Exam 1: Ch 1, Ch 3 Flashcards
Def of Stigma
- Destructive beliefs and attitudes held by a society that are ascribed to groups considered different in some way
- Psychological disorders remain the most stigmatized condition in the 21st century
Psychopalogy def
The field concerned with the nature, development, and treatment of psychological disorders
Four Characteristics of Stigma
1) distinguishing label is applied
2) label refers to undesirable attributes
3) people with the label are seen as different
4) people with the label are discriminated against
==> leads to stigma
Ending Stigma
- People’s knowledge has increased, but stigma has not decreased
- Social Media: Websites and blogs serve as a medium to share personal stories, raise awareness, and increase social connectedness
- Public figures speaking about their experiences with mental illness may help to reduce stigma
Defining Psychological Disorders: DSM-5
- The disorder occurs within the individual
- It involves CLINICALLY SIGNIFICANT difficulties in thinking, feeling, or behaving
- It usually involves personal distress of some sort
- It involves dysfunction in psychological, developmental, and/or neurobiological processes that support mental functioning
- It is not a culturally specific reaction to an event
- It is not primarily a result of social deviance or conflict with society
Three Characteristics of a Comprehensive Definition of Psychological Disorder
Personal Distress, Violation of Social Norms, Disability and Dysfunction
Personal Distress
- def
- examples
*A person’s behavior causes significant distress
-Examples of distress:
Difficulty paying attention;
Emotional pain and suffering
-An individual may violate the law without guilt, remorse, or anxiety
-Not all behaviors that causes distress are disordered
E.g., Distress of hunger due to religious fasting
Disability:
*Impairment in an important area (e.g., work, relationships)
Chronic substance abuse resulting in job loss
Rejection by peers due to social anxiety
Dysfunction
- Developmental, psychological, and/or biological systems are not working as they should (impairment)
- These systems are interrelated
Violation of Social Norms
*Social norms are widely held standards
Beliefs and attitudes used to make judgments about behaviors
Behaviors that violate social norms may be classified as disordered
why is “violation of social norms” criticized
- Too broad and too narrow of a definition
- Criminals violate social norms (too broad)
- Highly anxious people typically do not violate social norms (too narrow)
- Social norms vary across cultures and ethnic groups
History of Psychopathology
- Supernatural explanations
- Early biological explanations: Hippocrates (5th Century BC)
- Dark Ages (2nd century AD)
- Lunacy Trials
- Asylums
- Pinel’s Reforms and moral treatments
- Dorothea Dix
Supernatural explanations (history of Psychopathology)
- Displeasure of the gods or possession by demons
- Treatment: Exorcism—Ritualistic casting out of evil spirits
(I belive this was the first thing in the history of psychopathology)
Early biological explanations: Hippocrates (5th Century BC)
Mental disturbances have natural causes (brain pathology)
- Three categories of mental disorders: Mania, melancholia, & phrenitis (brain fever)
- Healthy brain functioning depended on balance of four humors: Blood, black bile, yellow bile, & phlegm
- Treatment: Physicians restored natural balance (e.g., tranquility, sobriety, care in choosing food)
Dark Ages
- when
- treatments
-Dark Ages (2nd century AD)
-Christian monasteries replaced physicians as healers
-Return to the belief of supernatural causes
-Treatments: Cared and prayed for by monks;
Touched with relics; Drank potions in the waning phase of the moon
Lunacy Trials
- after dark ages
- Began in 13th century England
- Trials held to determine a person’s mental health: Orientation, memory, intellect, daily life, habits & - Strange behavior attributed to physical illness or injury
- Municipal authorities assumed responsibility for care of people with psychological disorders in hospitals
- Lunacy attributes insanity to misalignment of moon (“luna”) and stars
Asylums
- when
- example
- treatment
- Asylums (15th century)
- Establishments for the confinement and care of people with psychological disorders
- Treatment non-existent or harmful at asylums
- Priory of St. Mary of Bethlehem (founded in 1243)
Pinel’s Reforms
-date
*Philippe Pinel (1745–1826)
Pioneered humane treatment in asylums
People should be approached with compassion and dignity
Humanitarian treatment reserved for upper class
Biological Origins
General paresis and syphilis
-Deterioration of mental and physical abilities, and progressive paralysis (general paresis)
-Some people with general paresis also had syphilis
In 1905, biological cause of syphilis found:
Causal link between infection, damage to the brain, and psychopathology
Biological causes of psychopathology gained credibility
Genetics
Galton’s (1822–1911)
- Originator of genetic research with twins
- Work lead to notion that mental illness can be inherited
- Nature (genetics) and nurture (environment)
- Eugenics
Biological Treatments (3)
- Insulin-coma therapy : Sakel (1930s)
- Electroconvulsive therapy (ECT) : Cerletti and Bini (1938) + Induce epileptic seizures with electric shock
- Prefrontal lobotomy : Moniz (1935)
- Destroys tracts connecting frontal lobes to other areas of brain
- Often used to control violent behaviors
- Led to listlessness, apathy, and loss of cognitive abilities
Psychological approaches
- Mesmer (1734–1815): Hysteria caused by a disruption of a universal magnetic fluid in the body. Used rods and stares to influence the fluid and induce behavioral change. Early practitioner of hypnosis
- Charcot (1825–1893): His support legitimized hypnosis as treatment for hysteria
- Breuer (1842–1925): Used hypnosis to facilitate catharsis in Anna O. Cathartic Method: Release of emotional tension triggered by expressing previously forgotten thoughts about an earlier emotional trauma
Freud
*Psychoanalytic theory
Psychopathology results from unconscious conflicts
*Mind is divided into three principle parts: Id, ego, superego
*Id, ego, and superego continually in conflict
-Conflict generates anxiety
*Defense mechanism: Strategy used by ego to protect itself from anxiety
Freuds Structures of the Mind
- Id: Present at birth. Biological and unconscious. Seeks Immediate gratification.
- When id is not satisfied, tension is produced and id drives a person to get rid of tension (e.g., eat when hungry).
- Ego: Primarily conscious. Mediates between demands of reality and id’s demands for immediate gratification
- Superego: A person’s conscience. Develops as we incorporate parental and society values
Psychoanalytic Therapy
- Goals of Psychoanalysis
- Transference: Responding towards an analyst in a similar way as towards important people in the person’s past
- No formal research on the causes and treatment of psychological disorders
-Goals of Psychoanalysis
- Understand early-childhood experiences, the nature of key relationships, and the patterns in current relationships
- Therapist is listening for core emotional and relationship themes
Major Techniques of Psychoanalysis
Free association, Interpertation, Analysis of transference
Continuing Influences of Freud and His Followers
- Childhood experiences help shape adult personality: Childhood experiences and environmental events are crucial. Early relationships influence adult relationships
- There are unconscious influences on behavior: People can be unaware of the causes of their behavior
- The causes and purposes of human behavior are not always obvious: Look under the surface to find hidden meaning in behavior
Operant Conditioning examples (2)
- E. Thorndike (1874–1949)
* B.F. Skinner (1904–1990)
B.F. Skinner (1904–1990)
- Operant conditioning
- Principle of Reinforcement: positive and negative reinforcement
- Positive reinforcement: Presentation of a pleasant event strengthens a response
- Negative reinforcement: Removal of an aversive event strengthens a response
Modeling
- Learning by watching and imitating others’ behaviors: Can occur without reinforcement
- Modeling can increase or decrease diverse kinds of behavior : Sharing, aggression, fear, etc.
Behavior Therapy
- Systematic Desensitization
- Intermittent Reinforcement : Rewarding a behavior only occasionally is more effective than continuous schedules of reinforcement
Cognition
How we think, or appraise, a situation influences our feelings and behaviors
Cognitive Therapy
- How people construe themselves and the world is a major determinant of psychological disorders
- Focus on becoming more aware of maladaptive thoughts
- Changing cognitions to change feelings, behaviors, symptoms
Have We Learned from History?
- We have made several advancements and still have much to learn!
- Do “reality” TV shows depicting psychological disorders educate or perpetuate stigma?
- People with psychological disorders are more likely to be housed in jails than in a hospital due to gaps in available services
- Many are unable to work and thus have very little income, limiting housing resources
- Medications have unpleasant side effects
Psychologists
Advanced graduate training in the assessment and diagnosis of psychopathology and how to practice psychotherapy
Ph. D. (additional emphasis on research) or Psy. D.
Psychiatrists
Medical degree (M.D.) with postgraduate training (residency) in diagnosis and pharmacotherapy Can prescribe psychotropic medications
Mental Health Professions
Psychologists, Psychiatrists, Psychiatric Nurses, Social Workers
Psychiatric Nurses
- Bachelor’s or master’s level training
* Nurse practitioners receive specialized training to prescribe psychotropic medications
Social Workers
- Master of Social Work (M.S.W.)
- Typically requires 2 years of graduate study
- Trained in psychotherapy
- Not trained in psychological assessment
Diagnosis
Agreed-on definitions and classification of disorders by symptoms and signs
Advantages of diagnosis:
- First step in good clinical care
- Facilitates communication among professionals
- Advances research for causes and treatments
Reliability
-Consistency of measurement (results are consistance)
-Measured from 0 to 1.0
(Higher the number the better the reliability)
Types of Reliability (4)
Interrater
Test-retest
Alternate Forms
Internal Consistency
Alternate Forms
Similarity of scores on tests that are similar but not identical
Internal Consistency
- slide 6 has an example
- Extent to which test items are related to one another
T/F Reliability does not guarantee validity
TRUE
ex: Height can be measured reliably, but it is not a valid measure of anxiety
Content validity
- Whether a measure adequately samples the domain of interest
- E.g., all of the symptoms of a disorder
Diagnostic and Statistical Manual of Mental Disorders (DSM)
Published by American Psychiatric Association
First edition published in 1952
Revised 5 times
For each psychological disorder, the DSM-5 provides:
- Diagnostic criteria for a diagnosis : Criteria have become more detailed and concrete over time
- Description of associated features: Laboratory findings, results from physical exams
- Summary of research literature: Age of onset, course, prevalence, risk and prognosis factors, cultural and gender factors, differential diagnosis
Defines diagnoses on the basis of _________
-symptoms
Our knowledge base is not yet strong enough to organize diagnoses around etiology
Criticisms of the DSM:
Too Many Diagnoses, Categorical vs. Dimensional Classification, Many risk factors increase risk for multiple disorders, Research Domain Criteria (RDoC), Reliability of DSM in Everyday Practice
Why say that Too Many Diagnoses is a criticism for DSM?
*Number of diagnoses continues to increase
-Should relatively common reactions be pathologized?
Trying to be more inclusive… but creates stigmas at the same time
*Comorbidity
-Presence of a second diagnosis
45% of people diagnosed with one DSM-IV disorder meet criteria for a second disorder
the current DSM is categorical or dimensional?
categorical but has added some dimensional classification by adding severity rating for nearly all disorders
Life stressors
Environmental problems that trigger the subjective sense of stress
Personality Inventory
Self-report questionnaire
Standardized
(a personality test)
Ecological Momentary Assessment (EMA)
Collection of data in real time using diaries or smart phones
A person is signaled and asked to enter responses directly into the device in real time
- an example of self-monitoring
Dysfunctional Attitude Scale (DAS)
example of Cognitive-Style Questionnaires
Dysfunctional Attitude Scale (DAS)
example of Cognitive-Style Questionnaires
Electrocardiogram (EKG)
Measures heart rate using electrodes on chest
what remains the most stigmatized condition in the 21st century?
*Psychological disorders remain the most stigmatized condition in the 21st century
way to reduce stigma
-Public figures speaking about their experiences with mental illness may help to reduce stigma
according to the professor, a better word for abnormal psychology is…
psychopharmacology: “brain illness”
syntonic (Def and example)
does not necessarily feel bad to have this
*example= mania
Egodystonic
do NOT feel good for us to have this disorder; usually easier to get people to treat
syntonic disorders vs egodystonic disorders
syntonic- does not necessarily feel bad to have this; –example= mania
Egodystonic: do NOT feel good for us to have this disorder; usually easier to get people to treat
A psychological disorder must be … in order to be classified by the DSM-5
clinically significant
T/F : Not all psychological disorders cause distress
TRUE
- E.g., Antisocial personality disorder
- An individual may violate the law without guilt, remorse, or anxiety
T/F If a behavior causes distress then it is considered a disordered
FALSE
E.g., Distress of hunger due to religious fasting
T/F Not all psychological disorders involve disability
TRUE
T/F All disabilities are considered to be psychological disorders
FALSE
Violation of Social Norms examples (2)
- Repetitive rituals performed by people with obsessive-compulsive disorder
- Talking to nonexistent voices that some people with schizophrenia experience
do Social norms vary across cultures and ethnic groups
Yes, this is a criticism of social norms
Early biological explanations for abnormal psychological disorders: Hippocrates (5th Century BC)- what are the humors?
Healthy brain functioning depended on balance of four humors:
Blood, black bile, yellow bile, & phlegm
Treatments used in the Dark Ages
Treatments:
Cared and prayed for by monks
Touched with relics
Drank potions in the waning phase of the moon
Priory of St. Mary of Bethlehem
-when was it founded
-(founded in 1243)
One of the first mental institutions
-The wealthy paid to gape at the patients
-Origin of the term bedlam (wild uproar or confusion)
-Treatment non-existent or harmful at asylums
Origin of the term bedlam (wild uproar or confusion)
Priory of St. Mary of Bethlehem (founded in 1243)
Benjamin Rush recommended:
-@ asylums
-(father of American psychiatry) recommended: Drawing copious amounts of blood to relieve brain pressure +
Fear as a cure (e.g., convince patient that death is near)
Moral Treatment
- Small, privately funded, humanitarian mental hospitals
- Friends’ Asylum (Pennsylvania, 1817)
- Patients engaged in purposeful activities (e.g., gardening)
- They talked with attendants and led lives as close to normal as possible
Dorothea Dix
(1802–1887)
- Crusader for improved conditions for people with psychological disorders
- Worked to establish 32 new public hospitals
- Took many of the people whom private hospitals could not accommodate
- Small staffs at public hospitals could not provide necessary individual attention that was a hallmark of moral treatment
what caused Biological causes of psychopathology to gain credibility
*General paresis and syphilis
Deterioration of mental and physical abilities, and progressive paralysis (general paresis)
Some people with general paresis also had syphilis
In 1905, biological cause of syphilis found:
Causal link between infection, damage to the brain, and psychopathology
Biological causes of psychopathology gained credibility
-Eugenics under Galton (1822–1911)
-Eugenics
Promotion of enforced sterilization to eliminate undesirable characteristics from the population
Many state laws required people with psychological disorders to be sterilized
- Mesmer
- date
A Psychological Approach
*Mesmer (1734–1815): Hysteria caused by a disruption of a universal magnetic fluid in the body. Used rods and stares to influence the fluid and induce behavioral change. Early practitioner of hypnosis