Abnormal Psychology Final Exam
Brain development
-brain and nervous system begin to develop at 3 weeks gestation with the closing of the neural tube -by 4 weeks, the major regions of the brain can be recognized in primitive form (forebrain, midbrain, hindbrain, and optic vesicle) -ridges and convolutions are seen by 6 months
Comorbidity with schizophrenia
-over 90% suffer from at least one other disorder -mood disorders (depression: little or no interest in activities -anxiety disorder -substance use disorders (delusions and hallucinations) -hard for clinicians because they are looking at the same condition but have to figure out the cause
Schizophrenia: neurological factors (genetics)
-strongest predictor that a given person will develop schizophrenia -the more genes, the higher the risk (but not 100% predictive of the disease) -older fathers are 3x more likely to produce schizophrenic offspring
Limbic system
-subcortical structure that participates in (mostly unconscious) emotional processing -hypothalamus, amygdala, and hippocampus are the three key parts
SSD: social factors
-observational learning: children who have a parent constantly in pain are more likely to report pain themselves--> ill parent inadvertently models behavior -operant conditioning may also play a role, as family members may have accidentally reinforced behavior in a child
Lobes of the brain
-occipital= vision -parietal= processing spatial information -temporal= hearing -frontal= executive functioning (last to develop in humans)
Gender differences and prevalence of intellectual disability
-occurs in 1% of the population -must develop at birth -male to female ratio of 1.5:1
Cluster A personality disorders
-odd or eccentric behaviors that have elements related to those of schizophrenia -paranoid personality disorder -schizoid personality disorder -schizotypal personality disorder
Schizoid personality disorder
-odd/eccentric personality disorder -characterized by a restricted range of emotions in social interactions and few (if any) social relationships -lack social skills -nuances social cues -flat -lack anger -little desire for relationships
Paranoid personality disorder
-odd/eccentric personality disorder -characterized by persistent and pervasive mistrust and suspiciousness, accompanied by a bias to interpret other people's motives as hostile -doubt the behavior of others and always think that partner is cheating on them
Schizotypal personality disorder
-odd/eccentric personality disorder -eccentric thoughts, perceptions, behaviors -few relationships (on the schizophrenic spectrum)
Quadruplets with schizophrenia
-odds of both identical twins have schizophrenia= 48% -odds of all four in quads= 16% -symptomology was not all identical in severity even though they all had the same genes--> something environmentally leads to differences (could even be an environmental difference in utero)
Goals of treating substance use disorders
-one goal is abstinence -alternative goal is harm reduction (because there is high relapse with abstinence)
Stimulants: psychological factors
-operant conditioning is related to pleasant consequences -reward craving= the desire for the gratifying effects of using a substance -relief craving= the desire for the temporary emotional relief that can arise from using a substance -classical conditioning: drug cues= the stimuli associated with drug use that come to elicit conditioned responses through their repeated pairings with use of the drug -classical and operant conditioning interact
Other abused substances: neurological factors
-opioids: directly effect the brainstem (involved in breathing and coughing); overtime reduce the body's natural pain-relieving ability -hallucinogens: activated dopamine reward system; atrophy of brain areas that contain receptors for cannabinoids (especially hippocampus and cerebellum) -dissociative anesthetics: increase level of glutamate, which can be toxic if too much is present
Diffuse modulatory systems
-originate with several, small sets of neurons in the brain stem -axons in these systems make divergent contacts with more than 100,000 postsynaptic neurons spread across the brain -spill neuromodulators into the vicinity where they have connections (basically flood the area with neurotransmitters) -backdrop against which all other specific (sensory and motor) activity takes place -make brain more or less excitable
Genes and environment interaction
-there is a back and forth between genes and the environment -something can go awry so that perception/behavior can go beyond what is normative -environment can impact genes by learning and epigenetics -genes can impact environment as well
Suicidal ideation
-thoughts of suicide -does not actually indicate the presence of a psychological disorder or an actual suicide risk
Exposure with response prevention
a behavioral technique in which a patient is carefully prevented from engaging in his or her usual maladaptive response after being exposed to a stimulus that usually elicits the response
Sensate focus exercises
a behavioral technique that is assigned as homework in sex therapy, in which a person or couple seeks to increase awareness of pleasurable sensations that do not involve genital touching, intercourse, or orgasm
Interoceptive exposure
a behavioral therapy method in which patients intentionally elicit the bodily sensations associated with panic so that they can habituate to those sensations and not respond with fear (example: holding breath)
Social desirability
a bias toward answering questions in a way that respondents think makes them appear socially desirable, even if the responses are not true
Persistent depressive disorder (dysthymia)
a depressive disorder that involves as few as two symptoms of a major depressive episode but in which the symptoms persist for at least 2 years
Disruptive mood dysregulation disorder (DMDD)
a depressive order in children characterized by persistent irritability and frequent episodes of out-of-control behavior
Antabuse
a medication for treating alcohol use disorder that induces violent nausea and vomiting when it is mixed with alcohol
Hypothesis
a preliminary idea that is proposed to answer a question about a set of observations
Theory
a principle or set of principles that explains a set of data
Electroconvulsive therapy
a procedure that sends electrical pulses into the brain to cause a controlled brain seizure, in an effort to reduce or eliminate the symptoms of certain psychological disorders
Transcranial magnetic stimulation
a procedure that sends sequences of short, strong magnetic pulses into the brain via a coil places on the scalp, which is used to reduce or eliminate the symptoms of certain psychological disorders
Factitious disorder
a psychological disorder marked by the false reporting or inducing of medical or psychological symptoms in order to receive attention
Schizophreniform disorder
a psychotic disorder characterized by symptoms that meet all the criteria for schizophrenia except that the symptoms have been present for only 1-6 months, and daily functioning may or may not have declined over that period of time
Brief psychotic disorder
a psychotic disorder characterized by the sudden onset of positive (no negative symptoms are present) or disorganized symptoms that last between 1 day and 1 month and are followed by full recovery
Double-blind design
a research design in which neither the participant nor the investigator's assistant knows the group to which specific participants have been assigned or the predicted results of the study
Case studies
a research method that focuses in detail on one individual and the factors that underlie that person's psychological disorder or disorders
Meta-analysis
a research method that statistically combines the results of a number of studies that address the same question to determine the overall effect
Anxiety
a sense of agitation or nervousness, which is often focused on an upcoming possible danger
Projective test
a tool for personality assessment in which the patient is presented with ambiguous stimuli (such as inkblots or stick figures) and is asked to make sense of and explain them
Acute stress disorder
a traumatic stress disorder that involves (a) intrusive re-experiencing of the traumatic event, (b) avoidance of stimuli related to the event, (c) negative changes in thought and mood, (d) dissociation, (e) hyperarousal and reactivity, with these symptoms lasting for less than a month
Paraphilia
an intense and persistent sexual interest that is different than the usual fondling or genital stimulation with "normal physically mature consenting human partners"
Rapid cycling (of moods)
having four or more episodes that meet the criteria for any type of mood episode within one year
Obsessions
intrusive and unwanted thoughts, urges, or images that persist or recur and usually cause distress or anxiety
The cognitive contribution
investigation of how people pay attention to stimuli and develop biases in what they expect and remember
Problem with modulating drug
it will impact other brain systems (side effect)--> do not necessarily want to affect these systems, but drugs are not specific
Mood disorders
psychological disorders characterized by prolonged and marked disturbances in mood that affect how people feel, what they believe and expect, how they think and talk, and how they interact with others
Substance use disorders
psychological disorders that are characterized by loss of control over urges to use a psychoactive substance, even though such use may impair functioning or cause distress
Talk therapy
psychotherapist will listen to negative thoughts and challenge them to help with reframing--> changing brain circuits being used by cognitive reconstructing
Compartmentalizing
putting things "away" and not thinking about them again
Gender role
the outward behaviors, attitudes, and traits that a culture deems masculine or feminine
Replication
the process of repeating a study using the same data collection methods under identical or nearly identical conditions to obtain data that should have the same characteristics as those from the original study
Common liabilities model
the model that explains how neurological, psychological, and social factors make a person vulnerable to a variety of problematic behaviors, including substance use disorders; also called problem behavior therapy
Prevalence
the number of people who have a disorder in a given period of time
Evidence based research
using current literature as a basis for determining diagnosis and treatment
Phenotype
the traits that you allow or "express" (some are hidden and resurface in later generations)
Complex inheritance
the transmission of traits that are expressed along a continuum by the interaction of sets of genes
Epidemiology
the type of correlational research that investigates the rate of occurrence, the possible causes and risk factors, and the course of diseases or disorders
Photo therapy
treatment for depression that uses full spectrum lights
Gender differences in schizophrenia
-1.4 men develop the disorder for every 1 woman -men are more likely to develop the disorder in their early 20s, whereas women do in their late 20s -women generally function at higher levels before developing schizophrenia
Prognosis of schizophrenia
-1/3 improve significantly -1/3 stay the same -1/3 become chronically and severely disabled -10-15% commit suicide -a small percentage commit violent acts
Prevalence (and stability) of personality disorders
-10 to 15% of the US population -after 12 months, 25% no longer meet the diagnostic criteria for personality disorder--> not as stable as once thought -high rate of suicide (30%) and attempted suicide (40%)
Schizophrenia case study: Sonny
-21 year old living with parents (socially isolated) -difficulty concentrating, obsessional thoughts and delusions, anxiety -marijuana use -extremely close with father, bad relationship with mother -adopted so there was no way to know his genetic vulnerability -tending towards paranoia: contracted HIV, mom not being accepting of homosexuality, thought FBI were after him, believed that certain things on the TV were aimed at him -came to the attention of a psychiatrist because his therapist referred him to inpatient care -took him a while to adjust to medications/find one that worked (did not like tardive dyskenesia) -fearful of hospital environment because he was not used to it and had gone to a community college (as to always stay at home) -got let out 2 weeks early and was doing well at first -went to a day program in the hospital and stopped taking his medication because he improved so much -eventually ended up doing well in school
Gender difference in borderline personality disorder
-75% female -most common in women who have been abused physically or sexually
ASD: psychological treatments
-ABA (applied behavior analysis): a technique used to modify maladaptive behaviors by reinforcing new behaviors through shaping -complex behavior is broken down into short, simple actions that are reinforced and then ultimately strung together
Intellectual disability: social treatments
-ADA and IDEA say children ages 3-21 are entitled to a special education with related services that are individually tailored to the child's needs at no cost to the parents -entitled to an IEP -facilitate inclusion: LRE (does not mean mainstreaming)
Disorders of disruptive behavior and attention: neurological factors
-ADHD: brain systems and neural communication--> impaired frontal lobe functioning; children have smaller brains specifically in the frontal lobe area -smaller cerebellums (crucial for attention and timing) -emerges from how different brain areas interact -lower than normal levels of dopamine -problems with basal ganglia, which regulates voluntary movement -runs in families and is highly correlated in monozygotic twins -among the most heritable of psychological disorders -the effect of genes depend in part on the environment
Psychopathy and antisocial personality disorder: psychological factors
-problems with classical and operant conditioning processes -criminals do not learn to avoid painful stimuli so they cannot easily learn from punishing experiences
Paraphilic disorders: psychological treatments
-CBT -decrease cognitive distortions that promote paraphilic fantasies, urges, and behaviors -relapse prevention training: identify and recognize high-risk situations and learn strategies to avoid them
Personality disorders: psychological treatments
-CBT and psychodynamic therapy -focus on core issues that are theorized to give rise to the disorders -psychodynamic therapy addresses unconscious drives and motivations, whereas CBT addresses maladaptive views of the self and others and negative beliefs that give rise to the problematic feelings, thoughts, and behaviors of the personality disorder -could also include motivational enhancement therapy
Treating psychological factors of eating disorders
-CBT for anorexia: effective in reducing symptoms of anorexia and preventing relapses; focuses on identifying and changing thoughts and behaviors that impede normal eating and that maintain the symptoms of the disorder; therapist also helps the patient develop more adaptive coping strategies -CBT for bulimia: focuses on thoughts, feelings and behaviors that prevent normal eating and promote bingeing, purging, and other behaviors that are intended to offset the calories eaten during a binge; may also address issues with perfectionism, low self-esteem and mood
Treating fearful/anxious personality disorders
-CBT: exposure to avoided stimuli as well as cognitive restructuring of maladaptive beliefs and strategies -family or couples therapy to help family members change their responses to (and thus the consequences of) the patient's maladaptive behaviors
Schizophrenia: targeting psychological factors
-CBT: learn to distinguish hallucinatory voices from people actually speaking; highlight the importance of taking effective medications; address issues that interfere with compliance; develop more effective coping strategies -treating comorbid substance abuse: motivational enhancement
Genetic causes of specific intellectual disabilities
-Down Syndrome: abnormality in chromosome 21 -Rett's Disorder (females only): abnormality in X chromosome (which is lethal for male fetuses) -Fragile X: repetition of a piece of genetic code on the X chromosome that becomes progressively more severe in each generation -Phenylketonuria (PKU): a genetically based defect in an enzyme, phenylalanine hydroxylase, that leads to failure to convert phenylalanine to tyrosine; unconverted phenylalanine is toxic to brain cells, leading to intellectual disability, which can be prevented if PKU is identified (through a blood test at birth) and the person adheres to a diet that restricts phenylalanine -Congenital hypothydroidism: inadequate production of thyroid hormone caused by a genetic mutation; the fetus gets thyroid hormone from the mother, but after birth, the deficiency leads to defects in the developing brain; if hypothyroidism is not detected within the first 3 months of life, the damage cannot be reversed, even with thyroid hormone replacement
Borderline personality disorder: treating social factors
-IPT -help the patient develop more adaptive interpersonal skills so that he or she feels and functions better -tries to help patients integrate their extreme but opposed feelings about a person (when they talk about feeling one way about someone, the therapist tries to discuss the opposite feelings as well)
Problems with the DSM-5 (IMPORTANT for exam)
-NIMH won't fund research based on definitions in this manual (because they wanted change the way research was done and work on it from a biological perspective rather than the artificial categories in the DSM-5) -"working document" causes confusion -subjectivity in determining clinical significance -disorders are categories rather than continuous dimensions -people with different symptoms can be diagnosed with the same disorder -duration criteria are arbitrary -some sets of criteria are too restrictive -psychological disorders are created to ensure payment -social factors are deemphasized -comorbidity is common -unscientific and lack rigor
Neurological prevention of intellectual disability
-PKU screening in hospital and dietary treatment when detected (dietary proteins cannot be digested in the protein phenylketonuria once the baby is not being fed by the placenta--> causes problems with dopamine which is needed for normal brain function, melanin, and proteins -lead screening in paint and in blood tests of infants
Magnetic resonance imaging (MRI)
-Providing a highquality, three-dimensional image of organs and structures inside the body without X-rays or other radiation (noninvasive), MRIs are unsurpassed in anatomical detail and may reveal minute changes that occur over time -tell scientists when structural abnormalities first appear in the course of a disease, how they affect subsequent development, and precisely how their progression correlates with mental and emotional aspects of a disorder -different atoms in the brain resonate to different frequencies of magnetic fields
Borderline personality disorder: treating neurological factors
-SSRIs may diminish symptoms of emotional liability and anxiety and help with anger management -antipsychotics can alleviate psychotic symptoms -mood stabilizers may also help
Paraphilic disorder
-a category of disorders characterized by paraphilias that lead to distress, impaired functioning, or harm (or risk of harm) to the person or to others -unusual preferences in either sexual activity or the target of the activity -characterize paraphilic disorders according to whether they involve: non-consenting adults or children, nonhuman objects/ body parts, or suffering or humiliating oneself or one's partner -form a predictable pattern of arousal that is consistent for the person -pattern of arousal must be present for at least 6 months
Personality disorders
-a category of psychological disorders characterized by an enduring pattern of inflexible and maladaptive thoughts, emotional responses, interpersonal functioning, and impulse control problems that arise across a range of situations and lead to distress or dysfunction -influence affect (range, intensity, and changeability of emotions and emotional responsiveness), behavior (ability to control impulses and interactions with others), and cognition (perceptions and interpretations of events, other people, and oneself) -inflexible and maladaptive thoughts, feelings, and behaviors
Somatic symptom disorders
-a category of psychological disorders characterized by symptoms about physical well-being along with cognitive distortions about bodily symptoms and their meaning; the focus on these bodily symptoms causes significant distress or impaired functioning -common factors: bodily preoccupation, symptom amplification
Neurocognitive disorders
-a category of psychological disorders in which the primary symptom is significantly reduced cognitive abilities, relative to a prior level of functioning; also referred to as cognitive disorders -cannot be present at birth -the changes in functioning (in mental processes) constitute the primary set of symptoms -almost exclusively caused by neurological factors
External validity
-a characteristic of a study that indicates that the results generalize from the sample to the population from which it was drawn and from the conditions used in the study to relevant conditions outside the study -if a study does not have internal validity, it cannot have external validity
Catatonia
-a condition in which a person does not respond to the environment or remains in an odd posture or position, with rigid muscles, for hours -positive symptom of schizophrenia
Anhedonia
-a difficulty or inability to experience pleasure -can lead to social withdrawal
Obsessive-compulsive disorder (OCD)
-a disorder characterized by one or more obsessions or compulsions -most people with OCD recognize that the beliefs that underlie their obsessions and compulsions are not valid in all situations -performing the behavior prevents or relieves anxiety temporarily
Separation anxiety disorder
-a disorder that typically arises in childhood and is characterized by excessive anxiety about separation from home or from someone to whom the person is strongly attached -the anxiety, distress, or impaired functioning must be excessive and typically is exhibited over a period of at least 6 months for adults -can exhibit physical symptoms as well as constantly checking in and refusing to separate -some children will literally never go beyond 5 feet away from their parent
Attention-deficit/hyperactivity disorder
-a disorder that typically arises in childhood and is characterized by inattention, hyperactivity, and/or impulsivity -must have 6 or more symptoms -vary in terms of which symptoms are most dominant: difficulty maintaining attention, difficulty with hyperactivity and impulsivity, combination -must impair functioning in at least 2 settings (school, work, home) and some symptoms must have been present by age 12 -problems with: inattention, listening, following through, organization, sustained effort, losing things, distractedness, impulsivity, hyperactivity -benefits from: frequent rewards for appropriate behavior, close supervision, new situations, doing something interesting, having someone's undivided attention
Oppositional defiant disorder
-a disorder that typically arises in childhood or adolescence and is characterized by angry or irritable mood, defiance or argumentative behavior, or vindictiveness -must exhibit 4/8 symptoms -must have occurred for at least 6 months, more frequently than would be expected for the person's age and developmental level, and must impair functioning -disruptive behaviors are: generally directed toward authority figures; not usually violent and do not usually cause severe harm; in children, often exhibited in specific situations with parents or other adults the children know well *aggressive but not violent
Depersonalization-derealization disorder
-a dissociative disorder, the primary symptom of which is a persistent feeling of being detached from one's mental processes, body, or surroundings -still recognize reality, but feel like a robot -may not react emotionally to events: may feel that they don't control their behavior and are just being swept along with what is happening around them
Treating neurological and biological factors of eating disorders
-a focus on nutrition and variety of foods eaten: meal plans for increasing caloric intake at a reasonable pace -medical hospitalization to treat the specific problem and stabilize the patient's health -SSRIs may help the patient from developing anorexia again -SSRIs can also reduce the symptoms of comorbid depression
Cyclothymic disorder
-a mood disorder characterized by chronic, fluctuating mood disturbance with numerous periods of hypomanic symptoms alternating with depressive symptoms, each of which does not meet the criteria for its respective mood episodes -person may never be diagnosed because symptoms don't interfere with functioning quite so much
Major depressive episode (MDE)
-a mood episode characterized by severe depression that lasts at least 2 weeks -not a diagnosis, but a set of symptoms that help make a diagnosis
Avolition
-a negative symptom of schizophrenia marked by difficulty initiating or following through with activities -what you see in movies when people appear to do nothing all day -person cannot be motivated
Mild neurocognitive disorder
-a neurocognitive disorder characterized by a modest decline from baseline in at least one cognitive domain, but that decline is not enough to interfere with daily functioning -patient is still independent
Panic attack
-a specific period of intense fear or discomfort, accompanied by physical symptoms, such as a pounding heart, shortness of breath, shakiness, and sweating, or cognitive symptoms, such as fear of losing control -sometimes panic attacks are "cued" by certain circumstances
Biofeedback
-a technique in which a person is trained to bring normally involuntary or unconscious bodily activity, such as heart rate, or muscle tension, under voluntary control -electrodes are attached to a targeted muscle and the patient can see whether the targeted muscles are tensed or relaxed -treatment for GAD
Delirium
-a neurocognitive disorder characterized by a relatively sudden disturbance in attention and awareness as well as disruption of at least one other aspect of cognitive functioning -symptoms develop rapidly over hours or days and fluctuate within a 24 hour period -disturbance in attention is evidenced by difficulty directing, focusing, sustaining, and shifting attention, as well as decreased awareness of the external environment -person may appear to be stoned or seem to be focusing on internally generated stimuli -may have a hard time understanding a question or shifting to a new question -clinician must infer the patient's mental state from his or her behavior and unusual responses and then seek information from family members of friends -may be disoriented -content of speech may resemble that of someone in a manic episode -may experience perceptual alterations such as misinterpretations, illusions, and hallucinations -most commonly occurs among the elderly, the terminally ill, patients who have just had surgery, dehydrated people
Major neurocognitive disorder
-a neurocognitive disorder characterized by evidence of a substantial decline in at least one cognitive domain, and impaired daily functioning -person cannot live independently
Intellectual disability
-a neurodevelopmental disorder characterized by cognitive abilities that are significantly below normal, along with impaired adaptive functioning in daily life; also called intellectual development disorder and previously referred to as mental retardation -IQ score at least 2 standard deviations below average (70 + or - 2) -adaptive functioning involves conceptual, social, and practical domains -must emerge during childhood and cannot be the result of brain trauma in adulthood -levels: mild, moderate, severe, profound -exhibit a wide variety of personality characteristics like people with normal intelligence
ASD
-a neurodevelopmental disorder characterized by deficits in communication and social interaction skills, as well as stereotyped behaviors and narrow interests -engage in very repetitive play -much more or less reactive to sensory stimuli -often display stereotyped behaviors -become distressed when certain routines are not carried out or completed--> may rock themselves to self-soothe -symptoms usually become evident during infancy or early childhood -avoid eye contact and shy away from social interactions -appear to ignore others and be uninterested in making friends -IQ scores are typically average+ -could be autistic savants: set of unique skills in art, music, numbers, or calendars -often have sleep and dietary problems
Specific learning disorder
-a neurodevelopmental disorder characterized by skills well below average in reading, writing, or math, based on the expected level of performance for the person's age, general intelligence, cultural group, gender, and education level -deficits must significantly interfere with school or work performance or daily living (when services and supports are not provided) -two SD below average IQ score -3 categories: reading (dyslexia), written expression, mathematics -50% more likely to drop out of school than the general population
Pedophilic disorder
-a paraphilic disorder in which recurrent sexually arousing fantasies, sexual urges, or behaviors involve a child who has not yet gone through puberty -person must be at least 16 years old, and at least 5 years older than the child (who has not yet reached puberty) -many of the people believe that they are not harming children, but "sharing the pleasure"
Transvestic disorder
-a paraphilic disorder in which the person cross-dresses for sexual arousal and experiences distress or impaired functioning because of the cross-dressing -almost always men -usually begins before age 10 -distinction: not gender dysphoria because they do not actually want to be the opposite sex -comfortable with their biological sex, but they cross dress because it makes them feel calmer -these men may have a different name for themselves when they are cross dressing
Manic episode (and expansive mood)
-a period of at least 1 week characterized by abnormally increased energy or activity and abnormal and persistent euphoria or expansive mood or irritability -expansive mood: a mood that involves unceasing, indiscriminate enthusiasm for interpersonal or sexual interactions or for projects -one type of mood disorder in bipolar
Narcissistic personality disorder
-a personality disorder characterized by an inflated sense of self-importance, an excessive desire to be admired, and a lack of empathy -overvalue themselves and undervalue other people -self-esteem can be fragile, leading them to fish for compliments -relatively insensitive to others' feelings and points of view -manipulative: almost impossible to cut someone like this out of your life
Histrionic personality disorder
-a personality disorder characterized by attention-seeking behaviors and exaggerated and dramatic displays of emotion -seek out novelty and excitement when they feel bored -have difficulty delaying gratification -become excessively frustrated by life's challenges -main "goal": desiring frequent attention from others -we have a lot of trouble empathizing with these people because they are so exaggerated that they become unbelievable
Avoidant personality disorder
-a personality disorder characterized by extreme shyness that usually stems from feeling inadequate and being overly sensitive to negative evaluation -characterized as shy, isolated, timid, or lonely -limit social interactions to avoid being socially rejected or humiliated -afraid of embarrassment -so reluctant to engage in social interactions that they may turn down a promotion if the position requires increased social contact -like social phobia, but broader
Obsessive-compulsive personality disorder
-a personality disorder characterized by preoccupations with perfectionism, orderliness, and self-control, as well as low levels of flexibility and efficiency -decision making is a painful long process -appear rigid and inflexible because they do not change their minds after making a decision -relationships are normally formal and serious -preoccupied with logic and intellect -feel uncomfortable with others who express emotions easily and openly
Dependent personality disorder
-a personality disorder characterized by submissive and clingy behaviors, based on fear of separation -intended to elicit attention, reassurance, and decisive behaviors from other people--> part of a chronic pattern of helpless behavior -chronically plagued by self-doubt and consistently underestimate their abilities -prefer to have others make choices for them -because they are quick to believe that they are wrong, they are likely to see any criticism or disapproval as proof of their negative beliefs about themselves -rely on others and make sure they are never alone/ not in a relationship -limited social circle with only a few friends who they depend on
Borderline personality disorder
-a personality disorder characterized by volatile emotions, an unstable self-image, and impulsive behavior in relationships -emotion dysregulation -relationship pattern of of idealizing the other person at the beginning of the relationship, spending a lot of time with the person and revealing much, thus creating an intense intimacy --> positive feelings quickly switch to negative ones -strong responses to emotional stimuli -parasuicidal behavior is often exhibited when the person is in a dissociated state (cutting)--> emotional dysregulation is so upsetting so cutting and pain associated with cutting allows them to focus on this and relieves tension -extremely sensitive to any hint of being abandoned -very difficult to diagnose -achieve sense of self from external (not internal) reference -most terrible part is that they say horrible things and then act perfectly fine -most common of personality disorders
Placebo effect
-a positive effect of a medically inert substance or procedure -one way to determine whether a treatment is effective is to compare it to no treatment
Gender dysphoria
-a psychological disorder characterized by an incongruence between a person's assigned gender at birth and the subjective experience of his or her gender, and that incongruence causes distress -typically begins in childhood -profound sense of identifying with the other gender, to the point of denying one's own sexual organs -adolescents and adults may feel uncomfortable living publicly as their assigned, natal gender -symptoms must cause significant distress or impair functioning -most commonly people are heterosexual relative to their gender identification -about 3x more common in natal males than females
Schizophrenia
-a psychological disorder characterized by psychotic symptoms that significantly affect emotions, behavior, and mental process and mental contents -must have two or more positive and negative symptoms at least one of which must be hallucinations, delusions, or disorganized speech -symptoms must be present for a minimum of 6 months and must significantly impair functioning
Conduct disorder
-a psychological disorder that typically arises in childhood and is characterized by the violation of the basic rights of others or of societal norms that are appropriate to the person's age -involves four types of behavior: aggression to people and animals, destruction of property, deceitfulness or theft, serious violation of rules -must have at least 3/15 types of behavior within the past 12 months, and at least 1 of such behavior must have occurred during the past 6 months -requires impaired functioning in some area of life, but does not require distress -outbursts of anger, recklessness, poor frustration tolerance -diagnosed under age 18--> changes to antisocial personality disorder after that -do not exhibit genuine remorse for their misdeeds and typically blame others -mild, moderate, and severe subtypes -more likely to use and abuse substances at an earlier age -also more likely to have ADHD than the average individual -may live in foster homes or attend special schools -two types: adolescent onset (after puberty) and childhood onset (two types: callous and not)
Schizoaffective disorder
-a psychotic disorder characterized by the presence of both schizophrenia and a depressive or manic episode -greater risk for committing suicide because of mood disorders -prognosis is better than schizophrenia, because it is often triggered by stressors or events
Delusional disorder (and types of delusions)
-a psychotic disorder characterized by the presence of delusions that have persisted for more than 1 month -these people may appear normal when they are not talking about their delusions -erotomanic: belief that another person is in love with the patient -grandiose: belief that the patient has a great ability, talent, or achievement -persecutory: belief that the patient is being spied on, drugged, harassed, or otherwise conspired against -somatic: the false belief that something is wrong with the body -jealous: belief that the patient's romantic partner is unfaithful
Randomized clinical trial
-a research design that has at least two groups--a treatment group and a control group (usually a placebo control)--to which participants are randomly assigned -best way to evaluate therapies because they use the scientific method to identify the specific factors that underlie a beneficial treatment -independent variable is the type of treatment or technique and the dependent variable is some aspect of the patient's symptoms
Tarasoff rule
-a ruling by the supreme court of California (and later other courts) that psychologists have a duty to protect against potential victims who are in imminent danger by warning the victim, notifying law enforcement agency, and taking reasonable steps to prevent harm -Mr. Poddar shot Ms. Tarasoff after telling his therapist that he had a gun and thought of doing so
Psychopathy
-a set of emotional and interpersonal characteristics marked by a lack of empathy, an unmerited feeling of high self-worth, and a refusal to accept responsibility of one's actions -similar to antisocial personality disorder but patients do not feel remorse, and the category is much more narrowly defined
Dementia
-a set of neurocognitive disorders characterized by deficits in learning new information or recalling information already learned plus at least one other type of cognitive impairment (aphasia, apraxia, agnosia, executive function problems) -arises over a period of time, as brain functioning degrades -symptoms change over time, usually becoming progressively worse -umbrella term -not actually diagnosed in the DSM-5 -all types of dementia are caused by neurological factors
Male hypoactive sexual desire disorder
-a sexual dysfunction characterized by a persistent or recurrent lack of erotic or sexual fantasies or an absence of desire for sexual activity -may be related to social life/issues
Genito-pelvic pain/penetration disorder
-a sexual dysfunction in women characterized by pain, fear, or anxiety related to the vaginal penetration of intercourse -creams and estrogen suppositories can sometimes help this
Illness anxiety disorder
-a somatic symptom disorder marked by preoccupation with a fear or belief of having a serious disease in the face of either no or minor medical symptoms and excessive behaviors related to this belief -may or may not realize that their worries are excessive for the situation
Conversion disorder
-a somatic symptom disorder that involves sensory or motor symptoms that are incompatible with known neurological and medical conditions -do not consciously produce the symptoms they experience -common symptoms: motor, sensory, seizures
PTSD
-a traumatic stress disorder that involves persistent (a) intrusive re-experiencing of the traumatic event, (b) avoidance of stimuli related to the event, (c) negative changes in thoughts and mood, and (d) hyperarousal and reactivity that persists for at least a month -symptoms may not emerge until months or years after the traumatic event
Vascular dementia
-a type of dementia caused by reduced or blocked blood supply to the brain, which arises from plaque buildup or blood clots -plaque builds up on artery walls, making the arteries narrower, which then diminished blood flow to the brain -bits of clotted blood block the inside of the arteries, which then prevents blood from reaching the brain -clots can cause a series of mini strokes, in which blood supply to parts of the brain is temporarily blocked, leading to transient impaired cognition or consciousness (little periods of confusion serving as a warning sign that the blood vessels are compromised) -gradual onset -the course of vascular dementia is variable
Psychopathy and antisocial personality disorder: neurological factors
-abnormal brain structures as well as abnormal brain function -unusually small frontal lobes--> problems in inhibiting and planning behavior -frontal and temporal lobes show less activation than normal during many tasks --> problems with planning -problems with serotonin and dopamine genes--> motivated by reward not by threat of punishment
Labile affect
-affect that changes inappropriately rapidly -emotionally unstable
Comparison of antisocial, borderline, and histrionic
-all want attention for different reasons -histrionic: want attention from others -antisocial: seek power and material gain -borderline: want nurturance
Understanding dementia
-almost 3/4 of dementia cases are caused by Alzheimer's disease (referred to as neurocognitive disorder due to Alzheimer's disease) -diagnosed by ruling out other causes -the progression of Alzheimer's: difficulty remembering recent events or newly learned information--> other cognitive deficits become prevalent--> personality may change and such changes may become more pronounced as cognitive functioning declines--> perceptual motor problems arise, creating difficulties walking, talking, and with self-care -brain abnormalities associated with Alzheimer's disease: neurofibrillary tangles and amyloid plaques -certain people are more susceptible to late onset Alzheimer's disease than people who do not have the apo E gene
Gender dysphoria: neurological treatments
-alter some or all of their biological sexual characteristics: taking hormones -sex reassignment surgery
Dementia and Alzheimer's disease
-alzheimer's= a medical condition in which the afflicted person initially has problems with both memory and executive function and which leads to progressive dementia -most common cause of dementia -problems with both memory and executive function due to degeneration of the brain -75% of cases -memory problems gradually worsen--> attention--> language abilities--> spatial abilities--> psychotic -in the final stage, the patient's memory loss is complete and they cannot recognize family members and friends, can't communicate, and is completely dependent on others for care -neurofibrillary tangles and amyloid plaques are hallmarks of the disease
Understanding fearful/anxious personality disorders
-amygdala is involved -fear and anxiety are psychological factors -temperament can contribute to the development of any of these disorders -patients avoid situations that lead to discomfort and anxiety -anxious or avoidant attachment style
Specific phobia
-an anxiety disorder characterized by excessive or unreasonable anxiety about or fear related to a specific situation or object -works hard to avoid feared stimulus -5 types of specific phobia: animal, natural environment, blood-injection-injury, situational, other -majority of people who have one specific phobia are likely to have at least one more--> may have 2 types: a focused type and a generalized type -humans have a natural readiness for certain stimuli to produce certain conditioned responses--> whatever our earlier ancestors were afraid of made them more likely to survive and reproduce and they passed on their genes to us
Panic disorder
-an anxiety disorder characterized by frequent, unexpected panic attacks, along with fear of further attacks and possible restrictions of behavior in order to prevent such attacks -panic attacks= the key ingredient -culture affects the specifics of this disorder
Social anxiety disorder: social phobia
-an anxiety disorder characterized by intense fear of public humiliation or embarrassment -social situations fall into 3 categories: social interactions, being observed, and performing -may avoid making eye contact and avoid social situation whenever possible -when the social situation cannot be avoided, the person experiences upset stomach, diarrhea, sweating, muscle tension, and heart palpitations -tend to be very sensitive to criticism and rejection and worry about not living up to the perceived expectations of others -achievement at work and school may suffer -people with social anxiety disorder fear other people's scrutiny -people with social anxiety disorder rarely have panic attacks when alone
Agoraphobia
-an anxiety disorder characterized by persistent avoidance of situations that might trigger panic symptoms or from which help would be difficult to obtain -half of these people also have panic disorder or panic attacks -must exhibit a general pattern of avoiding many kinds of environments or situations -people with extreme agoraphobia are completely housebound
Generalized anxiety disorder
-an anxiety disorder characterized by uncontrollable worry and anxiety about a number of events or activities, which are not solely the result of another disorder -worry is primarily focused on family, finances, work, and illness -worries intrude into their awareness when they are trying to focus on other thoughts, and they lead people to feel on edge or have muscle tension -most people come to see worrying and anxiety as a part of themselves, not a disorder
Bulimia nervosa
-an eating disorder characterized by binge eating along with vomiting or other behaviors to compensate for the large number of calories ingested -do not have a significantly low weight like anorexia -2 or 3x more prevalent than anorexia but same prevalence among males and females as anorexia -become ravenous and crave food (only to make themselves feel bad about eating it) -"lose control" of themselves -turns into anorexia 50% of the time
CNS (central nervous system)
-composed of the brain and spinal cord -neurons do not regenerate (damage is permanent)
Binge eating disorder
-an eating disorder characterized by binge eating without subsequent purging -must have at least 3 of these: eat faster than normal, eat until uncomfortably full, eat a lot even when not hungry, eat alone because of being embarrassed by the quantity eaten, have significant negative feelings about themselves because of the amount eaten -do not fantisize about food or enjoy eating -bingeing causes distress -most people are obese -more prevalent than anorexia and bulimia combined
Anorexia nervosa
-an eating disorder characterized by significantly low body weight along with an intense fear of gaining weight or using various methods to prevent weight gain -10-15% of people who are hospitalized die as a direct or indirect consequence of the disorder -half to 90% have a comorbid disorder -approximately 75-90% are female -can be restricting or binge eating/ purging
Phobia
-an exaggerated fear of an object or a situation, together with an extreme avoidance of the object or situation -avoidance can interfere with everyday life
Psychosis
-an impaired ability to perceive reality to the extent that normal functioning is difficult or not possible -two types of psychotic symptoms are hallucinations and delusions
Psychomotor agitation and psychomotor retardation
-an inability to sit still, evidenced by pacing, hand wringing, or rubbing or pulling the skin, clothes, or other objects -a slowing of motor functions indicated by slowed bodily movements and speech and lower volume, variety , or amount of speech -behavioral and physical symptoms of depression
Personality disorders: neurological treatments
-antipsychotics -antidepressants -mood stabilizers -often not helpful
Cluster C personality disorders
-anxious or fearful behaviors -avoidant personality disorder -dependent personality disorder -obsessive compulsive personality disorder
Paraphilic disorders: neurological factors
-apparent similarities with OCD (involving obsessions and compulsions) -abnormal functioning in the basal ganglia and frontal lobes -dopamine and serotonin do not function properly -genetic contribution (runs in families)
Prevalence of schizophrenia
-approximately 1% of the population will develop schizophrenia -men develop symptoms earlier than women -1 of the top 5 causes of disability among adults in developed nations -34% live independently, 5% are homeless, 5% are in hospitals, 6% in jails
Personality disorders: social factors
-attachment style: insecure attachment can involve a negative view of their own worth, the expectation that others are unavailable, or both -can develop insecure attachment from childhood abuse, neglect, or inconsistent discipline
Psychological factors of depressive disorders
-attentional biases: more likely to pay attention to sad or angry stimuli--> lead depressed people to be more sensitive to other people's sad moods and to negative feedback from others, compounding their depressive thoughts and feelings -dysfunctional thoughts: distorted negative views about the world, the self, and the future -rumination and attributional style -learned helplessness
Schizophrenia: psychological factors
-attentional deficits make it hard for people with schizophrenia to discern which stimuli are important and which are not--> problems in organizing what they perceive and experience -don't often realize that they are having unusual experiences or behaving abnormally (lack of insight)--> see no need for treatment -cognitive deficits that are present before symptoms occur affect what the person comes to believe -distortions influence what these people pay attention to and what beliefs go unchallenged -facial expressions of people with schizophrenia are less pronounced than those who do not have the disorder -less accurate in labeling emotions expressed by faces they are shown: difficulty conveying and recognizing emotions
Psychological factors of eating disorders
-automatic, irrational, and illogical thoughts about weight, appearance, and food--> may come to define self-worth -dissatisfaction with one's body -abstinence violation effect= the result of violating a self-imposed rule about food restriction, which leads to feeling out of control with food, which then leads to overeating -operant conditioning: reinforcing disordered eating--> provide relief from what the person might otherwise be preoccupied about or positive reinforcement when restricting behaviors make the person feel powerful and "master" over their appetite -personality traits as risk factors: perfectionism and low self-esteem -insensitive to internal cues of hunger and fullness, so they end up trying to tune out sensations of hunger -presence of a psychological disorder early in adolescence
Behavioral methods of psychotherapy for GAD
-awareness and control of breathing -awareness and control of muscle tension and relaxation -elimination, reduction, or prevention of worries and behaviors associated with worries -biofeedback -habituation with exposure therapy: after enough exposure, the image or thought loses its valence
Operant conditioning
-behavior is paired with reward or punishment to change its frequency -reinforcement increases likelihood of behavior and punishment decreases likelihood of behavior -OCD is very responsive to breaking the S-R connection
Targeting psychological factors in treating depression
-behavioral therapy -cognitive therapy -cognitive behavioral therapy
PTSD: psychological factors and treatments
-beliefs that the person has made about himself or herself and the world: considering yourself unable to control stressors and the conviction that the world is a dangerous place -history of trauma -comorbidity with severe mental disorders or anxiety disorders -classical and operant conditioning -behavioral methods: exposure, relaxation, and breathing retraining -treatment aims to increase a sense of control over PTSD symptoms and to decrease avoidance -cognitive methods: psychoeducation and cognitive restructuring
Gender differences in bipolar
-bipolar I is equally common among males and females, but females are more likely to have bipolar II -overall, women have more depressive episodes (hormonal episodes, reporting differences)
SSD: psychological factors
-bodily preoccupation and symptom amplification, as well as catastrophic thinking (about physical sensations or fears of illness) -mental processes focus on bodily sensations -somatic symptoms can serve as a coping strategy
Depressants: neurological factors
-brain systems and neural communication: directly affect GABAnergic system (which primarily activates inhibitory neurons) -biological by-products of alcohol use disorder: may become malnourished when alcoholic calories substitute calories for food; deficiency in vitamin B1 (indirectly leads to memory problems); hangover indicates alcohol withdrawal -genetics of alcoholism: substance use disorders tend to run in families; biological offspring of alcoholics are about twice as likely to become alcoholics as people without such a family history
Neurological factors of bipolar disorders
-brain systems: amygdala is large and more active for people with this disorder--> amygdala contributes to valence -neural communication: serotonin and norepinephrine have roles in bipolar disorders -genetics: genes influence who will develop a disorder
ASD: neurological factors
-brain systems: frontal lobes do not communicate properly with other brain areas; brain areas in the same immediate region appear to communicate excessively, whereas brain areas in distant regions do not communicate enough; parts of frontal lobes are less active than normal--> lack of executive functioning -large heads (consequence of not pruning back neurons and synapses) -no single gene that gives rise to ASD, but interactions of genes -appears to run in families to some degree -Fragile X and Rett Syndrome are the only clear genetic influences that we can identify by a chromosome
Neurological factors of depressive disorders
-brain systems:low activity in the frontal lobe that has direct connections to the amygdala and to other brain areas involved in emotion -neural communication: disorder arises from complex interactions among numerous neurotransmitters and depends on how much of each is released into the synapses, excess of cortisol -genetics: genes can influence how a person responds to a particular stressful event
Dissociative amnesia: neurological factors
-brain trauma -may result in part from damage to the hippocampus, which is critically involved in storing new information about events in memory
Causes of delirium
-can be a side effect of a prescribed medication, substance use or exposure -can result from a medical condition
Emotions
-can be systematized from parents, siblings, peers, etc -we can recognize emotions in others because we have empathy -a short-lived experience evoked by a stimulus that produces a mental response, a typical behavior, and a positive or negative subjective feeling
Main parts of a neuron
-cell body -axon: sends electrical signals to other neurons -synapse: electrical signal converted to chemical signal -dendrites: receive chemical signal, converts to electrical signal
Sexual dysfunctions: psychological factors
-certain beliefs and experiences can predispose people to develop sexual dysfunctions (such as the belief that sex is sinful) -women may believe that women in general lose their sexual desire as they age, and a man may believe that "real men" have intercourse at least twice a day and that only rock-hard erections will satisfy women --> lead to self fulfilling prophecies -being sexually abused as a child predisposes a person to sexual dysfunction (3x more likely)
Classical conditioning
-certain triggers cause certain behaviors because of some classical conditioning in the past (example: must change environment of a person who has just come out of rehab so that their addictive behaviors do not resurface) -pairing neutral stimulus with unconditioned response to produce conditioned response
Peptides
-chains of amino acids linked together -the brain has opioid peptides like endorphins, which act like opium to kill pain and cause sleepiness
Neurotransmitters
-chemical substance released into the synapse -each type of neurotransmitter plays a different role in the brain -an imbalance of neurotransmitters can lead to psychological disorders -can be excitatory or inhibitory
Autoerotic asphyxia
-choking, hanging, breathing in a plastic bag or with other devices to limit air intake -can be practiced alone or with sexual partners -asphyxia causes heightened sensations during orgasm -very often results in death (especially in men)
Medical effects of bulimia nervosa
-chronic vomiting can cause the parotid and salivary glands to swell and can erode dental enamel, making teeth more vulnerable to cavities and other problems -laxatives can lead to a permanent loss of intestinal functioning, as the body comes to depend on the laxatives to digest food and eliminate waste -constipation, abdominal bloating, discomfort, fatigue, irregular menstruation
Dopamine reward system
-classic study by Olds and Milner '54 showed that rats would lever press to death for stimulation of the dopamine reward pathway originating in the ventral tegmental area -all stimulants (and alcohol) directly activate this pathway -reward--> block inhibition of dopamine neurons--> block dopamine reuptake--> stimulate dopamine neurons directly
Depersonalization-derealization disorder: psychological factors
-cognitive deficits in which the root cause is attention -not clear whether attention is the cause or effect
Dissociative amnesia: social factors
-combat and abuse (indirect effects)
Gender dysphoria: social treatments
-communication and educating family about gender dysphoria -groups that provide support and information (includes help from others about how to BE the opposite sex)
Functional magnetic resonance imaging (fMRI)
-compares brain activity under resting and active conditions -combines the high-spatial-resolution, noninvasive imaging of brain anatomy offered by standard MRI with a strategy for detecting increases in blood oxygen levels when brain activity brings fresh blood to a particular area of the brain, which is a correlate for neuronal activity -this technique is often preferred for studies investigating dynamic cognitive and behavioral changes
7 domains of neurocognitive disorders
-complex attention -executive functions -learning and memory -language -perceptual -motor -social cognition
ANS (autonomic nervous system)
-composed of sympathetic and parasympathetic nervous systems (same organs controlled by two different systems, have opposite effects) -sympathetic= fight or flight--> STRESS -parasympathetic= rest and digest--> NO STRESS
OCD: psychological factors and treatments
-compulsive behavior can provide short-term relief from anxiety that is produced by an obsession--> operant conditioning occurs when the behavior is negatively reinforced -obsessional thinking is normal but people with OCD decides that his or her thoughts refer to something unacceptable--> mental or behavioral rituals arise in order to reduce these feelings -processing makes threatening stimuli easier to remember and harder to ignore, which keeps them in the patients' awareness longer than normal and makes the irrational fears seem more plausible -treatment focuses on decreasing the compulsive behaviors and obsessional thoughts -exposure with response prevention, as well as cognitive restructuring are often used
Privileged communication
-confidential information that is protected from being disclosed during leading proceedings is privileged -but, in some instances clinicians are legally obligated to violate confidentiality and information is no longer privileged
Brain functions
-consciousness -learning and memory -perception -sensory and motor processing -vegetative functioning
Disorders of disruptive behavior and attention: social treatments
-contingency management: changing parents; behavior--> psychoeducation -parent management training -multisystemic therapy
Stress response HPA axis
-cortisol is a stress hormone released by the adrenal glands into the blood -it increase bodily energy and by way of a negative feedback loop, eventually inhibits its own release -the hypothalamus notices when there are high cortisol levels and shuts the system off so that "normal" people do not have excessively high stress levels
Preventing suicide
-crisis intervention -long term prevention: increasing awareness about suicide
Cognitive functioning in normal aging
-crystallized intelligence= a type of intelligence that relies on using knowledge to reason in familiar ways; such knowledge has "crystallized" from previous experience -often remains stable or increases with age -fluid intelligence= a type of intelligence that relies on the ability to create novel strategies to solve new problems, without relying solely on familiar approaches -declines with age (must be judged in relation to each person's unique baseline)--> usually around age 55-65 -elderly generally have problems recalling previously stored information but have little difficulty with recognition -people generally process information slowly as they reach old age: myelin sheaths coating the axons of neurons degrade or disappear -the higher the IQ, the more preserved function (cognitive reserve) over time -recall is more impaired than recognition -explicit (for facts and ideas; easy to acquire and easy to forget) memory is more impaired than implicit (for automatic motor movements) -personal information (episodic memory) is often preserved
Social factors of eating disorders
-culture promotes "ideal" body shape: cultural ideal of thinness, repeated media exposure to thinness ideal and a person's assimilation of the thinness ideal -influence of family and peers: provide models and shape a person's relationship to eating, food, and body
Paraphilic disorders: neurological treatments
-decrease or eliminate sex drive: chemical castration to reduce testosterone levels--> problem is that it does not diminish the interests of men that are associated with these urges -SSRIs may help decrease the sexual fantasies, urges, and behaviors in men whose disorder has O-C elements
Deficit/nondeficit subtypes of schizophrenia
-deficit (more severe): severe neurocognitive deficits in attention, memory, and executive function; positive and negative symptoms -nondeficit: positive symtoms with intact cognitive function; better prognosis
Cognitive deficits in schizophrenia
-deficits in attention : difficulties in sustaining and focusing attention, which can involve distinguishing relevant from irrelevant stimuli; easily distracted -deficits in working memory: do not organize information effectively; not good at holding information in their heads while using it to perform some type of operation -deficits in executive functioning: difficulty doing things that require multiple steps such as planning, organizing, problem solving, abstract thought, and making judgments (example: remembering the steps for making mashed potatoes -cognitive deficits endure over time -cognitive symptoms appear between 16 and 30, but there are abnormalities that can be detected much earlier
Dementia due to other medical conditions
-dementia due to Parkinson's: approximately 50% develop dementia; these people are usually at least 65 years old or in a more advanced stage of the disease; dementia generally involves problems in memory and executive functions; affects the substantia nigra in the brain -dementia due to Lewy bodies: a type of protein that builds up in neurons that produce dopamine or acetylcholine and can eventually cause the neurons to die; neurons most affected are involved in memory and motor control; appears to be very similar to Alzheimer's -dementia due to HIV infection: impaired memory, concentration, and problem solving as well as cognitive slowing; apathy, social withdrawal, delirium, delusions, hallucinations; tremors, problems with balance, repetitive movements -dementia due to Huntington's disease: a progressive disease that kills neurons and affects cognition, emotion and motor function--> leads to dementia--> results in death; inherited and based on a single gene -dementia due to head trauma: precise deficits and severity depend on which brain areas are affected and to what degree; most common among young males who are likely to engage in risk-taking behaviors -substance/medication-induced neurocognitive disorder: persist beyond the period of intoxication or withdrawal; long history of use and is rarely seen in patients younger than 20 years; prognosis depends on the specific substance and its deficits
Synapse
-dendrites are covered with synapses -neurotransmitters are released into the synaptic cleft -all vesicles at the synapse contain the same type of neurotransmitter because all of the receptors only accept one type
Intellectual disability: psychological treatments
-depend on the person's specific symptoms and comorbid disorders -treatment may target significant communication deficits: may teach nonvocal communication
Alcohol
-depressant -approximately 6% of americans (12 or older) have alcohol use disorder -crucial variable that determines intoxication is BAC (women get intoxicated more "easily" than men) -binge drinking occurs when BAC reaches at least 0.08% in a 2-hour period--> repetitive binge drinking can lead to alcohol use disorder -alcoholism is marked by: craving, loss of control, physical dependence, and tolerance
Sedative-hypnotic drugs
-depressant -reduce pain and anxiety, relax muscles, lower blood pressure, slow breathing and heart rate, induce sedation and sleep -lower inhibitions and bring a sense of well-being but also cause memory problems, confusion, poor concentration, fatigue, and even respiratory arrest -can be lethal when combined with alcohol -barbiturates: usually prescribed to treat sleep problems; must be helped by a physician when weaning off -benzodiazepines: usually prescribed to alleviate muscle pain, aid sleep, or as short-term treatment for anxiety; should also gradually taper off the drug
Psychopharmacology of depression
-depression is responsive to medications affecting serotonin and norepinephrine systems -these neuromodulators affect how much neurotransmitter is released, how long it lingers, and how it interacts with receptors -psychiatric disorders can simply be though about as problems with synapses
Opioids: narcotic analgesics
-derived from the opium poppy plant -methadone, heroin, codeine, morphine, synthetic deviations such as oxy -legal analgesics are prescribed for persistent coughing, severe diarrhea, and severe pain -can be injected, snorted, or taken by mouth -pleasant, relaxing effects along with pain relief -very highly addictive -mood fades t apathy, unhappiness, impaired judgment, psychomotor agitation, or psychomotor retardation -could experience confusion -depress the central nervous system and can cause drowsiness, and slower breathing--> can lead to death if it is taken with a depressant -withdrawal begins 8 hours after the drug was last used and peaks within several days: symptoms include nausea, vomiting, muscle aches, dilated pupils, sweating, fever and diarrhea -heroin is the most addictive
Treating neurological factors of substance use disorders
-detoxification -medications that: interfere with pleasant effects of drug use, reduce unpleasant effects of withdrawal, or help maintain abstinence
Borderline personality disorder: treating psychological factors
-dialectical behavior therapy -an emphasis on validating the patient's experience -a Zen Buddhist approach -a dialectics component: these patients are especially sensitive to a therapist looking at mental contents and trying to reframe them (for this reason, CBT feels like criticism) -entails both group and individual therapy -initial priority is to reduce self harming behaviors and then focus on other behaviors that interfere with therapy and with the quality of life -helps patients to develop skills to change what can be changed -warm and collaborative bond with therapist -emphasis on validating pateint's experience -must make it believable when they are evaluating a patient's experience
Diagnosis of personality disorders
-difficult to diagnose because most are unaware of their symptoms (blame interpersonal problems on other people) -can't recognize lifelong patterns of emotional responses, behavioral tendencies, mental processes and contents -75% have another type of psychological disorder (mood, anxiety, substance) -half have more than one personality disorder -some clinicians will not treat personality disorder because it is very frustrating and may often be a lifelong process due to the fact that patients do not think they have a problem
Social forces of psychological disorders
-difficulties with attachment and role of relationships in buffering negative life events
Disorders of disruptive behavior and attention: psychological factors
-difficulty recognizing emotions and facial expressions -attributional style that leaves them vulnerable to low self esteem -socially rejected: parental stress and resentment
Schizophrenia: social factors
-difficulty with tasks that require an accurate ToM and may find relating to others confusing and unpredictable -symptoms of paranoia and social withdrawal may directly result from this social confusion -stressful environments increase likelihood in those who are genetically vulnerable -stress also contributes to whether someone who recovered will relapse -high expressed emotion (a lot of arguing, negative emotions--> upsets a child's sense of stability) in families -schizophrenia is more common among immigrants -low socioeconomic class -people in collectivist cultures have a more favorable course and prognosis
Dissociative amnesia: psychological factors
-disconnected mental processes -aspects of dissociation and neodissociation theories have been supported through research
Sexual dysfunctions: neurological factors
-disease or illness can produce sexual dysfunction directly (prostate and cervical cancer), as well as indirectly (diabetes, circulation problems that limit blood flow to genital areas) -aging can affect sexual functioning among older people
Medical factors that can affect cognition
-diseases and illness: encephalitis and brain tumors directly affect the brain and therefore cognition; some chronic illnesses indirectly affect cognition by creating pain, which can disrupt attention, concentration, and other mental processes -stroke= the interruption of normal blood flow to or within the brain, which results in neuronal death -aphasia= a neurological condition characterized by problems in producing or comprehending language -Broca's aphasia= a neurological condition characterized by problems producing speech -Wernicke's aphasia= a neurological condition characterized by problems comprehending language and producing meaningful utterances -apraxia= a neurological condition characterized by problems in organizing and carrying out voluntary movements even though the muscles themselves are not impaired -apperceptive agnosia: problems with spatial relations -associative agnosia: cannot associate shape with meaning -head injury -substance induced changes in cognition
Depersonalization-derealization disorder: neurological factors
-disruptions of emotional processing -increased activity in the frontal lobes when viewing emotion (frontal lobes suppress emotions) -activity in the limbic system decreased when viewing emotions rather than increasing -unusual levels of brain activity during perception -produce too little norepinephrine
ASD: social factors
-don't respond to their own name or parents' voices as children -pay attention to other people's mouths rather than eyes -social interactions are confusing and unpredictable due to cognitive deficits in communication and in the ability to recognize faces and emotions -often don't understand elements of conversation involving a back-and-forth exchange of information and interest in the other person -also difficult for the average person to understand the emotions of an autistic person
Hypersomnia
-sleeping more hours a day than normal -symptom of depression (insomnia can be a symptom too even though they are opposites)
Stimulants: neurological factors
-dopamine plays a key role in both the pleasurable experience of taking stimulants and the abuse of stimulants -"reward system" is activated by a wide range of pleasurable activities such s eating and having sex -dopamine reward system is primarily in the nucleus accumbens and ventral tegmental area -stimulants affect the dopamine reward system directly --> the rewarding effects of drugs arise from the dopamine reward system
Major neurotransmitters (dopamine, serotonin, acetylcholine, adrenaline, norepinephrine, glutamate, GABA, endogenous cannabinoids)
-dopamine= reward, motivation, executive function, control of movement -serotonin= mood, sleep, motivation -acetylcholine= storing new information in memory, fight-or-flight response -adrenaline= attention, fight-or-flight response -norepinephrine= attention, fight-or-flight response -glutamate= registering pain, storing new information in memory -GABA= inhibits brain activity in certain areas -endogenous cannabinoids= emotion, attention, memory, appetite, control of movements
Antisocial personality disorder
-dramatic/erratic personality disorder -difficulty regulating emotions -diagnosed in adulthood characterized by a persistent disregard for the rights of others -may violate rules or laws and may lie or act aggressively, hurting others, believing that they are entitled to break the rules -may act impulsively, putting themselves at risk of harm -shirk their responsibilities -called "conduct disorder" when the patient is below 15 years of age (these kids appear to be very bratty and obnoxious) -more boys than girls
Other abused substances: social factors
-dysfunctional family interactions -higher proportion of substance abusing peers -economic hardships and unemployment -chronic stress that arises from economic adversity
Depressants: social factors
-dysfunctional family interactions -peers' use of depressants -norms or perceived norms about depressant use -economic hardship and unemployment -culture
Borderline personality disorder: psychological factors
-dysregulation of emotion, the sense of self, of cognition, and of behavior -behavior can be extreme -self destructive behaviors may help people try to feel better after an interpersonal stress--> maladaptive behaviors can be negatively reinforcing because they do temporarily relieve emotional pain -unsure of self worth (must constantly be reassured by others)
Genetics
-each cell has identical DNA with the same genes, but the genes are differentially expressed depending on where in the body (tissue specific proteins) -genes primarily encode proteins-->proteins determine cell function-->neuronal cell function determines behavior -almost all psychological disorders have a genetic component
Schizotypal personality disorder
-eccentric behaviors and difficulty with relationships -may have very few friends, may feel as if they do not fit in, may experience social anxiety -does not involve psychotic symptoms (like schizophrenia) -some research suggests it may be a milder form of schizophrenia -problems in relationships by early adulthood
Rationality and reason in the 18th and 19th centuries
-efforts to treat the mentally ill more humanely -patients were given more moral treatment
SSD: neurological factors
-either disorder is inherited or temperament and other characteristics that are influenced by genetics predispose a person to develop the disorder in certain environments -specific experiences of a person affect whether a person develops this disorder
Emotional factors in psychological disorders
-emotional disturbances contribute to some psychological disorders (not feeling or expressing emotions to a normal degree and having difficulty regulating emotions) -emotions and mental processes are often intertwined, so disturbances in one will affect the other -emotions involve both a psychological and neurological response to a stimulus
Cluster B personality disorders
-emotional, dramatic, or erratic behaviors that involve problems with emotional regulation -antisocial personality disorder -borderline personality disorder -histrionic personality disorder -narcissistic personality disorder
Schizophrenia: neurological factors (brain systems)
-enlarged ventricles (meaning that the size of the brain itself--especially the temporal lobe--is reduced) -impaired frontal lobe functioning: excess of pruning -impaired temporal lobe and thalamus: may underlie auditory hallucinations; difficulties in focusing attention, in distinguishing relevant from irrelevant stimuli -abnormal hippocampus: may contribute to deficits in memory -interactions among brain areas: thalamus fails to screen out sensory information, which overwhelms subsequent processing, and the form and content of the person's thoughts become confused--> don't have shared reality with everyone else -possible causes of brain abnormalities: maternal malnourishment, maternal illness, oxygen deprivation -biological markers: difficulty maintaining smooth, continuous eye movements when tracking light as it moves across the visual field; sensory gating (people with schizophrenia respond just as strongly to second click as to first); involuntary movements
Dementia: social treatments
-enlist others to structure the patient's environment so that memory is less important -may receive day treatment services
Dangerousness: legal consequences
-evaluating dangerousness -actual dangerousness -confidentiality and dangerous patient -duty to Warn and Protect -maintaining safety: confinement
Single-participant experiments
-experiments with only a single participant that may rely on ABAB design -cause and effect can be inferred
Dyslexia: psychological factors
-factors that determine motivation to overcome the disorder -self determination -recognizing particular areas of strength -identifying the learning disability -developing ways to cope with it
Assessing social factors of mental disorders
-family functioning -community (necessary to understand what normal functioning is in that environment) -culture (different cultures have different views about complaining and how to describe different types of distress or other symptoms)
Sympathetic activation
-fight or flight response -increases norepinephrine into nervous system -adrenal medulla releases adrenaline into blood -HPA axis causes adrenal cortex to release cortisol into blood (takes a while for this stuff to leave the blood)
Dementia: psychological treatments
-first line of intervention should help patients maintain as high a quality of life as possible, given the symptoms -may be taught strategies and given devices to compensate for memory loss (such as mnemonics) -patients may be given a GPS tracking device to wear so that they can be found relatively quickly and easily if they get lost -structured days -reality orientation therapy: designed to decrease a patient's confusion by focusing on the here and now -reminiscence therapy: stimulates the patient's memories that are least affected by dementia -caretakers may be trained to treat behavioral disturbances, such as agitation and aggression that sometimes arise with dementia
Behaviorism
-focused on directly observable behaviors rather than unobservable mental processes -helps explain how maladaptive behavior can arise from previous associations with an object, a situation, or an event -Pavlovian conditioning
ASD: social treatments
-focuses on facilitating communication and interpersonal interactions -helps patient understand how to read the emotional expressions of others -could be training through a social skills group or teaching the child to recognize emotions -parents are asked to model desired social behaviors and reinforce their children for improved behavior
Borderline personality disorder: neurological factors
-frontal lobes, hippocampus, and amygdala are unusually small -frontal cortex is needed to help us behave in ways that are socially acceptable -difficulty focusing attention, organizing visual material, and making decisions -amygdala is more strongly activated than normal when they see faces with negative expressions--> explanation for emotional dysregulation -serotonin receptors are less sensitive than normal, so the effects of serotonin and diminished -neurologically vulnerable to emotional dysregulation -genetic vulnerability to components of this disorder, such as impulsivity, emotional volatility, and anxiety
Types of anxiety disorders
-generalized anxiety disorder -panic disorder -social phobia -specific phobias -obsessive compulsive disorder -post-traumatic stress disorder
Personality disorders: neurological factors
-genes clearly influence temperament, which is the aspect of personality that reflects a person's typical affective state and emotional reactivity -genes that affect personality traits can predispose some people to develop a personality disorder
Psychotic symptoms in schizophrenia, mood disorders, and substance-related disorders
-hallucinations and delusions: these psychotic symptoms only arise during a mood episode or with substance use -social isolation -little or no interest in activities; staring into space for long periods of time -short or empty replies to questions
Genes and the development of psychological disorders
-having a particular temperament may make a person especially vulnerable to certain psychological disorders -genes contribute strongly to temperament -effects of genes need to be considered within the context of specific environments -psychological disorders in parents can contribute to psychological disorders in their children
Medical effects of anorexia
-heart muscle becomes thinner (muscle wasting= when the body breaks down muscle in order to obtain needed calories) -low heart rate and blood pressure -abdominal bloating or discomfort -constipation -loss of bone density -slower metabolism -dry and yellow/orange skin, brittle nails, loss of hair on the scalp -irritability, fatigue, headaches, hyperactive, restless -dehydration--> can create an imbalance in the body's electrolytes--> can lead to death
Cognitive methods of psychotherapy for GAD
-helping patients identify thought patterns that are associated with their worries and anxieties and then helping them to use cognitive restructuring and other methods to prevent these thought patterns from spiraling out of control -psychoeducation -mediation: helps patients learn how to "let go" of thoughts -self-monitoring: helps patients become aware of cues that lead to anxiety and worry -problem solving: teaches patient to think about worries in very specific terms -cognitive restructuring: helps patients learn to identify and shift automatic, irrational thoughts related to worries
Gender dysphoria: psychological treatments
-helps people understand themselves and their situation as well as being aware of their options and goals regarding living publicly as the other gender: psychoeducation -provides information about medical and surgical options -problem solving related to living as the other gender -help with relationships
Gender dysphoria: neurological factors
-hormones especially during fetal development (default pathway without enough testosterone is female) -increased cortisol levels due to maternal stress can decrease androgen levels (possible that while the genitalia turn out male, the brain doesn't get androgenized fully) -genes (62% of the variance is attributed to genes) -bed nucleus of the stria terminalis (extension of the amygdala) is larger in typical males, but female sized in transgendered men
Schizophrenia: targeting social factors
-identify early warning signs of positive and negative symptoms through family education and therapy -reduce certain negative symptoms through social skills training -improve overall functioning through community-based interventions -inpatient treatment -group therapy
Assessing psychological factors of mental disorders
-identify ways in which psychological functioning is disordered and the ways in which it is not -clinical interview= a meeting between a clinician and patient during which the clinician asks questions related to the patient's symptoms and functioning (may be unstructured, structured, or semistructured) -observations of appearance and behavior -patient's self report -tests of psychological functioning -personality assessment
Diathesis-stress model
-if a person has a predisposition to a psychological disorder, stressors may trigger its occurrence
Gender dysphoria: social factors
-may be associated, but are unlikely to cause the disorder -college students rated photographs of natal boys with gender dysphoria as cuter and prettier than photos of boys without the disorder (girls with the disorder were rated as less attractive than girls without)--> reflect the prenatal influence of hormones
Disorganized speech
-may not be aware that they are speaking incoherently -word salad: random stream of seemingly unconnected words -neologisms: words that the patient makes up -lose accuracy in making associations between things
Borderline personality disorder case study
-imagined that husband was cheating on her when there were no signs whatsoever -therapist had hypothesis (because patient was faking suicide in order to have others constantly around her and taking care of her) that hospitalization was reinforcing parasuicidal behavior and patent got extremely upset that therapist was not validating her thoughts--> made it so that the patient could go to the hospital even if she was not feeling suicidal -referred by psychiatrist and husband initially helped, but ultimately filed for divorce (ultimately set her back in the long run) -went to 3 month long residential program and was doing well but was still fragile -husband (divorced) was with another woman, and since patient was still so fragile, she committed suicide -threatened people with suicide for neglecting her all of the time -made up disparaging things that husband was not thinking at all -smart and capable but her early life experience of being physically abused by her mother and sexually abused by her father ruined her and corrupted her sense of self -contagiousness about suicide especially among young or unstable people
Dyslexia: neurological factors
-in dyslexia, brain systems involved in auditory processing do not function as well as they should (two rear areas in the left hemisphere) -two other brain areas are also more strongly activated in people with dyslexia: appear to be used in carrying out compensatory strategies, which rely on stored information instead of the vision-sound conversion process -a specific learning disorder in reading is moderately to highly heritable: 4 specific genes are thought to affect the development of this disorder
Distinction between incidence and prevalence
-incidence= number of NEW cases identified in a given period -prevalence= number of people who have the disorder in a given period- NEW and OLD
DSM-5
-includes over 300 disorders across 22 categories -wanted it to be a living document with frequent updates (has been criticized for creating confusion)
Treating psychological factors of substance use disorders
-increasing a user's motivation to cease or decrease substance use: stages of change that characterize how ready a person is to change problematic behaviors -changing the user's expectations of the drug experience -increasing the user's involvement in treatment -decreasing the conditioned behaviors associated with use of the drug: CBT
Ethical issues
-informed consent -role of confidentiality
Basic organization of the nervous system
-input sensory neurons: PNS -processing neurons: CNS -output motor neurons: PNS
Treating social factors of eating disorders
-interpersonal therapy: as problems with relationships resolve, symptoms decrease, even though the symptoms are not addressed directly by the treatment; IPT reduces longstanding interpersonal problems; the resulting improvement of relationships make people feel hopeful, empowered, and increases their self-esteem; these changes lead people to change other aspects of their life -family therapy: Maudsley approach--> helps parents view patient as distinct from her illness, and supporting the parents as they figure out how to lead their daughter to eat appropriately -psychiatric hospitalization: recommended when less intensive treatments have failed to change disordered eating behaviors sufficiently; short-term goals include increasing weight to a normal range and establishing a normal eating pattern -prevention programs: for people who have symptoms of eating disorders but do not meet all of the diagnostic criteria
Targeting social factors in treating depression
-interpersonal therapy: the form of treatment that is intended to improve the patient's skills in relationships so that they become more satisfying -systems therapy: a focus on the family
Medical model
-introduced by Hippocrates -no supernatural forces or physical basis--> biological basis for all psychological disorders -still used to some degree today
Hangover/ withdrawal
-kidneys remove "toxin" by changing water balance--> dehydration -liver removes "toxin" by converting alcohol to acetaldehyde, which is another toxin, which is converted to acetate (harmless) -alcohol withdrawal: delirium tremens - headache, weakness, tremor, anxiety, high BP, HR, &RR, seizure, fever, agitation, irritability, convulsions, hallucinations
Hypomanic episode
-last type of mood disorder associated with bipolar disorders -same criteria as manic episode but the symptoms are not as severe and they last a minimum of 4 days
Brain basis of emotions
-left frontal lobe: approach emotions (love, happiness) -right frontal lobe: withdrawal emotions (fear, sadness) -amygdala: learned fear, reactive fear, early warning system (can completely save you or trick you) -hippocampus: memory
Conversion disorder: social factors
-life stressors, such as combat, can trigger conversion disorder -the greater severity or number of stressors, the more severe the conversion symptoms
Neurological factors of eating disorders
-low activity in the frontal lobes (which are involved in inhibiting responses and regulating behavior) and the portions of the temporal lobes that include the amygdala (involved in fear and other strong emotions) -structure of the brain changes with these disorders: loss of both gray and white matter -losing large amounts of weight changes the amount of serotonin and other neurotransmitters: prior to developing an eating disorder, patients tend to be obsessional and anxious and these traits persist even after recovery--> biologically based anxious temperament -less responsive to serotonin than normal -people with eating disorders are more likely to have family members with eating disorders -heritability from 33% to 88%: the way that the environment interacts with genes is important
PNS (peripheral nervous system)
-made up of the sensory-somatic and autonomic nervous systems -neurons can regenerate over time -autonomic is critically important for involuntary and unconscious actions -sensory-somatic is important for conscious control
Why is there a difference in views of gender dysphoria between men and women?
-masculinity is idealized in our society, and we do not want to see masculinity "toyed" with -it makes people uncomfortable to see a man in a dress -women have more leeway in terms of fashion -male-->female transitions are often ridiculed -it is very difficult for people who do not have gender dysphoria to understand what it really is and what it feels like -women's clothes are meant to accentuate their bodies, and men do not have the same figure/body parts to be enhanced -men are 2-6x more likely to have this
Comorbidity of anxiety disorders
-may occur with mood disorders, body dysmorphic disorder, and anorexia nervosa -anxiety and depression occur together 50% of the time -clinicians must determine whether the anxiety and avoidance symptoms are the primary cause of the disturbance or a by-product of another type of problem
Positron emission tomography (PET)
-measures blood flow or energy consumption in the brain -this method of measuring brain function is based on the detection of radioactivity emitted when positrons, positively charged particles, undergo radioactive decay in the brain -helped scientists understand more about how drugs affect the brain
Magnetic resonance spectroscopy (MRS)
-measures the concentration of specific chemicals — such as neurotransmitters — in different parts of the brain instead of blood flow -MRS is ideal for studying the natural course of a disease or its response to treatment
Targeting neurological factors in treating depression
-medication: SSRIs, TCAs, MAOIs -brain stimulation: electrical pulses are sent to the brain to cause a controlled brain seizure which can reduce or eliminate the symptoms of certain psychological disorders
Dementia: neurological treatments
-medications have been developed to delay the progression of cognitive difficulties in people with Alzheimer's disease -drugs that treat mild to moderate cognitive symptoms increase levels of acetylcholine -antipsychotic medications are sometimes given for psychotic symptoms or behavioral disturbances, but the side effects of both traditional and atypical antipsychotics caution against their long-term use
Ancient views of psychopathology (including medical model)
-mental illness arose from either magical or spiritual supernatural forces -Chinese believed psychopathology was caused by an imbalanced Qi -Greeks believed psycopathology was caused by an imabalance of bodily humors -medical model= Hippocrates' view that illness results from a biological disturbance
Forces of evil in the Middle Ages and the Renaissance
-mental illness was viewed as the result of demonic possession
Why has suicide increased by 60% from 1950-1995?
-more guns available -higher stress levels beginning in childhood -we are aware of more suicides (reporting issue) -social media -more access to medications -we have become even more individualistic -a lot of suicides are among veterans
Psychological effects of anorexia
-more sensitive to the sensations of light, cold, and noise -sleep less -lose sex drive -mood worsens: symptoms of depression and anxiety -obsessed with food -may come to believe that there is nothing wrong with their weight
An ethical principle: the role of confidentiality
-most common feature is confidentiality (not to disclose information about a patient to others unless legally mandated to do so) -there are many ambiguities involving confidentiality such as couples therapy, group therapy, children under 18 and situations where the therapist cannot insure confidentiality -limits of confidentiality: HIPAA in action -legal restrictions on confidentiality -privileged communication refers to confidential information that is protected from being disclosed during legal proceedings
Rational drug design
-most of the drugs we have, we have discovered serendipitously -in rational drug design, you know the molecular defect that is the etiology for the disorder--> the drug is designed to target the specific molecular defect
Spinal cord functions
-motor output -sensory input -reflexes
Conversion disorder: neurological factors
-must rule out malingering or faking of symptoms -some patients with chronic pain develop sensory deficits, a kind of "psychological" anesthesia -could be abnormal processing in brain areas responsible for executive functions might inhibit brain areas that process sensation and pain or that produce movements, which in turn causes them to fail to function properly
Gender dysphoria: psychological factors
-natal boys with gender dysphoria do not have as high an activity level as their counterparts without the disorder -more rough and tumble play (RTP) in typical boys than in typical girls -GID girls and boys are less likely to seek out and play with same sex peers -GID in children does not usually persist into adulthood
Alogia
-negative symptom of schizophrenia -poverty of speech: slow, minimal responses
ASD: psychological factors
-neurological factors produce psychological symptoms -cognitive deficits in shifting attention and in mental flexibility --> extreme difficulty shifting from one activity to another -mental inflexibility -focus on details at the expense of the broader picture (has to do with frontal lobe function) -difficulty recognizing facial expressions of emotions--> do not have a well developed fusiform cortex -difficulty using theory of mind (usually developed by age 5): there is no difference between what they think and what everyone else thinks
Treating dissociative disorders as a whole
-neurological: medication is not used except for a comorbid disorder -psychological and social: reinterpreting symptoms so that they don't create stress or lead the patient to avoid certain situations; learning additional coping strategies to manage stress; for DID patients, addressing the presence of alters and dissociated aspects of their memories or identities
How to assess paraphilic disorders
-neurological: penile plethysmograph is placed on a man's penis and measures penile rigidity (sexual arousal) -psychological: self reports of arousal -social: relies on reports from partners of the criminal justice system
ASD: neurological treatments
-no treatments successfully target the neurological factors that underlie ASD -medication may help treat symptoms of comorbid disorders or of agitation or aggression (antipsychotics or SSRIs)
Depressants: psychological factors
-observational learning of depressant use -operant conditioning in which: positive reinforcement leads to positive expectations of depressant use and to reward craving; negative reinforcement can lead to relief craving and to depressant use becoming a chronic coping strategy -classical conditioning, whereby drug cues elicit cravings
Other abused substances: psychological factors
-observational learning, operant conditioning, and classical conditioning all contribute to substance use disorders as a maladaptive coping strategy
Criticisms of sexual dysfunctions in the DSM-5
-overlooks subjective experience -emphasis on orgasm -normal= adolescent male (what about females and adults?) -overlooks problems with discrepancy in desire: usually males want more sex than females and they may tend to feel rejected -duration of the disorder is not considered
PTSD: neurological factors and treatments
-overly strong sympathetic nervous system reactions and abnormal hippocampi -serotonin and norepenephrine play a role -SSRIs can help treat the disorder by allowing serotonin to moderate the effects of stress -medication is combined with treatment that directly addresses psychological and social factors
Schizophrenia: neurological factors (neural communication)
-overproduction of dopamine or an increase in the number or sensitivity of dopamine receptors is responsible for schizophrenia--> excess dopamine triggers a flood of unrelated thoughts (delusions are attempts to organize these thoughts) -serotonin enhances the effect of glutamate--> excess glutamate in people with schizophrenia--> disrupts timing of neural activation in the frontal lobe (important in learning and memory) -react more easily to stress and have higher baseline levels of cortisol -estrogen protects against symptoms of schizophrenia
Understanding and treating separation anxiety disorder
-overprotective family members may reinforce behaviors associated with anxiety about separation and may punish behaviors associated with actual separation -more common in children whose fathers are absent -treatment may involve CBT and family treatment
Disorders of disruptive behavior and attention: social factors
-parents do not give children as much credit for positive behaviors as do parents of children without ADHD--> tend to attribute children's positive behaviors to random situational factors -more vulnerable if they have been raised in a home where lead paint has been applied
When can confidentiality be violated?
-patient gives permission -clinicians suspect abuse -clinician suspects self harm or suicide -clinician suspects harm to someone else
Stimulants: social factors
-patterns of family interactions -perceived social norms -sociocultural factors
Why diagnose?
-people feel comfortable once they are diagnosed -helps determine etiology= underlying causes -promotes research -suggests treatment, support, and benefits -"naming" or "labeling" can provide relief -suggests prognosis= what to expect
Cognitive symptoms of depression
-people often feel worthless or guilt-ridden -negative evaluations of the self for no objective reason -rumination over past failings -may misinterpret ambiguous statements made by others as evidence of their worthlessness
Informed consent to participate in research on mental illness: can patients truly be informed?
-people who have anxiety disorders may be able to understand fully the research procedure and possible adverse effects...but what about schizophrenia? -general rule of thumb is that potential participants must be capable of understanding and reasoning about what they are consenting to -researchers are developing ways to ensure that patients who may be cognitively impaired by a psychological disorder adequately understand the benefits and risks of their participating in research
Delusions (4 types)
-persistent false beliefs that are held despite evidence that the beliefs are incorrect or exaggerate reality -often focus on a particular theme 1) paranoia: persecutory delusions; believe people are out to get them 2) grandeur: Jesus Christ, famous 3) delusions of control: frequently having thoughts that they believe someone else is inserting into their minds (not their own) 4) delusions of reference: external events have special meaning
Personality disorders: psychological factors
-personality traits involve sets of learned behaviors and emotional reactions to certain stimuli--> what is learned is in part shaped by the consequences of behavior, including how other people respond to the behavior (operant conditioning) -people can develop maladaptive and faulty beliefs based on what they have learned, which can lead them to misinterpret other people's words and actions--> bias the way they pay attention -consequences of behavior can lead to pervasive dysfunctional beliefs
Treating dyslexia
-phonological practice (learning to divide words into individual sounds and learning to identify rhyming words) -alphabetic principle: governs the way in which letters signal elementary speech sounds -only need to help with the one impaired part of that person's life
SLD: social factors
-play a role in shaping motivation to persist in the face of a learning disorder -parents and teachers are important in supporting and encouraging children to later succeed in learning disabilities -certain social environments apparently can contribute to dyslexia
Positive vs. negative reinforcement Positive vs. negative punishment
-positive reinforcement= the type of reinforcement that occurs when a desired reinforcer is RECEIVED after a behavior, which makes the behavior more likely to occur again in the future -negative reinforcement= the type of reinforcement that occurs when an aversive or uncomfortable stimulus is REMOVED after a behavior, which makes that behavior more likely to be produced again in the future -positive punishment= the type of punishment that takes place when a behavior is followed by an undesirable consequence, which makes that behavior less likely to recur -negative punishment= the type of punishment that takes place when a behavior is followed by the removal of a pleasant or desired event or circumstance, which decreases the possibility of that behavior's recurrence
Variants of depression
-postpartum depression: ratio of hormones drops right after birth -seasonal affective disorder: summer or winter -dysthymic disorder
Course of schizophrenia
-premorbid phase: before symptoms develop -prodromal phase: between the onset of symptoms and time when the minimum criteria for a disorder are met -active phase: full blown positive (and possibly negative) symptoms -residual phase: residue of negative symptoms, but positive symptoms have faded away
Dissociative identity disorder (PT model and SC model)
-previously known as multiple personality disorder -controversial because it is so hard to diagnose -posttraumatic model: sufferers of severe physical abuse report "leaving their bodies" -sociocognitive model: therapist unintentionally causes patient to act DID because they were seeing the diagnosis but it wasn't really there -incidence increased after Sybil was released
Dissociative anesthetics
-produces a sense of detachment from the user's surroundings -like depressants and also affect glutamate activity -often called "club drugs" -phencyclidine: "angel dust"; users feel powerful and invulnerable while the drug is in their system, but may become violent or suicidal; increased blood pressure, heart rate, sweating, coordination problems, numbness in hands and feet; at higher doses hallucinations, delusions, paranoia, disordered thinking, memory problems -ketamine: "special k" similar to PCP but less intense; at high dosages, people may feel as if they are dying
Grossly disorganized psychomotor behavior
-psychomotor: intentional movements -this behavior is so unfocused or disconnected from a goal that the person cannot successfully accomplish a basic task, or the behavior is inappropriate in the situation -behavior does not match the behavior expected in the environment -catatonia
Sexual dysfunctions: social factors
-quality of the partners' relationship -partner's sexual functioning -history of abuse -sexual mores in the person's subculture
Paraphilic disorders: psychological factors
-reason more males have these: position of the penis and testicles on a male's body can easily lead to their inadvertently being stimulated -classical conditioning can occur if the genitals are stimulated right after or at the same time as seeing or feeling an object -males may be biologically prepared to develop classically conditioned sexual arousal to some situations or objects
Treatments of delirium
-rectify the cause -treat the underlying medical condition or substance use that affects the brain and causes the delirium -for temporary relief, the patient may be given antipsychotic medications -treatment can also target psychological and social factors and involve giving the patient hearing aides or glasses to help with perception as well as teaching them to be here and now through presentations of calendars or time
Personality disorders: social treatments
-relationship between therapist and patient allows patient to become aware of his or her interaction style and to develop new ways to interact with others -family education, family therapy, or couples therapy -interpersonal or group therapy helps patient recognize disorderdness in others, which may help them recognize disorderdness in themselves
Borderline personality disorder: social factors
-relationships are intense, chaotic, and difficult -could be that family members were likely to invalidate a patient's experience--> fear of rejection and abandonment -friends and family members may come to respond with caring and concern only when the patient exhibits self-destructive behaviors
Requirements of classification systems
-reliability= a property of classification systems that consistently produce the same results -validity= a property of classification systems that actually characterize what they are supposed to characterize -each disorder should have a unique set of criteria for what it is classifying
Treating social factors of substance use disorders
-residential treatment -group based treatment: group therapy, self-help groups -family therapy
Legal issues: treatment
-right to treatment -right to refuse treatment -competence to refuse treatment -mental health and drug courts
Psychopathy and antisocial personality disorder: social factors
-risk factor is child's relationship with his or her parents or primary caregivers -children with insecure attachment have a relatively high risk of developing conduct disorders
Criminal actions/insanity
-sane or insane -insanity defense -competent to stand trial
Culture and schizophrenia
-schizophrenia is more common among people in urban areas and lower socioeconomic classes than among people in rural areas and higher socioeconomic classes -blacks are twice as likely as whites and latinos -people with schizophrenia in non-western countries are generally better able to function in their societies than their western counterparts
Hallucinations
-sensations that are so vivd that the perceived objects or events seem real, although they are not -hallucinations can occur in any of the 5 senses (auditory/ hearing voices is the most common) -difficulty distinguishing between verbal information that is internally generated and verbal information that is externally generated -more likely to (mis)attribute their own internal conversations to another person
Hallucination
-sensations that are so vivid that the perceived objects or events seem real, although they are not -hallucinations can occur in any of the five senses
3 types of neurons
-sensory -motor -interneuron (local and do not connect different parts of the brain--> no myelin sheath)
Depersonalization-derealization disorder: social factors
-severe and chronic emotional abuse experienced during childhood
Sexual dysfunctions: psychological treatments
-sex therapy -psychological therapies
Ritalin
-simulant -frequently prescribed for ADHD -swallowing pills does not usually lead to use disorder -inhaling or snorting crushed pills leads to a quick "high" -injecting drug in liquid form produces similar effects as cocaine -heightened alertness, increased attention, decreased appetite
Neurological factors of suicide
-since the main risk factors are depression and impulsivity, the neurological factors are very similar
How does learning influence thinking?
-social phobia: unreasonable fear or anxiety in social situations -learned helplessness: no behavior eliminates punishment and people give up trying (bad things happen and no matter what you do, you cannot escape so you just stop trying and come to accept it) -modeling: learning through observation of others (people parent a great deal the way they have been parented)
PTSD: social factors and treatment
-socioeconomic factors: people who face severe financial challenges have fewer emotional resources available to cope with a traumatic event; may also be more likely to experience trauma -people who receive support from others after a trauma have a lower risk of developing PTSD -safety, support, and family education
Dissociative identity disorder: social factors
-some countries do not even have these symptoms -depends on how country interprets symptoms
Dissociative identity disorder: neurological factors
-something is neurologically different when person is in two different states -person may be self hypnotizing
Diminished emotional expression: muted expression
-sometimes referred to as flat affect -person does not display a large range of emotion, sometimes speaking robotically and seeming emotionally neutral -may not express or convey much information through their facial expressions, body language, tone of voice, and tend to refrain from making eye contact
Illness anxiety disorder: neurological factors
-sometimes serotonin does not function properly -genetic differences contribute to hypochondriasis
Illness anxiety disorder: psychological factors
-specific biases in reasoning: seek evidence of health threats and also fail to consider evidence that such threats are minimal or nonexistent -focus closely on unpleasant sensations -may engage in behaviors that temporarily reduce their anxiety
Intellectual disability: psychological factors
-stereotyped behaviors: repetitive behaviors that don't serve a function, such as hand flapping, slight but fast finger and hand motions, and body rocking -self-injurious behaviors: hitting the head against something and hitting or biting oneself -people with both types of behaviors have greater deficits in nonverbal social skills than those with only one type of problematic behavior -consistently choosing to interact with objects rather than people, inappropriately touching others, resisting physical contact or affection
How can CBT help people with bipolar?
-stick with medication schedule -sleep strategies -recognize signs of mood swings
Methamphetamines
-stimulant -"meth" or "speed" -similar to amphetamines, but have a greater and longer-lasting effect on the central nervous system -can be inhaled, swallowed, smoked or injected -leads to an intense "rush" of pleasure
"Bath salts"
-stimulant -chemical related to cathinone, which is found in the khat plant -every packet is different -very addictive even when the outcome is unpleasant -may lead some users to feel more outgoing and happy but others to become agitated and paranoid and even hallucinate or become violent -increase activation of dopamine and may kill neurons -some people have died
Nicotine
-stimulant -increased alertness, irritability, dizziness, increased blood pressure -increase in carbon monoxide and tar in lungs -withdrawal= insomnia, anxiety, irritability, reduced concentration
Amphetamines
-stimulant -typically produce same effects as cocaine, but they last longer -usually available as pills -people may feel hostile to others, develop a sense of grandiosity, or exhibit disorganized thinking or behavior -problems with memory and physical coordination can result from an amphetamine use disorder -withdrawal symptoms can include depression, fatigue, anxiety, and irritability
MDMA (ecstasy)
-stimulant -usually taken in tablet form -stimulant effect of increased energy and hallucinogenic effect of distorted perceptions -people report well-being, empathy, and warmth towards others, with a heightened sensitivity to touch when first using it -reduced anxiety and distorted time perception -abuse can result in poor mood, difficulty regulating emotions, anxiety, aggression, sleep problems, decreased appetite -impaired cognitive functioning after the drug wears off -reduced amount of serotonin in cortex -affect serotonin nerve pathways (especially the raphe nucleus): 1 of the 4 diffuse modulatory systems
Cocaine and crack
-stimulants -cocaine that is obtained in the form of a powder is typically inhaled or "snorted" -as crack, a crystalline form, cocaine is smoked -acts as a local anesthetic: leaves user's nose numb and can lead to a diminished sense of smell and difficulty swallowing -higher doses can lead to paranoia, hallucinations, compulsive/ repetitive behaviors, and increased heart rate and blood pressure -users lose their appetite and can develop malnutrition over time -"high" of mental clarity, energy, and well-being only lasts minutes--> depression and craving for drug
Disorders of disruptive behavior and attention: neurological treatments
-stimulants that target dopamine: increase attention level and reduce general activity level and impulsive behavior--> disrupt the reuptake of dopamine at the synapse leaving more dopamine and correcting some of the imbalance -stimulants help bring the frontal lobes "online"
Stimulants
-stimulate central nervous system (causing increased activity and arousal) -can make the user feel alert, less hungry, and more energetic, mentally and physically
OCD: social factors and treatments
-stress and culture contribute to OCD -family therapy or consultation with family members
Illness anxiety disorder: social factors
-stressful events can precipitate hypochondriasis
Social factors of depressive disorders
-stressful life events -social exclusion -social interactions: emotions can be contagious in social settings -culture -gender difference: women are twice as likely as men to be diagnosed in North America
Social factors of bipolar disorder: social and environmental stressors
-stressful life events can affect the course of bipolar disorder -social factors can also have indirect effects which trigger neurological factors that can lead to a mood episode
Evolution of the DMS-5 (some things are good and some are bad)
-subjectivity in determining clinical significance -disorders as categories, not continuous dimensions (optional dimensional scales are included so clinicians can rate the severity of symptoms) -people with different symptoms can be diagnosed with the same disorder -duration criteria are arbitrary -some sets of criteria are too restrictive (can be diagnosed with an "other" type disorder) -pathological disorders are created to ensure payment -social factors are deemphasized -comorbidity is common -unscientific and lack rigor
Hallucinogens
-substances that induce sensory or perceptual distortions in any of the senses -LSD: alters user's visual or auditory sensations and perceptions as well as inducing shifting emotions; effects can be unpredictable such as a "bad trip"; psychosis and "flashbacks" can occur after use -marijuana: minor perceptual distortions that lead a person to experience more vivid sensations and to feel that time has slowed down; cognitive or motor abilities are slowed or temporarily impaired -can have long term effects
Treating somatic symptom disorders: targeting social factors
-support -family education: family may be reinforcing behaviors accidentally
Negative symptoms
-symptoms of schizophrenia that are characterized by the absence or reduction of normal mental processes, mental contents, or behaviors -normalities that are not present -includes diminished emotional expression and avolition -flat affect
Positive symptoms
-symptoms of schizophrenia that are characterized by the presence of abnormal or distorted mental processes, mental contents, or behaviors -abnormalities that are present -hallucinations (false sensory information), delusions (false beliefs), disorganized speech, disorganized behavior (odd postures, wearing several laters of clothing)
Dale's law
-synapses are specific--> most neurons make only one type of neurotransmitter
Diagnostic bias
-systematic error in diagnosis -can cause groups of people to receive a particular diagnosis disproportionately on the basis of an unrelated factor -when a mental health clinician is not familiar with the social norms of the patient's cultural background, the clinician may misinterpret certain behaviors as pathological
Medication in bipolar disorders
-take a mood stabilizer: can reduce occurrence of both manic and depressive episodes -lithium is the oldest mood stabilizer
East vs. West coast duration of therapy
-takes longer for people to recover from psychological disorders in the east vs. west -could have a different definition of improvement -people in the east may experience more psychological disorders -difference in pace of life
Intellectual disability: neurological treatments
-target of prevention efforts -testing infants at birth to modify their lifestyle from the start to either prevent a disorder from fully developing or modify the effects -prevent exposure to lead (can trigger brain abnormalities) -no actual neurological treatments
Depressants
-tend to slow a person down, decreasing behavioral activity and level of awareness -regular use leads to tolerance, and discontinuing use can produce withdrawal symptoms
Intellectual disability: neurological factors
-teratogens: substances or other stimuli (radiation) that are harmful to a fetus (examples: alcohol, marijuana) -fetal alcohol syndrome is an example -could result from particular complications during birth: insufficient oxygen -the brain does not process information appropriately when it is exposed to toxins or deprived of oxygen
Dose-response relationship
-the association between more treatment (a higher dose) and greater improvement (a better response) -generally, a higher dose of therapy is associated with a better response
Fight-or-flight response
-the automatic neurological and bodily response to a perceived threat; also called the stress response -increase in heart rate and breathing rate, increase in palm sweat, dilating pupils -some people with anxiety have an overactive stress response, while others may misinterpret their arousal during this response and attribute bodily sensations to a physical ailment
OCD: neurological factors and treatments
-the basal ganglia, thalamus, and frontal lobes are part of a neural loop of repeating brain activity associated with OCD -too little serotonin -genetic contribution to OCD is neither simple nor straightforward: members of the family of a person with OCD are more likely than other people to have an anxiety disorder, not OCD specifically -SSRI is usually used first to treat OCD
Diagnosis
-the identification of the nature of a disorder -allow someone to infer why they have developed the disorder and whether the symptoms would be likely to shift in frequency or intensity over time
Factors that determine whether a trauma-related disorder will develop following a traumatic event
-the kind of trauma: trauma involving violence is more likely to lead to a stress disorder -the severity of the traumatic event, its duration, and its proximity -person's response to the traumatic event
Shared psychotic disorder: schizophrenia
-the pair that kidnapped Elizabeth Smart -wife shared a delusion that the husband was God -kidnapped Smart, made her marry husband, sexually abused her -threatened to kill her family in order to keep her quiet -kept in a tent for 6 months -thought husband deserved a fresh, young, sacrificial wife -female partner kept Elizatbeth ready whenever male wanted her -Smart was also somewhat brainwashed and developed a type of Stockholm Syndrome
Habituation
-the process by which the emotional response to a stimulus that elicits fear or anxiety os reduced by exposing the patient to the stimulus repeatedly -common treatment for anxiety disorders
Attrition
-the reduction in the number of participants during a research study -important because more than half of people who begin a treatment that is part of a research study do not complete the treatment
Objectification theory
-the theory that girls learn to consider their bodies as objects and commodities -male bodies are considered as agents (instruments that perform tasks) and female bodies are mainly to be looked at and evaluated in terms of appearance
Freud- Psychoanalytic theory
-thoughts, feelings, and behaviors result from conscious and unconscious forces (such as sexual and aggressive urges) -mind is structured to function across the conscious, the preconscious, and the unconscious -id, ego, and superego are continually interacting and negotiating -each person passes through five psychosexual stages from infancy to adulthood--> for healthy psychological development, each stage requires the successful completion of a key task -difficult to look at unconscious scientifically
What happens if something goes wrong in diffuse modulatory systems?
-too many or too few dendrites or receptors -too much or too little neurotransmitter produced -faulty reuptake mechanisms-->can be plugged, leading us to have excess of neurotransmitters -someone with a faulty diffuse modulatory system could perceive the same thing as others but in a completely abnormal way
The humanist response to Freud
-too mechanistic and opposed to free will -proposed that symptoms of distress and mental illness aries when there is an incongruence between ideal and real selves
Schizophrenia: targeting neurological factors
-traditional antipsychotics (block action of dopamine)--> quickly sedate patients (treat only positive symptoms) -atypical antipsychotics: affect dopamine and serotonin activity (treat positive and negative symptoms) -brain stimulation: ECT (only used when medication does not help)
Disorders of disruptive behavior and attention: psychological treatments
-treatments usually employ behavioral and cognitive methods to address disruptive behaviors -low frustration tolerance and difficulty in working for delayed reward -reinforcement program that uses concrete rewards as well as social rewards -behavioral methods may also be used to modify social behaviors: program of rewarding child for increasingly longer times of not speaking out or waving frantically -cognitive methods to help child interpret social cues in a more realistic way
Specific disorders related to OCD
-trichotillomania: hair pulling -excoriation disorder: skin picking -hoarding disorder: can't throw anything away
Temperament
-typical emotional state and reactivity -inherited and influenced by the environment you were born into -novelty seeking, harm avoidance, reward dependance, persistence
Intellectual disability: social factors
-understimulation -undernourishment -example: children who live in orphanages where they are essentially warehoused, ignored and neglected, may develop this disorder -can develop "failure to thrive" just from not being touched -many types can be prevented such as those related to PKU and lead poisoning
The insanity defense: current issues
-use of the insanity defense only applies to about 1% of cases and successful use is extremely rare and only happens about 1/4 of the time it is used -whether the person knew the act was wrong (a moral question) versus illegal (a legal question) -whether the person knew in the abstract that the act was wrong versus knew that the specific behavior was wrong in a particular circumstance
Hormones
-used by the endocrine system for chemical systems -hormones are mostly released into the blood through the pituitary gland--> dumped into the blood and get delivered by the circulatory system -activation and control of basic behavioral activities such as sex, emotion, response to stress, and the regulation of bodily function -the brain has receptors for many neurons (target cells have tissues with certain receptors) -allow brain to adjust its performance and control of behavior in response to a changing environment -sex hormones: testosterone, estrogen, and progesterone -can impact on a permanent or dynamic level depending on when they are delivered
What percentage of people have gender dysphoria? Is it common?
-very uncommon but gets a lot of publicity -only 0.014% of people have this condition
"Abnormal is the New Normal"
-we are better at detecting mental illness, getting "sicker", and things that used to be considered healthy are now considered to be mental disorders -definition of mental illness has broadened -we think erroneously that being odd or having difficulties must be an expression of mental illness -people want a quick fix and a label and medication help with that
The debate about dissociative identity disorder
-we know that severe trauma can lead to dissociate disorders and can have adverse effects -do not know whether all of the people diagnoses with DID have actually experienced traumatic events or how severe an event must be to consider it "traumatic"
Assessing neurological and other biological factors of mental disorders
-x-rays -CT scans -MRIs -PET scans and fMRI are not associated with abnormal brain structures, but with abnormal brain functioning -neuropsychological testing= the employment of assessment techniques that use behavioral responses to test items in order to draw inferences about brain functioning
Types of learning that can contribute to psychological disorders
1) classical conditioning 2) operant conditioning 3) observational learning
4 types of sexual dysfunctions
1) desire: hypoactive sexual desire disorder, erectile disorder, female sexual interest/arousal disorder 2) arousal (same as above) 3) orgasm: female orgasmic disorder, delayed ejaculation, premature ejaculation 4) pain: genito-pelvic pain/penetration disorder
Three criteria for determining psychological disorders
1) distress 2) impairment in daily life 3) risk of harm (also context and culture)
3 types of paraphilic disorders
1) nonconsenting adults or children: exhibitionistic disorder, voyeuristic disorder, frotteuristic disorder, pedophilic disorder 2) suffering or humiliating oneself or one's partner: sexual masochism disorder, sexual sadism disorder 3) arousal by nonhuman objects: fetishistic disorder, transvestic disorder
Treating somatic symptom disorders: targeting psychological factors
CBT
Specific phobia: neurological factors and treatments
FACTORS -brain systems and neural communication: hair-trigger in patients with specific-phobia, too little of the inhibitory neurotransmitter GABA -genetics: some genes predispose people to develop some sort of particular specific phobia, whereas others predispose people to develop some type of specific phobia but do not affect which particular type it will be; amygdala is "prepared" to overreact to certain stimuli -particular life experiences can lead to a particular specific phobia for people who--through genes or other life experiences--are neurologically vulnerable -amygdala is more active -less serotonergic and dopamenergic activity TREATMENTS -medication is not recommended for specific phobia, as it can be eradicated by specific exposure -even a single session of CBT is highly effective in treating specific phobia
Panic disorder and agoraphobia: neurological factors and treatments
FACTORS -brain systems: brains have a low threshold for detecting decreased oxygen in the blood (suffocation), which triggers a brain mechanism that warns us when we are suffocating -neural communication: too much norepinephrine -genetics: first-degree biological relatives of people with panic disorder are more up to eight times more likely to develop the disorder, and up to 20 times more likely to develop it if the relative developed it before 20 years of age--> the more genes in common, the higher the concordance rate (proven with twin studies) TREATMENTS -andtidepressants (can take up to 10 days to work, but are better in the long run) or benzodiazepine (fast and temporary relief)
Generalized anxiety disorder: neurological factors and treatments
FACTORS -brain systems: decreased arousal that arises from an unusually responsive parasympathetic nervous system -neural communication: dopamine in frontal lobes does not function normally (as well as GABA, serotonin, and norepinephrine) -genetics: equally heritable for men and women (common underlying genetic vulnerability) TREATMENTS -Buspar effectively reduces the symptoms of GAD, probably by decreasing the serotonin release--> may impair learning to fear or worry about specific objects or situations -SNRIs (serotonin and norepinephrine inhibitor) and SSRIs are also used because most people with GAD are also depressed
Social anxiety disorder: psychological factors and treatments
FACTORS -cognitive biases and distortions: tend to pay more attention to and remember faces that were perceived as critical; view the world as a very dangerous place and become chronically hyper vigilant for potential social threats and negative evaluations -classical and operant conditioning: a social situation becomes paired with a negative social experience to produce a conditioned emotional response; person might avoid social situations in order to decrease the probability of an uncomfortable experience TREATMENTS -help people identify irrational thoughts about social situations, develop more realistic thoughts and expectations, and test predictions about the consequences of engaging in specific behaviors
Social anxiety disorder: social factors and treatments
FACTORS -extreme overprotection by parents--> may lead children to avoid certain situations to cope with their anxiety -different cultures emphasize different concerns about social interactions, and these concerns influence the specific nature of social anxiety disorder TREATMENTS -group interactions by group therapy--> allows patients to try new skills immediately
Generalized anxiety disorder: psychological factors and treatments
FACTORS -hypervigilance= a heightened search for threats in the environment -typically feel that their worries are out of control and they can't stop or alter the pattern of their thoughts, no matter what they do -the mere act of worrying prevents anxiety from becoming panic--> the act of worrying is negatively reinforcing TREATMENTS -increase a person's sense of control over thoughts and worries -allow the person to assess more accurately how likely and dangerous perceived threats are -decrease muscle tension
Panic disorder and agoraphobia: psychological factors and treatments
FACTORS -learning: person may have had a first panic attack in response to a dangerous or stressful life event--> produces conditioning whereby the initial bodily sensations of panic become false alarms associated with panic attacks -cognitive explanations: catastrophic thinking and anxiety sensitivity--> people with panic disorder may misinterpret normal bodily sensations as indicating catastrophic events TREATMENTS -CBT is the first line of treatment for any panic disorder because it has the most enduring beneficial effects of any treatment -behavioral methods: relaxation, breathing, retraining, and exposure -cognitive methods: psychoeducation and cognitive restructuring--> help the patient recognize misappraisals of bodily symptoms and learn to correct mistaken inferences about such symptoms
Specific phobia: social factors and treatments
FACTORS -modeling: seeing other people being afraid of a particular stimulus -culture plays a huge role depending on where people spend the majority of their time in that culture TREATMENTS -observational learning is not effective because patients' cognitive distortions are powerful enough to negate any positive effects modeling might provide
Social anxiety disorder: neurological factors and treatments
FACTORS -possible that social phobia arises when the innate mechanism of animals lower on a dominance hierarchy becomes too sensitive or otherwise responds inappropriately -amygdala is strongly activated when people see faces with negative expressions -neurotransmitters function abnormally--> less activation in areas that rely on dopamine, as well as too little serotonin -genetics: 37% heritability rate, behavioral inhibition (temperament) TREATMENTS -for people whose social fears are limited to periodic performances, a beta-blocker is administered--> make norepinephrine and epinephrine less receptive -SSRIs are more common for people whose social anxiety is more frequent and across a wider set of circumstances
Panic disorder and agoraphobia: social factors and treatments
FACTORS -social stressors contribute to panic disorder (tend to have a higher number of stressful events during childhood and adolescence) -culture's influence on personality traits (example: higher baseline level of anxiety in the United States TREATMENTS -group and couples therapy
Generalized anxiety disorder: social factors and treatments
FACTORS -stressful life events (death in the family, friction in a close relationship, trouble on the job) can trigger symptoms in someone who is neurologically and psychologically vulnerable to it -related more directly to relationships TREATMENTS -very few treatments for GAD that specifically target social factors, and none are successful enough to mention
Specific phobia: psychological factors and treatments
FACTORS -tendency to overestimate the probability of a negative event's occurring based on contact with the feared stimuli -classical conditioning: Little Albert experiment -operant conditioning: plays a key role in maintaining a specific phobia--> by avoiding the feared stimulus, a person can decrease the fear and anxiety that he or she would experience in the presence of it, which reinforces the avoidance TREATMENTS -behavioral method: exposure--> patient and therapist progress through an individualized hierarchy of anxiety producing stimuli or events as fast as the patient can tolerate -cognitive methods: therapist and patient identify illogical thoughts pertaining to the feared stimulus, and the therapist helps highlight discrepant information and challenges the patient to see the irrationality of his or her own thoughts and expectations
Reactivity
a behavior change that occurs when one becomes aware of being observed
Polysubstance use
a behavior pattern of abusing more than one substance
Mood stabilizer
a category of medication that minimizes mood swings (lithium is the oldest mood stabilizer)
Eating disorder
a category of psychological disorders characterized by abnormal eating and a preoccupation with body image
Dissociative disorders
a category of psychological disorders in which consciousness, memory, emotion, perception, body representation, motor control, or identity are dissociated to the point where the symptoms are pervasive, cause significant distress, and interfere with daily functioning
Anxiety disorder
a category of psychological disorders in which the primary systems involve fear, extreme anxiety, intense arousal, and/or extreme attempts to avoid stimuli that lead to fear and anxiety
Internal validity
a characteristic of a study that indicates that it measures what it purports to measure because it has controlled for confounds (results are not a by-product of other, extraneous variables)
Psychoactive substances
a chemical that alters mental ability, mood or behavior
Mood
a persistent emotion that is not attached to a stimulus; it exists in the background and influences mental processes, mental contents, and behavior
Body dysmorphic disorder
a disorder characterized by excessive preoccupation with a perceived defect or defects in appearance and repetitive behaviors to hide the perceived defect
Dissociative identity disorder
a dissociative disorder characterized by the presence of two or more distinct personality states, or an experience of possession trance, which gives rise to a discontinuity in the person's sense of self and agency
Dissociative amnesia
a dissociative disorder in which the sufferer has significantly impaired memory for important experiences or personal information that cannot be explained by ordinary forgetfulness
Identity problem
a dissociative symptom in which a person is not sure who he or she is or may assume a new identity
Derealization
a dissociative symptom in which the external world is perceived or experienced as strange or unreal
Depersonalization
a dissociative symptom in which the perception or experience of self--either one's body or one's mental processes--is altered to the point that the person feels like an observer, as though seeing oneself from the "outside"
High expressed emotion
a family interaction style characterized by hostility, unnecessary criticism, or emotional over involvement
Control group
a group of participants in an experiment for which the independent variable is not manipulated, but which is otherwise treated identically to the experimental group
Age cohort
a group of people born in a particular range of years
Clinical psychologist
a mental health professional who has a doctoral degree that requires several years of related coursework and several years of treating patients while receiving supervision from experienced clinicians
Psychiatrist
a mental health professional who has an M.D. degree and has completed a residency that focuses on mental disorders
Psychiatric nurse
a mental health professional who has an M.S.N. degree, plus a C.S. certificate in psychiatric nursing
Social worker
a mental health professional who has an M.S.W. degree and may have had training to provide psychotherapy to help individuals and families
Counseling psychologist
a mental health professional who has either a Ph.D. degree from a psychology program that focuses on counseling or an Ed.D. degree from a school of education
Major depressive disorder (MDD)
a mood disorder marked by 5 or more symptoms of an MDE lasting more than 2 weeks
Computerized axial tomography (CT)
a neuroimaging technique that uses X-rays to build a three-dimensional image of the brain
Biological marker
a neurological, bodily, or behavioral characteristic that distinguishes people with a psychological disorder from those without the disorder
Sexual sadism disorder
a paraphilic disorder in which recurrent sexually arousing fantasies, urges, and behaviors inflict, or would inflict, physical or psychological suffering on a nonconsenting person
Frotteuristic disorder
a paraphilic disorder in which recurrent, intense, sexually arousing fantasies, sexual urges, or behaviors involve touching or rubbing against a nonconsenting person
Sexual masochism disorder
a paraphilic disorder in which the person repeatedly becomes sexually aroused by fantasies, urges, or behaviors related to being hurt--specifically, being humiliated or made to suffer in other ways--and this arousal pattern causes significant distress or impairs functioning
Fetishistic disorder
a paraphilic disorder in which the person repeatedly uses nonliving objects or nongenital body parts to achieve or maintain sexual arousal and such an arousal pattern causes significant distress or impairs functioning
Allegiance effect
a pattern in which studies conducted by investigators who prefer a particular theoretical orientation to obtain data that supports that particular orientation
Psychological disorder
a pattern of thoughts, feelings, or behaviors that causes significant personal distress (anguish or suffering), significant impairment in daily life, and/or significant risk of harm (to self or other), any of which is unusual for the context and culture in which it arises
Delayed ejaculation
a sexual dysfunction characterized by a man's delay or absence of orgasm
Erectile disorder
a sexual dysfunction characterized by a man's persistent difficulty obtaining or maintaining an adequate erection until the end of sexual activity, or a decrease in erectile rigidity; sometimes referred to as impotence
Female orgasmic disorder
a sexual dysfunction characterized by a woman's normal sexual excitement not leading to orgasm or to her having diminished intensity of sensations of orgasm
Female sexual interest/arousal disorder
a sexual dysfunction characterized by a woman's persistent or recurrent lack of or reduced sexual interest or arousal; formerly referred to as frigidity
Premature (early) ejaculation
a sexual dysfunction characterized by ejaculation that occurs within a minute of vaginal penetration and before the man wishes it, usually before, immediately during, or shortly after penetration
Somatic symptom disorder (SSD)
a somatic symptom disorder characterized by at least one somatic symptom that is distressing or disrupts daily life, about which the person has excessive thoughts, feelings, or behaviors
Ego
according to Freud, the psychic structure that is charged with mediating between the id's demands for immediate gratification and the superego's standards for high morality, as well as the constraints for external morality
Id
according to Freud, the seat of sexual and aggressive drives, as well as the desire for immediate gratification of physical and psychological needs
Superego
according to Freud, the seat of the conscience, which works to impose morality
The Dodo Bird Verdict
all psychotherapies, regardless of their specific components, produce equivalent outcomes
Affect
an emotion that is associated with a particular idea or behavior, similar to an attitude
Hysteria
an emotional condition marked by extreme excitability and bodily symptoms for which there is no medical explanation
Tardive dyskinesia
an enduring side effect of traditional antipsychotic medications that produces involuntary lip smacking and off facial contortions as well as other movement-related symptoms
Heritability
an estimate of how much of the variation in a characteristic within a population (in a specific environment) can be attributed to genetics
Inappropriate affect
an expression of emotion that is not appropriate to what a person is saying or the situation
Panic
an extreme sense (or fear) of imminent doom, together with an extreme stress response
Highest mortality rate of any psychological disorder
anorexia
Monoamine oxidase inhibitors
antidepressant medications that increase the amount of monoamine neurotransmitter in synapses
Purging
attempting to reduce calories that have already been consumed by vomiting or using diuretics, laxatives, or enemas
Nonspecific neuromodulators
conductivity systems throughout the brain that all have cells of origin in the brain stem (norepinephrine, serotonin, dopamine, acetylcholine)
Subthreshold cases
cases in which patients have symptoms that fit all the necessary criteria, but at levels lower than required for the diagnosis of a disorder
Partial cases
cases in which patients have symptoms that meet only some of the necessary criteria but not enough of the symptoms to meet all the necessary criteria for the diagnosis of a disorder
Sexual dysfunctions: social treatments
couples therapy
Prodrome
early symptoms of a disorder
Binge eating
eating more food at one time than most people would eat in the same period of time or content
Personality
enduring characteristics that lead a person to behave in relatively predictable ways across a range of situations
Neodissociation theory
executive monitoring system disconnected from other cognitive processes- amnestic barrier (ongoing personal narrative)
Confounding variables
factors that might inadvertently affect the variables of interest in an experiment
Kendra's law
grants judges the authority to require people who meet certain criteria to regularly undergo psychiatric treatment
Common factors
helpful aspects of therapy that are shared by virtually all types of psychotherapy
Dissociative identity disorder: psychological factors
hypnotizability
Predictions
hypotheses that should be confirmed if a theory is correct
Malingering
intentional false reporting of symptoms or exaggeration of existing symptoms, either for material gain or to avoid unwanted events
Anhedonia
lack of pleasure
Reframing
looking at a stressful circumstance as less negative and distressing
Sexual dysfunctions: neurological treatments
medicalization of sex therapy (viagra)--> allows the penis to become engorged with blood
Selective serotonin reuptake inhibitors
medications that slow the reuptake of serotonin from synapses
Amnesia
memory loss, which in dissociative disorders is usually temporary but, in rare cases, may be permanent
Bipolar disorders
mood disorders in which a person's mood is often persistently and abnormally upbeat or shifts inappropriately from upbeat to markedly down
Tricyclic antidepressants
older antidepressants named after the three rings of atoms in their molecular structure
Stigma
people are more embarrassed to admit a psychological disorder than a medical one (others may believe a psychological disorder such as alcoholism is a choice)
Delusion
persistent false beliefs that are held despite evidence that the beliefs are incorrect or exaggerate reality
Premorbid
referring to the period of time prior to a patient's illness
Compulsions
repetitive behaviors or mental acts that a person feels driven to carry out and that usually must be performed according to rigid "rules" or correspond thematically to an obsession
Experiments
research studies in which investigators intentionally manipulate one variable at a time, and measure the consequences of such manipulation on one or more other variables
Longitudinal studies
research studies that are designed to determine whether a given variable is a risk factor by using data collected from the same participants at various points in time
Conversion disorder: psychological factors
self hypnosis offers one possible explanation
Brain systems
sets of brain circuits that work together to accomplish a complex function
Brain circuits
sets of neurons that work together to accomplish a basic process
Sexual dysfunction
sexual disorders that are characterized by problems in the sexual response cycle
Psychological factors of bipolar disorders: thoughts and attributions
similar internal attributional style to people with depression
Treating somatic symptom disorders: targeting neurological factors
some treatments target specific symptoms
Dissociation theory
strong emotions narrow attention, disrupt integration
Tolerance
the biological response that arises from repeated use of a substance such that more of it is required to obtain the same effect
Specific factors
the characteristics of a specific treatment or technique that lead it to have unique benefits, above and beyond those conferred by common factors
Statistically significant
the condition in which the value of a statistical test is greater than what would be expected by chance alone
Criminally responsible
the determination that a defendant's crime was the product of both an action or attempted action (the alleged criminal behavior) and his or her intention was to perform that action
Competency to stand trial
the determination that a defendant's mental state during the time leading up to the trial enables him or her to participate in his or her own defense
Sampling bias
the distortion that occurs when the participants in an experiment have not been drawn randomly from the relevant population under investigation --> makes it impossible to generalize
Frequency quantity duration
the earlier you are exposed and the more substance you use, the more likely you are to be dependent
Neuropsychological testing
the employment of assessment techniques that use behavioral responses to test items in order to draw inferences about brain functioning
Behavioral genetics
the field that investigates the degree to which the variability of characteristics in a population arises from genetic versus environmental factors
Cognitive behavior therapy
the form of treatment that combines methods from cognitive and behavior therapies
Interpersonal therapy (IPT)
the form of treatment that is intended to improve the patient's skills in relationships so that they become more satisfying
Behavior therapy
the form of treatment that rests on the ideas that: 1) maladaptive behaviors stem from previous learning 2) new learning can allow patients to develop more adaptive behaviors, which in turn can change cognitions and emotions
Cognitive therapy
the form of treatment that rests on the ideas that: 1) mental contents influence feelings and behavior 2) irrational thoughts and incorrect beliefs lead to psychological problems 3) correcting such thoughts and beliefs will therefore lead to better mood and more adaptive behavior
Sexual response cycle
the four stages of sexual response outlined by Masters and Johnson: 1) excitement: response to sensory, motor, and cognitive stimulation--> leads to engorgement 2) plateau: intensity levels off at highest arousal before orgasm 3) orgasm: single in men, can be multiple in women 4) resolution: when men cannot orgasm (women do not have this refractory period)
Genotype
the genes you inherit from your parents (one copy of each gene from each person)
Social selection hypothesis
the hypothesis that people who are mentally ill "drift" to a lower socioeconomic level because of their impairment; also referred to as a social drift
Social causation hypothesis
the hypothesis that the daily stressors of urban life, especially as experienced by people in lower socioeconomic class, trigger mental illness in those who are vulnerable
Mental processes
the internal operations that underlie cognitive and emotional functions (such as perception, memory, and guilt feelings) and most human behavior
Experimenter expectancy effects
the investigator's intentionally or unintentionally treating participants in ways that encourage particular types of responses
Criminal commitment
the involuntary commitment to a mental health facility of a person charged with a crime
Civil commitment
the involuntary commitment to a mental health facility of a person deemed to be at significant risk of harming himself or herself or a specific other person
Dangerousness
the legal term that refers to someone's potential to harm self or others
American Legal Institute (ALI) test
the legal test in which a defendant is considered insane if he or she either lacks a substantial capacity to appreciate that his or her behavior was wrong or has a diminished ability to make his or her behavior conform to the law
Durham test
the legal test in which a person is considered insane if an irresistible impulse to perform criminal behavior was due to a mental defect or disorder present at the time of the crime
Irresistible impulse test
the legal test in which a person is considered insane if he or she knew that his or her criminal behavior was wrong but nonetheless performed it because of an irresistible impulse
M'Naghten test (or rule)
the legal test in which a person is considered insane if, because of a "defect of reason, from disease of the mind," he or she did not know what he or she was doing (at the time of committing the act) and did not know that it was wrong
Psychoeducation
the process of educating patients about research findings and therapy procedures relevant to their situation
Scientific method
the process of gathering and interpreting facts that generally consists of collecting initial observations, identifying a question, developing a hypothesis that might answer the question, collecting relevant data, developing a theory and testing the theory
Reuptake
the process of moving leftover neurotransmitter molecules in the synapse back into the sending neuron
Clinical assessment
the process of obtaining relevant information and making judgement about mental illness based on the information
Gateway hypothesis
the proposal that use can become a use disorder when "entry" drugs serve as a gateway to (or the first stage in a progression to) use of "harder" drugs
Correlational research
the relationship between the measurements of two variables in which a change in the value of one variable is associated with a change in the value of another variable -naturally occurring variations among measurements of different variables are compared
Substance intoxication
the reversible dysfunctional effects on thoughts, feelings, and behavior that arise from the use of a psychoactive substance
Dissociation
the separation of mental processes--such as perception, memory, and self-awareness-- that are normally integrated
Withdrawal
the set of symptoms that arises when a regular substance user decreases or stops intake of an abused substance
Mental contents
the specific material that is stored in the mind and operated on by mental processes
Gender identity
the subjective sense of being male or female (or having the sense of a more fluid identity, outside the binary categories of male and female), as these categories are defined by a person's culture
Delirium tremens
the symptoms of alcohol withdrawal that include uncontrollable shaking, confusion, convulsions, visual hallucinations, and fever
Response bias
the tendency to respond in a particular way, regardless of what is being asked by the question
Neuropsychosocial approach
the view that a psychological disorder arises from the combined influences of neurological, psychological, and social factors-- which affect and are affected by one another through feedback loops
Action potential
the wave of chemical activity that moves from the cell body down the axon when a neuron fires
Flight of ideas
thoughts that race faster than they can be said
Paraphilic disorders: social treatments
training men to emphasize with victims in the hopes that they will be less likely to reoffend in the future
Defense mechanisms
unconscious processes that work to transform psychological conflict in order to prevent unacceptable thoughts and feelings from reaching consciousness
Comorbidity statistic of ADHD and ODD
up to half of children with ADHD also have ODD (a lot!)
Mental processes (attention, perception, and memory) determine mental content
we all have cognitive distortions every once in a while- there is no abnormal behavior that is not just an excess of what happens normally
Paraphilic disorders: social factors
western societies provide many erotic stimuli to which males can become aroused
DSM-5 criticisms of paraphilic disorders
what is determined to be sexually "deviant" caries across cultures and over time
