Midterm 1

Chap 1:

*Abnormal psychology and Life*

Chapter 4

*Anxiety and Obsessive Compulsive and Related Disorders*

Chap 3:

*Diagnosis and Classification*

Chapter 6

*Disorders of Mood*

Chapter 5

*Disorders of Trauma and Stress*

Bipolar I disorder

*List specific symptoms*

Bipolar II disorder

*List specific symptoms*

Depersonalized/derealization disorder

*List specific symptoms*

Dissociative amnesia

*List specific symptoms*

Dissociative amnesia; fugue subtype

*List specific symptoms*

Dissociative identity disorder

*List specific symptoms*

cyclothymic disorder

*List specific symptoms*

Etiology (cause)

*OCD* -Biological perspective: abnormally low activity of the neurotransmitter serotonin/abnormal functioning in the orbitofrontal cortex and caudate nuclei -Psychodynamic perspective: children repeatedly feel the need to express their strong aggressive id impulses while at the same time knowing they should try to restrain and control the impulses. If this conflict between the id and ego continues, it may eventually blossom into obsessive-compulsive disorder. -Behavioral perspective: In a fearful situation, they happen just coincidentally to wash their hands, say, or dress a certain way. When the threat lifts, they link the improvement to that particular action. After repeated accidental associations, they believe that the action is bringing them good luck or actually changing the situation, and so they perform the same actions again and again in similar situations. -Cognitive perspective: People with OCD attempt to neutralize the disorder; when neutralizing efforts bring temporary reduction in discomfort, it is reinforced and will be repeated *Anxiety* -Biological perspective: Genetics/Low GABA activity -Psychodynamic perspective: the disorder can be traced to inadequacies in the early relationships between children and their parents -Cognitive perspective: maladaptive assumptions *Phobias* -Behavioral Perspective: Classical Conditioning; Two events that occur close together in time become strongly associated in a person's mind and the person then reacts similarly to both of them. If one event triggers a fear response, the other may also. *Panic Disorder* -Biological Perspective: Abnormal Norepinephrine activity -Cognitive Perspective: Cognitive theorists believe that panic-prone people may be very sensitive to certain bodily sensations; when they unexpectedly experience such sensations, they misinterpret them as signs of a medical catastrophe

Chap 2:

*Perspectives on Abnormal Psychology*

Chapter 7

*Suicide*

Biological treatment for Depressive and Bipolar disorders

-*Medication (antidepressants and mood stabilizers)*: 1.MAO inhibitors: originally used to treat TB. MAO inhibitors stop MAO from breaking down norepinephrine, leading to a rise in norepinephrine activity and a reduction in depressive symptoms. Can be dangerous because if you eat foods containing tyramine, it can cause a dangerous rise in blood pressure. 2.Tricyclics: Believed to reduce depression by affecting the neurotransmitter reuptake mechanisms. 3.Second-generation antidepressants: Prozac, Zoloft, Lexapro, ect. These drugs increase serotonin activity specifically. Clinicians prefer these drugs because it is harder to overdose on them. There are no dietary restrictions, can cause a reduction in sex drive. -*Electroconvulsive therapy (ECT)*: A treatment for depression in which electrodes attached to a patient's head send an electrical current through the brain, causing a convulsion -ECT works, but unsure why. Studies find 60-80% improvement in patients. This procedure seems particularly effective in cases of severe depression with delusions. -*Brain stimulation*: 1. Vagus nerve stimulation: Depression researches surmised they might be able to stimulate the brain by electrically stimulating the vagus nerve through the use of a pulse generator implanted under the skin of the chest. The procedure brings significant relief to as many as 40% of those with treatment-resistant depression. 2.Transcranial Magnetic Stimulation: found to reduce depression when administered daily for 2 to 4 weeks. 3.Deep Brain Stimulation: A treatment procedure for depression in which a pacemaker powers electrodes that have been implanted in Brodmann Area 25, thus stimulating that brain area.

Psychodynamic perspective

-*Perspective*: believe that a person's behavior, whether normal or abnormal, is determined largely by underlying psychological forces of which he or she is not consciously aware. -*Created by: Sigmund Freud* • early childhood experiences and unconscious conflict -*id, ego, and superego* -Id: term Freud used to denote instinctual needs, drives, and impulses. Pleasure. -Ego: According to Freud, the psychological force that employs reason and operates in accordance with the reality principle. -Ego Defense Mechanisms: The Ego develops basic strategies that controls unacceptable Id impulses. 1.Repression: avoiding anxiety by not allowing painful thoughts to become conscious. 2. Denial: Refusing to acknowledge existence of external source of anxiety. 3. Projection: Person attributes own unacceptable impulses, motives, or desires to other individuals. 4. Rationalization: Person creates socially acceptable reason for an action that reflects unacceptable motives. 5. Displacement: Person displaces hostility away from a dangerous object and onto a safer substitute. 6. Intellectualization: Person represses emotional reactions in favor of overly logical response to a problem. -Superego: According to Freud, the psychological force that represents a person's values and ideals. -*psychosexual stages/fixation* -Fixation: According to Freud, a condition in which the id, ego, and superego do not mature properly and are frozen at an early stage of development. -Oral Stage: First 18 months of life. -Anal stage: 18 months-3 years. -Phallic stage: 3 years - 5 years. -Latency stage: 5 years to 12 years. -Genital stage: 12 years to adulthood. • *dream analysis - manifest vs. latent content* -Manifest: the consciously remembered dream; -Latent: its symbolic meaning. • free association: A psychodynamic technique in which the patient describes any thought, feeling, or image that comes to mind, even if it seems unimportant. • resistance: An unconscious refusal to participate fully in therapy. • transference: According to psychodynamic theorists, the redirection toward the psychotherapist of feelings associated with important figures in a patient's life, now or in the past.

Biological Perspective

-*Perspective*: biological theorists view abnormal behavior as an illness brought about by malfunctioning parts of the organism. -*Brain Chemistry*: Biological researchers have learned that psychological disorders can be related to problems in the transmission of messages from neuron to neuron. Information is communicated throughout the brain in the form of electrical impulses that travel from one neuron to one or more others. An impulse is first received by a neuron's dendrites. From there it travels down the neuron's axon. Finally, it is transmitted through the nerve ending at the end of the axon to the dendrites of other neurons. A tiny space, called the synapse, separates one neuron from the next. When an electrical impulse reaches a neuron's ending, the nerve ending is stimulated to release a chemical, called a neurotransmitter, that travels across the synaptic space to receptors on the dendrites of the neighboring neurons. Some neurotransmitters give a message to receiving neurons to to trigger their own electrical impulse. Other neurotransmitters carry an inhibitory message; they tell receiving neurons to stop all firing. -*Genetics*: Abnormalities in brain anatomy or chemistry are sometimes the result of genetic inheritance. Studies suggest that inheritance also plays a part in mood disorders, schizophrenia, and other mental disorders. -*Drug Therapy*: In the 1950s, researchers discovered several effective psychotropic medications that mainly affect emotions and thought processes. These drugs have greatly changed the outlook for a number of mental disorders and today are used widely, either alone or with other forms of therapy. Four major psychotropic drug groups: -antianxiety: also called minor tranquilizers or anxiolytics, help reduce tension and anxiety; -antidepressant: help improve the mood of people who are depressed; -antibipolar: also called mood stabilizers, help steady the moods of those with a bipolar disorder, a condition marked by mood swings from mania to depression; and -antipsychotic drugs: drugs help reduce the confusion, hallucinations, and delusions of psychotic disorders, disorders (such as schizophrenia) marked by a loss of contact with reality.

Persistent Depressive Disorder (Dysthymia)

-A chronic form of unipolar depression marked by ongoing and repeated symptoms of either major or mild depression -Symptoms: 1.Person experiences the symptoms of Major Depressive Disorder or Dysthymic Disorder for at least 2 years. 2.During the 2-year period, symptoms not absent for more than 2 months at a time 3. No history of mania or hypomania 4. Significant distress or impairment

Body dysmorphic disorder

-A disorder in which individuals become preoccupied with the belief that they have certain defects or flaws in their physical appearance. Such defects or flaws are imagined or greatly exaggerated.

Premenstrual dysphoric disorder

-A disorder marked by repeated episodes of significant depression and related symptoms during the week before menstruation.

Specific Phobias

-A severe and persistent fear of a specific object or situation. 1. Marked, persistent, and disproportionate fear of a particular object or situation, usually lasting at least 6 months 2. Immediate fear is produced by exposure to object 3. Avoidance of the feared situation 4. Significant stress or impariement

Major depressive disorder

-A severe pattern of depression that is disabling and is not caused by such factors as drugs or a general medical condition. -Symptoms: 1. Presence of a major depressive episode 2. No pattern of mania or hypomania

Personality tests

-A test, designed to measure broad personality characteristics, consisting of statements about behaviors, beliefs, and feelings that people evaluate as either characteristic or uncharacteristic of them. • Minnesota Multiphasic Personality Inventory (MMPI-2): The MMPI consists of more than 500 self-statements, to be labeled "true," "false," or "cannot say."; Altogether the statements make up 10 clinical scales, on each of which an individual can score from 0 to 120. When people score above 70 on a scale, their functioning on that scale is considered deviant. -Scales: Hypochondriasis (bodily functions), Depression, Hysteria (unconsciously avoiding conflicts/responsibilities), Psychopathic deviate (disregard for social customs and emotional shallowness), Masculinity-femininity, Paranoia, Psychasthenia (obsessions), Schizophrenia, Hypomania, Social.

Panic Disorder

-An anxiety disorder marked by recurrent and unpredictable panic attacks.

Assessments

-Assessment: The process of collecting and interpreting relevant information about a client or research participant. -Clinical assessment: used to determine whether, how, and why a person is behaving abnormally and how that person may be helped. 1. Clinical interviews 2. Clinical test 3. Clinical observations

Psychological treatment for Depressive and Bipolar Disorders

-Behavioral therapy: Use a variety of strategies to help increase the number of rewards experienced by their clients by reintroducing clients to pleasurable activities and events by using a weekly schedule, appropriately reinforcing their depressive and non depressive behaviors, and by helping individuals improve their social skills. -Cognitive behavioural therapy -Cognitive therapy -Interpersonal therapy (IPT)

Etiology for Depressive and Bipolar disorders

-Biological (serotonin and dopamine) -Behavioral factors -Cognitive factors -Stress -Interpersonal issues -Family factors -Gender differences

Dissociative disorders

-Biological perspective for etiology and treatment -Environmental risk factors (trauma and culture) -Key goals of treatment

Humanistic Perspective

-Carl Rogers: Developed client-centered therapy -client centered therapy: The humanistic therapy developed by Carl Rogers in which clinicians try to help clients by conveying acceptance, accurate empathy, and genuineness -unconditional positive regard: We have a basic need to receive positive regard from important people in our lives. Those who receive unconditional (non-judgmental) positive regard early in life are likely to develop unconditional self-regard; meaning they come to recognize their self worth as persons. Children that are made to feel they are not worthy of positive regard grow to learn they can only be loved and accepted when they conform to certain guidelines.

Behavioral Perspective

-Classical Conditioning: A process of learning in which two events that repeatedly occur close together in time become fused in a person's mind and produce the same response. -Unconditioned stimulus -> Unconditioned response; Conditioned stimulus -> Conditioned response -Operant Conditioning: A process of learning in which behavior that leads to satisfying consequences is likely to be repeated. -Token economy: A token economy is a form of behavior modification designed to increase desirable behavior and decrease undesirable behavior with the use of tokens. -Systematic desensitization: A behavioral treatment in which clients with phobias learn to react calmly instead of with intense fear to the objects or situations they dread. -Modeling: A process of learning in which an individual acquires responses by observing and imitating others.

Stress

-Definition: -Stressor vs. Stress response -The physiological response to stress

4 D's

-Deviance: Different, extreme, Unusual -Distress: Unpleasant or upsetting to the person -Dysfunction: Interfering with person's daily life -Danger

Treatment options for PTSD and ASD

-Drug therapy -Exposure techniques (Eye movement desensitization and processing) -Cognitive therapy -Family therapy -Group therapy -Psychological debriefing

Behavioral treatment

-Exposure: Behavioral treatments in which persons are exposed to the objects or situations they dread. -Exposure and response prevention (ERP): A behavioral treatment for obsessive-compulsive disorder that exposes a client to anxiety-arousing thoughts or situations and then prevents the client from performing his or her compulsive acts. -Flooding: A treatment for phobias in which clients are exposed repeatedly and intensively to a feared object and made to see that it is actually harmless. -Systematic desensitization: A behavioral treatment that uses relaxation training and a fear hierarchy to help clients with phobias react calmly to the objects or situations they dread. -Modeling: A process of learning in which a person observes and then imitates others. Also, a therapy approach based on the same principle.

Postpartum depression

-For between 10 and 30 percent of new mothers, the weeks and months after childbirth bring clinical depression -Symptoms typically begin within 4 weeks and may last up to a year and include extreme sadness, despair, tearfulness, insomnia, anxiety, intrusive thoughts, compulsions, panic attacks, feelings of inability to cope, and suicidal thoughts.

Philppe Pinel

-French physician who worked to reform the treatment of people with mental disorder. -Believed patients were sick individuals who needed to be treated with kindness and sympathy.

Classification

-Kraepelin developed the first modern classification system for abnormal behavior called Diagnostic and Statistical Manual of Mental Disorders (DSM).

DSM-5

-Lists more than 500 mental disorders. Each entry describes the criteria for diagnosing the disorder and the key clinical features of the disorder. -Categorical: First, the clinician must decide whether the person is displaying one of the hundreds of psychological disorders listed in the manual. -Dimensional: displaying, diagnosticians assess the current severity of the client's disorder—that is, how much the symptoms impair the client.

Dorothea Dix

-Made humane care a public and political concern in the United States. -went from state legislature to state legislature and to Congress speaking of the horrors she had observed at asylums and calling for reform. Dix's campaign led to new laws and greater government funding to improve the treatment of people with mental disorders. -Each state was made responsible for developing effective state hospitals, all of which were intended to offer moral treatment.

Biological treatment

-Medication: *Anxiety*: benzodiazepines affect GABA activity *OCD*: antidepressant drugs that affect serotonin activity. *Panic*: Antidepressants and Benzodiazepines affect norepinephrine activity -Relaxation and breathing training: A treatment procedure that teaches clients to relax at will so they can calm themselves in stressful situations. -Biofeedback: therapists use electrical signals from the body to train people to control physiological processes such as heart rate or muscle tension. Clients are connected to a monitor that gives them continuous information about their bodily activities. By attending to the signals from the monitor, they may gradually learn to control even seemingly involuntary physiological processes.

Biological assessment

-Naturalistic: Clinicians observe clients in their everyday environments -Controlled: Observations in artificial setting like a office or lab. -self-monitoring: clients observe themselves

Hoarding Disorder

-People who display hoarding disorder feel that they must save items, and they become very distressed if they try to discard them -resulting in an extraordinary accumulation of items that clutters their lives and living areas; causes significant distress

Generalized Anxiety Disorder

-People with generalized anxiety disorder experience excessive anxiety under most circumstances and worry about practically anything. -Symptoms last at least 6 months -Dx Checklist: 1. For 6 months or more, person experiences disproportionate, uncontrollable, and ongoing anxiety and worry about multiple matters 2. The symptoms include at least three of the following: Edginess, fatigue, poor concentration, irritability, muscle tension, sleep problems 3. Significant distress or impairment

Panic Attack

-Periodic, short bouts of panic that occur suddenly, reach a peak within minutes, and gradually pass. 1. Unforseen panic attacks occur repeatedly 2. One or more of the attacks precedes either of the following symptoms: a) At last a month of continual concern about having additional attacks b) At least a month of dysfunctional behavior changes associated with the attacks

Rise of the asylum

-Private homes and community residences could only house a small number of individuals with mental illnesses, and hospitals were too small and there weren't enough, so the government began to convert monasteries and hospitals into asylums. -Began with good intentions, but when they began to overflow, they turned into prisons and patients were neglected.

Psychological Treatment

-Somatic control exercises -Cognitive therapy - examine and change maladaptive thoughts; reduce catastrophizing and misinterpretations -Biological challenge -Mindfulness based cognitive therapy

Automatic Nervous System (ANS)

-Sympathetic nervous system: "Fight or flight" -Parasympathetic nervous system: "Rest and digest" -Corticosteroids and the impact of cortisol

Acute and Post Tramatic Stress Disorders

-Symptoms -PTSD vs. ASD (differences in onset and duration) -Contributing factors (Neurochemical, neuroanatomy, genetics) -Personality -Childhood experiences -Social support -Culture and ethnicity -Triggers (Combat, disasters, victimization)

Response inventories

-Tests that measure a person's responses in one specific area of functioning, such as affect, social skills, or cognitive processes. -Beck's depression inventory: people rate their level of sadness and its effect on their functioning.

Neuropsychological assessment

-measure cognitive, perceptual, and motor performances on certain tasks; clinicians interpret abnormal performances as an indicator of an underlying brain problem. -Bender Gestalt Visual Motor Test: consists of nine cards, each displaying a simple geometrical design. Patients look at the designs one at a time and copy each one on a piece of paper. Later they try to redraw the designs from memory. Notable errors in accuracy by individuals older than 12 are thought to reflect organic brain impairment.

Diagnosis

A determination that a person's problems reflect a particular disorder.

William Tuke

A part of the reform movement. In 1796 he founded the York Retreat, a rural estate where about 30 mental patients lived as guests in quiet country houses and were treated with a combination of rest, talk, prayer, and manual work.

Community Mental health movement

A philosophy that believes in community care for people with severe psychological disturbances -too few community programs are available to address current needs in the United States

humors

According to the Greeks and Romans, bodily chemicals that influence mental and physical functioning. -yellow bile, black bile, blood, and phlegm

Validity

Accuracy

Agoraphobia

Afraid of being in public places or situations where escape might be difficult or help unavailable, should they experience panic or become incapacitated. Begins in 20s or 30s. 1.7% of population experiences agoraphobia, women twice as frequently as men.

Experimental studies

An experiment is a research procedure in which a variable is manipulated and the manipulation's effect on another variable is observed.

Exorcism

Coaxing evil spirits to leave a person's body. Performed by a shaman, who recited prayers, pleaded with evil spirits, insulted evil spirits, have person drink bitter potions, and in extreme cases starved or whipped the person afflicted

Reliability

Consistency; assessments always yield similar results in same situations

Projective tests

Definition: A test consisting of ambiguous material that people interpret or respond to. • Rorschach Test: Inkblot test; Clinicians administer the "Rorschach," as it is commonly called, by presenting one inkblot card at a time and asking respondents what they see, what the inkblot seems to be, or what it reminds them of. Testers pay attention to the style of the responses: Do the clients view the design as a whole or see specific details? Do they focus on the blots or on the white spaces between them? • Thematic Apperception Test: Pictorial projective test; commonly shown 30 cards with black-and-white pictures of individuals in vague situations and are asked to make up a dramatic story about each card. They must tell what is happening in the picture, what led up to it, what the characters are feeling and thinking, and what the outcome of the situation will be; Clinicians who use the TAT believe that people always identify with one of the characters on each card. The stories are thought to reflect the individuals' own circumstances, needs, and emotions.

Depression vs. Mania

Depression: A low, sad state marked by significant levels of sadness, lack of energy, low self-worth, guilt, or related symptoms. Mania: the opposite of depression, is a state of breathless euphoria, or at least frenzied energy, in which people may have an exaggerated belief that the world is theirs for the taking.

Mass madness

During the middle ages. Large numbers of people apparently shared absurd false beliefs and imagined sights or sounds. -tarantism (also known as Saint Vitus' dance): groups of people would suddenly start to jump, dance, and go into convulsions because they were all convinced that they had been bitten and possessed by a tarantula, and they sought to cure their disorder by performing a dance called a tarantella. -lycanthropy: people thought they were possessed by wolves or other animals. They acted wolflike and imagined that fur was growing all over their bodies

Moral treatment

Emphasized moral guidance and humane and respectful treatment for individuals with mental illnesses.

Experimental vs. Control Group

Experimental group: In an experiment, the participants who are exposed to the independent variable under investigation. Control group: In an experiment, a group of participants who are not exposed to the independent variable.

Standardization

Follows the same procedure every time; sets up common steps to be followed whenever test is administered

Managed care

Health care coverage in which the insurance company largely controls the nature, scope, and cost of medical or psychological services.

Trephining

In which a stone instrument was used to cut away a circular section of the skull in order to treat hallucinations, or melancholia caused by evil spirits

Independent variable vs. Dependent variable

Independent variable: The variable in an experiment that is manipulated to determine whether it has an effect on another variable. Dependent variable: The variable in an experiment expected to change as the independent variable is manipulated.

Demonic possession and exorcism

Later societies also explained abnormal behavior by pointing to possession by demons. Egyptian, Chinese, and Hebrew writings all account for psychological deviance this way, and the Bible describes how an evil spirit from the Lord affected King Saul and how David pretended to be mad to convince his enemies that he was visited by divine forces.

Seasonal affective disorder

Major Depressive Disorder that only occurs during seasonal changes.

Reform movement

Movement that made an effort to change the way that people approached the mentally ill and improved the way that the mentally ill were treated. Its purpose was to emphasize treatment and rehabilitation.

obessive-compulsive disorder

Obsessions: Persistent thoughts, ideas, impulses, or images that seem to invade a person's consciousness Compulsions: Repetitive and rigid behaviors or mental acts that people feel they must perform in order to prevent or reduce anxiety -OCD: A disorder in which a person has recurrent and unwanted thoughts, a need to perform repetitive and rigid actions, or both. 1. Occurrence of repeated obsessions, compulsions, or both 2. The obsessions or compulsions take up considerable time 3. Significant distress or impairment

Is treatment effective?

People differ in their problems, personal styles, and motivations for therapy. Therapists differ in skill, experience, orientation, and personality. And therapies differ in theory, format, and setting. Because an individual's progress is influenced by all these factors and more, the findings of a particular study will not always apply to other clients and therapists.

Positive vs. Negative correlation

Positive correlation: When variables change the same way, their correlation is said to have a positive direction Negative correlation: the value of one variable increases as the value of the other variable decreases.

Emphasis on prevention

Rather than wait for psychological disorders to occur, many of today's community programs try to correct the social conditions that underlie psychological problems (poverty or violence in the community, for example) and to help individuals who are at risk for developing emotional problems (for example, teenage mothers or the children of people with severe psychological disorders).

Correlational studies

The correlational method is a research procedure used to determine this "corelationship" between variables. This method can be used, for example, to answer the question, "Is there a correlation between the amount of stress in people's lives and the degree of depression they experience?"

Hippocrates

The father of modern medicine; Believed illness had natural causes and that abnormal behaviors equalled internal physical problems

Multicultural influences

The field that examines the impact of culture, race, ethnicity, and gender on behaviors and thoughts and focuses on how such factors may influence the origin, nature, and treatment of abnormal behavior.

Deinstitutionalization

The practice, begun in the 1960s, of releasing hundreds of thousands of patients from public mental hospitals.

Abnormal Psychology

The scientific study of abnormal behavior undertaken to describe, predict, explain, and change abnormal patterns of functioning.

Somatogenic Perspective

The view that abnormal psychological functioning has physical causes.

Psychogenic Perspective

The view that the chief causes of abnormal functioning are psychological.

Evidence-based treatment

Therapy that has received clear research support for a particular disorder and has corresponding treatment guidelines.

Greco-Roman treatment options

Treat the underlying physical pathology. -EX) the excess of black bile underlying sadness could be reduced by a quiet life, a diet of vegetables, exercise, celibacy, and even bleeding.

Case study

a detailed description of a person's life and psychological problems. It describes the person's history, present circumstances, and symptoms. It may also include speculation about why the problems developed, and it may describe the person's treatment.

The Diathesis Stress Model

attempts to explain a disorder, or its trajectory, as the result of an interaction between a predispositional vulnerability and a stress caused by life experiences.

Longitudinal Study

researchers observe the same individuals on many occasions over a long period of time.

Epidemiological designs

reveal the incidence and prevalence of a disorder in a particular population.

Placebo

something that looks or tastes like real therapy but has none of its key ingredients.

Incidence

the number of new cases that emerge during a given period of time. A part of epidemiological studies.

Prevalance

the total number of cases in the population during a given period; prevalence includes both existing and new cases. A part of epidemiological studies.

No causation

there is no consistent relationship

Comorbid

when 2 or more disorders are present in the same individual they are said to be comorbid

Cognitive Perspective

• Aaron Beck: Proposed cognitive processes are at the center of behaviors, thoughts, and emotions and that we can best understand abnormal functioning by looking to cognition. -therapists help clients recognize the negative thoughts, biased interpretations, and errors in logic that dominate their thinking and, according to Beck, cause them to feel depressed. Therapists also guide clients to challenge their dysfunctional thoughts, try out new interpretations, and ultimately apply the new ways of thinking in their daily lives.

Socio-Cultural Perspective

• family systems perspective: A theory that views the family as a system of interacting parts whose interactions exhibit consistent patterns and unstated rules. o prevention strategies 1. primary: efforts to improve community attitudes and policies. Overall goal to prevent psychological disorders altogether. 2. secondary: Identifying and treating psychological disorders in early stages before they become serious. 3. tertiary: provide effective treatment as soon as possible so that moderate or severe disorders become long term problems. o culture sensitive therapy: Approaches that are designed to help address the unique issues faced by members of cultural minority groups. -A number of studies suggest that two features of treatment can increase a therapist's effectiveness with minority clients: (1) greater sensitivity to cultural issues and (2) inclusion of cultural morals and models in treatment, especially in therapies for children and adolescents • impact of gender: Women diagnosed with anxiety disorders at least twice as often. • low socioeconomic status (SES) at higher risk for psychopathology o Rosenhan's Study (1973) "On Being Sane in Insane Places": Eight normal people, actually colleagues of Rosenhan, presented themselves at various mental hospitals, complaining that they had been hearing voices say the words "empty," "hollow," and "thud." On the basis of this complaint alone, each was diagnosed as having schizophrenia and admitted. Moreover, the pseudopatients had a hard time convincing others that they were well once they had been given the diagnostic label. Their hospitalizations ranged from 7 to 52 days, even though they behaved normally and stopped reporting symptoms as soon as they were admitted. In addition, the label "schizophrenia" kept influencing the way the staff viewed and dealt with them. For example, one pseudopatient who paced the corridor out of boredom was, in clinical notes, described as "nervous". For their part, the pseudopatients came to feel powerless, invisible and bored.

Interview

• structured vs. unstructured -Structured: Prepared, mostly specific questions. Sometimes use published interview schedule - a standard set of questions designed for all interviews. -Unstructured: Open ended questions • mental status exam: a set of questions and observations that systematically evaluate the client's awareness, orientation with regard to time and place, attention span, memory, judgment and insight, thought content and processes, mood, and appearance. • aspects to note in an interview: appearance, behavior, mood and affect, cognition, orientation (oriented x3 = time, place, and person)