Midterm One Flashcards
What is abnormal?
No clear definition
Something individuals see as not normal
Differs based on culture
What are the 5 elements of abnormality and what do they mean?
Subjective distress: psychological suffering
Maladaptiveness: impairment in important areas of life
Violation of social norms: acting outside of cultural standards
Irrationality or unpredictability: unexpected response to stressors
Dangerousness: Danger to self or others
*No element is sufficient to define and determine abnormality
How do we classify abnormality in the US and Canada?
DSM-5
*Classifies disorders not people
How does the DSM-5 classify mental disorder?
Psychological disorder
Biological, psychological or developmental dysfunction
Problem in behaviour, emotion regulation, or cognitive function
Distress or disability
Why do we classify?
Structure information to:
Comunicate findings
Organize meaningfully
Facilitate research
Define what counts as abnormal
Disadvantages of classification
Social implications (rehabilitation vs confinement)
Stigma (people are treated differently)
Define prevalence
Number of active cases in a given period of time, expressed as a percent
Why do we research?
To avoid misconception and error
Adopt scientific attitude and approach to the study of abnormal behaviour
Distinguish between what’s observable vs hypothetical or inferred
Sources of information (types of research)
Case study
Direct observation
Self-report
Implicit behaviour
What is an observational research design?
Study things as they are
Excellent way to determine correlation
What does experimental research involve?
Manipulation of an independent variable to see if it has an effect on the dependent variable
Can determine causation
What is the case study method?
Uses unique, individual cases to make causal inferences
What is etiology?
the cause of a disease or abnormal condition
What does somatogenic believe?
Originating in, affecting, or acting through the body
Biological basis
Physical (somatic) problem → thoughts and behavior problems → physical treatment
What does psychogenic mean?
Mental illness is due to a psychological malfunction
Psychodynamic
Define paradigm
A viewpoint/set of assumptions about how to understand, study, and treat psychological disorders
The way we look at things and how we interpret them
What are the 5 circles in First Nations Wellness
Self responsibility (human being)
Balance
Respect, wisdom, responsibility, relationships
Land, community, family nations
Social, environmental, cultural, economic
People
Define self responsibility (in regards to First Nations wellness)
The centre, where we take responsibility for ourselves and own wellness
Define balance (in regards to First Nations wellness)
Biopsychosocial
Balance between emotional, physical, spiritual, and mental wellness is necessary
Define respect, wisdom, responsibility, relationships (in regards to First Nations wellness)
Wisdom comes from those who have had a lot of experience
Respect for self and others
Strong community is essential for health and wellness
Relationships with oneself, family, community, land
Define land, community, family, nations (in regards to First Nations wellness)
Land is important in First Nations health
Nourishes, provides and connects
Western society views land as something to own vs share
Define social, environmental, cultural, economic (in regards to First Nations wellness)
Importance of access to food, water, housing
Reciprocal actions
Preserving pieces of culture (e.g., language)
Define people (in regards to First Nations wellness)
All the different people within a community encapsulate the values
What are the 5 circles for the approach to First Nations wellness
Wellness across continuum
Foundation (cultural and traditional healing)
Services appropriate to needs
Integrated services
Local Nation-based approaches
Define wellness across continuum (in regards to First Nations wellness approach)
Enhance conditions that support wellness
Address root causes to ensure all are prioritized
Define foundation (in regards to First Nations wellness approach)
Long heritage of treatment (intergenerational trauma)
Two-eyed seeing
Define services appropriate to needs (in regards to First Nations wellness approach)
Person centered
Looking at relationships
Acknowledge all of society
Define integrated services (in regards to First Nations wellness approach)
Addressing the whole needs
More holistic approach
Define local Nation-based (in regards to First Nations wellness approach)
Increased sense of cultural identity
Sense of belonging is essential
Culture is a premise to health and wellbeing
What are the 5 (*6) major Western paradigms?
Biological (temperament/neurotransmitters)
Psychoanalytical (Freud/Defence mechanisms)
Behavioural/Learning (Classical/Operant conditioning)
Cognitive (Schema)
Humanistic/Existensial
*Social factors
What are the Big 5 dimensions of temperament?
Openness (to new experiences)
Conscientiousness (organized)
Extraversion (higher energy)
Agreeableness (go with the flow)
Neuroticism (negative reactions to things)
What are the 5 main neurotransmitters?
Norepinephrine (NE)
Gamma aminobutyric acid (GABA)
Dopamine (DA)
Serotonin (5-HT)
Glutamate (GLU)
What is the function of Norepinephrine (NE)?
Excitatory, arousal/readiness for action
What is the function of Gamma aminobutyric acid (GABA)?
Inhibitory, behaviour and emotion
What is the function of Dopamine (DA)?
Motivation and reward
What is the function of Serotonin (5-HT)?
Regulates, mood, appetite, sleep, impulse control
What is the function of Glutamate (GLU)?
Excitatory, learning and memory
According to Freudian’s psychoanalytic theory what are the 3 structures of the mind and what are their roles?
Id: pleasure principle, controls basic urges for food, warmth, sex, how you stay alive
Ego: reality principle, how you deal with what you are faced with
Superego: Decides what is right and wrong
What is a defence mechanism?
Unconscious strategies to protect the ego from distress
Define repression
Shut down impulses
Events are pushed out of memory
Define denial
Pretend the event never occurred, although you are still aware of its occurrence
Define projection
Seeing ones own unacceptable qualities in others and disliking them for possessing those qualities
Putting your negative feelings onto someone else
Define displacement
Threatening impulse or desire is redirected onto another target
Taking it out on someone else
Define rationalization
Generating acceptable, logical reasons for outcomes that otherwise would not be acceptable
Define reaction formation
Do the opposite of what you are wanting to do
To stifle an unacceptable impulse, the exact opposite behaviours/desires are displayed
Define regression
Revert back to a way you used to act or something you used to do
Define sublimation
Convert unacceptable desire into acceptable behavior that still helps relieve anxiety
Define classical conditioning
Association of unrelated elements due to repeated pairing
Neutral stimulus → associated with something → reaction occurs
(E.g., dog salivates at bell)
Define operant conditioning
Based on the Law of Effect
Pleasant consequence leads to an increase of behaviour (+/- reinforcement)
Unpleasant consequences leads to a decrease in behaviour (+/- punishment)
What is the difference between +/- reinforcement and +/- punishment
+ Reinforcement: something is added to promote the behaviour
- Reinforcement: something is removed to increase behaviour (alarm clock turns off to promote waking up)
+ Punishment: something is added to decrease behaviour
- Punishment: something is removed to decrease behaviour
What is Mowrer’s two-factor theory?
Fears are acquired by classical conditioning (emotional response to a neutral stimulus) and maintained by operant conditioning (learned avoidance of a previously neutral conditioned stimulus)
What is the cognitive perspective?
Psychological disorders come from cognitive (thinking) errors
We actively interpret situations, imposing meaning through perception, interpretation,
judgment, memory, reasoning
Define schema
Organized network of accumulated knowledge that guides interpretation of events
Collection of the way we see things
What is the humanistic/existential perspective?
Core of human functions is inner, subjective experiences
Emphasis on positive growth, finding a meaning in life, taking responsibility
How do social factors relate to the 5 paradigms?
Poverty, parental stress, minoritized status can all link to psychopathology and lead to issues
How do we combine the paradigms?
The biopsychosocial model is a unified model of psychopathology that includes:
Biological factors
Psychological (cognitive/emotional) factors
Social (and cultural) factors
Looking at the biological and psychological that influences and is influenced by
the social relationships we have: Etiology
Presentation
Treatment
What is the diathesis-stress model?
Diathesis (predisposing cause or underlying vulnerability) + stress (precipitating cause or trigger circumstances) = disorder
What’s the difference between interactive and additive models
Interactive: needs the environment to activate
Additive: can develop, even without the necessary genes (e.g., PTSD)
What are protective factors?
Influence how a person responses and can also lead to resilience (ability to successfully adapt to difficult circumstances)
Explain gene-environment interactions
Genes - inherited tendencies (diathesis) create a vulnerability, not certainty
Environment - tendencies are activated (stressor) can override genes
Most disorders are polygenic
What is the underlying premise of Western treatment?
People can change, not who they are but how they interact
What are the 3 kinds of biological therapies
Psychopharmacology
ECT
TMS
What is psychopharmacology?
Biological therapy
Providing medication (most common method)
Con is people who prescribe are general practitioners
What is ECT?
Biological therapy
Shock therapy
Meant for things like treatment resistant disorder (e.g., depression)
What is TMS?
Biological therapy
Picks a section of the brain and activates or knocks them out
What is psychotherapy?
Type of psychological treatment
A variety of treatments that aim to help a person identify and change troubling emotions, thoughts, and behaviours
Can be evidence based or not evidence based
What is the difference between evidence based and not evidence based psychotherapy?
Evidence based: efficacy studies have found it efficacious
Treatment works to decrease symptoms and is equal or better than comparison groups
Not evidence based: based off experience, still being tested
What neurotransmitter is high in psychosis and what is used to treat it in psychopharmacology?
Dopamine (DA)
Antipsychotics
What neurotransmitter is low in BPD and what is used to treat it in psychopharmacology?
(GABA)
Lithium
What neurotransmitter is low in anxiety and what is used to treat it in psychopharmacology?
(GABA)
Benzodiazephines
What neurotransmitter is low in depression and what is used to treat it in psychopharmacology?
Serotonin (5-HT)
SSRIs
What are the types of evidence based (5) and non evidence based (2) psychotherapies?
Evidence based:
Behavioural
Cognitive
Cognitive-behavioural
Humanistic
Interpersonal therapy
Not evidence based:
Psychoanalysis
Psychodynamic
What is classic Freudian psychoanalysis?
Uses methods like free association, analysis of dreams, transference, resistance
What is transference?
When someone redirects their feelings about one person onto someone else
What is psychoanalytically oriented psychotherapy?
Object relations/attachment theory
What is behaviour therapy?
Believes if you modify behaviour feelings will follow
Examples:
Exposure therapy
Modeling
Reinforcement
Behavioural activation
What does behaviour therapy treat well?
Anxiety disorders, depression
What is cognitive therapy?
Believes thoughts cause feelings and moods which influence behaviour
Examines distorted patterns of thinking and changes behaviour by changing thoughts
What is cognitive behavioural therapy (CBT)?
Puts it all together
Most practiced
Incorporates thoughts and behaviours
What does CBT treat well?
Anxiety, mild-moderate depression, conduct disorder, bulimia
What is the CBT 3 component model?
ABC
Affect (feelings): hard to change
Behaviour (actions)
Cognitions (thoughts): very hard to change
Shaped like a triangle where they all influence each other
What is humanistic therapy?
Client centered
Uses motivational interviewing
Good for building commitment to treatment
What does humanistic therapy treat well?
Difficult to treat behaviours like substance abuse
What is interpersonal therapy?
Eclectic, uses multiple paradigms
Addresses clients relationships to others DBT premise
What does interpersonal therapy treat well?
BPD, depression
What is the relationship between psychotherapy and minoritzed groups?
People in minoritzed groups are:
less studied, use less services and have less access to empirically supported treatments
What is the stress HPA axis?
Hypothalamus releases a hormone
Pituitary gland releases the hormone
Adrenal gland lets out cortisol (stress hormone)
What are some effects of extreme stress?
Can create extensive physical and psychological problems
Increase reactivity in sympathetic nervous system
Decrease efficacy of immune system
Decrease psychological self efficacy
What are the psychosocial contributing factors?
External vs internal
Stressor, crisis, resources
What is PTSD?
Exposure to event threatening death, serious injury, sexual violence through Criterion A (need to have it to be diagnosed): Traumatic Event
Direct experience
Witness others experience
Learning it happened to close family/friends
Repeated/extreme exposure to aversive details of event
What are the 4 symptoms of PTSD?
Intrusion
Avoidance
Negative cognitions and mood
Arousal and reactivity
What is intrusion in relation to PTSD?
Uninvited and out of nowhere
E.g., flashbacks and nightmares
What is avoidance in relation to PTSD?
Avoid specific things associated with the trauma
E.g., outfit, location, person
What is negative cognitions and mood in relation to PTSD?
Detachment
Shame and anger
Disassociation
Distorted blame for self or others
What is arousal and reactivity in relation to PTSD?
Very common
Insomnia
Hypervigilance
Difficulty concentrating
High startle response
What are the most common triggering events?
Combat
Assault
Natural disaster
Torture
What is the difference between PTSD in men and women?
Men experience more traumatic events but women are 2x more likely to experience PTSD
Women are more likely to know the perpetrator for it to be intentional
How does human intent affect PTSD?
Assault is more likely to be intention and less likely to be forgiven making symptoms worse
Accidents are more likely to be reasoned
How does sexual assault influence PTSD?
Most common PTSD in women
Serious psychological problems depends on past coping skill, currently functioning
Disclosing the assault can help lessen the negative reaction and promote growth
How does transgenerational trauma influence PTSD?
Epigenetic make you more likely to carry the gene
Biopsychosocial model of PTSD: Etiology: Bio
Genes account for 1/3 variance in symptom severity (5-HT)
Neurobiological factors
Hyperactive limbic system
Higher NE
Less 5-HT
Biopsychosocial model of PTSD: Etiology: Psycho
Threat related psychology process, more attuned to danger means more likely to see danger
Neuroticism increased likelihood to experience negative emotions
Cognitive ability more IQ increases cognitive flexibility
Biopsychosocial model of PTSD: Etiology: Social
Previous trauma makes you more likely to experience trauma
Uncontrollable/unpredictable events
Social support (more support equals less likely)
Severity of trauma related to perception of trauma
Biopsychosocial model of PTSD: Presentation: Bio
Fear learning, amygdala is more likely to be activated, heighented reactivity
Memory and learning, hippocampus cell death
Stress response, limbic system hyperactivity
Biopsychosocial model of PTSD: Presentation: Psycho
Persistent reexperience (nightmares, flashbacks)
Avoidance and emotional numbing
Increased arousal
Biopsychosocial model of PTSD: Presentation: Social
Avoidance and emotional numbing
Biopsychosocial model of PTSD: Treatment: Bio
Beta blockers
Prophylactic decreases physiological response to prevent by numbing out
SSRIs decrease depression, intrusive thoughts
Biopsychosocial model of PTSD: Treatment: Psycho
CBT (53% effective)
Behavioural:
Prolonged exposure
EMDR talk about the event to see how you process
Cognitive how you make sense of what happened
Prevention:
Advanced preparation
Biopsychosocial model of PTSD: Treatment: Social
Disclosing trauma
Prevention of PTSD
Increased social support
What are some different types of anxiety disorders?
Specific phobias
Social anxiety disorder
Panic disorder
Agoraphobia
Generalized anxiety disorder
What are anxiety disorder commonalities in etiology?
Biological and psychological causes, genes, neuroticism, lack of perceived control
Influence of social factors depend on culture
What are anxiety disorder commonalities in presentation?
Unrealistic, irrational fears
Disabling intensity
What are anxiety disorder commonalities in treatment?
Most effective treatment is typically exposure
What does basic research in anxiety state?
The more predictably and perceived control, the lower anxiety
The less predictably and perceived control, the greater anxiety
Define specific phobia
Strong fear and avoidance of object or situation
Out of proportion to actual danger
Disruptive avoidance
Recognized as unreasonable
Types of specific phobias
Animals
Natural environment
Blood injection injury (BII)
Situational
Biopsychosocial model of Phobia:
Etiology: Bio
Genes speed and strength of conditioning of fear
Behaviourally inhibited (infants more likely to develop phobia younger when less other factors)
Biopsychosocial model of Phobia:
Etiology: Psycho
Prepared learning
If you process an event as traumatic more likely to develop phobia
Traumatic condition of fear
Biopsychosocial model of Phobia:
Etiology: Social
Vicarious learning
Fear immunization (immunization against a potential later fear development)
Biopsychosocial model of Phobia:
Presentation: Bio
Automatic arousal (fight or flight)
Biopsychosocial model of Phobia:
Presentation: Psycho
Heightened vigilance/attention to feared object or situation
Negative mood
Low sense of efficacy
Diminished internal focus of control
Biopsychosocial model of Phobia:
Presentation: Social
Avoidance of situation eliciting anxiety
Prevents learning new associations
Biopsychosocial model of Phobia:
Treatment: Bio
SSRIs
Benzodiazepines (super addictive, create biological avoidance)
Generally not helpful
Biopsychosocial model of Phobia:
Treatment: Psycho
Behaviour therapy
Habituation
Systematic desensitization
