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58 Cards in this Set
- Front
- Back
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Scientist-Practitioner Model
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Academic psychologists are researchers and teachers first (developmental, social etc.)
Clinical psychologists as scientist-practitioners Science informs practice (at least is should) Practice source of hypotheses for science Practice should be like science (develop hypotheses, test them) Detective work! |
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Types of Mental Health Professionals
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Clinical psychologists – Ph.D.; research; 6 years grad school; 1 year internship
Psychiatrists – M.D.; medication; 4 years med school; 3 or more years residency Social workers – MSW, DSW; community focus; 2 years (more for DSW) Counselors – usually education schools; specializations (e.g., marriage/family); 2 years School psychologists, nurse practitioners etc |
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Inquiring Skeptic 101
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Do vaccines cause autism?
Do antidepressants cause teen suicide? Are “recovered memories” of abuse real? Does “facilitated communication” work? Is depression located in the brain? Does masturbation make you crazy? (Idea arose about 300 years ago Accepted fact 150 years ago Still around in the 1930s) |
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Does masturbation make you crazy?
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Sexuality, Catholic Church in Europe
Onania or the Heinous Sin of Self-Pollution Tissot and other authorities – Benjamin Rush, William Maudesly, Sigmund Freud A theory: Blood drawn away from the brain!! Research evidence Case studies Treatments – castration, clitorectomy Prevention! Treatments failed Theory failed. Logic. Correlation and causation. Comparison groups (normal behavior). |
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Research Methods/Critical Thinking
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Does the measles/mumps/rubella (MMR) vaccine cause autism?
Contained mercury compound (thimerosal)Speculation/hypothesis Wakefield et al (1998). Lancet Original on class homepage Case studies good for generating hypotheses but not for proving hypotheses. But: Madsen et al. (2002). New England Journal of Medicine NICHD |
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Null hypothesis and burden of proof
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Burden of proof is on proponent of any hypothesis
Science: Not true until proven true Analogies to law Innocent until proven guilty Cannot accept the null hypothesis Not guilty NOT innocent Replication Key to science Different in law – double jeopardy |
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What Is Abnormal?
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Examples (case studies useful for this)
Anxiety disorders (agoraphobia with panic) Mood disorders (bipolar disorder) Schizophrenia (first case in Chapter 1) No lab test Diagnosis is imperfect Diagnosis can be political |
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Politics and Defining Mental Disorders
Illness or Moral Failing?? |
Insanity – John Hinckley; Andrea Yates
Alcoholism (Eating disorder etc?) Homosexuality Conduct disorder Congressman Mark Foley… Alcoholism Childhood abuse by priest?? |
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2) Guild? 3) Myth?
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2) Identity disorder
Developmental coordination disorder Learning disorder 3) Rosenhan, Science: On Being Sane in Insane Places |
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Variation on Normal?
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Not them but all of us?
Understand some symptoms (e.g., depression) Categories versus dimensions Or difference of kind vs. degree Or qualitative vs. quantitative differences Pregnancy vs. height. Labels and treatments are categorical Credit/no credit in class Diagnosis (PTSD?) Treatment (Medication for depression, ADHD) Learning disability case |
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1) Epidemiology
2) Prevalence |
1) The scientific study of the freq and distrib of disorders w/in a popul. 2) The total number of active cases of a disorder present in a popul during a specific per of time.
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1) Psychosis
2) Psychopathology 3) Abnormal psy |
1) A state of being profoundly out of touch w/ reality. 2) The manifestations of and study of the causes of mental disorders. 3) The application of psy science to the study of mental disorders.
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1) Syndrome 2) Am approach to defining whether a condition is a mental disorder in terms of its harm to the person and whether the condit results from the inability of sme mental mech to perform its mental function.
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1) A group of symptoms that appear together and are assumed to rep a specific type of disorder. 2) Harmful dysfunction
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1) Hippocrates 2) Argued that mental disorders could be traced to immoral beh, stress or improper living condit; optimistic about curing mental illnesses.
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Saw mental disorders as diseases having natural causes, like other forms of phy diseases. 2) Samuel Woodward.
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1) Jerome Wakefield 2) The DSM-IV-TR defines mental disorder in terms of personal...
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1) Proposed the harmful dysfunction approach to defining mental disorder. 2) distress; functioning, risk of harm.
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1) Much of our current estimates of the prevalence of mental disorder is based on the: 2) Epid studies indicate the percentage of people had at least one disorder at one time in their life.
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1) ECA 2) 32%
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1) The concept of disease burden combines which two factors? 2) mental disorders produce 47% of all:
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1) mortality and disability 2) disabilities
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1) Saw masturbation among other "morally objectionable" beh as the cause of: 2) Fever therapy involved:
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1) Woodward. 2) Malaria
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Disorganized speech 2) Psychopathology
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A type of formal thought disorder characterized by significant disruptions of verbal communication. 2) Pathology of the mind
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1) A mental disorder is typically defined by: 2) Not psychotic symptom.
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1) A set of characteristic features. 2) Depression
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1) Defense mechanisms 2) The mode of operation for the ego, where the need to gratify impulses is balanced with demands of reality.
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1) Unconscious processes that reduce conscious anxiety by distorting anxiety-laden memories, emotions, and impulses. 2) Reality principle
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1) The cause of abnormal behavior. 2) General paresis
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1) Etiology 2) A disorder w/ delusions of grandeur, dementia, and progressive paralysis; progressively worsens, ending in death; caused by untreated syphilis.
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1) Cognitive behavioral paradigm. 2)A psychoanalytic diagnostic category involving the conversion of psy conflicts into physical symptoms.
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1) Asserts that beh is learned and examines the processes underlying learning. 2) Hysteria, now categorized as conversion disorder.
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1) The use of diff perspectives, subsystems, or lenses to conceptualize causal factors. 2) Response cost
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1) levels of analysis 2) When the removal of a stimulus decreases the freqency of the beh.
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1) Viewing psy illness as the same as phy illness. 2) Systems theory
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1) Medical model. 2) A paradigm that emphasizes interdependence, cybernetics, and holism.
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1) Pavlov 2) A learning theory asserting that beh is a function of its conseq; that beh inc if it is rewarded and decreases if it is punished.
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1) Classical 2) operant conditioning.
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1) When the intro of a stimulus dec the freq of a beh 2) Premorbid history
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1) Punishment 2) The pattern of beh preceding the onset of the disorder.
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1) Bidirectional causality 2) The same psy disorder may have diff causes 3) The same event can lead to diff outcomes
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1) Reciprocal causality 2) equifinality 3) multifinality
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1) Developmental psychopathology 2) Age-graded averages
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1) An approach to abnormal psy that emphasizes the importance of age-graded avg and determining what constitutes abnormal beh. 2) Developmental norms
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1) Causation operates in one direction only. 2) A brain grouping including the medulla, pons, and cerebellum. 3) Limbic sys
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1) Linear causality 2) Hindbrain 3) Regulates emotion and basic learning processes.
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Not one cause of psychological problems
Bottom Line Systems Theory |
Multiple causes despite what some claim about
Trauma Chemical imbalances etc Multiple contributions (risk factors) “Lifestyle illness” So are heart disease, cancer etc -Holism (versus reductionism) Levels of analysis – Martian scientists Equifinality—multiple pathways to same destination Multifinality—same event has multiple effects Reciprocal causality Diathesis-stress model |
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Historical Theories
Paradigms. Psychological paradigms include: |
Assumptions about human nature
Assumptions about causation Assumptions about appropriate treatment Assumptions about how to do research |
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Freudian theory
Structure of personality |
Id
Sex and aggression Ego More conscious; defense mechanisms Neurotic anxiety Superego Moral anxiety Some defense mechanisms The unconscious Psychosexual development Psychoanalysis (Chap 3) Case studies Untestable theory In decline Important for literary criticism! |
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Need to Know
Biological “ |
Neuron and neuronal transmission
MAJOR brain structures Genetics - Behavior genetics Study of genetic contributions to complex behavior Focus on individual differences But people share 99.9% of genes with each other It’s Genetic” What Does That Mean? Behavior genetics Study of genetic contributions to complex behavior Focus on individual differences But people share 99.9% of genes with each other |
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Evolutionary psychology
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Study of genetic contributions to species typical behavior
Focus on shared motivations and behavior People share 98% of genes with chimpanzees |
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Psychological Disorders Rarely Show Mendelian Inheritance
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Huntington’s disease (dominant gene)
Phenylketonuria PKU) (recessive genes; environment too) |
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Polygenic Inheritance
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Most disorders (and characteristics) are polygenic (multiple genes) (
Depression, ADHD, intelligence Height of peas is polygenic; Mendel’s experiments wouldn’t have worked… Polygenic = quantitative not qualitative differences Dimensions not categories |
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Dimensions vs. Categories
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What do you think when someone says, “It’s genetic”?
“Genetic” does not mean categorical You can be “a little bit depressed” We always face issue of where to draw line between normal and abnormal for dimensional problems like depression Treatment decisions are categorical (take medication) |
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Behavior Genetic Methods
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Fraternal twins
Full brothers/sisters Parent/child --> 50% First cousins -->Third degree relative, 12.5% Second cousins-->Fourth degree relative, 6.25% |
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Behavior Genetic Methods
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Family studies
“It runs in families” does not mean genetic Families share genes and environment Adoption studies (important but harder) Twins studies – compare MZ and DZ All genes MZ = 1; DZ = .5 All shared environment MZ, DZ = 1 All nonshared environment MZ, DZ = 0 |
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Divorce is Genetic (?)
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McGue & Lykken – twin study
722 MZ twins; 794 DZ twins Risk of divorce if MZ divorced = .45 Risk of divorce if DZ divorced = .30 Heritability of divorce = .525 |
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What Does This Mean?
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Divorce probably is genetic
But what is the mechanism? A divorce gene? No! A personality characteristic? In part (antisocial behavior and rule violation) Many factors, maybe including things like age a menarche, physical appearance, etc Our study of menarche and stepfather presence |
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Genes and Environment
(Characteristic can be “Genetic” while Group Differences are Environmental) |
Mechanism – think about same issues for depression, eating disorders etc
Not necessarily a “gene for X disorder” Heritability ratio – false dichotomy Genetic” does not mean “predetermined” “Genetic” means predisposition The American Dream (equal environments) Would lead to GREATER genetic effects Sexist/racist concerns The Bell Curve – Murray spoke here a few years ago… By the way, racial differences are shrinking… |
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Eugenics – Our History of Shame
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Promotion of “good breeding” in the human stock
Dates to Frances Galton – 1883 Strongly influenced by Darwin’s idea Positive eugenics Encourage desirables to bear children Negative eugenics Prevent undesirables from having children Genocide Nazi Germany 20th Century U.S. social policy |
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Eugenics – Right Here in Cville
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“Three generations of imbeciles is enough!” Supreme Court Justice Oliver Wendell Holmes in Buck v Bell, 1927
60,000 forced sterilizations |
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Miller & Keller – discussing “isms”
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Reductionism
Dualism “Biological” disorder does not mean only effective treatment is biological (or vice versa) Healthy lifestyle, stress reduction helps heart disease, diabetes Pain relievers help tension headaches Depression is not (necessarily) a “chemical imbalance” requiring medication Behaviorism didn’t make biology extinct; biology isn’t going to make psychology go away Different levels Although one level not necessarily reducible to other |
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de Waal – Evolutionary Psychology
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“Looking at the social sciences as a relative outsider, I see thousands of ideas that are barely interconnected.”
Just because something exists, doesn’t mean it’s adaptive Account of abnormal behavior incomplete without account of normal behavior How modular is the modular mind? Question is not: How are humans and animals different? Question is: How are humans and other animals alike? |
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Turkheimer – behavior genetics
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All behavioral traits are affected by genes
Family effects are smaller than genetic effects (shared environment) Much variation is not accounted for by either genes or families (nonshared environment) This is his “gloomy prospect” for psychology [Taylor and Luce (Treatment chapter) Range of internet treatments Exciting… but early stages ] |
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Psychotherapy Outcome Research 1) Meta-analysis 2) Spontaneous remission
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Meta-analysis
A means of combining results from different studies “Psychotherapy” helps 2 out of 3 (see Figure 3-2) Emery: The “Chicken McNugget” problem Spontaneous remission How many people improve without treatment? 1/3? Is talking to friend, parent, professor therapy? |
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Placebo effect; Double blind study
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Placebo effect
Placebo = sugar pill; a treatment without active ingredients Need placebo control groups to measure real effects What is a placebo psychotherapy? Double blind study Patients’ and therapists’ expectations affect outcomes Double blind = neither knows if treatment is real Can therapists be “blind” to their treatment? |
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Allegiance effect; Efficacy (can it work) versus effectiveness (does it work in real world
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Allegiance effect
Treatments work better if researcher believes in treatment (not double blind) Comparing rival therapies and rival therapists Efficacy (can it work) versus effectiveness (does it work in real world How much does commitment and enthusiasm affect outcome in therapy? (A lot…) |
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Psychotherapy process research
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Common factors versus active ingredients
Empathy, warmth, genuineness: Rogers Persuasion and social influence: Frank Some specifics: Table 3-4 One way to think about this: Placebos change through psychological means Placebos aren’t placebos in psychotherapy We need to understand how placebos work and put them to use |
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DSM-IV-TR
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The “bible” of mental health professionals
Categorical classification system Descriptive diagnosis to maximize reliability Atheoretical and sometimes controversial list Homosexuality, identity disorder, developmental coordination disorder Binge eating disorder? DSM V (coming around 2010) |
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Concepts/Concerns
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Criteria for grouping
Appearance is only one basis for classification, perhaps not the most useful one Reliability – repeatability Inter-rater reliability key for diagnosis Is 82% agreement a good rating? Kappa correction (Subtracting chance agreement from reliability) |
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Concepts/Concerns
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Coverage – Omit things? Include too much?
Family diagnoses (Reliability?) Personality disorders (They stump me.) Pain – disorders aren’t everything 25% of people who seek treatment do not meet diagnostic criteria for any mental disorder Dimensions versus categories Are psychological disorders qualitative or quantitatively different from normal experience? Where do we draw the line dividing normal and abnormal? |
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Concepts/Concerns
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Validity – Accuracy and value in relation to some criterion
Etiological validity Concurrent validity Predictive validity (treatment response, course). Should we classify people? Labeling – a bad thing and a good thing Self-fulfilling prophesy, stigmatizing, label disorder not individual Common language, value for treatment, having a diagnosis can be reassuring |
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Bottom Line
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DSM is a useful if imperfect system of classification
Future surely will bring many changes That’s why understanding principles is important Whatever the system… We need to be sensitive to fact that we’re classifying people not things |
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Assessment Summary
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Interview is most common tool
Standardized interviews increase reliability Behavioral observations Less biased, less complete, less interesting Projective tests Something to projection; not a test (even though people love a mystery) Rating scales Do psychological lie detectors work? (imperfect at best) |
