Exam 1 (Chapters 1 - 3)

DSM-5

Diagnostic and Statistical Manual of Mental Disorders - 5th ed.

five criteria common to all mental disorders

1) clinical significance

2) a behavior must reflect a dysfunction in a psychological, biological, or developmental process

3) functioning is associated with significant personal distress or impairment

4) individual's behavior can not be "socially deviant" as defined in terms of religion, politics, or sexuality

5) disorder reflects a dysfunction within the individual

clinical significance

the behavior includes a measurable degree of impairment that a clinician can observe

psychopathology

scientific study of mental disorders

psychopathy

scientific study of psychopaths

what causes abnormal behavior?

1) biological - factors within the body that influence abnormal behavior

2) psychological - thoughts, feelings, behavior due to past learning or problems coping with stress

3) sociocultural - social policies, stigma, and discrimination

biopsychosocial perspective

the interaction of biological, psychological, and sociocultural factors is seen as influencing the development of the individual over time

- potency of each factor varies by disorder

spiritual approach

psychological disorders are the product of possession by evil or demonic spirits

- trephining, exorcism, and beatings

moon and stars approach (1400s-1500s)

movement of heavenly bodies produced gravitational effects on bodily fluids (mental disorders)

- lunatic

humanitarian approach

psychological disorders are the result of cruelty, stress, or poor living conditions

- patients comfort is most important

- lead to rise of poorhouses, monasteries, and eventually mental institutes (overcrowding)

moral treatment

the belief that people could develop self-control over their behaviors if they had a quiet and restful environment

Dorothea Dix

deinstitutionalization movement (1960s)

the release of hundreds of thousands of patients from mental hospitals

- pharmacological treatments

scientific approach

psychological disorders are the result of causes that we can objectively measure, such as biological alterations, faulty learning processes, or emotional stressors

positive psychology

perspective that emphasizes the potential for growth and change throughout life (to stay mentally well)

- scientific approach

scientific method

the process of testing ideas about the nature of psychological phenomena without bias before accepting these ideas as adequate explanations

experimental design

investigators change variable A to see how this affects variable B

- tests cause and effect and used to study treatment effectiveness

- control of extraneous variables through random assignment

independent variable (IV)

the variable whose level is adjusted or controlled by the experimenter

dependent variable (DV)

the variable whose value is the outcome of the experimenter's manipulation of the independent variable

extraneous variable

any variable other than the independent or dependent variable

randomized controlled trial (RCT)

gold standard for research in clinical psychology

participants are randomly assigned to intervention groups

experimental group

the group in an experiment that receives the variable being tested

placebo group

control group that receives a treatment similar to the experimental treatment, but lacks the key feature of the treatment of interest

ex) sugar pill

control group

the group that does not receive the experimental treatment

double blind

experiment procedure in which neither the person giving the treatment nor the person receiving the treatment knows whether the participant is in the experimental or control group

correlational design

study in which researchers test relationships between variables that they cannot experimentally manipulate

- no manipulation, no random assignment

demand charachteristics

expectations about an experiment's outcome that can affect both the researcher and participant

- remedy = double blind study

survey

research tool used to gather information from a sample of people considered representative of a particular population, in which participants are asked to answer questions about the topic of concern

- useful for finding out incidence and prevalence rates

incidence

the frequency of new cases within a given time period

prevalence

the number of people who have ever had a disorder at a given time or over a specified period

case study

intensive study of a single person described in detail

single-case experimental design

design in which the same person serves as the subject in both the experimental and control conditions

- ABAB design, remedy = multiple baselines

client

a person seeking psychological treatment

patient

in the medical model, a person who receives treatment

clinician

the person providing treatment

psychologist

licensed health care professional offering psychological services

psychiatrist

person with a degree in medicine (MD) who receives specialized advanced training in diagnosing and treating people with psychological disorders

clinical psychologist

a mental health professional with training in the behavioral sciences who provides direct service to clients

diagnosis

process of determining whether the problem afflicting the individual meets all criteria for a psychological disorder

reliability

the degree to which clinicians provide diagnoses consistently across individuals who have a particular set of symptoms

validitiy

the extent to which a test, diagnosis, or rating accurately and distinctly characterizes a person's psychological status

DSM-3 and DSM-4

multiaxial system

1) included all mental disorders except for those on axis 2

2) intellectual disabilities and personality disorders

3) medical conditions

4) psychosocial stressors

5) GAF

DSM-5 layout

monoaxial system - 22 chapters

1) neurodevelopmental disorders: disorders first identified in childhood

2) internalizing disorders: harder to see; suffer internally

3) externalizing disorders: easier to see; impulsivity, conduct disorders; oppositional defiant disorders

steps to making a diagnosis

1) examine client's signs and symptoms

2) make a principle diagnosis

3) provisional diagnosis

4) case formulation

5) treatment plan

signs

objective evidence of a disorder

symptoms

subjective evidence of a disorder

differential diagnosis

the process of systematically ruling out alternative diagnoses

comorbidity

two (or more) disorders that co-occur within the same individual

principle diagnosis

the disorder must closely align with the primary reason the individual is seeking professional help

provisional diagnosis

a tentative diagnosis made while waiting for more information or a passage of time

case formulation

a clinician's analysis of the factors that might have influenced the client's current psychological status/disorder

treatment plan

the outline for how therapy should take place

what is the most important component of therapy?

having a therapeutic relationship with the therapist

psychological assessment

a broad range of measurement techniques that provide scorable information about an individual's psychological functioning

uses of psychological assessments

1) gain a dearer diagnostic picture

2) personnel screening, especially for positions that require public trust

3) CST: competency to stand trial

4) insanity determinations

psychometric properties of instruments

reliability, validity, standardization

assesses the quality of the measure

standardization

a psychometric criterion that clearly specifies a test's instructions for administration and scoring

Barnum effect

the tendency for clinicians to unintentionally make generic and vague statements about their clients that do not specifically characterize the client

- avoid when interpreting results

clinical interview

a series of questions that clinicians administer in face-to-face interaction with the client

unstructured interview

a series of open-ended questions aimed at determining the client's reasons for being in treatment, symptoms, health status, family background, and life history

- allows for rapport building

structured interview

a standardized series of assessment questions, with a predetermined wording and order

- allows for consistency across clients and/or clinicians

mental status examination

a method of objectively assessing a client's behavior and functioning in a number of spheres, with particular attention to the symptoms associated with psychological disturbance

what are the areas of functioning assessed by a mental status examination?

A: appearance and behavior

T: thought processes

M: mood and affect

I: intelligence

S: sensorium

thought processes

1) rate and flow of speech

2) continuity of speech

3) delusions: distorted views of reality, hallucinations: client is hearing, seeing, feeling, things that aren't there

mood

predominant feeling state

affect

feeling state that accompanies what we say in a given moment

intellectual functioning

vocabulary, abstractions, metaphor, and memory

sensorium

general awareness of surroundings

- time, where, who they are, who clinician is

what do intelligence test measure?

perceptual, memory, reasoning, and speeded tasks

mean - 100, standard deviation - 15, on standard bell curve

two most common IQ tests

1) Stanford-Binet

2) Wechsler Intelligence Scales

deviation intelligence (IQ)

an index of intelligence derived from comparing the individual's score on an intelligence test with the mean score for that individual's reference group

Wechsler Adult Intelligence Scale (WAIS)

the first comprehensive individual test that researchers specifically designed to measure adult intelligence

what is needed to be successful in life?

IQ and conscientiousness

two types of personality tests

1) self reports

2) projective tests

self-report clinical inventory (self reports)

a psychological test with standardized questions (T/F, Y/N, strongly agree/disagree) having fixed response categories that the test-take completes independently, self-reporting the extent to which the responses are accurate characterizations

- objective

Minnesota Multiphasic Personality Inventory (MMPI)

self-report personality inventory containing 567 true-false items, all in the form of statements that describe the individual's thoughts, behaviors, feelings, and attitudes

- most widely used self-report inventory in clinical settings

- measures severe psychopathology

- four validity scales to prevent lying

Personality Assessment Inventory (PAI)

a self-report clinical instrument that offers an alternative to the MMPI, differing in item content and scaling

NEO Personality Inventory (NEO-PI-R)

a 240-item questionnaire that measure five personality dimensions, or sets of traits; the scales are designed so the test-taker can complete them as well as individuals who know the test-taker, such as spouses, partners, or relatives

- NOT used for clinical diagnosis

projective test

a technique in which the test-taker is presented with an ambiguous stimuli and is asked to respond by providing his or her own meaning or perception

- less guarded, taps into the unconscious, subjective

Rorschach Inkblot Test

projective assessment method in which individuals describe their perceptions of each of a set of symmetrical inkblots

- most widely used projective test

Thematic Apperception Test (TAT)

a projective test in which individuals invent a story to explain what is happening in a set of ambiguous pictures

behavioral assessment

the psychologist records behavior over a specified timeframe

target behavior

the behavior of interest or concern in an assessment

self-monitoring

the client keeps a record of the frequency of his/her own targeted behavior

neuropsychological assessment

the process of gathering information about the brain's functioning based on psychological tests

executive functioning

the ability to set goals, make plans, and carry them out in an effective way

neuroimaging

assessment method that provides a picture of the brain's structures or level of activity and therefore is a useful tool for "looking" at the brain