PSYCH 405 Exam I
Cognitive Model
- Focuses on maladaptive thinking processes -- Inaccurate/disturbing assumptions and attitudes -- Illogical thinking -- overgeneralize: draw broad negative conclusions on the basis of single insignificant events - Some people may make assumptions and adopt attitudes that are disturbing and inaccurate Therapists help clients recognize, challenge, and change problematic thinking
IRB Requirements
- The participants enlist voluntarily. - Before enlisting, the participants are adequately informed about what the study entails ("informed consent"). -- This can be confusing to read and people may not fully understand what they are agreeing to - The participants can end their participation in the study at any time. - The benefits of the study outweigh its costs/risks to participants. - The participants are protected from physical and psychological harm. - The participants have access to information about the study. - The participants' privacy is protected by principles such as confidentiality or anonymity.
deinstitutionalization
- The practice, begun in the 1960s, of releasing hundreds of thousands of patients from public mental hospitals. - Mental patients could recover more fully or live more satisfying lives if they were integrated into the community, with the support of community based treatment facilities --Not met it's goals because of funding Prison population (60%) + homeless people struggling majorly with abnormal functioning
Is therapy effective?
- Therapy clients show greater improvement than non-therapy clients by 75% - 3-15% of patients seem to get worse therapy outcome studies: studies that measure and compare the effects of various treatments (1) Is therapy in general effective? (2) Are particular therapies generally effective? (3) Are particular therapies effective for particular problems?
DSM-5 vs old DSM versions
- Updated background text information - Addition of a new mental disorder, prolonged grief disorder - Minor changes in the wording of the criteria for certain disorders - The introduction of alternative names for two disorders - The addition of several client conditions that diagnosticians are required to indicate, if present, when making diagnoses - A few changes in the terminology used in certain discussions - Deeper discussions regarding the impact of racism and other kinds of discrimination on mental disorders Improvements in matching the DSM's numerical diagnostic codes to the ICD codes
The Psychodynamic Model
- a person's behavior, normal or abnormal, is determined largely by underlying psychological forces of which the individual is not consciously aware -- Forces are dynamic (they interact with one another) and their interaction gives rise to behavior, thoughts, and emotions - deterministic assumption that no symptom or behavior is "accidental" -- all behavior is determined by past experiences conflicts are tied to early relationships
correlational method
- a research procedure used to determine this "co-relationship" between variable - Direction of Correlation -- Positive Correlation: When variables change the same way (up and right) -- Negative Correlation: value of one variable increases as the value of the other variable decreases (down and right) -- Unrelated: no consistent relationship between them (no slope) - Has higher external validity but LOWER internal validity - describes the relationship between two variables, they DO NOT explain the relationship -- Could be explained by factors not tested
Roger's Client-Centered Therapy
- clinicians try to help clients by conveying acceptance, accurate empathy, and genuineness - therapist must display 3 qualities throughout --- unconditional positive regard (full and warm acceptance for the client) --- accurate empathy (skillful listening and restating) --- genuineness (sincere communication)
case study
- detailed description of a person's life and psychological problems - describes the person's history, present circumstances, and symptoms - may also include speculation about why the problems developed and their treatment strengths - allows to study rare/unusual cases limitations - they are reported by biased observers -- Therapists want to se their clients improve - rely on subjective evidence -- Don't have internal accuracy, or internal validity - provide little basis for generalization -- What helps one person may not help another -- Low in external accuracy, or external validity
natural experiments
- experiment in which nature, rather than an experimenter, manipulates an independent variable nature itself manipulates the independent variable, while the experimenter observes the effects - Used for studying psychological effects of unusual/unpredictable events --- ex floods, pandemic, earthquakes, plane crashes, and fires - Participants are selected by accident of fate rather by experimenters
Clinical Interview
- often the first contact between client and clinician - collect detailed information about the person's problems and feelings, lifestyle and relationships, and other personal history - Structured -- asks specific questions (interview style) - Unstructured -- open-ended questions
Longitudinal Approach
- participants assessed on two or more points over time -Examines whether causes are present before disorder develops -High risk method -- Include only those who are at greatest likelihood of developing a disorder -- Reduces the cost of longitudinal research
How Are People with Less Severe Disturbances Treated?
- private psychotherapy - 43% of people with psychological disorders in the US receive treatment in the course of a year
DSM-5
- the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders - a widely used system for classifying psychological disorders Requires both.... - Categorical information: The name of the category (disorder) indicated by the client's symptoms. - Dimensional information: A rating of how severe a client's symptoms are and how dysfunctional the client is across various dimensions of personality // 1883, Emil Kraepelin developed the first modern classification system for abnormal behavior. His categories formed the foundation for psychological disorders
Rogers' Humanistic Theory
- the road to dysfunction begins in infancy - unconditional (nonjudgmental) positive regard - unconditional self-regard: they come to recognize their worth as persons, even while recognizing that they are not perfect --- children with unconditional positive regard develop this - conditions of worth: standards that tell them they are lovable and acceptable only when they conform to certain guidelines --- when children do NOT have unconditional positive regard
Positive psychology
- the study and enhancement of positive feelings such as optimism and happiness, positive traits like hard work and wisdom, and group-directed virtues, including altruism and tolerance
The Elusive Nature of Abnormality
-Abnormality is defined by general criteria in society. -Criteria are used to judge particular cases. -Szaz posits that societal involvement may invalidate the concept of mental illness. --- mental illness as a myth -Any definition of abnormality may be unable to be applied consistently.
experimental method
-research procedure in which a variable is manipulated and the manipulation's effect on another variable is observed -- Cause and effect -Treatment Studies: impacts of a certain treatment on the patient - independent variable: manipulated variable - dependent variable: the variable being observed for change - eliminate confounds -- Uses a Control group and experimental group -- Random Assignment: any selection procedure that ensures that every participant in the experiment is as likely to be placed in one group as the other
Group Study Comparison Study
2 or more groups are compared on variables of interest
Continuous Variable
2 or more variables are measured and the correlation between them is examined
Power of the Label
33% - Americans who would not seek counseling for fear of being labeled "mentally ill" 51% - Americans who would hesitate to see a psychotherapist if a diagnosis were required
Syndrome
A cluster of symptoms that usually occur together - Symptoms that co-occur are known as a syndrome - When the syndrome follows a particular course, we determine that a disorder exists
Diagnosis
A determination that a person's problems reflect a particular disorder - Does the client's syndrome match a known disorder? -- Using all available information, clinicians attempt to paint a "clinical picture" and make a diagnosis -- Used to predict the future course of the person's problem and the treatments that are likely to be helpful
single-subject experiments
A research method in which a single participant is observed and measured both before and after the manipulation of an independent variable -- ABAB Design- starting and stopping manipulation to show cause and effect -- rely first on baseline data — information gathered prior to any manipulations --- Compared to later changes - independent variable is manipulated systematically so that the investigator can, with some degree of confidence, draw conclusions about the cause of an observed effect
Somatogenic perspectives (early 20th century)
Abnormal functioning has physical causes -German researcher, Emil Kraepelin (1856-1926) --Compendium der Psychiatrie - Syphilis causes Paresis: an irreversible disorder with both mental symptoms such as delusions of grandeur and physical ones like paralysis
Psychogenic perspective (early 20th century)
Abnormal functioning has psychological causes - Hypnotism: trancelike mental state during which they become extremely suggestible -- demonstrated its potential -- Hysterical disorders - established that a mental process — hypnotic suggestion — could both cause and cure even a physical dysfunction - technique of psychoanalysis
Existential Theories
Existentialists believe that from birth we have total freedom, either to face up to our existence and give meaning to our lives or to shrink from that responsibility - Emphasis on accurate self-awareness and meaningful life (authentic) - Psychological dysfunction is caused by self-deception -- people hide from life's responsibilities and fail to recognize that it is up to them to give meaning to their lives -- dominant emotions are anxiety, frustration, boredom, alienation, and depression
managed care programs / parity
Health care coverage in which the insurance company largely controls the nature, scope, and cost of medical or psychological services - insurance company determines such key issues as which therapists its clients may choose, the cost of sessions, and the number of sessions for which a client may be reimbursed - in the mental health realm, both therapists and clients typically dislike managed care programs - federal parity law that directed insurance companies to provide equal coverage for mental and physical problems
Sigmund Freud & psychodynamic theory
ID - devil (instinctual needs, libido, pleasure principle) Ego - Referee (reality principle / rational thinking) Superego - Angel (moral standards / Conscience (Jiminy Cricket)) Fixation: according to Freud, a condition in which the id, ego, or superego do not mature properly and are frozen at an early stage of development
role of Institutional Review Boards in protecting the rights of human participants
IRBs directly watch over the rights and safety of human participants - very research facility has an IRB — a committee of 5+ members who review and monitor every study conducted at that institution, starting when the studies are first proposed - Has the power to change or stop a study Performs risk-benefit analysis in their reviews - IRBs are empowered by two agencies of the federal government — the Office for Human Research Protections and the Food and Drug Administration
prevention
Interventions aimed at deterring mental disorders before they can develop - Rather than wait for psychological disorders to occur, many of today's community programs try to correct the social conditions that underlie psychological problems (poverty or violence in the community, for example) and to help individuals who are at risk for developing emotional problems (for example, teenage mothers or the children of people with severe psychological disorders) - growing emphasis on positive psychology
clincal observation
Naturalistic Observation - clinicians observe clients in their everyday environments - homes, schools, institutions such as hospitals and prisons, or community settings Analog Observation - observe them in an artificial setting - such as a clinical office or laboratory Self-Monitoring - clients are instructed to observe themselves - only way to observe and measure private thoughts or perceptions
counseling psychologists, educational and school psychologists, mental health counselors, psychiatric nurses, marriage therapists, family therapists, and — the largest group — clinical social workers
Psychotherapy and related services are also provided by
drug therapy
Psychotropic Medications: drugs that mainly affect emotions and thought processes - used with therapy Antianxiety drugs: minor tranquilizers or anxiolytics / help reduce tension and anxiety Antidepressant drugs: help improve the functioning of people with depression and certain other disorders Antibipolar drugs: mood stabilizers / help steady the moods of those with a bipolar disorder (mood swings from mania to depression) Antipsychotic drugs: help reduce the confusion, hallucinations, and delusions that often accompany psychosis, a loss of contact with reality found in schizophrenia and other disorders.
Factors of Successful Therapy
Rapprochement Movement: a movement to identify a set of common factors, or common strategies, that run through all successful therapies A positive relationship An explanation or interpretation of why client is suffering Encouragement to confront negative emotions An integrative approach
Standards for What is Normal and Abnormal
Standard 1: Cultural Relativism - No universal standards or rules for labeling a behavior as abnormal - Instead, behaviors can only be abnormal relative to cultural norms - Gender Role Expectations Standard 2: Unusualness - Is the behavior rare? Standard 3: Discomfort - Proponents of this view argue that behavior is only abnormal if the individual suffers as a result of the behavior(s) and wishes to be rid of them. Standard 4: Mental Illness - Is the behavior caused by an identifiable disease?
multicultural psychology
The field that examines the impact of culture, race, ethnicity, and gender on behaviors and thoughts, and focuses on how such factors may influence the origin, nature, and treatment of abnormal behavior - field of multicultural psychology has begun to have a powerful effect on our understanding and treatment of abnormal behavior
Correlation Coefficient / magnitude
The sign of the coefficient (+ or −) signifies the direction of the correlation the number represents its magnitude Closer to 1 = stronger relationship .00: no relationship - magnitude: strength of relationship between variables -- steeper = stronger - statistically significant if p < .05 // correlation coefficient (r)
uniformity myth
a false belief that all therapies are equivalent despite differences in the therapists' training, experience, theoretical orientations, and personalities
placebo therapy
a pretend treatment that the participant in an experiment believes to be genuine
matched designs
a research design that matches the experimental participants with control participants who are similar on key characteristics - Uses pre-existing groups - Comparison group matched to criterion group -- Have the researchers matched the "right" variables? - Limitations on casual statements (form of correlation bc of pre established groups)
analogue experiments
a research method in which the experimenter produces abnormal-like behavior in laboratory participants and then conducts experiments on the participants in the hope of shedding light on the real-life abnormality - Often use animals as participants Advantages -- They allow for manipulation of independent variables Disadvantages -- Not clear if behavior in the laboratory setting is similar to clinical pathology -- Are animal models accurate reflections of human behavior? -- Generalizability (external validity)
epidemiological studies
a study that measures the incidence and prevalence of a problem, such as a disorder, in a given population - Incidence: the number of new cases that emerge in a population during a given period of time - Prevalence: the total number of cases in the population during a given period includes both existing and new cases - Risk Factors: some variable that increases your likelihood of developing a particular disorder - The National Comorbidity Survey-Replication
Existential Therapy
a therapy that encourages clients to accept responsibility for their lives and to live with greater meaning and value - help clients recognize their freedom so that they may choose a different course and live with greater meaning - therapists place great emphasis on the relationship between therapist and client and try to create an atmosphere of honesty, hard work, and shared learning and growth
The Biological Model
abnormal behavior as an illness brought about by malfunctioning parts of the organism - Brain is the cause of such behavioral - Many conditions temporarily disrupt information- processing capabilities of the brain - aka Medical Model
sociocultural models
abnormal behavior includes cultural and social forces influencing an individual - Address Norms of society & culture - Role in society - Cultural/family background -- Family Systems Theory: A theory that views the family as a system of interacting parts whose interactions exhibit consistent patterns and unstated rules --- enmeshed: helicopter parents --- disengaged: rigid boundaries
evidence-based treatment
also called empirically supported A movement in the clinical field that seeks to identify which therapies have received clear research support for each disorder, to develop corresponding treatment guidelines, and to spread such information to clinicians.
ancient theories of abnormal behavior
ancient peoples - Stone age (Spirit possession) - Trephination: a stone instrument, or trephine, was used to cut away a circular section of the skull - Ancient cultures still invoked magic/gods/demons in explaining "abnormal" behavior Romans/Greeks (Hippocrates) - Role of brain pathology as cause of mental disease imbalance of four fluids, or humors, that flowed through the body: yellow bile, black bile, blood, and phlegm -Role of heredity - origins of the medical model and DSM - Hippocrates' focus on internal causes for abnormal behavior persons in the age of the Renaissance - individuals might be kept at home while their families were aided financially by the local parish // loving care and respectful treatment - first in Gheel in Belgium - community mental health program - converted hospitals and monasteries into asylums, institutions whose primary purpose was to care for people with mental illness // -called people with mental illness UNSTABLE back then
Psychosurgery
brain surgery for mental disorders - deep brain stimulation
International Classification of Diseases (ICD)
developed by the World Health Organization - lists both medical and psychological disorders - numerical codes similar to DSM
The Four Ds
deviance: different, extreme, unusual, perhaps even bizarre // different from norms/culture distress: unpleasant and upsetting to the person dysfunction: interfering with the person's ability to conduct daily activities in a constructive way danger: behavior is consistently careless, hostile, or confused // risky behavior
Clinical Tests
device for gathering information about a few aspects of a person's psychological functioning from which broader information about the person can be inferred - projective tests --- Thematic Apperception Test (TAT) - makes up a story about a picture of people --- Rorschach - inkblot tests --- Sentence Completion Tests --- drawing - Personality Inventories --- Minnesota Multiphasic Personality Inventory (MMPI): 500 self-statements, to be labeled "true," "false," or "cannot say" - Response Inventories - Psychophysiological Tests --- ex. polygraph or EEG - Neurological (images of brain structure/ activity) - Intelligence Tests (IQ)
Biological Treatments
drug therapy brain stimulation psychosugery
What Therapeutic Approaches Should Be Used?
drugs help for many cases, but they shouldn't always be used for everyone psychotherapy can even be more successful long term many therapists use dugs with psychotherapy use both nomothetic (general) & idiographic (individual) information to form a treatment plan
Behavioral Model
explanation of human behavior, including dysfunction, based on principles of learning and adaptation --- abnormal behaviors also can be learned behaviors that are not "normal" - conditioning - classical conditioning (pavlov's dogs) - modeling (Bandura's Bobo Doll Study) - operant conditioning (reinforcement/punishment) therapists seek to replace a person's problematic behaviors with more appropriate ones
sociocultural therapies
group therapies support group (ex AA) Family Therapy Couple Therapy Community Mental Health Treatment - prevention is key Race/Gender Sensitive Therapy
Research Domain Criteria (RDoC)
guides researchers to identify disorders as clusters of underlying biological variables rather than as syndromes of specific clinical symptoms - The diagnostic classification system whose criteria are neuro/biological focused
neural communication
impulse received by dendrites → travels down the neuron's axon → transmitted through the nerve ending to a new neuron's dendrites Message moves across the synapse Neurotransmitter is released → travels across the synaptic space to receptors on the dendrites of the neighboring neurons -- Excitatory or inhibitory action
brain stimulation
interventions that directly or indirectly stimulate certain areas of the brain - Electroconvulsive Therapy (ECT): A biological treatment in which a brain seizure is triggered when an electric current passes through electrodes attached to the patient's forehead -- Primarily used on severely depressed people
linkage vs. association
linkage = Looks to see if some physical characteristic is more prevalent with someone with a psychological disorder than compared to the public (aka are they linked?) association = Collect genetic information from many people / Analyze differences in gene expression / Look for associations of genes to psychological disorders / LOOKING AT portions of the genome or the entire genome
stages of psychosexual development
oral (birth to 18 months), anal (18 months to 3 years of age), phallic (3 to 5 years), latency (5 to 12 years), and genital (12 years to adulthood)
psychiatrists
physicians who complete three to four additional years of training after medical school (a residency) in the treatment of abnormal mental functioning
masked design (blind design)
placebo therapy: a pretend treatment that the participant in an experiment believes to be genuine Rosenthal effect: the result when an experimenter's preconceived idea of appropriate responding influences the treatment of participants and their behavior Experimenters must act unaware as well (double blind)
clinical psychologists
professionals who earn a doctorate in clinical psychology by completing four to five years of graduate training in abnormal functioning and its treatment as well as a one-year internship in a mental health setting
How are people with severe disorders cared for?
psychotropic medications: drugs that primarily affect the brain and reduce many symptoms of mental dysfunction - antipsychotic drugs: correct extremely confused and distorted thinking - antidepressant drugs: lift the mood of depressed people - antianxiety drugs: reduce tension and worry
cross-sectional study
research that compares people of different ages at the same point in time - participants assessed at one point in time
moral treatment
the 19th century approach to treating the mentally ill with dignity in a caring environment
practice-based treatment
the integration of the best available research with clinical expertise in the context of patient characteristics, culture and preferences
Rosenthal effect
the result when an experimenter's preconceived idea of appropriate responding influences the treatment of participants and their behavior
abnormal psychology
the scientific study of abnormal behavior in an effort to describe, predict, explain, and change abnormal patterns of functioning - Behavior exists on a continuum
Gestalt's humanistic theory and therapy
therapists actively move clients toward self-recognition and self-acceptance by using techniques such as role playing and self-discovery exercises - challenging and even frustrating the clients - demanding that they stay in the here and now during therapy discussions - pushing them to embrace their real emotions - Role playing - Gestalt therapists often guide clients to express their needs and feelings in their full intensity by banging on pillows, crying out, kicking, or pounding things.
Ego Defense Mechanisms
to control unacceptable id impulses and avoid or reduce the anxiety they arouse - Repression, denial, rationalization, intellectualization - Regression: people seem to return to an earlier developmental stage -- Babytalk, biting nails, bed wetting - Projection: tale your feelings and saying someone else has them -- Emotion based -- Calling your friend fat bc you feel fat - reaction formation: take your feelings and express the opposite -- Boys being mean to girls they like - Sublimation: channeling feelings into something productive -- going to gym, playing football, making art - Displacement: individual transferring negative feelings from one person or thing to another -- Action based towards a safer target -- Slamming a door after a fight
Clincal Assessment
used to determine whether, how, and why a person is behaving abnormally and how that person may be helped - Also used to evaluate the effectiveness of treatment - Collection of idiographic information
Demonological Model
used to explain abnormal functioning during the Middle Ages -- Religious ties/roots -- Treatment: prayers, whippings, exorcism
Clinical researchers
work to determine which concepts best explain and predict abnormal behavior, which treatments are most effective, and what kinds of changes may be required - Search for a nomothetic, understanding of the nature, causes, and treatments of abnormality across individuals -- Nomothetic: a general understanding of the nature, causes, and treatments of abnormal functioning, in the form of laws or principles that apply across people -- Rather than searching for idiographic understanding --- Individual understanding - they do not assess, diagnose, or treat individual clients (that is the job of clinical practitioners)