psych 239 midterm 1 Flashcards
what is abnormal psychology
abnormal psychology is the branch of the science of psychology that addresses the description, causes, and treatment of abnormal behavior pattern
how do we define abnormal behavior
- is the behavior UNUSUAL
- Does the behavior VIOLATE SOCIAL NORMS
- does the behavior involves a FAULTY INTERPRETATION OF REALITY.
- does the behavior cause PERSONAL DISTRESS
- is the behavior maladaptive (does it cause problems)
- Is the behavior DANGEROUS to the person or to others
What gauges our perception of what is abnormal
- cultures: what is viewed as abnormal can be seen as normal in other behavior. Also we should be aware how different culture experiences states of emotional distress (depression and anxiety). Ex: those under the influence of God are positively viewed in India but can be viewed as abnormal in North America. If there is a failure to recognize culture difference, then there will be failure to treat and diagnose the abnormal behavior
- context: what is normal in one context, can be abnormal in another context
what is another word for abnormal behavior pattern
Abnormal behavior pattern can be classified as psychological disorder if it affect the psychological functioning/behavior of the behavior
how percent of Canadian will suffer from a psychological disorder
20% of Canadians will suffer from a
psychological disorder in their lifetime
how many percent of adults will be affected with anxiety disorder in their lifetimes
Affects almost 30% of adults in their lifetime
how many percent of adults will be affected with mood disorder in their lifetimes
affects over 20% of adults in their lifetime
how many percent of adults will be affected by substance abuse disorder in their lifetimes
affects over 20% of adults in their lifetime
how many percent of adult will be affected by any other disorder in their lifetimes
affects over 46% of adults in their lifetime
WHAT ARE THE MAIN RISK FACTORS FOR
DEVELOPING A PSYCHOLOGICAL DISORDER?
- age. People can be more or less prone to developing psychological disorders depending on their age
- education.Education tend to be a protective factor against psychological disorder as people who stay to pursue their education tend to have high internal states to pursue their help when needed
- Childhood traumas
- Current stress
- Life events
- Lack of social
supports - Gender. Some conditions affect more gender than others
- Physical health
- Genetic
Predisposition. genetic predisposition is a important factor in developing a psychological disorder
WHAT ARE THE RISK FACTORS FOR DEVELOPING A PSYCHOLOGICAL DISORDER?
- the exposure to multiple risks increases the likelihood
- exposure to two risk factors increase four times fold
- exposure to four risk factors increases tenfold
in the medieval times, what were the treatment of abnormal behavior
the doctrine of possession held that abnormal behavior were a sign of possession by evil spirits or the devil. Exorcists were employed to persuade evil spirits that the bodies of individuals were uninhabitable
how was abnormal behavior seen as witchcraft
Priest compiled a manual for witch hunting called the Malleus Maleficarum to help identify suspected witches
then later they were seen as witchcraft. the malleus maleficarum were going around to diagnose witchcraft
what is the demonological model
the view that abnormal behavior reflects invasion by evil spirit or demons. Trephining is a method to remove the evil spirit or demon by drilling a hole in their head
what is the origin of the medical model: an “ill humour”
since not all ancient greeks believed in the demonological model. the seeds of naturalistic explanation of abnormal behavior were sown by hippocrates and galen. hippocrates challenged the belief that illness of the body and mind were the result of natural causes not by the possession of supernatural spirits
he foreshadowed the development of the modern medical model, the view that Abnormal behavior results from underlying biological processes
what did Hippocrates believed the health of the body and mind depend on
he believed the health of the body and mind depended depended on the balance of humours. humours are four fluid I the body which are phlegm, black bile, blood, and yellow bile. the imbalance of humours caused abnormal behavior
what is phlegmatic
it is slow and stolid.
a lethargic or sluggish person was believed to have an excess of phlegm
what is melancholia
states of severe depression. an overabundance of an excess of black bile was believed to cause depression or melancholia
what is sanguine
cheerful
an excess of blood created a sanguine disposition: cheerful, confident and optimistic
what is choleric
having or showing much temper
an excess of yellow bile made people “bilious” and choleric (quick-tempered)
what happens in asylums in Europe and new world
the first asylums in north America was the Hotel Dieu in Quebec city. it was founded in 1639 by the duchesses d’Aiguillon to care for people with psychological disorder and intellectual disabilities, poor, the destitturand the physically disabled. outside Quebec, people in the asylums were treated poorly
what is the reform movement:reform therapy
The reform movement: moral theory was meant to discourage immoral practice in the asylum. They did this with the mentality that if the asylum patients were treated better than there will be an improvement in their condition
however the treatment took a step back in Canada by returning back to their improper method of treating mental health patients. As the Mental institutions move to custodial care
what is the community mental health movement I Canada
provides advocacy, programs and resources that help to prevent mental health problems and illnesses. Pharmacology and phenothiazines were to treat the psychosis such as violated, agitated, illusions and more
what is phenothiazines
it is a group of antipsychotic drugs that helped suppress the most flagrant behavior patterns associated with schizophrenia. they began experimenting with chlorpromazine, a dug that was being used in conjunction with Anaesthesia for surgery. it had soothing qualities and potential worth aas treatment for psychotic symptoms. chlorpromazine was used to treat schizophrenia. it reduced the need for indefinite hospital stay and permitted many people with schizophrenia to be discharged to less restrictive home. this was a crucial moment in the mental health care system in canada
what did the policy of deinstitutionalization
it was based on the belief that psychiatric patient would benefit from the opportunity to lead more independent and fulfilling lives in the community while relying on general hospital for short term care during episode of illness
the textbook definition: practice of discharging large number of hospitalized mental patients of the community and reducing the need for new admission through the development of alternative treatment approaches such as halfway houses and crisis intervention services
who is Dr Ruth Kajander
Dr Ruth Kajander is a noticeable individual in the antipsychotic medication as she used medicine (chlorpromazine) to treat schizophrenia
what is medical model
Emil Kraepelin was involved in dementia praecox, he discovered it as a form of psychosis. today it is known as schizophrenia, he is considered as a biological illness
the medical model is a major advance over Demonology
what is the psychological model
Charcot was involved in hypnosis and hysteria. to study hysteria, he used hypnosis to treat and study his patients with hysteria . The patient with hysteria had physical symptoms such as paralysis or numbness that cannot be explained by any underlying physical causes
Freud was involved in the psychodynamic model, the model shows abnormal behavior lies in the interplay of forces within the unconscious mind
Freud conceptualized the term “catharsis” as an emotional release of paralyzing affects associated with negative, traumatic memories.
what is the SOCIOCULTURAL model
sociocultural model: Thomas szasz: the myth of mental illness
the SOCIOCULTURAL therapist believe that to better understand the root of abnormal behavior we must consider the broader social context in which behavior occur. they believe the cause of abnormal behavior may be found in the failure of society rather than the person such as poverty, lack of economic opportunity
according to Thomas szasz, mental illness is a myth. he believed mental illness is a problem in living
what is the biological perspective on abnormal behavior
depression and schizophrenia is a result of neuronal communication. in depression, we want to increase the amount of serotonin by reducing the uptake of serotonin
One can adopt a biologically oriented
perspective without using the terminology of the
medical model.
what is genome
All the genetic material encoded in DNA
what is DNA
The molecular structure of the genome comprised
of four organic compounds
A: adenine
T: thymine
C: cytosine
G: guanine
what are the stats about human genome
genome: all of the genetic material encoded in DNA. there are 2.8 billion pairs with 20-25 thousand genes
what parts of neurons
- soma
- Dendrites
- axon
- axon
- terminal
- knobs
how is neural impulse transmitted across the synapse
neurons transmit message neural impulses across synapse, which consist of the axon terminal of the transmitting neurons; the gap or synaptic cleft, between the neurons and the Dendrites of the receiving neurons. the message consists of neurotransmitters that are released by synaptic vesicles (sacs) into the synaptic cleft and taken up by receptor sites on the receiving neurons. finally neurotransmitter are broken down and reabsorbed by the axon terminal to be recycled
what neurotransmitter plays a role in psychological disorder
- Excesses and deficiencies of the
neurotransmitter norepinephrine have been
connected with mood disorders and eating
disorders - Reduced levels of neurotransmitter
acetylcholine is associated with Alzheimer’s
Disease - Excessive levels of neurotransmitter dopamine appear to be involved in schizophrenia
- Serotonin, another neurotransmitter, is linked to
anxiety disorders, mood disorders, sleep
disorders and eating disorders
what is Psychodynamic Models
the psychodynamic models is called psychoanalytic model which is based on the belief that psychological problems are derived from unconsciousness psychological conflicts , which can be traced to childhood. Freud held that meud of our behavior is driven by unconcious motives and conflicts of which we are unaware, these underlying conflict revolve around primitive sexual and aggressive instinct or drives and the need to keep these primitive impulses out of direct awareness. since awareness of these primitive impulses including murderous urges and incestuous impulses would flood the conscious self with crippling anxiety
what is the structure of mind
Freud believes the mind is like an iceberg. freud believe the largest part of the mid, which includes our deepest wishes, fears,and instinctual urges remains below the surface of consciousness.
conscious: our present awareness
preconscious: beneath the surface of awareness. the memories of experiences can be found that are not in awareness but can be brought into awareness with focus
unconscious: beneath the surface of awareness. the largest part of the mind. Freud believed the unconcious is the repository of biological drives or instinct such as sex and aggression
what is the structure of personality
according to Freud, the personality is divided into three mental entities or psychic structure which are id, ego, and superego
what is id
it is the psychic structure present at birth. it is the repository of our baser drives and instinctual impulses including hunger, thrist, sex and aggression. operates completely in the unconscious and was described by Freud as chaos. the id follows the pleasure principles as it demands instant gratification of instinct without consideration of social rules or customs or the needs of others. it operates primary process thinking, the primary process thinking is the mode of relating to the world through imagination and fantasy. this enables the id to achieve gratification by conjuring up a mental image of the object of desire
what is ego
ego is developed during the first year of life to organize reasonable way of coping with frustration in the delay of gratification. ego seeks to curbs the demands of the id and to direct behavior in keeping with social customs and expectation. gratification can be achieved but not at the expense of social disapproval. the ego is governed by the reality principle, it considers what is practical and possible as well as the urging of the id. the ego engages in secondary process thinking, which is the remembering, planning and weighing of circumstance that permit a compromise between the fantasies of the id and the realities of the world outside. the go lays the groundwork for the development of the conscious senses of the self
what is superego
during the middle childhood, the superego developed. the moral standard and values of parents and other key people become internalized through a process of identification. the superego operates according to the moral principles, it demands strict adherence to moral standard. the superego represents the moral values of an ideal self called the eo ideal. it also serves as a conscience or internal moral guardian that monitors the ego and passes judgement on right and wrong. it distributes out punishment in the form of guilt and shame when it finds the ego has failed to adhere to the superego’s moral standard
what is structural hypothesis
in Freud theory, the belief that the clashing forces within the personality could be divided into three psychic structure, the id,the ego, and the superego
what are the stages of Psychosexual development
- oral stages: babies use their mouth to analyze the world. oral fixation is caused by unmet oral needs causing smoking, nail biting and more in adulthood
- anal stages: retentive & expulsive traits: The Anal retentive personality is stingy, with a compulsive seeking of order and tidiness. The person is generally stubborn and a perfectionist. The Anal expulsive personality is an opposite of the Anal retentive personality, and has a lack of self control, being generally messy and careless.
- phallic stages: Oedipus/electra complex. The Oedipus complex is a Freudian term that wasnamed after a man that unknowingly killed his father and slept with his mother. Freud said that a boy develops an unconscious infatuation towards his mother, and simultaneously fears his father to be a rival. This happens at an unconscious level. The Electra complex, whose name was inspired by a Greek myth, refers toa young girl’s attraction to the parent of the opposite sex during thephallic stage. At that time of psychosexual development, the daughter develops a sense of competition with her mother. Castration anxiety is a psychoanalytic concept introduced by Sigmund Freud to describea boy’s fear of loss of or damage to the genital organ as punishment for incestuous wishes toward the mother and murderous fantasies toward the rival father.
- latency stages: The latent period is a time of exploration in which the sexual energy is repressed or dormant. This energy is still present, but it is sublimated into other areas such as intellectual pursuits and social interactions. This stage is important in the development of social and communication skills and self-confidence.Fixation at this stage can result in immaturity and an inability to form fulfilling relationships as an adult.
- genital stages: The genital stage appears when the sexual and aggressive drives have returned. The source of sexual pleasure expands outside of the mother and father. If during the phallic stage, the child was unconsciously attracted to the same-sex parent, then homosexual relationships can occur during this stage.
what did Freud believe is the difference between normal and abnormal
Freud believed there is a thine line between normal and abnormal. both normal and abnormal behavior are motivated or driven by irrational drives of the id. the difference may be largely a matter of degree. normality is a matter of the balance of energy among the psychic structures of if, ego, superego. in normal people, the ego has the strength to control the instinct of the id and to withstand the condemnation of the superego.
what is defense mechanisms
in psychodynamic theory, the reality-distorting strategies used by the ego to shield itself from conscious awareness of anxiety-evoking or troubling material
It prevents socially unacceptable impulse from rising into consciousness
if not for the defense mechanisms , the darkest sins of our childhood, the primitive demands of our ids and the censures of our superego might disable us psychologically
what are the different types of defense mechanism
- repression
- regression
- displacement
- denial
- reaction formation
- rationalization
- rationalization
-projection - sublimation
what is repression
expulsion from awareness of unacceptable ideas or motives
ex: a person remains unaware of harbouring hateful or destructive impulses toward others
what is regression
the return of behavior that is typical of earlier stages of development
ex: under stress, a university student starts biting his nails or becomes totally dependent on others
what is displacement
the transfer of unacceptable impulses away from threatening individuals toward safer or less threatening objects
ex: a worker slams a door after his boss chews him out
what is denial
refusal to recognize a threatening impulse or desire
ex: a person harshly rebukes his or her spouses but denies feeling angry
what is reaction formation
behaving in a way that is the opposite of one’s true wishes or desires in order to keep these repressed
ex: a sexually frustrated person does on a person crusade to stamp out indecency
what is rationalization
the use of self-justification to explain unacceptable behavior
ex: a woman says when asked why she continues to smoke “ cancer doesn’t run in my family”
what is projection
imposing one’s own impulses or wishes onto another person
ex: a sexually inhibited person misinterpret other people friendly approach as sexual advance
what is sublimation
the channeling of unacceptable impulses into socially constructive pursuits
ex: a person channels aggressive impulses into competitive sports
what is psychosis
psychosis results when the urges of the id spill forth into consciousness, untempered by an ego that either has been weakened or is underdeveloped. the fortress of the ego is overrun and the person loses the ability to distinguish between fantasy and reality
what is neo Freudians
it is a term used to describe the second generation of theriorst who followed into the Freudian tradition. on the whole neo Freudians such as Jung, alder, Horney, Sullivan placed greater emphasis on the importance of cultural and social influence on behavior and lesser importance on sexual impulses and the functioning of the id
what is the behaviorism aspect of normal and abnormal behavior
people can learn abnormal behavior from situational factors such as harsh punishment for early exploratory behavior in the form of masturbation which might give rise to adult anxieties. also poor child rearing can have a contribution
watson, skinner and other behaviorists believed human behavior is a product of genetic endowment and environmental or situational influences. however Freud saw us as driven by irrational unconscious forces, behaviourists see us as a product of environmental influences that shape and manipulate our behavior.
behaviorists focus on the role of two major forms of learning in shaping normal and abnormal behavior: classical conditioning and operant conditioning
what is involved in classical conditioning
-Conditioned response (CR)
- Unconditioned stimulus (US)
- Conditioned stimulus (CS)
Unconditioned Response (UR
what is conditioned response (CR)
in classical conditioning, a learned or acquired response to a previously neutral stimulus. a response to a conditioned stimulus
what is unconditioned stimulus (US or UCS)
stimulus that elicits an instinctive or unlearned response from an organism
what is unconditioned response (UR or UCR)
unlearned response or a response to an unconditioned stimulus
what is conditioned stimulus (CS)
previously neutral stimulus that comes to evoke a conditioned response following repeated pairing with a stimulus (unconditioned stimulus) that had already evoked that response
what is the process of classical conditioning
before conditioning:
the neural stimulus doesn’t evoke no response or orienting response
AND
the unconditioned stimulus lead to unconditioned response
during conditioning:
the conditioned stimulus will begin to be associated with the unconditioned response and the unconditioned stimulus still leads to unconditioned response
after conditioning:
the conditioned stimulus lead to conditioned response
what is associated with operant conditioning
- reinforcement and reward
- positive and negative reinforcer
- primary and secondary reinforcer
- positive punishment and negative punishment
what is reinforcement
stimulus that increases the frequency of the response it follows.
what is positive reinforcers
types of reinforcers that increase the frequency of a behavior when they are presented. food and social approval are generally, but not always, positive reinforcers
what is negative reinforcer
reinforcers whose removal increase the frequency of an operant behavior. anxiety, pain and social disapproval often function as negative reinforcers: that is their removal tends to increase the rate of the immediately preceding behavior
what is the social cognitive theory
a broader view of learning theory that emphasizes both situation determinants of behavior (reinforcement and punishment) and cognitive factors (expectancies, values, attitude, beliefs, etc)
what is reciprocal determinism
the ongoing process of two way interaction among personal factors (cognitive abilities: expectancies, values, attitude,and belief and affective and biological characteristics), behavior (skills, talents, habits and interpersonal relations) and environmental factors(physical surrounding and other people)
what is expectancies
in social cognitive theory, a personal variable describing people’s predictions of future outcomes
what are the view of social cognitive theorist
A social-cognitive theorist emphasized the roles of thinking or cognition and of learning by observation or modeling in human behavior. also, they view people as affecting their environment just as the environment affect them.
and this is all associated with Alberta Bandura
based on social cognitive theory, if the model was reward or punish for their actions, will make it more or likely to behavior is recreated. if the behavior is modeled then it will most likely be recreated. observational learning is used to learn behavior using rewards and punishment
what are the humanistic approach to the PSYCHOLOGICAL perspective
Humanistic-Existential Models
* Carl Rogers
* Self actualization
* Abraham Maslow
* Living Authentically
what is self-actualization according to Carl Rogers
self-actualization is the ongoing process of maintaining and enhancing the individual’s self-concept through reflection, reinterpretation of experience, allowing the individual to recover, develop, change, and grow
who is abraham Maslow
he is associated with the hierarchy of need
Maslow asserted that so long as basic needs necessary for survival were met (e.g., food, water, shelter), higher-level needs (e.g., social needs) would begin to motivate behavior. According to Maslow, the highest-level needs relate to self-actualization, a process by which we achieve our full potential.
who is les Greenberg
he is associated with Emotional intelligence. Emotional intelligence involves the ability to motion one’s own and others’ feelings and emotions to discriminate among them and to use this information to guide one’s thinking and action
what is Carl Roger associated with
- Conditional (versus unconditional)
positive regard - Conditions of worth
what is Conditional (versus unconditional) positive regard according to carl roger
Conditional positive regard means giving someone esteem, love, or support only on the basis of certain conditions. By contrast, unconditional positive regard means giving love and support regardless of the person’s behavior will lead to a healthy and not too bad child with no mental health illness
what is the condition of worth according to Carl Rogers
According to humanistic psychologist Carl Rogers, conditions of worth develop early in life based on the conditional positive regard and approval we receive from significant others, especially parents.
A condition of worth arises when the positive regard of a significant other is conditional, when the individual feels that in some respects he is prized and in others not. Gradually, this same attitude is assimilated into his own self-regard complex, and he values an experience positively or negatively solely because of these conditions of worth which he has taken over from others, not because the experience enhances or fails to enhance his organism.
lecture definition: needed to behave in a way to be approved
this can be good so we don’t behave as wild animal
what is THE PSYCHOLOGICAL PERSPECTIVES: COGNITIVE PERSPECTIVE
Cognitive Perspectives
* Information Processing Approaches
* Interpretive biases
* Albert Ellis
* Activating events->Beliefs->Consequences
* Aaron Beck
* Tripartite model
what is Information Processing Approaches
it is an approach to cognitive development studies that aims to explain how information is encoded into memory. there are four stages of information processing in the brain. these four stages include attending, encoding, storing and retrieving
what is interpretation bias
Interpretation bias is a form of cognitive bias in which ambiguous situations are appraised as negative or threatening. Although the domain of interpretation bias can vary by diagnosis (e.g., social anxiety vs. panic), the general process of interpreting ambiguity in a negative manner is transdiagnostic.
who is Albert Ellis
he believed troubling events in themselves do not lead to anxiety, depression or disturbed behavior. rather it is the irrational belief about unfortunate experience that foster negative emotions and maladaptive behavior
he used an ABC approach to explain the cause of the misery
Activating events –> beliefs –> consequences
what is catastrophize
to exaggerate or magnify the negative consequences of events; to blow things out of proportion
this term is associated with Albert Ellis
who is Aaron Beck
he proposed that depression may result from cognitive error
he is associated with Tripartite model
what is beck’s four cognitive errors AKA Cognitive distortions
- selective abstraction
- overgeneralization
- magnification
- absolutist thinking
what is selective abstraction
people may selectively abstract (focus exclusively on) the parts of their experiences that reflect on their flaws and ignore evidence of their competencies
what is overgeneralization
people may overgeneralize from a few isolated experiences. for example, they may see their future as hopeless because they were laid off or believe they will never marry because they were rejected by a dating partner
what is magnification
people may blow out of proportion or magnify the importance of unfortunate events. students may catastrophize a bad test grade by jumping to the conclusion that they will flunk out of university and their lives will be ruined
what is absolutist thinking
people see the world in black and white terms rather than in shades of grey. absolutist thinkers may assume any grade less than a perfect A or a work evaluation less than rave is a total failure
what is Cognitive-behavioral modification
Cognitive-behavioral modification (CBM) approaches altering self-talk and life narrative to promote positive behaviors, and thus outcomes.
Donald Meichenbaum uses cognitive–behavioral therapy with a constructive-narrative perspective in which he looks at the stories clients tell about themselves and considers ways that the client could develop a different, more positive story.
what is the SOCIOCULTURAL PERSPECTIVE to abnormal behavior
*Must consider the impact of social and cultural
factors, such as ethnicity, gender and social roles,
and poverty.
* Sociocultural theorists seek causes of abnormal
behaviour that may reside in the failures of society
rather than in the person. For example, the
Downward Drift Hypothesis
what is the Downward Drift Hypothesis
the belief that people with psychological problems may drift downward in socioeconomic status
since they are more likely to not take care of themselves causing them to lose their jobs, lose contact with friends resulting in homelessness and more
what is the INTERACTIONIST PERSPECTIVE to abnormal behavior
- No one theoretical perspective can account for
the complex forms of abnormal behaviour - Many theorists today adopt an interactionist
perspective. * I.e., The belief that we need to take into account
the interaction of multiple factors representing
biological, psychological, sociocultural, and
environmental domains in order to explain
abnormal behaviour.
what is The Diathesis-Stress Model
it is related with interactionist perspective . it is the model of abnormal behavior positing that abnormal behavior patterns such as schizophrenia involve the interaction of genetics and environmental influence. in this model, a genetic or acquired predisposition or Diathesis increases an individual’s vulnerability to developing the disorder in response to stressful life circumstance. if , however the level of stress is kept under the person’s particular threshold, the disorder may never develop, even among people with the predisposition
Diathesis (a predisposition of vulnerability) stress (environmental stressor) —> development of the disorder
what is Biopsychosocial model
a conceptual model emphasizing that human behavior is linked to complex interactions among biological, psychological and sociocultural factors
The Biopsychosocial Model
Dynamic interplay of three major systems or
domains:
* Two INTERNAL systems: biological, psychological
* One EXTERNAL system: sociocultural and
environmental factors.
what is collaborative therapy
it is client centered approaches that places the emphasis on collaboration, honesty, respect
when the client are treated as a friend
what does assessment shows
- provides a wealth of
information about a client’s personality, behaviour,
and cognitive functioning. - This information helps clinicians acquire a broader
understanding of their clients’ problems and
recommend appropriate forms of treatment.
what does a Assessment need to have to be effective
to be reliable and valid
what are the different types of reliability
- Internal Consistency
- Temporal Stability
- Interrater Reliability
what is Internal Consistency in relation to reliability
Internal consistency, in the context of reliability, refers to the degree of consistency or agreement between different items or parts of a test or measurement instrument that are intended to measure the same construct or attribute.
High internal consistency indicates that the items in the test are strongly related to each other, suggesting that they are measuring the same underlying construct reliably. On the other hand, low internal consistency suggests that the items may not be measuring the same thing or that there may be inconsistency in the way respondents interpret and respond to the items.
what is Temporal Stability in relation to reliability
Temporal stability, also known as test-retest reliability, is a measure of the consistency of a test or measurement instrument over time. It assesses the extent to which the scores obtained from the same individuals on the same test are consistent when the test is administered on two different occasions.
A high degree of temporal stability indicates that the test produces consistent results over time, suggesting that the construct being measured is stable and enduring. On the other hand, low temporal stability suggests that the measurement may be influenced by factors that change over time, such as fluctuations in the respondent’s mood, environment, or other variables not related to the construct being measured.
what is interrater reliability in relation to reliability
Interrater reliability, also known as interobserver agreement or interrater agreement, is a measure of the consistency or agreement between two or more raters or observers who independently evaluate or score the same set of data, such as behaviors, performances, or responses.
High interrater reliability indicates strong agreement among raters or observers, suggesting that the evaluation process is consistent and reliable. On the other hand, low interrater reliability suggests inconsistency or disagreement among raters or observers, which can raise questions about the validity and accuracy of the evaluation process.
what is content validity
Content validity is a type of validity that refers to the extent to which a test or measurement instrument adequately represents the entire domain of content it is supposed to measure. In other words, it assesses whether the items or questions in a test are relevant, appropriate, and comprehensive in capturing the construct or attribute being measured.
If a test lacks content validity, it may fail to provide a comprehensive or accurate representation of the construct, leading to invalid conclusions or decisions based on the test results
what is criterion validity
Criterion validity is a type of validity that assesses the extent to which scores on a test or measurement instrument are predictive of or correlate with scores on an external criterion that is considered the “gold standard” for measuring the construct of interest.
Criterion validity is important because it demonstrates the usefulness of a test or measurement instrument by showing that it accurately predicts or correlates with an external criterion that is relevant to the construct being measured. If a test demonstrates high criterion validity, it suggests that the test scores can be trusted to make predictions or decisions about individuals’ performance or behavior in real-world settings.
what is construct validity
Construct validity is a type of validity that assesses the extent to which a test or measurement instrument accurately measures the underlying theoretical construct or concept it is intended to measure. In other words, it examines whether the scores obtained from the test truly represent the theoretical construct or attribute being studied.
Establishing construct validity is essential for ensuring that a test or measurement instrument accurately measures the intended construct and provides valid interpretations of the scores obtained. It is a critical aspect of test development and validation, particularly in fields such as psychology, education, and social sciences, where theoretical constructs play a central role in research and assessment.
what are criticization of some assessment
- Assessment techniques may be reliable & valid in one culture, but not in another
- Most diagnostic instruments consider culture to some
degree, but most fail to provide adequate norms for different cultural & ethnic groups. - Interviewers need to be sensitive to problems that can arise when interviews are conducted in a language other than the client’s mother tongue
what does the interview covers
- identifying data: sociodemographic characteristics, marital status,age, gender, racial/ethnic characteristics, religion and more
2. description of the presenting problems: how does the client perceive the problem? what troubling behavior thought or feeling are reported? how do they affect the client’s functioning? when did they begin
psychosocial history: information describing the client’s developmental history: educational, social, and occupational history , early family relationships
4. medical psychiatric history: history of medical and psychiatric treatment and hospitalization. is the present problem a recurrent episode of a previous problem? how was the problem handled in the past ? was treatment successful? why or why or
5. medical problems/medication : deception of present medical problems and present treatment including medication
what are the three types of interview format
-unstructured
- semi-structured
- structured
what is Unstructured interview
types of clinical interview in which interviewers determine which questions to ask rather than following a standard interview format
what is semi structured
type of clinical interview in which interviewers are guided by a general outline but are free to modify the order in which questions are asked and to branch off in other directions
what are structured interview
means by which an interviewer obtains clinical information from a client by asking a fairly standard series of questions concerning such issues as the client’s presenting complaints or problems, mental state, life circumstance and psychosocial or development history
what are the advantages of Unstructured interview
its spontaneity and conversational styles
what are the disadvantages of Unstructured interview
lack of standardization
failure or touch on important clinical information needed to from a diagnostic impression
what are the advantages of Structured interview
provide the highest level of reliability and consistency in reaching diagnostic judgement
what are the advantages of semi Structured interview
- great flexibility
what are example of structured interview
the structured clinical interview for the DSM. the SCID includes closed-ended question to determine the presence of behavior pattern that suggest specific diagnostic categories and open ended questions that allows Clint’s to alabtroes on their problems and feeling
what is mental status examination
structured clinical evaluation to determine various aspects of a client mental functioning
what is intelligence
it is global capacity to understand the world and cope with its challenges. traits or traits associated with successful performance on intelligence test
what is David Wechsler view on intelligence
he is the originator of the widely used series of intelligence tests. he defined intelligence as capacity to understand the world and resourcefulness to cope with its challenges. from his perceptive, intelligence has to do with the ways in which we mentally represent the world and adapt to its demands
his scales included both verbal and performance subtest
what is the stanford Binet intelligence scale
by Alfred Binet and theodore Simon in response to the French school system quest for a test that could identity children who might profit from the education. the initial scale yielded a score called a mental age
what is mental age (MA)
age equivalent that correspond to the person level of intelligence as a measured by performance on the stanford Binet intelligence scale
who is lewis terman
he adapted the binet-simon test for American children and it became known by its full current name: the Stanford-binet intelligence scale(SBIS). The SBID also yielded an intelligence quotient (IQ)
what is intelligence quotient (IQ)
measure of intelligence derived on the basic of scores on a intelligence test. called a quotient because it was originally derived by divided a respondent mental age by his or her actual age
what is deviation IQ scores
intelligence quotient derived by determining the derivation between the individual’s score and the norm (means)
comparing the individual score on an intelligence test with the mean score
what was the result based on the IQ scores
most IQ scores cluster around the mean. just 5% are above 130 or below 70
he classified people who scored 130 and above as ver superior, while people who scored below 70 are diagnosis with intelligence disability
what are the types of personality
- self report test
- projective tests
what is the intention of self-report test
to measure particular traits or conditions such as anxiety or depression
a common tool used is Minnesota Multiphasic Personality Inventory (MMPI-II): a test consisting of hundreds of true-false questions, used as a diagnostic tool by psychologists.
MMPI-II has validity that assess tendencies to distort test response in a favourable way like faking good or unfavourablelike faking bad direction
what is objective test
tests that allow a limited specific ranges of response option or answer so that they can be scored objectivity
what are the advantages of self-report test
- relative ease and economy of administration. as the client can complete the test on their own
what are the disadvantages of self-report test
rely on client themselves as the sources of data. can reflect underlying biases such as tendencies to answer items in a socially desirable direction rather than accurate self-perception
limited to high functioning individuals who can read well, respond to verbal material and focus on a potentially tedious task
what is projective test
unlike like objective tests, they offer no clear, specific answer
in this test, client are presented with ambigos stimulus such as vague drawing or inkblots and are usually asked to describe what the stimulus look like or to relate stories about them:
The instruments used are:
- Rorschach Inkblot Test: showing respondents a series of inkblots and asking them to describe what they see in each one. designed to assess personality characteristics, emotional functioning, and thought processes. It is often used in clinical settings to help diagnose psychological disorders, understand underlying personality dynamics, and gain insights into unconscious processes.
- Thematic Apperception Test (TAT): ambiguosus pic where individual depicts stores about them. it assumed the stores reflect their experiences and outlook in life
it is also suggestive of clients attitudes towards others particularly family members and lovers - blacky test: presents respondents with a series of black-and-white pictures depicting ambiguous scenes or scenarios. Respondents are asked to tell a story about each picture. Like the TAT, the Blacky Pictures Test is used to assess personality characteristics, motivations, and unconscious processes
what are criticism of the Thematic Apperception Test (TAT)
the stimulus properties of some of the cards such as cues deception sadness or anger may exert too strong a stimulus pull on the subject. the picture themselves may pull for certain types of stories, if so client response may represent reaction to the stimulus cues rather than projective of their personalities. meaning instead of the test being based on their personality, it is based on subjective impression
what is neuropsychological assessment
Used to evaluate whether or not psychological
problems reflect underlying neurological damage
or brain defects.
the first test to be developed is the bender visual motor gestalt test consist of geometric figures that illustrates various gestalt principles of perception. the client is asked to copy geometric design. Signs of possible brain damage include rotation of the figures, distortion in shape and incorrect sizing of the figure in relation to one another
it is convenient and economical means of uncovering possible impairment
what is Luria-Nebraska Battery
reveals a pattern of skills deficits that are suggestive of particular sites of brain damages. a wide range of skills are assessed. tests measure tactile, kinesthetic and spatial skills; complex motor skills; auditory skills; receptive and expressive speeches skills; reading, writing and arithmetic skills; and general intelligence and memory functioning
what is Halstead-Reitan Neuropsychological Battery
measures perceptual, intellectually and motor skills and performance. permits psychologist to observe pattern of results and various patterns of test permits the psychologist to observes pattern of results and various patterns of performance deficits are suggestive of certain kinds of brain defects such as the occurrences
what is the purpose of Neuropsychological assessment
to reveal Brain dysfunction without surgical procedures
what is a psychometric approach
method of psychological assessment that seeks to use psychological tests to identify and measure the reasonably stable traits in an individual’s personality that are believed to largely determine his or her behavior
what is behavioural assessment
approach to clinical assessment that focuses on the objective recording or description of problem behavior rather than on inference about personality traits
-Focuses on the objective recording and/or
description of behaviour
* Functional analysis
* Behavioural interview
* Reactivity
* Self-monitoring
* Analogue Measures
* Behavioural Rating Scales
what is cognitive assessment
Involves the assessment of cognitions (thoughts,
beliefs, and attitudes)
what are method of cognitive assessment
- thought diaries
- cognition checklist
- dysfunctional attitudes scale
what are disadvantages of direct observation
- lack of consensus in defining problems in behavioural terms
-lack of reliability or inconsistency of measurement ( due to response biases)
What are advantages of direct observation
- doesn’t rely on a client’s self-report
- provide an accurate rate measurement of problem behavior
what is Analogue Measures
intended to stimulate the settings in which the behavior naturally takes place but are carried out in laboratory or controlled settings
what are some physiological measurement
- Examines people’s physiological responses
- Galvanic skin response (GSR)
- Electroencephalograph (EEG)
- Electromyograph (EMG)
- Measures of sexual arousal (PPG and VPP)
what is Galvanic skin response (GSR)
measure of the changes in electrical activity of the skin caused by increased activity of the sweat glands that accompanies states of sympathetic nervous system arousal, such as when a person is anxious
what is Electroencephalography (EEG)
instrument for measuring the electrical activity of the brain (brain waves)
what is Electromyography (EMG)
instrument often used in biofeedback training for measuring muscles tension
what are the method of assessment in probing the brain
- Computerized tomography (CT Scans): consists of narrow x-rays beam aimed at the head. it reveal abnormalities in shape and structure that may be suggestive of lesions, blood clots, or tumors
- Positron emission tomography (PET Scans): a small amount of radioactive compound or tracer is mixed with glucose and injected into the bloodstream. used it reveal differences in brain activity in people with schizophrenia
- Magnetic Resonance Imaging (MRI): a person is placed in a doughnut shaped tunnel that generates a strong magnetic field. used to investigate brain abnormalities associated with schizophrenia and other disorder such as obbesive-complusive disorder
- Functional Magnetic Resonance Imaging (fMRI): a form of resonance imaging that yield more info than a basic MRI . used to discover the neurobiology of stress
- Brain Electrical Activity Mapping (BEAM):
what are key point to remembers about the method of assessment
- Testing (by itself)
≠ Assessment - Proper assessment = Clinical history and observation +
Measurement + Expert knowledge + Formulation - Strengths must be considered as equally important: Can’t
just focus on pathology
how do we classify abnormal behavior
- Classification systems for abnormal behaviour date back to ancient times.
- The most modern system of classification – the DSM-5
– emerges out of the work of Kraepelin in the 19th century. - Classification is at the core of the scientific enterprise.
- Labels make communication about
psychological disorders possible
what are the current system of classification
- Diagnostic & Statistical Manual of Mental Disorders
(DSM) - International Statistical Classification of Diseases and
Related Health Problems (ICD) - Chinese Classification of Mental Disorders (CCMD)
what are the feature of DSM and model of abnormal behavior
- DSM doesn’t assume that abnormal behavior necessarily stems from biological causes or defects. it recognizes that the causes of mental disorder are unclear
- in DSM, abnormal behavior patterns are classified as mental disorder
- classifying disorder not people
- An attempt to define and discover actual
diseases (mental or psychological disorders). Strictly speaking, the term disease process is
reserved for conditions with well understood
cause and course - Most mental disorders do not qualify as genuine
disease processes, which doesn’t disqualify them
as forms of illness.They are clinical pictures, or syndromes - *Specific diagnostic criteria are used
- Abnormal behaviour patterns that share features
are grouped together
what are the goals in re-constructing DSM-5
- Atheoretically: without a theoretical basis
- descriptive: look at observable facts
3.polythetic: flexible criteria as the same condition can look subtly different - Good interrater reliability: agreement between clinicians
what are the results of the evaluation of the DSM system
reliability: hasn’t improved since DSM-III.Estimates may be inflated due to focus on high
severity populations
Validity: Can be inadvertently sacrificed in the interests
of maximizing reliability
what is predictive validity
based on the ability of the diagnostics system to predict the course the disorder is likely to follow or its response to treatment
what are the DSM-5 major changes
- updated descriptive and background information on each disorder. so exciting disorders were reclassified or consolidated with other disorders under holistic label
- classified abnormal behavior pattern or psychological disorder according to developmental model allowing relevant lifespan information included in decision regarding clinical diagnoses
- adoption of a dimensional component in assessment and diagnosis allowing evaluate the opportunity to identify the shades of grey rather than categorical
- Criterion Changes and Replacement of DSM-IV
Disorders With More Relevant Disorders
what are sociocultural factors in assessment
- Reliability and validity of assessment tools may be
culture-specific - Disentangling psychopathology from sociocultural
factors - Issues of translation
what is culture-bound syndromes
patterns of
psychological distress that are limited to one or only
a few cultures
ex: Tajinn-kyofu-sho (TKS) is a common
disorder seen in Japan, characterized by an
excessive fear that one will behave in embarrassing
ways or offend other people
how many disorder are there in DSM
- DSM I: 106 mental illness
- DSM II: 182 mental illness
- DSM III: 265 mental illness
- DSM III R: 292 mental illness
- DSM IV/TR: 297 mental illness
- DSM 5: 300+ mental illness
types of mental health professional
- Clinical Psychologist
- Psychiatrist
- social workers
- psychiatric nurses
- family physicians
what is bill 30
Bill 30 (The Mental Health Services Protection Act)
received Royal Assent in December 2018
what are the method of treatment
- biological therapies
- psychodynamic therapies
- behavior therapy
- humanistic-existential therapies
-cognitive-behavior therapies - eclectic (integrative) therapy
- group, family and martial therapy
- computer- assisted therapy
what is psychotherapy
method of helping involving a systematic interaction between a therapist and a client that brings psychological principle to bear on influencing the client’s thought, feeling or behavior to help that client overcome abnormal behavior or adjust to problem in living
what is eclectic orientation
adoption of principles or techniques from various systems or theories
what is psychopharmacology
in relation to biological therapies. field of study that examines the effects of drugs on behavior and psychological functioning and explores the use of psychoactive drug in the treatment of emotional disorders
what is rebound anxiety
occurence of strong anxiety following withdrawal from a tranquiliser
what is neuroleptics
groups of antipsychotic drugs used in the treatment of schizophrenia such as the phenothiazines
what is antidepressants
types of drugs that act to relieve depression. tricyclics, MAO inhibitors, selective serotonin-reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors are the major classes of antidepressant
what is tricyclics (TCAs)
group of antidepressant drug that increase the activity of norepinephrine and serotonin in the brain by interfering with the reuptakes of these neurotransmitter by transmitting neurons
what is monoamine oxidase (MAO) inhibitors
antidepressants that act to increase the availability of neurotransmitter in the brain by inhibiting the action of an enzymes, monoamine oxidase, that normally break down or degrades neurotransmitter (norepinephrine and serotonin) in the synaptic cleft
what is selective serotonin-reuptake inhibitors (SSRIs)
types of antidepressant medication that prevent serotonin from being taken back up by the transmitting neurons, thus increasing its action
what is serotonin-norephrine reuptake inhibitors (SNRIs)
types of antidepressant medication that work specifically on increasing level on serotonin and norephrine by interfering with the reuptakes of these chemicals by transmitting neurons
what is placebo
iert medication or form of bogus treatment intended to control the effect of expectancies. sometimes referred to as a sugar pill
what are instrument of biological therapies
- medication
- Electroconvulsive therapy (ECT): induction of a convulsive seizure by means of passing an electric current through the head; used primarily in the treatment of severe depression
- psychosurgery
- deep brain stimulation: involves implanting electrodes (like a heart pacemaker) within the part of the brain that affect mood. used to relieve depression
what are instrument of psychodynamic therapies
- free association: when the individual is asked to lay down and prompt to utter whatever comes to mind. then the analyst offers interpretation, drawing attention to connection between your disclosure and unconscious conflict
- transference: when clients respond to the psychologist (freud) in a way that reflects their feeling and attitudes toward important people in their lives
- modern psychodynamic approaches : Contemporary theories include object relations theory, self-psychology, attachment theory/mentalization, and postmodern models. Each of these psychodynamic theories provides a conceptual framework for therapists to help their patients understand themselves and overcome problematic behaviors and thought processes.
what are the instruments of behaviour therapy
- Systematic desensitization: involves exposing imagination or y means of picture or slides to progressively fearful stimulus until it is deeply relaxed
- Gradual exposure: people troubled by purposely expose themselves to the stimulus that evokes their fear
- token economies: seek to increase adaptive behavior by allowing patients to earn tokens for performing adaptive behavior such as self-grooming or making their bed
- modeling: first observe and then intimate others who approach or interact with fear-evoking situations or object
what are the instruments used in humanistic-existential therapies
- person-centered therapy (rogers): emphasizing the establishment of a warm, accepting therapeutic relation that free clients to engage in a process of self-exploration and self-acceptance. related to conditional positive regard (empathy, genuineness, and congruence about his or her thoughts, feelings and behavior)
- emotion-focused therapy (greenberg): based on the premise that emotion, motivation, cognition and action occur as an integrated response package. they help become aware and accept their emotion
what are the instrument used for Cognitive-Behaviour Therapies
- Ellis’ Rational Emotive Therapy: focuses on helping individuals identify and challenge irrational beliefs and thought patterns that contribute to emotional distress and unhealthy behaviors.
-Beck’s Cognitive Therapy: encourage clients to recognize and change errors in their thinking that affect their mood and impair their behavior.in other words, focuses on helping individuals identify and challenge negative and distorted thoughts, beliefs, and cognitive patterns that contribute to emotional distress and dysfunctional behavior.
- Meichenbaum’s Cognitive-Behavioural Therapy: attempts to integrate therapeutic techniques that focus not only on making overt behavioural change but also on changing dysfunctional thought and cognition. draws on the assumption that cognition and information processing play important roles in the beginning and maintenance of maladaptive behavior and the impact of external event is filtered through thinking process
what is Eclectic (Integrative) Therapy
look beyond the theoretical barrier that divides the school of psychotherapy from another in an effort to define what is common among the school of therapy and what is useful in each of them
integrates techniques and principles from multiple therapeutic modalities and theoretical orientations
what is Group, Family, and Marital Therapy
Group therapy, family therapy, and marital therapy are all forms of psychotherapy that involve multiple individuals participating in therapy sessions. While they share some similarities, each modality has its own focus, goals, and techniques tailored to the dynamics and needs of the group or relationship.
what is computer-assisted therapy
Computer-assisted therapy refers to the use of technology, particularly computer software and digital tools, to supplement or enhance traditional therapeutic approaches. This form of therapy can take various forms and may include both self-guided interventions and therapist-guided treatments.
what is the indigenous perceptive
- mental wellness as balance of physical, mental, emotional, spiritual]mental wellness as a continuum and multi-levelled:individual,family , community meaning it can be examined through the lens of other around the individual
what is the benefit of computer therapy
Computer programs are as capable as skilled
clinicians of obtaining information from clients and
reaching an accurate diagnosis, and are less
expensive and more time-efficient
does psychotherapy work
Yes, based on stats average psychotherapy client was better off than 75-80% of the client who remained untreated
what is the dodo bird effect
states that all psychotherapeutic techniques are equally effective in the end
What are the nonspecific factors in relation to psychotherapy
-the mobilization
of hope
- the attention and support
provided by the therapist,
-the development of a good
working alliance between the client and therapist (necessary for some).The variable that stands out more than any other as
important to successful psychotherapy is the quality of the therapeutic alliance. Correlation with outcome is typically in the range of 0.20
-All of these are the benefits of psychotherapy
are there focus on address diversity in mental healthcare resources
Mental-health care practitioners have become
increasingly sensitive to Canada’s multicultural make
up
what are pscyholegal issues
looks at whether the patient is dangerous to others and themselves
Civil commitment (psychiatric commitment): involuntary hospitalization of a patient
the textbook definition: legal process involved in placing an individual in a psychiatric institution even against his or her will. also called psychiatric commitment
- having a mental disorder
- likely to harm themselves or others
- unsuitable for admission to a facility other than as a moral patient
it is important to know mental disorder and the risk of harm being done with farther degeneration
Legal commitment (NCRMD: Not Criminally Responsible on Account of Mental Disorder. this means the person is incapable of understanding the implication and effect of their action
textbook definition: legal process involved in confining a person found “not criminally responsible on account of a mental disorder” in a psychiatric institution. also called criminal commitment
community treatment order (CTOs): a tool to help patients comply with treatment while in the community. Its purpose is to break the cycle of involuntary hospitalization,
what is used to predict dangerousness
- Psychopathy: Psychopathy Checklist: tool that is commonly used to assess the presence and extent of psychopathy in individuals—most often those institutionalized in the criminal justice system—and to differentiate those high in this trait from those with antisocial personality disorder, a related diagnosable disorder
- The Post Hoc Problem: an argument that draws the conclusion that one event is directly caused by another event without evidence to prove this
- Leaping From the General to the Specific
an over prediction of dangerousness due to inaccurate prediction in general
what are the checklists that are determined if a defendant can’t stand trial
- Incapable of participating in their own defence
- Can’t distinguish between pleas
- Doesn’t understand the purpose of trial
- Cannot communicate with counsel rationally or make
critical decisions on counsel’s advice - Is unable to take the stand to testify
what are the obligation to the public
duty to warn (tarasoff ruling)
what are patients rights
- right to treatment: first provide the least invasive treatment
- right to refuse treatment
- form 15 treatment order criteria
1. Likely to improve with treatment.
2. . Likely to get worse without treatment.
3. The benefit of treatment outweighs the risks of the
treatment.
4. The treatment is the least limiting and invading of
all possible measures that meet the first three
conditions
what is the differential diagnosis
Differential diagnosis ensures that doctors consider all possibilities before they make a diagnosis for a patient’s illness. It involves making a list of all possible explanations for a patient’s symptoms and eliminating each one until only the correct diagnosis is left
what is anxiety
Anxiety is a general state of apprehension or
foreboding.
– Adaptive when it prompts us to seek medical attention, to study for an upcoming test or
avoid a dangerous situation.
– Maladaptive when the level of anxiety is out of proportion to the level of threat or when it
occurs out of the blue, not in response to
environmental changes. ex: putting your hands on a hot stove
- Common: Most people experience it in varying degrees
what are the major types of anxiety
- panic disorder
with Agoraphobia
without Agoraphobia
-Agoraphobia without hx of panic disorder - specific disorder
- Social Phobia
- Generalized Anxiety Disorder
- Obsessive-Compulsive Disorder (OCD)
- Postraumatic Stress Disorder (PTSD)
- Acute Stress Disorder
- anxiety disorder due to a general medical condition
- substance-induced anxiety disorder
- Most are more common in females than males.
what is anxiety sensitivity
the fear that anxiety symptoms are somehow dangerous (enough to kill the individual)
what is hostile attribution bias
the tendency to interpret the ambiguous behavior of other as hostile even when other have no such intention
what is duty to warn
obligation imposed on therapist to warn third parties of threat made against them by the therapists’ clients. in the united states, the tarasoff case established the legal basis for duty-to-warn provision. although US law does not applying canada, the canadian psychological association states that ethically therapists have a duty to warn
wat is insanity defense
based on the belief that when a criminal act derives from a distorted state of mind and not from the exercise of free will , the individual should not be punished but rather treated for the underlying mental disorder
Not Criminally Responsible on Account of Mental Disorder (NCRMD) is canada’s version of the insanity disorder
what is a panic attack
it is the building block of panic disorder
according to the DSM-5/TR: it is a discrete period of intense fear or discomfort, in which four or more of the following symptoms developed abruptly and reached a peak within 10 minutes
the symptoms are:
-palpitation, pounding heart, accelerated heart rate
- sweating
- trembling or shaking
- sensation of shortness of breath or smothering
- feeling of choking
- chest pain or discomfort
- nausea or abdominal distress
- feeling dizzy, unsteady, lightheaded, or faint
-derealization (feelings of unreality) or
depersonalization (being detached from oneself)
- fear of losing control or going crazy
- fear of dying
- paresthesias (numbness or tingling sensations)
- chills or hot flushes
there can be culturally bound symptoms
what is the difference between situationally bound vs situally predisposed
Situationally predisposed attacks are defined as those occurring in situations where the patient experiences attacks with a higher probability, but not regularly. Situationally bound attacks are defined as those that occur exclusively and regularly in certain situations
what is panic disorder
it is recurrent unexpected panic attacks and at least one of the attacks has been followed by one month or more of one or more of the following
– (a) persistent concern about having additional attacks– (b) worry about the implications of the attack or its
consequences (e.g., losing control, having a heart attack,
“going crazy”)
– (c) a significant change in behavior related to the attacks
what are keys times to know about panic disorder
- The Panic Attacks are not due to the direct
physiological effects of a substance (e.g., a drug of
abuse, a medication) or a general medical condition (e.g., hyperthyroidism). - The Panic Attacks are not better accounted for by another mental disorder
- 1-5% prevalence (lifetime)
-anxiety sensitivity
what is agoraphobia
(fear of the market place) accompanies panic attacks in a large minority of cases (30 – 50%; other writers report up to 75%).
textbook definition: a fear of place and situations from which it might be difficult or embarrassing to escape in the event of panicky symptoms or of situation in which help may be unavailable if such problems occur. it is usually fear of having another panic attack that is most impairing.Makes treatment less likely unless patient gets strong
support to attend, or psychologist makes house calls
even though panic disorder and agoraphobia are separate disorders. people who develop panic disorder often report agoraphobia before the onset of a panic disorder
more common in women than men
Even without agoraphobia, panic disordered patients are often reluctant to discuss their episodes for fear of triggering another attack
what is Generalized Anxiety Disorder (GAD)
An anxiety disorder characterized by general feelings of dread, foreboding, and heightened states of sympathetic arousal
they are chronic worriers and excessive uncontrollable worrying is considered the key feature of the disorder. They are excessively worried about life circumstance such as finance, the wellbeing of their children, social relationship, academics, feeling tense and more
more common in women
–Not linked to any one particular fear or trigger
–Formerly referred to as free-floating anxiety
*Freudian term
what are the DSM-5/TR criteria in GAD
- At least 6 months of “excessive anxiety and worry” about a variety of events and
situations. Generally, “excessive” can be
interpreted as more than would be expected for a particular situation or event. - . There is significant difficulty in controlling the anxiety and worry. If someone has a very difficult struggle to regain control, relax, or
cope with the anxiety and worry, then this
The requirement is met. - The presence for most days over the
previous six months of 3 or more (only 1 for children) of the following symptoms:
1. Feeling wound-up, tense, or restless
2. . Easily becoming fatigued or worn-out
3. Concentration problems
4. irritability
5. significant tension in muscles
6. difficult with sleep
what is phobic disorder
- specific phobia (claustrophobia)
- social phobia
- agoraphobia
people with phobias are not of touch with reality; they generally recognize that their fears are excessive or unreasonable
what are the five diagnostic subtypes of specific phobias
- animal types
- natural environment
- blood-injection-injury
- situation type
- other types such phobias of choking or contracting an illness
is there a strong relationship between age ( developmental stage) and the type of phobia is developed
yes, as the age of onset appears to reflect the level of physical and cognitive development and life experiences
as young children tend to have phobias of animals
teenagers tend to have phobias of social
adults tend to have agora or claustrophobia
what are physical feature of anxiety disorder
jumpiness, jitters, increased perspiration and heart rate, shortness of breath,
dizziness, nausea
what are the behavioural feature of anxiety disorder
the need to escape or
avoid a situation, agitation, clinginess, need for
reassurance
what are the cognitive features of anxiety disorder
excessive and prolonged
worrying, overly aware of bodily sensations, jumbled
thoughts, nagging thoughts
what are the DSM-5/TR criteria for specific phobia
- Marked and persistent fear that is excessive or
unreasonable, cued by the presence or anticipation
of a specific object or situation (e.g. flying, heights,
animals, receiving an injection, seeing blood) - Exposure to the phobic stimulus almost invariably
provokes an immediate anxiety response, which may take the form of a situationally bound or situationally pre disposed panic attack. Note: in children, the
anxiety may be expressed by crying, tantrums,
freezing or clinging. - The person recognizes that the fear is excessive and unreasonable. Note: in children this feature may be
absent. - The phobic situation is avoided or is endured with
intense anxiety or distress. - The avoidance, anxious anticipation, or distress in
the feared situation(s) interferes significantly with a person’s routine, occupational (or academic)
functioning, or social activities or relationships or
there is a marked distress about having the phobia. - In individuals under the age of 18 years the duration is at least 6 months.
what is obsession and compulsion in the obsessive-compulsive disorder
Obsession: An intrusive, unwanted, and recurrent thought, image, or urge that seems beyond a person’s ability to control.
Compulsion: A repetitive behaviour or mental act that a person feels compelled or driven to perform
what is adjustment disorder
it is among the mildest of psychological disorders. it is a maladaptive reaction to an identified stressor that develops within a few months of the onest of the stressor
the maladaptive reaction is characterized by significant impairment in social, occupational academic functioning or by states of emotional distress that exceed those normally induced by the stressor
the maladaptive reason may be resolved if the stressor is removed or the individual learns to cope with it. if the maladaptive reaction lasts for more than six months after the stressor has been removed the diagnosis may be changed
what is acute stress disorder (ASD)
A traumatic stress reaction occurs in the days and weeks following exposure to a traumatic event.
– A prolonged reaction to a traumatic event that
threatened death or serious injury to one’s own or another’s physical safety
what is posttraumatic stress disorder (PTSD)
disorder involving impaired functioning following exposur ot a traumatic experiences such as combat, physical assault or rape, or natural or technological disaster in which the person experiences for at least one month such problem as reliving or re-experiencing the trauma, intense fear, avoidance of evtn, related stimuli, generalized numbing of emotional responsiveness and heightened autonomic arousal
what are features of traumatic stress reactions
- Extreme anxiety or dissociation (feelings of detachment from one’s self or one’s environment)
- Intrusive memories & flashbacks (chronic reexperiencing, extremely vivid, may feel like they’re back in the situation)
- Heightened arousal or vigilance
- Difficulty concentrating
associated with PTSD and ASD
what is the Psychodynamic Perspective
Anxiety is warning sign that some unconscious conflict is approaching consciousness
Projection: anxiety is brought about by the
perception that some external threat is posed by
someone or something else onto the phobia object ex: a person avoid height since they have a unconscious wish to jump
* Anxiety likely to be more specific in focus* Displacement: anxiety more likely to be
generalized.
what is two factor model
O hobart Mower’s theory that both operant and classical conditioning are involved in the acquisition by means of classical conditioning (pairing a previously neutral stimulus with a aversive stimulus) and the avoidance component of acquired by means of operant conditioning (relief from anxiety negatively reinforces avoidance behavior)
what is Prepared conditioning
The reason we seem to develop phobias to some things more readily than others – a diathesis
what is a cognitive perspective to anxiety disorder
- Self-defeating or irrational beliefs
- Oversensitivity to threat
- Anxiety sensitivity
- Misattributions for panic attacks
what is the cognitive model
loop
subjective threat (increase heart rate, sweating and more) -> misinterpretation of bodily sensation (i’m going to have a heart attack) -> intensification of bodily sensation -> increased anxiety and fear
what is biological perspective
genetic factors:
* Higher concordance rates MZ twins (high genetic similarity) than DZ for many anxiety disorder
* Neuroticism (trait that reflects a person’s level of emotional stability). people with high level of neuroticism tend to cope poorly with stress and frequently experiences feeling anxiety, anger, guilt and depression, they have increased risk of developing anxiety disorder and other emotional problem
-GABA inhibitory neurotransmitters play a role in regulating anxiety, if low on it there will be increased anxiety
- Benzodiazepines: anti-anxiety
- Biological Aspects of Panic Disorder: people with biological basis for panic disorder than without it are likely to experiences panicky symptoms in response to certain biological changelle (* Hyperventilation – Can bring about panic-like symptoms)
- Biological Aspects of Obsessive-compulsive Disorder: involves heightened arousal of a particular anxiety circuit, a neural network in the brain involved in signaling danger
TYING IT TOGETHER
- Not all people who experience traumatic events develop related phobias or anxiety reactions.
- Some people may inherit a genetic predisposition (diathesis) that makes them respond with greater negative arousal or makes them more likely to
panic in response to changes in bodily sensations.* Whether anxiety gets out of control may depend on another vulnerability factor, anxiety sensitivity
the behavioural, biological, emotional and cognitive, social environmental factors work together in the development of disorder
what are treatment method
Psychodynamic Approaches
* Free association and psychoanalysis to resolve the
deeper conflict.
* Phobic objects are symbolic of those conflicts.
Humanistic Approaches
* Unconditional positive regard allows integration of
inauthentic social presentation with authentic self.
Biological Approaches
* Antidepressants
SSRIs / SNRIs - Less likely to have enduring benefit than CBT
Cognitive Approaches
* Irrational beliefs, bolstering self-efficacy, individual
meaning, regular “worry periods” (Borkevic, 1985)
Learning-Based Approaches
* Best approaches combine exposure with response
prevention
* Systematic Desensitization
* Fear-Stimulus Hierarchy
* Gradual Exposure
* Behavioural Treatment of Social Phobia
* Behavioural Treatment of Agoraphobia
* Behavioural Treatment of Obsessive-compulsive disorder
* Cognitive-Behavioural Treatment of Generalized Anxiety* Cognitive-Behavioural Treatment of Panic Disorder
Virtual reality research.
For Combat vets with PTSDThe system contains eye-tracking software to study a person’s
response when exposed to a
virtual combat environment
what is an important note considered in the treatment for anxiety disorder
It’s important to realize that treatment for anxiety disorders often
improves the condition significantly, but doesn’t necessarily eliminate it completely.
