Exam 1 Flashcards
normal
the average or mean, conforming to the standard or the common type
abnormal
condition or state that is irregular or deviant from typical functioning of an organism
dysfunction
abnormality or impairment in the function of a specified bodily organ or system
In what situations does dysfunction account of psychopathology falls short?
may be seen as adaptive in a certain environment, for example hallucinations are seen as good in some cultures and may even be incorporated in a religious enactment
What is meant by the subjective distress account of psychopathology?
subjective distress is actually needed in daily life/for motivation, as distress is not unhealthy or problematic (ex. exercise) and emotional stress and failures can help you in the future
What might be one problem with relying on one’s report of distress to categorize someone as mentally ill or not? Be sure to know what
malingering is and in what situations it is likely to occur
Someone may be exacerbating/under reporting their feelings, can vary from person to person
Some people also take part in malingering (exaggerate or fake an illness to get out of responsibilities such as work, family events, etc., mostly used for monetary incentives)
How do social norms influence the definition and diagnosis of mental illness? (Be
familiar with the curious case of 302.0)
The curious case of coe 302.0 dealt with having homosexuality in the DSM-II
thought homosexuals were born different, with internal defects, or seen as a normal part of development that one grows out of
through voting and protests, homosexuality did NOT appear in the DSM-III
neurodiversity
there exists variation in the human brain with respect to learning, attention, mood, sociability, and other mental processes and operations
how does neurodiversity factor into our understanding of behavior disorders?
shows how social values are more relevant to identifying behavior disorders than essentialist reality
different from the norm but does it make them a problem to be fixed?
What are the two components of the harmful dysfunction model?
harmful - the impairment in function is seen to be harmful to the individual and/or society
dysfunction - break-down or impairment in the natural function of behavior
what are some of the problems with the harmful dysfunction model?
who decides what is harmful? No one has stated an exact way to determine what is harmful or not. We also don’t know why things have evolved in certain ways and not all disorders necessarily represent dysfunction in a biological sense (ex. anxiety disorders)
What is the purpose of classification; that is, why do we need a classification system for behavior disorders?
basis for diagnosis, prognosis and treatment
nomenclature/shared jargon for communication
descriptive psychopathology, epidemiology, etiological theories
sociopolitical functions
supernatural models
a current focus is on whether spiritual issues should be incorporated into our understanding of mental health issues and their treatment, most clients are religious
influenced classification as it showed how fuzzy the connection to supernatural relates to mental health
not used in the medical world today
moral model
modeled around what was and wasn’t acceptable, thought an illness was the result of “immoral behavior” and due to the stigma, you were forced to hide
problem: you couldn’t control whether or not to have a panic attack
has led to poor outcomes (ex. its your fault for a behavior disorder), putting only accountability on someone rather than taking into account influences and environment
factitious disorders
a mental disorder in which a person repeatedly acts as if they have a physical or mental illness when they really don’t (ex. Munchausen by proxy, reserved for physical benefits)
determinism
assuming one has no ability to alter outcomes
etiological/biological model
popular in the 18th century but classification was a mess
clear relationship between physical and mental health
established evidence that psychotropic medication can prove useful for a variety of mental health conditions
psychosis vs. neurosis
psy - a severe mental disorder characterized by a break with reality, where someone losses touch with reality (ex. delusions)
neu - a milder mental disorder characterized by distortions of reality, one understands the world but behaving irrationally
What did Kraepelin view as the origin/cause of mental illness?
thought the origin of mental illness was biological and genetic (ex. depression = something is broken within you and can/should be fixed)
What were the guiding principles behind Kreaplin’s classification system?
anatomical pathology (relationship of disease to symptom)
etiology (development/why it is happening)
course/prognosis (what’s going to happen)
What did Kraepelin ultimately conclude with respect to his approach and why?
his program for classification fails, acknowledging that classifying based on pathological anatomy nearly impossible and most etiological theories were largely speculative
What was the history around the development of the DSM? Be able to discuss the major discrepancies between the DSM-I/II and later editions of the DSM (starting with DSM-III)
DSM-I/II: First DSM was mainly freudian, no real differentiation between normal and abnormal behavior, not reliable, system with psychotic v neurotic and organic v non-organic
DSM-III: Neo-Kraepelinian, organized by Phenomenology (how they appeared), more holistic with 5 axises, stricter criteria
Who were the neo-Kraepelinians and what did they stand for?
movement to reaffirm mental illness and psychiatry as a branch of medicine
What were the main critiques of the DSM?
conception of mental illness (viewed as socio-political rather than scientific)
comorbidity (co-occurence of different diagnostic criteria)
not therapeutically useful
uncertain process of including, excluding, and defining diagnosis
What is aversive conditioning and how does in factor into anxiety?
an adaptive process, making a behavior or habit be associated with something unpleasant to quit this behavior
this factors into anxiety as the signals elicit necessary responses before the outcome occurs
What differentiates anxiety from an anxiety disorder?
when it impairs your day-to-day activities/behavior/if they become problematic
whether there is a threat that justifies the avoidance behaviors
What are the two-factors of Mowrer’s two-factor theory of anxiety?
classical conditioning (pairing stimuli with outcomes) and operant conditioning (rewards and punishments)
What are some of the problems that two-factor theory has in accounting for specific phobias?
can’t remember being conditioned (infantile amnesia, insidious acquisition (over time), subconsciously)
preparedness theory (people are predisposed to fear certain things due to evolutionary pressures, harder to condition certain phobias and easier to extinguish them)
identify the different pathways to fear acquisition
direct conditioning
modeling (ex. never been shot but learned to fear it as you have seen what happens when people are shot)
instructional transference (learned something from being told what to and not to do)
lumping vs. splitting
lump - similar enough to group together but end up lack specificity, general, only one anxiety disorder
spilt - different stimuli cause different behaviors. specific, multiple anxiety disorders
What is it ultimately that creates different topographies across the anxiety disorders?
proximity of the signal to the threat:
panic - as things are happening, imminent
worry - problem solving to mitigate threat, further in time
fight or flight - proximal but avoidable threat, closer in time (ex. hoping prof is sick to cancel test)
What is the rationale for lumping all anxiety disorder into one?
high comorbidity amongst anxiety disorders, some disorders can be known as the same process towards different stimuli
What would be lost in terms of information about specific disorders if lumping was done?
specificity on the different disorders as well as how we develop these behaviors
What are the common diagnostic features across anxiety disorders?
excessive worry and fear in non-threatening situations
What are the specific diagnostic features of agoraphobia?
marked anxiety in 2 or more of the following situations:
Public transportation (big one since no escape)
Open spaces
Enclosed spaces
Standing in line or being crowded
Being outside of the home
What are the specific diagnostic features of GAD?
Excessive anxiety and worry (apprehensive expectation), occurring more days than not for at least 6 months, about a number of events or activities (such as work or school performance). Individual finds it difficult to control the worry and out of proportion.
Associated with at least 3 of the following 6 symptoms:
Restlessness, on edge
Being easily fatigued
Difficulty concentrating or mind going blank
Irritability
Muscle tension
Sleep disturbance
(children only need 1 of the above)
What are the specific diagnostic features of panic disorder?
recurrent and “out of the blue” panic attacks
and then after a month, need to have persistent concern about having additional attacks, worry about the implications of the attack or its consequences (e.g., losing control, “going crazy”), or a significant change in behavior related to the attacks
What are the specific diagnostic features of specific phobias?
Marked and out of proportion fear within an environmental or situational context to the presence or anticipation of a specific object or situation, the person knows it is out of proportion, needs to be problematic/interfering with daily life, and an immediate reaction to the stimulus
What are the specific diagnostic features of obsessive compulsive disorder?
An anxiety characterized by either obsessions or compulsions that are time and energy consuming as well as having more often than not, out of proportion
features of specific phobias
if you are susceptible to fear aversions, you will have a lot of phobias
What is the preparedness account of phobias
Individuals are predisposed to fear certain things due to evolutionary pressures
In what ways does the preparedness account of phobias address problems with two-factor theory accounts?
How uneven distribution of fears are present: certain stimuli are more often tied to phobias
How can two-factor theory also account for problems with the preparedness account?
rapid acquisition and resistant to extinction for certain fears, doesn’t explain irrational fears
What characteristics of the first panic attack may predispose individuals to future attacks?
If the person cannot identify the source of the threat that induced panic (a false alarm), the recurrence of a panic attack becomes more likely
What is meant by panic disorder being a “fear of fear”?
They learn that their physiological symptoms are to be feared
fear of having future panic attacks
What aspects of an initial panic attack are associated with the development of agoraphobia?
You fear having a panic attack in public, especially if you cannot locate the source of your panic attacks. This will cause you to not want to go out in public, even though being home will just increase your anxiety for future events
What is the key feature of GAD (not just the label, be sure to understand the phenomenon and its function)?
excessive anxiety and worry about several events and activities. Nervous something bad is going to happen all the time. Past experience of random, aversive events can make one believe something bad will happen at any moment. Individual experiences chronic and uncontrollable worry that is excessive and unrealistic (unfounded concerns).
Low probability events being worried about frequently will happen.
Know the information linking temperament and attachment style to Social Anxiety Disorder
Temperament: Infants with inhibited temperament more frequently develop into children and adolescents who avoid novel of unfamiliar people, objects, and situations. (crying with unfamiliar faces vs being curious)
Attachment style: (Insecure attachment) others are critical and unreliable; template for self (unlovable). This is where SAD sets in (conditional love)
What are obsessions and compulsions?
obsessions - intrusive and recurring thoughts, impulses, and images that are irrational and appear uncontrollable to the individual.
compulsions - a repetitive behavior or mental act that the person feels driven to perform to reduce the distress caused by obsessive thoughts
Are both obsessions and compulsions needed for an OCD diagnosis?
NO! only one or other other is needed, but it is common for both to be present
What are the general categories or types of obsessions and compulsions?
contamination, responsibility for harm, incompleteness, checking, and unacceptable thoughts with immoral, sexual, or violent content.
What are some problems with biological accounts of OCD?
There’s no explanation about why serotonin or structural abnormalities cause OCD behaviors. Unable to explain themes and content in OC behaviors. Treatment doesn’t necessarily inform the cause.
Are most disorders we talk about a dysfunction?
most disorders are not a dysfunction, they are the normal functioning of your psychological apparatus. It’s different contexts that make them problematic
What are the key features of the cognitive and behavioral model of OCD?
With OCD, person cannot tolerate or dismiss mental intrusions. They view them as abnormal/it poses a threat, and it stokes anxiety.
It’s not abnormal, but they appraise it as something that’s abnormal.
Attempt to inhibit thoughts have paradoxical effects (trying not to think about something causes you to think about that thing, white bear phenomenon)
Barlow’s (1998) “alarm theory”
If the panic attack is a true alarm, then the recurrence of panic attacks is less likely
If the person cannot identify the source of the threat that induced panic (a false alarm), the recurrence of a panic attack becomes more likely
Eysenk (1992): Worry has three primary functions
Alarm:
Upon detection of threat, information pertinent to threat enters cognitive awareness
See a threat on the horizon, not in a panic, form plans into prompt
Prompt:
Brings threat-related thoughts and images from long-term memory into conscious awareness
Try to think what can help us solve this, can help decrease anxiety no matter how good the plans are
Preparation:
Generation of hypothetical scenarios of the future (e.g., catastrophizing)
what are the axis of classification in the DSM-III?
I: clinical disorders (episodic/come and go)
II: personality disorders (more stable overtime)
III: general medical conditions (holistic)
IV: psychosocial and environmental problems (holistic but looking for broader context)
V: global assessment of functioning
what kind of cognitive distortion is:
“I got a B on the test, I am a total failure”
all-or-nothing thinking
what kind of cognitive distortion is:
“my husband always comes home from work late;he must be having an affair”
arbitrary inference
what kind of cognitive distortion is:
“I don’t get along with my neighbor; I’ll never get along with anyone”
overgeneralization
what kind of cognitive distortion is:
“My teacher took 2 points off of my essay; I am a terrible writer”
selective abstraction
what kind of cognitive distortion is:
“Who cares that I got a good performance evaluation? I got a ‘needs improvement’ in one area.”
magnification/minimization
what kind of cognitive distortion is:
“That person just cut me off in traffic because he thinks I’m a bad driver.”
personalization
what kind of cognitive distortion is:
“I know my boyfriend says I’m a great person with lots of great qualities, but I just feel like an awful, worthless person.”
emotional reasoning
reason why enslaved persons attempted to escape
drapetomania
when you are unable to recognize detriment in behavior when behavior is perpetuated
neurotic paradox
critical component in one’s initial panic attack
setting
interoceptive avoidance
when you pay attention to the body during nervousness; avoidance of your own body
the gradual acquisition of fear, even if you do not remember it
insidious acquisition
this component of OCD supports that compulsive behaviors are quickly learned and reinforced because of immediate reduction of anxiety
behavioral component
in the 2-factor model of GAD, the conditioned stimulus is usually _______, which creates feelings of fear and anxiety
uncertain situations
syndrome vs. disorders vs. disease
s - symptoms that multiple people experience where pathology and etiology aren’t known
disorder - syndromes that cannot be readily explained by other conditions
disease - disorders in which pathology and etiology are understood
why are mental disorders believed to be myths
thought to be common problems and labels were just for societal norms
why are mental illnesses thought to be invalid
do not provide us with new info
Rosenhan experiment and main idea
had normal people be admitted to psychiatric institutions for the same symptom, hearing voices. Once in, they acted normal but nurses/people still thought they were experiencing symptoms and diagnosed with schizophrenia. Main idea: labels obstruct people’s ability to differentiate between illness and normality.
roschian construct
attempt to define disorder explicitly is sure to fail as disorder is intrinsically undefinable
polythetic vs. monothetic
poly - signs and symptoms are neither necessary nor sufficient for a diagnosis
mono - signs and symptoms are singly necessary and jointly sufficient for diagnosis
is attentional bias the same across people with SAD
no
cognitive avoidance theory of worry
the verbal activity of worry distracts people. from the full experience of fear and other emotional states
symptom accommodation
when a friend participates in the loved one’s rituals for OCD, contributes to maintenance
ego-syntonic vs. ego-dystonic
syn - believe behaviors are rational/appropriate
dys - experiencing unwanted and upsetting behaviors
how is the two-factor theory related to OCD
represents the maintenance of OCD through negative reinforcement of compulsions as the reduce anxiety
A baby or child who appears fearful or withdraws when faced with unfamiliar and novel people, situations, and objects is an example of which characteristic correlated with social anxiety:
behavioral inhibition
True or False: Salient low base rate events and early attachment problems are most common in the histories of individuals with Social Anxiety Disorder.
false
A critical component of panic disorder is the setting or context of the initial panic attack because
it becomes conditioned with the panic
Which of the following signified a turning point for psychiatry, as it is no longer considered a field based on assumptions?
Identifying syphilitic bacteria in patients with Dementia Paralytica
It has been difficult to establish prevalence estimates for generalized anxiety disorder due to
Changes in diagnostic criteria and high comorbidity with depression and conceptualization as a “residual disorder”
what is the most common form of psychopathology
depression
A syndrome is a behavior disorder that solely impacts social functioning in a negative
way (T or F)
false
The birth of formal classification of psychological disorders began with which of the two
following classification systems:
international classifications of diseases and the DSM
