Abnormal Psych Overview (Ch1,2,3)

Describe factors that must be considered to provide optimal treatment

evidence based treatment -drug has efficacy -involve randomized clinical trials medication or psychotherapy? -Concern: side effects, dosage, drugs chance biochemical changes & don't help individual change maladaptive behaviors, discontinued drugs combined therapy -psychosocial interventions are typically combined w/ psychiatric medications -combined tx = effective b/c medications & psychotherapy may target different symptoms & work @ different rates -pharmacotherapy said to provide rapid, reliable relief from acute distress & psychotherapy appears to provide broad & enduring change w/ combined tx retaining specific benefits of each -limitation: adding psychiatric medications may not be effective in treating anxiety disorders

distinguish fear vs anxiety

fear -basic emotion that involves activation of fight/flight response of sympathetic NS -adaptive alarm reaction in response to immediate danger -may cause panic attack anxiety -general feeling of apprehension about possible danger -adaptive to help prepare for possible threat

interpersonal psychotherapy IPT

focus on current relationships win patients life & sets goals of reducing symptoms & improve fx -IPT = time limited, emphasis in tx is on the present, not the past

Classical conditioning

form of learning where: - NS + UCS --> UCR (repeat) -CS (previously NS) --> CR

fMRI

functional MRI -measures changes in local oxygenation of specific areas of brain tissue that in turn depend on neuronal activity in those specific regions -allows "mapping" brain structure -studies suggest it is effective for detecting neural correlates for self-critical thinking -used to study aphasia limitations: 1) sensitive to instrument errors or inaccurate observations from slight movements of person being evaluated 2) results are often difficult to interpret, don't provide much specific info about processes studied 3) not considered valid or useful diagnostic tool for mental disorders or in forensic evaluations

what Gender Differences occur in Diagnosis:

gender difference noted for some disorders -e.g. antisocial personality = males > females -e.g. anorexia = females > males -males & females w/ same disorder show different symptom patterns -males have higher rate of fighting & aggression vs. females have greater tendency to lie & be truant from school/ run away from home -DSM 5 allows gender differences to be incorporated into diagnosis

extinction

gradual disappearance of conditioned response when no longer reinforced

how has abnormal behavior been viewed throughout history

greeks: hippocrates believed mental disorders resulted from natural causes and brain pathology (from imbalance in 4 humors) -mental disorders classified into: mania, melancholia, phrenitis (brain fever) middle ages: mental illness due to supernatural effects

what are the 3 components of personality according to psychoanalytic theory?

id, ego, supergo

intrapsychic conflict

inner mental struggles resulting from interplay of id, ego and superego when they strive for different goals

give example of psychodynamic explanation of alcoholism

intrapsychic conflict and anxiety arise that causes person to reduce through alcohol consumption

ego-defense mechanisms

irrational protective measures used by the ego in the unconscious to reduce anxiety

what are the 3 components of fear & panic:

(1) cognitive/subjective components (i am in danger) (2) physiological components (increased HR) (3) behavioral components (escape desire)

differentiate between manifest and latent content

(1) manifest content (dream as it appears to dreams), (2) latent content (actual motives that are seeking expression but so painful/unacceptable they are disguised)

key elements of therapeutic relationship

(1) sense of working collaboratively on problem (client & therapist), (2) agreement b/w patient & therapist about goals & tasks of therapy, (3) affective bond b/w patient & therapist -therapists help provide new perspective, a safe env for client to feel safe

The Hamilton Rating Scale for Depression (HRSD)

(HRSD) = most widely used procedure for selecting research subjects who are clinically depressed & also for assessing response of such subjects to various tx

tangentiality (thoughts)

(more or less logical but doesn't get to point)

circumstantiality (thoughts)

(overly detailed & takes long time to get to point)

Strength and weakness of projective personality tests

*projective personality tests' strengths = focus on unique aspects of personality - same time their weaknesses b/c interpretations are subjective, unreliable, & difficult to validate

Temperament

- a child's reactivity and characteristic ways of self-regulation -biologically programmed (but pre and postnatal environmental influences also play a role in development) -eg some babies startle easier than others

Sufficient cause

- a condition that guarantees the occurrence of a disorder -Eg one current theory hypothesizes that hopelessness (x) is a sufficient cause of depression (Y) -if X occurs then Y will also occur

Lycanthropy

- a condition where people believed themselves to be possessed by wolves and imitate their behavior

Tarantism

- a disorder in 13th century Italy with uncontrollable impulse to dance -often attributed to the bite of a tarantula/spider

Mental hygiene movement

- a method of treatment that focused almost exclusively on the physical well-being of hospitalized patients with mental illness, followed from moral management. Although patients comfort levels improved, patients received no help for their mental problems and so were condemned to helplessness and dependency.

Genotype

- a person's total genetic endowment -no 2 individuals (except identical twins) ever begin life with the same genetic make up

Behavioral perspective

- a theoretical viewpoint that learning is central in determining human behavior

Diathesis

- a vulnerability/predisposition toward developing a disorder that can derive from biological, psychological or sociocultural causal factors

Moral management

- a wide-ranging treatment method that focused on a patients social, individual and occupational needs -popular during early period of humanitarian reform In asylums, moral management emphasized: -the patients moral and spiritual development -rehabilitation of their character rather than their physical or mental disorders (little alternative treatment available at the time) -treatment attempted via manual labor, spiritual discussion, humane treatment

No-treatment control

- allows experiments to see what happens when they do not provide any treatment / expectation of treatment at all

Lifetime prevalence

- an estimate of the number of people who havce had a particular disorder at any time I their lives even if recovered

Negative correlation

- an inverse correlation between variables of interest (high income and decreased psychopathology risk)

Placebo effect

- any improvement due to belief, not due to clinical benefit from IV

Fixation

- attaching oneself in an unreasonable/exaggerated way to some person, or arresting emotional development on a childhood or adolescent level -Eg an unmarried, middle-aged man still depends on mother to provide basic needs

Projection

- attributing ones unacceptable motives or characteristics to others -Eg an expansionist-minded dictator is convinced that neighboring countries are planning to invade

Etiology

- causes of disorders, research allows understanding of this

chromosomes? relation to abnormality?

- chain-like structures within a cell nucleus that contain the genes -23 pairs (46 total) -Most disorders influenced by gene abnormalities (that are polygenic) on the chromosomes -Collectively genes may lead to structural abnormalities in the CNS, NT abnormalities or to excesses/deficiencies in reactivity of the autonomic NS which is involved in mediating many of our emotional responses

Sublimation

- channeling frustrated sexual energy into substitutive activities -Eg sexually frustrated artist paints wildly erotic pictures

Hormones

- chemical messengers secret by a set of endocrine glands in our bodies.

Halstead-Reitan battery

- composed of several tests & variables from which an "index of impairment" can be computed -provides specific info about subject's fx'ing in several skill areas

systematic desensitization

- controlled, slow, gradual process of exposing fear stimulus -rationale: find behavior that is incompatible w/ being anxious & repeatedly pair w/ stimulus that provokes anxiety

1-year prevalence

- count everyone who experienced depression at any point in time throughout the entire year (would be higher than point prevalence)

Evaluating humanistic-experiential therapies:

- criticisms: lack of agreed-on therapeutic procedures & vagueness about what is supposed to happen b/w client & therapist

what is involved in clinical observation of behavior

- direct observation of client's characteristic behavior (hygiene, appearance, emotions) - may use analogue situations such as staged role playing - designed to yield info about person's adaptive strategies - help client by providing instruction in self-monitoring: self observation & objective reporting of behavior, thoughts, feelings

Displacement

- discharging pent-up feelings, often of hostility on objects less dangerous than those arousing the feelings -Eg woman harassed by boss at work initiates argument with husband

Point prevalence

- estimated proportion of actual, active cases of a disorder in a given population at a given time. -Eg conduct and count number of people with major depressive disorder (clinical depression) on Jan 1 next year, this would provide us with a point prevalence estimate of active cases of depression

role playing

- event reenactment used in clinical observations - designed to yield info about person's adaptive strategies

Analogue studies

- experiments where we study not the true item of interest but an approximation to it (often in animal subjects with the assumption that findings from here can be generalized to humans) -helplessness theory of depression (dogs shocked failed to remember escapes route and endures pain)

IV

- factor that is manipulated in experimental research study

Castration anxiety

- fear of losing penis forces boy to press sexual desire for mother and hostility towards father -If all goes well, boy eventually identifies with father and comes to have only harmless affection for mother, channeling sexual impulses toward another woman

Shared envr influences

- features that make children in family more similar (poverty, high-quality school) -influence tested in family history, twin and adoption studies

Neural plasticity

- flexibility of the brain in making changes in organization and function, in response to pre and postnatal experiences, stress, diet, disease, drugs, maturation etc. -effects either beneficial or detrimental depending on circumstance.

Describe the different intelligence tests used in psychological tests?

- for children (WISC-IV) -Stanford-Binet Intelligence scale (most widely used for children) -WAIS-IV = most common adult intelligence test widely used -WAIS-IV includes both verbal & performance material & consists of 15 subtests: vocabulary (verbal) - consists of oral words to define. Designed to evaluate knowledge of vocabulary which is highly related to general intelligence Digit span (performance) - short term memory test where number sequence administered orally. person repeats digits in order or reverses order sequence ce

How can a childs Genotype interact with the environment?

- genetic factors not necessary and sufficient to cause mental disorders, but instead can contribute to the diathesis to develop psychopathology -that only happens if there is a significant stressor in the persons life. Eg PKU-induced intellectual disability. -Children with PKU react very differently to many common foods with phenylalanine as they cannot metabolize this AA. Its metabolic products then build up and damage the brain

Comparison(control) group

- group of people who do not exhibit the disorder being studied -but who are comparable in all other major respects to the criterion group (age, gender ratio, educational level), typically considered healthy or "normal", -allows comparison with criterion group on the variables of interest

Asylums

- historically were sanctuaries or places of refuge meant solely for the care of people with mental illness from 16th century -early ones were used as human storage unit to remove unwanted/troublesome individuals from society -deplorable conditions

Polygenic

- influenced by multiple genes / polymorphisms of genes with any one gene have only very small effects -collectively may lead to structural, NT, endocrine abnormalities

Prospective research strategy

- involves looking ahead in time with the goal of identify individuals who have a higher than average likelihood of becoming psychologically disordered -to focus research attention on them before disorders manifest

Retrospective research strategy? problems of this?

- involves looking back in time eg collect information about how patients behaved early in their lives with goal of identifying factors that may have been associated with later condition -invites biased procedure (psychopathology thought to be due to early sexual abuse and so convince patients they must have been abused, repressed memories)

Correlational research design

- involves studying associations among observed phenomena -does not involve manipulation of variables and controls so no causation can be made -Allows identification of factors that appear to be associated with a clinical condition

Observational Learning

- learning through observation alone, without directly experiencing an UCS (for CC) or a reinforcement (OC) -Eg children learn new fear simply by watching parent behaving fearfully with something they did not originally fear

Insanity

- legal term for mental disorder -implying lack of responsibility for ones acts and inability to manage one's affairs

Positive correlation

- measures that vary together in a direct corresponding manner (breast augmentation surgery correlated with increased suicide risk)

Correlation coefficient (r)

- measures the strength of the coefficient - goes from -1 (negative correlation) - 0 (no correlation) - +1 (positive correlation)

Ego

- mediates the demands of the id and realities of the external world (meets id demands but ensures well-being and survival of the individual), -develops after first few months of life -uses secondary process thinking as adaptive measure -operates on reality principle

Psychoanalysis

- methods developed by Freud to study and treat patients -includes free association and dream analysis

Diathesis-Stress model

- model describing how someone with a preexisting vulnerability for that disorder experiences a major stressor -model describing the situation that mental disorders develop when someone with pre-existing vulnerability for disorder experiences a major stressor

Aversion therapy:

- modifying undesirable behavior through punishment - e.g. use drugs w/ noxious effects e.g. Antabuse - induces nausea/vomiting when person ingests alcohol

Deinstitutionalization? pros and cons?

- movement to close mental hospitals and treat people with severe mental disorders in the community. Pros: -to provide a more integrated and humane treatment than what was available in the isolated psychiatric hospital environment -medications to alleviate symptoms allowed this - cost effective. Cons: Although good goals: -created difficulties for many with psychological challenges as well as the communities

Double-blind study

- neither subjects nor experimenter knows who got genuine treatment

Object-Relations Theory? example?

- newer psychodynamic perspective that focuses on 1) individuals' interactions with real (external) and imagined people (internal obj) and on, 2) relationships that people experience between their external and internal objects example: -Child incorporates into personality important people in their life ( -internalizes image of punishing father, then that image becomes a harsh self-critic influencing how the child behaves -Internalized objects may have various conflicting properties -which could split off from the central ego and maintain independent existences (causing inner conflicts) -When an individual experiences splitting among internalized objects they cannot lead an integrated orderly life.

Interpersonal perspective

- newer psychodynamic perspective that focuses on social determinants of behavior. -Humans are social and much of what we are is a product of our relationships with others, - psychopathology thus rooted in the unfortunate tendencies developed while dealing with interpersonal environment. -Focus on social and cultural forces rather than inner instincts as determinants of behavior -In this view people are inherently social beings motivated primarily by desire to belong to and participate in a group

Ego psychology

- newer psychodynamic perspective that refined and elaborated on the ego-defense mechanisms -gave ego important organizing role in personality development. -view that psychopathology develops when ego: 1) does not function adequately to control or delay impulse gratification, or 2) does not make adequate use of defense mechanisms when faced with internal conflicts

Incidence

- number of new cases that occur over a given time period (typically 1 year), tend to be lower than prevalence figures as exclude pre-existing cases

Oedipus complex

- occurs during phallic stage of psychosexual development -each young boy longs for mother sexually and views father as hated rival. -But fears father will punish his son's lust by cutting off his penis (castration anxiety)

Hysteria

- old term used for conversion disorders, involves appearance of symptoms of organic illness in absence of any related organic pathology

Contributory causes

- one that increases the probability of a disorder developing -but is neither necessary nor sufficient for the disorder to occur -eg if X occurs, Pr Y occurring increases

Self-schemas

- our view of who we are, what we might become and what is important to us

Trust & Rappert b/w clinician & client: did providing test feedback to clients aid them in their adjustment?

- patients given feedback on test results tend to improve just from gaining perspective > ppl who don't get feedback

Criterion group

- people with the disorder being studied

Reaction formation

- preventing awareness or expression of unacceptable desires by an exaggerated adoption of seemingly opposite behavior -Eg a man troubled by homosexual urges initiates a zealous community campaign to stamp out gay bars

Repression

- preventing painful or dangerous thoughts from entering consciousness -Eg a mothers occasional murderous impulses toward her hyperactive child are denied access to awareness

secondary process thinking

- process where the ego component of personality uses reality-oriented rational processes for dealing with the external world and control over id demands

primary process thinking

- process where the id component of personality generates mental images and wish-fulfilling fantasies -but cannot undertake the realistic actions needed to meet instinctual demands

Internal validity

- reflects how confident we can be in the results of a study, -extent to which a study is free of confounds, error and able to be used to draw valid conclusions

Analysis of resistance

- resistance = unwillingness or inability to talk about certain thoughts, motives, experiences

Regression

- retreating to an earlier developmental level involving less mature behavior and responsibility -Eg Man with shattered self-esteem reverts to childlike showing off and exhibits genitals to young girls

Endings

- risk of suicide is considered

Convenience sample

- sampling method that relies on data collection from those conveniently accessible to participate

Behaviorism

- school of psychology that formerly restricted itself to study of overt behavior -instead of theoretical mentalistic constructs by Watson

External validity

- the extent to which we can generalize our findings beyond the study -the more representative our sample, the more able to generalize and thus the higher our external validity

Concordance rate

- the percentage of twins sharing the disorder or trait -used in twin method studies to determine influence of genes in disorder

Unconscious

- the portion of the mind that contains experiences and processes of which a person is unaware but important in determining behavior

Attribution

- the process of assigning causes to things that happen -eg in cognitive-behavioural perspective we attribute behavior to external events like reewards/punishments (he did that for money) or assume causes are internal and come from our traits (did that because generous) -causal attributions help explain and predict behavior

Stress

- the response or experience of an individual to demands that they perceive as taxing or exceeding their personal resources.

Mass madness ? example?

- the widespread occurrence of group behavior disorders due to hysteria -whole groups affected simultaneously. Eg. Dancing manias in 10th century (middle ages)

Psychoanalytic perspective

- theory of psychopathology developed by Freud that emphasized the inner dynamics of unconscious motivates

Synapse

- tiny fluid-filled space between presynapse of one and postsynaptic of other -Interneuronal transmission accomplished by NTs

Random assignment

- to ensure all participants have equal chance of being placed in either group -used to ensure the 2 groups are as equivalent as possible except for presence or absence of IV -increases external validity

Exorcism

- treatment of people with mental disturbances by the clergy/monasteries -by expulsion of the evil spirit that possessed them

Rationalization

- using contrived explanations to conceal or disguise unworthy motives for ones behavior -Eg a fanatical racist uses ambiguous passages from scriptures to justify hostile actions toward minorities

Attachment theory

- very influential theory in child and adult psychopathology - newer psychodynamic perspective that emphasizes importance of early experience, especially early experience with attachment relationships -this lays foundation for later functioning throughout childhood, adolescence and adulthood -quality of parental care v. impt to development of secure attachments

Genotype-environment correlation? example?

- when the genotype shapes the environmental experiences a child has -Eg child with genetic predisposition to aggressiveness. Aggressive to peers in early grades leading to rejection. This rejection causes him to associate with similarly aggressive and delinquent peers in later grades and leads to an increased likelihood of delinquency in later adolescence

what is a general physical exam?

-'medical checkup' -medical history, physical exam taken, major body systems checked

Monoamine oxidase inhibitors (MAOI):

-1st antidepressant developed in 1950s -1st developed to tx tuberculosis but found to elevate patients' moods -inhibit activity of monoamine oxidase -patients on MAOI must avoid foods rich in AA - Tyramine like salami & stilton cheese

Lithium TX:

-1st used as salt substitute for patients w/ hypertension before toxic side effects known -used to tx bipolar disorder -side effects: increased thirst, GIT difficulties, weight gain, tremor, fatigue -lithium toxicity = serious medical condition that can cause neuronal damage / death

Describe association method to study genetic influences on abnormal behavior. limitations?

-2 large groups of individuals used (1 with disorder, 1 without) -frequencies of known genetic markers on chromosomes are compared between groups (eye colour or blood) -If one or more of the genetic markers occur with much higher frequency in the individuals with disorder, researchers infer that genes associated with disorder are located on the same chromosome -Better than linkage studies for identifying small effects on any gene for disorders that are polygenetically influenced

What is self-report data? Describes advantages and disadvantages.

-An approach used to study behavior in a more rigorous manner -can involve completion questionnaires, interviews advantages: -quick, easy, cheap disadvantages: -misleading (retrospective memory not accurate) -inaccurate (misinterpretation of question, socially desirable responding)

Why are schemas and self-schemas so important for understanding abnormal behavior and its treatment?

-Both vital to ability to engage in effective and organized behavior as allows focus on the most relevant and important bits from senses. -also sources of vulnerability as some of our schemas / aspects of self-schemas may be distorted and inaccurate. -Different forms of psychopathology are characterized by different maladaptive schemas, leading to distort thinking -characteristic of certain disorders such as anxiety, depression and personality disorders.

Describe the major treatment approaches used for social phobia.

-CBT may involve cognitive restructuring techniques = therapist helps client w/ social phobia to identify underlying negative automatic thoughts -Medications can help social phobias (unlike specific phobias) but not as effective as CBT

what does it mean to use culturally fair assessments?

-Cultural competence = issues involved in multicultural assessment -critical for psychologist to be informed of cultural competence & to use testing procedures that have been adapted & validated for culturally diverse clients (eg non english test takers will score diff on english test) -most widely used personality measure internationally = MMPI (Minnesota multiphasic personality inventory)

Explain how cultural differences can influence perceptions of abnormal behavior

-Cultural perspective concerned with impact of culture on the definition and manifestation of mental disorders - some universal symptoms and patterns appear, but sociocultural factors often influence which disorders develop, the forms they take, how prevalent they are and their courses eg depression manifests physically in China eg Hikikomori in Japan

Why is abnormality so hard to define?

-Culture:what is normal in one may not be in another -societal values/norms: constantly changing too (homosexuality, piercings)

what is the DSM

-Diagnostic & Statistical Manual of mental disorders -latest version is DSM-5 -includes criteria for diagnosing mental disorders, major categories of mental disorders (+ exmaples):

How do risk factors, protective factors, stress interact in development to form maladaptive behavior

-During development, a child may acquire a variety of cumulative risk factors that may interact to determine his or her risk of psychopathology - risk factors also interact with protective factors and stressors, to determine whether the child develops in a normal and adaptive way as opposed to showing signs of maladaptive behavior

How were biological discoveries important in the generation of contemporary perspectives of ab psych ?

-Established link between the brain and mental disorder -biological and anatomical features seen here to underly both physical and mental disorders occurred here -eg organic factors underlying general paresis (brain syphilis) -led to other investigations that established brain pathology as underlying mental disorders

How was the psychoanalytic perspective important in the generation of contemporary perspectives of ab psych ?

-Freud encouraged patients to talk freely under hypnosis, after which they would feel catharsis (significant emotional release) upon waking up -Led to discovery of the unconscious and its role in determining behavior -Free association and dream analysis were the 2 methods to understand the conscious and unconscious thought processes:

what is the psychoanalytic theory

-Freud's theory that a persons behavior results from the interaction of the 3 components of the personality (id, ego, superego) -believed inner mental conflicts arise because the 3 subsystems are striving for different goals. If unresolved, these intrapsychic conflicts lead to mental disorder

in what 3 ways can an imbalance of NT systems result in abnormal behavior?

-Functional NT excess due to production or release -Dysfunction in NT deactivation (reuptake or degradation) -Abnormal sensitivity/insensitivity of receptors on PSN

most powerful therapeutic method to treat anxiety disorders

-Graduated exposure to feared cues, objects, situations - until fear or anxiety begins to habituate -addition of cognitive restructuring techniques can provide added benefit through understanding distorted thought patterns about anxiety-related situations + how can be changed

what was the effect of humanism on abnormal psych?

-Humanism emerged following Middle ages. -scientific questioning re-emerged -Superstitious beliefs that hindered therapeutic treatments and understanding were challenged here

Superego

-Inner control system that deals with the uninhibited desires of the id (our conscious) -Develops as child grows and gradually learns the rules of parents and society regarding right and wrong.

MRI

-Magnetic Resonance imaging -can differentiate subtle variations in soft tissue so images of brain interior sharper > CAT -MRI procedure less complicated to administer > CAT & does not subject patient to ionizing radiation -MRI can be problematic some ppl have claustrophobic rx, current beliefs about MRI draw on cultural ideas about technology & reinforced by health care policies; MRI scans don't reveal truth about body & do not always lead to better outcome for patients

MMPI-2 (revised for adults)

-Minnesota Multiphasic Personality Inventory -most widely used objective personality assessment today (revised to increase validity) -120 scales

Are the same disorders always found worldwide, regardless of culture?

-Most things that are considered abnormal are behaviors that most would consider to reflect abnormality -however, 2 disorders found in specific cultures that are not found in others e.g. Tajin kyofusho + ataque de nervios

Evaluating Cognitive behavioral therapies

-REBT most useful in helping health ppl to cope better w/ everyday stress & prevent from developing full blown anxiety or depressive disorders -CBT extremely beneficial in alleviating many different types of disorders -CBT comparable to dx tx, offers long term advantages, tx choice for bulimia, have promise in tx of conduct disorder in children -Meta-analysis on CBT: (1) Effective for treating depression since since 1970s, (2) benefit fm> m, (3) more experienced clinicians have better tx effects, (4) effectiveness of CBT decreasing OT

Describe the stigma on mental health? how should you describe someone with a mental disorder?

-WHO estimates that mental disorders affect ¼ ppl at some point in their lives -2/3 of ppl diagnosable mental disorder do not seek tx -best to use "People First Language" - words that refer to the person first > person's condition -Avoid terms like "the schizophrenics" & say "people w/ a diagnosis of schizophrenia"

Explain how culture affects what is considered abnormal and describe two different culture-specific disorders

-Within culture, many shared beliefs and behaviors exist that are widely accepted and that may constitute one or more customary practices -Psychological distress described differently in diff cultures. First Nations - no word for depression -Culture shapes the clinical presentation of disorders like depression, which are present across cultures around the world. Here there is a focus on physical pain in depression (Fatigue, dizziness, headaches) rather than verbalizing feelings of melancholy or hopelessness (same in Chinese depressed patients) Tajin kyofusho - disorder that is highly culture specific in japan - characterized by fear that one's body parts (facial expression, gaze) / odor will upset others "Attack of nerves" - disorder prevalent in those of latino descent, clinical syndrome that does not correspond to any specific diagnosis within DSM. Symptoms triggered by stressful event such as divorce, bereavement, crying, trembling, uncontrollable screaming and sense of being out of control. Person may become physically or verbally aggressive or may faint / seizure-like fit. Once 'ataque' is over person promptly resumes normal manner with no memory of incident

Hikikomori

-a cultural specific disorder in japan. -characterized by acute social withdrawal -young people remain in their room in parent's house and refuse social interaction for at least 6 months or many years. - caused by shyness, parental rejection, poor parental attachment and peer social exclusion

Risk factor

-a factor associated with an increased risk of developing condition -eg if only X precedes Y, X is risk factor

CC

-a form of learning in behavioral approach where specific stimulus elicits specific response -UCS + NS --> UCR (repeat) -CS (NS) --> CR -extinction may occur following repeated CS with no UCS, so CR does not occur -may spontaneously recover

variable risk factor

-a risk factor that can be changed

causal risk factor

-a risk factor that can be changed, and when manipulated changes risk of outcome

variable marker

-a risk factor that when changed/manipulated does not change risk of outcome

Antipsychotic drugs:

-able to reduce intensity of delusions & hallucinations by blocking dopamine receptors -e.g. 1st gen atypical antipsychotics= chlorpromazine, 2nd gen - clozapine & conventional antipsychotics -cons: great risk to patients w/ dementia - associated w/ increased rates of death -1 problematic side effect w/ conventional antipsychotic meds like chlorpromazine = tardive dyskinesia = movement abnormality -patients must have blood tested every week for 1st 6 months -clozapine = use after considering other meds b/c side effect = life threatening drop in WBC = agranulocytosis

What is the DSM ? Why is it important?

-accepted standard for defining various types of mental disorders from APA - diagnostic and statistical manual of mental disorders -Provides clinicians with specific diagnostic criteria for each disorder, allowing common language for each diagnosis between clinicians. -Also important for research

antidepressants target and examples

-affect 5HT a d NE NT systems -SSRIs, SNRIs, TCAs, MAOIs

projective personality tests

-aimed at discovering ways in which individual's past learning & personality structure may lead him or her to organize & perceive ambiguous info from env -unstructured, rely on various ambiguous stimuli such as inkblots or vague pictures which is better than explicit verbal questions, person's responses not limited to "true", "false", "cannot say" examples include: -inkblot -thematic apperception test (TAT) -sentence completion tests

give example of behavioral explanation of alcoholism

-alcoholism due to learning of negative habits to reduce stress and environmental conditions that worsen condition

Thought

-allows assessment of THOUGHT processes: normal vs. circumstantiality vs. tangentiality and content -Tangentiality can lead to 'flight of ideas' where thoughts are connected but there are abrupt shifts in topics (associated w/ manic stress) -loose associations = connections b/w sentences or thoughts are loose (associated w/ drug induced states) -Word salad = extreme form of loosened associations where words have no connection to one another -May reveal Delusions and obsessions

Why are comparison or control groups so important?

-allows comparison between groups on the variables of interest by removing extraneous variables that may confound data

Placebo treatment

-allows control for the possibility that simply believing one is getting an effective treatment produces a therapeutic benefit

what medications are used in anxiety disorders?

-anxiolytics -antidepressants

Developmental systems approach

-approach used by developmental psychopathologists -acknowledges that genes influence neural activity, which influences behavior, which influences the environment. -But these influences are bidirectional. So various aspects of environment (physical, social and cultural) also influences behavior, which affects of neural activity, which can even influence genetic activity)

Experimental research

-approach used to draw conclusions about causality and resolve questions of directionality. -All factors controlled but one that is thought to have effect on variable/outcome of interest -This factor is then actively manipulated (IV)

Categorical Approach

-assumes that all human behavior can be divided into categories of 'healthy' and 'disordered' -assumes that w/in the latter, there exist discrete, classes of disorder that have high degree of homogeneity in both symptoms displayed & the underlying organization limitation of such distinct categories = 2 or + identified disorders occur together in same individual (comorbidity) but this doesn't mean that person has 2 or more entirely separable & distinct disorders

Dimensional Approach

-assumes that person's behavior is product of differing strengths of behavior along several definable dimensions such as mood, aggressiveness, anxiousness, etc. -dimensions once established are same for everyone and traits range from very low to very high between individuals

Accommodation

-basic goal of cognitive-behavioural therapy -defined as changing our existing frameworks to make it possible to incorporate new info that doesn't fit -more difficult and threatening especially when important assumptions are challenged

Level of consciousness

-being on continuum from being alert to drowsy to reactive to pain to completely

What are the 3 different approaches used to gather information about mental disorders?

-case studies -self-report data -observational approaches

Necessary cause

-characteristic that must exist for disorder to occur -Eg general paresis cannot develop unless a person has previously contracted syphilis -if Y occurs, then X must precede it

describe clinical features of social phobia/social anxiety disorder -what it is -DSM -subtypes -prevalence,onset -psychological causal factors -biological causal factors -treatments

-characterized by disabling fears of one or more specific social situations (eg public speaking, urinating in a public bathroom, or eating in public) Prevalence, age of onset, gender differences: -more common in women > men -1/3 abuse alcohol to reduce anxiety -Remarkably persistent - only about 1/3 recover spontaneously over 12 year period DSM5: -marked fear/anxiety about one or more social situations where individual is exposed to possible scrutiny by others -fears they will act in way that shows anxiety symptoms and will be negatively evaluated -social situations almost always provoke fear or anxiety, and so are avoided or endured with intense fear or anxiety -fear/anxiety is out of proportion to actual danger posed -fear,anxiety, avoidance persistent for 6 months or more, causes significant distress in social, occupational areas Subtypes: -Focus on performance situations(public speaking) -nonperformance situations (public eating) Psychological causal factors: -Social phobia as learned behavior: either direct or vicarious classical conditioning -Social fears & phobia in an evolutionary context: evolved as by-product of dominance hierarchies that are a common social arrangement among animals such as primates; ppl w/ social phobia show greater activation of amygdala in response to negative facial expressions > normal -Perceptions of uncontrollability & unpredictability: leads to submissive & unassertive behavior = socially anxious or phobic characteristics -Cognitive bias: ppl w/ social phobia expect others to reject them Biological causal factors -most important temperamental variable is behavioral inhibition (those shy at increased risk of developing) - shares characteristics w/ both neuroticism & introversion -genetic contribution Treatments: -CBT may involve cognitive restructuring techniques = therapist helps client w/ social phobia to identify underlying negative automatic thoughts -Medications can help social phobias (unlike specific phobias) but not as effective as CBT

NT ? effect of transmission?

-chemical substances released into the synapse by presynaptic neuron when a nerve impulse occurs. -Acts on receptors of post synaptic membrane to either sitmulate PSN to initiate or inhibit impulse. - broken down by MAO or vesicle reuptake

Exposure therapy:

-client confronted w/ fear producing stimulus in therapeutic manner -may involve systematic desensitization or flooding

What are observation approaches? Describes advantages and disadvantages.

-collecting information in a way that does not involve asking people directly (self-report), we are using some form of observational approach -eg direct observation of child's behaviour or collection of biological variables (hr, cortisol, brain regions during fMRI)

How is illness severity associated with comorbidity?

-comorbidity more likely to occur in people who have serious forms of MDs, when condition is mild, comorbidity is the exception rather than the rule

T-score distribution

-comparing individuals test score on a distribution of test scores from a large normative population -enables user to evaluate whether individual's score is low, avg, or high along distribution of scores

(CAT)

-computerized axial tomography -uses X-rays sections and computer analysis to generate image that can be interpreted -rapid access, no surgery needed, accurate -increasingly replaced by MRI -limited to anatomical features

Reliability of Info

-consider if info gathered is reliable -did person cooperate? Did they have insight? Delusions?

unstructured assessment interview

-content of interview is general, follow up questions tailored for each client -pro = more sensitive to needs -con = unplanned questions therefore important criteria needed for DSM5 diagnosis might be skipped -difficult to quantify -subjective, does not follow predetermined set of questions

Evaluating Psychodynamic therapies:

-criticisms: time consuming, expensive, no adequate proof of general effectiveness -pros: newer methods helpful in tx of depression, panic disorder, PTSD -transference-focused psychotherapy helpful in tx'ing borderline personality disorder

reinforcement

-delivery of a reward or pleasant stimulus -removal of or escape from an aversive stimulus (new responses are learned and recur if they are reinforced) in operant conditioning, any event that strengthens the behavior it follows -eg scared of water, avoid water as causes anxiety = reinforcement and leads to phobia

family therapy

-designed to reduce high levels of criticism & family tensions -developed when individual tx in clients showed relapse once they returned home includes: 1) Structural family therapy = based on systems theory; goal is to change organization of family so members will behave more supportively & less pathogenically toward e/o - therapist gathers info & acts like one of the members & participates in interactions as an insider

What are case studies? Describes advantages and disadvantages.

-detailed portrayal of unusual clinical condition advantages: - detailed info about new condition - provides limited support for theory -source of new ideas for research Disadvantages: - anecdotal info subject to bias - low generalizability conclusions

Speech sounds perception test

-determines ability to identify spoken words -measures concentration, attention and comprehension

focus of developmental psychology

-determining what is abnormal at any point in development -by comparing normal /expected behaviours during course of development. -To understand what is abnormal, one must have a good understanding of normal human development at biological, psychological and sociocultural levels of analysis -Eg 3 year old fear of dark not considered abnormal. However, intense fear of dark causing considerable distress and avoidance in college would be considered a phobia

What challenges are involved in reducing stigma toward people with mental illness?

-deterrent for people seeking treatment for mental health, especially in younger, men, ethnic minorities, military personally and mental health professionals -prejudicial attitudes commonplace everywhere, educating that mental illnesses were real brain disorders did not change stigma level (even though people understand mental illness caused by problems in the brain, does not make them less prejudiced toward those with mental illness)

give example of interpersonal perspective explanation of alcoholism

-difficulties in past and present relationships create stress that contribute to drinking

What is stigma? How common is it?

-disgrace, often associated with having a psychiatric diagnosis -common in 96% schizophrenic patients

interesting features of Anxiety disorders

-earliest age of onset of all mental disorders & associated w/ an increased prevalence of medical conditions - asthma, chronic pain, hypertension, arthritis, -neurotic disorders = show maladaptive & self-defeating behavior but are not incoherent, dangerous or out of touch w/ reality -anxiety disorders once considered to be classic neurotic disorders

effect of maladaptive peer relationships on children

-effect: increased risk of disorders eg bullying (anxiety, school phobia, low self-esteem, suicide)

hypothesis

-effort to explain, predict something through testing -allows determination of therapeutic approaches used to treat a clinical problem

EEG

-electroencephalogram -assess brain wave patterns in awake & sleeping states -obtain graphical record of brain's electrical activity due to placing electrodes on scalp & amplifying the minute brain wave impulses from various brain areas -may reveal dysrhythmia = irregular pattern in brain's electrical activity

psychodynamic perspective

-emphasized role of unconscious motives and thoughts -and their dynamic interrelationships in the determination of both normal and abnormal behavior

What does the DSM5 emphasis in psychosocial assessment interviews?

-emphasizes "operational" assessment approach (specifies observable criteria for diagnosis & provides specific guidelines for making diagnostic judgments) leads to more reliable psychiatric diagnoses, -important to consider racial or ethnic factors

what are assessment interviews and what occurs here

-face to face interview -simple or complex -structured or unstructured assessment interview -reliability of interview enhanced by rating scales -DSM5 emphasizes "operational" assessment approach (specifies observable criteria for diagnosis & provides specific guidelines for making diagnostic judgments) which leads to more reliable psychiatric diagnoses -important to consider racial or ethnic factors which may influence interview outcome

Protective factors give example

-factors that decrease likelihood of negative outcomes among those at risk -something that actively buffers against the likelihood of a negative outcome among those with some risk factors -May lead to resilience -warm relationship with a parent

Behavior genetics

-field that focuses on studying the heritability of mental disorders. Has 5 methods for study: -family history method -twin method -adoption method -linkage studies -association studies

Delusions

-fixed false belief that is inconsistent w/ persons' cultural norms & doesn't change even when provided with proof to the contrary -commonly occur in psychosis = 'break from reality' where delusions & hallucinations can both occur -7 subtypes: 1) Persecutory delusions 2) Grandiose delusions 3) Somatic identity 4) Delusional jealousy 5) Erotomanic delusions 6) Delusions of control 7) Delusions of reference

Humanistic-experiential therapies

-focus is always expanding a client's "awareness" -assumes that ppl have both freedom & responsibility to control their own behavior -cient must take most responsibility for direction & success of therapy where therapist acts as a guide includes: -client-centered therapy -motivational interviewing -gestalt therapy

give example of cognitive-behavioural explanation of alcoholism

-focus on maladaptive thinking including deficits in problem solving and information processing -eg irrational beliefs and alcohol needed to reduce stress

Behavioral Perspective

-focused on role of learning on directly observable behavior -and on role of stimuli and reinforcing conditions

Cognitive-behavioral perspective

-focuses on how thoughts and information processing can become distorted and lead to maladaptive emotions and behavior -involves schemas, self-schemas, attribution

client-centered therapy

-focuses on natural power of organism to heal itself -employs nondirective techniques, therapist does not give answers but listens actively

structured assessment interview

-follows predetermined set of questions that interviewer cannot deivate from -pro = each question structured to allow responses to be quantified/ clearly determined -more reliable results than flexible -con = take longer to administer & may include unnecessary questions - frustrating

operat/instrumental conditioning

-form of learning in behavioral approach with emphasis on reinforcement to achieve desired goal or escape from something unpleasant

How is temperament relevant to development of maladaptive behavior? give an example

-forms basis from which personality develops -starting at 2-3 months old 5 dimensions of temperament are identifiable (fearfulness, irritability, positive affect, activity level, attentional persistence/effortful control) -These are related to the 3 important dimensions of adult personality: 1. Neuroticism / negative emotionality - corresponded by infant dimensionalities of fearfulness and irritability 2. Extraversion / positive emotionality - corresponded by infant positive affect and activity level 3. Constraint/ control - corresponded by infant dimensionalities of attentional persistence and effortful control -Temperament of infanthas profound effects on important developmental processes eg Child with a fearful temperament has many opportunities for classical conditioning of fear to situations in which fear is provoked, later child may learn to avoid entering those feared situations and may later learn to fear social situations

describe clinical features of agoraphobia -what it is -DSM -subtypes -prevalence,onset -psychological causal factors -biological causal factors -treatments

-frequent complication of panic disorder -most patients do not experience panic so given distinct disorder under DSM5 -involves gradual spreading of fearfulness in aspects outside of home -most commonly feared & avoided situations = streets & crowded places like malls, movie theaters, stores DSM: -marked fear/anxiety about 2+ of 5 situations (public transport, open space, enclosed space, crowds, outside home alone) -fears/avoids these situations as worries escape difficult if panic-like symptoms occur -agoraphobic situations almost always provoke fear/anxiety, actively avoided and require companion or are endured with intense fear/anxiety -fear/anxiety is out of proportion to actual danger posed -fear,anxiety, avoidance persistent for 6 months or more, causes significant distress in social, occupational areas Prevalence, onset, gender diff: -most often panic disorder occurs without agoraphobia -typically occurs 20s to 40s -once panic disorder develops, tends to have chronic and disabling course even though intensity varies -both PanicD and agoraphobic more frequent in women > men due to sociocultural reasons (men expected to tough it out due to societal expectations, so more likely to not cope with medication/alcohol to cope with enduring panic attacks, rather than developing agoraphobic avoidance)

Generalization and discrimination can occur in both CC and OC. Differentiate between the two.

-generalization occurs when response is conditioned to one stimulus but is evoked by another similar stimuli -Eg a person who fears bees may generalize that fear to all flying insects -Discrimination occurs when person learns to distinguish between similar stimuli and to respond differently to them based on which ones are followed by reinforcement -eg red strawberries taste good and green ones don't, so a conditioned discrimination will occur if a person has experience with both

Insight

-good insight = aware, acknowledges his or her own thoughts & feelings, condition -poor insight = info gathered from interview is less reliable

rating scales

-help focus inquiry & quantify interview data to enhance reliability of assessment interviews

Purpose of psychological tests and benefits

-indirect means of assessing psychological characteristics -can measure coping patterns, motive patterns, personality characteristics, role behaviors, values, levels of depression or anxiety, intellectual fx'ing -many procedures available in a computer-administered format pros: --psychological tests are more precise & often more reliable > interviews -supply probable dx -indicate likelihood of certain kinds of behavior -predict outcome cons: -practitioners trained before use of computers may not be comfortable -may limit their practice of psychological tx -may have little interest for systematic evaluation - may feel that methods are not warm/sensitive to clients

Non-shared envr influences

-influences which the children in a family differ (unique features at school or parent upbringing) -influence tested in family history, twin and adoption studies

TCAs

-inhibit reuptake of norepinephrine & serotonin to lesser extent -1st developed to tx schizophrenia but found to elevate mood -SSRI & TCA used to tx bulimia nervosa

biopsychosocial perspective

-integrative approach that acknowledges that biological, psychological and social factors all interact and play a role in psychopathology and treatment. -The cultural context in which each of these factors plays out influences how we think about both normal and abnormal behavior

DSM5 has 5 criteria for specific phobia

-intense fear/anxiety about specific object/situation -phobic object/situation almost always triggers immediate fear/anxiety -fear/anxiety is out of proportion to actual danger posed -fear,anxiety, avoidance persistent for 6 months or more, causes significant distress in social, occupational areas

Mood

-internal & subjective state of how we feel -more stable > affect -5 types: depressed, euphoric, euthymic (normal), irritable, anxious -'anhedonia' = state where person is unable to experience enjoyment from pleasurable activities

What is the ICD-10? Who produced it?

-international classification of diseases = other classification system -produced by WHO

Describe family history method to study genetic influences on abnormal behavior. limitations?

-investigator observes samples of relatives of each subject/ carrier of the disorder in question -to see whether the incidence increases in proportion to the degree of hereditary relationship -Normal population used as control Limitation: -Those with similar genetic relatedness also tend to share more similar environments - therefore, difficult to discern genetic and environmental effects

Cultural competence

-issues involved in multicultural assessment

Why cant correlations be used to infer causation?

-just because 2 variables are correlated does not tell why they are correlated -e.g. (eating icecream and drowning) -an unknown third variable might be causing both events to happen (hot weather, icecream and hot weather, swim and drown) -directionality unknown also (Does A cause B or B cause A) -however can show inference, formulate hypothesis and research questions -to draw conclusions about causality and resolve questions of directionality, an experimental research approach must be used (controls, randomization, variable manipulation)

What is the problem of labeling?

-label describes behavioral pattern associated w/ persons' current level of fx'ing but once labeled, may close off further inquiry -more likely to make assumptions about person that may/may not be accurate when person is labeled 'depressed' for example -person may accept redefined identity and play out expectations of that role -'patient' is not called 'client' b/c it implies greater participation on part of an individual & more responsibility for bringing about his or her own recovery -Additional info req'd may be extensive & extremely difficult to unearth

effect of prejudice and discrimination on abnormality

-leads to increased anger, cardio reactivity, risk-taking behavior, lower levels of well-being, high stress

Describe the mental status exam. What type of information is provided from this assessment method? What do you think are the strengths and limitations of it?

-looks at current symptoms and not individuals' history or context of current life categories = ABC STAMP LICKER -appearance -behavior -cooperation -speech (Rate, volume) -thought -affect -mood -perception -level of consciousness -insight -cognitive fx (orientation, memory) -knowledge base -endings -reliability of info -cannot establish a diagnosis in isolation but can give us good guesses as to what appropriate diagnosis might be

effect of low SES and unemployment on children

-lower SES correlated with higher MD (unable to get help to recover, prejudice, stigma) -unemployed face greater stressors then those -effect: hostility and child abuse

Presenting problem

-major symptoms/ behavior client is experiencing -must 1st be identified in assessment

rhythm test

-measures attention and sustained concentration through auditory perception tasks

Finger oscillation task

-measures speed at which individual can depress level with index finger

Halstead category test

-measures subjects ability to learn and remember material -provides clues to judgement and impulsivity

Tactual performance test

-measures subjects motor speed, response to unfamiliar, and ability to learn using tactile and kinaesthetic cues

explain the roles that social values and culture play in psychological treatment

-members of minority groups are seriously underrepresented in tx research studies makes it difficult to fully assess their needs & outcomes -minority patients tend to prefer ethnically similar therapists -some believe same ethnic background therapists are more 'credible' -serious limitation: lack of trained therapists familiar w/ issues important to different ethnic groups

Rating scales are also used in clinical observations with clients. They help organize info & encourage reliability & objectivity. What features make rating scales useful? Name example.

-most useful arethose that enable a rater to indicate presence or absence of trait/behavior but also its prominence or degree 1)Brief Psychiatric Rating Scale (BPRS) 2)The Hamilton Rating Scale for Depression (HRSD) 3) DSM5's rating scale ="cross cutting symptom measures" WHO's rating scale = "WHODAS 2.0"

Brief Psychiatric Rating Scale (BPRS)

-most widely used rating scale for recording observations in clinical practice & in psychiatric research -provides structured & quantifiable format for rating clinical symptoms like anxiety, guilt, hostility, -contains 24 scales scored from ratings made by clinician following interview w/ patient -extremely useful in clinical research, esp for purpose of assigning patients to tx groups on basis of symptom similarity -not widely used for making tx/diagnostic decisions in clinical practice

What are the advantages of classification?

-nomenclature (common language for clinicians) -structured info (facilitates research) -pragmatic (allows identification of conditions)

Beck's Cognitive Therapy:

-originally developed to tx depression & later for anxiety disorders -assumes that problems result from biased processing or external events or internal stimuli -errors in logic behind thinking lead them (1) to perceive world as harmful while ignoring evidence to contrary, (2) to overgeneralize on the basis of limited examples, (3) to magnify significance of undesirable events, (4) to engage in absolutistic thinking -clients do not change beliefs by debate & confrontation like REBT but encouraged to gather info about themselves

what is the impact of professional orientation on structure and form of psychological evaluation?

-phychiatrist may focus on biological assessment methods aimed @ determining any underlying organic malfx'ing -psychodynamic may choose unstructured personality assessment techniques such as Rorschach inkblots -orientations determine assessment used and certain assessments are more conduce than others in uncovering particular causal factors or finding info about symptoms

How was mesmerism used in treatment of ab psych ?

-planets believed to affect a universal magnetic fluid in the body, the distribution of which determined health or disease -Treated patients using animal magnetism (hypnosis) to influence distribution of magnetic fluid

describe clinical features of specific phobias -what it is -DSM -subtypes -prevalence,onset -psychological causal factors -biological causal factors -treatments

-present if a person shows strong & persistent fear that is triggered by presence of a specific object or situation & leads to significant distress/impairment in person's ability to fx -DSM5 has 5 criteria for specific phobia -intense fear/anxiety about specific object/situation -phobic object/situation almost always triggers immediate fear/anxiety -fear/anxiety is out of proportion to actual danger posed -fear,anxiety, avoidance persistent for 6 months or more, causes significant distress in social, occupational areas -5 subtypes of specific phobias in DSM-5: animal, natural env, blood-injection-injury, situational, other Prevalence, onset: -common, more in women > men. Animal phobias begin in childhood vs. claustrophobia begin in adolescence or early adulthood Psychological Causal Factors 1) Psychoanalytic viewpoint: -phobias represent a defense against anxiety that stems from repressed impulses from the id 2)Phobias as learned behavior: -fear response can readily be conditioned to previously neutral stimuli when stimuli are paired w/ traumatic or painful events -vicarious conditioning = watching phobic person behaving fearfully w/ phobic object can be distressing to observer and fear being transmitted from 1 person to another through vicarious or observational classical conditioning -Individual differences in learning where some life experiences may serve as risk factors & make certain ppl more vulnerable to phobias than others, may serve as protective factors for the development of phobias -Evolutionary preparedness for learning certain fears prepared learning = Evolutionary prepared to rapidly associate certain objects w/ frightening events ('prepared' fears are not inborn or innate but easily acquired) biological causal factors: 1) genetics, temperament affect speed and strength of fear conditioning (eg behaviourally inhibited toddlers (v. shy) had higher risk of developing specific phobias > uninhibited children Treatment: 1) Exposure therapy -most effective for specific phobias as clients encouraged to gradually expose themselves to fear stimuli -variation = participant modelling where therapist calmly models way of interacting with phobic stimulus -effective when therapy administered in single long day(advantage as ppl more likely to seek tx if go once only)

Couples therapy:

-primary reasons for seeking tx= communication problems & lack of affection couple therapy: 1) traditional behavioral couple therapy (TBCT) = based on social learning model & views marital satisfaction/distress in terms of reinforcement focus on change Pros: -tx is usually short, guided by manual limitations: -TBCT not appropriate for every couple so IBCT developed 2) integrated behavioral couple therapy (IBCT) = focuses on acceptance & includes strategies that help each member of couple come to terms w/ & accept some limitations of partner -IBCT > TBCT

reality principle

-principle where the ego component of personality is aware of the demands of the environment and adjusts behavior to meet these demands

pleasure principle

-principle where the id component of personality engages selfish and pleasure-oriented behavior -concerned only with the immediate gratification of instinctual needs

Evaluating Behavior therapy:

-pro: achieve results in short period of time, faster relief for client, lower costs -limitation: not as useful in tx'ing complex personality disorders -effective tx for vocal & motor tics - Tourettes syndrome -behavioral activation = recent form of therapy to tx depression - therapist & client work together to find ways to become more active & engaged w/ life

Prototypal Approach (atheoretical)

-prototype = personality disorder depicting an idealized combination of characteristics occurring together in a less than perfect way @ the level of actual observation; determine symptoms, then label

Psychosocial Assessment

-psychosocial assessment used where psychological difficulty is thought to result from nonorganic causes -allows formulating hypotheses & discard or confirm them as they proceed

Effect size? what does effect size 0 mean? studies with similar effect size?

-reflects the size of the association between 2 variables -independent of the sample size. -useful when comparing the strength of findings across different studies -effect size = 0 : no association between the variables -if effect size similar in studies, can conclude that both studies had similar findings regardless of whether results were significant in one but not in other

what 3 measures are important in understanding clinical assessments and the utility of psychological tests?

-reliability -validity -standardization

Describe linkage analysis method to study genetic influences on abnormal behavior. limitations?

-relies on known chromosomal locations of genes for other inherited physical characteristics (eye colour/blood group) -Eg look at family with schizophrenia, keep track of eye colour due to known genetic marker on particular chrom. if eye colour same for members with disorder, infer gene affecting schiz located nearby gene marker for eye colour Limitation: -most successful in locating genes for single-gene brain disorders (Huntingtons) -MDs likely due to variety of genes not just one

Selective Serotonin Reuptake Inhibitors (SSRI):

-replaced 1st gen TCA & MAOI -e.g. fluoxetine (Prozac) -increase levels of serotonin by inhibiting reuptake of serotonin following its release into synapse -TCAs inhibit both serotonin & norepinephrine -Adv: easier to use, less side effects, not fatal in OD -When tx of depression = at least 50% improvement in symptoms, -When tx of depression = removal of all symptoms, = remission for 1st several months, then = recovery if sustained for longer > 6-12mos patients are well -SSRIs often used to tx OCD, panic disorder, social phobia, anxiety

why can abnormal psychology research be conducted in almost any setting

-research can take place anywhere, through many contexts/forms (naturalistic observations, case studies) -methodology determine whether a given research project may be undertaken, not setting -As new techniques become available (brain imaging / statistical procedures), methodology will evolve

what can influence statistical significance?

-sample size -magnitude of correlation e.g. correlation of 0.3 not significant if sample size (n) = 20, but significant if n = 50). -typically , correlations drawn from small samples need to be very large to reach statistical significance

self-monitoring

-self observation & objective reporting of behavior, thoughts, feelings -used by clients and physicians in clinical observations

Significance of diathesis-stress model

-shows us that diathesis results from prior cause, but not sufficient on own to cause disorder eg genetics for alcoholism -instead, there must be a more recent factor (like stress) that may contribute eg stress so drink more and establish binge drinking behavior -but not sufficient on own to cause disorder except in someone with diathesis

catharsis

-significant emotional release (eg by talking about past trauma) -describes feeling patients had after hypnosis with Freud following free association

Id

-source of instinctual drives and first structure to appear in infancy -inherited drives are life instincts (libido) and death instincts (instincts that tend to death) -operates on pleasure principle -undergoes primary process thinking

Meta-analysis

-statistical approach that calculates and combines the effect sizes from all studies -each separate study can be thought of as being equivalent to an individual participant in conventional research design -provides better summary of research findings than possible with a literature review as it uses effect sizes

focus of Cognitive & Cognitive behavioral therapy

-stems from both cognitive psychology & behaviorism -2 main themes: (1) conviction that cognitive processes influence emotion, motivation, behavior & (2) use of cognitive & behavior change techniques in a pragmatic (hypothesis testing) manner includes: -Rational emotive behavior therapy (REBT) -Beck's cognitive therapy

disadvantages of classification?

-stigma (perpetuated by labelling) -stereotyping (incorrectly infer behaviours present in person with specific condition) -loss of information

Objective Personality tests

-structured, use questionnaires, self-report inventories, rating scales quantification = reliable) example: 1) MMPI-2 (revised for adults) = Minnesota Multiphasic Personality Inventory -most widely used personality assessment today (revised to increase validity) -120 scales -MMPI = the original MMPI, most widely used test for clinical & forensic assessment clients encouraged to answer all items as "true" or "false" -includes 10 clinical scales and 9 validity scales to detect whether patient has answered questions honestly (criticism = test is superficial, too oriented toward measuring unobservable 'mentalistic' constructs such as traits - computerized MMPI interpretations employ powerful actuarial procedures = descriptions of actual behavior of subjects w/ particular patterns of test scores stored in the computer (but difficult to accumulate enough cases to serve as adequate database) -computerized assessments are quick & efficient means of providing a clinician w/ needed info early in decision-making process

Longitudinal design

-study that follows same people over time and tries to identify factors that predate the onset of a disorder

exteroceptive conditioning

-term used in the Comprehensive learning theory of panic disorder describing influence of psychosocial causal factors -means modifying the perception of environmental stimuli acting on the body

interoceptive conditioning

-term used in the Comprehensive learning theory of panic disorder describing influence of psychosocial causal factors -refers to learning process that involves 2 conditioned stimuli and one unconditioned response

Resilience give example

-the ability to adapt successfully to very difficult circumstances. -Eg child who does very well in school and perseveres despite parents drug addiction

Electra complex

-the female counterpart of the Oedipus complex, occurs during phallic stage of psychosexual development - girl desires to possess father and replace mother. Each girl experiences penis envy, wishing she could be more like father and brothers. -Emerges from complex when identify with mother and settles for a future man who she will have a baby (unconscious penis substitute) -resolution of this conflict essential if young adult is to develop satisfactory heterosexual relationships.

Learning

-the modification of behavior as a consequence of experience. -central theme of behavioral approach

Prevalence

-the number of active cases in a population during any given time period, expressed often as percentages (% population with disorder)

DV-

-the outcome of interest (measured in response to IV manipulation)

Statistical significance : p <0.05

-the probability that the correlation would occur purely by chance is less than 5 out of 100. -Correlations with a p < 0.05 are statistically significant and worthy of attention (result occurred not very likely to occur by chance).

Perception

-the way person perceives world is examined -5 sensory modalities: visual, auditory, olfactory, gustatory, tactile

Analysis of transference

-transference = when people unconsciously apply attitudes & feelings they had in their relations w/ person in past to their therapist -countertransference = therapist may have mixture of feelings toward client must be recognized & handled properly by therapist

Schema

-underlying representation of knowledge that guides the current processing of information and often leads to distortions in attention, memory and comprehension. -People develop different schemas based on their temperament, abilities and experiences -Eg schemas about social roles - what are appropriate behaviors at funeral

Systematic reinforcement:

-use reinforcement to increase frequency of desired behavior - may involve response shaping or token economies

Describe the use of neuropsychological tests in evaluating the behavioral effects of organic brain disorders

-used as behavioral and psychological impairments due to organic brain abnormalities may manage before any organic brain disorder becomes detectable by scans -so need other reliable techniques to measure alterations in functioning

How did adherents of nancy school treat ab behavior? what did they believe?

-used hypnosis in practise -adherents accepted hysteria was a form of self-hypnosis

Single-case research designs

-used in case studies to develop and test therapy techniques within scientific framework, -same individual is studied over time so behaviour at one point compared to behavior at a later time after intervention/treatment introduced -example: ABAB design

Dream analysis

-used in psychoanalysis -Involved patient recording and describing their dreams

Free association

-used in psychoanalysis -patients talk freely about themselves, thereby providing information about their feelings, motives

neuropsychological assessment

-various testing methods to measure person's cognitive, perceptual, & motor performance as clues to the extent & location of brain damage eg Halstead-Reitan battery test which includes: 1) Halstead category test 2) Tactual performance test 3) Rhythm test 4) Speech sounds perception test 5) Finger oscillation task

genes? influence on abnormality?

-very long DNA molecules present at various locations on chromosomes -carries genetic info from parents -don't fully determine whether person develops disorder but most mental disorders show some genetic influences

Affect

-visible or objective manifestation of emotional state -some ppl may display very little or no affect = blunted or flat affect -can be differentiated from what person is feeling inside - in MSE, we always need to ask cant assume smile = happy

panic attack

-when fear response occurs w/o obvious external danger

Analysis of dreams

-when person is asleep, repressive defenses lowered & forbidden desires/feeling may find an outlet in dreams -dreams = 'royal road to unconscious' -2 kinds of content analysed: (1) manifest content (dream as it appears to dreams), (2) latent content (actual motives that are seeking expression but so painful/unacceptable they are disguised)

Cognitive Fx & Knowledge base

-within MSE, simple assessment tool = mini-MSE -includes simple questions: what month, year, date to test cognitive fx quickly

contrast authoritative vs authoritarian styles of parenting

1) Authoritative -Parents warm and careful to set clear standards and limits , while allowing considerable freedom within these limits -Children friendly and show development of general competencies for dealing with others and environment -Less likely to exhibit emotional disorders (anxiety and depression) or behavioral problems (conduct problems and delinquency) 2) Authoritarian -Parents are low on warmth and high on control. Often cold and demanding -Children tend to be conflicted, irritable and moody. -in adolescence, children have more negative outcomes -If overly severe discipline is used child tends to have increased aggression

contrast the role of different parenting styles and its contribution as a social factor to abnormality

1) Authoritative -Parents warm and careful to set clear standards and limits , while allowing considerable freedom within these limits -Children friendly and show development of general competencies for dealing with others and environment -Less likely to exhibit emotional disorders (anxiety and depression) or behavioral problems (conduct problems and delinquency) 2) Authoritarian -Parents are low on warmth and high on control. Often cold and demanding -Children tend to be conflicted, irritable and moody. -in adolescence, children have more negative outcomes -If overly severe discipline is used child tends to have increased aggression 3) Permissive / indulgent -Parents high on warmth and low on self-control and disciple -Children impulsive and aggressive -Overly indulged children are characteristically spoiled, selfish, impatient, inconsiderate and demanding 4) Neglectful / uninvolved -Parents low on warmth and control -Children moody, low self-esteem and conduct problems in later childhood. Also have problems with peer relationships and academic performance -Parenting styles - reflects an attitude and values that are expressed toward a child across a wide range of settings and thus have different developmental outcomes for children

List psychological approaches used to treat abnormal behavior

1) Behavior Therapy -exposure therapy (systematic desensitization, flooding) -aversion therapy (nausea after drink) -modeling -systematic reinforcement (response shaping and token economy) 2) Cognitive and cognitive-behavioural therapy -Rational emotive behavior therapy (REBT) -Beck's cognitive therapy 3) Humanistic-experiential therapies -client-centered therapy -motivational interviewing -gestalt therapy 4) Psychodynamic therapies -Freudian psychoanalysis (analysis of dreams, resistance, transference) -object relations, attachment-based approaches, self-psychology 5) couples and family therapy -couples therapy (traditional behavioral couple therapy TBCT, integrative behavioral couple therapy IBCT) -family therapy (structural family therapy)

What 4 major themes in 19th and 20th century generated powerful influences on contemporary perspectives?

1) Biological discoveries 2) Development of classification system for mental disorders -Freud psychoanalytic perspective -Mesmerism (magnetic fluid) -Nancy school and hypnosis 3) Emergence of psychological causation views 4) Experimental psychological research developments -behavioral perspective (behaviourism, operant conditioning for learned abnormal behaviours)

what are the non medical biological tx

1) ECT 2) TMS 3) neurosurgery

compare and contrast 5 important neurological procedures. What makes each one valuable?

1) EEG -assess brain wave patterns in awake & sleeping states -may reveal dysrhythmia 2) CAT -uses X-rays sections and computer analysis to generate image that can be interpreted -increasingly replaced by MRI and limited to anatomical features 3) MRI -differentiates subtle variations in soft tissue so images of brain interior sharper > CAT -MRI procedure less complicated to administer > CAT & does not subject patient to ionizing radiation -limited due to claustrophobic rx, don't reveal truth about body & do not always lead to better outcome for patients 4) PET -provides metabolic portraits by tracking glucose metabolism by brain -Allows for appraisal of how organ is fx'ing (vs. CAT that can only distinguish anatomical features ) -revealing conditions not immediately apparent anatomically -Limitations: low-fidelity pictures, cost, questionable use in forensic evaluations 5) fMRI -measures changes in local oxygenation of specific areas of brain -effective for detecting neural correlates for self-critical thinking -used to study aphasia limitations: 1) sensitive to instrument errors or inaccurate observations from slight movements of person being evaluated 2) results difficult to interpret, don't provide much specific info about processes studied 3) not considered valid or useful diagnostic tool for mental disorders or in forensic evaluations

What are the 4 newer psychodynamic perspectives/theories?

1) Ego psychology 2) Object-relations theory 3) Interpersonal perspective 4) Attachment theory

What biological causal factors implicated in panic disorder

1) Genetic factors 2) Panic & the brain - increases amygdala plays central role in panic attack 3) Biochemical abnormalities - 5HT and NE NT most implicated in panic attacks

Compare and contrast the 2 molecular genetic methods used to study genetic influences on mental disorders

1) Linkage analysis -relies on known chromosomal locations of genes for other inherited physical characteristics (eye colour/blood group) Limitation: -most successful in locating genes for single-gene brain disorders (Huntingtons) 2) Association studies -frequencies of known genetic markers on chromosomes compared between 2 large groups of individuals (1 with disorder, 1 without) -If markers occur with higher frequency in disorder group, researchers infer that genes associated with disorder are located on the same chromosome -Better than linkage studies for identifying small effects on any gene for disorders that are polygenetically influenced

What are the 5 most studied NTs? Describe their effects and what condition they are implicated in

1) NE - monoamine class of NTs -Fight or flight response when body exposed to acutely stressful/dangerous situations as well as attention, orientation and basic motives 2) DA - monoamine class of NTs -Pleasure and cognitive processing -Implicated in schiz and addictive disorders 3) 5HT - monoamine class of NTs -Thinking and informational processing from environment -role on behaviors and moods. -Implicated in emotional disorders (anxiety, depression) and suicide 4) Glutamate -Excitatory NT implicated in Schiz 5) GABA - gamma aminobutyric acid -Implicated in reducing anxiety and other high arousal emotional states

What are Freud's 5 psychosexual stages of development?

1) Oral stage 2) Anal stage 3) phallic stage (oedipus, electra, castration anxiety) 4) Latency period 5) Genital stage

differentiate between PET scan and fMRI

1) PET -provides metabolic portraits by tracking glucose metabolism by brain -Allows for appraisal of how organ is fx'ing (vs. CAT that can only distinguish anatomical features ) -revealing conditions not immediately apparent anatomically -Limitations: low-fidelity pictures, cost, questionable use in forensic evaluations 2) fMRI -measures changes in local oxygenation of specific areas of brain -effective for detecting neural correlates for self-critical thinking -used to study aphasia limitations: 1) sensitive to instrument errors or inaccurate observations from slight movements of person being evaluated 2) results difficult to interpret, don't provide much specific info about processes studied 3) not considered valid or useful diagnostic tool for mental disorders or in forensic evaluations

how can a childs genotype shape their environment

1) Passive effect - resulting from genetic similarity of parents and children. -High intelligent parents provide stimulating environment for child allowing positive interaction with environment in addition to childs high intelligence 2) Evocative effect - evokes particular reactions from social and physical envirionment. Happy baby evokes more positive response than unresponsive infants 3) Active effect - genotype plays more active role in shaping environment. Extraverted children may seek company of others, enhancing their own tendencies to be sociable

What are the most prominent psychological perspectives on abnormal psychology

1) Psychodynamic perspective -psychoanalytic theory -ego psychology -object-relations theory -interpersonal perspective -attachment theory 2) Behavioral perspective -Learning (OC, CC, Observational learning, generalization and discrimination) 3) Cognitive-Behavioural perspective

What 3 things does a psychosocial assessment require?

1) assessment interviews (+ rating scales) -structured assessment interview -unstructured assessment interview 2) clinical behavior observation -role-playing -self-monitoring -Brief Psychiatric Rating Scale BPRS 3) Psychological tests -intelligence tests (vocabulary, digit span) -projective personality tests (Rorschach inkblot test) -Themati Apperception Test (TAT) -Objective Personality Tests (MMPI)

What are the 8 ego defence mechanisms?

1) displacement 2) fixation 3) projection 4) rationalization 5) reaction formation 6) regression 7) repression 8) sublimation

What social factors contribute to abnormal behavior?

1) early deprivation or trauma -institutionalization -neglect and home abuse -separation 2) Parenting style 3) Marital Discord/Divorce 4) Low SES and unemployment 5) Maladaptive peer relationships (bullying) 6) Prejudice and discrimination in race, gender and ethnicity

what are the 3 factors involved in assessment of physical organism

1) general physical exam 2) neurological exam 3) neuropsychological exam

contrast the role of different early deprivations/trauma on contributing to abnormal behavior

1) institutionalization -environment less warm, less physically, intellectually, emotionally and socially stimulating for positive learning -show reductions i both gray and white matter volume, severe emotional, behavioral and learning problems 2) neglect and home abuse -tendency for overt aggression and damage on schemas and self-schemas leading to self-abuse -severe linguistic development, emotional, behavioral, social functioning -atypical patterns of attachment (insecure, disorganized and inconsistent with caregiver) 3) Separation -increased vulnerability to stressors in adulthood (more likely depressed)

what are the basic elements in assessment

1) relationship between assessment and diagnosis (diagnosis must be made to allow insurance coverage, planning and managing treatment) 2) social or behavioral history 3) culturally sensitive assessment procedures 4) influence of professional orientation 5) reliability, validity, standardization 6) trust and rapport between clinician and client

Describe how the Hypothalamic-Pituitary-Adrenal (HPA) axis works. How is it involved in psychopathology?

1)Hypothalamus releases CRH to pituitary 2) Pituitary releases ACTH stimulating the adrenal to produce E and Cortisol (mobilize body for stress) into general circulation 3) Cortisol provides negative feedback to the hypothalamus and pituitary to decrease release of CRH and ACTH, effectively reducing E and cortisol. -Malfunctioning of this system implicated in depression and PTSD

What are the 5 methods are used to study genetic influences on abnormal behavior

1. Family history method 2. Twin method 3. Adoption method 4. Linkage analysis 5. Association studies

What are the indicators of abnormality? Does any one behaviour make someone abnormal? How does culture play a role in abnormality

1. Subjective Distress 2. Maladaptiveness 3. Statistical deviancy 4. Violation of societal standards 5. Social discomfort 6. Irrationality and unpredictability 7. Dangerousness -no one behavior makes someone abnormal -but the more someone has difficulty in the following areas, the more likely to have some form of mental disorder -Culture plays large role in determining what is and is not normal

what 4 categories of biological factors are relevant to development of maladaptive behavior (often interact together):

1. genetic vulnerabilities 2. Brain dysfunction and neural plasticity 3. NT and hormonal abnormalities in CNS 4. Temperament

Freudian Psychoanalyssis:

4 basic techniques: (1) free association, (2) analysis of dreams, (3) analysis of resistance, (4) analysis of transference

Genital Stage

5th and final of Freud's psychosexual stage of development -after puberty, the deepest feelings of pleasure come from sexual relations

response shaping

= (+) reinforcement used to establish response by gradual approximation that is actively resisted

rational emotive behavior therapy (REBT)

= 1st form of behaviorally oriented cognitive therapy -REBT attempts to change client's maladaptive thought processes & behavior & restructure individual's belief system - e.g. dispute person's false belief through rational confrontation -REBT aims to increase individual's feelings of self-worth & clear way for self-actualization by removing false beliefs

Token economies

= based on principles of operant conditioning , resembles the outside world where individual is paid for work in tokens (money) that can be exchanged for desired objects & activities

Structural family therapy

= based on systems theory; goal is to change organization of family so members will behave more supportively & less pathogenically toward e/o

Psychotherapy

= belief that ppl w/ psychological problems can change

Delusional jealousy

= believing one's partner is unfaithful even if parter is not

panic provocation procedures

= broad range of procedures that produce panic attacks in panic disorder clients @ much higher rate > normal -shows that these challenges put stress on neurobiological systems that in turn produce arousal (increased HR, respiration, bp)

Psychodynamic therapy

= broad tx, focuses on individual personality dynamics includes: -Freudian psychoanalysis (analysis of dreams, resistance, transference) -object relations, attachment-based approaches, self-psychology

modeling

= client learns new skills by imitating another person who performs the behavior to be acquired

Reliability

= degree to which an assessment measure produces the same result each time it is used to evaluate the same thing

efficacy

= drug cures or relieves some target condition -test efficacy through human subjects

Delusions of reference

= everyday events, objects, ppl is believed to have special significance (e.g. message through billboard has hidden meaning especially for them)

Validity

= extent to which a measuring instrument actually measures what it is supposed to measure

flooding

= extreme exposure therapy where patient directly confronts feared stimulus @ full strength

*tactile hallucinations

= false perception of tactile sensory input that creates hallucinatory sensation of physical contact w/ imaginary object

Delusions of control

= feelings, thoughts, impulses controlled by someone else

Evidence based practice

= how research findings are used to alter the way in which tx are selected & how they're delivered to an individual •having research evidence available doesn't mean we always see corresponding changes to clinical practice many possible 'leaks' from research evidence to practice •leaks: clinician may not accept info if not applicable in certain case, clinician may not have skills or training or time to implement changes to their practice •quality improvement needs to look at mental health systems & services to ensure they are structured to promote & support evidence based practice

Grandiose delusions

= inflated sense of worth, power, knowledge, identity

dysrhythmia

= irregular pattern in brain's electrical activity -revealed by EEG

aphasia

= loss of ability to communicate verbally

personality tests

= measures personal characteristics other than intellectual ability -often grouped into projective & Objective measures

transcranial magnetic stimulation (TMS)

= newer, targeted approach that uses electric field to change brain fx'ing -pulsed magnet positioned over a carefully selected area & used to create an electrical field that increases or decreases neuronal activity in brain -TMS less invasive > surgical interventions & has fewer & less severe side effects > ECT -Most common side effects= mild headache & small risk of seizure -No impairments in memory or concentration vs. ECT

signs

= objective observations that diagnostician may make directly or indirectly

Persecutory delusions

= one feels they're being attacked, harassed, cheater, conspired against

electroconvulsive therapy (ECT)

= pass electric current through patient's head -ECT down-regulate NE receptors, increasing fx'al availability of this nt pros: can help severely depressed or suicidal patients who have failed to other tx methods - tx of choice for pregnant women who are severely depressed and elderly ppl w/ medical conditions that make taking antidepressant dx dangerous -Can be administered bilaterally -Patient has amnesia for period immediately preceding therapy -Tx typically 2-3x/wk & <12 sessions -Bilateral ECT > unilateral but also associate w/ more cognitive side effects & memory problems

Phobia

= persistent & disproportionate fear of some specific object or situation that presents little or no actual danger & yet leads to a great deal of avoidance of these feared situations 3 main categories: (1) specific phobia (2) social phobia (3) agoraphobia

Somatic identity

= pertains to appearance of fx'ing of patients' body

*Alogia

= poverty of speech, general lack of additional, unprompted content seen in normal speech

Standardization

= process by which a psychological test is administered, scored, interpreted in a consistent or "standard" manner

behavioral activation

= recent form of therapy to tx depression - therapist & client work together to find ways to become more active & engaged w/ life

Obsessions

= recurrent & persistent thoughts that person cant easily control -different from delusions, ppl know their actions are irrational

symptoms

= refers to patient's subjective description, complaints

Sentence completion tests

= related to free association method where client is asked to respond freely (con = responses are subjective and unreliable)

neurotic disorders

= show maladaptive & self-defeating behavior but are not incoherent, dangerous or out of touch w/ reality

*psychomotor retardation

= slowing down of thought & reduction of physical movements in an individual

-'anhedonia'

= state where person is unable to experience enjoyment from pleasurable activities

*pressure of speech

= tendency to speak rapidly & frenziedly as if motivated by urgency not apparent to listener

Erotomanic delusions

= think another person usually of higher status is in love with them

*ego-syntonic

= thoughts & behaviors that are in harmony w/ needs & goals of the ego

*ego-dystonic

= thoughts & behaviors that re in conflict w/ needs & goals of the ego

manualized therapies

= to minimize variability in patient's clinical outcomes that might result from characteristics of therapist

anxiety sensitivity

= trait-like belief that certain bodily symptoms may have harmful consequences -ppl w/ high levels of anxiety sensitive are more prone to developing panic attacks;

cognitive restructuring techniques

= treatment used in CBT where therapist helps client w/ social phobia to identify underlying negative automatic thoughts

Anxiety disorders

= unrealistic, irrational fears or anxieties that cause significant distress & or impairments in fx'ing include: specific phobia, social anxiety disorder, panic disorder, agoraphobia, GAD

Psychopharmacology

= use of medications to tx mental disorders Concern: side effects, dosage, drugs chance biochemical changes & don't help individual change maladaptive behaviors, discontinued drugs

Rorschach Inkblot Test

= uses 10 inkblot pics, patient describes what they see, what it reminds them of, and what it means to them (pro = can be useful in uncovering certain psychodynamic issues such as unconscious motivations; con= results can be unreliable b/c of subjective nature of test interpretations)

Thematic Apperception Test (TAT)

= uses series of pics (highly representational & others abstract), patients instructed to make up stories; -developed to focus on different aspects of subject's stories - content is highly ambiguous so subjects project own needs and conflicts onto it (con = time consuming, much room for error, little clinical contribution, 'dated' quality to test stimuli (pics developed in 1930)

-randomized clinical trials (RCTs) aka efficacy trials

= voluntary & informed patients as subjects, use double blind study -challenge: creating placebo condition that will appear credible to patients, withholding tx = ethical concerns,

What is the amygdala? which disorder is it implicated in?

=collection of nuclei of brain that is involved in emotion of fear (early theory implicated locus coeruleus & norepi to be responsible for panic attacks) -increases amygdala plays central role in panic attack (in panic disorder)

ABAB design? give example? importance?

A - baseline data collected B - treatment introduced (observe behavior change here, may be extraneous) A2 - treatment withdrawn (to see where treatment actually important) B2 - treatment reinstated (see whether first behavior seen again) -Helps establishment of whether the treatment itself was important for change in single-case research

Describe adoption method to study genetic influences on abnormal behavior. limitations?

Adoption = situation in which individuals who do not share a common family environment are nonetheless genetically related -eg compare rates of disorder in biological parents of someone with schiz vs. adopted parents - If genetic influence presence, one expects to find higher disorder rate in the biological relatives of the person with schiz than in adopted parents

describe major diagnostic features of both panic disorder and agoraphobia. Why do these disorders often occur together?

Agoraphobia: frequent complication of panic disorder -most patients do not experience panic -involves gradual spreading of fearfulness in aspects outside of home -most commonly feared & avoided situations = streets & crowded places like malls, movie theaters, stores DSM: -marked fear/anxiety about 2+ of 5 situations (public transport, open space, enclosed space, crowds, outside home alone) -fears/avoids these situations as worries escape difficult if panic-like symptoms occur -agoraphobic situations almost always provoke fear/anxiety, actively avoided and require companion or are endured with intense fear/anxiety -fear/anxiety is out of proportion to actual danger posed -fear,anxiety, avoidance persistent for 6 months or more, causes significant distress in social, occupational areas Panic disorder = occurrence of panic attacks that often seem to come 'out of the blue' DSM5: person must have experienced recurrent, unexpected attacks & must have been persistently concerned about having another attack for at least 1 month -Full blown panic attack req' at least 4/ 13 symptoms -Panic attacks peak intensity w/in 10 mins, often subside in 20-30mins, rarely last more than 1 hour -Can occur during relaxation or sleep = nocturnal panic -Symptoms mostly physical (palpitations, sweating, shaking, choking, chest pain) occurrence of panic attacks that often seem to come 'out of the blue'

describe the psychological and biological causal factors of panic disorder

Biological Causal factors 1) Genetic factors 2) Panic & the brain - increases amygdala plays central role in panic attack 3) Biochemical abnormalities - NE and 5HT systems most implicated in panic attacks Psychological causal factors 1) Cognitive theory of panic: 2) Comprehensive learning theory of panic disorder 3)Anxiety sensitivity & perceived control 4) Safety Behaviors & the persistence of panic 5) Cognitive biases & maintenance of panic

compare and contrast learning/conditioning theory and cognitive models of panic disorder

Both are models describing role of psychological causal factors in panic disorder 1) Cognitive theory of panic: proposes that ppl w/ panic disorder are hypersensitive to their bodily sensations; interpreted as catastrophic, that raises perceived threat, increasing apprehension about situation, which further increases body sensations and repeats panic cycle 2) Comprehensive learning theory of panic disorder: -initial panic attacks become associated w/ initially neutral internal & external cues -this occurs either through 1) interoceptive conditioning (learning process that involves 2 conditioned stimuli and one unconditioned response) 2) or exteroceptive conditioning (modifying the perception of environmental stimuli acting on the body) -conditioning of anxiety to internal or external cues is associated w/ panic which then sets stage for development of 2 of 3 components of panic disorder: (anticipatory anxiety & sometimes agoraphobic fears) -3rd component - panic attacks likely to be conditioned to certain internal cues

What role do cognitive distortions and attributions have in psychopathology, according to the cognitive-behavioral perspective?

Cognitive distortions -reinforce / maintain one's current state. Eg scared of water, being near water creates anxiety so avoid. this reinforcement water phobia Attributions styles: -characteristic way in which an individual tends to assign causes to good or bad events - Eg people with depression tend to attribute bad events to internal, stable and global causes (I failed the test because im stupid, rather than I failed the test because the teacher was in a bad mood and graded it unfairly). -However inaccurate attributions may be, they become important parts of our view of the world and can have significant effects on our emotional well-being

delusion vs obsession

Delusions -fixed false belief that is inconsistent w/ persons' cultural norms & doesn't change even when provided with proof to the contrary -commonly occur in psychosis Obsessions -recurrent & persistent thoughts that person cant easily control -different from delusions, ppl know their actions are irrational

Describe the approach used to study the effects of brain dysfunction and plasticity on abnormal behavior

Developmental systems approach -approach used by developmental psychopathologists -acknowledges that genes influence neural activity, which influences behavior, which influences the environment. -But these influences are bidirectional. So various aspects of environment (physical, social and cultural) also influences behavior, which affects of neural activity, which can even influence genetic activity)

What procedures/scans are involved in a neurological exam?

EEG anatomical brain scans: -CAT -MRI -PET -fMRI

what ethical issues to consider when integrating assessment data for treatment planning

Ethical Issues in Assessment: -potential cultural bias of the instrument or the clinician (some psychological tests may not elicit valid info for patient from minority group) -Theoretical orientation of clinician (psychoanalyst vs. behaviorist = different tx) -Underemphasis on external situation (overemphasize personality traits as cause of problems but ignore stressors) -Insufficient validations -Inaccurate data or premature evaluation

Explain how evolutionary factors have influenced which objects and situations we are most likely to learn to fear.

Evolutionary preparedness for learning certain fears= prepared learning - Evolutionary prepared to rapidly associate certain objects w/ frightening events ('prepared' fears are not inborn or innate but easily acquired)

what is the most effective treatment for specific phobias

Exposure therapy -most effective for specific phobias as clients encouraged to gradually expose themselves to fear stimuli -variation = participant modelling where therapist calmly models way of interacting with phobic stimulus -effective when therapy administered in single long day(advantage as ppl more likely to seek tx if go once only)

1) Oral Stage

Freud's 1st psychosexual stage of development - during first 2 years of life, mouth is principal erogenous zone. Infants greatest source of gratification is sucking (necessary process for feeding)

2) Anal Stage

Freud's 2nd psychosexual stage of development - from age 2 to 3, anus provides major source of pleasurable stimulating during the time when toilet training is often going on and there are urges both for retention and for elimination

3) Phallic Stage

Freud's 3rd psychosexual stage of development - from ages 3 to 5/6 self-manipulation of the genitals provides the major source of pleasurable sensation -oedipus, electra and castration anxiety occurs here

4) Latency Period

Freud's 4th psychosexual stage of development - from 6 to 12, sexual motivations recede in importance as a child becomes preoccupied with developing skills and other activities

describe clinical features of generalized anxiety disorder -what it is -prevalence,onset -psychological causal factors -biological causal factors -treatments

Generalized anxiety disorder = worry about many different aspects of life (including minor events) -must have at least 3 of 6 other symptoms + excessive worrying -children only req' 1 of 6 -most common areas of worry = family, work, finance, personal illness Prevalence, age of onset, gender differences -2x more common in women > men -most common anxiety disorder in adults

Operant (instrumental) conditioning

learning where behavior is shaped through: -reinforcement -punishment

Describe 3 biological approaches used to treat abnormal behavior

medications 1) antipsychotic drugs/neuroleptics - to treat psychotic disorders (schizophrenia) 2) antidepressants (SSRIs eg Prozac, MAOIs, TCA, SNRIs) 3) anti anxiety drugs (benzodiazepines) 4) Lithium and other mood stabilizing drugs non-medicinal biological treatments 1) ECT 2) TMS 3) Neurosurgery

when summarizing research findings in a certain area, better to conduct literature review of meta-analysis>

meta-analysis better summary of research findings than possible with a literature review as it uses effect sizes

actuarial procedures

methods whereby data about subjects are analyzed by objective procedures rather than by humans

Rank from Highest to low: incidence, prevalence, point prevalence, 1 year prevalence, life time prevalence

Lifetime prevalence > 1 year prevalence > point prevalence > incidence

What are most common mental disorders?

Major Depressive Disorder > alcohol abuse, specific phobias (fear of small animals, insects, flying, heights) > social phobias (Fear of public speaking)

neurosurgery

Past: prefrontal lobotomy -frontal lobes severed from deeper centers underlying them , causing permanent structural changes in brain -25% death rate + undesirable side effects - permanent inability to inhibit impulses modern techniques: 1) psychosurgery sometimes used in OCD tx, intractable anorexia nervosa but risky 2) deep brain stimulation = surgery but no permanent lesions made in brain -involves electrical stimulating patients' brains electrically over a period of several months

Describe the original classical conditioning explanation for the origins of specific phobias as well as how vicarious conditioning may be involved.

Phobias as learned behavior: -fear response can readily be conditioned to previously neutral stimuli when stimuli are paired w/ traumatic or painful events -vicarious conditioning = watching phobic person behaving fearfully w/ phobic object can be distressing to observer and fear being transmitted from 1 person to another through vicarious or observational classical conditioning -Individual differences in learning where some life experiences may serve as risk factors & make certain ppl more vulnerable to phobias than others, may serve as protective factors for the development of phobias

Identify three of the psychological causal factors for social phobia and two of the biological causal factors.

Psychological causal factors: 1) Social phobia as learned behavior: either direct or vicarious classical conditioning 2) Social phobia as evolutionary by-product of dominance hierarchies common social arrangement among primates; ppl w/ social phobia show greater activation of amygdala in response to negative facial expressions > normal 3) Perceptions of uncontrollability & unpredictability: leads to submissive & unassertive behavior, which is characteristic of those who are socially anxious or phobic 4) Cognitive bias: ppl w/ social phobia expect others to reject them Biological causal factors: 1) behaviorally inhibited temperament (those shy at increased risk of developing) - shares characteristics w/ both neuroticism & introversion 2) genetic contribution

Differ between self-report and observational data

Self-report - collects info in a way that involves asking a someone directly observational collects info in a way that does not involve asking someone directly (observes)

SNRI

Serotonin & Norepienphrine reuptake inhibitors: -block both reuptake of norepi & serotonin -slightly more effective > SSRI in tx major depression -SSRI & TCA used to tx bulimia nervosa

How do social factors contribute to abnormal behavior?

Social factors are environmental influences (often unpredictable and uncontrollable negative events) that can negatively affect a person psychologically, making them less resourceful in coping with events

Describe twin method to study genetic influences on abnormal behavior. limitations?

Tests Concordance rate -MZ twins 100% same genes so if 1 has other will too if completely heritable Limitation: -higher concordance rate for a disorder in MZ twin than DZ not conclusive evidence of a genetic contribution -always possible that MZ treated more similar by parents than DZ -Best to study MZ reared apart

Describe major treatment approaches for panic disorder and their advantages/disadvantages

Treatments: 1) CBT -original tx: prolonged exposure therapy, worked but did not specifically target panic attacks new techniques: 2) interoceptive exposure 3) cognitive restructuring technique e.g. CBT tx for panic disorder = panic control tx (PCT) - targets both agoraphobic avoidance & panic attacks Medication: 4) anxiolytics: benzodiazepine (e.g. Xanax increase GABA): advantage of anxiolytics: -act very quickly (30-60 min) so can be used in acute situations of intense panic or anxiety; disadvantage: -drowsiness, sedation, impaired cognitive & motor performance, -dependency on drug w/ high dosage, withdrawal can be slow & difficult = relapse; 5)Antidepressants (SSRI, TCA, SNRI) adv: don't create physiological dependence that benzodiazepines (anxiolytics) can disadvantage: cannot be used for acute situation (4 weeks to see effect)

Unstructured vs structured diagnostic interviews

Unstructured Diagnostic Interviews: -allows clients to answer freely -drawback: info that interview yields is limited to content of that interview, unreliable Structured Diagnostic Interviews: - highly controlled, more reliable -e.g. Schedules for Clinical Assessment in Neuropsychiatry (SCAN) by WHO enables them to arrive at an ICD-10 diagnosis

How can external validity be maximized?

Using a more representative sample allows us to better generalize (extend findings from study to larger group)

fixed marker

a risk factor that cannot be changed (ethnicity, childhood abuse)

what kind of studies can animal studies be described to be, as it uses an approximation to true items of interest?

analogue studies

5 subtypes of specific phobias in DSM-5:

animal, natural env, blood-injection-injury, situational, other

What are the essential features of anxiety disorders

anxiety disorders characterised by: -unrealistic, irrational fears/anxieties that cause significant distress and/or impairments in functioning 5 recognised in DSM-5: 1) specific phobia 2) social anxiety disorder 3) panic disorder 4) Agoraphobia 5) Generalized Anxiety Disorder

how is the success of psychological treatment measured?

attempts at estimating gains in therapy depend on multiple sources: (1) clien'ts self-reports of chance in symptoms/fx'ing, -eg Beck depression inventory -may be unreliable (2) clinician's ratings of changes -eg Hamilton Rating Scale for Depression -may be biased, limited observational sample to assess overall change (3) reports from client's family or friends, (4) comparison of pretx & posttx scores on instruments designed to measure relevant facets of psychological fx'ing, -limitation: changes may be artifactual as w. regression to the mean (high/low scores when repeated drive toward avg giving false impression of real change) (5) measures of change in selected overt behaviors -objective behavior hard to fake -less appropriate for problems that are hard to observe (suicidal thoughts)

What are the 3 traditional perspectives that have dominated the study of abnormal behavior in recent years? Describe the role of each

biological -to understand how factors such as genetics neurobiology and hormonal responses can influence psychopathology psychological -To understand how dysfunctional thoughts, feelings and behaviors can lead to psychopathology sociocultural -To understand how social and cultural factors can influence the way that we think about abnormal behavior

motivational interviewing

brief form of therapy delivered in 1 or 2 sessions -employs a more direct approach unlike Client centered therapy

list couple and family therapies

couples therapy 1) traditional behavioral couple therapy TBCT 2) integrative behavioral couple therapy IBCT family therapy 1) structural family therapy

explain process for classifying abnormal behavior

differing models of classification: 1) categorical approach 2) dimensional approach 3) prototypal approach Formal diagnostic classification of MD: 1) ICD-10 2) DSM-5 -ethnicity, gender, culture considered in appraisal of mental health symptoms for DSM diagnosis -arriving at diagnosis usually required, in form of diagnostic impression before commencement of clinical services

effect of marital discord and divorce on children

discord -stressors cause negative effects on children, but buffered if one or both parents warm and don't reject children -effects child's romantic relationships later divorce -stressful for adults with most adapting constructively in 3 years, sometimes never -effect on children: lower education, income, life satisfaction

Freud believed anxiety plays a key role in most disorders, sometimes manifesting overtly and other times repressing and then transform into other conditions. He believed the ego helps cope with elevated anxiety through rational measures, but when thoughts enter our unconscious it can only be dealt irrationally. What mechanisms does the ego use in the unconscious to reduce anxiety?

ego-defense mechanisms

describe clinical features of panic disorder -what it is -DSM -subtypes -comorbidity -prevalence,onset -psychological causal factors -biological causal factors -treatments

occurrence of panic attacks that often seem to come 'out of the blue' DSM5: person must have experienced recurrent, unexpected attacks & must have been persistently concerned about having another attack for at least 1 month -Full blown panic attack req' at least 4/ 13 symptoms -Panic attacks peak intensity w/in 10 mins, often subside in 20-30mins, rarely last more than 1 hour -Can occur during relaxation or sleep = nocturnal panic -Symptoms mostly physical (palpitations, sweating, shaking, choking, chest pain) occurrence of panic attacks that often seem to come 'out of the blue' comorbidity: -most ppl w/ panic disorder have at least 1 comorbid disorder most often - GAD, social phobia, specific phobia, PTSD,etc. -depression common Onset: -1st panic attack reported occurs after 1 or + negative life events (stress loss), after which full blown panic disorder develops Biological Causal factors 1) Genetic factors - vulnerability manifested @ psychological level at least in part by personality trait called neuroticism 2) Panic & the brain - increases amygdala plays central role in panic attack 3) Biochemical abnormalities - panic provocation procedures = produce panic attacks in panic disorder clients @ much higher rate > normal; 2 primary NT most implicated in panic attacks: noradrenergic & serotonergic systems; meds used = SSRI, gaba Psychological causal factors 1) Cognitive theory of panic: propose that ppl w/ panic disorder are hypersensitive to their bodily sensations; body sensations interpreted as catastrophic, that raises perceived threat, increasing apprehension about situation, which further increases body sensations and repeats panic cycle 2) Comprehensive learning theory of panic disorder: initial panic attacks become associated w/ initially neutral internal (interoceptive) & external (exteroceptive) cues through interoceptive conditioning or exteroceptive conditioning -conditioning of anxiety to internal or external cues associated w/ panic which then sets stage for development of 2 of 3 components of panic disorder: (anticipatory anxiety & sometimes agoraphobic fears) -3rd component - panic attacks likely to be conditioned to certain internal cues 3) Anxiety sensitivity & perceived control -ppl w/ high levels of anxiety sensitive are more prone to developing panic attacks; -having sense of perceived control reduces anxiety & even blocks panic 4) Safety Behaviors & the persistence of panic -important during tx to identify safety behaviors (e.g. fear of fainting = constantly lean on walls) so person can learn to give up safety behaviors & see that feared catastrophe does not occur 5) Cognitive biases & maintenance of panic -ppl w/ panic disorder automatically have attention drawn to threatening info that represents things they fear - palpitations, numbness, faint Treatments: 1) Behavioral & cognitive-behavioral tx -original tx: prolonged exposure therapy, worked but did not specifically target panic attacks 2 new techniques: -interoceptive exposure (deliberate exposure to feared internal sensations) -cognitive restructuring technique (recognize that catastrophic automatic thoughts may help maintain panic attacks); e.g. CBT tx for panic disorder = panic control tx (PCT) - targets both agoraphobic avoidance & panic attacks 2) Medication anxiolytics from benzodiazepine category (e.g. Xanax increase GABA): -major advantage of anxiolytics = act very quickly (30-60 min) so can be used in acute situations of intense panic or anxiety; -limitation = side effects - drowsiness, sedation, impaired cognitive & motor performance, -dependency on drug w/ high dosage, withdrawal can be slow & difficult = relapse; Antidepressants (SSRI, TCA, SNRI) -adv = don't create physiological dependence that benzodiazepines (anxiolytics) can but cannot be used for acute situation (4 weeks to see effect)

symptoms of panic attack

panic attacks occur when fear response occurs w/o obvious external danger Symptoms mostly physical (palpitations, sweating, shaking, choking, chest pain)

what are the important elements in a social or behavioral history during assessment?

personality factors -Any relevant long term personality characteristics (eg perform deviant behaviours?) Social context -what kinds of environmental demands are typically placed on person & what supports or special stressors exist in his/her life situation (eg primary caretaker has Alzheimers)

PET Scans

positron emission tomography scan -provides metabolic portraits by tracking natural compounds (glucose) metabolism by brain or other organs -Allows for appraisal of how organ is fx'ing (vs. CAT that can only distinguish anatomical features - shape of particular internal structure) -obtain more clear cut diagnoses of brain pathology, revealing conditions not immediately apparent anatomically -Limitations: low-fidelity pictures, cost, questionable use in forensic evaluations

define prejudice

prejudgment based on personal characteristics

psychological assessment

procedure by which clinicians use psychological tests, observations, interviews to develop summary of clients symptoms and problems

clinical diagnosis

process through which clinician arrives at general summary classification of patients symptoms by following clearly defined system (DSM-5/ICD-10)

spontaneous recovery

returned of learned response some time after extinction has occurred

Representative sample

small group sample whose characteristics are representative of the larger group

Strengths/weaknesses of objective personality tests

strengths = cost effective, highly reliable, objective, can be quantified; limitations = illiteracy, req' individual's cooperation; person might distort answers

Epidemiology

study of distribution of diseases, disorders or health-related behaviors in a given population

gestalt therapy

teach clients to recognize bodily processes & emotions they had been blocking off from awareness -main goal is to increase self awareness & self acceptance -elements of a dream considered to be representations of unacknowledged aspects of dreamer's self

Sampling

technique used to select people who are representative of a much larger group of individuals with a certain condition

What developments led to contemporary view of abnormal psyc

technological discoveries ushered in experimentally oriented view of abnormal behavior

Pituitary gland

the master gland of the body, producing a variety of hormones that regulate or control the other endocrine glands

Phenotype

the observed structural and functional characteristics that result from an interaction of the genotype and the environment -gene expression is not only due to DNA but is end product of process influenced by the internal and external environment. -certain genes can be turned on/off in response to environmental influences such as stress

Who seeks psychological treatment? what are the most common goals?

those who are/with: -psychological disorders and stressful life circumstance (divorce, unemployment) -reluctant clients (court ordered, spousal threat) -seek personal growth

What is Abnormal psyc

understanding the nature, causes and treatment of mental disorder

define discrimination

unjust treatment of others based on perceived group membership

antianxiety drugs (anxiolytics)

used for conditions in which tension & anxiety are significant components -not a cure, just help keep symptoms under control -cons: addictive potential, sedating effects includes: 1) Benzodiazepines: -work by enhancing GABA receptors (GABA inh NT that inhibits anxiety in stressful situations ) -most common & widely used antianxiety dx for acute anxiety & agitation -rapidly absorbed from Digestive tract & work quickly -@ low doses, help w/ anxiety, @ high doses, act as sleep inducing agents -con: dependence & patients must be 'weaned' off gradually b/c of risks of withdrawal symptoms (seizures) Others: -e.g. buspirone - low potential for abuse b/c no sedative or muscle-relaxing properties so less pleasurable for patients, no withdrawal effects -cons= takes 2-4 wks to exert any anxiolytic effects, cant tx insomnia

prepared learning

view that people are biologically prepared through evolution to more readily acquire fears of certain things that may have posed a threat to our early ancestors (snakes)

Family aggregation

whether a disorder runs in families