Exam 1 Lecture Study Guide

Question 1

Dementia Paralytica

Answer 1

Accounted for 1/4 of psychological cases in the 1800’s
- Flu-like symptoms
- Personality changes
- Memory loss and attention deficits
- Mania and depression
- Asocial behavior
- Delusions of grandeur
- Involuntary motor movements

Question 2

Behavior VS Disorder

Answer 2

Emotions, cognitions, and interpersonal relationships
VS
Some sort of abnormal condition

Question 3

Syndrome

Answer 3

A collection of signs and symptoms that seem to co-occur, with little knowledge of their pathogenesis

Question 4

Essentialist Definition

Answer 4

A set of characteristics that make something what it is (its defining features)

Question 5

What is meant by normal and abnormal?

Answer 5

Normal = typical functioning, social standards, commonality, and/or average
Abnormal = the opposite (things that are of personal or societal concern, aka deviance)

Question 6

Neurodiversity

Answer 6

Normal and natural differences in brain functioning from person to person

Question 7

What is meant by dysfunction and malfunction?

Answer 7

Dys. = impairment in the function of a bodily organ or system
Mal. = the system or part of it is still functioning, but not as it should

Question 8

In what situations does the dysfunction account of psychopathology fall short?

Answer 8

Most behavior disorders are actually your body functioning as it SHOULD, what makes it problematic is the way its contextually defined

Question 9

Impairment

Answer 9

A function being weakened or damaged, implying that there is something worthy of clinical attention and/or treatment

Question 10

What is meant by subjective distress?
Why might relying solely on the individual’s account of distress to diagnose be a problem?

Answer 10

S.D. = reports of pain, suffering, or upset
Some people are not distressed by their behavior, such as psychopaths and serial killers, who lack empathy and guilt for their actions

Question 11

What is malingering? In what situations is it likely to occur?

Answer 11

Faking a disorder for some indirect gain
- Factitious disorder, in which someone pretends to be sick because they like the attention they receive
- Court cases in which people feign insanity to receive a lighter criminal sentence
- Interpersonal Theories, in which someone does have a problem but adapts to the maladaptive lifestyle to the point where they don’t want to change

Question 12

How do social norms influence the definition and diagnosis of mental illness? What functions do social and political factors serve?

Answer 12

The subjective definition of a behavior disorder can be dangerous because people may look at something outside the social norm or status quo, such as homosexuality, and categorize it as a behavior disorder to justify maltreatment and establish social control
Social and political processes, controlled by a small subset of people, influence what gets categorized as a disorder and what doesn’t, which often opens things up to abuse of power

Question 13

What are some examples of past behavior disorders that were mainly categorized as so due to social norms?

Answer 13

Code 302.0 (homosexuality as a deviant sexual behavior)
Drapetomania (“mental illness” that caused Black slaves to flee captivity)
Masturbation

Question 14

What are the two components of the harmful dysfunction model and what are some of the problems with this model?

Answer 14

Classification as a behavior disorder must include both dysfunction of a biological system AND a negative value judgment/social perception
Problems:
- the pathology and etiology of many psychological phenomena are unclear (so how do we determine if it’s a dysfunction?)
- speculative
- what defines harmful and who decides?

Question 15

What do Widiger and Sankis (2000) propose as an alternative to the harmful dysfunction model?

Answer 15

Dyscontrolled maladaptivity
Dyscontrol = impairment to something that a person should have adequate control over
Maladaptive = functions that were originally (evolutionarily) adaptive are now considered maladaptive in modern context

Question 16

What is the purpose of classification? Why do we need a classification system?

Answer 16

The ultimate goal of a classification system is utility (we need something to help address this problem in society now, even if we don’t have an exact definition figured out)

Question 17

What does a classification system provide?

Answer 17

• A nomenclature or common language for practitioners to communicate the problem
• Sets a structure for research
• Sociopolitical functions
• Basis for diagnosis, prognosis, and treatment

Question 18

Descriptive Psychopathology

Answer 18

This co-occurring collection of signs and symptoms (that we notice when observing the patient) has this name

Question 19

Epidemiology vs Etiology

Answer 19

To who is this happening and where
VS
How did this start and develop over time

Question 20

Supernatural Model of Classification

Answer 20

Model: abnormal behavior is caused by possession, witchcraft, curses, sin, God, etc.
Historically: led to improper treatments such as magical/religious rituals, bribery, and trephination (hole in skull)
Today: lack of funding and knowledge about the impact of religion and spirituality on treatment success

Question 21

Moral Model of Classification

Answer 21

Model: abnormal behavior is deliberately adopted by the individual
Historically: ostracization/forcing individuals to live a life of confinement and abandonment
Today: we must acknowledge that there are factors outside of our control that infringe on our decisions (environmental, social, and biological determinants), but we cannot completely absolve people of responsibility and accountability for their actions

Question 22

Biological Model of Classification

Answer 22

Model: your physical status or biology is in some way related to your mental status
Historically: early theories included the four humors and phrenology
Today: evidence shows that exercise, diet, sleep, and medication can all impact physical + mental health (thus the medical model is now the basis for our classification systems)

Question 23

What is the Reductionist Fallacy and how does it relate to the Medical Model of behavior disorders?

Answer 23

Reducing our understanding to the lowest possible level of explanation (attributing it to nothing more than the sum of its parts)
In Psych, there is a tendency to give priority to the biological level with little knowledge about the impact of politics, finances, social norms, etc.

Question 24

Psychosis VS Neurosis

Answer 24

The two earliest broad classifications (they were fairly right, but not that useful)
Psych. = a severe mental disorder characterized by a break with reality
Neuro. = a milder mental disorder characterized by distortions of reality

Question 25

What did Kraepelin view as the origin or cause of mental illness?

Answer 25

Purely biological and genetic factors

Question 26

What were the guiding principles behind Kraepelin's classification system?

Answer 26

Detailed observation, careful description, and organization of data into categories Emphasized anatomical pathology, etiology, and prognosis

Question 27

What did Kraepelin ultimately conclude about his classification approach and why?

Answer 27

It lacked utility because classifying disorders based on pathological anatomy is nearly impossible - there is little knowledge about it - most etiological theories are speculative - many disorders are polygenetic

Question 28

Psychological Model

Answer 28

Created by Freud Biological impulses give rise to motivations that conflict with our morals, reasoning, and societal expectations

Question 29

What was the history of the DSM's creation?

Answer 29

- Psychological model created - Proof of concept (dementia paralytica discovered to be syphilis) - Psychiatry becomes a respectable medicine - The International Classification of Diseases was created (diagnostic manual) - The DSM was created in the US as a more universal system

Question 30

Major Differences between the DSM-I/II and the DSM-III (and beyond)

Answer 30

DSM-I/II: Freudian approach, no distinction b/w normal and abnormal, subjective descriptions, POOR DIAGNOSTIC RELIABILITY DSM-III: theoretically agnostic (but rooted in medical model), hierarchal system, specific diagnostic criteria, multi-axial system

Question 31

What were the criticisms of the DSM-I and DSM-II?

Answer 31

- Szasz: mental illness is a myth meant to make people conform to social norms by labeling undesired behavior - Stigmatizing - Self-fulfilling prophecies - Rosenhan: people can't even tell the difference between normal and abnormal behavior

Question 32

Who were the Neo-Kraepelinians and what did they stand for?

Answer 32

Wanted to abandon the psychological model of the DSM-I and II and reaffirm psychiatry as a branch of medicine with a biological basis - Given major influence over the creation of the DSM-III - Political pressure led to exclusion of theoretical references in the DSM but it was obviously rooted in the medical model

Question 33

What are the main critiques of the DSM overall?

Answer 33

- Explicitly atheoretical - Categorical model sucks - Comorbidity due to overlapping diagnostic criteria - Not therapeutically useful - Process of including and excluding diagnoses is heavily influenced by social and political processes

Question 34

What are the main critiques of the DSM-V specifically?

Answer 34

- New disorders with little research and support - Lowering diagnostic thresholds - Novel severity scales - Unnecessarily complex personality disorders section - Concerns about the lack of field testing and forensic review

Question 35

What is aversive conditioning and how does it factor into anxiety?

Answer 35

An adaptive process in which a neutral stimulus becomes paired with a bad experience to produce a reflexive behavior, done as a way of learning what signals danger and avoiding threats before they occur This process is how anxieties or fears are acquired

Question 36

What differentiates anxiety from an anxiety disorder?

Answer 36

- If the avoidance is excessive or not justified by the nature of the perceived threat (increased frequency and intensity) - If the avoidance leads to impairment and/or subjective distress (e.g. perceived inability to control worry)

Question 37

What are the diagnostic features of specific phobias?

Answer 37

- Marked/out of proportion fear to the presence or anticipation of a specific object or situation - Exposure to phobia = anxiety and potential panic attacks - Recognize that fear is out of proportion - Avoided or endured with intense anxiety or distress - Avoidance interferes with the person's life

Question 38

What are the components of Mowrer's two-factor theory of anxiety?

Answer 38

Factor 1 (the acquisition of fear): when a stimulus is repeatedly paired with a bad experience, a fear or new meaning is learned that tends to prevent the recurrence of that experience (aka classical conditioning) Factor 2 (the maintenance of anxiety): when a stimulus is repeatedly paired with a good experience, a new meaning is learned that tends to ensure the recurrence of that experience (aka operant conditioning) - the avoidance of fear = relief = reinforcement for avoidance

Question 39

What is the biggest problem or critique that two-factor theory has in accounting for specific phobias?

Answer 39

Many people can't remember the fear being conditioned (i.e. having any sort of negative experience associated with the stimulus)

Question 40

How can two-factor theory actually account for the critiques regarding not remembering the conditioning?

Answer 40

Infantile Amnesia - being conditioned in the infant phase Insidious Acquisition - conditioning occurring without your knowledge (ex: watching movies) Fear responses don't need verbal remediation - just because you don't remember it doesn't mean it didn't happen

Question 41

What is the preparedness account of phobias? How does it also address the critiques of the two-factor accounts?

Answer 41

Individuals are predisposed to fear certain things due to evolution - certain stimuli are more tied to phobias - more instructional transference occurs for certain stimuli - certain phobias can be rapidly acquired and hard to get rid of - fears develop over time

Question 42

What are the different pathways to fear acquisiton?

Answer 42

Direct Conditioning, Modeling (aka Vicarious Conditioning - seeing it happen to someone else), Instructional Transference (someone telling you it's dangerous)

Question 43

What is the difference between lumping and splitting anxiety disorders?

Answer 43

Lumping = putting all anxiety disorders into one diagnosis (potentially too broad) Splitting = keeping the various anxiety disorders separate (potentially too granular)

Question 44

What is the rationale for lumping all anxiety disorders into one? What would be the downside of doing this (what info would be lost)?

Answer 44

Reasons to lump: - Two-factor explains the underlying causes for all anxieties - High comorbidity among the anxiety disorders Downside: - Different anxiety disorders have different topographies (observable descriptive features) and this info would be lost if lumped together (creates problems for treatment)

Question 45

What ultimately creates different topographies across the anxiety disorders?

Answer 45

The thing that you're afraid of will lead to different observable symptoms and require different clinical approaches Ex: a phobia of something observable (like a dog) is different than a phobia of something not observable (like germs)

Question 46

What is a panic attack and what are its diagnostic features?

Answer 46

An abrupt surge of intense fear that reaches its peak within a few minutes At least four of the following symptoms must be present: Pounding heart, sweating, shaking, choking, difficulty breathing, chest pain, nausea, dizziness, chills, derealization/depersonalization, and/or fear of going crazy or dying

Question 47

What are the diagnostic features of panic disorder?

Answer 47

Repeated unexpected panic attacks plus at least one of the following (for at least 1 month): - persistent concern about having another panic attack - worry about the potential consequences of having an attack - significant changes in behavior related to attacks

Question 48

What is agoraphobia and what are it's diagnostic features?

Answer 48

Fear of being in places in which escape might be difficult or help might be unavailable in the case of an emergency (like a panic attack) Must have anxiety in two or more of the following conditions: Public transportation, open spaces, enclosed spaces, crowds, being outside the home

Question 49

What characteristics of the first panic attack may predispose individuals to future attacks?

Answer 49

If the individual is unable to discern what the trigger of the panic attack was (or even that they're having a panic attack in the first place), they will be more likely to have attacks in the future (alarm theory)

Question 50

What is meant by panic disorder being a “fear of fear”?

Answer 50

Fearing the potential of having a panic attack (especially in situations in which an attack might lead to impaired function, entrapment, or negative social evaluation) will lead to an increased focus on bodily sensations, a cognitive misappraisal of physical symptoms, heightened anxiety, and eventually, an actual panic attack

Question 51

What aspects of an initial panic attack are associated with the development of agoraphobia?

Answer 51

Predictors of agoraphobia include: - concerns about the social consequences of panic - specificity of and ability to avoid the feared situation(s) - being unemployed

Question 52

What are the diagnostic characteristics of generalized anxiety disorder?

Answer 52

- Excessive anxiety about a variety of events that occurs on more days than not (for at least 6 months) - Difficulty controlling worry - Restlessness and irritability - Easily fatigued - Difficulty concentrating - Muscle tension - Sleep disturbance

Question 53

What is the key feature of GAD?

Answer 53

Chronic and uncontrollable worry that is excessive and unrealistic

Question 54

What is the intended/adaptive function of worry?

Answer 54

Worry is a way of avoiding future threats that have yet to materialize by: prompting people to generate solutions and take action to prevent the perceived difficulty - It also allows people to regulate their emotions in response to uncertain situations (i.e. temporarily relieves fear)

Question 55

How does worry play into GAD?

Answer 55

Learning that involves negative unpredictable/uncontrollable events = situational uncertainty becoming a conditioned stimulus that elicits worry as a conditioned response (hence the "chronic, uncontrollable, and excessive worry")

Question 56

What information links temperament and attachment style to Social Anxiety Disorder?

Answer 56

Children with an inhibited (shy) temperament are more likely to respond to novel stimuli with fear or withdrawal, a pattern that may continue into adolescence Children with an insecure attachment to a caregiver that was harshly critical, conditional, unpredictable, or rejecting are more prone to SAD (teaches them that people are inherently critical)