Midterm 3 Flashcards

Question

Big Five and Behaviour

Answer 1

* Predict many important real-world behaviours – Job performance and grades in school (high openness to experience, low neuroticism, and perhaps high agreeableness) – Physical health and life span (high conscientiousness) * Relatively similar traits seen across cultures (e.g., China, Italy, Turkey) – Openness doesn’t emerge in all cultures * Some investigators have found dimensions in addition to the Big Five – Chinese tradition factor encompasses aspects of personality distinctive to Chinese culture, including an emphasis on group harmony and saving face to avoid embarrassment – Honesty and Humility factor Cultural differences in prevalence rates (some traits are more common in some cultures than others) * Individualist vs. collectivist societies – Focus on personal goals vs. relations to others – Personality traits may be less predictive of behaviour in collectivist than individualistic cultures § Could be that behaviour in collectivist cultures is more likely to be influenced by social norms § But we must be careful not to make overgeneralizations and we need to be aware of stereotypes

Answer 2

* HEXACO – Similar to Big Five, but with honesty-humility as 6th trait – E = emotionality (neuroticism) – X = eXtraversion * Big Three – Impulse control (combo of agreeableness, conscientiousness, (low) openness to experience) – Extroversion – Neuroticism

Answer 3

* Some variability prior to age 30, but little thereafter * Between late teens and early thirties: – openness, extroversion, and neuroticism tend to decline a little – conscientiousness and agreeableness tend to increase a little * Levels of most traits don’t change much after age 30 and change even less after about age 50 * Personality is quite stable once we reach adulthood

Answer 4

* Highly influential through the early and mid-twentieth century * Criticisms by Walter Mischel concerning behavioural inconsistency – Found low correlations among different behaviours that supposedly were to reflect the same trait – Argued measures of personality aren’t especially helpful for what they were designed to do—forecast behaviour * Counterargument by Seymour Epstein: traits are predictors of aggregate, not isolated behaviours * Trait theories primarily describe individual differences rather than what causes them – Pro: improved our understanding of personality structure and helped psychologists predict performance in jobs – Con: don’t provide much insight into the causes of personality

Answer 5

* Plagued by number of dubious methods – Phrenology (head shape) – Physiognomy (facial characteristics) – Sheldon’s body types * All lacked two key criteria – reliability and validity

Answer 6

* Paper-and-pencil tests consisting of questions you respond to in one of a few fixed ways * Prepared using a rational/theoretical method – Requires test developers to begin with a clearcut conceptualization of a trait and then write items to assess it * Some have strong reliability and validity (NEO PI-R; measures big five) but others do not (Myers-Briggs)

Answer 7

* Ask examinees to interpret or make sense of ambiguous stimuli * Based on projective hypothesis – When interpreting ambiguous stimuli, people project aspects of their personality * Controversial, because reliability and validity are in dispute

Answer 8

* Consists of ten symmetrical inkblots: five in black-and-white and five containing colour * Examiners ask respondents to look at each inkblot and say what it resembles * This supposedly tells you about personality traits of the respondent

Answer 9

* Unknown test-retest and problematic interrater reliability scores * Little evidence that it detects features of mental disorders or predicts criminal behaviours – Studies have replicated associations between Rorschach scores and schizophrenia, bipolar disorder, and other conditions involving abnormal thinking – Not many replicated associations between Rorschach scores and other mental illnesses

Answer 10

* Requires subject to construct a story based on pictures * Include in the story descriptions of: – What has led up to the event shown – What is happening in the scene – The thoughts and feelings of characters – The outcome of the story * Responses are then scored based on the extent to which respondents’ stories emphasize achievement-oriented themes * Little evidence for adequate reliability or validity for most applications

Answer 11

* Human figure drawings require you to draw a person(s) in any way you wish – drawings interpreted based on features (e.g., large eyes = suspiciousness) * Graphology – analysis of handwriting – is another projective test * Neither has scientific support for its use and claims

Answer 12

* Psychopathology (mental illness) is often seen as a failure of adaptation to the environment * Failure analysis approach tries to understand mental illness by examining breakdowns in functioning * Mental disorder does not have a clear-cut definition * Many different conceptions of mental illness, each with pros and cons 1. Statistical rarity 2. Subjective distress 3. Impairment 4. Societal disapproval 5. Biological dysfunction

Answer 13

* During the Middle Ages, mental illnesses were often viewed through a demonic model – Odd behaviours were the result of evil spirits inhabiting the body – Exorcisms and witch hunts were common during this time * During the Renaissance, the medical model saw mental illness as a physical disorder needing treatment – Began housing people in asylums – but they were often overcrowded and understaffed – Treatments were no better than before (e.g., bloodletting) * Reformers like Phillippe Pinel and Dorothea Dix pushed for moral treatment – Focused on treating patients with dignity, respect, and kindness * Still no effective treatments, though, so many continued to suffer with no relief

Answer 14

* Psychiatric treatment * In early 1950s, a drug was developed called chlorpromazine (Thorazine) * Moderately decreased symptoms of schizophrenia and similar problems * With advent of other medications, policy of deinstitutionalization was enacted – Goals: releasing hospitalized psychiatric patients into the community, closing mental hospitals * Deinstitutionalization had mixed results * Deinstitutionalization had mixed results * Some patients returned to almost normal lives * Tens of thousands had no follow-up care and went off medications – Continues to be a problem today due to lack of affordability – A key cause of housing insecurity and homelessness * Community mental health centers and halfway houses (free or lowcost care facilities in which people can obtain treatment) attempt to help this problem

Answer 15

* Certain conditions are culture-bound – Koro involves believing your genitals are shrinking and receding into your abdomen – Windigo involves craving the consumption of human flesh and fear of becoming a cannibal * Many severe mental disorders (schizophrenia, alcoholism, psychopathy) appear to be universal across cultures

Answer 16

* Common Misconceptions: 1. Psychiatric diagnosis is nothing more than pigeonholing (putting people into a “box”) 2. Psychiatric diagnoses are unreliable 3. Psychiatric diagnoses are invalid 4. Psychiatric diagnoses stigmatize people * Psychiatric diagnosis serve two critical functions: – Pinpointing the psychological problem – Facilitating communication between professionals * Robins and Guze Criteria for Validity – Distinguishes that diagnosis from other, similar diagnoses – Predicts performance on laboratory tests, including personality measures, neurotransmitter levels, and brain-imaging findings – Predicts family history of psychiatric disorders – Predicts natural history (change over time) – Predicts treatment response

Answer 17

* Diagnostic and Statistical Manual of Mental Disorders (DSM) is a system that contains the criteria for mental disorders – Fifth edition, DSM-5 (DSM-V) released 2013 – Text revision, DSM-5-TR, published in 2022 * Contains diagnostic criteria and decision rules for each condition – Warns to “think organic” (rule out physical causes of symptoms first) * Contains information on prevalence (percentage of people within a population who have a specific mental disorder) * Uses a biopsychosocial perspective – Recognizes that there’s more to people than their disorders – Acknowledges cultural and social diversity

Answer 18

* Not all diagnoses meet Robins and Guze criteria for validity (e.g., mathematics disorder) * Not all criteria and decisions rules are based on scientific data * High level of comorbidity (two or more diagnoses in the same person) * Reliance on categorical model rather than dimensional model of psychopathology

Answer 19

* Used in the assessment of psychopathology * Developed using empirical method – approach to building tests in which researchers begin with two or more criterion groups and examine which items best distinguish them * Test has low face validity – extent to which respondents can tell what the items are measuring * Low face validity is thought to be an advantage – Cannot “fake” responses * Considered to have good validity, can distinguish between disorders * Can be interpreted manually or via a program * Problematic in some aspects – Some overlap between scales – Cannot be the sole basis of diagnosis – One scale alone does not predict an illness * 567 true-false questions, 10 basic scales * Contains three validity scales designed to detect various types of distorted responses – L (Lie) detects impression management – F (Frequency) detects malingering (i.e., faking symptoms) – K (Correction) measures defensive responding

Answer 20

* Most anxieties are transient and can be adaptive * They can also become excessive and inappropriate * One of the most prevalent and earliest onset of all classes of disorders – 31% will meet the diagnostic criteria for one or more anxiety disorders at some point in our lives * Inappropriate anxiety exists in other disorders and problems

Answer 21

* Somatic symptom disorders are physical symptoms with psychological origins * Illness anxiety disorder (formerly hypochondriasis) is a preoccupation that you have a serious disease, despite no evidence

Answer 22

* Continual feelings of worry, anxiety, physical tension, and irritability about many areas * About 3% of the population * 1/3 develop it after major stressor or life change * More prevalent in females and Caucasians

Answer 23

Panic attack: brief, intense episode of extreme fear characterized by sweating, dizziness, light-headedness, racing heartbeat, and feelings of impending death or going crazy – Many patients feel like they are having a heart attack. * Panic disorder is characterized by repeated, unexpected panic attacks, along with either – Persistent concerns about future attacks – A change in personal behaviour in an attempt to avoid them * Can be associated with specific situation or come “out of the blue”

Answer 24

* Intense fear of an object or situation that’s greatly out of proportion to its actual threat * For a fear to be diagnosed as a phobia, it must restrict our lives, create considerable distress, or both * Most common anxiety disorder (11%) * Different forms of phobias – Agoraphobia: fear of being in a place or situation in which escape is difficult or embarrassing, or in which help is unavailable in the event of a panic attack * Specific phobia vs social anxiety disorder – Specific phobia: intense fear of objects, places, or situations that is greatly out of proportion to their actual threat – Social anxiety disorder: intense fear of negative evaluation in social situations

Answer 25

* PTSD * Marked emotional disturbance after you experience or witness a severely stressful or traumatic event * To qualify for a diagnosis of PTSD, the event must be physically dangerous or life-threatening, either to oneself or someone else * Symptoms include: – Flashbacks and recurrent dreams – Avoiding reminders of the trauma – Increased physiological arousal (e.g., increased heart rate, sweating)

Answer 26

* Marked by obsessions - persistent ideas, thoughts, or impulses that are unwanted and inappropriate and cause marked distress * This distress is relieved by compulsions – repetitive behaviours or mental acts they undertake to reduce or prevent distress, or relieve shame and guilt * Must spend at least 1 hour per day engaging in obsessions, compulsions, or both to warrant diagnosis of OCD * OCD is NOT the same as being particular, meticulous, or organized – If OCD simply caused people to want everything to be neat, organized and colorcoded all the time, it would not be an illness * Falsely claiming to have OCD trivializes the illness for people who are clinically diagnosed

Answer 27

* Learning models focus on acquiring fears via classical conditioning (recall: Pavlov’s salivating dogs), then maintaining them through operant conditioning (rewards and punishment) * Anxious people tend to think about the world in different ways from non-anxious people – Catastrophic thinking (catastrophizing) - predicting terrible events despite low probability * Biological influences – Twin studies suggest genetic influence – Genes affect whether we inherit high levels of neuroticism (tendency to be high-strung and irritable), which can set the stage for excessive worry – Those with GAD are genetically similar to those who experience major depression

Answer 28

* Over 20% of North Americans will experience a mood disorder – Major Depressive Disorder (MDD) is the most common, at 16% – Bipolar Disorder * Major depressive episode: state in which a person experiences – a lingering depressed mood or diminished interest in pleasurable activities – along with symptoms that include significant weight loss (when not dieting) or gain – and sleep difficulties * Major Depressive Disorder (MDD): chronic or recurrent experience of a major depressive episode * More prevalent in females, most likely to develop in 30s * Depression symptoms can develop gradually or suddenly, but are often recurrent * Average episode lasts 6 months to 1 year, most people experience 5-6 episodes * Can also be chronic – present for years/decades with no relief * Generally, the earlier depression strikes the first time, the more likely it will persist or recur * Can cause extreme functional impairment across all areas

Answer 29

* Feeling sad or irritable * Sleep difficulties * Fatigue * Loss of energy * Weight changes * Self-harming behaviours * Thoughts of death or suicide

Answer 30

* Complex interplay of biological, psychological, and social influences * Life events such as loss of something that is dearly valued can set stage for depression * Depression can create interpersonal problems, which cause lack of social support – James Coyne found that when people become depressed, they seek excessive reassurance, which in turn leads others to dislike and reject them – Constant worrying, mistrust, and socially inappropriate behaviours can be a social turn-off to many people

Answer 31

* Lewinsohn’s behavioural model: depression results from a low rate of positive reinforcement in the environment – (i.e., when people with depression try different things and receive no payoff for them, they eventually give up) – People with depression sometimes lack social skills, making it even harder for them to obtain reinforcement from others – If people respond to individuals with depression with sympathy and concern, they may reinforce and maintain these individuals’ withdrawal

Answer 32

* Beck’s cognitive model - depression is caused by negative beliefs and expectations – Cognitive triad – negative views of oneself, the world, and the future (negative schemas) – Cognitive distortions – skewed ways of thinking § Polarized thinking (black-and-white or all-or-nothing thinking) § Negative mental filtering (focus on the bad, ignore the good) § Overgeneralization (drawing negative conclusions about future based on single negative experience) § Catastrophizing (magnification: over-exaggeration of a negative thought)

Answer 33

* Learned helplessness - tendency to feel helpless in the face of events we can’t control – Depressed people tend to differ in their beliefs regarding the attribution of outcomes - why did this happen? § Negative outcomes due to internal factors § Positive outcomes due to external factors

Answer 34

* The role of biology – Genes exert a moderate influence on MDD – Depression is often associated with low levels of the neurotransmitters serotonin (often called the “feel good” chemical) and dopamine (the neurotransmitter most closely tied to reward)

Answer 35

* Have both depressive and manic episodes * Manic Episode: experience marked by dramatically elevated mood, decreased need for sleep, increased energy, inflated self-esteem, increased talkativeness, and irresponsible behaviour – First manic episode often after early 20’s – Equally common in men and women * Bipolar disorder: condition marked by a history of at least one manic episode * Heritability as high as 85% * Produces serious problems in social and occupational functioning * Brain imaging studies suggest that people with bipolar disorder experience: – increased activity in structures related to emotion (e.g., amygdala) – decreased activity in structures associated with planning (e.g., prefrontal cortex) * Very heavily genetically influenced, but stressful life events can cause episode onset – These can be negative or positive events

Answer 36

* MDD and bipolar disorder are at higher risk for suicide than most disorders * Suicide is the 12th leading cause of death in Canada (2020) – 3rd leading cause of death among children aged 10-14 – 2nd leading cause of death among youth and young adults (15-34) – Risk is 5-7 times higher among Indigenous youth * Prediction is difficult due to lack of research and low base rates (prevalence) – 30 to 40 percent of all people who die by suicide have made at least one prior attempt – Males 3x more likely to die by suicide, though women attempt more

Answer 37

1 Talking to persons with depression about suicide often makes them more likely to carry out the act. 2 Suicide almost always occurs with no warning. 3 As a severe depression lifts, people’s suicide risk decreases. 4 Most people who threaten suicide are seeking attention. 5 People who talk a lot about suicide almost never actually carry out the act.

Answer 38

– The diathesis-stress model proposes that psychopathology results from the interaction over time of: § a predisposition or vulnerability to psychological disorder (diathesis) AND § the experience of stressful events

Answer 39

* Distinguishing normal variations in personality and sense of self from personality and identity disorders can be challenging * Historically the least reliably diagnosed * Should only be diagnosed when – Personality traits first appear by adolescence – Traits are inflexible, stable, and expressed in a wide variety of situations – Traits lead to distress or impairment

Answer 40

* Marked by extreme instability in mood, identity, and impulse control – Relationships often alternate between extremes – Often highly self-destructive * Prevalence: about 2% of population, mainly women * Sociobiological model: individuals with BPD inherit a tendency to overreact to stress and experience lifelong difficulties with regulating their emotions – Twin studies suggest substantial heritability

Answer 41

* Psychopathic personality: Condition marked by superficial charm, dishonesty, manipulativeness, self-centeredness, and risk taking – Guiltless & callous, yet also tend to be charming, personable, engaging – NOT listed in the DSM-V, but overlaps with ASPD * Antisocial personality disorder (ASPD): condition marked by a lengthy history of irresponsible and/or illegal actions * ASPD describes behaviours, psychopathic personality describes personality traits * Primarily males * Heightened risk of crime: ~25% of the prison population qualifies * Commonly have history of conduct disorder in childhood – a repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate societal norms or rules are violated ▪ Aggression to people and animals ▪ Destruction of property ▪ Deceitfulness and theft ▪ Serious violations of rules * Causes are largely unknown, but may stem in part from a deficit in fear * Alternatively, they may be perpetually under-aroused and experiencing stimulus hunger

Answer 42

* Involve disruptions in consciousness, memory, identity, or perception * Depersonalization disorder: frequent experiences of feeling detached from oneself and/or the sense that the external world is strange or unreal – often accompanies panic attacks * Dissociative Amnesia: inability to recall important personal information—most often related to a stressful experience – Beyond ordinary forgetfulness * Controversial – Memory gaps regarding nontraumatic events are common in healthy individuals – Unmotivated to remember negative events – Lack of research evidence * Dissociative Fugue: forget significant events in their lives AND flee their stressful circumstances – Rare

Answer 43

* Characterized by presence of two or more distinct identities (alters) * More often among women, who report more alters than men * Intriguing differences between alters shown (e.g., brain wave activity) – But differences are often easily explained in other ways * Posttraumatic model: DID arises from a history of severe abuse during childhood, which leads individuals to “compartmentalize” their identity into alters as a means of coping – Little evidence to support this view – Early abuse is not specific to DID * Sociocognitive model: origin and maintenance of DID can be explained by certain psychotherapeutic procedures and cultural influences that shape people’s expectancies and beliefs – Most DID patients don’t show alters prior to therapy – Treatment reinforces idea person has alters and tends to increase the number of alters

Answer 44

* Marked by severe deficits in language, social bonding, and imagination – Often accompanied by mental deficits * Two defining features of autism in DSM-5 – Social and communication deficits – Restricted and repetitive interests and behavior * Individuals with ASD vary tremendously in the degree, nature, and causes of their deficits and characteristics * Distinct categories are no longer used: – “Classic” autism – Pervasive developmental disorders – Child disintegrative disorder – Asperger syndrome * ASD diagnoses – a spectrum * Dramatic increase in autism diagnoses from early 1990s to today – 1987: autism affected 4 or 5 of every 10,000 children – 2006: 1 in 110 – Two years later: 1 in 88 * Is there an epidemic? * Why are rates rising? – NOT due to vaccines: the study linking vaccinations to autism was found to be fraudulent and incorrect ▪ Celebrities continue to perpetuate this myth ▪ Illusory correlation: Symptoms of ASD appear around same time as infant vaccinations (15 months) – Increased awareness – Broader definition that includes the entire spectrum (even the more mild cases) – Increased diagnosis of children who were previously diagnosed with language impairments or learning disabilities – Policy changes * Suspected causes – NOT bad parenting – Genes are a contributing factor ▪ If one identical twin has ASD, the other twin will be as well in 60-70% of cases – Environmental triggers could interact with genetic predisposition – Certain viruses and chemicals, such as rubella, alcohol, and thalidomide are also known to contribute to ASD

Answer 45

* Primary symptoms: – Inattention: Easily distracted, misses details, forgetful – Hyperactivity and impulsivity: Restless, fidgety, and difficulty in taking turns * Diagnosable in 3-7% of school children – Males more likely to be diagnosed than females (3:1) – Females are underdiagnosed because their symptoms are often less obvious * Related to numerous functional problems in both children and adults – Children often struggle with learning disabilities, verbal processing difficulties, and poor balance and coordination – Most children with ADHD also have other comorbid conditions (e.g., conduct disorder, anxiety, depression) * Highly genetically influenced * Can often be successfully treated with stimulant medication * Environmental influences are also important – Help determine whether a genetic risk turns into a reality

Answer 46

Schizophrenia: Severe disorder of thought and emotion associated with a loss of contact with reality

Answer 47

* Symptoms include disturbances in attention, thinking, language, emotion, and relationships * Less than 1% of population, but over half of people in mental institutions * Usually develops in mid- (men) to late-twenties (women) * A hallmark symptoms: – Delusions – strongly held, fixed beliefs with no basis in reality – Psychotic symptoms: psychological problem reflecting serious distortions in reality – Hallucinations: sensory perceptions that occur in the absence of external stimuli ▪ Can affect any of the senses ▪ Command hallucinations: tell patients what to do – May be associated with a heightened risk of violence toward others * Researchers believe that individuals with language that skips from topic-to-topic results from thought disorder – Word salad: Disorganized speech that is impossible to understand * Catatonic symptoms: motor problem, including extreme resistance to complying with simple suggestions, holding the body in bizarre or rigid posture, or curling up in a fetal position – Echolalia: repeating a phrase in conversation in a parrotlike manner – May occasionally engage in bouts of frenzied, purposeless motor activity * Deterioration of self-care, personal hygiene, and motivation

Answer 48

* Early theories of schizophrenia mistakenly laid the blame for the condition on mothers, with so-called schizophrenogenic mothers being the culprits * Modern theories suggest that psychosocial factors play a role in schizophrenia, but only trigger it in persons with genetic vulnerabilities – Family members don’t “cause” schizophrenia – Family members can influence whether patients will relapse ▪ Patients 50-60% more likely to relapse after leaving hospital when relatives display high expressed emotion: (criticism, hostility, and over-involvement)

Answer 49

* Highly genetically influenced disorder * Number of brain abnormalities seen – Enlarged ventricles – Increased sulci size – Hypofrontalitiy * Use of marijuana in adolescence may increase risk of developing schizophrenia, especially for those who already have a genetic vulnerability * Neurotransmitter differences also found (e.g., dopamine, glutamate, serotonin) * Dopamine hypothesis: schizophrenia is causes by excess in dopamine and rests on the following evidence: – Most antischizophrenic drugs block dopamine receptor sites – Amphetamine, a stimulant drug that blocks the reuptake of dopamine, tends to make the symptoms of schizophrenia worse * But it’s not that simple * A better supported rival hypothesis is that abnormalities in dopamine receptors produce symptoms of schizophrenia

Answer 50

* Approximately 10% of the population has a genetic predisposition to schizophrenia * Diathesis-stress models propose genetic vulnerability (diathesis) and stressors that trigger mental illness * Early warning signs of schizophrenia vulnerability – Social withdrawal – Thought and movement problems – Lack of emotions, decreased eye contact

Answer 51

* “Dr. Google” & “Dr. TikTok” * Recent increase in teens and young adults using Google and social media to self-diagnose conditions – ADHD and Autism seem to be particularly common * There are many accounts, hosted by educated, trained, and licensed professionals where reliable information can be found – but not all posts contain accurate, science-backed information

Answer 52

* Making a psychiatric diagnosis is a complicated process that should only be conducted by trained mental health professionals – Big difference between experiencing symptoms and having a disorder – May be pathologizing ordinary human behaviour (recall discussion of being “so OCD”) – Could be missing another treatable medical condition * If you suspect that you may have a mental condition, the best step is to seek professional confirmation – First step is usually a visit to your primary doctor, who may refer you to a mental health professional for further evaluation and treatment

Answer 53

* Psychotherapy is a broadly defined as a psychological intervention designed to help people resolve emotional, behavioural, and interpersonal problems and improve the quality of their lives – Often known simply as “therapy” * Over 600 “brands” of psychotherapy

Answer 54

* The effectiveness of therapy depends on a host of individual differences * In 2018, 17.8% of Canadians aged 12 and older (roughly 5.3 million people) needed some help with their mental health – Half felt their needs were fully met * Females go more than males, Caucasians more than minority groups * Research shows therapy can benefit all these groups equally – Culturally sensitive therapy is important * Indigenous peoples at greater risk of mental health issues – In large part due to the colonial history (and present) of Canada and assimilationist practices (e.g., residential “schools”, foster care systems) * These same traumas can result in the avoidance of treatment or therapy * Need culturally sensitive approaches that respect and work to restore traditional knowledge and practice – Supports individual healing – Promotes holistic and Indigenous worldview

Answer 55

* Clinical psychologists, psychiatrists (medical doctors who specialize in mental health), counsellors, and clinical social workers with professional degrees and licenses * But people with non-advanced degrees also often offer psychological services – Religious, vocational, and rehabilitation counsellors – Social services agencies, crisis intervention centers

Answer 56

* Paraprofessionals: People with no professional training who provide mental health services – May obtain agency-specific training or workshops to enhance education – Help to compensate for the sizeable gap between the high demand for and meagre supply of licensed practitioners – Quality of care is a concern, but studies have found few differences in effectiveness between experienced and novice therapists * Professionals can operate within the system and choose more effective, evidence-based treatments – Adhere to ethical guidelines

Answer 57

* Warm and direct * Establish a positive working relationship * Tend not to contradict clients * Select important topics to focus on in session * Match treatments to needs of clients – The choice of therapists is every bit as important as the choice of therapy

Answer 58

* Insight therapies: psychotherapies where the goal is to expand awareness or insight * Includes psychodynamic, humanistic, and group approaches

Answer 59

* Psychodynamic therapies refer to treatments inspired by classical psychoanalysis and influenced by Freud’s techniques * Share the following approaches and beliefs: 1. The causes of abnormal behaviours stem from traumatic or other adverse childhood experiences (ACEs) 2. Analyze avoided thoughts and feelings, wishes and fantasies, and significant past events 3. When clients achieve insight into unconscious material, the causes and significance of symptoms become evident 4. This insight then often causes symptoms to disappear

Answer 60

* Developed by Freud, one of the first forms of therapy * Goal is to decrease guilt and frustration and make the unconscious conscious * Try to bring to awareness previously repressed impulses, conflicts, and memories, which cause psychological distress

Answer 61

* Key Approaches: 1. Free association: patients express themselves without censorship 2. Interpretation: forming and sharing hypotheses regarding the origin of the patient’s difficulties 3. Dream analysis: therapist interprets the dream’s symbolic significance 4. Resistance: attempts to avoid confrontation and anxiety associated with uncovering previously repressed thoughts, emotions, impulses – Therapists minimize resistance by making patients aware they’re unconsciously obstructing therapeutic efforts 5. Transference: projecting intense, unrealistic feelings and expectations from the past onto the therapist 6. Work through is the last stage where patients confront and resolve problems, conflicts, and ineffective coping responses in everyday life

Answer 62

* Neo-Freudians are more concerned with conscious aspects of the client’s functioning * Emphasize the impact of cultural and interpersonal influences on behaviour * More positive, emphasize needs for power, love, status (not just sex and aggression) * More optimistic regarding health prospects * Henry Stack Sullivan’s influence: – The analyst’s proper role is that of participant observer ▪ Through the therapist’s ongoing observations, the analyst discovers and communicates to clients their unrealistic attitudes and behaviours in everyday life – Interpersonal therapy (IPT): treatment that strengthens social skills and targets interpersonal problems, conflicts, and life transitions ▪ Short term (12-16 sessions), originally developed for depression ▪ Also effective at treatment of substance abuse and eating disorders

Answer 63

* Research shows that insight is not necessary to relieve distress * Many concepts are difficult to falsify (non-scientific) * Research shows no evidence for repressing hurtful memories – Disturbing events are more memorable and less subject to forgetting

Answer 64

* Many are questionable from a scientific standpoint, difficult to research – Freud’s research was highly flawed * Still, brief psychodynamic therapy is better than no treatment, for issues just as depression, substance abuse, & eating disorders – But less effective than cognitive-behavioural methods * Not effective for psychotic disorders (e.g., schizophrenia)

Answer 65

* Humanistic therapies emphasize: – Development of human potential – Belief that human nature is basically positive * Reject interpretive techniques of psychoanalysis * Strive to understand clients’ inner worlds through empathy and focus on clients’ thoughts and feelings in the present moment * Stress importance of assuming responsibility for our lives and living in the present

Answer 66

* Carl Rogers’ person-centred therapy centers on the client’s goals and ways of solving problems (therapist doesn’t tell patients how to solve their problems) * To ensure positive outcome, therapist must – Be authentic and genuine – Express unconditional positive regard – Show emphatic understanding * Tries to increase awareness and heightened self-acceptance * This is intended to cause people to – Think more realistically – Become more tolerant of others – Engage in more adaptive behaviours

Answer 67

* Gestalt (configuration) = organized whole * Gestalt therapists believe that people with psychological difficulties are “incomplete gestalts” – they’ve excluded from their awareness experiences and aspects of their personalities that trigger anxiety * Gestalt therapy aims to integrate differing and sometimes opposing aspects of our personality into a unified sense of self * Keys to personal growth: – Becoming aware of and accepting responsibility for one’s feelings – Maintaining contact with the here and now (remain present, not focused on the past) * Utilizes two-chair technique

Answer 68

* Refers to therapies that treat more than one person at a time * Range from 3-20 people, can be efficient, time-saving, and less costly than individual therapies * Effective for a wide range of problems and about as helpful as individual treatments

Answer 69

* Self-help groups are composed of peers who share a similar problem; often they don’t include a professional mental illness specialist – Have become very popular and widespread * Alcoholics Anonymous (AA) – The largest organization for treating alcoholics, with more than 1.7 million members worldwide – Argues that total abstinence is required for recovery – Based on “12 Steps” method, but there is little research demonstrating its effectiveness

Answer 70

* Behavioural view of alcoholism: excessive drinking is a learned behaviour that therapists can modify/control without total abstinence – Programs that teach people skills to cope with stressful life circumstances and tolerate negative emotions are at least as effective as programs like AA * Controlled drinking programs encourage people to set limits and drink moderately – Can be effective for many people – Relapse prevention treatment assumes people will “slip up” and plans accordingly (lapse does not equal total relapse)

Answer 71

* Family therapists see most psychological problems as rooted in a dysfunctional family system * The “patient” is the whole family system, not one individual * Focus on interactions among family members * Strategic family interventions are designed to remove barriers to effective communication – E.g., scapegoating one family member as the one with problem, when the real difficulties lie within the dysfunctional ways of the family – Identify the family’s unhealthy communication patterns and unsuccessful approaches to problem solving – Invite family members to carry out planned tasks (directives) * Structural family therapy has the therapist immerse themselves in the family to make changes * Both are more effective than no treatment and at least as effective as individual therapy

Answer 72

* Behaviour therapists focus on specific problem behaviours and variables that maintain them * Assume that behaviour change results from the operation of basic principles of learning – Classical conditioning – Operant conditioning – Observational learning * Behavioural therapists seek to: – Pinpoint environmental causes of the person’s problem – Establish specific and measurable treatment goal – Devise therapeutic procedure * Progress is evaluated based on whether there is measurable improvement in target behaviours

Answer 73

* Exposure therapy: aims to reduce a fear by exposing the patient to that fear * Earliest was systematic desensitization, which gradually exposes clients to anxiety-producing situations through imagined scenes – Patients are taught to relax as they are gradually exposed in a stepwise manner to what they fear – developed by Joseph Wolpe in 1958

Answer 74

* Based on principle of reciprocal inhibition – the idea that patients can’t experience two conflicting responses simultaneously (e.g., we can’t be anxious and relaxed at the same time) * Uses counter conditioning by repeatedly pairing an incompatible relaxation response with anxiety * Desensitization can be imagined, or it may occur in vivo (in real life) * Effective for a wide range of phobias, anxiety, and some cases of problematic substance use * Behavioural therapists strive to discover not only what works, but why * Can evaluate many therapeutic procedures by isolating the effects of each component and comparing these effects with that of the full treatment package (dismantling) – Helps rule-out rival hypotheses about the effective mechanisms of various treatments

Answer 75

* Dismantling research showed that no single component of systematic desensitization was essential * Led to development of exposure with response prevention therapies like flooding – Flooding therapists jump right to the top of the anxiety hierarchy and expose patients to images of the stimuli they fear the most for prolonged periods, ***while therapists prevent patients from performing their typical avoidance behaviours (called response/ritual prevention)*** * Very effective for many anxiety disorders, like phobias, OCD, social phobia, and PTSD

Answer 76

* Participant modelling has the therapist: – Model a calm encounter with the client’s feared object or situation – Guide the client through the steps of the encounter until she can cope unassisted * Used in assertion and social skills training along with behavioural rehearsal – Assertion training: therapists teach clients to avoid extreme reactions to others’ unreasonable demands (e.g., submissiveness or aggression) – Behavioural rehearsal: patient engages in role-playing with a therapist to learn and practice new skills

Answer 77

* Token economies reward clients for desirable behaviours with tokens to exchange for items * Aversion therapies: use punishment to decrease the frequency of undesirable behaviours – Mixed support (e.g., Antabuse and alcohol)

Answer 78

* Cognitive behavioural therapies (CBT): treatment that attempts to replace maladaptive or irrational cognitions and behaviours with more adaptive, rational ones. * Three core assumptions 1. Cognitions are identifiable and measurable 2. Cognitions are key in both healthy and unhealthy psychological functioning 3. Irrational beliefs or thinking can be replaced by more rational and adaptive cognitions * The most popular theoretical orientation in Canada

Answer 79

* Developed by Albert Ellis starting in 1950s – Argued that we respond to an event with a range of emotional and behavioural consequences – The crucial difference in how we respond to the same objective events depends on our belief systems ▪ Some are rational and promote self-acceptance and others are irrational and are associated with unrealistic demands * REBT emphasizes changing how we think, but also how we act * How we feel about the consequences of an event is determined by our beliefs or opinions * Our vulnerability to psychological disturbance is a product of the frequency and strength of our irrational beliefs * To the ABC, Ellis added D (dispute the beliefs) and E (adopt more effective ones) Activating event Beliefs Consequences Dispute the beliefs Adopt more Effective ones

Answer 80

* CBT therapists differ in the extent to which they incorporate behavioural methods * Cognitive therapy developed by Aaron Beck – Focuses on identifying and then modifying distorted thoughts and longheld core beliefs – Works best with depression, evidence for bipolar disorder and schizophrenia

Answer 81

* After behavioural (1st wave) and cognitive (2nd wave), 3rd wave CBT therapies focus on acceptance – Consistent with this goal, research suggests that avoiding and suppressing disturbing experiences, instead of accepting or confronting them, often backfires, creating even greater emotional turmoil * Highly eclectic – Acceptance and Commitment Therapy – Dialectical Behaviour Therapy * More research needed to determine whether these are superior to accepted CBT methods

Answer 82

* More effective than no or placebo treatment * At least as effective, and in some cases more effective than psychodynamic and humanistic therapies * At least as effective as drug therapies for depression * In general, CBT and BT are about equally effective for most problems * Third wave approaches are successful in treating a variety of disorders, including depression and alcoholism, but more research needed to determine whether these are superior to accepted CBT methods * Can be combined effectively with other forms of treatment

Answer 83

* Prior to 1970s, considerable controversy on it – Argued that all therapies appeared to be helpful but are roughly equivalent in their outcomes * Meta-analysis studies proved that therapy does work in alleviating human suffering

Answer 84

* Behavioural, psychodynamic, and person-centered approaches shown to be more successful than no treatment, but no different from each other in their effect * But there are clear cut exceptions, like – BT and CBT best for childhood and adolescent behaviour problems – BT and CBT best for anxiety disorders * Some therapies may actually be harmful

Answer 85

* Facilitated communication (autism “treatment” discussed earlier in the term) * Scared Straight Programs * Crisis debriefing * DARE programs (Drug Abuse Resistance Education) * Coercive restraint therapies * Self-help book industry

Answer 86

* Many therapies may be comparable due to nonspecific factors that are common across therapies – e.g., empathetic listening, instilling hope, etc. – Essential components for instilling in clients the motivation to change (not just a placebo effect) * Specific factors are those that characterize only certain therapies – e.g., exposure, challenging irrational beliefs, social skills training * Most agree that both matter, but are divided over the degree of each

Answer 87

* Scientist-practitioner gap: sharp divide between psychologists who view psychotherapy as more an art than a science and those who believe clinical practice should reflect well-replicated scientific findings * Empirically supported therapies (ESTs): interventions for specific disorders supported by high-quality scientific evidence – BT, CBT, acceptance, and interpersonal therapies have emerged as ESTs – If a treatment is not on the list of ESTs that does not necessarily mean it isn’t effective! * Concept of ESTs is controversial – Underdeveloped research to determine superiority for many treatments * However, practitioners have an ethical obligation to rely on ESTs unless there’s a compelling reason not to

Answer 88

* 5 reasons why bogus therapies can gain a dedicated public following: 1. Spontaneous remission 2. Placebo effect 3. Self-serving biases: ▪ e.g., convincing yourself/others that you are improving because you spent so much time and money on a treatment 4. Regression to the mean: ▪ Extreme scores statistically more likely to be less extreme when retested 5. Retrospective rewriting of the past: ▪ Misremembering pre-treatment condition as worse than it truly was

Answer 89

* Attempt to directly alter the brain’s chemistry or physiology to treat psychological disorders * Psychopharmacotherapy – use of medications to treat psychological problems – Most common biomedical treatment today – Began with use of thorazine to treat schizophrenia in 1954 – Today, almost 15% of the population are on antidepressants

Answer 90

* Today, medications are available to treat most psychological disorders * Antianxiety, antidepressants, mood stabilizers, antipsychotics, psychostimulants * Unfortunately, we don’t know exactly why most of these work * Many medications may exert their effects largely by affecting the sensitivity of receptors rather than the levels of neurotransmitters – But there’s no scientific evidence for an “optimal” level of dopamine, serotonin or other neurotransmitters in the brain

Answer 91

* Most meds have numerous side effects that need to be weighed * Most dissipate after discontinuing the drug, but not all – A serious side effect of some antipsychotic medications includes tardive dyskinesia (involuntary movements of the facial muscles and mouth and twitching of the neck, arms, and legs) * One dose doesn’t “fit all” – Weight, age, and even racial differences often affect drug response – Physicians try to determine the lowest dose possible to achieve positive results and minimize unpleasant side effects * Questions about efficacy and safety of SSRIs, particularly among children and adolescents – Risk of suicidal thoughts (though not completed suicide) * Overprescription is also a concern for many, especially of psychostimulants for ADHD * Polypharmacy: prescribing many medications at the same – Can be hazardous due to potential interaction effects * Pharmacotherapy is not a cure-all

Answer 92

* In many cases, therapy alone can produce as great or better benefits for many disorders as Psychopharmacotherapy – CBT is at least as effective as antidepressants, even for severe depression, and perhaps more effective than antidepressants in preventing relapse – Psychotherapy alone is also effective for a variety of anxiety disorders, dysthymia, bulimia, and insomnia * Clear advantages to combining meds and therapy when – Symptoms interfere greatly with functioning – Therapy alone hasn’t worked for a 2 month period

Answer 93

* Electroconvulsive therapy (ECT) involves patients receiving brief electrical pulses to the brain that produce a seizure – Used to treat severe problems (intractable depression, schizophrenia) as a last resort – 6-10 treatments given three times a week * Misconceptions about ECT: false beliefs that ECT is painful or dangerous and that it invariably produces long-term memory loss, personality changes, and even brain damage – These are not true

Answer 94

* Most who undergo ECT would do so again, and report improvements – However, even if patients report feeling better after ECT, they don’t always show evidence of parallel changes on objective measures of depression and mental functioning * Must weigh benefits against potential adverse effects – Over 50% relapse in six months – Short-term confusion and clouded memory (but generally subsides within a few weeks

Answer 95

* Brain surgery to treat psychological disorders, like prefrontal lobotomies * Used today as an absolute last resort with a handful of conditions – Severe OCD, depression, bipolar disorders * To most critics, the benefits of psychosurgery rarely, if ever, outweighed the costs of impairing memory, diminishing emotion and creativity, and the general risks of brain surgery * Institutional review boards (IRBs) must approve each operation * Brain surgery to treat psychological disorders, like prefrontal lobotomies * Used today as an absolute last resort with a handful of conditions – Severe OCD, depression, bipolar disorders * To most critics, the benefits of psychosurgery rarely, if ever, outweighed the costs of impairing memory, diminishing emotion and creativity, and the general risks of brain surgery * Institutional review boards (IRBs) must approve each operation

Midterm 3 Flashcards

(119 cards)