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
How to make decision about what constitutes mental illness?
Rests on clinical judgement regarding functional effects of disordered behaviour, specifically whether it leads to clinically significant distress or impairment in functioning. Establishing biological substrate does not matter. Biology alone does not shape behaviour/thoughts/feelings, this occurs with interactions with social events environment
Mediator
(Or mediating variable). Lies between 2 other variables and helps explain relationship between them. Like an intermediate variable
Psychodynamic perspective
Founded by sigmund Freud. Emphasizes role of unconscious motives and thoughts and their dynamic interrelationships in determination of both normal and abnormal behaviour. Conscious part of memory is very small, focus on unconscious part. Unconscious material has been repressed, but continues to seek expression through fantasies, dreams, slips of tongue etc. until unconscious material is brought to conscious part of mind, may lead to irrational and maladaptive behaviour
Freud’s theory on structure of personality
To explain behaviour, Freud theorized that person’s behaviour results from three components of personality/psyche: id, ego and superego
Id
Source of instinctual drives, first structure to appear in infancy. Drives are inherited and considered to be 2 opposing types: life instincts and death instincts. Operates in pleasure principle. Can generate mental images and wish fulfilling fantasies (primary process thinking), cannot undertake realistic actions needed to meet instinctual demands
Life instincts
Constructive drives primarily of sexual nature, constitute libido
Libido
Basic emotional and psychic energy of life
Death instincts
Destructive drives that tend toward aggression, destruction and eventual death
“Sexual“ (Freud)
Term used to refer to almost anything pleasurable, from eating to painting
Pleasure principle
Engaging in completely selfish and pleasure oriented behaviour, concerned only with immediate gratification of needs without reference to reality or moral considerations
Primary process thinking
Mental images and wish fulfilling fantasies
Ego
Second part of personality. Develops after first few months of life. Mediate between demands of id and realities of external world. Basic functions is to meet id demands in such a way as to ensure wellbeing of individual. Requires use of treason and other intellectual resources in dealing with external world, and exercise control over id demands
Secondary process thinking
Ego’s adaptive measures, where ego operates on reality principle
Superego
Third part of personality that gradually emerges from ego as child grows and gradually learns rules of parents and society regarding right and wrong. Is outgrowth of internalizing taboos and moral values of society about what is right and wrong.
“Conscience”.
Becomes inner control system that deals with uninhibited desires if id
Executive branch of personality
Because ego mediates among desires of id, demands of reality, and moral constraints of superego, it is often called executive branch of personality
Intrapsychic conflicts
Inner mental conflicts that are arising because three subsystems are striving for different goals, Freud theorized this can lead to mental disorders
Anxiety (psychoanalytic perspective)
Generalized feelings of fear and apprehension. Prominent in psychoanalytic viewpoint, Freud believed it plays key role in most forms of psychopathology. If anxiety is repressed, it can transform into and manifest in other overt symptoms such as paralysis. Ego can cope with anxiety through rational measures, but when anxiety exists only in unconscious, it cannot be dealt with through rational measures -then ego resorts to ego-defence mechanisms
Ego-defence mechanisms
Irrational protective measures that ego resorts to when cannot deal with anxiety through rational measures. These defence mechanisms reduce anxiety by helping person push painful ideas out of consciousness (forget), and result in distorted view of reality
Psychosexual stages of development
Freud proposed there are five psychosexual stages of development:
1. Oral stage
2. Anal stage
3. Phallic stage
4. Latency period
5. Genital stage
Appropriate gratification at each stage is important if person is to avoid being stuck or fixated at that level
Ego defence mechanisms (8)
- displacement
- fixation
- protection
- rationalization
- reaction formation
- regression
- repression
- sublimation
Displacement
Discharging pent up feelings, often of hostility, on objects less dangerous than those arousing feelings
Fixation
Attaching oneself in an unreasonable or exaggerated way to some person, or arresting emotional development on a childhood or adolescent level
Projection
Attributing ones unacceptable motives or characteristics to others
Rationalization
Using contrived explanations to conceal or disguise unworthy motives for one’s behaviour
Reaction formation
Preventing the awareness or expression of unacceptable desires by an exaggerated adoption of seemingly opposite behaviour
Regression
Retreating to an earlier developmental level involving less mature behaviour and responsibility
Repression
Preventing painful or dangerous thoughts from entering consciousness
Sublimation
Channeling frustrated sexual energy into substitutive activities
Oral stage
During first 2 years of life, mouth is principle erogenous zone: infants greatest source of gratification is sucking, a process that is necessary for feeding
Anal stage
From ages 2-3, the anus provides major source of pleasurable stimulation during time when toilet training is often going on and there are urges for retention and elimination
Phallic stage
From ages 3-6, self manipulation of genitals provides major source of pleasurable sensation
Latency period
From ages 6-12, sexual motivations recede in importance as child becomes preoccupied with developing skills and other activities
Genital stage
After puberty, deepest feelings of pleasure come from sexual relations
Oedipus complex
Conflict that occurs during phallic stage, when pleasures of self stimulation and accompanying fantasies pave way for this complex. Each young boy longs for his mother sexually and views his father as hated rival, but also fears his father will punish his sons lust by cutting off his penis. Eventually, boy identifies with his father and comes to have only harmless affection for mother, channeling sexual impulses to other woman
Castration anxiety
When young boy fears father will punish son’s lust by cutting off his penis. Anxiety forces boy to repress sexual desire for mother and hostility towards father
Electra complex
Female counterpart of Oedipus complex. Each girl desires to possess her father and replace her mother. Each girl experiences penis envy, wishing she could be more like father and brothers. Emerges from complex when identifies with mother and settles for idea that one day she will have man of her own who can give her a baby- which unconsciously serves as penis substitute
What is best we can hope for with psychoanalytic perspective?
That we will reach a compromise among our warring inclinations. Presents a deterministic view of human behaviour that minimizes rationality and freedom of self determination. Interprets violence, war etc as inevitable products of aggressive and destructive instincts present in human nature
Ego psychology
New direction taken by Anna Freud. Gives ego important organizing role in personality development. Psychopathology develops when ego does not function adequately to control or delay impulse gratification or does not make adequate use of defence mechanisms when faced with internal conflicts
Object-relations theory
Focus on individuals interactions with real and imagined other people (internal and external objects) and on relationships that people experience between their external and internal objects
Object in object-relations theory
Refers to symbolic representation of another person in the infant’s of child’s environment, most often parent
Introjection
Process where child symbolically incorporated into their personality ( through images and memories) important people in their life
Internalized objects could have…
Various conflicting properties, and also that these objects could split off from central ego and maintain independent existences, giving rise to inner conflicts. Individual becomes the “servant of many masters” and cannot lead an integrated, orderly life
Borderline personality theory and object-relations theory
Chief characteristic is instability (especially in personal relationships), are unable to achieve full and stable personal identity because of inability to integrate and reconcile pathological internalized objects. Also perceive external world in such abrupt extremes (a person may be all good one moment and then all bad the next)
Interpersonal perspective
Focuses on social determinants of behaviour. Psychopathology is rooted in unfortunate tendencies we have developed while dealing with interpersonal environments. Emphasizes social and cultural forces rather than inner instincts as determinants of behaviour. People are social beings motivated by desire to belong to and participate in a group. Started by Adler, a defector from psychoanalytic viewpoint
Erich Fromm
Took issue with psychoanalytic theory for neglect of social factors. Developed theory that focused on orientations or dispositions that people adopted in interactions with others. Believed that when orientations to social environment were maladaptive, they served as bases for psychopathology
Karen horney
Independently developed similar view to Fromm, and vigorously rejected Freud’s demeaning psychoanalytic view of women
Erik Erikson
Extended interpersonal aspects of psychoanalytic theory. Broadened Freud’s psychosexual stages into socially oriented concepts, describing crises or conflicts that occurred at eight stages and could be resolved in healthy or unhealthy way. Resolving conflicts in healthy way is necessary for master competence in life
Attachment theory
Roots in interpersonal and object-relations perspectives. Emphasizes importance of early experience, especially with attachment relationships, as laying foundation for later functioning throughout life. Stresses importance of quality of parental care to development of secure attachments, but also sees infant as playing more active role in shaping course of their own development than earlier theorists
Two of Freud’s most important contributions
- Developed therapeutic techniques such as free association and dream analysis for becoming acquainted with conscious and unconscious aspects of mental life
- Demonstrated that certain abnormal mental phenomena occur in attempt to cope with difficult problems and are simply exaggerations of normal ego defence mechanisms -same psychological principles apply to both normal and abnormal behaviour, dissipated much of mystery and fear surrounding mental disorders
What are three of Freuds points that have been incorporated into current thinking?
- There are psychological factors outside conscious awareness that influence behaviour
- Early childhood experiences can have important and lasting impact on development of normal and abnormal personality
- Sexual factors can play large role in human behaviour and mental disorders
Two important criticisms of traditional psychoanalytic theory
Centre on its failure as scientific theory to explain abnormal behaviour.
1. Fails to realize scientific limits of personal reports of experience as primary mode of obtaining information
2. There is lack of scientific evidence to super many of its explanatory assumptions or effectiveness of traditional psychoanalysis.
(Also criticized for overemphasis on sex drive, demeaning view of women, pessimism about basic human nature, exaggerating role of unconscious processes, and failing to consider motives toward personal growth and fulfillment)
Interpersonal therapy
Focus is on alleviating problem-causing relationships and helping people achieve more satisfactory relationships. Can be nearly as effective as cognitive-behavioural therapy in certain disorders such as depression, bulimia, and some personality disorders
Humanistic perspective
Views human nature as basically “good”. Pays less attention to unconscious processes and past causes, emphasizes present conscious processes and people’s inherent capacity for responsible self-direction. Perspective is concerned with processes such as love, hope, creativity, values, meaning, personal growth, and self-fulfillment. The self is a unifying theme and a focus on values and personal growth. Importance of individuality. Values and process of choice are key in guiding behaviour and achieving fulfilling lives. People must develop values and sense of own identity rather than blindly accepting values of others -> become self-actualizing
Carl Rogers’ formulation of the self-concept
Each individual exists in private world of experience of which the I, me, or myself is the center. The most basic striving is an individual is towards maintenance, enhancement, and actualization of self, and tendencies are towards health and wholeness under normal conditions. Perceived threat to self is followed by defence, including tightening of perception and behaviour and introduction of self-defence mechanisms
Self-actualizing
When someone is achieving their full potential
Psychopathology in humanistic view
Psychopathology is blocking or distortion of personal growth and natural tendency toward physical and mental health
Existential perspective
Resembles humanistic view in its emphasis on uniqueness of individual, quest for values and meaning, and existence of freedom for self-direction and self-fulfillment. Takes less optimistic view of human beings and places more emphasis on irrational tendencies and difficulties inherent in self-fulfillment. Living is much more a “confrontation”. Especially concerned with inner experiences of individual in their attempts to understand and deal with deepest human problems
Three basic themes of existentialism
- Existence and essence. Existence is a given but what we make of it (essence) is up to us. Our essence is created by our choices because our choices reflect values in which we base and order our lives.
- Meaning and value. Will-to-meaning is basic human tendency to find satisfying values and guide one’s life by them.
- Existential anxiety and encounter with nothingness. Nonbeing or nothingness (final form is death) is inescapable fate of all human beings. Awareness of our inevitable death and its implications for our living can lead to existential anxiety, deep concern over whether we are living meaningful and fulfilling lives
What do existential psychologists focus on?
Importance of establishing values and acquiring level of spiritual maturity worthy of freedom and dignity bestowed by one’s humanness. Avoiding central issues creates corrupted, meaningless, and wasted lives
Abnormal behaviour in Existential perspective
Abnormal behaviour in this perspective is seen as product of failure to deal constructively with existential despair and frustration
Behavioural perspective vs psychoanalysis
Arose as reaction against unscientific method of psychoanalysis. Believe that study of subjective experience did not provide acceptable scientific data because such observations were not open to verification by other investigators. Only study of directly observable behaviour and of stimuli and reinforcing conditions that control it could serve as basis for understanding human behaviour, normal and abnormal
Development of behavioural perspective
Developed through laboratory research rather than clinical practice with patients. Roots are in Pavlov’s classical conditioning and skinner’s operant conditioning.
Learning
Modification of behaviour as consequence of experience, central theme of behavioural approach.
Behaviourists focus on…
Effects of environmental conditions (stimuli) on acquisition, modification, and possible elimination of various types of response patterns, both adaptive and maladaptive
Classical conditioning
Where a specific stimulus may come to elicit a specific response. Hallmark : formerly neutral stimulus acquire capacity to elicit biologically adaptive responses through repeated pairings with unconditioned stimulus. Ex food and salivation. Food is unconditioned stimulus and salivation is unconditioned response. Stimulus that signals food delivery and eventually elicits salivation is the conditioned stimulus. Conditioning has occurred when presentation is conditioned stimulus alone elicits salivation- conditioned response. Responses are well maintained over time
Stimulus-stimulus expectancy
Animals and people actively acquire info about what CSs allow them to predict, expect, or prepare for upcoming biologically significant event. Only CSs they provide reliable and nonredundant info about occurrence of UCS acquire capacity to elicit CRs
Extinction
Process that occurs if CS is repeatedly presented without UCS, conditioned response gradually extinguishes (not to be confused with unlearning). Also somewhat weaker CR may also still be elicited in different environmental contexts than in one in which extinction event took place
Spontaneous recovery
When conditioned response returns at some future point in time
Operant (or instrumental) conditioning
Individual learns how to achieve a desired goal. Goal may be to obtain something enticing or escape something unpleasant. Essential is concept of reinforcement
Reinforcement
Refers to delivery of rewards or pleasant stimulus or removal of or escape from aversive stimulus. New responses are learned and tend to recur if they are reinforced. Animal/person learns response-outcome expectancy
Response-outcome expectancy
When person learns that response will lead to reward outcome. If sufficiently motivated for that outcome, person will make response they have learned to produce outcome
Rate of reinforcement in operant conditioning
Initially high rate may be necessary to establish instrumental response, but lesser rates usually sufficient to maintain it. Instrumental response appears to be especially persistent when reinforcement is intermittent (ex gambling). When reinforcement is consistently withheld over time, conditioned response gradually extinguishes
Conditioned avoidance response
Arises when subject has been conditioned to anticipate aversive event and so consistently avoid those situations. This avoidance response is highly resistant to extinction as avoiding aversive events lessens anxiety and is reinforcing. Prevents subject from having experiences with aversive event that could bring about extinction. This plays role in many patterns of abnormal behaviour
Instrumental learning and real world
Important mechanism for discriminating between what will be rewarding and what will be unrewarding, this for acquiring behaviour essential for coping with world. What we learn is not always useful in long term. May learn to value things that seem attractive in short term but hurt us in long run, or may learn coping patterns that are maladaptive in long run
Generalization
In both classical and operant conditioning. When response is conditioned to one stimulus, it can be evolved by other, similar stimuli
Discrimination
Occurs when person learns to distinguish between similar stimuli and respond differently to them based on which ones are followed by reinforcement (ex eating red strawberries vs green strawberries)
Generalization and maladaptive behaviour
Possibility of making inappropriate generalizations when using past experiences in sizing up new situations (discriminate between friendly and hostile teasing among peers)
Observational learning
Learning through observation alone, without directly experiencing unconditioned stimulus or reinforcement.
Bandura and observational learning
Children observationally learned various novel, aggressive responses towards a large bobo doll after they observed models being reinforced for these responses. Shows how observational learning can lead to both adaptive and maladaptive behaviour
What does behavioural perspective attempt to explain?
The acquisition, modification, and extinction of nearly all types of behaviour
What is Maladaptive behaviour in behavioural perspective?
Viewed as result of:
- Failure to learn necessary adaptive behaviours or competencies, such as hours to establish good relationships
- Learning of ineffective or maladaptive responses
- >is this result of learning that has gone awry and is defined in terms of specific, observable, undesirable responses
What does behaviour therapist focus on?
Focus of therapy is on changing specific behaviour and emotional responses, eliminating undesirable reactions and learning desirable ones
What is behavioural approach well known for?
It’s precision and objectivity, it’s wealth of research, and it’s demonstrated effectiveness in changing specific behaviours (behaviour therapist specifies behaviour to be changed, then effectiveness of therapy can be evaluated objectively by degree to which stated goals have been achieved)
Why has behavioural perspective been criticized?
- Early criticism was that behaviour therapy was concerned only with symptoms, not underlying causes (criticism has been deemed unfair by therapists given that successful symptom focused treatment often has positive effects on other aspects of persons life).
- Behavioural approach oversimplifies human behaviour and is unable to explain all of it’s complexities - this criticism stems from misunderstanding about current developments in behavioural approaches
Cognitive psychology involves…
basic information processing mechanisms such as attention and memory, as well as higher mental processes such as thinking, planning, and decision making
Why did cognitive psychology begin?
Began as reaction against relatively mechanistic nature of traditional, radical behavioural viewpoint, including its failure to attend to importance of mental processes, both in own right and for influence on emotions and behaviour
What did Albert bandura’s early cognitive-behavioural perspective emphasize?
Cognitive aspects of learning. Stressed that human beings regulate behaviour by internal symbolic processes: thoughts. Learn by internal reinforcement. Prepare ourselves for difficult tasks by visualizing what consequences would be if we did not perform them. Cognitive abilities allow us to solve many problems internally. Humans have capacity for self-direction. Self-efficacy
Self-efficacy
Belief that one can achieve desired goals
Modern cognitive-behavioural perspective focus
Focuses on how thoughts and information processing can become distorted and lead to maladaptive emotions and behaviour. Central concept is concept of schema
Schema
Underlying representation of knowledge that guides current processing of information and often leads to distortions in attention, memory, and comprehension. People develop different schemas based on temperament, abilities, and experiences. They are our guides through complexities of living in world as we understand it. Can have schemas about people, social roles, and events
Self-schemas
Include views on who we are, what we might become, and what is important to us. Also on our notions of various roles we occupy our might occupy in social environment such as women, man, student etc
Why are schemas important?
Vital to our ability to engage in effective and organized behaviour because they enable us to focus in most relevant and important bits of information among complex array of information that is available to our senses
Why can schemas be a detriment?
They can be a source of psychological vulnerability because some of our schemas or certain aspects of them may be distorted or inaccurate. We often hold some schemas with conviction, making them resistant to change, because we are usually not completely conscious of our schemas, and don’t consider that there might be different views of the “real” world
Assimilation
Tend to work new experiences into our existing cognitive frameworks, even if new information has to be reinterpreted or distorted to make it fit. We are likely to cling to existing assumptions and reject or distort new information that contradicts them
Accommodation
Changing our existing frameworks to make it possible to incorporate new information that doesn’t fit. Is more difficult and threatening, especially when important assumptions are challenged. Basic goal of psychological therapies
Schemas and psychopathology
Different forms of psychopathology are characterized by different maladaptive schemas that have developed as function of adverse early learning experiences. Lead to distortions in thinking that are characterized of certain disorders such as anxiety, depression and personality disorders
Nonconscious mental activity
Mental processes that are occurring without our being aware of them. Studied by cognitive psychologists. Ex anxious people have their attention drawn to threatening information even when that information is presented subliminally, without persons awareness
Implicit memory
Demonstrated when persons behaviour reveals that they remember previously learned word or activity even though they cannot consciously remember it, Ed not being able to recall a phone number but when pick up phone, can dial it correctly
Attribution
Process of assigning causes to things that happen. Are they external or internal? Causal attributions help us explain behaviours and make it possible to predict what people are likely to do in the future
Attributional style
Characteristic way in which person tends to assign cases to bad or good events. Ex people with depression tend to assign bad events to internal, stable, global causes
Self-serving bias
Seen in non depressed people, which they are more likely to make internal, stable, global attributions for positive rather than negative events
Fundamental to cognitive therapy:
Idea that the way we interpret events and experiences determines our emotional reactions to them. Central issue to cognitive therapy is how best to alter distorted and maladaptive cognitions, including underlying maladaptive schemas that lead to different disorders and associated emotions
What are cognitive-behavioural clinicians concerned with?
Clients self-statements; what their clients say to themselves by way of interpreting their experiences. Cognitive-behavioural clinicians use wide variety of techniques designed to alter whatever negative cognitive biases client has
Impact is cognitive-behavioural viewpoint on contemporary clinical psychology
Many researchers have found support for principle of altering human behaviour through changing way people think about themselves and others.
Behaviourists have remained sceptical about this viewpoint because cognitions are not observable, though criticisms have decreased in recent years.
Cognitive-behavioural approach has been greatly advanced by accumulation of information processing studies of effects of emotion on cognition and behaviour
Why is cognitive behavioural perspective open to criticism from behaviourists?
Previous studies relied on self report techniques. Now, studies do not rely on these techniques as much
What does adoption of psychological perspective do?
Influences our perception of maladaptive behaviour, the types of evidence we look for, and the way we interpret the data. Sometimes viewpoints provide contrasting explanations
Result of exposure to multiple uncontrollable and unpredictable frightening events
Likely to leave person vulnerable to anxiety and negative affect, central problem in number is mental disorders such as anxiety and depression (note, person exposed to same number of negative events, but they are predictable and controllable will experience less stress and be less likely to develop disorder)
Social factors
Environmental influences, often unpredictable and uncontrollable negative events, that can negatively affect a person psychologically, making them less resourceful in coping with events
6 different types of social factors that can have detrimental effects on child socioemotional development
- Early deprivation or trauma
- Problems in parenting style
- Marital discord or divorce
- Low socioeconomic status
- Maladaptive peer relationships
- Prejudice and discrimination
Early deprivation or trauma
Children without needed resources (food, shelter, love, attention) can have psychological scars. Usually seen in abandoned/orphaned children, maybe institutionalized or multiple foster homes, but can also occur in intact homes where parents can’t or won’t provide attention and nurturing
Institutionalization
When children placed in institution, less likely to have warmth and physical contact, intellectual, emotional and social stimulation, and lack of encouragement and help in positive learning. Long range prognosis is unfavourable, especially if in institution for longer than 6 months. Children can show severe emotional, behavioural, and learning problems and are at risk for disturbed attachment relationships and psychopathology
Why do institutions result in poor psychological outcomes for children?
Seem to be mediated by poor brain development. Children show reductions in gray and white matter volume. However, with some intervention (such as moving to foster home), some effects of early deprivation can be partially reversed (children showed smaller decreases in white matter volume when placed in foster home after institutionalizations)
Neglect and abuse in home
Majority of cases are neglect, with physical abuse and sexual abuse being less common. Abuse associated with many negative effects on emotional, intellectual, and physical development. Abused children have tendency to be more aggressive, have difficulties in linguistic development and problems in behavioural, emotional and social functioning, including conduct disorder, depression and anxiety, and impaired relationships with peers, who avoid or reject them. Also likely to develop atypical patterns of attachment
Atypical patterns of attachment in abused/maltreated children
Most often disorganized or disoriented style of attachment, characterized by insecure, disorganized and inconsistent behaviour with primary caregiver. Child might be dazed and show frozen behaviour when reunited with their caregiver, or might approach caregiver but then immediately reject them. As these children grow up, might avoid new relationships and experiences that could correct expectations
Effects of abuse in adulthood
Previously abused children have lower levels of education, employment, and earnings. Predicts violence in adolescence and adulthood, especially in abused men. 30% chance of pattern of intergenerational transmission of abuse
Can maltreated children improve?
Can improve to some extent when caregiving environment improves. If child had more protective factors (such as good relationships with other adults or higher IQ), child might show less negative outcomes
Effects of separation from parents on children
First, short term/acute effects of separation, includes despair during separation and detachment from parents upon reunion (this is normal response in even securely attached children). Children who undergo number of separation may develop insecure attachment. Can be longer term effects: ex increased vulnerability to stressors in adulthood. Long term effects depends on whether support and reassurance are given to child by patents/other significant people
Parent-child relationship is always ______.
Bidirectional. Behaviour of each person affects behaviour of the other
Parental psychopathology
Parents who have psychopathology tend to have children who are at heightened risk for wide range of developmental difficulties. Though there is genetic component, researchers believe that genetic influences cannot account for all adverse effects that parental psychopathology can have on children
Children of parents with alcohol abuse problems
Can have elevated rates of truancy, substance abuse, and greater likelihood of dropping out of school, as well as higher levels of depression, anxiety, lower levels of self esteem
Children of parents who are seriously depressed
At enhanced risk for depression and other disorders themselves, partly because depression makes for unskilled parenting (including intrusive or withdrawn behaviour, criticism etc). Children of mothers with depression are more likely to live in environments with high level of stress
4 types of parenting styles
- Authoritative
- Authoritarian
- Permissive/indulgent
- Neglectful/uninvolved
Styles vary in degree of parental warmth and degree of parental control
Parental warmth
Amount of support, encouragement, and affection vs shame, rejection and hostility)
Parental control
Extent if discipline and monitoring vs leaving children largely unsupervised. Includes behavioural control (rewards and punishments) and psychological control (expression of approval vs disapproval or guilt induction)
Authoritative parenting
Parents are both warm and careful to set clear standards and limits on certain kinds of behaviours while allowing freedom within those limits. Children tend to be friendly and to show development of general competencies for dealing with others and with their environments. Children have secure attachment relationships. Less likely to have disorders. Promotes resilience in children
Authoritarian parenting
Parents are low on warmth and high on control and often cold and demanding. Children tend to be conflicted, irritable and moody. These children have more negative outcomes, boys doing particularly poorly in social and cognitive skills and at higher risk of substance use and delinquent activity. Increased aggressive behaviour
Permissive/indulgent
Parents are high on warmth and low in control and discipline. Children tend to be impulsive and aggressive. Overly indulged children are characteristically spoiled, selfish, impatient, inconsiderate and demanding. Tend to do less well academically, show antisocial behaviours. Confusion, adjustment when reality catches up
Neglectful/uninvolved
Parents low on warmth and low on control. Disengaged and not supportive of children. Disruptions in attachment. Children tend to be moody and have low self esteem and conduct problems. Also have problems with peer relations and academic performance
Marital discord (extreme) on children
More severe may lead to stressors such as abuse/neglect, living with parents with mental disorder, authoritarian or neglectful parenting, spousal abuse. Less severe cases of marital discord can have negative effect. Children show greater disposition to behave aggressively, may show high levels of marital conflict in relationships later in life, which could lead to poorer quality of own romantic relationships. Intergenerational transmission of marital discord
How can children be buffered from negative effects of marital discord?
If one or both parents have following characteristics: warmth, proneness to giving praise and approval, and ability to inhibit rejecting behaviour toward their children
Effects of divorce on parents
Negative effects are often temporary; most people able to adapt constructively within 2-3 years. Divorced and separated people over represented among psychiatric patients, though direction is causal relationship isn’t clear. Divorce can benefit some people, with women more likely to benefit than men. People in high sisters marriages more likely to show increased happiness after divorce than people in low distress marriages
Favourable outcome after divorce associated with…
Higher income, dating someone steadily, remarriage, having had relatively favourable attitudes towards divorce before it happened, and being partner who initiated divorce
Effects of divorce on children
Feelings of insecurity and rejection may be aggravated by conflicting loyalties. Delinquency, anxiety and depression are more frequent among children and adolescents from divorced families, though contributing factor here may be continued parental strife (and children had shown these problems even before divorce). Young adults from divorced families have lower educational attainment, lower incomes, lower life satisfaction, and increased probability of being on welfare and having children out of wedlock. Also more likely to have own marriages end in divorce (even occurred in third generation, where divorce in grandparents was associated with lower education, more marital discord, and weaker parental ties in grandchildren)
Negative vs positive effects of divorce in children
Negative effects tend to be quite modest and seem to decrease throughout the decades (maybe result of decreased stigma). Effects are often more favourable than they would have been to remain in home torn by marital conflict. Children living with stepparent were often no better off than children living with single parent, truer for girls than boys. Children living with stepparent are at increased risk of physical abuse by stepparent relative to children living with two biological parents
The lower the socioeconomic status, the _______ the incidence of mental and physical disorders
Higher.
Strength of correlation varies with different types of mental disorder (ex antisocial personality disorder has stronger correlation with low socioeconomic status than depression).
Why is there an association between low socioeconomic status and mental disorders?
A) People with mental disorders slide down rungs of economic ladder, sometimes don’t have resources to climb back up or experience prejudice and stigma.
B) people who live in poverty encounter more stressors in their lives and usually have fewer resources for dealing with them
Adolescents perceptions of social status
Are most strongly linked to higher rates of mental disorders, more so than factors like family income
Unemployment and psychopathology
Unemployment, with its financial hardships, self devaluation, and emotional distress, is associated with enhanced vulnerability to psychopathology. Rates of depression, marital problems, and somatic (bodily) complaints increased during unemployment but normalize when employment rates recover. Wives of unemployed men are also adversely affected. Children can also be seriously affected. Children of unemployed father are more likely to be abused
Underemployment and psychopathology
When people have to take job that requires lower skills or pays less than earned in past. Rates of depression were comparable to rates seen in unemployed people
Studies in bullies
Bullies show high levels of proactive aggression (where they initiate aggressive behaviour) and reactive aggression (where they overreact when confronted). Bullies behave this way because of deficits in social skills, and to manipulate and organize their peers so they can avoid being caught while making others suffer
Children’s reactions to bullies
Children have negative attitudes towards bullying, but most students do nothing to intervene or support victim. ~20% will take side of victim and may help defend them. Victims who have classmates defend them show less distress and higher self esteem
Cyberbullying
Includes sending offensive, harassing or intimidating messaging over internet, or spreading rumours or personal information. Psychological consequences include anxiety, school phobia, lower self esteem, suicidal ideation and occasional cases of suicide
Positive aspects of peer relations
Can be sources of key learning experiences for coming to grips with real world. Such resources can be strong protective factors against parental rejection, frustration, demoralization, despair, and mental disorder
Prosocial popular children
Communicate with peers in friendly and assertive yet cooperative ways. Tend to be good students
Antisocial popular children
Usually boys. Tend to be “tough boys”. May be athletically skilled but do poorly academically. Tend to be highly aggressive and defiant of authority
2 types of rejected children
Those who are too aggressive and those who are too withdrawn
Aggressive rejected children
Take excessively demanding or aggressive approach when interacting with peers. Often take offence to readily and attribute hostile intent to teasing of peers, thus escalating confrontations. Also tend to take more punitive and less forgiving attitude toward such situations. May be especially likely in children who have been maltreated by parents and developed maladaptive mental representations of caregivers, thus approaching social situations with hyperarousal, anxiety, and angry activity
Withdrawn rejected children
Highly unassertive and submissive toward peers, often because of social anxiety and fear of being scorned or attacked. Leads to peer rejection, which deprives child of further opportunities to learn rules of social behaviour and interchange. Result is usually repeated social failings or becoming victim of bullies, which has damaging effects on self confidence and self esteem, sometimes leads to loneliness, depression and anxiety
2 common types of discrimination that occur in the workplace
- Access discrimination
2. Treatment discrimination
Access discrimination
Members is certain group are not hired because if personal characteristics
Treatment discrimination
Certain types of people are given a job but paid less and receive fewer opportunities for promotion
Prejudice and discrimination and psychopathology
Can lead to higher levels of stress and have negative downstream effects on health. Prejudice against minority groups may help to explain increased prevalence of certain mental disorders such as depression. Perceived discrimination may serve as stressor
Experimental laboratory studies on prejudice and discrimination
Experience of racial discrimination leads to increases in anger and cardiovascular reactivity. Discrimination also increases risk taking behaviour, an effect that is partially mediated by increased cardiovascular reactivity. Perceived discrimination also predicts lower levels of well being for women
Impact of the social perspective
Research in this area has led to programs designed to improve social conditions that foster maladaptive behaviour and mental disorders, and to community facilities for early detection, treatment, and long range prevention of mental disorders
The cultural perspective
What is considered to be normal and abnormal differs in different places around the world. Patterns of physical and mental disorders within given society could change over time as sociocultural conditions change. Cultural perspective is concerned with impact id culture on definition and manifestation of mental disorders
Sociology and anthropology have shown that individual personality development reflects…
Larger society (its institutions, norms, values and ideas) as well as immediate family and other groups
Universality of psychological disturbances
Many psychological disturbances are universal, appearing in most cultures studied
Adapting psychological tests across cultures
Ex when tests are translated into language of different cultures, they may need to be adapted so that they are appropriate for new cultural context. Care must also be taken to ensure cultural specific elements of certain disorders are not missed
Minnesota multiphasic personality inventory (MMPI-2)
Best validated and most widely used test that has been adapted for use in many cultures.
What do sociocultural factors influence?
Often influences which disorders develop, forms they take, how prevalent they are, and their courses. Ex prevalence of depression varies widely across cultures of world (3% in Japan, 17% in USA). Differences can also emerge in prognosis or outcomes of several severe mental disorders (ex studies have found more favourable course of schizophrenia in developing countries than in developed countries).
Cultural differences in dealing with stress
In western societies, depression is frequent reaction to individual stress. In China, effects of stress were more typically manifested in physical problems such as fatigue, weakness and other complaints
Cultural differences in elements of depression
Western societies: acute sense of guilt. This does not appear in other cultures. Symptoms of depression (sadness, hopelessness, unhappiness, and lack of pleasure in things of world and social relationships) have different meanings in different societies (ex Buddhists view seeking pleasure from things to be a type of suffering; other cultures, grief can be a religious experience)
Hikikomori
Cultural specific manifestation. Common in Japan, disorder of acute social withdrawal in which young people just remain in their room in their parents house and refuse social interactions for at least 6 months. Seems to be caused by shy temperament, parental rejection, poor parental attachment, and social exclusion by peers
Under controlled behaviour
Aggression, disobedience, and disrespectful acts in children
Over controlled behaviour
Shyness, anxiety and depression
Under controlled behaviour in Thailand
Intolerant of under controlled behaviour in Thailand. Children taught to be polite and deferential and inhibit expressions of anger
Are childhood problems stemming from under controlled behaviour lower in Thailand than in USA?
Studies show that yes, they children have greater prevalence of over controlled behaviour problems than American children. Although there were no differences in rate of under controlled behaviour present, there were differences in kinds of under controlled behaviour problems reported. Thai children had higher rates of indirect and subtle forms of under control (difficulty concentrating, being cruel to animals). American children had higher levels in behaviour like bullying, fighting and disobeying at school. Thai parents also less likely to refer children for psychological treatment (maybe because of Buddhism, or because of embarrassment)
Culture and attachment relationships
Cross cultural differences in views on ideal attachment relationships. Western societies, secure attachment relationships thought to occur when mother responds in sensitive fashion to child’s signals yet gradually allows child to explore environment and develop autonomy. In Japan, parents goal is to anticipate all child’s needs and thereby avoid exposure to stress such as hunger, and foster dependency. Children who are considered securely attached are dependent on mothers, and independent children thought to have disturbed attachment. In Japan, socially competent children are dependent and emotionally restrained. In USA, children who show autonomy and express emotions are considered socially competent. This also leads to different clinical interventions
The eclectic approach
When 2 or more diverse approaches/perspectives are combined in a more general, eclectic approach. Different working ideas are accepted from several viewpoints and whichever is useful is incorporated. There is no attempt to synthesize theoretical perspectives because underlying principles of many theoretical perspectives are incompatible
Criticism of eclectic approach
Purists say that claiming eclectic approach tends to lack integrity and produces crazy quilt of inconsistent practice with little rational
Biopsychosocial unified approach
Only attempt at unified perspective. Reflects conviction that most disorders are result of many causal factors interacting with one another. Particular combination may be unique for any given person
What are indicators of abnormality?
subjective distress Maladaptive Ness Statistical deviancy Violation of the standards of society Social discomfort Irrationality and unpredictability Dangerousness
What is the DSM?
The DSM provides all the information necessary to diagnose mental disorders. It does not provide treatment information. It provides clinicians with the specific diagnostic criteria for each disorder, creating common language so a specific diagnosis means the same thing to every clinician. This also helps ensure diagnostic accuracy and consistency and is important for research. The DSM excludes predictable or culturally approved responses to common stressors or losses. The DSM should be always regarded as a work in progress, with regular updates and modifications to be expected
Advantages of classification for mental disorders
Classification provide us with a nomenclature, giving a common language in short hand terms for complex conditions. Another advantage is that they enable us to structure information in a more helpful manner. Organizing information within a classification system allows us to study the different disorders that we classify and therefore learn new things, facilitating research. Defining the domain of what is considered to be pathological establishes the range of problems that the mental health profession can address, warranting insurance reimbursement and the extent of such reimbursement.
What are the disadvantages of classification?
Using any form of shorthand leads to loss of information. I can still be some stigma associated with having a psychiatric diagnosis. people may be stereotyped for their diagnosis. A persons self-concept may be directly affected by being given a diagnosis of a mental disorder
 How can we reduce stigma towards mental illness?
For a long time it was thought that educating people that mental illnesses were real brain disorders might be the solution but this does not seem to be the case. Though many people now understand that mental disorders have neurobiological causes, this increased awareness has not resulted in decreases in stigma. Stigma does seem to be reduced by having more contact with people in the stigmatized group. But there are barriers to this, for example simply imagining interacting with a person who has a mental disorder can lead to distress and also to unpleasant physical reactions. This suggests that people may tend to avoid those with mental illness because the psycho physiological arousal these encounters create is experienced as unpleasant.
Culture and abnormality
The way some disorders present themselves may depend on culturally sanctioned ways of articulating distress. Culture can shape the clinical presentation of disorders like depression. However the vast majority of the psychiatric literature originates from euro American countries so there is much under representation of abnormal psychology in different cultures. Prejudice toward people with mental illness seems to be found worldwide but some types of psychopathology appear to be highly culture specific. abnormal behaviour is behaviour that deviates from the norms of the society in which the person lives. Experiences might be regarded as normative in one culture yet abnormal in another culture.
Taijin kyofusho
An anxiety disorder which is quite prevalent in Japan. It involves a marked fear that one’s body, body parts, or body functions may offend, embarrass, or otherwise make others feel uncomfortable. Often people with this disorder are afraid of blushing or upsetting others by their gaze, facial expression, or body odour
Ataque de nervios
Attack of nerves, a culturally rooted expression of distress, found in people of Latino dissent, especially those from the Caribbean. This syndrome does not seem to correspond to any specific diagnosis within the DSM. The symptoms are often triggered by a stressful event such as divorce, and include crying, trembling, and uncontrollable screaming. There is also a sense of being out of control. Sometimes the person may become physically or verbally aggressive or the person may faint or experienced a seizure like fit. Once over, the person may promptly resume their normal behavior, with little or no memory of the incident
Behaviours that are universally considered to be abnormal
Hearing voices, laughing at nothing, defecating in public, drinking urine, and believing things that no one else believes
National Comorbidity survey replication [NCS-R]
The most comprehensive source of prevalence estimates for adults in the US diagnosed with mental disorders. The lifetime prevalence of having any DSM disorder is 46.4%. This survey did not assess for eating disorders, schizophrenia, or autism. It did not include measures of most personality disorders. The most prevalent category of psychological disorders is anxiety disorders. The most common individual disorders are major depressive disorder, alcohol abuse, and specific phobias. Social phobias are also very common. The rates of disorders appear to be high, the duration of the disorder may be relatively brief. The disorder may also be relatively mild. This survey is over a decade old so the data is not always the current. This survey also found widespread occurrence of comorbidity among diagnosed disorders. Half of the individuals with a disorder rated as serious had two or more additional disorders. But only 7% of the people who had a mild disorder also had two or more other conditions. This indicates that comorbidity is much more likely to occur and people who have the most serious forms of mental disorders.
National survey on drug use and health [NSDUH]
Another survey that is conducted every year that provides information on the prevalence of mental disorders. Though this survey does not include information about specific disorders, we can be used to provide the most recent information. This survey shows that the one year prevalence of serious mental illness in adults in the US is 4.1% overall, excluding substance use disorders. This is similar to the data reported by the NCSR, which did include substance use disorders, and was 5.8%.
Which disorder results in the biggest global burden
Depression, which accounts for more than 40% of the D a L Y’s. It is also estimated that mental disorders will cost US$16 trillion during the next 20 years worldwide, not including the costs of treatment or emotional costs
What is typical of individuals and treatment for mental disorders
Even when they recognize that they have a problem, it is typical for individuals to wait a long time before deciding to seek help. Half of individuals with depression delay seeking treatment for more than 6 to 8 years. For anxiety disorders, the delay ranges from 9 to 23 years. Stigma is also a factor that makes some people especially reluctant to seek help. When people do seek help they are often treated by their family physician rather than by a mental health specialist. Also most treatment is administered on an outpatient basis.
Why has admission to mental hospitals decreased during the past 45 years?
One reason is the development of medication that control the symptoms of the most severe disorders. Budget cuts have also forced many large state or county facilities to close. As well the insurance companies put limitations on hospital admissions.
What is an unfortunate consequence of trending away from the use of traditional hospitalization for mental disorders?
The number of prison inmates being treated for severe mental illness has increased dramatically. When people with severe mental illness are unable to find Adequate treatment in the community, this increases the likelihood that they will end up coming to the attention of law-enforcement.
What is a negative consequence of studying individual cases and deriving Inferences from them
We are as likely to develop errors in our thinking as we are to obtain knowledge. One error is that we often attend only to data that confirm our view of how things are.
Who should be included in a research study?
In general, we want to study groups of individuals who have similar abnormalities of behavior. Ideally, we would study everyone in the world who met our criteria because these people constitute our population of interest. This is impossible to do, so instead we try to get a representative sample of people who are drawn from this underlying population
Correlations and causality
Correlation does not mean causation. Just because two variables are correlated does not tell us anything about why they are correlated. This is true regardless of the size of the correlation.
Ethical concerns in experimental method for treatment
Sometimes the waiting list control group strategy is deemed in advisable for ethical or other reasons. Withholding a treatment that has been established as beneficial just to evaluate a new form of treatment may deprive control subjects of valuable clinical help for longer than would be considered appropriate. For this reason, stringent safeguards need to be in place regarding the potential costs versus benefits of conducting the particular research project. In certain cases a standard treatment comparison study may be done instead
Our understanding of causes of psychopathology
For many forms of disorders we don’t have a clear understanding of whether there are necessary or sufficient causes but we do have a good understanding of many of the risk factors.
