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psychological disorder

a pattern of atypical behavior that results in personal distress or a significant impairment in a person's social or occupational functioning; 1. distress 2. disability 3. danger

Hern's Disease

after hearing symptoms, tendency of diagnosing or recognizing characteristics in ourselves or others around us, the impact of behavior is most important

Medical Model of mental illnesses

treat psych disorders like physical diseases: have biological bases and can be classified into discrete categories

symptom

sign of a disorder

diagnosis

distinguishing one disorder from another

etiology

initial cause that led to the development of this disorder

prognosis

prediction about the likely course of this disorder

atypical behavior

significantly above or below the average in frequency

violation of cultural norms

what's typical depends on reference population

maladaptive behavior

disruptive or harmful for the person in society

personal distress

experiencing troubling emotions about behavior

psychosis

a break from reality

psychodynamic theoretical perspective

behavior is controlled by unconscious forces

behavioral theoretical perspective

focuses on observable behavior, patterns of reinforcement

cognitive theoretical perspective

understands behavior by studying thoughts, information, processing, and interruption of experiences

sociocultural theoretical perspective

emphasizes social and cultural influences on behavior

biological theoretical perspective

examines physiological processes, esp. brain functioning

The Diathesis-Stress Model

proposes that the interaction of both the predisposition for a disorder and environmental stressors are what causes the psychological disorder

diathesis

the predisposition for a psychological disorder

DSM-IV-TR

diagnostic and statistical manuel of mental disorders; descriptive rather than explanatory, atheoretical, provides directions to clinicians

Axis Categorization of Disorders

Axis I- clinical disorders that are temporary and treatable, Axis II- personality disorders and mental retardations, Axis III- general medical conditions, Axis IV- psychosocial and environmental problems, Axis V- global assessment of functioning

General Categorization of Disorders

anxiety, mood, dissociative, schizophrenia, somatoform, and personality

culture bound syndromes

syndromes limited to specific societies, localized, diagnostic categories

falling out syndrome

southern US and Caribbean cultural disorder- dizziness, spinning, collapsing

ghost sickness

Navajo cultural disorder- weakness, bad drams, feelings of danger, feelings of futility, loss of appetite, dizziness, hallucinations, and loss of consciousness

Latah syndrome

Malasia cultural disorder- exaggerated startle response after trauma

Evil Eye

Mediterranean cultural disorder- causes injury or bad luck

benefits of diagnostic labels

summarizes symptoms and problems, conveys info about causes of disorder and prognosis

risks of diagnostic labels

dehumanizing, discrimination, and limitations due to negative stereotypes, expect people with label to act abnormally and misperceive disorders

mood disorders

disroder characterized by emotional extremes that cause significant disruption daily functioning

Major Depressive Disorder

most common mood disorder, experience dysphoria and andhedonia, changes in eating and sleeping habits, restlessness or lethargy, fatigue, worthlessness and guilt, difficulty concentrating, suicidal ideation=> at least 5 symptoms for at least 2 weeks; age 30-44 high risk, women more so

dysphoria

extreme and persistent negative moods

anhedonia

inability to experience pleasure by participating in activities on previously enjoyed

Disthymia

disorder: similar symptoms as depression, but less intense, only 3 symptoms to be diagnosed, longer lasting

suicide

higher rates among men, elderly adult, unemployed and retired adults, widowed adults, and Native or European Americans

Bipolar Disorder

disorder: high levels of manic symptoms followed by high levels of depressive symptoms; persists for weeks and interferes with daily functioning; occurs earlier in life and equally for men and women

Mania

excessively elated, active emotional state

Biological Etiology of Bipolar Disorder

etiology: family risk very high, amygdala may be enlarged (has to do with emotion), imbalance in neurotransmitter systems specifically with serotonin and norepinephrine

Biological Etiology of Major Depressive Disorder

etiology: heredity moderate, low activity in frontal lobe where there are connections with emotional centers, serotonin, norepinephrine, dopamine imbalances, smaller hippocampus and higher activity in amygdala showing rumination and worry

Cognitive Etiology of Mood Disorders

etiology: negative view of self, the world, and the future, misinterpret daily experiences to support negative outlook

Behavioral Etiology of Mood Disorders

etiology: low social reinforcements, skill deficits and decreased opportunities to interact with others

Seasonal Affective Disorder

symptoms of depression at particular times of year, unusually high metabolic rates, physiological differences from other depression patients i.e. light therapy is quite effective at restoring serotonin levels

Anxiety Disorders

disorders characterized by distressing, persistent, anxiety or maladaptive behavior, high lifetime prevalence

5 Major Anxiety Disorders

panic disorder (episodes of intense fear sudden and unexpected), phobic disorder (strong irrational and specific fears), generalized anxiety disorder (constant state of moderate anxiety), OCD, PTSD

agoraphobia

fear of going out in public, results from panic attacks

compulsion

checking, washing, ordering, etc

Biological Etiology of Anxiety Disorders

etiology: genetics may predispose, biological and chemical bases

Behavioral Etiology of Anxiety Disorders

etiology: classical conditioning, operant conditioning, phobias identify with traumatic conditioning event associated with anxiety, panic disorders misinterpret or exaggerate significance of physiological symptoms

Schizophrenia

disorder: characterized by severe impairment in thinking, profoundly alters ABC's, symptoms must persist for at least 6 months, severe impairment in daily life

ABC's

Affect, Behavior, Cognition

Positive Symptoms for Schizophrenia

delusions, hallucinations, disordered behavior, disorganized speech

Negative Symptoms of Schizophrenia

flat affect, no emotional delivery, alogia, monotone, aphasia, avolition (lack of motivation to do things)

Paranoid Schizophrenia

schizophrenia that has hallucinations and delusions of persecution or grandeur

Disorganized Schizophrenia

schizophrenia that is unrelated hallucinations and delusions, incoherent, speech, strange facial grimaces (very rare)

Catatonic Schizophrenia

schizophrenia that is characterized by some extreme level of activity

Undifferentiated Schizophrenia

schizophrenia that is patterns of disordered behavior, thought, and emotion that cannot be classified as any other subtype

Residual Schizophrenia

individuals who had prior episodes involving any other subtype but are not currently experiencing the major symptoms of schizophrenia

Biological Etiology of Schizophrenia

type of etiology: strong genetic base, increase dopamine, enlarged cerebral ventricles and shrinkage in surrounding cerebral cortex, PET scans

Behavioral Etiology of Schizophrenia

type of etiology: Diathesis-Stress Model: behavioral interactions with biological factors in triggering onset, more reactive to stress, high baseline cortisol

Dissociative Disorders

disorder: loss of contact with portions of one's consciousness or memory, significant aspects of experience kept separate in consciousness and memory

Symptoms of Dissociative Disorders

symptoms of this disorder: identity confusion, identity alteration, derealization, depersonalization, amnesia

Psychodynamic Etiology of Dissociative Disorders

type of etiology: dissociation results from attempt to repress some troubling event

Biological Etiology of Dissociative Disorders

type of etiology: undetected neurological problem

Cognitive Etiology of Dissociative Disorders

type of etiology: dissociate as a way of coping with intense distress; may become automatic

Somatoform Disorders

type of disorder: physical complaints without physical causes

Conversion Disorder

type of disorder: ex. "glove anesthesia" not possible in nerves biologically

Personality Disorders

type of disorder: enduring pattern of thinking, feeling, behaving; inflexible ineffective behavior patterns that "impair social functioning"

Cluster A Types and Symptoms

personality disorder cluster: odd/eccentric; paranoid, schizoid (detachment, restricted range of emotions), schizotypal (cognitive and perceptual distortions)

Cluster B Types and Symptoms

personality disorder cluster: dramatic, emotional, erratic; borderline (instability of interpersonal relationships, self-image, and emotion), Histrionic (excessive emotionality and attention seeking), Narcissistic (grandiosity, need for admiration, and lack of empathy), Antisocial (disregard for a violation of other's rights)

Cluster C Types and Symptoms

personality disorder cluster: anxious, fearful; Avoidant (social inhibition, feelings of inadequacy, hypersensitivity to negative evaluation) Dependent (excessive need to be taken care of, submissive and clinging behavior, fear of separation), Obsessive- Compulsive

Antisocial Personality Disorder

type of disorder: exhibits anti-social behavior across all realms of life, no remorse or concern for others, often charming and likable even though their behavior is selfish; 80% male inmates and 65% female inmates

Oppositional Defiant Disorder

type of disorder: developmental precursor in young children for antisocial personality disorder

Conduct Disorder

type of disorder: older children to adolescent precursor for antisocial personality disorder

Biological Etiology of Personality Disorders

etiology: genetic component, abnormal brain development, chronic under arousal of both the autonomic and central nervous systems , environmental factors react with biological ones to cause problem

psychoanalysis

first use of "talking cure," developed by freud, identify unconscious motives, dream analysis

Freudian Theory

some traumatic childhood event leaves people with troubling memories of feelings; to manage resulting anxiety, repress troubling memory; material is now unconscious and continues to effect functioning

catharsis

bring memory to consciousness through therapy

Psychoanalytical Technique

type of technique: directed toward helping client gain insight, interpret underlying meaning in dreams, art, poetry, etc.

free association

say whatever comes to mind without inhibiting or filtering speech

freudian slips

client means to say one thing but actually says something else

Issues and Criticisms of Psychoanalytical Technique

criticisms of technique: transference (feelings client develops for therapist reflect their feelings for significant others early in life) countertransference (feelings therapist develops for client reflect feelings they had for others early in life) resistance (anything the client does to interfere with therapeutic progress)

Psychodynamic Theory

theory: similar to psychoanalytical theory, less frequent sessions, lower emphasis on sexual drives, interpretation

Humanistic Therapies

type of therapy: Help people get in touch with their feelings, "true selves" and purpose in life, client-centered therapy (therapist is a facilitator)

Humanistic Theory

theory: psychological problems develop when outside forces stifle our natural tendency to seek personal growth

Gestalt Therapy

theory: stresses awareness of feelings in the here and now, directive approach and instruction, empty chair technique

Behavior Therapy

therapy: focuses on changing observable, measurable behaviors

counterconditioning

conditioning new response to stimuli that trigger unwanted behaviors

systematic desensitization

commonly used with phobias, gradual exposure to feared object

response prevention

commonly used to treat compulsive behavior, situation triggers responses, distressing response prevented

Aversion Conditioning

clients are classically conditioned to react with aversion to a harmful or undesirable stimulus

operant conditioning

learning through reinforcement or punishment, behavior modification

observational learning

learning by observation and imitating behavior of others

modeling

desirable behaviors are demonstrated as a way of teaching them to clients

social skills training

clients are taught how to interact with others more comfortably, modeling and role playing

Cognitive Therapy

a type of therapy that focuses on thoughts rather than feelings or behaviors

Dichotomous thinking

type of thinking: yes or no, black or white

common cognitive distortions

dichotomous thinking, mental filter, mind reading, catastrophic exaggeration

Cognitive Therapy Techniques

technique: clients confronted with irrational beliefs; develop more realistic way of thinking; confrontational; step out of character

Beck's Cognitive Therapy

type of therapy: cognitive restructuring, daily record of dysfunctional beliefs, identify automatic thoughts, identify rational responses

Family Systems Theory

theory: "whole is greater than the sum of its parts" => an individual family member's problems cannot be understood and treated in isolation

Group Therapy

therapy: group members can become support group, helps clients realize they aren't alone

Psychopharmacology and Biomedical Therapies

therapy: use of drugs in treating psych disorders has steadily increased, neurons and synapse action

Schizophrenia Biomedical Therapy

therapy: antipsychotic medication targets positive symptoms side effect- tardive dyskinesia (not correctable facial tick); aytpical antipsychotics target positive and negative symptoms

antipsychotic medications

block dopamine receptor sites in the brain, reducing activity, improves control of severe symptoms

antidepressant drugs

monomamine oxidase inhibitors (MAOI) inhibits MAO enzyme that is involved in breaking down norepinephrine and serotonin (more of these left over elevates mood)

Tricyclic Antidepressants

most popular antidepressant, selective serotonin reuptake inhibitors (SSRI's)

Lithium

chemical that treats Bipolar Disorder by reducing manic attacks to as little as one every 9 years, unclear how it works, compliance issues

Anti-anxiety Drugs

most widely used legal drugs, Benodiazepines are most frequently prescribed, reduces anxiety by facilitating the action of the gamma-amino-butyric acid (GABA), has inhibitory response to central nervous system

Electroconvulsive Therapy (ECT)

therapy: used to treat depression only now as last resort if patient can't tolerate drugs, brief electric shock is administered to brain to scramble signals, unclear why is effective

Psychosurgery

rarely used anymore, brain tissue worked on, now MRI-guided precision on specific areas with extreme care

Prefrontal Lobotomy

"scramble" prefrontal cortex, personality is drastically changed

Insurance Company Care

use most cost effective solution, choose drugs and therapists used, has significant effects on therapy effectiveness

Effects of Manage Care

cost-cutting introduced by HMO's means: long term therapies are rare, more referrals to therapists who aren't trained as extensively, less effective drugs prescribed

Psychotherapy's Positive Effects

brief therapy 50% improvement by 8th session, but more therapy=more improvement

Issues in evaluating treatment

outcome, control vs. generalizability, random assignment, compliance, consistency in therapy, magnitude/duration of effects

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