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Psych 100 > week 21 > Flashcards

week 21 Flashcards

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1
Q

Psychopathy

A

categorizationin criminal justice
personality disorder

  • antisocial behavior (aka breaking social norms)
  • lack of empathy (KEY)
  • remoreseles
  • decetiful
  • manipulative
  • selfish
  • violent (very concerning)

Precevied as “severe” presentation of antisocial personality disorder

WHAT ITS NOT:
- clinical diagnosis (not in DSM or ICD-10)
- Not in DSM since 1980 (replaced with ASPD antisocial personality disorder)

PREVALENCE:

community samples:
- 1.2% men
- 0.3-0.7% women
- Rare but as common as bulimia and 2X more common than BD

More Common in Institutionalized Samples
- 11%. forensic psychiatric population
25% correctional population
————————
vs offenders without psycopathy:
– commit different crimes
- mostly instrumental (not based on emotional hostile)
(homicides 93% vs 48% among non psychopathic offenders)
- more likely to use weapons and violence
- more unrelated / stranger victims
- more self reported sadistic sexual violence

3x the recidivism (they are 300% more likely to reoffend than individuals without those traits)

But 2.5x more likely to get conditional release (get onto probation) THEY ARE HIGHLY CHARISMATIC WHAT THE FUCKKK

why is matters:

individuals with psycopathy in community samples:
- more substance use
- smoke cigs
homelessness / employment instability
- risky sex
- divorce
- worse physical health
- die at younger age from more violent causes

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2
Q

Sociopathy

A
  • not diagnostic category
    depends on who u ask:
    distinctions based on etiology biology (psychopath) vs development (socioppathy)

robert hare:
socio non normatice moral system
psycho: lack of empathy

some claim interchangeable

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3
Q

Antisocial PD

A
  • replaced psychopathy in DSM III
  • exploitative, socially irresponisble behavior / violating others

-breaking laws / lying /highly impuslive/ lack remorse/ aggression

high overlap only a thers of those with ASPD would meet criteria for psychopathy

vs offenders without psycopathy:
– commit different crimes
- mostly instrumental (not based on emotional hostile)
(homicides 93% vs 48% among non psychopathic offenders)
- more likely to use weapons and violence
- more unrelated / stranger victims
- more self reported sadistic sexual violence

3x the recidivism (they are 300% more likely to reoffend than individuals without those traits)

But 2.5x more likely to get conditional release (get onto probation) THEY ARE HIGHLY CHARISMATIC WHAT THE FUCKKK

why is matters:

individuals with psycopathy in community samples:
- more substance use
- smoke cigs
homelessness / employment instability
- risky sex
- divorce
- worse physical health
- die at younger age from more violent causes

_____________________

Antisocial persons will tend to be irresponsible and negligent (during treatment)

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4
Q

Psychopathy checklist revised (PCLR)

A
  • has to be adminsitsterd by trained professional
  • have to refer to records post interviews (psychopathic ppl are known to lie and manipulate)
    cut off: 30/40
    most ppl score under 5
    scores on 2 factors:

interpersonal affective
- INTERPERSONAL:
(superficial charm, grandiosity, pathological lying / manipulation/ tp get money)

  • AFFECTIVE:
    (lack of remorse and empathy/ no responsibility for actions)

antisocail devience:
LIFESTYLE:
- prone to boredom
parasitic lifestyle
no long term goals
impulsive
irresponsible

Antisociality: poor behavioral control / early behaviour problems / juvenile delinquency / revocation of conditional release / criminal versatility

having high number of short length relationships = not good sign

community sample

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5
Q

Psychopathic Personality inventroy

A

are they violent? psychopath testing in community setting

  • fearless dominance
    (social potency / fearless)
  • self centered impulsivity
    (no concern of consequences / lack of empathy/ impulsivity/)
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6
Q

Triarchic Model

A

psychopathis 3 factors

  1. Disinhibition
    - cant regulate emtion / weak behavioural constrait
  2. Boldness
    - dominance / risk taking
  3. Meanness
    - cruel, predatory, destructive

emotionally focused theories:
- reduced eye blink startle response
impaired recognition of emotional facial expressions
- defects in fear based conditioning
- reduced amygdala activity in response to fearful faces
- reduced connectivity between vmPFC (ventromedial prefrontal cortex) and the amygdala (this stuff senses threats) shows impulsivity which is key in psychopathy

DEFECTS IN EMOTIONAL SYSTEMS

** show pics of different emotionally charged pictures (they look at how u blink)

Cognitive atential theories:
- states that psychos pay less attetion to empotional info unlesss ints central to their goal directed behavior

  • Baskin Sommars
  • green box - no shock
  • red box - shock (threat related info on screen)

(BASICALLY HOW MUCH ATTENTION IS PAYED TO EMOTIONAL RESPONSE)

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7
Q

Genetic

A
  • modersately to highly heritable

twin study: up to 70%
adoption study (no mother and daugher) storng connection to psychpathic father

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8
Q

potential causes

A

environmental:
- convict parent
- physical neglect
- low parental involvement
- abuse
- harsh discipline

(potential gene - environment correlation)

Brain Injury
- acquired sociopathy or pseudopsychopathy
- traumatic injury to prefrontal cortex amygdala
- earlier age trauma brain injury may result in worse outcomes

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9
Q

Teatment

A

NOPE NUH UH

  • higher psycho levels = less likely to follow any therapy
  • criminal reoffending AFTER therapy WTFFFFFFFFFFFFFFF
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10
Q

—–START OF READING 1——

A
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11
Q

Personaity disorder

A

when personality traits cause major distress, social / occupational issues

—–there are 10 in the DSM-5 ——
- antisocial
- avoidant
- borderline
- dependent
- histrionic
- narcissistic
- obsessive-compulsive
- paranoid
- schizoid
- schizotypal

UPD (unspecified personality disorders) and OSPD (other specified personality disorder) in DSM-5 are most common diagnosis
WHICH MEANS THE OTHER 10 AREN’T THAT ACCURATE

personality disorders are syndromes cuz not only dependant on one maladaptive trait.

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12
Q

Avoidant PD

A
  • avoiding social situations
  • feeling not good enough / inadequate
  • sensitive to criticism

combo of introverted and neuroticism traits

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13
Q

Big 5 traits / 5 factor model

A

neuroticism | emotional stability
extraversion | intraversion
openness | closeness
agreeableness | antagonism
conscientiousness |disinhibition

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14
Q

Dependant PD

A
  • excessive need to be taken care of
  • clingy
  • submissive
  • fear of separation

combo of neuroticism and maladaptive agreeableness traits

dependent patients can become overly attached to and feel helpless without their therapists.

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15
Q

Antisocial PD (aka psychopathy)

A

(antisocial means breaking rules of society)

  • violating other’s rights
  • could be aggressive / violent
  • theft / deceit

combo of antagonism and low conscientiousness

considered to be the result of an interaction of genetic dispositions for low anxiousness, aggressiveness, impulsivity, and/or callousness, with a tough, urban environment, inconsistent parenting, poor parental role modeling, and/or peer support

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16
Q

Obsessive - compulsive D

A

preoccupied with orderliness, perfectionism, mental & interpersonal control

sacrificing flexibility, efficiency, and openness

largely maladaptive conscientiousness

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17
Q

Schizoid PD

A

detached from social relationships AND lack of expression / emotions when with ppl

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18
Q

Borderline PD

A

instability in relationships, self image, and impulsivity, intense emotions

is generally considered to be the result of an interaction of a genetic disposition to negative affectivity interacting with a malevolent, abusive, and/or invalidating family environment
____________________________
- Can form intense manipulative attachments to therapists

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19
Q

Histrionic PD

A
  • Attention Seekers
  • overly emotional
  • seductiveness
  • strong attachment needs

maladaptive extraversion

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20
Q

Narcissistic PD

A
  • overly grandiose
  • need admiration
  • lack empathy

combo of neuroticism, antagonism, extraversion, and conscientiousness

narcissistic patients can be dismissive and denigrating

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21
Q

Schizotypal PD

A
  • discomfort / reduced capacity of social relationships.
  • perceptual distortions
  • unconventional behaviour

combo of neuroticism, antagonism, introversion, and conscientiousness

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22
Q

PDs that were slated for deletion

A

histrionic, schizoid, paranoid, and dependent

said to have had less empirical support than diagnosis being retained at the time

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23
Q

Paranoid PD

A

overly suspicious of others and their intentions

during treatment: paranoid patients will be unduly suspicious and accusatory

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24
Q

Treatment issues (PDs)

A

borderline disorder is the only one with an empirically validated treatment.

usually treated with therapy and stuff I think

PDs generally happen when ppl are ego-syntonic (aka comfortable within themselves) hence why its hard to get them to get treated for:
- antisocial
- narcissistic
- histrionic
- paranoid
- schizoid

also:
maladaptive personality traits will be evident in many individuals seeking treatment for other mental disorders, such as anxiety, mood, or substance use.

very hard to treat cuz its deep engraved into person’s self image / behaviour
——————–

The development of an ideal or fully healthy personality structure is unlikely to occur through the course of treatment BUT ITS STILL HELPFUL YAY

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25
Q

EXCEPTION (treatment-wise)

A

borderline PD (and avoidant PD)

because these are both focused on neuroticism (feelings of pain and suffering) and they will seek treatments to alleviate symptoms

contrastingly……..
narcissistic ppl are least likely to want to get treatment.

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26
Q

more stats (pd related)

A

The prevalence of personality disorders within clinical settings is estimated to be well above 50%

As many as 60% of inpatients within some clinical settings are diagnosed with borderline personality disorder

Antisocial personality disorder may be diagnosed in as many as 50% of inmates within a correctional setting

10% to 15% of the general population meets criteria for at least one of the 10 DSM-IV-TR personality disorders

and quite a few more individuals are likely to have maladaptive personality traits not covered by one of the 10 DSM-5 diagnoses.

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27
Q

Treatment of Borderline Personality Disorder

A

Dialectical behavior therapy and mentalization therapy

Dialectical behavior therapy is a form of cognitive-behavior therapy (draws on principles from Zen Buddhism, dialectical philosophy, and behavioral science)
four components:
- individual therapy
- group skills training
- telephone coaching
- therapist consultation team
typically last a full year

relatively expensive form of treatment, but research has indicated that its benefits far outweighs its costs, both financially and socially

28
Q

why treatments weren’t really developed for other types of PDs (other than borderline)

A
  • many PDs are known to be unresponsive to treatment
  • the 10 PDs are very heterogeneous and only 5 of 9 symptoms are enough to diagnose borderline for example
  • aka lots of overlap
  • many ppl with one pd meet diagnostic criteria for another

ALSO ppl rarely seek treatment for thier disorder which is why so little treatment exists

29
Q

A structure in the brain associated with liking is the:

A

nucleus accumbens
also:
connects motivation and action

30
Q

how to PDs arrise?

A

“They likely involve genetic and environmental factors”

31
Q

——START OF READING 3———-

A

(skipped 2)

32
Q

Psychoanalysis therapy

A

phsychoanalysis: earliest treatment for mental disorders

freud’s theory

  • rooted in unconscious conflicts and desires (which need to be identified and addressed)
  • exploring childhood experiences
  • often long term approach treatment
33
Q

Freud Stuff (history of psychoanalyctic theory / psychodynamic)

A

freud first thought:
—mental health problems come from suppressing inappropriate sexual urges out of conscious awareness

freud’s structural model: (problems come from tension between different parts of the mind)
- id
- ego
- superego

psychoanalysis then got mostly transformed into psychodynamic therapy
(using main ideas from but more specific to each person)

34
Q

Psychoanalysis vs psychodynamic theory

A

analysis: was the OG

dynamic: altered version —> more individualized
- more broadly defined
- briefer
- more effort to put clients into their social context
- more on relieving psychological distress than changing the person

DISADVANTAGES:
- expensive (cuz long term)
- not enough empirical support
- doesn’t work for patients with sever psycopathology and intellectual disability
———————-

The key to psychoanalytic theory :
- patients uncover the buried,
- conflicting content of their mind,

TECHNIQUES:
- seating patients to face away from them—to promote a freer self-disclosure.
- as a therapist spends more time with a patient, the therapist can come to view their relationship with the patient as another reflection of the patient’s mind.

35
Q

Freud’s Structural Model

A

problems come from tension between different parts of the mind:

  • id
    the pleasure driven unconscious urges (Sex / aggression)
  • ego
    partialy conscious
    between id and superego
  • superego
    semi-conscious part of the mind (morals and societal judgment)
36
Q

Free Association

A

When you’re asked to say all of your thoughts out loud without censorship

therapist interprets it

often applied to childhood recollections to get understanding of patient’s psychological makeup

37
Q

Dreams (freud theory)

A

dreams contain:
- manifest (or literal) content
- latent (or symbolic) content (the interpretation of the manifest content)

38
Q

receptive

A
39
Q

transference

A

That is, the patient may be displacing feelings for people in their life (e.g., anger toward a parent) onto the therapist.

40
Q

countertransference

A

opposite of transference, therapist putting emotions onto the patient

41
Q

humanistic / Person - centered therapy (PCT)

THINK GOOD WILL HUNTING

A

creating a supportive environment for self-discovery

believes mental illness comes from inconsistency between behaviour and person’s true self

essentially feel comfy within you, have self worth, and behave true to you.

DISCOVERED BY: CARL ROGERS in mid 20th century. HE BELIEVED:
– all ppl have capability to change and improve
–therapist should help patient find self worth
—patient - therapist relationship should have egalitarian (equal) relationship
— therapist should be empathetic and nonjudgemental

In PCT, the patient should experience both a vulnerability to anxiety, which motivates the desire to change, and an appreciation for the therapist’s support.

42
Q

Techniques in PCT

(THINK GOOD WILL HUNTING)

A

largely unstructured conversation between the therapist–> patient

therapist takes PASSIVE role, guidance in patients self discovery
(unlike psychoanalytical theory)

og name was non-directive therapy (flexible nature of therapy)

therapists don’t try to change patients thoughts/ behaviours directly (kinda like in good will hunting??)

therapist = safe environment

therapist’s unconditional positive regard for the patient’s feelings and behaviours
(no criticism)

43
Q

Advantages vs disadvantages of PCT

A

advantages:
– highly acceptable by patients
– transfer well to other therapy styles

disadvantages:
–unspecific treatment factors (focus on one size fits all treating everyone with empathy / kindness)

44
Q

cognitive behavioural therapy (CBT)

A

changing thoughts and behaviours to alleviate mental illness

– focused on the NOW rather than the past & childhood experiences
– how bad thought –> bad emotion–> bad behaviour –> how to fix
– often homework assignment involved
– 12-16 weekly sessions (relatively short)
— empirical data has shown it to be efficient for basically all psychiatric illnesses
————————-
mid-20th century by Beck and Ellis

45
Q
A
46
Q

Automatic thoughts

A

spontaneous thoughts that ppl with depression report having

Beck (CBT guy) said automatic thoughts come from 3 belief systems:
1) beliefs of self
2) beliefs of world
3) beliefs of future

47
Q

reappraisal / cognitive restructuring

A

The process of identifying, evaluating, and changing maladaptive thoughts in psychotherapy. (in CBT)

48
Q

negative affect of maladaptive behaviours

A

reinforces the validity of the maladaptive thought

CBT works on fixing this with stuff like homework excersizes.

49
Q

Exposure therapy

A

(used in CBT)

patient confronts the problematic situation and fully engages in experience instead of avoiding.

goal: to reduce fear of situation through extintction learning

50
Q

Extinction learning

A

neurobiological / cognitive process by which person unlearns the irrational fear

51
Q

Advantages and Disadvantages of CBT

A

advantages:
- brief
- cost effective
- intuitive/logical to patients
- can be adapted to different populations
- lots of empirical support
- considered first line treatment for a lot of disorders

disadvantages:
- significant participation from patient (can be hard to get)

52
Q

assumptions about events (Beck) / self-statements (Elllias)

A

Meaning, it is not the event per se, but rather one’s assumptions (including interpretations and perceptions) of the event that are responsible for one’s emotional response to it.

aka its not the thing, but your interpretation of the thing.

53
Q

Ellias’ ABC model

A

CBT believes ur interpretation of certain events / things / ideas shapes your emotions and behaviour (yeah no shit)

A - Antecedent event
B - Belief
C - Consequence

during CBT patient has to do “detective” work on sequence of events, responses to them, and validity of beliefs (through behaviour experiments and reasoning)

54
Q

Acceptance and Mindfulness-Based Therapy (aka MBT)

A

age old buddhist / yoga practices

A process that reflects a nonjudgmental, yet attentive, mental state.

awareness of bodily sensations, thoughts, outside environments.

TWO STEPS:
1) self-regulation of attention,
2) orientation toward the present moment

compared to CBT doesn’t work to overcome maladaptive thought, but rather just accepts it and that it’s a spontaneous thought.

DRAWS ATTENTION AWAY FROM PAST AND FUTURE STRESSORS
- acceptance of thoughts
- physical relaxation

55
Q

MBCT - mindfulness-based cognitive therapy (type of MBT)

A

rather than reducing one’s general stress of specific problem, attention is focused on one’s thoughts and their associated emotions.

  • helps prevent relapses in depression by encouraging patients to evaluate their own thoughts objectively and without value judgment

CBT is more “pushing out” the maladaptive thought,
MBCT is more “not getting caught up” in it.

MBCT has helped:
-depression
- anxiety
- chronic pain
- coronary artery disease
- fibromyalgia

56
Q

MBCR - mindfulness-based stress reduction (type of MBT)

A
  • meditation
  • yoga
    aka physical relaxation to reduce stress

basically if reduce person’s overall stress, they’ll be in a better state to process / objectively evaluate thoughts and emotions

57
Q

DBT - Dialectical Behaviour Therapy

A

skills for fixing maladaptive thoughts and behaviours

often for treating borderline personality disorder

employs CBT and MBT

example of skills:
- distress tolerance
(ways to cope with maladaptive thoughts and emotions in the moment

cutting –> rubber band example

different from CBT in that:
DBT –> techniques that address the symptoms of the problem (e.g., cutting oneself) rather than the problem itself (e.g., understanding the psychological motivation to cut oneself).

CBT does not teach such skills cuz skills could be harmful in long term (keeps the same maladaptive thought / behaviour)

training because of the concern that the skills—even though they may help in the short-term—may be harmful in the long-term, by maintaining maladaptive thoughts and behaviours.

founded on the perspective of a dialectical worldview aka not everything black and white but theres lots of grey in the middle where things have both characteristics of good and bad.

So, in a case involving maladaptive thoughts, instead of teaching that a thought is entirely bad, DBT tries to help patients be less judgmental of their thoughts (as with mindfulness-based therapy)

58
Q

distress tolerance

A

ways to cope with maladaptive thoughts and emotions in the moment

59
Q

dialectical worldview (DBT)

A

not everything black and white but there’s lots of grey in the middle where things have both characteristics of good and bad.

emphasizes the joint importance of change and acceptance.

60
Q

ACT - acceptance and commitment therapy (part of MBT)

A

patients observe their thoughts from detached perspective

they’re not told to fix anything just to observe and recognize whats harmful and whats beneficial

61
Q

advantages and disadvantages of MBT

A

advantages:
- accessible
- acceptable
- efficient for anxiety / mood disorders
- cuz yoga / meditation widely known–> consumers of mental healthcare often interested in trying related psychological therapies.

disadvantages:
- no consensus of efficiancy among psychologists (but it is growing)

62
Q

cognitive bias modification (emerging treatment)

A

internet-and mobile-delivered therapies (more accessible to patients)

Using exercises (e.g., computer games) to change problematic thinking habits.

example:
alcoholic tapping on healthy image rather than image of alcohol –> learns to ignore alcohol cues in environment

however processes like this require further research

63
Q

CBT-enhancing pharmaceutical agents

A

drugs used to improve effect of the therapy

based on animal tested research there are drugs that influence bio processes of learning

SOOO if they take learning enhancing drugs while learning psychotherapy, it will be more effective

EXAMPLE:
d-cycloserine improves treatment for anxiety disorders by facilitating the learning processes that occur during exposure therapy

64
Q

comorbidity

A

having more than one physical or mental disorders at the same time.

64
Q

Pharmacological

A

psychiatric drugs frequently used for other mental disorders (e.g., schizofrenia, BD)

  • used a lot cuz they can be prescribed by general medical practitioners rather than a trianed psycologist prescribes psychotherapy

While drugs and CBT therapies tend to be almost equally effective, choosing the best intervention depends on the disorder and individual being treated, as well as other factors—such as treatment availability and comorbidity

65
Q

Integrative or eclectic psychotherapy

A

combining multiple types of therapies (e.g., CBT with psychoanalytic elements).

For example, a therapist may employ distress tolerance skills from DBT (to resolve short-term problems), cognitive reappraisal from CBT (to address long-standing issues), and mindfulness-based meditation from MBCT (to reduce overall stress). And, in fact, between 13% and 42% of therapists have identified their own approaches as integrative or eclectic

65
Q
A

Psych 100 (8 decks)

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