factor is changes, independent variable can be regarded as cause of outcome
Experimental method in treatment research
Proposed treatment is given to designated group of patients and withheld from similar group of patients. Should treatment group show significantly more improvement than untreated group, can have confidence in treatment’s efficacy. May not know why treatment works
Random assignment
Every research participant has equal chance of being placed in treatment or no-treatment condition. Once treatment has been established as effective, can then be provided for members of original control group (sometimes it’s unethical to withhold known treatment so stringent safeguards need to be in place regarding potential costs vs benefits of conducting particular research project)
Standard treatment comparison study
Alternative research design, 2 or more treatments are compared in differing yet comparable groups. Typically efficacy of control condition has been previously established, so question is if new treatment is better than control (established) treatment
Single-case research design
Case studies can be used to develop and test therapy techniques within scientific framework. Same individual is studied over time. Behaviour/performance at one point in time can then be compared to behaviour/performance at later time, after specific intervention/treatment has been introduced
Double-blind study
Neither subjects nor experimenter who was working with subjects knows who gets what condition
Placebo treatment
Enable experimenters to control for possibility that simply believing one is getting as effective type of treatment produces therapeutic benefit
ABAB research design
A phase 1: baseline condition (collect data)
B phase 1: introduce treatment
A phase 2: withdraw treatment (to establish whether it really was treatment that was important
B phase 2: reinstate treatment again (to demonstrate that behaviour during first B phase is attainable again)
Analogue studies
We study not the true item of interest but an approximation to it. May involve animals or people. Assumption: that the findings in animal studies can be generalized to humans (ex. Learned helplessness theory of depression/hopelessness theory of depression developed from experiments with dogs). Even though problems may arise when we generalize to readily from animal to human models of psychopathology, certain analogies and studies have generated much research and have allowed us to develop new understandings
Correlate
When a variable is associated with an outcome of interest, it is a correlate of that outcome
Risk factor
If a variable is shown to precede an outcome in time, we can infer that the variable is a risk factor for the outcome. Variable risk factor: if the variable can be changed. Fixed marker: variable cannot be changed.
Causal risk factor
If changing X leads to a change in Y, X is a causal risk factor for condition Y. (If changing X doesn’t lead to a change in Y, it is a “variable marker” of Y)
Etiology
Causal pattern
Necessary cause
A characteristic that must exist for a disorder (Y) to occur. If Y occurs, then X must have preceded it
Sufficient cause
A condition that guarantees the occurrence of a disorder (Y). If X occurs then Y will also occur. A sufficient cause may not be a necessary cause
Contributory cause
One that increases the probability of a disorder (Y) developing but is neither necessary nor sufficient for the disorder to occur. If X occurs, then the probability of Y occurring increases
Distal risk factors
Causing factors that occur relatively early in life that don’t show effects for many years
Proximal risk factors
Factors that operate shortly before the occurrence of the symptoms of a disorder. May be a condition that proves too much for a person and triggers the onset of a disorder. It also may involve biological changes such as damage to certain parts of the brain. sometimes a proximal risk factor for a problem at one stage in life may also serve as a distal risk factor that sets up a predisposition for another disorder later in life.
Reinforcing contributory cause
Condition that tends to maintain maladaptive behaviour that is already occurring
Causal pattern
When more than one causal factor is involved. Often there are a multitude of interacting causes. Can have difficulty distinguishing between what is a cause and what is an effect because effects can serve as feedback that can in turn influence causes. ie the effects of feedback and the existence of mutual, two-way influences must be taken into account
Diathesis
A vulnerability (diathesis) is a predisposition toward developing a disorder that can derive from biological, psychological, or sociocultural causal factors. Usually results from one or more relatively distal necessary or contributory causes but is not sufficient to cause disorder. Instead, must be proximal factor (stressor) which may also be contributory or necessary but not sufficient by itself to cause disorder except in someone with diathesis
Stress
Response or experience of an individual to demands that they perceive as taxing or exceeding their personal resources. Often occurs when individual experiences chronic or episodic events that are undesirable and lead to behavioural, psychological, and cognitive accommodations
Diathesis-stress models
Models that describe the situation: when a mental disorder develops when someone who has a pre-existing vulnerability for that disorder experiences a major stressor. Examples: additive model; interactive model
Additive model
Diathesis and stress sum together; when one is high, the other can be low. Ex. Someone with no/very low diathesis could still develop disorder when faced with truly severe stress (individuals with high level of diathesis may need only small level of stress before disorder develops)
Interactive model
Some amount of diathesis must be present before stress will have effect. ie someone with no diathesis will never develop disorder, no matter how much stress they experience, whereas someone with diathesis will demonstrate increasing likelihood of developing disorder with increasing levels of stress
Protective factors
Decrease likelihood of negative outcomes among those at risk. Not simply the absence of a risk factor, but something that actively buffers against likelihood of negative outcome among those with some risk factor. Ex having warm and supportive parent, allowing development of good attachment relationship. Don’t have to be positive experiences (sometimes exposure to stress that is dealt with successfully is protective factor, more likely to occur with moderate stressors than mild or extreme)
Resilience
The ability to adapt successfully to even very difficult circumstances. “Overcoming the odds”. If child’s fundamental systems of adaptation are operating normally, then most threatening circumstances will have minimal impact on them. Not an all or none capacity, and may show resilience in one domain but not others
Diathesis-stress models need to be considering in a broad framework of ___________.
Multi causal developmental models. In the course of development a child may acquire a variety of cumulative factors that may interact to determine their risk for psychopathology, and risk factors interact with variety of protective processes and sometimes stressors to determine whether child develops in normal and adaptive way
Developmental psychopathology
Concentrated on determining what is abnormal at any point in development by comparing and contrasting it with normal and expected changes that occur on course of development
Biopsychosocial viewpoint
Acknowledges that biological, psychological and social factors all interact and play a role in psychopathology and treatment. Cultural context in which these factors play out inflicted how we think about behaviour, no abnormal and normal
Biological viewpoint
Focuses on mental disorders as diseases, many of the primary symptoms of which are cognitive, emotional, or behavioural. Mental Disorders are viewed as disorders of the CNS, ANS, or endocrine system that are inherited or caused by pathological process.
Neurological diseases
Result from disruption of brain functioning by physical or biochemical means and often involve psychological and behavioural aberrations. These disorders were the first recognized as having biological or organic components.
4 categories of biological factors that are relevant to development of maladaptive behaviour
- Genetic vulnerabilities
- Brain dysfunction and neural plasticity
3 neurotransmitter and hormonal abnormalities in brain or other parts of CNS - Temperament
Genes
Long molecules of DNA that are present at various locations on chromosomes. Carriers of info we inherit from parents, and exist in 2 or more alternate forms called alleles. Most mental disorders show some genetic influence. Most often, personality traits and mental disorders are influenced by abnormalities in some genes or by naturally occurring variations of genes (polymorphisms)
Chromosomes
Chain-like structures within cell nucleus that contain genes
Polygenic
Influenced by multiple genes or multiple polymorphisms of genes, with any one gene having very small effects (often mental disorders are polygenic)
Genotype
Persons total genetic endowment. Except for identical twins, no two humans ever begin life with the same genetic makeup
Phenotype
Observed structural and functional characteristics that results from an interaction of the genotype and the environment
Genotype-environment interaction
Usually, genetic factors are not necessary and sufficient to cause mental disorders, but instead can contribute to vulnerability or diathesis to develop psychopathology that only happens if there is significant stressor in persons life
Genotype-environment correlation
When genotype/genes shape the environmental experiences a child has, affecting the phenotype in important ways. 3 ways this can happen
3 ways which individuals genotype may shape their environment
- Genotype may have a passive effect on the environment, resulting from genetic similarity of parents and children (ex intelligent parents may create stimulating environment for child which interacts with child’s endowment for high intelligence).
- Child’s genotype may evoke particular reactions from social and physical environment (evocative effect). Ex happy babies evoke more positive responses from others.
- Child’s genotype may play more active role in shaping environment (active effect). Child seeks out environment that is congenial (“niche building”). Ex extraverted children seeking company of others, enhancing own social tendencies
Behaviour genetics
Field that focuses on studying heritability of mental disorders/psychological functioning. Uses 3 primary methods:
1. Family history method
2. Twin method
3. Adoption method
(Recently, 2 additional methods, linkage studies and association studies, have been developed)
Family history method
Investigator observes samples of relatives of each proband/index case (carrier of trait or disorder in question) to see whether incidence increases in proportion to degree of hereditary relationship. Incidence of disorder in normal population is compared with incidence among relatives of index case. Limitation: people who are more closely related tend to share more similar environments
Twin method
Studying twins. If a given disorder were completely heritable, one would expect the concordance rate (the percentage of twins sharing same disorder or trait) to be 100%. No forms of psychopathology where concordance rates for identical twins are this high so we can conclude no mental disorders are completely heritable. Ideal study involves identical twins who have been reared apart in significantly different environments
Dizygotic twins
Twins who develop from 2 different fertilized eggs and do not share any more genes than siblings of same parents. If disorder has strong genetic component, concordance rate should be much lower than monozygotic twins. Most disorders have concordance rates lower for dizygotic twins than monozygotic
Adoption method
2 variations:
- bio parents of individuals with given disorder (who were adopted) are compared to bio parents of individuals without disorder (who were also adopted) - if genetic influence, would be higher rate of disorder in bio relatives of those with disorder than those without.
- compare rates of disorder in adopted away offspring of bio parents who have disorder with rates in adopted away offspring of normal parents
Shared environmental influences
Are those that would make children in a family more similar, whether influence occurs within family or in environment
Non-shared environmental influences
Those in which children in a family differ. Includes unique experiences at school and unique features of upbringing in home, such as parent treating one child qualitatively differently than another. Nonshared influences have appeared to be more important in psychopathology
Linkage analysis
Capitalize on currently known locations in chromosomes of genes for other inherited physical characteristics or bio processes (ex eye colour or blood group). Most results from current studies are inconclusive at this time (could not be replicated) because these disorders are usually influenced by many different genes. Has been successful for locating genes for single-gene brain disorders such as Huntington’s disease
Association studies
Start with 2 large groups of individuals, one group with and one group without disorder. Then compare frequencies in these groups of certain genetic markers that are known to be located on particular chromosomes (ex eye colour or blood group). If one or more of known genetic markers occur with higher frequency in individuals with given disorder than in people without, infer that one or more genes associated with disorder are located on same chromosome. Ideally, search for gene candidates starts with known genes for some bio process that is disrupted in disorder.
Association studies are more promising than linkage studies for identifying small effects of any particular gene and in disorders that are known to be influenced polygenically
Neural plasticity
Flexibility of the brain in making changes in organization and function in response to pre and postnatal experiences, stress, diet, disease, maturation etc. Existing neural circuits can be modified or new neural circuits can be generated. Can be beneficial or detrimental. Continues throughout the lifespan
Developmental systems approach
Acknowledges that genetics influences neural activity, which in turn influences behaviour, which in turn influences the environment, but also that these influences are bidirectional
Synapse
Tiny fluid filled space between axon endings of one neuron and the dendrites or cell body of another neuron
Neurotransmitters
Chemical substances that are released into synapse by presynaptic neuron when nerve impulse occurs. Can initiate or inhibit impulse transmission. Whether neural message is transmitted successfully depends on concentration of neurotransmitters in synapse
Monoamine oxidase
Enzyme that destroys neurotransmitters in synapse. Also present in presynaptic terminal and can destroy neurotransmitters there too
Neurotransmitter imbalances
One of basic tenets in biological perspective is that imbalances can lead to abnormal behaviour. Sometimes brought on by psychological stress. Can be created by:
- excessive production and release of neurotransmitters into synapse
- dysfunctions in normal processes by which neurotransmitters are deactivated
- problems with receptors in postsynaptic membrane, may be abnormally sensitive or insensitive
Chemical circuits
Neurons that are sensitive to a particular neurotransmitter tend to cluster together
Five different kinds of neurotransmitters
- Norepinephrine
- Dopamine
- Serotonin
- Glutamate
- Gamma aminobutyric acid (GABA)
Monoamines
Norepinephrine, dopamine, and serotonin. Synthesized from single amino acid
Norepinephrine
Plays important role in emergency reactions our body shows when exposed to acutely stressful situation, as well as attention, orientation and basic motives
Dopamine
Pleasure and cognitive processing, implicated in schizophrenia and addictive disorders
Serotonin
Important effects on way we think and process info from our environment and behaviours and moods. Plays important role in emotional disorders such as anxiety and depression, and suicide.
Glutamate
Excitatory neurotransmitter. Implicated in schizophrenia.
GABA
Strongly implicated in reducing anxiety and other emotional states characterized by high levels of arousal
Many medications used to treat various disorders have synapse at:
Site of action
Agonists
Medications that facilitate effects if neurotransmitter on post synaptic neuron
Antagonists
Medications that opposes or inhibit effects of neurotransmitter on post synaptic neuron
Hormones
Chemical messengers secreted by a set of endocrine glands in bodies. Each endocrine gland produces and releases own set of hormones directly into bloodstream. Hormones travel and directly affect target cells in various parts of brain and body, influencing events such as fight or flight reactions, sexual responses, physical growth etc
Pituitary gland
Links CNS to endocrine system by effects of hypothalamus. Master gland of body, producing variety of hormones that regulate or control other endocrine glands
Activation of hypothalamic-pituitary-adrenal (HPA) axis
- Messages in form of corticotropin-releasing hormone (CRH) travel from hypothalamus to pituitary.
- In response, pituitary releases adrenocorticotropic hormone (ACTH), which simulates cortical part of adrenal gland (located on top of kidney) to produce epinephrine and stress hormone cortisol, which is released into general circulation.
- Cortisol provides negative feedback to hypothalamus and pituitary to decrease their release of CRH and ACTH, which in turn reduces release of adrenaline and cortisol.
Malfunctioning of negative feedback system implicated in various forms of psychopathology (ex depression and ptsd)
Cortisol
Stress hormone. Mobilizes body to deal with stress
Sex hormones
Produced by gonadal glands and imbalance can contribute to maladaptive behaviour. Gonadal hormone influences in nervous system development seem to contribute to behaviour differences between men and women
Androgens
Male hormones
Temperament
Refers to child’s reactivity and characteristic ways of self regulation, believed to be biologically programmed. Strongly influenced by genetic factors, but prenatal and postnatal environments also play role. Early temperament is thought to be basis from which our personality develops
Dimensions of temperament
5, can be identified at 2-3 months of age. Include: fearfulness, irritability/frustration, positive affect, activity level, attentional persistence/effortful control
3 dimensions of adult personality
- Neuroticism or negative emotionality (infant dimensions of fearfulness and irritability, show few gender differences)
- Extraversion or positive emotionality (infant dimensions of positive affect and possibly activity level)
- Constraint ( conscientiousness and agreeableness) (infant dimensions of attentional persistence and effortful control)
Temperament in boys
Boys show slightly higher levels of activity and intense pleasure than girls
Temperament in girls
Girls seem to have greater control of impulses and greater ability to regulate attention
Stability in temperament
Some aspects of temperament show moderate degree of stability from late in first year of life through at least middle childhood
Temperament and developmental processes
Temperament can have effects on variety of important developmental processes. Ex. Children with fearful temperament have many opportunities for classical conditioning to fear situations where fear is provoked. Evidence suggests child may be especially likely to fear social situations. Ex. Children with high levels of positive affect and activity are more likely to show mastery motivation, but children with high levels of fear and sadness are less likely to show mastery motivation
Children with high levels of negative emotionality
Are more difficult for parents to be supportive of, and different parents have different styles of parenting such children. Families with less socioeconomic status are less supportive of difficult children than families of mid to high socioeconomic status (these families seem to be more resourceful in adapting their parenting styles when faced with high negative emotionality)
Behaviourally inhibited children
Children who are fearful and hyper-vigilant in many novel or unfamiliar situations. Trait has significant heritable component and is risk factor for development of anxiety disorders in later childhood and adulthood
Behaviourally uninhibited children
Shows little fear of anything, may have difficulty learning moral standards for their behaviour from parents or society, and have been shown at age 13 to exhibit more aggressive and delinquent behaviour. If combined with high levels of hostility, may lead to development of conduct disorder and antisocial personality disorder