Psyc3082 Exam 1

Front 1

myths and misconceptions about abnormal behavior

Back 1

no single definition of psychological abnormality or normality

Front 2

what is a psychological disorder?

Back 2

psychological dysfunction associated with distress or impairment and the response; which is either behavioral, emotional, or cognitive; is atypical or not culturally expected.

Front 3

psychological dysfunction:

Back 3

breakdown in

cognition (the way one thinks)
ex: thinking one is being followed by the fbi and cia

emotion (feeling)
ex: chronic sadness

behavioral functioning
ex: checking to see if the stove is off 50x before leaving the house

Front 4

personal distress/impairment:

Back 4

difficulty performing appropriate and expected roles

impairment is set in the context of a person's background

Front 5

atypical or not culturally expected response:

Back 5

reaction is outside cultural norms

ex: seeing visions/hallucinations. some cultures consider this normal, others do not.

Front 6

if something is outside the norm (atypical) does that always indicate psychological disorder?

Back 6

no, 3/100 people in the class are 6'5''. can simply be a statistical deviation

Front 7

psychological disorder consists of these three:

Back 7

psychological dysfunction

distress or impairment

atypical response

Front 8

just because something seems odd on the outside, doesn't mean there are reasons for the behavior.

examples:

Back 8

uncle drinks whiskey everyday and has trouble remembering names. Q: can he remember names when he doesn't drink? need to know more about culture.

23 y/o female smokes 5 joints/day. Q: successful student? medical marijuana?

Front 9

abnormal behavior:

Back 9

a psychological dysfunction associated with distress/impairment that is not a typical or culturally expected response

Front 10

DSM-IV:

Back 10

diagnostic and statistical manual version 4, contains diagnostic criteria

Front 11

the science of psychopathology

Back 11

scientific study of psychological disorders

Front 12

mental health professionals
all united under scientist-practitioner model

ph.d: clinical and counseling psychologists (don't give out drugs)

psy.d: clinical and counseling "doctors of psychology"

Back 12

m.d.: psychiatrists (from a mental pov, major role in prescribing and treating with medicine)

m.s.w.'s: psychiatric and non psychiatric social workers

mn/msn's: psychiatric nurses (some receive special training for psychology)

Front 13

the scientist-practitioner model:

Back 13

methods of assessment for evaluation and treatment used today.

producers of research: engaged in researching these areas

consumers of research

evaluators: of their work using empirical methods

Front 14

use of this is relatively new. this field was much less scientific 50 y ago

Back 14

scientific methodology

Front 15

scientist-practitioner model:

Back 15

mental health professional:

consumer of science: enhancing practice

evaluator: determining the effectiveness of the practice

creator of science: conducting research that leads to new procedures useful in practice

Front 16

studying psychological disorders entails three:

Back 16

FOCUS
clinical description
causation (etiology)
treatment and outcome

Front 17

Clinical description:

Back 17

begins with presenting problem

description aims to gain additional information

describe prevalence & incidence

describe onset of disorders

describe course of disorders

Front 18

clinical description:
1. presenting problem:

Back 18

reason why one is seeking help. problem that the person feels they have. vast majority of use have been to doctors. usually go for when something may be wrong.

ex: i have been crying for weeks

Front 19

clinical description:
2. gaining information:

Back 19

distinguish clinically significant dysfunction from common human experience

clinical description of the problem

ex: any thoughts of suicide? depression?

Front 20

clinical description:
3. prevalence & incidence:

Back 20

prevalence: rate of the disorder in population. how many people currently have disorder?

incidence: rate of disorder during a specified time period. how many have the disorder during a specified time period?

Front 21

clinical description
4. onset of disorders:

Back 21

onset: beginning of problem

acute vs. insidious onset

acute: sudden
insidious: gradual (how gradual? over a week? month)

Front 22

clinical description
5. course of disorder:

Back 22

course: pattern

episodic, time-limited, or chronic course

episodic: come and go
time-limited: certain period of time
chronic: long period of time

Front 23

causation, treatment, and outcome:

what factors contribute to the development of psychopathology?

Back 23

study of etiology: causation, root of problem

prognosis: outcome. what is the expected outcome? how can we best improve the lives of people suffering from psychopathology?

study of treatment development (pharmacologic, psychsocial, and/or combined treatments)

how do we know if we have alleviated psychological suffering?
study of treatment outcome

Front 24

historical conceptions of abnormal behavior. major psychological disorders have existed:

Back 24

in all cultures across all time periods

Front 25

the causes and treatment of abn. behavior varies widely:

Back 25

across cultures, time periods, particularly as a function of prevailing paradigms or world views.

Front 26

three dominant traditions:

Back 26

supernatural, biological, psychological

Front 27

supernatural tradition studies:

Back 27

deviant behavior as a battle of good vs. evil

Front 28

supernatural believed deviance to be caused:

Back 28

by demonic possession, witchcraft, sorcery

Front 29

treatments for supernatural deviance:

Back 29

exorcism, torture, beatings, crude surgeries

Front 30

evil was frequently blamed for behaviors that were not culturally expected/deviant. the moon and stars:

Back 30

paracelsus and lunacy

lunatic: crazy person. luna - moon, thought to be function of astrology

Front 31

biological tradition stemmed from:

Back 31

hippocrates - first to assume and state that abn. behavior is a physical disease. if something thought to be physical, should be treated as such.

Front 32

biological tradition fostered hysteria, which is:

Back 32

the wandering uterus, running around screaming and crying, breakdowns, associated with women. attributed to uterus, most solved with being married and given children to settle it down.

Front 33

galen extended hippocrates work with this theory.

Back 33

humoral theory

Front 34

humoral theory assumed:

Back 34

a person's brain functioning and behavioral functioning was related to 4 bodily fluids (humors):

blood from heart
phelgm from brain
black bile from spleen
yellow bile from liver

assumed diseases were a function of too much/too little of one or more of fluids

Front 35

humoral theory treatments:

Back 35

nutrition, rest, blood letting

Front 36

galenic-hippocratic tradition:

Back 36

foreshadowed modern views linking abnormality with brain chemical imbalances

Front 37

The 19th century, data supported abn. behavior was a disease linked between

Back 37

syphilis and madness

Front 38

general paresis (syphilis) and biological link with madness:

Back 38

associated with several unusual psychological and behavioral symptoms

pasteur discovered cause - bacteria

penicillin cured

bolstered view that mental illness = physical illness and should be treatment the same

Front 39

john grey and the reformers thought

Back 39

mental illness is always a disease and should be treated like one

Front 40

consequences of biological tradition:
mental illness = physical illness

Back 40

mental illness or abn. behavior seen as function of physicality

Front 41

conseq. of bio tradition:
philippe pinel coined 5 forms of insanity

Back 41

mania - maniac
melancholia with delirium
melancholia without delirium
dementia
idiotism

Front 42

conseq. of bio tradition:
emil kraepelin:

Back 42

considered father of the modern classification system of mental illness. published 2400pg book that contained classification system. known as first truly comprehensive system.

Front 43

kraepelin classed mental illness into 2 major groups, then further into:

Back 43

2 major groups:
manic depressive psychoses
dementia praecox

then into 18 further specific mental disorders

Front 44

kraepelin's book distinguished:

Back 44

psychiatry as a medical field that was separate from neurology. prior, they were considered same

Front 45

until the early 20th century, mental illness was understood mostly if not completely due to physical illness. b/c of this, abn. behavior was treated with:

Back 45

medicines (penicillin)
rest
nutrition
some were crude: lobotomy, shock therapy

Front 46

the psychological tradition:

Back 46

didn't begin immediately after bio. overlap.

Front 47

psyc tradition dates back to plato who thought

Back 47

problems with behavior were due to cultural and social issues

Front 48

prior to 1800s, patients not burned at stake/did not respond to treaments were

Back 48

locked up in crude hospitals and were not released

Front 49

in 1800s, rise of _____ which led to mental hygiene movement

Back 49

moral therapy

Front 50

moral therapy treatment was humane but not

Back 50

effective

Front 51

late 1700s, mesmer came up with treatment of

Back 51

hyponosis

used magnet and passed over parts ofthe body and then found other metal objects. wasn't too effective either

mesmerize

Front 52

the rise of moral therapy:

involved:

encouraged:

Back 52

involved more humane treatment of institutionalized patients

encouraged and reinforced social interaction

Front 53

proponents of moral therapy:

who crusaded for more human treatments. emphasis on moral guidance, more human teratment in hospitals.

who others

and who followed pinel's lead in england

Back 53

dorothea dix

philippe pinel and jean-baptiste pussin

william tuke

Front 54

psychoanalytic theory was this person's work

Back 54

freud

Front 55

freudian theory of the structure and function of the mind consisted of 3 folds:

Back 55

id
ego
superego

Front 56

freudian structure:

pleasure priniciple, illogical, emotional, irrational, impatient - child like component.

primary process thinking

Back 56

id

ex: if you're in a bar and see someone attractice, the id wants you to take them home now.

wants it and wants it now

Front 57

freudian structure:

reality principle, logical, and rational - mediates between the id and superego

Back 57

ego

ex: in bar, ego wouldn't deny attraction, but ego would be realistic, maybe make a data and might progress further

Front 58

freudian structure:

moral principles, ethical, driven by conscience, parental

Back 58

superego

ex: in club, might drive you to make friends, date, might encourage abstinence, marriage, or love

Front 59

conflicted between id, ego, and superego, freud says most of these occur in unconscious level

Back 59

intrapsychic conflicts

Front 60

defense mechanisms:

when ego loses the battle with id and superego

Back 60

displacement and denial

rationalization and reaction formation

projection, repression, and sublimination

Front 61

psychosexual stages of development

Back 61

oral
anal
phallic
latency
genital stages

Front 62

intrapsychic conflicts

Back 62

supergo: conscience - driven by moral principles

ego (mediator): logical; rational - driven by reality principles

id: illogical, emotional, irrational - driven by pleasure principles

moral
reality
pleasure

Front 63

Founded humanistic theory

Back 63

abraham maslow (hierarchy of needs)
carl rogers

Front 64

humanistic theory:

Back 64

assumes people are driven by good will

Front 65

major themes of humanistic theory:

Back 65

assume that people are basically good - freud assumed people were driven by sex and agression

Front 66

in humanistic therapy:

Back 66

therapist surveys empathy and unconditional positive regard
minimal therapist interpretation

Front 67

the behavioral model in mid-20th century

Back 67

more scientific, relies more on empirical data - approach to psychopathology

Front 68

behavioral model derived from a scientific approach to the study of

Back 68

psychopathology

Front 69

founders of behavioral model

Back 69

pavlov, watson, and classical conditioning

Front 70

pavlov's dogs:

Back 70

making dogs salivate at tone of bell. classical conditioning

he gave meat powder to dog - resulted in saliva (uncond. resp)

would pair with bell for a while

would then ring bell, dogs salivate, no meat (conditioned response)

bell is conditioned stimulus
meat is unconditioned stimulus

Front 71

classical conditioning: a form of a ubiquitous type of

Back 71

learning

Front 72

conditioning involves ___ between neutral and unconditioned stimuli

Back 72

contingency

Front 73

conditioning experiment extended to

Back 73

acquisition of fear

Front 74

beginnings of behavior therapy:

operant conditioning:

Back 74

if rewarded for behaviors, those behaviors will increase and get stronger. rewards outweigh potential consequences, those behavior will continue to become stronger

Front 75

operant conditioning properties:

Back 75

positive reinforcement; stimuli
negative reinforcement: punishment

Front 76

anxiety disorder explained by operant

Back 76

separation anxiety

Front 77

reactionary movement against psychoanalysis and non-scientific approaches lead by

Back 77

joseph wolpe: systematic desensitization

thorndike, skinner, and operant conditioning

most voluntary behavior controlled by consequences that follow behavior

Front 78

learning traditions greatly influenced development of behavior therapy:

behavior therapy tended to be:

Back 78

time-limited and direct
strong evidence supporting the efficacy of behavior therapies

Front 79

the PRESENT:

an intergrative approach

Back 79

unidimensional accounts of psychopathology are incomplete

consider reciprocal relationship between

biology, psychology, social, and experimental

bio-psycho-social model

mental illness combo of all three

Front 80

CHAPTER 2:
multidimensional models of abnormal behavior

Back 80

certain behaviors may be considered normal at a certain developmental level and abnormal for someone at another developmental level

biological influence
behavioral "
emotional "
social "
developmental "

Front 81

genetic contributions to psychopathology

phenotype vs genotype

Back 81

phenotype: outward physical manifestation, behavior, eye color, mood, hair color, thought patterns

genotype: genetically encoded, inherited info, prewired

Front 82

nature of genes -
DNA:
chromosomes:

Back 82

DNA = deoxyribonucleic acid - double helix

23 pairs of chromosomes, 46 altogether

last pair determined one sex
XX = female
XY = male

Front 83

dominant vs recessive

Back 83

dominant: genotype will be manifested
recessive: in order for a reces. to manifest, must be the only gene present

certain diseases are related to ne's genetic makeup.

ex: not a specific gene that says you will have cancer, but one can receive genetic makeup from parent and have great risk of development

Front 84

a number between 0 and 1 that indicates how much of a characteristic is related to genes. closer to 1 = more characteristic can be related to genes. close to 0 = more of environment

Back 84

heritability factor

Front 85

examples of heritability factors

Back 85

intelligence .5-.6
shyness .3-.5
lang. and accent prob only 2 that are as close to 0 as you can get

Front 86

development and behavior is often

Back 86

polygenetic

Front 87

genetic contrition to psychpathology
%

Back 87

less than 50%

Front 88

interaction of genetic and environmental effects:

eric kandal and gene-environmental interactions.

diathesis-stress model:

Back 88

states that person's inherit a genetic makeup that predisposes them to certain behaviors, characteristics, and emotions. can be activated by environment, stress may be trigger for some anxiety

depression tends to be genetic. person exposed more likely to develop depression

don't necessarily portray that trait

Front 89

reciprocal gene-environment model:

Back 89

newer model.

similar to diathesis-model. assumes you inherit the genetic makeup and that it makes it more likely to engage in a behavior and more likely to develop.

genetic things that might factor in: addiction, empathy, short fuse

if fraternal twin divorces, your probability rise 100%

if identical twin divorces, your probability rise 600%

genes are not the whole story

Front 90

neuroscience contributions to psychopathology

field of neuroscience:

Back 90

role of the nervous system in disease and behavior

Front 91

central nervous system consists of (CNS)

Back 91

brain and spinal cord
communicates with rest of body through PNS
uses neurons

Front 92

peripheral nervous system (PNS) consists of

Back 92

somatic and autonomic branches

Front 93

PNS somatic:

Back 93

controls voluntary muscles

Front 94

PNS autonomic:

Back 94

controls involuntary muscles

sympathetic: expends energy
parasympathetic: conserves energy

Front 95

neuroscience and the CNS

the neuron consists of

Back 95

a cell body with 2 branches (axons and dendrites)

Front 96

neuron:

cell body

Back 96

soma

Front 97

neuron:

branches that receive messages from other neurons

Back 97

dendrites

Front 98

neuron:

trunk of neuron that sends messages to other neurons

Back 98

axon

Front 99

neuron:

buds at end of axon form which chemical messages are sent

Back 99

axon terminals

Front 100

neuron:

small gaps that separate neurons

Back 100

synaptic cleft

Front 101

neuron:

neurotransmitters are reabsorbed if they are not passed on to the dendrite to the next neuron

Back 101

reuptake

Front 102

neurons function electrically, but communication chemically

Back 102

neurotransmitters are the chemical messengers

Front 103

a drug known as serotonin reuptake inhibitor. serotonin is released form the axon and passed on to a dendrite. someone who is depressed is unbalanced, not enough serotonin is passed on. just gets reabsorbed. this drug blocks the reuptake so that its not reabsorbed, so that more are available in the synaptic cleft to be passed on to dendrite

Back 103

paxil

Front 104

cerebral cortex houses about ___% neurons

Back 104

80

Front 105

they do not necessarily cause behavior. low level of serotonin does not cause depression, only increases likelihood.

Back 105

neurotransmitters

Front 106

neuroscience and division of the brain

Back 106

refer to pictures, though as last resort, for there will be no diagrams on exam

Front 107

major neutrotransmitters:

broadly related to mood (low 5HT = poor/depressed mood)

low levels lead to increase in likelihood of depression

low levels are also related to eating and excessive sexual behaviors

side effect: low libido

Back 107

serotonin (5HT)

Front 108

major neurotransmitters:

inhibits wide range of behaviors and emotions

low levels = anxiety

higher levels = calmness and relaxation

Back 108

GABA

Front 109

major neurotransmitters:

similar to adrenaline
fear, panic, alarm reaction, contributes to panic

Back 109

norepinepherine

Front 110

major neurotransmitters:

aids in exploratory and pleasure seeking behaviors

associated with schizophrenia, parkinson's disease (deficit) and other behavior/thought processes

high levels = schzophrenia

Back 110

dopamine

Front 111

neuroscience and major neurotransmitters in psychopathology
4

Back 111

norepinephrine (nonradrenaline)
serotonin (5HT)
dopamine
gamma aminobutyric acid (GABA)

Front 112

neuroscience: peripheral nervous and endocrine system

controls voluntary muscles and movement for the most part (nerves and neurons that communicate with the skin and muscles)

Back 112

somatic branch of PNS

Front 113

controls heart, stomach, many internal organs. regulates cardiovascular activity and endocrine

Back 113

autonomic branch of PNS

Front 114

sympathetic and parasymthetic branches

major function to ready and prepare body for fight/flight

Back 114

sympthetic NS

Front 115

sympathetic fight/flight response:

Back 115

fear response

blood rushes away from major internal organs - less likely to bleed out

increase in adrenaline

pupils dilate to see better

increase in respiration in increase oxygen intake

blood pressure rises - protective factor to prevent bleed out

digestion slows to reduce unnecessary energy usage

Front 116

part of autonomic of PNS

controls activities during rest/conservation of energy

regulates cardiovascular system & body temp

regulates endocrine and aids in digestion

Back 116

parasympathetic

Front 117

integration of endocrine and nervous system function

Back 117

hypothalamic-pituitary-adrenalcortical axis (HYPAC axis)

Front 118

neuroscience and brain structure

borders center of brain, thalamus & hypothalamus

Back 118

limbic system

Front 119

receives and integrates sensory information

one of major relay centers of brain

seeing, hearing, touching

Back 119

thalamus

Front 120

controls eating, drinking, aggression, sexual activity

controls motivated and emotional behaviors

plays an important role in fight/flight

4 F's

feeding, fighting, fleeing, fornicating

Back 120

hypothalamus

Front 121

also regulate emotions

very important in memory (hippo lost on campus)

involved in senses that trigger memory recovery

smell, song on radio

relay center for olfaction

Back 121

hippocampus

Front 122

brain controls the ____ system.

Back 122

endocrine

Front 123

endocrine controls

Back 123

emotions/reactions, any area of the brain we tk about do not solely control a behavior/emotion - complex interaction

Front 124

neuroscience - functions of main neurotransmitters

Back 124

agonists, antagonists, inverse agonists

Front 125

neurotrans. func.

increase activity of a specific neurotransmitter by mimicking the effects

Back 125

agonist

Front 126

neurotrans. func

decrease or block reabsorption of neurotrans. can also block transmission

Back 126

antagonist

Front 127

neurotrans. func.

produces effects opposite of a neurotrans.

Back 127

inverse agonists

Front 128

implications of neuroscience for psychopathology

Back 128

not only can brain function have an effect on our behavior, but our behaviors can affect and change brain function. as things can happen to us, trauma, abuse, it changes the chemistry of the brain and the chemical structure of brain

medicine can change chemical structure of brain.

effective psychotherapy can lead to changes in brain func., increased serotonin for example

Front 129

relations between brain and abnormal behavior

ex)

Back 129

OCD

Front 130

experience can change brain structure and function

ex)

Back 130

medications and psychotherapy

Front 131

psychological contributions to psychopathology

conditioning and cognitive processes:
1.
2.
3.
4.

Back 131

respondent and operant learning

learned helplessness

modeling and observational learning

prepared learning

Front 132

cognitive behavior therapy

Back 132

refer to pg 19 of lecture/slide notes

rescorla's experiment of showed contiguity

must be continuous or classical conditioning will not be effected with meat and music.

Front 133

summary of multidimensional perspective of psychopathology

multiple causation

take a broad, comprehensive, systematic perspective

useful in understanding the causes of psychopathology

Back 133

multiple causation - rule, not the exception, explaining normal & abn. behavior

addressing biological psychological social cultural and developmental

Front 134

assessing psychological disorders

purpose of clinical assessment (4)

Back 134

to understand the individual

to predict behavior

to plan treatment

to evaluate treatment outcome

Front 135

assessing psyc. dis.

analogous to funnel how?

Back 135

starts broad then becomes more specific as you learn more

multidimensional in approach

narrow to specific problem areas

Front 136

key concepts of assessment (3)

Back 136

reliability

validity

standardization

Front 137

consistency in measurement, examples include test-retest, inter-rater

Back 137

reliability

Front 138

what an assessment approach measures and how well it does

does it measure what it is supposed to

Back 138

validity

valid tool for diagnosing diabetes would be testing blood sugar levels

invalid would be doing CAT or MRI

Front 139

is the assessment method administered and scored (if necess) in a consistent method

are norms used?

standards and norms help ensure consistency in the use of technique

Back 139

standardization

a test assesses depression. scored severely. determined by comparing score to norm.

structured administration

Front 140

domains of assessment:

Back 140

clinical interview and physical exam

Front 141

most common clinical assessment method.

structure or semi-structured

Back 141

clinical interview

Front 142

clinical interview

closed and open ended questions that are chosen in response to previous asnwers

Back 142

semi structured

Front 143

clinical interview

basically would have a list of questions to ask no matter what

Back 143

structured

Front 144

components of good interview:

Back 144

identifying info - general info

presenting problem - why are you here?

specific symptoms - do you think of death? when do you feel sad?

detailed history of problems - how often? when?

social/life/family history - bio-psycho-social model

alcohol/drug history - does it run in family?

developmental history - any problems during pregnancy?

academic history - if appropriate

vocational history - do these symptoms affect your work?

medical history

history of mental health treatment

mental status exam

diagnostic impressions - what is the diagnosis, major depression?

recommendations - for treatment

prognosis - what does the outlook look like?

Front 145

systematic observation of a client and his/her behavior and their response to certain questions. presented in organized manner.

Back 145

mental status exam

Front 146

mental status exam information on

5

Back 146

appearance

thought processes

mood and affect

intellectual functioning

sensorium

Front 147

EXAMPLE OF MENTAL STATUS EXAM

appearance:
-grooming: casual, shabby, neat
-dress
-how do they look?
-appear stated age?

behavior
-restless, hyperactive, fidgety, calm
-psychomoto agitation

attitude
-cooperative, suspicious, psychomotor retardation

Back 147

mood
-happy, sad, depressed, elevated, euphoric, irritable

affect (how mood is conveyed - facial expressions)
-full range, blunted, flat, tearful, contricted
-----person's mood appeared sad, affect consistent with mood and was teared, smiled at appropriate times.
-------said they wanted to die with smile

speech
-understandale, goal directed, articulation problems, pressured, tangential, circumstantial, perseverative, echolalia

Front 148

thought processes
perceptual disturbance

a sensory experience without sensory input

-auditory
-visual
-tactile
-olfactory
-gustatory

Back 148

hallucinations

Front 149

thought process

firmly held belief that are out of touch with reality. remain strong despite evidence.

Back 149

delusion

buying tickets after superbowl

Front 150

thought process

thoughts of wanting to die/harm oneself

Back 150

suicidal ideation

Front 151

thought process

thoughts of killing others

Back 151

homicidal ideation

Front 152

do they know who they are? where they are? when?

person, place, time, and situation, oriented x 4 and demonstrating a clear ____

Back 152

orientation/sensorium

cloudy sensorium: few years off, couldn't remember last name.

clear sensorium: oriented x4

Front 153

thought process

intact, impaired

Back 153

attention and concentration

Front 154

thought process

immediate recall, short-term/long-term
intact/impaired

Back 154

memory

Front 155

thought process

superior, high average, low average, borderline, mental retardation

Back 155

estimation of intelligence

Front 156

thought process

good, fair, limited, poor

Back 156

insight and judgement

Front 157

physical exam

Back 157

physical

Front 158

domains of assessment: clinical interview and physical exam

Back 158

refer to pg. 22 of lecture notes

Front 159

domains of assessment: behavioral assessment and observation

behavior assessment:

Back 159

focus on present - here and now

focus on direct observation of behavior -environment relations

purpose is to identify problematic behaviors and situations

identify antecedents, behaviors, and consequences

Front 160

domains of assessment: psycho. testing and projective tests

psychological testing must be reliable and valid

projective tests (2nd and 3rd usually used)

project aspects of personality onto ambiguous test stimuli

2

Back 160

uses ambiguous stimuli

it is assumed that in the person's responses, they project personality or mood onto responses

Front 161

domains of psyc testing and proj. test roots in

Back 161

psychoanalytic tradition

requires high degree of clinical inference in scoring and interpretation

Front 162

examples of proj tests

Back 162

rorschach inkblot

thematic apperception test

reliability and validity data often mixed

Front 163

domains of asses. psyc testing and object testing

test stimuli are less ambiguous
require minimal clinical inference in scoring and interpretation

Back 163

objective tests

objective personality tests

minnesota multiphasic personality inventory (MMPI, MMPI-2, MMPI-A)
-over 500 t/f questions

extensive reliability, validity, and normative database

Front 164

domains of assessment: neuropsychological testing

assess behaviors related to brain functions

assess broad range of motor, cognitive, memory skills, and abilities

goal is to understand brain-behavior relations (person's assets and deficits)

Back 164

neuropsychological testing

Front 165

domains of ass. : neuroimaging and brain structures

if suspected to have brain damage or other problems

allows for a window on brain structure and function

Back 165

neuroimaging - pics of brain

Front 166

computerized axil tomography (CAT or CT) utilizes Xrays

magnetic resonance imagine (MRI) utilizes magnetic fields

Back 166

imaging brain structure

Front 167

positron emission tomography (PET)
single photo emission computed tomography (SPECT)
functional MRI - provides a view of brief changes in brain activity

Back 167

imaging brain function

Front 168

domains of ass. psychophysiological assess.

methods used to assess brain structure, function, activity of the nervous system

Back 168

psychophysiological

electroencephalogram (EEG) - brain wave activity

heart rate and respirations - cardiorespiratory activity

electrodermal response and levels - sweat gland activity

Front 169

diagnosing psycho. disorders: foundations in classification

diagnostic classification

not only used by the sciences. classify others everyday - good/bad, smart/dumb, etc

Back 169

classification central to all sciences

Front 170

assignment to categories based on

Back 170

shared attributes or relations

Front 171

terminology of classification systems

classification in a scientific context (entities/things)

Back 171

taxonomy

Front 172

terminology of class. sys.

application of a taxonomy to psychological/medical phenomena

Back 172

nosology

Front 173

issues w/ classifying and diagnosing psyc. dis.

father of classifications

Back 173

amil krapelin

Front 174

issues w/ classifying and diagnosing psychological disord.

Back 174

categorical vs. dimensional approach

Front 175

strict (or pure) approach

each order is unique and completely distinct from one another

assumes that because each disorder is unique, then each must have a distinct and separate underlying cause

problem: single or unique cause cannot be found for each disorder

Back 175

classical categorical approach

Front 176

classification along dimensions/involves severity rating

classifying psyc. disorders on contiuums. symptoms would be rated on a continuum. more flexible, allows for more variation

Back 176

dimensional approach

Front 177

combines classical and dimensional views

approach used today and over pat 40-50 years

one must have certain essential/required characteristics of certain symptoms but it allows for other non-essential symptoms that it does require a certain number of non-essential symptoms

Back 177

prototypical approach

Front 178

ex. of categorical approaches

Back 178

2 major symptoms of anxiety are needed. there is a list of non-essential symptoms and is required to have 3+ symptoms

Front 179

two widely used classification systems

Back 179

international classification of diseases and health related problems (ICD-10): published by the World Health Organization

diagnostic and statistical manual or mental disorders (DSM-IV and DSM-IV-TR): published by american psychiatric association

Front 180

DSM-IV

basic characteristics

Back 180

5 axes describing full clinical presentation (person and environment)

clear inclusion and exclusion criteria for disorders, including duration

disorders are categorized under broad headings

prototypic approach to classification; one that is empirically grounded

Front 181

DSM-IV

the five DSM axes

Back 181

axis I - clinical syndromes
-specific disorders (major depression) (schizophrenia)

axis II - stable, enduring problems (personality disorders, mental retardation)
-2 groups listed above are the only ones

axis III - medical conditions related to abnormal behavior
-heart disease for someone with panic disorder, something that would make the disorder worse

axis iv - psychosocial problems affecting functioning or treatment
-recently divorced; injured, death in the family

axis v - global clinician rating of adaptive functioning

Front 182

global assessment functioning

Back 182

0-100 rating

closer to 100 - the better off you are. close to 0 - close to death you are

55 would be severe panic attacks.

70 would be depression

Front 183

unresolved issues in DSM-IV

defined as two or more disorders for the same person

Back 183

comorbidity

high comorbidity is the rule clinically

comorbidity threatens the validity of separate diagnoses

Front 184

CHAPTER 4

Back 184

NATURE OF ANXIETY AND FEAR

Front 185

somatic symptoms of tension

future-oriented mood state characterized by marked negative affect

apprehension about future danger or misfortune

Back 185

anxiety

Front 186

immediate fight/flight response to danger/threat

involves abrupt activation of the sympathetic nervous system

present-oriented mood state, marked negative effect

Back 186

fear

Front 187

described as emotional trait, mood of this is both in emotional terms and somatic (bodily) symptoms, and cognitive symptoms (relating to a person's thoughts)

Back 187

anxiety

Front 188

_____ of tension could be headaches, muscle tensions

Back 188

somatic

Front 189

characterized by apprehension/excessive worry about future danger/misfortune. mood marked by negative emotions

Back 189

anxiety

Front 190

some argue that one can have anxiety about the past, however, how that even usually affects the

Back 190

future

ex. getting an F on a test last week, not necess. worried about test, but how that event affects GPA

Front 191

response to an immediate threat. fight/flight.

person's bodily/cognitive to an immediate danger. present here-and-now state, but anxiety's mood state is related to something in the future

Back 191

fear

Front 192

characteristics of anxiety disorders

Back 192

psycho. disorders - pervasive and persistent symptoms of anxiety and fear

involve excessive avoidance and escapist tendencies

symptoms and avoidance causes clinically significant distress and impairment

Front 193

is some anxiety/fear adaptive and even helpful?

Back 193

yes, if there was no apprehension for test, no worry, just blowing it off, not helpful at all

driving, particular alertness, even when sometimes automatic, alertness is adaptive

become excessive when it is chronic and becomes difficult to control

Front 194

cont. characteristics of anxiety disorders

Back 194

anxious apprehension starts to cause psyc. distress and affects functioning

ex: worrying so much for test, difficulty studying - worried of driving that you will not leave neighborhood

if one is excessively anxious, way to keep anxiety at bay is avoidance. escapist tendencies

Front 195

what is a panic attack?

Back 195

abrupt experience of intense fear/discomfort

accompanied by several physical symptoms (breathlessness, chest pain)

Front 196

DSM-IV subtypes of panic attacks

(3)

Back 196

1. situationally bound (cued) panic

2. unexpected (uncued) panic

3. situationally predisposed panic

Front 197

expected and bound to some situations

Back 197

situationally bound (cued) panic

Front 198

unexpected out of the blue w/o warning

Back 198

unexpected (uncued) panic

Front 199

may/may occur in some situation

Back 199

situationally predisposed panic

Front 200

panic is analogous to fear as an

Back 200

alarm response

vast majority believe first panic attack = heart attack. many discovered in ERs

Front 201

three subtypes of panic attacks (DISTINGUISH)

Back 201

situational bound (cued) panic: only occur in certain situations. bound. so much so that they are almost expected in certain repetitive situations/similar situations. virtually all will occur in certain situations, compared to

unexpected (uncued) panic: no rhyme/reason in appearance, NO PATTERN

predisposed: false alarm, equivalent to alarm response. if mike jumps at you, NOT a panic attack, but true fear. false alarm when reaction without mike threat

Front 202

Phenomenology of Panic attacks

Back 202

Emotional State
=Anxiety
-negative effect
-somatic symptoms of tension
-future-oriented
-feelings that one cannot predict/control upcoming events

=Fear
-negative affect
-strong sympathetic nervous system arousal
-immediate alarm reaction characterized by strong escapist tendencies in response to present danger or life threatening emergencies

----------------->>>>>>

=Panic Attack
-fear occurring at an inappropriate time
-three types:
~~situationally bound - cued
~~unexpected - cued
~~situationally predisposed

Front 203

biological contributions to anxiety and panic

inherit vulnerabilities for anxiety and panic, not anxiety disorders

stress and life circumstances activate the underlying vulnerability

Back 203

diathesis-stress

Front 204

biological causes and inherent vulnerabilities

Back 204

anxiety and brain circuits - GABA

limbic (amygdala) and the septal-hippocampal systems

behavioral inhibition (BIS) and fight/flight (FF) systems

Front 205

model holds true for anxiety disorder. inherit biological disposition to develop anx. diso. activated by life events, can trigger biological vulnerability

Back 205

diathesis-stress

Front 206

other causes of anxiety disorders:

associated with anxiety, specifically decreased levels of this associated with higher anxiety

Back 206

GABA

Front 207

other causes:

when triggered, will look like fight/flight responses

Back 207

limbic and septa-hippocampal

Front 208

psychological contributions to anxiety and freud

began with freud

anxiety is
(2)

Back 208

anxiety is a psychic reaction to fear

anxiety involves reactivation of an infantile fear situation

Front 209

psyc. contrib. to anx.

anxiety and fear result from direct classical/operant conditioning and modeling

Back 209

behavioral view

Front 210

early experiences with uncontrollability and unpredictability

Back 210

psychological views

Front 211

stressful life events as triggers of biol/psyc vulnerabilities

many stressor are familial and interpersonal

Back 211

social contributions

Front 212

freud's theory - assumed anxiety was an internal reaction to fear which involves a reactivating of the infantile fear response

Back 212

anxiety-reduction theory

Front 213

assumed that anxiety and fear are a function of direct classical conditioning/operate

Back 213

behavior view of anxiety

ex. if someone experiences anxiety in large crowd, when one starts to experience symptoms, one would become fearful/worry for others to notice attack. to relieve, they leave. in that leaving is rewarding, b/c person is gaining calm as they leave. anxiety goes away

Front 214

an integrated model

integrative view

Back 214

biological vulnerability interacts with psychological, experimental and social variables to produce an anxiety disorder

consistent with diathesis-stress model

Front 215

common processes: the problem of comorbidity

Back 215

common across the anxiety disorders

major depression is most common secondary diagnoses

about half have 2+ secondary diagnoses

Front 216

having more than 1 disorder is common among anxiety disorders - if one has one, 70-80% of meeting criteria of having an additional disorder.

having only one is less common than having more than 1

Back 216

comordity

Front 217

anx. disorder:

overlap

rare

Back 217

overlapping with depression - criticism of DSM - overlapping disorders

extremely rare for a person to fit into one and only one diagnostic criteria

Front 218

anxiety disorders: overview

(6)

Back 218

generalized anxiety disorder

panic disorder w / w/o agoraphobia

specific phobias

social phobia

posttraumatic stress disorder

obsessive-compulsive disorder

Front 219

generalized anxiety disorder: GAD

excessive uncontrollable anxious apprehension and worry about life events

coupled with strong, persistent anxiety

somatic symptoms differ from panic (muscle tension, fatigue, irritability)

and

persist for ______

Back 219

6 or more months

Front 220

GAD statistics

_% of gen. pop. meet criteria for GAD

females outnumber males approx. ___ ratio

onset is often ____ beginning in early adulthood

tendency to be anxious runs in _____

Back 220

4%

2:1

insidious

families

Front 221

marked by excessive worry about life events. excessive would be --- most of the time, MORE DAYS THAN NOT

excessive, anxious apprehension about life events. uncontrollable - person perceives uncontrollable/very difficult to control.

coupled with somatic symptoms

symptoms present for 6 months +

uncontrollable, difficult to control

excessive anxiety and worry occurring more days than not

restlessness

NOT this if not occuring more days than not

Back 221

GAD

Front 222

worry warts can be normal, but people with GAD find it

Back 222

difficult to control

Front 223

typically onset of GAD

Back 223

onset ---> insidious = gradual

Front 224

generalized anxiety disorder - associated features and treatment

persons with GAD have been called

Back 224

autonomic restrictors

fail to process emotional component of thoughts and images

Front 225

treatment of GAD

benzodiazapines: often prescribed (xanax, valium)

SSRI's, SSNIR's: prozac, paxil, zoloft

psychological interventions -

Back 225

cognitive behavioral therapy

Front 226

GAD people

Back 226

tend to have very constricted emotions. also tend to be restricted, fail to worry things through, sleep would be better than studying and improve chances for test.

Front 227

treatment for GAD

Back 227

benzodiazapines

SSRI's row - in low run are more effective, will lead to decrease anxiety

Front 228

basic premise that thoughts and beliefs have an effect on one's emotions/feelings. one is addressing thoughts/cognitions on a person's moods as opposed to event causing anxiety. physical event may trigger thought that leads to emotions. psychologists would target cognitions/self-talk and would address the person's behavior and have coaching skills etc to help with anxiety

Back 228

cognitive behavioral therapy

Front 229

generalized anxiety disorder

an integrative model of generalized anxiety disorder

Back 229

LOOK AT LECTURE NOTES PAGE 31.

BEST REFERENCES.

Front 230

panic disorder with or without agoraphobia

overview and definiting features

Back 230

experience of unexpected panic attack (false alarm)

develop anxiety, worry, or fear about having another attack or its implications

agoraphobia - fear or avoidance of situations/events associated with panic

symptoms and concern about another attack persists for ONE MONTH OR MORE

Front 231

facts and statistics of p.disor. w/w/o agora.

_% of gen pop meet diagnostic criteria for panic disorder
___ w/panic disorder are female
onset is __, beginning btwn 25-29 years

Back 231

3.5%

2/3

acute = sudden

Front 232

panic diso. w/w/o agoraphoba

one always unexpected, b/c of that, person develops fear & worry of having another attack/IMPLICATION of another panic attack. during that process, person develops pathological WORRY of future panic attacks

Back 232

fear of fear. worrying about having more fear. fear of having fear or response again.

recurrent unexpected panic attacks

persistent concern about having additional attacks/consequences relating to attack

significant change in behavior relating to attacks

Front 233

with agoraphobia,

(avoid situations where they are likely to have panic attacks)

Back 233

become social recluse

Front 234

onset acute, about 8-12% have experience symptoms of panic attack at some point, only 3-4% go on to have additional attacks

Back 234

and fill criteria for panic disorder

Front 235

panic disorder: associated features and treatment

associated features

Back 235

interoceptove/exteroceptive avoidance, catastrophic misinterpretation of symptoms

Front 236

medication treatment of panic disorder

Back 236

target serotonergic, noraadrenergic, and benzodiazepine GABA systems

SSRIs, SSNRI's (prozac) currently preferred

beta blockers

relapse rates are high following medication discontinuation

Front 237

research supports notion that genes increase likelihood of panic. having panic attacks is more related to genes where the development of agoraphobia is more related to social environmental/social learning factors

Back 237

people with panic disorder begin to misinterpret bodily symptoms, catastrophize what those symptoms mean

beta blockers - decreases physiology of panic attack

if all meds taken away, there will be relapses

Front 238

psycho. and combined treatments of panic disorder

cognitive behavior therapies are highly effective, exposure based, panic control treatment

combined treatments do well in the short term

Back 238

best long term outcome is with cognitive behavior therapy alone

lady exposed to outside environment a little bit at a time. gradual. better treatment and addressing cognition. not flooding in this situation.

Front 239

specific phobias

overview

Back 239

extreme irrational fear of a specific object or situation

markedly interferes with one's ability to function

persons will go to great lengths to avoid phobic object, while recognizing that the fear and avoidance are unreasonable

Front 240

facts and statistics of specific phobias

females are again overrepresented

about _% of gen pop meet diagnostic criteria for specific phobia

phobia runs a ___ course, with onset beginning between 15-20 years

Back 240

11%

chronic

Front 241

specific phobias: associated features and treatment

associated features and subtypes

Back 241

blood-injury-injection phobia - blood, injury, injection

situational phobia - public transportation, enclosed places (planes)

nature environment phobia - events occurring in nature (heights, storms)

animal phobia - animals and insects

other phobias - do not fit into the other categories -- chocking, vomiting, etc.

Front 242

specific phobia

fear of blood, injury, injection

Back 242

blood-injury-injection

Front 243

specific phobia

fear of public transporation, enclosed places, etc. involve fear in certain situations, settings, large crowds, elevators, etc.

Back 243

situational

Front 244

specific phobia

fear of events occuring in nature, storms, water, fire, oceans, wind, etc.

Back 244

nature environment

Front 245

specific phobia

fear of animals and insects, bigger animals more so than smaller one. adaptive in that some are dangerous

Back 245

animal

Front 246

specific phobia

do not fit into 4 previous catgories

blood-injury-injection
situational
nature environment
animal

Back 246

other phobias

Front 247

causes of phobias

Back 247

biological and evolutionary vulnerability, direct conditioning, observational learning, information transmission

Front 248

psychological treatments of specific phobias

Back 248

cognitive behavior therapies are highly effective

structured and consistent graduated exposure-based exercises

Front 249

specific phobias - associated features and treatment

model of various ways a specific phobia may develop

Back 249

PG 34 on LECTURE NOTES

Front 250

social phobia: overview

Back 250

extreme and irrational fear/shyness in social and performance situations

markedly interferes with one's ability to function

often avoid social situations or endure them with great distress

can occur across numerous social situations or relatively few

Front 251

facts and statistics of social phobia

_% of gen pop have criteria
prevalence slightly greater in ___
onset is usually during adolescence, with peak age at 15

Back 251

13%
females

Front 252

fear that he/she will act in a way that will be humiliating/embarassing

excessive/extreme/irrational and causes distress and impairment

exposure to situation almost always causes onset of anxiety/fear of being scrutinized/criticized by other for doing something embarassing

prevalence greater in females, rears head in adolescence. can develop into social phobia in given specific situations

fear of public speaking common

Back 252

social phobia

Front 253

social phobia: associated features and treatment

causes of social phobia

Back 253

biological and evolutionary vulnerability

direct conditioning, observational learning, information transmission

Front 254

psyc treatment of social phobia

Back 254

cognitive behavioral treatment - exposure, rehearsal, role-play in a group setting

highly effective

Front 255

medication treatment of social phobia

Back 255

tricyclic antidepressants and monoamine oxidase inhibitors reduce social anxiety

SSRI paxil is FDA approved for treatment of social anxiety disorder

relapse rates are high following medication discontinuation

Front 256

separation anxiety disorder

Back 256

occurs mostly in kids and is what it's called

difficulty in kids being separated form primary caregivers

difficulty separating

school avoidance, day care avoidance to point that isn't developmentally sound

will throw tantrums when they get to school

treatment is EXPOSURE based