Abnormal Midterm Review Flashcards

1
Q

What is abnormal Psychology

A

The field devoted to the scientific study of abnormal behavior to describe, predict, explain, and change abnormal patterns of functioning

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2
Q

Workers in the field may be:

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Clinical scientists, Clinical practitioners

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3
Q

“The Four Ds”

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Deviance, Distress, Dysfunction, Danger

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4
Q

Deviance

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– Different, extreme, unusual, perhaps even bizarre

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5
Q

Distress

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– Unpleasant and upsetting to the person

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6
Q

Dysfunction

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– Interfering with the person’s ability to conduct daily activities in a constructive way

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7
Q

Danger

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– Posing risk of harm

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8
Q

Deviance from what?

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From behaviors, thoughts, and emotions that differ markedly from a society’s ideas about proper functioning

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9
Q

Social Norms

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Explicit and implicit rules for proper conduct

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10
Q

exeptions to social norms

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Social context, some times some behaviors are okay, while in others it is not okay

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11
Q

Danger

A

being dangerous is the exception rather than the rule

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12
Q

Treatment/Therapy

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is a procedure designed to change abnormal behavior into more normal behavior

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13
Q

Features of therapy

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Sufferer, healer, series of contacts

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14
Q

Sufferer

A

A sufferer who seeks relief from the healer

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15
Q

Healer

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A trained, socially acceptable healer, whose expertise is accepted by the sufferer and his or her social group

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16
Q

Series of Contacts

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A series of contacts between the healer and the sufferer, through which the healer, often with the aid of a group, tries to produce certain changes in the sufferer’s emotional state, attitudes, and behavior

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17
Q

Anceint methods of treatment

A

The cure for abnormality was to force the demons from the body through trephination and exorcism

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18
Q

who changed view on illnesses?

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Hippocrates believed and taught that illnesses had natural causes

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19
Q

Somatogenic Perspective

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Abnormal functioning has physical causes

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20
Q

Psychogenic Perspective

A

Abnormal functioning has psychological causes

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21
Q

effects of the psychotrophic drugs

A

These discoveries led to deinstitutionalization and a rise in outpatient care

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22
Q

Clinical researchers face certain challenges that make their investigations particularly difficult:

A

Measuring unconscious motives
Assessing private thoughts
Monitoring mood changes
Calculating human potential

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23
Q

Clinical researchers must consider

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the cultural backgrounds, races, and genders of the people they study

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24
Q

must always ensure

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the rights of their research participants, both human and animal, are not violated

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25
Clinical researchers try to
discover laws, or principles, of abnormal psychological functioning
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nomothetic understanding
General or universal laws or truths
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scientific method
systematically collect and evaluate information through careful observations
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Case Study
Provides a detailed, interpretative description of a person’s life and psychological problems Can be a source of new ideas about behavior May offer tentative support for a theory May challenge a theory’s assumptions May inspire new therapeutic techniques May offer opportunities to study unusual problems
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limitations of the Case Study
``` Reported by biased observers Relies on subjective evidence Has low internal validity Provides little basis for generalization Has low external validity ```
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Correlational Method
the degree to which events or characteristics vary with each other Measures the strength of a relationship Does not imply cause and effect
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Correlational Method and The Experimental Method
Do not offer richness of detail Do allow researchers to draw broad conclusions Preferred method of clinical investigation Typically involve observing many individuals Researchers apply procedures uniformly Studies can be replicated Researchers use statistical tests to analyze results
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Advantages of the correlational method:
Has high external validity Can generalize findings Can repeat (replicate) studies on other samples Difficulties with correlational studies: Lack external validity Results describe but do not explain a relationship
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Experimental Method
An experiment is a research procedure in which a variable is manipulated and the manipulation’s effect on another variable is observed Manipulated variable = independent variable Variable being observed = dependent variable Causal relationships can only be determined through experiments
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double-blind design
both experimenters and participants are kept from knowing which condition of the study participants are in Often used in medication trials
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models or paradigms
the perspectives used to explain events | Each spells out basic assumptions, gives order to the field under study, and sets guidelines for investigation
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Models of Abnormality
Biological Model, Psychodynamic Model, Behavioral Model, Cognitive Model, Humanistic Model, Sociocultural Model,
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Biological Model
Adopts a medical perspective Main focus is that psychological abnormality is an illness brought about by malfunctioning parts of the organism Typically focused on the brain
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Sources of biological abnormalities
genetics
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inheritance plays a part in
mood disorders, schizophrenia, Alzheimer’s disease, and other mental disorders
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types of biological treatment
Drug therapy Electroconvulsive therapy (ECT) Neurosurgery
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Neurosurgery
roots in trephination Much more precise than in the past Considered experimental and used only in extreme cases
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Strengths
Enjoys considerable respect in the field Constantly produces valuable new information Brings great relief
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Weaknesses
Can limit, rather than enhance, our understanding Too simplistic Evidence is incomplete or inconclusive Treatments produce significant undesirable (negative) effects
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Psychodynamic Model
Based on belief that a person’s behavior (whether normal or abnormal) is determined largely by underlying dynamic psychological forces of which she or he is not consciously aware
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three UNCONSCIOUS forces
Id – guided by the Pleasure Principle Instinctual needs, drives, and impulses Sexual; fueled by libido (sexual energy) Ego – guided by the Reality Principle Seeks gratification, but guides us to know when we can and cannot express our wishes Ego defense mechanisms protect us from anxiety Superego – guided by the Morality Principle Conscience; unconsciously adopted from our parents
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Strengths:
First to recognize importance of psychological theories and treatment Saw psychological conflict as important source of psychological health and abnormality First to apply theory and techniques systematically to treatment – monumental impact on the field
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Weaknesses:
Unsupported ideas; difficult to research Non-observable Inaccessible to human subject (unconscious)
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Behavioral Model
Operant conditioning Modeling Classical conditioning All may produce normal or abnormal behavior
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Modeling
Individuals learn responses by observing and repeating behavior
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Classical conditioning
Learning by temporal association When two events repeatedly occur close together in time, they become fused in a person’s mind; before long, the person responds in the same way to both events
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Behavioral Therapy
Aim to identify the behaviors that are causing problems and replace them with more appropriate ones May use classical conditioning, operant conditioning, or modeling Therapist is “teacher” rather than healer
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Pyschodynamic Therapies
All seek to uncover past trauma and inner conflicts | Therapist acts as a “subtle guide”
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Classical conditioning treatments
systematic desensitization for phobia
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Strengths
Powerful force in the field Can be tested in the laboratory Significant research support for behavioral therapies
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Weaknesses
Too simplistic Behavioral therapy is limited Downplays role of cognition New focus on self-efficacy, social cognition, and cognitive-behavioral theories
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Cognitive Theory
Maladaptive thinking is the cause of maladaptive behavior Several kinds of faulty thinking: Faulty assumptions and attitudes Illogical thinking processes
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Cognitive Therapies
People can develop a new way of thinking to prevent maladaptive behavior The goal of therapy is to help clients recognize and restructure their thinking Therapists also guide clients to challenge their dysfunctional thoughts, try out new interpretations, and apply new ways of thinking in their daily lives Widely used in treating depression
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Strengths
``` Very broad appeal Clinically useful and effective Focuses on a uniquely human process Theories lend themselves to research Therapies effective in treating several disorders ```
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Weaknesses:
Precise role of cognition in abnormality has yet to be determined Singular, narrow focus Overemphasis on the present Limited effectiveness
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Humanistic Theory
Believes in the basic human need for unconditional positive regard If present, leads to unconditional self-regard If not, leads to “conditions of worth” Incapable of self-actualization because of distortion – do not know what they really need, etc.
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Humanistic Therapy
``` “client-centered” therapy Therapist creates a supportive climate: Unconditional positive regard Accurate empathy Genuineness ```
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Strengths:
Taps into domains missing from other theories Emphasizes the individual Optimistic Emphasizes health
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Weaknesses:
Focuses on abstract issues Difficult to research Not much influence Weakened by disapproval of scientific approach
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Sociocultural Model Strength
Added greatly to the clinical understanding and treatment of abnormality Increased awareness of labeling Clinically successful when other treatments have failed
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Weaknesses
Research is difficult to interpret Correlation ? causation Model unable to predict abnormality in specific individuals
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biopsychosocial model
Abnormality results from the interaction of genetic, biological, developmental, emotional, behavioral, cognitive, social, and societal influences
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Diathesis-stress approach
Diathesis = predisposition (bio, psycho, or social)
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Assessment
collecting relevant information in an effort to reach a conclusion
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Clinical assessment
used to determine how and why a person is behaving abnormally and how that person may be helped Also may be used to evaluate treatment progress Focus is idiographic
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Characteristics of Assessment Tools
To be useful, assessment tools must be standardized and have clear reliability and validity
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To standardize
technique is to set up common steps to be followed whenever it is administered One must standardize administration, scoring, and interpretation
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Reliability refers to
``` the consistency of a test A good test will always yield the same results in the same situation Two main types: Test–retest reliability Interrater reliability ```
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Test-retest
– Yields the same results every time it is given to the same people
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Interrater
– Different judges independently agree on how to score and interpret a particular test
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Validity refers to
the accuracy of a test’s results | A good test must accurately measure what it is supposed to measure
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Three Specific Types
Three specific types: Face validity Predictive validity Concurrent validity
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Face validity
– a test appears to measure what it is supposed to measure; does not necessarily indicate true validity
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Predictive validity
– a test accurately predicts future characteristics or behavior
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Concurrent validity
– a test’s results agree with independent measures assessing similar characteristics or behavior
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Clinical Interviews
Focus depends on theoretical orientation | Can be either unstructured or structured
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unstructured interviews
clinicians ask open-ended questions
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structured interviews
clinicians ask prepared questions, often from a published interview schedule
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Limitations
May lack validity or accuracy Individuals may be intentionally misleading Interviewers may be biased or may make mistakes in judgment Interviews, particularly unstructured ones, may lack reliability
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Projective tests
Require that clients interpret ambiguous stimuli Mainly used by psychodynamic practitioners Most popular: Rorschach Test Thematic Apperception Test Sentence Completion Test Drawings
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Projective tests | Strengths and weaknesses
Helpful for providing “supplementary” information Have rarely demonstrated much reliability or validity May be biased against minority ethnic groups
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Personality inventories
Designed to measure broad personality characteristics Focus on behaviors, beliefs, and feelings Usually based on self-reported responses Most widely used: Minnesota Multiphasic Personality Inventory For adults: MMPI (original) or MMPI-2 (1989 revision) For adolescents: MMPI-A
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Personality inventories | Strengths and weaknesses
Easier, cheaper, and faster to administer than projective tests Objectively scored and standardized Appear to have greater validity than projective tests Measured traits often cannot be directly examined – how can we really know the assessment is correct? Tests fail to allow for cultural differences in responses
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Response inventories | Strengths and weaknesses
Have strong face validity Rarely include questions to assess careless or inaccurate responding Not all have been subjected to careful standardization, reliability, and/or validity procedures (Beck Depression Inventory and a few others are exceptions)
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Psychophysiological tests
Measure physiological response as an indication of psychological problems Includes heart rate, blood pressure, body temperature, galvanic skin response, and muscle contraction Most popular is the polygraph (lie detector)
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Neurological and neuropsychological tests
Neurological tests directly assess brain function by assessing brain structure and activity Examples: EEG, PET scans, CAT scans, MRI Neuropsychological tests indirectly assess brain function by assessing cognitive, perceptual, and motor functioning Most widely used is Bender Visual-Motor Gestalt Test
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Intelligence tests
Designed to indirectly measure intellectual ability Typically comprised of a series of tests assessing both verbal and nonverbal skills General score is an intelligence quotient (IQ) Most popular: Wechsler Adult Intelligence Scale (WAIS) and Wechsler Intelligence Scale for Children (WISC)
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Intelligence Tests | Weaknesses
Performance can be influenced by nonintelligence factors (e.g., motivation, anxiety, test-taking experience) Tests may contain cultural biases in language or tasks
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Naturalistic and analog observations
Naturalistic observations occur in everyday environments Can occur in homes, schools, institutions (hospitals and prisons), and community settings Most focus on parent–child, sibling–child, or teacher–child interactions Observations are generally made by “participant observers” and reported to a clinician If naturalistic observation is impractical, analog observations are used in artificial settings
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Naturalistic and analog observations | Strengths and weaknesses
Reliability is a concern Different observers may focus on different aspects of behavior Validity is a concern Risk of “overload,” “observer drift,” and observer bias Client reactivity may also limit reliability Observations may lack cross-situational validity
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Multiaxial
Uses 5 axes (branches of information) to develop a full clinical picture People usually receive a diagnosis on either Axis I or Axis II, but they may receive diagnoses on both
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two fundamental problems weaken the DSM
Basic assumption that disorders are qualitatively different from normal behavior Reliance on discrete diagnostic categories
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What distinguishes fear from anxiety
Fear is a state of immediate alarm in response to a serious, known threat to one’s well-being Anxiety is a state of alarm in response to a vague sense of threat or danger Both have the same physiological features – increase in respiration, perspiration, muscle tension, etc.
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Is the fear/anxiety response adaptive
Yes, when the “fight or flight” response is protective However, when it is triggered by “inappropriate” situations, or when it is too severe or long-lasting, this response can be disabling Can lead to the development of anxiety disorders
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Sociocultural Perspective Anxiety Disorder
According to this theory, GAD is most likely to develop in people faced with social conditions that truly are dangerous Although poverty and other social pressures may create a climate for GAD, other factors are clearly at work Most people living in “dangerous” environments do not develop GAD
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Psychodynamic Perspective Anxiety Disorders
Controlled studies have typically found psychodynamic treatments to be of only modest help to persons with GAD Short-term psychodynamic therapy may be beneficial in some cases
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Humanistic Perspective Anxiety Disorders
Theorists propose that GAD, like other psychological disorders, arises when people stop looking at themselves honestly and acceptingly Lack of “unconditional positive regard” in childhood leads to “conditions of worth” (harsh self-standards) These threatening self-judgments break through and cause anxiety, setting the stage for GAD to develop Practitioners using this “client-centered” approach try to show unconditional positive regard for their clients and to empathize with them
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Cognitive Perspective Anxiety Disorder
suggested that GAD is caused by maladaptive assumptions
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Albert Ellis identified
basic irrational assumptions: It is a dire necessity for an adult human being to be loved or approved of by virtually every significant person in his community It is awful and catastrophic when things are not the way one would very much like them to be When these assumptions are applied to everyday life and to more and more events, GAD may develop
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Aaron Beck
GAD constantly hold silent assumptions that imply imminent danger: A situation/person is unsafe until proven safe It is always best to assume the worst
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Metacognitive theory
Developed by Wells; holds that the most problematic assumptions in GAD are the individual’s worry about worrying (meta-worry)
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Intolerance of uncertainty theory
Certain individuals believe that any possibility of a negative event occurring means that the event is likely to occur
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Avoidance theory
Developed by Borkovec; holds that worrying serves a “positive” function for those with GAD by reducing unusually high levels of bodily arousal
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cognitive therapy
Changing Maladaptive Assumptions | Helping clients understand the special role that worrying plays, and changing their views and reactions to it
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Biological Perspective Anxiety Disorder
GAD is caused by biological factors, but then there is the issue of shared environment
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GABA inactivity
Benzodiazepine receptors ordinarily receive gamma-aminobutyric acid (GABA, a common neurotransmitter in the brain) GABA carries inhibitory messages; when received, it causes a neuron to stop firing In normal fear reactions: Key neurons fire more rapidly, creating a general state of excitability experienced as fear or anxiety A feedback system is triggered; brain and body activities that reduce excitability Some neurons release GABA to inhibit neuron firing, thereby reducing experience of fear or anxiety Malfunctions in the feedback system are believed to cause GAD Possible reasons: Too few receptors, ineffective receptors Benzodiazepine receptors ordinarily receive gamma-aminobutyric acid (GABA, a common neurotransmitter in the brain)
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How do phobias differ from these “normal” experiences?
More intense and persistent fear Greater desire to avoid the feared object or situation Distress that interferes with functioning
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Social Phobias
Severe, persistent, and unreasonable fears of social or performance situations in which embarrassment may occur May be narrow -– talking, performing, eating, or writing in public May be broad – general fear of functioning poorly in front of others In both cases, people rate themselves as performing less adequately than they actually do Severe, persistent, and unreasonable fears of social or performance situations in which embarrassment may occur May be narrow -– talking, performing, eating, or writing in public May be broad – general fear of functioning poorly in front of others In both cases, people rate themselves as performing less adequately than they actually do
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Cuase of Phobias
Phobias develop through conditioning (most widely accepted explanation) Once fears are acquired, the individuals avoid the dreaded object or situation, permitting the fears to become all the more entrenched Phobias develop through modeling Observation and imitation Phobias are maintained through avoidance A behavioral-evolutionary explanation Called “preparedness” because human beings are theoretically more “prepared” to acquire some phobias than others Model explains why some phobias (snakes, spiders) are more common than others (faces, houses)
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Treatments for Specific Phobias
Systematic desensitization Teach relaxation skills Create fear hierarchy Pair relaxation with the feared objects or situations Since relaxation is incompatible with fear, the relaxation response is thought to substitute for the fear response Other behavioral treatments: Flooding Forced nongradual exposure Modeling Therapist confronts the feared object while the fearful person observes
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Treatments for Social Phobias
Overwhelming social fear Address behaviorally with exposure Lack of social skills Social skills and assertiveness trainings have proved helpful Unlike specific phobias, social phobias are often reduced through medication (particularly antidepressants) Several types of psychotherapy have proved at least as effective as medication People treated with psychotherapy are less likely to relapse than people treated with drugs alone One psychological approach is exposure therapy, either in an individual or group setting Another treatment option is social skills training, a combination of several behavioral techniques to help people improve their social functioning Therapist provides feedback and reinforcement
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Panic Disorder
Panic, an extreme anxiety reaction, can result when a real threat suddenly emerges The experience of “panic attacks,” however, is different Panic attacks are periodic, short bouts of panic that occur suddenly, reach a peak, and pass Sufferers often fear they will die, go crazy, or lose control Attacks happen in the absence of a real threat
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Panic Disorder: The Biological Perspective
Neurotransmitter at work is norepinephrine Irregular in people with panic attacks Research suggests that panic reactions are related to changes in norepinephrine activity in the locus ceruleus Research conducted in recent years has examined brain circuits and the amygdala as the more complex root of the problem It is possible that some people inherit a predisposition to abnormalities in these areas
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Drug therapies
Antidepressants are effective at preventing or reducing panic attacks Function at norepinephrine receptors in the panic brain circuit Bring at least some improvement to 80% of patients with panic disorder Approximately 50% recover markedly or fully Improvements require maintenance of drug therapy Some benzodiazepines (especially Xanax [alprazolam]) have also proved helpful
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Panic Disorder: The Cognitive Perspective
Misinterpreting bodily sensations Panic-prone people may be very sensitive to certain bodily sensations and may misinterpret them as signs of a medical catastrophe; this leads to panic Why might some people be prone to such misinterpretations? Experience more frequent or intense bodily sensations Poor coping skills Lack of social support Unpredictable childhoods Overly protective parents
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Cognitive therapy
May use “biological challenge” procedures to induce panic sensations Induce physical sensations, which cause feelings of panic: Jump up and down Run up a flight of steps Practice coping strategies and making more accurate interpretations
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Obsessive-Compulsive Disorder
Made up of two components: Obsessions Persistent thoughts, ideas, impulses, or images that seem to invade a person’s consciousness Compulsions Repetitive and rigid behaviors or mental acts that people feel they must perform to prevent or reduce anxiety
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Compulsions
“Voluntary” behaviors or mental acts Feel mandatory/unstoppable Most recognize that their behaviors are irrational Believe, though, that catastrophe will occur if they do not perform the compulsive acts Performing behaviors reduces anxiety ONLY FOR A SHORT TIME! Behaviors often develop into rituals
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OCD: The Psychodynamic Perspective
The battle between the id and the ego Three ego defense mechanisms are common: Isolation: Disown disturbing thoughts Undoing: Perform acts to “cancel out” thoughts Reaction formation: Take on lifestyle in contrast to unacceptable impulses Freud believed that OCD was related to the anal stage of development Period of intense conflict between id and ego Not all psychodynamic theorists agree
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OCD: The Behavioral Perspective
Learning by chance People happen upon compulsions randomly In a fearful situation, they happen to perform a particular act (washing hands) When the threat lifts, they associate the improvement with the random act After repeated associations, they believe the compulsion is changing the situation Bringing luck, warding away evil, etc. The act becomes a key method to avoiding or reducing anxiety
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Behavioral therapy
Exposure and response prevention (ERP) Clients are repeatedly exposed to anxiety-provoking stimuli and are told to resist performing the compulsions Therapists often model the behavior while the client watches Homework is an important component Treatment is offered in individual and group settings Treatment provides significant, long-lasting improvements for most patients However, as many as 25% fail to improve at all, and the approach is of limited help to those with obsessions but no compulsions
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OCD: The Cognitive Perspective
Overreacting to unwanted thoughts To avoid such negative outcomes, they attempt to “neutralize” their thoughts with actions (or other thoughts) Neutralizing thoughts/actions may include: Seeking reassurance Thinking “good” thoughts Washing Checking
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OCD: The Biological Perspective
Two additional lines of research: Abnormal serotonin activity Evidence that serotonin-based antidepressants reduce OCD symptoms; recent studies have suggested other neurotransmitters also may play important roles Abnormal brain structure and functioning OCD linked to orbitofrontal cortex and caudate nuclei Frontal cortex and caudate nuclei compose brain circuit that converts sensory information into thoughts and actions Either area may be too active, letting through troublesome thoughts and actions
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The state of stress has two components:
Stressor – event that creates demands Stress response – person’s reactions to the demands Influenced by how we appraise both the event and our capacity to react to the event effectively People who sense that they have the ability and resources to cope are more likely to take stressors in stride and respond constructively
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Autonomic nervous system (ANS)
An extensive network of nerve fibers that connect the central nervous system (the brain and spinal cord) to all other organs of the body
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Endocrine system
A network of glands throughout the body that release hormones
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hypothalamus
The features of arousal and fear are set in motion by it
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The Fight-or-Flight Response
When we face a dangerous situation, the hypothalamus first excites the sympathetic nervous system, which stimulates key organs either directly or indirectly When the perceived danger passes, the parasympathetic nervous system helps return body processes to normal The second pathway is the hypothalamic-pituitary-adrenal (HPA) pathway When confronted by stressors, the hypothalamus signals the pituitary gland, which stimulates the adrenal cortex to release corticosteroids – stress hormones – into the bloodstream
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trait anxiety
Some people are usually somewhat tense; others are usually relaxed Differences appear soon after birth
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state anxiety
Situation-based (example: fear of flying) | Their sense of which situations are threatening
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Psychological Stress Disorders
During and immediately after trauma, we may temporarily experience levels of arousal, anxiety, and depression For some, symptoms persist well after the trauma These people may be suffering from: Acute stress disorder Posttraumatic stress disorder (PTSD) The event usually involves actual or threatened serious injury to self or others The situations that cause these disorders would be traumatic to anyone (unlike other anxiety disorders)
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Victimization and stress disorders
People who have been abused or victimized often experience lingering stress symptoms Research suggests that more than 1/3 of all victims of physical or sexual assault develop PTSD A common form of victimization is sexual assault/rape Around 1 in 6 women is raped at some time during her life Psychological impact is immediate and may be long-lasting One study found that 94% of rape survivors developed an acute stress disorder within 12 days after assault
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Why Do People Develop a Psychological Stress Disorder
extraordinary trauma can cause a stress disorder However, the event alone may not be the entire explanation To understand the development of these disorders, researchers have looked to the: Survivors’ biological processes Personalities Childhood experiences Social support systems/cultural backgrounds Severity of the traumas
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Biological and genetic factors
Traumatic events trigger physical changes in the brain and body that may lead to severe stress reactions and, in some cases, to stress disorders Some research suggests abnormal neurotransmitter and hormone activity (especially norepinephrine and cortisol) Evidence suggests that other biological changes and damage may also occur (especially in the hippocampus and amygdala) as a stress disorder sets in There may be a biological/genetic predisposition to such reactions
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General goals of Treatment
End lingering stress reactions Gain perspective on traumatic experiences Return to constructive living
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Treatment of Psychological Stress Disorders
Drug therapy Antianxiety and antidepressant medications are most common Behavioral exposure techniques Reduce specific symptoms, increase overall adjustment Use flooding and relaxation training Use eye movement desensitization and reprocessing (EMDR) Insight therapy Bring out deep-seated feelings, create acceptance, lessen guilt Often use family or group therapy formats; rap groups Usually used in combinations
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Ulcers
Lesions in the wall of the stomach that result in burning sensations or pain, vomiting, and stomach bleeding Experienced by 20 million people at some point in their lives Causal psychosocial factors: Environmental pressure, anger, anxiety, dependent personality style Causal physiological factors: Bacterial infection
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Asthma
A narrowing of the body’s airways that makes breathing difficult Affects up to 20 million people in the U.S. each year Most victims are children at the time of first attack Causal psychosocial factors: Environmental pressures, troubled family relationships, anxiety, high dependency Causal physiological factors: Allergies, a slow-acting sympathetic nervous system, weakened respiratory system
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Insomnia
Difficulty falling asleep or maintaining sleep Affects 35% of people in the U.S. each year Causal psychosocial factors: High levels of anxiety or depression Causal physiological factors: Overactive arousal system, certain medical ailments
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Chronic headaches
Frequent intense aches of the head or neck that are not caused by another physical disorder Tension headaches affect 40 million Americans each year Migraine headaches affect 23 million Americans each year Causal psychosocial factors: Environmental pressures; general feelings of helplessness, anger, anxiety, depression Causal physiological factors: Abnormal serotonin activity, vascular problems, muscle weakness
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Hypertension
Chronic high blood pressure, usually producing no outward symptoms Affects 65 million Americans each year Causal psychosocial factors: Constant stress, environmental danger, general feelings of anger or depression Causal physiological factors: 10% caused by physiological factors alone Obesity, smoking, poor kidney function, high proportion of collagen (rather than elastic) tissue in an individual’s blood vessels
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Coronary heart disease
Caused by blockage in the coronary arteries Includes angina pectoris (chest pain), coronary occlusion (complete blockage of a coronary artery), and myocardial infarction (heart attack) Leading cause of death in men older than 35 years and women older than 40 years in the U.S. Causal psychosocial factors: Job stress, high levels of anger or depression Causal physiological factors: High level of cholesterol, obesity, hypertension, the effects of smoking, lack of exercise
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Psychoneuroimmunology
Researchers now believe that stress can interfere with the activity of lymphocytes, slowing them down and increasing a person’s susceptibility to viral and bacterial infections Several factors influence whether stress will result in a slowdown of the system, including biochemical activity, behavioral changes, personality style, and degree of social support
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Somatoform disorders
problems that appear to be medical but are due to psychosocial factors
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Dissociative disorders
patterns of memory loss and identity change that are caused almost entirely by psychosocial factors rather than physical ones
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somatoform and dissociative disorders have much in common:
Both may occur in response to severe stress Both have traditionally been viewed as forms of escape from stress A number of individuals suffer from both a somatoform and a dissociative disorder Theorists and clinicians often explain and treat the two groups of disorders in similar ways
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Somatoform Disorders
People with a somatoform disorder do not consciously want, or purposely produce, their symptoms They believe their problems are genuinely medical There are two main types of somatoform disorders: Hysterical somatoform disorders Preoccupation somatoform disorders
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Hysterical Somatoform Disorders
People with hysterical somatoform disorders suffer actual changes in their physical functioning These disorders are often hard to distinguish from genuine medical problems It is always possible that a diagnosis of hysterical disorder is a mistake and that the patient’s problem has an undetected organic cause
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Conversion disorder
In this disorder, a psychosocial conflict or need is converted into dramatic physical symptoms that affect voluntary or sensory functioning Symptoms often seem neurological, such as paralysis, blindness, or loss of feeling Most conversion disorders begin between late childhood and young adulthood They are diagnosed in women twice as often as in men They usually appear suddenly and are thought to be rare
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Somatization disorder
People with somatization disorder have many long-lasting physical ailments that have little or no organic basis Also known as Briquet’s syndrome To receive a diagnosis, a patient must have a range of ailments, including several pain symptoms, gastrointestinal symptoms, a sexual symptom, and a neurological symptom Patients usually go from doctor to doctor in search of relief This disorder lasts much longer than a conversion disorder, typically for many years Symptoms may fluctuate over time but rarely disappear completely without psychotherapy
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Pain disorder associated with psychological factors
Patients may receive this diagnosis when psychosocial factors play a central role in the onset, severity, or continuation of pain Although the precise prevalence has not been determined, it appears to be fairly common The disorder often develops after an accident or illness that has caused genuine pain The disorder may begin at any age, and more women than men seem to experience it
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Hysterical vs. medical symptoms
It can be difficult to distinguish hysterical disorders from “true” medical conditions Studies across the world suggest that as many as one-fifth of all patients who seek medical care may actually suffer from somatoform disorders Physicians sometimes rely on oddities in the patient’s medical picture to help distinguish the two For example, hysterical symptoms may be at odds with the known functioning of the nervous system, as in cases of glove anesthesia
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Hysterical vs. factitious symptoms
Hysterical somatoform disorders are different from patterns in which individuals are purposefully producing or faking medical symptoms Patients may be malingering—intentionally faking illness to achieve external gain (e.g., financial compensation, military deferment) Patients may be manifesting a factitious disorder—intentionally producing or faking symptoms simply out of a wish to be a patient
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Factitious Disorder
Munchausen syndrome is the extreme and chronic form of factitious disorder In Munchausen syndrome by proxy, a related disorder, parents make up or produce physical illnesses in their children
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Preoccupation Somatoform Disorders
Preoccupation somatoform disorders include hypochondriasis and body dysmorphic disorder People with these problems misinterpret and overreact to bodily symptoms or features Although these disorders also cause great distress, their impact on one’s life differs from that of hysterical disorders
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Hypochondriasis
People with hypochondriasis unrealistically interpret bodily symptoms as signs of serious illness Often their symptoms are merely normal bodily changes, such as occasional coughing, sores, or sweating Although some patients recognize that their concerns are excessive, many do not
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Body dysmorphic disorder (BDD)
People with this disorder, also known as dysmorphophobia, become deeply concerned over some imagined or minor defect in their appearance Most often they focus on wrinkles, spots, facial hair, swelling, or misshapen facial features (nose, jaw, or eyebrows) Most cases of the disorder begin in adolescence but are often not revealed until adulthood Up to 5% of people in the U.S. experience BDD, and it appears to be equally common among women and men
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Causes Somatoform Disorders | The psychodynamic view
Today’s psychodynamic theorists take issue with Freud’s explanation of the Electra conflict They continue to believe that sufferers of these disorders have unconscious conflicts carried from childhood
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Causes Somatoform Disorders | The psychodynamic view
Psychodynamic theorists propose that two mechanisms are at work in the hysterical disorders: Primary gain: hysterical symptoms keep internal conflicts out of conscious awareness Secondary gain: hysterical symptoms further enable people to avoid unpleasant activities or receive sympathy from others
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Causes Somatoform Disorders | The behavioral view
Behavioral theorists propose that the physical symptoms of hysterical disorders bring rewards to sufferers May remove individual from an unpleasant situation May bring attention from other people In response to such rewards, people learn to display symptoms more and more This focus on rewards is similar to the psychodynamic idea of secondary gain, but behaviorists view the gains as the primary cause of the development of the disorder
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Causes Somatoform Disorders | The cognitive view
Some cognitive theorists propose that hysterical disorders are a form of communication, providing a means for people to express difficult emotions Like psychodynamic theorists, cognitive theorists hold that emotions are being converted into physical symptoms This conversion is not to defend against anxiety but to communicate extreme feelings
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Causes Somatoform Disorders | A possible role for biology
The impact of biological processes on somatoform disorders can be understood through research on placebos and the placebo effect Placebo: substances with no known medicinal value Treatment with placebos has been shown to bring improvement to many—possibly through the power of suggestion or through the release of endogenous chemicals Perhaps traumatic events and related concerns or needs can also trigger our “inner pharmacies” and set in motion the bodily symptoms of hysterical somatoform disorders
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How Are Somatoform Disorders Treated
People with somatoform disorders usually seek psychotherapy only as a last resort Individuals with preoccupation disorders typically receive the kinds of treatments applied to anxiety disorders, particularly OCD: Antidepressant medication Exposure and response prevention (ERP)
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Treatments for hysterical disorders
often focus on the cause of the disorder and apply the same kind of techniques used in cases of PTSD, particularly: Insight – often psychodynamically oriented Exposure – client thinks about traumatic event(s) that triggered the physical symptoms Drug therapy – especially antidepressant medication Other therapists try to address the physical symptoms of the hysterical disorders, applying techniques such as: Suggestion – usually an offering of emotional support that may include hypnosis Reinforcement – a behavioral attempt to change reward structures Confrontation – an overt attempt to force patients out of the sick role Researchers have not fully evaluated the effects of these particular approaches on hysterical disorders
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Dissociative Disorders
When such changes in memory lack a clear physical cause, they are called “dissociative” disorders In such disorders, one part of the person’s memory typically seems to be dissociated, or separated, from the rest Keep in mind that dissociative symptoms are often found in cases of acute or posttraumatic stress disorders When such symptoms occur as part of a stress disorder, they do not necessarily indicate a dissociative disorder (a pattern in which dissociative symptoms dominate) On the other hand, research suggests that people with one of these disorders also develop the other as well
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Dissociative amnesia may be:
Localized (circumscribed)—most common type; loss of all memory of events occurring within a limited period Selective—loss of memory for some, but not all, events occurring within a period Generalized—loss of memory beginning with an event, but extending back in time; may lose sense of identity; may fail to recognize family and friends Continuous—forgetting of both old and new information and events; quite rare in cases of dissociative amnesia All forms of the disorder are similar in that the amnesia interferes primarily with episodic memory (one’s autobiographical memory of personal material) Semantic memory—memory for abstract or encyclopedic information—usually remains intact Clinicians do not known how common dissociative amnesia is, but many cases seem to begin during times of serious threat to health and safety
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Dissociative Fugue
People with dissociative fugue not only forget their personal identities and details of their past lives but also flee to an entirely different location For some, the fugue is brief—a matter of hours or days—and ends suddenly For others, the fugue is more severe: people may travel far from home, take a new name and establish new relationships, and even a new line of work; some display new personality characteristics
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Dissociative Identity Disorder (Multiple Personality Disorder)
At any given time, one of the subpersonalities dominates the person’s functioning Usually one of these subpersonalities—called the primary, or host, personality—appears more often than the others The transition from one subpersonality to the next (“switching”) is usually sudden and may be dramatic Most cases are first diagnosed in late adolescence or early adulthood Symptoms generally begin in childhood after episodes of abuse Typical onset is before age 5 Women receive the diagnosis three times as often as men
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How do subpersonalities interact?
The relationship between or among subpersonalities varies from case to case Generally there are three kinds of relationships: Mutually amnesic relationships—subpersonalities have no awareness of one another Mutually cognizant patterns—each subpersonality is well aware of the rest One-way amnesic relationships—most common pattern; some personalities are aware of others, but the awareness is not mutual Those who are aware (“co-conscious subpersonalities”) are “quiet observers”
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How do subpersonalities differ?
Subpersonalities often display dramatically different characteristics, including: Vital statistics Subpersonalities may differ in features as basic as age, sex, race, and family history Abilities and preferences Although encyclopedic knowledge is not usually affected by dissociative amnesia or fugue, in DID it is often disturbed It is not uncommon for different subpersonalities to have different abilities, including being able to drive, speak a foreign language, or play an instrument
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How do subpersonalities differ?
Subpersonalities often display dramatically different characteristics, including: Physiological responses Researchers have discovered that subpersonalities may have physiological differences, such as differences in autonomic nervous system activity, blood pressure levels, and allergies
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How common is DID?
The number of people diagnosed with the disorder has been increasing Although the disorder is still uncommon, thousands of cases have been documented in the U.S. and Canada alone Two factors may account for this increase: A growing number of clinicians believe that the disorder does exist and are willing to diagnose it Diagnostic procedures have become more accurate Despite changes, many clinicians continue to question the legitimacy of the category
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Explain Dissociative Disorders | The psychodynamic view
Psychodynamic theorists believe that dissociative disorders are caused by repression, the most basic ego defense mechanism People fight off anxiety by unconsciously preventing painful memories, thoughts, or impulses from reaching awareness
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Explain Dissociative Disorders | The behavioral view
Behaviorists believe that dissociation grows from normal memory processes and is a response learned through operant conditioning: Momentary forgetting of trauma leads to a drop in anxiety, which increases the likelihood of future forgetting Like psychodynamic theorists, behaviorists see dissociation as escape behavior Also like psychodynamic theorists, behaviorists rely largely on case histories to support their view of dissociative disorders While the case histories support this model, they are also consistent with other explanations…
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Explain Dissociative Disorders | State-dependent learning
If people learn something when they are in a particular state of mind, they are likely to remember it best when they are in the same condition This link between state and recall is called state-dependent learning This model has been demonstrated with substances and mood and may be linked to arousal levels It has been theorized that people who are prone to develop dissociative disorders have state-to-memory links that are unusually rigid and narrow; each thought, memory, and skill is tied exclusively to a particular state of arousal, so that they recall a given event only when they experience an arousal state almost identical to the state in which the memory was first acquired
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How Are Dissociative Disorders Treated
People with dissociative amnesia and fugue often recover on their own Only sometimes do their memory problems linger and require treatment In contrast, people with DID usually require treatment to regain their lost memories and develop an integrated personality Treatment for dissociative amnesia and fugue tends to be more successful than treatment for DID
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How do therapists help individuals with DID?
Therapists usually try to help the client by: Recognizing the disorder Once a diagnosis of DID has been made, therapists try to bond with the primary personality and with each of the subpersonalities As bonds are forged, therapists try to educate the patients and help them recognize the nature of the disorder Some use hypnosis or video as a means of presenting other subpersonalities Many therapists recommend group therapy Therapists usually try to help the client by: Recovering memories To help patients recover missing memories, therapists use many of the approaches applied in other dissociative disorders, including psychodynamic therapy, hypnotherapy, and drug treatment These techniques tend to work slowly in cases of DID Integrating the subpersonalities The final goal of therapy is to merge the different subpersonalities into a single, integrated entity Integration is a continuous process; fusion is the final merging Many patients distrust this final treatment goal and many subpersonalities see integration as a form of death Once the subpersonalities are integrated, further therapy is typically needed to maintain the complete personality and to teach social and coping skills to prevent later dissociations
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Depersonalization Disorder
The central symptom is persistent and recurrent episodes of depersonalization, which is a change in one’s experience of the self in which one’s mental functioning or body feels unreal or foreign People with depersonalization disorder feel as though they have become separated from their body and are observing themselves from outside This sense of unreality can extend to other sensory experiences and behavior Depersonalization is often accompanied by derealization—the feeling that the external world, too, is unreal and strange The disorder occurs most frequently in adolescents and young adults, hardly ever in people older than 40 The disorder comes on suddenly and tends to be long-lasting Relatively few theories have been offered to explain depersonalization disorder and little research has been conducted on the problem
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Mood Disorders
Most people with a mood disorder experience only depression This pattern is called unipolar depression Person is no history of mania Mood returns to normal when depression lifts Others experience periods of mania that alternate with periods of depression This pattern is called bipolar disorder
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How Common Is Unipolar Depression
Women are at least twice as likely as men to experience severe unipolar depression Lifetime prevalence: 26% of women vs. 12% of men Among children, the prevalence is similar among boys and girls These rates hold true across socioeconomic classes and ethnic groups Approximately 50% recover within six weeks and 90% within a year, some without treatment Most will experience another episode at some point
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Diagnosing Unipolar Depression
Marked by five or more symptoms lasting two or more weeks In extreme cases, symptoms are psychotic, including Hallucinations Delusions Criteria 2: No history of mania
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Major depressive disorder
Criteria 1 and 2 are met Dysthymic disorder Symptoms are “mild but chronic” Depression is longer lasting but less disabling Consistent symptoms for at least two years When dysthymic disorder leads to major depressive disorder, the sequence is called “double depression”
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What Causes Unipolar Depression
Stress may be a trigger for depression People with depression experience a greater number of stressful life events during the month just before the onset of their symptoms Some clinicians distinguish reactive (exogenous) depression from endogenous depression, which seems to be a response to internal factors Today’s clinicians usually concentrate on recognizing both the situational and the internal aspects of any given case
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What Causes Unipolar Depression? The Biological View: Genetic factors
Family pedigree, twin, adoption, and molecular biology gene studies suggest that some people inherit a biological predisposition Researchers have found that as many as 20% of relatives of those with depression are themselves depressed, compared with fewer than 10% of the general population Twin studies demonstrate a strong genetic component: Concordance rates for identical (MZ) twins = 46% Concordance rates for fraternal (DZ) twins = 20% Adoption studies also have implicated a genetic factor in cases of severe unipolar depression Using techniques from the field of molecular biology, researchers have found evidence that unipolar depression may be tied to specific genes
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What Causes Unipolar Depression? The Biological View | Biochemical factors
NTs: serotonin and norepinephrine In the 1950s, medications for high blood pressure were found to cause depression Some lowered serotonin, others lowered norepinephrine The discovery of truly effective antidepressant medications, which relieved depression by increasing either serotonin or norepinephrine, confirmed the NT role Depression likely involves not just serotonin nor norepinephrine… a complex interaction is at work, and other NTs may be involved
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What Causes Unipolar Depression? The Biological View Biochemical factors Endocrine system / hormone release
People with depression have been found to have abnormal levels of cortisol Released by the adrenal glands during times of stress People with depression have been found to have abnormal melatonin secretion “Dracula hormone” Other researchers are investigating whether deficiencies of important proteins within neurons are tied to depression
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What Causes Unipolar Depression? The Biological View Biochemical factors Model has produced much enthusiasm but has certain limitations
Relies on analogue studies: depression-like symptoms created in lab animals Do these symptoms correlate with human emotions? Measuring brain activity has been difficult and indirect Current studies using modern technology are attempting to address this issue
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What Causes Unipolar Depression? The Psychological Views | Psychodynamic view
Link between depression and grief When a loved one dies, an unconscious process begins and the mourner regresses to the oral stage and experiences introjection – a merging of his/her own identity with that of the lost person For most people, introjection is temporary If grief is severe and long-lasting, depression results Those with oral stage issues (unmet or excessively met needs) are at greater risk for developing depression Some people experience “symbolic” (or imagined) loss Newer psychoanalysts (object relations theorists) propose that depression results when people’s relationships leave them feeling unsafe and insecure
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What Causes Unipolar Depression? The Psychological Views | Behavioral view
Depression results from changes in rewards and punishments people receive in their lives Lewinsohn suggests that the positive rewards in life dwindle for some people, leading them to perform fewer and fewer constructive behaviors, and they spiral toward depression Research supports the relationship between the number of rewards received and the presence or absence of depression Social rewards are especially important
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What Causes Unipolar Depression? The Psychological Views | Cognitive views
Negative thinking Beck theorizes four interrelated cognitive components combine to produce unipolar depression: Maladaptive attitudes Self-defeating attitudes are developed during childhood Beck suggests that upsetting situations later in life can trigger an extended round of negative thinking This negative thinking typically takes three forms, called the cognitive triad: Individuals repeatedly interpret (1) their experiences, (2) themselves, and (3) their futures in negative ways, leading to depression Depressed people also make errors in their thinking, including: Arbitrary inferences Minimization of the positive and magnification of the negative Depressed people experience automatic thoughts
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Learned helplessness
There has been significant research support for this model Human subjects who undergo helplessness training score higher on depression scales and demonstrate passivity in laboratory trials Animal subjects lose interest in sex and social activities In rats, uncontrollable negative events result in lower serotonin and norepinephrine levels in the brain Recent versions of the theory focus on attributions Internal attributions that are global and stable lead to greater feelings of helplessness and possibly depression Example: “It’s all my fault” [internal]. “I ruin everything I touch” [global] “and I always will” [stable]. If people make other kinds of attributions, this reaction is unlikely Example: “She had a role in this also” [external], “the way I’ve behaved the past couple weeks blew this relationship” [specific]. “I don’t know what got into me – I don’t usually act like that” [unstable].
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What Causes Unipolar Depression? The Sociocultural View | The Multicultural Perspective
Two kinds of relationships have captured the interest of multicultural theorists: Gender and depression A strong link exists between gender and depression Women cross-culturally are twice as likely as men to receive a diagnosis of unipolar depression Women also appear to be younger, have more frequent and longer-lasting bouts, and to respond less successfully to treatment
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artifact theory
The artifact theory holds that women and men are equally prone to depression, but that clinicians often fail to detect depression in men
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hormone explanation
The hormone explanation holds that hormone changes trigger depression in many women
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life stress theory
The life stress theory suggests that women in our society experience more stress than men
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body dissatisfaction theory
The body dissatisfaction theory state that females in Western society are taught, almost from birth, to seek a low body weight and slender body shape – goals that are unreasonable, unhealthy, and often unattainable
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lack-of-control theory
The lack-of-control theory picks up the learned helplessness research and argues that women may be more prone to depression because they feel less control than men over their lives
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self-blame explanation
The self-blame explanation holds that women are more likely than men to blame their failures on lack of ability and to attribute their successes to luck – an attribution style that has been linked depression
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rumination theory
The rumination theory holds that people who ruminate when sad – keep focusing on their feelings and repeatedly consider the causes and consequences of their depression – are more likely to become depressed and stay depressed longer
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Bipolar Disorders
People with a bipolar disorder experience both the lows of depression and the highs of mania Many describe their lives as an emotional roller coaster
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Five main areas of functioning may be affected:
3. Behavioral symptoms Very active – move quickly; talk loudly or rapidly Flamboyance is not uncommon Cognitive symptoms Show poor judgment or planning Especially prone to poor (or no) planning Physical symptoms High energy level – often in the presence of little or no rest
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What Causes Bipolar Disorders?
Neurotransmitters This apparent contradiction is addressed by the “permissive theory” about mood disorders: Low serotonin may “open the door” to a mood disorder and permit norepinephrine activity to define the particular form the disorder will take: Low serotonin + Low norepinephrine = Depression Low serotonin + High norepinephrine = Mania
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Low serotonin + High norepinephrine =
Low serotonin + Low norepinephrine = Depression
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Low serotonin + Low norepinephrine =
Low serotonin + High norepinephrine = Mania
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Treatments for Unipolar Depression
Approximately one-third of people with unipolar depression (major depressive or dysthymic disorder) enter treatment in a given year In addition, many other people in therapy experience depressed feelings as part of another disorder – thus, much of the therapy being administered today is for unipolar depression
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Treatments for Unipolar Depression: Psychological Approaches | Psychodynamic therapy
Believing that unipolar depression results from unconscious grief over real or imagined losses, compounded by excessive dependence on other people, psychodynamic therapists seek to bring these issues into consciousness and work through them Psychodynamic therapists use the same basic procedures for all psychological disorders: Free association Therapist interpretation Review of past events and feelings Despite successful case reports, researchers have found that long-term psychodynamic therapy is only occasionally helpful in cases of unipolar depression Two features may be particularly limiting: Depressed clients may be too passive or weary to fully participate in clinical discussions Depressed clients may become discouraged and end treatment too early when treatment is unable to provide quick relief Short-term approaches have performed better than traditional approaches
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Treatments for Unipolar Depression: Psychological Approaches | Behavioral therapy
Lewinsohn, whose theory tied a person’s mood to his/her life rewards, developed a behavioral therapy for unipolar depression in the 1970s: Reintroduce clients to pleasurable activities and events, often using a weekly schedule Appropriately reinforce their depressive and nondepressive behaviors Use a contingency management approach Help them improve their social skills
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Treatments for Unipolar Depression: Psychological Approaches | Cognitive therapy
Beck’s cognitive therapy – which includes a number of behavior techniques — is designed to help clients recognize and change their negative cognitive processes This approach follows four phases and usually lasts fewer than 20 sessions Phases: Increasing activities and elevating mood Challenging automatic thoughts Identifying negative thinking and biases Changing primary attitudes Over the past three decades, hundreds of studies have shown that cognitive therapy helps unipolar depression Around 50%–60% of clients show a near-total elimination of symptoms It is worth noting that a growing number of today’s cognitive-behavior therapists disagree with Beck’s proposition that individuals must fully disregard negative cognitions This treatment has also been used in a group therapy format
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Electroconvulsive therapy (ECT)
The discovery of the effectiveness of ECT was accidental and based on a fallacious link between psychosis and epilepsy The procedure has been modified in recent years to reduce some of the negative effects For example, patients are given muscle relaxants and anesthetics before and during the procedure Patients generally report some memory loss ECT is clearly effective in treating unipolar depression Studies find improvement in 60%–70% of patients The procedure seems particularly effective in cases of severe depression with delusions, but it has been difficult to determine why ECT works so well Although effective, the use of ECT has declined since the 1950s because of the memory loss caused by the procedure, the frightening nature of the procedure, and the emergence of effective antidepressant drugs
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Antidepressant drugs: MAO inhibitors
Originally used to treat TB, doctors noticed that the medication seemed to make patients happier The drug works biochemically by slowing down the body’s production of MAO MAO breaks down norepinephrine MAO inhibitors stop this breakdown from occurring This leads to a rise in norepinephrine activity and a reduction in depressive symptoms About half of patients who take these drugs are helped by them
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Antidepressant drugs: Tricyclics
Hundreds of studies have found that depressed patients taking tricyclics have improved much more than similar patients taking placebos Drugs must be taken for at least 10 days before such improvement is seen About 60%–65% of patients find symptom improvement Most patients who immediately stop taking tricyclics upon relief of symptoms relapse within one year Patients who take tricyclics for five additional months (“continuation therapy”) have a significantly decreased risk of relapse Patients who take antidepressant drugs for three or more years after initial improvement (“maintenance therapy”) may reduce the risk of relapse even more Tricyclics are believed to reduce depression by affecting neurotransmitter (NT) reuptake mechanisms To prevent an NT from remaining in the synapse too long, a pump-like mechanism recaptures the NT and draws it back into the presynaptic neuron The reuptake process appears to be too effective in some people, drawing in too much of the NT from the synapse This reduction in NT activity in the synapse is thought to result in clinical depression Tricyclics block the reuptake process, thus increasing NT activity in the synapse
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Second-generation antidepressant drugs
A third group of effective antidepressant drugs is structurally different from the MAO inhibitors and tricyclics Most of the drugs in this group are labeled selective serotonin reuptake inhibitors (SSRIs) These drugs act only on serotonin (no other NTs are affected) This class includes fluoxetine (Prozac) and sertraline (Zoloft) Selective norepinephrine reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors are also now available The effectiveness and speed of action of these drugs is on par with the tricyclics, yet their sales have skyrocketed Clinicians often prefer these drugs because it is harder to overdose on them than on other kinds of antidepressants There are no dietary restrictions like there are with MAO inhibitorss They have fewer side effects than the tricyclics These drugs may cause some undesired effects of their own, including a reduction in sex drive
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Treatments for Unipolar Depression: Biological Approaches | Brain stimulation
As one third or more of people with unipolar depression are not helped by any of the treatments discussed previously, clinical investigators continue to search for alternative approaches, including: Vagus nerve stimulation Transcranial magnetic stimulation Deep brain stimulation
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Treatments for Bipolar Disorder: Lithium and Other Mood Stabilizers
The use of lithium (a metallic element occurring as mineral salt) and other mood stabilizers has dramatically changed this picture Lithium is extraordinarily effective in treating bipolar disorders and mania Determining correct dosage for a given patient is a delicate process Too low = no effect Too high = lithium intoxication (poisoning) All manner of research has attested to the effectiveness of lithium and other mood stabilizers in treating manic episodes More than 60% of patients with mania improve on these medications Most individuals experience fewer new episodes while on the drug Findings suggest that the mood stabilizers are also prophylactic drugs, ones that actually help prevent symptoms from developing Mood stabilizers also help those with bipolar disorder overcome their depressive episodes to a lesser degree Researchers do not fully understand how mood stabilizing drugs operate They suspect that the drugs change synaptic activity in neurons, but in a different way from that of antidepressant drugs Although antidepressant drugs affect a neuron’s initial reception on NTs, mood stabilizers seem to affect a neuron’s second messengers Another theory is that mood stabilizers correct bipolar functioning by directly changing sodium and potassium ion activity in neurons
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Treatments for Bipolar Disorder: Adjunctive Psychotherapy
Psychotherapy alone is rarely helpful for persons with bipolar disorder Mood stabilizing drugs alone are also not always sufficient 30% or more of patients don’t respond, may not receive the correct dose, and/or may relapse while taking it As a result, clinicians often use psychotherapy to as an adjunct to lithium (or other medication-based) therapy Therapy focuses on medication management, social skills, and relationship issues Few controlled studies have tested the effectiveness of such adjunctive therapy Growing research suggests that it helps reduce hospitalization, improves social functioning, and increases clients’ ability to obtain and hold a job
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How Do the Treatments for Unipolar Depression Compare?
Findings from a number of research studies suggest that: Cognitive, cognitive-behavioral, interpersonal, and biological therapies are all highly effective treatments for mild to severe unipolar depression Although cognitive, cognitive-behavioral, and interpersonal therapies may lower the likelihood of relapse, they are hardly relapse-proof Findings from a number of research studies suggest that: These various trends do not always carry over to the treatment of depressed children and adolescents Among biological treatments, antidepressant drugs and ECT appear to be equally effective for reducing depression, although ECT seems to act more quickly In addition, the newly developed brain stimulation treatments seem helpful for some severely depressed individuals who have been repeatedly unresponsive to drug therapy, ECT, or psychotherapy
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Which of the following is an analogue study?
Studying the effects of stress in nonhumans
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external validity refers to the extent to which the results of a study
apply to the subjects and situations other than the ones studied
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the following experiment is conducted to study the causes of aggression in children. Holf the children eat a sugared cereal; the remaining half eat cornflakes. The number of aggressive acts displayed by the children in one-hour play period after breakfast is then recorded. In this experiment:
The type of ceral is the independent variable, and the number of aggressive responses is the dependent variable
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The ability to generalize results from a study of certain individuals to other individuals not studied is called:
external validity
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Imagine that a longitudinal study found tat children raised by schizophrenics are more likely to commit crimes later. This resuslts tells us that:
Children of schziphrenics are at higher risk for criminal behavior
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Describing the number of cases of mental retardation in the children of older mothers in 2005 would be a legitimate goal for a(n) _______ study:
Epidemiological
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Various obstacles interfere with the study of abnormal psychology. All of the follwing are examples except:
Most clinicians oppose the scientific study of their discipline
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Dr. Time required half of a group of health volunteers to study a passage for 1 hour. The other half of the participants studied for 15 minutes. Dr. Time then administered a test of their memory of details from the passage. What was the dependent variable?
The results of the memory test
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There were ten new cases of schizophrenia in a small town in the Midwest this week. This observation refers to the _______ of schizophrenia in this small population.
incidence
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Experiments are consistent with the _____ aproach.
nomothetic
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Which of the following research pairs are most logically similar?
natural experiment and quasi-experiment
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Which of the following is not true about the obstacles that clinical scientists face in studying pschological disorders?
humans have unusually stable (unchanging) moods and behavior
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The major advantage of a correlational study over a case study is that it:
has better external validity
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Case studies are useful for
studying unusual problems
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In a multiple-baseline design involving the treatment of two problem behaviors, when the first behavior is treated (but not the second), what does one expect to happen to the second behavior?
it should stay the same
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what is the term for studies that have the strucutre of expeirments except that they use groups that already exist, instead of reandomly assigning participants to control and experimental groups?
quasi-experiments
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Which of the following types of research is most likely to involve nonhuman participants?
analogue experiment
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A researcher randomly divides young women suffering from anorexia into two groups. Participants in Group A receive psychotherapy and drug treatments; participants in Group B receive attention (but no therapy) and a "sugar pill." The researcher then compares participants in the two groups on relief of anorexia symptoms.
experiment
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Using generally accepted standards, what is the change that a statistically significant result is due to chance?
5 percent
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Internal validity reflects how well a study:
Rules out the effects of all causes excpet those being studied
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The form of correlational research that seeks to find how many new cases of a disorder occur in a group in a given time period is termed:
epidemiological (incidence)
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Challenges faced by clinical reserachers include all of the follwing expect:
there are very few graduate students trained in clinical research
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The finding that women have higher rates of anxeity and depression than men in the United States is most likely due to _______ research.
Epidemiological
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Which of the following is the best example of the nomothethic approach?
Review of records to see if Autism runs in families in the United States
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If an epidemiological study shows that eating disorders are more common in Western countries than in Eastern ones, we can appropriately ocnclude:
nothing about the cause of such a finding
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A case study differs from a single-subject experiment because single-subject experiments involve:
observation of a subject before and after independent variable manipulation
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The number of new cases of a disorder in the population that emerge in a particular time interval is called the
incidence
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in order to justify experiments with animals, reserachers must:
balance the suffering of the animals with the knowledge to be gained
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the incidence of HIV+ results on campus tells you:
the number of new HIV+ cases measured in a time period
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The prevalence of sexual dysfunction in older men seen at a clinica tells you the:
total number of older men with sexual dysfunction at the clinic
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Which of the following correlations is momst likely to be statistically significant?
(-).80 based on a sample of 100 people
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If you were to graph the relationship between the number of negative life events experienced in the last month and that person's perception of stress, you would prabably find a(n):
upward-sloping line (to the right).
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The idea that children from a single-parent families show more depression than those from two-parent families is a(n):
hypothesis
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In correlational research, external validity is established when:
the smaple is representative of the larger population
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All of the follwing are merits of the correlational method except:
provides individual information
256
When more than one research method produces similar results, we:
can have more confidence in the results
257
A reseracher reandomly divides young women suffering form anorexia into two groups. Participants in Group A receive psychotherapy and drug treatments; participatns in Group B receive attention (but no therpay) and a "sugar pill". The researcher then compares participatns in the two groups on relief of anorexia symptoms.
placebo study
258
if you were a schizophrenic living in the first half of the twentieth century and had a mother who was thought to be schizophrenogenic, she would have been seen as:
cold and domineering
259
Imagine that there is a statistically significant result foun in an experimntal research project. The most appropriate conclusion would be that:
differences in the dependent variable are likely due to the independent variable
260
A psychologist does a study of an individual invovling a hsitory, tests, and interviews of associates. A clear picture is constructed of this individual so that the bahavior is better understood. This study is a(n)
case study
261
experimenters are generally willing to:
subject animals to more discomfort than humans
262
Which of the following is a limitation of the case study?
it does not result in a high external validity
263
If researchers studied Vietnam veterans for 30 years after their return, the study would be:
longitudinal
264
Imagine that you are doing an ABAB reversal design study in which you are measuring level of depression with and without the addition of an exercise program. What is the first "A" in the study?
no exercise
265
Which of the following is an example of an idiographic approach to knowledge?
a clinical evaltuion of an individual
266
Freud's study of Little Hans involved:
letters sent to Freud by Hans' father
267
In an experiment on the effects of two new drugs on mood, neither the patients, researchers, nor those who are evaluating mood know which drug the patients are getting. The study is a ______ blind.
triple
268
Research shows that the result of lobotomies was:
irreversible brain damage and withdrawal.
269
Which of the following is the best way for clinicians to come to an understanding of abnormal behaivor?
to rely on findings that have been supported by multiple research methods
270
A researcher is interested in the effects of a new drug for testing anxeity nd decided to study it in rats by conditioning the fear of a high-pitched noise and then testing rats' reactions with and without the drug. This is an example of a(n):
analogue experiment
271
A response inventory that asks individuals to provide detailed information about their typical thoughts and assumptions is a(n):
cognitive inventory
272
Racine has recently broken up with her boyfriend and at the same time lost her job. Which axis of DSM-IV-TR would these factors be included undr?
Axis IV
273
The intial problem in stuying the effectiveness of psychotherapy is:
defining what it means for a treatment to be successful
274
Which of the following tests is likely to have the lowest reliability?
the draw-a-person Test
275
A high school bully constantly ignores other's rights, and appears not even to realize that others do have rights. A likely DSM-IV-TR partial diagnosis for this bully would be:
antisocial personality disorder on AXIS II
276
Clinical interviews are the preferred assessment technique of many practitioners. One particular strength of the interview process is:
the chance to get a general sense of the client
277
Deciding that a client's psychological problems reperesent a particualr disorder is called
diagnosis
278
the assessment instrument most likely to be used to detect brai nabnormalities is the:
neuropsychological test
279
If a clinician wanted to know more detailed information about a person's functioning is a specific area, the clinician would use:
a response inventory
280
Of the following, who is most at risk for misinterpreting a cultural response as pathology?
a dominant-culture assessor
281
How does an MRI make a picutre of the brain?
It relies on the magnetic properties of the atoms in the cells scanned
282
Dr. Ross and Dr. Carman agree that Suzette if suffering from posttraumatic stress disorder. Their judgement is said to have:
reliability
283
When a person has organic brain impairment, that person would most likely have difficulty completing:
the Bender-Gestalt test
284
The most legtimate criticism of intelligence tests concerns their:
cultural fairness
285
Which of the following would be most likely to have been in therapy at some pint in their lives?
women with a postgraduate education
286
A campus newspaper publishes an "exam anxiety" test, which was put together by the newspaper staff one evening just before their publishing deadline. Despidte its hasty construction, the test most likely has:
face validity
287
Compared to projective tests, personality inventories generally have:
greater reliability and greater validity
288
Studies of diagnostic conclusions made by clinicians show that:
they pay too much attention to some information and too little to other information
289
if a person responds to a TAT card by relating to the main character and applying his or her own concerns, the person is said to be identifying with the:
hero
290
Youssef is the kind of person who breaks laws and rules with no feeling of guilt and is emotionally shallow. He would probably score high on the MMPI-2 scale called:
psychopathic deviate
291
One of the assumptions of a functional analysis is that:
abnormal behaviors are learned
292
Which category of clinical tests tends to have the best standardization, reliability, and validity?
intelligence tests
293
Which of the follwing is a reson to question the validity of clinical interviews?
clinicians might overemphasize pathology
294
A test is constructed to identify people who will develop schizophrenia. Of the 100 people the test identifies, 93 show signs of schizophrenia within five years. The test may be said to have high:
predictive validity
295
If your friend had her brain waves recorded in order to measure electical activity, she most likely had a(n):
EEG
296
The technique that uses X-rays of the brain taken at different angles to create a static picture f the strucutre of the brain is called:
computerized axial tomography
297
The controversy among clinicians concerning suicide sites on the internet pits ______ against ________
risk to patients; freedom of speech
298
The knowledge that the person a clinician is about to interview has already been diagnosed as haiving an anxiety dsorder could lead to:
observer bias
299
What kind of validity is most important to clinicnas in ealuating the utility of a classfication system?
predictive validity
300
The major focus of a clinical practitioner when dealing with a new client is to gather what type of infomration?
idiographic
301
Georgeis consumed with concern that his house will burn down. Before he leaves, he makes sure that all his applicances are unplugged. He often has to go back home and check to make he did not leave any plugged in. Which MMPI-2 scale would he most likely score high on?
psychasthenia
302
Which of the following tests is a personality inventory?
MMPI-2
303
If a graph shows the years of the twentieth century along the horizontal axis, and confidence in assessment of abnormality--from low to confidence to high confidence--going up the vertical axis, then confidence in assessment of abnormality over the past 50 years would be a(n):
"U"-shaped function--high then low then high
304
A patient complains of a phobia. Two lines of questioning y the clinician concern the specific object of the phobia and what the person does when he or she confronts that object. This clinicna's orientation is probably:
behavioral
305
A cluster of symptoms that go together and define a mental disorder is called a:
syndrome
306
a clinicnan has developed a new assessment tool. Clients write stories about their problems, then two different judges independently evaluate the stories in terms of how lgically they are written. For this assessment technique to be useful, there must be:
high interrate raliability
307
A clinician intervier says, in part, "How do you feel about yourself today? How do you feel about what's going on in your life?" Most likely, that clinical interviewr's orientation is:
humanistic
308
Which of the following is an inaccurate belief that many clinicians appear to have?
Clinicians using their own logic are more accurate than statistical analyses
309
While someone is watching. Jennifer actually eats fewwer sweets than usual. This tendency to decreas a behavior while being observed is an exampole of:
reactivity
310
If a enw test for anxeity is normed on individuals who are waiting to take introdcutory psychlogy final exams, the new test is surely lacking:
adequate standardization
311
A panel of psychologists and psychiatrists evaluates the test results and clinical interviews of a client in a sanity hearing. They all arrive at the same diagnosis. The panel has high:
interrater reliability
312
An adult frequenly displays symptoms of depression at home, but seldom does so at work. In this case, clinical observations of this person at home would lack:
external validity
313
Which of the following is designed to disclose a patient's thoughts and assumptions?
cognitive inventory
314
The most effective treatment for phobias is
behavioral therapy
315
Patients recieveing therapy for a pscyhological problem, on average, experience imporvement greater than _____ of peole with similar problems who do not receive treatment.
75%
316
If you received the diagnoses of both social phobias and agorophobia, your diagnoses would be:
comorbid
317
The singlem ost effective treatment for schizophrenia is
drug therapy
318
Dr. Martin has just asked a potential clinet to talk about herself. After she responsds, the doctor's next question is based on some interesting point she brought up. There are few constraints on the conversation. Dr. Martin has just:
conducted an unstrucutred interview
319
Imagine that you are asked to give a scientific opinion on the use of polygraphic evidence. Your best resopnse would be
although they are widely used, they are not particularly valid
320
A clinician has developed a test that requried test takes to tell sotreis about a seirs of pictures of city skilying. Most likely, this new test is a:
Projective test
321
All of the following are considered traditional psychophysiological disorder except
cancer
322
Some people are stimulated by exciting, potentially dangerous activities that terrify others. These varying reaction represented differnces in:
State anxiety
323
At the outset of a(n) _______, fear of losing control leads to hyperventilation leads to a fear of suffocation, fear of suffocation leads to a feeling that the stiatuion is very dangerous and that the person is losing control.
Panic Attack
324
If you wanted a drug to improve the functioning of GABA, you would choose:
A benzodiazepine
325
The effect of norepinephrine and corticosteroids on a body experiencing stress is:
initially to stimulate the immune system, then to inhibit it
326
Exposure and resonse prevention as treatment for obsessive-compulsive disorder:
does not work as well for those who have obsessions but no compulsions
327
Which of the following would you not find on the Social Readjustment Rating Scale?
exercise
328
Surveys show that in the U.S., the typical female victim of rape
is not tested for HIV, and has long term health problems
329
All of the following are biological treatments for generalized anxiety except:
rational emotive therapy
330
Of the following, the most serious limitation of the Social Readjustment Rating Scare is that it:
Deos not take into account the stresses of diverse populations
331
A person with posttraumatic stress disorder who is having flashbacks is:
reexperiencing the traumatic event
332
The organ most releated to controlling emotional memories and "turning off" the bod's arousal is the
hippocampus
333
A flash flood hits a smal appalachian community. Those providing critical incident stress debriefing intervention would
provide short-term counseling services
334
Which of the following statemtns best describes the raltionship between biology and stress?
Arousal generated by trauma leads to stress disorders, which may produce more brain changes
335
Cognitive researchers have found that lives full of anxiety most often are associated with:
unpredictable negative eents
336
Which phase of the general adaptation syndrome is assumed to invovle activation of the sympathetic nervous system?
alarm
337
which of the following is an example of a narrow social phobia?
fear of public speakiing
338
Jethro hates his mother-in-law and can't seem to stop imagining her lying in apool of blood, in pieces. These thoughts are interfering with his daily life. He is exhibiting:
obsessive images
339
What type of drug is alprazolam (Xanax)
benzodiazepine
340
Which of the follwing convinces researchers that panic disorder is biologically different from generalized anxity disorder?
differencces in the brain circuitry in the two disorder
341
College studetns who are so anxious that they can't functioni unless their clothes are arranged by color and type in their closts are xperiencing a(n):
obsessive-compulsive disorder
342
Imagine that researchers investigating panic disorder gave you a drug that caused you to hyperventilate and your heart to beat rapidly. You would have been given a(n):
biological challenge test
343
The part of the body that releases hormones into the bloodstream is the ______ system.
endocrine
344
Mindfulness-based cognitive therapy
Receives support in therapy application for wide range of disorders, including generazlied anxeity disorder
345
If someone were to correlate scores on the Social Readjustment Rating Scale with the number of phsycial (health) complaints, one would most likely find:
a significant positive correlation
346
A returning combat veteran with a stress disorder would most likely be in ________ to help change dysfunctional attitudes and styles of interpreation that resulted from the trauma
cognitive therapy
347
When was acute stress disorder as a result of combat (called "shell sock") first recognized?
after World War I
348
At what point is distress the greatest after a rape?
withink one month after the assault
349
Apparently, people develop phobias more readily to such objects as spiders and the dark than they do to such objects as computers and radios. This observation supports the idea of:
Preparedness
350
According Freud, obsessive-compulsive disorders have their origin in the ____ stage of development.
Anal
351
Rene Descartes's mind-body dualism is
inconsistent with modern views of the relatinship between the mind and bodily illnesses
352
Research using the Social Adjustment Rating Scale indicates that:
The greater the life stress, the greater the illness
353
For a typical U.S. soldier serving in Iraw or Afghanistan, which one of the following would most characterize that soldier's vulnerability to a stress disorder?
The soldier would have about a 50/50 chance of having seen a budy killed or seriously wounded
354
Which of the following statements most accurately reflects what we know from recent studies?
phobias usually are a result of classcial conditioning
355
one who is experiencing a panic disorder would most likely also be phobic about:
leaving home
356
If you have a high level of C-reactive protein, we know that:
you are at greater risk for heart disease, stoke, and other illness.
357
Please flex your biceps. Now release your biceps. Now flex your thigh. Now release it." These statements might be made by a therapist using:
muscle relaxation therapy
358
Which of the follwing relfects the most common obsessive thought?
if I touch that doorknob, I will be dirty and contaminated
359
A person who is restless, keyed up, and on edge for no apparent reason is experiencing:
free-floating anxiety
360
The relationship between income and rate of generalized anxiety disorder is:
negative--the higher the income, the lower the rate of generalized anxiety disorder
361
Combat veterans in a therapy group express a great deal of guilt and rage. Most likely, the vetrans are in a:
rap group
362
Posttraumatic stress disorders:
last longer than a month
363
Jan s very fearful of speaing in pblic and will do evertyhing she can to avoid that behavior. If her fear is judged to be phobic, the most accurate diagnosis would be:
narrow social phobia
364
Maxine started worrying about cleanliness when her first child was born. That worry has intensified and she cannot stop thinking athat germs lurk everywhere . She is exhibiting a(n):
obsessive idea
365
Helping survivors talk about their feelings and fears regarding a disaster is designed to:
Help people express anxiety, anger, and frustration
366
A friend asks you whether to try relaxation training or biofeedback to reduce anxiety. Based upon present research, your best answer is:
Try either one; they're both modestly effective.
367
Which of the following therapies is an effective long-term, nonpharmocological treatment for panic attack that involves teaching patients to interpret their physical sensations accurately?
cognitive
368
A professor who becomes anxious unless students sit in alphabetical order, turn in their papers in alphabetical order, nadl eave tests in the same order is experiencing a(n):
obsessive-compulsive disorder
369
A person who witnessed a horrible accident and then ebcame unusually anxious and depressed for 3 weeks is probably experiencing:
acute stress disorder
370
Alberto has been workign 18 hours a day trying to keep his business afloat. He has high blood pressure, an ulcer, and has just been takne to the hospital with the chest pains. He is in Selye's stage of:
exhaustion
371
Which of the following is true about research on the effectivenss of cognitive therapy for treating unipolar depresion?
Hundreds of studies show its effectiveness
372
A woman who is in conflict with her husband over whether she should have a career or stay at home fulltime to care for their children is experiencing
interpersonal role dispute
373
Recent research indicates that behaviroal therapy is the treatment of choice:
over placebo tretament
374
Clients who tend to see everything that occurs as either all right or all wrong, with nothing in between, needd to focus on wich phase of Beck's treatment for depression?
identifying negative thinking and biases
375
Which phase of the genral adaptation syndrome is assumed to invovle activation of the parasympathetic nervous system?
resistance
376
Apparently tricylclics work by:
blocking the reuptake of norepinephrine and serotinin
377
The use of ECT was prompted by the discovery that psychotic people:
rarely had epilepsy
378
People who talk rapidly, dress flamboyanlty, and get involved in dangerous activities are showing _____ symptoms of mania.
behavioral
379
Increasing pleasant activitis is most likely to be a part of a _______ therapy program.
behavioral
380
Which of the following medication/side effect pairings is correct?
MAO inhibitors cuasing diatery restrictions
381
Which theoretical orientation would support the finding that there is a significant relationshi between positive life events and feelings of life satisfaction and happiness?
behavioral
382
arron's persistent feelings of sadness and impeding doom dominate his life. Every time he says anything even a little positivee to his therapist, the therapist smiles. Otherweise the therapist has a stone face. This therapist is probably using some variation of:
behavioral therapy
383
Electroconvulsive therapy
appears to be msot effective in treating unipolar depression
384
Which of the following is not an example of a biological treatment for depression?
contignency management
385
A person who becomes depressed because of several recent tragic events would be experiencing depression
exogenous
386
Which of the following is true about unipolar depression?
most people recover from depression, but experience a recurrence
387
Although iniitally thought to be due to an excessive amount of a particular neurotransmitter, mania has been found to be due to low levels of which neurotransmitter?
serotoniin
388
Mnay of today's cognitive-behavioral therapists would agree that
negative cognitions should be accepted, not necessarily eliminated
389
Researchers have found that the sleep cycle in depressed people is
reversed
390
Biochemical explanation for bipolar disorder center on all of the following except
hormonal functioniong
391
Which of the following would a psychodynamic therapist be most likely to say about studied regarding the effectiveness of psychodynamic therapy for depression?
the therapy des not lend itself to empirical research
392
The most common form of mood disorder is
uniponlar depression
393
A key to preventing relapse of unipolar depression appears to be:
continue the therapy, no matter its type, after the sympotoms have gone
394
Which theoretical orientation would support the finding that Western experience more psychological symptoms of depression?
sociocultural
395
All of the following are types of major depressie disorder expet:
posttraumatic
396
Which of the following are people most likely to do to improve their mood?
talk to friens/ family
397
People experiencing mani:
want excitement and comopanionship
398
Dna is depressed and has been for a while. He, his twin brother, his mother, nad his father all participate in a fmily pedigree Study. Identify the proband(s) in his study.
Dana
399
Researchers were searching for drugs to treat schizophrenia when they came across imipramine, which aleviated the symptoms of depression, although it was not effective against schizophrenia. It became the first of a class of drugs, all sharing a similar molecular structure, called:
tricyclics
400
Assume a researcher develops something called the "Sick Neuron" theory which proposes that the "poor health" of neurons leads to unipolar depression. Based upon research, the substance most likely to be imipolicated in the theory as making neurons "sick" is:
Brain-derived neurotrophic factor (BDNF)
401
The chief differnce betwee nlearned helplessness created in laboratory settings and real-life depression is that:
laboratory depression is more likely to be accompanied by anxiety
402
The clinician who would be most likely to say, "Tell me about how your parents cared for and protect you" is a:
Psychodynamic clinician
403
The hormone most closely associated with the noset of seasona affective disorder is
melatonin
404
The experience of a lack of desire to engage in sexual activity with one's sopuse would be considered a(n) ______ symptom of depression
motivational
405
in general, object relations theorist follow which theoretical perspective?
psychodynamic
406
after a couple has divorced, you learn that one of them is suffering form depression. Most likely:
a troubled marriage led to the depression
407
If biochemical ibmabalce were the cuase of a person's depression, the latest research would lead us to expect that person to have:
an abnormality in the activity of certain neurotransmitters, especially serotinin nad neorepinephrin
408
the person associated with developing a cognitive theory of depression basedo n negative and maladaptive thinking was:
BECK
409
Clients who test their assummtpin about what is cuasing their depression are working in which phases of Beck's treatment program?
changing primary attitudes
410
Seasonal affective disorder is thought to be due to
increased levels of melatonin
411
If your therapist concentrated on helping you recognize and change negavite thoughts and thus improve your mood, yor therapist would be using
cognitive therapy
412
Therapists who treat African American clints for depression need to be aware that their clients are
less likely to receive newer second-gerneation drugs
413
Judtih is currently experiencing a period of sadness that interferes with her ability to go to work and to take care of her children. It has lasted now for three weeks, and hse has experienced similar episodes in the past. What type of major depression would she most likely be diagnosed with?
recurrent
414
A person experiencing unpoilar depression writes the following in an activity schedule, "go to store; doctor's appointment; visit museum; read novel; clean room." What treatment approach is this perosn most likely recieiving?
cognitive therapy
415
The treatments that are most likely to work in the broadest of cases of depression are
cognitive, interpersonal, and biological
416
A baby who was seperated from its mother at brith, and who subsequently became withdrawn, sad, and tearful, could be experiencing
anaclitic depression
417
A talented artist is expericing severe bipolar disorder. In terms of artistic output only, the best thing that artist could do is:
seek treatment: psychological distubance is not necessary ofr godo artistic output.
418
Which of the following is important in using contingency management effectively?
make sure that thep erson receives reinforcement for engaging in postivie activities.
419
Lithium has been found to
enhance the effectiveness of antidepressant drugs in treating unipolar depression
420
Interpersonal psychotherapists believe that therapy must address
role transitions in relationships