exam 4 - psychology

negative symptoms of schizophrenia

1) Anhedonia 2) Flat affect 3) Social withdrawal 4) Poverty of speech 5) Lack of motivation

what 3 factors play in understanding schizophrenia

1. brain abnormalities 2. genetics and risk 3. prenatal environment and risk

general criteria for diagnosing mental illness

1. subjective distress 2. Social/Occupational Dysfunction 3. Danger to self or others

Disorganized Symptoms (Positive)

1.speech 2.behavior

Clarice seeks treatment for a history of childhood sexual abuse. She is interested in therapy which will help provide insight into her ongoing symptoms. Clarice is MOST likely to receive:

psychodynamic treatment.

In a _____ disorder, a person exhibits a disturbance in thought, emotion regulation, or behavior.

psychological

Spencer has been diagnosed with schizophrenia. His parents have a difficult time understanding him because his speech is fragmented and bizarre. He jumps from one idea to another, sometimes within sentences, creating a word _____.

salad

Mrs. Higgins believes that aliens from another planet have removed her stomach and are watching to see how long it takes her to grow another. Mrs. Higgins is MOST likely suffering from:

schizophrenia.

A diagnosis of DID can be made:

If two or more of entities, or personality states, each with its own independent way of relating, perceiving, thinking, and remembering about herself and her life, take control of the person's behavior at a given time.

major depressive disorder

Person experiences two or more weeks with five or more symptoms, at least one of which must be either (1) depressed mood or (2) loss of interest or pleasure.

generalized anxiety disorder

Person is continually tense, apprehensive, and in a state of autonomic nervous system arousal

Types of Psychotherapy

Psychoanalytic/Psychodynamic Behavioral Humanistic Cognitive

Delilah is continually tense and plagued by muscle tension, sleeplessness, and an inability to concentrate. Delilah MOST likely suffers from _____ disorder

generalized anxiety

Research examining genetic contributions to depression suggests that depression is the result of:

many genes working together

anxiety disorders

marked by distressing, persistent anxiety or maladaptive behaviors that reduce anxiety

Epidemiology of DID

•1% of general population •Childhood trauma or abuse •Comorbid with PTSD, depression, anxiety or panic disorders •May be equally prevalent in men and women, but men are more often diagnosed •Treated with psychotherapy

Obsessive-compulsive disorder (OCD)

•Characterized by persistent and repetitive thoughts (obsessions), actions (compulsions), or both

Schizophrenia symptoms

•Disturbed perceptions •Disorganized thinking and speech •Diminished and inappropriate emotions and actions

All Therapy provides:

•Hope for demoralized people •New perspective for oneself and the world •Empathic, trusting, caring relationship (therapeutic alliance)

Symptom Patterns of schizophrenia (negative)

•Insidious onset •Chronic •Generally don't •Poorer prognosis

the effects of labeling: Disadvantages

•Labeling can be stigmatizing •Gross categorization can mask variability •Is psychopathology a continuous spectrum? •What about over-labeling? (ADHD)

Understanding Schizophrenia Prenatal environment and risk

•Low birth weight •Lack of oxygen during delivery •Maternal prenatal nutrition •Midpregnancy viral infection (e.g., flu, dense population, season of birth)

Understanding Schizophrenia Genetics and risk

•Odds of being diagnosed with schizophrenia are nearly 1 in 100; 1 in 10 for those with diagnosed family member •Adopted children risk is related to biological parent •Schizophrenia influenced by many genes •Epigenetic factors influence gene expression

Types of Maladaptive Thoughts

•Overgeneralization •Selective abstraction •Catastrophizing •Dichotomous thinking

Does therapy work?

•People often enter therapy in crisis (regression to the mean) •Clients believe in the treatment (placebo effect) •Clients want to believe the therapy was worth it (justification of effort) •Clients tend to speak positively about therapists (social norms, bonding)

Why classify disorders?

•Predicts the disorder's future course •Suggests appropriate treatment •Prompts research into its causes

Rates of Psychological Disorders

•Psychological disorder rates vary, depending on the time and place of the survey •Poverty is a risk factor

the effects of labeling: Advantages

•Treatment implications for different disorders •Easier communication between researchers •Useful in establishing categories for research

Update: Psychodynamic Therapy techniques

•client-centered face-to-face meetings •exploration of past relationship troubles to understand origins of current difficulties

Humanistic Therapy techniques

•client-centered therapy (non-directive) •focus on taking responsibility for feelings and actions, and on present and future rather than past •active listening •unconditional positive regard

Psychoanalysis

•to bring patients' repressed feelings into conscious awareness •to help patients release energy devoted to id-ego-superego conflicts so they may achieve healthier, less anxious lives.

Update: Psychodynamic Therapy goals

•to help people understand current symptoms •to explore and gain perspective on defended-against thoughts and feelings

Humanistic Therapy goals

•to reduce inner conflicts that interfere with natural development and growth •to help clients grow in self-awareness and self-acceptance promoting personal growth

depression

A prolonged feeling of helplessness, hopelessness, and sadness

DSM-5

American Psychiatric Association-Fifth edition - Describes disorders and estimates their occurrence

Findings that any theory of depression must explain

Behaviors and thoughts change with depression. Depression is widespread. Women's risk of major depression is nearly double men's. Most major depressive episodes end on their own. Stressful events related to work, marriage, and close relationships often precede depression. With each new generation, depression is striking earlier in life and affecting more people.

natural selection

Biological preparedness to fear threats-easily conditioned and difficult to extinguish

The depressed brain

Brain activity slows during depression Left frontal lobe less active Scarcity of norepinephrine and serotonin

Understanding Schizophrenia Brain abnormalities

Brain chemistry Abnormal brain activity and anatomy

dissociative disorders

Conscious awareness becomes separated (dissociated) from previous memories, thoughts, and feelings

Psychological and social influences: Social-cognitive perspective

Depressed people view self and world negatively; Learned helplessness may exist with self-defeating beliefs, self-focused rumination, and self-blaming and pessimistic explanatory style

Post traumatic stress disorder (PTSD)

Is disorder characterized by haunting memories, nightmares, social withdrawal, jumpy anxiety, numbness of feeling, and/or insomnia lingering for four weeks or more after a traumatic experience

Are People With Psychological Disorders Dangerous?

Mental disorders seldom lead to violence and clinical prediction of violence is unreliable

signs and symptoms of major depression

Must include either pervasive depressed mood (verbal report) or pervasive loss of ability to experience pleasure or interest in other things (anhedonia). & at least 5 of other

Marcus is a young male recently diagnosed with schizophrenia. His symptoms, however, developed over a long period of time. According to the research available on schizophrenia, what are the chances that he will recover?

Not good; the slow progression of symptom development suggests he will probably never fully recover.

Phobias

Person experiences a persistent, irrational fear and avoidance of a specific object, activity, or situation

persistent depressive disorder

Person experiences mildly depressed mood more often than not for at least two years, along with at least two other symptoms.

Less common condition of bipolar disorder

Person experiences not only depression but also mania—impulsive behavior.

panic disorder

Person experiences sudden episodes of intense dread and often lives in fear of when the next attack might strike

_____ therapy evolved out of the classic psychoanalytic therapy.

Psychodynamic

Schizophrenia

Psychological disorder characterized by delusions, hallucinations, disorganized speech, and/or diminished, inappropriate emotional expression

Dissociative Identity Disorder

Rare dissociative disorder in which a person exhibits two or more distinct and alternating personalities •Formerly called multiple personality disorder

Changes in DSM-5

Some label changes, New or altered diagnoses, New categories

Classical Conditioning Techniques Aversive Conditioning goal

Substituting negative response for a positive response to a harmful stimulus; conditioning an aversion to something the person should avoid

DSM-5 Benefits

System helps mental health professionals communicate and is useful in research

the brain

Trauma linked to new fear pathways, hyperactive danger detection, impulse control and habitual behavior areas of brain

Classical Conditioning Techniques Aversive Conditioning technique

Unwanted behavior is associated with unpleasant feelings; ability to discriminate between aversive conditioning situation in therapy and all other situations can limit treatment effectiveness

Classical Conditioning Techniques counterconditioning

Uses classical conditioning to evoke new responses to stimuli that are triggering unwanted behaviors

Operant Conditioning Techniques issues

What happens when the rewards end? (practical) Is training people too authoritarian? (ethical)

psychological disorder

a clinically significant disturbance in an individual's cognition, emotion regulation, or behavior

behavior (schizophrenia)

a. Compulsive acts b. Catatonia c. Inappropriate affect

Speech (schizophrenia)

a. Loosening of associations b. Confabulation c. Poverty of content --Word salad

OCD is more common in

among teens and young adults than older people

Psychotherapy

an emotionally charged, confiding interaction between a trained therapist and someone who suffers from psychological difficulties 250+ types

Rates of depression

around the world, woman are more susceptible

PTSD happens more with

battle-scarred veterans (7.6 percent of combatants; 1.4 of noncombatants) and survivors of accidents, disasters, and violent and sexual assaults (two-thirds of prostitutes)

therapists uses classical and operant conditioning to change the person's behavior from maladaptive to adaptive

behavior therapists

The demographic landscape of cocaine use disorder was dramatically different in the early twentieth century than it is today. Then, cocaine was a legal stimulant contained in a variety of remedies, tonics, and other consumer products. Cocaine use disorder was seen most often in upper-middle-class women. The influence of cocaine's legal status on its disordered use is most consistent with the _____ model of psychological disorders.

biopsychosocial

Boris is a prolific painter. However, he is also prone to periods of hopelessness and depression, which are followed by periods of mania. It is MOST likely that Boris is suffering from _____ disorder.

bipolar

_____ disorder consists of states of sadness alternating with periods of overexcited hyperactivity.

bipolar

observing others

can contribute to development of some fears. Olsson and colleagues: Wild monkey research findings

Mimi works in a hospital psychiatric unit. She cares for a patient with schizophrenia who often stands motionless in a corner for several hours. This _____ usually ends abruptly and then the patient becomes quite agitated.

catatonia

Which symptom is NOT diagnostic of schizophrenia?

catatonia multiple personalities hallucinations delusions answer: multiple personalities

_____ is a behavior therapy procedure that uses classical conditioning to evoke new responses to stimuli that are triggering unwanted behaviors.

counterconditioning

Mr. James incorrectly believes that people are constantly laughing at him and that FBI agents are trying to steal his savings. Mr. James is demonstrating a false belief called a(n) _____.

delusion

Taresa feels that her life is empty. She has lost interest in career and hobbies, and she wonders if she would be better off dead. She is MOST likely suffering from a(n):

depressive

Social/Occupational Dysfunction

due to the disorder, the individual is having significant problems functioning socially/interpersonally and/or professionally/occupationally

Cognitive therapists are MOST likely to:

emphasize the importance of clients' personal interpretations of life events.

Brain chemistry

excess number of dopamine receptors

Dr. Barlow states that most individuals wish to become better people and that today's problems are more important than the experiences of the past. Dr. Barlow's beliefs are MOST consistent with _____ therapy.

humanistic

Person-centered therapy is a specific type of _____ therapy.

humanistic

cognitive-behavioral therapy (CBT)

integrative therapy that combines cognitive therapy (changing self-defeating thinking) with behavior therapy (changing behavior) •Aims to alter the way they act AND the way they think

_____ disorder consists of a prolonged state of hopeless sadness.

major depressive

_____ disorder is characterized by a person having repetitive thoughts that may lead to repetitive actions.

obsessive-compulsive

Years after he barely survived an attack that killed his wife and two children, Mr. Puskari suffers recurring flashbacks and frequent nightmares of the event. They render him incapable of holding a steady job. Mr. Puskari is MOST clearly showing signs of _____ disorder.

posttraumatic stress

therapists use free association and dream analysis to help people gain insight into unconscious origins of their disorders and release repressed feelings

psychoanalysis

Conflicts among the id, ego, and superego are a central concern in _____ therapy.

psychoanalytic therapy, but not psychodynamic

therapists use face to face sessions to analyze the person's conflicts and defenses in Current relationships

psychodynamic therapy

If a person exhibits a disturbance in thought, feeling, or action, they may have a(n) _____ disorder.

psychological

mania

refers to an excitable, hyperactive state present during bipolar disorder.

Operant Conditioning Techniques

reinforce desired behavior (token economy)

stimulus generalization

research demonstrates how a fearful event can later become a fear of similar events.

classical conditioning

research helps explain how panic-prone people associate anxiety with certain cues.

Interpretations and expectations

shape reactions (hypervigliance)

This occurs when a person experiences a fearful event and then transfers that fear to other, similar events.

stimulus generalization

Which therapy is NOT based on classical conditioning?

systematic desensitization exposure therapy a token economy aversion therapy answer: token economy

behavior therapy

therapy that applies learning principles to the elimination of unwanted behaviors

cognitive therapy

therapy that teaches people new, more adaptive ways of thinking and acting - just change the way you think

This is an operant conditioning procedure in which people earn a coin or a button of some sort for exhibiting a desired behavior and can later exchange these coins or buttons for various privileges or treats.

token economy

Which technique is an example of operant conditioning in behavior therapy?

token economy

PTSD is more common in

women

Conditioning and Anxiety Disorders

classical conditioning stimulus generalization reinforcement

John has been having difficulties getting out of bed, is not interested in going out with friends, and does not even answer the phone. He has let a number of bills go unpaid, he is sleeping 12 to 14 hours a day, and he cannot concentrate at work. He has called in sick to work at least once each week. John is MOST likely suffering from _____ disorder.

depressive

Thirty-year-old Nellie has been diagnosed with schizophrenia. Her selective attention is deficient, she is unable to ignore irrelevant stimuli, and she often gives her undivided attention to minute stimuli such as a spotlight shining in a window. This type of attention problem contributes to:

disorganized thoughts

Psychotic Symptoms (Positive)

1) hallucinations 2) delusions

DSM criteria for schizophrenia

2 or more for 1 month if untreated; - Delusions - Hallucinations - Disorganized speech - Disorganized behavior -Negative Sx (affect flat, avolition, alogia) - Social & Occupational Dysfunction - 6 months of continuous signs

Which psychologist is MOST likely to agree with the idea that dreams offer valuable clues to the unconscious mind?

Dr. Dominguez, a psychoanalytic therapist

genes

Genetic predisposition to anxiety, OCD, and PTSD

psychoanalysis technique

Historical reconstruction through: •hypnosis •free association •interpretation of resistance •transference

Biology and Anxiety disorders

genes, the brain, and natural selection

Michael complains that threatening voices are constantly telling him he is so evil he should kill himself. Michael is experiencing:

hallucinations

Historically there have been a variety of models used to explain psychological disorders. The _____ model assumes that mental disorders have physical causes that can be diagnosed and treated.

medical

Thirty-seven-year-old Steven is a single male who has suffered from depression all his life. He has been in treatment for the last week and a half and has begun taking an antidepressant. He is starting to feel better, but he is tired of living this way and does not want to face another depressive episode. In terms of risk factors for suicide, Steven is _____ likely to attempt suicide _____.

more; because his energy and initiative are rebounding

Marcus' twin brother and maternal grandmother both have previously been diagnosed with schizophrenia. This means that Marcus' risk for developing schizophrenia:

much higher than average

insight therapy

psychoanalysis & humanistic

Danger to self or others

significantly increased risk of suffering death, pain, or disability.

Walter has an intense fear of speaking in public. Because he can only engage in one-on-one discussions, he has been passed over for promotions. He may be suffering from _____ disorder.

social anxiety

Will has an intense fear of speaking in public. Because he can only engage in one-on-one discussions, he has been passed over for promotions. Will may be suffering from _____ disorder.

social anxiety

Amanda blames herself for her recent job loss. Her therapist suggests that her depression results from this blaming of herself rather than the slumping economy. Her therapist's suggestion BEST illustrates a:

social-cognitive perspective

According to the _____ model, mental illness needs to be cured through therapy

medical

Reinforcement

(operant conditioning) can help maintain a developed and generalized phobia.

DSM-5 Criticism

- Antisocial personality disorder and generalized anxiety disorder did poorly on field trials - DSM-5 contributes to pathologizing of everyday life - System labels are society's value judgments (homosexuality was once a disorder)

Abnormal brain activity and anatomy

- Problems with several brain regions and their interconnections - Low activity in frontal lobes - More rapid brain tissue loss

The Heritability of Various PsychologicalDisorders

- Risk increases if family member has disorder - twin studies data estimated heritability of major depression at 37 percent - Linkage analysis points to "chromosome neighborhood" - Many genes work together and produce interacting small effects that increase risk for depression

Diagnosis of Schizophrenia

- Signs of disturbance must last at least 6 months - Must affect social or occupational functioning

The police brought Corinne to the emergency room after she was seen running down the street in her underwear yelling that she has the power. Corinne was also spending large amounts of money across town and was rude and reckless over the last five days. In the emergency room, Corinne would not be quiet long enough for the nurse to ask her questions. Corinne is MOST likely suffering from _____ disorder.

bipolar

Susan's mother suffered from the flu during her pregnancy with Susan. Statistically, this increases Susan's risk of later developing schizophrenia. Maternal influenza is an example of a(n) _____ factor because it may influence the expression of a genetic predisposition to schizophrenia.

epigenetic

The study of environmental influences on gene expression is called _____.

epigenetics

Hallucinations

false sensory experiences, such as seeing something in the absence of an external visual stimulus

Subjective Distress

feeling unhappy, dissatisfied; life is not turning out the way one wants it and a change would be nice

Nancy's therapist is an active listener who often paraphrases what she says. He does not judge her and is quite open to her exploration of her weaknesses. He gives her appropriate validation and encourages her to reflect on her feelings. He wants to deepen her self-understanding. Her therapy is MOST likely:

humanistic

_____ therapy emphasizes people's inherent potential for self-fulfillment.

humanistic

therapist uses unconditional positive regard, genuineness, and empathy to help the person gain self-awareness and self-acceptance

humanistic therapists

Psychoanalysis LC

involves dream analysis and the analysis of past experiences in childhood; it attributes thoughts and actions to unconscious motives and conflicts.

"He is as slow as molasses" might be a good way to describe the energy level for people suffering from _____disorder.

major depressive

For the past four weeks, Odessa has been feeling lethargic and worthless. Her friends are worried because she no longer shows interest in her normal social activities. It is MOST likely that Odessa is suffering from: Please choose the correct answer from the following choices, and then select the submit answer button.

major depressive

Cognition and Anxiety Disorders

observing others and Interpretations and expectations

At some point in Don's life, he became one of those people who crossed the line from normal preoccupations and fussiness to his current debilitating condition known as _____ disorder.

obsessive-compulsive

In a residential treatment facility for troubled youth, adolescent children receive large colored buttons when they hang up their clothes, make their beds, and come to meals on time. The children return the buttons to staff members to receive bedtime snacks or television privileges.

operant conditioning

Central assumption

our thoughts play a causal role in our emotional reactions by serving as a mediator between environmental events and those reactions

Psychodynamic therapy is based on the premise that:

people unconsciously avoid issues that are painful.

Although Claude realizes his behavior is unreasonable, he is so distraught by high bridges that he avoids them and takes an unnecessarily lengthy route to and from work each day. Claude appears to suffer from a(n) _____.

phobia

Thirty-five-year-old Lucy needs to have her blood taken. She is so distraught by this that she must mentally prepare herself for it as well as take a short-acting sedative. Lucy seems to be suffering from:

phobia

_____ occurs when a person who is attacked by a fierce dog later develops a fear of all dogs.

stimulus generalization

Classical Conditioning Techniques Systematic desensitization

type of exposure therapy in which the patient learns to associate a pleasant, relaxed state with gradually increasing, anxiety-triggering stimuli •e.g., generate fear hierarchy, introduce progressive relaxation techniques

Symptom Patterns of schizophrenia (postive)

•Acute onset •Episodic •Symptoms respond to meds •More favorable prognosis

Humanism

Emphasis on potential for self-actualization

social-cognitive perspective

Explores how people's assumptions and expectations influence their perceptions - Self-defeating beliefs and negative explanatory style contribute - Views depression as an ongoing cycle of stressful experiences

Delusions

False beliefs that may accompany psychotic disorders

Sherry recognizes that depressed people do not exhibit the same self-serving bias common in nondepressed people. She is MOST likely a _____ therapist.

cognitive

therapists use dialogue with the client to identify irrational thoughts and unrealistic beliefs, then teaches the person to think in more adaptive ways

cognitive therapists

Aaron Beck's therapy teaches people new and more adaptive ways of thinking. It is based on the assumption that thoughts intervene between events and our emotional reactions, and is called:

cognitive therapy