Chapter 14 And 15

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•became famous for demanding that thementally ill be treated with kindness, personally unlocking the chains ofinmates in France

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Philippe Pinel

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treatment methods aimed at making people feel better and function more effectively

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Therapy:

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–one based primarily in psychological theory and techniques

–the other uses medical intervention to bring symptoms under control

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Two broad categories

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therapy for mental disorders in which a person with a problem talks with a psychological professional

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Psychotherapy:

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psychotherapies in which the main goal is helping people to gain insight with respect to their behavior, thoughts, and feelings

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insight therapies

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psychotherapy in which the main goal is to change disordered or inappropriate behavior directly

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action therapy

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therapy for mental disorders in which a person with a problem is treated with biological or medical methods to relieve symptoms

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Biomedical therapy

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•: insight therapy based on the theory of Freud, emphasizing the revealing of unconscious conflicts

–dream interpretation

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Psychoanalysis

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the actual content of one’s dream

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manifest content

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the symbolic or hidden meaning of dreams

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latent content

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Freudian technique in which a patient is encouraged to talk about anything that comes tomind without fear of negative evaluations

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free association

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–occurs when a patient becomes reluctant to talk about a certain topic, either changing the subject or becoming silent

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resistance

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the tendency for a patient or client to project positive or negative feelings for important people from the past on to the therapist

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transference

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•actively giving interpretations of a client’s statements in therapy, even suggesting certain behavior or actions

–psychoanalysis today is generally --

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Directive

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•a newer and more general term for therapies based on psychoanalysis, with an emphasis on transference, shorter treatment times, and a more direct therapeutic approach

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Psychodynamic therapy

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•form of therapy for depression which incorporates multiple approaches and focuses on interpersonal problems

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Interpersonal therapy (IPT):

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•a non-directive insight therapy in which the client does all the talking and the therapist listens

–based on the work of Carl Rogers

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Person-centered therapy

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–therapeutic style in which the therapist remains relatively neutral and does not interpret or take direct actions with regard to the client, instead remaining a calm, nonjudgmental listener while the client talks

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non directive

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•Four elements:

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authenticity, unconditional positive regard, empathy, reflection

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the genuine, open, and honest response of the therapist to the client

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authenticity

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the warmth, respect, and accepting atmosphere created by the therapist for the client in person-centered therapy

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unconditional positive regard

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the ability of the therapist to understand the feelings of the client

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empathy

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the therapist restates what the client says rather than interpreting those statements

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reflection

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–In contrast to client-centered therapy,

-- has specific goals: namely, to reduce ambivalence about change and to increase intrinsic motivation to bring that change about

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•Motivational interviewing (MI)

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•form of directive insight therapy inwhich the therapist helps clients accept all parts of their feelings and subjective experiences, using leading questions and planned experiences such as role-playing

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Gestalt therapy

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are not based in experimental research and work best with intelligent, highly verbal persons

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Humanistic therapies

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•action therapies based on the principles of classical and operant conditioning and aimed at changing disordered behavior without concern for the original causes of such behavior

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Behavior therapies

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use of learning techniques to modify or change undesirable behavior and increase desirable behavior

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Behavior modification or applied behavior analysis

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behavioral technique used to treat phobias, in which a client is asked to make a list ofordered fears and taught to relax while concentrating on those fears

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Systematic desensitization

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replacing an old conditioned response with a new one by changing the unconditioned stimulus

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counter conditioning

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•form of behavioral therapy in which an undesirable behavior is paired with an aversive stimulus to reduce the frequency of the behavior

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Aversion therapy

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•behavioral techniques that introduce the client to situations (under carefully controlled conditions) that are related to their anxieties or fears

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Exposure therapy

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technique for treating phobias and other stress disorders in which the person is rapidly and intensely exposed to the fear-provoking situation or object and prevented from making the usual avoidance or escape response

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flooding

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–controversial therapy for post traumatic stress disorder and similar anxiety problems in which the client is directed to move the eyes rapidly back and forth while thinking of a disturbing memory

-needs more controlled studies

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eye-movement desensitization reprocessing (EMDR):

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learning through the observation and imitation of others

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Modeling

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–technique in which a model demonstrates the desired behavior in a step-by-step, gradual process while the client is encouraged to imitate the model

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participant modeling

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the strengthening of a response by following it with a pleasurable consequence or the removal of an unpleasant stimulus

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Reinforcement

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–the use of objects called tokens to reinforce behavior in which the tokens can be accumulated and exchanged for desired items or privileges

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token economy

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a formal, written agreement between the therapist and client (or teacher andstudent) in which goals for behavioral change, reinforcements, and penalties are clearly stated

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contingency contract

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•the removal of a reinforcer to reduce the frequency of a behavior

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Extinction:

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an extinction process in which a person (usually a child) is removed from the situation that provides reinforcement for undesirable behavior, usually bybeing placed in a quiet corner or room away from possible attention and reinforcement opportunities

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time-out

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Can be effective in treating specific problems, such as bed wetting, drug addictions, and phobias. Can also help improve some of the more troubling behavioral symptoms associated with more severe disorders.

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Behavior therapies

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therapy in which the focus is on helping clients recognize distortions in their thinking and replace distorted, unrealistic beliefs with more realistic, helpful thoughts

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Cognitive therapy

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Cognitive distortions

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arbitrary inference, selective thinking, over-generalization, magnification and minimization, personalization

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–drawing a conclusion without any evidence

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arbitrary inference

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focusing on only one aspect of a situation while ignoring all other relevant aspects

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selective thinking

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drawing, sweeping conclusions based on only one incident or event and applying those conclusions to events that are unrelated to the original

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over-generalization

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–blowing a negative event out of proportion (magnification) while ignoring relevant positive events (minimization)

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magnification and minimization

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–taking responsibility or blame for events that are unconnected to the person

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personalization:

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•action therapy in which the goal is to help clients overcome problems by learning to think more rationally and logically

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Cognitive-behavioral therapy (CBT)

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Three goals

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1.Relieve the symptoms and solve the problems.

2.Help develop strategies for solving future problems.

3.Help change irrational, distorted thinking.

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cognitive-behavioral therapy in which clients are directly challenged in their irrational beliefs and helped to restructure their thinking into more rational belief statements

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Rationale motive behavior therapy (REBT):

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•family members meet together with a counselor or therapist to resolve problems that affect the entire family

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Family counseling (family therapy):

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•a group composed of people who have similar problems and who meet together without a therapist or counselor for the purpose of discussion, problem solving, and social and emotional support

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Self-help group (support group):

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–cannot afford individual therapy

–may obtain a great deal of social and emotional support from other group members

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Group therapy is most useful to persons who:

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•psychotherapy that is offered on the Internet

–also called online, Internet, or Web therapy or counseling

–offers the advantages of anonymity and therapy for people who cannot otherwise get to a therapist

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Cyber therapy:

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therapies that directly affect the biological functioning of the body and brain

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Biomedical therapies

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•the use of drugs to control or relieve the symptoms of psychological disorders

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Psychopharmacology

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–used to treat psychotic symptoms such asdelusions, hallucinations, and other bizarre behavior

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antipsychotic drugs

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–used to treat and calm anxiety reactions

--typically minor tranquilizers

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antianxiety drugs

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–used to treat bipolar disorder

--include lithium and certainanti-convulsant drugs

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mood-stabilizing drugs

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–used to treat depression and anxiety

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antidepressant drugs:

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•biomedical treatment in which electrodes are placed on either one or both sides of a person’s head and an electric current strong enough to cause a seizure or convulsion is passed through the electrodes

–still used to treat severe depression

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Electroconvulsive therapy (ECT):

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•surgery performed on brain tissue to relieve or control severe psychological disorders

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Psychosurgery:

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–the connections of the prefrontal lobes of the brain to the rear portions are severed

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prefrontal lobotomy:

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–an electrode wire is inserted into the anterior cingulated gyrus area of the brain for the purpose of destroying that area of brain tissue with an electric current

--electrode is inserted with the guidance of a magnetic resonance imaging (MRI) machine

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Bilateral anterior cingulotomy:

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•is a software-generated three-dimensional simulated environment with can be used in the treatment of PTSD]

–like playing a video game

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Virtual Reality

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In ancient times holes were cut in an ill person’s head to let out evil spirits in a process called

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•trephining

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•believed that mental illness came from animbalance in the body’s four humors

–phlegm, black bile, blood, and yellow bile

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Hippocrates

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In the Middle Ages, the mentally ill were labeled as--

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witches

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the study of abnormal behavior

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Psychopathology

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•any pattern of behavior that causes people significant distress, causes them to harm others, or harms their ability to function in daily life

–statistically rare

–deviant from social norms

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Psychological disorders

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the social or environmental setting of a person’s behavior

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Situational context

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–emotional distress or discomfort

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subjective discomfort

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–anything that does not allow a person to function within or adapt to the stresses and everyday demands of life

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maladaptive thinking or behavior

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•any pattern of behavior that causes people significant distress, causes them to harm themselves or others, or harms their ability to function in daily life

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Psychological disorder:

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•psychological disorders have biologicalor medical causes

–biological changes in the chemical,structural, or genetic systems of the body

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Biological model

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abnormal behavior stems from repressed conflicts and urges that are fighting to become conscious

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Psychodynamic theorists

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•abnormal behavior is learned

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Behaviorists

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•abnormal behavior comes from irrational beliefs and illogical patterns of thought

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Cognitive theorists

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•abnormal behavior is the product of family, social, and cultural influences

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Sociocultural perspective

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–the need to consider the unique characteristics of the culture in which behavior takes place

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cultural relativity

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–disorders found only in particular cultures

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culture-bound syndromes

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•incorporates biology, psychology, and culture into a single explanation of abnormal behavior

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Biopsycho social model

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•manual of psychological disorders and their symptoms

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Diagnostic and Statistical Manual, Fifth Edition, (DSM-5):

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•an international resource published by the World Health Organization (WHO) currently in its tenth edition (ICD-10)

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International Classification of Diseases (ICD):

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describes about 250 different psychological disorders

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The DSM-5

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In a given year, about 26.2 percent of American adults over age 18 suffer from a--

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mental disorder

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only about 5.8 percent suffer from a--

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severe mental disorder

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–provide a common language to professionals

–establish distinct categories of diagnosis for treatment and understanding

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pros for labeling disorders

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–overly prejudicial

–“psychology student’s syndrome”

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cons for labeling disorders

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•the main symptom is excessive or unrealistic worry and fearfulness

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Anxiety disorders:

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–anxiety that is unrelated to any realistic, known source

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free-floating anxiety

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an irrational, persistent fear of an object, situation, or social activity

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Phobia

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–fear of interacting with others or being in social situations that might lead to a negative evaluation

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social phobia (social anxiety disorder):

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–fear of objects or specific situations or events

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specific phobia

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•fear of being in a small, enclosed space

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Claustrophobia

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•fear of heights

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Acrophobia

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•fear of being in a place or situation from which escape is difficult or impossible

–diagnosis requires that one feels anxiety in at least two of five situations

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Agoraphobia

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•panic attacks occur frequently enough to cause the person difficulty in adjusting to daily life

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Panic disorder

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sudden on set of intense panic in which multiple physical symptoms of stress occur,often with feelings that one is dying

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panic attack

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•excessive anxieties and worries occur more days than not for at least 6 months

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Generalized anxiety disorder

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•intruding, recurring thoughts or obsessions create anxiety that is relieved by performing a repetitive,ritualistic behavior

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Obsessive-compulsive disorder

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•a disorder resulting from exposure to a major, traumatic stressor

–symptoms include anxiety, dissociation, recurring nightmares, sleep disturbances, problems in concentration, and moments in which people seem to relive the event in dreams and flashbacks

–lasting as long as one month after the event

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Acute stress disorder (ASD)

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the symptoms associated with ASD last for more than one month

–symptoms may not develop until more than 6 months after a traumatic event

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Post-traumatic stress disorder (PTSD):

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•Irrational thinking

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magnification, all-or-nothing thinking, over generalization, minimization

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–the tendency to interpret situations as far more dangerous, harmful, or important than they actually are

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magnification

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the belief that one’s performance must be perfect or the result will be a total failure

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all-or-nothing thinking

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–the interpretation of a single negative event as a never-ending pattern of defeat and failure

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over generalization

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the tendency to give little or no importance to one’s successes or positive events and traits

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minimization

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in psychological terms, emotion or mood

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Affect

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•disorders in which mood is severely disturbed

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Mood disorders

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–severely depressed mood that comes on suddenly and seems to have no external cause

--may include thoughts of death or suicide

--most common of diagnosed disorders of mood

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major depressive disorder

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–a mood disorder caused by the body’s reaction to low levels of sunlight in the winter months

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seasonal affective disorder (SAD):

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–a period of excessive excitement, energy, and elation or irritability

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manic episode

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–periods of mood that may range from normal to manic, with or without episodes of depression (bipolar I disorder),or spans of normal mood interspersed with episodes of major depression and episodes of hypomania (bipolar II disorder)

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bipolar disorder

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•a condition in which a person reduces eating to the point that their body weight is significantly low, or less than minimally expected

–in adults, this is likely associated with a BMI <18.5

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Anorexia nervosa (anorexia):

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•a condition in which a person develops a cycle of “binging,” or overeating enormous amounts of food at one sitting, and then using unhealthy methods to avoid weight gain

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Bulimia nervosa (bulimia)

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•also involves uncontrolled binge eating but differs from bulimia primarily in that individuals with binge-eating disorder do not purge

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Binge-eating disorder

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•disorders in which there is a break in conscious awareness, memory, the sense of identity, or some combination

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Dissociative disorders

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loss of memory for personal information, either partial or complete

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dissociative amnesia

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–traveling away from familiar surroundings with amnesia for the trip and possible amnesia for personal information

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dissociative fugue

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–disorder occurring when a person seems to have two or more distinct personalities within one body

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dissociative identity disorder (DID):

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–dissociative disorder in which sufferers feel detached and disconnected from themselves, their bodies, and their surroundings

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depersonalization/derealization disorder

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•severe disorder in which the person suffers from disordered thinking, bizarre behavior, and hallucinations, and is unable to distinguish between fantasy and reality

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Schizophrenia

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•the break away from an ability to perceive what is real and what is fantasy

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Psychotic

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false beliefs held by a person who refuses to accept evidence of their falseness

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Delusions

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•false sensory perceptions, such as hearing voices that do not really exist

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Hallucinations

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•a lack of emotional responsiveness

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Flat affect

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•either wildly excessive movement or total lack there of

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Catatonia

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•excesses of behavior or occur in addition to normal behavior

–hallucinations, delusions, and distorted thinking

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Positive symptoms

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•less-than-normal behavior or an absence of normal behavior

–poor attention, flat affect, and poor speech production

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Negative symptoms

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•assumes a biological sensitivity, or vulnerability, to a certain disorder that will develop under the right conditions of environmental or emotional stress

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Stress-vulnerability model

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•a disorder in which a person adopts a persistent, rigid, and maladaptive pattern of behavior that interferes with normal social interactions

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Personality disorder

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•a person has no morals or conscience and often behaves in an impulsive manner without regard for the consequences of that behavior

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Antisocial personality disorder

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•maladaptive personality pattern in which the person is moody and unstable, lacks a clear sense of identity, and often clings to others

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Borderline personality disorder