Exam 1

abnormal psychology

deviance, distress, dysfunction, and danger

1. the person is a danger to themself or others/posing risk of harm
2. they may be careless, hostile, or confused
3. danger is exception rather than rule

1. behavior, thoughts, and emotions that differ markedly from a society's norms about proper psychology functioning
2. judgements about what constitutes abnormality vary by culture

1 . stated and unstated rules for proper conduct
2. grow from culture (history, tech, values, institutions)

1. behavioral, cognitive, emotional dysfunctions
2. unexpected in cultural context
3. personal distress
4. substantial impairment in function

usually have to cause distress before labeled as abnormal, but some people with abnormal function maintain positive state of mind

upsets, distracts, or confuses people that they cannot care for themselves properly, participate in ordinary social interactions or work productively

1. he was a clincal theorist who emphasized society's role in abnormal behavior
2. mental illness = invalid myth
3. "problems in living" not something wrong within person

if a behavior is familiar enough, society fails to recognize the 4 D's that it is abnormal

special systematic procedure designed to change abnormal behavior into more normal behavior/to help overcome psychological difficulties

1. sufferer who seeks relief from healer
2. trained and socially accepted hearler, whose expertise is accepted by the sufferer and the sufferer's social group
3. series of contacts between healer and sufferer, through which healer tries to product certain changes in emotional state, attitudes, and behaviors

1. clinician who view abnormality as illness
2. clinicial who view abnormality as problem in living

30 and 17

1. thought to be work of evil spirits
2. cure was to force demons from victim's body e.g. trephination, exorcism by shaman

believed deviance was a battle of good vs. evil, etiology was devil or witchcraft and treatment should be exorcism, torture, or crude surgeries

ancient treatment to hallucinations or melancholia to release evil spirits, stone trephine used to cut circular sections from skull

religious or spiritual figure like shaman says prayers, chants, insults demons, etc. makes body uncomfortable place for demon to live

brain pathology caused abnormal behavior, imbalance of four humors

black bile --> melancholia (depressive), yellow bile --> choleric (hot-tempered), blood --> sanguine (cheerful and optimistic, insomia and delirium due to blood in brain), phlegm --> phlegmatic (apathy and sluggishness)

more demonology, clergy controlled education so distrust of science, abnormal behavior = Satan's influence

large numbers of people had shared delusions and hallucinations like tarantism (bitten and possessed by wolf spider so jumping, dancing, convulsing), lycanthropy (possessed by wolves or other animals so acted wolflike and imagined fur growing)

absurd false beliefs

imagined sights or sounds

rise of asylums, converted hospitals and monasteries into asylums, but they became virtual prisons since patients lived in filthy conditions and were treated cruelly

institutions that care for people with mental illness, virtual prisons since patients lived in filthy conditions and were treated cruelly

German physician in Renaissance, thought the mind was susceptible to sickness, founder of psychopathology

a psychic healing institution in Belgium, cared for mental patients, first community mental health program

example of terrible asylum, bedlam now means uproar and confusion because the patients would scream and babble against the barred windows

asylum reform and moral treatment

first site of asylum reform led by Philippe Pinel, moral treatment emphasized moral guidance and humane and respectful techniques

there was an increased number of patients (immigrants and homeless), staffing problems, outcome = decreased treatment efficacy

19th century asylum reform that emphasized moral guidance and humane and respectful techniques

father of modern psychiatry, came up with humane treatments like reading and talking to patients and taking them on regular walks, give small gifts to their patients now and then

leader of mental hospital/asylum reform in the United States

moral treatment declined and long term hospitalization returned

20th century perspective that abnormal psychological functioning has physical causes led by Emil Kraeplin (classification of behavior) and Krafft-Ebing (syphilis), led to eugenics

German researcher, first to classify abnormal behaviors, foundation of DSM

found out syphilis caused general paresis = physical factors responsible for mental disorders

STD with psychosis-like symptoms, delusions and hallucinations, etiology --> bacterial microorganism

19th century American proponent of biological tradition who believes the etiology was always physical and treamtent should be like physical illness (rest, diet, and room temp.), he improved hospital conditions

1. insulin shock therapy
2. brain surgery
3. electroconvulsive shock therapy (Ben Franklin) as treatment for depression

20th century perspective that abnormal functioning had psychological causes, led to hypotism e.g. Mesmer who created mesmerism and cured people of hysterical disorders, also led to Freud

unconscious psychological processes are the cause

therapeutic process in which clinicians help people gain insight into unconscious psychological processes

biological, social, and psychological factors
1. psychotropic medications
2. deinstitutionalization as a result
3. prevention
4. positive psychology
5. multicultural psych
6. parity law vs. managed care program

those that affect the brain and reduce symptoms of mental dysfunction, developed in 1950s and became increasingly available and systematically developed

psychotropic medications, became increasingly available and systematically developed, e.g. neuroleptics (reserpine and psychosis), tranquilizers (benzodiazepines and anxiety)

1. increased hopsitalization due to "untreatable conditions" meaning conditions bio treatment didnt change
2. improved diagnosis and classification (Emil Kraeplin)
3. increased role of science in psychopathology

Plato and Aristotle, believed etiology was social and environmental factors and that treatment should be reeducation via discussion and therapeutic environments

1. treating patients normally
2. encouraging social interactions
3. focus on relationships
4. individual attention
5. education
Pinel, Mann, Benjamin Rush

correct extremely confused and distorted thinking

lift mood of depressed people

reduce tension and worry

interventions aimed at deterring mental disorders before they can develop

the study and enhancement of positive feelings, positive traits, and group-directed virtues

federal law requiring insurance companies to give same amount fo coverage for mental and physical problems

insurance decides which therapists its clients may choose, the cost of sessions, and the number of sessions for which a client may be reimbursed

scientific study of psychological disorders

1. presenting problem
2. statistics (prevalance and incidence)
3. course (episodic, time-limited, chronic)
4. onset (acute or insidious)
5. prognosis (good or guarded)
6. developmental considerations

population rates

number of new cases over some period of time

cause or development of psychopathology

pharmacological and/or psychosocial, movement in psychosocial towards EST

field that looks at genetic contributions to psychological conditions

Huntington's disease

both genetic and environmental factors, combining both yields activation under right conditions, diathesis is inherited tendency to express traits and behaviors (genetic vulnerability), stress is life events or contextual variables (environmental)

genes can also shape how we create our environments, inherited predispositions or traits that increase one's likelihood to engage in activites or seek out situations

shows that there is too much emphasis placed on genes

determine whether, how, and why a person is behaving abnormally and how they may be helped

1. clinical interviews
2. tests
3. observations

allows clinician to understand the individual, predict behavior, generate a treatment plan, and evaluate outcomes

use multiple methods, looks for triangulation

convergence of information so that a clinician or researcher can get accurate representation of symptoms and see if those symptoms are consistent with a diagnosis present in the DSM

standardized; validity and reliability

common steps to be followed when administered and way the results are interpreted, test on large "typical" group to create baseline score

consistency of measures, yield similar results in same situation; test-retest reliability and interrater reliability

similiar results on same people multiple times

different people agree independently on how to score and interpret it

accurately measure what it is supposed to measure; face, predictive, and concurrent

makes sense, seems reasonable

predict future characteristics or behavior

measures from one tool agree with another

face-to-face encounter between client and clinician (often the first) to collect info about person's current functioning and history, used to develop rapport; unstructured, semi-structured, and structured, "conversation with a purpose"

1. presenting issue
2. psychological/psychiatric history
3. medical history
4. developmental history and family dynamics
5. social history and current info
6. occupational/educational history
- interview varies depending upon setting and kinds of patients seen

open-ended question like tell me about yourself

may have interview schedule, specific prepped questions

evaluation given to look at psychiatric/neurological presentation, tests the following domains:
1. awareness
2. orientation with time and place
3. attention span
4. memory
5. judgment
6. insight
7. thought processes
8. mood and affect
9. appearance

1. they lack validity and accuracy
2. subjective responses
3. interviewer bias
4. lack reliability since different interview could inspire different responses from client

1. projective tests
2. personality inventories
3. response inventories
4. psychophysiological test
5. neuroimaging and neurophysical tests
6. intelligence tests

necessary evaluation to diagnose or rule out medical explanations (physical etiologies) for psychological conditions; toxicities, medication side effects, allergic reactions, metabolic conditions

clients interpret vague stimuli or follow open-ended instructions, project aspects of personality into task (psychodynamic)

Roschach test, Thematic Apperception Test, sentence completion test, drawing tests

inkblots

Thematic Apperception Test (pics of people in ambiguous situations, make up a story)

no validity or reliability?

questions about behavior, beliefs, feelings, does this statement apply to you?

Minnesota Multiphasic Personality Inventory, true/false/cannot say, questions about mood, sexual behavior, and social activities

Minnesota Multiphasic Personality Inventory, any clinical scale (10 total) with a score greater than 70 (range 0-120) is deviant, all 10 scales is profile, the original goal was to diagnose from one spike but the reality is profiles have multiple spikes

1. Hypochondriasis
2. Depression
3. Hysteria
4. Psychopathic Deviance
5. Masculinity-femininity
6. Paranoia
7. Psychasthenia
8. Schizophrenia
9. Hypomania
10. Social Introversion

more validity/accuracy than projectives but still low

provide detailed info about themsevles but focus on one area of functioning; affective inventory, Beck Depression inventory, social skill inventory, cognitive

reliable and valid but not standardized

severity of emotions like anxiety, depression, anger

rate level of sadness and effect on functioning

how they'd react in a variety of social situations

reveal person's typical thoughts and assumptions

measure physiological responses as possible indicators of psychological problems; polygraph test detects changes in breathing, sweating, and heart rate against control baseline

look for physical abnormality in the brain

measure brain structure and activity directly

electroencephalogram, records brain waves/electrical activity from neurons not high resolution

computerized axial tomography

positron emission tomography, computer-produced motion picture of chemical activity in brain

magnetic resonance imaging (structural)

function MRI, structure and function, sometimes unable to detect subtle brain abnormalities

diffuse tensor imaging - measures water perfusion, used to evaluate white matter fiber tracts in brain

measure cognitive, perceptual, and motor performances on tasks like visual perception, memory, visual-motor coordination
examine cognitive deficits, examine specific domains of thinking using non-invasive tests
scores less than 2 standard deviations = severe impairment
language, learning and memory, attention, executive/self-regulatory

Wisconsin Card Sorting Test, example of a neurosychological test, assesses abstract reasoning

neuropsychological test, assesses visual-motor coordination, redraw geometric designs from memory

a series of tests each targeting specific skill area

created by Alfred Binet and Theodore Simon, verbal and nonverbal skills, high reliability, high validity, low motivation/high anxiety affect performance, used to be for academic prediction, now for intellectual capability and cognitive performance
verbal comprehension, perceptual organization, working memory, processing speed

1. naturalistic
2. analog
3. self-monitoring

everyday environments like school or home, participant-observers like parents or teachers

artificial setting like lab or office, video cam, one way mirror

1. observer bias (judgments, expectations)
2. observer errors --> observer drift (fatigue), observer overload (can't see/'record it all)
3. client's reactivity, behavior affected by observer presence
4. lack cross-situational validity, behavior is situation-specific

collect info to make clinical picture, ready to make diagnosis, assessment is primary tool for obtaining diagnosis for a client

determination that person's psychological problems constitute a particular disorder, degree of fit between symptoms and diagnostic criteria

list of diagnostic categories with descriptions of symptoms and guidelines for diagnosing, when certain symptoms occur together regular that is a syndrom, if cluster of symptoms follow particular course, make up a particular mental disorder

diagnostic and statistical manual of mental disorders, by the American Psychiatric Assocation, 500 mental disorders, entry has criteria for diangosis, key clinical features, and features often related (prevalnce, incidence, etiology, and predisposing factors); text revision

name of disorder, using number of symptoms endorsed

rating of how severe a client's symptoms are, how dysfunctional the client is across various dimensions of personality and behavior, using specifiers to code for severities and other unique characteristics

such that disorders classified together are thought to be related

biological, psychodynamic, cognitiv-behavioral, humanistic, and sociocultural

physical processes are key to human behavior, malfunctioning brain, abnormal activity by neurotransmitters and flawed interconnectivity in brain circuits, genes and inheritance

drugs, brain stimulation (ECT, TMS, VNS), psychosurgery

people's unconscious internal processes and conflicts, explores past, childhood, early relationships, trauma, deterministic assumption = no behavior is accidental
excessive conflict between ego, id, and superego
id = impulse and instinct, ego = seeks gratification but reason, superego = personality, conscience

subtly guide therapy discussions so patients discover underlying problems themselves
free association, therapist interpretation, catharsis, working through

role of self, strengthen wholeness of self

people motivated by a need to have relationships with others

describe what comes to mind, uncover unconscious events

when clients show resistance, transference, dreams (manifest and latent content)

reliving of past repressed feelings

examine same issues over and over in many sessions, clarity

emphasize behavior, ways it is learned, and thinking that underlies behavior, cognitive processes --> ways of thinking, classical conditioning, operant conditioning (reinforcement, punishment), modeling --> learn behaviors by observing others

replace problematic behaviors, assumptions, attitudes, and illogical thinking processes, maladaptive thinking

acceptance and commitment therapy, acceptable problematic thoughts rather than judge or try to change, thoughts are just thoughts

focus on a single problem

therapist discloses info about their life

stressed role of values and choices

human beings have an innate tendency to be good, need to recongize and accept weaknesses, establish personal values, self-actualize

believe in total freedom, even to be negative

Carl Rogers, humanist, warm supportive approach, client given unconditional positive regard, accurate empathy, genuineness

Perls, stay in here and now, embrace emotions, role playing

accept responsibility for their lives and problems

social and cultural forces key to human functioning

family and social interactions are responsible, social labels and roles create self-fulfilling prophecy, focus on family structure and communication, family is a system of interacting parts with unwritten rules unique to family, structure and communication patterns force individuals to behave abnormally to maintain family dynamic

members are grossly involved in each other's activites

members have very rigid boundaries between them

therapist and group of clinets with similar problems, develop insights together

all members of family, point out problem behaviors and interactions, help whole family change its ways

long-term relationships, focus on structure and communication patterns

treatment in familiar social surroundings

clinicians actively reach out to at-risk individuals before they seek treatment

improve community attitudes and policies

identify and treat psych problems in early stages

provide treatment to specific person so disorder doesn't become long-term problem

cultural context helps understand individual abnormality, intersectionality, prejudice, discrimination

different developmental paths lead to same disorder

similar development variables may have different clinical outcomes

offsets impact of negative variables

focus on timing of treatment not specific techniques

immediate state of alarm

vague sense of being in danger

1. 6 months or more, disproportionate, uncontrollable, ongoing anxiety and worry about multiple matters
2. at least 3 symptoms: edginess, fatigue, poor concentration, irritability, muscle tension, sleep problems
3. significant distress or impairment

even is the factors play a role doesn't explain why not everyone develops disorder in dnagerous societal conditions

childhood is to blame, anxiety provoking id impulses or weak ego defense mechanisms (punished or sheltered as a child), treatment only helpful if shortterm

failed to receive unconditional positie regard, harsh self standard, self critical, need to recongize true emotions, thoughts, and needs

maladaptive assumptions --> Ellis

Adrian Wells, positive and negative belifs about worrying