Psyc 331: Abnormal Psychology

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Psyc 331: Abnormal Psychology

Study Guide for Exam # 1

Fall, 2014Chapter 1 and Related Materials

Case of Joyce Brown Homeless, living on the streest of NYC. She had disheveld and odd behavior. Attempted to treat her for mental illness but she refused treatmentDefinition of abnormal psychology Study of abnormal behavior in order to describe, predict, explain, and change abnormal patterns of functioning. Features of abnormality: The Four Ds1) Deviance Different, extreme, unusual

2) Distress Unpleasant and upsetting

3) Dysfuntion Causes interference with life

4) Danger Poses risk of harm to to yourself and community

Thomas Szaz; mental illness as a myth

Problems in living but it is not something wrong with the person. Concept of mental illness invented by societies to control people

Culture

Values, beliefs, and practices that are shared by a specific community or group of people. These values and beliefs influence views about abnormal and normal behavior.

Cross-cultural studies: Severe forms of psychopathology found in virtually every culture social scientist have studiedMurphys findings Studied 2 groups (Alaska and West Africa). In both cultures, certain forms of being were seen as being crazy. Consistent with what we call schizophrenia. Both cultures has specific explanations and treatment approachesGeneral epidemiological findings. Severe forms of mental disorders are not limited to Western cultures. Other disorders are more tied to certain cultures (such as eating disorder)Supernatural traditions: Primitive Demonology evil spirits: (Stone Age to Early Greeks)Trephination: An ancient operation in which a stone instrument was used to cut away a circular section of the skill, to treat ab. behavior

Medieval Demonology devil: There is a devil inside that needs to be taken outBiological traditions

Greek and Roman civilizations

Hippocrates: Believed that imbalances of the four humors (yellow bile, black bile, blood, phlegm) affected personality. Treatment was through living a healthy life. 19th century and 20th century

Somatogenic perspective: The view that abnormal psychological functioning has physical causes

Treatment - wet packs, hydrotherapy, insulin coma therapy, lobotomyPsychological traditions

Moral treatment: to treat people with mental dysfunction that emphasized moral guidance and humane and respectful treatment

Dorothea Dix - strong advocate of humane treatment and of mental hospitals

Rush Father of American Psychiatry. He was the reason for the spread of moral treatment. He required that the hospital hire intelligent and sensitive attendants to work closely with patients. He also gave gifts to his patients. Psychogenic perspective -Freud and Psychoanalysis

Treatment of abnormal mental functioning that emphasizes unconscious psychological forces as the cause of psychopathologyCurrent Trends

Psychotrophic medications: Drugs that mainly affect the brain and reduce many symptoms of mental dsyfunctioning.

Deinstitutionalization: The practice of releasing hundreds of thousands of patients from public mental hospitals. Private psychotherapy An arrangement in which a person directly pays a therapist for counseling servicesPrevention: Intervention aimed at deterring mental disorders before they can developMultiple theoretical perspectives and mental health professionals: Theories of biological, behavioral, cognitive, humanistic-existential, sociocultural. Counseling therapists, educational, school psychologists, nurses, marriage therapist, family therapistChapter 2 and Related Materials

Nomothetic understanding: A general understanding of the nature, causes, and treatments of ab psychological functioning in the form of laws and principles. Case study --value and limitations

Value: New ideas, Tentative support for a theory, Challenge a theorys assumptions,Inspire new therapeutic technique, Study unusual problems

Limitations: Relies on subjective evidence, poor internal validity, Provides little basis for generalization, poor external validityInternal validity: The accuracy with which a study can pinpoint one of the various possible factors as the cause of a phenomenonExternal validity: The degree to which the results of a study may be generalized beyond that studyCorrelational Method: the degree to which events or characteristics are related to each other. It does not imply causes and effect (Directionality and third variable) Correlation coefficient: -1.00 to 1.00 = strength and direction of a relationship.

Positive correlation: The relationship is positive and increasing

Negative correlation: The relationship is negative and decreasingCorrelation and causation

Third variable: This refers to the possibility that there is an unmeasured variable, Variable C, that is causing changes in both Variable A and Variable BDirectionality: This refers to the possibility that Variable A is causing changes in Variable B, or that Variable B is causing changes in Variable A. Experimental Method: causal relationships

Hypothesis: An education guess

Independent variable: Manipulated variable

Dependent variable: Variable being observed

Manipulation: Random assignment: A selection procedure that ensures that participants are randomly placed in control or experimental groupTreatment Research clinical trials

Experimental group: Exposed to independent variable

Control group: not exposed to independent variablePlacebo group: A sham treatment that the participant in an experiment believes to be genuine

Bias experimenter or participantSingle blind: Participants do not know whether they are the experimental or control groupDouble blind: Neither participant nor the experimenter knows whether the participants has received the experimental treatment or a placeboEpidemiological studies: A study that measures the incidence and prevalence of a disorder in a given population

Incidence: number of new cases of a disorder or illness during a period of timePrevalence: total number of cases (new and existing) in a population during a period of time

Natural experiment: Nature, rather than experimenter, manipulates an independent variable (Ex: Natural disasters)Analogue experiment: The experimenter produces ab like behavior in laboratory participants and then conducts experiments on the participants (Usually done to animals due to ethical issues)Ethical review- Institutional Review Board

Ethical principles

Respect for persons - Informed Consent

Beneficence do no harm, benefits outweigh risk

Justice do not exploit

Chapter 3 and Related Materials

Model or paradigm: A set of assumptions and concepts that help scientists explain and interpret observationsOne-dimensional versus multi-dimensional models: Single cause Vs. multiple influences that may occur at many different points in timeBiopsychosocial model

Interaction of genetic, biological, developmental, emotional, behavioral, cognitive, social, and societal influences

Importance of these influences may vary depending on disorder and individualGenetics

Genetic contributions to behavior

Huntingtons disease degenerative brain disease appears early 40s genetic defect

PKU inability of body to metabolize PKU present at birth cause mental retardationPolygenic inheritance

Diathesis-stress model: Diathesis: inherited tendency to express certain traits vulnerability

Stress environmental events which may activate vulnerabilty

Biological factors

Neuroscience

Central nervous system: brain and spinal cordPeripheral nervous system: somatic (muscles) and autonomic nervous system (cardiovascular and endocrine systems)

Neuron: Nerve cell

Dendrites: receptor sites, signal is received here

Axon: Signal travels through axonsSynapse: neurotransmitters ( A chemical that, released by one neuron, crosses the synapstic space to be received at receptors on the dendrites of neighboring neuronsReuptake

Degradation

Electrical versus chemical transmission

Important neurotransmitters

Dopamine: special neurotransmitter because it is considered to be both excitatory and inhibitory. Norepinephrine: excitatory neurotransmitter that is responsible for stimulatory processes in the bodySerotonin: inhibitory neurotransmitter which means that it does not stimulate the brainGABA: inhibitory neurotransmitter; When GABA is out of range (high or low excretion values), it is likely that an excitatory neurotransmitter is firing too often in the brain. GABA will be sent out to attempt to balance this stimulating over-firing.Endocrine system hormonesHormones carry messages through the body. It affects moods and energy levels. System of glands producing hormones.

Biological treatments

Psychotrophic medications

ECT

Psychodynamic Model unconscious conflict - Behavior is determined largely by underlying dynamic psychological forces of which she or he is not aware - unconsciousFreudParts of personality

Id Pleasure Principle produces instinctual needs, drives, and impulsesEgo Reality Principle employs reason and operates in accordance with reality principle

Superego Morality Principle represent a persons values and idealsDevelopmental stages Oral (0 to 18 months of age)

Anal (18 months to 3 years of age)

Phallic (3 to 5 years of age)

Latency (5 to 12 years of age)

Genital (12 years of age to adulthood)Other psychodynamic theories:

Ego theories: emphasize ego

Self theories sense of self

Object-relations theories need for relationships

Psychodynamic therapies

Uncover past trauma and unconscious conflictsA major criticism of psychodynamic model: lack of empirical support

Behavioral Model: principles of learning Emphasis is on observable behavior and environmental factors

Focus on how behavior is acquired (learned) and maintained over time

Operant Conditioning: rewards

Classical conditioning: Pavlov

UCS and UCR

CS and CR

Behavioral treatments: Systematic desensitization exposing phobia slowly to react calmlyCognitive Models: Maladaptive thinking is cause of abnormal behavior and emotionsFaulty or maladaptive thinking: assumptions, attitudes or beliefs,

illogical thinking, overgeneralization

Beck: cognitive therapy - help clients recognize and restructure thinking

Humanistic-Existential Models

Self actualize: humans fulfill their potential for goodness and growthCarl Rogers: client-centered therapy: help by conveying acceptance, accurate empathy, and genuinessSociocultural Model

Group therapy and self-help groups

Family therapy

Community mental health treatment

Chapter 4 and Related Materials

Idiographic approach: understanding behavior of a particular individualAssessment: collecting and interpreting relevant info abt participant

Interview

Unstructured

Semi-structured

Structured Mental Status Exam: know areas observed that we discussed in class Appearance and behavior

Thought processes

Mood and affect

Intellectual functioning

Sensorium how well is one oriented

Tests: know general uses of each

Personality inventories: MMPI (reading statements and having the respond indicate their personality)

Response inventories: Beck Depression Inventory

Projective tests: Rorschach, TAT, Sentence Completion

Intelligence: Wechsler scales

Neuropsychological tests

Battery approachPsychophysiological measures: polygraph

Neurological tests: EEG

Neuroimaging: CT Scan, PET scan, MRI, fMRI

Choosing tests questions to considerSome controversies Rorschach and Wikipedia, IQ tests and eBayPsychometric properties

Standardization - test is administered to a large group whose performance serves as a common standard (norm)Reliability interrater reliability (independent judges)Validity predictive, concurrentAssessment problems: types of bias

1) Interviewer bias = Interviewer can introduce a bias in the way that he/she wants to see the situation

2) Self report bias = How the person talking and reporting in the interview is biased. They are not always truthful

3) Culture bias = A lot of the tests are favoring the white middle class people. The non-majority culture people will have a difficulty in taking the test. Even if they do, it will not reflect their distress

Special problems: children and cultural issues

Children: limited ability to report

Parents or teacher report

Observation

Clients from other cultures

Language

Bias or stereotypes

May think or talk about symptoms differently

ObservationsDiagnosis - Label attached to a set of symptoms

Syndrome

DSM classification system 1st edition in 1952, most recent revision in 2013 = DSM-5Changes introduced in DSM-III

Multiaxial system abandoned in DSM-5, but know what the 5 axes are Axis I

Clinical syndrome

Axis II

Personality disorders and mental retardation

Axis III

Relevant general medical conditions

Axis IV

-- Psychosocial and environmental problems

Axis V

Global assessment of functioning (GAF) on 0100 scale

Operational definitionChanges introduced in DSM-5

Eliminated the multiaxial system Reorganized categories, changed names of some categories, created some new categories, and changed some criteria Eliminated general category of Disorders First Diagnosed in Infancy, Childhood, and Adolescence some of these disorders were moved to other categories and some kept in a new category called neurodevelopmental disorders Divided anxiety disorders into three general categories anxiety disorders, trauma- and stressor-related disorders, obsessive-compulsive and related disorders

Separated mood disorders into two general categories bipolar and related disorders and depressive disorders Combined autism and Aspergers disorder into new category autism spectrum disorder Replaced terms dementia with neurocognitive disorder and mental retardation with intellectual developmental disorder Combined substance abuse and substance dependence substance use disorder Created some new diagnoses e.g., hoarding, premenstrual dysphoric disorder, mild neurocognitive disorder binge eating disorder, disruptive mood disregulation disorder Added more dimensional features And others which we will discuss as we review diagnostic categories ComorbidityDangers of Diagnosis

Labeling

Rosenhan (1973) 8 pseudopatients admitted to 12 hospital Symptoms empty, hollow, thud

Self fulfilling prophecy

Purpose of diagnosis/ classification - Organize information, Guide treatment, Facilitate communication and research

Chapter 5 and Related Materials

Components of Anxiety

Fear vs. anxiety

Fear

Immediate alarm reaction

Danger

Recedes when danger removed

Anxiety

Future-oriented

Vague source of threat

PersistentWhen is anxiety adaptive? Prepare to confront threatMaladaptive: In the absence of realistic threat

Out of proportion to threat

Persists after threat ends

Leads to maladaptive coping or defensive strategies

Panic Alarm response but no clear danger

Panic attack abrupt experience of intense fear accompanied by physical symptoms

Situationally bound phobias

Situationally predisposed

Unexpected

Agoraphobia anxiety of certain placesDSM-5 reorganization of disorders into three categories: anxiety disorders, trauma-and stress-related disorders, obsessive-compulsive and related disordersKnow key symptoms and DSM-5 criteria given in book for the following:

Generalized Anxiety Disorder

Phobias

specific phobia Excessive, unreasonable fear cued by presence or anticipation of object or situation

Exposure provokes immediate anxiety reaction

Person recognizes the fear is unreasonable or excessive (adult)

Phobic situation is avoided or endured with great anxiety)

Interferes with persons functioning

Subtypes animal, natural environment, blood-injection-injury, situational, other

social phobia or social anxiety disorder

Panic Disorder

Recurrent, unexpected Panic Attacks

At least attack followed by 1 month or more of 1 or more of the following:

Persistent concern about additional attacks

Worry about implications or consequences

Significant change in behavior

Often occurs with agoraphobia

Obsessive Compulsive Disorder

Either obsessions or compulsions:

Obsessions

Persistent thoughts, ideas, impulses, or images

Compulsions

Repeated and rigid behaviors or mental acts that people feel they must perform in order to prevent or reduce anxiety

Biopsychosocial approach to Anxiety Disorders - biological, emotional/cognitive,

behavioral, and social influences

Biological Influences

Inherited vulnerability

Activation of specific brain circuits, neurotransmitters, neurohormonal systems

Emotional/cognitive

Heightened sensitivities

Unconscious beliefs about physical symptoms Behavioral

Operant conditioning

Classical conditioning

Modeling

Avoidance of situations associated with panic or anxiety

Social

Stress

Support reduces intensity

Lack of support intensifies symptoms

Obsessions: Persistent thoughts, ideas, impulses, or imagesCompulsions: Repeated and rigid behaviors or mental acts that people feel they must perform in order to prevent or reduce anxiety

Relationships of obsessions and compulsions

Cognitive-Behavioral Model of OCD

Normal intrusive thought, idea

Misinterpret as significant or threatening

Subjective distress

Safety seeking behavior (e.g., rituals)

Anxiety reduction

Operant conditioning Reinforcements Biological factors in OCD

NT serotonin

Serotonin-based antidepressants reduce OCD symptoms

Brain abnormalities

orbital region of frontal cortex and caudate nuclei

brain circuit that converts sensory information into thoughts and actions

may be too active, letting through troublesome thoughts and actions

serotonin

orbital region of frontal cortex

caudate nuclei

Treatments of OCD

Antidepressant drugs

Combination therapies

Exposure and response prevention

Psychodynamic perspective on OCDPanic attack

Explanations of Panic Disorder

Biological norepinephrine

Locus cereleus

Cognitive Perspective misinterpretation

factors contributing to vulnerability to misinterpretations

Explanations for Generalized Anxiety

Psychodynamic perspective

Cognitive perspective: maladaptive assumptions

Biological perspective: GABA

Treatments for Generalized Anxiety

Antianxiety drugs: benzodiazepines

Relaxation training

EMG Biofeedback

Stress-inoculation training

Behavioral explanations for phobiasClassical conditioning: Little Albert and white ratGeneralization

Extinction

Preparedness

Treatments for phobias

Systematic desensitization fear hierarchy

In vivo

Covert

Exposure treatments

Social skills training for social phobiaChapter 6 and Related Materials

Stressor: event creating demandsStress response: reactions to the demandsFight or flight response

Hypothalamus

Autonomic nervous system

Sympathetic nervous system

Parasympathetic nervous system

Endocrine system - Hypothalamic-pituitary-adrenal (HPA) pathway

Adrenocorticotrophic hormone (ACTH)

Corticosteroids cortisol

Trauma

Dissociation

Symptoms of Acute Stress Disorder and Posttraumatic Stress Disorder

Acute stress disorder

Symptoms begin within four weeks of event and last for less than one month

Posttraumatic stress disorder (PTSD)

Symptoms can begin at any time following the event but must last for longer than one month

May develop from acute stress disorder

DSM-5 criteria for PTSD

Delayed onset

History of PTSD

Combat neurosis

Vietnam War unique features of this war

Vulnerability to PTSD

Genetic factors research with Vietnam veterans

Cortisol

Personality or coping style

Childhood experiences

Social support

Emotional Processing Edna Foa

Veteran Outreach Centers rap groups

Prevention disaster response

Critical incident debriefing

EMDRAdjustment DisordersPsychophysiological Disorders psychosomatic disorders

DSM IV - Axis III

DSM-5 Psychological Factors Affecting Other Medical Conditions

Difference from somatoform and factitious disorders

Holmes and Rahe initial study with naval personnel

General research approach

Health psychology

General Adaptation Syndrome

Alarm

Resistance

Exhaustion

General Theories

Somatic Weakness Theory

Personality or coping style

Type A personality

Friedman and Rosenman

3 key features

Risk factors for coronary heart disease

Psychoneuroimmunology

Immune system and stress

Cortisol

Lymphocytes

Behavioral medicine

Relaxation training

Biofeedback

Support groups