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Module 1 Abnormal Psych
concordance rate - โ๏ธ how much agreement between proband and productive the concordance rate is the percent of cases in which both members of a pair have a particular attribute family study - โ๏ธ you are going to be similar to your family in some ways- how much agreement? high levels of concordance- it is possible that it could be genetic, the other reason is that it could be a learned behavior Definition of abnormal behavior - โ๏ธ Violation of norms, statistical infrequency, personal distress, disability or dysfunction DSM-5 - โ๏ธ Diagnostic and statistical manual Mental Disorder - โ๏ธ a syndrome that is present that involved significant disturbance in behavior emotion regulation or cognitive functioning Violation of Norms - โ๏ธ rules that tell us what is right and wrong to do emerge from culture and vary across time Statistical infrequency - โ๏ธ substantial deviation from a statistically calculated average Personal Distress - โ๏ธ an individual who is experiencing symptoms that cause unhappiness disability or dysfunction - โ๏ธ can a person meet the demands of their own life? Given their behavior pattern Prevalence of abnormal behavior - โ๏ธ 30% adults 20% kids in any given year are in need of treatment Mental health epidemiology - โ๏ธ the study of the distribution of mental disorders prevalence - โ๏ธ the number of active cases in a population during a given period of time lifetime prevalence - โ๏ธ estimated of number of people with a particular disorder at any point of their life National Comorbidity Survey - โ๏ธ -epidemiological study lifetime prevalence of any disorder was 46.4%
Most common disorders - โ๏ธ 1. anxiety 2.mood disorder 3. substance abuse Demonology - โ๏ธ Theory that deviant behavior is the result of supernatural forces treatment: exorcism Hippocrates - โ๏ธ father of modern medicine believed that mental illness is due to a biological cause somatogenic hypothesis - โ๏ธ there is something wrong in your body causing something wrong with your brain Three Hippocrates Achievements - โ๏ธ 1. observed and recorded observations of mental disturbances
- developed biological theory of abnormal behavior Example: women with hysteria have a floating uterus Cause of mental disorders= imbalance of humors/vital fluid
- Developed classification system All disorders fit into mania, melancholia, phrenitis (brain fever) Outbreaks of mass madness - โ๏ธ tarantism: convinced they were bitten and had convulsions lycanthropy- possessed by a wolf and act wolf-like koro- men fears that their gentiles vanished/sucked into their own bodies in Nigeria Witch hunts - โ๏ธ 80% accused of being witches were women endorsed by the churc asylum - โ๏ธ isolate mental patients from society ST. Mary of Bethlehem very bad conditions moral therpay - โ๏ธ Phillipe Pinel- treating the mentally ill badly will hurt their treatment made changes in asylums replaced dungeons forbid violent treatments talking with patient and gave advice- kept the records
observational learning - โ๏ธ -occurs when one person performs an action another person observes and the observed thereby acquire the ability to repeat the behavior -allows you to pack huge amounts of information into your memory (memory) classical conditioning - โ๏ธ a type of learning in which one learns to link two or more stimuli and anticipate events (PAVLOV) Cognitive behavioral approach - โ๏ธ -emphasis on observable relationships -both normal and abnormal behavior are learned Best way to study to study concordance - โ๏ธ twins separated at birth and see what their concordance is like ANS example 2 - โ๏ธ those with anxiety may have hyperactive ANS (over aroused hyper) ANS example 1 - โ๏ธ -those with antisocial personality disorder may have hyperactive ANS- low levels of fear low levels of arousal-underactive- do not do well with punishment- no guilt (a lot of criminals) autonomic nervous system - โ๏ธ ANS controls the smooth muscles the glands and the internal organs Brain structures involved with abnormal behavior - โ๏ธ --Schizophrenia- enlarged ventricles --hippocampus might be smaller in patients with PTSD Heritability - โ๏ธ refers to the extent to which variability in particular behavior or disorder in a population can be accounted for by genetic influence ONLY applicable to a large population of people, not an individual neurotransmitters - โ๏ธ a chemical that acts as a messenger from one neuron to the next examples of medications that affect neurotransmitters - โ๏ธ - phenothiazines- antipsychotic drugs- reduce levels of dopamine in schizophrenia-- Hadol, Thorazine
- benzodiazepines-- Xanax valium- minor tranquilizers -Selective serotonin reuptake inhibitors--SSRIS-- Prozac and Zoloft Examples of imbalances in neurotransmitters - โ๏ธ dopamine-schizophrenia GABA-anxiety Serotonin-depression and eating disorders, personality disorders- Gene-environment interaction -
โ๏ธ your genes affect how you react to the environment example of gene environment interaction - โ๏ธ children followed for 20 years with childhood maltreatments and depression levels measured = no maltreatment, no difference in depression rates example of gene environment interaction - โ๏ธ children were born to mom who was schizophrenic- disturbed home had more chance of schizophrenia adoption studies - โ๏ธ compare concordance rate with biological parent and compare to adopted child and adoptive parent that he was raised with twin studies - โ๏ธ monozygotic vs dizygotic if you have concordance with MZ its possible that that thing is genetic-- it's also possible they were raised similar so it would not prove genetic genetic paradigm - โ๏ธ how many genes are involved in abnormal behavior behavior is polygenic aka influenced by multiple genes nature VIA nurture shared environment - โ๏ธ factors include those things that members of a family have in common, such as family income level, child-rearing practices, and parents' marital status and quality. neuroendocrine system - โ๏ธ - Endocrine system releases hormones
- Nervous system uses neurotransmitters nonshared environment - โ๏ธ (sometimes referred to as unique environment) factors are those things believed to be distinct among members of a family, such as relationships with friends or specific events unique to a person (e.g., being in a car accident or on the swim team), and these are believed to be important in understanding why two siblings from the same family can be so different primary reasons to make diagnoses? - โ๏ธ Primary reasons
- communication/ common vocabulary among therapists and doctors
- necessary to further knowledge and to figure out the best treatment secondary reasons to make diagnoses? - โ๏ธ 1. practical (insurance $$)
- regulating client flow
- protecting clients from harm (least harmful label) 4, rationalizing decision-making
- advancing a political agenda Reliability -
raised the possibility that any psychological state may be due to different emotional states Jossef Breuer (catholic method) - โ๏ธ Treated Anna O under hypnosis and had some relief- talking cure Freud grew from this- behavior happens in unconscious Freud - โ๏ธ unconscious Id, ego, supergo psychosexual stages defense mechanisms psychologist - โ๏ธ doctoral degree, grad school plus internship PhD - โ๏ธ more research based psy D. - โ๏ธ doctorate in psychology more clinical based dimensional model - โ๏ธ abnormal behavior is different from normal behavior only by degree stigma - โ๏ธ refers to the destructive beliefs and attitudes held by society that are ascribed to groups considered different in some manner Stigma characteristics - โ๏ธ 1. labels that distinguish a group from others
- Labels linked to deviant behavior/undesired attributes
- labels "us vs. them"
- labels that cause discrimination 2 ways to reduce stigma - โ๏ธ contact, familiarity Read more about it Chap 1 - โ๏ธ 1. fight for housing rights
- educate people on mental health
- personal contact
- children should have mental health evaluations
- mental health professionals should receive training in stigma issues
- educate families
- support advocacy groups Is DSM dimensional or categorical? - โ๏ธ categorical
Concerns with DSM - โ๏ธ -arbitrary cutoffs (4 vs 5 symptoms of major depressive disorder) -danger of losing information (only addressing the label) heterogeneity - โ๏ธ the idea that individuals who share the same disorder may share few common features example of heterogeneity - โ๏ธ milton (depressed mood, crying, difficulty sleeping, fatigue, difficulty concentrating) sally (anhedonia, decreased appetite and weight loss, slowed motor behaviors, feelings of worthlessness, thoughts of suicide) Comorbidity - โ๏ธ -refers to meeting criteria for more than one diagnosis problems of comorbidity - โ๏ธ almost half the individuals who meet the criteria for one disorder meet the criteria of another problems of labeling people - โ๏ธ may lose sight of individual, self-fulfilling prophecy, may cause problems in society Inferiority model - โ๏ธ racial and ethnic minorities were inferior (less intelligent, not as hardworking, etc) deprivation model - โ๏ธ differences based on cultural deprivation, minority groups should just 'act more white' Multicultural model - โ๏ธ replaced the bad ones different doesn't mean worse each culture has strengths and limitations How does DSM address multicultural issues? - โ๏ธ -describe cultural factors for each disorder -list culture concepts of distress in appendix Examples of culture-bound syndromes/culture concepts of distress - โ๏ธ Ghost sickness, Kufungisia, Taijin Kyofusho assessment definition - โ๏ธ the collection, organization, and interpretation of information about a person and his or her situation Goals of assessment - โ๏ธ - gather information for diagnosis
- get to know person before therapy
- legal purposes Clinical interview -
macrophages also produce cytokines Proinflammatory cytokines IL(1) and TNF-alpha in depression IL(6) and IL (8) in schizophrenia Therapies for observational learning - โ๏ธ symbolic modeling- watches other kid have good experience with dog participant modeling- child participates in not being afraid of dog The hardest part of cognitive restructuring - โ๏ธ identifying negative thoughts because they are so automatic Cognitive therapy - โ๏ธ disorders may be caused by negative cognitive triad (world self future) have to treat with verbal persuasion very effective treatment- equal or better than medication Socioemotional approach - โ๏ธ abnormality within r external individual emphasis on social and cultural factors- more external Relationship between SES and Mental disorders - โ๏ธ lowest income category 3x more anti social 1.5 more depressive 1.5-3x more likely schizo Unemployment and Mental disorders - โ๏ธ Higher marital and depression problems diathesis-stress model - โ๏ธ abnormal behavior is result of complex interactions environment and biology- tipping point to getting mental disorder additive model - โ๏ธ individuals who have high diathesis may need only small amount of stress to put them over the edge low diathesis may need high levels of stress before getting over threshold to developing disorder additive/ adding together interactive model - โ๏ธ some amount of diathesis must be present before the stress will be in affect
resilience - โ๏ธ ability to adapt successfully to difficult circumstances Emotions - โ๏ธ Influence how we respond to problems and challenges in our environment organize explicit and implicit thoughts guide our behavior affect/short lived states moods - โ๏ธ emotional experences that endure for a longer period of time couples therapy - โ๏ธ between 30 and 40% marriages in US end in divorce people distressed marriage are 2 to 3 times more likely to experiment psychological disorder major relationship distress Family therapy - โ๏ธ problems of the family influence each member and the problems of each member influence the family focus on roles within the family Problems of Comorbidity - โ๏ธ half of individuals with one diagnosis will meet the criteria for another examples of projective techniques - โ๏ธ Rorschach inkblots thematic apperception test- come up with story of person in painting strengths and weakness of projective examples - โ๏ธ strengths- allow clients great freedom in expressing themselves taps into the unconscious weaknesses
- poor validity
- moderate levels of reliability
- expensive and insurance does not like to pay
- tends to over pathologize people personality inventories - โ๏ธ specific responses as inventory as predetermined relationships to personality traits all true/false questions
semistructured interviewee and interviewer work in collaboration Goals of LEDS - โ๏ธ 1. designed to address several problems in life stress assessment and life events
- exclude life events that might be consequence of symptoms intelligence Tests - โ๏ธ IQ- test cognitive ability Wechsler and Standord Binet test for language skills, abstract thinking, non verbal reasoning, visual spatial skills, attention, speed processing highly reliable and valid strong correlation to IQ test and school performance Bias in assessment - โ๏ธ a measure developed for one culture ethnic or racial group may not be equally reliable and valid with a different group just translating language does not sure that the meaning of those words will be the same across diff cultures ITC - โ๏ธ guidelines for translating and adapting tests to achieve equivalence in different cultures and ethnic groups still need to work on eliminating racial bias in clinical interview ways for clinicians to eliminate bias - โ๏ธ 1. students learn basic issues in assessment like reliability and validity
- become informed abt ways culture or ethnicities may impact assessment rather than just focusing on stereotypes
- must consider that culture, race or ethnicities may not impact assessment in every individual case
