Chapter 1 And 2

Front 1

Etiology

Back 1

Possible causes for abnormal behaviour.

Front 2

Clinical psychologist

Back 2

-Holds PhD or psyd

-Trained in psychopathology, personality, diagnosis, psychological testing, psychotherapy, and human physiology.

Front 3

Mental health counselor

Back 3

Training includes masters in counseling or psychology and hours of supervised clinical.

Front 4

Counseling psychologist

Back 4

Academic and internship requirements similar to clinical psychologist, but with focus on life adjustment problems rather than mental illness.

Front 5

Psychiatrist

Back 5

MD who can provide medication. Completes 4y medical school then 3-4 in psychiatry training.

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Psychiatric social worker

Back 6

Holds masters in social work. Specializes in assessment, screening, and therapy with high need clients and outreach to other agencies.

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Substance abuse counselor

Back 7

Professional training requirements vary, many have personal addiction experience. Works in agencies that specialize in evaluation and treatment of drug and alcohol addiction.

Front 8

3 components of a mental disorder

Back 8

-involves significant disturbance in thinking, emotional regulation, or behaviour caused by a dysfunction in the basic psychological, biological, or developmental processes involved in normal development.

-causes significant distress or difficulty with day to day functioning.

-not merely a culturally expected response to common stressors or losses or a reflection of political or religious beliefs that conflict with societal norms.

Front 9

Cost of mental health and substance abuse in us

Back 9

135B/y

Front 10

Prevalence of mental health disorders in us

Back 10

24.8% in last 12m, with 5.8% being serious. 50% of youth meet criteria for at least one disorder, 40% for 2. 22.2% of youth reported disorder caused them severe impairment or distress.

Front 11

Szarz

Back 11

People have problems in living but not mental illness. Claimed abnormal behaviour labeled by society for being different, that unusual belief systems are not necessarily wrong, and abnormal behaviour reflects something wrong with society rather than an individual.

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Prehistoric

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No distinction between physical and mental disorder. Attributed symptoms to demonic possession, sorcery, or retribution from ancestral spirit. Trphining was the opening of the skull to let out spirits. Exorcism practiced by Greeks, Chinese, Hebrews, Egyptians; prayers and extreme measures used to cast out spirits.

Front 13

Greco roman

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Scientific view. Hippocrates believed because brain was central organ of intellect, disease of the brain leads to deviant behaviour. Considered heredity and environment as causes of abnormal behaviour. Plato thought we should not punish the mentally ill. Galen examined CNS and its role in mental function.

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Middle ages

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Return to religious explanations. Monks either provided care or punishment. Early 13th c in Italy saw group hysteria (appearance of sudden symptoms with no known cause). Tarantism is agitation and frenzied dancing, a type of hysteria. Hysteria common due to daily stress caused by plague, war, famine, etc.

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Humanism

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Movement promoting welfare and worthiness of individuals.

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Humanism: Weyer

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Challenged beliefs about witchcraft. Stated many charged as witches were mentally disturbed.

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Moral treatment movement: Pinel

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Took over Bicetre asylum in Paris. Humane treatment resulted in greater recovery rate.

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Moral treatment movement: tuke

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Quaker. Humane treatment centre in York.

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Moral treatment movement: Rush

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Father of us psychiatry. Did work therapy.

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Moral treatment movement: Dix

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Raised money and campaigned for moral and better hospitals.

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Moral treatment movement: Beers

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Wrote book the mind that found itself, about own issues with mental illness. Account aroused public sympathy. Founded National committee for mental hygiene.

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Biological viewpoint: Griesinger

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Believed all mental disorders had physiological basis.

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Biological viewpoint: kraeplin

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Some symptoms cluster into syndromes. Outlined system for classifying mental illness based on physiological causes, still used today by dsm.

Front 24

Biological viewpoint: Biological evidence for psychological conditions

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-Pasteurs germ theory of disease.

-Further evidence with discovery of cause of general paresis (degenerative mental disorder caused by syphilis).

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Psychological viewpoint: Mesmerism

Back 25

Sleep like state induced, similar to hypnotism. But showed mental and physical disorders can have psychological component as were affected by psychological intervention.

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Psychological viewpoint: Breuer

Back 26

discovered after discussing abuse in hypnotic state that woman lost symptoms of disorder.

Front 27

Cultural and ethnic bias in diagnosis

Back 27

Overpathologizing disorders among clients of minorities whose lifestyles differ markedly from the therapists own.

Front 28

Positive psychology

Back 28

Study and understanding of positive human qualities associated with thriving. Interested in feelings of well being. Research into positive traits of individuals, address civic virtues and institutions that move us towards better citizenship and responsibility.

Front 29

Recovery movement

Back 29

Perspective that the mentally ill can recover and live satisfying, hopeful, contributing lives.

Front 30

Managed healthcare

Back 30

Industrialization of healthcare whereby insurance companies in private sector monitor and control delivery of services. But insurance company decides what conditions and treatments are covered, putting pressure on therapists.

Front 31

One dimensional models

Back 31

Biological, psychological, dysfunctional social relationships, sociocultural.

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Model

Back 32

Describes or attempts to explain a phenomenon or process that we cannot directly observe.

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Assumptions of the multipath model

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No one perspective is enough.

Explanations of abnormal behaviour must consider all 4 elements.

Not all 4 elements contribute equally to disorders. Factors can combine in complex ways so different persons with same influences may not develop same disorder.

Biological and physiological strengths of person and positive aspects of social and cultural environment can protect against psychopathology.

Front 34

Protective factors

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Conditions or attributes that lessen or eliminate risk of negative psychological or social outcome.

Front 35

Assumptions of the biological model

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Characteristics are embedded in dna.

Thoughts, emotions, behaviour involve physiological activity occuring in brain. Can affect brain structure.

Mental disorders associated with inherited biological vulnerabilities or brain abnormalities.

Medications and other biological interventions used to treat mental disorders influence various psychological processes in the brain.

Front 36

Biological model: motivation for behaviour

Back 36

State of biological integrity and health.

Front 37

Biological model: theoretical foundation

Back 37

Animal and human research, case studies, neuroimaging.

Front 38

Biological model: source of abnormal behaviour

Back 38

Genetics, epigenetics, brain anatomy, physiology, autonomic overreactivity.

Front 39

Biological model: treatment

Back 39

Medications, ect, rtms, DBs, vagus nerve stimulation

Front 40

Psychodynamic: motivation for behaviour

Back 40

Unconscious influences

Front 41

Psychodynamic: theoretical foundation

Back 41

Case studies, correlational methods.

Front 42

Psychodynamic: source of abnormal behaviour

Back 42

Early childhood experiences.

Front 43

Psychodynamic: treatment

Back 43

Psychoanalysis, uncovering unconscious conflict, dream analysis, free association.

Front 44

Behavioural: motivation for behaviour

Back 44

External influences

Front 45

Behavioural: theoretical foundation

Back 45

Animal research, case studies, experimental methods

Front 46

Behavioural: source of abnormal behaviour

Back 46

Learning maladaptive responses, not acquiring appropriate responses.

Front 47

Behavioural: treatment

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Directly modifying behaviour, analyzing and changing the environmental factors controlling behaviour.

Front 48

Cognitive: motivation for behaviour

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External and cognitive influences

Front 49

Cognitive: theoretical foundation

Back 49

Human research, case studies, experimental methods.

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Cognitive: source of abnormal behaviour

Back 50

Learned patterns of irrational or negative thoughts or self statements.

Front 51

Cognitive: treatment

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Understanding the relationship between thoughts and problem behaviour, modifying internal dialogue.

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Humanistic: motivation for behaviour

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Self actualization

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Humanistic: theoretical foundatkon

Back 53

Case studies, correlational methods.

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Humanistic: source of abnormal behaviour

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Incongruence between self and experiences

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Humanistic: treatment

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No directive reflection, unconditional positive regard.

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Family systems: motivation for behaviour

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Interaction with significant others.

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Family systems: theoretical foundation

Back 57

Case studies, social psychological studies, experimental methods.

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Family systems: source of abnormal behaviour

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Faulty family interactions and inconsistent communication patterns.

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Family systems: treatment

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Treating the entire family, not just the identified patient.

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Multicultural: motivation for behaviour

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Cultural values and norms

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Multicultural: theoretical foundation

Back 61

Data about cultural groups from various disciplines.

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Multicultural: source of abnormal behaviour

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Culture conflicts, discrimination, oppression.

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Multicultural: treatment

Back 63

Adapting therapy to consider both individual and cultural factors.

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The brain...

Back 64

Regulates activities for survival.

Receives and interprets sensory information.

Transmits information to muscles and organs.

Coordinates responses to incoming stimuli.

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Forebrain

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Responsible for higher level mental processes.

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Midbrain

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Involved in basic functions like hearing and vision, motor movement, alertness, sleep wake cycle...

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Hindbrain

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Most primitive. Designed for self preservation and survival, responsible for instinctive behaviour, balance/equilibrium, and basic bodily functions.

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Cerebral cortex

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In forebrain, consists of layers of neurons.

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Prefrontal cortex

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Part of cerebral cortex in forebrain. Region responsible for executive functioning (attention, behaviour, emotions for long and short term goal planning).

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Limbic system

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Group of deep brain structures associated with emotions, decision making, and formation of memories.

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Amygdala

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Facilitate recall of emotional memories and respond to threats.

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Hippocampus

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Part of limbic system. Helps form, organize, and store memory.

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Autonomic nervous system

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Fight or flight response. Originates in limbic system.

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Hypothalamus

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Regulates bodily drives and conditions. Part of HPA axis which is activated under conditions of stress. Stimulates pituitary gland to release hormones that prepare body to respond to potentially dangerous situation.

Front 75

Glia

Back 75

Cells that perform supportive roles like shaping neural circuits or signal relaying systems.

Front 76

Acetylcholine (ACH)

Back 76

Influences attention and memory, dream sleep states, muscle activation. Has excitatory and inhibitory effects. Important in Alzheimer's.

Front 77

Dopamine

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Influences motivation and reward seeking behaviours, regulates movement, emotional responses, attention, and planning. Has excitatory and inhibitory effects. Associated with ADHD, autism, depression, schizophrenia, substance use disorders, Parkinson's.

Front 78

Epinephrine and norepinephrine

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Excitatory functions include regulation of attention, arousal, concentration, dreaming, moods. As a hormone, influences physiological reactions related to stress response. Associated with anxiety, stress disorders, sleep disorders.

Front 79

Glutamate

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Major excitatory neurotransmitter involved in cognition, memory, learning. Associated with Alzheimer's, autism, depression, ocd, schizophrenia.

Front 80

GABA

Back 80

Major inhibitory neurotransmitter that calms nerves, regulates mood and muscle tone. Associated with anxiety, ADHD, bipolar, depression, schizophrenia.

Front 81

Serotonin

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Inhibitory effects regulate temperature, mood, appetite, and sleep. Reduced serotonin increase impulsive behaviour and aggression. Associated with depression, suicide, OCD, anxiety, PTSD, and eating disorders.

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Cortisol

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Steroid hormone released in response to stress. Anorexia nervosa, depression, stress related disorders.

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Ghrelin

Back 83

Stimulates hunger and boosts appeal of food. Eating disorders, obesity.

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Leptin

Back 84

Suppresses appetite. Anorexia nervosa, schizophrenia.

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Melatonin

Back 85

Regulates circadian sleep and wake cycles. Bipolar disorder, depression, SAD, schizophrenia, OCD.

Front 86

Oxytocin

Back 86

Neuropeptide hormone influencing lactation and complex social behaviours. Associated with autism, anxiety, schizophrenia.

Front 87

Classes of psychotropic medications

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1) antianxiety drugs (minor tranquilizers)

2) antipsychotics (major tranquilizers).

3) antidepressants

4) mood stabilizers (antimanic drugs)

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Thorazine

Back 88

Originally synthesized in France. First drug with antipsychotic properties. Medications based on thorazine are typical antipsychotics. Stop nerve activity that relies on neurotransmitter dopamine. But also causes extrapiramidal symptoms.

Front 89

Extrapiramidal symptoms

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Involuntary muscle contractions affecting gait, movement, and posture. Common side effects of typical antipsychotics.

Front 90

Psychodynamic models

Back 90

Mental disorders as result of childhood trauma, anxieties, and unresolved conflicts. Originally by Freud. Human behaviour was attempt to express, gratify, or defend against sexual and aggressive drives that operate subconsciously. Some experiences and conflicts are too threatening to face so become blocked.

Front 91

Components of personality according to psychodynamic models

Back 91

Id: key part of unconscious psyche, present at birth. Seeks immediate gratification.

Ego: represents realistic and rational part of the mind. Influenced by reality principle.

Superego: moralistic considerations. Instills guilt to help prevent immoral or unethical behaviour.

Front 92

Defense mechanisms

Back 92

Used to distance self from feelings of anxiety associated with unpleasant thoughts or other internal conflicts. Ways of thinking or behaving that operate unconsciously by distorting reality.

Front 93

Contemporary adaptations to psychodynamic theory

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Adler and Erickson disagree with prominence given to instinctual drives and suggested ego had adaptive capacity, such as to operate without the id. Others proposed that having needs met are of primary importance in early development and identity formation. Mental distress occurs when people people seek interpersonal experiences lacking in childhood.

Front 94

Traditional psychodynamic therapy

Back 94

Aims to overcome clients defenses so material blocked from consciousness can be uncovered, allowing client to gain insight into inner thoughts and unresolved childhood conflicts. Uses free association and dream analysis. Assume healthy behaviour patterns will develop once clients understand and resolve unconscious issues. Last years.

Front 95

Free association

Back 95

Tell therapist whatever CDs to mind, regardless of how illogical or embarrassing. If you spontaneously express thoughts, will reveal the contents of unconscious, including unrecognized worries and conflicts.

Front 96

Dream analysis

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Technique focused on interpreting hidden meanings in dreams. When sleeping, ego defenses and inhibitions weaken so unacceptable impulses or repressed anxieties more likely to surface.

Front 97

Therapy based on later psychodynamic theories

Back 97

View experiences with early attachment figures as having powerful effects on current interpersonal relationships rather than on unconscious conflicts. Some attempt to change adult personality patterns by analyzing recurring themes in problematic relationship experiences. Also focus on link between childhood experiences and current relational patterns; focus on improving relationships, decreasing social distress, and helping clients learn ways of interacting that are more effective than the maladaptive patterns acquired during childhood.

Front 98

Defense mechanisms: repression

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Preventing forbidden or dangerous thoughts or desires from entering ones conscious.

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Defense mechanisms: reaction formation

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Acting in a manner opposite to ones unconscious wishes or feelings.

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Defense mechanisms: projection

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Distancing oneself from unwanted desires or thoughts by attributing them to others.

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Defense mechanisms: displacement

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Directing an emotion towards a substitute target.

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Defense mechanisms: undoing

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Attempting to right a wrong or negate an unconscious thought, impulse, or act.

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Defense mechanisms: rationalization

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Explaining ones behaviour by giving socially acceptable reasons unrelated to ones true motives.

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Defense mechanisms: regression

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Retreating to an earlier developmental level that demands less mature responses and aspirations.

Front 105

Three learning paradigms of behavioural theory

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Classical conditioning, operant conditioning, observational learning.

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Classical conditioning

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UCS: unconditioned stimulus.

UCR: unconditioned response; naturally present response to unconditioned stimulus.

CS: conditioned stimulus; presented with unconditioned stimulus eventually becomes paired to unconditioned response.

CR: conditioned response; same physically to unconditioned response, but now occuring with only presentation of CS.

Front 107

Watson

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Little Albert experiment to prove phobias are conditioned responses.

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Operant conditioning paradigm

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Same as classical, but involves voluntary behaviours that are reinforced (positively or negatively) or punished (positive or negative).

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Observational learning paradigm

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Suggests we can acquire new behaviours and emotional reactions simply by watching other people perform them. Called vicarious conditioning or modelling. Reinforcement not needed for learning. Posits that abnormal behaviour comes from mimicking abnormally behaving models.

Front 110

Observational learning paradigm: bandura

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Self efficacy: individuals belief in their ability to make changes in their environment. Implied we are not just subjects of conditioning, but able to master situations to get good outcomes.

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Exposure therapy

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Behavioural therapy. Treatment approach based on extinction principles that involves gradual or rapid exposure to feared objects or situations.

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Systematic desensitization

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Treatment technique involving repeated exposure to a feared stimulus while client is in competing emotional or physiological state such as relaxation.

Front 113

ABC theory of emotional distubrance

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Ellis. A is an event, a fact, or someone's behaviour/attitude. C is persons emotional or behavioural reaction. A never causes C. B, a person's beliefs about A, cause C.

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Catastrophizing

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Envisioning the worst possible outcome for situations.

Front 115

REBT

Back 115

Rational emotive behavioural therapy. Strong focus on challenging irrational thinking. Ellis.

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Third wave therapies

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Based on premise that nonreactive attention to emotions can reduce their power to create emotional stress. If we continuously avoid distressing thoughts and feelings, they are more likely to persist. Mindfulness allows experiencing stressful emotional states without undue stress or physiological arousal.

Front 117

Dialectical behaviour therapy

Back 117

Supportive collaborative therapy involving close therapist client teamwork. Empathetic and validating environment to help clients learn to regulate emotions, cope with stress, and improve social skills. Therapists reinforce positive actions while avoiding reinforcement of maladaptive behaviours, including behaviours that interfere with therapy. Use mindfulness to accept things that cannot be changed.

Front 118

Acceptance and commitment therapy

Back 118

Focuses on learning to notice accept and embrace uncomfortable thoughts and emotions that are associated with mental illness.

Front 119

Humanistic view of psychopathology

Back 119

Anxiety, depression, etc occur when society blocks innate tendency for growth by imposing conditions on whether we have personal value. Standards transmitted via conditional positive regard (valued only when attitudes meet expectations). Then begin to believe have worth only when have approval of others.

Front 120

Humanistic therapy: person centred therapy

Back 120

Therapists to communicate respect, understanding, acceptance.

Front 121

Social relational explanations of mental distress assume...

Back 121

Healthy relationships are important for optimal human development and functioning.

Social relationships provide many intangible health benefits.

When relationships prove dysfunctional or are absent, individual may be vulnerable to mental distress.

Front 122

Family systems model

Back 122

Assumes behaviour of one family member directly affects the entire family. Personality development strongly influenced by family characteristics. Mental illness in an individual often reflects unhealthy family dynamics, especially poor communication, thus disorder exists within the family, not the individual. Therapy must focus on family system rather than individual.

Front 123

Conjoint family approach

Back 123

Stresses importance of clear and direct communication and teaches message sending and message receiving skills to family members. Satir believed family member experiencing mental distress or behavioural difficulties is reflection of dysfunction in the family system.

Front 124

Strategic family approaches

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Consider power struggles within the family and focus on developing a more healthy power distribution.

Front 125

Structural family approaches

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Attempt to reorganize family relationships based on assumption that family dysfunction occurs when family members have too much or too little involvement with one another.

Front 126

Taijin kyofusho

Back 126

Culture specific disorder in Japan where individual fears their body parts or functions are offensive to others.

Front 127

Ataque de nervios

Back 127

Puerto Rico only. Uncontrollable shouting, siezure like episodes, trembling, and crying.

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Acculturative stress

Back 128

The psychological, physical, and social pressures experienced by individuals who are adapting to a new culture.

Front 129

Universal shamanic tradition

Back 129

The set of beliefs and practices from non western indigenous traditions that assume that special healers are blessed with powers to act as intermediaries or messengers between the human and spirit worlds.