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Abnormal Psych Midterm 1
Negative Reinforcement - Increasing behaviors by stopping or reducing negative stimuli. Integrative Approach - The process of analyzing psych disorders through biological, social/environmental, and psychological/mental lenses. Any disorder probably has all three as causes, symptoms, and in treatment. Biological Approach - Anatomy, biology, genetics, neurology, physiology. An approach to psychology focusing on the body, especially the brain and nervous system. An approach to psychology in which behavior and behavior disorders are seen as the result of physical processes, especially those relating to the brain and to hormones and other chemicals. Social Approach - Environment, external, community, family/home influences, social norms and cultural expectations. Reducing disorder focuses on changing the social environment in which individuals live to reduce the underlying causes of disorder. Treatments include group, couples, and family therapy, as well as community outreach programs. Psychological Approach - Internals workings of your mind, thoughts, judgements, patience, feelings, interpretations. Things that come not from the world/environment, but also not completely biological. Emphasizes the contributions of experiences, thoughts, emotions, and personality characteristics in explaining psychological disorders Abnormal definition - Three components MUST be met according to the DSM:
- Psychological dysfunction (things like won't eat, can't feel joy, unnatural psychological operations).
- Distress and impairment (to self or others/relationship)
- Atypical (not culturally expected, unique w/in your culture...entire cultures can't be "abnormal" just because they differ from yours) Psychological disorder - DSM: A (1) psychological dysfunction within an individual associated with (2) distress or impairment in functioning and a response that is (3) not typical or culturally expected.
(1) Psychological Dysfunction - A breakdown in cognitive, emotional, or behavioral functioning. Lines are blurry on if dysfunctions abnormal or normal...it's a continuum or dimension. Therefore, dysfunction =/= disorder, more is needed! (2) Distress of impairment - A disorder is indicated when a condition results in excessive distress and functional impairment. Can't stop thinking about it, can't carry out your job, can't treat your family right, etc. This can sometimes be normal, life is stressful, so must be paired with the other two qualifiers to be a disorder. Phobia - A psychological disorder characterized by marked and persistent fear of an object or situation. (3) Atypical or not culturally expected - Deviate from the average in your culture, more deviation = more "abnormal." This factor helps eliminate cultural bias but in itself is insufficient to characterize a disorder because of all the harmless unique traits people have (exceptionally talented people are "atypical"). Prototype of a disorder - "Typical" profiles of someone with a disorder, check used to see if someone fits a diagnosis. Psychopathology - The scientific study of psychological disorders. Types of Psychologists? p.2 - Scientist-practitioner model - Psychologists must be both (scientist=research, new frontiers, discovery; practitioner= how does it apply/matter to real world and helping people) A model of training of professional psychologists that emphasizes the development of BOTH research and clinical skills. A model or framework for education in an academic discipline based on understanding the scientific principles and findings evidenced in the discipline and how they provide the basis for the professional practice. Presenting problem - Original complaint reported by the client to the therapist. First and most obvious issue in a patient... the reason they came. The actual treated problem may be a modification derived from the presenting problem.
Treatment - A procedure designed to change abnormal behavior into more normal behavior. =/= Outcome because treatment could work but relapse often/quickly Outcome - The long-term effects of treatment/status of the disorder. More holistic way of viewing and assessing treatment. Supernatural Model - Explanation of human behavior and its dysfunction that proposes important roles for spirits, demons, grace, sin, etc. Generally relying on deities or "the Universe" to explain phenomenon. Superstition Model - Relying on gut, instinct, "common knowledge," or traditional tales to explain phenomenon. Biological Model of Behavior - Every disorder can be solved, cured and explained by biological factors. Germ theory was a big contributor to the rise of this mindset- syphilis the first one! Has some historical basis in the Hippocratic "four humors" David Rosenhan Study - Book: "On Being Sane in Insane Places." Had colleagues fake a mental illness (said they heard voices) once labeled they acted completely normal but every behavior within the hospital was interpreted as a sign of schizophrenia. One of his confederates remained hospitalized for 58 days. This showed the powerful influence of labeling someone with a disorder; it also questioned the care for the mentally ill. After criticism, he told hospitals he would send fakes and to see if they could catch them but never sent fakes and a lot of legitimate cases got turned away. Shows damage of false negatives and false positives. Multi-dimensional Integrative Approach - Approach to the study of psychopathology that holds psychological disorders as always being the products of the three level of the integrative approach in every dimension of the disorder: etiology/causes, symptomology, and treatment. John P. Grey - 1850s psychiatrist who believed mental illness had physical roots. Could be cured by good eating, sleeping, air quality/temp problems, etc. Needed to "heal" like a physical ailment. Championed biological tradition in the U.S. Led to reforms of hospitals to give psychiatric patients better/humane care but also led to a massive influx in patients and an inability to care properly at times. Most influential American PsychMD of that era Superintendent of Utica State Hospital (NY) Causes of insanity are always physical
- Mentally ill should be treated similar to physically ill
- Conditions in hospitals greatly improved More humane, livable institutions
- However, overcrowding resulted in lack of individual care & downsizing was highly recommended Deinstitutionalization: Releasing patients to the community Dorothea Dix - Leader of the "mental hygiene movement." A reformer and pioneer in the movement to treat the insane as mentally ill, beginning in the 1820's, she was responsible for improving conditions in jails, poorhouses and insane asylums throughout the U.S. and Canada. She succeeded in persuading many states to assume responsibility for the care of the mentally ill. She served as the Superintendant of Nurses for the Union Army during the Civil War. Rights activist on behalf of mentally ill patients - created first wave of US mental asylums. Led to "moral theory"/thinking of moral implications of treatment, but unintended consequence of flood of patients that reduced the quality of care in institutions. Mental Status Exam - A set of interview questions and observations designed to reveal the degree and nature of a client's abnormal functioning. Relatively coarse preliminary test of a client's judgment, orientation to time and place, and emotional and mental state; typically conducted during an initial interview. Preliminary assessment that helps diagnosis process, 5 categories:
- Appearance and behavior (nonverbal/external, clothes, twitch, posture, motor retardation)
- Thought process (stutter, rate/flow of speech, derailment, delusions)
- Mood+Affect (ask them about former, observe the later to see if it matches... laughing at death=bad affect sign)
- Intellectual functioning (vocab+grammar, memory)
- Sensorium (awareness of surroundings.. "clear" is good) Taxonomy - The science of classifying organisms. Nosology - Classification and naming system for medical and psychological phenomena "taxonomy in psychological/medical phenomena" Made up of nomenclature Nosology=Anxiety disorders?? Nomenclature= GAD?? Idiographic Approach - Approach to personality that focuses on identifying the unique configuration of characteristics and life history experiences within a person. Tailored, unique to each person. Nomothetic Approach (Jake/Bonior: is dimensional approach part of idiographic or here??) - Approach to personality that focuses on identifying general laws that govern the behavior of all individuals.
maximum change has been noted in the first behavior, the treatment variable is applied in sequential fashion to each of the other behaviors in the design. Frontal Lobe - A region of the cerebral cortex that has specialized areas for movement, abstract thinking, planning, memory, and judgement. Associated with reasoning, parts of speech, impulsive behavior, emotions, and problem solving. Parietal Lobe - A region of the cerebral cortex whose functions include processing information about touch. Portion of the cerebral cortex lying at the top of the head and toward the rear; receives sensory input for touch and body position. Occipital Lobe - A region of the cerebral cortex that processes visual information. Temporal Lobe - A region of the cerebral cortex responsible for hearing and language. An area on each hemisphere of the cerebral cortex near the temples that is the primary receiving area for auditory information. Agonists - Chemical substances that mimic or enhance the effects of a neurotransmitter on the receptor sites of the next cell, increasing or decreasing the activity of that cell. Drugs that increase the action of a neurotransmitter by mimicking it. Has to do with replicating/enhancing the neurotransmitter (could be an excitatory OR inhibitory neurotransmitter so not necessarily about "more" or "less"). Antagonists - Chemical substances that block or reduce a cell's response to the action of other chemicals or neurotransmitters. Drugs that block the function of a neurotransmitter. Inverse Agonists - Chemical substance that produces effects opposite those of a particular neurotransmitter. Produce effects opposite to those produced by the neurotransmitter. Implicit Memory - Retention independent of conscious recollection. (Also called procedural memory.) *Is seen when someone acts on the basis of something that happened but they cannot remember the events. Study using the "black box," unobservable feelings or cognitions inferred because of subjects reports or behaviors. Prepared Learning - An ability that has been adaptive for evolution, allowing certain associations to be learned more readily than others. Learning that occurs without extensive training because of an evolved predisposition to the behavior (fear of snakes).
Predisposed to form associations between certain stimuli=easier to produce/induce in lab etc. Class: concept claims we've evolved to be highly prepared to learn about certain objects/situations Ex.: even without any contact/experience, we can more quickly teach/condition fear at a toy spider in a subject than a toy gun even though guns are actually more deadly. One Structure System - ??? nowhere in index or internet Social effects on health - Having a strong social circle results in much lower rates of depression, suicide, and even general health like beating illnesses and living longer. Something about the support we need as social creatures helps us greatly- feeling loved, having hope. Blood pressure, depression, alcoholism, arthritis. Social Learning - Bandura's theory that suggests we learn social behaviors by watching and imitating others. Organisms can learn just as well/almost as well? by observing the actions and consequences of others. AKA 'Modeling' or 'Observational Learning' Process of altering behavior by observing and imitating the behavior of others. Learning through observing others. Autonomic Restrictors - Term for people with generalized anxiety disorder (GAD) because they show lower heart rate, blood pressure, skin conductance, and respiration rate activity than do people with other anxiety disorders. They've fought to control it/dealt with it so much they're repressed it. People with GAD show less responsiveness on physiological measures such as heart rate, blood pressure, respiration, skin conductance, etc. Sensitivity to Threat - People with GAD are more likely to show a strong sensitivity to threat. Muscle Tension - People with GAD are significantly different from those with other anxiety disorders due to their high and chronic muscle tension. Very tense people. GAD Treatment - Cognitive Behavioral Therapy, certain Selective Serotonin Re-uptake Inhibitors (SSRIs), some Serotonin-norepinephrine Re-uptake Inhibitor (SNRIs)= first line Benzodiazepines dangerous = second line Types of Psychology - Behavioral (conditioned, tendencies, reactions) Biological (blood pressure, hormones, diseases) Emotional/Cognitive (fear, stress, love, logic)
Amphetamines had different effects on monkeys at top or bottom of social hierarchy (increased dominant behaviors of dominant monkeys and submission behaviors of submissive monkeys). Epigenetics - The study of environmental influences on gene expression that occur without a DNA change. "around" "genes" How environments affect which genes are expressed and how, also how history and hormones affect. Neuroscience - The scientific study of the central nervous system/brain (CNS). Neurons - Individual cells in the nervous system that receive, integrate, and transmit information. Nerve cells; the basic building block of the nervous system. 4 main components:
- Dendrite
- Receptor
- Axon
- Synapse Action Potential - A neural impulse; a brief electrical charge that travels down an axon; how info is transmitted w/in neurons. To the terminal button where it jumps the synaptic cleft to the dendrite of the next neuron The change in electrical potential associated with the passage of an impulse along the membrane of a nerve cell. Dendrite - Bushy, branching extensions of a neuron that receive messages and conduct impulses toward the cell body A short branched extension of a nerve cell, along which impulses received from other cells at synapses are transmitted to the cell body. Receptor - A small area on the dendrite that receives the signal from the other neuron. Axon - The extension of a neuron, ending in branching terminal fibers, through which messages pass to other neurons or to muscles or glands Synapse - The junction between the axon tip of the sending neuron and the dendrite or cell body of the receiving neuron, including the synaptic gap
Synaptic Cleft- The narrow gap that separates the presynaptic neuron from the postsynaptic cell. Synapse= axon tip of sending neuron+synaptic gap between+dendrite of receiving neuron Synaptic Cleft - A gap into which neurotransmitters are released from the axon terminal. Included as part of synapse. Terminal Button - The bud at the end of a branch of an axon from the sending neuron; forms synapses with another neuron; sends information to that neuron; secretes neurotransmitters. Where Action Potential travels to in order to send/activate/pass along Neurotransmitters - Chemicals that cross the synaptic gap to transmit information from one neuron to another. Neurons=cells, neurotransmitters=how they communicate and know what to do. Excitatory Neurotransmitters - Chemicals released from the terminal buttons of a neuron that excite the next neuron into firing. Excitatory transmitters promote the generation of an electrical signal called an action potential in the receiving neuron. Increase likelihood neuron fires/(passes info?) Excite the next cell into firing Inhibitory Neurotransmitters - Decrease the likelihood that the neuron will fire an action potential. Slow down transmission of neurological info. GABA good example. Brain Circuits - Neurotransmitter current or neural pathway in the brain. Sets of connected neurons that work together to accomplish a basic process. Re-uptake - A neurotransmitter's reabsorption by the sending neuron. The reabsorption by a presynaptic nerve ending of a neurotransmitter that it has secreted. Broken down quickly and brought back up into the neuron that absorbed it. Many drugs work by manipulating the re-uptake process. Amino Acid Neurotransmitters - GABA- Inhibitory transmitter that inhibits or regulates the transmission of info. Reduces arousal and anxiety. Glutamate- Excitatory neurotransmitter that "turns on" many different types of neurons, leading to action. Increases arousal. Yin and Yang but not two people have the same responses. Monoamine Neurotransmitters -
fight/flight response - Physiological response in the sympathetic nervous system triggered when we feel a strong emotion like fear. A sequence of internal processes that prepares the organism for struggle or escape. The immediate reaction to perceived danger or threat whereby efforts are directed toward protecting against potential harm, either by confronting the source of danger (fight), or by escaping from the situation (flight). If not prepared or overwhelmed it can become dangerous as we (freeze). Fear - The central nervous system's physiological and emotional response to a serious threat to one's well-being. Three components:
- Feeling terror 2. Motivation for behavior (fight/flight) 3. complex physiological response (heart pumping, adrenaline, sweat, etc.) The usual reaction when a stressor involves real or imagined danger. Can be a good thing- why emotions are contagious, it can save lives. Emotion v Mood - Emotions are linked to action tendencies (fear=fight/flight). Usually short, temporary states in response to external events. Approach and avoidance tendencies/behaviors. Three elements to emotion: Behavior (motivation/actions), Physiology (biology/body responds), Cognition (appraisals/attributions/processing change) Moods are a more persistent period of emotionality. Anxiety disorders can fit w/in mood. Affect of Emotion - Two dimensions: Valence Dimension- positive/pleasant or negative/unpleasant Arousal Dimension- high or low Together these make up the Circumplex Model of Emotions (you can add time too) Gender differences in anxiety - Women respond with "tend and befriend" just like their ancestors would have had to do (less strong, rely on social connections to get through challenges). Many disorders more common in one gender. Mental disorders are __% of the global burden of disease (WHO) - 13% but cultures differ. Healthcare access and war torn areas affect rates of disorders. Life-span Development - Vein of psych focused on long-term care +treatment and a holistic approach (we shouldn't take a snapshot and summarize a person). Many different life periods are "developmental," not just youth.
The field of study that examines patterns of growth, change, and stability in behavior that occur throughout the entire life span. Concept of human development as a lifelong process, which can be studied scientifically Equifinality - A basic principle of developmental psychopathology that holds that one symptom can have many causes. Many routes to same "end' of disorder. Sigmund Freud - Austrian physician whose work focused on the unconscious causes of behavior and personality formation; founded psychoanalysis. Oedipal Complex- Freudian Slip- Dream analysis- dug real deep here (sort of right- trashcan analysis, cleaning brain) Unconscious Mind- Super-ego (angel on shoulder, knows laws/morals), Id (primal, aggressive base), Ego (conscious mind trying to moderate these two). Defense Mechanisms - Freud claimed we use these to escape the discomfort our ego has to navigate/emotions and thoughts that aren't acceptable to us: Denial- straight up lying about what we think/feel Displacement- punch wall Projecting- "No you're..." Rationalization- find logical reasoning for the unacceptable thought Reaction formation- do opposite publicly of how we feel inside Repression- denial on steroids, shove it down to unconscious level Sublimation- take negative and channel it to good Psychosexual Stages - The childhood stages of development (oral 0-2, anal 2-4, phallic 4-6, latency 6- puberty, genital puberty-adult) during which, according to Freud, the id's pleasure-seeking energies focus on distinct erogenous zones. Disruption in each stage correlates to ticks and behaviors later in life. oral=chew nails, vape to cope anal= neat freak/perfectionist or mess (depends on kinds of disruption- parents scream and spank at accident or ignore it??) Alfred Adler - Inferiority complex- Adler's conception of a basic feeling of inadequacy stemming from childhood experiences We have unrecognized fears and "self-sabotage"; "Adler's (Magical) Question" Carl Jung - Contemporary of Freud, built on him Collective Unconscious- a bit of a mystical version of unconscious mind; we carry unconscious of our ancestors/species, all myths/ancient stories have the same plots as our tales today, a bit supernatural. Inspired Myers-Briggs (extrovert v introvert is "where do you draw your energy?" =/= "shyness" that's social anxiety)
Can be improved with large heterogenous sample. Rorschach Inkblot Test - The most widely used projective, ambiguous test, a set of 10 inkblots, designed by Hermann Rorschach; seeks to identify people's inner feelings by analyzing their interpretations of the blots, lots of correlations/HUGE bank of study. Other ambiguous tests: sentence completion test, Thematic Apperception Test (TAT), homophones to measure anxiety/threat sensitivity (write: die/dye, weak/week, patience/patients) Semi-structured Clinical Interviews - Tactics like:
- Physical
- Behavioral assessment (get in their head w/ "analogue" setting that mimics reality)
- Hypnosis
- Brain scans -Meetings with hyper-specialized clinicians Observation - Usually done in the present and concerned with immediate before/after (antecedents/consequences) of actions. Formal observation involves 'operational definitions' of specific observable behaviors for documentation/study. More subjective, need to show inter-rater reliability. Could be Naturalistic Observation Informal Observation is not 'operationalized' Self-monitoring is a type. Projective Testing - A personality test designed to let a person respond to ambiguous stimuli, presumably revealing hidden emotions and internal conflicts projected by the person into the test. Personality Inventories - A questionnaire (often with true-false or agree-disagree items) on which people respond to items designed to gauge a wide range of feelings and behaviors; used to assess selected personality traits. Minnesota Multi-phasic Personality Inventory (MMPI)... high correlation due to massive data (many schizophrenic or depressed answer the same way on lots of Qs). Intelligence Testing - A method for assessing an individual's mental aptitudes and comparing them with others using numerical scores. Psychometric instruments that compare individuals in a population to others in terms of cognitive capabilities. Stanford-Binet original IQ test, first to assess 'mental age,' then used to find rank/percentile w/in your age group, you get a deviation score.
What it means: increased chance to be a high performer in our school system Does NOT mean: intelligence, guaranteed school outcome, or even close to something like 'genius' or 'creativity' Neuropsychological Tests - A test that detects brain impairment/dysfunction (to contribute to disorder diagnosis) by measuring a person's cognitive, perceptual, and motor performances (concentration, memory, ex. "copy down the image"). Issues with false negatives and false positives, usually supplemented with other tests. Neuroimaging - Sophisticated computer-aided procedures that allow examination of nervous system structure and function. Pictures of the structures (x-ray, CT, MRI, static) and functions (blood flow, activity, fMRI, PET, SPECT) of the brain. PET and SPECT (cheaper, less accurate version) tracers put isotopes in blood (invasive!) Psychophysiological Assessment - Measurement of changes in the nervous system reflecting psychological or emotional events such as anxiety, stress, and sexual arousal. The evaluation strategies that measure brain structure, brain function, and nervous system activity. EEG can track emotions by viewing brain activity. ex. sympathetic nervous system activity=stress and emotional arousal Comorbidity - The co-occurrence of two or more disorders in a single individual. They can influence each other and make it hard to tell what is caused by what. Confounds - Greatest threat to validity and we're often unaware of them. Statistical Significance - Number crunching to reach a statistical statement of how likely it is that an obtained result occurred by chance. Clinical Significance - Degree to which research findings have useful and meaningful applications to real problems. Severe side effects for a small % ?? Maybe not good then even if statistically significant. Patient Uniformity Myth - Tendency to consider all members of a category as more similar than they are, ignoring their individual differences. No two patients are exactly alike. Average doesn't always hold for individuals. Genotype - Genetic makeup of an organism
Agoraphobia - Fear or avoidance of situations, such as crowds or wide open places, where one has felt loss of control/escape Symptomology=Marked fear/anxiety of 2+
- public transit
- being in large open spaces
- being in enclosed spaces
- standing in line/crowd
- being outside home alone Escape might be difficult or help unavailable. AVOID those situations^ to the extreme Disproportionate fear Usually fear of being trapped/unhelped/ashamed IF they had a panic attack (but you can't have both this and panic disorder unless distinct traits for both, no double whammy) Can also have interoceptive avoidance in some cases? Interoceptive Avoidance - Avoidance of situations or activities that produce sensations of physical arousal similar to those occurring during a panic attack or intense fear response. Agoraphobic Avoidance - A disproportionate and irrational avoidance of large open spaces, crowded places, small places, or anywhere escape/help might be challenging. This is a symptom of Agoraphobia. Generalized Anxiety Disorder (GAD) - A disorder characterized by chronic excessive worry (more days than not for 6+ months about more than one area of life) accompanied by three or more of the following symptoms:
- restlessness
- fatigue
- concentration problems
- irritability
- muscle tension
- sleep disturbance A diffuse state of constant anxiety not associated with any specific object or event. Panic attacks not necessary. A bit odd Autonomic Restriction so you actually experience less physiological reactions to anxiety because you keep it down so much.... LOTS of muscle tension with GAD people. Also acute threat sensitivity. Treatment: Cognitive Behavioral Therapy (exposure+handling), SSRIs Etiology (all anxiety disorders, incl. GAD):
- sleep deprivation makes you more sensitive to threat (can start the cycle when you're exhausted)
- past experience affect on stress/sensitivity (check threat sensitivity w ambiguous homophones :o)
- Behavioral Inhibition System (BIS), biological, even in babies we can see tendency toward fight, flight, freeze (and for certain things).
- cigarette smoking=higher risk
- families/parenting--> tell you what to fear/stress about Worry v Aniety - Worry is cognitive/mental trigger for anxiety Anxiety is worry+response (physiological, behavioral) CBT - Cognitive Behavior Therapy; exposure therapy (maybe less "working through it" here); and Systematic Desensitization (for phobias) Social Anxiety Disorder - Intense fear of negative evaluation in social situations leading to avoidance. Symptom- blushing. One sub-type is the "Performance-only Subtype"= fine chit chatting but not hitting freethrows. Specific Phobias - Any of the disorders characterized by extreme and irrational fear of a particular object or situation:
- Expected panic attacks
- Must disrupt daily life (who cares if you're afraid of Komodo dragons but never see them)
- Excessive and unreasonable fear
- Most common categories:
- Blood, injection, injury (highly genetic)
- Situational (claustro, agora)
- Natural environment (storms, heights, ocean, even bridges (combo of height and water))
- Animals (insects, etc.) Treatment: Systematic Desensitization (type of CBT), more gradual than another option: Exposure Therapy. Break cycle of thoughts-->actions May also need medication Etiology (all anxiety disorders, incl. phobias):
- sleep deprivation makes you more sensitive to threat (can start the cycle when you're exhausted)
- past experience affect on stress/sensitivity (check threat sensitivity w ambiguous homophones :o)
- Behavioral Inhibition System (BIS), biological, even in babies we can see tendency toward fight, flight, freeze (and for certain things).
- cigarette smoking=higher risk
- families/parenting--> tell you what to fear/stress about Systematic Desensitization -
