270 exam 2

basic characteristics of research

skeptical attitudes - question everything

validity

internal validity

results aren’t confounded

external validity

results can be replicated

experimenter effects (and solutions)

self fulfilling prophecy - you get what you look for

solutions - double-blind, placebo

statistical significance

probability of a finding being random is less than 0.05

case study

key goal is to obtain a rich description of one person. can be a powerful counterexample to supposedly universal theories

correlational research

focuses on relationship between 2+ variables

correlation coefficient

has direction and magnitude

epidemiology

study of the frequency and distribution of a disorder

incidence

# of new cases over given period of time

prevalence

% with disorder over a certain period of time

analogue studies

ability to test in a controlled setting, limitations on generalizability

single-case subject design

ABAB - looking for changes only when treatment is presented

popular classification systems

DSM-V (APA)

international classification of diseases (WHO)

disadvantages of diagnosing

• can give psychiatrists control

• diagnosis is mistaken for explanation

• labeling can be harmful

• problems with categorical systems

categorical approach

differences are based on possession of a quality

dimensional approach

differences are based on how much is posessed

DSM differences

DSM-IV: five axes

DSM-V: elimination of five axes, elimination of certain subtypes (Asperger’s), changes in organization and labeling (hypochondria → illness anxiety disorder), new disorders (non-suicidal self injury, premenstrual dysphoric disorder)

DSM-V TR: added prolonged grief disorder, attempted to examine for racism

premenstrual dysphoric disorder

severe pms

interview

most basic form of assessment. can be subjective/ variable

psychological tests

IQ tests, stanford-binet tests, weschler scales, aptitude vs achievement

weschler scales

greater focus on performance, separate scores on subtests

projective hypothesis

when individuals must make meaning out of something ambiguous, their response will reflect their inner feelings

MMPI empirical keying

items were kept if they differentiated diagnostic grouo from normal group

laboratory tests

to establish organicity - EEG, FMRI

to identify disorders - GSR, blood pressure

basic components of anxiety

subjective reports, behavioral response, physiological response, cultural variations

symptoms of panic attacks

• sudden and unexpected bout of anxiety associated with feelings of impending catastrophe

• reports of derealization and depersonalization

• often initially perceived as a heart attack

• cued and uncued types

• sometimes confounded w agoraphobia, ~of panic attack sufferers also suffer from agoraphobia, ~75% of women

• cultural variation - ataques de nervios relations to marianismo?

agoraphobia

• fear of public spaces

• typically avoided: shopping malls, cars, buses, trains, restaurants, theaters

ataques de nervios

• common among the carribbean latin

• uncontrollable shouting

• bursting into tears

• verbal/physical aggression

• typically direct result of stressor

marianismo

set of ideal beliefs for a latin woman

• sacred duty

• self-sacrifice

• dispensing care and pleasure

• living in the shadow of men

GAD - chronic state of diffuse anxiety

• worries about family, money, work, health

• affects cognitive and physiological functioning

• gradual onset

• cultural variation, e.g. ghost sickness

ghost sickness

preoccupation with death and disease, frequently seen in native americans

phobias

intense fear and avoidance

different from “normal fears”

• intense

• irrational

• handicapping

acrophobia

heights

ergasiophobia

work

gamophobia

marriage

monophobia

being alone

xenophobia

strangers

social phobias

fear of negative evaluations

typically self-considered shy

cross cultural variation

• in japan and korea, fear of offending others

• taijin kyofusho - fear that blushing, eye contact, b.o. will offend others

OCD

obsession - persistent thought

compulsions - persistent behavior, does not include addictive behavior (e.g. gambling)

acute physical reactions related to trauma

sources of stress must be external and extreme

symptoms include heightened arousal and reactivity

survivor’s guilt

psychodynamic perspective of anxiety

root of neurosis is unacceptable id impulses, intrapsychic conflict

humanistic/existential perspective of anxiety

anxiety as a function of an impaired self-concept (actual vs ideal self disparity)

existential - human condition is defined by anxiety

behavioral perspective of anxiety

learning to be anxious is a two-staged model

• neutral stimulus paired with anxiety arousing stimulus

• avoidance = anxiety relief

cognitive perspective of anxiety

barlow’s theory of panic: anxiety as misperception

• learned apprehension of physiological cues

  • e.g. irregular heart palpitations = heart attacks

sociocultural perspective of anxiety

we live in an age of anxiety

biological perpsective of anxiety

evidence supporting genetic influence in panic disorder

• higher concordance amongst 1st degree relatives

gaba has been implicated in many, but not all, anxiety disorders

dissociative amnesia

often associated with psychological stress

often anterograde

• localized

• selective

• generalized

• continuous

• systematized

blank periods

not bothered by the disorder

memories can be “recovered” in some cases

localized amnesia

lost recall for a specific period of time

selecive amnesia

recall some but not all events

generalized amnesia

no recall at all (rare)

continuous amnesia

failure to recall from traumatic event to present

systematized amnesia

failure to recall certain categories of amnesia

dissociative fugue

forgetting of one’s own history

can lead to leaving home and taking new identity

DID (prior to DSM-V, multiple personality disorder)

typically 2+ integrated personalities

common patterns

• alternating personalities; co-conscious subordinate personalities

• personalities often opposites

often associated with early childhood trauma/sexual abuse

false positives?

• spanos- role enactment

• malingering - deliberately feigning symptoms w/ ulterior motive

Nicolas Spanos

said DID is role enactmenrt

depersonalization disorder

out of body experience

can be associated with derealization or strangeness of the outside world

deja vu and jamais vu are not uncommon

psychodynamic perspective of dissociative disorders

repression, defense against anxiety

behavioral perspective of dissociative disorders

reinforcement of dissociative behavior

• mitigates accountability and responsibility

cognitive perspective of dissociative disorders

dossociations are a function ofd memory impairment

• problems with episodic memory involving the self

sociocultural perspective of dissociative disorders

iatrogenesis - creation of a disorder by an attempt to treat it

• often through leading questions

somatoform disorders

psychological complaint becomes physical

body dysmorphic disorder

dysfunction due to excessive preoccupation with real or perceived physical defects

• historically referred to as beauty hypochondria and dysmorphophobia

in the u.s., typically the nose and mouth

hypochondriasis (illness anxiety disorder0

fear of disease

misinterpretation of physical signs

• doctor hopping

often found in individuals with family history

somatic symptom disorder

recurrent physical complains without organic cause

sometimes, unnecessary surgery

rare, but more common in women

pain disorder

psychological factors are believed to influence the onset, severity, exacerbation, or maintenance of pain experience

conversion disorder

physical impairment without known cause

• blindness

• deafness

• paralysis

• anesthesia

  • glove anesthesia

rapid onset following trauma

la belle indifference - unusual indifference

selective symptoms?

common misdiagnosis when actually organic (62-80%)

Factitious disorder

Munchausen syndrome - tendency to self-inflict injury to seem sick with no clear ulterior motive other than desire to be hospitalized

• by proxy- deliberately inducing in another

psychodynamic perspective of somatoform disorders

threatening emotions - expressed physically when can’t emotionally

behavioral perspective of somatoform disorders

reinforcement of sick role is greater than reinforcement of illness free life

• attention seeking

cognitive perspective of somatoform disorders

dysfunctional cognitive style related to overattention to symptoms - tendency to catastrophize small issues

sociocultural perspective of somatoform disorders

society promotes ideas of ideal body image (barbie doll syndrome)

biological perspective of somatoform disorders

higher rate is there is a family history

diagnosis by exclusion - essential to rule out biological causes

Ken Biachi

serial killer that faked DID

clinical assessment

the systematic evaluation and measurement of psychological, biological, and social factors in an individual presenting with a possible psychological disorder

mental status exam

systematic observation of an individuals behavior

covers five categories

• appearance and behavior

• thought processes

• mood and affect

• intellectual functioning

• sensorium (general awareness of surroundings)

privileged communication

laws that prevent information exchanged in therapy from being leaked

semistructured interviews

made up of carefully phrased questions, tested to elicit only useful info

behavioral assessment

using direct observation to assess an individual

informal observation

relies on observer’s recollection and interpretation

formal observation

identifies measurable, specific behaviors (using an operational definition)

self-monitoring

observing your own behavior to find patterns

reactivity

a phenomenon in which the knowledge that one is being observed can cause changes in their behavior

projective tests

in which subjects are asked to state what they see in ambiguous stimuli

face validity

how the wording of a question seems to match the desired information

personality inventories

self-report questionnaires that assess personality traits

neuropsychological test

assessment of brain and nervous system functioning by testing an individual’s performance on behavioral tasks

primarily used as screening devices

neuroimaging

sophisticated computer-aided procedure that allows nonintrusive examination of nervous system structure and function

psychophysiological assessment

measures changes in nervous system indicative of psychological changes

event-related/evoked potential

EEG pattern in response to specific event

alpha waves

waking activities

delta waves

deepest sleep

electrodermal responding

previously galvanic skin response, measure of sweat gland activity controlled by PNS

biofeedback

patients are given their own bio readings to regulate

idiographic strategy

a research approach that focuses on understanding unique and individual cases

nomothetic strategy

A research approach that focuses on identifying general principles and patterns that apply to a large group of individuals

nosology

classification and naming of psychological and medical phenomena

taxonomy

classification and naming in science

nomenclature

labels applied in taxonomy and nosology

prototypical approach

categorizes objects or concepts based on their resemblance to a typical or idealized prototype