unit 4

Bipolar Disorders

Major depression and dysthymia = unipolar disorders bc characterized by mood changes in only one direction Manic-depression was former name Mood swings in both directions; episodes last from few days to several months often separated by months/years of relatively normal mood Bipolar I disorder - at least one manic episode which may or may not be followed by depressive episode Bipolar II disorder - less extreme high phase (hypomania) Predisposition for disorder is strongly heritable more than unipolar depression or most other disorders Stressful life events my help bring on manic/depressive episodes but evidence not as strong as depression Can usually be controlled with lithium (promote survival, development, and function of neurons) The Manic Conditions Expansive, euphoric feelings; elevated self-esteem; increased talkativeness; decreased need for sleep; enhanced energy and enthusiasm which may be focused on one or more grandiose projects or schemes During hypomania and early stages of manic episode, high energy and confidence may lead to inc in productive work but judgment becomes increasingly poor and behavior maladaptive → bizarre thoughts and dangerous behaviors (jump off building, spending sprees, absence from work, sexual escapades) Not all exp manic state as euphoric: extraordinary irritability, suspiciousness, destructive rage POssible RElation of Hypomania to Enhance Creativity Many creative ppl suffered from a bipolar disorder and were most productive during hypomanic phases (elevated mood but not to such extreme as to prevent coherent thought and action) Robert Schumann (depression) composed extraordinary number of valued musical works during two episodes of apparent hypomania Emily Dickinson wrote much of best poetry during episodes of hypomania that follow winter depression Analyses of biographies and historical documents criticized on grounds that diagnosis of mood disorders made on basis of written material that may not have been fully accurate Possible that hypomania is result of high creativity than cause or ppl who suffer from extremes of mood may be more drawn to creative activities, which help them express feelings and thoughts Meta-analysis found relationship btwn creativity and ppl assessed to be at risk for bipolar disorder Ppl who manifested moderate mood swings were judged to be more creative in regular work and home life 16 yr olds revealed pos correlations btwn tendencies to exp hypomania and high scores on tests of creativity and oppress to exp Ppl with BD found to score higher on tests of creativity and openness to exp Writers and artists w higher levels of psychopathology were rated as being more eminent whereas scientists/composers/thinkers showed inverted-U relationship btwn eminence and psychopathology level Causal nature of link not yet determined

Gender

Women score higher than men in agreeableness, women are more concerned than men with developing and maintaining positive social relationships, higher neuroticism (women report higher levels of anxiety and feelings of vulnerability than men), higher on conscientiousness, tend to score higher on warmth and gregariousness facets of extraversion but lower on excitement-seeking facet, score higher on feelings and aesthetics facets of openness to exp but not other other four facets Gender also affects relationship of personality to life satisfaction Shyness or behavioral inhibition correlates positively w feelings of emotional distress and unhappiness in young men but not women Cultural expectations make life more difficult for shy men than women Men generally expected to initiate romantic and sexual relationships and to be more assertive/dominant in social interactions Women who have relatively competitive orientation toward others rather than similarity/agreeableness score lower on measures of self-esteem; opp for men Men high in neuroticism viewed more negatively than women Evolutionary Foundations of Gender Differences Universality of certain gender differences and long history of evolution in which males and females were subject to diff reproductive challenges Females' greater role in child care, perhaps need for cooperative relationship w other adults in relation to child care → personality qualities promoting nurturance, cooperation, cautions Males' greater need to compete in order to reproduce → competitiveness, aggressiveness, risk taking Male and female mammals tend to respond diff to stressful situations: males become more aggressive, females become more nurturant and more motivated to strengthen social connections and more likely to attempt to placate rivals rather than intimidate them and seek comfort and support from friends Diff is not all or none and there is overlap between sexes Sex diff in hormones contribute to diff in personality: oxytocin at higher levels in females and tends to promote affiliation, testosterone higher levels in males promote aggression Cultural Foundations of Gender Differences Diff experiences, expectations, role models, and opportunities provided by culture for girls and boys Social forces encourage girls to develop nurturant, agreeable, and conscientious aspects of nature and boys to develop competitive, aggressive risk-taking aspects Some gender diff in personality have changed over historical time in keeping with changing social roles and expectations Systematic analysis of scores of various tests of assertiveness revealed that gender diff in trait changed over time in keeping w changes in culture During Great Depression and World War II, women generally expected to self-sufficient → relatively small gender diff in assertiveness After war women expected to be passive and domestic → women's scores on assertiveness tests declined considerably while men constant Mid-1960s: women entered workforce and took on roles prev considered to be masculine → score inc, some as high as men's Examine gender diff cross-culturally: gender diff greater in developed/prosperous/egalitarian countries than in relatively undeveloped/poor/traditional cultures Women score higher than men in neuroticism, extraversion, agreeableness, conscientiousness → diff greater in developed countries than latter Support for idea of inherent biological personality diff → in wealthier countries ppl are freer to choose own routes in life so choose ways of life consistent w and reinforce inborn personality traits As women become more accepted in traditionally male roles, women have bought more feminien orientation to roles (ex: women business leaders are on avg more likely to lead thru nurturance and encouragement and exert greater conscientiousness and less aggressiveness) Inc freedom of occupational choice in weather countries accompanied by inc flexibility within each occupational role so that ppl of either gender can bring their personality strengths ot bear rather than modify personalities to fit job → speculation

phobia

intense, irrational fear that is clearly related to particular category of object or event Fear is some specific, nonsocial category of object or situation (animal, substance, situation) Fear must be long-standing and sufficiently strong to disrupt everyday life in some way (ex: leave job or refrain from leaving home to avoid) Diagnosable at some time in life in 7-13% of ppl in western societies Usually aware that fear is irrational but still cannot control it; suffer doubly from fear itself and from knowing how irrational they are to have such a fear Hypervigilant specifically for category of obj that they fear → ex can find spiders in photographs more quickly → once spotted obj avert eyes from it more quickly than others RElation of Phobias to Normal Fears Diff between normal condition and disorder is one of degree not kind Phobias are usually of things many ppl fear to some extent (spiders, blood, darkness) Much more often diagnosed in women than men; males less likely to report fears of things; sex diff could stem from fact that boys are more strongly encouraged to overcome/hide fears Phobias Explained in Terms of Learning and Evolution 40% of ppl w phobias recall traumatic situation in which they first acquired fear Classical conditioning: dog = CS for fear, bite = US → dog elicits fear even w/o bite; just one pairing can be enough for strong conditioning to occur Often develop phobias of objs that have enver inflicted damage to them((no traumatic exp) Evolutionary account: ppl genetically prepared to be wary of and to learn easily to fear objs and situations that would have posed realistic dangers during evolutionary history (snakes, spider, darkness, heights are more common than others) Ppl can acquire strong fears of such evolutionarily significant objs and situations more easily than they can acquire fears of other sorts of objects: observing others respond fearfully to them or reading/hearing fearful stories can initiate/contribute to phobia Children not innately fearful of snakes but more easily associate them w fearful responses than other animals:infants and toddlers watched vids of snakes and other animals and heard fearful/happy voice → looked longer than snakes when heard fearful voice than happy (no diff in looking times for other animals) Monkeys more readily react fearfully aft watching monkey respond w fright to snake than rabbit or flower; monkeys have specific neurons that respond selectively to visual images of snakes Infants are prepared to acquire fear of snakes Neither children nor monkeys are born w fear, but possess perceptual biases to attend to certain types of stimuli and to associate them w fearful voices or reactions → fears can develop into phobias Other predisposing factors: genetic temperament, prior experiences If you had a great deal of safe prior exp w snakes, would be less likely to develop snake phobia aft traumatic encounter w snake than would someone whose first exposure was traumatic Classical conditioning of fears is reduced or blocked if conditioned stimulus is first presented many times in absence of unconditioned stimulus Ppl w phobias have strong tendency to avoid looking at or being anywhere near objs they fear → behavior pattern perpetuates disorder (negative reinforcement of reduced anxiety) Without exposure to obj, there is little opportunity to overcome fear of them

Behavior Therapy

rooted in research on basic learning processes (Pavlov, Watson, Skinner); clients exposed by therapist to new environmental conditions that are designed to retrain them so that maladaptive habitual or reflexive ways of responding become extinguished and new healthier habits and reflexes are conditioned Contingency Management: Altering the Relationship Between Actions and Rewards Operant conditioning: behavioral actions reinforced by consequences Contingency management - therapy programs that alter contingency btwn actions and rewards; desired actions are rewarded and undesired ones are not Parent management training - behavioral work w families aimed at altering contingencies btwn actions and rewards at home Principal tool in applied behavior analysis, which focuses on changing some target behaviors (nail biting, head banging, study habits) by changing patterns of reinforcements Instituted in many community drug rehabilitation programs: patients who remain drug free receive vouchers that they can exchange for prizes → successful for cocaine and heroin, less expensive Exposure Treatments for Unwanted Fears Treating specific phobias in which person fears something well defined (heights, animal) Fear is reflexive response which thru classical conditioning can be triggered Opinions differ as to whether particular fear such as snakes is unconditioned/unlearned or conditioned/learned, but treatment same either way Fear reflex declines and disappears if eliciting stimulus presented many times or over prolonged period in context where no harm comes to person In case of unconditioned fear reflex (startle response) → habituation Conditioned fear reflex → extinction (CS pressented w/o US) Exposure treatment - treatment for unwanted fear or phobia that involves exposure to feared stimulus in order to habituate or extinguish fear response; three diff means Imaginal exposure - imagine fearful scene as vidildy as possible until it no longer seems frightening → imagine somewhat more fearful scene → works up to most feared scene Ability to imagine prev feared situation w/o exp fear will generalize so that person will be able to tolerate actual situation w/o fear In vivo exposure - real-life exposure; confront feared situation in reality Generally more effective than imaginal exposure but more time consuming and expensive and not practical bc situation too difficult to arrange Virtual reality exposure - wear goggles and exp 3D images that simulate real-world objs and situations Reasonably effective: overcame fear of flying within 6 1 hr sessions A Case Example: Miss Muffet Overcomes Her Spider Phobia Fear of spider led to spider phobia and OCD: regularly fumigating car w smoke and pesticides, sealing bedroom windows w duct tape, sealing clothes in plastic bags aft washing; avoided places where she had ever encountered spiders Ten 1-hr sessions of virtual reality exposure: spider exp that were more frightening than any she would encounter in real world to convince her at gut emotional level that encountering real spiders would not cause her to panic or go crazy Hold live tarantula

Cluster B

"Dramatic" Personality Disorders Display highly emotional, dramatic, or erratic behavior that makes it difficult for them to have stable, satisfying relationships Antisocial Personality Disorder Violate or disregard rights of others Sociopaths or psychopaths → psychopathy Lie, lack moral conscience, behave impulsive, disregard consequences of actions Freq find themselves in trouble w law → 30% of ppl in prison population meet diagnosis criterion Poor emotional regulation and deficits in some of components of executive function 3-3.5% in US have, four times more common in men than women Borderline Personality Disorder Instability in emotions: swinging in and out of extreme moods and self image → dramatic changes in identity, goals, friends, sexual orientation Impulsive, often engaging in reckless behavior, sometimes lashing out at others, turning anger inward (self-injurious behavior) Attempted suicide is common (75% of ppl w disorder and 10% succeedigng) Relationships are intense and stormy, fears of abandonment → frantic efforts to head off anticipated separations 1-2.5% of ppl have; 75% women Histrionic Personality Disorder Continually seek to be center of attention; behave as if they are always "on stage," using theatrical gestures and mannerisms Vain, self-centered, "emotionally charged" (exaggerated moods and emotions)Constantly seek attention and approval from others and concerned w how others will evaluate them, often wearing provocative clothing to attract attention Difficult time delaying gratification and may overreact in order to get attention (feign physical illness)Males and females equally likely; 2-3% Narcissistic Personality Disorder Even more self-centered than borderline personality Seek admiration from others, tend to lack empathy, grandiose and overconfident in talents or characteristics Exaggerate abilities and achievements and expect others to see same exceptional qualities in them Arrogant, general lack of interest in others Often make good first impressions (good social skills) but rarely maintained 1% of population, 75% men

Attachment

Durable emotional bonds that infants develop toward their principal caregivers More broadly, long-lasting emotional bonds that any individual develops toward any other • We begin to form strong bonds with caregivers early in life • Those bonds do not depend on sharing resources or providing attention/food/shelter • Harlow's monkey experiment - bonding with mother-like structure rather than structure that provides milk -- Harlow raised infant rhesus monkeys w inanimate surrogate (substitute) mothers Isolated cages → 2 surrogate mothers (bare wire vs. soft terry cloth, one provide milk) Regardless of which surrogate contained nipple with milk, all infant monkeys treated cloth-covered surrogate as mother: clung to it, ran to it when frightened, braver in exploring unfamiliar room with surrogate was present, pressed lever repeatedly to look at it thru window in preference to other objs Role of contact comfort in development of attachment bonds: provision of nutrition and physical necessities is not enough, infants also need close contact w comforting caregivers Form and functions of human infants' attachment Bowlby observed attachment behaviors in humans from 8 mo to 3 yrs → similar to monkeys Children showed distress when moms (objs of attachment) left them esp in unfamiliar environment; showed pleasure when reunited w moms; showed distress when approached by stranger unless reassured/comforted by moms; were more likely to explore unfamiliar environ when mom present Attachment is universal human phenomenon w biological foundations derived from natural selection Infants potentially in danger when out of sight of caregivers esp novel environ Prottest moms' departure and avoided unfamiliar objs when mom absent → survive Similar behaviors occur in all human cultures and other mammals Attachment begins to strength at abt age 6-8, when infants begin to move around on own → can gt into more danger, so exploration balanced by drive to stay near caregiver social referencing: look to caregivers for cues abt danger and safety as they explore need not just presence of attachment object but also emotional availability and expressions of reassurance to feel most secure in novel situation → infants who cannot see mom's face typically move around until they can Relax more if mom smiles cheerfully at stranger vs not

Psychological Disorders

Evaluate behavior in terms of Four Ds Deviance - degree to which behaviors a person engages in or his/her ideas are considered unacceptable or uncommon in society Distress - negative feelings person has bc of disorder or neg feelings of other ppl Dysfunction - maladaptive behavior that interferes w person beings able to successfully carry out everyday functions Danger - dangerous/violent behavior directed at other ppl or self DSM-5 - most recent various in 2013, specifies criteria for deciding what is officially a disorder and what is not; lists categories and subcategories of disorders along w criteria for identifying them fuzzy concept, DSM-5: "syndrome characterized by clinically significant disturbance in individual's cognition, motion regulation, or behavior that reflects dysfunction in psychological, biological, or developmental processes underlying mental functioning.."; clinically significant detriment, derive from internal source, not subject to voluntary control Ambiguous: how much distress/dysfunction must syndrome entail be considered "clinically significant", how can we tell impairment is within person rather than in environment (normal responses to conditions?), ppl claim could behave normally if they wanted to can we believe them, who has right to decide diagnosis: psychiatrist or psychologist or court of law or health insurance administrator or self or family? Human judgments, tinged by social values and pragmatic concerns

traits

1. From our families - high heritability E.g., 5HTTLPR - serotonin transporter; short allele -> neuroticism and related behaviors 2. From the environment? It depends Personalities of biological family members raised in the same household are generally no more similar than of those raised apart --- WHY IS IT USEFUL THAT WE'RE ALL DIFFERENT? Diverse personalities in an unpredictable world - different people excel in different situations Bold vs. cautious fish Human variation in Big Five -> alternative strategies for survival and reproduction In siblings: contrast and split-parent identification may reduce rivalry and diversify parental investment -- Heritability of Traits Heritability - degree to which individual diff derive from diff in genes rather than from diff in environmental exp Traits identified by trait theories are strongly heritable Administer standard personality questionnaires to pairs of identical twins and fraternal twins → identical twins are much more similar than fraternal on every personality dimension measured (avg heritability estimate of roughly 0.5 for most traits) Criticism that parents and others may treat identical twins more similar than fraternal → similar personality; so Gave personality tests to twins separated in infancy vs. raised in same home → identical twins still more similar to each other than fraternal Relative Lack of Shared Effects of the Family Environment Being raised in same family has almost negligible effect on measures of personality Those aspects of family environment that contribute to personality differentiation are typically as diff for ppl raised in same fam as they are for ppl raised in diff families; two children raised in same fam may exp that environment very differently from each other Compared nontwin, adopted children w both biological siblings raised in diff home and adoptive siblings → far more similar to biological siblings than adoptive (adoptive siblings were on avg no more similar to each other than were any two children chosen at random) Single Genes and Physiology of Traits Genes affect personality by influencing physiological characteristics of nervous system: one route is thru influence on neurotransmission in brain → significant correlation btwn specific personality characteristics and specific genes that alter neurotransmission Neuroticism and gene that influences activity of ntm serotonin in brain (5-HTTLLPR gene) Short s allele and long l allele Homozygous for l form are on avg lower in neuroticism than ppl who have at least one s allele Serotonin play a role in brain processes involved w emotional excitability Significant relationship between trait of novelty seeking (more assertive form of openness to exp which includes impulsiveness, excitability, and extravagance) and alleles that alter action of ntm dopamine Dopamine involved in reward and pleasure systems in brain Such effects are relatively small, not seen in all populations → variation in personality derives from combined effects of many genes interacting w influences of environment; effect that any specific gene has on personality may depend on mix of other genes and environment exp

Social Pressure in Group Discussions

Group Discussion Can Make Attitudes More Extreme When group is evenly split on issue, each side partially convinces other so get more moderate view on issue than before and compromise If group is not evenly split - if all or large majority of members argue on same side of issue - discussion typically pushes majority toward more extreme view in same direction as initial view aka group polarization Mock juries evaluated traffic-violation cases that had been constructed to produce either high or low initial judgments of guilt → after group discussion jurors rated high-guilt cases as indicating even higher levels of guilt and low-guilt cases as indicating even lower levels of guilt Researcher divided ppl into groups on basis of initial views on controversial issues and found that discussions held separately by each group widened the gaps between the groups Discussion caused groups favoring a strengthening of military to favor it even more strongly and vice versa Political views shift more after joining club, prisoners who enter prison w a little respect for a law and talking w other prisoners who share that view are likely to leave prison w even less respect for law than before Conditions that Lead to Good or Bad Group Decisions failed White House policy decisions: Bay of PIgs invasion of CUba, escalate Vietnam War, cover up Watergate burglary, came abt bc tightly knit clique of presidential advisers, whose principal concerns were upholding group unity and pleasing leader, failed to examine critically choice leader seemed to favor and instead devoted energy to defending choice and suppressing criticisms of it Groupthink - a mode of thinking that ppl engage when they are deeply involved in a cohesive in-group, when the members' striving for unanimity overrides motivation to realistically appraise alternative courses of action NASA launch Challenger in below-freezing weather explosion of vehicle and deaths sof 7 crew members); endorsements by corporate boards of shady accounting practices → downfall of Enron; and decision by GW Bush administration concerning invasion and occupation of Iraq Ability of groups to solve problems and make effective decision is improved if Leaders refrain from advocating view themselves and instead encourage group members to present own views and challenge one another Groups focus on problem to be solved rather than on developing group cohesion Group that values dissenter has potential to make fully informed, rational decisions

SOCIAL PSYCHOLOGY

How we view and are influenced by one another

Norepinephrine

is a monoamine composed of norepinephrine, epinephrine, and dopamine is released into the bloodstream when experiencing stress is involved in fight-or-flight bodily response, which PTSD patients experience in the absence of stressful stimuli (via re-experiencing)

ASCH'S CONFORMITY EXPERIMENTS

A college-student volunteer was brought into the lab and seated with six to eight other students Group was told that their task = judge the lengths of lines On each trial, they were shown one standard line and three comparison lines: which comparison line is the same length as the standard? Unbeknownst to participants, the others in the group were pre-instructed to give a wrong answer 3⁄4 of participants convinced themselves to give that same wrong answer! Works for other types of decisions (e.g., trolley problem)

PSYCHOANALYSIS

Dig around for clues about the unconscious mind by analyzing speech and behavior Prompted patients to give uncensored accounts of experiences and dreams, which he thought would lend insight Paid close attention to unintentional turns of phrase - Freudian Slips

summary

Disorder stems from exaggerated presentations of what we think of as "normal" behavior Just as the symptoms of mental disorders are not qualitatively different from those of normal behavior, neither are the causes The behaviors generated by many disorders are recursive - they tend to keep the person in the disordered state We don't want to become "armchair experts;" we leave the diagnosis up to clinicians -- Psychiatric disorders are complex, and the contributing factors/mechanisms underlying them (etiology) include: Genetics (+ high heritability) Brain function, structure, and circuitry The environment Diagnosis, intervention, and treatment are fraught, because: Complex underlying mechanisms (see above!) Heterogenous presentation across patients Recent advances in a) ways to examine such mechanisms (i.e., neuroimaging), and b) changing our conceptualization of what constitutes "a disorder" (from a symptom checklist to a dimensional approach) can give us insight that aids in both diagnostic reliability and treatment efficacy

TREATMENT ROUTES

Drug-based Neuro/Biological Psychotherapy

Infancy

Erik ERikson: each stage of life is associated with particular crisis or problem to be resolved thru interactions w other ppl; the way person resolves each problem influences how he/she approaches subsequent life stages In infancy, developing sense of trust - secure sense that other ppl can be relied upon for care and help John Bowlby: emotional bond between human infant and adult caregiver is promoted by set of instinctive tendencies in both partners (crying = discomfort, adult's distress and urge to help on hearing crying; infant's smiling and cooing → adult's pleasure); evolutionary perspective Infants biologically prepared to learn who caregivers are and elicit from them help needed; not passively dependent Babies prefer voices of own mom over other voices, prefer smell and sight too Newborns signal distress thru fussing/crying; 3 mo old → express interest/sadness thru facial expression and respond to such expressions in others Active role in building emotional bonds (attachment) between themselves and caregivers

Asch's Classic Conformity Experiments

Og purpose was to demonstrate the limits of conformity; prev research had shown that ppl conform ot others' judgments when objective evidence is ambiguous → wanted to use clear-cut evidence College-student volunteer brought into lab and seated with 6-8 other students, group was told that task was to judge lengths of lines Each trial shown one standard line and three comparison lines and asked to judge which comparison line was identical in length to standard → easy perceptual task, subjects performing task alone almost never made mistakes Others in groups were instructed to give specific wrong answer on certain prearranged "critical" trails → choices stated out loud by group members one at time in order of seating (real subject next to last to respond) 75% were swayed by confederates on at least one of 12 critical trials, a few conformed every trial, others on only one/two, with most 5% responding independently at least once On avg, subjects conformed on 37% of critical trials Replicated many times → some decline in conformity in NOrth America after 1950s Conformity to social pressure also occurs for moral judgments Hypothetical moral dilemmas: some of which most ppl think are permissible (ex: pushing switch so runaway trolley is diverted down a track killing 1 person rather than 5) and others which most ppl think are impermissible (killing one's oldest son to appease leader of clan whose land you have trespassed) → subjects who rated the dilemmas in presence of confederates who rated impermissible dilemmas as permissible were more likely to also rate as permissible than control subjects who were alone when rating

CONTRIBUTORS TO DIFFERENT STAGES OF DISORDER

Predisposing: Exist before disorder onset; make one susceptible Precipitating: Immediate causes that lead to onset Perpetuating: Consequences of disordered behaviors and cognitions

Psychodynamic therapy

Psychoanalysis - forms of therapy that adhere most closely to ideas set forth by Freud Psychodynamic therapy - include psychoanalysis and therapies that are more loosely based on Freud's ideas Unconscious Conflicts, Often Rooted in Early Childhood Experiences, Underlie Psychological Disorders Mental problems arise from unresolved mental conflicts, which themselves arise from holding of contradictory motives and beliefs motives/beliefs/conflicts may be unconscious or partly so but influence conscious thoughts and actions Freud: unconscious conflicts originate in first 5-6 yrs of life and have to do w infantile sexual and aggressive wishes → today are concerned w conflicts that can originate at any time in life and have to do w any drives or needs that are important to person most see sexual and aggressive drives as particularly important bc they often conflict w learned beliefs and societal constraints childhood also particularly vulnerable period during which frightening/confusing exp can affect (sexual/physical abuse, lack of security, lack of consistent love from parents) Approach linked to developmental psych; growing up entails resolving conflicts → failure = problems Patients' Observable Speech and Behavior Provide Clues to Their Unconscious Conflicts Symptoms are surface manifestations of disorder; disorder itself buried in unconscious mind and must be unearthed Anorexia nervosa → find out why she is starving self (underlying conflict) Analyze clues found in speech and observable behavior Symptoms and unique way they're manifested Elements of thought and behavior that are least logical (elements of unconscious mind that leaked out relatively unmodified by consciousness) Free association, dreams, slips of tongues/behavioral errors Free Associations as Clues to the Unconscious Free of association - patient encouraged to sit back, relax, free mind, refrain from trying to be logical/correct, report every image/idea that enters awareness usually in response to some word or pic that therapist provides as initial stimulus Dreams as Clues to the Unconscious Dreams are purest exercise of free association Remember dreams/write them down upon awakening During sleep conventional logic largely absent, unconscious partially disguised Underlying unconscious meaning of dream = latent content Dream as itis consciously exp and remembered by dreamer = manifest content Disguises in dreams come in various forms, Freudian symbols (common disguises) Mistakes and Slips of the Tongue as Clues to the Unconscious Mistakes are not random accidents but expressions of unconscious wishes or conflicts Roles of Resistance and Transference in The Therapeutic Process Resistance - patients often resist therapist's attempt to bring unconscious memories/wishes into consciousness ((refusing to talk abt certain topics, forgetting tot come to therapy sessions, arguing in way that subverts therapeutic process) Stem from general defensive processes by which ppl protect themselves from becoming conscious of anxiety-provoking thoughts Provides clues that therapy is going in right direction, but can slow it down To avoid triggering, must present interpretations gradually when patient is ready Transference - patients' unconscious feelings abt significant person in life are experienced consciously as feelings abt therapist; provides opportunity for patient to become aware of strong emotions The Relationship Between Insight and Cure Once conscious, conflicting beliefs and wishes can be experienced directly and acted upon or modified by conscious mind into healthier, more appropriate beliefs and pursuits Patient freed of defenses that kept material repressed and has more psychic energy for other activities Patient must truly accept insights viscerally as well as intellectually; therapist must lead patient to actually exp emotions and arrive at insights him/herself

Defensive Styles

Psychological defense = most popular and lasting idea of Freud Some ppl habitually employ certain defenses as routine modes of dealing w stressful situations in lives such that defense mechanism is dimension of personality → repressive coping Repressive Coping as a Personality Style Ppl regularly repress emotions that accompany disturbing events in lifes: can recall and describe events but claim memories do not disturb them = these ppl are repressors Repressors identified by scores on standardized questionnaires for assessing anxiety and defensiveness (exp littell anxiety but ans Qs in ways that seem highly defensive) Esp strong need to view themselves in very favorable light; do not admit to foibles typical of most ppl Compare reactions to moderately distressing situations in lab Complete sentences that contain sexual/aggressive themes, describe least-desirable traits, recall fearful exp, imagine unhappy event Repressors report less psychological distress in situations than nonrepressors; but by physiological indices (HR, muscle tension, perspiration) manifest more distress than non Not lying; they do believe it: somehow banished anxious thoughts from conscious but not bodily reactions of anxiety Repressors report less anxiety or other unpleasant emotions in daily diaries, recalled fewer neg childhood exp, less likely to notice consciously or remember emotion-arousing words or phrases presented during experiment; avoid experiences of anxiety by diverting conscious attention away from anxiety-arousing stimuli and dwell on pleasant thoughts Repressive style may often originate at time when person coping w seriously disturbing life event common among adolescent cancer survivors), help them maintain pos outlook on life Help ppl who have had heart attacks or lost ppl to sucide to cope psychologically Help ppl by preserving conscious minds (working memories) for rational planning and prob solving However, may develop more health probs and exp more chronic pain → exp stress physically rather than as conscious emotion promoting cognitive functioning at some cost to bodies) Distinction Between Mature and Immature Defensive Styles Some defenses are more conducive to long-term well-being than others Harvard men filled out questionnaire concerning issues as work, ambitions, social relationships, emotions, health over 30 yrs → interviewed in depth some of the men → systematically analyze content and style of responses in interview and prev questionnaires → rated extent to which each man used specific defense mechanisms Divided defense mechanisms into categories according to judgment of degree to which they would seem to promote either ineffective or effective behavior Immature defenses - distort reality the most and lead to most ineffective actions (projection) Intermediate defenses (neurotic defenses) - involve less distortion of reality and lead to somewhat more effective coping (repression and reaction formation) Mature defenses - least distortion of reality and lead to most adaptive behaviors (suppression - conscious avoidance of neg thinking, diff from repression bc has more conscious control over decision to think abt distressing exp; humor - reduces fear by making fun of feared ideas) Men who used most mature defense were most successful on all measures of ability to love and work and happiest As men matured avg maturity of defenses increased Similar results for other groups; as they grow older ppl rely less on defenses that deny/distort reality and more on defenses that allow them to accept reality Use of mature defenses correlates positively w measures of life satisfaction and success (not cause and effect tho)

ATTACHMENT STYLES

Secure: Parent is supportive and available; child is happy and exploratory Avoidant: Parent is insensitive or rejecting; child only seeks parent when necessary Anxious/Insecure: Parent is unavailable or self-centered; child attention- seeking, sensitive to separation before it occurs; struggles to accept comfort Disorganized/fearful: parent is scary/abusive; child has no coping skills Mary AInsworth developed Strange-situation test Mom and infant (12-18 mo) enter small room → mom shows baby some toys and lets child explore/play Unfamiliar adult enters room, talks to mom, and interacts w infant → 3 min later mom leaves room, leaving child w stranger →> mom returns Based on babies' responses when mom returns, 3 (one added later) attachment classifications Secure attachment - 60% of babies in middle-class samples in U.S., infants actively explore while in room w moms, become upset when moms leave, when mom returns will often run/crawl to her and greet her warmly, mom is able to soothe child ot extent that sometimes child returns to play w stranger Insecure-resistant attachment - 10%, anxious even w moms and don't explore much, very distressed when mom leaves but ambivalent and display anger on return, stay near mom after she returns but seem to resent earlier departure and often resist attempts at contact, wary of unfamiliar adult even when mom present Insecure-avoidant attachment - 15%, show little distress when mom departs, avoid contact with mom when she returns, don't show wariness of stranger but may avoid stranger much like mom disorganized/disoriented attachment - 15%, no coherent strategy for dealing w stress during separation and reunion; seek to be close in moms in erratic ways, often showing patterns typical of secure/avoidant/resistant simultaneously (ex: strong approach to mom followed by strong avoidance); sometimes look dazed and disoriented upon reunion; freeze in middle of movement, approach her backwards, or wait inordinate amt of time before approaching her; no consistent way of handling separation and reunion

Factor analysis

Statistical procedure for analyzing the correlations among various measurements (such as test scores) taken from a given set of individuals Identifies hypothetical, underlying variables (factors) that could account for the observed pattern Assesses the degree to which each factor is adequately measured (i.e., operationalization) Factors that "hang together" can be grouped into a dimension method of analyzing patterns of correlations in order to extra mathematically defined factors, which underlie and help make sense of those patterns First, collect data in form of set of personality measures taken across large sampling of ppl: indicate on scale of 1 to 5 to degree which each adjective describes self Statistically correlates scores for each adjective with those for each of other adjectives → matrix of correlation coefficients that show correlation for every possible pair of scores Factor extraction: adjectives that are strongly related to one another/cluster tgt identified Research provides label for factors → 2 dimensions of personality are relatively independent of each other such as conscientiousness and agreeableness

treatment

TODAY: RATES ARE HIGH + TREATMENT ISN'T THAT SUCCESSFUL One way to help develop better treatment and prevention methods is to better understand the etiology - or underlying - mechanisms of the major mental disorders. Just as the symptoms of mental disorders are not qualitatively different from those of normal behavior, neither are the causes.

UNDER PRESSURE

The experience of being observed: Facilitates effortful action Interferes with conscious cognition and attention Can do both within the same task Novices vs. experts - what's the difference? Distractionlimits working memory capacity Stereotype threat

treatment summary

Treatments largely involve altering neural mechanisms through drugs or other biological methods vs. addressing cognitive and behavioral aspects via therapy In the present day, we're doing a...better?...job of nailing down which treatments work for which symptoms • But! Recurrence is still high, compliance is a problem, and outcomes aren't always ideal • We need to continue to focus on addressing underlying (biological, cognitive, predispositional) factors that lead to / perpetuate disorder

Other Biologically Based Treatments

Used more rarely Electroconvulsive therapy (ECT) Used for severe depression that does not respond to psychotherapy to antidepressants Painless and safe unlike before (broke bones) General anesthesia and muscle-blocking drug so no pain and no damaging muscle contractions → electric current passed thru skull → seizure in brain that lasts 1 min → given in series (one every 2-3 days for abt 2 weeks) 50-80% of ppl who have not been helped by other forms of treatment exp remission w ECT; sometimes permanent sometimes depression recurs aft several months or more In nonhuman animals shocks cause immediate release of all ntms → longer-lasting changes in transmitter production and sensitivity of postsynaptic receptors; also stimulate growth of new neurons in brain → maybe contribute to antidepressant effect? Side effect: memory loss (retrograde amnesia can't remember events immediately before event and anterograde amnesia inability to form new memories following event) → clears up within few months Unilateral right-hemisphere ECT disrupts memory much less than applied across whole brain Psychosurgery - surgically cutting or producing lesions in portions of brain to relieve psychological disorder 1930s-1950s: prefrontal lobotomy - anterior portions of frontal lobes surgically separated from rest of brain for schizo, bipolar, depression, OCD, pathological violence → obsolete bc newly developed drug treatments offered alt and evidence that altho relieved ppl of incapacitating emotions also left them incapacitated in new ways (executive function: ability to integrate plans w action) → can't make plans and act according to them, needed constant care Refined versions used in rare cases: very small areas of brain are destroyed by temporarily implanting fine wire electrodes into targeted areas and applying radiofrequency current thru them; primarily for OCD as last resort (over many yrs untreatable by other means) OCD associated w abnormal amts of activity in neural circuit involved in converting conscious thoughts into actions (prefrontal cortex, limbic system's cingulum, basal ganglia) Surgical destruction of either of a portion of cingulum or of specific neural pathway that enters basal ganglia reduces/abolished OCD symptoms in 50% Side effects: confusion, weight gain, depression, epilepsy Deep brain stimulation - for treating intractable cases of OCD, depression, pain in cancer patients, motor symptoms of Parkinson disease; thin wire electrode implanted permanently into brain (cingulum or portion of basal ganglia for OCD) → electrode electrically stimulate (not destroy) neurons near it → high freq but low intensity stimulation desynchronize and disrupt ongoing neural activity, produces effect like lesion → can be reversed by turning off current, may be as effective as psychosurgery w/o neg side effects Transcranial magnetic stimulation - send pulse of electricity thru small copper coil held above head → magnetic field passes thru scalp and skull and induces electric current in neurons below coil When focused on prefrontal cortex, changes in activity of neurons reduce depression in some patients when administered daily over 2-4 weeks

Trait

a relatively stable predisposition to behave a certain way Identified/characterized via psychometrics - the science of how we measure psychological properties Reliable way to distinguish people from one another in a way that is consistent across time and space Actual manifestation in form of behavior requires trigger from environ Are not all-or-none characteristics but Dimensions (continuous, measurable characteristics) along which ppl differ by degree → normal distribution Describe differences among ppl in tendencies to behave in certain ways but not explanations of those diff; meaningless to say Harry argues and fights a lot bc he is highly aggressive (circular reasoning)

Psychodynamic

• People are largely unaware of why they develop their personality types - unconscious drives are responsible • Observable behaviors give insights into the unconscious, which is responsible for why we are the way we are 1. People are largely not conscious of what motivates them to do the things they do 2. The mind doesn't like to be challenged, so defense mechanisms work to guard it against anxiety Freud: People are pleasure- seeking Adler: People desire competency Erikson: People are shaped by society -- Sigmund Freud = pioneer of clinical psych Unconscious mind - disturbing memories buried in there, can't be recalled consciously but clues in behavior Treatment: patients talk freely about self and analyze what they said to make patient conscious of unconscious memories/motives/emotions → conscious mind can deal w them Psychoanalysis - refers both to method of treatment and theory of personality Psychodynamic theories - personality theories that emphasize interplay of mental forces Ppl are often unconscious of their motives Processes called defense mechanisms work within mind to keep unacceptable/anxiety-producing motives and thoughts out of consciousness Personality diff lie in variations in ppl's unconscious motives, how motives are manifested, and ways ppl defend themselves from anxiety Personality developed in series of stages: oral, anal, phallic, latency, gential stages Sex drive is primary instinct expressed at all stages Main source of pleasure satisifcation/tension reduction is centered on specific bodily zones (erogenous zones), which change during course of development (oral to anal, etc) How parents deal with pleasure-seeking impulses affect later development Little research evidence supporting it - The Concept of Unconscious Motivation Main causes of behavior lie in unconscious mind (part of mind that affects individual's conscious thought and action but is not itself open to conscious inspection); like posthypnotic suggestion Reasons ppl give to explain behavior are often not true causes; conscious reasons are cover-ups, plausible but false rationalizations we believe to be true Psychoanalysis - analyze certain aspects of speech and observable behavior to draw inferences abt unconscious motives Elements of thought and behavior that are least logical would provide best clues to unconscious, represent elements of unconscious mind that leaked out relatively unmodified by consciousness Slips of tongue, other mistakes, describe dreams, report uncensored fashion whatever thoughts - Sex and Aggression as Motivating Forces in Freud's Theory Considered drives to be analogous to physical forms of energy that built up over time and released Ppl some often inhibit direct expressions of sexual and aggressive drives → build up Much of human behaivor consists of disguised manifestations of sex and agression and personality diff lie in dif ways that ppl disguise and channel drives Sex drive = main pleasure-seekign and life=seeking drive; aggressive drive = destructive actions - Social Drives as Motives in Other Psychodynamic Theories Viewed ppl as social, fored to live in societies by necessity than desire; social interactions derive primarily from sex, agression Now: ppl are inherently social beings whose motives for interaction extend beyond sex and aggression Alfred Adler: ppl's drive to feel competent; everyone begins life w feeling of inferiority, which stems from helpless and dependent nature of early childhood, manner in which ppl learn to cope with/overcome feeling provides basis for personalities Inferiority complex - ppl who become overwhelmed by sense of inferiority, go thru life acting incompetent and dependent OR Superiority complex - go thru life trying to prove they are better than others as means of masking inferiority Erik Erikson: psychosocial theory of development Believed in psychosexual stages and three part structure of mind (id, ego, superego), unconscious Also emphasized role of society in shaping personality: society place demands on ppl as they develop and how they handle demands affects personalities Eight stages: as ppl face conflicts/crises at each of these stages in relationships w other ppl, how they deal w crisis at one stage influence how they will deal at following stages In all theories first few yrs of life are esp crucial in forming personality → earliest attempts to satisfy drives result in pos/neg responses from others that have lifelong effects on how drives are manifested

Alteration of brain function

• Physiological treatments that address some dysfunction in the brain/neural pathways: • ECT (Electroconvulsive therapy): electrical current applied to skull to induce brained seizures -safe and effective but causes some loss of current memories -typically used for recurrent depression in both major depressive disorder and bipolar disorder (relieves neg symptoms) • TMS (Transcranial Magnetic Stimulation): uses magnetic field to stimulate or deactivate a swath of brain tissue (e.g. Medial frontal lobe) • DBS (Deep Brain Stimulation): Uses electrical current to disrupt activity at specific brain locations but deep within tissue rather than thru skull (surgical implant of "brain pacemaker")

PERSONALITY DISORDER

Cluster A: Odd • Paranoid - deep distrust of others • Schizoid - emotionally flat and avoidant of relationships • Schizotypal - bizarre thinking and perceptions Cluster B: dramatic • Antisocial - disregard of others' rights or feelings • Borderline - instability; wild mood and personality swings • Histrionic - attention- seeking • Narcissistic - self-centered; grandiose Cluster C: Anxious • Avoidant - excessive shyness and inhibition in social situations • Dependent - extreme need to be cared for • Obsessive- compulsive (OCPD) - preoccupation with order; inflexible Ego- syntonic vs. ego- dystonic

Prisoner's Dilemma

Do you choose to exploit others for your own benefit?Or to trust that others will not take advantage of you? What's most beneficial to both is cooperating in silence, but people generally ASSUME that others act in their own self interest, so they talk - and when they both talk, they both get one year in prison (oops)

Traumatic and Stress-Related Disorders: Posttraumatic Stress Disorder

DSM-5 includes five disorders in which exposure to traumatic or stressful events are listed in diagnosis Two disorders of childhood in which children experienced neglect/abuse/insufficient care Reactive attachment disorder - children or inhibited or emotionally withdrawn from caregivers Disinhibited social engagement disorder - children are overly familiar with unfamiliar adults Remaining three involve exposure to traumatic events or threats of trauma Acute stress disorder - individuals exp distressing memories, negative mood, memory loss, sleep disturbance that persist for at least 3 days Adjustment disorder - exp emotional distress out of proportion to severity of stressor in response to identifiable event such as death or termination of romantic relationship PTSD Posttrauamtic stress disorder (PTSD) - necessarily brought on by stressful experiences Symptoms must be linked to one or more emotionally traumatic incidents that affected person has experienced (survivors of horrific or life threatneing experienes such as car accident, battefield mayhem, torture, rape, confinement in concentration camp, prisoner of war) Three major symptoms Uncontrollable re=experiencing - often involves nightmares, "flashbacks" when attack, distress when reminded abt traumatic event Heightened arousal - sleeplessness, irritability, exaggerated startle responses, difficulty concentrating Avoid of trauma-related stimuli - Actively avoid thoughts and situations that remind them of trauma and often exp emotional numbing and social withdrawal Difficult to assess prevalence bc depend on sample population in US 60% men and 50% women exp at least one traumatic event in lives → 8% of these men and 20% women develop PTSD Algeria: nearly everyone victim of terrorist attacks, 40% of adults have PTSD 15-30% in Cambodia, Ethiopia, Palestine Esp common in soldiers returning from war; probs of veterans w PTSD are often compounded by other behaviors and conditions → more likely to abuse alcohol and other substances, involved in domestic violence, exp depression and other anxiety disorders Deficits in cognitive abilities (speed of info processing, working memory, verbal learning and memory, inhibitory control, episodic memory, imagining future events) Don't know exp trauma causes cognitive deficits; maybe ppl w lower levels of these cognitive abilities are more susceptible to effects of trauma Exposed repeatedly to distressing conditions are more likely to develop than single/short-term incident Incidence of PTSD among Vietnam War veterans correlated more strongly with long-term exposure to daily stressors and dangers of war (heat, insects, loss of sleep, sight of corpses, risk of capture by enemy) than w exposure to single atrocity War refugees % of PTSD rose in direct proportion to number of traumatic events exp Children exposed to repeated abuse particularly prone to PTSD Most ppl can rebound reasonably well from single horrific event but repeated exp of such events wear resilience down perhaps thru long-term debilitating effects of stress hormones on brain Some ppl more susceptible to PTSD than others Ability to regulate one's emotions (executive functions) Firefighters who showed low on test of emotional regulation showed significant correlations between number of traumatic events and incidence of PTSD; no significant relationship for firefighters with high emotional self-regulation abilities Social support also affects Genes: identical twins were considerably more similar to each other in incidence of disorder and in types of symptoms developed than fraternal twins

depression

Depressive Disorders Prolonged sadness, self-blame, sense of worthlessness, absence of pleasure decreased/increased sleep, decreased/increased appetite, retarded/agiated motor symptoms (retarded = slowed speech and slowed body movements, agiated are less common = repetitive, aimless movements such as hadn wringing and pacing) Symptoms must be very severe or prolonged and not attributable just to a specific life exp tho may be triggered or exacerbated by exp Major depression - very severe symptoms that last essentially without remission for at least 2 weeks Dysthymia (persistent depressive disorder) - less severe symptoms that last for at least 2 weeks Double depression - bouts of major depression superimposed over more chronic state of dysthymia Comparisons Between Depression and Generalized Anxiety Both are predisposed by same genes: identical twins of ppl suffering from either one exhibit equally enhanced rates of either disorder; two disorders often occur in same individuals (60% of ppl diagnosed with GAD also suffer from depressive disorder at some pt in life; typically GAD occurs first) Former is frantic, relatively ineffective attempt to cope with life's real and imagined threats thru worry and hypervigilance; latter is giving up despairing of coping and concluding life not worth living Former worry about what might happen in future, latter feel that all is alr lost, more likely to stop caring and stay in bed all day Maybe low self-esteem contributes to depression Negative Thought Pattern as a Cause of Depression Hopelessness theory - depression results from a pattern of thinking about negative events that has three characteristics Assuming that neg event will have disastrous consequences Assuming that neg event reflects something negative about self Attributing cause of negative event to something that is stable (won't change) and global (capable of affecting many future events) Controversy is whether three-factor thought pattern reflects depression or is also a cause Study: first-yr nondepressed college students w no prior history of clinical depression filled out questionnaire that measured hopeless style of thinking abt negative events and another designed to assess current level of mood → assessed at various times for depression over 2.5 yrs → those who scored high on measure of neg thinking were six times as likely to manifest episode of major depression at some pt even if equivalent in mood level at beginning of study Cognitive therapy (help ppl change habitual patterns of thinking) has been shown to reduce depression and likelihood of recurrence children /adolescents who have never been depressed can be partially inoculated against future depression by training in which they learn to interpret neg events in hope-promoting ways Rumination - thinking style which involves repeatedly and passively focusing on symptoms of distress and on possible cause and consequences of theses symptoms Does not lead to problem solving but fixation on prob and neg feelings Strongly related to depression and worsens it by maintaining neg thinking and interfering w problem solving Maladaptive emotional regulation strategy that depressed ppl use, believing that it provides increased self-understanding and awareness Stressful Experiences Plus Genetic Predisposition as Cause of Depression Ppl who have recently suffered stressful exp more likely to become depressed (esp losses that alter life: spouse/daily companion, job, social status, income, health) → promote hopeless thinking Some ppl are resilient tho → genes 1000 women who had twin sisters: identify if recently exp stressful life event, whether or not period of major depression began within a month aft event, level of genetic predisposition for depression (based on whether twin sister had history of major depression and whether identical of nonidentical) Among women who had not recently exp highly stressful life event, incidence of depression very low regardless of level of genetic predisposition If exp event, incident of depression strongly related to lvl of genetic predisposition Major depression requires BOTH genetic predisposition and severely stressful event Gene 5-HTTLLPR alters effects of ntm serotonin in brain: two copies of long allele tends to protect adults from becoming depressed in response to severe stressful events but only under certain rearing environments Short version of 5-HTT gene more likely to exp depression than ppl w long version but only if exp multiple stressful events in childhood (controversial, some not replicated) Diff alleles of gene DAT1 involved in transportation of dopamine: adolescents were more apt to be depressed if had exp high levels of maternal rejection as children but only if had combination of alleles (TT vs CC or CT) → interaction btwn genetic disposition and childhood exp for depression Possible Brain Mechanisms of Depression Treatment drugs inc amt/activity of norepinephrine and/or serotonin Disorder may result from brain deficiency in one or both of these transmitters → theory much doubted bc does not explain delayed effectiveness of drug treatments (enhance activity immediately but don't relieve dep until at least 2 weeks) and most depressed ppl do not appear to have unusually low lvls Stress and worry associated w inc cortisol (hormone produced by adrenal glands, can act on brain to shut off certain growth-promoting processes) → high lvl can cause prefrontal cortex and hippocampus to shrink (reversible changes: inc in morphine and serotonin can stimulate growth in areas, maybe that's why there is delayed effect of treatment) Depression in humans results partly from stress-induced loss of neurons or neural connections in certain parts of brain and recovery results in regrowth in areas → consistent w evidence that depression often follows prolonged period of anxiety, anxiety stimulates production of hormones that interfere w brain growth Altered ways of thinking can change predisposition: hopefulness reduces psychological distress → reduce production of growth-inhibiting hormones and protects brain from changes Possible Evolutionary Bases for Depression Depression may be exaggerated form of response to loss that in less extreme form is adaptive Moderate depression slows us down, makes us think realistically rather than optimistically, leads us to turn away from goals we can no longer hope to achieve, signals to others that we are not threat and need help Signals of helplessness resemble appeasement displays used by other animals signal submissiveness and need for care Soul-searching → may establish new more realistic goals and new approach to life Depressed moods may come in diff forms each adapted for diff survival purposes In northern latitudes Depressed mood during winter (extreme form: seasonal affective disorder SAD) → inc appetite, inc sleepiness, and lethargy → may be useful for ancestors for building layers of fat and conserving energy to survive winter Depressed mood following death of loved one/loss or romantic partner esp characterized by crying and other expressions of sadness, which may signal need for help from others Depressed mood following repeated failure esp characterized by self-blame and pessimism, which may motivate person to withdraw from futile activities and begin period of realistic appraisals of life goals

Diagnosing Psychological Disorders

Diagnosis - process of assigning label to person's psychological disorder; system must be reliable and valid Reliability - extent to which diff diagnosticians reach same conclusion when independently diagnose same individuals APA published DSM as standard system for labeling and diagnosing psych disorders; revised w goal of defining psychological disorders as objectively as possible in terms of symptoms that could be observed or assessed by asking simple Qs Conducted field studies in which ppl who might have particular disorder diagnosed independently using each of several alt diagnosis systems → systems that produced greatest reliability (most agreement) Diagnostic criteria for anorexia nervosa: a) refuse to maintain body weight at or above minimally normal weight for age and height b) express intense fear of gaining weight or becoming fat c) manifest disturbance in exp of body weight/shape, show undue influence of body weight/shape on self-evaluation or deny seriousness of current low body weight d) missed at least three successive menstrual periods (due to lack of body fat) → if any one not met diagnosis would not be made; observable characteristics or self-descriptions, not inference Validity - index of extent to which categories diagnostic system identifies are useful and meaningful for clinicians; can be reliable but not valid (suffer in similar ways, similar causes, help treatment) More complicated than reliability; must be based on research Must first form reliable diagnostic system → identify ppl whose disorder fits definition ⇒ study ppl to see if disorders have similar origins, course of development, response to particular forms of treatment → results lead to new means of defining and diagnosing or new subcategories → inc validity WHO developed International CLassification of Diseases (ICD-10): used to classify psych disorders; Hierarchical Taxonomy of Psychopathology ((hiTOP) reflect scientific evidence and address limitations associated with DSM-5; NIMH (National Institute of Mental Health) plans to develop own classification system w use of objective laboratory measures w focus on bio, genetics, neurosci -> lots of controversies of identification, definition, and classification of psychological disorders Possible Dangers in Labeling Can interfere w person's ability to cope w environment Stigimize person and reduce esteem accorded to person by others Reduce own self-esteem Blind clinicians and others to qualities of person not captured by label To reduce: APA recommends clinicians apply diagnostic labels only to ppl's disorders not ppl themselves: client is person w schizo or suffers from alcoholism not a schizophrenic or alcoholic Diagnostic systems are never completely reliable Medical Students' Disease Aka introductory psychology students' disease - strong tendency to relate personally to and to find in oneself symptoms of any disease or disorder described in textbook Everyone has at least some of the symptoms to some degree of every disorder

Bystander Effect

Failure to respond to an emergency situation Why do we ignore? If you spring into action and others don't - fear of judgment Also, we assume someone else will do something

Possible Causes of Sex Differences in the Prevalence of Specific Disorders

More women with anxiety disorders and depression; more men with intermittent explosive disorder (relatively unprovoked violent outbursts of anger) and antisocial personality disorder (antisocial/harmful to others acts w no sense of guilt) and substance-use disorders (alcohol and drug) Diff in reporting or suppressing psychological distress - diagnoses of anxiety disorders and depression depend on self-reporting; men may be less inclined than women to admit in interviews or questionnaires Experiments show that when subjected to same stressful situation such as school exam men report less anxiety than women even tho show same or greater physiological signs of distress Clinicians' expectations - diagnosticians may find disorder more often in one sex than other bc expect to find it Experiment demonstrate expectancy bias: clinical psychologists asked to amke diagnoses on bases of written case hiostries mailed to them (some resmelbe antisocial personality disorder or histrionic persoanlity disorder → written in duplicate forms differing in sex) → diagnoses strongly affected by sex; given exact same case histories man was more likely than woman to receive diagnosis of antisocial personality while for women histronic personality Differences in stressful experiences - women more likely than men to live in poverty, experience discrimiantoin, have been sexually abused in childhood, and physically abused by spouses which can contribute to disorders that occur more often in women than men; typical responsibilities that women assume in fam such as caring or children are more conducive to anxiety and depression than roles men assume Differences in ways of responding to stressful situations- women "internalize" discomfort by ruminating on distress and seek causes within themselves → manner of responding tends to promote anxiety and depression; men more often "externalize" discomfort by looking for cause outside self and try to control causes sometimes thru aggression or violence In part biologically predisposed; male and female hormones influence reactions

Milgram's Experiments

Obedience = cases of compliance in which requester is perceived as authority figure or leader and request is perceived as order Crimes of obedience - cases in which ppl in response to others' orders cary out unethical or illegal actions Identify psychological pressures that underlie willingness to follow malevolent order Milgram's Basic Procedure and Finding Read off questions on test of verbal memory and give learner electric shock whenever he gives wrong answer → inc shock each time there is mistake "Please continue" → "experiment requires that you continue" → "it is absolutely essential that you continue" → "you have no other choice; you must go on"65% of subjects continued to very end of series, pleaded w experimenter to let them stop, almost all of them showed signs of great tension such as sweating and nervous tics Experimenter was not physically aggressive/did not make threats, $5 pay for participating was small, subjects had been told that $5 was theirs just for showing up Explaining the Finding Experiment yielded same results no matter gender, country, job and ppl aren't sadistic (subjects were upset) Norm of obedience to legitimate authorities norm of obedience - social world trains ppl to obey legitimate authorities and to play by rules experimenter must be legitimate authority in context of laboratory, which subject respects but doesn't fully understand When experiment moved from Yale to donwton office building under fictitious organization → percentage of fully obedient dropped from 65 to 48% (easier to doubt legitimacy of researcher at unknown office than Yale scientist) Experimenter's self-assurance and acceptance of responsibility Obedience predicated on assumption that person giving orders sis in control and responsible; your role is cog in machine Expeirmenter's self-confidence helped subjects to continue accepting role Often asked experiment Qs like "who is responsible if that man is hurt" and experimetner routinely ans that he was → reassure themselves Obedience ropped sharply when subjects told beforehand that they were responsible for learner's well-being → importance of attributing responsibility Proximity of experimenter and distance of learner Og experiment: experimenter in same room as subject, learner in anotehr room out of sight Experimenter left room and communicated w subject by telephone → only 23% obeyed to end Experimenter remained in room w subject but learner also brought into room → 40% Subject required to hold learner's arm on shock plate → 30% obeyed to end Absence of an alternative model of how to behave Novel situation; no examples of how to respond to orders Second subject (confederate) added: if refused to continue at specific point and experimenter asked real subject to take over whole job, only 10% obeyed to end; when confederate continued 93% too Incremental nature of requests At beginning of experiment, subjects had no compelling reason to quit (weak shocks) Foot-in-the-door technique: having complied w earlier, smaller requests, subjects found it hard to refuse new, arger requests Esp effective bc each shock was only a little stronger than prev one; not instructed to do something radically diff To refuse to give next shock would be to admit that it was prob wrong to give prev shocks → dissonant w knowledge that they had given those shocks Critiques of Milgram's Experiments The Ethical Critique Was study of sufficient scientific merit to warrant inflicting such stress on subjects, leading them to believe that they might have killed a man Before leaving lab, were fully informed o real nature and purpose of experiment; informed that most ppl in situation obey orders to end; reminded of how reluctant they had been to give shocks; reintroduced to learner who offered further reassurance that he was fine and felt well disposed toward them Survey: 84% of subjects were glad to have participated, fewer than 2% said sorry Psychiatric interviews of 40 of former subjects revealed no evidence of harm Full replication of exp would not be approved today by ethics review boards Question of Generalizability to Real-World Crimes of Obedience Results may be unique to artificial conditiosn of lab and have little to tell us abt crimes of boedience in real world such as Nazi Holocaustt Perhaps subjects knew at some level of consciousness that they could not really be hurting learner → real conflict may have been between belief that they weren't hurting learner and possibility that they were vs. Nazis who were actually gassing ppl and had no doubt abt effects of actions Subjects had no opportunity outside situation to reflect on what they were doing vs. Nazis who go home at night and return next ay Motives for obedience on Nazis (rampant anti-Semitism and nationalism) that are unlike motives subjects had Milgram's findings do not provide full explanations of real-world crimes of obedience but do shed light on some general principles that apply to such crimes: preexisitng beliefs abt legitimacy of endeavor, authority's confident manner, immediacy of authority figures, lack of alternative models of how to behave, incremental nature of requests/orders apply even when motives are diff

Obsessive-Compulsive Disorder

Obsession - disturbing thought that intrudes repeatedly on person's consciousness even tho recognize it as irrational Compulsion - repetitive action that is usually performed in response to obsession (most ppl exp moderate forms) Characteristics of OCD Obsessive-compulsive disorder - thoughts and actions are severe, prolonged, and disruptive of normal life DSM-5: obsessions and compulsions consume more than hour per day of person's time, seriously interfere w work or social relationships 1-2% of ppl at some time in their lives Similar to phobia bc involves specific irrational fear; diff from phobia bc fear is of something that exists only as a thought can be reduced only by performing ritual Suffer also from knowledge of irrationality of actions and try to hide them from others Obsessions are similar to but stronger and more persistent than ones experienced by general population Most common obsessions: disease, disfigurement, death; most common compulsions: checking or cleaning Ppl w/ checking compulsions amy spend hours each day repeatedly checking doors to be sure they are locked, gas stove to be sure it is turned off, automobile wheels to be sure they are on tight, and so on Cleaning compulsion: wash hands every few mins, scrub everything they eat, sterilize dishes and clothes in response to obsessions about disease-producing germs and dirt Some compulsions bear no logical relationship to bosession that triggers them: woman obsessed by thought that husband would die in car accident protect him by dressing and undressing self in specific pattern 20 times/day Brain Abnormalities Related to OCD Disorder may first appear aft known brain damage (blow to head, poisons, diseases) Brain damage resulting from difficult birth Brain abnormalities from unknown causes Particularly involved: portions of frontal lobes of cortex and parts of underlying limbic system and basal ganglia → these normally work tgt in circuit to control voluntary actions (actions controlled by conscious thoughts) Theory: damage in areas may produce obsessive-compulsive behavior by interfering w brain's ability to produce psychological sense of closure or safety that normally occurs when protective action is completed Ppl with OCD often do not exp normal sense of task completion aft washing hands or inspected gas stove so feel overwhelming need to perform same action again Areas also associated w executive function (planning, regulating behavior, perform complex cognitive tasks; three components of working memory, inhibition, and tasking switching) May have deficits → less able to inhibit undesirable behavior or switch tasks Meta-analyses (statistical technique used to evaluate magnitude of significant effect across large number of studies) suggest that ppl with OCD display impairments in all aspects of executive function

PERSONALITY

Our personal style of interaction with the world and with other people relatively consistent patterns of thought, feeling, and behavior that characterize each person as a unique individual

Members of Groups

Personal identity - self-descriptions that pertain to the person as a separate individual Social identity - self-descriptions that pertain to social categories or groups to which person belongs In-groups and out-groups and their effects on perception and behavior View others in terms of personal identities → see them as unique individuals, view in terms of social identities → gloss over individual differences and see all embers similar to one another Out-groups - members of groups to which we do not belong In-groups - groups we belong to

personality summary

Personality is often measured and characterized using trait theories, which bundle like facets together and emphasize dimensions that are largely stable across time Personality can be influenced by genetics, the environment, family relationships, and evolutionary motives Psychodynamic and humanistic perspectives debate how much we are conscious of underlying mental processes that contribute to personality

POSTTRAUMATIC STRESS DISORDER

Precipitated by a particular traumatic incident Characterized by the re-experiencing (e.g., nightmares, daytime thoughts, and flashbacks) Other symptoms include sleeplessness, irritability, guilt, and depression Increased risk -> genetic liability, repeated exposure to trauma, inadequate social support Traumatic Event Threat of death, serious injury, or physical integrity of self/others Intense fear/horror or helplessness Symptoms Following Event Re-experiencing leads to avoidance of associated stimuli Increased arousal, distress, and impairment PTSD Diagnosis if symptoms persist > one month Reduced hippocampal volume in PTSD patients Deteriorated ability to discriminate between past and present events Failure to properly interpret context

SCHIZOPHRENIA

Positive Symptoms (adding): Delusions - false beliefs held in the face of contradictory evidence Hallucinations - false sensory perceptions Disorganized Symptoms (changing): Disorganized thought and speech Grossly disorganized behavior and catatonic behavior Negative symptoms (taking away) - lack of or reduction in expected behaviors, thoughts, feelings, and drives NEURAL CONTRIBUTORS • Reduced gray matter volume • Enlarged ventricles • Detected before disease onset suggests... it is not a consequence of disorder or treatment, but a potential cause • Disruptions in dopamine signaling • Abnormality in synaptic pruning - too many neuronal connections lost DETECTING CHANGES IN WHITE-MATTER INTEGRITY • DTI studies show that first-episode SCZ patients have less myelin than in healthy controls overall • Tracts tend to run in different directions than is typical OTHER RISK FACTORS Older paternal age Cannabis use during teen-hood Maternal stress or nutrition deficiencies during pregnancy Increased de novo mutations Complications during birth Rhesus incompatibility between mother and child -- Accounts for higher percentage of in-patient population of mental hospitals than other disorders Somewhat more prevalent in men than in women and earlier and more severe too First manifests in late adolescence or early adulthood and avg age for first diagnosis is 4 yrs later in women than men Sometimes can make full/partial recovery Split among mental processes as attention, perception, emotion, motivation, and thought → processes operate in relative isolation from one another → bizarre and disorganized thoughts and actions "Split mind" but not having two mins or having multiple personality Diagnostic CHaracteristics of Schizophrenia Ppl have diff symptoms DSM-5: Manifest serious decline in ability to work, care for self, and connect socially with others Manifest for at least 1 month, two or more of following five categories of symptoms: disorganized thought and speech, delusions, hallucinations, grossly disorganized or catatonic behavior, negative systems Symptoms are nott continuously present → episodes of active phases of disorder (weeks/months) separated by periods of comparative normalcy Disorganized Thought and Speech Speech patterns that reflect underlying deficit in ability to think in logical, coherent manner Sometimes thought and speech guided by loose word associations (fruitful year with apple year) Do poorly on tests of logic when in active phase of disorder Encode prob info incorrectly, fail to see meaningful connections, base reasoning on superficial connections having more to do w sounds of words than with meanings May show this long before other symptoms apparent Delusions Delusion - false belief held in face of compelling evidence to contrary Delusions of persecution - others are plotting against one Delusions of being controlled - thoughts/movements are being controlled by radio waves or invisible wires Delusions of grandeur - beliefs in one's extraordinary important (queen of England, love object of famous movie star) May result from fundamental difficulty in identifying and remembering og source of ideas or actions Ex: delusions of being controlled may be from failure to mentally separate voluntary actions from involuntary actions → Find themselves performing actions w/o remember they willfully initiated those actions Delusions of persecution may stem from attempts to make sense of horrible feelings and confusion Grandeur may derive from inability to separate fantasies from real world exp Buttressed by deficits in logical reasoning Hallucinations Hallucinations - false sensory perceptions - hear/see things that aren't there Most common is auditory (voices) Work tgt with delusions (delusion of persecution hear voice of persecutor) Auditory hallucinations derive from own intrusive verbal thoughts thoughts that thers of us would exp as disruptive but self-generated) → hear such thoughts as if they were broadcast aloud and controlled by someone else Say source of voices come from inside own heads or voices produced against their will by own speech mechanisms Can usually stop voices by humming/counting/silently repeating word → interfere w ability to imagine vividly other sounds fMRI showed verbal hallucinations are accompanied by neural activity in same brain regions that are normally involved in subvocally generating and "hearing" one's own verbal statements Grossly Disorganized Behavior and Catatonic Behavior Inappropriate actions for context (wearing overcoats on hot day, giggling at solemn occasion) Inability to keep context in mind and coordinate actions with it Even when engaging in appropriate behaviors ((prep meal) may fail bc unable to generate or follow coherent plan of action Catatonic behavior - behavior that is unresponsive to environment Excited, restless motor activity that is not directed meaningfully toward environment Cataontic stupor - complete lack of movement for long periods May be means of withdrawing from world that seems difficult to understand/control Negative Symptoms Negative symptoms - lack of or reduction in expected behaviors, thoughts, feelings, drives Slowing down of bodily movements, poverty of speech ((slow, labored, unspontaneous speech), flattened affect (reduction in or absence of emotional expression), loss of basic drives like hunger, loss of pleasure that comes from fulfilling drives, social withdrawal catatonic stupor doesn't count bc believed to be actively maintained Majority of ppl with schizo manifest to some degree and for many these are most prominent symptoms Neurological Factors Associated with Schizophrenia Characterized primarily as cognitive disorder; deficits in essentially all basic processes of attention and memory Perform poorly at tasks that require sustained attention over time or responding only to relevant info while ignoring irrelevant info; abnormally slow at bringing perceived info into working-memory stores, poor at holding onto info → contribute to diagnostic symptoms Disruptions in Brain Chemistry Dopamine theory: schizo arises from too much activity at brain synapses where dopamine is ntm Clinical effectiveness of drugs in reducing positive symptoms of schizo was directly proportional to drug's effectiveness in blocking dopamine release at synaptic terminals Drugs such as cocaine and amphetamines which inc action of dopamine can exacerbate symptoms and even induce symptoms in ppl who don't have disorder Ppl today DO NOT ACCEPT theory Does not explain neg symptoms of schizo which are not well treated by drugs that act solely on dopamine and are not typically exacerbated by drugs that inc dopamine action Maybe involve unusual patterns of dopamine activity Overactivity of dopamine esp in basal ganglia may promote pos symptoms Underactivity of dopamine in prefrontal cortex may promote neg symptoms Glutamate - major excitatory ntm at fast synapses throughout brain One of major receptor molecules for gluate is defective in ppl who have schizo → decline in effectiveness of glutamate neurotransmission → cognitive debilitation Drug phencyclidine (PCP) interferes w glutamate neurotransmission and capable of inducing full range of symptoms (incl negative disorganized hallucinations and delusions) in normal ppl Alterations in Brain Structure Enlargement of cerebral ventricles (fluid-filled spaces in brain) and reduction in neural tissue surrounding ventricles Abnormal blood flow (too much or too little) to certain areas of brain Abnormal organization and activation patterns in cerebellum Decreased neural mass esp in hippocampus (memory) and prefrontal cortex (conscious control of thought and behavior) difference s are relatively small and vary from person to person → not reliable to diagnose During adolescence: brain normally undergoes certain structural changes Neural cell bodies are lost thru process of pruning and New neural connections grow → decrease in gray matter masses of cell bodies) and increase in white matter bundles of axons running from one brain area to another) Abnormality in pruning (loss of too many cell bodies) may underlie some cases of schizo Neuroimaging studies of ppl at risk for schizo revealed larger decline in gray matter during adolescence or early adulthood in those who subsequently developed disorder than those who didn't Genetic and Environmental Causes of Schizophrenia Predisposing Effects of Genes identify group of ppl with disorder (index cases) → relatives of index cases are studied to see what percentage of them have the disorder ((percentage = concordance for the disorder for the class of relatives studied) More closely related a person is to an index case the greater chance of developing schizo High concordance for schizophrenia between biological relatives but not adoptive → so it is genetic similarity not environmental similarity btwn relatives that produces high concordance for schizo Many genes involved: some influence dopamine neurotransmission or glutamate neurotransmission; or influence major histocompatibility complex (important for immune system function) Effects of Prenatal Environment and Early Brain Traumas Malnutrition: ppl born in western NEtherlands following severe famine were twice as likely as others to have developed schizo; same for ppl born in CHina during or shortly after famine Prenatal viral infections and birth complications may also contribute Heightened rates of schizo found in ppl whose mothers had rubella (German measles) or certain other viral diseases during pregnancy Ppl who had difficult births (O2 deprivation or other trauma to brain) Head injury later on in childhood before age 10 can inc likelihood Effects of Life Experiences Various stressful life events and precipitate schizo and exacerbate symptoms Study of two groups of adopted children in FInland: one group at high genetic risk for schizo (biological moms diagnosed) and other low risk high-risk children whose adoptive parents communicated in a relatively disorganized, hard-to-follow, or highly emotional manner were much more likely to develop schizo or midler disorder than were high-risk children whose adoptive parents communicated in clamer more organized fashion Relationship not found among low-risk children A Cross-Cultural Study of the Course of Schizophrenia WHO initiated study of schizo in 13 diff nations (industrialized developed countries and relatively non industrialized developing countries) Diagnosed new cases of schizo in each location, classed them according to symptom types and apparently severity, reassessed each case thru interviews conducted at various times Consistency: relative prevalence of various symptoms, severity of initial symptoms, avg age of onset of disorder, sex diff in age of osnet later for women) were similar Quite a high percentage of ppl were found to recover from schizo, rate of recovery greater in developing countries than developed countries Family members in less-industrialized countries generally place less value on personal independence and more on interdependence and family ties than do those in industrialized countries → feel less resentful and more nurturing toward family member who needs extra care More likely to live in large, extended families → more ppl → more accepting and less critical of individuals diagnosed with schizo Also less likely to call disorder schizophrenia or to think of it as permanent; refer to it as case of nerves vs. in developed countries there is a stigma associated w mental illness and many ppl w symptoms are reluctant to seek out therapy or fully engage in it In less-industrialized countries those w schizo are more able to play an economically useful role: chores son fam farm or at family trade or local business Being less stigmatized, less cut off from normal course of human activity, and better cared for by close fam members and neighbors Another explanation is drugs Patients in developed countries generally treated w antipsychotic drugs for prolonged periods vs. in developing countries more often not treated w drugs or treated only for short periods to bring initial symptoms under control Controversial studies suggested that prolonged use of antipsychotic drugs while dampening pos symptoms may impede full recovery see A Developmental Model of Schizophrenia

Conformity

Two reasons why we tend to conform to others' examples Information and pragmatics: they may know something that we don't know, in absence of better info, to be safe Advantage of social life lies in sharing of info: can follow ex of others and profit and trials and errors from generations ago Informational influence - social influence that works through providing clues about the objective nature of an event or situation Other general reason is to promote group cohesion and acceptance by group; adopt ideas/myths/habits of group to generate sense of closeness with others and acceptance and function as unit Normative influence - social influence that works through the persons' desire to be part of a group or to be approved by others Conformity to group norms is found early in development 2 and 3 yr olds when shown demonstration of puppet forming a novel set of actions, will correct a person who fails to use the same words and actions in performing task → children recognize what is normative and attempt to enforce social norms on others Conformity to peer pressure esp important during school yrs peaking in early adolescence -- Effects of Implicit Norms in Public-Service Messages Public-service msgs are urging ppl not to behave in certain way (smoke/drunk drive/litter) but als sending implicit msg that behaving in that way in normal Cialdini proposed that messages would be more effective if they emphasized that majority of ppl behave in desired away, developed a public-service msg designed to inc household recycling and aired it on local radio and TV stations: msg depicted group of ppl all recycling and speaking disapprovingly of a long person who did not recycle → 25% increase in recycling in those communities (far bigger than usual) Created two signs aimed at dec pilfering of petrified wood from Petrified Forest National Park Sign 1: many past visitors have removed petrified wood from pPark, changing natural state of petrified forest and depicted 3 visitors taking wood Other sing: single visitor taking piece of wood with ared circle-and-bar symbol superimposed over his hand w/ msg please do not remove petrified wood from Park in order to preserve natural state o forest On alternate weekends one or the other of these signs was placed and marked pieces of petrified wood placed along each path 7.92% of visitors tried to steal marked pieces on days when first sign as present, 1.67% when second sign present, Previous research shown w neither sign was 3% Emphasizing that many ppl steal → inc amt of stealing above baseline Implying stealing is rare and wrong → dec below baseline --- Conformity as a Basis for Failure to Help: The Passive Bystander Effect Person is much more likely to hep in an emergency if he/she is only witness than if other witnesses are also present College students filling out questionnaire interrupted by sound of research behind screen falling and crying out → 70% of those who were alone went to aid of researcher, but only 20% of those who were in pairs did so Diffusion of responsibility - more ppl present, the less any one person feels it is his or her responsibility to help If you are only witness: you decide whether it is emergency, whether you can help or not But if other witnesses are present, you look also at them and wait to see what they are going to do → they do nothing, inaction is source of info that may lead you to question initial judgment Implicit social norm → if spring into action might look foolish to others Each person's inaction promote inaction in others thru both informational and normative influences --- Emotional Contagion as a Force for Group Cohesion Ppl in social group tend to behave more like one another than would if not in group: mimic posture, mannerisms, styles of speech, same emotions Facial expressions help members of group know how to interact w one another; tend automatically to adopt emotions they perceive in those around them to help group function as unit (fear → extra protection, laughter → playfulness mood) Spread of emotions can occur completely unconscious: facial expressions of emotions flashed on screen too quickly for conscious recognition can cause subjects to express same emotion on own faces or experience brief changes in feeling Political leaders often achieve status thru ability to manipulate others' emotions: Reagan and Clinton were "great communicators" w/ persuasive facial expressions University students watched film clips of Reagan expressing happiness, anger, or fear as he spoke to public (in some cases sound track kept on, others turned off) → in all cases students' own emotional reactions were recorded by measuring HR, perspiration, and movement of facial muscles → regardless of whether they were supporters/opponents and could hear what he was saying, bodily changes indicated that they were responding to Reagan's performance w emotions similar to those he was displaying

social psychology summary

We learn a lot from other people - social interactions affect our self-view, worldview, and behaviors How we see ourselves and others is not always accurate (and definitely not objective) Social pressures can exert strong effects on our behaviors, in ways we are and are not cognizant of

Cluster C

"Anxious" Personality Disorders Fear and anxiety; similar to depression and anxiety disorder, diff is one of degree Avoidant Personality Disorder Excessively shy; uncomfortable and inhibited in social situations Inadequate and extremely sensitive to being evaluated, exp dread of criticism Extreme fear of rejection → timid and fearful in social settings and avoid social contact Rarely take risk or try out new activities, exaggerating difficulty of tasks before them Similar to GAD and ppl are sometimes classified with both 1-2% in population, men and women equal Dependent Personality Disorder Extreme need to be cared for Clingy, fear separation from significant ppl in lives, believing that they cannot care for self Fear upsetting relationship partners (partners may leave them) → obedient and rarely disagree w them and permitting partners to make important decision for them Often feel lonely, sad, distressed → high risk for anxiety, depression, and eating disorders Prone to suicidal thoughts esp when relationship breaking up 2-3% of ppl, same number of men and women Obsessive-Compulsive Personality Disorder Preoccupied w order and control; inflexible and resist change Highly focused on details of task that often fail to undretand pt of activity Excessively high standards for self and others, exceeding normal degree of conscientiousness Difficulty expressing affection → relations are shallow and superficial 1-2% of ppl, twice as many men than women

biological treatments (drugs)

Attempt to relieve disorder by directly altering bodily processes Drilling holes in skull and bloodletting → drugs > ECT > psychosurgery Drugs 1950s: drug chlorpromazine reduced symptoms if schizo; systematic studies of use of lithium for treatment of mania; Nearly always produce side effects (ex: addictive) Antipsychotic drugs Treat schizophrenia and other disorders in which psychotic symptoms ((hallucinations and delusions) predominate Reduce in sometimes abolish hallucinations, delusions, and bizarre actions in active phase of schizo, reducing need for hospitalization Decrease activity of ntm dopamine at certain synapses in brain → reduction in psychotic symptoms Two classes Typical (haloperidol) first developed Atypical (olanzapine and risperidone) are newer; early research suggested that they were more effective than older in reducing psychotic symptoms and produced fewer harmful side effects but more recent unbiased studies questioned claims No strong evidence that atypical drugs > typical; both work by dec dopamine activity altho atypical also affect receptors for other ntm such as serotonin Side effects: dizziness, confusion, nausea, dry mouth, blurred vision, heart rate irregularities, constipation, weight gain, heightened risk for diabetes, sexual impotence in men, disrupted menstrual cycles in women Interfere w motor-control processes in brain and sometimes produce symptoms akin to Parkinson's disease (shaking and difficulty in controlling voluntary movements) → take for many yrs develop motor disturbance called tardive dyskinesia (involuntary jerking of tongue, face, other muscles) Many patients diagnosed w schizo stop taking drugs as soon as psychotic symptoms decline or before → "failure to comply" is problem bc more likely to have another psychotic episode and require readmission to hospital However many patients who stop taking drugs do well w/o them → unknown to clinicians bc do not return to clinic Antianxiety Drugs Aka tranquilizers Used to be barbiturates such as phenobarbital but many ppl addicted → replaced w safer group of benzodiazepines (chlordiazepoxide/Librium, diazepam/Valium, alprazolam/Xanax) Frequently abused for recreational purposes primarily by ppl w primary abuse to other drugs such as alcohol Augment action of ntm GABA in brain GABA is main inhibitory ntm → dec excitability of neurons almost every where in brain Side effects: drowsiness, decline in motor coordination, consequent inc in accident Enhance action of alcohol → can produce coma or death Moderately addictive → withdrawal symptoms: sleeplessness, shakiness, anxiety, headaches, nausea Questionable effectiveness: more than half ppl randomly assigned to benzodiazepine condition dropped out bc of lack of anxiety relief or intolerance of side effects; those on placebo did nearly as well as those on drug Used to treat GAD and panic disorder but rarely for other anxiety disorders → declined partly bc of growing recognition of harmful side effects and evidence that anxiety may be better treated w antidepressant drugs in SSRI class Close biological relationship btwn anxiety and depression Antidepressant Drugs Tricyclics (imipramine/Tofranil and amitriptyline/Elavil): block normal reuptake of ntm serotonin and norepinephrine into presynaptic neurons aft release into synapse → prolong action of transmitter molecules on postsynaptic neurons In mid 1980s replaced by newer class: selective serotonin reuptake inhibitors (SSRIs): block reuptake of serotonin but not other monoamine transmitters (fluoxetine/Prozac, citalopram/Celexa, sertraline/Zoloft) Tricyclics and SSRIs abt equally effective in treating depression; only abt 50% of ppl show clinically significant improvement in mood compared to 30% who improve w placebo mild /moderate depression: even less evidence for efficacy of antidepressant drugs Side effects for tricyclics: more likely to be fatal if taken in overdose, more likely to produce fatigue, dry mouth, blurred vision SSRI side effects are milder but more neg side effects than older benzodiazepines; reduced sexual drive, headache, nausea, diarrhea Advised to continue taking even aft clinical episode lifts Effect on ntm immediate but effects take several weeks: some gradual process (maybe growth of new neurons) underlies therapeutic effect → not sure

Cognitive Therapy

Behavior therapist = trainer, cognitive therapists = teacher Deals with maladaptive habits of thought (not behavior) Cognitive therapy - greater focus on roles of thoughts/beliefs/attitudes in controlling behavior; use objective measures to determine if treatment is helping client Ppl's beliefs and ingrained, habitual ways of thinking affect behavior and emotions Ppl disturb themselves thru own, often illogical beliefs and thoughts → make reality seem worse than it is Identify maladaptive ways of thinking and replace them w adaptive ways that provide base for effective coping w real world Centers on conscious thoughts tho such thoughts may be automatic and occur w little conscious effort Rational-emotive therapy - rational thought will improve clients' emotions Three general principles of cognitive therapy: Identifying and Correcting Maladaptive Beliefs and Habits of Thought Diff approaches to point out patients' irrational ways of thinking Beck's Socratic approach: thru questioning gets patient to discover and correct own thought Ellis: humorous names to certain styles of irrational thinking Musturbtion - one must have some particular thing or must act in some particular way in order to be happy or worthwhile Awfulizing - mental exaggeration of setbacks or inconveniences ABC theory of emotions - A is activating event in environment, B is belief that is triggered in client's mind when event occurs, C is emotional consequence of triggered belief (therapy change B) Establishing Clear-Cut Goals and Steps for Achieving Them Long-held beliefs and thoughts do not disappear once recognized as irrational; occur automatically unless actively resisted Assign homework: keep diary, fill out form to record neg emotions felt and describe situations and automatic thoughts that accompanied emotions → describe rational alternative thought that might make them feel less upset Such exercises help train clients to become more aware of automatic thoughts and change them Record of progress → see if pos thinking inc over time and neg emotions dec MOving From a Teaching Role to COnsulting Role With Client Therapist helps client identify set of goals, develops curriculum for achieving goals, assigns hw, assesses client's progress using most objective measures available, maintain warm/genuine/empathic relation As client becomes increasingly expert in spotting and correct maladaptive thoughts, client becomes inc self-directive in therapy and therapist act more like consultant May meet w therapist just occasionally to describe continued progress and ask for advice when needed A Case Example: Beck's Cognitive Treatment of a Depressed Young Woman First session: identify automatic neg beliefs (things won't get better, nobody cares for me, I am stupid) → try to invalidate thoughts by doing certain things for hsrself that might make life more fun (take children on outing, visit mom, shop, read, jion tennis group) second session: questioning strategy that helped her to distinguish btwn fact of what happened (not understanding a question) and belief abt it (looking dumb); homework to catch, write down, adn correct own dysfunctional thoughts Eradicate ach of depressive thoughts one by one and reinforcing steps taking to improve life → during next several months joined tennis league, got job, took college courses in sociology, left husband aft trying and failing to get him to develop better attitude toward her or to join in couples therapy → cured of depression Cognitive therapy is Basis for some new types of therapy: Mindfulness-based cognitive therapy - traditional aspects of CT w mindfulness and mindfulness meditation (becoming aware of all incoming thoughts and feelings, accepting but not reacting to them) Effective in depression Dialectical behavior therapy - aspects of T plus mindful awareness along w training in emotion regulation to treat ppl with borderline personality disorder

Causes of Psychological Disorders

Brain is Involved in All Psychological Disorders All thoughts, emotions, and actions are products of brain; all factors that contribute to causing psych disorders do so by acting on brain (genes that influence brain development, environmental assaults on brain such as blow to head, O2 deprivation, viruses, bacteria, effects of learning consolidated in pathways) Brain's Role in Irreversible Psychological Disorders Ex of chronic disorder includes autism spectrum disorder - no definite cause identified, correlation btwn autism and particular brain abnormality that may be caused by genes or prenatal toxins or birth complications that disrupt normal brain development Down Syndrome - congenital (present at birth) disorder that appears in about 1/7-- babies in US; error in meiosis ⇒ extra chromosome 21 in egg cell (or sometimes sperm) → extra chromosome retained in all cells → damage to many regions of developing brain such that person has moderate to severe intellectual disability and difficulties in physical coordination Alzheimer's disease - primarily in older adults (inc prevalence with age); progressive deterioration in all cognitive abilities (memory, reasoning, spatial perception, language) followed by deterioration in brain's control of bodily functions Physical disruptions in brain: presence of amyloid plaques - deposits of protein beta amyloid which form in spaces between neurons and may disrupt neural communications Caused by combination of genetic predisposition and general debilitating effects of old age Genes affect rate of production and breakdown of beta amyloid Age contribute partly thru deterioration of blood vessels which become less effective in carrying excess beta amyloid out of brain Risk factors; being over 50 (greatest risk factor), high cholesterol and blood pressure, sedentary lifestyle, tobacco use, obesity, head injury, family history Role of Brain in Episodic Psychological Disorders Episodic = reversible; may come and go in episodes Episodes may be brought on by stressful environmental experiences but predisposition for disorder resides in brain Heritable - more closely genetically related more likely to share same disorders regardless of whether raised in same home Not known which genes are involved or how they influence likelihood of developing disorder but effects occur primarily thru genes' roles in altering biology of brain Environmental assaults to brain and effects of learning also contribute to predisposition for disorders

Common Factors in Therapy Outcome

Diff types of psychotherapy share common factors, which may be more important to therapy effectiveness than specific theory-derived factors that differentiate therapies Support Acceptance, empathy, encouragement Devoet time to client, listen warmly/respectfully, not being shocked → attitude that client is worthwhile human being → enhance client's self-esteem Therapist's responsiveness to client's behavior inc likelihood that client will return for additional sessions and thus eventual success of therapy Study: psychodynamic therapists provide more support and less insight than expected form psychoanalytic theory but still produced stable therapeutic gains Cognitive behavioral therapy for depression: bond of rapport clients felt w therapists early in treatment was good predictor of subsequent improvement College professors w no training in psych or methods of therapy but w reputations for good rapport w students able to help depressed college students in twice-a-week therapy sessions as effectively as did clinical psychologists Hope Expectation that things will get better; come from sense of support and faith in therapy process Confident psychotherapists → clients come to believe it will work Ppl who believe they will get better have improved chance at getting better even if specific reason for belief is false; patients who take a placebo are likely to improve if believe taking drug will help Important for psychotherapy and drug therapy Psychotherapy-outcome experiments that compare accepted forms of psychotherapy w made-up false forms of psychotherapy lack specific ingredients that mark any well-accepted type of therapy) Cognitive behavioral therapy for anxiety vs. made-up treatment "systematic ventilation" (clients talked about fears in systematic manner) Problem: hard for therapists ot present "false" therapy to clients in convincing manner, but when it is equivalent in credibility to client it is also equal in effectiveness Motivation Active agent of change in psychotherapy is client Motivation for change comes from support and hope engendered by therapist (make change seem worthwhile and feasible) and other common aspects of psychotherapy process Psychotherapy provide options and keep client focused on working toward goals rather than telling client what goals should be or right way to get there Therapists start sessions by asking client how things have gone → anticipation of reporting cause clients to be give more conscious attention to actions and feelings → think more consciously, fully, and constructively abt p problems → enhance motivation to improve and new insights abt how to improve Reporting may also make client aware of progress, and progress engenders desire for more progres A Final Comment Social animals - need positive regard from other ppl in order to function well Thinking animals - sometimes emotions and disappointments get in way of thinking Self-motivated and self-directed, but sometimes los motivation and direction Therapist provides context in which we can solve problems ourselves

Evaluating Psychotherapies

Even if therapy has no effect, most ppl will feel better at some time aft entering it than they did when they began → can't attribute improvement to therapy using case studies Is Psychotherapy Helpful, and Are Some Types of It More Helpful Than Others? Perform controlled experiments: groups of ppl undergoing therapy compared w similar control groups not undergoing therapy Evidence-based treatment - using only therapies that have been shown empirically to be effective A Classic Example of a Therapy-Outcome Experiment Psychiatric outpatient clinic in PHiladelphia; 94 subjects Assigned by random procedure to one of three groups: once a week sessions of behavior therapy for 4 months (imaginal exposure and training in assertiveness), psychodynamic therapy (probing into childhood memories, dream analysis, interpretation of resistance), no-therapy group (placed on waiting list and given no treatment but called periodically to let them know that they would eventually be accepted) All subjects assessed both before and aft 4 month period by psychiatrists who were not informed of groups to which subjects had been assigned All three groups improved but treatment groups improved more and two treatment groups did not differ from each other Psychotherapy works but not one variety of therapy regularly better than others Evidence that Psychotherapy Helps 75-80% of ppl in psychotherapy condition improved more than avg person in nontherapy Psychotherapy is at least as effective as drug therapy in treating depression and GAD and more effective in treating panic disorder Caution: psychotherapy-outcome experiments usually carried out at clinics associated w major research centers, therapists are highly experienced and since now work being evaluated they are functioning at miami capacity → outcomes are more positive than avg therapy outcomes (where therapists not as experienced or motivated) Bias for researchers to publish results that show significant pos effects of psychotherapy and not to publish results that show no effects → overestimation of therapy effectiveness Evidence that No Type of Therapy Is Clearly Better Overall THan Other Standard Types Psychotherapy-outcome experiments provide no convincing evidence that any of major types is superior to any other Mostly compared cognitive or cognitive behavioral w psychodynamic; humanistic also seems to work as well Behavioral exposure treatment is most effective treatment for phobias Cognitive and behavioral therapies generally work best for clients who have specific problems Two yrs of psychodynamic therapy vs. five months of cognitive-behavioral therapy in 70 patients w bulimia nervosa 15% of psychodynamic had stopped binge eating and purging, 44% of cognitive behavioral Patients in both treatment groups showed improvements in other areas of psychological health related to eating (concern for weight, anxiety, depression) but sooner for cognitive Psychodynamic and humanist more effective for clients who have multiple or diffuse problems or probs related to personalities For PTSD, therapies that focus on trauma memories or encourage them to find meaning in trauma produce better results Good therapists, regardless of type of therapy, use methods that overlap w other types of therapy Cognitive and behavior therapists become nondirective (like humanistic) when working w clients who seem unmotivated to follow their lead Psychodynamic therapists often use cognitive methods (correct maladaptive automatic thoughts); cognitive use psychodynamic (ask clients abt childhood exp)

ANXIETY DISORDERS

Generalized Anxiety Disorder: prolonged, severe anxiety that is not associated consistently with any particular trigger, event, or experience DSM-5 Criteria: Disruptive to life/work/relationships More days than not for at least 6 months Independent of other diagnoses Phobia: irrational fear related to a particular object or event (avoidance behavior) Panic Disorder: repeated occurrence of panic attacks at unexpected times with no obvious trigger DSM-5 Criteria: Recurrent, unpredicted attacks At least one of which is followed by >1 month of debilitating anxiety surrounding the possibility of another OCD Repeated, disturbing, irrational thoughts (obsessions) - can only be terminated by performing some action (compulsion) DSM-5 criteria: obsessions and compulsions must... Consume more than an hour per day of the person's time Must seriously interfere with work or social relationships • Frontal lobes + limbic system and basal ganglia seem to be particularly involved --- fear or anxiety is most prominent disturbance Research with twins indicates roughly 30-50% of individual variability in risk to develop any given anxiety disorder derives from genetic variability

Humanistic Therapy

Grew partly out of existentialist philosophy (humans create own life meanings) and as reaction against psychodynamic approach Each person decide for self what is true and worthwhile in order to live full, meaningful life; meaning and purpose cannot be thrust upon person from outside Ppl have capacity to make adaptive choices regarding their own behavior- choices that promote survival and wellbeing; in order to feel good abt themselves and to feel motivated to move forward in life need to feel accepted and approved of by others Actualizing potential - inner potential for positive growth For self-actualizing potential to exert effects, ppl must be conscious of feelings and desires and not deny/distort them (which occur when ppl perceive others consistently disapprove of their feelings/desires) Humanistic therapy - help ppl regain awareness of their own desires and control of their own lives Carl Rogers' client-centered therapy: focuses on abilities and insights of client rather than those of therapist → aka person-centered therapy bc relationship btwn two unique persons (therapist must attend to own thoughts/feelings and those of client to respond in supportive yet honest ay) Relationship btwn therapist and client: understand and empathize, think positively and genuinely of client as competent valuable person → regain self-understanding and confidence to control life Allowing the Client to Take the Lead Clients not patients bc latter implies passivity and lack of ability Therapists' task is to understand not direct discussion or interpret client's words in ways that client does not intend (only paraphrase) LIstening Carefully and Empathetically Empathy - therapist's attempt to comprehend what client is saying or feeling from client's POV rather than outside Reflects back ideas and feelings client expresses: shows that therapist is listening and trying to understanding, distills and reflects back to client feeling that lies behind words (may not have been aware of), offers client chance to correct therapist's understanding and therefore self Providing Unconditional but Genuine Positive Regard Unconditional positive regard - belief that client is worthy and capable even when client may not feel/act that way Therapist express pos feelings abt client regardless of what client says or does → safe nonjudgmental environment for client Clients begin to feel more pos abt self Does not imply agreement w everything or approval, but imply faith in clients' underlying capacity to make appropriate decisions Shift in focus from neg act to positive values affirms inner worth and ability Be both positive and genuine: impossible to fake empathy and pos regard therapist must rly exp them; can be cultivated by deliberately trying to see things as client sees them Emotionally focused therapy - adopts many of practices but emphasises importance of emotion (related to attachment); often used for couples and family therapy; emphasizes relationships are attachment bonds and effective therapy must address security of bonds w change involving new exp of self and others (emotion is target of change); therapist is consultant

MOOD DISORDERS

Major Depressive Disorder Major Symptoms Chronic feelings of sadness, hopelessness, or loss of interest (anhedonia) Changes in: appetite, sleep patterns, energy, weight, etc. No manic symptoms present Perpetual negative thought patterns Bipolar 1: both mania and depression Bipolar II: hypomania and depression amygdala fluctuations w mood state (see graphic) Mood = prolonged emotioanl state that colors many aspects of person's thought and behavior (continuum running from depression at one end to elation/mania at other) Depressive disorders - prolonged or extreme depression Bipolar and related disorders - alternating episodes of mania and depression

DEFENSE MECHANISMS

Include: repression, displacement, projection, reaction formation, and rationalization Some lend themselves to better coping strategies than others Mature defenses (e.g., humor or suppression) lead to better outcomes - mental processes of self-deception operate to reduce one's consciousness of wishes, memories, and other thoughts that would threaten self-esteem or in other ways provoke strong sense of insecurity or anxiety (5 examples) Repression - process by which anxiety-producing thoughts are pushed or kept out of conscious mind Provides basis for most of other defense mechanisms Damming up of mental energy → repressed wishes and memories will leak into conscious mind, but Mind can still defend self by distorting ideas in ways that make them less threatening → other defense mechanism are means by which we create distortions Displacement - unconscious wish or drive that would be unacceptable to conscious mind is redirected toward more acceptable alternative Child long past infancy may still have desire to suck at breast (desire is threatening and repressed bc violates conscious understanding of what is possible and proper) → suck on lollipop (action symbolically equivalent to og desire but more acceptable and realistic) Sublimation - Direct energies toward activities that are particularly valued by society (artistic, scientific, humanitarian endeavors) Highly aggressive person perform valuable service in competitive profession like lawyer as _ of drive to beat others physically Vinci's fascination w painting Madonnas was _ of desire for mom (separation from her) Reaction formation - conversion of frightening wish into safer opposite Young woman unconsciously hates her mom and wishes her dead consciously exp feeling as intense love for mom and strong concern for safety Homophobia: ppl who have tendency toward homosexuality but fear it may protect themselves from recognizing it by vigorously separating themselves from homosexuals Men who scored highly homophobic on qustionnaire showed more penile erection while watching male homosexual video than other men even tho denied exp sexual arousal Projection - person consciously exp an unconscious drive or wish as though it were someone else's Person with intense, unconscious anger feels that her friend is angry Men who were rated by fraternity brothers as extreme on particular characteristic such as stinginess, but who denied that trait in themselves, tended to rate others as particularly high on that same characteristic Rationalization - use of conscious reasoning to explain away anxiety provoking thoughts or feelings Man rationalize beatings he gives children by convincing himself that children need to be disciplined and that he is only carrying out fatherly duty sadistic tendencies) Be wary of conscious logic, as it often mask true feelings and motives

A Framework for Thinking About Multiple Causes of Psychological Disorders

Most disorders derive from joint effects of more than one causes and first appear at some point later in life Subsequent course of disorder persistence, severity) influenced by exp one has after disorder appears Three categories of causes of psychological disorders Predisposing causes of psychological disorders - in place before onset of disorder and make person susceptible to disorder Genetically inherited characteristics that affect brain damaging environmental effects on brain (poisons such as alcohol or drugs consumed during pregnancy, birth difficulties such as oxygen deprivation during birth, viruses or bacteria that attack brain) prolonged psychologically distressing situations (abusive parents/spouse) certain types of learned beliefs and maladaptive patterns of reacting to or thinking about stressful situations Ex: young woman reared in upper-class Western society is more likely to acquire beliefs and values that predispose her for eating disorder than rural community in China Highly pessimistic habits of thought (anticipate for worst and think abt reasons for hope) → mood and anxiety disorders Precipitating causes of psychological disorders - immediate events in person's life that bring on disorder Any loss such as death of loved one or loss of job, Any real or perceived threat to wellbeing such as physical disease, Any new responsibility such as marriage or job promotion, or any large change in day-to-day course of life → Bring on mood or behavior change that leads to diagnosis Ex: recent economic recession served as precipitating event for inc in suicides in US Often talked about under rubric of stress - refers to life event itself and sometimes to worry/anxiety/hopelessness/other neg exp that accompany life event When predisposition is very high, event that seems trivial to others can be sufficiently stressful to bring on disorder; when predisposition is very low even high degree of loss/threat/change may fail Assumption: early eng exp disturbs development and leads to maladaptive behavior and poor mental health (more risk factors = worse) → but from evolutionary developmental perspective it's adaptive Signs of maladjustment in modern society reflect a "fast life history strategy" in which ppl engage in more risky behaviors which is actually adaptive in uncertain and stressful environments Perpetuating causes of psychological disorders - consequences of disorder that help keep it going once it begins May gain rewards which help perpetuate maladaptive behavior, or neg consequences help (depression withdraw from friends → lack of friends perpetuate depression) Behavioral changes: poor diet, irregular sleep, lack of exercise → prolong disorder Expectations associated w disorder: culture regards it as incurable → person give up trying to change

HOW DO WE KNOW IF THIS STUFF WORKS?

Sloane et al., 1995 study: • Psychiatrists rated the severity of each participants's symptoms before and after a 4-month treatment period • those in the two therapy groups improved more than did those who were placed on the waiting list. Common factors that may contribute to outcome: Support - someone to accept/value/empathize -> increased confidence Hope - therapist's faith in the process leads client to feel similar Motivation - outside regulation and encouragement -> self- improvements

MASLOW'S HIERARCHY

Must fulfill lower portion before moving up the pyramid If "deficiency needs" are satisfied, energy is free for self- actualization -> psychological health see diagram -- Being One's Self: Self-Actualization and Maslow's Hierarchy of Human Needs Central aspect of PR Is self-concept, understanding of who he/she is Rogers' self theory - common goal of ppl is to "discover/become real selves" Self-actualization - process of becoming one's full self, realizing one's dreams and capabilities Specific route will vary from person to person and time to time but must be self-chosen Full actualization requires fertile environment but direction of actualization and ways of using environment must come from within the organism In course of evolution, organisms have acquired capacity to use environment in ways that maximize growth In humans, capacity to make free, conscious choices that promote positive psychological growth is actualizing tendency; be permitted to make those choices and trust themselves to do so Maslow: to self-actualize one must satisfy five sets of needs arranged in hierarchy Physiological needs (minimal essentials for life like food and water) Safety needs (protection from dangers in environment) Attachment needs (acceptance and love) Esteem needs (competence, respect from others and self) Self-actualization needs (needs of self-expression, creativity, "sense of connectedness w broader universe") Person can focus on higher needs only if lower ones (more immediately linked to survival) are satisfied so do not claim peron's full attention and energy Makes sense from evolutionary perspective: physiological and safety needs are most immediately linked to survival; social needs for acceptance love and esteem are also linked to survival but not quite as direct and immediate (social relationships ensure cooperation in meeting physiological and safety needs and helping us reproduce) Self-actualization needs = self-educative needs: playing, exploring, creating can lead to acquisition of skills and knowledge that help in endeavors such as obtaining food, fending off predators, attracting mates, securing goodwill and protection of community Self-actualization is not "higher" than other needs but part of long-term way of satisfying those needs in evolutionary perspective

Generalized Anxiety Disorder

Not focused on any one specific threat; attaches itself to various threats real or imagined Manifests itself primarily as worry: worry continuously about multiple issues and exp muscle tension, irritability, difficulty in sleeping Worry about same kind of issues most of us worry about (fam, money, work) but to far greater extent and w much less provocation DSM-5: worry must occur on more days than not for at least 6 months independently of other diagnosable psychological disorders 6% of ppl in NOrth America at some time in lives; rarely in children avg onset is 31 yrs Most often appears following major life change in adulthood like new job/baby or disturbing event such as accident/illness Particularly attuned to threatening stimuli (notice threatening words such as cancer or collapse more quickly, reliably, and automatically than do other ppl but not nonthreatening words) Quicker to disengage from negative stimuli; heightened attention to potential threat = hypervigilance Vigilance begins early 8 nlife and precedes development of GAD; may be predisposing cause and symptom May result from genetic influences of brain development Amygdala responds automatically to fearful stimuli even if don't reach conscious awareness Connections from prefrontal lobe of cortex help control fear reactions but inhibitory connections are less effective in ppl who are predisposed for GAD Exp unpredictable traumatic exp in early childhood → vigilance is adaptive Avg level of generalized anxiety in Western cultures has inc sharply since middle of 20th century maybe bc of reduced stability of typical person's life (job skills might not be useful soon, frequent divorce and high mobility, rapidly changing values and expectations)

BIG FIVE

OPENNESS: imaginative, artistic, emotional, venturesome, liberal, nonjudgmental CONSCIENTIOUSNESS: self- efficacious, dutiful, achievement- seeking, cautious, disciplined EXTRAVERSION: friendly, gregarious, assertive, excitement-seeking, likes large groups and loud environments AGREEABLENESS: trustful, moral, cooperative, sympathetic, non- argumentative NEUROTICISM: anxious, tense, depressed, emotionally unstable, tends toward negativity CONVENTIONALITY: routine- oriented, prefers familiarity, judgmental, closed-minded AIMLESSNESS: wandering, takes things as they come, unmotivated INTROVERSION: overly stimulated, prefers time alone, reserved, calm, quiet-minded DISAGREEABLENESS: distrustful, uncooperative, doesn't relate well to others; immodest or inappropriate EMOTIONAL STABILITY: collected, even-keeled, balanced, happy -- • Women > men on agreeableness, neuroticism, and conscientiousness • Potential influence of different reproductive challenges

CONFORMITY

Other people can affect us not just by observing or evaluating, but also by behaving in certain ways that we feel compelled to emulate To benefit from others' trial- and-error process To stay safe To be accepted by a group Because we succumb to peer pressure Because we're worried we might be wrong

panic disorder

Panic Disorder and Agoraphobia Panic = feeling of helpless terror Comes at unpredictable times unprovoked by any specific threat in environment, cannot avoid it by avoiding certain situations Several mins long, high physiological arousal (inc HR and shortness of breath), fear of losing control, behaving in some frantic desperate way Panic attack - many ppl exp at one time or another; reflects some specific fear (public speaking); diff from disorder Panic disorder - reflects anxiety that panic attack may occur DSM-5: must have experienced recurrent unexpected attacks, at least one of which is followed by at least 1 month of debilitating worry about having another attack or by life-constraining changes in behavior (quit job, refuse to travel) motivated by fear of another attack Roughly 2% of North Americans at some time in life Often manifest aft stressful event or life change; particularly attuned to and afraid of physiological changes similar to those signifying fearful arousal → panic attacks can be brought on by procedures that inc HR and breathing rate (lactic acid injection, caffeine, CO2 inhalation, intense exercise) perpetuating cause and possibly predisposing cause of disorder is learned tendency to interpret physiological arousal as catastrophic Agoraphobia - fear of public places; afraid will be trapped or unable to obtain help Develops partly bc of embarrassment and humiliation that might follow loss of control (panic) in front of others

NEO Personality Inventory

Self-report questionnaire Assesses where you fall on each of the Big Five • Caveats: Requires honesty and insight (Un)intentional bias in reporting Does not assess pathology Limited validity and clinical utility -- Use results of trial tests in factor analysis and eliminate items whose scores do not correlate strongly (pos or neg) w scores of other items designed to measure same facet Usefulness of questionnaires depends on honesty and insight of respondent about own behavior and emotions In some studies personality inventories filled out both by person and by others who know person -- RElationship of Personality Measures to People's Actual Behavior Valid: scores are true measures of characteristics they are meant to measure Personality test is valid or degree that scores one each of the traits it measures correlate w aspects of person's real-world behavior that are relevant to that trait → use studies Ppl who score high on neuroticism have been found to pay more attention to and exhibit better memory of threats and other unpleasant info, manifest more distress when given surprise math test, exp less marital satisfaction and greater freq of divorce, be much more susceptible to mental depressions (depression, anxiety) Ppl who score high on extraversion attend more parties and rated as more popular, be more often seen as leaders and achieve leadership positions, live w and work w more ppl, mimic behavior of others presumably w goal of fostering affiliation, and be less distrubed by sudden loud sounds or other intense stimuli Ppl who score high on openness to exp are more likely to enroll in liberal arts programs rather than professional training programs in college, change careers ore often in middle adulthood, perform better in job training programs, be more likely to play musical instrument, be more tolerant of diverse world views, exhibit less racial prejudice Score high on agreeableness are more willing to lend money, have fewer behavior probs during childhood, manifest less alcoholism or arrests in adulthood, more successful in workplace, more satisfying marriages and lower divoce rate Score high on conscientiousness are more sexually faithful to spourses, receive higher ratings for job performance and higher grades in school, put more effort into academic subjects that are uninteresting, smoke less, drink less, drive more safely, follow more healthful diets, live longer Findings demonstrate that ppl's answers to personality test Qs reflect at least to some degree the ways they actually behave and respond to challenges in real world Personality diff do not reveal themselves equally well in all settings: in familiar roles/settings conforming to well-learned social norms job, classroom, formal functions) → common influence of situation override individual personality styles Personality diff may be most clearly revealed in novel/ambiguous/stressful situations and life transitions, where cues as to what actions are appropriate are absent or weak

Family Environment

Siblings raised in same home might exp diff environments (ex: one child may have accident/illness → more parental care, or preexisting diff btwn siblings lead to differential parental responses that magnify diff: "good child" vs. "problem child" → self-fulling prophecies; siblings interpret same objective events differently which affect development → forcing chores be done can be caring act or harsh discipline) Sibling Contrast: Carving Out a Unique Niche WIthin the Family Sibling contrast - within-family emphasis on differences between siblings Split-parent identification - tendency of each of two siblings to identify w different one of their two parents Phenomena showed in questionnaires filled out by parents and siblings Family members accentuate diff rather than similarities btwn siblings bc devices by which parents and children (un)consciously strive to reduce sibling rivalry (highly disruptive to family functioning) → if siblings are seen as having diff abilities/needs/dispositions → less likely to compete and more likely to be valued and rewarded speartely for unique characteristics Also diversify parental investment → siblings move into diff life niches → compete less w each other for limited resources both within fam and in larger environ → develop separate skills so help each other Sibling contrast and split-parent identification are stronger for adjacent parents of siblings than for pairs separtd in borth order; stronger for same-sex than for opposite-sex; greater contrast for close in age than distant in age Sibling contrast and split-parent identification are strongest for first two children in family is consistent w rivalry-reduction hypothesis → likely to exp greatest degree of sibling rivalry bc for period of time they are the only 2 children being compared → subsequent children have multiple comparisons so intensity muted

attachment factors

Sensitive care correlates w secure attachment and positive later adjustment Infants become securely attached to moms who provide regular contact comfort, respond promptly and helpful to infant's signals of distress, and interact w infant in an emotionally synchronous manner (sensitive care) Positive correlation between ratings of mom's sensitive care and security of infant's attachment to mom assessed thru home visits early in infancy and strange-situation test several months later Bowlby: infants develop internal "working model"/cognitive representation of first attachment relationship and this model affects subsequent relationships throughout life Erikson: secure attachment in infancy results in general sense of trust of other ppl and oneself → enter subsequent stages of life in confident, growth-promoting manner Ainsworth: secure attachment lead to positive effects later in life Children more confident better at solving problems, emotionally healthier, and more sociable later than those who were insecurely attached Secure attachment is "multivitamin" that prevents probs and fosters healthy development Longitudinal study of 32 years → social adjustment (romance) and educational attainment Know it's cause and effect (not third variable like infant temperament) through training studies Moms with temperamentally irritable babies (by disposition as fussy, easily angered, difficult to comfort) participated in 3 month training program (infants 6 months old) to help and encourage moms to perceive and respond appropriately to babies' signals esp distress 12 months old → tested in strange-situation test → 62% of infants w trained moms showed secure attachment, 22% in control condition did Parental training for foster parents can result in more sensitive parenting, more secure attachment, reduced physiological evidence of distress in child, and fewer prob behaviors Some children are more susceptible to parental effects than others Relationship between parental care and infants' attachment depends partly on genetic makeup Infants differ in certain gene that affects neurotransmitter serotonin 5-HTTLLPR gene: a short (s) allele and a long (l) allele (greater uptake of serotonin into brain neurons) Homozygous for l allele are less affected by negative environmental exp than are other children (less likely to become depressed/fearful as result of living in abusive homes) Parents assessed for level of sensitive care when infants 7 months old, infants' attachment behavior assess using strange-situation test when infants were 15 months old; 28 of 88 infants had ll genotype, rest had ss or sl Attachment security inc significantly w inc maternal sensitivity for ss/sl group but not significantly affected for ll group (ll showed highly secure attachment regardless of level of maternal sensitivity) Cross-cultural differences in infant care !Kung San people - hunter-gatherer cultures in Africa Infants spend most of time during first year in direct contact w mom's bodies (at night mom sleeps w infant, during day carries infant in sling as side → constant access to mom's breast and can nurse at will usually every 15 min and can see what mom sees) passed around others who cuddle, fondle, kiss, and enjoy the baby; never leave infant to cry alone and usually detect distress and begin to comfort before crying begins Hunter-gatherers are highly indulgent toward infants Efe - Ituri forest of central Africa Infants are in physical contact w moms for only abt half of day; rest of day direct contact w other caregivers such as siblings, aunts, unrelated women Infants nursed at will from moms and other lactating women 8-12 months of age: (attachment strengthens) infants begin to show increased preference for own moms: less readily comforted by others and will often reject breast of another women such indulgence of infants by hunter-gatherer mothers does not lead to greater dependence or prevent them learning to cope w life's frustrations !Kung children extraordinarily cooperative and brave → older than 4 yrs explored more and sought mothers less in novel environ than British Paternal involvement appears to be greater in hunter-gatherer cultures than in agricultural/industrial cultures Aka of central Africa (related to Efe) - fathers hold infants an avg of 20% of time during daylight hrs and get up w them frequently at night; whole family sleep in same bed

Actively constructing our self-perceptions

Social comparison - process of comparing ourselves with others in order to identify unique characteristics and evaluate abilities Self-concept varies depending on reference group - group against whom comparison was made Children's self-descriptions focus on traits that most distinguished them from others in group Racially homogeneous classrooms rarely mentioned race, but those in racially mixed classrooms did Children who were unusually tall/short mentioned height Children w opposite-gender siblings mentioned own gender more frequently Ppl identify themselves largely in terms of ways in which they perceive themselves to be diff from others Big-fish-in-small-pond effect - academically able students at nonselective schools typically have higher academic self-concepts than do equally able students at very selective schools; reflects diff in reference groups First year college students earned high grades in HS → crushed when marks are avg/less compared to new, more selective reference group of college classmates

Placebo Effects

Test drugs for effectiveness in treating disorders → comparisons made among at least 3 diff treatment conditions; double-blind manner (neither patients nor researchers who evaluate them are told who is receiving drug vs placebo) → three categories of effects No treatment Placebo - inactive substance indistinguishable in appearance from drug Drug Spontaneous remission effect - any improvement shown by those who receive no treatment Placebo effect - any improvement shown by those receiving placebo that goes beyond improvement shown by those receiving no treatment Drug effect - any improvement shown by those receiving drug that goes beyond improvement shown by those receiving placebo antianxiety/antidepressant → most of improvement results from spontaneous remission and placebo effect (antidepressant experiment: 25% SR, 50% PE, 25% to drug's chemical effects) Depression characterized by feelings of helplessness and hopelessness → simply participating in treatment program (meet someone who cares and who offers what is believed to be useful drug) may restore feelings of control and hope and produce expectations of improvement → promote life changes such as self-care, involvement w friends → further improvement in mood → placebo effect

VIEWING OURSELVES THROUGH ROSE-COLORED GLASSES

We sometimes enhance our views of ourselves through... Self-serving attributional bias Positive bias and selective remembering Better-than-average effect Overinflating our sense of self disproportionate to accomplishments Most of us think relatively well of ourselves (North America and Western Europe) Most college students rate themselves as better students than avg college student 94% of college instructors rated themselves as better teachers tthan avg college instructor Positive illusory bias - adults' overestimation of their abilities (even greater in children), associated w greater psychological well-being Maintain unduly high self-evaluations by treating evidence abt self differently from way we treat evidence abt others Way one: systematically skew attributions we make abt our successes and failures Person bias - general tendency to attribute ppl's actions, whether good or bad, to internal qualities of person and to ignore external circumstances that constrained or promoted the actions → applies to others but not our own Self-serving attributional bias - tendency to attribute successes to inner qualities and failures to external circumstances Students who performed well on exam attributed high grades to own ability and hard work; those who performed poorly attributed to bad luck/unfairness of test/other factors beyond own control Same for college professors who were asked to explain why paper submitted to scholarly journal had been accepted/rejected Way two: selective memory - ppl generally exhibit better LTM for positive events and successes in lives than for negative events and failures (does not occur in memory for successes and failures of other ppl); esp strong in older adults May be maladaptive: child's parents provide nothing but praise to children → overinflated sense of self and unrealistically high level of self-esteem Self-esteem of American adolescents increasing over past several decades (societal emphasis on building self-esteem) Generally associated w better academic achievement and psychological health Too much is bad → adolescents' self-esteem w respect to academic performance has inc over recent decades but accompanied by DECLINES in actual academic performance and inc in adjustment problems including depression In comparison of 40 countries, American teens ranked below avg in math achievement but first in math self-concept Overinflated self-esteem esp prevalent among children from more affluent homes, whose parents strive to protect offspring from feelings of failure in order to promote sense of self-worth "Self-esteem movement" in U.S. resulted in young ppl who felt good abt themselves w/o achievements to warrant feelings → unstable foundation to build personality and can to lead to depression when encounter failure

Choking Under Pressure

he Working-Memory Explanation Social interference is subcategory of choking under pressure phenomenon Highly aroused mental state produced by any strong form of pressure to perform well can cause performance to worsen Esp likely to occur with tasks that make strong demands on working memory (part of mind that controls conscious attention and holds items of info needed to solve problem) Nondominant responses make heavy demands on working memory Pressure and accompanying anxiety can worsen performance by creating distracting thoughts (being evaluated, difficulty, consequences of failing, etc.) → usurp capacity of working memory and interfere w concentration on problem to be solved Choking can occur even in students who normally do not suffer from test anxiety; occurs specifically w test items that make highest demands on working memory Students given math probs that varied in difficulty and in degree to which students had opportunity to practice in advance Told some students that they were part of team and if they failed to perform above certain criterion entire team would not win prize, also videotaped so that teachers can examine High-pressure group performed significantly worse than low-pressure group on unpracticed difficult probs but not on easy or thoroughly practice probs that were less taxing in working memory Stereotype Threat as a Special Cause of Choking Stereotype threat - threat that test-taker experience when they are reminded of stereotypical belief that the group to which they belong is not expected to do well on test; choking that occurs when members of stigmatized group are reminded of stereotypes about their group before performing a relevant task Steele found that African American college students performed worse on various tests if tests were referred to as "intelligence tests" than other labels but not white) Drop in performance became even greater if students deliberately reminded of their race before taking test Threat = common stereotype that African Americans have lower intelligence than white Older adults perform worse on working-memory tests when they know they are being contrasted with a group of young adults than when they are told that tasks are "age fair" and do not vary with age Women perform worse on problem-solving tests that are described as math tests than on same tests when given other names; effect magnified if attention drawn to stereotype that women have lower math aptitude than do men Elementary and middle school children Girls as young as 5 years White males shown exhibit stereotype threat in math when stereotype that whites have less math ability than do Asians is made salient Christians perform more poorly on science-related tests when reminded that Christians are less competent in science than non-Christians Self-fulfilling prophecy - expectation that you will perform badly in fact causes you to perform badly Produce effects by inc anxiety and mental distraction Report higher levels of felt anxiety and manifest greater physiological evidence (HR inc) when taking test in stereotype-threat condition Threat undermines confidence while at same time inc motivation to do well resulting in inc anxiety → reduces performance by occuupying working memory with worrisome thoughts, reducing amt of working memory capacity available to solve problems Reduces performance on problems that tax working memory more than on problems that can be answered largely thru recall from LTM Being aware of stereotype-threat phenomenon leads test-takers to attribute incipient anxiety to stereotype threat rather the difficulty of probs or inadequacy → help concentrate on prob rather than on fears Self-affirming thoughts before test (list strength and values) can reduce threat by boosting confidence or reducing importance attributed to test

prejudice

prejudgment, unjustified attitude toward group discrimination is behavior, acting on this can be non-conscious and automatic

Social development

the changing nature of our relationships with others over the course of life

Stereotypes

the schemas that we have about groups of people We tend to have more positive associations with in- groups (groups we belong to) than with out-groups (groups we don't belong to) Implicit:Sets of mental associations that automatically guide judgments and behaviors toward a group; can be modified by classical conditioning - positive associations made with members of a stereotyped group can help to reduce implicit prejudice - but we have to seek out situations that allow us to form those associations Explicit: Conscious factors we use when judging others -- schema (organized set of knowledge or beliefs) that we carry abt any group of ppl Gain largely from the ways our culture as a whole depicts and describes each social category May accurately portray typical characteristics of group or exaggerate or be fabrication Can hold about in-groups and out-groups Useful to the degree that they provide some initial valid info about person but also sources of prejudice and social injustice → prejudge others on basis of group w/o seeing qualities as individuals Three levels of stereotypes: public (what we say to others abt a group), private ((what we consciously believe but generally do not say to others), implicit Explicit stereotypes - both public and private stereotypes; person consciously uses them in judging other ppl Measured by questionnaires on which ppl asked to state their views abt particular group; hope that they will be honest thru anonymous Implicit stereotypes - sets of mental associations that operate more or less automatically to guide judgments and actions toward members of group in question even if run counter to conscious beliefs Measured w tests in which person's attention is focused on performing quickly and accurately objective task that makes use of stimuli associated with stereotype implicit association test: ppl can classify two concepts tgt more quickly if they are alr strongly associated in minds than if not On computer: individual stimulus appears on screen and person press one or two keys on keyboard depending on category Use pics of white/black faces along with good/bad words → classify together Same-race bias is universal and emerges early in development Nearly everyone shares stereotype that males are relatively violent and females not Implicit Stereotypes Can be Deadly White ppl implicitly view unfamiliar black ppl as more hostile, violent, and suspicious looking than unfamiliar white ppl White ppl implicitly associate black faces more strongly with guns and violence than they do white faces White subjects categorized threatening and nonthreatening objs after being shown brief pics of white and black faces → subjects made faster decision and fewer errors categorizing threatening objs when preceded by black faces than white even if those faces were of 5 year old children Even when subjects were police officers: mistakenly shot unarmed black suspects more often than unarmed white suspects in simulation → with practice during which they received immediate feedback as to whether they had shot armed/unarmed person, gradually overcame bias Implicit prejudice cause police officers to shoot at black suspects more readily than at white Defeating Explicit and Implicit Negative Stereotypes People often hold implicit stereotypes at odds with explicit beliefs about stereotype group Explicit stereotypes are products of conscious thought processes and modifiable by deliberate learning and logic; implicit stereotypes are products of more primitive emotional processes, modifiable by classical conditioning White ppl who have close black friends exhibit less implicit prejudice than those w/o Exposure to admirable black characters in literature movies, and TV can reduce implicit prejudice in white ppl Association of positive feelings w individual members of stereotyped group helps reduce automatic negative responses toward group as whole White students who volunteered for diversity-training course showed significant reductions in both explicit and implicit prejudice toward black ppl Two reducations correlated weakly w each other: those who showed greatest decline in explicit did not necessarily show much decline in implicit Those students who felt most enlightened by verbal info and reported greatest conscious desire to overcome prejudice showed greatest declines in explicit prejudice Those who made new black friends during course or who most liked the African American professor showed greatest declines in implicit prejudice

ABNORMALITY

• Outside of cultural and societal expectations? • Behaviors are exaggerated? • Behaviors are misplaced? • Reactions to stimuli are inappropriate? The symptoms of mental disorders are not qualitatively different from the experiences that most of us have had; they differ only in degree For clinical diagnosis: • Impairment of functioning • Duration

cluster A

"Odd" Personality Disorders Much in common with schizo esp in delusional component Ppl w diagnosis of Cluster A personality disorder often have close relatives with schizo or have schizo Paranoid Personality Disorder Deeply distrustful of others and suspicious of motives Believe ppl are "out to get them" and read hostile intentions into actions of others Most of these attributions are inaccurate but not delusional Frequently blame others for failures and tend to bear grudges More freq in men than women Schizoid Personality Disorder Display little in way of emotion either positive or negative; tend to avoid social relationships Avoid others not bc fear or mistrust them like paranoid personality disorder but bc genuinely prefer to be alone Make no effort to initiate or maintain friendships, often including sexual relations and interactions w fam Tend to be self-centered and not much influenced by either praise or criticism Relatively rare: less than 1% of population Schizotypal Personality Disorder Extreme discomfort in social situations, bizarre patterns of thinking and perceiving, and behavioral eccentricities (wearing odd clothing or repeatedly organizing kitchen shelves) Anxious and distrustful of others and often loans See significance in unrelated events (esp as they relate to themselves) May believe they have special abilities (extrasensory perception or magical control over others) Poor attentional focus → vague convos often w loose associations difficult to get and keep jobs and often lead idle, unproductive lives occurs 2 to 4% of all ppl and slightly more common in men than women

DARK TRIAD

1. Narcissism: extreme selfishness with a grandiose view of one's own abilities and a need for admiration -Associated with overconfidence, deceit, and seemingly inability to learn from mistakes Associated with leadership and found in celebrities and political leaders Narcissism positively associated w overall greatness, public persuasion, crisis management, and agenda setting in 42 US presidents Also associated w congressional impeachment and unethical behaviors 2. Machiavellianism: a personality type in which the person is predisposed to manipulate other people, often through deception 3. Psychopathy: amoral or antisocial behavior, coupled with a lack of empathy and an inability to form meaningful personal relationships At extreme is personality disorder (antisocial personality disorder) but can also be expressed at preclinical levels - Some researchers add "everyday sadism" - enjoy inflicting verbal or physical harm → dark tetrad Score low on agreeableness and conscientiousness and often have difficulty getting along with others, but tend to make good impressions on first dates and brief job interviews; better luck with exploitative, short-term mating opportunities

treatment history

18th - early 20th century: people with severe mental illness were hospitalized, often under inadequate conditions Mid 20th century: deinstitutionalization, a response to... • failure of large institutions to provide adequate treatment • relative success of new types of pharmacologic treatment TREATMENT TODAY Outpatient + inpatient Comprehensive treatment includes combination of pharmacologic and behavioral approaches Mental health professionals: Psychiatrists (MD) Clinical psychologists (PhD) Counselors / social workers (Masters-level) Psychiatric nurses (RN, BSN, masters or doctoral) -- Western cultures felt little obligation toward ppl w psych disorders 17th century: ppl w psych disorders (madness/lunancy) were considered to be in league w devil → torture, hanging, burning at stake 18th centurY: "put away" in hospitals and asylums often under poor conditions Middle of 20th centurY: major change in treatment began bc of inc in number of PhD programs in clinical psych to train psychologists to treat mental health problems of World War II veterans, disenchantment w large state institutions, and development of antipsychotic drugs → deinstitutionalization: ppl c ould be returned to community or live in transitional homes receiving outpatient care Many are homeless and in prisons (16% of prisoners) even tho most do not commit violent crimes (rate of engaging in violent behavior is somewhat higher than general population tho), rundown rooming houses, understaffed nursing homes, long-term residential care facilities or group homes (provide room and board, supervise medication, offer assistance w problems of daily living) Alt hospitalization that deinstitutionalization movement envisioned (improved care in community setting) was never fully realized

Mental Health System

Assertive community treatment ACT or other outreach programs aimed at helping individuals w severe mental illness wherever they are in community Each person in need assigned to multidisciplinary treatment team (case manager, psychiatrist, general physician, nurse, social workers); someone on team available at any time to respond to crises Each patient whether living on st or in boarding house or w fam is visited at least twice a week by a team member who checks on health, sees if any services are needed, and offers counseling as appropriate Team meets freq w family members to support them in care for patient Such programs highly effective in reducing need for hospitalization and inc satisfaction w life Expensive to operate but generally save money in long run by keeping individuals out of hospitals (where care is much more expensive) Majority of ppl w schizo and families in US do not receive such services :( - Kinds of services ppl seek depend on severity of disorder, what they can afford, services available in community → mental health professionals, self-help groups organized by peers who suffer from similar probs or disorders (AA), religious organizations, general practice physicians, assistance offered online Mental Health Professionals Received special training and certification to work w ppl who have psychological probs/disorders Psychiatrists - medical degrees thru standard medical school training followed by special training and residency in psychiatry; only mental health specialists who can regularly prescribe drugs; typically work in private offices, mental health clinics, hospitals Clinical psychologists - usually doctoral degrees in psych w training in research and clinical practice; some are employed by universities as teachers and researchers in addition to having own clinical practices; often work in private offices, clinics, hospitals Counseling psychologists - usually have doctoral degrees in counseling; training is similar to that of clinical but entails less emphasis on research and more on practice; are likely to work w ppl who have probs of living that do not warrant diagnosis of psych disorder Mental health counselors - usually master's degrees in counseling or social work; receive less training in research and psychological diagnostic procedures than doctoral-level clinical or counseling psychologists; often work in schools or other institutions, counseling those w school or job-related probs; may also conduct psychotherapy in priv practice including specialties such as couples or marriage counseling, career counseling, child guidance counseling Psychiatric social workers - usually have master's degrees in social work, followed by advanced training and exp working w ppl who have psych probs; most often employed by public social-work agencies; may conduct psychotherapy sessions or visit ppl in their own homes to offer support and guidance Psychiatric nurses - degrees in nursing followed by advanced training in care of patients w mental illness; usually work in hospitals and may conduct psychotherapy sessions as well as providing more typical nursing services - Where People With Common Psychological Disorders Go for Treatment 22% of sample in survey of ppl w psych disorders in U.S. received treatment from mental health professional within past yr, 599% no treatment, most of remainder from medical doctor or nurse who did not have mental health specialty Typical person w psych disorder who saw general practice physician saw that person just once or twice usually to receive prescription for drug treatment and/or few mins of counseling Those who saw mental health professional met for avg of seven sessions of at least half hr length mostly for counseling or psychotherapy Wealthier and more education → more likely to have met for sessions w mental health professional Those who have insurance and can afford deductibles and co-pays are able to see private practice mental health professionals, but most either go untreated or seen by care provider w/o special training in mental health Community-based programs are successful but only reach minority of ppl Prisons may be country's largest mental health providers mostly to ppl who have not committed serious crimes Society has recognized important of treating ppl but the cost, stigma associated w seeking treatment, and difficulty of getting therapy to ppl who need it make effective provision of treatment problematic

Compliance

If request small and made politely, tend to comply automatically Norm of reciprocity - tend to honor requests of ppl who have done things for us More apt to honor request from someone in in-group even if don't know person personally Tendency to comply → doing things for others pays off as others in turn do things for us Throwing the Low Ball: Increasing the Price After Commitment to Buy Low-ball technique - customer first agrees to buy product at low price and after delay salesperson "discovers" that low price isn't possible and product must be sold for more Customers aft agreeing to initial deal are motivated to reduce cognitive dissonance by setting aside any lingering doubts abt product During delay between low-ball offer and real offer, mentally exaggerate product's value → primed to pay more than they would have initially Putting a Foot in the Door: Making a Small Request to Prepare the Ground for a Large One Foot-in-the-door technique - ppl are more likely to agree to a large request if they have already agreed to a small one Compliance with first request induces sense of trust/commitment/compassion toward person making request; or induce sense of commitment toward particular product/cause Esp effective in soliciting donations for political causes and charities: ppl who first agree to make small gesture of support such as signing petition are subsequently more willing to make larger contribution Small donation or gesture of support leads person to develop firmer sense of support for cause → promotes willingness to make larger donation

COGNITIVE DISSONANCE

Innate mechanism that makes us uncomfortable when we hold two contradictory beliefs, attitudes, or pieces of information in mind We really don't like this - it feels bad! Often leads people to avoid things that contradict our explicit attitudes (+ insufficient- justification effect) mechanism built into workings of mind that creates uncomfortable feeling of dissonance/lack of harmony when we sense some inconsistency among various explicit attitudes, beliefs, and items of knowledge that constitute mental store Discomfort motivates us to seek ways to resolve contradictions or inconsistencies among conscious cognitions Adaptive functions related to logic: inconsistencies imply that we are mistaken → mistakes can lead to danger Favorable attitude about sunbathing, learn that overexposure to UV rays is cause of skin cancer → discrepancy between pre existing attitude and knowledge create cognitive dissonance → change attitude about sunbathing from pos to neg to bring in third cognition that it's relatively safe in moderation if use sunscreen lotion Dissonance-reducing mechanism does not always function adaptively (like hunger drive can lead us to eat things that are bad) → reduce dissonance in illogical and maladaptive ways Avoiding Dissonant Information People generally choose things that they believe will support their existing views (ex: TV and news sources for political views) Senate Watergate hearings in 1973: illegal activities associated with PResident Richard Nixon's 1972 reelection campaign against George McGovern → interview voters before/during/aft hearings Nixon supporters avoided news about hearings (but not other political news) and were as strongly supportive of Nixon aft hearings as before McGovern supporters eagerly sought out info abt hearings and were as strongly opposed to Nixon afterward as they had been before Previously undecided voters paid moderate attention to hearings and were only group whose attitude toward Nixon was significantly influenced (in neg direction ) by the hearings Consistent with cognitive dissonance theory: all but undecideds approached hearings in a way that seemed designed to protect/strengthen existing views rather than challenge Firming up an attitude to be consistent with an action After made irrevocable decision, any lingering doubts are discordant w knowledge of what we have done → motivated to set doubts aside Even in absence of new info, ppl suddenly become more confident of their choice aft acting on it than they were before Bettors at horse race were more confident that their horse would win if were asked immediately after they had placed their bet than asked immediately before; voters who were leaving polling place spoke more positively abt favored candidate than did those who were entering Changing an attitude to justify an action: the insufficient-justification effect Insufficient-justification effect - change in attitude that occurs only if person has no easy way to justify behavior, given previous attitude Low-incentive requirement: no obvious, high incentive for performing counterattitudinal action College students had boring task (loading spools into trays and turning pegs in pegboard) and offered to "hire" them to tell another student that task was exciting and enjoyable Some were offered $1 for recruiting; other was $20 Those in $1 condition changed attitude toward task and recalled it as truly enjoyable while $20 called it boring $1 condition couldn't justify their lie to other student on basis on little money promised, so convinced themselves that they were not lying, while $20 condition could justify lie Free-choice requirement: subjects must perceive action as stemming from own free choice (or else could justify action and relieve dissonance by saying forced to do it) Students asked to write essays expressing support for bill in state legislature that most students personally opposed → students in free choice condition were told that they didn't have to but were encouraged to do so → none refused; students in no choice condition were simply told to write essays After writing essays, free-choice condition showed significant shift in direction of favoring bill; no-choice reamined as opposed to it as did students who had not been asked to write essays at all Attitude change in free-choice condition occurred bc students could justify choice to write essays only by deciding they did favor bill

Personality Disorders

Personality = person's general style of interacting w world Personality disorder - enduring pattern of behavior, thoughts, and emotions that impairs a person's sense of self, goals, and capacity for empathy and/or intimacy and is associated with significant stress and disability DSM-5 identifies 10 personality disorders divided into three clusters → limitations: many patients meet criteria for more than one personality disorder or have disorders that do not fall neatly into one of the 10 categories and personality dysfunction may reflect maladaptive extremes of normal personality trait dimensions Origins of Personality Disorders (not as investigated as other psychological disorders) Biological (genetic and neurotransmitter) Genetic connection for paranoid personality Abnormalities in ntm for schizotypal and antisocial Abnormalities in brain structures for schizotypal, antisocial, borderline Experiences in childhood related to schizotypal, antisocial, borderline, dependent Sociocultural explanations for narcissistic ((family values in Western societies promote narcissism) and histrionic (more cultures are more accepting of extreme behaviors than others) Genes operate in interaction w environ at all levels (family, culture), influencing brain structure (formation of synapses, pruning of neurons, abundance of ntm receptors) and function (thru presence of ntm such as dopamine, serotonin, glutamate) Person must be at least 18 yrs old to be diagnosed w personality disorders, but roots of such disorders are in development w features being apparent to less degrees during childhood and adolescence

Adaptation to Life Conditions

Proximate explanation - causal mechanisms that operate in lifetime of individual to produce phenomenon in question; ways by which differing genes and exp work to make us diff Distal explanation - function/evolutionary survival value Advantages of Being Different From One Another Some evolutionary psychologists view personality traits as by-products not selected thru evolution Others believe individual diff in personality provide variation among ppl → adaptive for range of environments Sexual reproduction is adaptation that ensures diversity of offspring (cloning is easier) Many dimensions of personality identified in nonhuman animals have equivalents in five-factor model (esp extraversion, neuroticism, agreeableness) Diversifying One's Investment In Offspring Diversified investment greatly reduces potential for dramatic loss while maintaining potential for substantial gains over long run Chance hat individual's genes will die out can be reduced if offspring differ from one another in characteristics → over evolution natural selection would favor mechanisms that ensure diversity The Big Five Traits as Alternative Problem-Solving Strategies Extraversion-introversion: extraverts more likely to have many seual partners, get divorced, become hospitalized bc of accidents → extraversion could, depending on environmental conditions, either inc/dec number of offspring High neuroticism could save lives in truly dangerous conditions Low openness could lead to more stable family lives and more children Disagreeable ppl sometimes do get their way, sometimes meanness more viable Sometimes long-term goals are not likely to work out, so opportunities/impulsive approach to life could be more conducive to survival and reproduction (low conscientiousness) In environment that varies unpredictably, chances that some offspring will survive are enhanced in offspring genetically inclined toward diff life strategies (heritable), but also need to be flexible so can move along personality dimension in direction compatible w life situation (introvert can be more bold)

Attitude

any belief or opinion that has an evaluative component - a judgment or feeling that something is good or bad, likable or unlikeable, moral or immoral, attractive or repulsive Tie us cognitively and emotionally to social world Values = most central attitudes, help us judge appropriateness of whole categories of actions First studied to predict how individuals would behave in specific situations; conceived of attitudes as mental guides that ppl use to make behavioral choices → now, attitude-behavior relationship depends on way in which attitude is assessed In many cases implicit and explicit coincide and behavior corresponds well w attitude, but sometimes they don't Eating meat is bad thing for animals, planet, and health → negative explicit attitude toward eating meat Long history of enjoying meat → positive implicit attitude toward eating meat If meat is put before you, implicit attitude automatically makes you want to eat meat unless consciously think about explicit attitude and use restraint Ppl who successfully maintain vegetarian diet generally have negative implicit and explicit attitudes toward eating meat and positive implicit and explicit attitudes toward eating vegetables fmRI: implicit attitudes are reflected directly in portions of brain's limbic system involved in emotions and drives; explicit in portions of prefrontal cortex concerned w conscious control Explicit attitude counters implicit: subcortical areas respond to relevant stimuli in accordance to implicit attitude but downward connections from prefrontal cortex may dampen response Eating meat: pleasure and appetite centers respond immediately to meat put before you → think abt explicit attitude → responses overcome thru connections from prefrontal cortex

Psychotherapy

any theory-based, systematic procedure, conducted by a trained therapist, for helping people to overcome or cope with mental probs thru psychological rather than directly physiological means Dialogue btwn person and therapist → restructure way of feeling/thinking/behaving More than 400 types Psychodynamic and humanistic are both holistic while cognitive and behavioral focus more directly on specific symptoms and problems 30% psychotherapists are eclectic/integrative Talk, reflection, learning, practice Combination of drug therapy and psychotherapy as treatment Changes in brain can alter way person feels/thinks/behavies, changes in feeling/thought/behavior can alter brain Brain is dynamic biological organ that is constantly growing new neural connections and losing old ones as it adapts to new exp and thoughts Each major approach in psychotherapy draws on set of psych principles and ideas that apply to behavior Psychodynamic: unconscious memories and emotions influence conscious thoughts and actions Humanistic: value of self-esteem and self-direction; ppl often need psychological support from others in order to pursue freely their own chosen goals Behavioral: roles of basic learning processes in development and maintenance of adaptive and maladaptive ways of responding to environ Cognitive: ppl's ingrained, habitual ways of thinking affect moods and behavior Psychotherapy II: Behavioral and Cognitive Therapies Symptoms are prob and not necessarily merely reflection of underlying cause Concerned w data; objective measures to assess whether or not treatment is helping client Cognitive-behavioral therapy (CBT) - combine cognitive and behavioral methods

Explicit attitudes

conscious evaluations we are aware of and can verbally state conscious, verbally stated evaluations; measured by traditional attitude tests in which ppl are asked to state evaluation of some object/form of behavior (strongly agree to strongly disagree scale) Require thought; the more we think abt what we are doing, the more influence our explicit attitudes have

Trait theories of personality

endeavor to specify manageable set of distinct personality dimensions that can be used to summarize fundamental psychological differences among individuals Cattell Identified 16 basic trait dimensions → 16 PF Questionnaire (statements abt specific aspects of behavior) Many trait researchers found Cattell's 16-factor theory to be redundant and complex Five-factor model (Big Five theory) of personality - personality is most efficiently described in terms of score on each of the five relatively independent global trait dimensions: neuroticism (vulnerability to emotional upset), extraversion (tendency to be socially outgoing), openness to experience, agreeableness, and conscientiousness Each global trait dimension encompasses six subordinate trait dimensions referred to as facets of that trait; facets within any given trait dimension correlate w one another(score for 30 facets) Other researchers argue sixth trait honesty-humility should be added → HEXACO model (honestly-humility, emotionality, extraversion, agreeableness, conscientiousness, and openness)

Obedience

is typically not a bad thing - it reinforces a social structure in which some people make decisions that others willingly follow But! Authority can be taken too far WHAT WE LEARN FROM MILGRAM'S EXPERIMENT We can be convinced to obey, even if it hurts others, when: Responsibility falls on someone else (the experimenter) We aren't in proximity to the person we're hurting We don't have a good example of how we should behave in that context We start out with a small discretion and create an attitude that it's "not so bad," allowing us to go forward (to assuage cognitive dissonance)

Implicit attitudes

manifested in automatic mental associations, though we are not cognizant of them attitudes that are manifested in automatic mental associations Implicit association tests - ppl can classify two concepts tgt more quickly if they are alr strongly associated in minds than if they are not strongly associated Score is based on speed of associations Faster at socciating meat and meat-related words/pics with good terms such as wonderful than w bad terms → positive implicit attitude toward meat (if opp, then negative implicit attitude) Gut-level attitudes, object of attitude automatically elicits mental associations that connote good or bad and influence bodily emotional reactions → automatically influence behavior The less we think abt what we are doing, the more influence implicit attitudes have

Differential susceptibility to environmental influence

one trait that is associated w change instead of stability Children w fearful, anxious, and "difficult" dispositions are more sensitive to effects of parenting than other children → readily change behavior and personalities to novel environments → may fare esp poorly in bad environ but do rly well in supportive environ; other children less influenced by extreme environ Orchid children - children who are biologically sensitive to context: flourish when receive loving care, wilt when environ not supportive Dandelion children can survive in any environ 5-6 yo yrs classified as having high or low neurobiological stress reactivity based on RSA measure of ability to regulate reactions to pos/neg stimuli) and classified based on home adversity Children high in stress reactivity displayed poorer adjustment (inc externalizing behavior, dec prosocial behavior, poor school performance) in high adversity environ but better adjustment in low-adversity environ Dandelion children displayed less change for most measures Gene associated w susceptibility to parental influence: parents of 1-3 yr olds w/ high levels of externalizing behavior (conduct disorder) took part in parenting program → children who had one version of allele associated w dopamine receptor showed reductions in externalizing behavior, but children w diff allele displayed no change Highly sensitive personality (HSP) trait: ppl more aware of subtleties in surroundings, process exp more deeply, more easily overwhelmed in highly stimulating environments → questionnaires show about 20% of ppl More affected by both pos and neg exp: highly sensitive college students scored lowest in negative affectivity in easy task and highest in difficult task condition; students who were rated as not highly sensitive did not vary in their assessments of neg emotions in 2 conditions

Self-esteem

our perception of how much people approve of and accept us, as well as how much we like ourselves; strong evaluative component of self-concepts, one's feeling of approval, acceptance, and liking of oneself; Usually measured w questionnaires: rate degree to which they agree/disagree w statements -- VIEWING OURSELVES THROUGH THE LOOKING GLASS sociometer theory reflects the level of acceptance or rejection we believe we can expect from others; Judgments about self derive primarily from perceptions of others' attitudes toward us; self-esteem acts like a meter to inform us of degree to which we are likely to be accepted/rejected by others at any given time, reflects best guess abt degree to which other ppl respect and accept you Individual diff in self-esteem correlate strongly w individual diff in degree to which ppl believe that they are generally accepted or rejected by others In experiments and correlational studies involving real life experiences, ppl's self-esteem inc aft praise, social acceptance, or other satisfying social exp and decreased aft evidence of social rejection Feedback about success or failure on test had greater effects on self-esteem if person was led to believe that others would hear of this success or failure than if private → if self-esteem depended on just our own judgments about self, then it shouldn't matter whether others know Evolutionary explanation: survival depends on others' acceptance of us and willingness to cooperate with us → self-esteem motivate us to act in ways that promote our acceptance by others Decline in self-esteem → change ways in order to become more socially acceptable or seek more compatible social group; inc → continue on present path Often based on social comparison - what are our unique characteristics? how do we evaluate our abilities with reference to others? If we differ from the reference group on some quality, we tend to focus on it

Grit

perseverance and passion for long-term goals, requiring persistent interest and effort having growth mindset helps higher-order personality trait independent of IQ that is predictive of success in wide range of domains Two lower-order factors: perseverance of effort and consistency of interest Tendency to work hard at achieving important goals even in face of setbacks and to stick w particular goal rather than changing goals and interests Consistency of interest items assess the degree to which ppl are apt to pursue goal without distraction, perseverance of effort items assess degree to which ppl are apt to work hard and persistently at completing task without being discouraged by setbacks Associated with conscientiousness in Big Five but accounted for additional individual diff in outcomes beyond that and IQ and practice Meta-analysis: statistical technique that allows investigator to evaluate magnitude of significant effect across large number of studies → grit highly correlated w conscientiousness and perseverance factor but not consistency factor accounted for individual diff in outcomes beyond effects of conscientiousness (same for subjective well-being) Benefits are limited to certain tasks difficult and well defined, requiring substantial practice for success); less predictive of success on relatively easy tasks or novel/ill-defined tasks → persisting w difficult task for too long may be detrimental if prevents ppl from seeking help for sticking with problem when switching to other, more solvable probs would be more beneficial

SELF CONCEPT

personal sense of self, way that person defines him/herself A social product: to become aware of yourself must first become aware of others in your species and become aware that you are one of them Self-awareness = awareness of physical self, personality, and character, reflected psychologically in reactions of other ppl Reporting more positive than negative traits could be a product of: • Self-esteem maintenance • Better-than-average effect • Positive life events often more easily remembered than negative often thought of as private But! Research suggests it depends on: Cultural context in which you are raised Others' reactions to you Self-fulfilling prophecies Social comparison

Social pressure

set of psychological forces that are exerted on us by others' judgments, examples, expectations, and demands, whether real or imagined Most strongly influenced by ppl who are physically or psychologically closest to us Arises from ways we interpret and respond emotionally to social situations around us Useful bc promotes social acceptability and help create order and predictability in social interactions, but can also lead us to behave in ways that are foolish or morally repugnant Facilitating and Interfering Effects of an Audience Social facilitation - being observed improves performance Usually occurred with relatively simple or well-learned tasks Social interference/social inhibition - audience hinders performance Occurred with complex tasks or tasks that involved new learning Zajonc: present of others facilitates performance of dominant actions and interferes with performance of nondominant actions Dominant actions = simple, species-typical, well learned; can be produced automatically w little conscious thought Nondominant actions = actions that require considerable conscious thought or attention Presence of audience inc person's level of drive or arousal → heightened drive inc effort which facilitates dominant tasks where amt of effort determines degree of success; however interferes w controlled/calm/conscious thought and attention and thereby worsens performance of non dominant actions Presence of observers does inc drive and arousal as measured by self-reports and physiological indices such as increased HR and muscle tension Either facilitation or interference can occur in same task depending on performs' skill Expert pool players performed better when watched conspicuously; opposite for novice pool players College students explain something they had just learned to another student: interference inc when subjects were given negative feedback just before test to make them feel unconfident and more anxious abt their ability; interference dec/abolished when given pos feedback

socialization

social process thru which we develop our personalities and human potential and learn abt society and culture primary: 1st exp w lang/values/beliefs/beahviors/norms of society --> family provides cultural capital gender/race/social --> anticipatory (take on values of groups they plan to join) secondary: outside home (ex: school); peer groups

Clinical psychology

the field of practice and research dedicated to helping people who suffer from mental disorder and distress Up until now, we've been talking about psychology largely as an investigative science. Here, we're going to look at the ways that psychology can operate as an applied, practical science

Diagnosis

threshold of symptom count met (DSM-IV) • What are potential problems with symptom-count-dependent diagnoses? • Too much heterogeneity • For example - under DSM-IV, a diagnosis of depression requires 5 out of 9 possible symptoms be present: so, two people could be diagnosed while sharing only one symptom between them 2013 DSM-5: updated to reflect "dimensional" approach to diagnosis Accounts for symptoms lying on a spectrum of behavioral presentations

Impression management

ways by which ppl consciously and unconsciously modify behavior to influence others' impressions of them Humans as Actors and as Politicians Goffman: we are actors playing at diff times on diff stages to diff audiences Not necessarily aware that we are performing There need not be a division in our minds btwn images we try to project and our sincere beliefs abt ourselves; at any given moment we may simply be trying to exhibit our best self/those aspects of our self that seem most appropriate and useful to meet moment's needs, which change w audience Alternative metaphor: we are intuitive politicians: perform in front of others not just to tell story or portray character but also to achieve real-life ends over long term that may be selfish or noble or both To do what we want to do need approval and cooperation of other ppl → "campaign" for ourselves and our interests naturally often w/o conscious awareness of strategies Try to make ourselves look good → if see good qualities others will be inclined to collaborate with us; more concerned with impression management w new acquaintances than w familiar friends and companions May or may not be conscious of balancing act btwn showing off/appearing modest or sincerity/ingratiation, but act requires effort

Looking-glass self

we all naturally infer what others think of us from their reactions and use those inferences to build our own self-concepts (looking glass = other ppl who react to us) Effects of others' appraisals on self-understanding and behavior Self-fulfilling prophecies/Pygmalion effects - beliefs and expectations that others have of a person whether true or false can to some degree create reality by influencing that person's self concept and behavior Pygmalion in the classroom effect Rosenthal and Jacobson led teachers sto believe special test had predicted that certain students would show spurt in intellectual growth during next few months "Spurters" selected at random, but when tested 8 months later showed significantly greater gains in IQ and academic performance than classmates Teachers' expectations created reality Teachers became warmer toward "spurters," more time to ans difficult Qs, more challenging work, noticed and reinforced self-initiated efforts → created better learning environment for them Treatment also changed self-concepts → students began to see themselves as more capable academically → work harder to live up to perception Experiments w/ adults: supervisors led to believe some of subordinates have special promise → do perform before Extra attention and encouragement received and change in self-concepts

Humanistic

• It is necessary to be aware of what we have and what we need to cultivate - conscious pursuit of self-actualization • We govern our lives according to sets of beliefs and stories we create, separating us from other animals Conscious understanding of self leads to the capacity to choose one's own path to fulfillment Based on: Phenomenological reality Self concept Self-identified path to "actualization" -- arose partly in reaction to psychodynamic; emphasize conscious understanding of themselves and capacity to choose own paths to fulfillment Humanistic bc center on aspect of human nature that seems to distinguish us from other animals: tendency to create belief systems, to develop meaningful stories abt ourselves and our world, and govern lives in accordance w those stories Phenomenology - study of conscious perceptions and understandings Phenomenological reality - each person's conscious understanding of his/her world Claim that PR is one's real world, there are as many real worlds as there are ppl

Pharmacologic treatments

• Often address dysfunctional neurotransmitter systems • Short-term to address acute symptoms • Long-term for maintenance / prevention of recurrence • Must consider side effects - Antipsychotic • Treat psychosis (ex schizo) • Not curative; bad side effects (tremors, inc risk of diabetes, tardive dyskinesia) • Block dopamine receptors -> reduce pos. symptoms Antianxiety (anxiolytics) • Increase inhibitory NTs -> sedative • Potentially addictive- causes physical dependence • Side effects can be severe + withdrawal Alters activity at the GABA receptor, allowing for increased inhibition across the brain Antidepressant • Prolong action of NTs in synapse • Depression + anxiety treatment • Tricyclics v. SS(N)Ris (fewer side effects) EFFECTS OF DRUG TREATMENT When testing for effectiveness, we ideally compare at least three different treatment conditions 1. Spontaneous remission effect Any improvement shown by those who receive no treatment 2. Placebo effect Any improvement shown by those receiving the placebo (inactive substance) that goes beyond the improvement shown by those receiving no treatment 3. Drug effect Any improvement shown by those receiving the drug that goes beyond the improvement shown by those receiving the placebo

TRAIT STABILITY

• Personality is relatively stable; becomes more stable with age • Correlation coefficients for repeated tests across lifetime, even many years apart, range from .50 to .70 • Some age-related changes are relatively consistent across samplings of individuals; may constitute increased maturity The General Stability of Personality Studies have been conducted in which ppl fill out personality questionnaires or are rated on personality characteristics by fam/friends at widely separated times in lives → high stability of personality throughout adulthood (correlation coefficients on repeated measures of major (such as Big Five) during adulthood typically range from 0.5 to 0.7 even w intervals of 30-40 yrs) Stability cannot be dismissed as resulting from consistent bias in how individuals fill out personality questionnaires as similar consistency is found even when ppl rating participants' personalities are not same in second test as in first Personality becomes increasingly stable w inc age up to about age 50 → relatively constant level of stability aft age 50 Patterns of Change in Personality with Age Some of changes in personality that occur w age are relatively consistent across sampings of individuals and constitute increased maturity Over adult years, neuroticism and openness to experience tend to decline somewhat, and conscientiousness and agreeableness tend to inc somewhat Other studies show similar results but suggest that agreeableness continues to inc even into and possibly beyond 70s and 80s; consistent w findings of inc life satisfaction in old age Individual's personality can change at least to some degree at any age → likelihood of change inc when person exp major life change such a new career, altered marital status, onset of chronic illness Other studies suggest that ppl who have particular personality characteristic often make life choices that alter personality even further in pre existing direction (ex: higher extraverted person choose career that involves a lot of social activity, which cause person to become even more extraverted)

"Talk" and behavioral therapies

• Theory-based, systematic • Conducted by a trained mental health professional • Psychological (not physiological/biological) approaches 1. Psychodynamic approach: address unconscious memories / emotions that influence our conscious thoughts and actions 2. Humanistic approach: improve self-esteem and self- direction; assumes that people need psychological support from others in order to pursue chosen goals / outcomes 3. Behavioral approach: emphasizes roles of basic learning processes in the development / maintenance of adaptive and maladaptive ways of responding to the environment Exposure Therapy: Imaginal, In Vivo (real), Virtual Reality Based on classical conditioning; used to habituate or extinguish reflexive fear responses in specific phobias 4. Cognitive approach: emphasizes ingrained ,habitual ways of thinking affect their moods and behavior (and can be restructured) Therapist's Role:Identify maladaptive or harmful thoughts and beliefs Help client to see irrationality Guide client toward eliminating or replacing them Client's Role: Replace old ways of thinking with new, more adaptive ways • Complete "homework" to encourage incremental progress Assume more responsibility over time -> therapist steps back

SOCIAL DEVELOPMENT summary

• We are influenced by many factors! • People need to grow up around people - a lack of socialization is bad for emotional processing, language skills, personality development, etc. • Social institutions (e.g., school) expose children to "norms" + different types of people individually and in group contexts • We can also learn social skills through media, which is pretty powerful and shaping our behaviors and beliefs