PSYC 2010 Gitter Exam 4

Diathesis-Stress Model

a diagnostic model that proposes that a disorder may develop when an underlying vulnerability is coupled with a precipitating event

Diathesis

a vulnerability or predisposition to developing a disorder

Stressor

environmental or psychological event

When would a stressor be considered a diathetic predisposition?

a stressor would be considered a diathetic predisposition when it creates a lasting vulnerability that remains after the event itself is over.

Criteria for Disordered Behavior

deviates from cultural norms, distress, and dysfunction/maladaptive (impairs capability to live a normal life)

Why is it not enough to meet only some criteria to be considered a disorder?

some behaviors may be unusual but harmless or distressing but normal reactions.

What is the DSM (Diagnostic and Statistical Manual of Mental Disorders)?

a guidebook for mental health symptoms and criteria and classification system for a broad range of disorders

What does the DSM provide?

- 237 disorders divided across 20+ broad diagnostic categories

- systematic guidelines for each disorder based on symptoms and criteria

Symptoms

presence of impairing psychological states or behaviors

Criteria

e.g. must have x number of symptoms

What does the DSM not provide?

etiology (causes) or treatment of disorders

Limitations of DSM

symptom overlap, cultural bias concerns, labeling/stigma, and the fact that human experiences do not always fit neat categories

Primary symptoms

the core symptoms most central to a disorder

Secondary symptoms

common accompanying symptoms but not unique to the disorder

Differential symptoms

symptoms that help distinguish one disorder from another.

Prognosis

a prediction of the course and likely outcome of a disorder

Diagnosis

identifies disorder

Mental Health Status Exam (MSE)

a structured clinical assessment of a person's current psychological functioning. observes behavior; outcome: referral; non-diagnostic

Structured clinical interview

a standardized interview with set questions

outcome: diagnosis

high reliability

Unstructured clinical interview

open-ended conversation

outcome: diagnosis

low reliability

Neuropsychological Assessment

assesses abilities (e.g. planning, coordination, memory, motor skills, etc.) related to neuropsychological damage/impairment

What does the neuropsychological assessment do?

helps detect brain injury, dementia, ADHD, learning disorders, or cognitive deficits

what is the intended outcome of these approaches?

DSM/Interviews: reach accurate diagnosis and treatment plan

Mental status exam: assess current functioning

Neuropsychological testing: understand cognitive strengths/weaknesses and possible brain involvement

What is a funneled procedure?

this procedure starts broad and becomes more specific. Clinicians begin with general questions, then narrow toward particular symptoms and diagnoses. This helps identify primary symptoms first, then differential symptoms.

Generalized Anxiety Disorder (GAD)

a disorder characterized by chronic excessive worry accompanied by three or more of the following symptoms: restlessness, fatigue, concentration problems, irritability, muscle tension, and sleep disturbance

intensity: moderate

Panic Disorder

an anxiety disorder that consists of sudden, overwhelming attacks of terror

intensity: high

Specific Phobia

a disorder that involves an irrational fear of a particular object or situation that markedly interferes with an individual's ability to function

intensity: moderate-high

Obsession

an intrusive unwanted thought, image, or urge that cause distress

Compulsion

a repetitive behavior or mental ritual done to reduce anxiety caused by obsessions

Obsessive-compulsive disorder (OCD)

an anxiety disorder characterized by unwanted repetitive thoughts (obsessions) and/or actions (compulsions)

Anxiety disorders

primary symptom is the presence of anxiety

Major Depressive Disorder (MDD)

more severe depressive episodes lasting at least 2 weeks

Persistent Depressive Disorder (PDD)

long term depressed mood lasting 2+ years, often less severe but chronic

Maniac Episode

experience marked by dramatically elevated mood, decreased need for sleep, increased energy, inflated self-esteem, increased talkativeness, and irresponsible behavior

Bipolar I

at least one manic episode

Bipolar II

hypomanic episodes and full depressive episodes

Cyclothymia

disorder that consists of mood swings from moderate depression to hypomania and lasts two years or more

Hypomanic

elevated, expansive, or irritable mood that is less severe than full-blown manic symptoms (not severe enough to interfere with functioning and not accompanied by psychotic symptoms)

Substance use disorder

continued substance craving and use despite significant life disruption and/or physical risk

Stimulants

increase nervous system activity

examples: caffeine, cocaine, amphetamines

Depressants

slows nervous system activity

examples: alcohol

Hallucinogens

alter perception and thinking

Biological Contributors

genetics, dopamine reward system

Psychological Contributors

coping deficits, trauma, depression

Social Contributors

peer pressure, family modeling, availability, stress

Schizophrenia

a psychological disorder characterized by delusions, hallucinations, disorganized speech, and/or diminished, inappropriate emotional expression

Positive Symptoms

delusions: false beliefs about self and/or world

hallucinations: false perceptions (auditory most common)

Negative Symptoms

loss of motivation (avolition)

poverty of speech (alogia)

social withdrawal

Disorganized Symptoms

disorganized speech

inappropriate emotional responses

confused thinking

disconnected emotions

Bipolar Disorder

A mood disorder in which the person alternates between the hopelessness and lethargy of depression and the overexcited state of mania.

Psychopharmacology

using medication to reduce mental health symptoms

first introduced in the 1950s

targets neurotransmitters

Electroconvulsive Therapy (ECT)

controlled brain stimulation for severe disorders

DBS (deep brain stimulation)

neurosurgery in which electrodes implanted in the brain stimulate a targeted area with a low-voltage electrical current to facilitate behavior

TMS (transcranial magnetic stimulation)

the use of strong magnets to briefly interrupt normal brain activity as a way to study brain regions

Anti-anxiety Medication

used for anxiety and panic symptoms

often affect GABA (calming neurotransmitter)

Antipsychotics

used for schizophrenia, psychosis, bipolar mania

often target dopamine or serotonin

Mood Stabilizers

used for bipolar disorder

often affect neurotransmission broadly rather than just one

Antidepressants

used for depression and some anxiety disorders

often targets serotonin, norepinephrine, and dopamine

MAOI inhibitors (anti-depressants)

block enzymes that breakdown epinephrine, dopamine, and serotonin

Tricyclic (anti-depressants)

block reuptake of epinephrine, dopamine, and serotonin

Electroconvulsive Therapy (ECT)

a biomedical treatment in which electric shock is used to produce a cortical seizure accompanied by convulsions used for severe depression, urgent psychiatric cases, etc.

why are we moving away from electroconvulsive therapy?

-memory loss or confusion side effects

-stigma from older inaccurate portrayals

-invasiveness compared with medication/talk therapy

What are the replacements for Electroconvulsive therapy?

-TMS (Transcranial Magnetic Stimulation)

-improved medications

Psychoanalytic Therapy

Sigmund Freud's therapeutic approach focusing on resolving unconscious conflicts, childhood experiences, and unresolved inner tension through free association, dream analysis, and interpretation

Psychodynamic Therapy

a newer and more general term for therapies based on psychoanalysis with an emphasis on transference, shorter treatment times, and a more direct therapeutic approach that focuses on emotions and past experiences affecting present behavior

Cognitive Therapy

a treatment method designed to identify and correct distorted thinking patterns that can lead to feelings and behaviors that may be troublesome, self-defeating, or self-destructive

-associated with Aaron Beck

Behavioral Therapy

therapy that applies learning principles to the elimination of unwanted behaviors through exposure therapy, reinforcement, etc.

OARS

used in Motivational Interviewing, a counseling style that helps people resolve ambivalence and increase motivation for change

O in OARS

open-ended questions - encourages detailed responses

A in OARS

affirmations - recognizes strengths and effort

R in OARS

reflective listening - restates meaning to show understanding and encourage deeper thought

S in OARS

summaries - pulls together key points and guides progress

How do we evaluate therapies?

- symptom improvement

- relapse rates

- daily functioning

- relationship improvement

- client satisfaction

- research evidence

Psychoanalytic / Psychodynamic strengths:

- explores deep emotional causes

- useful for recurring patterns

Psychoanalytic / Psychodynamic weaknesses:

- can be lengthy

- less measurable

Cognitive therapy strengths:

- strong research support

- practical tools

- effective for depression/anxiety

Cognitive therapy weaknesses:

may underemphasize past trauma or environment

Behavioral therapy strengths:

- highly effective for phobias/anxiety

- measurable progress

Behavioral therapy weaknesses:

may ignore thoughts/emotions if used alone

Biomedical treatments strengths:

can reduce severe symptoms quickly

Biomedical treatments weaknesses:

- side effects

- relapse if medication stops

- may not address root issues

Psychiatrist

- medical doctor (M.D. or D.O.)

- can prescribe medication

- focuses more on diagnosis/medical treatment

Psychologist

- PhD/PsyD

- provides assessment and therapy

- usually not medication prescribers (varies by location)

Licensed Counselor / Therapist

- Master's level training

- provides talk therapy

- common in outpatient counseling

Person/Client-centered approach

all individuals have a tendency toward growth when provided with support and acceptance

Behavioral Therapy

focuses on changing behavior by identifying problem behaviors, replacing them with appropriate behaviors, and using rewards or other consequences to make the changes

Marriage and Family Therapy

form of psychotherapy that involves all the members of a nuclear or extended family

Applied Behavioral Analysis

an intensive behavior therapy for autism; this treatment is based on operant conditioning.

Dispositional/Internal Attribution

explaining a person's behavior using an internal cause such as a personality trait or character

Situational/External Attribution

behavior is explained by outside circumstances or environmental factors

What is the Actor-Observer Bias?

we explain our own behavior using situational causes but explain other people's behavior using dispositional causes

Fundamental Attribution Error (FAE)?

the tendency for observers, when analyzing another's behavior, to underestimate the impact of the situation and to overestimate the impact of personal disposition

Self-Serving Bias (SSB)?

giving ourselves the credit when something goes well, blaming the situation when something goes bad.

Normative Social Influence

influence resulting from a person's desire to gain approval or avoid disapproval

Informational Social Influence

influence resulting from one's willingness to accept others' opinions about reality

Compliance

publicly agreeing while privately disagreeing

Internalization

private or public acceptance of a proposition, orientation, or ideology

Central Route Persuasion

occurs when interested people focus on the arguments, logic, and facts and respond with favorable thoughts

Peripheral Route Persuasion

occurs when people are influenced by incidental cues, such as a speaker's attractiveness or popularity

What does Stanley Milgram's research on obedience teach us about the effects of power?

Stanley Milgram found that ordinary people may obey authority figures even when asked to do harmful or uncomfortable actions