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abnormal psych exam 1

Terms in this set (33)

Context and defining abnormal behavior/mental illness
o Cultural norms can determine if something is abnormal or not, still must be functional
o "behavior that is inconsistent with the individuals development, cultural and social norms, and creates emotional distress or interferes with daily functioning"
o 47% of adults have in the US have suffered from a psychological disorder in their life (28% anxiety disorders)
------------ functionality (if it takes away from everyday functions and behaviors), Age (what might be normal at one age is considered not normal at another age), need to be negative.
- Abnormal Behavior- behavior that is inconsistent with the individual's development, cultural and social norms, and creates emotional distress.
- The most common disorders in the US are anxiety disorders (28%) and depression (20%).
• Deviance, Distress, Dysfunction
o Deviant behaviors "differ from prevailing societal standards", but those standards are always changing (The Beatles with their loud music and wacky hair cuts). Goodness of fit- the understanding of a behavior within a specific context
o Distress- "worries are so frequent and pervasive that they cause anxiousness and to loose sleep at night"
o Dysfunction- behaviors that begin to affect life- the distress feelings are causing someone to be late for work or social obligations.
_________• Deviance-Behaviors that violate societal and cultural norms.
- Age- As children mature, behaviors that were previously considered developmentally appropriate can become abnormal.
-Eccentricity- behaviors that violate cultural societal norms but is not always negative or harmful\• Distress- worries result in negative mood or anxiety.
• Dysfunction- when occupational and social functions are impaired. Change in daily routine.
• DSM-5 and categorical versus dimensional approach
o Diagnostic and Statistical Manual for Mental Disorders uses categorical
o Categorical approach- all or nothing approach (preg or not preg) that is better than previous approaches as it relies more on data then theories, but has two main problems(a) symptoms rarely fall into just one category and (b) symptoms often are not of sufficient severity to determine that they represent a psychological disorder despite distress and impairment. People rarely only ever have one disorder (eating disorders are usually paired with depression)
o Dimensional approach-scientific. Would allow an understanding of how abnormal behavior varies in severity over time, perhaps increasing and decreasing, or how behaviors change from one disorder to another.
• Demographic characteristics (sex/gender, race/ethnicity, SES, age) and incidence & prevalence of psychological disorders
- Sex- women are more likely to suffer from anxiety disorders and mood disorders. Men are more likely to suffer from alcohol and drug abuse.
- Race and Ethnicity- whites and African Americans suffer equally from most disorders. Hispanics are more likely to have mood disorders such as depression.
- Socioeconomic Status- drug and alcohol abuse occurs most among individuals with middle educational level, psychological disorders occur most within individuals of the lowest incomes and lowest education. Lower income means less access to treatment.
- Age- by age 16, 1/3 has suffered from a psychological disorder. It is highest among 9-10 year olds, lower at age 12, and higher again in adolescence. Development trajectory- common symptoms of a disorder vary according to a person's age.
- Biological- hormonal changes associated with puberty may increase the likelihood of an eating disorder.
Trephination
using a circular instrument to cut away sections of the brain. Trephination was usually done to cure an abnormal behavior. They thought that opening up the skull was a way to release evil spirits that were controlling the person and the reason for abnormal behavior.
Ancient Greece and Rome
The ancient Greeks believed that the gods controlled abnormal behavior and that defiance of the deities could result in mental illness
- Melampus of Pilus
- introduced an organic model of illness and provided treatment using plants.
- Asclepius
An historical figure who was known for his healing abilities and was given god status
- Galen
physician. Believed that hysteria was the cause of women lacking interest in sexual activities.
o Hippocrates
father of medicine. He produced a diagnostic classification system and a model to explain disorders. He identified common symptoms such as hallucinations, delusions, melancholia, and mania. Introduced the term hysteria.
o Hysteria
described in patients who had blindness or paralysis with no organic cause. He believed that it was only found in women and that was due to an empty uterus wandering throughout the body. It was believed that the cure was marriage or pregnancy.
o Humors-
fluids found within the body that were thought to cause abnormal behavior. During this time it was thought that mental illnesses were caused by a traumatic event or an imbalance of fluids in the body.
o Avicenna
prince and chief of physicians wrote 450 works. He believed depression resulted from a mix of humors, and certain physical diseases were caused by emotional distress. He believed in humane treatment of mental disorders.
• Middle Ages
Role of the Church, Mass hysteria, emotional contagion
o Role of the church- church officials thought negative behavior was due to works of the devil and witchcraft. At least 200,000 people were assumed of witchcraft.
o Mass Hysteria-People possessed by a demonic spirit. Emotional Contagion- The automatic mimicry and synchronization of expressions, and movements. Thought that these behaviors are not under voluntary control.
• Renaissance
Weyer, Paracelsus, Bedlam
o Weyer- First physician to specialize in the treatment of mental illness.
o Paracelsus- debuted the idea that abnormal behaviors were linked to demonic possessions. Believed that abnormal behaviors could have a hereditable component and some had psychological origins.
o Asylums- separate facilities designed to isolate the mentally ill from the general public. They were created to be beneficial, but they soon came to be over-capacity. Treatment usually consisted of confinement, tortuous practices,
o "bedlam"- St. Mary's Assylum. Chaotic and uncontrollable situations
• Mesmer & placebo effect
Thought that the body was a magnet and that using the physician as a magnet could cure mental illnesses. His cures led to the idea of the placebo effect in which symptoms are diminished because the patient believes that the treatment is effective.
o Pinel, Tuke, Moral treatment, Dorthea Dix, Kraeplin, Dementia praecox, Breuer
o Pinel- Believed that mental disease was curable, and in order to apply appropriate treatment the physician must listen to the patient and observe his behavior. He called for calmness in the asylums and removed chains. He advocated for work and occupation.
o Tuke- established the York Retreat which was a small country house designed to allow people with mental disease to live, work, and relax in a compassionate and religious environment.
o moral treatment- idea of kindness and occupation established by Pinel and Tuke.
o Dorthea Dix- Associated with moral treatment. Established 32 facilities that included programs in psychological treatment, research, and education.
o Kraeplin-He introduced two diagnostic categories not based on symptoms but rather on etiology and prognosis.
o dementia praecox- Kraeplin's term for schizophrenia or a type of mental disability characterized on mental deterioration. He believed the cause of this disorder was due to self-poisoning of the brain cells as a result of abnormal body metabolism.
o Breuer- used hypnotism to treat patients with hysteria. The talking cure- because during hypnosis people would talk about things that they otherwise couldn't remember.
• Humanistic
Gestalt Approach
believes that the individual has his or her own answers. Individual expert of the situation. Focused on unconditional love, and believing in yourself.
o Phenomenology-- one's perception of the world is more important than the world. Belief that people are good and want to self actualize.
o Carl Rogers
o Gestalt approach- the knowledge is in yourself, you just don't believe yourself. You may be stuck in the past and worry about the future. Founded by Fitz Pearls.
o Client-centered therapy and unconditional positive regard
o Empathy (2 levels)- Primary- trying to feel what the client feels. Show them that you are listening. Advanced- interpreting what they tell you and sharing information with them.
o Empty-chair technique-imagine another person is there. Have interaction with ourselves and the other person. Understanding you're perfect the way you are. Only use on people with less serious symptoms. Not on suicidal patients.
• Psychodynamic
listening, say very little, unbiased state of events, diverging conversation into something else.
o Freud- believed that the roots of abnormal behavior began before 5 years old. Because they were developed so early, he thought that individuals had no conscious memory of them, but the unconscious memory of them would influence behavior.
o 3 levels of consciousness
o Id- basic instinctual drives, unconscious, out of our awareness.
o Ego-The mediator between the drives of the id and the restrictions of society. Has both conscious and unconscious components.
o Superego- imposes moral constraint on the id's impulses. Both unconscious and conscious.
o Eros- God of love, Thanatos- god of death. Everything that motivates us is a product of creation, pleasure focused, distractions, anger, fear.
o Fixation- 5 different psychosexual stages. Happens when too little or too much gratification.
o Treatment- goal is insight. Transference, projecting patient's emotion onto the therapist. Free association- minimizes conscious control and tells the therapist everything that comes to mind. Dream analysis- encouraged to recount their dreams. Interpretation- the therapist makes interpretations about associations between the past and the present.
o Psychosexual stages
- Oral Stage- 0-1 year. Sucking and chewing are pleasurable experiences and aggressive impulses occur after teeth development.
- Anal Stage- 1-3 years. Toilet training. Emphasis on discipline. Aggressive impulses could lead to personality traits of negativism, destructivity, and hostility.
- Phallic Stage- 3-5. Genitals. Derive pleasure from touching themselves. May have fantasies about the opposite sex parent.

o Disadvantages-expensive, takes awhile, falsely blames parents for situation a lot
o Assumptions-1) Psychic determinism- behavior is guided by our inner forces, id, ego, superego. All of our behavior can be read from our inner conflicts.
2) Unconscious motivation- we are not always aware of our behavior.
3) Psychosexual stages- any problem you have as an adult can be traced back to age 12.
4) Insight to change
o Defense Mechanisms
Defense mechanisms helped the mind's negative thoughts to be disguised to emerge to consciousness in a more acceptable form.
• Biological
search for a medical reason. Hormone changes affect symptoms.
o Phineas Gage- sparked biological approach.
o Behavioral genetics- the role of genes and the environment in hereditability of disorders.
o Genotype, phenotype, gene by environment interaction
o Neurotransmitters- neurotransmitter activity is the basis for brain activity such as emotions and behavior and are related to disorders.
o Twin studies-if one identical twin has a disorder, higher chance that the other twin will have the disorder as well.
o Psychoactive medications - what you can give to calm down the symptoms. Might not have the symptoms but still have the disorder. Disadvantages are that they have strong side affects and the symptoms can come back.
• Behavioral
- all behavior is learned as result of experiences or interactions in the environment.
o Watson, Pavlov, classical conditioning- a conditioned stimulus is paired with an unconditional stimulus and that always produces a unconditional response. Little Albert- emotional aspects such as fear could be learned through classical conditioning. Little Albert's fear of a white rat was paired with a loud noise.
o B.F. Skinner, operant conditioning- reinforcement, punishment
o Bandura, vicarious conditioning- no trial learning, can learn a behavior through directly watching another person perform the behavior.
o Systematic desensitization- expose patient to what is being feared
o Aversive conditioning- pairing the negative stimulus with something negative, and the positive stimulus with something positive.
o Positives- treatments are affective, have results, testable
o Disadvantages- over simplifying, hard if the person has multiple disorders, doesn't explain all disorders, makes people a victim of their environment.
o Assumptions-
1) Behaviors are learned
2) Behaviors that can be observed are measured
• Cognitive
cognition affects behavior. Events don't influence our behavior, but rather the way we perceive the events do.
o Aaron Beck,
o Albert Ellis- emotion reaction therapy
o Schemas- cognitive structures of what we believe the world to be, of others, or of the future. Shape how you see the world and how you behave.
o Cognitive triad- people with depression have 3 types of negative emotions: a negative view of the self, of the world, and the future.
o Cognitive distortions (define and give examples)- negative assumptions. Jumping to conclusions, making should decisions, personalizing.
o Advantages- treatments are affective
o Disadvantages- the way you think about a problem doesn't make you avoid a problem.
• Define fear, anxiety, worry
o Fear-"a reaction to an existing or threatening event". Fear=the moment , whereas anxiety= future (see Fear Cycle)
o Anxiety- "a common emotion that is characterized by physical symptoms (faster heartbeat, feelings of tension) and thoughts or worries that something bad will happen. Anxiety is thought to be composed of three parts: physical, cognitive, escape/avoidance behavior". It is normal to have some anxiety, it motivates you. Anxiety is emotional (uncomfortable), physiological (heart rate), and cognitive (fear, future oriented)
o Worry-"apprehensive (negative) expectations about the future that are considered to be unreasonable in light of the actual situation"
• What is the function of anxiety?
o Anxiety can motivate us--> homework, testing
o Future orientated --> what if? You become prepared
• What are the 3 components of anxiety?
o "Anxiety is thought to be composed of three parts: physical, cognitive, escape/avoidance behavior". It is normal to have some anxiety, it motivates you. Anxiety is emotional (uncomfortable), physiological (heart rate), and cognitive (fear, future oriented)
• Fight-or-flight response
o "a general discharge of your sympathetic nervous system (SNS). Your hypothalamus sends a message to your adrenal gland to release adrenaline".
o Cycle of Fear
Stimulus (snakes)--> physical symptoms (increased heart rate, sweating) --> misinterpretation of symptoms -->increased scrutiny/ because you're looking out for that symptom...---> this will increase your anxiety--> avoidant behavior--> you feel better now that you avoid your fears and you confirm your beliefs --> strengthen your physical symptoms ...continues on
o Expectancy Model
(Reiss+McNelly, 1985) 1. People are motivated to avoid danger 2. People differ in their anxiety sensitivity (peoples disposition to interpret symptoms as threatening when they really aren't) 3. People learn that certain things make them anxious
anxiety sensitivity
(peoples disposition to interpret symptoms as threatening when they really aren't)
o Emotional Processing Model (Foa & Kozak)
Stimulus we fear--> our translation of verbal and physiological responses into action
I see a rat--> physical symptoms ignite (heart rate increases, run away)--> meaning is assigned to action ( I ran from the rat so I must fear the rat)
Course of Anxiety Disorders
What % of people have an anxiety disorder
o 57% of people who are diagnosed with an anxiety disorder are comorbid for another anxiety disorder or depression
o Panic disorder, agoraphobia, Generalized anxiety disorder, social anxiety disorder, specific phobia, selective mutism, separation anxiety disorder,
• Biopsychosocial
o Diathesis-Stress Model- 2 components that create the stress for the disorder, biological and environmental.
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