Final Exam Flashcards
1
Q
Cravings
A
Often for nutrient poor foods; Rarely for things we actually have deficiencies in; Hunger/dieting intensifies cravings but doesn’t cause; Response to negative moods (incl. boredom); Chocolate contains precursors to dopamine;
2
Q
Systemic stressors
A
Pose a direct physical threat to survival
3
Q
Processive stressors
A
Psychological, not life-threatening;
4
Q
Define stress
A
Pattern of cognitive appraisals, physiological responses, behavioral tendencies that occur in response to a perceived imbalance between situational demands and the resources needed to cope with them; Highly personal, different things stress different people;
5
Q
Cognitive appraisal of stress
A
1) Primary appraisal = demands of the situation; What do I have to do? 2) Secondary appraisal = resources available to cope; How can I cope? 3) Judgements of consequences of situation; What are the costs to me? 4) Personal meaning - what does the outcome imply? If demands exceed resources, stress occurs and 3/4 define intensity of the stress
6
Q
Endocrine System
A
System of glands that secrete and regulate hormones in the body
7
Q
Hormones
A
Chemicals secreted by glands that travel through the bloodstream and deliver messages
8
Q
Pituitary gland
A
In the brain under hypothalmus; Controls the release of hormones throughout the rest of the body
9
Q
Hypothalmus
A
Major role in controlling biological drives (sexual behavior, eating, drinking, aggression, emotion); Controls neuroendocrine system; Contains neuro-secretory cells; Connection with pituitary gland;
10
Q
Adrenal Glands
A
Sits on top of kidneys; Divided into cortex (outside) and medulla (inside); Release hormones important in regulating stress response and emotions;
11
Q
Neurosecretory cells
A
Controlled by hypothalmus; Release chemicals into the blood stream (not synapse);
12
Q
Catecholemines
A
Fast-acting, immediate stress hormones; Ex: epinephrine and norepinephrine; Released from medulla of adrenal gland;
13
Q
How does hypothalmus connect to pituitary?
A
Through releasing factors, which tell pituitary when to release hormones;
14
Q
Glucocorticoids
A
Slow-acting, prolonged stress hormones; Released from cortex of adrenal gland; Ex: cortisol
15
Q
Adrenal-medullary system
A
Hypothalmus sends instructions to brainstem, which activates sympathetic NS; Sympathetic NS neurons tell the adrenal medulla to release norepinephrine; Activates fight or flight response;
16
Q
Fight or flight response
A
See more sharply; blood flow to limbs; Stop digestion; Pupils dilate; Allows stronger ability for physical activity;
17
Q
Hypothalmic-Pituitary-Adrenal (HPA) Axis
A
Hypothalmus releases hormone called corticotropin releasing factor (CHF); CHF instructs pituitary to release adenocorticotropic hormone (ACTH); ACTH stimulates the release of cortisol from the adrenal cortex;
18
Q
Cortisol
A
Major glucocorticoid in humans; Mobilizes body for long-term stress response; Secreted by adrenal cortex;
19
Q
Physiology of Stress overview image
A
20
Q
Physiological Toughness
A
Some people are physically not as reactive to stress;
Cortisol and catecholamines are involved in fight or flight response;
Physiologically tough have lower levels of cortisol and catecholimines;
Catecholimines shoot up much higher than average and then come right back down in stress response;
21
Q
General Adaption Syndrome (GAS)
A
Stress resistance occurs in stage 2. Requires adrenal glands releasing epinephrine, norepinephrine and cortisol to maintain increased arousal;
Can’t keep it up forever;
Adrenal glands will lose function and exhaustion incurs;
22
Q
Psychoneuroimmunology
A
The study of the effects os stress, emotions, thoughts and behaviour on the immune system;
Stress has:
Direct physiological effects (higher bloodpressure, decrease in immunity, increased hormonal activity); Can lead to damage to heart;
Harmful behviours (smoking/alcohol/drugs, bad nutrition, less sleep);
Indirect health-related behaviours (less complicance with medical advice, increased delays in seek medical attention);
23
Q
Appraisal of stressor
A
Maters because if you don’t percieve it as stressful, then you won’t have the stress response
24
Q
Stress and immunity
A
Prolonged stress response places wear and tear on the body, which leaves us susceptible to illness;
Stressed people heal more slowly (includes fear of surgery);
Stressed people get sick more often;
25
Natural Immunity
Inborn processes that help remove foreign substances from the body;
Eg: inflammation after cutting your hand.
26
Acquired Immunity
Body's response to specific antigens;
Antigens are any foreign substances that trigger an immune response;
Principle beind the effectiveness of vaccines;
27
Ader's Tase Aversion - immune system and stress
UCS: toxin that induced nausea
UCR: Nausea in response to toxin
CS: Saccharin water
CR: Nausea in response to saccharin water
Toxin doubles as an immunosuppressor. Result was decreased immunity when drinking this water. So conditioning can evoke immune suppression
28
Stress and memory
Hippocampal neurons atrophy;
Fewer dendrite branches on hippocampal neurons;
Makes it more difficult to remember;
29
Stress and Personality
Type A are competitive, driven, impatient, hostile;
Type B are lack urgency, serene, cooperative;
Type A personalities tend to think more time has passed than really has;
Type A more vulnerable to stress;
Stress most correlated with hostility and anger and Type A;
30
Risk of heart attack
Higher with Type A;
Hostility and anger induce increased blood ressure of stress response;
Hostility and anger correlated with arterial blockage and increased rate of heart attack;
31
Post-traumatic stress disorder
* Triggered by exposure to trauma;
* -Exposure to Stressor;
* -Painful re-experiencing of the event;
* -Avoidance of trauma-related stimuli;
* -Negative alterations in cognitions and mood;
* -Increased arousal and reactivity;
* No longer classified as anxiety disorder in DSM5 5 - now a trauma and stress related disorder
32
Prolongues Exposure Therapy for PTSD
Present the fear stimulus with nothing bad happening;
Related to classical conditioning;
Extinguish fear response;
Contradicts characteristc avoidance in PTSD;
33
Stress coping strategies:
1) Problem-focused coping
2) Emotion-focused coping
3) Seeking social support
1) Making a plan to deal with the situation; Best if you *can* deal with the stressor but otherwise will bring more stress;
2) Eliminate the negative stress emotions; Coping mechanisms (positive and negative ones);
3) Getting someone else to help; Distraction; Enjoyment from social connection;
34
Storytelling and health: Emotional disclosure
People who wrote about their trauamtic events reported feeling better and having better health;
Discussing events narratively decreses arousal and improves health;
35
Positive psychology
Optimism and self-efficacy associated with health;
Optimistic people live longer;
36
Health Psychology
* Study of psychological and behavioural factors in promotion of health
* Health Enhancing behaviours (exercise, nutrition, medical check ups)
* Health comprimising behaviours (smoking, sedentary lifestyle, unprotected sex)
37
Health Psychology:
Transtheoretical Model
1. **Precontemplation** - problem unacknowledged
2. **Contemplation** - recognition of problem
3. **Preparation** - preparing to change behaviour
4. **Action** - implementing change strategies
5. **Maintenance** - maintaining behaviour change
6. **Termination** - Permanent change; habit now
Goals of health psychology is to get people to the termination stage
38
Deep breathing
* Take in more oxygen per breath
* Slows heart rate
* Engages parasympathetic NS
* How meditation keeps people calm
39
Drug that causes msot net harm to people:
Incidence of smoking
* Alcohol causes the most net harm to people in society
* On-the-job accidents, drowning, murders, suicide, highway fatalities, rape, child abuse, pedestrian fatalities
* As government makes smoking more difficult, incidence of smokers has been going down.
*
40
Diagnostic Criteria (selected): Alcohol use disorder
* Problematic patters of use causing significant impairment and distress as manifested by 2 or more of the following within a 12 month period.
1. Too much consumed at once or for too long than intended
2. Persistent desire; unsuccessful attempts to cut down
3. Time spent obtain, using and recovering
4. Use results in failure to fulfill major obligations
5. Continued use despire recurrent problems
6. Important activities are given up
7. Tolerance
8. Withdrawal
41
Drinking motives
* **Coping motives**: Internal; Negative reinfircement; Eliminate the negative feeling; Related to problem drinking;
* **Enhancement Motives:** Internal; Positive reinforcement; Get a high; Related to problem drinking
* **Conformity motives**: External; Negative reinforcement; If you drink they won't tease you; Mostly not problematic;
* **Social motives**: External; Positive reinforcement; Enjoyment of social interaction;
42
Negative reinforcement
* Attempt to eliminate a bad thing
43
Substance Abuse Treatment: Multimodal treatments
* Motivational interviewing
* Aversion Therapy
* Positive reinforcement
* Relaxation techniques
* Family counseling
Combination of many to make the best therapy.
* Motivational Interviewing; Humanistic; Focus on discrepancies bt ideal and actual selves;
* Aversion therapy; Behavioural;
* Positive reinforcement; Behavioural;
* Relaxation techniques + mindfulness meditation' 3rd wave;
* Family counseling to reduce conflict; Psychodynamic;
Still high relapse rate.
44
Abstinence violation effect and therapy to combat it
* **abstinence violation effect** = upset after a minor relapse, often causing them to stop changing
* Cognitive Therapy fixes black and white thinking; progress, not perfection
45
Harm reduction
* Trying to reduce the harmful effects of the behaviour rather than trying to reduce the behaviour altogether
* Needle exchange programs
* Methadone clinics
* Free condoms for adolescents
* Wet homeless shelters
46
Pros and cons of Marijuana
* Less addictive and harmful than cigarettes and alcohol;
* Low addiction; Not a gateway drug;
* Does result in dependence;
* Increases risk of schizophrenia in young users;
* Increased risk for motor vehicle accidents;
47
What constitutes as abnormal?
1. Distress (to self or others)
2. Dysfunction (for person or society)
3. Deviance (violates social norms)
48
Psychdynamic perspective on mental disorder
* Mental illness derives from inappropriate use of defense mechanisms = **neuroses**
* eg: depression, anxiety, personality prob
* Withdrawal from reality = **psychoses**
* eg: splits from reality, bipolar
49
Behavioural perspective on Mental disorder
* Principles of operant and classical conditioning to define a disorder and treat it.
50
Cognitive perspective on mental disorders
* Thought processes in mental disorder and how to change them
51
Humanistic perspective on mental disorder
# Define disorders as frustration with achieving self-actualization; negative self-concept;
52
Biological perspective on mental disorder
* Neurological damage, chemical imbalance, genetic predisposition
* Treat mental illness as a biological problem
53
Sociocultural perspective on mental disorder
How culture and society creates disorders, or defines what is abnormal.
54
Vulnerability-Stress Model (= Diathesis-Stress Model)
* **Vulnerability factors** such as:
* Genetics, biological characteristics, psychological traits, low social support etc
* **Environmental stressors**
* Economic adversity, trauma, stresses, losses, occupational setbacks or demands
* Psychological disorders are a result of BOTH of these
55
Protective factors
Opposite of vulnerability factors; decrease the risk of disorders.
56
DSM IV Axis system (1 and 2)
1. *Clinical Symptoms*
* Diaognosis you get
2. *Developmental and Personality Disorders*
* Developmental - Eg: Autism, mental retardation
* Evident in childhood
* Personality - Eg: paranoid, borderline personality disorder
* Long lasting & huge impact on life
* Resistant to treatment
57
DSM IV Axis System (3, 4, 5)
3. *Physical Conditions*
* Eg: brain injury, AIDS - can result in symptoms of mental illness
* Type 2 diabetes strong susceptible to depression and resistant to treatment
4. *Severity of Psychosocial Stressors*
* Eg: death of loved one, new job, marriage
5. *Highest Level of Functioning*
* Level of functioning both at present time anf highest level within previous year.
58
Anxiety and components
Emotional
Cognitive
Physiological
Behavioural
State of tension that one feels naturally in theatening situations;
* *Emotional* - apprehension/tension
* *Cognitive* - Worry, thoughts about inability to cope
* *Physiological* - Increased heart rate, muscle tension, arousal symptoms
* *Behavioural* - Avoidance of feared situations, decreased task performance, increased startle response
59
Anxiety disorders
Classified by excessive responses that are out of proportion to the situation that triggers them.
60
Phobias
* **Specific Phobias** - specific triggers (eg spiders)
* **Social Phobias** - Fear of situation where a person might be evalutated/embarrassed
* **Agrophobia** - fear of open/public places from which escape would be difficult.
61
Obsessive Compulsive Disorder
* *Obsessions **-*** persistent and unwelcome thoughts that keep recurring
* *Compulsions* - irritable urges to repeatedly carry out some act that is unreasonable
* Classified as an obsessive-compulsive and related disorder in DSM 5 (not anxiety disorder)
62
Panic Disorder
* Characterized by panic attacks (sudden and unpredictable surge of anxiety that can last from seconds to hours)
* Life becomes dominated of fear of the next panic attack
63
Generalized Anxiety Disorder
* Chronic, or ongoing, state of anxiety that is not attached to any specific situation or object
* Less intense than panic disorder, but more consistent
64
Causes of Anxiety disorders
* Psychoanalytic
* Behavioural
* Cognitive
* Biological
* Personality
* *Psychoanalytic* - Neuroses occur when unecceptable urges threaten to overwhelm the ego's defenses and bcm conscious
* *Behav* - Created through classic conditioning, observational learning, or operant conditioning
* *Cognitive* - Problem of maladaptive thought patters and beliefs
* *Biological* - Genetics. Deficiency in GABA. More common in women than men.
* *Personality* *-* Neuroticism is a risk factor
65
Anorexia Nervosa
Reduced caloric intake and excessive weight loss; Low self esteem and problems interpreting body image
66
Binge Eating Disorder
Binge eating without compensatory behaviours; Person doesn't feel under their own control; Mood and eating are intrinsically tied;
67
Bulima Nervosa
Cyclical binge eating and compensatory behaviours (eg vomiting, excessive exercise, laxatives)
68
Eating Disorders Not Otherwise specified
Disorders that are eating disorders but fail to meet the full criteria for any; Most common diagnosis;
69
Causes of eating disorders
Biological factors
Psychological factors
Social factors
* *Biological factors*: Genetics, lack of internal awareness, sensory changes
* *Psychological factors*: Personality, negative emotions, low self esteem, body dissatisfaction, disrupted thought patterns
* *Social Factors:* Family dynamics; Interpersonal problems; Idealization of thinness
70
Mood Disorders
Severe disturbances in emotion; Depression and/or mania strong enough to intrude every day life
71
Depression
Emotional
Cognitive
Motivational
Somatic
Mood disorder
* *Emotional* - sadness, hopelessness, anxiety, inability to enjoy
* *Cognitive* - Negative congitions about self and world
* *Motivational* - Loss of interest, lack of drive
* *Somatic* - Loss of appetite, lack of energy, sleep difficulties, weight loss/gain
72
Major Depression - Clinical Depression
* Extreme sadness, despair, with no obvious cause
* Symptoms so severe they interfere with everyday life
* Typically cyclical and chronic; Major depressive episode followed by recovery and continuous relapse
* More common in women than men
73
Bipolar Disorder
* Internal struggle with depression (usually the dominant state)
* Alternated with periods of mania (DIGFAST)
* Distractability, Indiscretion, Grandiosity, Flight of Ideas, Activity Increased, Sleep (decreased need), Talkativeness
*
74
Dysthymia
Chronic, moderate depressive symptoms
* Low grade depression all the time for 3 years or more
* Intervals of normal mood never appearing for more than a few weeks or months
* Symptoms not as extreme as normal depression but typically more long-lasting
75
Cyclothymia
Like Dysthymia, but refers instead to alternating between depressive and manic phases like bipolar
76
Biological Causes of Mood Disorders
* Strong genetic link; Bipolar is 40-70% heritable
* NTs involved in behavioural activations (serotonin, norepinephrine, dopamine)
* Underactivity in depression
* Overactivity with mania
77
Depression - learned helplessness
**Learned Helplessness**: Depression occurs when bad events occur and we feel powerless to do anything about it.
78
Perspectives on Depression
1. Psychoanalytic
2. Cognitive
3. Interpersonal
4. *Realisitcally*
1. *Psychoanalytic* - Depression occurs when an early traumatic loss of rejection creates vulnerability that is not properly resolved
2. *Cognitive* - A person's perceptions, thoght, or self-statements cause feelings of worthlessness and inadequacy
3. *Interpersonal* - Caused from our surrounding culture and the presence/absense of strong social support network when dealing with negative factors.
4. *Realistically* - Symptom with many causes.
79
Dissociative Disorders
A break in consciousness or memory; Breakdown in normal personality;
Very rare; often driven by stress of trauma;
80
Dissociative Amnesia
* Forgetting caused by psychological factors
* Extreme response to a stressful event with extensive selective memory loss
* Formerly psychogenic amnesia
81
Dissociative Fugue
Moving to a new location with loss of identity and memory;
* Losing all sense of personal identity
* Giving up current life and creating a new identity in a faraway place
* Formerly psychogenic fugue in DSM
82
Dissociative Identity Disorder (DID)
More than one personality residing in an individual
* Two or more seperate personalities coexist in the same person
* Can be any number of personalities
* Previously called Multiple Personality Disorder
83
Dissociative Identity Disorder - proposed models
Socio-cognitive model
Trauma model
* **Socio-cognitive model** - DID is therapist or media-induced; people are just playing roles that are reinforced
* **Trauma Model** - DID is an atypical response to past trauma
84
Somatoform Disorders
Belief that one is physically ill with no physical ailment
* Individual experiences symptoms or physical health problems that have psychological, rather than physical causes
* Differ from psychophysiological disorders (where physiological features play a role) - these symptoms are as if they were caused by the body
85
Hypochondriasis
Worrying about having or contracting a disease
* Distress is very real
* Not faking symptoms, legitimately scared that they will die of a disease and they are just looking for someone to believe them
* Constant worrying can lead to other health problems that intensify the hypochondriasis
* Possible causes incl. disordered thought processes and anxiety
86
Conversion Disorder
Physical loss of function with no physical reason
* Involves actual physical disturbance to one's body which can cause blindness, deaflness, paralysis
* Eg Glove Anesthesia is where all feeling is lost below the wrist. Must be psychological because the nerves in the arm don't allow for that kind of loss of feeling
* Can be caused by extreme trauma
87
Factitious Disorder Imposed on Another
* Munchausen syndrom represents extreme cases
* *Imposed on Self* - falsifying medical data to fake medical history, manipulating assessment instruments, trying to mimic disease
* Frequently found in health professionals
* Often associated with personality disorders
* *Imposed on Another* - Same, except you do this to your child
* Still a somatoform disorder bc it involves sympoms with no physical cause, but in this case there is willful faking of symptoms
88
Malingering
* Not an actual disorder
* Faking illness to to receive a teritary gain (like to get out of work)
* Differs from factitious disorder where the person gets a perosnal benefit out of being in the "sick role"
89
Causes of somatoform disorder
* Could be extreme trauma (Conversion disorder)
* Disordered
90
Schizophrenia
A split between thoughts, emotions and behaviour
* *Positive Symptoms* - Hallucinations (sensations that aren't really occurring), delusions (unrealistic thoughts), disturbed speech patterns (nonsense words)
* *Negative Symptoms* - Flat or inappropraite affect, catatonia/immobility, little social interaction
* *o Cognitve Symptoms (*Problems with information processing) - Problems with problem solving, attention, working memory
91
Disorganized (hebephrenic) schizophrenia
* Disorganized speech and behaviour
* Flat or inappropriate affect (eg inappropriate laughter, silliness, infantile behaviour etc)
92
Paranoid Schizophrenia
* Most common subtype.
* Delusions and hallucination of persecution and greatness
* Loss of judgement
* Erratic and unpredictable behaviour
* Auditory hallucinations common
93
Catatonic Schizophrenia
* Major disturbances in movement
* Loss of all motion - might sit in the same position all day
* In other phases, hyperactivity and wild movement
* Somtimes mutism or parroting what other people say
94
Undifferentiated Schizophrenia
* Variable mixture of symptoms
* Used to classify any patient who doesn't fit clearly into a subtype
95
Residual Schizophrenia
Minor signs of schizophrenia after a more serious episode (in remission)
96
Biological causes of schizophrenia: Brain
* *Brain abnormalities*
* General brain atrophy and other structural abnormalities
* Enlarged ventricles filled with spinal fluid (side affect of other brain areas shrinking)
* Biochemical imbalances
* Excess dopamine activity (drugs that block dopamine alleviate +ve symtoms)
* Dopamine imbalance can occur in extreme cases of mania as well
97
Biological causes of schizophrenia: Genes
* Risk of developing schizophrenia highly correlated with genetic predisposition
98
Psychological causes for Schizophrenia
* Not very useful for explaining schizophrenia
* *Cognitive theory* suggests that it results from overattention to stimuli in the environment
99
Environmental Causes for Schizophrenia
* **Vulnerability-Stress Model**
* In presence of genetic or biological vulnerability, environmental features can increase risk or highten symptoms of schizophrenia
* Marijuana
100
Personality Disorders
Extremely rigid maladaptive behaviour patterns that keep a person from functioning normally in society.
101
What diorders are included in the Dramatic-Emotional Cluster?
Narcissistic Personality Disorder
Histronic Personality Disorder
Antisocial Personality Disorder
Borderline Personality Disorder
102
Narcissistic Personality Disorder
* Dramatic-Emotional cluster
* Grandiose fantasies or behaviour
* Lack of empathy
* Oversensitivity to evaluation, constant need for admiration from others
* Proud self-display
103
Histronic Personality Disorder
* Part of the Dramatic Emotional Cluster
* Excessive, dramatic emotional reactions and attention seeking
* Often sexually provocative
* Highly impressionable and suggestible
* Out of touch with negative feelings
104
Antisocial Personality Disorder
* Dramatic-emotional cluster
* Disregard for social rules, norms and cultural codes
* Impulsive behaviours
* Indifference to the rights and feelings of others
* Beginning in childhood and continuing past age 18
* Lower prefrontal cortex activity
* Extreme levels of psychopathy (murderers)
* Relatively unaffected by punishment
105
Borderline Personality Disorder
* Part of the Dramatic Emotional cluster
* Patterns of severe instability of self-image, interpersonal relationships, emotions
* Often expressing alternating extremes of love and hatred toward the same person
* High frequency of suicidal and self-injury behaviours
106
What is included in the Anxious-Fearful Cluster
Avoidant PD
Obsessive Compulsive PD
Dependent PD
107
Avoidant PD
* Part of anxious-dearful cluster
* Extreme social discomfort and timidity
* Feelings of inadequacy
* Fearfulness of being negatively evaluated
108
Obsessive Compulsive PD
* Extreme perfectionism
* Preoccupied with mental and interpersonal control
109
Dependent PD
* Excessiv need to be taken care of
* Submissive and clinging behaviour
* Fear of seperation
* Beginning in early adulthood and present in a variety of contexts
110
What is included in the Odd/Eccentric Cluster?
Schizotypal PD
Schizoid PD
Paranoid PD
111
Schizotypal PD
Odd thoughts, appearance and behaviour;
Extreme dicomfort in social situations;
112
Schizoid PD
Indifference to social relationships and a restricted range of experiencing and expressing emotions
113
Paranoid PD
An unwanted tendency to interpret the behaviour of other people as threatening;
114
Autism Spectrum Disorder
* Begins in childhood
* Sever language and social impairment, repetitive habits, inward-focused behaviours
* Often associated with oversensitivity to external stimuli, limited range of interests, preference for inanimate objects
115
Self harm and borderline personality disorder
* Borderline PD characteized in DSM with recurrent suicidal behaviour or slef-mutilation
* Self harm is parasuicidal - deliberate harm to self with or without intention to die
* High rates in BPD
* An attempt to escape from or avoid emotional pain
* People with BPD report self harm reduces emotional arousal
116
How does self-harm alleviate emotional states?
* **Opioid Hypothesis** - self-injury releases natural opioids that alleviate pain and emotional stress
* **Distraction Hypothesis** - physical pain distracts from emotional pain
* **Self-punishment** - Individuals believe that they are "bad". Harm alleviates guilt but also might alleviate external punishments from others.
117
Clinical Psychologists
PhD + 5 years training
Techniques, assessment, research
118
Psychiatrists
MD + specialization
Can administer drugs
119
Counselors
Usually have an MA
Specialize in a particular area
Social work, marriage/family, addiction
120
Psychoanalysis
* Abnormal behaviour result of unconscious conflict among id, ego and supergo
* Treatment involved relaxing barriers of conscious mind; bring unconscious conflights to awareness
* Aims to achieve insight through **catharsis** (making the unconscious conscious)
* Very intensive and long term.
121
Psychoanalysis Techniques: Free association
* Therapist sits out of view
* Client reports any thoughts/feelings without self-censorship
* Therapist interprets these based on theory
122
Psychoanalysis Techniques: Dream interpretation
* Can also incorporate free association
* Freud believed that dreaming is where our unconscious wishes are fulfilled
* *Latent Content* = meaning of dreams
* *Manifest Content* = apparent storyline of dreams
123
Resistance
Defense mechanisms that hinder therapy
Often when you get close to the heart of the problem, a lot of people with disorders put up walls again or quit.
124
Transferance
* Client responds irrationally to therapist as if the therapist were someone else in their life
* Considered an essential part of therapy
* Can be positive (affection) or negative (anger)
125
Psychodynamic Therapies
* More modern theories built on Freud's ideas
* Briefer
* Focus on maladaptive past influences
* Employ psychoanalytic concent in focused, active way
* Interpersonal therapy
* Focus on client's relationships with important people in their life
* Reasonable effectiveness
126
Humanistic Theories
* Reaction to Freud - gives agency back to people rather than making them victims of their unconscious
* Help client become more aware of themself to unblock inner resources for self-healing
* Carl Rogers - client centered
* Be genuine, empathetic, friend
127
Core ideals of Client-Centered Therapy
1. Unconditional positive regard
2. Empathy
3. Genuineness
* Consistency bt therapist's feelings and behaviours
128
Cognitive Therapies
Very effective for depression
* Focused on teaching adaptive change in thinking and thus behaviour
* *Ellis's Rational-Emotive Therapy* - the beliefs activated by an event are what causes the emotions and behaviours as a result of the event
* *Back's Cognitive Therapy*
129
Behavioural Perspectives on Therapy
* Uses principles of classical and operant conditioning to treat various psychological disorders
* *Classical Conditioning* - Behaviour changes due to association of two stimuli (UCS, UCR, CS, CR)
* *Operant Conditioning* - Behaviour changes due to consequences that follow it (Rewards and punishments)
130
Exposure Therapy
used to treat anxiety, especially phobia
* Exposure to the conditioned stimulus without the unconditioned stimulus while using response prevention
* **response prevention** - can't run away
* Should extinguish the phobia
131
Systematic Desensitization
Good effectiveness for anxiety
* **Stimulus hierarchy** - imagine scenes of fear from least to most anxiety provoking.
* Paired with deep relaxation techniques (**countercoding)**
* UCS - relaxation exercises, UCR - relaxation
* CS - fear, CR - relaxation
132
Aversion Therapy
* Designed to reduce undesirable behaviours
* Pair stimulus with something unappealing, such that the stimulus takes on that unappealing quality
* UCS - alcohol, UCR - drink to excess
* CS - Antabuse, CR - Nausea when drinking alcohol
133
Token Economies
Operant conditioning
* *Specify target behaviour* - what do you want the person to do?
* *Tokens* - points that can be traded in for something desireable
* *Backup Reinforcers* - Positive or negative reinforcers are received for trading in tokens
* Used in mental health wards. Token get you outings, food, movies.
134
Third Wave Mindfulness Based Therapies
* Takes cognitive and behavioural therapies and incorporates ideas from humanistic theories as well as concepts of mindfulness and meditation
* **Mindfulness** = Mental state of awareness, focus, openness and acceptance of immediate experience
135
Dialectical Behavioural Therapy
Third wave treatment designed to treat borderline personality disorder
* Helps deal with intense, uncontrollable emotions
* Eg: paced breathing
136
Value of meta analysis of treatments for mental disorders
Combinations of individual research studies to see if a treatment works;
Also shows the effect size (how large the improvement is);
137
Which therapies work best?
Psychodynamic/Client-centered/Gestlat/ etc all seem to work, but it is possible that certain techniques work best for certain people.
138
Excitatory NTs
Depolarize the neuron's membrane (Na+ or K+ in);
Increase likelihood of action potential;
Ex: Dopamine, serotonin, norepinephrine
139
Inhibitory NTs
Hyperpolarize the neuron's membrane (K+ out or Cl- in)
Decrease likelihood of action potential;
Ex: GABA;
140
Deactivation of NTs
1. **Breakdown** - other chemicals in the synpase break down NTs into their chemical components
2. **Reuptake** - NTs are taken back into presynaptic axon terminal
141
Agonist
Increase activity of a NT
142
Antagonist
Decrease activity of a NT
143
Barbiturates
* Anti-anxiety drug
* first class of anxiolytics
* GABA agonists (increase duration of Cl- channel open)
* Addictive, potential for overdose
* Ex: pentoarbital, phenobarbital, thopental
* No longer used for anxiety, but used as an anticonvulsant
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Benzodiazepines
* Anti anxiety drug
* Most widely used
* GABA agonists - increased frequency of Cl- channel opening
* Safer than barbiturates (harder to overdose)
* Addictive
* Ex: Diazepam (valium), alprazolam (Xanax)
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Buspirone (BuSpar)
* Newst anti-anxiety drug
* Serotonin partial agonist
* Serotonin causes some oxytocin stim too
* Dopamine antagonist
* Used to treat GAD and PTSD
* Less potential for abuse, less sedation, takes longer to work
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Tricyclics
* Antidepressant drugs
* First developed
* Norepinephrine and Seratonin agonists
* Inhibit reuptake of seratonin and norepinephrine
* Many bad side effects: Sedation, sexual disturbances
* Ex: imipramine (Tofranil), amitrypyline (Elavil)
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SSRIs
* Antidepressants
* Replacing tricyclics
* SSRI = selective seratonin reuptake inhibitors
* Seratonin agonist
* Work like tricyclics but more selective for serotonin
* Milder side effects
* Can also treat anxiety
* Ex: fluoxetine (Prozac), sertraline (zoloft)
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MAO-I's
* Antidepressant drugs
* Manoamine oxidase inhibitors
* Inhibits the breakdown of monoamines such as serotonin, dopamine, norepinephrine.
* Serotonine, dopamine and norepinephrine agonists
* Only used if responses to other drugs are poor
* Many side effects (Cheese crisis)
* Ex: tranylcypromine (parnate), phenelzine (Nardil)
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Antipsychotic drugs
* Dopamine antagonists
* Act by blocking DA receptors
* Reduce positive symptoms, little effect on negative symptoms
* *Traditional antipsychotics*: Phenothiazines, haloperidol
* Common side effect: **tardive dyskinesia**
* *Atypical Antipsychotics* (clozapine)- Do not evoke tardive dyskinesia, but can reduce white blood cell count (and sometime rarely blood disorder)
* Introduction of antipsychotics greatly reduced hosiptalizations
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Lithium
* Natural salt used to stabilize mania associated with bipolar disrder
* Mechanisms unclear, appears to influence many systems, including glutamate
* Side effects: Diarrhea, nausea, tremors, kindey failure, brain damage, adverse cardiac effects
*
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Electroconvulsive Therapy
* Inititally used for a wide variety of disorder.
* Now only used for _severe_ depression
* Can caue permanent memory loss
* Relapse rate is high
* Current treatments use much milder shocks
* Last resort treatment when meds fail.
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Frontal Lobotomy
* Used extensively in 1930s.
* Severe connections between prefrontal cortex and emotion-related areas of brain
* Immense calming, reduced aggression
* Loss of executive functions
* Done in psych wards to make caring for patients easier
* Absolute last resort
* Fereman went on tour with his. Many died
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Cingulotomy
* Severe fibres near corpus callosum.
* Cuts off communication bt frontal lobes and limbic system (emotional responses)
* Can lead to maladaptive communication bt higher order processing and emotional response
* Absolute last resort.
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Repetitive Transcranial Magnetic Stimulation
* Exposure of specific brain structures to bursts of high-intensity magnetic fields instead of electricity
* Targets areas of the brain showing to be underaroused
* Can reduce symptoms of severe depression and negative symptoms of schizophrenia in some patients
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Revolving door phenomenon
* If community care is poor/absent, repeated hospitalizations are common
* 75% admissions are former patients
1. Patients respond well to antipsychotics
2. Released into community
3. Don't get adequate support; Stop taking meds;
4. Back into hospital or homeless
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Depersonalization
Workers in mental health facilities stop seeing the patients as human and don't treat them with the same respect and dignity that they would a person they met on the street.
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co-morbid
More than one disorder
