Psychological disorder or Abnormal behavior
"A psychological dysfunction within an individual associated with distress or impairment in functioning and a response that is not typical or culturally expected." (p.1 par. 1)
"A psychological disorder characterized by marked and persistent fear of an object or situation." (p.1 par. 5)
"A breakdown in cognitive, emotional, or behavioral functioning." (p. 2 par.1)
What are the 3 criteria that define a psychological disorder?
Psychological dysfunction, distress or impairment, atypical response. (p. 2 Fig. 1.1)
Must all three criteria for defining psychological disorder be present in a disorder?
No. They are helpful tools but not necessary requirements for a disorder. (pp. 2-4)
How does the DSM-IV-TR describe behavioral, psychological or biological dysfunction?
"...unexpected in their cultural context and associated with present distress and impairment in functioning, or increased risk of suffering, death, pain, or impairment." (p. 4 par. 1)
What is Psychopathology?
"...the study of psychological disorders." (p. 4 par. 4)
What are some professions in the field of Psychopathology?
"...clinical and counseling psychologists, psychiatrists, psychiatric social workers, and psychiatric nurses, as well as marriage and family therapists and mental health counselors." (p. 4 par. 4)
What are mental health professionals who take a scientific approach to their clinical work called?
Scientist-practitioners (p. 4 par. 8)
What is a "presenting problem"?
The reason why a patient came to a hospital or clinic. (p. 5 par. 2)
What is "clinical description"?
"...the unique combination of behaviors, thoughts, and feelings that make up a specific disorder." (p. 5 par. 2)
What is the prevalence of a disorder?
The amount of people in the population as a whole who have the disorder. (p. 5 par. 4)
What is the incidence of a disorder?
The number of new cases that occur in a set period of time. (p. 5 par. 4)
What is the sex ratio?
The "...percentage of males and females who have a disorder and the typical age of onset, which often differs from one disorder to another." (p. 5 par. 4)
What is a chronic course?
The course of a disorder that lasts a long time, sometimes a lifetime. (p. 5 par. 5)
What is an episodic course?
The course of a disorder that is likely to last only a few months, disappear and reappear later. (p. 5 par. 5)
What is a time-limited course?
A disorder that will likely improve without treatment in a relatively short period of time. (p. 5 par. 5)
What is acute onset?
A disorder that begins suddenly. (p. 5 par. 6)
What is insidious onset?
A disorder that develops gradually over an extended period of time. (p. 5 par. 6)
What is prognosis?
"The anticipated course of a disorder..." (p. 5 par. 6)
What is etiology?
The study of why a disorder begins. (p. 6 par. 2)
What are the 3 historical models of human behavior?
Supernatural, Biological and Psychological. (p. 6 par. 9)
Who was the first well known person to postulate the idea that psychological disorder can be treated like any other disease?
Hippocrates (p. 10 par. 3)
Who are the two men most influential in the development of the humoral theory of disorders?
Hippocrates and Galen (p.10 par. 4)
What are the 4 humors that Hippocrates assumed were related to four bodily fluids and whose imbalance could cause psychological disorder?
Blood, black bile, phlegm, and choler or yellow bile. (p. 10 par 4)
A sexually transmitted disease caused by a bacterial microorganism entering the brain, including believing that everyone is plotting against you (delusions of persecution) or that you are God (delusions of grandeur).
Beliefs that are not based in reality.
Perceptions that are not based in reality.
Who discovered the nature of Syphilis and was a champion of the biological tradition?
John P. Grey
What was a great modern development advanced by John P. Grey
Better sanitation, rest, diet , temperature and ventilation in mental hospitals.
What are some new techniques that were developed by the biological tradition?
Insulin shock therapy and electric shock therapy.
What are the basic tenets of moral therapy?
Treating institutionalized patients as normally as possible in a setting that encouraged and reinforced normal social interaction.
Who was influential in removing restraints and chains and implementing positive psychological interventions.
Who was responsible for the mental hygiene movement?
What was an unforeseen consequence of the mental hygiene movement?
A dramatic increase of mental patients because of Dorothy Dix's efforts to make sure all who needed it had access to car including the homeless.
What process allowed Breuer and Freud to "discover" the unconscious mind?
What is one of the most important discoveries in made in the history of psychopathology?
The "discovery" of the unconscious mind.
The release of emotional material after recalling unconscious emotional trauma.
What is the psychoanalytic model?
Created by Freud it has 3 major facets: 1. The structure of the mind and the distinct functions of personality that sometimes clash with one another. 2. The defense mechanism with which the mind defends itself from these clashes, or conflicts; and 3 the stages of early psychosexual development that provide grist for the mill of our inner conflicts.
Source of our strong sexual and aggressive feelings. The animal within. Pleasure principle.
What are the 2 energies of the id?
libido and thanatos
The part of our mind that ensures we act realistically. Reality principle. Mediator between id and superego.
Represents the moral principle instilled in us by our parents and our culture.
Conflicts between the id, ego and superego are called what?
Unconscious protective processes that keep primitive emotions associated with conflicts in check so that the ego con continue its coordinating function.
Being angry at a professor but yelling at your dog is an example of what?
If someone redirects energy from conflict into work that would be an example of what?
Refusal to acknowledge some aspect of objective reality or subjective experience that is apparent to others.
Transfers a feeling about, or a response to and object that causes discomfort onto another , usually less-threatening object.
Falsely attributes own unacceptable feelings, impulses, or thoughts to another individual or object.
Conceals the true motivations for actions, thoughts, or feelings through elaborate reassuring or self-serving but incorrect explanations.
Substitutes behavior, thoughts or feelings that are the direct opposite of unacceptable ones.
Blocks disturbing wishes, thoughts, or experiences from conscious awareness.
Directs potentially maladaptive feelings or impulses into socially acceptable behavior.
What are the psychosexual stages of development?
oral, anal, phallic, latency, and genital
What did Freud call all non-psychotic disorders?
Who was the first proponent of ego psychology?
Abnormal behavior develops when the ego is deficient in regulating such functions as delaying and controlling impulses or in marshaling appropriate normal defenses to stronger internal conflicts.
What is object relations?
The study of how children incorporate the images, the memories, and sometimes the values of a person who was important to them and to whom they were emotionally attached.
Who rejected many of the sexual aspect of Freud's theory and introduced the concept of the collective unconscious?
A wisdom accumulated by society and culture that is stored deep in individual memories and passed down from generation to generation.
Who believed that the basic quality of human nature is positive and that there is a strong drive toward self-actualization?
Jung and Alder
What are two therapeutic methods developed by Freud?
Free association and dream analysis
What are the 7 tactics that characterized psychodynamic psychotherapy?
1. a focus on affect and the expression of patients' emotions. 2. an exploration of patients' attempts to avoid topics or engage in activities that hinder the progress of therapy 3. the identification of patterns in patients' actions, thoughts, feelings, experiences, and relationships 4. an emphasis on past experiences 5. a focus on patient's interpersonal experiences 6. an emphasis on the therapeutic relationship 7. an exploration of patient's wishes, dreams, or fantasies.
What movement included Maslow (hierarchy of needs) and Rogers (person-centered therapy)?
Humanistic psychology (self-actualization)
What approach is Unconditional positive regard critical to?
The humanistic approach.
Ivan, Petrovich Pavlov initiated the study of...?
Subjects simply report on their inner thoughts and feelings after experiencing certain stimuli.
Individuals are gradually introduced to the object they fear so that the fear can be extinguished.
Who is known for his study of operant conditioning?
What 2 developments, important to Psychology, came about in the 1990's?
1 Increasing sophistication of scientific tools and methodology and 2 the realization that no one influence --- biological, behavioral, cognitive, emotional, or social --- ever occurs in isolation.
Who was the most notable early adherent to the idea that psychopathology is multiply determined?
The systematic evaluation and measurement of psychological, biological, and social factors in an individual presenting with a possible psychological disorder.
The process of determining whether the particular problem afflicting the individual meets all criteria for a psychological disorder as set forth in the DSM-IV-TR
What or the 3 values assessment depends on?
Reliability, Validity, Standardization
The degree to which a measurement is consistent.
The degree to which a technique measures what it is designed to measure.
Application of certain standards to ensure consistency across different measurements.
To organize information obtained during in interview, many clinicians use a...?
Mental status exam
What are the 5 categories of an individual's behavior covered in a mental status exam?
Appearance and behavior, thought process, mood and affect, Intellectual functioning, and sensorium.
What is a term for a disorganized speech pattern?
Loose association or derailment.
Predominant feeling state of the individual.
The feeling or state that accompanies what we say at a given point. (example: laughter accompanying a joke.)
Our general awareness of our surroundings. (date, time, location, identity)
If a person is "oriented times three" they are...?
Aware of their surroundings in terms of person, time and place.
What method of assessment is more useful for assessing individuals thoughts, feelings, and behaviors in specific situations or contexts?
What is the focus of observational assessment?
The here and now. The antecedent, behavior and consequences.
Observation of one's own behavior to find patterns is a technique known as what?
What kind of test includes a variety of methods in which ambiguous stimuli, such as pictures of people or things, are presented to people who are asked to describe what they see?
A way of testing to see finding out if someone has a disorder based on test questions that were answered the same by other people with the disorder.
What is the most widely used personality inventory in the United States?
MMPI (Minnesota Multiphasic Personality Inventory
What are positive and negative aspects of the MMPI?
A positive is that there is little room for interpretation. Scoring is objective. A negative is the way in which people may downplay their problems and the time and tedium of taking the test.
Why was IQ testing developed?
To predict who would do well in school.
Who developed the IQ test?
French psychologist Alfred Binet
What did IQ tests initially measure?
What do IQ tests measure today?
Does IQ measure intelligence?
No. It measures a person's chance of doing well in school.
What do Neuropsychological tests measure?
Abilities in areas such as receptive and expressive language, attention and concentration, memory, motor skills, perceptual abilities, and learning and abstraction.
A child is given the Bender Visual-Motor Gestalt Test using a series of cards on which are drawn various lines and shapes. The task is for the child to copy what is drawn on the card. The errors on the test are compared to test results of other children of the same age; if the number of errors exceeds a certain amount, then brain dysfunction is suspected. What kind of test is this?
Measurable changes in the nervous system that reflect emotional or psychological events. The measure may be taken either directly from the brain or peripherally from other parts of the body.
Measuring electrical activity in the head related to the firing of a specific group of neurons which reveals brain activity.
Used to determine what is unique about an individual's personality, cultural background, or circumstances. Lets us tailor our treatment to the person.
Used to identify the general class or group to which the disorder belongs.
The classification of entities for scientific purposes.
Taxonomy in a clinical setting is called...?
Who originated the classical categorical approach to classification?
Classical categorical approach to classification
Assumes that every diagnosis has an underlying pathophysiological cause such as a bacterial infection or a malfunctioning endocrine system.
We note the variety of cognitions, moods and behaviors with which the patient presents and quantify them on a scale.
What is the prototypical approach?
Identifies certain essential characteristics of an entity so that we can classify it. It also allows certain nonessential variations that do not necessarily change the classification.
Who publishes the DSM?
What landmark event took place in the history of nosology in 1980?
The DSM-III was published.
What is the international equivalent of the DSM?
What is it called when an individual is diagnosed with more than one disorder?
Premenstrual dysphoric disorder.
A negative mood state characterized by bodily symptoms of physical tension and by apprehension about the future is called.
Is a little anxiety good for us?
An immediate alarm reaction to danger.
An abrupt experience of intense fear or acute discomfort, accompanied by physical symptoms that usually include heart palpitations, chest pain, shortness of breath, and, possibly dizziness.
What are the 3 types of panic attack?
Situationally bound, unexpected and situationally predisposed.
List at least 7 of the 13 diagnostic criteria for panic attack.
Pounding heart, sweating, trembling, sensations of shortness of breath, feeling of choking, nausea, dizziness, derealization, fear of losing control, fear of dying, numbness, chills or hot flashed.
What is the main difference between anxiety and fear?
Anxiety is more future oriented and fear is an intense present feeling of danger or emergency.
What can parents do for their children to lessen their anxiety later in life?
Provide a secure home base but allow their children to explore their world and develop the necessary skills to cope with unexpected occurrences.
What are the three categories of contribution to anxiety disorders?
Biological, Psychological and Social.
A three part theory of the development of anxiety and related disorders.
Triple vulnerability theory
What are the 3 parts of triple vulnerability theory?
Biological vulnerability, psychological vulnerability and specific psychological vulnerability.
Name a few of the diagnostic criteria for generalized anxiety disorder. (GAD
Excessive anxiety occurring for more days than not for at least 6 months about a number of things, difficulty controlling worry, restlessness, fatigue, difficulty concentrating, Irritability, muscle tension, sleep disturbance, focus of anxiety is not merely a part of another Axis I disorder, causes clinically significant distress or impairment in social, occupational or other important areas of functioning, Disturbance is not directly due to the use of a substance.
Generalized anxiety disorder.
What is different about children with GAD?
They only need 1 physical symptom for the diagnosis.
What is the median age of onset for GAD?
What age group is GAD most common in?
What is the most often prescribed drug for GAD?
How effective are drug vs. psychological treatments for GAD?
In the short term they are about equal but psychological treatment is superior in the long run.
Panic disorder with agoraphobia.
Fear and avoidance of situations in which you would feel unsafe in the event of a panic attack or symptoms.
Panic disorder without agoraphobia
Avoidance of internal physical sensations that resemble the beginning of a panic attack. (Hot room, argument, exercise...)
When do most initial unexpected panic attacks occur?
Panic Control Treatment
A new drug looking promising for treatment of social anxiety disorder or panic disorder.
What are the 5 types of phobia?
Animal, blood-injection-injury, situation and other.
A child's persistent worry about the safety of the child's parents, loved ones or the child itself.
Separation anxiety disorder
Social anxiety disorder
A disorder similar to social phobia experienced by the Japanese in which the individual is anxious of offending people around them with blushing, stuttering, body odor etc.
What is a natural contributing factor in social phobia?
We are programmed to avoid angry faces.
What is the precursor to PTSD in the first month after the trauma?
Acute stress disorder
Name some diagnostic criteria for posttraumatic stress disorder.
Traumatic even that posed a threat to life, injury or physical integrity responded to with intense fear and helplessness, persistent recollection (dreams, intrusive thoughts, distress at exposure to cues that are reminiscent of the trauma), avoidance of stimuli associated with the trauma and numbing of general responsiveness, detachment, reduced interest, restriction of emotional range, sense of foreshortening, persistent symptoms of increased arousal.
If duration of symptoms is less than 3 months.
If duration of symptoms is 3 months or more.
Delayed onset PTSD
If onset of symptoms at least 6 months after the stressor.
A family history of anxiety suggests a what?
A generalized biological vulnerability to anxiety disorders like PTSD.
What is the most widely accepted treatment process for PTSD?
Individuals should face the original trauma, process the intense emotions and develop effective coping procedures in order to overcome the debilitating effects of the disorder.
What anxiety disorder is most common in hospitalizations?
Intrusive and mostly nonsensical thought, images or urges that the individual tries to resist or eliminate.
Thoughts or actions used to suppress the obsessions and provide relief.
How much time do obsessions and compulsions have to take a day?
At least 1 hour and include distress.
What are the 4 types of Symptom subtype in OCD?
Symmetry/exactness, Forbidden thoughts or actions, Cleaning/contamination, Hoarding.
What compulsion is usually associated with needing things to be symmetrical/aligned just so and urges to do things repetitively until they "feel right"?
Putting things in a certain order. Repeating rituals.
What compulsion is usually associated with Fear, urges to harm self or others and fears of offending God?
Checking, avoidance, repeated requests for reassurance.
What compulsion is usually associated with obsessions with germs, fear of germs or contaminants?
Repetitive or excessive washing, using gloves and masks to do daily tasks.
What compulsion is usually associated with a fear or throwing anything away?
Collecting/saving objects with little or no actual or sentimental value such as food wrappings.
What is the key difference between someone who likes to shop and collect and a hoarder?
Hoarders experience strong anxiety and distress about throwing anything away.
Are the majority of OCD people male or female?
OCD individuals equate thoughts with the specific actions or activity represented by the thoughts.
Clinical disorders, Other conditions that may be a focus of clinical attention (V-score).
Personality disorders, mental retardation (may include prominent maladaptive personality features and defense mechanisms.)
General Medical Conditions.
Psychosocial and Environmental Problems.
GAF (Global Assessment of Functioning)
Under what Axis would you list illiteracy?
Under what Axis would you list OCD?
Under what Axis would you list Parkinson's?
Under what Axis would you list autism?
What are the 4 symptoms the GAF range focuses on?
Depressed Mood, Psychosis, Suicide, Communication.
Not Otherwise Specified. No diagnosis in the DSM to include the set of symptoms.
DSM code for deferred diagnosis.
Designations for various conditions and problems that may be the focus of clinical attention but which in themselves do not constitute a specific mental disorder. within the DSM classification system. DSM lists in "Other Conditions that may be a focus of clinical attention"
How is the DSM altered from the Medical model?
It should not be categorical.
Can you be insidious and also have a sudden onset of a disorder?
What are the two types or prognosis?
Good and guarded
Earliest "treatments" for mental disorder/
Exorcism, torture and crude surgery.
Caught under the spell or the moon. Lunacy.
When did psychotropic medications begin to be systematically developed?
What is Reserpine prescribed for?
Who was largely responsible for the increased role of science in psychopathology?
Who studied birth-order, inferiority complex and self-actualization?
What the patient brings to the table.
Comparing patient to other people.
What is the minimum timing of panic attacks?
At least 4 all at least 8 minutes long.