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124 Cards in this Set
- Front
- Back
Categories of Disorders
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- Anxiety Disorders
- Mood Disorders - Dissociative Disorders - Schizophrenia - Personality Disorders |
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Disorders: Important Points
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- The humanist perspective
--> Empathy vs. Sympathy --> We don't ask to get them... and they won't get better without treatment - Statistically speaking, 50% of population develops a psych disorder in their lifetime - Aren't we all a little weird? --> Yep, everyone really is. |
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Common Myths About Abnormality
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- Bizarre
- Different in kind - Shameful, self-induced - Lazy, crazy, dumb - Weak in character - Dangerous to self or others - Mental illness is a hopeless situation |
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Abnormality: The Four Ds
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- Deviant
- Distressful - Dysfunctional - Dangerous |
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Deviant
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1. Statistical
- Normal Distribution: top and bottom 2.5% are "deviant" 2. Social Norms (from, created by) - Social Causes |
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Social Causes of Deviance
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*** Labeling bias
- Thomas Szasz --> Contends mental illness is a myth --> Key to mental disorders is the label --> Without the label, no disorder - Langer & Abelson (1974) --> Psychotherapists rating maladjustment * Behavioral and psychodynamic orientations * Patient vs. Job Applicant > Psychoanalytic psychologists diagnosed those seen as a patient as less adjusted - Rosenhan's Study --> Volunteers complained of hearing voices and asked to be admitted --> Schizophrenia Label * Kept in mental hospital for 19 days * Interpretations at the Clinic: every behavior was seen as symptomatic of schizophrenia --> After the clinic, schizophrenia interpreted as in remission |
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Deviant Continued
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3. Culture (vast majority of world consumes insects)
4. Historical |
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Other Labels for Deviant
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- Nursing home patient
- ADD/ADHD - Learning disabilities - Patient --> Consumer --> Client (Name changed over time) |
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Distressful
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- Personal discomfort
- Unpredictable and loss of control - Difficulty performing appropriate and expected roles - Impairment is set in the context of the person's background - However, there are times when abnormal behavior is not distressful --> Manic phase of bipolar --> Antisocial personality disorder --> Hoarding (sometimes) |
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Dysfunctional
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- Maladaptive behavior
- Breakdown in cognitive, emotional, or behavioral functioning |
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Danger
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- Self or other's life at risk, intentionally or accidentally
- Careless or forgetful behavior - More exception than rule when compared to three other Ds |
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Mental Health Professionals
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- Ph.D's: clinical, counseling, and school psychologists
- Psy.D's: " --> "Doctors of Psychology" - M.D.'s: psychiatrists (medication) --> Child or Adult Board-certified - M.S.W.'s: psychiatric and non-psychiatric social workers - MN/MSN's: psychiatric nurses - LPC: licensed mental health/professional counselor |
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Medical Model Perspective on Causes of Mental Disorders
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- Mental disorders are caused by specific abnormalities of the brain and nervous system
- Genetic influences, biochemistry --> Depression and schizophrenia - "A mental ILLNESS (a psychopathology) needs to be DIAGNOSED on the basis of its SYMPTOMS and cured through THERAPY, which may include TREATMENT in a psychiatric HOSPITAL." - Myers |
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Medical Model
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- Etiology: causation and development of the disorder
- Diagnosis: identifying (symptoms) and distinguishing one disease from another - Treatment: treating a disorder --> Drugs --> Psychiatric, Hospital - Prognosis: Forecast about the disorder |
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Psychodynamic Perspective
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- Mental disorders originate in an intrapsychic conflict produced by the id, ego, and superego
--> Ego defense mechanisms break down * Distort reality |
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Cognitive Behavioral Perspective
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- Mental disorders are learned maladaptive behaviors and thought patterns that can best be understood by focusing on environmental factors
--> Reinforcements from the environment --> Maladaptive behavior |
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Humanistic Perspective
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- Mental disorders arise when people perceive that they must earn the positive regard of others
--> Conditions of worth --> Depression |
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Sociocultural Perspective
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- Culture plays a significant role in the development of mental disorders. Moreover, some mental disorders appear to exist only in certain cultures
--> Culture-Bound Syndromes (Brain Fag in West Africa, Koro in Southeast Asia) |
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Biopsychosocial Model
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- Biological Roots
--> Genetic factors, injury, diseases processes * Results in brain abnormalities, which can result in abnormal behavior - Psychological Roots --> Individual's life history and experiences contribute to: * Ability to cope * Degree of vulnerability to stress - Social and Cultural Contexts --> People are greatly influenced by: * How other people act toward them * Expectations of others |
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Anxiety Disorders
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- Psychological disorders that feature motor tension, hyperactivity, and apprehensive expectations and thoughts
- Fear vs. Anxiety - Fear/Stress is Necessary --> Fight or flight (sympathetic nervous system arousal) - Arousal is Necessary (Yerkes-Dodson Law) --> Typically, performance is highest with medium level of arousal --> Performance lowest at both extremes of arousal --> Depending on nature of task, curve changes |
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OCD
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- Obsessions: recurring thoughts
--> Unwanted, intrusive - Compulsions: recurring behaviors --> Senseless rituals; no pleasure derived * If resisted, anxiety increases * If yielded, anxiety lessens = reinforcing --> 3 Cs: checking, cleaning, counting - Diagnosis: cause distress --> Interfere with functioning --> 1+ hour/day spent on obsessions and compulsions --> Personal recognition of distress |
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OCD Prevalence
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- 2-3% of adult population
--> ~20-22 years dx * 20-25% have depression/anxiety associated with onset * 50-60% had stress with onset * Often is cyclical or subsides --> 1:200 children - ~90% have both obsessions and compulsions --> ~10-20%: pure obsessional OCD - Runs in families: family member 9x more likely to have OCD |
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Components & Variations of OCD
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- Trichotillomania (pull out hair)
- Pathologic Gambling - Excessive Grooming - Monosymptomatic Hypochondriases - Body Dysmorphobia - Bowel & Urinary Obsessions - Obsessive Fears of Disease - Compulsive Face Picking - Compulsive Water Drinking and Eating Disorders - Hoarding(?) |
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OCD Continued
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- Subclinical: symptoms without impairment or distress
- Obsessive-Compulsive Personality Disorder --> 6% w/ OCD have this --> Rigid and stubborn --> Preoccupied with details, rules, lists * Organized to the extent where the point of the task is lost --> Inflexible about matters of morality and values - Tics |
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Poststreptococcal Autoimmunity
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- Childhood OCD and tics
- Autoimmune antibodies after strep infection --> Anti-CNS --> Damage in Basal Ganglia --> Must have genetic predisposition - Onset: About 3 years - Puberty |
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Hoarding
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3 Subtypes
- Common: Has some sort of goal - Diogenes: "Senile Squalor Syndrome" --> Self-neglect --> Living in squalor and trash --> Less or no value in material possessions - Animal Hoarding --> No food or treatment --> More likely to be women (75%) --> Half are over age 60 |
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Bipolar Disorder
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- Diagnosis between 18-24
- 6th leading cause of disability worldwide (1990 WHO statistic) - Bipolar depression is the leading cause of impairment and death among patients with bipolar disorders --> Suicide - Mania, Hypomania, Psychosis, Depression - Prevalence: 1% - Associated Problems: --> Cognitive functioning --> Substance abuse --> Anxiety disorder is co-morbid --> Relationships |
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Characteristics of Mania
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- Feelings of being able to do anything
- Little sleep is needed - Feeling filled with energy - Not caring about financial situations - Delusions - Substance Abuse |
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Characteristics of Hypomania
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- Feeling of creativity
- Don't seriously worry about problems - Feeling as if nothing can bring you down - Have confidence in yourself - Similar to mania but not as intense |
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Characteristics of Depression
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- Excessive sleep
- Fatigue - Crying uncontrollably - Withdrawing from activities you once enjoyed - Staying in bed for days - Weight loss/gain |
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Biological Approach
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Attributes psychological disorders to organic, internal causes
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Structural Views
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Abnormalities in the brain’s structure cause psychological disorders
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Biochemical Views
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Imbalances in neurotransmitters or hormones cause psychological disorders
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Genetic Views
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Disordered genes causes psychological disorders
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Behavioral and Social Cognitive Perspectives
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Focuses on rewards and punishments in the environment that determine abnormal behavior
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Trait Perspectives
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The five-factor model that summarizes the broad dimensions of personality characteristics (neuroticism, extraversion, openness to experience, agreeableness, and conscientiousness)
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DSM-IV
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Abbreviation for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition; the current version of the APA’s major classification of psychological disorders
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Multiaxial System
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Classifies individuals on the basis of five dimensions, or axes, that take into account the individual’s history and highest level of functioning in the previous year
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Attention Deficit Hyperactivity Disorder (ADHD)
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Psychological disorder in which the individual shows one or more of the following characteristics over a period of time: inattention, hyperactivity, and impulsivity
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Generalized Anxiety Disorder
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An anxiety disorder that consists of persistent anxiety for at least 6 months; the individual with this disorder cannot specify the reasons for the anxiety
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Panic Disorder
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An anxiety disorder marked by recurrent sudden onsets of intense apprehension or terror
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Agoraphobia
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A cluster of fears centered on public places and on an ability to escape or to find help should one become incapacitated
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Phobic Disorder
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Commonly called a phobia, an anxiety disorder in which the individual has an irrational, overwhelming, persistent fear of a particular object or situation
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Post-Traumatic Stress Disorder (PTSD)
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An anxiety disorder that develops through exposure to a traumatic event, severely oppressive situations, severe abuse, and natural and unnatural disasters
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Mood Disorders
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Psychological disorders in which there is a primary disturbance in mood (prolonged emotion that colors the individual’s entire emotional state). Two main types are the depressive disorders and bipolar disorder
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Depressive Disorders
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Mood disorders in which the individual suffers from depression (an unrelenting lack of pleasure in life)
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Major Depressive Disorder (MDD)
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A mood disorder indicated by a major depressive episode and depressed characteristics, such as lethargy and hopelessness, lasting at least two weeks
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Dysthymic Disorder
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A depressive disorder that is generally more chronic and has fewer symptoms than major depressive disorder
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Dissociative Disorders
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Psychological disorders that involve a sudden loss of memory or change in identity
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Dissociative Amnesia
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A dissociative disorder involving extreme memory loss caused by extreme psychological stress
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Dissociative Fugue
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A dissociative disorder in which the individual not only develops amnesia but also unexpectedly travels away from home and assumes a new identity
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Dissociative Identity Disorder (DID)
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Formerly called multiple personality disorder, this is the most dramatic but least common dissociative disorder; individuals suffering from this disorder have two or more distinct personalities or selves
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Hallucinations
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Sensory experiences in the absence of real stimuli
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Delusions
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False, sometimes even preposterous, beliefs that are not part of the person’s culture
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Referential Thinking
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Ascribing personal meaning to completely random events
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Catatonia
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A state of immobility and unresponsiveness
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Flat Affect
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A negative symptom in which the person shows little or no emotion, speaks with no emotional inflection, and maintains an immobile facial expression; example of a negative symptom
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Disorganized Schizophrenia
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A type of schizophrenia in which an individual has delusions and hallucinations that have little or no recognizable meaning
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Catatonic Schizophrenia
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A type of schizophrenia characterized by bizarre motor behavior that sometimes takes the form of a completely immobile stupor
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Paranoid Schizophrenia
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A type of schizophrenia that is characterized by delusions of reference, grandeur, and persecution
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Undifferentiated Schizophrenia
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A type of schizophrenia that is characterized by disorganized behavior, hallucinations, delusions, and incoherence
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Diathesis-Stress Model
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A model of schizophrenia that proposes a combination of biogenetic disposition and stress as the cause of the disorder
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Personality Disorders
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Chronic, maladaptive cognitive-behavioral patterns that are thoroughly integrated into the individual’s personality
→ Odd/Eccentric includes paranoid, schizoid, and schizotypal disorders → Dramatic/Emotionally Problematic includes histrionic, narcissistic, borderline and antisocial personality disorders → Chronic-Fearfulness/Avoidant includes avoidant, dependent, passive-aggressive, and obsessive-compulsive personality disorders |
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History of Therapy: Middle Ages
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- Religious perspective on disorders
- Works of and with the Devil - Torture, hanging, burning, sent to sea (Ship of Fools) |
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18th Century
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- Secular perspective on disorders--> get rid of idea of "possession"
- Unworthy, degenerates - Removed from society into institutions - Guislain in Ghent, Belgium |
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19th Century & Attempts at Reform
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Dorothea Dix (1802-1887)
- Reform of U.S. system - Moral Treatment Movement - Kindly care - Led to large, state-supported public asylums (i.e. Danvers State Insane Asylum) --> Overcrowding, loss of public attention |
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20th Century
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- Deinstitutionalization (1950s-present)
--> Effective anti-psychotic drugs - Increased respect for and knowledge of psychology - Mix of psychotropic medications and psychotherapy |
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Who is in Therapy?
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- Most who have a psychological disorder DO NOT seek therapy
- <50% seek formal treatment - <25% seek treatment from a mental health professional - ~30% who visit a mental health professional have not been diagnosed with a disorder --> Maladjustment - Those in treatment: women, college educated, white, higher income --> YAVIS (Young, Attractive, Verbal, Intelligent, Successful) |
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Relation of "Schools" of Psychology
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- Biological (medication)
- Psychoanalytic (psychodynamic) - Humanistic (client-centered) - Behavior Therapy (learning) - Cognitive (*most significant today*) --> What is "done" in therapy will match the therapist's beliefs about what caused the problem and how to overcome it |
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Humanistic Therapy: Client-Centered Therapy
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- Carl Rogers
- A genuine, accepting, empathic environment to facilitate clients' growth - Focus on self-determination and incongruence - Unconditional positive regard --> Client is worthy, no matter what they say or do --> Safe, non-judgmental atmosphere |
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Humanistic Therapy: Insight
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- Help client understand their motives
- Changing beliefs about human potential, self-worth, and value |
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Humanistic Therapy: Active Listening
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- Empathic listening in which the listener echoes, restates, and clarifies
- Body Language: sit forward, eye contact, nod head - Open-Ended Questions: "What happened after that?" "Tell me more." "How did that work?" - Repeat Content: "So what I hear you saying is..." --> Put their message in your own words - Acknowledge feelings: "You're feeling _____" - Don't Judge - Be Quiet - Authenticity: Involves letting the client know the therapist’s feelings and not hiding behind a façade |
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Does Therapy Work for Everyone?
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- Severity of Disorder
- Intelligence - Belief in psychotherapy process (openness) - Many times, therapy is not a cure, but helps a person live with a problem --> Establish coping strategies |
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Clinical Assessment
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- Developed by Aaron T. Beck & Albert Ellis
- People disturb themselves with their own thoughts - Assumptions: Event --> Thought --> Emotional Reaction * You control your thoughts * Therefore, you control your feelings - Goal: restructure thinking --> Identify maladaptive ways of thinking --> Replace these with adaptive ways |
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Clinical Assessment: Methods
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- Therapist Challenges
- Self-Talk: internal dialogue, unrealistic things a person tells themself - Self-Defeating Beliefs --> Negative Thinking --> Catastrophizing!!! - Changing thought patterns will, in turn, alter problem behaviors and emotions |
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Clinical Assessment: Comparison w/ Humanistic
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Similarity: Focus on conscious mental experience
Differences: - Problem-centered rather than client-centered - Relationship is more directive |
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Beck's Cognitive Therapy
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- Treatment of Depression
- Cognitive Triad - Depressed People: --> Distort experiences and maintain negative views of themselves, the world, and their future --> Minimize positive and maximize negative experiences --> Misattribute negative experiences to own deficiencies |
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Unhealthy Self-Attributions
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- Dispositional (internal) attributions about self
--> Suppress the immune system - Negative attributions about self are associated with depression when they occur after an objective, negative event --> Stable --> Internal --> Global - Successes are attributed to external, unstable, and specific causes |
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Learned Helplessness Theory of Depression
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- Related to lack of perceived control over life events
- Learned helplessness and a depressive attributional style --> Internal Attributions: negative outcomes are one's own fault --> Stable Attributions: believing future negative outcomes will be one's own fault --> Global Attribution: believing negative events will disrupt many life activities *** All 3 domains contribute to a sense of HOPELESSNESS |
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Dysfunctional Thoughts
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4 Characteristics:
1. Automatic 2. Negative 3. Self-Focused 4. Incorrect Related Factors: - Stress triggers - Lack of sleep --> Bi-directional - Impulsive personality |
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Cognitive Therapy for Depression
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Learn:
1. To recognize automatic thoughts (ATs) 2. To dispute the ATs by marshaling contrary evidence 3. To make different attributions (reattributions) and use them to dispute your ATs 4. How to distract yourself from depressing thoughts 5. To recognize and question assumptions that govern much of what you do |
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Beck's Cognitive Therapy
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- Identify and change maladaptive thoughts
- First Sessions: therapist explains cognitive theory of emotional disorders - Middle Sessions: Client taught to identify, evaluate, and replace negative with positive --> Therapist is a collaborator - Final Sessions: prevention of recurrence |
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Biological Therapies
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Treatments to reduce or eliminate the symptoms of psychological disorders by altering the way an individual’s body functions
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Psychotherapy
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The nonmedical process used by mental health professionals to help individuals recognize and overcome their problems
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Antianxiety Drugs
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Commonly known as tranquilizers; drugs that reduce anxiety by making individuals calmer and less excitable
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Antidepressant Drugs
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Drugs that regulate mood
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Lithium
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A drug that is widely used to treat bipolar disorder
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Antipsychotic Drugs
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Powerful drugs that diminish agitated behavior, reduce tension, decrease hallucinations, improve social behavior, and produce better sleep patterns in people who have a severe psychological disorder, especially schizophrenia
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Neuroleptics
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Most widely used class of antipsychotic drugs
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Tardive Dyskinesia
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A potential side effect of neuroleptic drugs; a neurological disorder characterized by grotesque, involuntary movements of the facial muscles and mouth, as well as extensive twitching of the neck, arms, and legs
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Atypical Antipsychotic Medications
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Newer drugs that carry a much lower risk of tardive dyskinesia
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Electroconvulsive Therapy (ECT)
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Commonly called shock therapy; a treatment used for severely depressed individuals that causes a seizure to occur in the brain
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Psychosurgery
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A biological therapy that involves removal or destruction of brain tissue to improve an individual’s adjustment
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Prefrontal Lobotomy
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Procedure developed by Antonio Egas Moniz with the intention of alleviating symptoms of severe mental disorders
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Psychodynamic Therapies
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Therapies that stress the importance of the unconscious mind, extensive interpretation by the therapist, and the role of experiences in the early childhood years. The goal of the psychodynamic therapies is to help individuals recognize their maladaptive ways of coping and the sources of their unconscious conflicts
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Psychoanalysis
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Freud’s therapeutic technique for analyzing an individual’s unconscious thoughts. Freud believed that clients’ current problems could be traced to childhood experiences, many of which involved conflicts about sexuality
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Free Association
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The psychoanalytic technique of having individuals say aloud whatever comes to mind
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Dream Analysis
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The psychotherapeutic technique used to interpret a person’s dream. Psychoanalysts believe that dreams contain information about the individual’s unconscious thoughts and conflicts
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Transference
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The psychoanalytic term for the client’s relating to the analyst in ways that reproduce or relive important relationships in the client’s life
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Resistance
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The psychoanalytic term for the client’s unconscious defense strategies that prevent the analyst from understanding the person’s problems
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Gestalt Therapy
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Perls’s humanistic therapy, in which the therapist challenges clients in order to help them become more aware of their feelings and face their problems
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Behavior Therapies
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Therapies that use principles of learning to reduce or eliminate maladaptive behavior
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Systematic Desensitization
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A method of behavior therapy based on classical conditioning that treats anxiety by getting the person to associate deep relaxation with increasingly intense anxiety-producing situations
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Aversive Conditioning
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A classical conditioning treatment that consists of repeated pairings of the undesirable behavior with aversive stimuli to decrease the behavior’s rewards
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Behavior Modification
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The application of operant conditioning principles to change human behaviors; especially to replace unacceptable, maladaptive behaviors with acceptable, adaptive behaviors
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Token Economy
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Behavior modification system in which behaviors are reinforced with tokens that can later be exchanged for desired rewards
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Cognitive Therapies
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Therapies emphasizing that individuals’ cognitions, or thoughts, are the main source of abnormal behavior and psychological problems
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Cognitive Restructuring
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A general concept for changing a pattern of thought that is presumed to be causing maladaptive behavior or emotion; central to cognitive therapies
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Rational-Emotive Behavior Therapy (REBT)
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A therapy based on Ellis’s assertion that individuals develop a psychological disorder because of their beliefs, especially those that are irrational and self-defeating; the goal of REBT is to get clients to eliminate self-defeating beliefs by rationally examining them
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Cognitive-Behavior Therapy
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Therapy consisting of a combination of cognitive therapy and behavior therapy; self-efficacy is an important goal of cognitive-behavior therapy
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Self-Instructional Methods
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Cognitive-behavior techniques aimed at teaching individuals to modify their own behavior
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Group Therapy
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Attractive features include:
1. Information: Individuals receive information about their problems from either the group leader or other group members 2. Universality: Many individuals develop the sense that no one else has frightening and unacceptable influences 3. Altruism: Group members support one another with advice and sympathy and learn that they have something to offer others 4. Corrective Recapitulation of the Family Group: A therapy group often resembles a family, with the leaders representing parents and the other members’ siblings 5. Development of Social Skills: Corrective feedback from peers may correct flaws in the individual’s interpersonal skills 6. Interpersonal Learning: The group can serve as a training ground for practicing new behaviors and relationships |
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Family Therapy Techniques
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1. Validation: The therapist expresses an understanding and acceptance of each family member’s feelings and beliefs and thus validates the person
2. Reframing: The therapist helps families reframe problems as family problems, not an individual’s problems 3. Structural Change: The family therapist tries to restructure the coalitions in a family 4. Detriangulation: In some families, one member is the scapegoat for two other members who are in conflict but pretend not to be |
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Deinstitutionalization
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After passage of Community Mental Health Act of 1963, large numbers of individuals with psychological disorders were transferred from mental institutions to community-based facilities
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Primary Prevention
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Aims to reduce the number of new cases of psychological disorders, sometimes through targeting high-risk populations
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Secondary Prevention
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Screening for early detection of problems and early intervention may take place
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Tertiary Prevention
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Focuses on treating psychological disorders that were not prevented or arrested early in the course of the disorders
→ Halfway Houses: Community residences for individuals who no longer require institutionalization but who still need support in readjusting to the community |
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Empowerment
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Assisting individuals to develop the skills they need to control their own lives
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Collectivist Cultures
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Place more emphasis on the group
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Therapeutic Alliance
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The relationship between the therapist and the client
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Integrative Therapy
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A combination of techniques from different therapies based on the therapist’s judgment of which particular techniques will provide the greatest benefit for the client
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Managed Care
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Consists of strategies for controlling healthcare costs, including mental health treatment, and demand for accountability of treatment success
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Well-Being Therapy (WBT)
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A short-term, problem-focused, directive therapy that encourages clients to accentuate the positive
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Post-Traumatic Growth
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Improvements individuals can see in themselves as a result of a struggle with negative life events
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