Abnormal Psych
Differentiate depressions that are not mood disorders from those that are
Depressions such as Major Depressive Disorder (MDD) and Persistent Depressive Disorder (PDD) include the fact that the depressive episodes are usually random and not a reaction to any kind of situation. Postpartum Depression and grieving after a death are not considered mood disorders as they are medical/culturally sanctioned responses to major life changes
Distinguish between fear and anxiety
Distinction is based on whether the source of danger is obvious. When an obvious source of danger is present, it is fear. When the source of danger is not obvious, it is anxiety. Anxiety is also more future oriented than fear.
Summarize the central features of GAD and distinguish among psychoanalytic, conditioning, and cognitive theories of etiology.
GAD is diagnosed by at least 6 months of excessive worry and anxiety that must be ongoing more days than not, as well as that it must be difficult to turn off or control the worry process. GAD is physically presented in muscle tension, mental agitation, susceptibility to fatigue, some irritation, and difficulty sleeping.
Explain how various sociocultural factors affect unipolar and bipolar disorders
Gender roles in a society can help bring about a unipolar or bipolar disorder/ Females, being taught to be more passive, can have heightened feelings of uncontrollability and helplessness. Overprotective parenting can also help bring about a disorder
Identify the central nervous system processes and structures associated with GAD and evaluate treatments for the disorder
HPA Axis: Regulation of cortisol levels. Prefrontal cortex: Control impulse. Treatments: Medication (Benzodiazepines, antidepressants). Psychological: Uses images to help patients process the threatening information on an emotional level. Also help teach patients how to deeply relax and combat tension. (Cognitive-Behavioral therapy.)
Explain the risk factors in the development of PTSD
Neurobiological- elevated or restricted corticotropin-releasing factor (CRF) leading to an overactive HPA axis, hippocampus damage. Environmental- A family history of chronic anxiety, early experiences with uncontrollable or unpredictable experiences, family instability, lack of social support.
Discuss the issue of using psychotropic medications to treat PTSD
Psychotropic medications can cause fear and anxiety to come back and be placed into the long-term memory as well as augment extinction learning
Explain the importance of rating scales in clinical observations
Rating scales help assess the behavioral change someone is going through before and during treatment
Discuss the importance of reliability, validity, and standardization
Reliability is the degree to which a measurement is consistent. This is important so that a patient does not continuously receive a different diagnosis and treatment plan. Validity is whether something measures what it is designed to measure. It is important to make sure techniques assess what they are supposed to. Standardization is the process by which certain norms and standards are developed for a technique. This is important for base-line comparison and to see where someone stands compared to others with the same background
Describe how safety behaviors and cognitive biases help to maintain panic.
Safety behaviors can include things like breathing slowly before or during an attack. Sufferers can then mistakenly attribute the lack of catastrophe as being due to their engaging in the safety behavior as opposed to the idea that panic attack do not, for example, lead to heart attacks. Cognitive biases come forward in the way that sufferers process threatening information. Ambiguous bodily sensations and situations are often more threatening to these panic sufferers as well as words pertaining to things they fear (palpitations, faint, etc.)
Distinguish between signs and symptoms
Signs are manifestations of a disorder that can be observed by someone other than the person experiencing them. Symptoms are manifestations being experienced only by the person themselves.
Define the importance of incorporating culture into the assessment process
Some behaviors considered normal in one culture may not be normal in another culture and could be viewed as a symptom as opposed to a culturally sanctioned response
Discriminate between structured and unstructured interviews for the assessment of psychosocial functioning
Structured interviews use preset questions that do not change. Unstructured uses questions that are spontaneous and not prepared ahead of time.
Describe who is likely to attempt suicide and who is likely to complete suicide.
Suicide attempts can be made across all races and cultures. Adolescents and the elderly are at greater risk. Women are more likely to attempt suicide. Males are more likely to complete suicide due to usually choosing more lethal methods.
Trace the history of the development of antidepressants, explaining how one class of antidepressants was replaced by another
The Monoamine oxidase (MAO) inhibitors were the first class of antidepressants developed. The MAO Inhibitors were popular save for two side effects: any food or drink with tyramine could cause episodes of hypertension and possibly cause death and the fact that everyday medications like cold medicine could produce dangerous reactions when mixed with the MAOIs The Tricyclics were introduced shortly after and became the most popular until the release of the SSRIs. The Tricyclics had more side effects that, while less dangerous, were annoying (blurred vision, dry mouth, sexual dysfunction, etc.) Selective-Serotonin Reuptake Inhibitors (SSRIs) are currently the most popular choice of antidepressant. They have been linked to lower side effects and lower suicide rates (Except in rare cases) The Mixed Reuptake Inhibitors are similar to tricyclics but can help alleviate any side effects of SSRIs by blocking both serotonin and norepinephrine.
Describe the major intelligence tests
The Stanford-Binet test, which provides and IQ score. The test was designed to predict academic success. The score is provided by taking a person's mental age and dividing it by their chronological age. Another test is the Wechsler test which tests verbal skills (vocabulary, knowledge of facts, short term memory, and verbal reasoning skills) as well as performance scales (psychomotor skills, nonverbal reasoning, and ability to learn new relationships)
Identify the basic elements of clinical assessment and explain the relationship between assessment and diagnosis.
The clinician will begin by collecting information across a broad range of the individual's functioning to see where the source of the problem may lie. After getting the information, the clinician narrows it down to concentrate on areas that seem most relevant. Assessment leads to diagnosis (Reliability, validity, standardization.)
List the diagnostic criteria for panic disorder, contrast panic attacks and other types of anxiety disorders, and explain the association with Agoraphobia. Summarize prevalence, age of onset, and comorbidity.
The diagnostic criteria includes the occurrence of panic attacks that seem to come out of the blue, recurrent and unexpected attacks, worrying about additional attacks, and abrupt onset of four out of thirteen symptoms (sweating, trembling or shaking, nausea, fear of losing control) Panic attacks, unlike other types of anxiety disorders, are sudden and not caused by a particular object or situation. Those with panic disorder tend to develop Agoraphobia due to fear of having an attack in public and not being able to get help or having symptoms that will be viewed negatively. The prevalence rate is approximately 2.7% meeting the criteria in one one year period and 4.7% meeting the criteria at some point in their life. Age of onset is usually between mid-teens to 40 years old. Panic disorder is most often comorbid with Agoraphobia
Identify the most effective treatment package for bipolar disorders.
The most effective treatment includes a mix of medication and therapy, often Cognitive-Behavioral and/or Family therapy.
Discuss the advantages and disadvantages of personality tests
The objective personality tests (MMPI, BDI) advantages include the fact that they have high face validity and reduced reliability problems. The disadvantage is that information provided may not necessarily change how clients are treated and may not improve their outcomes.
Explain the difference between prevalence and the incidences of mental disorders
The prevalence rate is the number of active cases in a population at any given time. Incidences are new cases that occur at any given time.
Discuss the advantages and disadvantages of projective personality tests
The projective tests (Rorschach, Thematic Apperception Test) have the advantage of being open ended. Patients can project their own personality and unconscious fear, revealing their unconscious thoughts. The disadvantages are the fact that they can lack validity and reliability. The responses are judged based on the therapist's frame of reference. Most of these tests are administered differently based on the therapist that's administering them.
Discuss various approaches to the clinical observation of behavior and identify advantages of each
Usually observation of behavior takes place in different settings. It usually can occur in in an office, at a person's home, or at the person's place of work or school. These different ways of observing can often allow clinicians to find information that may have been withheld due to client embarrassment or feeling like it wasn't important. Sometimes clinicians will also use role play techniques to see how people react to everyday situations. This can help the clinician gather more information on a patient's everyday behavioral state.
Explain why we need to classify mental disorders and the advantages and disadvantages of classification
We need to classify mental disorders in order to advance our knowledge and create a clear system in order to break down personal interpretations and confusion. Advantages: Knowing what disorder someone has and what course it will take. Disadvantages: Labeling, stigma.
Discuss the prevalence rates for mental disorders
52% no disorder, 21% one disorder, 13% two disorders, 14% 3 or more disorders
Summarize the DSM-5 definition of mental disorders
A clinically significant behavioral or psychological pattern that causes distress or disability, is not a predictable or culturally sanctioned response to an event, and is considered to reflect behavioral, biological, or psychological dysfunction in the individual.
Explain what is meant by rapport between the clinician and client and outline the components of a relationship that leads to a good rapport.
A good working relationship between the client and clinician. The clinician can build a good rapport by not being aggressive in getting the client to talk, by making the client feel comfortable, etc.
Summarize the conditions under which a medical evaluation might be necessary. Describe the various approaches to assessment of physical problems, including the general physical examination, the neurological examination, and the neuropsychological exam
A physical examination is recommended if the patient has not had one within the last year. A neuropsychological exam is preformed when there is brain dysfunction and the effects can be seen in a person's functioning. In the General Physical exam mental and physical health professionals look at the possible causes for a patient's symptoms (Drug addicts coming off drugs can have panic attacks, etc.) The outcome determines whether the patient needs to receive physical care or be treated for a mental disorder. In neuropsychological exams, different tests can be administered to allow observation of how well an individual functions on certain tests. For instance, children can be given cards and told to copy what is on the card. Errors are compared to other children of their age and if it exceeds a certain number, dysfunction is suspected (Bender Visual-Motor Gestalt Test)
Differentiate between Cyclothymia, Bipolar 1, and Bipolar 2
Cyclothymia- Less severe than either Bipolar disorder. Chronic elevation or falling of moods that never reach levels of manic or hypomanic or major depressive episodes. Pattern lasts about 2 years Bipolar 1- Marked with full-blown episodes of Mania or mixed episodes. Bipolar 2- Marked with episodes of major depression and hypomania. There are no full-blown manic episodes or mixed episodes.
Summarize the evidence that anxiety sensitivity constitutes a diathesis for the development of panic attacks
Anxiety sensitivity is the tendency to become distressed in response to arousal related sensations, arising from the beliefs that these anxiety-related sensations have harmful consequences. Someone with higher anxiety sensitivity will become more distressed during stressful situations and be more prone to developing panic attacks than someone with lower anxiety sensitivity.
Explain the sociocultural and biological variables that affect suicide
Biological- Family history of suicide increases the possibility that a person will commit suicide. If a sibling or other close family member even attempts suicide the risk that a person will attempt shoots up. Low levels of serotonin can also be traced to suicide attempts. Sociocultural- Lack of social support especially among those suffering from a disorder. Media romanticization, they'll be remembered as a 'martyr'. Stress and uncontrollable events such as natural disasters can cause someone to commit suicide
Identify the major biological and psychsocial etiological theories in the bipolar disorders
Biological- Individuals are are genetically predisposed to Bipolar disorders due to many different patterns in many different genes. There could also be an imbalance of dopamine in the brain. Psychosocial- Bipolar disorders can be strongly influenced by personal stress in life, relations, etc. Lack of social support can also have a negative effect on the disorder.
Summarize the approaches that have been used to treat or prevent PTSD and evaluate their effectiveness
Catharsis- Reliving emotional trauma to relieve emotional suffering. Re-exposure is presented in a way as to be therapeutic and not traumatic. Imaginal Exposure- Trauma and the emotions associated with it are worked through slowly and systematically Prolonged Exposure Therapy- Develop a narrative of the traumatic event and review it intensely during treatment. Cognitive-Behavioral Therapy- Used to treat maladaptive thought patterns (It was my fault, feelings of guilt, etc.)
Identify how cultural issues can influence the definition of abnormal psychology as well as culture-specific disorders
Cultural factors influence the form and content of Psychopathology and can differ even from cultures side by side in the same country. In many cultures, individuals suffer from fright disorders caused by the beliefs of the culture system.
Explain why an individual would receive an EEG, a CAT scan, an MRI, a PET scan, or a functional MRI
EEG's measure electrical activity related to firing of neurons in the brain. One would receive one if they exhibited memory loss or bizarre, trance like behavior even for a short time. CAT scans help identify and locate abnormalities in the brain. One receives one if there is any possibility of brain damage. MRI's are received again if there is any possibility of brain damage. PET scans are received if there is any possible neurobiological cause of brain damage, along with functional MRI's.
Summarize current trends in patient care, including inpatient and outpatient care
Electroshock therapy and restraints/ deinstitutionalization due to lack of funding.
Explain the ethical issues involved in assessment.
Ethical issues can include cultural and gender bias. Gender bias in 'sexist' questions and cultural bias in language barriers, different cultural norms, and the different ways in which different cultures experience psychological disorders.
Describe the types of information sought in a clinical assessment and how the clinician would go about obtaining this information.
Information collected is about symptoms and their possible causes (Family history, substance abuse, etc.) The clinician could use different tactics including clinical interviews, symptom questionnaires, personality inventories, projective tests, and behavioral self-monitoring.
Identify prevention and treatment methods for suicide
Intervening in schools and other high-stress environments. Helping people develop healthy coping methods to deal with life stress. Cognitive-Behyavioral therapy/interventions.
Describe the defining features of OCD, summarize theories of etiology along with supporting evidence (or lack thereof), and outline treatment of OCD
OCD includes recurrent persistent thoughts, images, or urges that are experienced as intrusive and inappropriate and that usually cause much anxiety and stress. The individual tries to replace the thoughts, impulses, or urges with another thought or action (in the case of obsessions), repetitive actions that the individual feels compelled to perform to prevent anxiety or distress (in the case of compulsions) The obsessive-compulsions must be time consuming or impair functioning. Etiology- Biological: Dysfunction in brain circuits. Impulses carried by prefrontal cortex are weak, possibly due to a deficiency in serotonin. Psychodynamic: Obsessions/Compulsions are symbolic of unconscious conflict. Cognitive: Trouble turning off intrusive thoughts due to chronic stress, depression, or already being prone toward rigid thinking. Treatments- Cognitive-Behavioral therapy can expose the client to obsessions while simultaneously preventing compulsive behaviors and helping the client manage the anxiety that is aroused. Relaxation Training helps the client learn to control their anxiety with imaging and breathing techniques.
Compare and contrast the major treatment approaches for panic disorder and agoraphobia
One major treatment is medication, usually benzodiazepines. The advantages of medication are that they act very quickly and can be useful in situations of intense panic or anxiety. Disadvantages is that they can have undesired side effects and can be very addicting. Another approach is cognitive-behavioral therapy. This can help patients face the object or situation that they fear slowly (except in cases of flooding)
Describe how Dysthymia (Persistent Depressive Disorder) differs from Major Depressive Disorder
PDD differs from MDD in the fact that the symptoms tend to be milder and ongoing as well as the fact that depressive episodes in PDD last a minimum of two years but can last more.
Describe the major features of phobias, identify and differentiate the different subtypes of phobia, explicate the major etiological hypotheses, and discuss the most effective treatment approaches.
Phobias all include major anxiety related to certain situations, places, or objects. The different subtypes include Agoraphobia, Specific Phobias (Animal, Natural, Situational), and Social Phobia. Phobias can appear due to traumatic experiences, observing someone else experience a traumatic event, or just by being told about the danger. The most effective treatment is cognitive-behavioral therapy. Medication is not normally used save for special, as needed cases.
Identify the professionals responsible for working on the mental health 'team'
Psychiatrist, counseling and clinical psychologist, psychiatric nurse, psychiatric social worker, counselors
Outline the DSM-5 current diagnostic criterion for PTSD
To be diagnosed with PTSD, one must have a) exposure to to threatened or actual death, serious injury, or sexual violence in some way whether it be direct exposure, witnessing the event in person, learning that the event happened to a close family member or friend, or repeated exposure to in-depth details of the traumatic event b) Presence of recurring, involuntary, and distressing memories of the event c) Recurrent, distressing dreams about the event d) Dissociative reactions (like flashbacks) where the individual believes the event is recurring e) Intense psychological distress f) Marked physiological reactions to cues that resemble or symbolize the event g) Persistent avoidance of stimuli associated with the event h) Negative alterations in cognitions and mood associated with the event i) Marked alterations in arousal after the event (irritability, reckless behavior, hyper-vigilance, exaggerated startle response, problems concentrating) j) sleep disturbances k) Impairment of functioning And none of the effects can be brought about by substance use of any kind
Describe the criteria for diagnosing major depressive disorder and the subtypes
To diagnose MDD, the patient must have had at least one major depressive episode (2 weeks), the occurrence is not explained by any other psychological disorder (i.e. Schizophrenia), and there can not have been a manic or hypomanic episode
Discuss the prevalence of mood disorders in the United States as well as in other parts of the world and subgroup differences in prevalence rates
U.S.- 17% lifetime and 7% in a year for unipolar depressions. 1% lifetime for Bipolar disorders. World- 16% lifetime and 6% yearly for all mood disorders. Culturally it can vary dramatically. Native American cultures for instance, have a 28% prevalence rate
Describe unipolar depressive disorders
Unipolar Depressive Disorders are mood disorders that include only a depressive episode (MDD and PDD)
Describe the types of mood disorders
Unipolar- Includes MDD and PDD. Unipolar mood disorders only experience one polarity of moods. Unipolar disorders experience only episodes of depression. Bipolar- Includes Bipolar 1, Bipolar 2, and Cyclothymia. Bipolar includes two polarities of moods. Bipolar disorders are characterized by episodes of both depression and mania or hypomania.
