Abnormal Final

Positive Symptoms of Schizophrenia TYPE 1 (most common 80%)

"Pathological access", or bizarre additions to a person's behavior. -Delusions, disorganized thinking, and speech, heightened perceptions and hallucinations, and inappropriate effect are the ones most often found in schizophrenia. - Delusions of percussion are most common (feeling like they're being spied on or watched) -Delusions of reference: they attach special and personal meaning to the actions of others or to various objects or events. - People with delusions of grandeur believe themselves to be great inventors, religious saviors, or other specially empowered persons. - delusions of control believe their feelings, thoughts, and actions are being controlled by other people. - loose association (derailment): most common thought disorder, goes from one topic to another rapidly - neologisms: made up words - preservations: repeat the same words over and over again - clang: rhyming words -Auditory hallucinations are the most common - Tactile hallucinations may take the form of tingling, burning, or electric shock sensations. -Somatic hallucinations feel as if something is happening inside the body, such as a snake crawling inside one's stomach. -Visual hallucinations may produce vague perceptions of colors or clouds or distinct visions of people or objects. -People with gustatory hallucinations regularly find that their food or drink tastes strange -people with olfactory hallucinations smell odors that no one else does, such as the smell of poison or smoke.

Effects of Community Treatment

- 40 to 60 percent of all people with schizophrenia and other severe mental disorders receive no treatment at all - Two factors are primarily responsible: poor coordination of services and a shortage of services. - 8 percent enter an alternative institution such as a nursing home or rest home - 18 percent are placed in privately run residences where supervision often is provided by untrained staff - 34 percent of people with schizophrenia and other severe disorders live in totally unsupervised settings

Effects of Second Generation Drugs

1 to 1.5 percent risk of developing agranulocytosis, a life-threatening drop in white blood cells - some of the second-generation antipsychotic drugs may cause weight gain, particularly among women; dizziness; metabolic problems; sexual dysfunctions; cardiovascular changes; and significant elevations in blood sugar

Illness Anxiety Disorder

A disorder in which people are chronically anxious about and preoccupied with the notion that they have or are developing a serious medical illness, despite the absence of somatic symptoms. - Previously known as hypochondriasis. -Theorists typically explain illness anxiety disorder much as they explain anxiety-related disorders. Cognitive-behavioral theorists, for example, believe (1) that the illness fears are acquired through classical conditioning or modeling, and (2) that people with the disorder are so sensitive to and threatened by bodily cues that they come to misinterpret them -People with illness anxiety disorder usually receive the kinds of treatments that are used to treat obsessive-compulsive disorder -Many clients also improve when treated with the cognitive-behavioral approach of exposure and response prevention

Somatic Symptom Disorder

A disorder in which people become excessively distressed, concerned, and anxious about bodily symptoms that they are experiencing, and their lives are greatly and disproportionately disrupted by the symptoms -Person experiences an unreasonable number of thoughts, feelings, and behavior regarding the nature or implications of the physical symptoms, including one of the following: (a) Repeated, excessive thoughts about their seriousness. (b) Continual high anxiety about their nature or health implications. (c) Disproportionate amounts of time and energy spent on the symptoms or their health implications.

Sexual Masochism Disorder

A paraphilic disorder characterized by repeated and intense sexual urges, fantasies, or behaviors that involve being humiliated, beaten, bound, or otherwise made to suffer. - appears in early childhood - built through classical conditioning

Sexual Sadism Disorder

A paraphilic disorder characterized by repeated and intense sexual urges, fantasies, or behaviors that involve inflicting suffering on others. - psychological or physical suffering of a victim sexually exciting

Frotteuristic Disorder

A paraphilic disorder consisting of repeated and intense sexual urges, fantasies, or behaviors that involve touching and rubbing against a non-consenting person - almost all males - begins in early teens to 25 years old - 30% of US - person believes they are in a relationship with the victim

Pedophilic Disorder

A paraphilic disorder in which a person has repeated and intense sexual urges or fantasies about watching, touching, or engaging in sexual acts with children, usually 13 years or younger, and either acts on these urges or experiences clinically significant distress or impairment - 16 years old at least, 5 years older than child - 2/3 victims are female - 90% are men with immature and distorted thinking - Some theorists have proposed that pedophilic disorder may be related to biochemical or brain structure abnormalities such as irregular patterns of activity in the amygdala or in the frontal areas of the brain Attraction classified by: - classic: prepubescent children - hebephelic: early prepubescent children - pedonebephilic: attracted to both

Alzheimer's Disease

A progressive and irreversible brain disorder characterized by gradual deterioration of memory, reasoning, language, and, finally, physical functioning - African Americans and Hispanic Americans are twice as likely as non-Hispanic white Americans to develop this disease - diabetes and cardiovascular diseases can heighten the risk - 11 percent of all people over 65 have Alzheimer's disease - 17 percent of them develop major depressive disorder

Delirum

A rapidly developing, acute disturbance in attention and orientation that makes it very difficult to concentrate and think in a clear and organized manner. - When elderly people enter a hospital, which represents a major change in their environment and routine, to be treated for a general medical condition, 10 percent of them show the symptoms of delirium - At least another 10 to 20 percent develop delirium during their stay in the hospital - That number rises to 23 percent among those admitted suddenly for acute surgery. Between 18 and 50 percent of elderly nursing home residents have some delirium

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

Personality Inventories

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.

GAD: The Sociocultural Perspective

According to this theory, GAD is most likely to develop in people faced with social conditions that truly are dangerous - One of the most powerful forms of societal stress is poverty Lower social economic status experience: -higher crime rates - fewer educational/job opportunities - more health problems

Biological Model (ch 3)

Adopting a medical perspective, biological theorists view abnormal behavior as an illness brought about by malfunctioning parts of the organism. Typically, they point to problems in brain anatomy, brain chemistry, and/or brain circuitry as the cause of such behavior. -Biological therapists use physical and chemical methods to help people overcome their psychological problems. -The leading methods are drug therapy, brain stimulation, and psychosurgery

Generalized Anxiety Disorder (ch 5)

An anxiety disorder in which a person is continually tense, apprehensive, and in a state of autonomic nervous system arousal "free floating anxiety" People with generalized anxiety disorder experience excessive anxiety and worry about a wide range of events and activities. - According to the sociocultural view, societal dangers, economic stress, or related racial and cultural pressures may create a climate in which cases of generalized anxiety disorder are more likely to develop. - In the original psychodynamic explanation, Freud said that generalized anxiety disorder may develop when anxiety is excessive and defense mechanisms break down and function poorly. Psychodynamic therapists use free association, interpretation, and related psychodynamic techniques to help people overcome this problem. -Humanists explanation believed that people with generalized anxiety disorder fail to receive unconditional positive regard from significant others during their childhood and so become overly critical of themselves. Treat such individuals with client-centered therapy. Cognitive Behavioral: believe that generalized anxiety disorder is caused by various maladaptive assumptions and/or inaccurate beliefs about the power and value of worrying. Cognitive-behavioral therapists help their clients to change their maladaptive thinking and/or dysfunctional uses of worrying. -6% develop it - Women diagnosed with this disorder outnumber men 2 to 1. - Non-Hispanic white Americans are more likely than members of minority groups to develop the disorder - Around 43 percent of people who have generalized anxiety disorder receive treatment for it

Acute Stress Disorder

An anxiety disorder in which fear and related symptoms are experienced soon after a traumatic event and last less than a month

Panic Disorder

An anxiety disorder marked by unpredictable minutes-long episodes of intense dread in which a person experiences terror and accompanying chest pain, choking, or other frightening sensations.

Treatment for Paraphillas

Antiandrogens: lower the production of testosterone, the male sex hormone, and reduce the sex drive - SSRIs, the serotonin-enhancing antidepressant medications, to treat people with paraphilic disorders, hoping that the SSRIs will reduce these compulsion-like sexual behaviors just as they help reduce other kinds of compulsions. In addition, a common effect of the SSRIs is to lower sexual arousal. - aversion therapy - covert sensitization: guided to imagine the pleasurable object and repeatedly to pair this image with an imagined aversive stimulus until the object of sexual pleasure is no longer desired - masturbatory satiation: the client masturbates to orgasm while fantasizing about a sexually appropriate object, then switches to fantasizing in detail about fetishistic objects while masturbating again and continues the fetishistic fantasy for an hour. The procedure is meant to produce a feeling of boredom, which in turn becomes linked to the fetishistic object.

Sociocultural Model

Argue that abnormal behavior is best understood in light of the social and cultural forces that influence an individual - address norms and roles in society One sociocultural perspective, the family-social perspective looks outward to three kinds of factors: social labels and roles, social connections and supports, and the family system. - Practitioners from the family-social model may practice group, family, or couple therapy, or community treatment. The multicultural perspective, another sociocultural perspective, holds that an individual's behavior, whether normal or abnormal, is best understood when examined in the light of his or her unique cultural context, including the values of that culture and the special external pressures faced by members of that culture. - Practitioners of this perspective may practice culture-sensitive therapies

Tricyclics

Around 50 to 60 percent of patients who take tricyclics are helped by them -If recovered individuals stop taking the drugs immediately after obtaining relief, they run a high risk of relapsing. As many as half of recovered patients who discontinue the drugs in this way relapse within a year - As a result, most clinicians now keep patients on antidepressant drugs for at least five months after being free of depressive symptoms, an extension called "continuation therapy" or "maintenance therapy." Research indicates that this approach decreases their chances of relapse -Soon after tricyclics were discovered, they started being prescribed more often than MAO inhibitors. Tricyclics did not require dietary restrictions as MAO inhibitors did, although they can produce significant side effects such as very dry mouth, constipation, and blurred vision. -Also on the positive side, people taking them typically showed higher rates of improvement than those taking MAO inhibitors.

Unipolar Depression Stats (ch 7)

Around 8 percent of adults in the United States suffer from a severe unipolar pattern of depression in any given year - Around 20 percent of all adults experience an episode of severe unipolar depression at some point in their lives - Women are at least twice as likely as men to have episodes of severe unipolar depression -As many as 26 percent of women have an episode at some time in their lives, compared with 12 percent of men (onset is 19) -Approximately 85 percent of people with unipolar depression, including severe depression, recover within 6 months, some without treatment. More than half of those who recover from severe depression have at least one other episode later in their lives

Community Centers

Assertive community treatment: need medication, psychotherapy, help in handling daily pressures and responsibilities, guidance in making decisions, social skills training, residential supervision, and vocational counseling Community Health Centers: treatment facilities that would supply medication, psychotherapy, and inpatient emergency care to people with severe disturbances, as well as coordinate the services offered by other community agencies. When community mental health centers are available and do provide these services, patients with schizophrenia and other severe disorders often make significant progress

Second Generation (atypical)

Atypical initially because their biological operation differs from that of the first-generation antipsychotic medications: the second-generation drugs are received at fewer dopamine D-2 receptors and more D-1, D-4, and serotonin receptors than the others -Second-generation antipsychotic drugs appear to be at least as effective, and often more effective, than the first-generation drugs -Clozapine is often the most effective such drug -Approximately 5 percent of patients who take second-generation antipsychotics for an extended time develop tardive dyskinesia (in contrast to 15 percent of those on the first-generation drugs). -This lower rate may be because the second-generation drugs are less likely to be received by D-2 receptors, the dopamine receptors that are particularly involved in the development of tardive dyskinesia

Psychomotor Symptoms of Schizophrenia

Awkward movements, repeated grimaces, odd gestures - catatonia - catatonic stupor: stop responding to their environment, remaining motionless and silent for long stretches of time. - catatonic rigidity maintain a rigid, upright posture for hours and resist efforts to be moved. Still others exhibit catatonic posturing, assuming awkward, bizarre positions for long periods of time. They may, for example, spend hours holding their arms out at a 90-degree angle or balancing in a squatting position. - catatonic excitement, a different form of catatonia, move excitedly, sometimes wildly waving their arms and legs. -10% experience this

Course of Schizophrenia

Begins in late teens and mid-30s - Prodromal Phase: symptoms are not yet obvious, but the person is beginning to deteriorate. - Active Phase: symptoms become apparent. Sometimes this phase is triggered by stress or trauma in the person's life Residual Phase: they return to a prodromal-like level of functioning. They may retain some negative symptoms, such as blunted emotion, but have a lessening of the striking symptoms of the active phase. -25% recover

Cognitive Approaches for Unipolar Depression

Behavioral Activation: A therapy for depression in which the client is guided to systematically increase the number of constructive and pleasurable activities and events in his or her life. - Cognitive-behavioral therapists reintroduce clients to events and activities that they once found pleasurable, reinforce nondepressive behaviors, teach interpersonal skills, and further help the clients identify and change their dysfunctional cognitions BECK: A therapy developed by Aaron Beck that helps people identify and change the maladaptive assumptions and ways of thinking that help cause their psychological disorders. -Maladaptive attitudes lead people repeatedly to view themselves, their world, and their future in negative ways—the so-called cognitive triad. Such biased views combine with illogical thinking to produce automatic thoughts, unrelentingly negative thoughts that flood the mind and produce the symptoms of depression. - follows 4 phases New Wave Cognitive Therapy: Acceptance and Commitment Therapy (ACT), use mindfulness training and other cognitive-behavioral techniques to help depressed clients recognize and accept their negative cognitions simply as streams of thinking that flow through their minds, rather than as valuable guides for behavior and decisions

Panic Disorder: The Cognitive Perspective

Biological factors are only part of the cause of panic attacks - Cognitive treatment is aimed at correcting misinterpretations - full panic reactions are experienced only by people who misinterpret bodily events Step 1: education on symptoms Step 2: Interpretations Step 3: Coping - suggest that panic-prone people become preoccupied with some of their bodily sensations, misinterpret them as signs of a medical catastrophe, have panic attacks, learn to display avoidance and safety behaviors that help control their bodily sensations, and in some cases develop panic disorder. - Cognitive-behavioral therapists teach clients to interpret their physical sensations more accurately and to cope better with anxiety

Explanation of Unipolar Depression

Biological: low activity of two neurotransmitters, norepinephrine and serotonin, are linked to depression. - Hormonal factors, the result of an HPA stress pathway that is overly reactive to stress, may also be at work. - Research has also tied depression to abnormalities in a circuit of brain structures, including the prefrontal cortex, hippocampus, amygdala, and subgenual cingulate. - Immune system dysregulation has also been linked to depression. - All such biological problems may be linked to genetic factors Cognitive-Behavioral: features explanations of depression that are primarily behavioral, primarily cognitive, or a combination of behavioral and cognitive principles. - On the behavioral side, the model says that when people experience a large reduction in their positive rewards in life, they may display fewer and fewer positive behaviors. This response leads to a still lower rate of positive rewards and eventually to depression. - On the cognitive side, Beck's theory of negative thinking holds that maladaptive attitudes, the cognitive triad, errors in thinking, and automatic thoughts help produce unipolar depression. - Also, learned helplessness theory, people become depressed when they believe that they have lost control over the reinforcements in their lives and when they attribute this loss to causes that are internal, global, and stable. Sociocultural: propose that unipolar depression is influenced by social and cultural factors. Family-social theorists point out that a low level of social support is often linked to unipolar depression. And multicultural theorists have noted that the character and prevalence of depression often vary by gender and sometimes by culture.

Voyeuristic Disorder

Characterized by repeated and intense sexual urges to observe people as they undress or engage in sexual activity or spy on couples having intercourse - the person may masturbate during the act of observing - the risk of discovery often adds to the excitement - often caused by witnessing a sexual act at a young age, usually 15

Treatment for Stress Disorders

Clinicians are now developing more effective treatment programs for people with acute and posttraumatic stress disorders—programs that com Dissociative identity disorder typically requires treatment. - Approaches commonly used to help people with dissociative amnesia recover their lost memories are psychodynamic therapy, hypnotic therapy, and sodium amobarbital or sodium pentobarbital. -Therapists who treat people with dissociative identity disorder use the same approaches and also try to help the clients recognize the nature and scope of their disorder, recover the gaps in their memory, and integrate their subpersonalities into one functional personality. Techniques used to treat the stress disorders include antidepressant drugs, cognitive-behavioral therapy (including exposure techniques), family therapy, and group therapy. - Rapidly mobilized community interventions often follow the principles of critical incident stress debriefing. Such approaches initially appeared helpful after large-scale disasters; however, recent studies have raised questions about their usefulness

Assessment (ch 4)

Collecting relevant information in an effort to reach a conclusion - Used to: determine how/why a person is behaving abnormally, identify how that person may be helped, and evaluate the treatment progress - Must be standardized, reliable, and valid. Most clinical assessment methods fall into three general categories: clinical interviews, tests, and observations. - A clinical interview may be either unstructured or structured. Types of clinical tests include projective, personality, response, psychophysiological, neurological, neuropsychological, and intelligence tests. - Types of observation include naturalistic observation, analog observation, or self-monitoring CLINICAL Assessment: used to determine whether, how, and why a person is behaving abnormally and how that person may be helped. It also enables clinicians to evaluate people's progress after they have been in treatment for a while and decide whether the treatment should be changed.

Factitious Disorder (ch 10)

Condition in which a person acts as if he or she has a physical or mental illness when he or she is not really sick. - go to the extreme to appear sick - Factitious disorder seems to be particularly common among people who (1) received extensive treatment for a medical problem as children (2) carry a grudge against the medical profession, (3) have worked as a nurse, laboratory technician, or medical aide - A number have poor social support, few enduring social relationships, and little family life -The precise causes of factitious disorder are not understood, although clinical reports have pointed to factors such as depression, unsupportive parental relationships during childhood, and extreme needs for attention and/or social support that are not otherwise available -factitious disorder imposed on another, known popularly as Munchausen syndrome by proxy, parents or caretakers make up or produce physical illnesses in their children

Bender Visual-Motor Gestalt Test

Consists of nine cards, each displaying a simple geometrical design. Patients look at the designs one at a time and copy each one onto a piece of paper. Later they try to redraw the designs from memory.

Schneidmann's ideas (ch 8)

Death Seeker: Clearly intend to end their lives at the time they attempt suicide Death Initiators: Intend to end their lives because they believe that the process of death is already underway - wanting to have control of their own fate - older/have illness Death Ignorer: Do not believe that their self-inflicted death will mean the end of their existence - goal to go to another place, "with god" Death Darer: Have ambivalent feelings about death and show this in the act itself - have attempts, but also seek help Subintentinal Death: A death in which the victim plays an indirect, hidden, partial, or unconscious role - drug/alcohol abuse

Paraphillas (ch 13)

Defined and brought to life by cultural norms. Some clinicians argue that except when people are hurt by them, many paraphillic behaviors should not be considered disorders at all - lasts 6 months - characterized by intense sexual urges, fantasies, or behavior that involves: nonhumans, children, non consenting adults, humiliation

Brain Stimulation

ECT: A treatment for depression in which electrodes attached to a patient's head send an electrical current through the brain, causing a seizure. Vagus Nerve: A treatment procedure for depression in which an implanted pulse generator sends regular electrical signals to a person's vagus nerve; the nerve, in turn, stimulates the brain. Transcranial Magnetic Stimulation: A treatment procedure for depression in which an implanted pulse generator sends regular electrical signals to a person's vagus nerve; the nerve, in turn, stimulates the brain. Deep Brain Stimulation: A treatment procedure for depression in which a pacemaker powers electrodes that have been implanted in the subgenual cingulate, thus stimulating that brain structure.

Durkheim's Sociocultural View of Suicide

EGOISTIC: Society has little/no control Altruistic: Sacrifice own lives for society's well-being ANOMIC: Social environment fails to provide stable structures for support/meaning

How are specific phobias treated?

EXPOSURE THERAPY - Systematic desensitization several types: - in vivo desensitization (live) - covert desensitization (imaginal) Flooding: exposure therapy all at once Modeling: watching the therapist interact with the stimulus

Depression Symptoms

Emotional: Most people who are depressed feel sad and dejected. They describe themselves as feeling "miserable," "empty," and "humiliated." They tend to lose their sense of humor, report getting little pleasure from anything, and in some cases display anhedonia, an inability to experience any pleasure at all. A number also experience anxiety, anger, or agitation. Motivational: lose the desire to pursue their usual activities. Almost all report a lack of drive, initiative, and spontaneity. They may have to force themselves to go to work, talk with friends, eat meals, or have sex. Behavioral: Depressed people are usually less active and less productive. They spend more time alone and may stay in bed for long periods. Cognitive: holding extremely negative views of themselves. They consider themselves inadequate, undesirable, inferior, perhaps even evil. They also blame themselves for nearly every unfortunate event, even things that have nothing to do with them, and they rarely credit themselves for positive achievements. PESSIMISM Physical: physical ailments as headaches, indigestion, constipation, dizzy spells, and general pain. Disturbances in appetite and sleep are particularly common

Persistent Depressive Disorder

Experience a mildly depressed mood more often than not for two or more years - significant distress - no history of mania - DSYTHYMIC

Neurocognitive Disorders

Experience a significant decline in at least one (often more than one) area of cognitive functioning, such as memory, attention, visual perception, planning and decision making, language ability, or social awareness - personality changes

OCD: The Behavioral Perspective

Exposure and Response Prevention (ERP) - clients are repeatedly exposed to anxiety provoking stimuli and are told to resist performing the compulsions - homework is an important component

Effects of First Generation (conventional)

Extrapyramidal Effects : mirror effects similar to Parkinson's, unwanted movements, such as severe shaking, bizarre-looking grimaces, twisting of the body, and extreme restlessness, sometimes produced by antipsychotic drugs. - late onset, unchangeable - The Parkinsonian and related symptoms seem to be the result of medication-induced reductions of dopamine activity in the striatum, the brain structure that coordinates movement and posture, among other functions

Cognitive Behavioral Model

Focuses on the behaviors people display and the thoughts they have. The model is also interested in the interplay between behaviors and thoughts—how behavior affects thinking and how thinking affects behavior. In addition, the model is concerned with the impact the behavior-cognition interplay often has on feelings and emotions. - Many of the model's basic concepts—stimulus, response, reward, attitude, and interpretation—can be observed or, at least, measured. - Proponents of the cognitive-behavioral model focus on maladaptive behaviors and cognitions to explain and treat psychological disorders. - On the behavioral dimension, the theorists hold that three types of conditioning—classical conditioning, modeling, and operant conditioning—account for behavior, whether normal or dysfunctional. Therapists try to replace problematic behaviors with more appropriate ones, using techniques based on one or more of the principles of learning. - On the cognitive dimension, theorists such as Aaron Beck further point to cognitive problems, like maladaptive assumptions and illogical thinking processes, to help explain a person's abnormal functioning. In treatment, therapists may try to help clients recognize, challenge, and change their problematic ways of thinking. - In addition to the traditional cognitive-behavioral approaches, a new wave of cognitive-behavioral therapies, such as acceptance and commitment therapy, try to teach clients to be mindful of and accept many of their problematic thoughts

Gender Dysphoria

For 6 months or more, individual's gender related feelings and/or behavior is at odds with those of their assigned gender - transwomen outnumber transmen 2:1 Most common patterns: - female to male - male to female: Androphilic type (stereotypically female from birth) - male to female: Autogyneophilic type (sterotypically masculine from birth)

Causes of Alzheimer's Disease

Formation of plaques or tangles in areas of the brain controlling memory or vital cognitive functioning Senile Plague: Sphere-shaped deposits of beta-amyloid protein that form in the spaces between certain brain cells and in certain blood vessels as people age. People with Alzheimer's disease have an excessive number of such plaques. Neurofibrillary tangles: twisted protein fibers found within the neurons of the hippocampus and certain other brain structures, also occur in all people as they age, but again people with Alzheimer's disease form an extraordinary number of them. - Abnormal activity by the beta-amyloid protein is key to the repeated formation of plaques. - Abnormal activity by another protein, tau, is key to the excessive formation of tangles. - One of the leading theories holds that the many plaques formed by beta-amyloid proteins also cause tau proteins within neurons to start breaking down, resulting in tangles and the death of many neurons - people who inherit ApoE-4, a particular form of the apolipoprotein E (ApoE) gene, are particularly vulnerable to the development of Alzheimer's disease. - Apparently, the ApoE-4 gene form promotes the excessive formation of beta-amyloid proteins, helping to spur the formation of plaques and, in turn, the breakdown of the tau protein, the formation of numerous tangles, the death of many neurons, and ultimately, the onset of Alzheimer's disease. - A number of other causes have also been proposed for this disease, including high levels of zinc, lead, or other toxins; immune system problems; and a virus of some kind.

Bipolar 1 Disorder

Have full manic and major depressive episodes. Most of them experience an alternation of the episodes; for example, weeks of mania followed by a period of wellness, followed in turn by an episode of depression. - Some, however, have mixed features, in which they display both manic and depressive symptoms within the same episode—for example, having racing thoughts amidst feelings of extreme sadness.

Humanistic-Existential Model

Humanist view: people are friendly, cooperative. - focus is on a drive to self-actualize - Therapist creates a supportive climate, unconditional positive regard, and accurate empathy - active listening is key - make people feel loved and worthwhile - The humanistic-existential model focuses on the human need to successfully deal with philosophical issues such as self-awareness, values, meaning, and choice. - Humanists believe that people are driven to self-actualize. When this drive is interfered with, abnormal behavior may result. One group of humanistic therapists, client-centered therapists, tries to create a very supportive therapy climate in which people can look at themselves honestly and acceptingly, thus opening the door to self-actualization. - Existentialists, abnormal behavior results from hiding from life's responsibilities. Existential therapists encourage people to accept responsibility for their lives, recognize their freedom to choose a different course, and choose to live with greater meaning

Disorder 2 Disorder

Hypomanic (mildly manic) episodes alternate with major depressive episodes over the course of time. Some people with this pattern accomplish huge amounts of work during their mild manic periods.

Neuroleptic Malignant Syndrome

In as many as 1 percent of patients, particularly those who are elderly, first-generation antipsychotic drugs produce neuroleptic malignant syndrome, a severe, potentially fatal reaction consisting of muscle rigidity, fever, altered consciousness, and improper functioning of the autonomic nervous system

Selective Serotonin Reuptake Inhibitors (SSRI)

Increase serotonin activity specifically, without affecting norepinephrine or other neurotransmitters. - The SSRIs include fluoxetine (Prozac), sertraline (Zoloft), and escitalopram (Lexapro). - Other second-generation antidepressants are selective norepinephrine reuptake inhibitors (such as atomoxetine, or Strattera), which increase norepinephrine activity only, and serotonin-norepinephrine reuptake inhibitors (such as venlafaxine, or Effexor), which increase both serotonin and norepinephrine activity. - They do not produce as many undesired effects as MAO inhibitors or tricyclics. At the same time, these relatively newer antidepressants can produce significant side effects of their own. -Some people gain weight, feel drowsy, or have a reduced sex drive, for example

Exhibitionistic Disorder

Intense sexual arousal from exposure of one's genitals to an unsuspecting person in a public setting ("flasher", "streaker") - sexual contact is rarely initiated nor desired - "recurrent" 3 or more victims over 6+ months - begins before 18, most common in male

Tardive Dyskinesia

It is believed that more than 15 percent of the people who take first-generation antipsychotic drugs, especially the most powerful ones, for an extended time develop tardive dyskinesia to some degree, and the longer the drugs are taken, the higher the risk becomes - Patients over 50 years of age are at greater risk, perhaps 3 to 5 times the risk of younger patients. -the problem is related to the drugs' effect on dopamine receptors in the striatum, particularly the D-2 receptors

GAD: The Cognitive Perspective (Intolerance of Uncertainty Theory)

It is unacceptable of some people that negative events may occur - worry is an attempt to find "correct solutions"

Depersonalized-Derealization Disorder

Its central symptoms are persistent and recurrent episodes of depersonalization (the sense that one's own mental functioning or body are unreal or detached) and/or derealization (the sense that one's surroundings are unreal or detached).

Treatments for Bipolar

Lithium - mood stabilizers - 60% of people with mania are relieved with the drugs - Given the drugs' less powerful impact on depressive episodes, many clinicians use a combination of mood stabilizers and antidepressant drugs to treat bipolar depression, although research suggests that antidepressants may trigger manic episodes in some patients - many clinicians now use individual, group, or family therapy as an aid to mood stabilizing drugs

Halfway Houses

Living facilities that offer people with long-term mental health problems the opportunity to live in a structured, supportive environment while they are trying to reestablish employment and ties to family and friends -run by paraprofessionals - MILIEU THERAPY: emphasizes mutual support, resident responsibility, and self-government

Bipolar Explanations

Mania may be related to high norepinephrine activity along with a low level of serotonin activity. - Some researchers have also linked bipolar disorders to improper transport of ions back and forth between the outside and the inside of a neuron's membrane. - Still others have uncovered abnormalities in key brain structures. Genetic studies suggest that people may inherit a predisposition to these biological abnormalities - between 1 and 2.6% of all adults are suffering from a bipolar disorder at any given time - As many as 4% experiences one of the bipolar disorders at some time in their life. Bipolar disorders are equally common in women and men, but they are more common among people with low incomes than those with higher incomes - Identical twins of those with a bipolar disorder have a 40 to 70 percent likelihood of developing the same disorder, and fraternal twins, siblings, and other close relatives of such persons have a 5 to 10 percent likelihood, compared with the 1 to 2.6 percent prevalence rate in the general population

Major Depressive Disorder

Most common and severe experience of depression, including feelings of worthlessness, disturbances in bodily activities such as sleep, loss of interest, and inability to experience pleasure, persisting at least 2 weeks. For the same 2 weeks, person also experiences at least 3 or 4 of the following symptoms: - 5% weight loss in 2 weeks - sleep issues - reduction of concentration

GAD: The Cognitive Perspective (Metacognitive Theory)

Most problematic assumptions, involves worry about worry (metaworry)

How Subpersonalities Interact

Mutually Amnesic Relationships - sub personalities have no awareness of one another Mutually Cognizant Patterns - each sub personality is well aware of the rest One Way Amnesic Relationships - some personalities are aware, but isn't fully mutual - "co conscious" sub personalities (quiet observers) - most common Differ? dentifying Features - age, gender, race, family history, body language Abilities/preferences - knowledge, base, talents - food, language, writing, friends, music Physiological Response - blood pressure, allergies

Mild Neurocognitive Disorder

Neurocognitive disorder in which the decline in cognitive functioning is modest and does not interfere with the ability to be independent. - 47 million people with neurocognitive disorders around the world, with 4.6 million new cases emerging each year - Among people 65 years of age, the prevalence is around 1 to 2 percent, increasing to as much as 50 percent for those over the age of 85

OCD: The Cognitive Perspective

Neutralize thoughts with actions - be more depressed than others - have exceptionally high standards of conduct and morality - believe thoughts are equal to actions and are capable of bringing harm - believe that they can/should have perfect control over thoughts Obsessive-Compulsive Related Disorders: - hoarding - hair pulling - skin pulling - body dysmorphia

Transvestic Disorder

Paraphilia in which individuals, usually males, are sexually aroused or receive gratification by wearing clothing of the opposite sex. - heterosexual men - also known as cross-dressing - starts in early childhood - compensate for behavior by doing masculine jobs or activities

Thematic Apperception Test (TAT)

People who take the TAT are 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. -ambiguous stimulus, "write a story: -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.

Anorexia Nervosa (ch 11)

People with anorexia nervosa pursue extreme thinness and lose dangerous amounts of weight. - They may follow a pattern of restricting-type anorexia nervosa or binge-eating/purging-type anorexia nervosa. The central features of anorexia nervosa are a drive for thinness, intense fear of weight gain, and disturbed body perception and other cognitive disturbances. - People with this disorder develop various medical problems, particularly amenorrhea. - As many as 90 percent of all cases of anorexia nervosa occur among females. -Typically the disorder begins after a person who is slightly overweight or of normal weight has been on a diet

Bulima Nervosa

People with bulimia nervosa go on frequent eating binges and then force themselves to vomit or perform other inappropriate compensatory behaviors. - The binges are often in response to increasing tension and are followed by feelings of guilt and self-blame. -Compensatory behavior is at first reinforced by the temporary relief from uncomfortable feelings of fullness or the reduction of feelings of anxiety, self-disgust, and loss of control attached to bingeing. -Over time, however, sufferers generally feel disgusted with themselves, depressed, and guilty. -Some display a personality disorder. Around half are amenorrheic, a number develop dental problems, and some develop a potassium deficiency

Conversion Disorder

People with this disorder display physical symptoms that affect voluntary motor or sensory functioning, but the symptoms are inconsistent with known medical diseases -They have neurological-like symptoms—for example, paralysis, blindness, or loss of feeling—that have no neurological basis. Conversion disorder involves bodily symptoms that affect voluntary motor and sensory functions, but the symptoms are inconsistent with known medical diseases. Diagnosticians are sometimes able to distinguish conversion disorder from a "true" medical problem by observing oddities in the patient's medical picture. -In somatic symptom disorder, people become excessively distressed, concerned, and anxious about bodily symptoms that they are experiencing, and their lives - usually begins between late childhood and young adulthood; it is diagnosed at least twice as often in women as in men - It often appears suddenly, at times of extreme stress.

Social Anxiety Disorder

Persistent fear of 1 or more social situations in which the individual is exposed to possible scrutiny by others for 6+ months - avoidance of feared situations - experience severe and persistent anxiety about social or performance situations in which they may be scrutinized by others or be embarrassed. - Cognitive-behavioral theorists believe that the disorder is particularly likely to develop among people who hold certain dysfunctional social beliefs and expectations and learn to perform corresponding avoidance and safety behaviors. - Therapists who treat social anxiety disorder typically distinguish two components of this disorder: social fears and poor social skills. - They try to reduce social fears by drug therapy and/or cognitive-behavioral therapy (including exposure techniques). They may try to improve social skills by social skills training CAUSES: - unrealistically high social standards - views of oneself as unattractive and socially unskilled - beliefs that one is always in danger of behaving incompetently in social situations TWO COMPONENTS: 1) Overwhelming social fear - address fears behaviorally with exposure 2) Lack of social skills - social skills and assertiveness training have proved helpful

Phobias

Persistent fears of specific objects or situations for 6 months or more - when exposed to the object or situation, sufferers experience immediate fear - avoidance of the feared situation, significant distress or impairment Most common: - specific animals or insects - heights (acrophobia) - enclosed spaces (claustrophobia) - thunderstorms (brontophobia) - blood Behavioral evolutionary explanation: PREPAREDNESS: there is a species-specific biological predisposition to develop certain fears

Dissociative Identity Disorder (Multi-personality)

Person experiences a disruption to their identity, as reflected by atleast two separate personality states or experiences of possession - 15 to 100 personalities - One shows up more than the rest: HOST - NOT caused by substance or medical condition - late adolescence is the earliest it can develop (cant until 18) - significant abuse/trauma and distress - women are diagnosed 3x more than men

Psychodynamic model of abnormality

Psychodynamic theorists believe that an individual's behavior, whether normal or abnormal, is determined by underlying psychological forces. - They consider psychological conflicts to be rooted in early parent-child relationships and traumatic experiences. -The psychodynamic model was formulated by Sigmund Freud, who said that three dynamic forces—the id, ego, and superego—interact to produce thought, feeling, and behavior. - Other psychodynamic theories are self-theory and object relations theory. Psychodynamic therapists help people uncover past traumas and the inner conflicts that have resulted from them. They use a number of techniques, including free association and interpretations of psychological phenomena such as resistance, transference, and dreams. -The leading contemporary psychodynamic approaches include short-term psychodynamic therapies and relational psychoanalytic therapy. -Psychodynamic theories rest on the deterministic assumption that no symptom or behavior is "accidental": all behavior is determined by past experiences.

EEG (neurological tests)

Records brain waves, the electrical activity that takes place within the brain as a result of neurons firing. In an EEG, electrodes placed on the scalp send brain-wave impulses to a machine that records them.

Fetishistic Disorder

Recurrent intense sexual urges, sexually arousing fantasies or behaviors that involve the use of a nonliving object, often to the exclusion of all other stimuli - PARTIALISM: feet, hair, butt, and nothing else - NON LIVING: shoes, undies - TACTILE: leather, feathers, rope

MAO inhibitors

Stop the destruction of serotonin and norepinephrine -The result is a rise in the activity levels of these neurotransmitters, and, in turn, a reduction of depressive symptoms. - Approximately half of depressed patients who take MAO inhibitors are helped by them -When people who take MAO inhibitors eat foods containing the chemical tyramine—including such common foods as cheeses, bananas, and certain wines—their blood pressure rises dangerously -People on these drugs must stick to a rigid diet.

GAD: The Biological Perspective

Studies have in fact found that biological relatives of persons with generalized anxiety disorder are more likely than nonrelatives to have the disorder. - Approximately 15 percent of the relatives of people with the disorder display it themselves - most biological researchers now believe that dysfunction of the fear circuit underlies generalized anxiety disorder, they do not yet fully understand the fear circuit itself. -

Fight of Flight Response (ch 6)

Sympathetic nervous system: The nerve fibers of the autonomic nervous system that quicken the heartbeat and produce other changes experienced as arousal and fear. One of the two major routes by which the brain and body produce arousal and fear (induces fear) Parasympathetic: The nerve fibers of the autonomic nervous system that help return bodily processes to normal (calms down)

Negative Symptoms of Schizophrenia TYPE 2

Symptoms of schizophrenia that seem to be deficits in normal thought, emotions, or behaviors. - Poverty of speech, blunted and flat affect, loss of volition, and social withdrawal are commonly found in schizophrenia -Poverty of speech (alogia): a shortage of speech or speech context -Blunted/flat effect: person shows little or no emotions compared to others - avolition, or apathy, feeling drained of energy and of interest in normal goals and unable to start or follow through on a course of action. -

Antipsychotics drugs

The discovery of antipsychotic medications dates back to the 1940s, when researchers developed the first antihistamine drugs to combat allergies. - one group of antihistamines, phenothiazines, could also be used to help calm patients about to undergo surgery. After experimenting with several phenothiazine antihistamines and becoming most impressed with one called chlorpromazine - later called Thorazine - first generations drugs are called neuroleptic drugs because they mirror the effects of neuroleptic disorders -antipsychotic drugs reduce psychotic symptoms at least in part by blocking excessive activity of the neurotransmitter dopamine - reduce symptoms in around 70 percent of patients diagnosed with schizophrenia - people whose symptoms are largely positive generally have better rates of recovery from schizophrenia than those with predominantly negative symptoms

ID

The part of the personality containing inherited psychic energy, particularly sexual and aggressive instincts PLEASURE PRINCIPLE - Libido: psychic energy that fuels the life (sexual) instinct of the ID - Impulses operate according to the pleasure principle: they constantly strive for gratification. - Considered immature, simple, and childlike.

SUPER EGO

The part of the personality that represents conscience, morality, and social standards MORALITY PRINCIPLE - as children, we internalize, or unconsciously adopt, the values and norms of family and culture, evaluating ourselves with respect to them - governed by idealism - the EGO is a mediator between ID and SUPEREGO

EGO

The part of the personality that represents reason, good sense, and rational self control. REALITY PRINCIPLE - Develops at 6-8 months old, when we learn ID impulses can't always be satisfied -Governed by the reality principle: awareness that it is not always possible or acceptable to have all wants/desires met - responsible for satisfying impulses, but first assesses what is realistically

Dissociative Fugue

The sudden loss of memory for one's personal history, accompanied by an abrupt departure from home and the assumption of a new identity

PTSD and Stress Disorders

The symptoms of PTSD may begin either shortly after the traumatic event or months or years afterward - 25 percent of people with PTSD do not develop a full clinical syndrome until 6 months or more after their trauma - Person displays conspicuous changes in arousal or reactivity, such as excessive alertness, extreme startle responses, or sleep disturbances. - Many endure symptoms of dissociation, or psychological separation: that is, they feel dazed, have trouble remembering things, experience depersonalization (feeling that their conscious state or body is unreal), or have a sense of derealization (feeling that the environment is unreal or strange). 7 to 12 percent suffer from one of them during their lifetimes - Around half of these individuals seek treatment, but relatively few do so when they first develop the disorder - Approximately 20 percent attempt suicide - People with stress disorders often develop other psychological disorders as well, such as depressive, anxiety, or substance use disorders - around 20 percent of women who are exposed to severe trauma may develop one, compared with 8 percent of men In attempting to explain why some people develop a psychological stress disorder and others do not, researchers have focused on biological factors (particularly, overly reactive brain-body stress pathways, a dysfunctional brain stress circuit, and an inherited predisposition), childhood experiences, personal styles, social support systems, and the severity and nature of traumatic events, as well as on how these factors may work together to produce such a disorder. -MULTI PRONG is the best treatment, combatted in multiple ways

Day Center

Today's day centers provide patients with daily supervised activities, therapy, and programs to improve social skills. People recovering from severe disorders in day centers often do better and have fewer relapses than those who spend extended periods in a hospital or in traditional outpatient therapy - semihospital, or residential crisis center. These are houses or other structures in the community that provide 24-hour nursing care for people with severe mental disorders. Many individuals who would otherwise be cared for in state hospitals are now being transferred to these semihospitals

Dissociative Amnesia

Unable to recall personal information, usually when stress is involved. THREE TYPES: Localized amnesia: The most common type of dissociative amnesia - a person loses all memory of events that took place within a limited period of time, almost always beginning with some very disturbing occurrence. Selective: the second most common form of dissociative amnesia, remember some, but not all, events that took place during a period of time Generalized: the loss of memory extends back to times long before the upsetting period. In addition to forgetting battle-linked events, the soldier may not remember events that occurred earlier in her life. Continuous: forgetting continues into the present. The soldier might forget new and ongoing experiences as well as what happened before and during the battle. 2% of adults experience in lifetime

GAD - Cognitive Perspective (Avoidance Theory)

Worry serves a "positive" function by reducing unusually high levels of bodily arousal"

Sheltered Workshop

a supervised workplace for employees who are not ready for competitive or complicated jobs. supported employment: vocational agencies and counselors help clients find competitive jobs in the community and provide psychological support while the clients are employed

OCD

an anxiety disorder characterized by unwanted repetitive thoughts (obsessions) and/or actions (compulsions) OBSESSIONS: thoughts that feel both intrusive and foreign. Attempts to ignore or resist them trigger anxiety - forms: wishes, impulses, images, ideas, doubts - common themes: dirt/contamination, violence/aggression, orderliness, religion, sexuality 20% have obsessions AND compulsions 80% have BOTH COMPULSIONS: "voluntary" behaviors or mental acts that feel mandatory/unstoppable - performing behaviors reduces anxiety, but ONLY FOR A SHORT TIME -behaviors often develop into rituals