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Flashcards in Unit 1 Deck (95):
1

psychology

studies interplay of behavior, mind and brain

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abnormality

deviance, distress, danger, and dysfunction- presence of these 4 doesn't predict mental illness

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deviance

different, unusual, or bizarre- statistical connotations

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dysfunction

interfering with ability to carry out daily activities

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danger

to oneself/ others

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distress

upsetting or unpleasant mental states

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DSM V assumptions

1- a behavioral syndrome/ psych pattern occurs in the individual AND
2- the symptoms have psych and or bio cause AND
3- the consequence of the symptoms is either: clinically significant distress or dysfunction
4-the symptoms are above and beyond what would be normal response to stressors (CONTEXT)
5-BUT the perceived mental illness is not primarily a result of social deviance or conflict with society

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therapy

any process/ procedure that alleviates symptoms- includes bio, psych, and combinations

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3 major views on mental illness

1- spiritual/ supernatural- demon possession, etc
2- humanitarian- result of cruelty, stress, and poor living conditions
3- scientific- search for quantifiable causes

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trephination

earliest supernatural type treatment
-6500 BCE; focused on demon possession and sorcery

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Ancient Greek and roman

500 BCE-500 CE; philosophers and physicians rejected supernatural explanations

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hippocrates

did not believe mental illness was shameful or that mentally ill individuals should be held accountable for their behavior
-illness as imbalance of 4 humors

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middle ages

500-1350 CE; demonology returns
-Roman Catholic rejected scientific research; religious beliefs dominate; exorcisms (st. Martin)
-care of mentally ill became family based bc of shame; idea of contagious nature of mental illness and physical punishment to teach better behaviors

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renaissance

1400-1700 CE; demonological views decreased; medical views returned; Johann Weyer (German physician) believed that the mind was as susceptible to sickness as the body

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Asylums

first in the 1400s- for "lunatics"- primary purpose was care of mentally ill, conditions deteriorated over time

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mid 16th century

conditions decline in asylums, no treatment or supply for demand; individuals with mental illness were institutionalized alongside undesirables and no one improved or left
-most against will
-demonstrated to public for a fee
-treatments= purges, bleeding, emitting

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colonial america

1st asylum (1773)= Williamsburg VA- chained to wall of small room, one bed etc... soon overcrowded and deteriorated to filth and mistreatment

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late 1700s europe

moral treatment
-William tuke (England), Philippe pinel (france), and dorthea dix and Benjamin rush (US)
=patients in asylums are sick and should be treated with sympathy and kindness

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tukes retreat at Yorke

was run as a strict, well-run household
-sanity was to be restored via self control in family environment- rules and expectations and contributions (paternalistic)
-given support and advice
-critics claimed it encouraged dependency- replacing visible chains with less clear ones

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moral treatment vs asylums

freedom to move about, well-lit rooms, seen as potentially productive beings, engagement in activities

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19th century

moral treatment spread to US- some patients were able to leave, but not most

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Dorothea dix

American advocate for moral treatment (1840-1880) researched conditions in asylums throughout US- successfully lobbied US congress to pass bill that established a system of state hospitals to care for mentally ill
-32 hospitals (state) throughout country are credited to her

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state hospitals

meant to be self-supporting (somewhat) institutions
-patients engaged in "therapeutic work"- staff lived on premises to reduce cost
-patients worked on farm and did chores
-overcrowding eventually occurred due to lack of treatments
-public prejudice against patients in institutions led to reduced funding (many patients were poor immigrants)

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the somatogenic perspective (early 20th century)

abnormal functioning has physical causes. two factors were responsible for this rebirth
1) Emil Kraepelin= physical factors (fatigue) are responsible for mental dysfunction
2)bio discoveries on link between untreated syphilis and "general paresis"
-common somato treatments=hydrotherapy, radiation, sedatives, ECT, psychosurgery (lobotomies), insulin-induced comas
-improvements in treatment came in 1950s

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the psychogenic perspective

abnormal functioning has psychological causes
-rise in popularity of this was based in Friedrich Mesmer's work on hypnosis and later Sigmund freud's theory of psychoanalysis (early childhood and unconscious)
-by early 20th century, psychoanalytic theory was well accepted
-provided either out-patient or in-private psychiatric hospitals
-less likely to be part of therapy at state hospitals

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psychotropic medication

1949- introduction of lithium to treat extreme mood fluctuation
-in 1950s= antipsychotic drugs for schizophrenia, antidepressant drugs and anti anxiety drugs
-finally allowed discharge from hospitals

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deinstitutionalization

trend in which people with mental disorders were released from hospitals into communities
-caused by 1) medications, 2) public outcry on conditions, 3) JFK signed (1963) funding for community mental health centers (agency to meet with psychiatrists) and out patient treatment for formerly hospitalized patients

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current LESS severe MI treatment (US)

outpatient care is preferred mode of treatment
-private psychotherapy and psychiatry (med mngmt)
-non residential programs for subs abuse
-community based MH clinics

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current SEVERE MI treatment (US)

outpatient care is primary mode
-usually short hospitalization with discharge into community based care
**lack community programs for current pop
-significant number do not receive treatment of any kind
-needs of this pop= community programs are insufficient
-funding cuts continue
-250,000 with severe MI are incarcerated or homeless

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SAMHSA survey

18.5% of all US adults had mental illness
-of that, 4% had severe MI
-1/3 of severe receive no help

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Insurance with MI

-no coverage pre-WWII
-historically policies didn't cover MI to the same extent as physical illness

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Parity laws

laws that say insurance companies must cover physical and psych illness at the same rate of reimbursement
-2011= law went into effect
-some insurance companies solved by discontinuing all funding for MH

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biopsychosocial approach

integrates 3 areas of influence when considering causes of MI and their treatment
-bio= brain structure, chemistry, etc
-psych= trauma, cognition, stress
-social= culture, peers, family

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MH clinician

anyone who provides services to people with psych problems

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theoretical models

describe how MI forms and how it differs from the unaffected population
-models can conflict
-isolating a cause is very difficult (complex behavior)
== X is a RISK for Y (not a cause)

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necessary causes

factors that must be present for disorder to occur
-have not been identified for most MI
-exceptions= general paresis (due to syphilis) and HD

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contributory causes

factors that increase the risk of developing a MI, but don't guarantee

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distal risk factors

event occurs early in life, disorder appears later

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proximal risk factors

event occurs shortly before signs of disorder

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diathesis- stress model

person has predisposition, then with sufficient life stressors, may develop the disorder

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protective factors

decrease the likelihood of developing MI
-actively buffer against the risk
-can also be personality factors
-most common= one loving adult in life

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inoculation effect

dealing successfully with stressful experience can enhance your confidence in dealing with new stressors

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resilience

experiences that give sense of mastery over difficulties
-responsive relation ship with 1+ adult

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psychoanalytic/ dynamic model

behaviors/ psych problems are determined by the influence of the unconscious mind
-when conflict arises between id, ego, and superego, leads to increased anxiety
-function of ego defense mechanisms is to distort reality to avoid feelings of anxiety
-goal= make unconscious more conscious to deal with issues

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psychodynamic model

includes Freud's early 20th century psychoanalytic model
-in dysfunctional personality, the id and others are in excessive conflict
-type of treatment= minimal interaction between patient and therapist, couch, time intensive

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today's psychodynamic perspective

human functioning is shaped by unconscious dynamic forces
-specific emphases and seeks to uncover internal conflict from youth

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contemporary trends in psychoanalysis

-more interactive with therapist
-short-term therapy
-no couch= face to face
-relationships (therapist, family, etc)
-focus on internal dynamics

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behavior model

concentrates on behaviors and environmental factors
-believe all behavior is learned; maladaptive is due to faulty learning experiences
-operant (skinner) and classical (pavlov and Watson)

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modeling

we can learn behaviors by watching another perform them

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operant conditioning

behaviors and acquired if they are reinforced
-more apt to continue if rewarded, less apt with aversive consequences
-therapy focus= rewarding good behavior, rather than punishing the bad

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generalization

stimulus simular to CS begins to produce CR... even though this new stimulus has never been paired with the US

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contingency management

client is rewarded for desired behaviors; undesired behaviors are ignored
-token economy

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systematic desensitization

phobias- client is methodically introduced to frightening stimulus, while remaining relaxed
-learn relaxation skills> construct fear hierarchy> confront feared situation

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flooding

client is immediately placed in anxiety producing situation
-high drop out rates
-for job situation or time constraints

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cognitive model

psych disorders are the product of disturbed thinking- illogical thoughts can produce painful/ dysfunctional emotions and behaviors
-clinically investigate client's cognitions
-overcome problems via new ways of thinking

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Beck's cognitive therapy= cognitive restucturing

therapist guides clients to challenge dysfunctional thoughts, try out new interpretations, and apply new ways of thinking in daily life
-used widely in depression treatment

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reframing

technique of changing attitude surrounding a maladapt thought
-Albert Ellis= irrational emotive therapy

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cognitive behavior therapy

therapists use behavior and cognitive approaches- impacting thought patterns and maladaptive behaviors

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pro/ con- Cognitive model

pro- broad appeal, clinically useful, effective therapies and useful in research
con- not helpful for everyone, some disorders cannot be improved cognitively (bio)

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humanistic approach

humans have inherent worth and motivation for growth, to strive for self fulfillment and meaning in life
-more positive views of human nature= humans are basically good and oriented in positive directions
-maladapt behaviors/ disorders= when potential for living life to the fullest is blocked

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roger's theory

basic human need is for unconditional positive regard
-if not received, leads to incongruence= mismatch between one's view of oneself and reality of themselves

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client- centered view

unconditional positive regard
accurate empathy
strong emphasis on therapist- client relationship
genuineness
-therapist's role is to listen deeply, accept and understand, while providing input

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pro/ con humanistic

pro- major impact on therapist-client relationship= therapeutic alliance; established optimal healing environment; optimistic view of human nature
con- abstract issues and difficult to research

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sociocultural model

consider social and cultural influences on MH
-family therapy, couples counseling, group therapy, community MH

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family therapy approaches

direct participation of family members in the session- the initial client will be either child or adult, but rest of family will also attend
*therapist looks to influence communication among members in a way that strengthens and supports the entire system
-viewing how families interact

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community MH treatment

allow clients to receive treatment in familiar social surroundings as they try to recover
-fills deinstitutionalization needs

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pro/con social cultural model

pro- added elements of interaction and can be successful where other therapeutic forms fail
con- difficult to interpret research

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biopsychosocial model

integrative therapy that understands MH as stemming from multiple causes and issues

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eclectic approach

integrative= taking strengths from each model and using them in combination for a particular individual
**most common

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biological model

abnormalities associated with the body are associated with the symptoms of MI
1) genetics
2)abnormalities in brain structure
3)chemical imbalance
4) infections and autoimmune

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polygenic model of inheritance

often several genes combine to produce such characteristics, creating a genetic predisposition (diathesis) towards MI deviance

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temperment

infantile personality- children can have basic personality differences- innate

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biological treatments

drugs, ECT, psychosurgery

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4 drug classes

antianxiety, antipsych, antidepressants, mood stabilizers

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clinical assessment

interviews, observations, and psych tests= summary of clients symptoms

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diagnosis

classification of client's symptoms- results in label for treatment and insurance

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reliability

consistency of results obtained by assessment measure
-test-retest and interrater

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validity

accuracy of tool's result
-face, predictive, and concurrent

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clinical interviews

most common measurement- obtain: background info, description of symptoms, direct observations

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SCID-5

structured clinical interview for DSM 5- widely used for diagnosis and research- ensures DSM diagnoses are systematically evaluated

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mental status exam

structured clinical interview- evaluates client's current level of functioning
-content of thought= what client thinks and believes
-affect and mood= what they feel inside vs what they express outwardly
-orientation= time and location

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TAT

describe a story to describe a picture- psychodynamic

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neuropsych assessments

asses brain functioning- tells about cognitive functioning- bender visual motor, Gestalt, MoCA

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TBI on cognitive functioning

-memory
-attention
-executive function
-length of time to process info
-insight about one's condition

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ABC assessment

antecedent-behavior-consequence
= what happened before the targeted behavior occurred and what happened after= what causes this response

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clinical observations

-naturalistic
-analog= contrived/ lab
-self-monitoring

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DSM

includes clinical features and related features, along with stats- does not cover treatment and theories on causation
1)categorical info= name of disorder indicated by symptoms
2)dimensional info= rating of how severe symptoms are

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comorbidities

psych disorders that are co-existing 1+ diagnosis

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differential diagnosis

the process of ruling out alternative diagnoses

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clinical significance

symptoms are not fleeting in duration and not of little concern to the client

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inpatient

most restrictive option -short term= hospitalization for danger to oneself and others

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specialized inpatient

various inpatient centers- subs abuse and eating disorders

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group home

smaller institutional setting in community with 24/7 staff- for clients that need regular monitoring

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day treatment

day time program of structured activities

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outpatient

majority of clients- client lives in community and receives services via appts with clinicians