exam 1 class notes Flashcards
conceptualizations of psychopathology (6)
statistical deviance (too intelligent?), maladaptive functioning (shyness?), distress and disability (how much?), social deviance (deviant from what?), “dysregulation” (voluntary and involuntary?), “harmful dysfunction” (dysfunction, as defined by evolution)
DSM vs ICD
DSM: first published in 1952; expanded and revised 5 times since first publication; organizes our conceptualization of “psychopathology;” prior conceptualizations reflected in definition; subject to revision; all the old questions remain
ICD: similar format to the DSM; evolved with the DSM; text published by the World Health Organization (WHO); covers a variety of mental and physiological issues
categories vs dimensions
categories: normal or abnormal; yes or no; someone has it or does not have it (light switch notion)
dimensions: recognition of a continuum; spectrum of pathology (shades that might be richer in some than in others); not all or none; severity of symptoms
dimensional perspective
burgeoning, though incomplete scientific validation; reflects our increasing recognition that we can make clear, scientifically-based distinctions between psychologically well or healthy and persons who are psychologically ill; specific diagnoses are “created” or “constructed”
“psychopathology”
socially constructed; subjective; under continuous revision; “social artifacts” in addition to our more noble qualities; not a rejection of “objective truth,” but rather, an appreciation of our struggle to recognize it
Albert Einstein’s view of insanity
doing the same thing over and over again and expecting different results
obligation of scientists
to pursue objective truth –> conceptualization of objective truth is still in need of constant revision
categories of reasons for making a diagnosis (5)
scientific, clinical, political, financial, personal
neurotransmitters
chemical messengers, mediating transmission between neurons; operate in a localized matter (regionally and with specific receptors); unique to different regions in the brain; varied in form, composition, and function
psychotropic drugs
exert influence by altering the receptivity of neurotransmitters
neurotransmitters examples (acetylcholine, dopamine, epinephrine and norepinephrine, GABA, glutamate, serotonin)
acetylcholine: muscle contraction, attention, memory
dopamine: reward, antipsychotic drugs, drugs that treat depression
epinephrine and norepinephrine: arousal, alertness, “fight or flight”
GABA: inhibitory function, treatment for depression
glutamate: excitatory function
serotonin: behavioral and emotional regulation
right hemisphere
appears to have a special role in mediating emotion, though both the left and right are implicated and work in tandem
prosody
(in speech) the emotional charge (i.e. kind, angry)
prosopagnosia
lack of facial recognition (part of the brain that mediates recognition of faces)
amygdala
receives sensory information and relays to other portions of the brain; plays a critical role in emotional processing; activates in presence of fearful and unpleasant stimuli and triggers a response; implicated in mood disorders; exerting a reaction even before we are consciously considering it
orbitofrontal cortex
interconnected with the amygdala; implicated in emotional processing; decision-making in emotional and social situations
basal ganglia
implicated in the processing of emotions (Parkinson’s disease –> impaired emotion/recognition of emotion)
polygenic
multiple genes implicated in the expression of a disorder (most psychological disorders)
genome-wide association studies
multiple thousands of participants and advanced statistical techniques; epigenetic effects (nongenetic influences on gene expression); biomarkers; attempt to find associations between specific areas on DNA and traits
developmental psychopathology
the investigation of the processes that mediate or moderate (influence) the development of disordered behaviors with a primary focus on the origins of the behaviors and how they manifest themselves in disorder or adaptation over development
key principles of the developmental psychopathology perspective (6)
chronological age, holism, directedness, differentiation of modes and goals, mobility of behavioral function, developmental cascades
chronological age (CA) reflects… (2)
(1) cognitive and biological maturity
(2) type and duration of environmental experiences
holism
development consists of several inter-related domains that exert influence over one another on an inter-psychological and an intra-psychological plain (consider “mental age”)
directedness
children (and adults, for that matter) are actively involved in shaping their environment, not passive (i.e., development is “bidirectional”)
differentiation of modes and goals
with development, children become increasingly flexible, more organized, and differentiated regarding their approach to their world
mobility of behavioral function
earlier, more undifferentiated forms of behavior become hierarchically integrated into later forms of behavior
developmental cascades
environment + genetic endowment + prior adaptation = exerts influence over development; the experiences that we have shape on how we adapt to the demands of the setting
regression
we attempt to cope with the demands of the moment and can regress in our behaviors/reactions (i.e. smashing a window when locking keys in the car)
equifinality vs multifinality (developmental pathway)
equifinality: multiple routes
multifinality: multiple endpoints (you are a function of your experience)
assessment
measures adaptive and maladaptive patterns of behavior; function of behavior, context, duration, replacement
continuity
“congruity, consistency, logical connections” across development
comorbidity
the co-existence of two or more psychological disorders (shared risk factors, unique pattern of syndrome, one disorder increases the risk for another)
risk and resilience
parents can help their child’s resilience and lower their risk for certain disorders; strengths and weaknesses, resources, relationships, stressors, mining for metals
longitudinal design
repeated observations of the same variables over short or long periods of time
archival research
archived manuscripts written by the School Sisters of Notre Dame (i.e. autobiographies); positivity and “idea density associated with longevity and decreased risk of Alzheimer’s disease (“The Nun Study”)
how our mindset is influenced by those around us (8)
illusions of unanimity (agreement); unquestioned beliefs; rationalizing (explain with logic); stereotyping (oversimplified idea of something); self-censorship (control over what one does); “mindguards” (omits information that causes doubt; attempts to preserve central idea); illusions of invulnerability (impossible to harm); direct pressure (groupthink)
groupthink
the process of how your opinion is shaped by the people who sit around you
Carl Sagan’s “baloney detection kit” (8)
(1) independent confirmation of the “facts”
(2) encourage substantive (meaningful) debate
(3) arguments from authority carry little weight (no authorities, only experts -> authorities can make mistakes)
(4) spin more than one hypothesis (different ways of explanation)
(5) don’t get overly attached to any one hypothesis (compare fairly to others)
(6) quantify (can discriminate from other hypotheses)
(7) adhere to Occam’s Razor (best explanation is often the simplest)
(8) replication (capable of falsification)
what to watch (listen) for in our interactions with others (11)
(1) ad hominem arguments (attack the person rather than the position)
(2) argument from authority (having experience)
(3) argument from adverse consequences (threatening harm)
(4) appeal to ignorance (don’t know very much)
(5) special pleading (feel so strongly)
(6) observational selection (testimonials testifying character)
(7) “all natural!” and similar claims
(8) science-like (but meaningless) jargon (slang)
(9) criticizing and/or stereotyping other options
(10) the therapy must be done “just right”
(11) ambiguous assertions (vague goals or results)
culture
values, beliefs, and practices of a group of people; a system in flux
goal of cultural research
investigate common experience of psychopathology, as well as unique expressions
cultural humility vs cultural competency
humility: requires historical awareness; lifelong process; establish a notion that one must be humble in his or her service to others; learn one’s own cultural background and how it influences attitudes, beliefs, values, and practices; develop knowledge of worldviews from diverse cultural backgrounds; recognize one’s limitations and avoid making assumptions
competency: the ability to work respectfully with people from diverse cultures, while recognizing one’s own cultural biases
dimensions of the mental industry that intersect with culture, race, and ethnicity (6)
clinical/therapeutic, political, moral and ethical, political, economic, clinician’s personal experience
race/ethnicity/culture considerations (5)
(1) comfort, familiarity, rapport with interview, testing, or questions
(2) questions may be interpreted differently
(3) cultural context may influence how behavior is interpreted (e.g., severity; what is maladaptation)
(4) culturally-influenced notions of time may affect reports
(5) experiences of “abnormality” may not comport with the experience of the clinician
conduct disorder
physical aggression (higher in males) and relational aggression (higher in females)
masking
seems to happen particularly in women; one has all the signs of autism, but by virtue of effect, they do not immediately appear as autistic
race bias and gender bias (disorders)
race bias: conduct disorder, antisocial personality disorder, comorbid substance abuse and mood disorders, eating disorders, PTSD, differential diagnosis of schizophrenia and psychotic affective disorders
gender bias: ASD, ADHD, conduct disorder, antisocial and histrionic diagnoses
bias
occurs when clinical instruments or judgements are more valid for one group than another
key purpose of classification
communication between parties
reason for DSM-I creation
need for classification system by military
DSM-III
innovative: (a) explicit criterion sets; (b) expanded discussion of each disorder; (c) removal of terms that favored a particular theoretical model
highlighted how little we knew
but lacked empirical validation
DSM-IV “Sourcebook”
included a discussion of cultural and ethnic variation; described systematic treatment and how the diagnosis was formulated
DSM-V criticism
majority of the committee members had financial ties to the psychopharmacology industry
current issues with the DSM-V (2)
empirical support in some parts, but rely on opinions and professional judgment in others
becoming more generalized when defining a pathology (definition of mental disorder)
lack of reliability vs lack of validity
reliability: doesn’t offer up consistent measure (i.e. scale weighing differently)
validity: different construct (i.e scale measuring height)
internal consistency
items appear to measure the same things under the same domains; intercorrelation of items; measure same trait
test-retest reliability vs interrater reliability
test-retest: test result consistency
interrater: measures agreement beyond chance
content, convergent, discriminant, predictive, concurrent, structural, and incremental validity
content: how well the instrument covers all relevant parts of the construct it aims to measure
convergent: how closely a test is correlated with other measures that target the same construct
discriminant: low correlations with measures that target other constructs (unrelated constructs are actually unrelated)
predictive: ability to predict/forecast future outcomes
concurrent: how a test compares against a validated test; relationship between two measures at the same time
structural: degree to which elements of the test correlate with one another; seeing which sections of the instrument speak to particular domains
incremental: the extent to which an instrument contributes unique information beyond available information
sensitivity and specificity
sensitivity: likelihood that one will test positive if one has the mental health condition
specificity: likelihood that one will test negative if one does not have the mental health condition
positive vs negative predictive power
positive: the likelihood of a disorder given the presents of a particular result on an assessment instrument
negative: the likelihood of a disorder given the presents of a particular result on an assessment instrument
signal detection theory (SDT)
statistical approach that analyzes data to establish cutoff scores of an instrument; can account for varying base rates across populations
norms
scores that form a frame of reference for interpretation of results for an individual
treatment utility
extent to which a measure contributes to decisions that lead to good outcomes
“validity scales”
items that are injected right into the instrument that turn the intent of the instrument on its head on purpose –> can see how the person responds
LEAD methodology acronym
longitudinal, expert, all data
LEAD methodology
diagnoses made by using interviews are compared
with diagnoses made by collecting longitudinal data; more accurately evaluate the validity of diagnoses based on unstructured, structured, or semistructured interviews
functional assessment of behavior (applied behavior analysis)
A –> antecedent (before behavior), B –> behavior, C –> consequence (immediately after behavior); the function of behavior is determined by the consequences that follow the behavior
process vs outcome research
process: component analysis; identify the critical ingredients of intervention, especially those elements that contribute to effectiveness
outcome: investigation of the effects of intervention (short- and long-term), including predictive research (who will benefit)
efficacy and effectiveness, implementation
efficacy: the power to produce an effect; typically established through well-controlled circumstances (found in confines of laboratory)
effectiveness: extent to which benefits are measured in less-controlled, more real-world circumstances (once we’ve established efficacy)
implementation: investigating variables such as cost, necessary training, dosage; attempt to make things “doable” for the public
randomized controlled trials
examine outcomes for those who received treatment A or treatment B; randomized samples; could be two treatments or one treatment and a control condition
experimental methodology
offers control over variables of interest; allows researchers to draw conclusions about causality; has benefits and drawbacks regarding internal and external validity (what intervention exerts greatest benefit for people)
experimental control
researchers systematically manipulate the independent variable to measure the dependent variable; all other factors held constant (determination of causality)
internal vs external validity
internal: allows you to conclude that a particular variable is the direct cause of a particular outcome; confidence that any changes in the dependent measure is a function of the intervention in your study
external: the degree to which conclusions drawn from a particular set of results can be generalized to other samples and situations (generalizability)
experimental vs control group
experimental: receives the intervention on treatment
control: serves as a direct comparison for the experimental group and receives either an inert version of the treatment or no treatment at all
attention control group
provides an experience as similar to the experimental group as possible, but without the “key factor” of interest
placebo effect
an effect of treatment that can be attributed to participants’ expectations from the treatment rather than any property of the treatment itself; benefits are real and measurable; attention and expectation of efficacy
