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109 Cards in this Set
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Question
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Answers
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What is the dilemma of distinguishing between normal and abnormal sexual behavior?
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1) Importance of Context (considered inappropriate in one context may seem normal in another) 2)Continuum between normal and abnormal 3) Historical & Cultural relativism (masturbation & homosexuality)
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4 questions to determine if normal or abnormal desires.
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Is/does the desire always required for sexual gratification? Is/does the desire involved nonconsenting individuals? Is/does the desire cause emotional distress? Is/does the desire impaired functioning in everyday life or in the relationship? The more yes the more abnormal many therapists may consider it.
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What is paraphilias?
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disorder involving atypical means of achieving sexual arousal.
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Paraphilias more common in…
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Men
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Objects of paraphilias attraction?
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non-human objects, suffering humiliation of others; non-consenting individuals
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Paraphilias does not need which HIDES criteria for a diagnosis?
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Emotional Distress & sig impairment
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Is paraphilias rare?
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thought to be but maybe people just don’t want to disclose
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What is fetishism?
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"Sexual arousal from nonliving objects (shoes, underwear, fur, etc.) to exclusion of person as a whole. Causes distress or impairment in functioning (required for diagnosis). Distinguish from mere preferences may be “normal” preferences for certain objects w/ sex
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What is transvestic fetishism?
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Recurrent, intense sexually arousing fantasies, sexual urges or behaviors involving cross-dressing in a heterosexual male (may simply wear women's underwear, or go out in drag). Transvestites do not wish to literally become women.
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What is exhibitionism?
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Arousal involving exposing one’s genitals to an unsuspecting stranger (sometimes also masturbate in front of victim). Rarely seek any contact or further activity with victim. Element of risk/danger and reaction of shock/distress is part of the attraction.
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What is voyeurism?
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Arousal from observing an unsuspecting person who is naked, bathing, disrobing, or engaging in sexual activity. Element of privacy invasion is key. Arousal decreased if victim is aware or consenting.
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What is frotteurism?
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Recurrent, intense sexually arousing fantasies, sexual urges or behaviors involving touching and rubbing against a non-consenting person. Typically occurs in a crowded places such as subway trains or busy sidewalks
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What is pedophilia?
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Sexual attraction to prepubescent children ( Defined by victim's body maturity, rather than actual chronological age) Pedophile usually 16 or older and victim 5 years younger or more. Usually begins in adolescence. Mostly males, w/ victims mostly female (but other combos exist)
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Two types of Pedophilia?
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Situational & Preference
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Describe Situational Pedophilia.
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Report “normal” heterosexual histories (many have adult partners and are married). Typically social & sexual skills underdeveloped. Usually prefer girls. Molesting behavior is impulsive & often feel disgusted afterward.
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Describe Preference Pedophilia.
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Prefer children (both boys & girls, though more often boys) as sexual partners; often don’t view their behavior as abnormal.
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What is sadism?
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recurrent fantasies, urges, or behaviors to inflict physical/psychological suffering or humiliation on a nonconsenting person. Aroused by seeing suffering on others (seen mostly in men). Difficult to identify the cause.
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What is masochism?
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Arousal from experiencing (or imagining) such suffering healthy couples may incorporate mild S&M (or Bondage & Discipline) into their sex life, but true paraphiliacs NEED the above for arousal. More common in females
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Describe the implications of labeling rape as a power/aggression or sex issue.
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Labeling rape as about power/aggression (and not sexual desire) has implications ─ Purpose of classification? Political, scientific, community advocacy? ─ What levels of explanation are being considered? Sociological? Psychological? Labeling the act or intent? From the victim’s perspective, it’s always an act of violence, but regarding the rapist’s motivation can be power and/or sex depending on the type of rapist.
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State Knight & Prentsky's rapist subtypes.
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Sadistic, Non-sadistic (Motivation primarily sexual) Vindictive, Opportunistic (motivation primarily aggressive)
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Describe rapist subtypes with primarily sexual motivation.
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Sadistic: preoccupied by sadistic fantasies, rapes typically brutal and violent. Non-sadistic: fantasies usually don't include "typical" violence, distorted views of sexuality & women, feelings of inferiority/poor social skills.
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Describe rapist subtypes with primarily aggressive motivation.
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Vindictive: "Women Haters"; intent on violence directed at women, actions intended to degrade & humiliate victims. Opportunistic: Impulsive & unplanned; seek immediate gratification; indifferent to victims plight; potentially antisocial PD; don't respond well to treatment.
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What are psychodynamic reasonings for sexual disorders? (2)
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1) Impaired sexual development and fixation at an earlier stage. 2) Paraphilias is a defense mechanism to underlying emotional conflict--the id energy is displaced to a safer object. Main defense mechanism is called turning active into passive or identification with the aggressor, where the individual does unto others what was some to himself--commonly: they wish to undo past humiliating experiences by humiliating someone else in the present. Also, to reduce fears of castration & to handle fears of inadequacy.
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What are biological reasonings for sexual disorders? (2)
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1) Potentially abnormalities in the endocrine system-->higher levels of androgens, primarily testosterone. 2) Left-temporal lobe dysfunction seen in pedophilia, fetishism, and exobitionism (but most with temporal lobe dysfunctions don't develop pharaphiliac symptoms)
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What are biological treatments for sexual disorders? (2)
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1)Administer anti-androgens which reduce testosterone levels and effects--> known as chemical castration. 2) some evidence for SSRI's (probably indirect)
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What are behavioral reasonings for sexual disorders? (2)
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1) Possible early inapprop. sexual experiences 2) Classical Conditioning: a sexually neutral/atypical stimulus paired with sexual arousal 3) Operant Conditioning: repeated reinforcement through fantasy & masturbation. Perhaps why paraphilias more common in men, who depend more than women on visual sexual imagery for arousal.
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What are behavioral treatment techniques for sexual disorders? (4)
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1) Aversive conditioning: Extinguish arousal by pairing with an aversive stimuli (electric shock, noxious smell, etc.) 2) Covert sensitization: pair fantatasies/images to imagined negative consequences, "play the tape all the way through, what could go wrong?" 3) Masturbatory satiation: masturbate to boredom while imagining fetish objects & continue to masturbate after orgasm; extinction sets in after a while. 4) Orgasmic reconditioning: masturbate to usual fantasies but substitute healthier/more appropriate image just before ejaculation.
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What are cognitive reasonings for sexual disorders? (1)
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"Repeated attempts to inhibit deviant thoughts/fantasies may paradoxically increase them.
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State the common distortions of a sex offender (5)
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1. Blaming the victim ("she was asking for it"), 2. Denying/minimizing sexual intent (" I was teaching him about sex"), 3. Debasing the victim ("she was a slut anyway"),4. Minimizing the consequence("my other daughter turned out fine" or "she was already messed up"), 5. Justifying the cause ("If it hadn't happened to me, I wouldn't do it")
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What are cognitive treatment techniques for sexual disorders? (3)
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1) Restructuring for distortions. 2)Empathy training for client to: take responsibility for actions, accept harm caused to victim & empathize w/ their pain. 3) Relapse Prevention: Identify high-risk situations (HRS) & (SUDs--seemingly unimportant decisions); Develop coping & self-control skills before urges get too strong.
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What reliability and validity issues are there with PD's?
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Validity: is this actually a disorder; is it distinct from a normal personality; are some PDs biased against women? (Normal--abnormal continuum) Reliability: Can therapists consistently distinguish between them? (messy & have similar features)
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Name three categories of PDs?
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A) Odd-eccentric: PDs similar to, but not always as severe as, schizophrenia. B) Dramatic-emotional: Themes of behavior so dramatic, emotional, or erratic that it interferes with satisfying relationships; often involves disregard of needs of others. C) Anxious-fearful: Feature inadequacy, hypersensitivity, and central theme of anxiety & behaviors to deal w/ anxiety.
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Describe Paranoid PD.
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(Odd-Eccentric) Pervasive mistrust of others; assume others intend them harm, Often unwarranted though can become self-fulfilling--Will “read into” the behavior of others; Often hostile & critical to others.
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Describe Schizotypal PD.
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(Odd-Eccentric) Social & Interpersonal decificits, cognitive or perceptual distortions and eccentricities of behavior; Odd thoughts/behaviors. E.g., Ideas of reference (see random, external events as related to them); Magical thinking (believe they have “special abilities” others don’t have); Similar to schizophrenia, though they might not believe in their symptoms as fiercely (still aware of reality); acute discomfort in close relationships (combination of schizoid and paranoid)
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Describe Schizoid PD.
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(Odd-Eccentric) Detachment from social relationships and a restricted range of expression; “Loners”-->Don’t desire (& actively avoid) interpersonal relationships; Often seen as aloof & cold; Relationships they have might be shallow, unemotional; Overall impaired social skills
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Describe Obsessive-Compulsive PD.
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(Anxious-Fearful) Strong desire for orderliness & neatness; Highly conscientious (devoted to work & productivity); Preoccupied w/ rules, lists, order, & schedules (rigid about them); Perfectionistic (sets high standards and must do things the right way); Emphasize thought over emotion (isolation of affect, intellectualization, emotionally constrained); Not the same as OCD!
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What are the differences between OCPD and OCD?
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OCPD doesn't feature overt obsessions or compulsions, symptoms are often ego symtonic (they like being that way)
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Describe Avoidant PD.
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"(Anxious-Fearful) Social Inhibition, Feelings of Inadequacy, Hypersensitivity to negative evaluation. Socially anxious: Often avoid activities w/ a lot of interpersonal contact b/c of
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Describe Dependent PD.
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(Anxious-Fearful) A pervasive and excessive need to be taken care of that leads to submissive and clingy behavior; Excessive need to be taken care of(very reliant on others for advice, reassurance and to make decisions); Submissive & “clingy” or “needy”; Feel helpless when alone (fear of abandonment--may be indiscriminant in mate selection); Difficulty disagreeing or initiating things on one’s own.
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Describe Histrionic PD.
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"(Dramatic-Emotional) Dramatic, attention-seeking behavior; Excessively emotional; Considers their relationships more intimate than they really are; Can be flirtatious or sexually provocative.
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Describe Narcissistic PD.
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"(Dramatic-Emotional) Grandiosity (exaggerates achievements or abilities, convinced of their own power, intelligence, and beauty), Sense of entitlement (Unreasonable expectations of others, May expect normal rules to not apply b/c they’re “special”) Little interest or empathy for others (very critical of others ""who are inferior and envious"") Interpersonally exploitive (Can be charming & make good first impressions, but mainly use others to meet their own needs, Need constant attention & admiration) Harsh reactions to criticism (Rage or depression).
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Describe Antisocial PD.
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(Dramatic-Emotional) Disregard for and violation of the rights of others; Failure to follow society’s norms; Deceitfulness (repeated lying & conning others for personal profit); Poor impulse control; Aggressiveness; Disregard safety of self and others; Lack of remorse for one’s actions; Consistent irresponsibility
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How does cleckley describe a psychopath?
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Cleckley (in The Mask of Sanity (1941)) described psychopaths as intelligent and superficially charming, shallow emotions little capacity for empathy, love, guilt, impulsive & unpredictable, unreliable & untruthful, doesn't learn from experience/punishment.
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How is a psychopath different from ASPD.
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Psychopath is not a personality disorder, however often in colloquial terms this word is reserved for the creepiest antisocial behavior. The DSM has renamed this disorder several times from sociopathic personality disorder (play of psychopath) to antisocial
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What are the biological prespective's reasoning for antisocial disorder? (3)
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1) Deficient in normal anxiety reactions--actions that would normally make someone nervous and uneasy, like committing a crime, are not necessarily anxiety provoking to someone with ASPD. 2) Structural abnormalities: may have smaller prefrontal white & gray brain matter which is associated w/ skin conductance (a measure of anxiety) & Differences in ANS arousal (pair a tone with shock to fingertips… ??) and they may seek antisocial behaviors/situations to generate more arousal 3) Prenatal drug exposure (however issues with multiple causality)
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What are the cognitive perpespecitve's reasoning for antisocial disorder?
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1) Distorted schemas about relating to others and what’s needed to survive in this world. 2) Other cognitive deficits including the inability to connect actions with their consequences.
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What are the psychodynamic perspective's reasoning for antisocial disorder? (2)
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1) Cruel, abusive early relationships and begins to use the defense mechanism identification with the aggressor--individual causes others to experience the victimization, powerlessness, or helplessness that he or she experienced in the past. 2) No healthy identification w/ parents; lack of normal parent-child attachments hinders the development of the superego and of the ability to trust & empathize.
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What are the behavioral perspective's reasoning for antisocial disorder?
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Many antisocial adults are the children of antisocial parents (family influences). Antisocial behaviors learned through modeling & reinforcement (rewarded for manipulative or abusive behaviors).
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Treatment for ASPD?
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25% of ASPDs receive TX. Similar to TX of other PDs, BUT:
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Describe Borderline PD.
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(Dramatic-Emotional) Emotional Instability (Vacillate among different feelings--“moody”) 1.May suddenly go from positive feelings to: Depression (Despair and low self-image--"no one really cares about me"), Anger (Trouble managing anger, may have volatile outbursts--"How can you treat me this way"), Anxiety--usually about being alone (feels angry when feel abandoned). 2. Intense fear of abandonment 3. Identity/self-image problems (Lacking a complete sense of “self”, Identity confusion: “Who am I?”--didn't grow up with a stable identity, Emptiness--may feel hollow or a void) 4. Turbulent Relationships: due to Idealization ("you're the only one I can trust") , Devaluation ("what kind of friend are you?"), Can get furious when expectations aren’t met, Extreme fear of abandonment. 5. Self destructive Behaviors ( E.g., substance abuse; suicidal attempts; promiscuity) (75% of those diagnosed are women)
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What is splitting in regards to Borderline PD
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A defense mechanism in which one views oneself or others as all-good (idealization--attempt to reassure) or all-bad (devalued--defense mechanism to decrease importance of person who inflicted emotional pain) in order to ward off conflicted or ambivalent feelings, has a difficult time integrating good and bad aspects of people. (similar to all or nothing thinking)
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What are a borderline's reasoning for self mutilation? (4)
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They may make cuts or burn their own body (arms, legs, etc.) for: 1) self-punishment, 2) interpersonal/manipulation 3) relief from mood (releases endorphins) 4) to feel something, symbolizes the pain on the inside
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What is dialectical behavioral therapy?
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Focuses on emotional dysregulation resulting from childhood traumatization & emotional invalidation. Elements: 1) warmly validating of clients intense emotional experiences 2) uses cog-beh techniques to help clients solve day-to-day problems effectively 3) focus on developing skills in order of: improving attentional focus, increasing emotional control, interpersonal effectiveness, tolerating distress 4) Addresses following behaviors: life threatening behaviors, therapy-interfering behaviors, quality-of-life interfering behaviors, posttraumatic stress reactions, self-respect behaviors.
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According to the psychodynamic perspective, what are the effects of a toxic environment?
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"1)Fixation at a stage
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According to the psychodynamic perspective, what are normal childhood needs and the results from receiving them?
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"1)""Stable Base,” Predictability
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According to the psychodynamic perspective, what is the structural diagnosis?
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PDs lie in the early parent-child relationship--> “Toxic” early relationships (healthy child-parent relationships leads to a stronger, healthier personality)
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Describe psychodynamic therapy for PD.
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"Interpret client’s current behaviors/feelings ─ explore their origin
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Did you look at table 11/12?
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Yes
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Do you know table 11.13?
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Yes
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Describe the behavioral perspective explanation of disorder and of treatment.
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"P.D.s are patterns of behavior learned through modeling and pun./reinf.
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Describe the cognitive perspective explanation of disorder and of treatment.
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"Distorted core schemas that developed and rigidified over a lifetime.
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(Odd-Eccentric): Paranoid; Schizoid; Schizotypal "
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"(Anxious-Fearful): Avoidant--Moderate; Dependent--Moderate; Obsessive-Compulsive--Moderate
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What does Polythetic mean?
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diagnostic criteria sets in which a person is required to meet a minimum number of perdetermined diagnostic criteria in order to warrant a diagnosis--no criteria is critical to the overall diagnosis (a limitation in PD diagnoses)
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What are the differences between dimensional vs categorical systems?
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Categorical is the current DSM system where individuals are diagnosised on the basis of whether or not they fit a certain defined criteria. Instead people suggest that the DSM should use a dimensional system where individuals are rated for the degree to which they xhibit traits along certain dimensions.
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What are the symptoms of Anorexia Nervosa?
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"1. Refusal to maintain normal body weight─ gets below 85% normal weight for age/height
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What are the features/statistics of Anorexia Nervosa?
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"1. Onset: early to middle teen years, usually triggered by dieting and stress
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What are the subtypes of Anorexia Nervosa?
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"Restricting─ Dieting, fasting, or excessive exercise to maintain low weight
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Describe the pro-anaorexia website controversy.
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"1. Sites created by anorexic patients who want to stay the way they are─ “It’s a lifestyle choice, not a disease”
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What are the symptoms of Bulimia Nervosa?
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"1. Recurrent, out-of control binges
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What are the features/statistics of Bulimia Nervosa?
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"1. Onset: middle to late teens
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What are the subtypes of Bulimia Nervosa?
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"Purging Type– Vomiting or abusing laxatives, diuretics (more common)
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Define binge.
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Binge: Eating > than most would in a discrete time period (usu. < 2hrs)
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Define purge.
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Purge: use vomiting, laxatives, diuretics, enemas to minimize caloric impact of food
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What is Eating disorder not otherwise specified (EDNOS)?
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Disordered eating that does not meet the meet the diagnosic criteria for anorexia or bulima nervosa. Examples: suffering from anorexia, but still above 15 percentile, chew and spit out food, binge eating disorder (binge with out compensatory behaviors afterward)
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What is reverse anorexia?
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Also known as muscle dysmorphia. Suffers (typically men) excessively worry that their muscles are too small and underdeveloped. They spend an inordinate amount of time lifting weight and exercising, even if their muscles are obviously overdeveloped. Often take anabotic steroids to increase muscle mass.
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How do cognitive & behavioral perspectives explain eating disorders?
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"Cognitive: dichotomous (black or white) thinking, low opinion of their body shape (overestimate their actual proportions by about 20%), body image and eating habits equated w/ strength, control, & confidence
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How do cognitive & behavioral perspectives treat eating disorders?
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"1)Self-monitor thoughts, feelings, & behavior
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How does the biological perspective explain eating disorders?
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"1) Genetics?: Eating disorders do run in families, Body dissatisfaction, desire for thinness, binge eating, and weight preoccupation all heritable; Set-point theory (the idea that our bodies resist marked variation) may play a role; More research needed
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How does the biological perspective treat eating disorders?
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"1) SSRIs? Mixed results--Some suggest SSRIs can help the mood disturbance commonly comorbid w/ eating disorders (thought less effectiv for AN)
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Explain medical/nutritional management.
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"Supportive nursing care including:
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How does the psychodynamic perspective explain eating disorders?
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"1) Disturbed parent-child interactions lead to serious ego deficiencies: sufferers striving for perfection to please there parents (extreme weight loss shows ability to achieve difficult goal and to chart her own course)
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How does the psychodynamic perspective treat eating disorders?
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"More active than when treating other disorders, but still less symptom-focused than cognitive-behavioral pproaches
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How does the family/systems perspective explain eating disorders?
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"Families of anorexics described as showing the following:
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How does the family/systems perspective treat eating disorders?
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"Will resemble aspects of interpersonal therapy
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What emotional factors explain eating disorders?
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"“Food as comfort” ─ eating (or compensatory behaviors) to relieve moods
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What personality factors explain eating disorders?
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"The trio of perfectionism, body dissatisfaction, and low self-esteem are particularly prominent
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Explain media & body image issues that contribute to eating disorders.
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Shifting standards of beauty increasing stress thinness since the 1960's. Promoted size by fashion/entertainment industry dramatically smaller than the average american. Models on the cover of magazines often digitally altered to look taller and thinner.
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Explain the prevalence of body dissatisfaction.
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more than ½ of North American women currently express sig concern w/ their body (and majority are currently dieting)
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Explain normative discontent.
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"societal shift in defining what’s a “normal” level of unhappiness w/ your weight/body.
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Explain culturally sactioned hostility.
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Frustration with societal pressures to be thin is breeding “culturally sanctioned hostility”, it is becoming fashionable to express open hostility toward skinny women
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Describe age/gender/class/culutre in eating disorders.
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Age: Most common in females ages 15-25; studies report 10-20% of college students affected by weight issues; some children as young as 6 express concerns for their weight, also prevalence in elderly individuals Gender: 90% of eating disorders occur in women Class: Current studies show that the prevalence does not vary significantly across classes, although used to be a higher SES disorder Culture: more common in caucasian women than in minorities however many studies report that there is growing prevalence in many minority groups
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Describe dissociation on a continuum from normal to abnormal.
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"Dissociations: Some aspect of cognition or experience becomes inaccessible to consciousness. Normal level: daydreaming, automatic processing. Abnormal when dissociation becomes chronic & a defining features of
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State DID sypmtoms.
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"1) Presence of 2 or more distinct identities or personality states
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State DID features/statistics.
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"1) Onset: typically in childhood, around age 5 (Rarely diagnosed until adulthood; almost all trace onset to before age 10)
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Describe switching
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transition from one alter to another
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Describe co-conscious & two way amnisia
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"Co-consciousness:
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What are the differences between an alter v. a complete personality?
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"A complete personality has: consistent set of responses to stimuli, a range of emotions, a history of experiences
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What are the types of alters and their main characteristics?
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"Host : Alter w/ executive control of body for greatest % of time
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Describe the diagnostic controversy.
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Describe the PTM model for DID.
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"Posttramatic Model: Disorder is a natural result of early childhood trauma--People develop alternative identities as a way of escaping severe physical or sexual abuse.
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Describe the SCM model for DID.
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"Sociocognitive Model (proponents of the disorder) believe DID is Iatrogenesis (doctor born) disorder & the client is role-playing, not conscious faking, but enacts a set of behaviors/roles based on the environment
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What is iatrogenic?
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a disorder unintentionally caused by the treatment
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How does the Psychodynamic perspective explain for DID?
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"DID results from the use of the defense mechanisms to cope with chronic and severe traumatization:
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How does the psychodynamic perspective approach treatment for DID?
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"1)create safe environment to explore past trauma & def. mech. at play
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How does the Behavioral perspective explain & approach treatment for DID?
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"**opperant conditioning negatively reinforces dissociative behaviors; individual removes themselves mentally during traumatic experinece and which brings relief
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How does the Cognitive perspective & explain & approach treatment for DID?
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"**Self-hypnosis theory: ability to put ones self into a trance to remove themselves from painful experiences which results in memory and attention loss that are also found during dissociations.
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How does the Biological perspective approach treatment for DID?
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Narcosynthesis: the use of medication to promote therapeutic remembering: used during WWII to help soldiers remember forgotten traumatic incidnets.
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What are the nine steps of Kluft's Nine stages of treament?
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"1) Establishing the psychotherapy (introduce client to treatment plan)
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