Exam 1 (Ch. 1-4) Flashcards
psychological disorder
psychological dysfunction that causes stress/impairment functioning/responses to stimuli that are not culturally expected.
psychological dysfunction
breakdown in cognitive, emotional, or behavioral functioning.
- stress
- impairment
- atypical/culturally unexpected
Supernatural Tradition
- treatments included exorcisms
- influence on Salem Witch Trials
- origin of term “lunatic”
- alive and well but with caveats (warnings/limitations)
- mass hysteria lent credibility to supernatural accounts of abnormal behavior
- emotional contagious
- mob psychology
Biological Tradition
- Hypocrates and Galen (humors/psychopathology)
- psychological symptoms of syphilis
- John P. Grey and mental “hospital”
- development of biological treatments
- Meduna’s research and shock therapy
- hydrotherapy
- psychosurgery
- trepanation
- Moniz, Freedman, and Lobotomy
- drugs
- consequences of biological tradition
Psychological Tradition
- Plato and psychosocial influences on behavior
- moral therapy
- positive reinforcement
- best with small groups patients
- paradox of the mental hygiene movement
- psychoanalytic approach: unconscious mind; past experiences left in unconscious
- humanistic theory/person-centered therapy: emphasizes looking at the whole individual and stresses concepts such as free will, self-efficacy, and self-actualization
- cognitive-behavioral therapy: goal-oriented, hands-on to problem-solving
Psychoanalytic Theory
- id: sexuality/aggression driven by libido and thanatos
- superego: keeps id in check through use of moral principles (SUBCONSCIOUS)
- ego: acts as buffer between id and superego to prevent intrapsychic conflict (CONSCIOUS)
Defense Mechanisms
- used by ego as “socially acceptable” outlets for intrapsychic conflicts
- denial
- projection
- rationalization
- repression
- intrapsychic conflicts cannot be quenched via defense mechs can result in abnormal behavior/symptoms
- ALL non-psychotic disorders (neuroses) result from conflicts between the id, ego, superego and defense mechs
- psychoanalytic theories use modifications to these principles
Humanistic Theory
- self-actualized if we are given room to grow
- self-discovery
- being honest with ourselves
- person-centered therapy relies on unconditional positive regard, empathy, genuiness, and therapist/client relationship
Behavioral Therapy
operant conditioning
- positive reinforcement: sticker on your HW
- negative reinforcement: stretching before a workout
- positive punishment: a christmas story
- negative punishment: being grounded
classical conditioning
- UCS (stimulus that automatically triggers a response): food
- UCR (unlearned response that occurs naturally): salivation
- CS (primed stimulus): bell ringing
- CR (response associated with previous stimulus): salivation
- extinction
One Dimension approach
suggest that psychological disorders have a single cause.
Multidimensional Integrative approach
many factors interact to contribute to psychopathology.
- biological
- psychological
- social
Biological Influences
- neurons separated by synaptic clefts but can still communicate with each other by neurotransmitters that travel across those spaces.
- brain circuits are groups of neurons that are sensitive to the same neurotransmitters.
- neurons have receptors that are sensitive to certain neurotransmitters
GABA: linked to seizures, tremors, and insomnia
Glutamate: overstimulating of brain, producing migraines/seizures
Serotonin: linked to depression; some antidepressant drugs raise serotonin levels
Norepinephrine: depresses mood and causes ADHD-like attention problems
Dopamine: linked to schizophrenia; tremors and decreased mobility in Parkinson’s and ADHD
Biological Influences (cont.)
- mechanisms of action for psychotropic medicines
- reuptake inhibition: inhibits the plasmalemmal transporter-mediated reuptake or a neurotransmitter from synapses into pre-synpatic neuron
- agonism: bind to synaptic receptors and increase the effects of neurotransmitters
- antagoism: bing to synaptic receptors but decrease the effect of the neurotransmitter
Biological Influences (cont.)
- most disorders are polygenic: disorder resulting from combined action of alleles or more than one gene
- genetic can affect how our brains work
- relative levels of neurotransmitters
- limbic system brain circuit and stress hormone release (biological vulnerability)
- evolutionary predisposition to certain phobias
Psychological Influences
genetics account for less than a third of mental illness
- unique thought patterns associated with different disorders
- locus of control
- hopelessness
Psychological Influences (cont.)
- learned helplessness
- learned optimism
- observational learning
- psychological vulnerabilities
Circumplex Model of Emotion
(see picture on slide)
Social Influences
- culture/ethnicity-specific fright disorders - exaggerated startle responses in addition to other fear and anxiety reactions
- Susto
- Ataques de nervios
- Gender
- does prevalence differ across gender or does willingness to report symptoms differ across gender?
- differences in how society has shaped men and women to react to certain emotional situations
Social Influences (cont.)
- effects of social realtionships on mental health
- media and body-image disorders (Fiji and exposure to western media)
- news reports of suicide
Interactions
Biological and psychological factors
- Diathesis (predisposition/tendency) stress model
- gene environment correlation model
- depression is similar across genders until puberty
- psychotherapy alters brain circuitry for a variety of clinical disorders
- early childhood experience can alter brain anatomy and in turn affect the likelihood of developing disorders later on
Psychological and Social factors
- importance of social support
- social stigma
- voodoo death
- media
Effects of Aging
- stress can be good for young but bad for old in some circumstances
- adults respond better to certain psychotropic meds than do children
- the same symptoms in older and younger people may not come from the same origins (equifinality: different early experiences in life can lead to similar outcomes)
Conducting Research in Psychopathology
- test hypotheses with research design, examining impact of an IV(s) on a DV
- hypotheses must be testable or falsifiable
- research design should be free of confounds (when researchers control certain extraneous variables that may influence results)
- internal validity (evidence that study design reflects what is observed) versus external validity ( the extent to which results of study can be generalized to and across other situations)
External Validity
ways to improve external validity
- analogue models/studies recreate real-world conditions in the laboratory
- focus on clinical significance in addition to statistical significance
- keep the patient uniformity myth in mind
Internal Validity
ways to improve internal validity
- control groups
- randomization
Research Design
- case studies
- correlational studies
- epidemiological research examines prevalence rates and incidence rates of disorders in greater populations
- experimental research
Experimental Research Designs
- aim to increase internal validity (but we still want external validity) through the use of control groups
- groups vs. single case experimental designs
- SCEDs are essentially well-controlled case studies
- group experimental designs permit formal statistical analyses
More on Single Case Experimental Designs
- involves repeated measurements
- can involve a withdrawal design which helps establish internal validity
- baseline, treatment, withdrawal…return to baseline?
- what about lasting effects?
- multiple baseline approach avoids some disadvantages of the withdrawal design
Genetics and Behavior
- family studies
- adoption studies
- twin studies
- genetic linkage analysis and association studies
Family Studies
- studies mental health of proband, their first-degree relatives, and their second-degree relatives
- if proband has depression and it is genetic, the first-degree relatives should show a tendency to be depressed and their second-degree relatives should also show this tendency but perhaps to a lesser degree
- such similarities can arise because family members tend to live together and have similar experiences
Adoption Studies
- siblings raised in different homes should have more genetic similarity than environmental similarity
- if they show similar traits, this provides evidence for genetic contributions
Twin Studies
- identical twins share the same genetic makeup while fraternal twins do not
- if identical twins are more similar than fraternal twins, this suggests genetic contribution to a trait
Genetic Linkage Analysis Association Studies
genetic linkage analysis
- examines common markers among people with a disorder
association studies
- similar to GLA except that markers are identified by comparing people with and without depression
Temporal Factors on Behavior
- gain insight into whether something is just a “phase”
- assess effectiveness of interventions
- gain insight into potential etiologies
- effects of aging on mental health
Research Design for Temporal Investigations
cross-sectional designs
- compare several cohorts of individuals who are different ages
- the cohort effect describes confounding differences between groups of people who are different ages
longitudinal designs
- follow the same individuals over time
- free from cohort effects and allow for prediction but are time consuming
- plagues by attrition and cross-generational effects
sequential designs combined cross-sectional and longitudinal designs
Studying Behavior across Cultures
- most research has examined behavior in western cultures
- cross cultural research treats culture as an IV and behavior as a DV
- describing symptoms of mental illness and openness about mental health
- tolerances in abnormal behavior
- approaches to treatment
Assessing Psychological Disorders
clinical assessment: systematic evaluation and measurement of psychological, biological, and social factors in a patient with a mental illness
- clinical interview
- physical exam
- behavioral assessment
- psychological testing
- neuropsychological testing
- psychophysiological assessment
diagnosis: determine what set of DSM-5 criteria are met by a patient’s symptoms
issues in assessment
- reliability
- validity
- standardization
The Clinical Interview
gathers broad into regarding…
- when problems started possible triggering life events - interpersonal history - family history of mental illness - current living situation - religion - educational history
Mental Status Exam
- part of clinical interview
- describes five aspects of a client
- appearance and behavior
- thought processes
- mood and affects
- intellectual functioning
- sensorium
- often semistructured
Physical Examination
- psychological symptoms sometimes reflect acute medial conditions
- avoids issues of social desirability in responding to interview questions
- provides info that clients may not know about themselves (i.e., side effects of medications they are taking)
Behavioral Assessment
- often useful with children who cannot verbalize their problems or who may have limited insight
- ABCs of observation
- antecedents: events, actions that occur immediately before behavior
- behavior: the behavior in detail
- consequences: actions/responses that follow the behavior
limitations of self-monitoring
- reactivity
- memory distortions
- self vs other ratings
formal vs informal observations
Psychological Testing
projective testing
- we “project” interpretations onto ambiguous stimuli
- problems with validity, reliability, and standardization
- usefulness as an icebreaker
personality inventories
- include self-reference ratings
- empirical approach vs face validity
IQ testing
- IQ vs intelligence
- G factor
Neuropsychological Testing, Neuroimagining, and Psychophysiological Assessment
- both ways of assessing brain damage
neuropsychological testing
- behavioral approach to estimating brain damage/cognitive impairment
neuroimagining
- structural vs functional imaging
psychophysiological assessment
- diagnosing DID
- role of EEG and biofeedback
Diagnosing Psychological Disorders
- idiographic strategy: what makes a person unique among those with their disorder?
- nomotheitic strategy: what is true about other people with the same symptoms as this individual?
- nosology: classification of a person’s symptoms as belonging to a specific mental disorder
- nomenclature: labels/names for disorders
Classification Issues
normal vs abnormal?
should behavior be measured on a continuum?
- classical categorical approach
- prototypical approach
- dimensional approach
- impact of labelling
- categories are not always informative regarding the best treatment approaches
Anxiety
apprehension about the future and/or a corresponding physical response
Fear
negative attack in response to a current situation
Panic Attack
abrupt, intense fear accompanied by intense physiological reactions
- expected (cued) panic attacks and corresponding disorders
- unexpected (uncued) panic attacks and corresponding disorders
Anxiety Disorders
- generalized anxiety disorder
- panic disorder/agoraphobia
- social anxiety disorder
Biological vulnerability
- behavioral inhibition system: creates sense of anxiety based on some threat
- fight or flight system: activates us to engage in threat or disengage/avoid threat
Generalized Psychological vulnerability
- personality charactertistics
Specific psychological vulnerability
- somatosensory amplification
Triple Vulnerability Theory
anxiety-related disorders differ primarily in the environmental stressor that triggers the vulnerabilities
Generalized Anxiety Disorder
- at least six months of uncontrollable excessive anxiety and worry on most days
key symptom: focus on anxiety is on a variety or minor and major everyday events
physiological hallmarks:
- show less physiological arousal but more frontal lobe activity in response to stressors compared to patients with other anxiety disorders
treatments:
- benzodiazepines and antidepressants
- psychological treatments offer better long-term prognoses than pharmaceutical treatments alone
Panic Disorder and Agoraphobia
fear of being unable to get to safety
- typically begins with an unexpected panic attack
- physiological symptoms of fear are often misinterpreted
treatment:
- pharmacological: Benzos and SSRIs (might have sexual side effects)
- exposure therapy and panic control treatment
Specific Phobia
irrational fear of specific object or situation that causes interference
- related to expected panic attacks
four major subtypes…
- blood-injection-injury phobia
- situational phobia
- natural environment phobia
- animal phobia
Blood-Injection-Injury Phobia
- marked by a drop in blood pressure and heartrate
- reflects the fear of fainting
Situational Phobia
- includes claustrophobia, fear of flying
- distinct from panic disorder w/ agoraphobia
Natural Environment Phobia
- fears of heights, storms, waters
- seem to cluster together and often develop early in life
- may be predisposed to fear these things
Animal Phobia
- arachnaphobia, etc
- develop early in life
Causes (Specific Phobia)
- direct experience
- experiencing panic attack in a specific situation
- vicarious experience: something we experience through someone else
- being warned of the dangers of a situation
any of these must lead to anxiety over a future reaction
Treatment (Specific Phobia)
- medications
- exposure therapy
Social Phobia/Social Anxiety Disorder
- fear/anxiety in one or more social or performance situations
- involves a fear or evaluation
- fears of others feeling embarrassed for the patient may play a role in non-western cultures
Causes (Social Phobia/Social Anxiety Disorder)
can develop in three basic ways
- perceived poor social skills
- unexpected panic attack in social situation
- actual social trauma
Treatment (Social Phobia/Social Anxiety Disorder)
- CBT focusing on perceived vs actual judgments by others
- social mishap exposure therapy
- SSRIs and beta-blockers can be helpful
- mixed evidence for combining meds and psychotherapy
Selective Mutism
- lack of speech in one or more settings
- must endure for longer than a month
- nearly always comorbid with other anxiety disorders
- treated with age-appropriate psychotherapy
Trauma and Stress-Related Disorders
- PTSD
- adjustment disorder
- attachment disorder
Causes (Trauma and Stress-Related Disorders)
triple vulnerability theory
- generalized biological vulnerability
- generalized psychological vulnerability
- traumatic experience + true alarm
- trigger + learned alarm = anxiety and avoidance
PTSD
- caused by witnessing a traumatic
- causes susceptibility to flashbacks and chronic levels of hyper-arousal
- PTSD in children can lead to developmental regression
treatment:
- ideally, patients should face the original trauma and process the associated emotions and feelings with learned coping strategies
Other Trauma and Stress-Related Disorders
- adjustment disorder: similar to PTSD but milder
- attachment disorders occur in children before the age of 5 and are caused by child abuse
- reactive attachment disorder: avoidance of relationships with caregiving adults
- disinhibited social engagement disorder: seeking comfort from adults who may not be appropriate caregivers
Obsessive-Compulsive and Related Disorders
model of causation
- generalized biological vulnerability
- generalized psychological vulnerability
- stress + GBV + GPV = specific psychological vulnerability
- thoughts (obsessions) resulting from SPV trigger anxiety
- thought-action fusion
- compulsions are used to try to suppress the thoughts/reduce the anxiety they elicit
Obsessive-Compulsive Disorder
- includes attempts to avoid intrusive thoughts, images, and/or impulses
types of obsessions
- symmetry: keeping objects in order or doing things a specific way
- forbidden thoughts or actions: fears, potentially dangerous urges
- cleaning/contamination: fear of germs, etc.
- hoarding: fear of throwing things away
treatment
- SSRIs and/or ERP
- psychosurgery
Body Dysmorphic Disorder
- irrational belief in some flaw in appearance that impairs functioning
- often comorbid with OCD
- etiology may be similar to that involved in OCD and social anxiety
treatment
- SSRIs and a variant on ERP (ERP may have longer lasting effects)
- while many patients seek help from plastic surgeons and dermatologists, this is typically counterproductive
Hoarding Disorder
- differences from OCD
- tends to get progressively worse rather than wax and wane
three hallmarks
- excessive acquisition of things
- difficulty discarding things
- living in a dangerously cluttered environment
treatment
- CBT that encourages throwing objects away that have greater and greater importance to the patient
Trichotillomania and Excoriation
trichotillomania: an urge to pull out hair that results in noticeable hair loss, distress, and significant social impairment
excoriation: repetitive and compulsive skin picking leading to tissue damage
treatment
- SSRIs can be effective
- CBT focuses on replacing picking/pulling behaviors with non-harmful habits such as gum chewing
