exam 4 Flashcards

1
Q

social psych & Kurt Lewin

A
  • Humans are fundamentally social creatures – complex communication has contributed to evolutionary success
  • Kurt Lewin (1890-1947) – behaviour is a function of the person and the social environment; not a vacuum
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2
Q

synchrony

social norms

social roles
- experiment

A

Synchrony – when 2 individuals’ speech, language, and physiological activity become similar during social interaction

a. Mimicry – copying the behaviours, emotional displays, and facial expressions of others
- Usually unconscious
- Serves as a ‘social glue’; helps coordinate behaviour in social settings

Social norms – guidelines for how to behave in social contexts; usually ‘unwritten’, implicit, or implied

a. Followed due to social pressures; to obtain social approval
b. To avoid ostracism – ignored or excluded from social contact; powerful form of social pressure; could result from not following norms
- Leads to – anger, sad, low self-esteem, self-confidence, violence (more extreme)

Social roles – guidelines that apply to specific positions within the group (ex. parent, child, student, professor)

a. Ex. Stanford prison experiment – people were picked randomly as prisoners and guards, heavily influenced their behaviour
- Represents how roles taken on influence our outward behaviour and sense of self

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3
Q

groupwork effects

A
  1. Social loafing – a member of the group puts in less effort into working on a task than others
    a. Relevant to any type of task (ex. physical, cognitive, creative), or group type
    b. Factors that encourage loafing
    - Low efficacy beliefs – ‘I don’t know where/how to start, the task is too hard’
    - Believing one’s contribution isn’t important – ‘my input doesn’t matter, why contribute’
    - Not caring about outcome – ‘I don’t identify with this group; this isn’t important to me’
    - Feeling like other’s aren’t trying either – ‘they aren’t trying, why should I’
  2. Social facilitation – a group members performance is affected the presence of others; better or worse; usually making you try harder (ex. Cyclists riding faster when racing against each other; ants digging more when working with other ants)
    a. Presence of others – may impair performance when the task is hard or skill level is low
    - Creates emotional arousal – occupies our attention; more of a distraction for novices than it is for experts
    b. Skill level – determines performance
    - If you’re really good – excitement of being watched; can improve performance
    - If you’re not good – harder to filter out distraction or use it in a positive way
  3. Conformity – change in behaviour to fit in with a group; can be unintentional; similar in some ways to mimicry
    a. Solomon Asch conformity studies (1950s) – participants answer questions based on confederates’ answers to a task (standard lines and comparison lines)
    b. Reasons for conforming
    - Normative influence – social pressure to adopt a group’s perspective in order to be accepted by the group; ‘public compliance’
    - Informational influence – genuine interest in the information provided by the group; ‘private acceptance’
    c. Personal and situational factors:
    Less likely to conform:
    - Only one other person is in the vicinity
    - Only strangers in the room
    - Extremely clear and simple tasks
    - There is one other nonconformist in the group
    - Responses are anonymous – this is why it’s important in research
    More likely to conform:
    - Larger group in the vicinity
    - There are friends, families, and acquaintances
    - The task is unclear/ambiguous
    - Others conform first
    - Responses are made public
  4. Groupthink – decision making problem in which group members avoid arguments and strive for agreement
    a. Doesn’t always make good decisions
    - May minimize/ignore potential problems or risks
    - May settle on the ‘easy’ solution too quickly, without considering other/better options
    - May lead to overconfidence, and less time considering consequences of a decision, learning from mistakes
    b. Usually occurs when there is a strong leader in the group who is unwilling to accept ideas of other group members, or when all group members have very similar ideals
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4
Q

Obedience to authority and Stanley Milgrim

A
  • People will obey authority figures – certain factors mediate this relationship such as others objecting
  • Obedience, authority, compliance – all topics of interest following WWII

Stanley Milgram obedience studies (1963, 1974) – tested the effects of authority figure; learner gets connected to shocks, teacher shocks leaner when they forgot a word; each time they got it wrong, shock increases; ‘learner’ wasn’t actually getting shocked; tested to see how long ‘teacher’ would shock learner when told to do so
- Large amount of cases – teacher continued to shock learner to the point where learner stopped responding; continued to shock even after
- Variations
a. Lowered obedience by 30% - physical distance to authority & subject:
o Experimenter gave orders from another room
o Teacher and learner were in the same room
o Required teacher to physically shock learner
b. 3 teachers (2 confederates) vs one ‘experimenter’ – when confederates decided to stop, the participant agreed 90% of the time
o Most effective
o You’re more likely to disobey authority when others are disobeying authority with you

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5
Q

The bystander effect

  • explanations
  • kitty genovese
  • study
A

(bystander apathy) – an individual is less likely to help when there are other people present, who are also not helping

Explanations

a. Normative influences – socially mediated and influenced
- What happens if I try to get help and embarrass myself by doing the wrong thing?
b. Informational influences – you’re not understanding the situation because other people aren’t doing anything either; trust that other people know things that you don’t
- What if others know something I don’t? am I overreacting?
c. Diffusion of responsibility – reduced personal responsibility that a person feels when more people are present in a situation
- If you’re the only one – you are the only one who can help

Ex. kitty Genovese (1964) – woman was stabbed outside of apartment building; screaming; a large number of residents reported hearing cries for help but it took a long time for anyone to call the police

Latane & Darley (1968) – participants engaged in conversation with 1, 2, or 3 others (actually confederates) via intercom; during the conversation one of the confederates reported having a seizure
The more confederates involved in the conversation, the longer it took the participant to react
a. 1 on 1 – participant got help right away
b. 3 – participant took longer to get help

Not always the case – ex. carnival ride starts to tip & crowd runs to hold so it wouldn’t fall

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6
Q

Altruism

  • evolutionary
  • ants
A

helping others in need without receiving or expecting reward for doing so

Evolution – seems counterintuitive to natural/sexual selection competition
o Kin selection – strategy that favours reproductive success of a relative; if you put yourself in danger but are saving a relative, some percentage of your genes are still being passed on
Ex. Hamilton’s rule (depends on how genetically related they are), green beard gene, etc.

Ex. ants – large portion of colony are not related to the queen but go out of their way to die for the queen

Is there such a thing as truly altruistic behaviour – is everything we do for others, on some level, because we will get something out of it in some form

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7
Q

social cognition

A

combines influence of social context and cognition (thought process)

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8
Q

dual processing models

A

models of behaviour that account for both explicit and implicit processes
o Explicit – conscious thought; deliberate, effortful, relatively slow, under intentional control
o Implicit – unconscious thought; intuitive, automatic, effortless, very fast, operate mostly outside of intentional control; lower level processing
Can lead to bias and stereotypes
o The 2 major processes interact with each other – our implicit processes influence how we explicitly explore situations

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9
Q

schemas & implicit bias

  • heuristics
A

organized clusters of knowledge, beliefs, and expectations; quick intuitive implicit thoughts and unconscious processes
- Related to certain relationships – will be faster if mapped closer together; causes quick associations/biases

Heuristics – ‘best guess’ problem solving strategies based on prior experiences; assumptions
o Economically viable – allows quicker processing; can be very beneficial
o Aren’t always the best answer – closer associations are often stereotypes
(people were quicker able to make stereotypical connections than unbiased ones)

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10
Q

person perception

  • evolutionary
  • counteracting
  • self-fulfilling prophesies
A

process by which individuals categorize and form judgements about other people; can occur very quickly, unconsciously (ex first impressions)

Thin slices of behaviour (small samples)
o We generalize to larger things – ex. judgements about sexual orientation, political affiliation
o We make snap, often accurate, assumptions about a person

Evolutionary – can make quick judgements in dangerous situations
o Today – still useful; can also get us in trouble because we are filling in portions of our schema; HERE

Explicitly examining our automatic thought processes can help counteract this

Self-fulfilling prophesies – a first impression or expectations affects one’s behaviour -> then affects other persons behaviour -> leading to confirmation of original impression, expectations
o Harmful stereotypes made about you will influence behaviour towards you, which in turn influences your behaviour (ex. ‘women are bad at math’; don’t go into STEM)
o HERE

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11
Q

self concept

  • related to
A

We tend to view the world and other people in it from the perspective of our own ‘self concept’

The way I am -> the way people should be (I think therefore I am)

  • Related to child development – aren’t able to view from others perspective
  • If this is the way I see the world – why would other people not see it the same way
  • ‘us’ vs ‘them’
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12
Q

biases from self concept

A

False consensus effect – tendency to project one’s self concept onto the social world (I feel this way, so everyone else probably does or should too)

Naïve realism – assumptions that our perceptions of reality are accurate, and we see things the way they are

Self-serving biases – biased ways of processing self-relevant information to enhance our positive self-evaluation

  • Ex. taking credit for success, blaming other people, circumstances, or bad luck for our failures
  • Better than average effect – we assume we are above average at skills/qualities that are important to us
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13
Q

internal vs external attributions

-FAE - fundamental attribution error

A

Internal attributions – dispositional attributions; explaining behaviour of another person in terms of innate quality; default when we talk about others
- Ex. that person made an error because they’re a bad driver

External attributions – situational attributions; explaining the behaviour of another person as the result of the situations
- Ex. that person may have been distracted or were tired

Fundamental attribution error (FAE) – tendency to over-emphasize internal (dispositional) attributions and under-emphasize external (situational) when explaining other people’s behaviour
- Individualistic cultures (ex. Canada, USA) more likely to make this error
HERE

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14
Q

ingroups and outgroups

A

Ingroups – groups someone feels positively toward and identifies with (ex. family, home team, coworkers)
- Ingroup bias – extension of a positive bias toward the self to include one’s ingroups; motivation to view ingroups as superior to outgroups

Outgroups – ‘other’ groups someone doesn’t identify with; or dis-identifies with

Even when grouped based on seemingly meaningless, random criteria – people demonstrate preference for ingroup and demonstrate prejudice and discrimination towards outgroups

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15
Q

improving intergroup relationships

A

Evidence suggest people’s implicit networks can be ‘reprogrammed’ with practice – helps avoid stereotypes
- Ex. training to replace internal/dispositional attributions with external/situational attributions

Contact hypothesis – social contact between members of different groups is extremely important to overcoming prejudice; can’t use thin slices of behaviour
Especially true if:
• Contact occurs in settings with equal status and power
• Meeting involves cooperating on tasks or pursuing common goals

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16
Q

stereotypes

discrimination

prejudice
- association tests & brain region

A

Stereotypes – a cognitive structure (ex. schema) that guides how we process info about our social world; set of beliefs about the characteristics of a specific social group
o Can be positive or neg (pos can still be harmful – not an accurate information source)

Based on our stereotypes we have
o Prejudice – emotionally charged response toward outgroup members; includes holding neg attitudes and making critical judgements of other groups
o Discrimination – behaviour that disadvantages members of a certain social group
o Racism, classism, sexism

Measuring prejudice – concepts linked within a schema/are categorized together will illicit faster response times

a. Implicit association tests (IAT; Greenwald et al., 1998) – measures how fast people can respond to images or words flashed on a computer screen
- Reaction time scores correlate with activation in the amygdala (emotion processing, fear response)
- Ex. reaction times are faster when grouping positive words and white people together and Black people with neg words that vice versa

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17
Q

4 common approaches to changing peoples behaviour

A

o Technological – making desired behaviours easier to accomplish, undesired behaviours more difficult; advances in technology help make things easier
o Legal – creating policies and laws to encourage positive behaviours, discourage negative behaviours
o Economic – providing financial incentives and penalties (ex. taxes, pricing)
o Social – raising awareness, education, illustration of pos and neg outcomes and related behaviours

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18
Q

elaboration likelihood model

A

Dual process model (explicit & implicit) of persuasion that predicts whether factual info or other types of info will be the most influential

Dependant on how interested audience is and how much time they have to consider it
o Rational explicit thinking – when an audience is motivated/has interest in topic & has time to make a decision
o Implicit, less rational – when an audience is not interested and has to make a quick decision

Central route to persuasion – focuses on facts, logics, and content of the message
o Audience needs both motivation and time to listen and think rationally about the message

Peripheral route to persuasion – focuses on the features of the issue/presentation that are not factual; fanciness that brings people in if they lack interest; style vs substance of argument
o Helps you get your ‘foot in the door’ – then bring facts
Ex. grabbing attention with batman ad about milk
Ex. attractiveness of the person who delivers the message; number of arguments that are made

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19
Q

Construal level theory

A

information affects us differently depending on our psychological distance from the information

Messages that are made to feel more personally relevant/closer are more successful motivator
o Ex. geographic distance, temporal distance (time), social distance, degree of specificity, certainty

We will be more interested in things that are relevant to us – ‘happening to people like you in your neighbourhood’

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20
Q

Identifiable victim effect

A

People are more powerfully moved to action by the story of a single, suffering person that information about a whole group of people (stats)

Dual processing model
o Experiential system – operates implicitly, quickly, and intuitively predominantly emotional (emotional story from individual)
Ex. intuition and feelings
o Analytic system – operates explicitly, slower and more methodical, uses logic to understand reality (stats)
Ex. understanding

Ex. Mahala in India – girls were unable to go to school for years before her; she brought attention and caring to issue

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21
Q

Attitude Inoculation

A

strategy for strengthening attitudes and making them more resistant to change

Give 2 argument
o First – audience is exposed to a weak argument against the message then
o Second – audience is exposed to a strong response in favour of the message

Similar to how a flu shot protects from the flu by introducing a weakened version of the virus, allowing the immune system to develop antibodies to protect against the real, stronger virus

Ex. convincing teens not to do drugs
o First – feels fun and cool; pressures
o Second – unhealthy and addictive

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22
Q

Tips for successfully communicating a message when using central vs peripheral route

A

Central route – make sure the message is being presented, clearly, in a manner accessible to all people
o People don’t like what they don’t understand – confusion, cognitively challenging topics can promote feelings of insecurity, frustration, and apathy in the listener
o Ex. the curse of knowledge – when you know a lot, you assume other people do as well

Peripheral route – use experts or authority figures, high status individuals; use likeable communicators (ex. attractiveness)
o Social validation – ‘other people are listening to this message, so should you’; new York times #1 bestsellers, billboard 100 charts, petitions; If 5000 people like it, 5000 people can’t be wrong

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23
Q

Sales based on reciprocity and consistency

A

both are natural behaviours and influences that can be used for persuasion

Reciprocity – strong social norm to repay others:
‘door in the face technique’
a. Asking for something relatively big
• Ex. would you like to buy 10 vacuums – no, slam the door
b. Then asking for something relatively small – usually the goal from the beginning
• Ex. one vacuum for a trial period – ‘catching them before they close the door’
c. You’ve made a request, respecting their answer, then making a ‘sacrifice’ by downgrading their own desires, you must repay their sacrifice
• Ex. The least you can do is buy their one vacuum; salesman usually comes in trying to sell only one vacuum

Consistency – hard to say no after saying yes
‘foot in the door technique’
a. Making a simple request – following up with larger requests
b. Ex. Since they’ve already said yes to signing the petition – obviously feel strongly, donate an hour of time to volunteer – asks you to start volunteering more
• Can utilize the door in the face – initially asking 4 days a week, then going down to 1 day a week

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24
Q

cognitive dissonance

A

Humans need to be psychologically consistent

Cognitive dissonance – inner tension, discomfort felt when we hold inconsistent beliefs

Motivates us to reduce this tension – we make decisions and find information that helps ease cognitive dissonance

  • Confirmation bias – only searching for evidence that will confirm one’s beliefs
  • Self-justification = justifying or excusing one’s behaviour

Can lead to extreme beliefs – once you make a decision on one side of the pyramid, you continually make decisions (more significant) that justify previous decisions you’ve made

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25
Q

smoking

  • health risks
  • media exposure & study
  • efforts to prevent
A

one of the most widely used studied health behaviours; 19.9% of canadian adults smoke (2012)

Associated with 
o	Lung, mouth, throat cancer
o	Heart disease
o	Pulmonary disease (ex. emphysema) 
o	Life expectancy is 7-14 years shorter 

Media exposure - Exposure to movies featuring smoking associated with smoking in adolescence – occurs even when controlled for confounding variables such as SES, personality, and parental or peer pressure
a. Priming effects – watching scenes that involve smoking increases the likelihood of smoking after viewing the scene
- Study – watching video of smoking; participants are more likely to take a smoke break if you’re a smoker
b. Increase in prevalence of smoking in movies from 1990-2007 – associated with increase in adolescent smoking rates
• Opposite pattern is observed as smoking in movies decreases – adolescents smoking rates decrease
c. Correlation doesn’t always suggest causation – relationship does still exist & creates big push to get smoking out of movies

Efforts to prevent
4 approaches to changing behaviour – technological, legal, economic, social
- Banning in public places – reduces the risk of second hand smoke exposure
- Increasing taxes on tobacco – raises funds for healthcare and anti-smoking campaigns
- Text/pictorial warnings of packaging
- Pictures are more effective – 40% Canadian smokers report the graphic warning motivated them to quit
- Construal level theory – the closer you bring an issue to someone, the more likely they are to take action; make it personal, current, and salient

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26
Q

obesity

  • how many Canadians
  • BMI
  • health risks
A

Obesity – energy (food) intake exceeds energy expenditure; 24% of Canadian adults are obese (2011)

Body mass index (BMI) – stats used to estimate a healthy body weight given an individual’s height
a. BMI = weight / (height^2)
<18.5 = underweight
18.5-24.9 = healthy range
25-29 = overweight
>30 = obesity
b. Usually only useful when studying large sample sizes – different shapes and sizes; individuals could have higher BMIs for many reasons while still being healthy (ex. body builder)

Rates of obesity increasing earlier in life – early onset of associated health problems

Associated with 
o	Cardiovascular disease 
o	Diabetes 
o	Osteoarthritis 
o	Cancer
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27
Q

genetics and body weight

A

twin/family/adoption studies suggest genes account for 50-90% of the variation in body weight

Hundreds of specific genes contribute to body weight – influences body type, metabolism, and other physiological processes
- Ex. “fat mass and obesity related (FTO)” gene – associated with elevated food intake

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28
Q

set point theory

A

Set point – hypothesized mechanisms that serve to keep the body weight around a physiological programmed level; Initially controlled by genetic mechanisms

Set point shifts upwards/downwards with weight gain/loss – environmental factors influencing genetic set point
a. Physiological processes (ex metabolism) then work to maintain the new set point
• If set point goes up because of food intake – your metabolism has adjusted to new set point
• Can explain why significant weight loss can be hard – your body is trying to maintain set point while you’re trying to change it

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29
Q

causes of obesity

A
  1. The sedentary lifestyle – types of leisure activities can have significant influence on weight
    a. Adults – hours watching TV positively correlated with obesity rates
    • Not the case for hours spent on the computer – varying amounts of mental engagement/stimulation
    b. Children – hours spent watching TV AND on video games/computer both positively correlated with obesity rates

Social factors – family influences

a. Children typically eat the type of food provided by parents
b. Certain families will restrict/limit certain types of food
c. Eating patterns developed in childhood are generally carried into adulthood

Obese individuals
a. Pay more attention to food cues
b. Double reward in brain during consumption and digestion – show greater activation in anticipation of food reward
c. Taste and taste processing is primed along with emotional anticipation
• Primary gustatory cortex – perception of taste
• Somatosensory cortex – processing of sensory info
• Anterior cingulate gyrus – emotion, attention and mood
d. Restrictive diets can actually increase a food’s reinforcing properties

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30
Q

psychological focus on motivations to change behaviour associated with weight loss

A

Psychology focuses on effective motivation to change behaviour – ex. eating healthy, exercise

Benefit of positive thinking – focusing on positive, self-defining values associated with weight loss and lower BMI
- Comparison group focussing on other values (not positive self-definitions) did not demonstrate these changes

Stress reduction – reduced caloric intake
- Allostasis – stress causes body to ‘prepare’ for future stresses

Mindfulness – intense focus on/awareness of one’s present state, senses and feelings; correlation with healthy eating habits

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31
Q

COVID & obesity

A

Online survey completed by UK adults during April-may 2020 – during lockdown

  • Negative changes in eating and physical behaviour (ex. snacking more frequently)
  • Barriers to weight mgmt. (ex. problems with motivation and control around food; no sports games; no gyms open)

Higher BMI associated with lower levels of physical activity and diet quality & higher levels of overeating – those who came into lockdown with higher BMI may have had more pronounced issues

Decline in mental health predictive of more overeating and lower physical activity

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32
Q

poverty SES high vs low

  • social and health effects
A

Positive correlation between health and wealth

High SES

  • Wealthy individuals experience better access to healthcare, greater sense of control over their environment
  • Gym memberships, healthy food, after school sports, nutritionists, time to dedicate to exercise and healthy eating

Low SES
a. Loss of control associated with poverty, discrimination, and other social stressors
• Self determination theory – psychological wellbeing is influenced by degree of control over one’s behaviour
b. Higher rates of depression, anxiety and other health problem
• Greater risk of developing heart disease – combination of stress, low nutrition diets

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33
Q

SES and psych distress during covid

A

Low SES individuals more likely to

  • Live in overcrowded accommodation, limited access to outdoor space
  • Unable to work from home
  • Experience unstable work conditions and incomes
  • Limited access to healthcare
  • Suffer from health conditions that are high Covid risk factors

Lower annual household income associated with higher psych stress during the pandemic
- Increased stress – same effects; allostasis,, overeating, etc.

SES increases prevalence of depressive symptoms during Covid crisis
- Must take into account financial stability

“were all in this together” – bullshit

  • Covid has widened the gap even more
  • Is not the ‘great equalizer’
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34
Q

discrimination

  • effects
  • covid
A

Discrimination – behaviours that disadvantage a particular group; social interactions, systemic and societal; effects certain groups of people

Prejudice and discrimination associated with
o Increased BP and HR
o Greater risk of unhealthy behaviours such as smoking and substance abuse
o Prolonged stress response, increased levels of stress hormones (ex. cortisol)

COVID
a. Marginalization and discrimination in the workforce makes certain groups more susceptible
Ex. service, travel, entertainment, retail industries – employ higher percentages of women, Black, Latinx, Native American
b. Survey of Chinese American uni students – higher perceived discrimination and anxiety during the pandemic
- Stronger link between perceived discrimination and anxiety during the pandemic (more strongly related during pandemic than before)
- Link is mediated by negative media exposure

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35
Q

social isolation effects

A

Family and social environment – we have a need to feel related to and feel close

Long term isolation can be as dangerous as smoking, obesity, high blood pressure – takes toll on mental and physical health

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36
Q

social resiliency

A

Social resilience – ability to keep positive relationships and to endure, recover from social isolation and life stressors
o People with higher social resilience – helps protect from negative health consequences associated with loneliness and social isolation

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37
Q

long term health benefits of marriage

A

married people – live longer and have better mental/physical health than non married adults
a. social support and combined resources
• may notice health issues you do not
• close, intimate relationships are good for wellbeing
b. also applies to other long term close relationships

non-married – higher rates of death due to heart disease, some forms of cancer, cirrhosis of the liver

  • unmarried women 50% more likely
  • unmarried men 250% more likely

marital/relationship problems – associated with higher rates of depression and physical illness

  • Gottman lab – 4 horseman of divorce apocalypse
  • It needs to be a healthy relationships for health benefits
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38
Q

hormones - relationships and health

A

During marital interactions tasks – talking about marital issues; problem solving task
a. Higher levels of oxytocin and vasopressin – positive interactions including acceptance, support, self disclosure, and faster healing of minor wounds
• Vasopressin – also implicated in social behaviour, pair bonding, stress reduction
• Intranasal injection of oxytocin promoted more positive, constructive behaviour during discussion about marital conflict (shows causation, not only correlation)
b. Lower levels of vasopressin and oxytocin – hostility, withdrawal, distress, slower healing of minor wound

Tend to get higher levels of oxytocin in women, higher levels of vasopressin in men (also implicated in status achievement wants)

39
Q

Covid and social isolation

  • effects of social connectedness
  • effects of loneliness
  • relationship quality
A

Greater social connectedness during lockdown – associated with lower levels of perceived stress, fatigue, and worries specific to covid

Perceived loneliness during lockdown associated with stress and exhaustion
- more stress = more fatigue and exhaustion; ties into less motivation to exercise; creates a feedback loop

Relationship quality and mental health – during lockdown, those with ‘good relationship quality’ scored better than those with ‘poor relationship quality’ or ‘without relationships’ on measure of

  • Quality of life
  • Wellbeing
  • Depression
  • Anxiety
  • Stress
  • Sleep quality
40
Q

social contagion

A

spreading of behaviour as a result of social interaction; usually subtle and unintentional

Can apply to smoking, body weight, and other health related behaviour
o Ex. people you work with go to mcdonalds everyday for lunch – you’ll start doing it as well

Answers why people start behaviours of bad habits – often their peer group

41
Q

stress
stressors
stress response

A

Stress – a psychological and physiological reaction that occurs when perceived demands exceed existing resources to meet those demands

Stressors – the event (ex. a bear; an exam); can be acute or chronic

Stress response – the experience in response to the event; how you feel about it

42
Q

cognitive appraisal theory of stress

A

Appraisal – cognitive act of assessing that evaluating the potential threat and demands of an event
a. Primary appraisal – perception of potential threat; is this a threat
• No – no stress
• Yes – physiological stress reaction; emotional reaction
b. Secondary appraisal – it is a threat/stressful event; how do I cope with this threat
• Adequate coping – no more stress
Ex. exam from previous material – you have good notes and are prepared; you have the time to study and are less stressed
• Inadequate coping – more stress
Ex. exam from previous material – you skipped every lecture and are unprepared; you have no time to study and will continue to be stressed

43
Q

measuring and quantifying stress

A

scoring > 300 points signify increased risk of developing heart problems, illnesses and infections (Holmes & Rahe, 1967)

Different types of stresses had different score

  • Low end – minor violation of the law (traffic ticket); new living conditions
  • Middle – mortgage payment; being fired
  • High – going to jail; death or illness of loved one (most stressful)
44
Q

stress and performance

  • individual zone of optimum functioning
A

a. Easy tasks – moderate/high arousal helps
- Being very skilled – crowd watching helps your performance
b. Difficult tasks – low arousal helps; a little bit still helps/is okay; it takes less stress to hurt your performance than on an easy task
- Not skilled – people create more pressure

Individual zone of optimal functioning – a range of emotional intensity in which a person is most likely to perform at their best; everybody has their own level of stress which helps them (exceeding this will impair their performance)

Social facilitation – novice vs expert experience
o Expert – social facilitation; improves your performance
o Newbie – stresses; detriment to you (not social facilitation

45
Q

physiology of stress

  • general adaption syndrome
A

stress can be related to a variety of sources/stimuli (ex. biological, cognitive, social), however physical responses to stressors are generally similar

This general reaction originally described as the ‘fight or flight’ response – set of physiological changes that occur in response to physiological or physical threats

General adaptation syndrome – theory of stress responses involving alarm, resistance, and exhaustion
3 subcategories
Stage 1 – alarm reaction
o Stress increases – fight or flight
o Likely inadequate coping
Stage 2 – resistance reaction
o Ability to cop increases – I can handle this or it is what it is; fight or flight diminishes
o Adequate coping
o Acute stressing – this is the end of the story
Stage 3 – exhaustion
o Burnout; stress takes its tole – your body cannot sustain stress levels
o Occurs with chronic stress – you can only maintain heightened ability to cope for so long

46
Q

2 stress pathways of the brain

A

happen simultaneously

Fight or flight response
a. Hypothalamus – SNS (part of autonomic) – adrenal medulla (part of adrenal gland) – release of epinephrine (adrenaline) and norepinephrine (noradrenaline) – fight or flight response (ex. increased HR)
• Hypothalamus – involved in feedback loops; will be told by brain regions to release hormones
SNS – stress
PSNS – peace
• Epinephrine – increased HR, perspiration, blood flow to muscles

Hypothalamic-pituitary-adrenal axis (HPA axis)
a. Hypothalamus – anterior pituitary gland (master gland) – adrenal cortex (part of adrenal gland) – cortisol
b. Cortisol – hormone that prepares the body to respond to stressful circumstances
o Increased access to energy stores & more glucose consumption; decreases inflammation & suppresses immune system to allow energy to flow to other areas
o Stress can be measured in experiments by how much cortisol is in the blood

47
Q

tend and befriend vs flight or flight

A

Tend and befriend – seeking out stable friendship networks for support; talk and vent

  • May be promoted by the release of oxytocin (influences social bonding, among other behaviours)
  • Oxytocin is present during stress

Sex differences in the type of response to stress – due to gender roles & social norms as well as physiological
a. Men – more likely to respond fight or flight; more reactive
b. Women – more likely to respond tend and befriend; tend to see higher oxytocin levels in women
• Evolutionary – women can’t afford to abandon children/die; you don’t have the same resources to ‘fight or flight’ because you need to care for child; men have more freedom

48
Q

hormones that decrease stress

A

Oxytocin

  • Inhibits amygdala activity – involved in fear and threat response
  • Some evidence suggests it prevents release of cortisol

Vasopressin – implicated in social behaviour, pair bonding, stress reduction

  • Controlled by hypothalamus, pituitary gland
  • Affects the levels of stress hormones released by adrenal gland – Injecting amounts into blood during stress decreases the amount of stress hormones

Oxytocin and vasopressin – both nt and hormones

  • Nt – work faster than hormones
  • Most are both or have an equal – depends on area of release and function

During stressful marital interactions

  • Higher levels of oxytocin and vasopressin – more loving, patient, kind behaviours than lower levels
  • Hormones are involved in stress reduction; allows conflict to be dealt with more pleasantly – suggests why these hormones are released during stressful situations
49
Q

immune system in stress

  • psychoneuroimmunology
A

protects body from infectious disease

Immune system is interconnected with NS – stress and immune responses interact

  • Acute stressors tend to activate the immune system (good) by way of the NS
  • Chronic stresses tend to suppress the immune system (bad) by way of the NS
    ex. Stress increases likelihood of catching common cold

Blood samples taken during stressful periods of time (med school final exams) show reduced immune responses

Psychoneuroimmunology – study of the relationship between immune and NS functioning

50
Q

the brain and disease in stress

A

Stress impairs the body’s ability to respond to vaccinations – complicates long term treatment relying on vaccine administrations (ex. AIDS/HIV)

Stress levels affect cancer progression

  • Norepinephrine supports cancer cell growth
  • Cortisol magnifies norepinephrine’s influence on cancer cell growth

Suggests that our mental reactions to stressors may be able to influence our body’s response to serious illness – If we can control our stress levels, we have some control over the way our body will be able to fight and respond to illness

51
Q

personality and heart disease in stress

A

High stress levels increase risk of coronary heart disease
a. Coronary heart disease – condition in which plaques form in the blood vessels that supply the heart with blood and oxygen, resulting in restricted blood flow; heart must pump and work harder
• Damage to arteries of the heart triggers inflammatory response by immune system (usually a good thing)
• Increased stress causes increased inflammation, leading to heart compilations (not good)
b. Type A is more likely to experience heart attack than Type B personalities – may be related to other correlated behaviour (alcohol consumption, smoking, sleeping less)

Type A personality – people who tend to be impatient, worry, easily angered, competitive, highly motivated
Type B – describes people who are more ‘laid back’ and are patient, easygoing, and relaxed

52
Q

food and drugs in stress

A

performing stressful tasks associated with eating sweet, high fat snacks (related to allostasis)

Low status monkeys eat more and self administer larger amounts of cocaine than more dominant monkeys when given the opportunity
- Lower status associated with more bullying and harassment – likely causes higher levels of stress

Some evidence to suggest chronic stress supresses reward (dopamine) systems – eating and drug use may return reward system activity to normal levels

53
Q

coping

A

processes used to manage demands, stress, and conflict

2 main strategies – certain problems lend themselves better to certain coping strategies
a. Problem focused coping – define the problem, work towards a solution; more logical thinkers may use more often
• Ex. late for work – figures out shorter route
b. Emotion focussed coping – finding ways to reduce negative emotions
• Ex. Journaling, support group, talking to friends

54
Q

positive coping

  • positive psych
  • broaden and build theory of positive emotions
A

Positive psych – uses scientific methods to study human strengths and potential; self-actualization; emphasizes focus on positive emotion
o Humanistic psych – carl rogers; all people are good or can become good given the time and resources to do so
o Bandura

Broaden and build theory of positive emotions – positive emotions help people broaden their thought processes and build new intellectual, social, and physical resources

a. Positive emotions can affect how we perceive and think about the world
- Positive emotions – expand attentional focus to encompass a broader part of the environment, increases creativity and flexible thinking (important for coping)
- Neg – narrow attentional focus; lack creativity, motivation to accomplish goals, mentally flexibility
b. Pos emotions increase the rate at which our heartrate returns to normal following a fearful stimulus (affects autonomic NS); opposite of SNS
- Ex. watching a positive film after a scary movie clip

55
Q

pessimism vs optimisms

  • pessimistic explanatory style
  • negative affectivity
  • mortality rate
A

Optimism – tendency to have a favourable, constructive view on situations and to expect positive outcomes
a. Correlated with better physical health, lower rates of coronary heart disease – better able to cope with stress
• Observed even when controlling for compounding variables (diet, work demands, stress)

Pessimism – tendency to have a neg perception of life and expect neg outcomes
a. Pessimistic explanatory style – tendency to interpret and explain neg events as internally based and as a constant, stable quality
• Negative event is due to their behaviour – something they did
b. Negative affectivity (state/feeling/emotion) – tendency to respond to problems with a pattern of anxiety, hostility, anger, guilt, nervousness
c. Correlated with higher mortality rate (19%) – could be related to lifestyle choices but:
• Observed even when controlling for compounding variables (diet, work demands, stress)

56
Q

resiliency

  • factors that contribute
  • Anna Freud
  • Post traumatic growth
A

ability to effectively recover from illness or adversity (still able to maintain positive growth despite hardships)

Factors/circumstances that may help contribute to resilience – people are still resilient without these, but they help
o Financial and social resources
o Opportunities for rest and relaxation
o Generally positive experiences & circumstances
o A person’s personality and emotional characteristics (ex. optimism)

Freud’s daughter – Anna
o Psychoanalysis – did work with children who lost their parents in holocaust; found resilience in children

Post traumatic growth – capacity to grow and experience long term pos effects in response to neg events (ex. car accidents, sexual assault, combat, severe and chronic illness)
o Often associated with feelings of vulnerability, followed by increased feelings of inner strength, appreciation, spirituality, and develop more meaningful and deep relationships
o Growth occurs during coping – not the original event

57
Q

mediation

  • 2 types
  • Farb et al. fMRI study
A

Mediation – any procedure that involves a shift in consciousness to a state in which an individual is highly focused, aware, and in control of mental processes; many types, practiced in some form in almost every known culture

  1. Focused attention (FA) meditation – focusing attention on a specific object, or physical sensation (ex. breathing); let everything else pass through
    - Intrusion of negative thoughts, distractions is accepted without judgement, followed by refocusing of attention to the original stimulus
  2. Open monitoring (OM) meditation – focusing attention on moment by moment sensations (without focusing on particular object)
    - Meant to reduce intrusive thoughts and distractions

Farb et al (2007) – put trained meditators in fMRI scanner

a. Read a list of positive or negative words, were asked to either
- Focus on the personal meaning of the words (narrative focus) – helps with a deeper understanding
- Focus on thoughts and bodily reactions to the work (experiential focus) – similar to mediation; saw increase in brain areas related to our perception of bodily senses/sensory areas and larger decrease in activity in the medial prefrontal cortex (related to self reference)
b. Suggests mediation increases separate ourselves from our own self narratives – decrease in areas related to yourself; differs from regular state where everything is defined by ourselves

58
Q

Mindfulness-based stress reduction

Integrated mind-body training

A

Mindfulness-based stress reduction (MBSR) – structures relaxation from based on elements of mindfulness and meditation; combines access of FA and OM mediation

a. Allow people to cope and relax by increasing the link between body and mind
- Ex. body scans – paying attention to sensations in different parts of the body
b. Participants are encouraged to recognize any emotions experienced during the meditation but ‘release them from their identity’ – an emotion you are feeling does not define you
c. Effects
- Shown to reduce stress, increase feelings of meaningfulness in life
- Enhanced attentional control – stretching your attention muscles by forcing yourself to focus on things you normally don’t
- Associated with increased activity in the insula (perceiving bodily sensations)

Integrated mind-body training (IMBT) – Developed from traditional Chinese medicine; Involves relaxation, posture correction, heightened body awareness

a. Shown to enhance attentional control
b. Shown to increase ability to control one’s body (ex. PSNS response)
- Increased activity within the anterior cingulate cortex (in the medial prefrontal cortex) – controlling attention and emotional responses
- Strengthened connections between the anterior cingulate cortex and areas related to processing emotion
- Lower heart rates, breathing rates, skin conductance - able to manage stress responses

59
Q

yoga

A

directed breathing while moving body into specific poses

o Voluntary breathing – influence on PSNS
o Decreased emotional arousal – stretching and strengthening attentional focus; obtain more control
o Associated with lower levels of physical and mental stress, more connections between the frontal cortex and areas responsible for emotional responding - Suggests top down control for attentional and emotional responses

60
Q

exercise and wellbeing

A

engaging in intense exercise can cause increase in dopamine, epinephrine, and BDNF

Brain derived neurotrophic factors (BDNF) – protein that promotes survival, growth, and formation of new synapses in the brain
o Implicated in neuronal growth and maintenance

Helps support development of new nerve cells in the hippocampus (memory) – Important for learning

61
Q

perceived control

  • learned helplessness
  • mental disorders often associated with
  • dog study
  • brain events
A

Learned helplessness – learned suppression of avoidance or escape behaviour in response to unpleasant, uncontrollable circumstances; the person or animal learns their actions cannot remove the stress, and generalizes the feeling of helplessness to other situations
o Similar thinking is characteristic of depression, anxiety disorders

Study

a. Some dogs learned they could turn shocks off
- In the cage – would figure out that the other half of the floor would not shock them
- Learned avoidance behaviour
b. Some dogs were not given the button
- In the cage – did not figure out relationship of the floor; didn’t try to go to the other side because they had no control over the shocks behaviour
- They wouldn’t try to escape it – they accepted it

In the brain

a. Stressful event perceived as controllable – brainstem produces a stress response (ex. increased HR, BP); stress response is inhibited by the frontal lobes
- Establish effective coping mechanism
b. Stressful event perceived as uncontrollable – brainstem produces a stress response that is uninhibited by the frontal lobes
- Leads to learned helplessness

62
Q

compensatory control

  • study
A

psychological strategies people use to preserve a sense of non-random order when personal control is compromised

Study – answering questions on a computer
2 groups
a. One group (red) – would tell you if you got it right or wrong
b. Other group (blue) – no control group; would tell you were right/wrong regardless of whether you were right or wrong
• Would ‘see’ hidden image of horse
• Increased need for structure
• Increased superstition and conspiracies
c. No control group – felt need to gain back perceived sense of control

63
Q

abnormal psych

A

psych studies of mental illness

Thoughts, feelings, behaviours that are maladaptive – not being able to properly adapt to environment
o causing distress to oneself or others
o Impairing day to day function
o Increasing the risk of injury or harm to oneself or others

Do not all respond to the same types of treatment – variety of mental illnesses
o We categorize in order to discover and treat them

64
Q

medical model of psychiatry

A

Medical model of psychiatry – early classification; 1800s; considers physiological conditions as being similar to physical conditions (a set of symptoms, causes, and outcomes)

a. Treatments aimed at changing physiological processes in order to alleviate symptoms
Ex. psychological disorders (depression, anxiety disorders, autism) were approached similarly to physical diseases (diabetes or cancer)

Emil Kraepelin (185601926) – recognizing medical model and categorizing disorders and treatments

a. Studies with Wilhelm Wundt
b. Kept extensive records of patients long term mental illness progression & Allowed him to learn which symptoms appeared to occur together (ex. depression and anxiety)
c. Importance of a collectively agreed upon terminology within the medical field
- If a case occurs, it can be documented and published to help treat future cases
d. Created ‘manual’ – diagnosing based on set of symptoms and using those to treat them
- Some ‘clusters’ coincide with the way we categorize mental illness today

65
Q

The diagnostic and statistical manual

A

The diagnostic and statistical manual (DSM) – used today; a standardized manual to help diagnose psychological disorders; goal was to make diagnosis of mental illness for objective

Created by the American psychiatric association during WWII (1st version) – many soldiers were coming back with head injuries
- Not the same as APA – American psychological association

Currently in its 5th version (DSM-5; 2013) – divides mental illnesses into 19 categories each containing subtypes

  • Important change to current version – defines disorders on a continuum/scale; different levels of severity
  • Ex. Asperger’s syndrome now considered to be part of the autism spectrum
66
Q

challenges associated with classifying behaviour

  • normal vs illness
  • diagnosis label
A

How can we determine who has a mental disorder – Is a disorder even a thing someone has (implies we ‘picked it up’)

How do we distinguish a ‘normal behaviour’ from a ‘symptom’

a. DSM – meant to make the judgement more objective and reliable; however, human behaviour and motivation is extremely diverse
b. Maladaptive – considered a symptom of a mental disorder
- There are various levels of interpretation (ex. substance abuse increases harm but may not cause distress)
- Who determines who is functioning normal on a day to day basis
c. Diagnoses are still largely influenced by the clinician, and therefore potentially unreliable – Is a behaviour maladaptive or just ‘quirky’

The ‘diagnosis’ label – should not be taken lightly by health professionals; has implications
o Positive – make people more likely to seek and receive treatment and facilitate communication among health professionals; ‘freeing’ as they understand why they have responded differently than others
o Negative – change the way the ‘labelled’ individual views themselves and are viewed by others; may lead to feelings of low self-esteem, helplessness, and withdrawal from social contact

67
Q

applications in:

  • classrooms
  • courtrooms
A

In classroom: ADHD – attention deficit hyperactivity disorder

a. Developmental disorder – children show inappropriate levels of hyperactivity and impulsivity while also having trouble maintaining their attention to people or activities
- Frontal lobes & dopamine release in the basal ganglia
- Frontal lobes – being able to inhibit
b. DSM-5 – requires an individual to demonstrate a minimum of 6 inattention symptoms or a minimum of 6 hyperactivity/impulsivity symptoms
- Positive – diagnosis can mean introduction of behavioural therapies, pharmaceutical treatments; parents and teachers can help them adapt to their learning style
- Negative – some argue the inclusion of DSM-5 leads to greater rates of misdiagnosis and unnecessarily prescribed medication
- Once something is given a ‘name’ – these diagnosis go up; people will start fitting certain categories even if they don’t belong; treatments are not justified

In courtroom: Mental disorder defense – used in the legal system; claims that person who committed the crime was in an extreme, abnormal state of mind that they could not discern that their actions were legally moral or wrong (ex. experiencing hallucinations or delusions)
a. Used in <1% of Canadian court cases; has a <25% success rate

68
Q

personality disorders

A

Particularly unusual patterns of behaviour that are maladaptive, distressing to oneself of others, resistant to change

Relative to the individual’s cultural context – no one is ‘normal’

Present for a long time – from adolescence or childhood
o Trauma to head may cause maladaptive behaviours – it would have to be persistent from that point on to be a ‘personality’ disorder

Should be distinct from other, separate psychological disorders, medical conditions, or substances – could be symptoms of other causes

DSM-5 – organized into 3 clusters (A, B, C)

69
Q

Cluster A

A

odd and eccentric behaviours; difficult to form social and close relationships; Individuals tend to perceive and interpret the world in abnormal and often inaccurate way

  1. Paranoid personality disorder – see threats where others don’t; difficulty trusting; belief that other people are attempting to harm or deceive them
    a. Often react with anger to imagined threats – typically suspicious and guarded around other people
    b. Affects 2-4% of the population
    c. Demonstrate faster neural response to auditory stimuli, larger levels of stress hormones in CSF
    - More vigilance for threats
    d. Social situation – activation of paranoid cognitive biases and behaviours – negative emotions and rumination – vigilance for new threats – brought into new social situations
    - Becomes a self fulfilling prophecy
  2. Schizoid personality disorder – socially detached; do not show desire for close relationships; do not find many activities enjoyable
    a. May appear indifferent, cold, emotionless
    b. Usually results in intentional self isolation
    - Not merely introverted – must be maladaptive and cause distress
  3. Schizotypal personality disorder – uncomfortable/difficulty with close relationships; demonstrate unusual or eccentric thoughts/behaviours/expressions
    a. Tend to be suspicious and superstitious – determine imaginary connections between thoughts and events (ex. thinking about actor, actor appears on TV, ‘someone is monitoring my thoughts’)
    - express thoughts using strange, abstract phrasing – linguistic
    b. Associated with smaller left superior temporal gyrus
    - auditory cortex and language processes – expression of strange wording and sentence formation
    c. Factors associated with development of schizotypal PD
    - Particular form of ‘COMT’ gene – related to dopamine and epinephrine nt
    - Problems during prenatal development (males)
    - Psychological trauma and chronic stress
70
Q

cluster B

A

dramatic and erratic behaviour; characterized by ‘emotional intensity’ and emotional outbursts that impair social functioning

  1. Borderline personality disorder (BPD) – individuals switch between extreme positive and extreme neg emotions
    a. Demonstrates unstable sense of self, impulsivity, and have difficulty maintaining social relationship
    - Relationships – strong feelings of attachment, fear of abandonment
    - manipulation to obtain sense of control – stems from fear of abandonment and need for attachment
    b. Medial frontal lobes (regulation of attention and emotional responses) smaller in BPD
    c. May be related to deep feelings of insecurity and severe emotional experiences early in life
    d. Dangerous, self destructive behaviour – ex. substance abuse, indiscriminate sex, self injury, suicide
    - reflect the individual’s difficulty coping with neg emotions
  2. narcissistic PD – inflated sense of self importance and an excessive need for attention and admiration AND intense fear of abandonment
    a. may be related to disruption of a frontal lobe circuit involved with feelings of empathy – they have trouble feeling empathy and remorse; taking other person’s perspective
    b. trait vs disorder
    - maladaptive – distress, impaired functioning, harmful to self
    - dark triad personality trait – egotistical preoccupation with self image and self importance
  3. histrionic PD – excessive attention seeking and dramatic behaviour; distinguished by flamboyant and exhibitionistic behaviours
    a. dramatic nature makes individuals with HPD seem (excessively) comfortable in social situations
    - histrionic – histrionicus histrio (latin) meaning actor
    b. often engage in indulgent and risky behaviours, tend to be sensitive to criticism, generally manipulative in relationships
    c. may have a strong genetic component
    - heritability = .63
  4. antisocial PD – lack of empathy or emotional connection with others; disregard for others rights or feelings, and a tendency to impose their own desires (can be violent) onto others regardless of consequences
    a. impulsive and prone to risk taking
    b. no remorse, rarely motivated to change or accept treatment – aren’t able to recognize that they’ve hurt someone & don’t feel they’re doing anything wrong
    c. factors that contribute
    - troubled upbringing, trauma, abuse
    - self-defence against extreme neg emotions affect ability to feel empathy, leading to cruel behaviour towards others
    d. reduced activity in frontal lobes – decision making; executive control & inhibition
    - experience difficulty learning tasks that require decision making and following complex rules
    e. conduct disorders – often a precursor to APD; reduced activity in frontal lobes
    - diagnosed at a younger age – violently acting out
  5. APD & psychopathy
    a. Approx. 15-20% of people with APD could also be diagnosed with psychopathy – technically they are 2 different diagnoses
    b. Hare psychopathy checklist-revised – 20 items
    2 main factors – psychopathy score high on both (higher on interpersonal)
  6. Interpersonal/emotional
    - Superficial charm – manipulative
    - Pathological lying
    - Lack of empathy & guilt
  7. Social deviance – people with APD (but not psychopathy) still score high on social deviance (is psychopathy an extreme form of APD?)
    - Need for stimulation
    - Impulsivity
    - Poor behavioural controls
    - Early behavioural problems
    c. Reduced amygdala and frontal lobe activation in response to aversive stimuli
    i. Anatomical differences – less connection between frontal lobes and amygdala
    - normally there is a feedback loop of arousal when shown disturbing or threatening images (threat response)
    ii. functional differences – demonstrate frontal lobe activity (planning) during perspective-taking tasks, instead of empathy-related area activity
    - Ex. you see someone get an ice cream cone
    Healthy – areas related to empathy
    APD – frontal lobe planning; suggests detached analytical approach
    iii. Blunted stimulation – requires higher levels of stimulation
    - Study – shown aversive images
    Healthy – more blinking
    APD and psychopathy – less blinking; reduced physiological response to images
71
Q

Cluster C

A

feelings of anxiety, nervousness that affect observable behaviour; inhibited behaviour

  1. Avoidant personality disorder (AvPD) – avoid social interactions, including school and work, because they feel inadequate and fear rejection
    a. Avoid new experiences due to fear of embarrassment and criticism
    b. Increased amygdala activity observed when judging the emotional content of neg stimuli – Increased activity pos correlated with self reported anxiety
  2. Dependant personality disorder – excessive need to be cared for; require frequent assurance from others and help with everyday decision making
    a. Fear of abandonment & rejection; lacking self confidence
  3. Obsessive compulsive PD (OCPD – not OCD) – high expectations for self and others; focused on perfection, details, organization, and productivity
    a. May avoid spending money or disposing of old, worthless objects
    b. Have trouble delegating or receiving help from others
    c. High incidence of OCPD in patients with Parkinson’s disease – possible role of dopamine in OCPD
    - Dopamine is important for purposeful mvmt
    d. Feedback loop: spend so much time focusing on one thing gets done right -> ignores other things -> increased anxiety
72
Q

Dissociative disorders

  • Dissociative identity disorder
A

mental disorders characterized by a split between person’s conscious awareness and their feelings, cognitions, memory, and identity
a. Can be caused by brain damage, psychological trauma, extreme stress – you cannot consciously cope
o Victims of extreme stress or psychological trauma – may cope with the experience by shifting consciousness to a different perspective (ex. experiencing the event of trauma as an ‘observer’)
b. Dissociative experiences – sense of separation (dissociation) between person and surroundings
o Ex. daydreaming, focusing intently on particular tasks

Dissociative identity disorder – experiencing a split in identity such that they feel different aspects of themselves, as though they were separated from each other (used to be multiple personality disorder; no longer considered a PD)

a. affects <1% of population
b. can be so severe that the person constructs entirely separate personalities – switch being in control
- some forms of learning and memory do not transfer between identities
- study – participant would learn skill with one identity; when other identity arises, they test if they still know it
c. DID diagnosis & number of alter identities has been increasing overtime – could be due to increased awareness of the disorder, or subjective biases of the treating psychologists
- Diagnosis are increasing – more attention; better able to be recognized
- Excitement by clinician – more likely to misdiagnose
- Initially was rare to have more than 2 identities; now more common to have 2+

73
Q

Anxiety disorders

A

category of disorder involving fear or nervousness that is excessive, irrational, and maladaptive
a. Affect 1/8 (12.5%) of Canadians
b. Often co-occur (comorbid) with other disorders – depression, OCD, substance abuse
c. Repeated activation of the fight or flight response (SNS) – healthy amount of anxiety is good
o Differs in intensity, duration of response
o Not necessarily connected to current circumstances – does not have a specific source

  1. Generalized anxiety disorder (GAD) – frequently elevated levels of anxiety, generally in response to normal challenges and stresses of everyday life
    a. Symptoms – difficulty sleeping, breathing, concentrating
    b. Hard to identify specific cause or source of anxiety – can’t pinpoint and therefore can’t reduce
    - Feel anxious about their anxiety
    c. Right amygdala is larger – more sensitive to stressors in people with GAD
  2. Panic disorder – occasional episodes of sudden, very intense fear
    a. Different than GAD – chronic but lesser vs short intervals of severe anxiety
    b. Panic attacks – brief (usually less than 10 min) moments of extreme anxiety that include a rush of physical arousal paired with frightening thoughts
    - Agoraphobia – intense fear of having a panic attack in public; may lead to avoidance of public settings and increased isolation
    - Feedback loop: noticing increased HR – fear of having panic attack – increasing HR further
  3. Phobias – severe, irrational fear of a very specific object or situation
    a. Specific phobias – fear of specific objects, activity, or organism
    - Natural environment – heights, thunder
    - Situational – closed spaces
    - Animal – snakes, spiders
    - Blood/injection/injury – needles, seeing blood/broken bones
    - Other – fear of vomiting or choking
    b. Social phobias – fear of interpersonal situations and relationships
    - Social anxiety disorder – very strong fear of being judged by others, embarrassed, or humiliated in public
    - Usually managed by developing familiar routines, controlled exits, and limiting social activities
74
Q

Mood disorders

A
  1. Major depression (different card)
  2. Bipolar disorder – Characterized by extreme highs and lows in mood, motivation, and energy; used to be called manic depression
    a. Differs than BPD – they don’t see their behaviours as abnormal
    b. Swings in emotion between depression and mania
    - Mania – extreme energy, positivity, speaking quickly, impulsive/spontaneous decision making, high risk behaviours
    - Frequency of episodes can vary
    - Will do regrettable things in the moment – returning to depression; ruminates on their actions; they feel worse
    c. Higher rates of suicide than major depression – may be due to increase in energy that accompanies manic episodes
    - Major depression – may not have enough energy
    - Energy of manic – can commit suicide during these times
75
Q

Major depression

A

Prolonged periods of

i. Sadness
ii. Feelings of worthlessness and hopelessness
iii. Social withdrawal
iv. Cognitive and physical sluggishness
- Often suffer from insomnia – contributes to physical symptoms

Development of pessimistic explanatory style – often make critical personal, stable and global attributions

a. Personal – this is my fault
- Normally we explicitly blame situation – instead we make it implicit (it’s who we are as a person)
b. Stable – things are never going to change; continue to dwell on negative situation
c. Global – if I fail at this, I’ll fail at everyhing else

Genetic vulnerability to depression – twin studies suggest genetic risk for developing major depression

i. Inheriting 2 copies of the short version of the 5-HTT (serotonin) gene increases risk of developing depression (vs. inheriting 2 copies of the long version or short and long)
- This risk increases with the degree of stress the person experiences
ii. Diathesis stress model – An interaction between genetic predisposition for a disorder and amount of stress will influence risk of developing that disorder
- If you are genetically predisposed but low stress – low probability
- Lots of stress – risk significantly increases with short-short gene combo

Biological aspects of depression
Non-depressed:
a. Amygdala stimulates -> hypothalamic pituitary adrenal gland axis -> releases stress hormones (ex. cortisol)
b. Hippocampus and frontal lobe inhibit HPA axis – executive control stops release of stress hormones
c. Feedback loop
Depressed:
a. Amygdala overstimulates and is overactive -> HPA axis -> increased release of many stress hormones
b. Prolonged presence of cortisol damages the hippocampus (and some of frontal lobes) – prevents inhibition of HPA axis
c. Pos feedback – leads to more and more cortisol

Long term effects

  1. Brain becomes more sensitized to stressful events & triggers more depressive episodes
  2. Damages hippocampus – reduces neurogenesis; reduction in new learning and flexible thinking (plays role in overcoming neg emotions)

Other dysfunction in brain

  1. Nucleus accumbens reduced activity (part of basal ganglia; positive rewards & dopamine) – anhedonia (reduced ability to feel pleasure)
  2. Medial prefrontal cortex – overactivation may cause ruminating on neg events

Facebook depression

  • People who are more exposed to social media – more likely to develop mood disorders
  • Pos correlated with frequency of checking soc media
  • Related to social comparisons
  • Envy and neg self evaluations
76
Q

Schizophrenia

  • stages
  • symptoms
  • genetics
  • the brain
A

brain disease; causes significant ‘breaks’/dissociation from reality (not identity); a lack of integration of thoughts and emotions, and problems with attention and memory

  • Affects <1% of adults worldwide
  • Symptoms may develop gradually overtime or rapidly – variability in expression and production of symptoms

3 stages – tend to occur in sequence; cycle may often repeat or be a long term sequence

  1. Prodromal phase
    - Confusion and difficulty organizing thoughts
    - Loss of interests and withdrawal from friends and family, seek isolation
    - General loss of motivation
  2. Active phase – symptoms are normally most pronounced
    - Delusional thoughts & hallucinations
    - Disorganized patterns of thoughts, emotions and behaviour
  3. Residual phase
    - Symptoms may disappear or lessen
    - Withdrawal from social contact, trouble concentrating and general lack of motivation

Symptoms – may be a combo of pos and neg at any time
a. Positive symptoms – maladaptive behaviour is present
- Confused and paranoid thinking; Inappropriate emotional reactions
- Hallucinations – incorrect & alternations in perception; senses something that does not exist outside persons mind
- Delusions – beliefs that stem from incorrect perceptions; not based on or well integrated with reality
Ex. delusions of grandeur – it’s geared towards they are very important; they have a significant role; conspiracies
- Disorganized behaviour – considerable difficulty completing everyday tasks
Ex. cooking, self hygiene, socializing
b. Neg symptoms – adaptive behaviours are absent; flat emotional reactions; neutral mask facial expression
- Lack of interactions with others
- Lack of motivation
- Working memory deficits
- Catatonia – mvmt disorder; unresponsive and does not move for long periods of time
Dopamine – likely plays a role based on its involvement in the initiation of mvmt

Genetics

a. High genetic component – 25-50% concordance in identical twins
- If one twin has, other has 25-50% chance of developing
b. 108 genes are associated with – normally a combination to causes development (not just a specific one)
- Many of these genes are also associated with other psychological disorders – suggests there may be a set of genes that contribute to development of mental disorder & are not technically related to specific disorder

The brain
o Larger ventricles due to loss of brain matter – particularly pronounced loss in amygdala and hippocampus
o Lowered activity in frontal lobes – attentional difficulties and organizing info with logic and integrating with reality
o Increased dopamine levels (over activity) – reward symptoms; perhaps related to pos symptoms (ex. hallucinations and delusions)
o Decreased glutamate (under activity) – primary excitatory nt in brain; perhaps related to neg symptoms; behaviours and responses become blunted

77
Q

Neurodevelopment hypothesis

A

Suggests the adult manifestation of schizophrenia is due to development early in life; patient always has it and becomes more pronounced later in life

Disruption in early stages of development

  • Exposure to flu in the womb – people with schizophrenia more likely to have been born during winter months (first trimester occurred during fall/flu season)
  • Amount of stress hormones during prenatal development – mother goes through traumatic event in first trimester

Symptoms emerging

  • Schizophrenia prodrome – behaviours in adolescence that resemble mild forms of schizophrenia
  • Become more pronounced into adulthood

First trimester of pregnancy and adolescence – both have periods of increased prefrontal cortex development and synaptic pruning

78
Q

Treating psych disorders

  • Canadians
  • types of treatment factors
  • mental health services include
A

Approx. 10% of Canadians seek some form of mental health each year

Types of treatment received depends on
o Age
o Type and severity of disorder
o Legal issues, concerns involved (ex. court ordered)

Mental health services include 
o	Inpatient and outpatient care 
o	Prescription drugs 
o	Therapy 
o	Support groups (ex. AA; same issue support)
79
Q

mental health providers

A

Clinical psychologists

a. Have obtained PhDs – typically 5 years of grad school + 1 year internship in clinical settings
- More school
b. Able to formally diagnose and treat mental health issues ranging from mild to severe, acute to chronic
- Very broad field of capability and applicability
- Treatment of more severe issues
c. Do not prescribe medication

Counselling psychologists

a. Have completed masters or PhD degree
b. Mental health professionals who typically work with people who need help with common problems
- Stress and coping
- Issues concerning identity, sexuality, and relationships
- Anxiety and depression
- Developmental issues such as childhood trauma
c. difference – more everyday issues
d. do not prescribe medication

psychiatry

a. typically complete undergrad, 4 med school, 5 yr residency
- medical doctors who specialize in mental health
b. able to diagnose and treat mental disorders through prescribing medication
c. can work with clinical or counselling psychologists

80
Q

inpatient treatment and deinstitutionalization

A

1400s-1900s – mentally ill patients were sent to asylums; segregated from the general public; conditions couldn’t be treated effectively

Deinstitutionalization (mid 1900) – shift to treating mental conditions as medical conditions that can be treated

a. Mvmt of large numbers of psychiatric inpatients from their care facilities back into regular society
- Made possible by the development of effective treatment of some disorder
b. Residential treatment centers – housing facilities in which residents receive psychological therapy and life skills training, which the explicit goal was reintegration into society; goal is to understand, treat, and return to families
- When required (safety, stability) – patients freedoms were restricted
c. Many previously hospitalized patients did not have family or social supports to return to

81
Q

community psych

A

focuses on identifying how an individuals mental health is influenced by their community & systemic issues within community contributing to mental health

Emphasizes community level variables such as social programs, support networks and community resource centers
o May not have facilities and faculties to take care of issues with the resources they already have

Research may involve environmental and neighbourhood factors that contribute to stress, anxiety, and depression
o Comorbidity between mental health and substance abuse

82
Q

Barriers to psych treatment

  • toronto stat
  • in canada & usa
  • why some people choose not to
  • non-choice factors
A

Toronto center for addiction and mental health (2016) – only 40% of adults who report significant anxiety or depression receive therapy

In Canada and USA
o Approx. 2/3 people with mental health issues don’t seek professional help
o Approx. 2/3 of people with mood or anxiety disorders reported waiting over a year to receive a diagnosis

Why do some people choose not to seek help

a. Difficulty defining or recognizing a disorder – a person may not recognize their state as a disorder requiring treatment; insist waiting until symptoms are severe or convinced by family and friends
b. Stigma associated with mental illness and therapy – afraid of being viewed as mentally ill
c. Skepticism surrounding treatment; psychological/psychiatric professionals
- May not trust professionals – won’t make themselves vulnerable enough to receive help
d. Gender roles
- Men are particularly adverse to seeking treatment & therapy – sign of weakness
- Campaigns are targeted to try and dismantle

Culture
o In Canada – Asian Canadians and indigenous peoples are less likely to use psych services
o Therapy less popular in countries – Israel, Hungary, Japan, and Korea
o Individuals who belong to certain ethnic minority groups may prefer mental health professional also from that ethnic background – there are not enough mental health professionals to meet this need

Geography – many rural communities in Canada do not have easy access to healthcare & mental health services

Financial
o Government healthcare in Canada generally only covers treatment by psychiatrists
o Therapy also associated with additional costs
ex. Time away from work, transportation, childcare
o Portions of population that would benefit the most do not have access due to financial reasons

83
Q

Psychological therapies

A

Insight therapies – general term referring to therapy that involves dialogue between patients and therapists for the purposes of gaining awareness and understanding of psychological problems and conflicts

Formally began with psychoanalysis (Sigmund Freud) – evolved into psychodynamic therapies

  • Form of insight therapy that emphasize the need to discover and resolve unconscious conflicts
  • You are having some sort of problems and you cannot figure out where its coming from – what subconscious processes are making you feel this way

Types

  • psychoanalysis
  • modern psychodynamic therapies
  • humanistic
84
Q

Psychoanalysis

A

intended to help patients become aware of unconscious urges

Established several methods to help access the unconscious motivations

a. Free association – patients encourage to talk to write without censoring their thoughts in any way
- Removing filter shows thoughts and motivations (superego keeps in check)
b. Dream analysis – examining the details of a dream in order to gain insight into the emotional unconscious material that is being communicated symbolically
- Manifest vs latent
c. Resistant recognition – recognize the strategies used by the patients to keep unconscious thoughts or motivations from entering conscious awareness; discovering what techniques they use can lead to a ‘breakthrough’
- Ex. using humour to avoid sincerity, anger, or cynicism towards therapy process
d. Transference – patients direct certain patterns or emotional experiences toward the analyst, rather than the original person involved in the experience
- Ex. sexual attraction, or defensiveness directed towards the analyst
- Considered a good sign – therapist will recognize the act and will go further into the initial relationship

85
Q

Modern psychodynamic therapies

A

focuses more on patients conscious experience than their unconscious experience (ID, libido)

Object relations therapy – variation of psychodynamic theory that focuses on how early childhood experiences and emotional attachments influences later psychological functioning

  • ‘objects’ – the clients mental representations of themselves and others
  • Everyone is an ‘object’ – you have relationships between objects
  • Early relationships between the child and these objects lead to the development of mental models that will influence future relationships

Ex. parents are rule makers & you need to follow – very strict about not expressing feelings

  • Build up mental model of keeping to yourself and following the rules; parental objects are in control
  • Later in life – anxiety and inability to make decisions stems from mental model of only following rules; transplanted to other relationships and situations
86
Q

humanistic

A

existential psychotherapy (vs psychoanalysis – tend to be opposite)

Similar to psychoanalysis – this is the situation you’re in, lets figure out what you may need to achieve wellbeing and self actualization

Human nature is fundamentally positive, rather than neg

Focus on conscious (vs unconscious) experiences

a. Phenomenological approach – addresses the clients feelings and thoughts as they unfold in the present moment, rather than looking for unconscious motives or focusing on past events
- Feelings and thoughts – not analyzing past relationships

Considers behaviour to be chosen freely by the individual (vs. determined by repressed urges or instincts)

Emphasizes people’s strengths (vs. neuroses/anxieties)

Tries to clarify the patients issues (vs explain to the patient what is wrong)
• Psychoanalysis – this happened in your childhood; this is why your behaviour is wrong
• Humanistic – not put on you as much

Unconditional positive regard towards the patients healing (vs insight into unconscious conflicts)

Carl rogers
a. Client-centered therapy – also ‘person-centered therapy’
o Their own strength and ability
b. Focuses on individuals abilities to solve their own problems and reach their full potential with the encouragement of the therapist
o You are in control and define your own self worth
c. Dealing with ‘conditions of worth’
o Everyone may have these – people define worth by success, material possessions, and others approval
d. Emotion focused therapy (EFT) – helps client face and accept difficult emotions; acceptance leads to self actualization and reaching your full potential
e. Given the opportunity – you can achieve well being

87
Q

behavioural therapies

A

attempts to directly address problem behaviour and the environmental factors that trigger them
- Using principles of classical and operant conditioning – associations between stimuli, behaviours and consequences

  1. Systemic desensitization – gradual exposure to a feared stimulus or situation is coupled with relaxing training (often used to treat phobias; conditioned to fear a particular stimulus)

Can involve anxiety hierarchy – list of fearful stimuli ranging from least fearful to most fearful
a. Step learning to decrease fear of stimulus & become more comfortable in each successive stage
b. Ex giving a speech
• Writing the speech
• Practicing the speech
• Performing the speech

Flooding – exposing the client to the most challenging, anxiety inducing aspect of the behaviour/situation

a. Start at the top, not the bottom – gives them worst case scenario; they will survive it
b. Ex. immediately have to give a speech

Virtual reality exposure (VRE) – uses graphical displays to create a virtual enviro to perform desensitization therapy

  • Ex. virtual reality of giving a speech in front of a large audience
  • Used for PTSD & military survivors – putting them back into warzone to work through feelings
  1. Aversive conditioning – a behavioural technique that involves replacing a positive response to a stimulus with a negative response; typically using punishment
    o Pavlov’s dogs – conditioned to expect food
    o Pairing maladaptive behaviour with unpleasant stimulus – learns to avoid that behaviour
    o Range from severe to mild
    o Thoughts you want to avoid – wearing an elastic band and snapping against your wrist whenever you have that thought; you associate thoughts with snapping band
    o Ex. with alcohol – Antabuse makes person sick when mixed with alcohol; taking drug causes sickness when they drink
88
Q

Cognitive behavioural therapies (CBT)

A

form of therapy that consists of procedures such as cognitive restricting, stress inoculation training, and exposure to experiences they may tend to avoid

Targets thought processes and cognitive behaviour
o Feelings we have towards stimulus and thoughts that arise
o If we can target the thoughts and ways we think about situation – it will help us deal with situation

Focussed on helping clients recognize their thoughts, emotions, and behavioural patterns in order to build more functional cognitive and behavioural habits

Used for treating depressions

a. Internal attributions – it’s always my fault
- CBT – Recognizing the role you played but also examining contextual factors
b. Stable attributions – assuming situations are permanent
- CBT – High light temporary nature of difficulties; how things of the past are no longer the case
c. Global attributions – results of neg event will apply to all aspects of a persons life
- CBT – challenge them to explain exactly how the effects will spill over into other parts of life; provide examples of situations when spill over did not occur

CBT in combo with medication has been effective in treating depression, anxiety, OCD, EDs, obesity, phobias

89
Q

mindfulness based cognitive therapy

A

combines mindfulness mediation with standard cognitive-behavioural therapy tools; mindfulness focuses on what is occurring here and now

Emphasis on accepting the problematic thoughts and feelings without reacting

a. COAL approach to self acceptance – curious, open, accepting, loving
- Negative feelings don’t make me bad – it’s just how I’m feeling in the moment
- Feel the bad feelings and moving into the next moment
b. Decentering – stepping back from normal consciousness and examining oneself objectively, as an observer
- Able to make decisions governed less by feelings in present situation

Associated with changes in white matter pathways connecting brain areas related to emotion and anxiety disorders
o Ex. amygdala, hippocampus, and anterior cingulate cortex (emotion, attention, and mood regulation)

MBCT – effective for social anxiety disorder, GAD/general anxiety disorder, bipolar disorder, depression, and suicidal ideation

90
Q

Group & family therapy

A

Group
o Grouping people together based on similar issues (alcohol addiction and divorce)
o Participants benefit from bonding and support provided by other group members
o Cost effective and accessible

Family
o Helpful when client’s difficulties are reinforced by healthy dynamics within the family - Different perspectives can be provided
o May help families deal with specific family members who demonstrate disruptive or dysfunctional behavioural issues
o Systems approach – views an individual’s symptoms as being influenced by multiple interacting systems (ex. family) and influences
o Ex. schizophrenia – helpful for individuals and family; Family is able to recognize symptoms and assist individual

91
Q

Biomedical therapies

A

Biomedical approaches – involves using drugs, surgery, or other medical procedures to alter central nervous system functioning to correct problems thought to be biological in nature

Types

  • psychopharmacology
  • surgical
  • brain stimulation
92
Q

Psychopharmacology

A

use of drugs to manage or reduce symptoms; usually paired with another form of therapy (ex. CBT)

Psychotropic drugs – meds designed to alter psychological functioning; have become a common form of treatment
a. Designed to cross the blood brain barrier & target specific nt
- Blood brain barrier – tightly packed cells that only allow specific substances to move from the bloodstream to the brain, therefore protecting the brain from potentially harmful substances
b. Review of neuronal communication – released from presynaptic cell, binds to receptor, nt enters into post synaptic, makes changes in next cell, creates action potential
- Staying in the synaptic cleft – post synaptic will continue firing
- Protein with either:
Reuptake – back into presynaptic cell
Other proteins will come in and ‘clean up’
- Drugs effect how nt communicate – whether message is still passed on or stops
- More nt in synapse = more messages

Antidepressants – reducing symptoms of depression
a. Monoamine oxidase inhibitors – deactivates monoamine oxidase (MAO); an enzyme that breaks down serotonin, dopamine, and norepinephrine at the synaptic cleft (pacman)
- Results in more serotonin, dopamine, and norepinephrine in the synapse
- Can have dangerous side effects – not widely used
- Changing relationships – can cause deregulation in the brain
b. Tricyclic antidepressants – block the reuptake of serotonin and norepinephrine; larger amounts in synapse
- Side effects – nausea, weight gain, sexual dysfunction, seizures – also not widely used
c. Selective serotonin reuptake inhibitors – ex. fluoxetine/prozax
- Block the reuptake of serotonin
- Most commonly prescribed since the 80s
- Do not work for everyone and side effects include changes in sleep patterns and sex drive
- SSRIs in the brain
• Decreases activity in amygdala
• Supports neurogenesis in hippocampus
• Increases activity in reward centers in the brain (connections with hippocampus) = Greater enjoyment
d. SNRIs – selective norepinephrine reuptake inhibitors
• Same as SSRIs but for norepinephrine

Mood stabilizers – drugs used to prevent or reduce the severity of mood swings experienced by people with bipolar disorder

a. Ex. lithium – one of the first regularly prescribed mood stabilizers
- Was the standard drug treatment for depression and bipolar disorders in 50s-80s
- Side effects – toxicity (kidney and endocrine system); not as popular anymore

Antianxiety drugs – influence the activity of GABA (inhibitory nt that reduces neural activity); more GABA decreases activity such as fight or flight response

  • Appear to temporarily alter the structure of GABA receptors, resulting in increased inhibition of neural activity
  • Ex. alprazolam (Xanax), diazepam (valium), lorazepam (Ativan)
  • Side effects – drowsiness, impaired attention, memory impairment, depression, decreased sex drive
  • Potential abuse and withdrawal

Antipsychotic drugs – used to treat symptoms of psychosis, delusions, hallucinations, and disturbed/disorganized thoughts

a. First gen targeted dopamine receptors
- Significant side effects – seizures, anxiety, nausea, impotence
- Tardive dyskinesia – mvmt disorder; involuntary mvmts and facial tics
b. Second gen are known as ‘atypical antipsychotics’
- Target dopamine and serotonin transmission
- Less likely to produce the side effects associated with 1st gen, but only work for approx. 50% of people, become less effective overtime, and can compromise user’s WBC

93
Q

Surgical

A

Early techniques involved surgically destroying brain tissues in prefrontal cortex
o Ex. leucotomy (lobotomy)
o Used to treat individuals with psychoses and other disorders in the early to mid 1900s

Modern focal lesioning surgery – small areas of brain that are surgically destroyed; only performed in extreme cases
o Ex. anterior cingulotomy
o brain imaging used to target and guide to specific locations

94
Q

Brain stimulation

A

electroconvulsive therapy (ECT) – passes electrical currency through brain to induce a temporary seizure
o introduced in 30s
o not considered relatively safe procedure – only performed as treatment for severe cases
o may alter the activity of certain networks in the brain
o has been shown to promote neurogenesis in the hippocampus

repetitive transcranial magnetic stimulation (rTMS) – exposes area of brain to powerful magnetic field to either stimulate or inhibit brain activity in that region
o treatment usually involves 10-25 sessions
o stimulation of the left prefrontal cortex (positive emotional experiences) and inhibition of the right prefrontal cortex (negative emotional experiences) associated with improvement of depressive symptoms

deep brain stimulation (DBS) – involves electrical stimulation of a specific brain region using thin electrodes that are carefully inserted into the brain
o results are observed immediately
o involves some risk associated with the surgical insertion of the electrodes
o may produce unexpected temporary behaviours