PSC 168: Abnormal Psychology Midterm 1
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222 Terms
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Stigma
destructive beliefs and attitudes held by a society that are ascribed to groups considered different in some manner
1. A label is applied to a group of people that distinguishes
them from others (e.g., “crazy”).
2. Label is linked to deviant or undesirable attributes by society (e.g., crazy people are dangerous).
3. People with the label are seen as essentially different from those without the label, contributing to an “us” versus “them” mentality (e.g., we are not like those crazy people).
4. People with the label are discriminated against unfairly
(e.g., a clinic for crazy people can’t be built in our
neighborhood).
1. A label is applied to a group of people that distinguishes
them from others (e.g., “crazy”).
2. Label is linked to deviant or undesirable attributes by society (e.g., crazy people are dangerous).
3. People with the label are seen as essentially different from those without the label, contributing to an “us” versus “them” mentality (e.g., we are not like those crazy people).
4. People with the label are discriminated against unfairly
(e.g., a clinic for crazy people can’t be built in our
neighborhood).
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Psychological disorders remain the most stigmatized of conditions in the 21st century. T/F
True
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key suggestions for fighting stigma
community strategies - housing options, educating people, personal contact (people with these disorders will shop and eat in local establishments alongside people without these disorders)
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Mental Health and Health Profession Strategies- mental health evaluation, Education, Training, and Support on stigma
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Individual and Family Strategies - Education for Individuals and Families (psychoeducation), Support and Advocacy Groups
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Mental Health and Health Profession Strategies- mental health evaluation, Education, Training, and Support on stigma
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Individual and Family Strategies - Education for Individuals and Families (psychoeducation), Support and Advocacy Groups
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Relationship between public knowledge and Stigma
Knowing more about the causes or available treatments of psychological disorders does not decrease stigma and is linked to a greater desire for more social distance from people with psychological disorders
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Two factors that can reduce stigma
contact and familiarity
\-→ Unfortunately, though, there is some evidence that greater familiarity, as in being a caretaker or mental health professional, is associated with more stigma because burnout can foster stigma
\-→ Unfortunately, though, there is some evidence that greater familiarity, as in being a caretaker or mental health professional, is associated with more stigma because burnout can foster stigma
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Defining Psychological Disorder
(personal distress, disability and dysfunction, and violation of social norms)
The DSM-5 definition of mental disorder includes the
following:
* The disorder occurs within the individual.
* Involves clinically significant difficulties in thinking, feeling, or behaving.
* Usually involves personal distress of some sort, such as in social relationships or occupational functioning.
* Involves dysfunction in psychological, developmental, and/or neurobiological processes that support mental functioning.
* Not a culturally specific reaction to an event (e.g., death of a loved one).
* It is not primarily a result of social deviance or conflict with society
The DSM-5 definition of mental disorder includes the
following:
* The disorder occurs within the individual.
* Involves clinically significant difficulties in thinking, feeling, or behaving.
* Usually involves personal distress of some sort, such as in social relationships or occupational functioning.
* Involves dysfunction in psychological, developmental, and/or neurobiological processes that support mental functioning.
* Not a culturally specific reaction to an event (e.g., death of a loved one).
* It is not primarily a result of social deviance or conflict with society
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Personal Distress
Not all psychological disorders cause distress.
* For example, an individual with antisocial personality disorder may treat others coldheartedly and violate the law without experiencing any guilt, remorse, anxiety, or other type of distress.
Not all behavior that causes distress is disordered
* grief/loss, distress of hunger due to religious fasting
* For example, an individual with antisocial personality disorder may treat others coldheartedly and violate the law without experiencing any guilt, remorse, anxiety, or other type of distress.
Not all behavior that causes distress is disordered
* grief/loss, distress of hunger due to religious fasting
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Disability and Dysfunction
disability alone cannot be used to define psychological disorder because some, but not all, disorders involve disability.
* bulimia involves binge eating to control weight, but it does not necessarily involve disability. Many people with bulimia lead lives without impairment, while bingeing and purging in private.
* chronic substance abuse -→ job loss
* rejection by peers due to social anxiety
Other characteristics that might be considered disabilities-such as being blind and wanting to become a professional race car driver—do not fall within the domain of psychopathology
\
dysfunction refers to the fact that developmental, psychological, and biological dysfunctions are all interrelated. That is, the brain impacts behavior, and behavior impacts the brain; thus, dysfunction in these areas is interrelated.
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PROBLEM:
not all psychological disorders involve disability
* bulimia nervosa
Not all liabilities are considered to be psychological disorders
* hard of hearing, visually impaired
Adaptive behavior is partially determined by context
* bulimia involves binge eating to control weight, but it does not necessarily involve disability. Many people with bulimia lead lives without impairment, while bingeing and purging in private.
* chronic substance abuse -→ job loss
* rejection by peers due to social anxiety
Other characteristics that might be considered disabilities-such as being blind and wanting to become a professional race car driver—do not fall within the domain of psychopathology
\
dysfunction refers to the fact that developmental, psychological, and biological dysfunctions are all interrelated. That is, the brain impacts behavior, and behavior impacts the brain; thus, dysfunction in these areas is interrelated.
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PROBLEM:
not all psychological disorders involve disability
* bulimia nervosa
Not all liabilities are considered to be psychological disorders
* hard of hearing, visually impaired
Adaptive behavior is partially determined by context
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Violation of Social Norms
social norms are widely held standards that people use consciously or intuitively to make judgments about where behaviors are situated on such scales as good-bad, right-wrong.
* the repetitive rituals performed by people with obsessive-compulsive disorder and the conversations with imaginary voices that some people with schizophrenia engage in are behaviors that violate social norms.
* talking to nonexistent voices that some people with schizophrenia experience
Problem with the definition:
* both too broad and too narrow.
* For example, it is too broad in that criminals violate social norms but are not usually studied within the domain of psychopathology; it is too narrow in that highly anxious people typically do not violate social norms.
* not all people who challenge social norma are mentally ill
* social norms vary across cultures (eye contact)
* the repetitive rituals performed by people with obsessive-compulsive disorder and the conversations with imaginary voices that some people with schizophrenia engage in are behaviors that violate social norms.
* talking to nonexistent voices that some people with schizophrenia experience
Problem with the definition:
* both too broad and too narrow.
* For example, it is too broad in that criminals violate social norms but are not usually studied within the domain of psychopathology; it is too narrow in that highly anxious people typically do not violate social norms.
* not all people who challenge social norma are mentally ill
* social norms vary across cultures (eye contact)
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What is DSM-5?
•Standard classification system of mental disorders \n •Allows for enhanced ease of communication \n between providers \n •Used by mental health professionals in U.S. \n and other countries
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2\. Which of the following definitions of psychological disorder is currently thought best?
a. personal distress '
b. disability and dysfunction
c. norm violation
d. none of the above
a. personal distress '
b. disability and dysfunction
c. norm violation
d. none of the above
d. none of the above
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Defining psychological disorder remains difficult. Several different definitions have been offered, but none can entirely account for the full range of disorders.
\
No single characteristic can fully define the concept, although each has merit and each captures some part of what might be a full definition
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Defining psychological disorder remains difficult. Several different definitions have been offered, but none can entirely account for the full range of disorders.
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No single characteristic can fully define the concept, although each has merit and each captures some part of what might be a full definition
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3\. What is an advantage of the DSM-5 definition of psychological disorder?
a. It includes information about both violation of social norms and dysfunction.
b. It includes many components, none of which alone can account for psychological disorder.
c. It is part of the current diagnostic system.
d. It recognizes the limits of our current understanding.
a. It includes information about both violation of social norms and dysfunction.
b. It includes many components, none of which alone can account for psychological disorder.
c. It is part of the current diagnostic system.
d. It recognizes the limits of our current understanding.
b. It includes many components, none of which alone can account for psychological disorder.
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psychological disorder is usually determined based on the presence of several characteristics at one time.
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psychological disorder is usually determined based on the presence of several characteristics at one time.
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Hippocrates was one of the first to propose that psychological disorders had a biological cause. T/F
True, Hippocrates, often called the father of modern medicine, separated medicine from religion, magic, and superstition.
Insisted instead that such illnesses had natural causes and hence should be treated like other, more common maladies, such as colds and constipation.
Insisted instead that such illnesses had natural causes and hence should be treated like other, more common maladies, such as colds and constipation.
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Who is considered the father of American psychiatry?
Benjamin Rush
* however, he believed that psychological disorder was caused by an excess of blood in the brain, for which his favored treatment was to draw great quantities of blood from people with psychological disorders.
* Rush also believed that many people with psychological disorders could be cured by being frightened.
* however, he believed that psychological disorder was caused by an excess of blood in the brain, for which his favored treatment was to draw great quantities of blood from people with psychological disorders.
* Rush also believed that many people with psychological disorders could be cured by being frightened.
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a primary figure in the movement for more humane treatment of people with psychological disorders in asylums.
Philippe Pinel
* Pinel came to believe that people in his care were human beings, and thus should be approached with compassion and treated with dignity.
* He surmised that if their reason had left them because of severe personal and social problems, it might be restored to them through comforting counsel and purposeful activity.
* Pinel came to believe that people in his care were human beings, and thus should be approached with compassion and treated with dignity.
* He surmised that if their reason had left them because of severe personal and social problems, it might be restored to them through comforting counsel and purposeful activity.
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Moral Treatment
privately supported mental hospitals were set up to provide humane treatment. People had close contact with attendants, who talked and read to them and encouraged them to engage in purposeful activity; residents led lives as close to normal as possible and in general took responsibility for themselves within the constraints of their disorders
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Dorothea Dix and the Mental Hygiene Movement
•Crusader for improved conditions for people with psychological disorders — “mental hygiene movement” \n •Worked to establish 32 new public hospitals \n •Took many of the people whom private hospitals could not accommodate \n •Small staffs at public hospitals could not provide necessary individual attention that was a hallmark of moral treatment
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The Mental Hospital Today
In the United States, more people with psychological disorders are found in jails and prisons than in mental hospitals—a national disgrace.
* deinstitutionalization of the 60’s and 70’s
* One consequences of having fewer mental hospitals is that people with severe psychological disorders go to hospital emergency departments in search of care. The stays are much longer
* more people with psychological disorders in jails or prisons than in mental hospitals
* deinstitutionalization of the 60’s and 70’s
* One consequences of having fewer mental hospitals is that people with severe psychological disorders go to hospital emergency departments in search of care. The stays are much longer
* more people with psychological disorders in jails or prisons than in mental hospitals
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Historical Antecedents of Contemporary Views
It is interesting to observe that about half of the presumed causes were biological (e.g., fever, hereditary, venereal) and half were psychological (e.g., grief, love, jealousy). Only about 10% of the causes were supernatural.
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Biological Approaches
Louis Pasteur established the germ theory of disease, which posited that disease is caused by infection of the body by minute organisms.
* in 1905, the specific microorganism that causes syphilis was discovered. For the first time, a causal link had been established between infection, damage to certain areas of the brain, and a form of psychopathology
* in 1905, the specific microorganism that causes syphilis was discovered. For the first time, a causal link had been established between infection, damage to certain areas of the brain, and a form of psychopathology
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Genetics
Francis Galton, often considered the originator of genetic research because of his study of twins attributed many behavioral characteristics to heredity
* coined the terms nature and nurture
* also credited with creating the eugenics movement
* coined the terms nature and nurture
* also credited with creating the eugenics movement
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Biological Treatments
* electroconvulsive therapy (ECT)
* insulin-coma therapy—which presented serious risks to health, including irreversible coma and death —was gradually abandoned.
* prefrontal lobotomy, a surgical procedure that destroys the tracts connecting the frontal lobes to other areas of the brain.
* insulin-coma therapy—which presented serious risks to health, including irreversible coma and death —was gradually abandoned.
* prefrontal lobotomy, a surgical procedure that destroys the tracts connecting the frontal lobes to other areas of the brain.
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____was a French neurologist who was influenced by the work of_____.
Jean-Martin Charcot, Franz Anton Mesmer
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____developed the cathartic method, which_____ later built on in the development of psychoanalysis.
Josef Breuer, Sigmund Freud
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The_____ is driven by the pleasure principle, but the_____ is driven by the reality principle
id, ego
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defense mechanism
a strategy used by the ego to protect itself from anxiety
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psychoanalytic
the goal of the therapist is to understand the person’s early childhood experiences, the nature of key relationships, and the patterns in current relationships.
* One component is transference refers to the person’s responses to his or her analyst that seem to reflect attitudes and ways of behaving toward important people in the person’s past.
* One component is transference refers to the person’s responses to his or her analyst that seem to reflect attitudes and ways of behaving toward important people in the person’s past.
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In psychoanalysis,_____ refers to interpreting the relationship between therapist and client as indicative of the client’s relationship to others.
transference
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Carl Jung
hypothesized that, in addition to the personal unconscious postulated by Freud, there is a collective unconscious, a part of the unconscious that is common to all human beings and that consists primarily of what Jung called archetypes, or basic categories that all human beings use in conceptualizing about the world.
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Adler and Individual Psychology
regarded people as inextricably tied to their society because he believed that fulfillment was found in doing things for the social good.
focus on helping people change their illogical and mistaken ideas and expectations and thinking more rationally.
focus on helping people change their illogical and mistaken ideas and expectations and thinking more rationally.
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Positive reinforcement refers to_____ a(n)_____ behavior; negative reinforcement refers to_____ a(n)____behavior.
increasing, desired -→ strengthening of a virtuous behavior (always increase behavior)
* eg. give student $5 if they complete HW on time
decreased, eliminating -→ removal of an aversive event
* if you do the HW on time you don’t have to do the dishes
* eg. give student $5 if they complete HW on time
decreased, eliminating -→ removal of an aversive event
* if you do the HW on time you don’t have to do the dishes
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Principle of Reinforcement
Positive reinforcement
* Presentation of a pleasant event strengthens a response
* give student $5 if they complete HW on time \n
Negative reinforcement
* Removal of an aversive event strengthens a response
* if you do the HW on time you don’t have to do the dishes
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Intermitted reinforcement
* Rewarding a response only a portion of the time it appears, resulting in more enduring learning of new behavior
* gambling
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Punishment
* Presentation of an aversive event (positive punishment) or removal of a desired event (negative punishment) weakens a response
* Presentation of a pleasant event strengthens a response
* give student $5 if they complete HW on time \n
Negative reinforcement
* Removal of an aversive event strengthens a response
* if you do the HW on time you don’t have to do the dishes
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Intermitted reinforcement
* Rewarding a response only a portion of the time it appears, resulting in more enduring learning of new behavior
* gambling
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Punishment
* Presentation of an aversive event (positive punishment) or removal of a desired event (negative punishment) weakens a response
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A cat comes running at the sound of a treat jar rattling, and his human friend then gives him a treat. The unconditioned stimulus in this example is____
sound of the jar rattling
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The Importance of Cognition
Researchers and clinicians realized that the ways in which people think about, or appraise, situations can influence behavior in dramatic ways.
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Clinical psychologists
* have a Ph.D. (or Psy.D.) degree
* requires a heavy emphasis on research, statistics, and the empirically based study of human behavior.
* learn techniques of assessment and diagnosis of psychopathology
* they learn how to practice psychotherapy, a primarily verbal means of helping people change their thoughts, feelings, and behavior to reduce distress and to achieve greater life satisfaction.
* requires a heavy emphasis on research, statistics, and the empirically based study of human behavior.
* learn techniques of assessment and diagnosis of psychopathology
* they learn how to practice psychotherapy, a primarily verbal means of helping people change their thoughts, feelings, and behavior to reduce distress and to achieve greater life satisfaction.
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Psychiatrists
* hold an M.D. degree
* have had a residency, where they received supervision in the practice of diagnosis and pharmacotherapy (administering medications).
* have had a residency, where they received supervision in the practice of diagnosis and pharmacotherapy (administering medications).
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A psychiatric nurse
typically receives training at the bachelor’s or master’s level.
Nurses can also receive more specialized training to become an advanced practice psychiatric nurse, which allows them to prescribe medications.
Nurses can also receive more specialized training to become an advanced practice psychiatric nurse, which allows them to prescribe medications.
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Social workers
* have an M.S.W. (master of social work) degree.
* Training programs requiring 2 years of graduate study. -
* The focus of training is on psychotherapy.
* Do not receive training in psychological assessment.
* Training programs requiring 2 years of graduate study. -
* The focus of training is on psychotherapy.
* Do not receive training in psychological assessment.
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Freud’s structure of the mind
Id -→
Present at birth - biological and unconscious. Seeks immediate gratification (pleasure principle) - when not satisfied, tension is produced and Id drives a person to get rid of tension (e.g., eat when hungry) \n
Ego -→ \n Primarily conscious; mediates between demands of reality and Id’s demands for immediate gratification (reality principle) \n
Superego -→ \n A person’s conscience; develops as we incorporate parental and society values
Present at birth - biological and unconscious. Seeks immediate gratification (pleasure principle) - when not satisfied, tension is produced and Id drives a person to get rid of tension (e.g., eat when hungry) \n
Ego -→ \n Primarily conscious; mediates between demands of reality and Id’s demands for immediate gratification (reality principle) \n
Superego -→ \n A person’s conscience; develops as we incorporate parental and society values
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Continuing influences of Freud and his followers
Childhood experiences help shape adult personality
•Childhood experiences and environmental events are crucial
•Early relationships influence adult relationships
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There are unconscious influences on behavior
• People can be unaware of the causes of their behavior
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The causes and purposes of human behavior are not always obvious
•Look under the surface to find hidden meaning in behavior
•Childhood experiences and environmental events are crucial
•Early relationships influence adult relationships
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There are unconscious influences on behavior
• People can be unaware of the causes of their behavior
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The causes and purposes of human behavior are not always obvious
•Look under the surface to find hidden meaning in behavior
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Classical Conditioning
neutral stimulus -→ bell by itself
Bell (conditioned stimulus) conditioned to salivate because it was paired with the meat powder
meat powder -→ UCR
Bell (conditioned stimulus) conditioned to salivate because it was paired with the meat powder
meat powder -→ UCR
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Operant Conditioning
E. Thorndike (1874–1949)
effect of consequences on behavior - law of effect \n •Behavior that is followed by satisfying consequences will be repeated \n •Behavior that is followed by unpleasant consequences will be discouraged
effect of consequences on behavior - law of effect \n •Behavior that is followed by satisfying consequences will be repeated \n •Behavior that is followed by unpleasant consequences will be discouraged
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What is the primary difference between a psychologist and a psychiatrist?
Psychiatrist is an MD and can prescribe medication and not trained that much in therapy, while a psychologist
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What’s one characteristic of a comprehensive definition of a psychological disorder?
Violate social norms, distress, dysfunction and disability
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What beliefs characterize supernatural explanations of mental illnes ?
Displeasure of the gods or possession by demons \n
Treatment: Exorcism (ritualistic casting out of evil spirits); trephination (remove part of skull so evil spirits can escape)
Treatment: Exorcism (ritualistic casting out of evil spirits); trephination (remove part of skull so evil spirits can escape)
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Chapter 2
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Genetic Influences
(1) almost all behavior is heritable to some degree (i.e., it involves genes) and
(2) genes do not operate in isolation from the environment. Instead, the environment shapes how our genes are expressed, and genes shape our environments
* the environment shapes how our gees are expressed
* our genes also shape our environment
* psychopathology is polygenic, meaning that the influence of several genes, perhaps operating at different times during development, turning themselves on and off as they interact with a person’s environment, is the essence of genetic vulnerability.
* Relationship between genes and environment is bidirectional
* We now know that we do not inherit psychological disorders from our genes alone; we develop them through the interaction of our genes with our environments
(2) genes do not operate in isolation from the environment. Instead, the environment shapes how our genes are expressed, and genes shape our environments
* the environment shapes how our gees are expressed
* our genes also shape our environment
* psychopathology is polygenic, meaning that the influence of several genes, perhaps operating at different times during development, turning themselves on and off as they interact with a person’s environment, is the essence of genetic vulnerability.
* Relationship between genes and environment is bidirectional
* We now know that we do not inherit psychological disorders from our genes alone; we develop them through the interaction of our genes with our environments
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Polygenic
Multiple genes expressions interacting with a person’s \n environment at different times during development
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Heritability definition
Extent to which variability in behavior is due to genetic factors
* Ranges from 0.00 (genes aren’t involved, all environment) to 1.00 (purely genetic)
* Group, rather than individual, indicator
* Example: ADHD- heritability estimate is 0.7, so on a population level 0.7 of the variation in the behavior is due to genetic factors.
Example- behavior is heritable: eye gaze pattern - identical twins showed concordance in the time they spent looking at the mouth
* Ranges from 0.00 (genes aren’t involved, all environment) to 1.00 (purely genetic)
* Group, rather than individual, indicator
* Example: ADHD- heritability estimate is 0.7, so on a population level 0.7 of the variation in the behavior is due to genetic factors.
Example- behavior is heritable: eye gaze pattern - identical twins showed concordance in the time they spent looking at the mouth
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Notion of a paradigm/ Framework
Goal: Study abnormal behavior scientifically \n •Science aims for objectivity \n •Paradigm
* Perspective or conceptual framework from within which a scientist operates
•We can never be totally objective
•No one paradigm sufficient to completely explain psychopathology, we cant just use genetics, or neuroscience.
* Perspective or conceptual framework from within which a scientist operates
•We can never be totally objective
•No one paradigm sufficient to completely explain psychopathology, we cant just use genetics, or neuroscience.
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Current thinking about psychopathology \n influences
Integrative and multifaceted \n •Necessary to study across scientific disciplines \n •Informed by clinicians and researchers \n •No one influences offers the “best” conceptualization
* Each informs causes and treatment
* Each informs causes and treatment
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Heritability
refers to the extent to which variability in a particular behavior (or disorder) in a population can be accounted for by genetic influences.
There are two important points
1. Heritability estimates range from 0.0 to 1.0: the higher the number, the greater the heritability.
2. Heritability is relevant only for a large population of people, not a particular individual. Thus, it is incorrect to talk about any one person’s heritability for a particular behavior or disorder. Knowing that the heritability of ADHD is around 0.70 does not mean that 70% of Jane’s ADHD is the product of her genes, it means that in a population, the variation is understood as being attributed to 70% genetic influences and 30% environmental influences.
There are two important points
1. Heritability estimates range from 0.0 to 1.0: the higher the number, the greater the heritability.
2. Heritability is relevant only for a large population of people, not a particular individual. Thus, it is incorrect to talk about any one person’s heritability for a particular behavior or disorder. Knowing that the heritability of ADHD is around 0.70 does not mean that 70% of Jane’s ADHD is the product of her genes, it means that in a population, the variation is understood as being attributed to 70% genetic influences and 30% environmental influences.
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Shared vs nonshared environment
* Shared environment factors include those things that members of a family have in common, such as family income level, child-rearing practices, and parents’ marital status and quality.
* Nonshared environment (unique environment) factors are those things believed to be distinct among members of a family, such as relationships with friends or specific events unique to a person (e.g., being in a car accident or on the swim team)
* hard to measure
* Nonshared environment (unique environment) factors are those things believed to be distinct among members of a family, such as relationships with friends or specific events unique to a person (e.g., being in a car accident or on the swim team)
* hard to measure
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Behavior Genetics
Behavior genetics is the study of the degree to which genes and environmental factors influence behavior. Note that behavior genetics is not the study of how genes or the environment determines behavior
* genotype - The total genetic makeup of an individual, consisting of inherited genes, the physical sequence of DNA (unobservable) - the degree they influence it
* phenotype - the totality of observable behavioral characteristics, such as level of anxiety. Depends on interaction of genotype and environment
* genotype - The total genetic makeup of an individual, consisting of inherited genes, the physical sequence of DNA (unobservable) - the degree they influence it
* phenotype - the totality of observable behavioral characteristics, such as level of anxiety. Depends on interaction of genotype and environment
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Molecular genetics
Identifies genes and their functions and differences between people in the sequence of their genes and in the structure of their genes \n Alleles
* Different forms of the same gene
Polymorphism
* Difference in DNA sequence on a gene occurring in a population
* Different forms of the same gene
Polymorphism
* Difference in DNA sequence on a gene occurring in a population
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SNPs
SNPs (single nucleotide polymorphisms)
* Difference between people in a single nucleotide in the DNA sequence of a particle
* Example: normal was ‘A’ but in a person with depression they had a ‘G’
* most common type of polymorphisms
* Difference between people in a single nucleotide in the DNA sequence of a particle
* Example: normal was ‘A’ but in a person with depression they had a ‘G’
* most common type of polymorphisms
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CNVs (copy number variations)
Abnormal copy of one or more sections of DNA within the gene(s)
Differences in structure of gene
* Additions or deletions in DNA within genes
Differences in structure of gene
* Additions or deletions in DNA within genes
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Genome-wide association studies (GWAS)
a key method for examining SNPs and CNVs. Using powerful computers, researchers look at all the thousands of genes to isolate differences in the sequence of genes between people who have a psychological disorder and people who do not.
* Studies have confirmed results indicating that many genes are involved in disorders (disorders are polygenic)
* Studies have identified striking genetic similarities across disorders. Are finding that diverse disorders share common genetic risk
* Studies have confirmed results indicating that many genes are involved in disorders (disorders are polygenic)
* Studies have identified striking genetic similarities across disorders. Are finding that diverse disorders share common genetic risk
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Gene-Environment Interactions
a given person’s sensitivity to an environmental event is influenced by genes.
Reciprocal GxE interaction: Genes predispose us to seek out certain environments that increase risk for developing a disorder
* PKU- Caused by a mutation in gene encoding the enzyme phenylalanine hydroxylase. solution is to reduce enzyme in ones diet.
* Childhood maltreatment and later depression: two short alles and the more maltreated they were they were more likely to have been diagnosed with major depression disorder as adults.
* EXAMPLE: a person has gene XYZ, so responds to a snakebite by developing a fear of snakes. A person without the XYZ gene would not develop a fear of snakes after being bitten.
Reciprocal GxE interaction: Genes predispose us to seek out certain environments that increase risk for developing a disorder
* PKU- Caused by a mutation in gene encoding the enzyme phenylalanine hydroxylase. solution is to reduce enzyme in ones diet.
* Childhood maltreatment and later depression: two short alles and the more maltreated they were they were more likely to have been diagnosed with major depression disorder as adults.
* EXAMPLE: a person has gene XYZ, so responds to a snakebite by developing a fear of snakes. A person without the XYZ gene would not develop a fear of snakes after being bitten.
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Genetics: What’s the bottom line?
Three challenges:
1. Understanding how genes and environments reciprocally influence one
another
2. Recognizing complexity Several genes contributing to a specific disorder •Each individual gene or genetic mutation may reveal a very small effect •Putting all the small genetic pieces together to tell the gene via environment story
3. Most genetic vulnerability appears to increase risk broadly for multiple disorders rather than one specific disorder
1. Understanding how genes and environments reciprocally influence one
another
2. Recognizing complexity Several genes contributing to a specific disorder •Each individual gene or genetic mutation may reveal a very small effect •Putting all the small genetic pieces together to tell the gene via environment story
3. Most genetic vulnerability appears to increase risk broadly for multiple disorders rather than one specific disorder
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epigenetics
The study of how the environment can alter gene expression or function
* refers to the chemical “marks,” such as histones, that are attached to and protect the DNA in each gene. These epigenetic marks are what control gene expression, and the environment can directly influence the work of these marks
* refers to the chemical “marks,” such as histones, that are attached to and protect the DNA in each gene. These epigenetic marks are what control gene expression, and the environment can directly influence the work of these marks
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Evaluating the Role of Genetic Influences in Psychopathology
three huge challenges
* specify exactly how genes and environments reciprocally influence one another.
* recognize the complexity of the task, knowing that several genes (not just one) will contribute to a specific disorder and that there is a long pathway between the genes and the complex behaviors that make up psychological disorders
* most of the genetic vulnerability appears to increase risk for psychopathology broadly more than risk for specific disorders.
* specify exactly how genes and environments reciprocally influence one another.
* recognize the complexity of the task, knowing that several genes (not just one) will contribute to a specific disorder and that there is a long pathway between the genes and the complex behaviors that make up psychological disorders
* most of the genetic vulnerability appears to increase risk for psychopathology broadly more than risk for specific disorders.
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SNPs tell us about the_______ of genes, and CNVs tell us about the____ of genes.
sequence; structure
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Neurons and Neurotransmitters
The cells in the nervous system are called neurons. Each neuron has four major parts:
(1) the cell body
(2) several dendrites, the short and thick extensions;
(3) one or more axons of varying lengths, but usually only one long, thin axon that extends a considerable distance from the cell body; and
(4) terminal buttons on the many end branches of the axon
\
Neurotransmitters are chemicals that allow neurons to send a signal across the synapse to another neuron.
* Several neurotransmitters have been implicated in psychopathology, including dopamine, serotonin, norepinephrine, and gamma-aminobutyric acid (GABA).
(1) the cell body
(2) several dendrites, the short and thick extensions;
(3) one or more axons of varying lengths, but usually only one long, thin axon that extends a considerable distance from the cell body; and
(4) terminal buttons on the many end branches of the axon
\
Neurotransmitters are chemicals that allow neurons to send a signal across the synapse to another neuron.
* Several neurotransmitters have been implicated in psychopathology, including dopamine, serotonin, norepinephrine, and gamma-aminobutyric acid (GABA).
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Synapse
Synapse
* Gap between neurons
Neurotransmitter
* Chemicals that allow neurons to send a signal across the synapse to another neuron
Receptor sites on postsynaptic neuron absorb \n neurotransmitter
* Excitatory
* Inhibitory - make the cell less likely to create impulse
Reuptake
* Reabsorption of leftover neurotransmitter by presynaptic neuron
* Gap between neurons
Neurotransmitter
* Chemicals that allow neurons to send a signal across the synapse to another neuron
Receptor sites on postsynaptic neuron absorb \n neurotransmitter
* Excitatory
* Inhibitory - make the cell less likely to create impulse
Reuptake
* Reabsorption of leftover neurotransmitter by presynaptic neuron
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Neurotransmitters and psychopathology
Ways in which neurotransmitters may contribute to psychopathology
* Excessive or inadequate levels
* Problems in synthesis of neurotransmitters at the metabolic level
* Insufficient reuptake
* Faulty neurotransmitters receptors
* Excessive or inadequate levels
* Problems in synthesis of neurotransmitters at the metabolic level
* Insufficient reuptake
* Faulty neurotransmitters receptors
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Neurotransmitters and psychopathology
Serotonin and dopamine \n •Implicated in depression, mania, and schizophrenia \n
Norepinephrine \n •Communicates with the sympathetic nervous system to produce states of high arousal \n •Implicated in anxiety and other stress-related conditions \n
Gamma-aminobutyric acid (GABA) \n •Inhibitory and implicated in anxiety
Norepinephrine \n •Communicates with the sympathetic nervous system to produce states of high arousal \n •Implicated in anxiety and other stress-related conditions \n
Gamma-aminobutyric acid (GABA) \n •Inhibitory and implicated in anxiety
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Structure and Function of the Human Brain
the amygdala is an important area for attention to emotionally salient stimuli. This is one of the key brain structures for psychopathology researchers, given the ubiquity of emotional problems in the psychological disorders.
The development of the cells and their migration to the appropriate layers of cortex comprise an intricate dance. Unfortunately, missteps can happen, and current thinking about several disorders, places the beginnings of the problem in early developmental stages.
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frontal lobe (prefrontal cortex) - implicated in many psychopathology
The development of the cells and their migration to the appropriate layers of cortex comprise an intricate dance. Unfortunately, missteps can happen, and current thinking about several disorders, places the beginnings of the problem in early developmental stages.
\
frontal lobe (prefrontal cortex) - implicated in many psychopathology
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Subcortical structures of the brain
Subcortical structures implicated in \n different forms of psychopathology:
* Anterior cingulate - emotional and mood regulation
* Hippocampus - long term memory
* Hypothalamus - metabolites temperature, metabolism, sleep and appetite
* Amygdala - emotional salient stimuli
* Anterior cingulate - emotional and mood regulation
* Hippocampus - long term memory
* Hypothalamus - metabolites temperature, metabolism, sleep and appetite
* Amygdala - emotional salient stimuli
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Brain development
Begins early in the first trimester of pregnancy
* A third of our genes are expressed in the brain, many responsible for laying out structure of brain
* Brain development continues into young adulthood
* A third of our genes are expressed in the brain, many responsible for laying out structure of brain
* Brain development continues into young adulthood
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Pruning
* Elimination of synaptic connections
* The connections become fewer, but faster
Circuitry relies on experience to customize connections to serve needs of individual
* Experience shapes neural connections and interactions within the constraints imposed by genetics
* The connections become fewer, but faster
Circuitry relies on experience to customize connections to serve needs of individual
* Experience shapes neural connections and interactions within the constraints imposed by genetics
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Brain connectivity
Connectivity of different brain regions vs functions of isolated regions \n Structural (anatomical) connectivity
* How different structures are connected via white matter
Functional connectivity
* How brain regions are functionally connected as assessed by correlations in blood oxygen dependent (BOLD) signals measured via fMRI
* How are brain regions working together and operating with one another
Effective connectivity
* Combines structural and functional connectivity
* Helps to understand direction and timing of activity in brain regions
Brain networks
* Clusters of brain regions that are connected to one another in that activation in these regions is reliably correlated
* How different structures are connected via white matter
Functional connectivity
* How brain regions are functionally connected as assessed by correlations in blood oxygen dependent (BOLD) signals measured via fMRI
* How are brain regions working together and operating with one another
Effective connectivity
* Combines structural and functional connectivity
* Helps to understand direction and timing of activity in brain regions
Brain networks
* Clusters of brain regions that are connected to one another in that activation in these regions is reliably correlated
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The Autonomic Nervous System
The ANS innervates the endocrine glands, the heart, and the smooth muscles that are found in the walls of the blood vessels, stomach, intestines, kidneys, and other organs. Much of our behavior is dependent on a nervous system that operates very quickly
sympathetic nervous system
* prepares the body for “fight or flight”
parasympathetic nervous system
* helps “calm down” “rest and digest“ the body
\
The autonomic nervous system figures prominently in many anxiety disorders and the HPA axis is central to the body’s response to stress.
\
relevant for PTSD and Anxiety disorders
sympathetic nervous system
* prepares the body for “fight or flight”
parasympathetic nervous system
* helps “calm down” “rest and digest“ the body
\
The autonomic nervous system figures prominently in many anxiety disorders and the HPA axis is central to the body’s response to stress.
\
relevant for PTSD and Anxiety disorders
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The neuroendocrine system – HPA axis
HPA axis involved in response to stress
* Hypothalamus releases CRF
* Pituitary gland releases ACTH
* Adrenal cortex promotes release of cortisol (stress hormone)
Takes 20—40 minutes for cortisol to peak and 1 hour to return to baseline
Chronic stress can impact function of HPA axis
* Hypothalamus releases CRF
* Pituitary gland releases ACTH
* Adrenal cortex promotes release of cortisol (stress hormone)
Takes 20—40 minutes for cortisol to peak and 1 hour to return to baseline
Chronic stress can impact function of HPA axis
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The Immune System
a wide range of stressors produce problematic changes in the immune system. The immune system involves a broad array of cells and proteins that respond when the body is infected or invaded. Inflammation or swelling is a sign of these immunity cells at work.
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Neuroscience Approaches to Treatment
The use of psychiatric drugs continues to increase. Nearly 17% of adults between the ages of 18-85 had at least one prescription for a psychiatric medication
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Evaluating the Role of Neuroscience Influences in Psychopathology
Neuroscientists have made great progress in elucidating brain-behavior relationships, however, we also want to caution against reductionism.
* There is not just one area of the brain that is linked to specific psychological disorders. Instead, networks of regions have been implicated
* The commonality of brain network dysfunction, as many of the same brain regions and networks have been found to be disrupted across many different disorders.
* There is not just one area of the brain that is linked to specific psychological disorders. Instead, networks of regions have been implicated
* The commonality of brain network dysfunction, as many of the same brain regions and networks have been found to be disrupted across many different disorders.
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Cognitive Behavioral Influences
Cognitive behavioral influences include learning principles and cognitive science concepts, such as attention, memory, schema, and appraisal. The basic principles from classical and operant conditioning as well as cognitive science have shaped the development of many cognitive behavioral therapies.
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Incorporate perspectives from behaviorism and cognitive science
* Insights from both approaches have influenced development of various cognitive behavioral therapies
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Incorporate perspectives from behaviorism and cognitive science
* Insights from both approaches have influenced development of various cognitive behavioral therapies
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Influences from Behaviorism
one key influence from behaviorism is the notion that problem behavior is likely to continue if it is reinforced.
Once the source of reinforcement has been identified, behavior therapy may be employed to alter the consequences of the problem behavior.
\
Rooted in learning principles and cognitive science
Problem behavior continues if it is reinforced
* Escape or avoidance
* Access to desirable objects or events
To alter behavior, modify the consequences
* Time out
* Behavioral activation (BA) therapy
* Exposure therapy
Once the source of reinforcement has been identified, behavior therapy may be employed to alter the consequences of the problem behavior.
\
Rooted in learning principles and cognitive science
Problem behavior continues if it is reinforced
* Escape or avoidance
* Access to desirable objects or events
To alter behavior, modify the consequences
* Time out
* Behavioral activation (BA) therapy
* Exposure therapy
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exposure
behavior therapy technique that is based on classical conditioning principles and used to treat phobias and anxiety
The basic idea is that the anxiety will extinguish if the person can face the object or situation long enough with no actual harm occurring
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PROBLEM:
criticized for minimizing the importance of two factors: thinking and feeling. The way we think and feel about things undoubtedly influences our behavior.
The basic idea is that the anxiety will extinguish if the person can face the object or situation long enough with no actual harm occurring
\
PROBLEM:
criticized for minimizing the importance of two factors: thinking and feeling. The way we think and feel about things undoubtedly influences our behavior.
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Cognitive Science
a term that groups together the mental processes of perceiving, recognizing, conceiving, judging, and reasoning. Cognitive science focuses on how people structure their experiences, how they make sense of them, and how they relate their current experiences to past ones that have been stored in memory.
* people’s past knowledge imposing a perceptual funnel on the experience.
* person fits new information into a network of accumulated knowledge (schema)
* people’s past knowledge imposing a perceptual funnel on the experience.
* person fits new information into a network of accumulated knowledge (schema)
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The Role of the Unconscious
much of human behavior was presumed to be unconscious, or outside the awareness of the individual.
implicit memory refers to the idea that a person can, without being aware of it, be influenced by prior learning
the unconscious reflects the incredible efficiency and automaticity of the brain.
implicit memory refers to the idea that a person can, without being aware of it, be influenced by prior learning
the unconscious reflects the incredible efficiency and automaticity of the brain.
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Cognitive Behavior Therapy
pay attention to private events—thoughts, perceptions, judgments, self-statements, and even unconscious assumptions—and have studied these processes in an attempt to understand and modify overt and covert disturbed behavior.
* Cognitive restructuring is a general term for changing a pattern of thought, changes in thinking → change feelings, behaviors, symptoms
* Treatment techniques designed to alter the consequences or reinforcers of a behavior include behavior activation therapy, time-out, and exposure.
* Cognitive restructuring is a general term for changing a pattern of thought, changes in thinking → change feelings, behaviors, symptoms
* Treatment techniques designed to alter the consequences or reinforcers of a behavior include behavior activation therapy, time-out, and exposure.
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Beck’s Cognitive Therapy
Aaron Beck developed a cognitive therapy for depression based on the idea that depressed mood is caused by distortions in the way people perceive life experiences.
* general goal is to provide people with experiences that will alter their negative schemas
* help a person learn to be more aware of emotions but to avoid immediate, impulsive reactions to those emotions.
* general goal is to provide people with experiences that will alter their negative schemas
* help a person learn to be more aware of emotions but to avoid immediate, impulsive reactions to those emotions.
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“Third wave” treatment
focus on values, emotion, spirituality, and acceptance
based on cognitive behavioral therapy.
* Dialectical behavioral therapy (DBT)
* Mindfulness-based cognitive therapy
* Acceptance and commitment therapy (ACT)
based on cognitive behavioral therapy.
* Dialectical behavioral therapy (DBT)
* Mindfulness-based cognitive therapy
* Acceptance and commitment therapy (ACT)
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Current research on the unconscious is conducted in much the same way as it was when Freud talked about the unconscious. T/F
False
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Socioemotional Influences
emotional, sociocultural, and interpersonal influences. Gender, culture, ethnicity, and social relationships bear importantly on the descriptions, causes, and treatments of different disorders.
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The Importance of Emotion
Emotions influence how we respond to problems and challenges in our environment. They help us organize our thoughts and actions, both explicitly and implicitly, and they guide our behavior.
* 85% of psychological disorders include disturbances in emotional processing of some kind
* Emotions are believed to be fairly short-lived states, lasting for a few seconds, minutes, or at most hours.
* Use duration, provocation, modulation, expression and awareness
* Emotions/ affect: used to describe short-lasting emotional feelings. (eg. angry)
* Moods: are emotional experiences that endure for a longer period of time. (eg. Irritable)
* The expressive, or behavioral, component of emotion typically refers to facial expressions of emotion.
* The experience, or subjective feeling, component of emotion refers to how someone reports he or she feels at any given moment or in response to some event
* 85% of psychological disorders include disturbances in emotional processing of some kind
* Emotions are believed to be fairly short-lived states, lasting for a few seconds, minutes, or at most hours.
* Use duration, provocation, modulation, expression and awareness
* Emotions/ affect: used to describe short-lasting emotional feelings. (eg. angry)
* Moods: are emotional experiences that endure for a longer period of time. (eg. Irritable)
* The expressive, or behavioral, component of emotion typically refers to facial expressions of emotion.
* The experience, or subjective feeling, component of emotion refers to how someone reports he or she feels at any given moment or in response to some event
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Sociocultural Influences
Research has focused on the ways in which sociocultural influences, such as gender, race, culture, ethnicity, and income inequality and poverty, can influence different psychological disorders.
* Income inequality is associated with mental health outcomes—in areas where income inequality is greater, people experience more psychological disorders
* Culture- no country or culture is without psychopathology, however, the conceptualization and meaning of symptoms observed in diverse cultures may vary
* Race and ethnicity- Some disorders, such as schizophrenia, are diagnosed more often among Blacks than Whites. Use of drugs and their effects vary by race.
* Income inequality is associated with mental health outcomes—in areas where income inequality is greater, people experience more psychological disorders
* Culture- no country or culture is without psychopathology, however, the conceptualization and meaning of symptoms observed in diverse cultures may vary
* Race and ethnicity- Some disorders, such as schizophrenia, are diagnosed more often among Blacks than Whites. Use of drugs and their effects vary by race.
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Components of emotion response
Expressive
* Your behavioral and facial expressions (blank disinterested stare)
Experiential
* Subjective feeling (I’m bored)
* How you feel at any given moment
Physiological
* Changes in the body that accompany emotion (reduced heart beat)
* Most psychopathology includes disturbances of one or more component of emotion
* Your behavioral and facial expressions (blank disinterested stare)
Experiential
* Subjective feeling (I’m bored)
* How you feel at any given moment
Physiological
* Changes in the body that accompany emotion (reduced heart beat)
* Most psychopathology includes disturbances of one or more component of emotion
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Interpersonal Influences and the Role of Stress
quality of relationships influences different disorders. Environmental influences can trigger, exacerbate, or maintain the symptoms that make up the different disorders.
Environmental influences: Family and marital relationships, social support, and even the amount of casual social contact all play a role in influencing the course of disorders.
\n Early life stress (adversity, trauma, difficult life experiences)
Environmental influences: Family and marital relationships, social support, and even the amount of casual social contact all play a role in influencing the course of disorders.
\n Early life stress (adversity, trauma, difficult life experiences)
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Types of therapy for social relationships
Interpersonal Therapy Interpersonal therapy (IPT)
* emphasizes importance of current relationships in a person’s life and how problems in these relationships contribute to psychological symptoms. Therapist encourages patient to identify feelings about the relationships and to express them and then helps the patient generate solutions to problems.
* four interpersonal issues are assessed
* Unresolved grief- delayed or incomplete grieving following a loss
* Role transitions- transitioning from worker to retired
* Role disputes—resolving different relationship expectations between partners
* Interpersonal or social deficits- not being able to begin a conversation with an unfamiliar person
Couples Therapy
* therapist works with both partners together to reduce relationship distress. Treatments for most couples focus on improving communication, problem solving, satisfaction, trust, and positive feelings
Family Therapy
* based on the idea that the problems of the family influence each member and that the problems of each member influence the family.
* teach strategies to help families communicate and solve problems more effectively.
* emphasizes importance of current relationships in a person’s life and how problems in these relationships contribute to psychological symptoms. Therapist encourages patient to identify feelings about the relationships and to express them and then helps the patient generate solutions to problems.
* four interpersonal issues are assessed
* Unresolved grief- delayed or incomplete grieving following a loss
* Role transitions- transitioning from worker to retired
* Role disputes—resolving different relationship expectations between partners
* Interpersonal or social deficits- not being able to begin a conversation with an unfamiliar person
Couples Therapy
* therapist works with both partners together to reduce relationship distress. Treatments for most couples focus on improving communication, problem solving, satisfaction, trust, and positive feelings
Family Therapy
* based on the idea that the problems of the family influence each member and that the problems of each member influence the family.
* teach strategies to help families communicate and solve problems more effectively.
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Evaluating the Role of Socioemotional Influences in Psychopathology
One challenge is discerning whether these factors are causal, cannot conduct experiments, therefore we must therefore use other methods to determine causality, such as longitudinal studies
many of the socioemotional factors are strongly related to one another (eg. living in poverty can be stressful) . Determining the role of poverty separately from that of stress is nearly impossible.
many of the socioemotional factors are strongly related to one another (eg. living in poverty can be stressful) . Determining the role of poverty separately from that of stress is nearly impossible.
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Continuous/Dimensional
Categorical
* Have it or don’t
* Like cancer or pregnancy
Continuous/Dimensional
* Can kinda have it
* Can be high or low on a thing
* Like blood pressure
Mix of Two
* Continuous but with cut-points
* Like cut-point for high blood pressure, where after you meet it, you need meds
* Have it or don’t
* Like cancer or pregnancy
Continuous/Dimensional
* Can kinda have it
* Can be high or low on a thing
* Like blood pressure
Mix of Two
* Continuous but with cut-points
* Like cut-point for high blood pressure, where after you meet it, you need meds
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Current model in clinical use: Categorical
DSM
* Discussed previously and big time next!
* What are the advantages and disadvantages of this model?
* How does this model compare to other historical and contemporary models?
(Also, should mention ICD-11 – bigger in Europe than here)
* Discussed previously and big time next!
* What are the advantages and disadvantages of this model?
* How does this model compare to other historical and contemporary models?
(Also, should mention ICD-11 – bigger in Europe than here)
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Models for understanding where \n psychopathology “comes from”
One-Dimensional Models
* Explaining behavior in terms of a single cause
* Problem: Other information is often ignored
\
Multidimensional Models
* Interdisciplinary, eclectic, and integrative
* “System” of influences that cause and maintain suffering
* Uses information from several sources
* Abnormal behavior is multiply determined
* Explaining behavior in terms of a single cause
* Problem: Other information is often ignored
\
Multidimensional Models
* Interdisciplinary, eclectic, and integrative
* “System” of influences that cause and maintain suffering
* Uses information from several sources
* Abnormal behavior is multiply determined
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Multidimensional Models
often include: Biological, Behavioral, Emotional, Social, Developmental factors
Example: Diathesis-stress model
* Holds for most forms of psychopathology
* Psychopathology results from having a vulnerability for a disorder (diathesis—usually genetic) that is ‘activated’ by a major life stressor or trauma
* Only that those at genetic risk are more negatively impacted by adverse environmental influences
Example: Diathesis-stress model
* Holds for most forms of psychopathology
* Psychopathology results from having a vulnerability for a disorder (diathesis—usually genetic) that is ‘activated’ by a major life stressor or trauma
* Only that those at genetic risk are more negatively impacted by adverse environmental influences
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Chapter 3 Diagnosis and Assessment
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Diagnosis
Agreed-on definitions and classification of disorders by symptoms and signs
* Based on DSM
* Diagnostic categories have evolved over time with new versions of the DSM, currently DSM-5•Advantages of diagnosis:
* First step in good clinical care
* Facilitates communication among professionals
* Advances research for causes and treatments
* Based on DSM
* Diagnostic categories have evolved over time with new versions of the DSM, currently DSM-5•Advantages of diagnosis:
* First step in good clinical care
* Facilitates communication among professionals
* Advances research for causes and treatments
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Assessment is a way of...
Observing behavior
* We have defined “abnormal” behavior
* Next want to think about observing and understanding how to apply this term
* We look at specific cases and determine what information is needed to decide if the individual is demonstrating “abnormal behavior”
* We have defined “abnormal” behavior
* Next want to think about observing and understanding how to apply this term
* We look at specific cases and determine what information is needed to decide if the individual is demonstrating “abnormal behavior”
Note 
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