Exam I Flashcards
The 4 D’s
deviance, distress, disfunction, danger
Epidemiological Study
distribution and determinants of health-related states or events
Epidemiological Incidence
number of new cases in a time period
Epidemiological Prevalence
number of people with a disorder in a period of time (includes lifetime prevalence)
Outcome Research Efficacy
tightly controlled experiments in labs; high internal validity
Outcome Research Effectiveness
looks at therapy in the real world; high external validity
Therapeutic Alliance
relationship between therapist and client; the best predictor of success
Central Nervous System
receives, processes, interprets, and stores incoming sensory information; includes brain and spinal cord
Peripheral Nervous System
handles the CNS’s input and output
Somatic Nervous System
part of PNS; connects to sensory receptors and skeletal muscles; contributes to anxiety responses such as chest tightening and breathing issues
Autonomic Nervous System
part of PNS; regulates internal organs and glands
Sympathetic Nervous System
part of autonomic NS; mobilizes bodily resources and increases the output of energy during emotion and stress; creates the fight/flight response; produces norepinephrine and epinephrine
Parasympathetic Nervous System
part of autonomic NS; operates during relaxed states and conserves energy
Occipital lobe (cerebrum)
vision
Parietal lobe (cerebrum)
contains information about pain, pressure, touch, and temperature (somatosensory cortex)
Temporal lobe (cerebrum)
hearing, memory, perception, emotion, and language comprehension
Frontal lobe (cerebrum)
short-term memory, higher-order thinking, initiative, social judgment, and speech production; contains motor cortex (produces voluntary movement)
Thalamus (forebrain)
relay center for cortex; handles incoming and outgoing signals
Hypothalamus (forebrain)
regulates basic biological needs; the 4 F’s
Concordance rate
amount of genetic influence in a behavior
Therapist Interpretation: resistance
an unconscious refusal to participate fully in therapy
Therapist Interpretation: transferance
the redirection toward the psychotherapist of feelings associated with important figures in a patient’s life, now or in the past
Catharsis
the reliving of past repressed feelings in order to settle internal conflicts and overcome problems
Short-term Therapy
patients choose a single problem (dynamic focus) to work on
Relational Therapy
considers therapists to be active participants in the formation of patients’ feelings and reactions, and therefore calls for therapists to disclose their own experiences and feelings in discussions with patients
Systematic desensitization
clients with phobias learn to react calmly instead of with intense fear to the objects or situations they dread
Climate for Growth
unconditional positive regard, accurate empathy, congruence (genuineness)
Primary prevention (community mental health)
improve community attitudes and policies
Secondary prevention (community mental health)
identifying and treating psychological disorders in the early stages, before they become serious
Tertiary prevention (community mental health)
provide effective treatment as soon as it is needed so that moderate or severe disorders do not become long-term problems
Social Supports
people who are isolated and lack social support or intimacy in their lives are more likely to become depressed when under stress and to remain depressed longer than are people with supportive spouses or warm friendships
4 Purposes of Diagnosis
clinical access to research, easier to research, makes communication between clinicians easier, data for social policy
4 Criticisms of Diagnosis
Labeling (stigma attached to mental illness, self-fulfilling prophecy), lack of reliability and validity, each person is unique, medicalization of problems in living
DSM I and II
divided into neurosis (minor) and psychosis (major) disorders; psychoanalytically based
DSM III and IV
explicitly non-etiological (no theory of causes, symptom description only)
DSM V
attempts to provide a biological explanation
International Classification System of Diseases
focuses on symptoms, not causes
DSM V view of abnormality
deviation alone is not sufficient for diagnosis; diagnosis is based on distress and dysfunction
Kappa
attempt to regulate inter-rater reliability in DSM; diference between 2 rates compared by how much agreement you would expect by chance
Mental Status Exam
set of questions and observations that systematically evaluate the client’s awareness, orientation with regard to time and place, attention span, memory, judgment and insight, thought content and processes, mood, and appearance
Projective Tests
test consisting of ambiguous material that people interpret or respond to; people often project elements of their personality into the task
Rorschach Test
projective test; ink blot interpretation
Thematic Apperception Test
projective test; shown pictures of individuals in vague situations and are asked to make up a dramatic story about each card
Personality Inventory
designed to measure broad personality characteristics, consisting of statements about behaviors, beliefs, and feelings that people evaluate as either characteristic or uncharacteristic of them
Response Inventories
designed to measure a person’s responses in one specific area of functioning, such as affect, social skills, or cognitive processes
Affective response inventory
measure the severity of such emotions as anxiety, depression, and anger
Social skill response inventory
ask respondents to indicate how they would react in a variety of social situations
Cognitive response inventory
reveal a person’s typical thoughts and assumptions and can uncover counterproductive patterns of thinking
Empirically supported/evidence based treatment
movement in the clinical field that seeks to identify which therapies have received clear research support for each disorder, to develop corresponding treatment guidelines, and to spread such information to clinicians
Reapproachment movement
effort to identify a set of common strategies that run through the work of all effective therapists
Amygdala
part of the limbic system that integrates environmental and internal reactions to anxiety, and helps regulate them
Reality anxiety (Freud)
fear, faced with an actual danger
Neurotic anxiety (Freud)
the source of “danger” is internal
Moral anxiety (Freud)
guilt or shame, source is our internal conscience
Behaviors are learned through…
classical conditioning
Behaviors are maintained through…
operant conditioning
Repression
person avoids anxiety by simply not allowing painful or dangerous thoughts to become conscious
Denial
person refuses to acknowledge the existence of an external source of anxiety
Reaction formation
person attempts to repress feelings and overcompensate for them
Intellectualization/Isolation
person represses emotional reactions in favor of overly logical response to a problem
Projection
person attributes own unacceptable impulses, motives, or desires to other individuals
Rationalization
person creates a socially acceptable reason for an action that actually reflects unacceptable motives
Regression
person retreats from an upsetting conflict to an early developmental stage at which no one is expected to behave maturely or responsibly
Displacement
person displaces hostility away from a dangerous object and onto a safer substitute
Sublimation
person channels their impulses into endeavors that are more socially acceptable and personally gratifying
Identification
rather than attempting to change reality, the person changes themselves to become more like an admired person or group
Ancient Times
Demonology; exorcisms as treatment
Greeks and Romans (Hippocrates)
mental disorders (mania, melancholia, and phrentis) had natural causes: the 4 humors (fluids) in the body (blood, bile, black phlegm, yellow phlegm)
Egypt
sanatoriums (mental health facilities) used much more pleasant treatments
Middle Ages
returned to demonology (church rejected science); Mass Madness: large “outbreaks” of mental illness, typically shared hallucinations and delusions, “caused” by tarantula bites (actually influenced by social oppression and alcohol); lycanthropy: possession by wolves
Renaissance
Back to science; originally a large improvement in humane care with the emergence of mental health hospitals; overcrowding caused conditions to decline; St. Mary of Bethlehem (Bedlam): London, horrible conditions and exploitation of patients
1st US Mental Hospital
Virginia, 1773; intimidating patients to “choose” rationality over insanity, even as late as 1830
Pinel/La Bicetre (19th Century: Moral Treatment)
Pinel ran La Bicetre after French Revolution; got permission to improve conditions and suggested that the previous treatments were giving patients more emotional/social problems; proposed a kinder treatment and introduced the concept of psychiatric records/history
19th Century: Moral Treatment
Tuke/The York Retreat: followed in Pinel’s footsteps in England; private hospitals began offering much better treatment; Dorthea Dix created campaign to establish more public hospitals with better conditions and educate about mental illness
Decline of Moral Treatment
speed at which the movement had spread (money/staff shortages, overcrowding); some needed more treatment that had not been developed yet and could not just be cured with humane treatment; emergence of prejudice against mental illness
Somatogenic (Early 20th Century)
shift to a biological/medical view with major advancements in medicine; organic factors led to mental illness; discovery of connection between General Paresis and syphilis; Kraeplin was the father of the modern diagnostic system
Psychogenic: Mesmer (Early 20th Century)
used hypnotism and magnets to shift the magnetic fluid in bodies, moved by people/space; helped patients “get in touch with their spirituality”
Psychogenic: Bernheim and Liebault (Early 20th Century)
hysterical disorders can be induced by hypnosis (blindness, deafness, paralysis, numbness); concluded that hysterical disorders were largely psychological
Psychogenic: Bruer (Early 20th Century)
patients who spoke about their problems under hypnosis often had alleviated symptoms
Psychogenic: Freud (Early 20th Century)
emphasizes the unconscious psychological forces as the cause of psychopathology; developed outpatient therapy
Neuropsychological Test
detects brain impairment by measuring a person’s cognitive, perceptual, and motor performances (Bender Visual-Motor Gestalt Test)
