PSYC 102 Midterm 2 Flashcards

Question

4 Dissociative Disorders

Answer 1

**Dissociative Fugue**: sudden unexpected travel far from home or workplace, loses memories of entire lives & sense of personal identity **Dissociative Identity Disorder (DID)**: coexistence in 1 person 2+ largely complete, usually very different personalities, with own name, memories, traits & physical mannerisms, extremely controversial & fad induced F>M, 1-4500 alters, physiological differences **Dissociative Amnesia**: sudden loss of memory for important personal info to extensive to be due to normal forgetting (ex. Memory loss of traumatic events) Controversy: nontraumatic events have memory gaps, traumatized not motivated to recall upsetting events, other factors can explain in studies **Depersonalization Disorder**: feeling detached from self, watching oneself form outside of one’s body Experience multiple episodes of depersonalization, derealization, or both Derealization, the sense that the external world is strange or unreal, often accompanies both depersonalization and panic attacks

Answer 2

No conclusive evidence of existence, cause a response to early trauma (posttraumatic model) > compartmentalize identity to cope with intense emotional pain, or is it a consequence of social and cultural factors (sociocognitive model) popular media, therapists, shaped by societal shifts

Answer 3

Least reliably diagnosed, usually comorbid with each other & other mental disorders, only a few extensively systematically reviewed **DSM**: condition in which personality traits, appearing first in adolescence, are inflexible, stable, expressed in a wide variety of situations & lead to distress or impairment Abnormal behavior depends on context **Antisocial Personality Disorder**: physically & verbally abusive, destructive, frequently in trouble with the law, lack empathy & remorse, reckless & impulsive **Borderline Personality Disorder**: intense extremes b/w positive & negative emotions, unstable sense of self, impulsivity & difficult social relationships * **Self-Destructive Quality:** drug abuse, overeating, self-mutilation, manipulation, jump between unhealthy relationships. * **Who**: 2% F>M **Psychopathic Personality (not formal or in DSM)**: superficial charm, dishonesty, manipulativeness, self-centredness & risk taking * **Who Sick**: M>F, seek out people with this as friends or lovers, aren’t physically aggressive, higher risk for crime, aren’t psychotic but entirely rational, know actions are morally wrong just don’t care, populate jails, leadership positions * **Causes**: correlation with deficit in fear, aren’t motivated to learn from punishment, underaroused seek out excitement when bored **Antisocial Personality Disorder**: lengthy history of irresponsible and/or illegal actions

Answer 4

**Childhood**: Problems developing sense of self & bonding emotionally to others in childhood (ex. Cold unempathetic mother > can’t integrate difference perceptions of people+themselves, Tend to split people+experiences into all good or all bad > unstable experience) **Sociobiological Model**: heritable tendency to overreact to stress, lifelong difficulties regulating emotions **Emotional Cascade Model**: intense rumination about negative/emotional events may result in uncontrolled self-injurious actions, succeed in providing brief distraction, often fuel further bouts of rumination, creating a vicious cycle of problems with regulating emotions

Answer 5

Legal system assumes actions are freely chosen, scientific psychology assumes actions are determined by prior variables genetics + learning **Insanity/Mental Disorder Defense:** used in courts of law, not psychologists, that an individual shouldn’t be held criminally responsible if they were not in their “right mind” (in Canada mental disorder) during the time of the crime, for those who lack free will * **M’Naghten Rule: **insanity exists when person with mental disorder can’t tell right from wrong at time of crime or what they were doing at the time * **Outcomes:** absolute discharge, conditional discharge, ordered to a mental institution **Automatism**: one shouldn’t be held responsible if they had no control over their behavior (sleep walking, sustained physical blows, carbon monoxide poisoning, seizures) **Unfit to Stand Trial:** because of mental disorder, defendant is incapable to communicate with lawyers, understand the legal proceedings or their consequences **Involuntary Commitment**: placing some people with mental illnesses in a psychiatric hospital or other facility based on their potential danger to themselves or others, or their inability to care for themselves only formally approved by a judge, 2 psychiatrist or other physicians can place an emergency hold on patients for a brief period of time, patient is legally entitled to a judicial hearing after (impedes on civil liberties, can be misdiagnosed)

Answer 6

1. Determination of qualifying for the mental disorder defense rests on a determination of a person's mental state at the time of the crime, no current. 2. Competence to stand trial bears on the defendant’s ability to assist in their own defense 3. 1% of criminal trials, ¼ successful, usually delivered by judges not juries, juries aren’t fooled 4. Acquitte spends close to 3 years in psych hospital, often longer than the length of criminal sentence, don’t go free 5. Faking mental disorder appear low

Answer 7

Stereotypical negative attitudes against people who have a mental illness label (devastation of being invisible, shameful, toxic makes situation unbearable). Prevent people from seeking help, labels, stigmatizes.

Answer 8

1. **Self-Stigma (Internalized)**: negative feelings about self, maladaptive behavior, identity transformation, or stereotype endorsement resulting from an individual’s experiences, perceptions or anticipation of negative social reactions on the basis of their mental illness * **Perceived Stigma**: individual’s beliefs about the attitudes of others to mental illness * **Reduce**: (1)interventions that alter stigmatizing attitudes & beliefs (ex. Cognitive Behavioral Therapy), (2)improve skills for coping/improving/empowerment/help-seeking behavior 2. **Social Stigma (Public):** social groups endorsing stereotypes about & acting against a stigmatized group, can lead to self-stigma * **Reduce**: educate & dispel myths, increased contact with those living with mental illness 3. **Structural Stigma**: policies & practices of institutions in positions of power, systematically restrict the rights & opportunities for people living with mental illnesses * **Reduce**: contact-based training & education programs for medical students, police, counselors, etc.

Answer 9

**Evolutionary Theories**: naturally selected programs designed for disgust/avoidance of contamination from individuals & anger/punishment others who don’t reciprocate socially who display low social capital **Social Psychological Theories:** individuals with mental illness prone to be categorized into on out-group, stigmatizing outgroup member provides a boost to self esteem of those in in-group **Terror Management Theory:** thoughts of disorder & demise prime, inspires defensive & stigmatizing responses (how could that be me) **Perceptions of Dangerousness**: media portrayals of individuals with mental illness emphasize a high potential for violence

Answer 10

**Psychoanalysis**: first forms of psychotherapy, make the unconscious conscious by bringing to awareness previously repressed impulses, conflicts & memories, recovery of unconscious conflicts, motives & defenses through techniques of free association, transference, dream interpretation, Freud emphasized sexuality & aggression as roots of internal conflict that results in abnormal thoughts & behaviors * Conscious: contains thoughts, feelings, images presently aware * Preconscious: contains info you’re not presently thinking about, can be easily retrieved * Unconscious: part of mind holding thoughts & memories about which person is unaware revealed via slips of tongue, dreams, psychoanalysis **Crits**: understanding/insight on emotional history is not required to relieve psychological distress, to improve, one must practice new adaptive behaviors to engage in working through, difficult to falsify interpretations/transference/reaction, based on small samples unclear external validity non-systematic unreplicable uncontrolled * Repressed Memories: unsettling events are usually more memorable, not repressed. * Effectiveness: better than no treatment, less effective than CBT-don’t emphasize insight, not effective for psychotic disorders

Answer 11

Causes of abnormal behaviors, including unconscious conflicts, wishes, and impulses, stem from traumatic or other adverse childhood experiences Strive to analyze (a) distressing thoughts and feelings that clients avoid, (b) wishes and fantasies, (c) recurring themes and life patterns, (d) significant past events, and (e) the therapeutic relationship Clients achieve insight into previously unconscious material, the causes and the significance of symptoms will become evident, often causing symptoms to disappear

Answer 12

1. **Free Association**: clients spontaneously express their thoughts & feelings exactly as they occur, with as little censorship as possible, analyst studies free associations for clues about what is going on in the client’s unconsciousness 2. **Dream Analysis**: clients encouraged & trained to remember dreams, therapist interprets symbolic meaning of them 3. **Interpretation**: therapist attempts to explain the inner significance of the client’s thoughts, feelings, memories & behaviors. Analysts don’t analyze everything, look for patterns & don’t typically provide dramatic revelations 4. **Resistance**: treatment brings up unconscious material that the client wishes to avoid, engaging in strategies for keeping the info out of conscious awareness (ex. Skipping sessions, draw blank), analysts make clients aware they’re unconsciously blocking efforts, how & what they’re resisting 5. **Transference**: clients direct emotional experiences/feelings/expectations that they’re reliving toward the therapist, rather than OG person involved in experience. Provides a vehicle for clients to understand irrational demands of others as we indeed react to people in present lives in ways similar to people in our past 6. **Working Through**: final stage, therapist helps client resolve issue(s) uncovered in therapy. Repeatedly address conflicts and resistance to achieving healthy behavioral patterns and help clients confront old and ineffective coping responses as they re-emerge in everyday life

Answer 13

**Humanistic Therapies:** emphasizes development of human potential & the belief that human nature is basically positive, reject psychoanalysis, assuming responsibility for decisions, not attributing them to the past, living fully, finding meaning in the present. * **Effectiveness**: can be falsified, strong alliance is helpful to success. 3 core aspects aren’t necessary and sufficient for improvement. Self help programs exist. Improvement than strong bond, the reverse. **Person (Client) Centered Therapy:** emphasizes providing supportive emotional climate for clients, who play a major role in determining the pace & direction of therapy, not to be clever guide client nondirective * Realize don’t always have to please others/win acceptance * Respect own feelings & values * Restructure self-concept to correspond better with reality * Ultimately foster self-acceptance & personal growth * Focus on the therapeutic alliance: emotional bond b/w therapist & client, along with agreement on goals & tasks of therapy Effectiveness: studies show it is no more effective than no treatment or comparable to CBT: studies show it is no more effective than no treatment or comparable to CBT

Answer 14

**Genuine Acceptance**: therapist should be honest & spontaneous, not phony or defensive, authentic, genuine, reveal own reactions **Unconditional Positive Regard**: therapist shows complete non-judgemental acceptance of the client as a person **Empathy**: therapist must provide accurate empathy for the person by way of reflection-mirroring back feelings

Answer 15

**Family Therapy:** systems approach, requires willing members * Focus on dynamics, interactions & communication often used to help families deal with specific members who are highly dysfunctional (ex. Addictions, poor emotional control, schizophrenia/bipolar) * Help family know how to react, to not perpetuate behavior by isolating, accepting blame * Identify the family’s unhealthy communication patterns and its unsuccessful approaches to problem solving. Then, they invite family members to carry out planned tasks known as directives-shift how family members solve problems and interact. They often involve paradoxical requests, which many of us associate with the concept of “reverse psychology. Success when resistant uncooperative unit to intentionally produce thought, feeling or behavior that troubled them * **Strategic Family Intervention**: remove barriers to effective communication * **Structural Family Therapy**: therapist actively immerses themself in the everyday activities of the family to make changes in how they arrange and organize interactions **Effective**: more than none, as effective as individual

Answer 16

**Group Therapy**: share personal stories & experiences, bonding & support occurs 4-15 (8 ideal) with similar psychological problem, age, sex, less costly, efficient, time saving, as effective as individual treatments **Therapist’s Role:** selecting participants, setting session goals & guidelines, initiate & maintain the therapeutic process, protect clients from harm, promote cohesiveness **Client’s Role**: function as therapists for each other, describe problems, share coping strategies & trade viewpoints, provide acceptance & emotional support **Alcoholics Anonymous (AA)**: self-help program based on 12 steps that provides social support for achieving sobriety, sponsored/mentored by senior members, assumes alcoholism is a physical disease, never drink after entering treatment, no clear research on it treatment programs that encourage people with alcoholism to set limits, drink moderately, and reinforce their progress, teaching coping/tolerance skills can be effective * **Abstinence Violation**: a slip can lead to continued drinking, thus removing stigma is imperative

Answer 17

**Behavioral Therapy**: all behaviors are learned and that behaviors can be changed. This form of therapy looks to identify and help change potentially self-destructive or unhealthy behaviors, current not history.

Answer 18

**Systematic Desensitization**: used for treating phobias, classical conditioning taught to relax as they are gradually exposed to what they fear in a stepwise manner, earliest exposure therapy, counterconditioning pairing incompatible * **Reciprocal Inhibition**: can’t experience 2 conflicting responses simultaneously (ex. Relaxed & anxious at the same time) * **Anxiety Hierarchy**: identifying & imagining situations that climbs from least to most anxiety provoking, any anxiety at any point, process is intterupted & help return relax * **Effectiveness**: measured using dismantling-examining effectiveness of isolated components of broader treatment, no single component of desensitization is essential can be variety of approaches, may fare no better than placebo **Flooding therapists** jump right to the top of the anxiety hierarchy and expose clients to images of the stimuli they fear the most for prolonged periods, often for an hour or even several hours. Provokes anxiety repeatedly in the absence of actual negative consequences so that extinction of the fear can proceed **Token Economy: **certain behaviors rewarded with tokens later exchanged for tangible rewards, crits: don’t generalize, impractical, **Aversion Therapy**: punishment to decrease the frequency of undesirable behaviours crits: mixed, ethicality must be considered

Answer 19

**Modeling in Therapy**: observing therapists that model positive behaviors, treating (although not curing) schizophrenia, autism, depression, attention-deficit/hyperactivity disorder (ADHD), and social anxiety **Participant Modeling**: therapist models a calm encounter with the client’s feared object or situation, and then guides the client through the steps of the encounter until they can cope unassisted **Assertion Training**: therapists teach clients to avoid extreme reactions to others’ unreasonable demands, such as submissiveness on the one hand and aggressiveness on the other hand. Assertiveness, the middle ground between these extremes, is the goal. **Behavioral Rehearsal:** client engages in role-playing with a therapist to learn and practise new skills, offered coaching, feedback, encouraged to practice skills outside

Answer 20

**Cognitive Behavioral Therapy:** varied combinations of verbal interventions & behavior modification techniques to help change maladaptive patterns of thinking, no history, all current, considers all aspects of client (gender, race, socioeconomic, culture, sexual orientation), evaluates effectiveness throughout therapy, apply new coping skills **3 Core Assumptions**: (a) Cognitions are identifiable and measurable; (b) cognitions are the key players in both healthy and unhealthy psychological functioning; and (c) irrational beliefs or catastrophic thinking, such as “I’m worthless and will never succeed at anything,” can be replaced by more rational and adaptive cognitions **Therapist’s Role**: help clients become more aware of the thought, emotion, & behavior patterns that arise in their current lives, behavioral change results from the operation of basic principles of learning, especially classical conditioning, operant conditioning, and observational learning **Client’s Role**: learn to identify their habitual dysfunctional tendencies (ex. Journals, diaries, schedules), then work on building more functional cognitive & behavioral habits **1st Wave** - Behavioral Component: clients given exercises, guidance, practice in gaining skills they may be lacking, techniques including: * **Systematic monitoring** of one’s behaviors, modeling, behavioral rehearsal **2nd Wave** - Cognitive Component: clients given exercises & strats to track negative thoughts then build more functional cognitive habits * **Cognitive Restructuring**: challenge negative thought patterns, question self-defeating beliefs, view situations in a different light **3rd Wave**: assist clients with accepting all aspects of their experience that they’ve avoided or suppressed, eclectic-integrate many techniques+theories, behavioral activation-participation in reinforcing activities **Effectiveness**: * They’re more effective than no treatment or placebo treatment * They’re at least as effective and in some cases more effective than psychodynamic and person-centred therapies, as drug therapies for depression. * In general, CBT and behavioral treatments are about equally effective for most problems.

Answer 21

**Rational Emotive Behavioral Therapy:** assumes unhealthy people frequently engage in catastrophic thinking about their problems, therapists encourage clients to actively dispute (D) their irrational beliefs and adopt more effective (E) and rational beliefs to increase adaptive responses **Beck’s Cognitive Therapy:** emphasizes identifying and modifying distorted thoughts and long-held negative core beliefs **Stress Inoculation Training (Vaccine):** “inoculate” clients against an upcoming stressor by getting them to anticipate it and develop cognitive skills to minimize its harm

Answer 22

1. **Spontaneous Remission**: common many phys/psych disorders get better without treatment thus must be compared to untreated/waitlisted patients 2. **Placebo Effect**: improvement due to the mere expectation of improvement 3. **Regression to the Mean**: extreme scores tend to become less extreme with retesting. In cases of rock bottom, only improvement to the mean is possible, misinterpret the treatment as effective 4. **Self-Serving Biases**: investment of time & money persuades that treatment is effective, overweighs evidence of efficacy while downplaying evidence of treatment failure 5. **Retrospective Rewriting** of the Past: expectations of treatment efficacy color one’s memory, misremembering previous symptoms as worse than they actually were

Answer 23

* Severity of depression, more severe more effective * Researchers may have financial or ideological interests * Underlying unsolvable socio-cultural-economic factors * Meta-analysis reveals psychotherapy works in alleviating human suffering * Socioeconomic status, gender, race, ethnicity, and age typically have little or no bearing on the outcome of therapy * Nonspecific Factors: cut across many/most therapies are responsible for improvement across diverse treatments, motivation to change, key ingredients (empathy, hope, strong emotional bond, social skills, offer new ways of thinking) * Scientist-Practitioner Gap: b/w psychologists who view it as an art vs as scientific, ranking therapies is unreliable as they are subjective in nature, some are understudies

Answer 24

Critics charge that psychologists don’t possess sufficient knowledge of the anatomy and physiology of the human body to adequately evaluate the intended effects and side effects of medications, one dose doesn’t fit all, harmful & overprescribed, concern of polypharmacy-prescribing many medications, are of little value in helping patients learn social skills, modify self-defeating behaviors, or cope with conflict

Answer 25

**Monoamine Oxidase Inhibitors (MAOIs)**: inhibits degrading enzymes, increases concentrations of monoamine NTs, many side effects “Cheese effect”, breaks down tyramine → surges of blood pressure that can lead to stroke for those who eat tyramine-rich foods **Tricyclic Antidepressants:** blocks reuptake of serotonin & norepinephrine, safer than MOAIs **Selective Monoamine Reuptake Inhibitors (SSRIs)**: most well known used, overprescribed for other “disorders” with side effects worse than condition (self-esteem, fear of failure, excessive sensitivity to criticism) Weight gain, sexual dysfunction or loss of interest **Atypical Antidepressants**: heterogenous group of antidepressants with own unique actions Bupropion: increasingly popular, favorable side effect profile, inhibitor of dopamine & norepinephrine reuptake

Answer 26

**Cognitive-Behavioral Therapy (CBT):** effective for mild-moderate depressions, combined with pharma for severe depression as only more effective than placebo by itself. No effects on remission (returning to normal social functioning), suicidality or quality of life **Sleep Deprivation**: brief improvement in 60%, REM deprivation produce more enduring effects, more effective in combo with antidepressants and/or light therapy **Electroconvulsive Therapy (ECT):** electric currents pass through brain, triggering a brief seizure & changes in brain chemistry as last resort for severe or treatment resistant depression, bipolar, schizophrenia, severe catatonia Not dangerous, patients happy to have received would receive again, less frightening, improvement rates high, isn’t a cure relapses, increases levels of serotonin, stimulates growth of hippocampus, not just placebo Short term confusion, clouded memory, weigh benefit vs cost **Repetitive Transcranial Magnetic Stimulation** (rTMS): large electromagnetic coil placed against scalp near the forehead, creates electric currents that stimulate nerve cells in regions involved in mood control & depression, few if any side effects **Exercise**: high intensity aerobic or anaerobic forms as effective as pharma (although quicker) or psych therapies, have longer lasting effects **Psychosurgery**: last resort for those with handful of conditions, radical, controversial, costs of impairing basic function+death outweighs benefits, historically punitive, precision improved, REB ensures ethics

Answer 27

**Cyclothymia** : chronic less severe form of bipolar disorder, mood alternate b/w hypomanic & depressive symptoms over 2 years, no evidence of mania, hypomania or major depression during this time, increases risk of developing bipolar disorder **Who Sick:** 1% F=M, strong tendency to run in families, onset 18-22 **Comorbidities**: anxiety, substance use, migraine headaches, cardiovascular disease **Mood Patterns**: mixed episode higher rates of suicide as high energy depressed state Rapid Cycle: 4+ mood changes/cycles in a year

Answer 28

**Genetics**: Most genetically influenced of all mental disorders, 85% heritability from twin studies. Increased sensitivity of dopamine receptors, decreased serotonin boosts risk of bipolar disorder. **Brain Structures:** Increased activity in emotion centers, less in planning **Stressful or Positive Life Events**

Answer 29

**Who Sick**: onset 15-24, “Common cold of psych disorders, increasing” Women 10-25%> Men 5-12% will experience clinical depression at least once in their lives, theories * Gender-related differences in physiology * Sociocultural norms, men are generally more reluctant to seek treatment; and they’re more likely to regard depression as a weakness * Alcoholism, higher incidence in men, might mask depression or self medication * Gender-specific social factors & traumas **Major Risks:** completed suicide in 8-15% with major depressive disorder, greater physical illnesses & decreased physical & social functioning, recurrent/chronic avg 5-6 times in a lifetime 6-12months

Answer 30

**Medical Students’ Disease**: condition where med students believe they’re experiencing the symptoms of a disease that they’re studying **Postpartum Depression:** A depressive episode that occurs within a month after childbirth in up to 15 percent of mothers Postpartum Psychosis: command hallucinations to kill the infant or delusions that the infant is possessed by an evil spirit **Premenstrual Dysphoric Disorder**: Occurs in females during the final week before the onset of menses, with marked mood swings, irritability, anger, and anxiety **Persistent Depressive Disorder:** Low-level depression of at least two years’ duration; feelings of inadequacy, sadness, low energy, poor appetite, decreased pleasure and productivity, and hopelessness

Answer 31

(1)distinguishes a particular diagnosis from other similar diagnoses, (2)predicts performance on lab tests (3)family history of psychiatric disorders (4)what happens to the individual overtime (5)response to treatment

Answer 32

**Motivational Interviewing**: one- to two-session procedure recognizes that many clients are ambivalent about changing long-standing behaviors and is geared toward clarifying and bringing forth their reasons for changing—and not changing—their live (exercise, diet, alcohol problems) **Gestalt Therapy (2 Chair):** integrate different & sometimes opposing aspects of personality into a unified sense of self, key to personal growth is accepting responsibility for one’s feelings and maintaining contact with the here and now. 2 Chair Technique: client moves chair to chair, dialogue b/w conflicting aspects of personality for synthesis of both

Answer 33

Affection is conditional - need to feel worthy distort shortcomings - incogruent self concept - recurrent anxiety - defnesive beahvior protects self-concept - incongruent self concept - loop

Answer 34

1. Insight Therapies: psychodynamic 2. Humanistic Therapies: Person Centered Therapy 3. Family Therapy 4. Group Therapy 5. Cyber Therapy 6. Behavioral Therapy: focuses on the present and the client's current behavior, Behavioural therapy is grounded in the scientific method and based on learning principles. 7. Cognitive Behavioral Therapy: addresses past experiences and how they contribute to current behavior, modify irrational and negative beliefs and distorted thoughts that contribute to unhealthy feelings and behaviours

Answer 35

* **behavioural, psychodynamic, and person-centred** approaches have found that all are more successful in helping clients compared with no treatment but no different from each other in their effects * **behavioural and cognitive-behavioural treatments** are clearly more effective than other treatments for children and adolescents with behavioural problems + consistently outperform most other therapies for anxiety disorders, including phobias, panic disorder, and obsessive–compulsive disorder * 5 to 10 percent, become worse following **psychotherapy**