Abnormal Psychology Test !

Mood & Affect

Mood is the predominant feeling state of the individual Affect- the feeling state that accompanies what we say at any given point. Can be appropriate, inappropriate or flat

Anxiety

Mood state characterized by marked negative affect and bodily symptoms of tension in which a person apprehensively anticipates future danger or misfortune. Anxiety may involve feelings, behaviors, and physiological responses.Difficult to study in humans, most testing done on animals. Closely related to depression. Good for us in moderate amounts, we perform better when we are the right amount of anxious. Anxiety is a future oriented mood state Howard Liddell anxiety as the "shadow of intelligence" the human ability to plan in some detail for the future was connected to that gnawing feeling that things could go wrong and we had be better prepared for them

Charles VI

"The Mad King" French King went insane and killed several members of his court, people believed this was due to some sort of outside evil power

Possible Pathways of Social Anxiety Disorder

1. Someone could inherit a generalized biological vulnerability to develop anxiety, a biological tendency to be socially inhibited, or both, the existence of a generalized psychological vulnerability such as the belief that events, particularly stressful events are potentially uncontrollable would increase their vulnerability 2. When under stress, someone might have an unexpected panic attack in a social situation that would become associated (conditioned) to social cues 3. Someone might experience a real social trauma resulting in a true alarm. early adolescence usually ages 12-15 is when children may be brutally taunted by peers who are attempting to assert their own dominance 92% of adults with social phobia in a research experiment experience severe teasing and bullying in childhood compared to only 35-50% among people with different anxiety disorders another factor→ the individual with the vulnerabilities and experiences previously described must also have learned growing up that social evaluation in particular can be dangerous, creating a specific psychological vulnerability to develop social anxiety

RIghts of Research Participants

1. The right to be informed about the purpose of the research study 2. The right to privacy 3. The right to be treated with respect and dignity 4. The right to be protected from physical/mental harm 5. The right to choose to participate or to refuse to participate without prejudice or reprisals 6. The right to anonymity in the reporting of results 7. The right to the safeguarding of their records informed consent→ formal agreement by the subject to participate after being fully apprised of all important aspects of the study including any possibility of harm Greg Aller 1988→ at UCLA Neuropsychiatric Institute participated in a study of people developing schizophrenia→ received medical tx and then assessed the withdrawals of medication→ Aller improved with meds and family was hesitant for 2nd phase in which the meds were removed→ grew considerably worse

Anna O.

1895 was a bright, attractive young woman who was perfectly healthy until she was 21. Shortly before her problems began, her father developed a chronic illness that led to his death in which Anna cared for him, spending endless hours at his bedside & she started to notice that during the day her vision would start blurring and from time to time she had difficulty moving her right arm & both legs→ soon began difficulty speaking & experienced unpredictable behavior By "talking through" each symptom one at a time, her "hysterical" ailments disappeared, but only after treatment was administered for each respective behavior

Development of Biological Treatments

1930s electro shock therapy & brain surgery were often used Insulin shock therapy used to induce convulsions in patients, many recovered their mental health but many others died or became comatose Electroconvulsive therapy→ Hungarian physician Jospeh von Meduna in the 1920s suggested that induced brain seizures could cure schizophrenia, 6 small shocks delivered to the brain has been known to cure patients 1950s→ use of sedative medicines were employed • fauwolfia serpentine (reserpine) & neuroleptics, and benzodiazepines Hallucinatory and delusional symptoms could be reduced in patients the first time

B.F. Skinner & Operant Conditioning

1938 Behavior of Organisms operant conditioning→ a type of learning in which behavior changes as a function of what follows the behavior Thorndike→ Law of Effect→ states that behavior is either strengthened (likely to occur more frequently) or weakened (likely to occur less frequently) depending on its consequences. Shaping→ a process of reinforcing successive approximations to a final behavior or set of behaviors

Conditioning & Cognitive Processes

1960's & 1970's behavioral scientists in animal labs began to uncover the complexity of the basic processes of classical conditioning & concluded that simply pairing two event closely in time is not what's important in this type of learning but rather a a combination of cognitive processes and judgments combine to determine the final outcome

DSM III/ DSMIII-R

1980 radically changed from 2 predecessors in 3 ways: attempted to take an atheoretical approach to dx, relying on precise descriptions of the disorders as they presented to clinicians rather than on psychoanalytic or biological theories of etiology The specificity and detail with which the criteria for identifying a disorder were listed made it possible to study their reliability and validity Allowed individuals with possible psychological disorders to be rated on 5 dimensions, or axes (multiaxial system) • the disorder itself was axis I axis II included what were thought to be more chronic disorders of personality axis III consisted of any physical disorders and conditions that might be present axis IV the clinician rated, in a dimensional fashion, the amount of psychosocial stress the person reported a AXIS V the current level of adaptive functioning

Genes & the Environment

1983 Eric Kandel→ the process of learning affects more than behavior; the very genetic structure of cells may change as a result of learning if genes that were inactive interact w/ the environment in such a way that they become active This type of mechanism could change the number of receptors at the end of a neuron and alter the biochemical functioning of the brain

Police Power

2 types of authority permit the government to take action against a person's will: police power & parents patriae. Police Power- the government takes responsibility for protecting the public health, safety, and welfare and can create laws and regulations to ensure this protection. Criminal offenders are held in custody if they are a threat to society.

Statistics of Panic Disorder/ Agoraphobia

2.7% of population meet criteria for PD during a given 1 year period & 4.7% at some point in their lives. 2/3 are women,probably attributed to cultural explanations many men turn to alcohol to cope 1.4% at some point during their lives develops agoraphobia without ever having a full blown panic attack onset usually occurs in early adult life (midteens - about 40 years old) median age of onset is between 20-24 prevalence of PD or comorbid PD & AG decreases among the elderly from 5.7% at ages 30-44 to 2% or less after age 60

DSM V

2013- similar to IV but some new disorders are introduced & others are modified. Other changes include The removal of the multiaxial system since the axes I, II, and III have been combined into the descriptions of the disorders themselves and clinicians can make a separate notion for relevant psychosocial or contextual factors (formerly axis IV) or extent of disability (formerly axis V) associated with Dx The use of dimensional axes for rating severity, intensity frequency, or duration of specific disorders in a relatively uniform manner across all disorders has also been substantially expanded in DSMV. DSMV introduces crosscutting dimensional symptom measures→ these assessments are not specific to any particular disorder but rather evaluate in a global sense important symptoms that are often present across disorders in all patients.

Statistics of General Anxiety Disorder

3.1% of the population meets criteria for GAD during a 1 year period & 5.7% at some point during their lifetime. Anxiety clinics like ours repost that only approx. 10% of their patients meet criteria for GAD compared with 30-50% for panic disorder 2/3 are female in clinical samples & epidemioglogical studies most studies find that GAD is associated with an earlier and more gradual onset than most other anxiety disorders, median onset is 31 found to be most common in the group over 45 years old and least common in the youngest group (15-24)

Nocturnal Panic

60% of people with PD have experienced nocturnal attacks (occur more often between 1-1:30 am)→ occur during delta/slow wave sleep which typically occurs several hrs after we fall asleep and is the deepest stage of sleep→ attack starts as they are sinking into delta sleep and awaken amid an attack Causes-the change in stages of sleep to slow wave sleep produced physical sensations of "letting go" that are frightening to an individual with panic disorder.

John P. Grey

Most influential American psychiatrist of the time. Held that the causes for insanity were always physical→ therefore, mentally ill patients Should be treated as physically ill→ conditions in hospitals improved and they became more humane institutions, however they became so large that individual treatment was often impossible

treatment of Specific Phobia

Mostly straightforward-require structured and consistent exposure-based exercises. Patients who expose themselves gradually to what they fear must be under therapeutic supervision. Brain-imaging has shows that after treatment, change occurs in brain functioning in an enduring way by modifying neural circuitry in such areas as the amygdala, insula, and cingulate cortex.

Idiographic Strategy

A close and detailed investigation of an individual emphasizing what makes that person unique

Tactics of Psychodynamic Psychotherapy

A focus on affect & the expression of patient's emotions An exploration of patients' attempts to avoid topics/hinder the progress of therapy The identification of patterns in patients' actions, thoughts, feelings, experiences, & relationships An emphasis on past experiences A focus on interpersonal experiences An emphasis no the therapeutic relationship An exploration of patients' wishes, dreams, or fantasies additional features: Significantly briefer than classical psychoanalysis Deemphasis the goal of personality reconstruction, focusing instead on relieving the suffering that is associated w/ psychological disorder

Trauma & Stress Related Disorders

A group of mental disorders distinguished by their origin in stressful events (e.g., traumatic experience, major life stressor, childhood neglect )include attachment disorders in childhood following inadequate/abusive child-rearing practices, adjustment disorders characterized by persistent anxiety and depression following a stressful life event & reactions to trauma such as PTSD and acute stress disorder A wider range of emotions—such as rage, horror, guilt, and shame in addition to fear & anxiety may be implicated in the onset

Disinhibited Social Engagement Disorder

A similar set of child rearing circumstances—perhaps including early persistent harsh punishment—would result in a pattern of behavior in which the child shows no inhibitions whatsoever to approaching adults

Research By Correlation

A statistical relationship between two variables Correlational designs are used to study phenomena just as they occur.Correlation does not imply causation Positive correlation→ the association b/w marital discord and child problems→ great strength or quantity in one variable is associated with great strength of quantity in the other variable Directionality→ which variable causes the effects

Clinical Efficacy Axis

One of a proposed set of guidelines for evaluating clinical interventions on the evidence of their effectiveness (compare with clinical utility axis).in order to determine this, clinical trials must establish whether the intervention is question is better than no therapy, better than a nonspecific therapy, or better than an alternative therapy by collecting systematic data, they can ascertain how many are "cured," how many improve somewhat w/out recovering, and how many fail to respond to the intervention→ quantified clinical observation/clinical replication series clinical consensus→ of leading experts is also a valuable source of info

Appearance & Behavior

ANy overt physical behavior such as dress, facial expression, posture, general appearance. Psychomotor retardation may indicate severe depression

Prepared Learning

Ability adaptive for evolution, allowing certain associations to be learned more readily than others. According to this concept, we have become highly prepared for learning about certain types of objects/situations over the course of evolution b/c this knowledge contributes to the survival of the species.

Testability

Ability of a hypothesis, for example, to be subjected to scientific scrutiny and to be accepted or rejected, a necessary condition for the hypothesis to be useful.

Self-Monitoring

Action by which clients observe and record their own behaviors as either an assessment of a problem and its change or a treatment procedure that makes them more aware of their responses. Also known as self-observation.

Supreme Court & Civil Commitment

Addington vs. Texas (1979) the Supreme court said that more than just a promise of improving QOL is required to commit someone involuntarily→ if nonviolent people can survive in the community without the help of others, they shouldn't be detained against their will→ substantially limited the government's ability to commit individuals unless they were dangerous 1957 Kenneth Donaldson was committed to FS hospital for treatment of paranoid schizophrenia→ not considered dangerous yet was continuously detained by Dr. O'Connor & virtually received no treatment for 15 years→ won $48,500 in lawsuit

Asylum Reform/ Decline of Moral Therapy

After mid-19th century, human treatment declined. After the Civil War, enormous waves of immigrants arrived in the US and increased pt loads in hospitals→ immigrants were thought not to deserve the same privileges as native-born Americans so they were not given moral treatments Dorothea Dix's mental hygiene movement- an unforeseen consequence of a substantial increase in the number of mental patients→ transition from moral therapy to custodial care.

Causes of Panic Disorder

Agoraphobia develops after an individual has unexpected panic attacks but whether it develops & how severe it becomes seems to be socially and culturally determined. PD seems to be strongly related to biological and psychological factors & their interaction Learned alarms-cues that become associated w/ a number of different internal & external stimuli through a learning process Research indicates that the development of PD is attributed greatly to generalized psychological vulnerability and generalized biological vulnerability David Clark emphasizes the specific psychological vulnerability of people with this disorder to interpret normal physical sensations in a catastrophic way.

Social Learning

Albert Bandura (1972, 1986)→ observed that organiss do not have to experience certain events in their environment to learn effectively→ can learn just as much from observing what happened to someone else in a given situation→ modeling/observation learning

Ego Psychology

Anna Freud, the concentration on how defense mechanisms determine behavior; the individual slowly accumulates adaptational capacities, skills in reality testing, and defenses.

Court-Ordered Assistant Outpatient Treatment (AOT)

Another route to civil commitment→ the person w/ severe mental illness agrees to receive treatment as a condition for continuing to live in the community in emergency situations of clear immediate danger, a short-term commitment can be made without formal proceedings required of a civil commitment

Guilty but Mentally Insane (GBMI)

One version allows the system to both treat and punish the individual. The person found guilty is given a prison term just as if there were no question of mental illness Second version convicted individuals are imprisoned, & prison authorities may provide mental health services if they are available→ the verdict itself is simply a declaration by the jury that the person was mentally ill at the time the crime was committed and doesn't result in differential treatment for the perpetrator (Idaho, Montana, Utah)

Agoraphobia

Anxiety about being in places or situations from which escape might be difficult in the event of unwanted physical symptoms (e.g., panic attack, incontinence, dizziness).o Coined in 1871 by Karl Westphal and in original greek refers to fear of the marketplace People with agoraphobia always plan for rapid escape Can be relatively independent of panic attacks Agoraphobic avoidance seems to be determined for the most part by the extent to which you think/expect you might have another attack rather than by how many attacks you actually have or how severe they are People avoid crowded, public places, can become individual of panic attacks.

General Anxiety Disorder

Anxiety disorder characterized by intense, uncontrollable, unfocused, chronic, and continuous worry that is distressing and unproductive, accompanied by additional symptoms such as tension, irritability, sleep difficulty, trouble concentrating and restlessness.

Panic Disorder

Anxiety disorder characterized by recurrent unexpected panic attacks and persistent worry about future attacks and/or lifestyle modification in response to attacks.

Obsessive Compulsive Disorder (OCD)

Anxiety disorder involving unwanted, persistent, intrusive thoughts and impulses, as well as repetitive actions intended to decrease anxiety the devastating culmination of the anxiety disorders. It is not uncommon for someone with OCD to experience severe generalized anxiety, recurrent panic attacks, debilitating avoidance & major depression, all occurring simultaneously with OCD symptoms.

Situational Phobia

Anxiety involving enclosed places (for example, claustrophobia) or public transportation (for example, fear of flying).Emerges in mid teens-20's, runs in families (30% of 1st degree relations share the phobia) never experience panic attacks outside the context of their phobic object/situation

Comorbidity of Anxiety & Related Disorders

Anxiety, panic & other disorders such as depression often co-occur demonstrating their related biological and psychological vulnerabilities/ common features. Disorders differ in what triggers the anxiety or panic. Comorbidity rates vary among disorders Study on DSM of mental disorders showed 55% of patients diagnosed with depression or anxiety also had an additional diagnosis of another depressive or anxiety disorder. Rate increased to 76% if it was for any point in the patients life and not just at the time of assessment. Most common disorder is major depression (50%)

Reliability in Diagnosis

Any system of classification should describe specific subgroups of symptoms that are clearly evident and can be readily identified by experienced clinicians. → one of the most unreliable categories in current classification is the area of personality disorders—chronic, trait-like sets of inappropriate behaviors and emotional reactions that characterize a person's way of interacting with the world.

Labeling & Stigma

Applying a name to a phenomenon or a pattern of behavior. The label may acquire negative connotations or be applied erroneously to the person rather than that person's behaviors. the label of a disorder associated with cognitive or behavioral impairment may have negative connotations and contributes to stigma→ a combination of stereotypic negative beliefs, prejudices, and attitudes resulting in reduced life opportunities for the devalued group in question, such as individuals with mental disorders

Analogue Models

Approach to research that employs subjects who are similar to clinical clients, allowing replication of a clinical problem under controlled conditions.

Behavior Therapy

Array of therapeutic methods based on the principles of behavioral and cognitive science, as well as principles of learning as applied to clinical problems. It considers specific behaviors rather than inferred conflicts as legitimate targets for change.

Arthur

Arthur's family was brought to the clinic by family members b/c he was speaking and acting strangely→ talking about secret plan to save all the starving children in the world→ planning to break into German embassy to present plan to ambassador→ couldn't admit him to a psychiatric hospital unless he was in danger of doing harm to himself or others → trying to balance the rights of people who have psychological disorders with the responsibilities of society to provide care

Statistics of Social Anxiety Disorder

As many as 12.1% of the population suffer from SAD at some point in life. In a given 1 year period the prevalence is 6.8% and 8.2% In adolescents. 2nd to specific phobia as the most prevalent anxiety disorder afflicting more than 35 million people in the US alone sex ratio is about 50:50 45.6% of people suffering from SAD sought professional help in a recent 12 month period usually begins in adolescence with a peak age of about 13 years pld. higher prevalence in those who are young (18-29), undereducated, single, and of low socioeconomic class. Less than half as prevalent in individuals Over 60 at a rate of 6.6% 13.6% prevalence rate in young people (18-29) more likely in White Americans than African Americans, Hispanics, and Asian americans. Russians and US samples have the highest rates and Asian cultures have the lowest Olfactory reference syndrome→ manifestation of the anxiety disorder in the Japanese disorder taijin kyofusho which is focused on offending/embarrassing others rather than embarrassing oneself through their body odor Japanese males outnumber women with this disorder 3:2

Neurological Testing

Assessment of brain and nervous system functioning by testing an individual's performance on behavioral tasks. Measure abilities in areas such as receptive and expressive language, attention and concentration, memory, motor skills, perceptual abilities and learning and abstraction

Classification

Assignment of objects or people to categories on the basis of shared characteristics.

Studying neurotransmitters

NT function focuses on when activity levels changes- can control the level of this change to see the effects • Agonists→ substances that effectively increase the activity of a NT by mimicking its effects Antagonist→ decrease/block a NT Inverse agonists→ that produce effects opposite to those produced by the NT Reuptake→ after a NT is released, it is quickly drawn back from the synaptic cleft into the same neuron • Monoamines & amino acids→ types of NTs; considered classic because they are synthesized in the nerve Monoamines→ Include norepinephrine, serotonin, & dopamine Amino acids→ GABA & glutamate

False Negatives/ False Positives

Negative- Assessment error in which no pathology is noted (that is, test results are negative) when one is actually present. Positive- Assessment error in which pathology is reported (that is, test results are positive) when none is actually present.

Norepinephrine

Neurotransmitter active in the central and peripheral nervous systems, controlling heart rate, blood pressure, and respiration, among other functions. Because of its role in the body's alarm reaction, it may also contribute generally and indirectly to panic attacks and other disorders. Stimulates 2 groups of receptors alpha-adrenergic & beta-adrenergic receptors→ a widely used class of drugs are called beta-blockers & are used in treating hypertension/difficulties regulating heartrate. These drugs block beta-receptors so that their response to a surge of NE is reduced, which keeps Blood pressure & heart rate down A major circuit of NE begins in the hindbrain which is known to control bodily functions such as respiration Another appears to influence the Emergency reactions or alarm responses that occur when we are in a dangerous situation

Serotonin

Neurotransmitter involved in processing of information and coordination of movement, as well as inhibition and restraint. It also assists in the regulation of eating, sexual, and aggressive behaviors, all of which may be involved in different psychological disorders. Its interaction with dopamine is implicated in schizophrenia 5HT→ 5-hydroxytryptamine. It is in the monoamine category of NTs along w/ NE and DE about 6 major circuits of 5HT spread from the midbrain, looping around its various parts. Believed to influence a great deal of our behavior, particularly the way we process info Regulates our behavior, moods, & thought processes. Low activity levels of 5HT are associated w/ less inhibition & instability, impulsivity & the tendency to overreact to situations Low activity has been associated w/ aggression, suicide, impulsive overeating, and excessive sexual behavior. Selective 5HT reuptake inhibitors (SSRIs)→ including fluoxetine (Prozac) affects 5HT more directly than other drugs, including the tricyclic antidepressants-→ used to treat a number of psychological disorders (anxiety, mood, & eating)

Dopamine

Neurotransmitter whose generalized function is to activate other neurotransmitters and to aid in exploratory and pleasure-seeking behaviors (thus balancing serotonin). A relative excess of dopamine is implicated in schizophrenia (although contradictory evidence suggests the connection is not simple), and its deficit is involved in Parkinson's disease.Research also implicates that it has a significant role in depression & ADHD DE circuits merge w/ 5HT circuits at many points and therefore influence many of the same behaviors. DE is associated w/ exploratory, outgoing, pleasure-seeking behaviors & 5HT is associated w/ inhibition & constraint→ balance each other in a sense Drugs that affect DE circuits→ L-dopa→ a DE agonist (increases levels) One of the systems DE switches on is the locomotor system , which regulates ability to move in a coordinated way & once turned on, is influenced by 5HT activity→ relations to Parkinson's disease 2 major DE pathways→mesolimbic system→ implicated in schizophrenia→ the path to the basal ganglia contributes to problems in the locomotor system

DSM Dimensions & Spectra

New findings on brain circuits, cognitive processes, and cultural factors that affect our behavior could date dx criteria relatively quickly. In addition to problems noted earlier w/ comorbidity & the fuzzy boundary b/w diagnostic categories, little evidence has emerged validating these categories, such as discovering specific underlying causes associated w/ each category→ not one biological marker, such as a lab test, that would clearly distinguish one disorder from another has been discovered. Even neuroscientists are abandoning the notion that groups of genes or brain circuits will be found that are specifically associated with DSM5 categories→ now assumed that neurobiological processes will be discovered that are associated with specific cognitive, emotional, and behavioral patterns/traits.

Incidence

Number of new cases of a disorder during a specific period

Prevalence

Number of people with a certain disorder in the total population at any time

Phenotype

Observable characteristics or behaviors of an individual. Knowledge of phenotypes of different psychological disorders exceeds that of genotypes

ABC's of Observation

Observational testing focuses on the present, the clinician looks at the immediate behavior, it's antecedents and it's consequences. Antecedents-Behavior-Consequence Informal observation→ clinician visited a patient at the house and observed child's behavior through interactions with his mother→ there are issues with this method because it relies on the observer's recollection, as well as interpretation, of the events Formal observation→ involves identifying specific behaviors that are observable and measurable (operational definition)

Body Dismorphic Disorder (BDD)

Obsessive-compulsive and related disorder featuring a disruptive preoccupation with some imagined defect in appearance ("imagined ugliness").

Neurosis

Obsolete psychodynamic term for a psychological disorder thought to result from an unconscious conflict and the anxiety it causes. Plural is neuroses.

Combining Psychological/ Drug Treatments

Because initial treatment often comes from primary care physicians whenhey are referred to psychological treatments they are already on meds In a study conducted by the National Institute of Mental Health there was a double-blind study in which patients were randomized into 5 treatment conditions: CBT, drug treatment (imipramine) alone, combined treatment condition, and 2 "control conditions" using one placebo alone and one using PBO and CBT→ the data indicated that all treatment groups responded significantly better than the placebo group but approx. the same amount of patients responded to both drug and psychological treatment→ combined treatment was no better than individual. After an additional 6 months of maintenance treatment results were almost the same except there was a slight advantage for combine treatment at this point & # of people responding to PBO had diminished. 6 months after treatment was discontinued, patients on meds whether combined with treatment or not had deteriorated somewhat and those receiving CBT w/out drug had maintained some of their gains. Benzos shown to disrupt psychological treatment & long term use associated with impaired cognitive functioning Studies suggest that psychological treatment should be offered initially followed by drug treatment for those who don't respond adequately or for whom psychological treatment is unavailable

Criminalization

Because of tightened restrictions that prevailed in the 60's and 70's, many people who would normally have been committed to mental health facilities for treatment were instead being handled by the criminal justice system

Other Ways to Observe Behavior

Behavior-rating scales→ assessment tools used before treatment and then periodically during treatment to assess changes in the person's behavior Brief Psychiatric Rating Scale→ assesses 18 general areas of concern. Each symptom is rated on a 7-point scale from 0 (not present) to 6 (extremely severe) Reactivity→ a phenomenon can distort any observational data, the mere presence of an observer can cause the individual to change their behavior

Judy's Reaction (fainting)

Behavioral influences→ her reaction (unconditioned response) became associated with situations similar to the scenes in the movie Biological influences→ 61% of people in the families of individuals with blood-injection-injury phobias have a similar condition Emotional influences→ emotions can affect physiological responses Social influences→ family & friends rushed to her side, principal dismissed it, -→ rejection, especially be authority figures can make psychological disorders worse than they otherwise would be → being supportive only at the site of symptoms can increase the frequency & intensity of the reaction Developmental influences→ the timing, the changes an individual undergoes as they develop and move through different stages of life Outcome- Judy had a brief stay at a clinic and returned to school in a week

Biological Tradition

Belief that psychological disorders are biologically caused, the mind can influence the body and the body can influence the mind

Types of Neurological Testing

Bender Visual Motor Gestalt Test→ a child is given a series of cards on which are drawn various lines and shapes→ the child is asked to copy what is drawn on the card→ errors made are compared to errors made by children of the same age group Luria-Nebraska Neuropsychological battery & Halstead-Reitan Neuropsychological battery→ advanced tests of organic damage that allow precise determinations of the location of the problem. Halstead-Reitan test includes the Rhythm Test→ asks a person to compare rhythmic beats, thus testing sound recognition, attention, and concentration. Strength of grip test Tactile performance test→ requires the test taker to place wooden blocks in a form board while blindfolded, thus testing learning and memory skills Research showed that these tests were about 80% correct

Treatments of General Anxiety Disorder

Benzodiazepines are most often prescribed for GAD (relief in short term) Therapeutic effect is relatively modest Risks: seem to impair both cognitive and motor functioning (falls and impaired driving) Produce both psychological and physiological dependence, difficulty to stop taking them. Encouraged for short term Treatment-stronger evidence for the usefulness of antidepressants such as paroxetine and venlafaxine Psychological treatments are better in the long term than drug treatments, treatments have been designed to help patients with GAD process the threatening information on an emotional level, using images, so that they will feel (rather than avoid feeling anxious) CBT in early '90s CBT shows to be effective in children

Electrodermal Responding

Bodily responses formally known as the galvanic skin response (GSR), which is a measure of sweat gland activity controlled by the PNS.

Delta Waves

Brain waves are slower and more irregular than the alpha waves, which occur s1-2 hours after a person falls asleep. If frequent delta wave activity occurred while the person was awake this could indicate dysfunction of localized areas of the brain

Human Genome Project

Ongoing scientific attempt to develop a comprehensive map of all human genes. Using advances in molecular scientists have created a rough draft of mapping 25,000 human genes Identified genes that contributed to inherited diseases.

Multiaxial System in DSM IV

Only personality disorders & intellectual disability were now coded on axis II. Pervasive developmental disorders, learning disorders, motor skill disorders, and comm disorders, previously coded on Axis II were now on axis I. Axis IV which rated the patients amount of psychosocial stress was not useful and was replaced with reporting psychosocial and environmental problems that might have an impact on the disorder

Sensorium

Our general awareness of our surroundings,from these observations, the clinician is able to make a preliminary determination of which areas of the pt's behavior & condition should be assessed in more detail. Occasionally, the problem reported by the patient may not be the major issue in the eyes of the clinician

Moon & Stars

Paracelsus ( Swiss physician) suggested that the movement of the moon & stars had effects on psychological functioning (where the word lunatic derives from)

Collective Unconscious

Carl Jung & Alfred Adler→ a wisdom stored deep in individual memories & passed down from generation to generation. Jung suggested that spiritual/religious drives are as much a part of human nature as are sexual drives Adler focused on feeling of inferiority & striving for superiority→ inferiority complex→ believed that the quality of human nature is positive & that there is a strong drive toward self-actualization

Nosology

Classification and naming system for medical and psychological phenomena.

Classical Categorical Approach

Classification method founded on the assumption of clear-cut differences among disorders, each with a different known cause. Also known as pure categorical approach. The causes could be psychological or cultural instead of pathophysiological, but there is still only one set of causative factors per disorder that doesn't overlap with other disorders. Only one set of defining criteria needed and patients must fall under this criteria to be considered a victim of a disorder Mental health field has not adopted this approach since there are believed to be many causes of disorders

Assessing Psychological Disorders

Clinician begins by collecting info across a broad range of the individual's functioning to determine where the source of the problem may be→ then he tries to narrow the focus by ruling out problems in some areas and concentrating on areas that seem most relevant 3 basic concepts help determine the value of clinician's assessments: reliability, validity, and standardization

Treatments of Social Anxiety Disorder

Cognitive therapy program developed by Clark and colleagues proved to be 84% effective in individuals receiving treatment & these results were maintained at a 1 year follow up. Superior to another treatment called interpersonal psychotherapy (IPT) Another treatment specifically targets the diff factors that are maintaining the disorder, one important reason why SAD is maintained in the presence of repeated exposure to social cues is because individuals with SAD engage in a variety of avoidance & safety behaviors to reduce the risk of rejection and prevent pt from critically evaluating their catastrophic beliefs about how embarrassed and foolish they will look if they attempt to interact w/ somebody Beta-blockers (drugs that lower HR and BP such as Inderal) work, particularly for performance anxiety → evidence disproved that this was an effective treatment Since 1999, the SSRIs Paxil, Zoloft, and Effexor have received approval from the Food and Drug Admin. For treatment of SAD Several studies indicate that adding the drug D-cycloserine (DCS) to CBTs significantly enhances the effects of treatment → research indicated that this dx works in the amygdala (a structure in the brain involved in the learning and unlearning of fear & anxiety) → facilitates extinction of anxiety by modifying NT flow in the glutamate system

Triple Vulnerability Theory

Combination of these diatheses contribute to anxiety: Generalized biological vulnerability- inherited tendency to be uptight or high strung, this alone not enough to produce anxiety Generalized psychological vulnerability- grow up thinking the world is dangerous, perception that things are out of your control and unable to cope based one early childhood experiences Specific psychological vulnerability- learning from early experience that certain situations are dangerous even if they are not.

Defense Mechanisms

Common pattern of behavior, often an adaptive coping style when it occurs in moderation, observed in response to a particular situation. Psychoanalytic theory suggests that defense mechanisms are unconscious processes originating in the ego.Developed more fully by Freud's daughter, Anna Other more severe internal conflicts that produce anxiety can cause elf-defeating defensive processes or symptoms such as phobic and obsessive symptoms which according to Freud, reflect an inadequate attempt to deal with such conflicts. Phobic symptoms typically incorporate elements of the conflict

Criticisms of DSM V

Comorbidity-individuals are often diagnosed with more than one psychological disorder at the same time Systems strongly emphasize reliability, sometimes at the expense of validity. Methods of constructing a nosology of mental disorders have a way of perpetuating definitions handed down to us from past decades, even if they are fundamentally flawed→ Carson makes the argument that it may be better to start fresh once in a while and create a new system of disorders based on emerging scientific knowledge

Competence to Stand Trial

Competence-Ability of legal defendants to participate in their own defense and understand the charges and the roles of the trial participants. Dusky v. US (1960) before people can be tried for a criminal offense they must be able to understand the charges against them and to assist with their own defense In addition to interpreting a person's state of mind during the criminal act, experts must also anticipate his state of mind during the subsequent legal proceedings Because a trial requires a determination of competence—most people with obvious and severe impairments who commit crimes are never tried Final issue relates to the legal concept of burden of proof→ weight of evidence needed to win a case

Psychoanalytic Theory

Complex and comprehensive theory originally advanced by Sigmund Freud that seeks to account for the development and structure of personality, as well as the origin of abnormal behavior, based primarily on inferred inner entities and forces.Most comprehensive theory yet constructed on the development and structure of our personalities The structure of the mind and the distinct functions of personality that sometimes clash with one another The defense mechanisms with which the mind defends itself from these conflicts The stages of psychosexual development that contribute to our inner conflicts

Components of Emotion

Composed of 3 related components→ behavior, physiology, & cognition→ most emotion scientists tend to concentrate on one component or another Emotion & behavior→ basic patterns of emotional behavior (freeze, escape, approach, attack) that differ in fundamental ways Emotional behavior is a means of comm Cognitive aspects of emotion-Appraisals, attributions, and other ways of processing the world around you that are fundamental to emotional experience Physiology of emotion (Cannon) Emotion is a brain function involving (generally) the more primitive brain areas Direct connection between these areas & the eyes may allow emotional processing to bypass the influence of higher cognitive processes

Clinical Utility Axis

Concerned with external validity, the extent to which an externally valid intervention is effective in diff settings or under diff circumstances form those where it was tested and how easily it can be disseminated and implemented in those settings an issue is generalizability → a tx can be highly effective as determined by the clinical efficacy axis but unless the treatments widely generalizable, feasible and cost effective, it is unlikely to be disseminated or implemented

Intrapsychic Conflicts

Conflicts within the mind

Glia Cells

Connect & insulate neurons, play active role in neural activity

Hippocrates

Considered the father of western medicine, wrote Hippocratic Corpus, suggested that psychological disorders could be treated like any other disease. Thought that disorders could be caused by pathogens or head trauma or be hereditary

Clinical Assessment Strategies

Consists of a number of strategies & procedures that help clinicians acquire the info they need to understand their pt.s and assist them Include: a clinical interview & w/in the context of the interview, a mental status exam that can be administered either formally or informally

Clinical Interviews

Consists of a number of strategies & procedures that help clinicians acquire the information needed to understand their patients and assist them Include: a clinical interview & within the context of the interview, a mental status exam that can be administered either formally or informally

Validity in Diagnosis

Construct validity→ the signs and symptoms chosen as criteria for the diagnostic category are consistently associated or "go together" and what they identify differs from other categories. Familial aggregation→ the extent to which the disorder would be found among the patient's relatives Predictive validity/criterion validity→ when the outcome is the criterion by which we judge the usefulness of the diagnostic category. The course of a disorder in a typical patient. Content validity→ which simply means that if you create criteria for a Dx of say, social phobia, it should reflect the way most experts in the field think of social phobia.

Structure of Neurons

Contains a cell body with 2 kinds of branches- dendrites that have numerous receptors that receive messages in the form of chemical impulses from other nerve cells, which are converted into electrical impulses. Axons transmit these impulses to other neurons The synaptic cleft is the space between the axon of one neuron and the dendrite of another in which chemical transmitters act to move impulses from one neuron to the next. Neurotransmitters are the biochemicals that are released to transmit an impulse between neurons

Midbrain

Contains parts of reticular activation system→ contributes to processes of arousal & tension such as whether we are awake or asleep

Psychodynamic Psychotherapy

Contemporary version of psychoanalysis that still emphasizes unconscious processes and conflicts but is briefer and more focused on specific problems.

Peripheral Nervous System

Coordinates with the brain to make sure the body is functioning properly. Made up of somatic & automatic nervous systems. Somatic controls muscle functioning while automatic regulates cardiovascular and endocrine systems in addition to digestion & body temperature (divided into sympathetic & parasympathetic systems) o Sympathetic → primarily responsible for mobilizing the body during times of stress/danger by rapidly activating the organs & glands under its control Parasympathetic→ one functions of this system is to balance the sympathetic system

Social & Cultural Considerations to DSM

Cultural formulation allows the disorder to be described from the perspective of the pt's personal experience and in terms of his or her primary social and cultural group. Cultural formulation interview will accomplish the following goals What is the primary reference group of the pt? New immigrants→ how involved are they with their new culture vs. their old one? Language acquisition? Does pt use terms from old country to describe disorder? Do they accept Western models of disease/disorder for which tx is available in health-care systems, or does the pt also have an alternative health care system in another culture What is means to be disabled to the individual, which are acceptable and which are not in their culture.

Clinical Description

DSM IV combined panic disorder/ agoraphobia.not all people who experience panic attacks necessarily develop panic disorder. to meet criteria for panic disorder, a person must experience an unexpected panic attack & develop substantial anxiety over the possibility of having another attack or about the implications of the attack or its consequences→ the person must think that each attack is a sign of impending death/incapacitation DSM-5 notes that agoraphobia may be characterized either by avoiding the situations or by enduring them w/ intense fear and anxiety. Approx. 50% of people with it have never had a panic attack or any fearful spells whatsoever → may have other distressing unpredictable experiences such as dizzy spells, possible loss of bladder/bowel control such that they can never be far from a bathroom or fear of falling most patients with panic disorder and agoraphobic avoidance also display another cluster of avoidant behaviors that are called interoceptive avoidance-avoidance of internal physical sensations, involve removing oneself from situations/activities that might produce the physiological arousal that somehow resembles the beginnings of a panic attack

Clinical Description of General Anxiety

DSM-5 criteria specifies that at least 6 mo. Of excessive anxiety & worry (apprehensive expectation) must be going on more days than not. Characterized by muscle tension, mental agitation, susceptibility to fatigue, some irritability, and difficulty sleeping. Focusing one's attention is difficult, the mind switches from crisis to crisis Mostly worry about minor, everyday life events (distinguishes GAD from other anxiety disorders such as panic which is characterized by autonomic arousal, sympathetic nervous system) Adults worry about misfortune/ responsibilities, children worry about competence

Reliability

Degree to which a measurement is consistent—for example, over time or among different raters. One way psychologists improve their reliability is by carefully designing their assessment devices and then conducting research on them to ensure that two or more raters will get the same answers→ interrater reliability Test-retest reliability- if an individual receives a certain score on a test one day then they should expect a similar score another day

Psychoanalytic Psychotherapy

Designed to reveal the nature of the unconscious mental processes through catharsis and insight

American Law Institute (ALI)

Developed criteria for determining whether a person's mental competence makes him answerable for criminal behavior Diminished Capacity-people's ability to understand the nature of their behavior and therefore their criminal intent can be diminished by their mental illness Mens rea→ "guilty mind" criminal intent

Minnesota Multiphsic Personality Inventory (MMPI)

Developed in the late 1930s and early 402 and first published in 1943 based on an empirical approach, the individual reads statements as True or False,little room for interpretation. Example of statement- cry readily, am being followed, happy for no reason etc. The individual responses are not evaluated, rather the pattern of responses is reviewed to see whether is resembles patterns form groups of people who have specific disorders Lie scale→ a statement might be used as an indication that the person may be falsifying the answers to look good Infrequency scale→ measures false claims about psychological problems/determines whether the person is answering randomly Subtle defensiveness scale→ accesses whether the person sees himself in unrealistically positive ways Problem with this is the time & tedium of answering over 500 questions- MMPI-A for adolescents. People answer in ways to downplay their problems

Selective Mutism

Developmental disorder characterized by the individual's consistent failure to speak in specific social situations despite speaking in other situations. To meet diagnostic criteria the lack of speech must occur for more than one month and cannot be limited to the first month of school High comorbidity rate between SM and anxiety disorders, particularly SAD About 0.5% of children diagnosed, girls more affected than boys Some evidence that well-meaning parents enable this by being more readily able to intervene and "do their talking for them" Treatment→ employs many of the same CBT used successfully to treat SAD in children but with greater emphasis on speech

Somatic Symptom Disorders

Disorders in which symptoms such as paralysis are the result of a problem for which no physical cause can be found. Ancient societies believed these were only prevalent in women and blamed them in a "wandering uterus"

Problems With IQ TEsts

Do not necessarily measure intelligence, rather the likelihood that an individual will succeed i our educational system. Other factors contribute to intelligence such as ability to retain information, create new ideas, ability to adapt to the environment etc.

Neurotransmitters & Psychopathology

Effects of NT on psychological disorders are not specific, Changes in NT activity may make people more or less likely to exhibit certain kinds of behavior in certain situations without causing the behavior directly Brain circuits interact so often that the affects have been hard to predict

Diagnosis Pre 1980

Emil Kraepelin- first identified what we now know as schizophrenia→ at the time called it dementia praecox→ refers to the deterioration of the brain that sometimes occurs with advancing age and develops earlier than it is supposed to, or "prematurely" 1913 Psychiatry: A Textbook for Students and Physicians described not only dementia praecox but also dipolar disorder, then called manic depressive psychosis & other organic brain syndromes 1948 WHO added a section classifying mental disorders to the 6th edition of the International Classification of Diseases and Related Health Problems (ICD) 1952 DSM published, that and the ICD did not have much influence 1968 the American Psychiatric Association published a second edition of its DSM 1969 WHO published the 8th edition of the IDC-these systems still lacked precision, often differing substantially from one another by relying heavily on unproven theories of etiology not widely accepted by all mental health pros. Late as 1970s→ many countries had their own version of nosology

Fear

Emotion of an immediate alarm reaction to present danger or life-threatening emergencies.Protects us by activating our autonomic nervous system in times of danger, is a response to present problems unlike anxiety Strong sympathetic nervous system arousal as opposed to anxiety which causes somatic symptoms of tension

Limbic System & Anxiety

Emotional part of the brain, mediates between brains stem & cortex. Brain stem monitors changes in bodily functions & relays these potential danger signals to the brain through the limbic system. People with anxiety have overactive limbic system. Gray pointed out the Behavioral inhibition system-Brain circuit in the limbic system that responds to threat signals by inhibiting activity and causing anxiety.Receives boost from amygdala

Post Traumatic Stress Disorder (PTSD)

Enduring, distressing emotional disorder that follows exposure to actual or threatened death, serious injury or sexual violation to self or others. The victim experiences the trauma, avoids stimuli associated with it, and develops a numbing of responsiveness and an increased vigilance and arousal for Americans, perhaps the most notorious traumatic events of this century have been the wars in Iraq & Afghanistan, the terrorist attacks on 9/11 or hurricanes → also, emotional disorders also occur after physical assault, car accidents, natural catastrophes, or the sudden death of a loved one

Epidemiological Research

Epidemiology-The study of the incidence, distribution, and consequences of a problem or set of problems in one or more populations Incidence-the estimated number of new cases during a specific period

Biological Contributions to Anxiety

Evidence shows that we inherit a tendency to be tense, uptight, & anxious,seems to be polygenic-genetic vulnerability also does not directly cause anxiety/panic Tendency to panic runs in families, slightly different genetic contribution than anxiety Stress and vulnerability factors combine with different combinations of genes. Anxiety also associated with several brain system & neurotransmitters Depleted levels of GABA Noradrenergic system→ Serotonergic NT system→ CRF (corticotrpin-releasing factor) and its activation of the HPA axis. Effects areas of the brain implicated in anxiety such as the emotional brain (limbic system), the hippocampus & amygdala particularly, the locus coeruleus in the brain stem, the prefrontal cortex, and the dopaminergic NT system

Separation Anxiety Disorder

Excessive, enduring fear that harm will come to oneself or a caregiving loved one when separated. 4.1% of children have SA at a severe enough level to meet criteria for a disorder. Recently discovered that if untreated an extend into adulthood in approx. 35% of cases. Occurs in Approximately 6.6% of the adult pop over the course of a lifetimeIn treatment, parents are often included to help structure the exercises and also to address parental reaction to childhood anxiety. Different than school phobia (related to a specific factor in school)

Treatments for Possession

Exorcisms, confinements, beating, torture, shock therapy, hydrotherapy, people hung over snake pits

Emotion Contagion

Experience of an emotion can spread to those around us

REsearch By Experiment

Experiment involves the manipulation of an independent variable and the observation of its effects→ we manipulate the independent variable to answer the question of causality

Freud & Breuner

Experimented with hypnosis in which they were asked to describe their problems, conflicts & fears. 2 phenomena occurred in patients- Became extremely emotional as they talked and felt relived and improved after returning form the hypnotic state. Gained an understanding of the relationship b/c their emotional problems and their psychological disorder Discovered the unconscious mind & its apparent influence on the production of psychological disorders Reliving emotional trauma can be therapeutic (catharsis- Rapid or sudden release of emotional tension thought to be an important factor in psychoanalytic therapy.)

Mental Health Professionals as Expert Witnesses

Expert witness-Person who because of special training and experience is allowed to offer opinion testimony in legal trials. Can help identify malingering (fake or exaggerate symptoms)

The Behavioral Model

Explanation of human behavior, including dysfunction, based on principles of learning and adaptation derived from experimental psychology.Also known as the cognitive behavioral model or social learning model

External Validity

Extent to which research findings generalize, or apply, to people and settings not involved in the study

Internal Validity

Extent to which the results of a study can be attributed to the independent variable after confounding alternative explanations have been ruled out.

Social Anxiety Disorder (Social Phobia)

Extreme, enduring, irrational fear and avoidance of social or performance situations.Performance anxiety is a subset of SAD

Natural Environment Phobia

Fear of situations or events in nature, especially heights, storms, and water. Have a peak age of onset of about 7 yrs. must be persistent to be a phobia (lasting at least 6 months) and interfere substantially with the person's functioning leading to avoidance of situations where they will encounter their phobia. Phobias often cluster together (deep water- storms etc.)

Cognitive Science

Field of study that examines how humans and other animals acquire, process, store, and retrieve information.

Brain Systems & Panic

Fight/ flight system- Brain circuit in animals that when stimulated causes an immediate alarm-and-escape response resembling human panic. distinct from BIS, originates in the brain stem and travels through several midbrain structures, including the amygdala, the ventromedial nucleus of the hypothalamus, and the central gray matter. Activated partially by serotonin deficiency ENvironmental factors change sensitivity of these circuits.

Images of Brain Structure

First was the X-ray CAT scan Computerized axial tomography (CT)→ particularly useful in locating brain tumors, injuries, & other structural and anatomical abnormalities Magnetic resonance imaging (MRI)→ head is placed in a high-strength magnetic field in which radio frequency signals are transmitted→ brain tissue Is excited which alters the protons in the H atoms, the alteration is measured, along with the time it takes the protons to "relax" or return to normal. Where there are Lesions/damage the signal will show lighter/darker

Structure of the Brain

Forebrain & brain stem. The brain stem is the lower & more ancient part of the brain- most essential automatic functions (breathing, sleeping) Forebrain more advanced, evolved more recently

Free Association

Freud→ patients are instructed to say whatever comes to mind. Intended to reveal emotionally charged material that may be repressed because it is too painful/threatening to bring to consciousness

Causes of General Anxiety Disorder

Generalized biological vulnerability- tendency to become anxious. Patients with GAD called autonomic restrictors because they show less responsiveness to stressors than do those with other anxiety disorders more closely related to panic. Less responsive on physiological measures such as heart rate, blood pressure, skin conductance & respiration rate. Patients are chronically tense, highly responsive to threat in general, particularly to a threat that has a personal relevance, allocate their attention more readily to sources of threat than do people who are not anxious → may arise out of generalized psychological vulnerability. This acute awareness seems to be unconscious. peripheral autonomic arousal of individuals with GAD is restricted- intense cognitive processing in the frontal lobes as indicated by EEG activity, particularly in the left hemisphere. this suggests frantic, intense thought processes or worry w/out accompanying images, this is what causes them to be autonomic restrictor. they are thinking to hard about upcoming problems that they don't have the attentional capacity left for all the important process of creating images of the potential threat, images that would solicit a more negative affect & autonomic activity

Model of Causes of Panic Disorder- With/Without Agoraphobia

Generalized psychological/ biological Vulnerability→ stress due to life events→ false alarm (associated with somatic sensations, interoceptive cues such as beating heart)→ learned alarm→ specific psychological vulnerability (unexplained physical sensations are dangerous)→ anxious apprehension (focused on somatic sensations)→ panic disorder→ development of agoraphobia determined by cultural, social & pragmatic factors & moderated by presence or absence of safety signals

Endophenotypes

Genetic mechanism that contributes to the underlying problems causing the symptoms and difficulties experienced by people with psychological disorders.

Family Studies

Genetic study that examines patterns of traits and behaviors among relatives. Proband- In genetics research, the individual displaying the trait or characteristic being studied. If there is a genetic influence then it should occur more often in 1st degree relatives than in second degree relatives or more distant relatives

Glutamate & GABA

Glutamate→ an excitatory NT that "turns on" many different neurons, leading to action GABA→ an inhibitory NT; its function is to inhibit (regulate) the transmission of information & action potentials, helps with anxiety Reduces postsynaptic activity, which in turn inhibits a variety of behaviors and emotions. Benzodiazepines (minor tranquilizers) facilitates the attachment of GABA molecules to the receptors of specialized neurons-→ higher level of benzodiazepines, more GABA attachment→ more calm (to a point) Reduces levels of anger, hostility, aggression, & perhaps even positive emotional states such as eager anticipation & pleasure Both operate relatively independently at a molecular level but the relative balance of each in a cell will determine whether an action potential is fired or not Fast acting

Self Psychology

Heinz Kohut→ the formation of self-concept and the attributes of the self that allow an individual to progress toward health/conversely, to develop neurosis

Humoral Theory

Hippocrates believed that normal brain functioning was related to 4 bodily fluids or humors- blood, black bile, yellow bile and phlegm. Blood came from the heart, black bile from the spleen, phlegm from the brain and yellow bile from the liver. Physicians believed that disease came from too much or too little of one or more of the humors. Humors related to 4 basic qualities- heat, moisture, dryness and cold (Greek conception.)

Causes of Social Anxiety Disorder

Hummus seem to be evolutionarily "prepared" to fear angry, critical, or rejecting people. Studies by Ohman and colleagues has shown that we learn more quickly to fear angry expressions than other facial expressions and this fear diminishes more slowly than other types of learning 3 possible pathways

Basic Components of a Research Study

Hypothesis-Educated guess or statement to be tested by research. Research design-Plan of experimentation used to test a hypothesis. Dependent Variable-In an experimental study, the phenomenon that is measured and expected to be influenced Independent Variable-Phenomenon manipulated by the experimenter in a study and expected to influence the dependent variable.

Nomothetic Strategy

Identification and examination of large groups of people with the same disorder to note similarities and develop general laws.

Treatment

If a new drug or treatment is successful in treating a disorder, it may give insight into the causes of the disorder, however effect does not always imply cause

Life-Span Development

Important developmental changes occur at all points in life Erik Erikson (1982) suggested that we go through 8 major crises during our lives, each determined by our bio maturation & the social demands made at particular times The influence of developmental stage & prior experience has a substantial impact on the development & presentation of psychological disorders, an inference that is receiving confirmation from sophisticated life-span developmental psychologists. Equifinality- Developmental psychopathology principle that a behavior or disorder may have several causes.

Nomenclature

In a naming system or nosology, the actual labels or names that are applied. In psychopathology, these include mood disorders and eating disorders.

Syphilis

In advanced syphilis, a bacterial microorganism enters the brain and causes delusions of persecution, delusions of grandeur. Patients would deteriorate steadily, becoming paralyzed and dying w/in 5 years of onset→ in 1825 it was designated the disease of general paresis Patients with malaria recovered more so than others , the fever "burned out" the bacteria causing the psychosis- disease linked to curable infection Penicillin late discovered as the cure

Adoption Studies

In genetics research, the study of first-degree relatives reared in different families and environments. If they share common characteristics, such as a disorder, this finding suggests that those characteristics have a genetic component. scientists Identify adoptees who have a particular behavioral pattern or psychological disorder and attempt to locate first degree relatives who were raised in different family settings. Problem is that families often live together and there could be an environmental factor causing high aggregation

Psychological Testing

Include specific tools to determine cognitive, emotional, or behavioral responses that might be associated with a specific disorder and more general tools that assess long-standing personality features, such as tendency to be suspicious.Specialized areas include intelligence testing to determine the structure and patterns of cognition. Neuropsychological testing determines the possible contribution of brain damage or dysfunction to the patient's condition. Neuroimaging uses sophisticated technology to assess brain structure and function.

Diathesis Stress Model

Individuals inherit tendencies to express certain traits/behaviors, which then may be activated under conditions of stress. Each inherited tendency is a diathesis→ a condition that makes someone susceptible to developing a disorder; can also be known as a vulnerability The greater the underlying vulnerability, the less stress is needed to trigger a disorder Individuals with 2 copies of a long allele (LL) can better cope with stress than those with 2 of the short allele (SS)

Carl Rogers

Influential humanist Developed Person-centered therapy→ the therapist takes a passive role, making as few interpretation as possible. The point is to give the individual a chance to develop, unfettered by threats to the self. Unconditional positive regard→ the complete acceptance of most of the client's feelings & actions, is critical to the humanistic approach

Research Ethics

Informed consent→ a research participant's formal agreement to cooperate in a study following full disclosure of the nature of the research and the participant's role in it. Basic components are competence, voluntarism, full information, and comprehension on the part of the participant Participatory action research→ the concern over not only how people are treated in research studies but also how the info is interpreted and used has resulted in many gov't agencies providing guidance on how the people who are the targets of the research should be involved in the process. The idea of a study where we test people's abilities fueled by different emotions... running a sprint when mad/happy/sadArtists given the challenge to make pieces with certain emotions/nostalgia/memories as themes...

Diagnosing Psychological Disorders

It is important to learn about how an individual may resemble other people in terms of the problems he presents to help diagnose- allow the investigator to make certain inferences about what will happen next and what treatments may work

Reactions to Insanity Defense

John W. Hinckley Jr→ March 31, 1981→ Hinckley fired several shots as president Ronald Reagan outside the Washington Hill Hotel→ hitting & seriously wounding the president, a SS agent, a PO and James Brady (the president's press secretary)→ claimed to try to kill president to impress Jodie Foster, an actress he was obsessed with→ judged not to be guilty be reason of insanity using the ALI standard→ a displeased country and legal community About 75% of the states substantially changed their insanity defense after Hinckley's verdict, making it more difficult to use this defense. In contrast to public perceptions, the length of time a person is confined to a hospital after being judged NGRI may exceed the time the person would have spent in jail had that person been convicted of the crime 1984 Congress passed the Insanity Defense Reform Act of 1984→ incorporated these suggestions of modifications making the successful use of the insanity defense more difficult

Systematic Desensitization

Joseph Wolpe. Behavioral therapy technique to diminish excessive fears, involving gradual exposure to the feared stimulus paired with a positive coping experience, usually relaxation.

Humanistic Theory

Jung and Adler in contrast to Freud, emphasized the positive, optimistic side of human nature.

Other Theories

Kate Horney & Erich Fromm—> emphasized development over the life span & the influence of culture and society on personality Erik Erikson→ theory of development across the life span, in which he described the crises & conflicts that accompany 7 specific stages

Consequences of the Biological Tradition

Kraepelin one of the first to distinguish among various psychological orders noting that they have different ages of onset, symptoms and causes. Interest focused on diagnosis and brain pathology

Mass Hysteria

Large scale outbursts of bizarre behavior. Also known as Saint Vitus' Dance and Trantism Also happens in modern day- school example of 17 students and 4 teachers with no physical abnormalities hospitalized

Cognitive Science & the Unconscious

Lawrence Weiskrantz (1992) described the phenomenon called blind sight/unconscious vision→ relates the case of a young man who, for med reasons had a small portion of the visual cortex removed→ althought the operation was a success, the man became subsequently blind in both eyes-→ was still able to sense things/objects → able to function visually but have no awareness / memory of their visual abilities→ process of dissociation b/w behavior & consciousness Implicit memory→ apparent when someone clearly acts on the basis of things that have happened in the past but can't remember the events Ex: story of Anna O remembered events surrounded her father's death & the connection of these events to her paralysis

Criminal Commitment

Legal procedure by which a person found not guilty of a crime by reason of insanity must be confined in a psychiatric hospital.People held because 1. They have been accused of committing a crime and are detained in a mental health facility until they can be assessed as fit/unfit to participate in legal proceeding against them, or 2. They have been found not guilty of a crime by reason of insanity

Civil Commitment Laws

Legal proceeding that determines a person is mentally disordered and may be hospitalized, even involuntarily• Date back to the late 19th century in the US → a trend that accompanied development of a large public hospital system devoted to treating such individuals: involuntary commitment of people for reason unrelated to mental illness

Semistructured Clinical Interviews

Made up of questions that have been carefully phrased and tested to elicit useful info in a consistent manner so that clinicians can be sure they have inquired about the most important aspects of particular disorders

Neurotransmitters

Major neurons that are relevant to psychopathology include norepinephrine, serotonin, dopamine, gamma-aminobutyric acid (GABA), and glutamate excess or deficit of these is related to several psychological disorders

Cultural/ Social/ Interpersonal Factors

Many cultures suffer from fright disorders- exaggerated startle responses and other fear & anxiety reactions o Susto→ in Latin American countries & describes various anxiety-based symptoms, including insomnia, irritability, phobias, & the marked the somatic symptoms of sweating & increased HR→ the cause is that the individual believes that they are the victim of black magic/witchcraft Gender can influence psychopathology. The likelihood of having certain phobias is powerfully influenced by your gender partially due to gender roles in society

Physical Examination

Many problems presenting as disorders of behavior, cognition, or mood may have a clear relationship to a temporary toxic state→ could be caused by bad food, the wrong amount or type of medication., or an onset of a medical condition

Social Effect on Health

Many studies have demonstrated that the greater the number & frequency of social relationships & contacts, the longer you are likely to live Some people think that interpersonal relationships give meaning to life & that people who have something to live for can overcome physical deficiencies & even delay death. The effects may differ with age People more likely to develop schizophrenia in cities, not yet known why Stigma associated with psychological disorders negatively portrays those with mental health problems

Learned Helplessness

Martin Seligman's theory that people become anxious and depressed when they make an attribution that they have no control over the stress in their lives (whether or not they actually have control) people become depressed if they "decide" or "think" they can do little about the stress in their lives Opposite is learned optimism

Electroencephalogram (EEG)

Measure of electrical activity patterns in the brain, taken through electrodes placed on the scalp, related to the firing of specific group of neurons reveals brain wave activity; brain waves come from the low-voltage electrical current that runs through the neurons.

Psychological Assessment

Measurement of changes in the nervous system reflecting psychological or emotional events such as anxiety, stress, and sexual arousal. Psychophysiology refers to measurable changes in the nervous system that reflect emotional or psychological events

Behavioral Assessment

Measuring, observing, and systematically evaluating (rather than inferring) the client's thoughts, feelings, and behavior in the actual problem situation or context• Sometimes clinicians don't have access to observe the patient directly in their natural setting, so they arrange Analogue→ similar settings. Target behaviors are identified and observed with the goal of determining the factors that influence them

Excoriation

Mental disorder characterized by recurrent picking of one's own skin.1-5% of the population noticeable damage to skin occurs, sometimes requiring medical attention. These are found to often co-occur with OCD and BDD, as well as with each other. Treatment-habit reversal training→ most success→ pt are carefully taught to be more aware of their repetitive behaviors particularly as it is just about to being and then substitute a different behavior that is reasonably pleasurable but harmless behavior Drugs→ serotonin-specific reuptake inhibitors hold some promise, specifically with trichotillomania

Duty to Warn

Mental health professional's responsibility to break confidentiality and notify the potential victim whom a client has specifically threatened. Tarasoff v. Regents of the Univ. of Cali (1974, 1976)→ In 1969, Prosenjit Poddar, a grad student at the UC, Berkley, killed a fellow student Tatiana Tarasoff who had previously rejected his romantic advances→ at the time of the crime he had been seeing two therapists and U health center & had received dx of paranoid schizophrenia→at his last session Poddar hinted that he was going to kill Tarasoff→ therapist believed the threats were serious and contacted campus police, who investigated the allegation and received assurances from Podder that he would leave her alone→ weeks later shot and stabbed her to death Tarasoff family sued Univ. claiming that Tatiana should have been warned of the potential danger→ the court agreed and ever since this case has been used as a standard for the therapists concerning their duty to warn a client's potential victims. Thompson v. County of Alameda (1980) the cal supreme court ruled that a therapist doesn't have a duty to warn when a person makes nonspecific threats against nonspecific people

Randomization

Method for placing individuals into research groups that assures each an equal chance of being assigned to any group, thus eliminating any systematic differences across groups.

Dimensional Approach

Method of categorizing characteristics on a continuum rather than on a binary or all-or-none basis. The physician notes the variety of cognitions, moods, & behaviors with which the patient presents and quantify them on a scale. Not adopted by many since it is disagreed upon how many dimensions are necessary foe diagnosis

Gene-Environment Correlation Model

Model that posits one's genetic make-up may increase the probability that an individual will experience certain events (such as stressful relationships) that trigger genetic vulnerabilities to disorders. Some studies indicate that genetic endowment may increase the probability that an individual will experience stressful life events such as someone who is predisposed to depression may tend to seek out difficult relationships/other circumstances that lead to depression

Clinical Description of OCD

The dangerous event is a thought, image, or impulse that the client attempts to avoid as completely as someone with a phobia, unlike other disorders where the danger is external.

Validity

The degree to which a technique measures what it is designed to measure

The Insanity Defense

The law recognizes that under certain circumstances, people are not responsible for their behavior and it would be unfair and perhaps ineffective to punish them 150 years ago in England Daniel M'Naghten who might've today received the dx of a paranoid schizophrenic held the delusion that the English Tory party was persecuting him and set out to kill the prim minister→ he mistook the secretary for the minister and killed the secretary→ in essence the ruling that people are not responsible for their criminal behavior if they don't know what they're doing or they don't know what they're doing is wrong. Durham Rule (1954)→ Durham v. US→ broadened the criteria for responsibility from knowledge of right/wrong to state that the accused is not criminally responsible if his unlawful act was the product of mental disease/mental defect It was soon apparent that mental health professionals didn't have the expertise to assess reliably whether a person's mental illness caused the criminal behavior in question and therefore that decisions were being based on unscientific opinions

Causes of PTSD

The one disorder for which we know the cause at least in terms of the precipitating event→ but whether or not a person develops it is a surprisingly complex issue involving bio, psycho, and socio factors. We know intensity of exposure contributes Ex. . 67% of POWs in Vietnam developed PTSD→ 33% of POWs did NOT develop the disorder (ex John McCain) A family history of anxiety increased vulnerability for PTSD Evidence of brain damage to the hippocampus has appeared in groups of patients with war-related PTSD, adult survivors of childhood sexual abuse, and firefighters exposed to extreme trauma (critical in regulating the HPA axis) Damage to this region might result in persistent and chronic arousal as well as some disruptions in learning and memory.

Superego

The psychic entity representing the internalized moral standards of parents and society represents moral principles instilled by parents & culture. Mediates conflict b/w the id and the superego.

Ego

The psychic entity responsible for finding realistic and practical ways to satisfy id drives.operates on the reality principle instead of the pleasure principle. The cognitive operations or thinking styles of the ego are characterized by logic and reason→ secondary process

Event Related/ Evoked Potential

The response when brief periods of EEG patterns are recorded in response to specific events such as hearing a psychologically meaningful stimulus

Psychological Effects on Brain Structure & Development

The structures on neurons themselves, including the number of receptors on a cell, can be changed by learning and experience during development & these effects on the CNS continue throughout our lives

Epigenetics

The study of factors other than inherited DNA sequence, such as new learning or stress, that alter the phenotypic expression of genes.

Id

The unconscious psychic entity present at birth representing basic drives.It is the source of our sexual & aggressive feelings or energies The energy or drive within the Id is the libido Also driven by the death instinct (thanatos) These 2 drives are constantly in opposition Operates on pleasure principle & primary process of thinking (emotional, irrational)

Onset

The way in which a disorder shows itself, could be acute (suddenly) or insidious (gradually)

Single Case Experimental Design

This method involves the systematic study of individuals under a variety of experimental conditions. Skinner though it was much better to know a lot about the behavior of one individual. Than to make only a few observations of a large group for the sake of presenting the "average" response. Differ from case studies in their use of various strategies to improve internal validity, thereby reducing the number of confounding variables REPEATED MEASUREMENTS→ a behavior is measured several times instead of only once before you change the independent variable and once afterward. The researcher takes the same measurements repeatedly to learn how variable the behavior is and whether it shows any obvious trends→ important parts: 1. The level or degree of behavior change w/ diff interventions 2. The variability of degree of change over time 3. The trend or direction of change

One Dimensional versus Multi Dimensional Models

To say psychopathology is caused by a single cause is to accept a linear or one-dimensional model. Systemic→ it implies that no single influence contributing to psychopathology—that is, the biology & behavior or the individual and the cognitive, emotional, social & cultural environment—can be considered out of context

Psychological Intervention

Treatment originally concentrated on reducing agoraphobic avoidance, using strategies based on exposure to feared situations As many as 70% of patients undergoing these treatments substantially improve as their anxiety & panic are reduced and their agoraphobic avoidance is greatly diminished Panic control treatment (PCT) concentrates on exposing patients with panic disorder to the cluster of interoceptive (physical sensations) that remind them of their panic attacks → therapist attempts to create a "mini" panic attack in the office by having patients exercise to elevate their HR or by making them dizzy Basic attitudes and perceptions concerning dangerousness of the feared but objectively harmless situations are identified and modified

Psychosocial Treatment

Treatment practices that focuses on social and cultural factors (such as family experience), as well as psychological influences. These approaches include cognitive, behavioral, and interpersonal methods.

Blood Injection Injury Phobia

Unreasonable fear and avoidance of exposure to blood, injury, or the possibility of an injection. Victims may experience fainting and a drop in blood pressure. experience a marked drop in HR and BP→ fainting. Differ from all other phobias because many people with phobias although they believe they are going to faint, their BP and HR are rising → runs in families more than any other phobia

Specific Phobia

Unreasonable fear of a specific object or situation that markedly interferes with daily life functioning, 4 types

Animal Phobia

Unreasonable, enduring fear of animals or insects that usually develops early in life.Age of onset peaks around 7 years old

Therapeutic Jurisprudence

Using what we know about behavior change to help people in trouble with the law. there is a built in tension between the judicial system and the mental health system→ the legal system is by design, adversarial→ It was created with prosecutors and defendants, winners and losers→ mental health system is set up to find solutions to important psychological problems w/out placing blame on any parties Society has long recognized the need to ID criminals who may not be in control of their behavior and who may not benefit from simple incarceration→ the challenge is in trying to do what may be impossible: determining whether the person knew that she was doing, knew it right from wrong, and could control her behavior. Must resolve the simultaneous and conflicting interested of wanting to assist people with mental illness and wanting to be protected from them

Psychological Contributions to Anxiety

Variety of factors- in childhood we may acquire awareness that things are not always in our control, the continuum of the perception of how much things are out of our control may range from total confidence in our control of all aspects of our lives to deep uncertainty about ourselves and our ability to deal with upcoming events Panic has conditioning & cognitive explanations- internal/external cues after an event of extreme danger and future events with similar circumstances (form of conditioning)

Intellectual Functioning

Vocabulary, speaking in abstractions/metaphors, memory all contribute to a rough estimate of the individuals intelligence

Physiology & Purpose of Fear

Walter Cannon (1929) believes that fear activates the cardiovascular system Blood vessels constrict and decrease blood flow to the extremities, breathing becomes faster & usually deeper to provide O2 to the brain & increase the quickness of thoughts & decision making. Increased amount of glucose is released from the liver into the bloodstream, energizing crucial muscles & organs, including the brain. Pupils dilate to allow for a better view of the situation Fight or flight response- Biological reaction to alarming stressors that musters the body's resources (for example, blood flow and respiration) to resist or flee a threat.

Clinical Practice Guidelines

When evidence that has accumulated on the effectiveness of psychological treatments for specific disorders both in research clinics and in clinics that serve the public directly is put in the form of recommendations on how to treat a particular problem 1989 the Agency for Health Care Policy and Research was founded 1999 the agency was reauthorized by the Congress and renamed the Agency for Healthcare Research and Quality→ the purpose was to establish uniformity in the delivery of effective health and mental health care and to communicate to practitioners, policy makers, and patients alike throughout the country the latest developments in treating certain disorders effectively→ also responsible for research into improving systems for the delivery of health and mental health services the task force decided that clinical practice guidelines for specific disorders should be constructed on the basis of two considerations: clinical efficacy axis & clinical utility axis

Global Incidence of Psychological Disorders

World Health Org. (WHO)→ 13% of mental disorders account for the global burden of disease. Treatments that work in the US cannot be administered in poorer nations (Cambodia example lack of psychiatrists as opposed to US) Most societies have not developed the social context needed to alleviate and prevent psychological disorders and in turn end up maintaining them

Treatment of Anxiety/ Agoraphobia

a large number of drugs affecting the noradrenergic, serotonergic, or GABA-benzodiazepine NT systems or some combination, seem effective in treated PD High-potency benzodiazepines such as Xanax (aplrozolam) work quickly but are hard to stop taking. All benzos adversely affect cognitive & motor functions to some degree. Remain the most widely used class of drugs in practice although they aren't as highly recommended at SSRIs Selective serotonin reuptake inhibitors (SSRIs) such as Prozac and Paxil-currently the indicated drug for PD based on all available evidence although there is an observed sexual dysfuntion in 75% or more people taking them Serotonin-norepinephrine reuptake inhibitors (SNRIs) such as venlafaxine 60% of patients with PD are free of panic as long as they continue taking meds→ 20% or more stop taking the drug before treatment is over and relapse rates are high ( 50%) once meds are stopped→ those who stop taking benzos experience a relapse rate of about 90%

Restrictions to Commitment Procedures

a movement emerged calling for a return to broader civil procedures that would permit commitment not only of those who showed dangerousness to self or others but also of individuals in need of treatment and those with grave disability & not dangerous Overall here is a need to address the parameters for committing a person with a severe mental illness

Sleep Terrors

a related phenomenon occurring in children→ often children scream and get out of bed as if something were after them however do not wake up and have no memory of the event in the morning,occur at a later stage of sleep (stage 4) which is associated with sleepwalking

Withdrawal Design

a researcher tries to determine whether the independent variable is responsible for changes in behavior. Baseline→ a person's condition is evaluated before tx Then comes the change in the independent variable, the beginning of treatment Then, treatment is withdrawn "return to baseline" and the researcher assesses whether or not the individuals levels change again as a function of this last step An important diff b/w this an a case study is that the change in treatment is designed specifically to show whether treatment caused the changes in behavior

Pavlov & Classical Conditioning

a type of learning in which a neutral stimulus is paired with a response until it elicits that response. One way in which we acquire new information

Multiple Bases

another single-case experimental design strategy used often that doesn't have some of the drawbacks of a withdrawal design→ rather than stopping the intervention to see whether it is effective, the researcher starts tx at diff times across settings, behaviors, or people. Functional communication training→teaching children on the autism spectrum to communicate instead of misbehave

Basil Ganglia

at the base of the forebrain, includes the caudate (tailed) nucleus→ believed to control motor activity because injuries to this area cause people to change posture, twist or shake

Repression

blocks disturbing wishes, thoughts, or experiences from conscious awareness

DSM IV & DSM IV-TR

by the late 1980s, clinicians and researchers realized the need for a consistent, worldwide system of nosology. In the 10th edition of ICD (1993) the US was required to by treaty obligations to use the IDC-10 codes in all matters related to health. Work continued simultaneously for the DSM-IV (1994) and the ICD-10. 12 independent studies or field trials examined the reliability and validity of alternative sets of definitions or criteria and, in some cases, the possibility of creating a new Dx. Most substantial change in the DSMIV may have been that the distinction b/w organically based disorders and psychologically based disorders that was present in previous editions was eliminated.

Studying Individual Cases

case study method-investigating intensively one or more individuals who display the behavioral and physical patterns

Noting What is & WHat is Not

clinicians observations of diffs among one person or one group with a disorder, people with other disorders, and people w/ no psychological disorders

Rationalization

conceals the true motivations for actions, thoughts, or feelings through elaborate reassuring/self-serving but incorrect explanations

Sublimation

conceals the true motivations for actions, thoughts, or feelings through elaborate reassuring/self-serving but incorrect explanations

Adjustment Disorders

describe anxious/depressive reactions to life stress that are milder than one would see in acute stress disorder/PTSD but are nevertheless impairing in terms of interfering w/ work or school performance, interpersonal relationships or other domains of life at times, particularly in adolescence, the life stress may provoke conduct problems

Prevention Research

different methods can be used in positive development strategies (health promotion), universal prevention strategies, selective prevention strategies, and indicated prevention strategies Health promotion/positive development→ involve efforts to blanket entire populations of people to prevent later problems and promote protective behaviors Universal prevention strategies focus on enter populations and target certain specific risk factors w/out focusing on specific individuals Selective prevention→ specifically targets whole groups at risk Indicated prevention→ a strategy for those individuals. Who are beginning to show signs of problems but don't have a disorder yet

Statistics of Specific Phobia

during a given 1 year period the prevalence is 8.7% overall but 15.8% in adolescents→ specific phobia one of the most common psychological disorders in the US and around the world 4:1 ration of women to men 1-2 year old children are normally anxious about separating from parents, fears of animals/dark persist into 4/5 y/o Hispanics are 2x as likely to report specific phobias than white-nonhispanic americans Once a phobia is developed it tends to run a chronic course Chinese fear- Pa-leng (fear of the cold)

Emotional Phenomena

emotion-Pattern of action elicited by an external event and a feeling state, accompanied by a characteristic physiological response. a tendency to behave in a certain way, elicited by an external event (a threat) and a feeling state (terror) and accompanied by a (possibly) characteristic physiological response. The purpose of a feeling state is to motivate us to carry out a behavior: if we escape, our terror, which is unpleasant, will be decreased, so decreasing unpleasant feeling motivates us to escape. mood-Enduring period of emotionality. Affect usually refers to the momentary emotional tone that accompanies what we say or do

Hoarding Disorder

estimates of prevalence range between 2-5% of the population which is 2x as high as prevalence of OCD, with nearly equal numbers of men & women, and is found world wide. There are 3 characteristics 1. Difficulty discarding anything 2. Excessive acquisition of things 3. Living w/ excessive clutter under conditions best categorized as gross disorganization - can begin early in life and get worse with each passing decade

Causes & Treatment

etiology is unknown. Seems to be related to OCD & SADF But there are 2 and only 2 treatments known to have any effectiveness 1. Drugs that block reuptake of serotonin, such as chlomipramine (Anafranil) & fluvoxamine (Luvox) 2. Exposure & response prevention, the type of CBT effective with OCD Many seek plastic surgery

Clinical Description of PTSD

exposure to a traumatic event during which an individual experiences/witnesses death or threatened death, actual or threatened serious injury, or actual/threatened sexual violation. Afterward, victims re-experience the event through memories & nightmares→ when memories occur suddenly, accompanied by strong emotion & victims find themselves reliving the event, they are having a flashback Victim avoids almost anything that reminds them of the trauma, often display a characteristic restriction or numbing of emotional responsiveness which may be disruptive to interpersonal relationships Typically chronically overaroused, easily startled, and quick to anger Dissociation and reckless/self-destructive behavior have been newly added to the DSM5 Diagnosis cannot be made until at least one month after the occurrence of the traumatic event Delayed onset→ individuals Show few/no symptoms immediately or for mo after trauma, but at least 6 mo later, and perhaps years afterward develop full-blown PTSD

Projection

falsely attributes own unacceptable feelings, impulses, or thoughts to another individual or object

Clinical Description of BDD

for many years, BDD was considered a somatic symptom disorder because of its central ft is a psychological preoccupation with somatic (physical) issues→ increasing evidence indicated that is was more closely related to OCD. People with BDD complain of persistent, intrusive and horrible thoughts about their appearance, and they engage in such compulsive behaviors as repeatedly looking into mirrors to check their physical features

Statistics of BDD

hard to estimate becasue by its nature it is usually kept a secret→ without treatment it tends to run a lifelong course. As many as 70% of college students report at least some dissatisfaction with their bodies, with 4-28% of these appearing to meet all the criteria for the disorder Overall prevalence found in a sample of 566 adolescents b/w ages 14-19 was 2.2% with girls more dissatisfied with their bodies than boys and AA's of both genders more satisfied w/ bodies than others. Men tend to focus more on body build, genitals and thinning hair & tend to have more sever BDD. Women focus more on varied bodied areas and are more likely to also have an eating disorder Age of onset ranges from early adolescence through 20s, peaking at the age of 16-17 Depression and substance abuse are common

Brain Imaging Procedures

have yielded more information about the neurobiology of anxiety & panic, now general agreement that in people with anxiety disorders, the limbic system, including the amygdala, is overly responsive to stimulation or new info (abnormal bottom-up processing) & also controlling functions of the cortex that would down-regulated the hyperexcitable amygdala are deficient (abnormal down processing)

Franz Aton Mesmer

hypnosis. Suggested to his patients that their problem was caused by an undetectable fluid found in all living organisms called "animal magnetism" which could become blocked Had patients sit in a dark room around a large vat of chemicals while extending from it and touching them. He would ID and tap various areas of their bodies where their magnetism was blocked, while suggesting strongly that they were being cured. Strongly opposed by the medical establishment

WHO World Mental Health Survey Initiative

in the late 1990s, researchers from 28 countries began a series of coordinated and rigorously implemented population surveys to estimate the prevalence of psychological disorders around the world and to identify risk, protective factors, and treatments used for each disorder.

Anxiety Disorders

include generalized anxiety disorder, panic disorder and agoraphobia, specific phobia, and social anxiety disorder & two new disorders (separation anxiety disorder and selective mutism)

Endocrine System

includes a number of glands, each of which produces its own chemical messenger called a hormone & releases It into the blood stream One brain connection implicated in some psychological disorders involves the hypothalamus & the endocrine system→ the hypothalamus connects to the adjacent pituitary gland which is the master/coordinator of the endocrine system→ the pituitary gland in turn may stimulate the cortical part of the adrenal glands on top of the kidneys, The cortical part of adrenal gland also produces the stress hormone cortisol-→ this system is now called the hypothalamic-pituitary-adrenocortical axis or (HPA axis) it was been implicated in several psychological disorders we discuss in this text

Forebrain

just above the thalamus & hypothalamus is the limbic system→ limbic meaning border, includes structures such as the hippocampus (sea horse), cingulate gyrus (girdle) , septum (partition), & amygdala (almond) Helps to regulate our emotional experiences and expression and to some extent our ability to learn and control our impulses. Involved with the basic drives of sex, aggression hunger and thirst

Cerebral Cortex

largest part of the forebrain→ contains more than 80% of all neurons in the CNS; provides us w/ our distinctly human qualities, allowing us to plan, reason, create, right & left hemisphere- right perceives world around us and creates images while left responsible for verbal and other cognitive processes Temporal lobe→ associated w/ recognizing various sights and sounds & w/ LT memory storage Parietal lobe→ associated w/ recognizing various sensations of tough & monitoring body position Occipital lobe→ associated w/ integrating & making sense of various visual inputs Frontal lobe/prefrontal cortex→ responsible for higher cognitive functions such as thinking & reasoning, planning for the future, as well as LT memory; synthesizes all info received form other parts of the brain and decides how to respond; what enable us to relate to the world around us

Statistics of OCD

lifetime prevalence of OCD ranges from 1.6-2.3% and in a given 1year period the prevalence is 1%. Male to female ratio of 1:1 In children there are more males than females Onset ranges from childhood to mid 30s, median age of onset at 19 → onset peaks earlier in males (13-15) than females (20-24) Remarkably similar across cultures

Genes

long molecules of deoxyribonucleic acid (DNA) at various locations on chromosomes w/in the cell nucleus Seldom determine our physical development in any absolute way 46 chromosomes, 23 pairs- first 22 pairs contain codes for the body and brain, last pair determines the sex polygenic→ influenced by many genes, each contributing only a tiny effect, all of which, in turn, may be influenced by the environment quantitative genetics→ sums up all the tiny effects across many genes w/out necessarily telling us which genes are responsible for which effects

Statistics of PTSD

military mental health officials were very concerned that rates of PTSD might be as high as 30% or more as based on experiences from Vietnam War Based on study of more than 47k members of the armed forces, only 4.3% of personnel developed PTSD Those experiencing combat exposure, rates increased to 7.6% vs. 1% among those not 6.8% have experience PTSD at some point in their life and 3.5% in the past yr adolescents→ 3.9% highest rates of PTSD are associated with experiences of rape, being held captive, tortured, or kidnapped, or being badly assaulted.rates of PTSD are 2.4-3.5 times higher for woman experiencing a single rape assault or rape and 4.3-8.2 times higher for those who have been re-victimized. close exposure to trauma seems to be necessary to developing this disorder WW II vets did not have as many symptoms of PTSD as those who fought in Vietnam, IRaq or Afghanistan because many did not see the direct effects of dying

Treatment of PTSD

most clinicians agree that victims of PTSD should face the original trauma, process the intense emotions, and develop effective coping procedures in order to overcome the debilitating effects of the disorder Catharsis→ reliving emotional trauma to relieve emotional suffering Imaginal exposure→ the content of the trauma & the emotions associated w/ it are worked through systematically has been used for decades under a variety of names Some drugs such as SSRIs (Prozac & Paxil) are effective

Treatment of OCD

most effective drugs seem to be those that specifically inhibit the reuptake of serotonin, such as clomipramine or the SSRIs, which benefit up to 60% of patients with OCD Highly structured psychological treatments work somewhat better than drugs but they are not readily available Exposure & ritual prevention (ERP)→ the rituals are actively prevented and the pt is systematically & gradually exposed to the feared thoughts/situations.ERP whether alone or with a drug showed 86% response rate vs. 48% when drug was used alone→ combining treatment did not produce any add'l advantage Psychosurgery→ more radical treatment→ surgical lesion to the cingulate bundle (cingulotomy) approx. 30% benefited substantially Deep brain stimulation→ electrodes are placed through small holes drilled in the skull and are connected to a pacemaker-like device in the brain→ this is reversible unlike surgery

Right to Treatment

one of the most fundamental rights of people in mental health facilities is the right to tx→ for too many and for too long conditions were poor and tx was lacking in numerous large mental health facilities Wyatt v. Stickney (1972) grew out of a lawsuit filed by the employees of large institutions in Alabama who were fired because of funding difficulties→ the case also established for the first time, the minimum standards that facilities had to meet in relation to the people who were hospitalized Minimum staff-pt ratios and physical requirements, such as a certain number of showers and toilets for a given number of residence Further expanded on a concept called the least restrictive alternative, indicating that, wherever possible, people should be provided with care and tx in the least confining and limiting environments A gap is left as to what constitutes proper tx The case of Youngberg v Romeo (1982)→ reaffirmed the need to treat people in nonrestrictive settings but essentially left to professionals the decisions about the type of treatment to be provided

Causes of Specific Phobia

originally, we thought that most specific phobias began with an unusual traumatic event but we now know this is not always the case There are phobias resulting from a direct experience→ real danger/pain results in an alarm response Experiencing a false alarm (panic attack) in a specific situation Observing someone else experience severe fear (vicarious experience) Being told about danger → information transmission A true phobia also requires anxiety over the possibility of another extremely traumatic event/false alarm & we are likely to avoid situations in which that terrible thing might occur several things have to occur for a person to develop a phobia. First, a traumatic conditioning experience often plays a role (even hearing about a frightening event it sufficient for some).Second, fear is more likely to develop if we are "prepared" (carry an inherited tendency to fear situations that have always been dangerous to the human race) third, we also have to be susceptible to developing anxiety about the possibility that the event will happen again finally, social and cultural factors are strong determinants of who develops and reports a specific phobia→ gender differences→ cultural differences

Transference

patients come to relate to the therapist much as they did to important figures in their childhood, particularly their parents, patients fall deeply in love with therapist

Cultural Influence on Panic Disorder

prevalence rates are similar in US, Canada, Puerto Rico, New Zealand, Italy, Korea, and Taiwan (a bit lower rates) somatic symptoms may be emphasized in 3rd world cultures-subjective feelings of dread or angst may not be a part of some cultures→ focus more on bodily sensations Hispanic Americans experience ataques de nervios- similar to panic attack Khmer (Cambodian) and Vietnamese refugees in the US have been found to experience orthostatic dizziness (standing up to quickly) and "sore neck" manifestation of panic attacks Khmer concept of kyol goeu ("wind overload")→ too much wind/gas in the body which may cause blood vessels to burst, becomes the focus of catastrophic thinking during panic attacks

Attachment Disorders

refers to disturbed & developmentally inappropriate behaviors in children, emerging before 5 y/o, in which the child is unable or unwilling to form normal attachment relationships w/ caregiving adults due to inadequate/abusive child-rearing practices Reactive attachment disorder-the child will seldom seek out a caregiver for protection, support, and nurturance and will seldom respond to offers from caregivers to provide this kind of care. Evidence a lack of responsiveness, limited positive affect and additional heightened emotionality such as fearfulness & intense sadness

Denial

refuses to acknowledge some aspect of objective reality/subjective experience that is apparent to others

Longitudinal Designs

researchers may follow up with one group over time and assess change in its members directly→ the advantages are that they do not suffer from cohort effect problems and they allow the researchers to assess individual change. Cross-generational effect→ involves trying to generalize the findings to groups whose experiences are diff from those of the study participants Sequential design-→ involves repeated study of different cohorts over time

Isolated Sleep Paralysis

seems culturally determined,occurs during the transitional state between sleep and waking, when a person is either falling asleep or waking up (mostly when waking)→ individual is unable to move & experiences a surge of terror than resembles a panic attack & occasionally vivid hallucinations. possible that REM sleep is spilling over into the waking cycle

Causes of OCD

specific psychological vulnerability to develop OCD. & a generalized biological vulnerability When clients equate thoughts with the specific actions or activity represented by the thoughts, this is called thought-action fusion→ may be caused by attitudes of excessive responsibility and resulting guilt developed during childhood even when a bad thought is associated with evil intent May have the same bio/psycho precursors of anxiety

Social COntributions to Anxiety

stressful life events trigger our biological and psychological vulnerabilities to anxiety

Cross-Cultural Behavior

studying the differences in behavior or people from diff cultures can tell us a great deal about the origins and possible treatment of abnormal behavior Some researchers see the independent variable is the effect of diff cultures on behavior, rather than say the effect of cognitive therapy vs simple exposure for the treatment of fears

Reaction Formulation

substitutes behavior, thoughts, or feelings that are the direct opposite of unacceptable ones

Top of Brainstem

thalamus and the hypothalamus→ involved broadly with regulating behavior and emotion; function primarily as a relay b/w the forebrain & remaining lower areas of the brain stem

Generalizability

the extent to which results apply to everyone with a particular disorder

Hindbrain

the lowest part of the brain stem containing the meulla, the pons, and the cerebellum. Regulates many automatic activities such as breathing, the pumping action of the heart, & digestion, also controls motor coordination

Abraham Maslow

the most systematic in describing the structure of personality. Hierarchy of needs, beginning with the most basic needs for food & sex, & ranging upward to our needs for self-actualization, love, & self esteem.

Studying Behavior Over TIme

the question of how a disorder or treatment pattern will change or remain the same over time is important because The answer will help decide whether to treatment a particular person Can provide insight into how problems are created and how they become more serious

Object Relations

the study of how children incorporate the images, the memories, and sometimes the values of a person to whom they were (or are) emotionally attached Object→ important people Introjection→ the process of incorporation

Dream Analysis

the therapist interprets the content of reams, supposedly reflecting the primary-process thinking of the id, & related the dreams to symbolic aspects of unconscious conflicts.

Self- Actualizing

the underlying assumption is that all of us could reach our highest potential if only we had the freedom to grow

Countertransference

therapists reflect some of their own personal issues and feelings, usually positive, onto their patient.

Procedural Changes & Civil Commitment

there are issues with deciding whether a person has a mental illness or is dangerous→ requires considerable subjective judgment, because of varying legal language, this determination can differ from state to state

Displacement

transfers a feeling about, or a response to, an object that causes discomfort onto another, usually less-threatening, object or person

Patients Rights & Clinical Guidelines

until about 40 years ago, people in Mental health facilities were accorded few rights→ led to legal action and subsequent rulings by the courts concerning the rights of people in these facilities

Parental Contributions to Anxiety

Parents who interact in a positive & predictable way w/ their kids by responding to their needs teach them that they have control over their environment and their responses have an effect on parents & environment→ parents who provide a "secure home base" but allow their children to explore their world and develop the necessary skills to cope w/ unexpected occurrences enable their children to develop a healthy sense of control

Average Client

Patient uniformity myth-Tendency to consider all members of a category as more similar than they are, ignoring their individual differences.o Leads researchers to make inaccurate generalizations about disorders and their treatments

Course

Pattern of development and change of a disorder over time, could be chronic, episodic or time-limited

Demons & Witches

People blamed abnormal behavior on the evil acts of entities such as demons & witches, continued into the 15th century

Control Groups

People who are similar to the experimental group is every way except they are not exposed to the independent variable. → ideally, they are nearly identical to the tx group in such factors as age, gender, socioeconomic backgrounds, and the problems they are reporting Placebo effect→ when behavior changes as a result of a person's expectation of change rather than as a result of any manipulation by an experimenter Placebo control groups→ Double-blind control→ a variant of the placebo control group procedure→ the participants are "blind" or unaware of what group they're in our what treatment they are receiving but so are the researchers. Allegiance effect→ when the researcher might try harder to make their to succeed

Trichotillomania

People's urge to pull out their own hair from anywhere on the body, including the scalp, eyebrows, and arms. This behavior results in noticeable hair loss, distress, & significant social impairments. Observed between 1-5% of college students, more common in females than in males

Psychological Tradition

Plato→ thought that the two causes of maladaptive behavior were the social & cultural influences in one's life & the learning that took place in that environment. Precursor to psychosocial treatment→ approaches to the causation of psychopathology, which focus not only on psychological factors but also the causation of psychopathology

Images of Brain Functioning

Positron Emission Tomography (PET Scan) An individual is injected with tracer substances attached to isotopes (groups of atoms that react distinctively) which interact with blood, oxygen and glucose.When parts of brain become active, blood oxygen or glucose rushes to these areas of the brain, creating "hot spots" picked up by detectors that ID the location of the isotopes, thus locating which parts of the brain are working and which aren't o Single photon emission computed tomography (SPECT)→ a different tracer substance is used and is somewhat less accurate Functional MRI (FMRI) only takes milliseconds, can take pictures of the brain as it changes and measures it's functionality. Currently most popular technique to study psychological disorders

Prognosis

Predicted development of a disorder over time

Diagnosis

Process of determining whether a presenting problem meets the established criteria for a specific psychological disorder.

Standardization

Process of establishing specific norms and requirements for a measurement technique to ensure it is used consistently across measurement occasions. This includes instructions for administering the measure, evaluating its findings, and comparing these to data for large numbers of people.

The Central Nervous System

Processes all information received from sense organs and reacts accordingly, determines what is important and the appropriate action. Spinal chord sends messages to and from the brain. The brain has millions of neurons, individual nerve cells responsible for transmitting information

Psychosexual Stages of Development

Psychoanalytic concept of the sequence of phases a person passes through during development. Each stage is named for the location on the body where id gratification is maximal at that time.The stages—oral, anal, phallic, latency, and genital—represent distinctive patterns of gratifying our basic needs and satisfying our drive for physical pleasure. Phallic stage-(age 3-5 or 6) early genital self-stimulation; Oedipus complex; electra complex

Projective Tests

Psychoanalytically based measure that presents ambiguous stimuli to clients on the assumption that their responses can reveal their unconscious conflicts. Such tests are inferential and lack high reliability and validity.• Rorschach inkblot test→ 10 inkblot picture that serve as the ambiguous stimuli→ presented one by one→ most is extremely controversial because of the lack of ddate on reliability or validity. Comprehensive system→ created by John Exner to respond to the concerns of the Rorschach inkblot test→ this system specifies how the cards should be presented, what the examiner should say, and how responses should be recorded. Thematic apperception test (TAT)→ consists of a series of 31 cards: 30 with pictures on them and 1 blank, although only 20 cards are typically used during each administration→ the person is asked to tell a dramatic story about the picture Children's TAT→ (CAT) Senior's TAT (SAT)

Phobia

Psychological disorder characterized by marked and persistent fear of an object os situation

Implications for Psychopathology

Psychological disorders typically mix emotional, behavioral, & cognitive symptoms so identifiable lesions (damage) localized in specific structures of the brain do not, for the most part, cause the disordersPsychopathologists have been mainly focusing on the more general role of brain function in the development of personality, with the goal of considering how different types of biologically driven personalities might be more vulnerable to developing certain types of disorders Thomas Insel described a case originally reported by Eslinger & Damasio (1985) of a man who had been a successful accountant & family man before undergoing surgery for a minor brain tumor→ he lost everything as he began to engage in lengthy and uncontrollable compulsive rituals over the next year→ damage to the orbital frontal cortex.

Psychological Disorder

Psychological dysfunction associated with distress or impairment in functioning and a response that is not typical or culturally expected

Cultural Influence on Anxiety

Psychological symptoms of panic & anxiety seem to be universal however the manifestations of these symptoms vary among countries which could explain the difference in prevalence rates- less people meet the western criteria for the disorder Some people more inclined to report symptoms than others (gender differences)

Moral Therapy

Psychosocial approach in the 19th century that involved treating patients as normally as possible in normal environments. Originated as a system with FrenchFrench psychiatrist Philippe Pinel & his associate Jean Baptiste Pussin 1833, Horace Mann, chairman of board of trustees of the Worcester State Hospital reported on 32 patients who had been given up as incurable, were treated with moral therapy, cured, and released to their families.

Classification Issues

Question of whether it is ethical to classify human behavior, what categorizes normal & abnormal

Thought Processes

Rate and flow of speech, pace and continuity of speech, disorganized speech pattern (loose association/ derailment) The content of speech & presence of delusions Delusion→ distorted view of reality Delusions of persecution→ someone thinks people are after him and out to get him all the time Delusions of grandeur→ an individual thinks she is all-powerful Ideas of reference→ everything everyone does somehow relates back to the individual Hallucinations→ things someone sees or hears when those things aren't really there

Obsessions

Recurrent intrusive thought or impulse the client seeks to suppress or neutralize while recognizing it is not imposed by outside forces. Symmetry obsessions→ account for most (26.7%)→ keeping things in order and doing something in a certain specific way Forbidden thoughts/actions (21%) Cleaning & contamination (15.9%) Hoarding (15.4%) Tic disorder & OCD→ involuntary movement is common to occur with OCD patients (particularly children) More complex tics with involuntary vocalization are referred to as Tourette's disorder.

Stress & Melancholy

Reflected the view that psychological disorders were caused by mental or emotional stress and were curable. Common remedies included rest, healthy environment, potions etc. Church condemned certain symptoms of depression and other disorders as sin (acedia)

Alpha Waves

Regular pattern of changes measured in a normal, healthy, relaxed adult (awake)

Treatment for Excess Humors

Regulating the environment to increase or decrease moisture, heat, dryness or cold. Rest, nutrition Bleeding/ bloodletting- blood removed form body often by leeches Induced vomiting

Mental Status Exam

Relatively coarse preliminary test of a client's judgment, orientation to time and place, and emotional and mental state; typically conducted during an initial interview. Covers 5 categories

Compulsions

Repetitive, ritualistic, time-consuming behavior or mental act a person feels driven to perform, usually in response to anxiety-provoking obsessive thoughts.

Association Studies

Research strategy for comparing genetic markers in groups of people with and without a particular disorder.

Group Experimental Designs

Researchers observe groups to see how different variables are associated Clinical trial→ an experiment used to determine the effectiveness and safety of a treatment or treatments Implies a level of formality with regard to how its conducted→ Is not a design by itself but rather a method of evaluation that follows a number of generally accepted rules

Cross-Sectional Designs

Researchers take a cross-section of a population across the different age groups and compare them on some characteristic. Cohorts→ groups in which all the members of their respective groups are the same age at the same time and thus have been exposed to similar experiences Cohort effect→ the confounding of age and experience is a limitation of the cross-sectional design

Galen

Roman physician who went further into Hippocrates' ideas and developed the Humoral Theory of disorders, first example of associating psychological disorders with an internal chemical imbalance

Psychoanalysis

School of thought brought about in the 20th century-Assessment and therapy pioneered by Sigmund Freud that emphasizes exploration of, and insight into, unconscious processes and conflicts.

Intelligence Quotient (IQ)

Score on an intelligence test estimating a person's deviation from average test performance. Initially, IQ scores were calculated by using the child's mental age. It was divided by chronological age and multiplied by 100.

Behaviorism

Second school of thought in 20th century associated with Pavlov, Watson & Skinner-Explanation of human behavior, including dysfunction, based on principles of learning and adaptation derived from experimental psychology.

Personality Inventories

Self-report questionnaire that assesses personal traits by asking respondents to identify descriptions that apply to themselves.o Paul Mehl pointed out that what is necessary form these types of tests is not whether the questions necessarily make sense on the surface, but, rather, what the answers to these questions predict→ importance relies in what the answers predict If, as a group, people with certain disorders tend to answer a variety of questions in a certain way, then this pattern may predict who else has this disorder. Empirical approach→ the collection and evaluation of data

Acute Stress Disorder

Severe reaction immediately following a terrifying event, often including amnesia about the event, emotional numbing, and derealization. Many victims later develop posttraumatic stress disorder.(symptoms of PTSD within the first month of traumatic event) 50% of those with ASD went on to develop PTSD however 52% of those with PTSD did not suffer from ASD

Power of Program Research

Significant issues often are resolved not by one perfectly designed study but rather by a series of studies that examine different aspects of the problem—in a program of research

Right to Refuse Treatment

Some believe that people with severe mental illness are incapable to decide if they need treatment. Can people be "forced" to become competent to stand trial?-→ dilemma→ if people facing criminal charges are delusional or have such frequent severe hallucintations that they cannot fully participate in legal proceedings, they can be forced against their will to take medication to reduce these symptoms Riggins v. Nevada (1992)→Supreme Court ruling stated that, b/c of the potential for negative side effects (such as involuntary motor movments associated with tardive dyskinesia) people cannot be forced to take antipsychotic medication. Other rulings make allowances for involuntary medications following a Harper hearing (washinginton v harper 1990) a due process hearing that allows mental health profs to argue for the merits of medication use and the pt to provide a counterargument Used to involuntary medicate Jared Loughner a man who eventually pleaded guilty to 19 charges of murder and attempted murder for a 2011 attack in Tuscon, AZ in which US rep Gabrielle Giffords was severaly injured, 6 others killed

Psychosocial Factors & Neurotransmitter Systems

Some experiments indicate that psychosocial factors directly affect levels of NTs. Insel, Scanlan, Champoux & Suomi (1988) raised two groups of rhesus monkeys identically except for their ability to control things in their cages. 1st group had access to treats & toys, 2nd group only got them when the 1st group did 1st group grew a sense of control later in life, all monkeys were administered a benzodiazepine inverse agonsist, (opposite effect of GABA) which had the effect of an extreme burst of anxiety. Monkeys w/out sense of control of their environment ran inot corner of cage and showed extreme signs of anxiety & panic • Monkeys w/ sense of control didn't seem anxious • Yeh, Fricke, & Edwards (1996)→ studied 2 male crayfish battling to est. dominance in their social group oWhen one won the battle & est. dominance, 5HT made a specific set of neurons likely to fire, and the inverse effect was seen in the loser Concluded that naturally occurring NTs have diff effects depending on the psychosocial experience of the organisms Berton et al. discovered that putting big mice into a cage that then proceeded to "bully" a smaller mouse produced changes in the mesolimbic DE system of the smaller mouse→ mesolimbic system is ordinarily associated w/ reward & even addiction→ in this instance, certain chemicals that produce new learning & other changes in other parts of the brain, specifically brain development neurotrophic factor (BDNF) were turned on in the mesolimbic DE system had diff effects on the mouse than it usually does→ the "bullying" experience produced BDNF, which altered the usual functioning of the mesolimbic DE system from facilitating glucocorticoid receptors located on dopaminergic neurons specifically in facilitating & maintaining this social aversion

Comparative Treatment Research

Some researchers compare different treatments the researcher give diff treatments to 2 or more comparable groups of people with a particular disorder and can then assess how or whether each treatment helped the people who received it Process research→ focuses on the mechanisms responsible for behavior change "why does it work"

Psychosocial Influence on the Brain

Sometimes the effects of treatment tell us something about the nature of psychopathology Lewis R. Baxter & colleagues used brain imaging on patients who had not been treated & then treated them w/ a cognitive behavioral therapy known to be effective in OCD pts and known as exposure & response prevention & then repeated brain imaging→ the brain circuit was normalized by a psychological intervention There has been success in this treatment that is associated w/ depression, social anxiety, & specific phobia→ termed as re-wiring the brain Research in placebo effects & the effects of pts seeing the medicine being administered Another research area is involved with exploring the specific ways in which drug or active psychological treatments work in terms of changes in brain function "top down" change-→ originates in the cortex and works its way down into the lower brain. Treatment for individuals w/ major depressive disorder Drugs often seem to work more in a "bottom up" manner, reaching higher areas of the cortex last.

Neuroimaging

Sophisticated computer-aided procedure that allows nonintrusive examination of nervous system structure and function. Can be divided into two categories Procedures that examine the structure of the brain, such as the size of various parts and whether there is any damage Procedures that examine the actual functioning of the brain by mapping blood flow and other metabolic activity

Genotype

Specific genetic makeup of an individual.

Intelligence Testing

Stanford-Binet test→ in 1904 Alfred Binet and colleague Theodore simon (French) were commissioned to develop a test that would ID slow learners who would benefit from remedial help→ they developed several tasks that presumably measured the skills children need to succeed in school, including tasks of attention, perception, memory, reasoning, and verbal comprehension→ gave the series of tasks to school children and eliminated those that didn't separate the slow learners form the children who excelled. In 1916 Lewis Terman of Stanford translated a revised version Current tests use a deviation IQ→ the persons score is compared with only scores of others of the same age. David Weschler→ includes tests for adults, children, and young children. Contain verbal scale→ measure vocab, knowledge of facts, STM, and verbal reasoning skills. Also performance scales→ assess psychomotor abilities, nonverbal reasoning, and the ability to observe new relationships

Parents Patriae

State acts as a surrogate parent when the patient is believed to be incapable hen citizens are not likely to act in their own best interest→ i/e to assume custody of children who have no living parents → individuals are committed with severe mental illness to mental health facilities when it is believed they may be harmed b/c they are unable to secure the basic necessities of life, or do not recognize needs for treatment usually begins with a petition by a relative or mental health professional to a judge→ the court may then request an examination to assess psychological status, ability for self-care, need for treatment and potential for harm the person must be notified that the civil commitment proceedings are taking place, must be present during the trial, must have representation by an attorney, and can examine the witnesses and request an independent evaluation

Criteria for Civil Commitment

States have permitted commitment when several conditions have been met: 1. The person has a "mental illness" and is in need of treatment 2. The person is dangerous to himself/herself/others 3. The person is unable to care for himself, a situation considered "grave disability"

Statistical/ Clinical Significance

Statistical-Small probability of obtaining the observed research findings by chance. Clinical-Degree to which research findings have useful and meaningful applications to real problems. effect size-A statistical process that eliminates how large a change in measure occurred. Often used before and after a clinical treatment to determine its relative success.

Etiology

Study of origins- why a disorder begins. Includes biological, physiological and social dimensions

Genetic Linkage Analysis

Study that seeks to match the inheritance pattern of a disorder to that of a genetic marker. This helps researchers establish the location of the gene responsible for the disorder.When a family is studied other inherited characteristics are looked at as well. The other characteristics, genetic markers (Inherited characteristic for which the chromosomal location of the responsible gene is known) are selected because their location is unknown.

Panic

Sudden, overwhelming fright or terror. A panic attack is an Abrupt experience of intense fear or discomfort accompanied by several physical symptoms, such as dizziness or heart palpitations. 2 types of panic: expected (cued), unexpected (uncuued)

Prototypical Approach

System for categorizing disorders using both essential, defining characteristics and a range of variation on other characteristics. identifies certain essential characteristics of an entity so that you (and others) can classify it, but it also allows certain nonessential variations that do not necessarily change the classification. Many possible features or properties of the disorder are listed and any candidate must meet enough of them to fall to that category. Blurs category boundaries & some symptoms apply to different disorders

Taxonomy

System of naming and classification (for example, of specimens) in science.

Clinical Assessment

Systematic evaluation and measurement of psychological, biological, and social factors in a person presenting with a possible psychological disorder.

Deinstitutionalization/ Homelessness

Systematic removal of people with severe mental illness or intellectual disability from institutions like psychiatric hospitals had two goals: 1. To close the large state mental hospitals 2. To create a network of community mental health centers where the released individuals could be treated About 2-3 million people will experience a nigh of homelessness in US each year→ more than 400k on any given night → estimate about 30% of those people have a disorder of severe mental illness Transinstitutionalization→ the movement of people with severe mental illness from large psychiatric hospitals to nursing homes or other group residences, including jails & prisons, many of which provide only marginal services

Dangerousness

Tendency to violence that, contrary to popular opinion, is not more likely among mental patients. There are specific symptoms (hallucinations, delusions or comorbid personality disorder) appear to be associated with people at increased risk of violence

Mental Illness

Term formerly used to mean psychological disorder but less preferred because it implies that the causes of the disorder can be found in a medical disease process legal concept, typically meaning severe emotional or thought disturbances that negatively affect and individual's health and safety. Each state has own definition- NY→ "mental illness means an affliction w/ a mental disease or mental condition which is manifested by a disorder or disturbance in behavior, feeling, thinking, or judgment to such an extent that the person afflicted requires care, treatment, and rehabilitation" Not synonymous with psychological disorder- receiving a diagnosis from the DSM V does not mean the condition fits the criteria for mental illness

Spectrum

Term used to describe groups of disorders that share certain basic biological or psychological qualities or dimensions

Anger & the Heart

The ability of the heart to pump blood efficiently thought the body diminished significantly during anger but not during stress or exercise

Emotion & Psychopathology

The basic emotions of fear, anger, sadness, or distress & excitement may contribute to many psychological disorders & may even define them Emotions & mood also affect our cognitive processes

Genes & Behavior

The best estimates attribute about ½ of our enduring personality traits & cognitive abilities to genetic influence Genetic factors make some contribution to all disorders but account for less than ½ of the explanation Adverse life events have been known to override genes Certain genes or groups of genes may be ultimately associated with certain disorders

Twin Studies

The comparison of twins with unrelated or less closely related individuals. If twins, particularly monozygotic twins who share identical genotypes, share common characteristics such as a disorder, even if they were reared in different environments, then strong evidence of genetic involvement in those characteristics exists. the obvious scientific question is whether individual twins share the same trait more often than fraternal twins Monozygotic→ identical twins; identical genes Dizygotic→ fraternal twins come from diff eggs and have only about 50% of their genes in common Michael Lyons and colleagues (1995) conducted a study of antisocial behavior among members of the Vietnam Era Twin Registry.