Abnormal psych. Test 1 (Ch 1-6 )

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Abnormal psych. Test 1 (Ch 1-6 )
2015-02-21 00:03:27
Comer anxiety OCD stress

for Dr. Reed's Psych 25 (Abnormal Psych. class). Abnormal Psychology in Science and Clinical Practice/ Problems of Stress and Anxiety
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  1. Carl Rogers 
    Pg 65
    • -The pioneer of the Humanist perspective
    • -developed client-centered therapy-clinicians try to help patients by conveying acceptance, accurate empathy, and genuineness
  2. Thomas Szasz
    pg 5
    • A clinical theorist who thinks the idea of mental illness is invalid, a societal idea
    • What we think of as deviations from normalcy are not illnesses, just a "problem in living"
    • society invented mental illness to control or change people who upset normal order
  3. General paresis
    Pgs 13,14
    • An irreversible medical dissorder whose Sx. include psychological abnormalties, such as delusions of grandeur & paralysis ;
    • -Caused by Syphillis (in turn caused by trepona pallida)
    • -Gave rise to somatogenic perspective
  4. Mesmerism
    pg 15
    • - F.A. Mesmer employed this to treat hysterical dissorders-mysterious ailments w/no physical basis
    • -Precursor to hypnotism
    • -was discovered that hystaria Sx. could be brought on & taken away using this- provided evidece for psychogenic theory
  5. A trephine
    pg 9, 52
    • -A stone instrument used in ancient times to cut circular sections of a  skull
    • - used to treat severe abnormal behavior  eg hallucinations, melancholia, 
    • Anthro conjectures:
    • -might have been used to release evil spirits or remove bone splinters& blood clots from aftermath of tribal warfare
  6. Views on abnormality VERSUS health:  behaviorists orientation
    • depends on influences of the 3 types of conditioning:
    • 1. Operant cond.- learn certain behaviors when they receive rewards for doing so 
    • 2. Modeling- learn responses by observing others and repeating the behavior
    • 3. Classical conditioning- learning by temporal association- notice 2 things occur together at same time, and respond the same way to both events

    • Ex fear of spiders= arachnophobia (made up examples)
    • 1.Op> shows fear of spider receives soothing affection
    • 2. Mod> mom terrified, then child becomes terrified
    • 3. Clas.> see spider, out comes raid, child reacts badly to chemical...
  7. Views on abnormality VERSUS health:
    psychoanalytic orientation
    abnormality occurs when the ego and supperego cannot find balance 
  8. Views on abnormality VERSUS health: biological orientation
    • Caused by:
    • Genetics-  the influence of many genes on each other can cause abnormal brain structure or brain chemistry
    • Evolution- mutations in genes passed down for generations may have been an advantage (eg those more prone to fear escaped sooner & avoided disaster)
    • Viral infection
  9. Views on abnormality VERSUS health: humanistic orientation
    • Certain children are not made to feel they are worthy of positive regard
    • Form Conditions Of Worth- guidelines that they convince themselves will make them "worthy"--> can be unrealistic
    • criticise themselves, deny or distort their thoughts & actions that do not match up to their COW
  10. Views on abnormality VERSUS health: cognitive orientation
    pg 62
    • a result of several cognitive problems:
    • 1. make assumptions/ adopt attitudes that are disturbing& inaccurate
    • 2. Illogical thinking process- think illogically arrive at self-defeating conclusions (overgeneralization in depression)
  11.  Views on abnormality VERSUS health:  existential orientation
    • psychological dysfunctioning is caused when people hide from life's responsibilities and fail to recognise it is up to them to bring meaning into their life
    • left with an empty inauthentic life
    • dominant emotions are anxiety, alienation, baredome frustration, & depression
  12. Bedlam (local name)
    pgs 11, 12
    • -1547 Henry VIII gave Bethlehem Hospital to help mentally ill 
    • -Patients were chained to beds and wailed for all to hear
    • -became a popular tourist attraction in london (look at the crazies :()
    • -private homes& community mental health programs were beneficial, but only treated a small % of people, enter Asylumshospitals & monasteries that care for people w/ mental illness. Asylums began to overflow with people and became like prisons.
  13. Dorothea Dix
    pg 12,13,22
    • -Boston schoolteacher who made humane care a public & political concern in USA
    • - Campained from 1841-1881 for reforms- resulted in more laws & gov. funding
    • -Resulted in State HospitalsState-run public mental institutions
  14. Hippocrates
    pg 9
    • -Greek philosopher, Called the father of modern medicine
    • -saw abnormal behavior as a product of some kind of brain pathology (had "natural" not spiritual cause)
    • - a result of imbalanced (4)humors:
    •   --yelow bile; excess=mainia
    •   --black bile; excess =melancholia
    •   --  blood
    •   --phlegm
  15. Research on eccentric people
    pg 5,6
    ((☄= eccentric people))

    • David Weeks (studied 1,000 ☄)
    • 1 in 5,000 persons are classic full time ☄
    • eccentricity is chosen& enjoyble for ☄. mental dissorder=thrust upon
    • Actually ☄ have fewer emotional problems than the general population
  16. What did the federal parity law do?
    • From: http://www.cms.gov/CCIIO/Programs-and-Initiatives/Other-Insurance-Protections/mhpaea_factsheet.html
    • a federal law that generally prevents group health plans and health insurance issuers that provide mental health or substance use disorder (MH/SUD) benefits from imposing less favorable benefit limitations on those benefits than on medical/surgical benefits.
  17. What is positive psychology?
    The study and enhancement of positive feelings, traits and abilities.
  18. Sigmund Freud (know his theory WELL).
    pg 53
    • About him: vienese neurologist
    • -- developed psychoanalysis
    • 3 forces Shape personality (linger in subconscious
    • Id: instictual needs, desires, impulses
    • operates on pleasure principle-seek gratification
    • --at birth Id free = nursing, defecating,masturbating etc. at will 
    • --Libido (sexual energy) major drive
    • Ego: we realize the enviornment won't meet every instinctual need
    • -- seeks gratification w/in reality principle- we learn its unnaceptable to express Id
    • --form Ego Defense Mechanisms
    • ----repression, denial, projection, rationalization(excuses), displacement, intellectualization("remove" emotion), regressions

    Superego: Conscience, unconsciously adopt parent's values

    • Developmental stages:
    • oral 0-18 mo
    • anal 18mo-3yrs
    • phallic 3-5yrs
    • latency 5-12yrs
    • genital 12+
    • Fixation-Id, Ego, Superego don't mature & person gets stuck in earlier stage

  19. Johann Weyer
    pg 11
    • the first physician to specialize in mental illness
    • alive during renassance-society moving away from demonological view
    • belived the mind was as suceptible to disease as body
    • founder of the modern study of psychopathology
  20. Experimental design36-38,
    • a research precedure in which a variable is manipulted & the effect is observed
    • independent variable= manipulated variable
    • dependent variable= variable being observed
    • Confounds- variables other than indep. that could be affecting the Dep. variable
    • Control group- participants not exposed to the indep.
    • Experimental group- exposed to indep. & under investigation
    • Statistical significance- when there is an improvement (over 5%) in functioning
    • Clinical Significance- if the improvement is meaningful to an individual's life

    subypes= randomassignment, blind design
  21. quasi-experimental design39,
    • Study groups that already exist in the world at large
    • Used when it is unethical to subject participants to experimentation (eg child abuse etc)
    • Violates rule of random assignment & introduces many confounds
    • Uses matched control participants- individuals with similar characteristics to the experimental participants
  22. correlational study 30-46, 
    • a research procedure used to determine how much events/ characteristics correlate w? each other
    • the sample must represent the larger population or else it won't have external validity
    • one would graph data to find line of best fit: 
    • --positive correlation= line increases on both axis
    • -- negative correlation 1 axsis decreases, other axsis increases
    • --no correlation=line is horizontal

    Correlation Ceofficient (r): +1.00= strong positive; -1.00=strong negative; 0=weak correlation

    has high external validity, but lacks internal validity 

    Epidemiological studies: measures incedence/ prevalance of a dissorder

    Longitudinal study: observes same participants over a long period of time
  23. naturalistic study 39
    • used for studying the psychological effects of unusual/ unpredictable events floods, plane crashes, fires, quakes etc.
    • cannot be repeated at will 
    • hard to draw broad generalizations on unique events

  24. case study,
    • a detailed acount of a person's life and psychological problems
    • may help a clinician better understand/treat person under discussion
    • a source for new ideas about behavior
    • offer tennative support for a theory or challenge assumptions
    • can show value in new theraputic techniques
    • allows the study of unusual problems
    • Limitations:
    • --repoted by biased observers
    • --rely on subjective evidence 
    • --low internal& external validity
  25. External validity
    • The degree to which the result of the study may be generalized beyond that study
    • --case studies= low ^^
    • --correlational method =high^^
    • --experimental method= high^^
  26. Views of schizophrenia (past and present)
    ps 25-26,
    • was caused by bad parenting,-->WRONG 
    • a schizophrenogenic mother= cold, domineering& unresponsive to child's needs
    • used lobotomy to cure--> INEFFECTIVE
    • -- a pointed instrument was inserted into frontal lobe then rotated to destroy the tissue
    • --Leaves patient withdrawn or in a stupor= brain damage

  27. What is meant by prevalence versus incidence?
    • P: the total number of cases of a dissorder occuring in a population over a specific amount of time
    • I: the number of new cases of a dissorder occuring in a population over a specific period of time
  28. Placebo
    • a sham treatment that the subject in an experiment belives to be genuine
    • ie: a sugar pill M.D.'s claim is heart medication
    • Eliminates participant bias in a study
  29. Informed consent (What is it?  Flaws?)
    pg 37,42
    • Researchers must inform test subjects about the nature of the study and of their rights
    • --can leave any time

    • Many consent forms are hard to read
    • --written @college level
    • --37% of the population are able to read it (NY magazine=43%, newspaper=75%)
  30. Albert Bandura
    pg 61,62, 128-130
    • a leading behaviorist, argued people must develop self efficacy to feel happy& function
    • self-efficacy=belif that one can master & perform needed behaviors when necessary
    • Also proposed Modeling-learning where a person observes & then imitates others, another way of aquiring fear reaction
    • --participants repeatedly hear a buzzer ring when another participant (secretly actor) is shocked. later participant jumps in sympathy
    • --a therapist can confront what a phobic patient fears, they see there is no basis for the fear
  31. Hippocampus
    • sends & receives signals from amygdala
    • plays major role in memory and stress hormones 
    • dysfunction= intrusive memories & constant arousal= PTSD
  32. Systematic desensitization
    • A behavioral treatment in which clients W/ phobias learn to react calmly instead of w/
    • intense fear to the objects or situations they dread
    • --Construct a list of what they fear least->fear most= fear hirearchy (reading word dog-> roughousing with a dog)
    • --works down the least (imagining or actually confronting) untill they aren't afraid

  33. Psychotropic medications
    Drugs that primarily affect the brain & reduce many Sx of mental dysfunctioning

    • developed in 1950's important in biological treatment
    • alters emotions& thought processes
    • has greatly changed outlook on mental illness, helps most but not  all
  34. Aaron Beck
    • Formed basis of Cognitive Model
    • found that some people consistently think in illogical ways & keep arriving @ self-defeating conclusions
    • developed rational-emotive therapy-helps clients identify and change the irrational assumptions & thinking that help cause ther psychological dissorder
  35. Biological factors in Depression, Huntington's disease, etc.
    (neurotransmitters &/or brain regions involved)
    low activity of serotonin and norepinephrine

    • marked by violent emotional outbursts, memory loss, suicidal thinking, involuntary body movements& absurd belifs
    • Caused by loss of cells in basal ganglia & cortex

  36. What is a projective test?
    • test where cients interpret vague stimuli or folow open-ended instructions. 
    •  with so little to go on patients will project aspects of their personality onto that task
    • examples: rorschach, TAT, sentance completion tasks, and drawings
  37. Mental status exam
    • a set of interview questions & observations designed to reveal the degree & nature of a client's abnormal functioning
    • tests awareness orietation(of time& place) attn span, memory, judgement & insight, thought content& processes, mood, & appearance
  38. **DSM-5 (What does it do/ not do? Also know: # of disorders, major criticisms, bias (??), etc)

    • 400 dissorders
    • Lists the criteria for diagnosing, key clinical features and features sometimes related to>> a given dissorder
    • --includes background info like research findings, age, culture, gender trends>> for a given dissorder
    • -- and prevalance, risk, course, complications, predisposing factors & family patterns
    • requires Dr. provide categorical (determined name from symptoms ) and dimensional (severity)info. for a proper diagnosis

    • there werent enough feild studies done to test merit of new criteria
    • many clinicians have difficulty distinguishing one related dissorder from another= not reliable

  39. Key criteria for assessments
  40. Percentage of people who will qualify for a Dx during lifetime?  Percent suffering from an anxiety disorder yearly?  (know stats for other key disorders).
  41. Koro
    • Culture bound abnormality: South East Asia
    • pattern of anxiety in which a man fears his penis will withdraw & he will die as a result
    • culture lore:
    • --result of an imbalance of Yin & Yang
    • -- treatment= holding on to p until fear subsides, family members can help, or clamping p in a wooden box
  42. Amok
    • Culture bound abnormality: Malaysia, Phillipines, Java, some parts of Africa
    • Jump around violently, yell loudly, grab weapons attack any living things/objects
    • Culture thinks= result of stress, severe shortage of sleep, alcohol consumption, & extreme heat
  43. Bender Visual-Motor Gestalt Test
    • Brain damage especially likely to affect visual perception , memory & visual-motor coordination
    • tests^^:
    • using 9 cards showing simple geometric design
    • patients see 1 card at a time and attempt to copy them on a paper
    • later try to re-draw them from memory
    • works for people older than 12
  44. MMPI (MMPI-2)
    • most widely used personality inventory
    • 500 (now 567) self statements to be labeled T/F or "cannot say"
    • covers mood, physical concerns, sexual behaviors, social activities
    • Can score from 0-120, 70+= concern
    • 10 clinical scales:
    • Paper & pencil test=quick, objectively scored, good test-retest reliability 
    • though one society's abnormal may be anothers "normal/spiritual"
  45. Rorschach test
    • "ink blot" test
    • testers play close attention to the style of response (origionally looked at symbolism)
    • --view whole design or details
    • --focus on blots or white space?
  46. Thematic Apperception Test (TAT)
    • Test where patien shown 30 black nd white pictures of people in vague situations& askd to make a dramatic story about them
    • thinking is: the patient identifies with one person in each card, and their stories reflect their own circumstances
  47. Internet "dark sites"
    • Websites (message boards etc.) taht promote behaviors that society/clinical community consider abnormal/ destructive
    • examples: pro-ana, suicide sites 
  48. Benzodiazepines
    • developed in 1950's& provide relief from anxiety
    • includes alprazolan (xanax), larezapan (Ativan) and diazepan (valium)
    • the receptors in the brain which accept^^ meant for neurotransmitter GABA- inhibits neuronal firing
    • --instructs neurons that provoke fear to stop fireing  
    • Anxiety dissorder= flaw in feedback loop

    Not cure: as soon as pills are stoped, anxiety is as high as before
  49. obsessive-compulsive related disorders
    • A group of dissorders in which obsessive-like concerns drive people to repetedly & excessively perform specific patterns of behavior that greatly disrupt their lives
    • Hoarding dissorder: Compelled to save items & feel significant stress if discarded

    Hair-pulling dissorder (trichotillomania): repeatedly pull out hair all over the body & head 

    Excortiation dissorder: repeatedly pick at skin results in significant sores/wounds

    Body Dysmorphic dissoder: become preoccupied w/ belief they have defects or flaws in physical appearance (imagined/ greatly exagerated)
  50. Generalized anxiety disorder : Humanist versus Freudian versus Biological view
    •  arises when people stop looking at themselves honestly& acceptingly 
    • --repeated denials of true thoughts, emotions, &behaviors
    • it can prevent them from fufilling their potential
    • a result of parents not issueing unconditional positive regard-> overly critical of self

    • Childhood anxiety goes unresolved
    • 3 anxieties we encounter in childhood= real, neurotic, moral
    • overrun by moral or neurotic anxiety is 1 cause
    • Or a child's ego is too weak to cope w/ normal levels of anxiety (overprotective parents can cause this)<- found to be valid
    • common defense mechanisms= repress, change topic, or deny having negative feelings

    •  bio relatives are more likely than non-relatives to have it -- 15% of relatives diplay it
    • --however families tend to live in similar surroundings so may not be inheritable?
    • a result of gamma-aninobutyric acid(GABA) receptors not working or there being too few
    • also a malfunctioning in brain circuts-networks of brain structures that work together w/ help from neurotransmitters to produce emotion reaction. (profrontal cortex, amygdala& anterior cingulate cortex)

  51. Types of anxiety disorders (key info, etc)
    • generalized anxiety disorder,
    • obsessive-compulsive disorder: beset by obsessions and/or perform compulsions (comp usually=response to ob. thoughts)
    • panic disorder,
    • phobia: severe, persistant & unreasonable fear 
    • post-traumatic stress disorder
    • social anxiety disorder
  52. Panic disorder
    Periodic, short bouts of panic that occur suddenly, peak at 10 mins, then gradually pass

    features: heart palipitations, hands&feet tingling, shortness of breath, sweating, Hot/ cold flashes...

    many fear they will die, go crazy, or lose control during a panic attack

    • many become dysfunctional as a result (thinks: am i crazy, will i panic soon etc.) 
    • 2.8% in USA have it per year, 5% in a lifetime

    often accompanied by agoraphobia
  53. Components of stress (and biological reactions)
    163, 172
  54. Social Adjustment Rating Scale
    • assigns numerical values to the stresses most people experience from time to time
    • --death of spouse =100 life change units
    • --retirement= 45 LCUs
    • over 300 LCU in a year= high risk for illness
    • doesnt take into account life experiences of non white americans
  55. Cortisol and Norepinephrine
    (research re: combat soldiers & rape victims)
    162, 180
    • evidence that traumatic events lead to changes in brian & body.
    • found an abnormal amt of ^ in urine, saliva & blood samples  of combat soldiers, rape victims etc. 
    • excess=  slows immune system
  56. Acute stress disorder -versus- PTSD
    • Both: DSM-5 defines as trauma and stressor related dissorders
    • --Sx include heightened arousal (long after stress occurred), anxiety, mood disturbances& memory difficulties
    • --caused by traumatic event= exposed to actual/threatened death,serious injury,or sexual violation.  eg combat, rape, earthquake, plane crash
    • Characterized by reexperiencing traumatic event, Avoidance of things related to event, Reduced Responsiveness desensitized to whole enviornment, Increased Arousal/ Negative Emotions/Guilt
    • 80% of A become P

    A:symptoms begin w/in 4 weeks of event last less than 1 month

    P:symptoms continue loner than 1 month

  57. Eye movement desensitization and reprocessing (EMDR)
    • An exposure treatment 
    • clients move eyes in rhythmic manner from side to side while flooding mind w/ images of objects & situations they normally avoid
    • may be the confrontation of fear, not actual eye movemtn that is effective
  58. Stats on stress disorders
    • Psychological:
    • --3.5% of people in US suffer from acute/PTSD in a given year
    • --7-9%""" in a lifetime
    • --2/3 who have acute/PTSD seek treatment at some point (few right after)
    • --20% of women, 8% of men exposed to trauma develop this
    • --29% of vietnam vets (male & female)
    • --20% iraq/afganistan Vets
    • --50% exposed to terrorism/torture
  59. Stats & info re: rape victims
    pg 160
    • Over 1/3 victims of sexual/physical assault develop PTSD
    • 200,000 cases of rape/attempted r. are reported in USA yearly
    • 1 in 6 women are raped in their lifetime
    • --29% under 11 yrs
    • --32% 11-17yrs
    • --29% 18-29yrs
    • 70% raped by relatives/ aquaintances
    • 46%=white Am
    • 27%=Afr.Am.
    • 19%=hisp. Am
    • 94% rape vict. qualified for acute S.D. 12 days after incedent

    • Victims experience enormous distress 1 week after
    • --continues to rise next 3 wks, remains at peak for 1mo or so
    • -- begin to recover from there
    •  improve psychologicall w/in 3-4 mo, effects may persist 18+ mo later= high levels of anxiety, suspiciousness, depression, self -esteem problems...
  60. Lymphocytes & B-cells
    • L: White Blood cell, circulate ltmph system& blood stream, help body ID& destroy antigens
    • B: a type of "L" produce antibodies ("tag" antigens for destruction)  
    • Stress slows production of these
  61. Hypothalamus
    when brain interprets danger, neurotransmitters send signals to THIS which activates the endocrine system-network of glands that secrete hormones and the autonomic system-controls involunatry actions of organs eg breathing heart rate etc.
  62. Fight-flight-freeze response
    pg 154
    2 systems that arouse the body in response to danger

    • when brain interprets danger, neurotransmitters send signals to the hypothalamus which activates the endocrine system-glands and the autonomic system-involunatry actions of organs
    • endo.& autonomic then stimulate the  arousal and fear reactions via the sympathetic nervous system(SANS) and the hypothalamic-pituitary-adrenal pathway(HPA) 
    • SANS- Quickens <3 beat,  etc., stimulates adrenal glands= epinephrine & norepinephrine produced
    • when danger passes, parasympathetic nervous system counteracts SANS= calms down body
    • HPA-pituitary gland secretes adrenocorticotropic hormone, which stimulates adrenal cortex w.s. corticosteroids like cortisol

    each person has a particular response ranging from always relaxed to high tension without "reason"
  63. Pituitary
    gland secretes adrenocorticotropic hormone, which stimulates adrenal cortex w.s. corticosteroids like cortisol