midterm 1 Flashcards
What are the influences contributing to psychopathology?
Psychological, biological, social and integrative
Diathesis-stress model
A theory that mental disorders develop due to a biological vulnerability combined with environmental stressors.
Diathesis-stress model: Distal threat and proximal threat
Distal: A past factor that contributes to psychopathology.
Proximal: A present factor contributing to psychopathology.
Psychodynamic Appraoch
Id (unconscious) Superego (learned social rules) Ego (conscious self, balances id and superego)
Psychosexual stages of developmental (Oral, Anal, Phallic, Latency, Genital)
Defense Mechanisms protect the ego:
Rationalization – Justifying behaviors.
Projection – Attributing personal faults to others.
Reaction Formation – Expressing the opposite of true feelings.
Sublimation – Redirecting impulses into socially acceptable activities.
Psychoanalytic Therapy includes techniques like free association, dream analysis, and transference interpretation.
Behavioral Approach
Classical conditioning: explains phobias (dog, little albert, initial vs future encounters)
Operant Conditioning shapes behavior through reinforcement and punishment: (REINFORCE: anorexia, people could reinforce and compliment you after losing your first 5 pounds, then you continue to lose more weight for compliments and validation, PUNISHMENT: decreases likelihood of behavior)
Observational Learning (learning by watching others) influences behaviors.
Cognitive appraoches
- Thoughts are central to everything, it can influence mood and behaviors and vice versa
- If cognitions are distorted in a maladaptive way, can lead to disorders
Learned Helplessness: could explain depression ( boss at your job is rude, and just accept the fact their boss will continue to be this way and don’t venture out to find a new job or speak up about it)
Attributional style: Internal vs. external (Do you blame yourself or do you blame your problems on outside forces), stable/unstable (Do we look at your inability in solving problems as something ongoing or something that’s current), Global/specific (Do I generalize? Can I not solve this problem vs I can not solve problems (in general)
Humanist/existential approach and treatment
- Humans strives for Self-actualization (achieving one’s full potential including creative actvities)
- congruence (when a person’s ideal self is consistent to their actual experiences
incongruence (when a person’a ideal self is not consistent with what happens in their life)
Genetic influence
- Looking at genetics through behavioral patterns
-Family history, adoptive, and twin studies
Syphilis and General Paresis
- if you get syphilis once, wont get it again
- Fredrich Von Esmarch: r injected 9 patients who had general paresis with syphilis
- germs can cause psychopathology, strong link between physical and mental illness
Brain sturcture and function
Amgydala: emotion center, threat detection/fear learning, aniexty and PTSD
Hippocampus: memory center, integrate sensory cues with memory, PTSD
Prefrontal cortex (PFC): executive control center, top down control of emotional responses (uses logic to regulate emotions)
Phineas Gage: frontal lobe got damaged –> it changed his personality, linking that parts of the brain are in charge of certain functions
Schnizophrenia: ventricles are enalrged and aysmmetry in the brain
Neuotransmitters
Glutamate: Primary excitatory neurotransmitter
GABA: Primary inhibitory neurotransmitter
Serotonin (5HT): Plays a role in many regulatory processes (behavior, mood, thoughts)
Norepinephrine: autonomic nervous system, mediates arousal
Dopamine: Plays a role in positive affect and rewards systems
Endogenous opioids: Pain regulation, modulating stress response
Social approach and treatment
SES, race, gender, access to healthcare, and cultural influences affect mental health
Treatment implications: Modify interpersonal relationships - interpersonal therapy, social skills training
Integrative approaches (not one approach is enough)
Biopsychosocial model:
Biological factor - focus on psychiatry
Psychological factor - focus of psychology
Social factors - focus of social work
endocrine - hormones
sympathetic/adrenal response - Short-term stress response (fight or flight), releases Epinephrine and norepinephrine, aniexty, PTSD
HPA Axis (hypothalamic-pituitary-adrenocortical), long term stress response, releases cortisol (stress hormome), if in constant stress = depression, generalized anixiety
Treatment Implications
Case Conceptualization
- The clinician’s theoretical orientation
- The client’s preferences
- The available research evidence
ex: biological option may not work, but CBT maybe more effective
Assessing Psychological Disorders:
- Clinical interviews
- Observation techniques
- Rating scales/symptoms inventories
- Objective tests
- Projective tests
- Neuroimaging
- Psychophysiological assessments
Clinical Interviews
- patients sit down with clinican
- unstructured interview
- semi-structured interview
- strcutured interview
types of questions:
- pre-determined, follow-up, closed, and open
observsation techniques
observers:
- clinican
- family member
-significant others
- patient self-observation
settings
- daily life
- lab
clinic
simulated
mental status exam
- appearance
- arousal
- cognition
- behavior
- mood
- affect
- demeanor
- speech
- attention
- eye contact
- thought
- thought content
- thought process
- insight
- judgement
Self Report Tests
- rating scales/symptom inventories
- Beck Depression inventory
- MMPI (Minnesota Multiphasic Personality Inventory)
Neurological tests: tests on..? what specific tests?
- neurocognitive impairments
- learning disabilites
neurodevelopmental disorders
Tests on:
- intelligence
-memory
- attention
- executive functioning
- language
- clock test
Projective tests
- developed in psychoanalytic theory, the unconsious is “projected” onto the stimulus
tests:
- house, tree, person test
- ink blot test
- thematic apperception test
Neuroimaging of brain function
MRI or fMRI
psychophysiological assessment
- Most commonly used in research, rarely used in diagnosis
tests:
- skin conductance
- heart rate
- respiration
Concepts in measurement
- reliability
- validity
- standarization
measurement reliability
- inter-rater reliability
- test-retest reliability
measurement validity (is what we are testing for valid?)
- content validity
- predictive validity
- concurrent validity
- criterion validity
diagnosis
- the act of identifying a disorder from its signs and symptoms
- Summarize information
- Treatment and intervention planning
- Professional communication
- Scientific study
- Financial
comorbidity
- High comorbidity is the not the exception, Meaning very likely for someone to have another disorder
- treatment planning, and prioritizing what is treated first (substance vs anxiety)
an adaquate assessment should what?
- focus on person (their life, social context)
- long term personality characteristics
categorial approach
- clarity and simplicity
- standardization
- practical use
- legal and administrative benefits
disadvantages:
- oversimplify
- risk of stigmatization
- limited flexibility
dimensional approach
- more variation
- prevents over-simplification
- better reflection of continuity
- flexibility for treatment
- can help identify subclinical symptoms (not just clinical symptoms)
cons:
- complex
- lack of standarization
- over-emphasis
- potential for “overdiagnosis”
what to look for in approach:
- perceptual reality testing
- social reality testing
- object relations
- identity
- impulse control
clinicians and psychopathology:
Rosenhan:
Believed that people should not have been so quick to be diagnosed with schizophrenia in remission
Spitzer: Did not agree with rosenhan
Found it rare to be diagnosed with schizophrenia in remission
declaration of hawaii: helped to reconcile member countries on issues of misuse of psychiatry.
Susannah Cahalan
- Was diagnosed with Schizoaffective disorder
- Inflammation in her brain, someone with a psychiatric disorder would not draw the clock just on the right side
(so she actually had neurological disorder)
psychological influence
- behaviors
- cognitions
- emotionas
they all circle back to each other
Basic research concepts:
- Scientific method
- Testability
- Internal and external validity
- Statistical vs clinical significance
type I vs type II error
type I: You conclude there is a significant effect when there isn’t one.
type II: You miss a significant effect that is actually present
research methods in abnormal psych
- case studies
- correlational studies
- experimental designs
case studies
In-depth, qualitative examination of abnormal psychology from one single patient (Phineas Gage and H.M.)
pros:
- sends us into direction of knowledge
- helps us where to direct our research w/ unique data
cons:
- external validity
- can not base research around case studies
single subject experiments
Intensive, quantitative measurement of one individual
pros: track patient overtime, see how interventions affect outcome
cons:
- external validity
- confounding variable, there could be other influences outside of experiment you cant account for
why is science important?
- empirical
- objective, self-correcting
- identify, detect, isolate, and reveal complex relationships
Facilitated communication (FC)
- A type of therapy invented for autism
basic and applied research
Basic research: creation and testing of a theory (animal lab studies)
Applied research: addresses practical problems/questions; our interest in translating our knowledge toward goals of everyday life (is CBT effective at decreasing depression in adolescent males?)
operational definition
A definition of a theoretical concept that is stated in terms of concrete, observable procedures or measured that are used in an experiment
variables
independent: Variable in experiment that’s being manipulated/compared
dependent: The outcome/importance of the measure
Extraneous/confounding variable: Variable that may have an impact on the relationship between the independent and dependent variables (participant, situational)
Randomized controlled studies
- We cannot experiment on the same people in different situations
- RCTs can help wash out extraneous variable
experimental design
- RCT
- independent variable (comparative, placebo control, waitlist control)
- dependent variable
- control variable (Variables controlled for in the statistical analysis)
correlational studies
pros:
- Clinical disorders cannot be experimentally manipulated
- large sample size
cons:
- confounding variables
- directionality issues
- coincidence
Criteria for Causation
Strength
Consistency
Specificity
Temporality
Gradient response
Plausibility
Coherence
Analogy
Methods to help establish causation
- Longitudinal studies
- Experimental manipulation
- Experimental research
Longitudinal
- Follow same group of participants over long period of time, and collect data over time
- Repeated measurements
- expensive
- large attrition rates
Experimental manipulation
- Do something to see if you can change something
Example: does violent video game increase aggressive behavior - could involve hindsight bias
epidemiological methods
- Natural experiments
- Heritability studies
- Meta-analyses
natural experiment
When condition is assigned by nature
1944 (WW2) - Dutch hunger famine study (refused to build railroads under nazi rule) → schizophrenia
Pregnant women, observed the trimesters, those going through this period, the child develops schizophrenia, if mother is famished, could be more likely for child to be schizophrenic
Heritability studies
Used to determine genetic contributions to risk of disorder
-twin, twin-adoption, family studies, adoption
Meta-analyses
- Studies can have individual variability
- Meta-analyses: combines the results of many studies
- Good studies are repeatable
Ethics guidelines:
- Informed consent
- Freedom to withdraw
- Confidentiality
- Do not harm
- Debriefing
Institutional Review Board (IRB):
- Each university, review center will have their own IRB board
- All studies must be submitted and preapproved
- researcher must demonstrate the risk of harm is compelling
