MCAT p/s 4 - Personality, Psychological Disorders, Social Psychology, Normative and Non-Normative Behaviour, Learning, Theories of Attitude and Behaviour Change

Psychoanalytical theory

Theory of Personality

• Sigmund Freud

• Personality shaped through childhood, unconscious thoughts/desires, feelings, past memories

• 2 instinctual drives motivate behaviour:

  • Libido - natural energy source that fuels motivations of the mind

  • Death instinct - drives aggressive behaviours fuelled by unconscious wish to die or hurt oneself/others

• Individual influences on behaviour include:

  • Projection - projecting own feelings of inadequacy on another

  • Reaction formation - defence mechanism where someone says or does exact opposite of what they actually want/feel

  • Regression - defence mechanism where one regresses to position of child in problematic situations

  • Sublimation - defence mechanism where unwanted impulses are transformed into something less harmful

• 3 parts of mind (exist in conscious or unconscious mind):

  • Id

  • Ego

  • Superego

Libido

Part of Psychoanalytical Theory

• Instinctual drive that motivates behaviour

  • Natural energy source that fuels motivations of the mind

  • When this energy is stuck/fixated at various stages of psychosexual development, conflicts can occur that have lifelong effects

• ___ impulses are what want to be gratified

  • when over-gratified or partially/not gratified at all, fixation occurs at a certain stage

Death instinct

Part of Psychoanalytical Theory

• Instinctual drive that motivates behaviour

  • drives aggressive behaviours fuelled by unconscious wish to die or hurt oneself/others

Projection

Part of Psychoanalytical Theory

• Individual influence on behaviour

  • projecting own feelings of inadequacy on another

Reaction formation

Part of Psychoanalytical Theory

• Individual influence on behaviour

  • defence mechanism where someone says or does exact opposite of what they actually want/feel

Regression

Part of Psychoanalytical Theory

• Individual influence on behaviour

  • defence mechanism where one regresses to position of child in problematic situations

Sublimation

Part of Psychoanalytical Theory

• Individual influence on behaviour

  • defence mechanism where unwanted impulses are transformed into something less harmful

Conscious Mind

Part of Psychoanalytical Theory

• Mental functions you are aware of

Unconscious mind

Part of Psychoanalytical Theory

• Consists of primitive, instinctual wishes and information that cannot be accessed

Id

Part of Psychoanalytical Theory

• Part of unconscious mind

• Develops after birth and demands immediate gratification

Ego

Part of Psychoanalytical Theory

• Part of conscious and unconscious minds

• Involves perceptions, thoughts, and judgments

• Seeks long-term gratification

• Acts as mediator between unconscious desires and moral demands

Superego

Part of Psychoanalytical Theory

• Part of conscious and unconscious minds

• Develops around age 4

• Moral conscience

Humanistic Theory

Theory of Personality

• Focuses on healthy personality, development, and sees humans as inherently good

• Self-actualization = most basic motive of humans (actualizing tendency)

• People have free will and will grow towards self-actualization

• Behaviour determined conscious self-motivation to improve (not unconscious desires like Freud says)

• Theorists:

  • Maslow: hierarchy of needs

  • Carl Rogers

    • For self-actualization and growth, need:

      • Genuine - must be open and revealing about ones self w/o fear of being wrong

      • Acceptance, unconditional positive regard for others

• Personality is self-concept - achieved when we bring genuineness and acceptance together to achieve growth-promoting climate

• Genuine + acceptance = self-concept

• Importance ofcongruencybetween self-concept and our actions to feel fulfilled

Biological theory

Theory of Personality

• Relates to brain and/or behaviour instead of traits

• Components of personality are inherited or determined by genes

• Theorists:

  • Buss

  • Hans Eysenck

  • Jeffrey Alan Gray

  • C Robert Cloninger

• Traits studied:

  • Social potency - tendency to assume leadership roles

  • Traditionalism - tendency to follow authority

  • Weaker genetic traits = achievement, closeness

Hans Eysenck

Biological and Trait Theory of Personality Theorist

• Extroversion level is based on differences in reticular formation (controls arousal and consciousness)

• Introverts are more aroused, so seek lower levels of stimulation than extroverts

• We all posses all traits, but express them to different degrees

• 3 major dimensions of personality:

  • Neuroticism - emotional stability

  • Extroversion - degree of sociability

  • Psychoticism - degree to which reality is distorted

    • All have degree of neuroticism and extroversion, but not necessarily psychoticism

Jeffrey Alan Gray

Biological Theory of Personality Theorist

• Biopsychological theory of personality

• Personality governed by behaviour inhibition (punishment/avoidance) and activation (reward) system

C Robert Cloninger

Biological Theory of Personality Theorist

• Linked personality to systems of the brain in reward/motivation/punishment

• Ex. low dopamine correlated to higher impulsivity

Behaviourist Theory

Theory of Personality

• Personality results from learned behaviour patterns based on environment

• Deterministic - humans begin as blank canvas and environment completely determines behaviour/personality

• Focuses on observable and measurable behaviours (not mental/emotional - opposite of psychoanalytical theory)

• Theorists:

  • Pavlov

  • Skinner

Skinner

Behaviourist Theory of Personality Theorist

• Strict behaviourist

• Associated with operant conditioning

• Uses rewards/punishment to increase/decrease behaviour,

Pavlov

Behaviourist Theory of Personality Theorist

• Associated with classical conditioning

  • Places a neutral stimulus with an unconditioned stimulus to trigger an involuntary response

  • Ex. dog experiment

Cognitive Theory

Theory of Personality

• Connects behaviourist and psychoanalytical theories

• Treats thinking as a behaviour

• Albert Bandura

Trait Theory

Theory of Personality

• Personality trait = stable predisposition towards a certain behaviour

• Personality = patterns of behaviour explained via traits

  • Relatively stable characteristic of a person that causes individuals to consistently behave in certain ways. Combination and interaction of traits forms the personality

• Surface traits = evident from a person’s behaviour

• Source traits = factors underlying human personality

• Ex.

  • Myers-Griggs Personality Test

  • Gordon Allport

  • Raymond Cattell

  • Hans Eysenck

  • 5 Factor Model

Extroversion/Introversion, Sensing/Intuition, Thinking/Feeling, Judgment/Perception

• Example of Trait Theory of Personality

• Myers-Briggs Personality Type letter meanings

Gordon Allport

Theorist of Trait Theory of Personality

• We all have different traits

• Came up with list of 4500 words for traits

• 3 categories of traits:

  • Cardinal traits:

    • Characteristics that direct most of person’s activities

    • Dominant traits that influence behaviour

  • Central traits:

    • Less dominant

    • Ex. shyness, honesty

  • Secondary traits:

    • Preferences or attitudes

    • Ex. love for modern art, reluctance to eat meat

Raymond Cattell

Theorist of Trait Theory of Personality

• Proposed 16 essential personality traits = basic dimensions of personality

• Turned into 16 personality factor questionnaire

5 Factor Model

Model of Trait Theory of Personality

• 5 big personality traits found in all people of all populations

  • Openness - independence/conforming, imaginative/practical

  • Conscientiousness - careful/careless, disciplined/impulsive, organized or not

  • Extroversion

  • Agreeableness - kind/cold

  • Neuroticism - stable/tense, calm/anxious

    (OCEAN)

Social Cognitive Theory

• Theory of behaviour change that emphasizes interactions between people and their environment

• Cognition also important (unlike behaviourism)

• Studied by Albert Bandora - Bobo Doll Experiment

  • Attention, Memory, Imitation, Motivation

Defense mechanisms

• Ways to protect ourselves

• Psychological shield against unconscious psychological processes/deal with unconscious wants, feelings, desires, impulses

• 4 categories

  • Pathological

  • Immature

  • Neurotic

  • Mature

Pathological

Type of Defense Mechanism

• Distort reality

• Denial - pretend something didn’t happen

• Most important defence mechanism

Immature

Type of Defense Mechanism

• Projection - throw your attributes at someone else

  • Ex. accuse others of being jealous if you are jealous

  • Can cause projective identification - person being accused (ex. of jealousy) starts to believe it

• Passive Aggression - aggressively doing something for someone and failing to doit or doing it slowly

Neurotic

Type of Defense Mechanism

• Intellectualization - separate emotions from ideas

• Rationalization - make yourself believe it’s not your fault

• Regression - acting like baby

• Repression - push thoughts down into unconscious

• Displacement - displace anger onto someone else

• Reaction Formation - unconscious feelings make person act in complete opposite way

Mature

Type of Defense Mechanism

• Humour

• Sublimation - channeling negative to positive energy

• Suppression - conscious thoughts pushed to unconscious to access later

• Altruism - in service of others

Pleasure Principle

• Freud

• As a child, immediately want to feel pleasure to avoid suffering

• Not willing to compromise

Reality Principle

• Freud

• When more mature, sacrifice short term reward and replace it with long term gratification

• Have to play my rules and compromise

Eros/Life Drives

• Type of drives - intrinsic, universal feelings we all have towards varying things

• Freud

• Health, safety, sex

• Comes with love, cooperation, collaboration

• Work with others to promote wellbeing

Thanatos/Death drives

• Type of drives - intrinsic, universal feelings we all have towards varying things

• Freud

• Self-destructive/harmful to others

• Comes with fear, anger, hate

Distress

• Negative stress that builds over time and is bad for your body

• Happens when you perceive a situation to be threatening to you some way (physically or emotionally) and your body becomes primed to respond to the threat

Eustress

• Positive type of stress that happens when you perceive a situation as challenging, but motivating

• Usually enjoyable

Neustress

• Neutral type of stress

• Happens when you are exposed to something stressful, but it doesn’t actively or directly affect you

• Ex. news about a natural disaster on the other side of the world

Biomedical model

Model of Mental Disorders

• Focuses on biological and physical abnormalities

• Ex. Abnormalities of cell of the brain that might cause disorders or havingabnormal pattern of connections b/w cells of the brain

Biopsychosocial model

Model of Mental Disorders

• Considers abnormalities, but also includes psychological and cultural/social factors that might be useful for cause or classification of mental disorder

ICD-10, DSM-5

The 2 classification systems of mental disorders

Neurodevelopmental disorder

Category of Mental Disorder (DSM-5)

• Distress/disability due to abnormality in development of nervous system

• Ex. intellectual disability, ASD, ADHD

Neurocognitive disorders

Category of Mental Disorder (DSM-5)

• Loss of cognitive/other functions of the brain after nervous system has developed

• Ex. delirium, dementia

Sleep-wake disorders

Category of Mental Disorder (DSM-5)

• Result in distress/disability from sleep-related issues

• Ex. insomnia, breathing-related sleep disorders, abnormal behaviours during sleep

• Occur in three areas: brain, upper airways, or lung/chest walls

Anxiety disorders

Category of Mental Disorder (DSM-5)

• Distress/disability from abnormal worry/fear

• Some related to specific stimuli, others non-specific

• Ex. social anxiety, selective mutism, general anxiety

Depressive disorders

Category of Mental Disorder (DSM-5)

• Distress/disability from abnormally negative mood

• Mood = long-term emotional state

• Hopelessness, loss of enjoyment in activities, high risk of suicide

Bipolar and related disorders

Category of Mental Disorder (DSM-5)

• Abnormal negative mood and may have periods of abnormally positive mood called mania

• Mania = little sleep, talking quickly, making bad decisions due to impaired judgement

Schizophrenia and other psychotic disorders

Category of Mental Disorder (DSM-5)

• Distress/disability from psychosis

• Delusions, hallucinations, disorganized thinking, other negative symptoms

Trauma/stressor-related disorders

Category of Mental Disorder (DSM-5)

• Distress/disability occurs after stressful/traumatic events

• Leads to mood, emotional, and behavioural abnormalities

• Ex. PTSD

Substance-related/addictive disorders

Category of Mental Disorder (DSM-5)

• Distress/disability from the abnormal use of substances that affect mental function

• Include alcohol, caffeine, cannabis, hallucinogens, inhalants, opioids, sedatives, hypnotics, anxiolytics, stimulants, tobacco, others

• Can cause mood abnormalities, anxiety symptoms, or psychosis

• Also includes gambling

Personality disorders

Category of Mental Disorder (DSM-5)

• Distress/disability related to personality

• Involve personality types outside societal norms

• Cluster A = odd/eccentric (weird)

• Cluster B = intense emotional/relationship problems (wild)

• Cluster C = anxious/avoidant/obsessive (worried)

Disruptive, Impulse-Control, and Conduct Disorders

Category of Mental Disorder (DSM-5)

• Distress/disability from behaviors that are unacceptably disruptive or impulsive for someone’s culture

• Inability to control inappropriate behaviours

Obsessive-Compulsive and Related Disorders

Category of Mental Disorder (DSM-5)

• Distress/disability from obsessions or compulsions

• Obsessions - thoughts that occur involuntarily, often unwelcome, occur repeatedly

• Compulsions - activities that one must do and are often related to an obsession

Somatic symptom and related disorders

Category of Mental Disorder (DSM-5)

• Distress/disability from symptoms similar to those that may occur to illness unrelated to mental disorder, but of psychological origin with or without having a general medical condition at the same time

Feeding and Eating Disorders

Category of Mental Disorder (DSM-5)

• Distress/disability from behavioural abnormalities related to food

• Ex. anorexia nervosa, bulimia

Elimination disorders

Category of Mental Disorder (DSM-5)

• distress/disability from urination/defecation at inappropriate times or places

• Ex. urinary accidents

Dissociative disorders

Category of Mental Disorder (DSM-5)

• Distress/disability from abnormalities of identity or memory

• Ex. multiple personalities, people who have lost memories for part of their lives

Sexual dysfunctions

Category of Mental Disorder (DSM-5)

• distress/disability from abnormalities in or performance of sexual activity

Gender dysphoria

Category of Mental Disorder (DSM-5)

• Distress/disability caused by person identifying as a different gender than society represents them as

• Must cause distress/disability

Paraphilic disorders

Category of Mental Disorder (DSM-5)

• Distress/disability from having sexual arousal to unusual stimuli for a person’s culture

• Must cause distress/disability or cause harm to another person, particularly people or a child who does not have decision making capacity for proper consent

Schizophrenia

Mental disorder

• Due to combination of genetics and environment (neurodevelopmental)

• Abnormal brain scans, high dopamine levels

  • Smaller cerebral cortex

  • Mesocorticolimbic pathway affected

• Diagnosed by clinical interview

• Abnormal beliefs (delusions), see/hear things (hallucinations)

• Isolate socially, disorganized, flat affect (lack emotion)

• Preceded by prodrome period before symptoms present

• Social repercussions

• Haloperidol = antipsychotic med used to treat

Prodrome

• Period of time before schizophrenia before symptoms are actually present

• Deterioration in person’s behavior and functioning

• School/work and relationships suffer, delusional ideas

Hallucinations

• Positive symptom of schizophrenia

• Sensory perceptions w/o stimuli like hearing or seeing not there

• Sounds or other sensations experienced as real when they exist only in the person's mind

Delusions

• Positive symptom of schizophrenia

• False fixed beliefs not explainable by a person’s culture

• Firmly-held idea that a person has despite clear and obvious evidence that it isn’t true

• Include ____ of persecution, reference, grandeur, control

Cognitive

_________ Symptoms of Schizophrenia

• Abnormalities of attention, organization, planning abilities

  • disorganized thinking, slow thinking, difficulty understanding, poor concentration, poor memory, difficulty expressing thought, difficulty integrating thoughts, feelings and behavior

Negative

_________ Symptoms of Schizophrenia

• Blunted emotions, loss of enjoyment “emotional abnormalities”

• Absence of normal behaviours found in healthy individuals

• Lack of emotional expression - inexpressive face, including a flat voice, lack of eye contact, and blank or restricted facial expressions

  • Affective flattening

• Lack of interest or enthusiasm - lack of motivation and self-care

  • Avolition

• Lack of interest in the world

• Speech difficulties/abnormalities

  • Alogia

Positive

_________ Symptoms of Schizophrenia

• “Psychosis,” hallucinations, delusions, “perceptual abnormalities,” disorganized speech/thinking, disorganized behaviour, catatonic behaviour

Catatonic schozophrenia

• Type/subtype of schizophrenia

• Includes extremes behaviours

• One end, can’t more/speak/respond

Depression

• Symptoms: feelings of hopelessness, loss of interest inactivities

• No consistent abnormalities in brain tissue, but scans suggest functional abnormalities of brain

  • Abnormal activity in frontal lobe and limbic structures (regulation of emotions/stress)

• Perhaps abnormalities in neurotransmitter pathways

  • Raphe nuclei of brainstem responsible for serotonin release

  • Locus coerulus pathway for norepinephrine release

  • VTA for dopamine

  • Medications that affect these neurotransmitters help symptoms

• Abnormalities in neuroplasticity

• Genetic predispositions

Generalized Anxiety Disorder (GAD)

Type of Anxiety/Obsessive Compulsive Disorder

• Person whose general state is tense and uneasy to a degree it influences their life

• Anxiety must last 6 months or more

• Continuous high level of anxiety

• Twitching eyelids, trembling, fidgeting, high BP

• Source of anxiety unclear

• 2/3 = women

• Often also have depression

Panic disorders

Type of Anxiety/Obsessive Compulsive Disorder

• Sudden burst of sheer panic and intense fear

• Heart palpitations or sweating or chest pain or shortness of breath

• In response to situations that typically don’t warrant that level of stress

Phobias

Type of Anxiety/Obsessive Compulsive Disorder

• Irrationally afraid of specific objects or specific situation

• Focused anxiety

• Can be debilitating or can have normal life

• Tend to form a pattern

OCD

Type of Anxiety/Obsessive Compulsive Disorder

• Characterized by obsessions and compulsions

  • Unwanted repetitive thoughts and actions

• 2-3% of people. Typically, teen and young adult.

PTSD

Type of Anxiety/Obsessive Compulsive Disorder

• Have lingering memories and nightmares about a past event that it impact them in daily life

• Have a trigger that leads to the disorder

• Symptoms persist for over 4 weeks after an event

• Acronym: TRAUMA

  • Traumatic event

  • Re-experience

  • Avoidance

  • Unable to function

  • Month or more of symptoms

  • Arousal increased

• Repressed memories

Dissociative Identity Disorder

• Two or more distinct personalities exist in a single body

• Both identities have influence on person’s thoughts and behaviours

• 2 identities are distinct, have own:

  • Mannerisms

  • Emotional responses

  • “Physical changes”

  • Denial of other identity or not aware

• People typically have a history of child abuse or other extreme life stressor

• Extremely rare

Conversion Disorder

Type of Somatic Symptom Disorder

• Neurological symptoms only - problems with speech, swallowing, seizures, paralysis, etc.

• Neurological symptoms incompatible with any known neurological or mental condition

Factitious Disorder

• Patient will falsify or disease their signs or symptoms to get a diagnosis/treatment

• Munchausen’s syndrome

• Munchausen’s by proxy-when one person makes another person look ill so medical attention/treatment provided further for another individual

Cluster A

Category of Personality Disorder

• Odd and Eccentric Traits

• Weird

• Includes:

  • Paranoid

  • Schizoid

  • Schizotypal

Paranoid

Cluster A (weird) Personality Disorder

• Profound distrust + suspicion of other people

Schizoid

Cluster A (weird) Personality Disorder

• Emotionally detached in relationships and shows little emotion

Schizotypal

Cluster A (weird) Personality Disorder

• Odd beliefs/ magical thinking

Cluster B

Category of Personality Disorder

• Dramatic, emotional, and erratic traits

• Wild

• Includes:

  • Antisocial

  • Borderline

  • Histrionic

  • Narcissistic

Antisocial

Cluster B (wild) Personality Disorder

• Little or no regard for others

• Commit crimes and show no remorse

• Inconsiderate of others

Borderline

Cluster B (wild) Personality Disorder

• Unstable relationships, emotions are unstable, variable self-image and compulsive (which can put them in danger)

• At the brink of an emotional/relationship issue

Histrionic

Cluster B (wild) Personality Disorder

• Are very attention seeking

• Display emotions outwardly, wear bright clothes

Narcissistic

Cluster B (wild) Personality Disorder

• Huge egos, need for admiration and praise, grandiose

• House

Cluster C

Category of Personality Disorder

• Anxiety and fearful traits

• Worried

• Includes:

  • Avoidant

  • Dependent

  • Obsessive-Compulsive Personality Disorders (OCPD)

Avoidant

Cluster C (worried) Personality Disorder

• Inhibited, feel inadequate and try to avoid putting themselves in a situation where they can be criticized

Dependent

Cluster C (worried) Personality Disorder

• Submissive and clingy

• Ex. Those who stay in physically abusive relationships

Obsessive-Compulsive Personality Disorders (OCPD)

Cluster C (worried) Personality Disorder

• Very focused on life being ordered and things being perfect and for them being in control to an extent where it annoys other people

• Not the same as OCD

Central Sleep Apnea

Type of Sleep-Wake Disorder

• Problem in brain (which regulates respiratory center of the lung)

• Problem with the brain’s control system for ventilation

• Cheynes-Stroke breathing–crescendo then decrescendo breathing followed by stop in breathing

  • Normal breathing pattern is inhale/exhale changes from a normal fixed pattern

• Believed heart failure/stroke/renal failure is the cause

Obstructive sleep apnea

Type of Sleep-Wake Disorder

• Problem in upper airways (obstruction from mouth to lungs)

• Soft tissues around our neck can relax at night and potentially cause obstruction of airflow for a short period of time

• Worse with age

• Causes snoring/gasping, tiredness

• Diagnosed by sleep stody

Hypoventillation Disorder

Type of Sleep-Wake Disorder

• Problem in lungs or chest walls (stops lungs from being able to expand)

• Not able to ventilate our lungs fully and remove all CO2

• Results in a buildup of CO2, and a decrease in O2

  • High CO2 - right sided heart failure

  • Low O2 - affects all organs/tissues of bodies, Cognitive impairment, heart problems, low RBC count

• Caused by medications or problems with chest/wall cavity, obesity

Alzheimer’s disease

• Most common disorder in dementia/neurocognitive category

• Loss of cognitive functions

• Later stages loss of motor functions/activities of daily living (ADL)

• Atrophy of brain tissue

• Loss of neurons, plaques, and tangles

  • Nucleus basalis responsible for cognitive functions and acetylcholine release lost early

• Loss of synapse function long before disease

Parkinson’s Disease

• Progressive neurological disorder involving motor abnormalities and mental dysfunction

• Slowed movements, tremors, increased muscle tone, abnormal walking, poor balance

• Substantia nigra in brainstem (basal ganglia) less dark

  • Important for motor and some mental functions

  • Processes info and send to other areas of cerebral cortex

• Only dopaminergic neurons lost

  • Lewy bodies = abnormal structures inside dopaminergic neurons of substantia nigra

    • Contain alpha synuclein protein that is clumped

Lewy body disease

• Less motor abnormalities from basal ganglia dysfunction

• More cognitive dysfunction from loss of function from cerebral cortex

• Separate from Parkinson’s.

Depression/Major Depressive Disorder

• Prolonged feelings of helplessness and discouragement about the future

• Acronym: Sadness and SIG E CAPSW

  • Suicidal thoughts

  • Interests decreased

  • Guilt

  • Energy decreased

  • Concentration decreased

  • Appetite changed

  • Psychomotor changes

  • Sleep disturbances

  • Weight gain or loss

• 3 Factors:

  • Biological

  • Psychological

  • Sociocultural/Environmental

Biopsychosocial model of depression

• 3 factors play a role in depression

  • Biological

    • Genetic component

    • Decreased activation of pre-frontal cortex

    • Lower activity of reward circuit of brain

    • Fewer receptors for serotonin and norepinephrine

  • Psychological

    • Behavioural theory - “learned helplessness”

    • Cognitive theory - trapped in negative thought patterns

    • Cognitive theory - form negative attribution style

    • Coping style and self-esteem related

  • Sociocultural/Environmental

    • Co-rumination/empathy

    • Low socio-economic status

    • Social isolation/child abuse

    • Internalization of prejudice

Dependent stressor

• Stressors influenced or caused by individual’s actions/choices

• Ex. bad test score, breakup