Abnormal Psych Midterm 1

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What is psychopathology?

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study of nature, development, and treatment of psychological disorders

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stigma

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putting a stereotype on someone because of their disorder; assume they are a certain way

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4 characteristics of stigma

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1. distinguishing label applied
2. label refers to undesirable attributes
3. people with label are seen as different
4. people with label discriminated against

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defining mental disorders

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personal distress, disability, violation of social norms, and dysfunction

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personal distress

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emotional pain and suffering

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disability

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impairment in a key area (job loss for example)

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violation of social norms

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makes others uncomfortable or cause problems

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dysfunction

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harmful behaviors caused by dysfunction of internal mechanisms (biological basis)

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demonology

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supernatural causes to unexplained environmental (eclipses) or behavioral phenomena; priests for treatment

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early biological explanations

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Hippocrates- psych disorders have natural causes and the imbalance lies in an imbalance of the 4 humors; doctors for treatment

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Hippocrates' 3 categories of disordered thinking

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mania, melancholia, phrenitis

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Hippocrates' 4 humors

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blood, black bile, yellow bile, phlegm

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lunacy trials

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trials to determine sanity (13th century England); municipial authorities assumed responsibility for care of mentall ill which are ill due to physicall illness, injury or emtional shock

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lunacy

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attributes insanity to misalignment of moon and stars (no scientific support)

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asylum

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establishments for the confinements and care of mentally ill- treatment non existent or harmful

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First mental institution

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Priory of St. Mary of Bethlehem (1243)- became a tourist attraction

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Benjamin Rush

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recommended drawing large amounts of blood to try to treat patients

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Philippe Pinel

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(1745-1826) pioneered humanitarian treatment at LaBicetre

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Friends Asylum

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(1817) small, private, humanitarian mental hospitals; patients engaged in purposeful, calming activities, and talked with attendants

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Dorthea Dix

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(1802-1887) crusader for prisoners and mentally ill; worked to establish 32 new, public hospitals

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General paresis

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degenerative disorder (delusions and progressive paralysis), Germ Theory

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Germ Theory

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disease is cause by infection in the body; a casual link established between infection (syphilis), brain damage, and psychopathology (general paresis)- gave credibility to biological causes of psychopathology

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General Paresis

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impairment of mental ability due to damage to the brain

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Syphilis Discovery

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syphilis caussed problems in the brain which leads to a mental disorder- helped in the Germ Theory

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Genetics

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mental illness is inherited (Francis Galton)

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Eugenics movement

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laws enforced sterilization of mentally ill (killing babies because they thought they would inherit mental illness)

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early biological treatments

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insulin-coma and electroconvulsive therapy (ECT), prefrontal lobotomy (remove piece of the brain)

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Emil Draepelin

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(1856-1926) pioneered classification of mental illness based on biological causes; defined mental illness as a syndrome- cluster of symptoms that occur; proposed dementia praecox and manic-depressive psychosis

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dementia praecox

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cognitive problems

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manic-depressive psychosis

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mania, depression, or psychotic symptoms

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Mesmer

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(1734-1815) treated patients with hysteria (blindness and paralysis) by adjusting their magnetic field; early practitioner of hypnosis

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Breuer

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1842-1925 used hypnosis to facilitate catharsis in famous case study (Anna O.-hysteria) (psychological approach)

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catharsis

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release of emotional tension triggered by reliving and talking about event- could be done through art, crying, music, etc. -doesn't need hypnosis (psychological approach)

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psychoanalytic theory

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Freud- psychopathology results from unconscious conflicts that keep us from maturing

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defense mechanisms

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psychological maneuvers used to manage stress and anxiety- unconscious

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repression

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puts memories, and traumatic or unacceptable events into the unconscious

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denial

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keeping things from conscious and saying it never happened

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projection

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saying your feelings are actually the feelings of someone else

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displacement

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redirecting emotional responses from their real target to a less threatening one

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reaction formation

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converting unacceptable feelings into its opposite

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regression

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going back to behaviors of your childhood when stressed

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rationalization

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making unacceptable feelings acceptable by making an excuse

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sublimation

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converting unacceptable feelings into something socially acceptable

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5 stages of psychoanalytic theory

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oral, anal, phallic, latent, genital

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major techniques of psychoanalysis

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free association, interpretation, analysis of transference

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free association in psychoanalysis

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the patient tries to say whatever comes to mind without censoring anything (psychoanalysis)

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interpretation in psychoanalysis

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the analyst points out to the patient the real meaning of certain of the patient's behavior

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analysis of transference in psychoanalysis

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the patient responds to the analyst in ways that the patient has previously responded to other important figures in his or her life and the analyst helps the patient understand and interpret these responses

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Jung

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Neo-Freudian who established "analytical psychology" and collective unconscious and archetypes of personality (categories that we use to organize the world

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Adler

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Neo-Freudian; established "individual psychology" -fulfillment comes from working for the social good and that is human's motivation

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Ego Analysis

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neo-freudian idea that emphasized individual's control of environment- contradicts Freud's possibility to change

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John Watson

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father of behaviorism; focuses on observable behavior and emphasis on learning rather than innate tendancies- doesn't care what is going on in the mind, only environment

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Pavlov

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behaviorist; classical conditioning- learning through association

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Watson and Raynor

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classically conditioned fear of white rat in Little Albert; behaviorism

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E Thorndike

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operant conditioning in behaviorism; law of effect: learning through consequences (sometimes you have to learn for yourself)

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B.F. Skinner

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operant conditioning in behaviorism; positive reinforcement (behaviors followed by reward) and negative reinforcement (following good behavior by taking away a negative thing)

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shaping in operant conditioning

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reward sequence of responses approximating final response- getting someone to do what you want by reinforcement

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modeling

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behaviorism; learning by imitating others behavior- can occur without reinforcement

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Bandura and Menlove

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modeling reduced children's fear of dogs

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Behavior Therapy

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behavior modification; systematic desensitization and aversive conditioning

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systematic desensitization

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uses a hierarchy or fears by gradually exposing the patient to feared situations

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aversive conditioning

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pairing the unwanted behavior with something bad to decrease behavior- often used in drug treatment

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mental health professions

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clinical psychologists, psychiatrists and psychiatric nurses, social workers, marriage and family therapist

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paradigm

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perspective or conceptual framework from within which a scientist operates- influences how abnormal behavior is defined, investigated, and treated

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genetic paradigm

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heredity plays a role in most behavior (genes)

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genes

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carry DNA; impacted by environmental influences that tell which genes are turned on or off- relationship is bidirectional

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gene expression

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proteins influence whether genes are turned on or off

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polygenic transmission

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multiple gene pairs vs. single gene determine vulnerability

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heritablility

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extenet to which variability behavior is due to genetic factors- from 0.00 to 1.00, higher means more from genetics- discusses large populations

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shared environment

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events and experiences that family members have in common

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nonshared environment

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events and experiences that are unique to each family member- explains why siblings can be different, greater influence on development of psychopathology

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behavior genetics

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study of the degree to which genes and environmental factors influence behavior

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genotype

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genetic material inherited by an individual; unobservable

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phenotype

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expressed gentic material, observable behavior and characteristics, depends on interaction of genotype and environment

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molecular genetics

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identifies particular genes and their functions

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alleles

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different forms of the same gene; different combination but produces the same characteristic

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polymorphism

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difference in DNA sequence on a gene occurring in a population; produces a characteristic that isn't expected

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knockout studies

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removing specific genes in animals to observe effect on behavior; ex-taking out gene for serotonin receptor leads to anxiety in mice

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gene-environment interaction

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one's response to a specific environmental event is influenced by genes; gene AND environmental cause produced disorder

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epigenetics

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study of how the environment can alter gene expression or function; cross-fostering adoptee method- rats born to mothers with low parenting skills who were raised by mothers with high parenting skills showed lower levels of stress

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reciprocal gene-environment interaction

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genes may predispose us to seek out environments that increase the liklihood of developing a mental disorder

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neuroscience paradigm

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examines the contribution of brain structure and function to psychopathology- mental disorders are linked to abnormal processes of the brain

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reductionism

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(neuroscienc paradigm) view that behavior can best be understood by reducing it to its basic biological componenets- ignores more complex views of behavior

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4 mechanisms of neuroscience

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1. neurons and neurotransmitters
2. brain structure and function
3. autonomic system
4. neuroendocrine system (hormones)

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neurotransmitter

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chemicals that allow neurons to send a signal to another neuron; can be excitatory or inhibitory

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receptor sites

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on postsynaptic neuron absorb neurotransmitter

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reuptake

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reabsorption of leftover neurotransmitter by presynaptic neuron

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neurons

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presynaptic- sending neuron or postsynaptic- receiving neuron

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serotonin and dopamine

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involved in depression, mania, and schizophrenia

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norepinephrine

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involved in anxiety and other stress related disorders when increased

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gamma-aminobutyric acid (GABA)

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involved in anxiety when decresed

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possible mechanisms for neurotransmitters and psychopathology

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excessive or inadequate levels, insufficient reuptake, excessive number or sensitivity of postsynaptic receptors

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agonists

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increase activity; SSRI's (serotonin), Xanax (GABA)

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antagonists

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decrease activity; dopamine antagonist drugs used to treat schizophrenia

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pruning

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during adolescence less synaptic connections are made but the connections they have are faster- makes us learn at a slower pace

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schizophrenia according to brain structure

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enlarged ventriclees

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PTSD, Depression and Schizophrenia according to brain structure

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smaller hippocamus which helps us to memorize and learn

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obsessive complusive disorder according to brain structure

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psychotherapy shown to have measureable effects on brain activity

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autonomic nervous system

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includes the sympathetic nervous system and the parasympathetic nervous system

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sympathetic nervous system

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involved in anxiety disorders; fight or flight

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parasympathetic nervous system

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rest and restores body and mind

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neuroendocrine system

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brain communicating with glands to release hormones; includes HPA axis

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HPA axis

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releases stress hormone corisol, early trauma can lead to increase in HPA activity; linked to schizophrenia, depression, PTSD

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pyschodynamic paradigm

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includes psychoanalysis (Freud); little research supporting the causes of psychopathology, the greatest contributions are in treatment

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pathogenic beliefs in psychodynamic paradigm

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bad thoughts produce lack of self confidence, depression, etc (survivors guilt)

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implicit memory in psychodynamic paradigm

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person can be unconsciously influenced by prior learning; psychoanalysts see this as a "safe place" to keep unwanted thougths; cognitive neuroscientists see it as the brain's capacity to store knowledge for later use "you don't know you know"

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object relations theory in psychodynamic paradigm

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what is your role in relationship? why is it not working?- longstanding patterns of relating to others because of early relationships

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attachment theory in psychodynamic paradigm

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type and style of infant's attachment to caregivers can influence later psychological functioning; how does that affect behavior today?

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relational self in psychodynamic paradigm

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individuals will describe themselves differently depending on which close relatinships they are told to think about- they are defined by their relationships- why codependent to identify self?

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brief psychodynamic therapy

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active therapist involvement with concrete goals and the interpretations concentrate on current life and not childhood- time limited

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interpersonal therapy (IPT)

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emphasizes how problems in current relationships are linked to psychological symptoms- unresolved grief, role transitions, role disputes, interpersonal deficits

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cognitive behavioral paradigm

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behavior is reinforced by consequences, to alter behavior modify consequences

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systematic desensitization

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use the hierarchy of fears to lessen people's fear- important for anxiety disorders

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cognition

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a mental process which includes: perceiving, judging, conceiving, and recognizing; focuses on how we organize our experiences, make sense of them and relate them to our memories

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Beck's cognitive theory

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depression caused by distorted thoughts- information processing biases- "nothing ever goes right for me"- help patients recognize and change maladaptive thought patterns by cognitive restructuring

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Ellis's Rational-Emotive Behavior Therapy

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irrational beliefs: internal, repetative thoughts that reflect assumptions about self and musts or shoulds: unrealistic demands we place on self, others and the world

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diathesis

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underlying predisposition that can be genetic or psychological that increases one's risk of developing a disorder

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diathesis-stress: an integrative paradigm

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psychopathology is unlikely to result from one single factor- includes diathesis and stress

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inter-rater reliability

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independent observer agreement and consistency

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test-retest reliability

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similarity of schores across repeated test administrations or observations

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alternate forms reliability

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similarity of scores on tests that are similar but not identical

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internal consistency

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extent to which test items are related to one another

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validity

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how well a test measure what it is supposed to measure

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content validity

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extent to which a measure adequately samples the domain of interest- compare to something well established (DSM IV)

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criterion validity

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extent to which a measure is associated with other; includes concurrent (two variables measured at the same time) and predictive (ability to predict another variable in the future); based off research that is well established

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construct validity

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correlating multiple measure of the same attribute- it is an abstract characteristic and is the beginning stages of a theory

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multiaxial system

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diagnosis based on 5 axis or dimensions

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axis I

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all diagnostic categories except personality disorders and mental retardation

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axis II

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personality disorders and mental retardation

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axis III

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general medical conditions

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axis IV

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psychosocial and environmental problems (stressor)

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axis V

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global assessment of functioning scale (GAF); rated from 0 to 100

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culture can influence...

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risk factors, types of symptoms experienced, willingness to seek help, availability of treatments; don't diagnose disorder unless they are atypical or problematic within a person's culture

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comorbidity

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presence of a second diagnosis

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categorical diagnosis

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yes or no about having a disorder or not

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dimensional diagnosis

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rank on a continuous quantitative dimension to see the degree to which a person exhibits behavior

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psychological assessment

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techniques employed to describe client's problem, determine causes, arrive at a diagnosis, develop treatment strategy, and monitor treatment progress

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clinical interviews

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interviewer attends to how questions are answered-emotion as well as answer; good rapport essential

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structured interview

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all interviews ask the same questions in the same order

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Minnesota Multiphasic Personality Inventory (MMPI)

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yields profile of psychological functioning with specific subscales that detect lying and faking; self-report personality test

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Rorshach Inkblot Test and Thematic Apperception Test (TAT)

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psychodynamic projective test; responses to ambiguous stimuli reflect unconscious processes

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Wechsler Adult Intelligence Scale, 3rd Edition (WAIS-III)

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intelligence test; has one for children also

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self monitoring

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individuals observe and record their own behavior: moods, stressful events, thoughts, etc

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ecological momentary assessment (EMA)

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collection of data in real time using diaries

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reactivity

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the act of observing one's behavior may alter it; desirable behaviors tend to increase whereas undesirable behaviors decrease

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Computerized Axial Tomography (CT or CAT scan)

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reveals structural abnormalities by detecting difference in tissue density (e.g. enlarged ventricles)

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Magnetic Resonance Imaging (MRI)

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similar to CT but higher quality; reveals structural problems in brain tissue

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fMRI

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images reveal function as well as structure by measuring blood flow in the brain when doing a certain activity

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Positron Emission Tomography (PET Scan)

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brain function

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neuropsychologist

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studies how brain abnormalities affect thinking, feeling, and behavior

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neuropsychological tests

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reveal persormance deficits that can indicate areas of brain malfunction

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Halstead-Reitan battery

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assesses area of brain damage

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Luria-Nebraska battery

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assesses motor skills, tactile, and kinisthetic skills, verbal and spatial skills, expressive and receptive speech

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psychophysiology

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study of bodily changes that accompany psychological characteristics or events

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Electrocardiogram (EKG)

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heart rate measure by electrodes on chest

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Electrodermal responding

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skin conductance; sweat gland activity measured by electrodes placed on hand

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Electroencephalogram (EEG)

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brain's electrical activity measure by electrodes placed on scalp

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cultural bias

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can lead to minimizing or exaggerating psychological problems

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case study

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detailed biographical description of an individual; can't determine cause and effect, biased by observers theoretical viewpoint (paradigm)

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correlational method

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do variable x and y vary together? variables measured but not manipulated

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cross-sectional studies

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conducted at only one point in time with numerous groups

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longitudinal studies

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assess the same group of people over time; examines factors that are present before disorder develops

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high risk method

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includ only those who are at greatest risk of developing a disorder

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cerrelation cofficient (r)

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measure the direction and strength of the relationship observed between 2 variables; 0.0-1.0

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Epidemiology

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studies distribution of disorders in a population and their risk factors; does not prove causeation

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3 features of a disorder

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prevalence, incidence, and risk factors

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prevalence

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proportion (%) of population with a particular disorder at any time in life

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incidence

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number of new cases of a disorder at a specific time

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risk factors

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any characteristic or condition that occurs more in people with a disorder than those without that disorder

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relative risk ration (RR)

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the higher the number the higher your risk of getting the disorder; 1.0 is no chance while 2.0 is twice as likey to get it- under 1.0 is less likely

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behavioral genetics

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reveals whether genetic predisposition for disorder is inherited

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family method

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measure concordance of disorders in relatives

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concordance

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consistence

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twin studies

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compares monozygotic and dizygotic twins for genetic predispositions for a disorder

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adoptee method

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used to study gene-environment interactions

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molecular genetics

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linkage analysis method- study individual with disorder and family members who also have disorder; relies on the study of genetic markers

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meta-analysis

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integrates results from several studies- identify relevant studies, compute effect size (transforms results to a common scale)

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dissociation

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some aspect of cognition or experience becomes consciously inaccessible; failure of conscious to integrate our cognitions, emotions, etc into our present awareness; avoidance response from stressful events

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common symptoms of dissociation

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unable to recall important personal events, temporarily forget one's identity or assume anothere identity, wander far from one's usual surroundings

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dissociation and memory

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extreme stress usually enhances rather than impairs memory; deficits in explicit memory and not implicit

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dissociation

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failure of consciousness to perform its usual role of integrating our cognitions, emotions, motivations, and other aspects of experience in our awareness

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dissociative amnesia

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memory loss, typically of a stressful experience and personal info-may last for hours or years-usually complete recovery-deficits in explicit memory

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dissociative fugue

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memory loss to the point where you don't know who you are and you flee to somewhere far away- may get a new job and new name but the duration of the fugue is generally more brief and recovery is full- can't remember the fugue

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depersonalization disorder

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"out of body experience"- no memory loss- triggered by stress- usually begins in adolescence and lasts a long time; the person feels as though they are watching themselves from the outside

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dissociative identity disorder (DID)

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multiple personality disorder; 2 or more distince alters with unique behaviors, characteristics, and relationships; alters don't recall important personal info; memory gaps; onset in childhood but usually diagnosed in adulthood; recovery less complete; major increase since 1970

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posttraumatic model of dissociative idenetity disorder

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DID results from severe psychological and/or sexual abuse in childhood- develops as a way to cope

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socio-cognitive model of dissociative identity disorder

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DID is a form of role-play in suggestive individuals; occurs in response to prompting by therapists or media

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treatment of DID

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supportive therapist, integration of alters into one fully functioning person, working on coping skills; psychoanalytic approach to reach regressed thoughts and memories

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somatoform disorders

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psychological problems take a physiological form; no medical cause of symptoms; become distressed when no medical cause found

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pain disorder

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patients seek medical treatment for pain but are unable to provide a physiological cause; not intentional or faked- antidepressants and cognitive behavioral therapy (validation of pain, relaxation therapy, develop coping in other ways that resorting to physical pain

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body dysmorphic disorder

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preoccupation with imagined defect; constant examination of self or avoids them all together; 1/2 with suicidal thoughts; prevalence less than 1%; cognitive behavioral therapy (exposure pluse response prevention) and antidepressants

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hypochondriases

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preoccupation with fears about having serious disease (headache=brain tumor); continues despite medical reassurance; symptoms last at least 6 months; often comorbid with mood and anxiety disorders; cognitive treatment by reducing excessive attention to bodily sensations, challenge neg perspectives

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somatization disorder

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seek treatment from numberous doctors beginning before 30 and lasting several years; onset in early childhood; symptoms dont appear to be faked and cause impairment; more frequent in african american and hispanic women

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necessary symptoms to diagnose somatization disorder

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at least 4 pain symptoms, 2 gastrointestinal symptoms, 1 sexual symptom, and 1 psuedo-neurological symptom

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treatment of somatization disorders

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medical professionals acknowledge pain; minimize use of medicals professionals and tests; give them attention when feeling pain as well as when not

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conversion disorder

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one or more symptoms affecting motor or sensory functioning but no known medical cause; symptoms related to conflict or stress; onset ins adolescence or early adulthood and more common in women; causes significant distress or functional impairment and warrant medical attention

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treatments of conversion disorder

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no known treatments to date