Abnormal psych. Test 1 (Ch 1-6 )

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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

Card Set Information

Abnormal psych. Test 1 (Ch 1-6 )
2015-02-21 05:03:27
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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