exam one Flashcards
(155 cards)
1
Q
definition of abnormal behaviour
A
psychological dysfunction
personal distress or impairment
atypical or not culturally expected
2
Q
psychological dysfunction
A
must show some level of impairment. very important to compare individuals to their own baseline
3
Q
personal distress or impairment
A
subjective sense, painful unpleasant, interfering with function
4
Q
atypical or not culturally expected
A
most disorder present similar across cultures, with slight variations but there are some specific regional disorders and some disorders display different in different cultures
5
Q
the DSM (DSM-5)
A
contains the listing of criteria for psychological disorders
6
Q
psychopathology
A
the scientific study of psychological disorders
7
Q
the scientist-pracitioner
A
consumers of science
evaluator of practice
creator of science
Means they are keeping up with the evidence, learn from mistakes and strive for improvements, do your own research, publish in scientific journal so your peers can learn as well
8
Q
psychiatrists
A
doctor specialized in mental illness, med school, 3 years residency, generally deal with more serious diagnoses
9
Q
psychologists
A
therapy, master and doctoral levels
10
Q
social workers
A
can do a lot of what psychologists can do, trained in case management
11
Q
consumer of science
A
enhancing the practice
12
Q
evaluator of practice
A
determine the effectiveness of the practice
13
Q
creator of science
A
conducting research that leads to new procedure useful in practice
14
Q
studying psychological disorders
A
focus:
- clinical description
- causation (ethology)
- treatment and outcome
15
Q
Clinical description
A
the unique combination of behaviours, thoughts, and feelings that make up a specific disorder
Prevalence and incidence of disorders
Onset of disorders (acute vs. insidious onset)
Course of disorders
16
Q
ethology
A
or the study of origins, has to do with why a disorder begins (what causes it) and includes biological, psychological, and social dimensions
17
Q
treatment:
A
the effects of a drug could give hints about the disorder
18
Q
the supernatural tradition
A
deviant behaviour: a battle between good and evil
tumultuous period chronicled by historians of the 14th century
conflicting opinions on treatment of insanity
19
Q
demons and witches
A
predominant thoughts during 14th and 15th centuries
madness and evils caused by witches and sorcery
unexplainable behaviour attributed to evil
20
Q
stress and melancholy
A
another opinion of 14th and 15th centuries
insanity is a natural phenomenon (caused by mental or emotional stress)
treatable: rest, sleep, happiness, portions, baths, do things to the body to restore a balance
21
Q
treatments for possession
A
abnormality considered a divine punishment for abhorrent behaviour
treatable: hanging person over snake pits, cold water baths
22
Q
hydrotherapy
A
patients were shocked back to their senses by having submerged in ice-cold water
23
Q
the moon and stars
A
psychological functioning affected by movements of moon and stars
-hence, lunatic (moon)
no scientific evidence
24
Q
hippocrates and galen
A
humors, hysteria: normal brain functioning related to bodily humors
blood, black bile, yellow bile, phlegm
imbalance of humors led to disease
25
biological tradition the 19th century
syphilis
general paresis
microscope to look at pathogens
pharmacology was surprising advanced at the time
26
the development of biological treatments
surgeries, medications
diagnoses are important
physical science often advances faster than society can handle
27
consequences of the biological tradition
some clinical success treating mental illness in early 20th century
psychological disorders approached scientifically
28
emil kraepelin (1856-1926)
one of the founders of modern psychiatry
29
moral therapy
originated with French psychiatrist Philippe pinel (1745-1826)
encouraged humane, socially facilitative atmosphere for patients
Benjamin rush (1745-1813) father of North American psychiatry
this was the origin of the talk therapy
30
who started the mental hygiene movement
Dorothea dix
31
asylum reform and decline of moral therapy
initiated metal hygiene movement
involved in construction of new asylums
waves of opening and closing of psych hospitals
32
psychoanalytic theory
unconscious mind
catharsis
id, ego and superego
defence mechanisms
33
defence mechanism
when the ego loses the battle with the id and superego
| Denial, displacement, projection, rationalization, reaction formation, repression, and sublimation
34
psychosexual stages of development
oral, anal, phallic, latency, genital
35
psychoanalytic psychotherapy
Hidden intrapsychic conflicts
Free association, dream analysis
Transference- transfer your own problems to your therapist
36
humanistic theory
Self-actualization
Carl Rogers (1902–1987)
Person-centred therapy
Unconditional positive regard- the therapist needs to show the patient that they will be fully accepted and it is a safe environment to be yourself
With the right support everyone can reach their true potential
Bringing the person back into the therapy
Abraham Maslow (1908–1970)
Hierarchy of needs: basic needs fulfilled before higher-order needs are met
Self-actualizing: all of us can reach our highest potential
Fritz Perls (1893–1970)
Gestalt therapy
37
the behavioural model
Pavlov, Watson, and classical conditioning
From introspection to extinction, introspection to observerable behaviour
SR psychology, stimulus response
Habituation & its clinical applications
The simplest form of learning: learning not to response
38
exposure therapy
In vivo vs. verbally elicited
| Habituation is how and why it works
39
reinforcement
an event that follows a behaviour that increases the likelihood of the behaviour
40
punishment
event that follows that lowers the likelihood it will happen again
41
The Present: The Scientific Method and an Integrative Approach
Psychopathology is multiply determined
Reciprocal relations between biological, psychological, social, and experiential factors
The supernatural tradition has no place in a science of abnormal behavior
No single approach is optimal, they are best when used together to get a look at the full picture
21st century: an explosion of knowledge about psychopathology
More information about the brain and its functioning made possible through fields of:
Cognitive science
Neuroscience
42
one dimensional model
attributes causes of behavior to a single cause
| Is linear in approach
43
Multi-demensional model
attributes causes of behavior to several causes, recognizes the complexity of human behaviour. Our healthcare system is not set up to be advantageous for this model
44
behavioural influences
Phobias can be conditioned
| Generalized to other situations
45
biological influences
Blood-injury-injection phobia interacts with other factors
46
emotional influences
Thoughts and feelings affect body’s biology, the effects of chronic stress
Emotions lead to development of many disorders, emotions are the software and the brain is the hardware so they are very related
Affect nervous system
47
social influences
Society and culture influence behaviour, guideline of acceptable behaviour
Support or rejection from friends and family
Receiving social attention or not
laughing at a child’s bad behaviour
can go in the wrong direction
48
developmental influences
Developmental critical periods
More or less reactive to given situations
When combined with other factors, may lead to psychological disorders
49
outcome and comments
Consider a variety of factors to arrive at causative factors of disorders
Examine research
Consider all possible causes
50
genetic contributions to psychopathology
Genes: long molecules of DNA (deoxyribonucleic acid) at various locations on chromosomes
Every human being has a unique set of genes, except identical twins
Roles of nature (genes) and nurture (environment) is an ongoing debate in psychology
51
the nature of genes
Normal human cells have 23 pairs of chromosomes
Each parent contributes one chromosome to each chromosome pair
22 pairs provide programs for development of brain and body
23rd pair are sex chromosomes
Abnormalities in sex chromosomal pairing leads to abnormalities
Wrong ordering of genes responsible too
Polygenic: behaviours influenced by many genes
Genome: a complete set of genes
Humans have 20 000 to 25 000 genes
52
New Developments in the Study of Genes and Behaviour
Research identifying genetic contributions to psychological disorders
Adverse life events also implicated
Genes interact with environment
53
The Diathesis–Stress Model
Certain traits or behaviours are inherited
Activated under conditions of stress
Inherited tendency is diathesis
Stress is environmental (sum of influences an individual experiences throughout a lifetime)
Interaction of the two can result in abnormalities
54
Gene‒Environment Correlation Model
Genetic endowment may increase probability of responding negatively to stressful events
55
Epigenetics and the Non-genomic “Inheritance” of Behaviour
Gene expression passed on from one generation to next
Served a survival function for ancestors
Environment contributes to genes turning “on” or “off (epigenetics)
56
The Peripheral Nervous System
Consists of:
Somatic nervous system, controlling muscles
Autonomic nervous system:
Sympathetic
Parasympathetic
Endocrine system produces hormones and works in conjunction with the autonomic nervous system
HPA axis implicated in several disorders
57
Neurotransmitters
```
Agonists, antagonists, inverse agonists
Glutamate and GABA
Serotonin
Norepinephrine
Dopamine
```
58
Implications for Psychopathology
Psychological disorders mix emotional, behavioural, and cognitive symptoms
Genetic contributions to neurotransmitters
Studying images of brain waves (activity)
Pathways of neurotransmitters
Connectivity between certain brain areas
59
Psychosocial Influences on Brain Structure and Function
Exposure and response prevention
Brief exposure-based therapy can change brain function dramatically
Placebos lead to positive psychological expectations
Cognitive-behavioural therapy (CBT) can be used alone
60
Interactions of Psychological Factors with Brain Structure and Function
Neurotransmitters have different effects on individual psychological histories
Psychological factors affect brain function and behaviour
Nervous system structure constantly changes as a result of learning experiences
61
Conditioning and Cognitive Processes
Classical and operant conditioning facilitate learning relationships among events
We make judgments based on this relationship
Our responses are protective (beneficial) to us, if not hurtful
62
Learned Helplessness
Encountering conditions over which we have no control
Giving up attempting to cope
Leads to depression
Positive psychology: instilling positive attitudes and happiness
63
Social Learning
Modelling, observational learning
64
Prepared Learning
Selective learning
| Learning behaviours that protect us, monkeys afraid of snake, from observing parents
65
Cognitive Science and the Unconscious
Blind sight
Implicit memory
Implicit cognition
66
Cognitive-Behavioural Therapy (CBT)
Rational-emotive therapy
Self-instructional training
Cognitive restructuring
67
Emotion
means to elicit or evoke motion (e-motion). Emotions have a direct and dramatic impact on our functioning and play a central role in many disorders. Excessive or disruptive emotions are often intimately tied with forms of psychopathology.
68
The Physiology and Purpose of Fear
Fight or flight
Evolutionary significance for survival
Survivors passed genes down to us
the raw material that connects all this is emotions
69
Emotional Phenomena
Emotion
Mood, like pain it is subjective to the patient
Affect, observable
70
when would mood and affect be different
how you have been culturally conditioned
71
emotions has there important overlapping components
behaviour
cognition
physiology
72
Emotions and Psychopathology
Emotion disruption (dysregulation) interferes with behaviour possibly resulting in:
Panic, a failure of normal phys arousal, and noticing sudden changes
Mania, evidence that it has a strong genetic component
Bipolar disorder,
Depression
73
permanent and severe mental illness
szchopherana
bipolar
BPD
74
Gender Roles
Cultural expectations of men and women’s roles
Gender differences exist in rates of mood disorders
Two-thirds with major depression are women
women are more likely to express their problems than men
Males more likely to self-medicate
much more likely to be diagnosed with substance abuse
Women respond better to treatments: emotional processing
female brain does better with everything verbal
Pressures on women to be thin
75
Social Effects on Health and Behaviour
Life expectancy and richness of life are related
Social phobia and depressive disorder related to (low) interpersonal contacts
Higher in Aboriginal Canadians
poverty, oppression, maltreatment of their children
76
seniors
Many do not get appropriate care
77
Lifespan Development
Experiences at different periods of development influence vulnerability to
Stress
Other psychological problems
78
The Principle of Equifinality
“Different paths can result from the interaction of psychological and biological factors during various stages of development.”
it means you can end up in the same spot after you travelled in very different paths
79
assessing psychological disorders
```
Clinical assessment and diagnosis
DSM-5
Reliability
Validity
Standardization
```
80
clinical assessment
exemplifies a multidimensional, integrative approach to gathering information about a client so as to make informed and accurate decisions.
81
diagnosis
is the process of determining whether a person’s problem(s) meets all the criteria for a psychological disorder according to the DSM-5.
82
Reliability
the degree to which a measurement is consistent
83
validity
whether something. measures what it is supposed to measure
84
standardization
a process by which a certain set of standards or norms is determined for a technique to make its use consistent
85
the clinical interview
the mental status exam
86
the mental status exam
Systematic observation of behaviour
Clinicians get enough information to determine presence of a psychological disorder
The Mental Status Exam covers five categories
87
the clinical interview: mental status exam
```
appearance and behaviour
thought processes
mood and affect
intellectual functioning
sensorium
```
88
structured clinical interviews
clinical interview can be structured or semistructured
89
physical examination
don't do that
90
freestyling Vs. structured
may come across information you wouldn't normally (freestyle)
makes interaction but natural, the patient is be comfortable (freestyle)
if you can do semi structured well patients don't seem to notice
may forget if you are not following a structure (structure)
91
behavioural assessment
target behaviours identified and observed, has to be overt and observable to us
92
ABCs of observation
Antecedents, behaviours, and consequences
| notice patterns when the behaviours occur
93
Self-monitoring or self-observation
Reactivity- base line, habituation
if you train people to do this they can eventually teach them to stop
all anxiety disorders work best
make it easy as possible
build a support system that they help them record
technology
94
Psychological Testing
Determine cognitive, emotional, or behavioural responses
Responses might be associated with a specific disorder
General tests given for personality assessment, can give us a good idea about whats going on
95
Projective Testing
```
Psychoanalytic tradition- you have to believe in the unconscious and that it can be discovered and that these mechanisms can get you there
Rorschach inkblot test
Thematic Apperception Test (TAT)
These tests widely used
Questionable reliability and validity
```
96
Personality Inventories
Minnesota Multiphasic Personality Inventory (MMPI)
Revised Psychopathy Checklist-R
Assesses psychopathy
97
An MMPI Profile
picks up on somatic disorders very well
high scale 1,3 low 2
what does that mean:
a lot of poorly defined somatic symptoms- expressing emotional pain through physical pain (conversion disorder)
the person is invested that it is not depression that is causing the issues
slowly being fazed out, too many questions
you cannot diagnose a personality disorder before the age of 18
98
Neuropsychological Testing
Bender Visual-Motor Gestalt Test
Halstead-Reitan Neuropsychological Battery
False positives: ADHD, BDP as bipolar
positive: present
False negatives, ADHD in women, depression in men. Eating disorders (?), complex PTSD, dissociation
negative: not present
99
Neuroimaging: Pictures of The Brain
```
Neuroimaging: pictures of brain structure and function
Categories:
Brain structure images
Brain function images
Images of Brain Structure
CAT scan
MRI
Images of Brain Functioning
PET scan
SPECT
fMRI
```
100
Psychophysiological Assessment
Electroencephalogram (EEG)- fluctuation of electrical activity in the brain
Event-related potential (ERP)
Evoked potential
Electrodermal response (skin conductance)- sweating: stress/anxiety
101
Diagnosis
concerns the general class of problems that a person is presenting with and how best to classify such problems based on information about others with similar kinds of problems.
102
Diagnosing Psychological Disorders
```
Classification
Taxonomy
Nosology
Nomenclature
DSM-5, ICD-10
```
103
classification
refers to any effort to construct groups or categories and to assign objects or people to these categories on the basis of their shared attributes or relations
104
taxonomy
The word “taxonomy” refers to classification in a scientific context.
105
nosology
The word “nosology” refers to the application of a taxonomic system to psychological or medical phenomena.
106
nomenclature
Nomenclature refers to the names or labels of the disorders that make up the nosology.
107
DSM
Diagnostic and Statistical manual of Mental Disorders; DSM-5 currently in use.
108
ICD-10
International Classification of Diseases and Health Related Problems
109
Classification Issues
Subject of classifying human behaviour is controversial
Distinctions between “normal” and “abnormal” unclear
for far can the continuum go before it is no longer normal
110
Categorical, Dimensional, and Prototypical Approaches
Classical categorical approach
Dimensional approach
Prototypical approach, has its own set of probelms
111
Classical categorical approach
we assume that every diagnosis has a clear underlying pathophysiological cause, such as a bacterial infection or a malfunctioning endocrine system, and that each disorder is unique
112
Dimensional approach:
we note the variety of cognitions, moods, and behaviours with which the patient presents and quantify them on a scale
113
Prototypical approach
identifies certain essential characteristics of an entity so it can be classified, but also allows for certain nonessential variations that do not necessarily change the classification
114
pros of diagnosing
not weird, we understand, we have a name for it, find proper resources
relief, of knowing you’re not making it up. Through the power of being understood
115
cons of diagnosing
stigma
| self-defeating behaviour, letting go of any adaptive properties
116
Fear
is an immediate alarm reaction to dangerous or life-threatening situations
117
A panic attack
A panic attack is an abrupt experience of intense fear or acute discomfort accompanied by physical symptoms such as heart palpitations, chest pain, shortness of breath, and dizziness.
118
comorbidity rates
Rates of comorbidity among anxiety and related disorders (and depression) are high. Anxiety disorders also co-occur with several physical conditions.
119
suicide
Rates of comorbidity among anxiety and related disorders (and depression) are high. Anxiety disorders also co-occur with several physical conditions.
120
causes of anxiety and related disorders
biological contributions
psychological contributions
social contributions, trauma, family models, some cultures are faster pace therefore more anxiety
triple vulnerability model
121
Biological contributions
for anxiety and panic suggest that people inherit the tendency to be anxious or highly emotional.
122
Psychological contributions
for anxiety and panic originated with Freud, who saw anxiety as a psychic reaction to danger surrounding the reactivation of an infantile fear situation. Behaviourists view anxiety as a product of classical conditioning or modelling.
123
Social contributions
focus on the relation between stressful life events as triggers for biological and psychological vulnerabilities for anxiety and panic
124
three vulnerabilities model
biological vulnerability
specific psychological
generalized psychological;
125
Comorbidity
occurrence of two or more disorders in a single person
| Depressive disorder and anxiety disorders most commonly comorbid
126
Comorbidity with
| Physical Disorders
Anxiety disorders co-occur with several physical conditions
People with physical disorders fit criteria for anxiety disorder
Anxiety precedes physical disorder
Both together lead to poor quality of life
127
Suicide
20% of panic disorder patients attempt suicide
Comparable to people with depression
Suicidal ideation common
Suicide attempts common
more likely by those who inflict self-harm
128
generalized anxiety disorders, clinical description
Uncontrollable, unproductive worrying about everyday events
Feeling impending catastrophe even after successes
Inability to stop the worry-anxiety cycle
129
GAD symptoms
Muscle tension, mental agitation, susceptibility to fatigue (never idle), irritability, difficulty sleeping
Arousal of the autonomic nervous system
Worry about everything, no problem is small enough to be off limits
130
GAD statistics
1% of Canadian population meets GAD criteria
3% over age 15 years
9% meet criteria at some point in life
Two-thirds female, more responsible? more aware?
Most common in people over 45 years, spike in demands of social roles
131
GAD causes
Possibility of a genetic cause
GAD runs in families
Greater risk for monozygotic twins
Heritability for anxiety sensitivity
132
cognitive characteristics of GAD
intolerance of uncertainty, the reliance on routine and predictability
positive beliefs about worry, believe they are doing good
poor problem orientation, they lack the ability to understand what is a real threat and what is not
cognitive avoidance
133
GAD treatment
Drugs: Benzodiazepines- cause addictions, anti-depressants
Psychological: Cognitive-behavioural treatment (CBT)
134
Panic Disorder (PD)
Sensation of dying or of losing control
| Racing heartbeat, rapid breathing, dizziness, nausea, or sensation of heart attack or imminent death
135
Agoraphobia
fear and avoidance of situations: unsafe and inescapable
rarely happens alone, like late stage panic attacks
break cycle, exposure therapy
136
PD and A causes
Biological, psychological, and social
| Agoraphobia often develops after a person has unexpected panic attacks
137
PD and A treatment
Drugs, therapy, virtual reality (WTF) how do you do exposure with a patients who can not leave their house
promising at helping with post combat PTSD
138
PD and A clinical description
PD and agoraphobia can occur together or alone
Recurrent unexpected panic attacks
Agoraphobic situations provoke fear and anxiety
139
The Development of Agoraphobia:
Could lead to drug and alcohol dependence
| Avoidant behaviors displayed: removing self from situations/activities leading to arousal
140
PD and A stats
3.7% Canadians over 15 years of age
Canadian women higher (4.6%) rate than men (2.8%)
Mean age of onset: 25–29 years
Initial attacks begin at or after puberty
141
PD and A cultural influences
PD exists worldwide: expression varies
Highest occurrence in white Americans
Lowest in Asian Americans
142
PD and A nocturnal panic
Occurs between 1:30 am and 3:30 am
| Delta (slow-wave) sleep
143
PD and A causes
Genetic vulnerability to stress
| People with PD develop anxiety over possibility of another panic attack
144
PD and A treatment
Medication: benzodiazepines, SSRIs, SNRIs
Relapse closer to 90% if medication stopped
Psychological Intervention: Panic control treatment (PCT)- the only way out is through
Combined Psychological and Drug Treatments
145
Panic control treatment (PCT)
concentrates on exposing patients with panic disorder to the cluster of interoceptive sensations that remind them of their panic attacks. The therapist attempts to create “mini” panic attacks in the office by having the patients exercise to elevate their heart rates or perhaps by spinning them in a chair to make them dizzy. Basic attitudes and perceptions concerning the dangerousness of the feared but objectively harmless situations are identified and modified.
146
specific phobia description
An irrational fear of a specific object or situation that markedly interferes with an individual’s ability to function
Blood-injury-injection phobia, situational phobias, natural environment phobias, animal phobias, other phobias
147
phobia stats
6.4% of Canadian population
8.9% women, 4.1% men
Goes untreated
Culture-specific
148
phobia causes
Traumatic experiences, could be a single trauma
Vicarious experience
Panic attack
Social and cultural factors
149
phobia treatment
Exposure therapy, virtual reality
Exposure-based exercises
Change brain functioning by modifying neural circuitry in amygdala, insula, cingulate cortex- don’t worry about anatomy
Virtual reality exposure therapy, a newer approach
150
social phobia description
SAD
Fear of being called for some kind of “performance” that may be judged:
Speaking in public, eating in a restaurant, or generally interacting with people
7.2% of Canadians
151
Anxiety-provoking physical reactions
include blushing, sweating, trembling, or, for males when urinating in a public restroom, “bashful bladder” or paruresis.
152
SAD stats
13.3% of general population in the US
8.1% of Canadians
SAD usually begins during adolescence
Inflicts young, less educated, single, lower SES individuals
Distribution relatively among different ethnic groups
153
SAD causes
Biological, conditioning (panic attack or social trauma), modelling
Biological vulnerability to develop anxiety
Biological tendency to social inhibition
Conditioned panic attack in a social situation
Experience of a real social trauma
154
SAD treatment
Antidepressants, CBT (rehearsal, role-play), cognitive therapy
Cognitive-behavioural group therapy (CBGT)
Interpersonal psychotherapy (IPT), more social component
SSRIs
155
selective mutism (SM)
Rare childhood disorder characterized by lack of speech in settings where public speech is expected
Speechlessness in selective situations only (school)
DSM-5 includes SM with anxiety disorders
