PSY 441 Abnormal Psychology Jane E. Fisher, Ph.D.Spring 2015

Exam I Study Guide

Exam I will cover material from the Barlow & Durand text chapters 1 – 3, lecture material, and in-class videos. The exam will consist of 50 multiple choice questions (2 points each). Exam I is scheduled for Thursday February 19. As described on the syllabus, no make-up exams will be given during the semester.

Students should bring a scantron to the exam.

Chapter 1

1) Describe different approaches to the definition of “abnormal behavior”. Provide an example of a behavior that is considered “abnormal” for each definition.

The abnormal behavior is a psychological dysfunction within an individual that is associated with distress or impairment in function and a response that is not typically or culturally expected. The approaches are psychological dysfunction, personal distress or impairment, deviance, dangerousness.—> Psysicological dysfunction: breakdown in cognitive, emotional or behavioral functioning. Ex: fear of a situation that it is not normal to be afraid.—> Personal distress or impairment: behavior that are accompanied by distress—> Atypical or not culturally expected: when you do something that is not accepted by the society—> dangerousness: behavior that is dangerous to one or others. Ex: antisocial behavior, suicidal behavior—> deviance: abnormality is relative to cultural or societal normal. ex: pedophilia

2) Describe the doctrine of demonology and how it affected the treatment of persons whose behavior was considered abnormal.

The demonology is the view of abnormal behavior is due the occupation by an evil being. The treatment of this was exorcism(religious ritualls where were performed in an effort to rid the victim of evil spots), torture, trephination.

3) Describe Hippocrates’ views about the causes of abnormal behavior. How did his theory of abnormal behavior influence the treatment of abnormal behavior in ancient Greece?

Hippocrates believed that abnormal behavior was the result of internal physical problems. It is duet brain pathology caused by the imbalance of body humors. The yellow bile excess causes mania, the the excess of black bile causes melancholia, the excess of blood causes phlegm. The treatment that he believed was based on the regulating the environment and increasing or decreasing heat, dryness, moisture or cold.

4) Describe how the condition known as general paresis influenced ideas about the causes of abnormal behavior. The general paresis helped in the concept of somatogenic perpective (abnormal functioning has physical causes)

5) Describe the contributions of the following individuals: Phillipe Pinel, Emil Kraepelin, John P. Grey.

Phullipe Pinel —> he believed in the moral treatment that was the care emphasized humane and respectful. Emil Kraepelin: he was the first one to distinguish among variouss psychological disorers, seeing that each may have a different age of onset and time course, with somewhat different cluster of presenting symptoms and probably a different cause. Physical factors are responsible for mental disfunctionJohn P. Grey: His position is that the cause of insanity were always physical. The mentality ill patient should be treated as physical ill.

6) Describe Freud’s structural theory of the mind.

Id: raw energy that powers the mind (gratification of basic urges for food, water warmth, affection and se. It is unconscious. Illogical, emotional, irrational.Ego: conscious part of the mind that deals with reality. Logical, rational (reality principle)Superego: it is the final part of the mind to emerge and is similar to the conscience. Moral principle.

7) Describe Freud’s conceptualization of the development of the personality. According to Freud what are the stages of psychosexual development? What occurs during each stage?

Freud argue that the personality develops in stages. In each stage the id derives pleasure from a distinct part of the body. Oral (birth - 18 m) - infant derives pleasure from eating and biting.Anal (18 m - 3 y) the focus of the pleasure is anusPhallic (3 to 6y) - the genitais are the focus of pleasureLatent (6 - 12y) id impulse are dominant genital: Heterosexual interest are dominant

8) Describe the major techniques of psychoanalysis

The goal of the psychoanalysis is insinght (understaunding) of the basis for anxiety. The techniquees of psychoanalytic therapy: —> free association: person says whatever comes to mind: the content is examined by the therapist for resistances (areas the person does not wish to talk about)dream analysis: unconscious impulses are expressed during dreams.

9) Evaluate the strengths and limitations of the psychoanalytic paradigm.

Core assumption of the psychoanalytic paradigm is that abnormal behavior reflects unconscious conflicts within the person. The psychological paradigm is derived from the theories of personality developed by Freud. (Fonte: slides)

Strengths:

1) Offers an in-depth perspective that emphasizes exploring the origins of psychopathology

2) The focus on developmental considerations

3) Most of the models address sexuality (except self psychology, which sees sexuality as a drive derivative—secondary to narcissistic concerns).

4) Freud brought gender issues to the fore with notion of "penis envy".

5) The notion of "repetition compulsion" transcends theory, often drawn by several models as a central concept.

6) Gabbard—Many people do not respond to medications or brief therapy—Some people want to derive deeper meaning about themselves beyond symptom reduction.

7) The notion of "unconscious" begins to explain behavior that we are unaware of.

8) There is biological research that supports some of Freud's claims ("divided brain" studies).

9) The focus on relationship (particularly by object relations)

10) Self psychology understands psychopathology in terms of "dysregulation states", which has been confirmed through neurobiological literature.

11) The universality of defense mechanisms and their use across theories.

Limitations:

1) Psychoanalytic jargon serves to confuse rather than clarify concepts.

2) Some of the ideas (penis envy, Oedipus) are outdated in terms of our contemporary world, and it is questioned by some theorists/practitioners whether these concepts are clinically useful.

3) The approach lacks a theory of intervention—not enough focus on technique.

4) The exclusive focus on the past can lead to "analysis paralysis"

5) The theory only provides a piece of the pie—often neglecting biological, cultural, and social considerations

6) Too many patients (perhaps psychotic, borderline) are not considered appropriate for psychoanalysis.

(Fonte: quizlet.com)

10) Describe how classical conditioning has been applied to explain the development of abnormal behavior.

Classical conditioning is learning by association. An abnormal behavior can be acquired by associating an environmental stimulus (e.g. a dog) with a biological response (e.g. pain and fear when bitten) so that every time a person that has been bitten by a dog

subsequently sees a dog, they experience the fear they felt when they were bitten. In this case the person would develop a phobia of dogs.

Behavior therapy applies principles of learning to change abnormal behavior, thoughts and feeling. Behavior therapists use classical conditioning techniques as well as modeling. Counterconditioning is a technique which consist of learn a new response, that include systematic desensitization (relaxation is paired with a stimulus that formerly induced anxiety) and aversive conditioning (an unpleasant event is paired with stimulus to reduce its attractiveness).

11) What is the law of effect? Describe how operant conditioning has been applied to explain the development of abnormal behavior.

Law of effect, developed by Edward L. Thondike, says that states that behavior is either strengthened (likely to be repeated more frequently) or weakened (likely to occur less frequently) depending on the consequences of that behavior.

Behaviors, abnormal or normal, have consequences through:

* Positive reinforcement: behaviors that terminate a negative stimulus are strengthened.

* Negative reinforcement: behaviors that terminate a negative stimulus are strengthened.

12) Describe the contributions of: John B. Watson, Ivan Pavlov, Edward Thorndike, B.F. Skinner.

Ivan Pavlov:

- study with dogs (salivation before the presentation of food)- response that occurs only on the combination of the presence of a particular event/situation (stimulus)- stimulus generalization: the response of a person when he/she generalizes to similar objects or people, for example, a person in a treatment to cancer, presents nausea when see something or someone similar to something in the process of chemotherapy.- when the stimulus requires no conditions, for example food with the dogs in lab or chemotherapy), the process is called unconditioned stimulus (UCS).

The natural/unlearned response to the stimulus (salivation and nausea) is called unconditional response (UCR)

- when a similar object or person associated with the unconditional stimulus, acquire the power to elicit by the conditional (conditional stimulus - CS), is called conditional response (CR).

EXAMPLE: chemotherapy (UCS) nausea (UCR) / nurse (CS) nausea (CR)

- extinction: when the person no more assimilate the conditional stimulus with the conditional response, for example, when one of the experiments (dog with food and salivation) replaced the footsteps that lead the dogs to salivate for the “metronome”, after a period the conditioned response of the dogs was eliminated.

John B. Watson

- considered the father of the behaviorism (cognitive-behavioral or social learning model)- very influenced by the work of Pavlov- “psychology, as the behaviorist view it, is a purely objective experimental branch of the natural science. Its theoretical goal is the prediction and control of behavior. Introspection forms no essential part of its methods.”- developed a laboratory experiment that first recorded the producing of fear of an object not previously feared (white rat and 11-month-old boy called Albert)- second experiment to try to show if fear could be unlearned or extinguished

- Boy of two years old who was afraid of furry objects, a rabbit and another boy who were not afraid of rabbit.

- After a period was noted that the fear gradually diminished

Edward Thorndike

- most known for the law of effect (consequences on behavior)- the behavior is either strengthened (likely to be repeated more frequently) or weakened (likely to occur less frequently) depending on the consequences of that behavior.

B. F. Skinner

- operating conditioning- type of learning in which changes as a function of what follows the behavior- our behavior is not automatically elicited by an unconditioned stimulus and that we must account for this.- was strongly influenced by Watson’s conviction that a science of human behavior must be based on observable events and relationships among those events.- behavior operates on the environment and changes it in some way

- Example: a boy shouting in a public place, the boy’s behavior affects his parents’ behavior of others around him. Therefore, he changes his environmental

- Most things we do socially provide the context for other people to respond to us in one way or another, thereby providing consequences for our behavior.

- reinforcement: effect on the behavior- he also believed that using punishment as a consequence is relatively ineffective in the long run and that the primary way to develop new behavior is to positively reinforce desired behavior.- skinner did not see the need to go beyond the observable and quantifiable to stablish a satisfactory science of behavior.- shapping: process of reinforcement successive approximations to a final behavior or set of behaviors.

13) Describe Carl Rogers’ assumptions about human behavior. What are the basic characteristics of client centered therapy?

- person-centered therapy- People can only be understood from the vantage point of their own

feelings- Give the individual a chance to develop during the course of therapy,

unfettered by threats to the self- unconditional positive regard: the complete and almost unqualified acceptance of most of the clients feelings and actions, is critical to humanistic approach.

14) Evaluate the contributions and limitations of Roger’s humanistic theory of human behavior.

The Roger’s humanistic theory of human behavior, that originated client-centered therapy, later known as person-centered therapy, is one of the most influential theory from the point of view of therapy:

- Substantial effect on theories of interpersonal relationships (e.g. human potential movements so popular in the 190s and 1970s)

- Emphasized the importance of the therapeutic relationship (different from Freud’s approach). Rather than seeing the relationship as a means to an end (transference), humanistic therapists believed that relationships, including the therapeutic relationship, were the single most positive influence in facilitating human growth.

- Substantial contributions to the scientific study of therapist-client relationships.

Nevertheless, the humanistic model contributed relatively little new information to the field of psychopathology. One reason for this is that its proponents, with some exceptions, had little interest in doing research that would discover or create new knowledge. Rather, they stressed the unique, nonquantifiable experiences of the individual, emphasizing that people are more different than alike. As Maslow noted, the humanistic model found its greatest application among individuals without psychological disorders. The application of person-centered therapy to more severe psychological disorders has decreased substantially over the decades, although certain variations have arisen periodically in some areas of psychopathology.

Be prepared to define the following terms:

Psychopathology: scientific study of physiological problems. Etiology: study of origins why disorder begins including biological, psychological and social dimensionsPrognosis: anticipated course of a disorderPresenting problem: the problem that is presented by the patient to the doctor.Prevalence: how many people in the population as a whole have the disorderIncidence: how many new cases occur during a given periodCourse: chronic, episodic, time limitedId: raw energy that powers the mind (gratification of basic urges for food, water warmth, affection and se. It is unconscious. Illogical, emotional, irrational.Ego: conscious part of the mind that deals with reality. Logical, rational (reality principle)Superego: it is the final part of the mind to emerge and is similar to the conscience. Moral principle.SymptomDenial: refuses to acknowledge some aspect of objective reality or subjective experience that is apparent to others.Syndrome: it is formed by a cluster of symptoms. Each syndrome has its own unique cause, course, symptoms, treatment, outcome.displacementProjection: falsely attributes own unacceptable feeling, impulses, or thoughts to another individual or object.Rationalization: conceals the true motivations for actions, thoughts, or feelings through elaborate reassuring or self0serving, but incorrect explanation. Reaction formation: substitute behavior, thoughts, or feelings that are the direct opposite of unacceptable ones.

Repression: blocks disturbing wishes, thoughts, or experiences from conscious awareness.Moral therapy: it is a psychosocial approach. Its basic tenets included treating institutionalized patients as normally as possible in a setting that encouraged and reinforced normal social interaction, thus providing them with many opportunities for appropriate social and interpersonal contact.defense mechanisms: it is unconscious protective process that keep primitive emotions associated with conflicts in check so that the ego can continue its coordinating function.Sublimation: directs potentially maladaptedtive feelings or impulses into socially acceptable behavior.Deinstitutionalization: reducing the population of mental hospitalsDisplacement: transfers a feeling about, or a response to, an object that causes discomfort onto another, usually less-threatening object or person.Free association: the patient are encouraged to say whatever comes to mind without the usual socially required censoring. It is intended to reveal emotionally charged material to bring into consciousness.Scientist-practitioner model Demonology: it is the view that abnormal behavior is due the occupation by an evil beingDream analysis: the therapist interprets the content of dreams, supposedly reflecting the primary-process thinking of the id, and systematically relates the dreams to symbolic aspects of unconscious conflicts.TrephinationAsylums: created for care or treatment of mentally ill. They were meant to be a place of refuge. Although the care and treatment within an asylum was not always humane or effective.Transference Classical conditioning: it is a type of learning in which a neutral stimulus is paired with a response until it elicits that response (Pavlov and dog). Unconditioned response: it is natural or unlearned response to this stimulus. For example, salivation. Positive reinforcement: behaviors followed by pleasant stimuli are strengthened. Unconditioned stimulus: when one stimulus is smoothing like food or chemotherapy. It because this stimulus that would elicit a response in almost anyone and requires no learning. Conditioned response: it is the response that occur only on the condition of a presence of a particular event or situation (stimulus)Negative reinforcement: behaviors that terminate a negative stimulus are strengthened Conditioned stimulus: in the case of the dog of the Pavlov experiment it was the footsteps of whom was feeding the dog.

Extinction Punishment Shaping: it is a process of reinforcing successive approximations to a final behavior or set of behavior. Systematic desensitization: individuals were graduated introduced to objects or situations they feared so that their fear could extinguish. It could test their fear and see that nothing bad happened in the presence of the phobic object or scene. Counter conditioning: learning a new response Systematic desensitization: relaxation is paired with a stimulus that formerly induced anxiety. Aversive conditioning: an unpleasant event is paired with a stimulus to reduce its attractiveness Behavior therapy: Behavior therapy applies principles of learning to change abnormal behavior, thoughts and feelings Behavior therapists use classical and operant conditioning techniques as well as modeling. Law of effect: behavior followed by consequences satisfying to the organism will be repeated.

Chapter 2

1) Describe the diathesis-stress model.

Diathesis-stress model: scientists have assumed a specific method for interaction between genes and environment. According to this diathesis-stress models, individuals inherit tendencies to express certain traits or behaviors, which may then be activated under conditions of stress. Each inherited tendency is a diathesis, which means, literally, a condition that makes someone susceptible to developing a disorder. When the right kind of life event, such as a certain type of stress, comes along, the disorder develops. Diathesis = vulnerability. You can see that diathesis is genetically based and the stress is environmental but that they must interact to produce a disorder.

2) What are behavior genetics? Describe the logic of the following approaches to the study of behavior genetics: a) twin method; b) family method; c) adoption study.

Behavior genetics is the study of how individual differences in genetic makeup contribute to differences in behavior. Genotype is the total genetic makeup, composed of

genes. Phenotype is the observable behavioral profile. The phenotype can change over times as a function of the interaction of genes and environment. Methods of behavioral genetics —> Behavioral genetics seeks to identify the extent to which an abnormal behavior is inherited vs. the result of environmental influences (nature vs nurture?).

Behavioral genetics:

Family method. Family method identifies persons who have a disorder: “ïndex cases” or “probands.” Do various relatives of the index cases have a greater likelihood of developing the psychological disorder? Brothers/sisters share 50% of genes. Cousins share 25% of genes. General population shares few genes.

Twin method compares the incidence of a disorder between twins: monozygotic (MZ) twins share 100% of genes. Dizygotic (DZ) twins share on average 50% of genes. Twin method identifies the disorder of interest in one of the twins and then determines the likelihood (concordance) of whether the other twin will also have the same disorder.

Adoption studies: Will a child born to a person with a disorder (but adopted out at birth and raised away from the biological parent) develop the same disorder? Leonard Heston study of schizophrenia.

3) Describe the gene-environment correlation model. Describe how this model has been applied to explain complex human behavior such as social relationships.

- The gene-environment correlation model. With additional study, psychologists have found the web of interrelationships between genes and environment to be even more complex. Some evidence now indicates that genetic endowment may increase the probability that an individual will experience stressful life events. For example, people with a genetic vulnerability to develop a certain disorder, such as blood-injection-injury phobia, may also have a personality trait - let’s say impulsiveness - that makes them more likely to be involved in minor accidents that would result in their seeing blood. In other words, they may be accident prone because they are continually rushing to complete things or to get to places without regard for their physical safety. These people, then, might have a genetically determined tendency to create the very environmental risk factors that trigger a genetic vulnerability to blood-injection-injury phobia. This is the gene-environment correlation model or reciprocal gene-environment model.

- Twin divorced — increases likelihood of another divorce. Why would this happen? Obviously, no one gene causes divorce. To the extent it is genetically determined, the

tendency to divorce is almost certainly related to various inherited traits, such as being high-strung, impulsive, or short-tempered, that make someone hard to get along with. Another possibility is that an inherited trait makes it more likely you will choose an incompatible spouse.

4) What are epigenetics?

Epigenetics is the study of the switches that control gene expressions, such as DNA methylation and histone modification.In biology, epigenetics is the study of cellular and physiological traits that are heritable by daughter cells and not caused by changes in the DNA sequence; epigenetics describes the study of stable, long-term alterations in the transcriptional potential of a cell. These alterations may or may not be heritable, although the use of the term epigenetic to describe processes that are not heritable is controversial.[1] Unlike simple genetics based on changes to the DNA sequence (the genotype), the changes in gene expression or cellular phenotype of epigenetics have other causes, thus use of the term epi-.

5) Describe the relationship between the following components of a neuron: a) cell body; b) dendrites; c) axon; d) terminal button; e) synapse. Describe the process involved in neuronal stimulation.

The typical neuron contains a central cell body with two kinds of branches. One kind of branch is called a dendrite. Dendrites have numerous receptors that receive messages in the form of chemical impulses from other nerve cells, which are converted into electrical impulses. The other kind of branch, called an axon, transmits these impulses to other neurons. At the end of the axon are the vesicles that keep neurotransmitters inside, called terminal buttons. Neurons are not actually connected to each other. There is a small space through which the impulse must pass to get to the next neuron. The space between the axon of one neuron and the dendrite of another is called the synaptic cleft. This "next neuron" is called post-synaptic neuron and the "prior" is called pre-synaptic neuron. The entire junction between neurons, including the pre-synaptic neuron's axon terminal, the synaptic cleft, and the dendrite of the post-synaptic neuron is called synapse.

Once a neuron is stimulated (commonly when neurotransmitters reach out its dendrite), the membrane potential overreaches the threshold, the cell body process the information and decides what response will give (e.g. inhibitory), an action potential is fired and goes down the axon up to reaches the axon terminal, leading to the release of the terminal buttons, which results in neurotransmitters release into the synaptic cleft. Once there, these neurotransmitters binds to the dendrites of the post-synaptic neuron and the same

will occur with the post-synaptic neuron. This is the way that information is transmitted through neurons.

6) What is a neurotransmitter? How might neurotransmitters be related to some forms of psychopathology?

Neurotransmitters are endogenous chemicals that transmit signals across a synapse from one neuron (nerve cell) to another 'target' neuron. Neurotransmitters are released from synaptic vesicles in synapses into the synaptic cleft, where they are received by receptors on the other neuron or target cell. Neurotransmitters are stored in a synapse in synaptic vesicles, clustered beneath the membrane in the axon terminal located at the presynaptic side of the synapse. Neurotransmitters are released into and diffused across the synaptic cleft, where they bind to specific receptors in the membrane on the postsynaptic side of the synapse.

The idea that certain psychological disorders are “caused” by biochemical imbalances, excesses, or deficiencies in certain neurotransmitter systems is no longer considered true. The effects of neurotransmitter activity are less specific than we thought. Therefore, for example, the idea that depression is caused by a lack of serotonin or that schizophrenia is caused by an overproduction and release of dopamine is not entirely accepted. Changes in neurotransmitter activity may make people more or less likely to exhibit certain kinds of behavior in certain situations without causing the behavior directly. In addition, broad-based disturbances in our functioning are almost always associated with interactions of the various neurotransmitters rather than with alterations in the activity of any one system.

7) Describe how psychosocial factors (e.g., control over environmental events) might affect neurotransmitter systems (hint: see textbook pages 51 – 52).

Several experiments illustrate the interaction of psychosocial factors and brain function on neurotransmitter activity, with implications for the development of disorders. Some even indicate that psychosocial factors directly affect levels of neurotransmitters. The situations that someone experience directly affects the structure of neurons at the synapses by altering the sensibility of neurotransmitters. This process is called neuroplasticity. So, changing the structure of the neuron, the neurotransmitter system is also being changed. The result of this process is a modification in the production, releasing and operation of neurotransmitter system and consequently the increasing or decreasing of psychological disorders arousal. Studies indicate early psychological experience affects the development of the nervous system and thus determines vulnerability to psychological disorders later in life. It seems that the very structure of the nervous system is constantly changing as a result of learning and experience, even into old age, and that some of these changes become permanent.

In conclusion, psychosocial influences directly affect the functioning and perhaps even the structure of the central nervous system.

8) Describe the learned helplessness model. How has this model been used to explain the development of depression?

The learned helplessness model occurs when rats or other animals encounter conditions over which they have no control. If rats are confronted with a situation in which they receive occasional foot shocks, they can function well if they learn they can cope with these shocks by doing something to avoid them (say, pressing a lever). But if the animals learn their behaviorhas no effect on their environment—sometimes they get shocked and sometimes they don’t, no matter what they do—they become “helpless”; in other words, they give up attempting to cope and seem to develop the animal equivalent of depression. Seligman drew some important conclusions from these observations. He theorized that the same phenomenon may happen with people who are faced with uncontrollable stress in their lives. Subsequent work revealed this to be true under one important condition: People become depressed if they “decide” or “think” they can do little about the stress in their lives, even if it seems to others that there is something they could do. People make an attribution that they have no control, and they become depressed.

9) Define modeling (or observational learning). How has this concept been applied to explain the development of abnormal behavior?

Albert Bandura says that observational learning occurs when organisms do not have to experience certain events in their environment to learn effectively. Rather, they can learn just as much by observing what happens to someone else in a given situation. Bandura expanded his observations into a network of ideas in which behavior, cognitive factors, and environmental influences converged to produce the complexity of behavior that confronts us. He also specified in some detail the importance of the social context of our learning; that is, much of what we learn depends on our interactions with other people around us. The basic idea in all Bandura’s work is that a careful analysis of cognitive processes may well produce the most accurate scientific predictions of behavior. Concepts of probability learning, information processing, and attention have become increasingly important in psychopathology.

10) Describe the physiology of fear and the “flight or fight” reaction.

The alarm reaction that activates during potentially life-threatening emergencies is called the flight or fight response. Fear activates your cardiovascular system. Your blood vessels constrict, hereby raising arterial pressure and decreasing the blood flow to your extremities (fingers and toes). Excess blood is redirected to the skeletal muscles, where it is available to the vital organs that may be needed in an emergency. Breathing becomes faster and, usually, deeper to provide necessary oxygen to rapidly circulating blood. Increased blood circulation carries oxygen to the brain, stimulating cognitive processes

and sensory functions, which make you more alert and able to think more quickly during emergencies. An increased amount of glucose (sugar) is released from the liver into the bloodstream, further energizing various crucial muscles and organs, including the brain. Pupils dilate, presumably to allow a better view of the situation. Hearing becomes more acute, and digestive activity is suspended, resulting in a reduced flow of saliva (the “dry mouth” of fear). In the short term, voiding the body of all waste material and eliminating digestive processes further prepare the organism for concentrated action and activity, so there is often pressure to urinate and defecate and, occasionally, to vomit.

Be prepared to define the following terms:

genotype phenotype index case or proband monozygotic twins dizygotic twins geneconcordance neurotransmitters re-uptakesynapse neuron electroconvulsive theapry (ECT) neurosurgery agonist

antagonistreuptake prepared learning emotionmood autonomic nervous system affectparasympathetic nervous systemsympathetic nervous system

Chapter 3

1) What are the purposes of psychological assessment?

Clinical assessment is the systematic evaluation and measurement of psychological, biological, social factors in an individual presenting with a possible psychological disorder. The process of clinical assessment in psychopathology begins by the clinician collecting a lot of information across a broad range of the individual’s functioning to determine where the source of the problem may lie. After getting a preliminary of everything, the clinician narrows the focus to problems in some most relevant areas. There are 3 concepts that help determine the value of our assessments: reliability, validity, standardization.

2) Describe the concepts of reliability and validity as they apply to clinical assessment. What is the relationship between reliability and validity? Describe different types of validity as they apply to clinical assessment.

Reliability: the degree to which a measurement is consistent. Psychologists improve their reliability by carefully designing their assessment devices and then conducting research on them to ensure that two or more raters will get the same diagnose.

Validity: whether something measures what it is designed to measure.

* Concurrent/descriptive validity: comparing the results of an assessment measure under consideration with the results of others that are better known allows you to determine the validity of the first measure. Ex: if the results of a standard, but long, IQ test were the same as the result from a new/brief version

* Predictive validity: how well your assessment tells you what will happen in the future. Ex: does it predict who will succeed in school and who will not (which is one of the goals of an IQ test)

3) What does it mean to “standardize” an assessment technique?

Is the process by which a certain set of standards or norms is determined for a technique to make its use consistent across different measurements. The standards apply to the procedures of testing, scoring, evaluating data. Ex: The assessment might be given to large numbers of people who differ on important factors as age, race, gender… their scores would be pooled with other individuals like them and be used as standard our norm for comparison purposes.

4) What typically occurs during a clinical interview? What is involved in mental status examination?

The interview gathers information on current and past behavior, attitudes, emotions and detailed history of the individual’s life in general and of the presenting problem. Clinicians determine when the specific problem started and identify other events (life stress, trauma…) that might occurred about the same time. Most clinicians gather some info about the patients current and past interpersonal/social history, sexual development, religious attitudes, relevant cultural concerns, educational history. To organize the info obtained during an interview, many clinicians use the mental status exam.

Mental Status Exam: involves systematic observation of an individual’s behavior. This observation occurs when one person interact with another.

The exam covers 5 categories:

* Appearance and Behavior: the clinician notes and overt physical behaviors, individual’s dress, general appearance, posture, facial expression

* Thought processes: When clinicians listen to a patient talk they have a good idea of a person’s thought processes. Ex: flow of speech, talk quickly/slowly, continuity of speech, does the patient makes sense when talking, the content of speech, any delusions or distorted views of reality?, hallucinations?

* Mood and affect: mood is the predominant feeling state of the individual (does the person appear to be down/continually elated? Does the person talks in a depressed or hopeless fashion?). affect refers to the feeling state that accompanies what we say at a given point (usually we laugh when we say something funny/look sad when we talk about something sad)

* Intellectual functioning: clinicians make a rough estimate of others intellectual functioning just by talking to them. Reasonable vocabulary? Can they talk in abstractions and metaphors? How is a person’s memory?

* Sensorium: our general awareness of our surroundings. Does an individual know what the date is, where he or she is, who he or she is?

5) What is a structured interview? What are the advantages and disadvantages of a structured interview as compared with an unstructured interview?

No livro está como semistructured, não sei se é a mesma coisa...

Semisstructured Clinical interview: are made up of questions that have been carefully phrased and tested to elicit useful information in a consistent manner so that clinicians can be sure they have inquired about the most important aspects of a particular disorder. One example is the Anxiety Disorders Interview Schedule for DSM-5.

Advantages: because the wording and sequencing of questions has been carefully worked, the clinician can feel confident that a semistructured interview will accomplish it purpose.

Disadvantages: it robs the interview of some of the spontaneous quality of two people talking about a problem

6) What is a psychological test? What does it mean to say that a test is standardized?

Psychological tests include specific tools to determine cognitive, emotional, or behavioral responses that might be associated with a specific disorder and more general tools that assess longstanding personality features, such as a tendency to be suspicious. They be standardized mean they requires all test takers to answer the same questions, or a selection of questions from common bank of questions. They also are scored in a standard or consistent manner, which make it possible to compare the relative performance of individual clients or groups of clients.

7) According to lecture what is a hypothetical construct?

An abstract concept used in particular theorical manners to relate different behavior according to their underlying features or causes.

8) Describe the assumptions underlying projective tests. Evaluate the strengths and limitations of projective tests.

Projective test is a type of personality test in which the individual offers responses to ambiguous scenes, words or images. This type of test emerged from the psychoanalytic school of thought, which suggested that people have unconscious thoughts or urges. These projective tests were intended to uncover such unconscious desires that are hidden from conscious awareness. It is good to learn qualitative information about a client. It may be used as a sort icebreaker as well. One of the weakness is the respondent answer can be heavily influenced by the examiners attitudes. As they don’t have standard grading scales tend to lack both validity and reliability.

9) What is the purpose of psychophysiological assessment?

It purposes measuring changes in the nervous system that reflect emotional or psychological events. The measurements may be taken either directly from the brain or peripherally from other parts of the body. Electroencephalogram is one example of psychophysiological assessment.

10) Describe the logic and purpose of intelligence tests.

Intelligent tests attempt to measure intelligence – that is, the basic ability to understand the world around, assimilate its functioning, and apply this knowledge to enhance the quality of life. Generally they have good reliability and validity.

11) Describe the logic and purpose of behavioral assessment. Why do you think naturalistic observations are most commonly pursued within behavioral assessment as opposed to other models of assessment?

Behavioral Assessment provide a thorough assessment of an identified behavior, including analysis of the interrelatedness of antecedent “triggers”, components of the behavior itself, and consequences of the behavior. Reinforcing factors are identified and recommendations are made for behavior changes. Because naturalistic observation allows the observer to directly observer the client in natural setting. It also allow the observer do not interfere in the client behavior and responses.

12) What steps are involved in a functional analysis?

1. Identify potentially relevant characteristics of the individual client, his or her behavior, and the context in which it occurs via broad assessment.

2. Organize the information collected in Step 1 into a preliminary analysis of the client's difficulties in terms of behavioral principles so as to identify important causal relationships that might be changed. 3. Gather additional information based on Step 2 and finalize the conceptual analysis. 4. Devise an intervention based on Step 3. 5. Implement treatment and assess change. 6. If the outcome is unacceptable, recycle back to Step 2 or 3.

13) What are the purposes of a classification system? Describe criticisms of classification systems.

The purpose of a classification system is to standardize, to organize observations, to turn knowledge advance accessible, study origin and functioning and allow comparisons. Some criticisms are the normal and abnormal label (“normal” and “abnormal” concepts may be questioned), and sometimes the classifications are not natural. E.g. Someone ask please In a scale from 0 to 10 how does it matter to you? Most of the time people just ask how you feel.

14) What is the difference between a dimensional and a categorical system for classifying human behavior?

The main difference between the Categorical classification and the dimensional one is in the categorical a system makes a yes/no decision as to the presence/absence of a disorder (e.g. Schizophrenic/not schizophrenic) and in the dimensional classification involves ranking of a person along a quantitative dimension. In the classical or pure categorical approach we assure that every diagnosis has a clear underlying pathophysiological cause, on the other hand in the dimensional approach we note the variety of cognitions, moods and behaviors which the patient presents and qualify them in a scale.

15) Describe the five axes of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V).

Axis I refers broadly to the principal disorder that needs immediate attention; e.g., a major depressive episode, an exacerbation of schizophrenia, or a flare-up of panic disorder. It is usually (though not always) the Axis I disorder that brings the person "through the office door." Axis II lists any personality disorder that may be shaping the current response to the Axis I problem. Axis II also indicates any developmental disorders, such as mental retardation or a learning disability, which may be predisposing the person to the Axis I problem. For example, someone with severe mental retardation or a paranoid personality disorder may be more likely to be "bowled over" by a major life stressor, and succumb to a major depressive episode. Axis III lists any medical or neurological problems that may be relevant to the individual's current or past psychiatric problems; for example, someone with severe asthma may experience respiratory symptoms that are easily confused with a panic attack, or indeed, which may precipitate a panic attack. Axis IV codes the major psychosocial stressors the individual has faced recently; e.g., recent divorce, death of spouse, job loss, etc. Axis V codes the "level of function" the individual has attained at the time of assessment, and, in some cases, is used to indicate the highest level of function in the past year. This is coded on a 0-100 scale, with 100 being nearly "perfect" functioning (none of us would score that high!).

16) How is reliability relevant for evaluating a classification system? What does it mean to say that a classification system is valid? How is the validity of a classification system evaluated?

Reliability is very relevant because it allows a accurate diagnosis, doctors should have the same diagnosis for the same person, same diseases, at the same day. A classification is valid when it is able to measure what it is designed to measure. Validity can the evaluated by the following contents: discriminability might be evident not only in presenting symptoms but also in the course of the disorder and possibly in the choice of treatment, it

may also predict familial aggregation, the extent to which the disorder would be found among the patient’s relatives, tells what is likely to happen with the prototypical patient, it may predict the course of the disorder and the likely effect of one treatment or another.

17) According to lecture, how would a prescriptive approach to diagnosis differ from the DSM?

At the prescriptive assessment, the diagnose behavior id based on the cause of the behavior (escape from aversive experience or pleasure seeking and on the most effective treatment. Differently from the DSM the prescriptive approach focus on determining reasons problem behavior occurs, identifying the “purpose” or motivation of a behavior problem for an individual patient, treatment utility.

18) How might diagnosis of a “mental disorder” harm an individual?

Because classification systems do not always capture the uniqueness of a person, categorical classification systems don’t allow for continuity between “normal” and “abnormal” behavior, classification may result in a label, stigmatization, discrimination, prophecy fulfillment, circularity of reasoning ( e.g. he has trouble paying attention because she has deficit disorder and he has deficit disorder because he has trouble paying attention)

Define the following terms:

construct validity: the appropriateness of inferences made on the basis of observations or measurements (often test scores), specifically whether a test measures the intended construct.

predictive validity: the extent to which a score on a scale or test predicts scores on some criterion measure.

content validity: refers to the extent to which a measure represents all facets of a given social construct.

interrater reliability: refers to the degree of agreement between two observers

concurrent validity: Extent to which features are shared by patients with the same diagnosis

comorbidity: the simultaneous presence of two chronic diseases or conditions in a patient.

reliability: to consistency of measurement across observers.

test-retest reliability: refers to the extent to which scores are similar for a person being observed twice or taking the same test twice.

reification of a label: one of the criticisms of diagnostic pratices ( e.g.you HAVE depression).

content validity: refers to the extent to which a measure represents all facets of a given social construct.

reactivity: a behavior that changes when monitoring

criterion validity: is a measure of how well one variable or set of variables predicts an outcome based on information from other variables, and will be achieved if a set of measures from a personality test relate to a behavioral criterion on which psychologists agree.

internal consistency: a measure based on the correlations between different items on the same test

projective hypothesis: The idea that ambiguous, unstructured stimuli, such as the Rorschach inkblot test, are necessary to bypass a person’s defenses and discover his or her unconscious needs, motives, and conflicts.

projective test: provide ambiguous stimuli that are interpreted by the test subject according to “unconscious needs/impulses”

clinical interview: interpersonal encounter in which language is used to gather information about a client

functional analysis: the application of the laws of operant conditioning to establish the relationships between stimuli and responses.

behavioral assessment: considered to be a problem-solving process for addressing student problem behavior.

structured interview: is an interview approach which ensures that each interview is presented with exactly the same questions in the same order.

Rorschach Inkblot Test: is a psychological test in which subjects' perceptions of inkblots are recorded and then analyzed using psychological interpretation, complex algorithms, or both.

intelligence test: a test designed to measure the ability to think and reason rather than acquired knowledge.

Minnesota Multiphasic Personality Inventory: psychometric test of adult personality and psychopathology.

Diagnostic and Statistical Manual of Mental Disorders (DSM-V): a diagnostic classification system created by the American Psychiatric Association